Reducing neonatal infections in south and south central Vietnam: the views of healthcare providers

PubMed Central

2013-01-01

Background Infection causes neonatal mortality in both high and low income countries. While simple interventions to prevent neonatal infection are available, they are often poorly understood and implemented by clinicians. A basic understanding of healthcare providers' perceptions of infection control provides a platform for improving current practices. Our aim was to explore the views of healthcare providers in provincial hospitals in south and south central Vietnam to inform the design of programmes to improve neonatal infection prevention and control. Methods All fifty-four participants who attended a workshop on infection prevention and control were asked to complete an anonymous, written questionnaire identifying their priorities for improving neonatal infection prevention and control in provincial hospitals in south and south central Vietnam. Results Hand washing, exclusive breastfeeding and safe disposal of medical waste were nominated by most participants as priorities for preventing neonatal infections. Education through instructional posters and written guidelines, family contact, kangaroo-mother-care, limitation of invasive procedures and screening for maternal GBS infection were advocated by a smaller proportion of participants. Conclusions The opinions of neonatal healthcare providers at the workshop accurately reflect some of the current international recommendations for infection prevention. However, other important recommendations were not commonly identified by participants and need to be reinforced. Our results will be used to design interventions to improve infection prevention in Vietnam, and may be relevant to other low-resource countries. PMID:23570330

Massage Therapy for Patients with Metastatic Cancer: A Pilot Randomized Controlled Trial

PubMed Central

Toth, Maria; Marcantonio, Edward R.; Davis, Roger B.; Walton, Tracy; Kahn, Janet R.

2013-01-01

Abstract Objectives The study objectives were to determine the feasibility and effects of providing therapeutic massage at home for patients with metastatic cancer. Design This was a randomized controlled trial. Settings/location Patients were enrolled at Oncology Clinics at a large urban academic medical center; massage therapy was provided in patients' homes. Subjects Subjects were patients with metastatic cancer. Interventions There were three interventions: massage therapy, no-touch intervention, and usual care. Outcome measures Primary outcomes were pain, anxiety, and alertness; secondary outcomes were quality of life and sleep. Results In this study, it was possible to provide interventions for all patients at home by professional massage therapists. The mean number of massage therapy sessions per patient was 2.8. A significant improvement was found in the quality of life of the patients who received massage therapy after 1-week follow-up, which was not observed in either the No Touch control or the Usual Care control groups, but the difference was not sustained at 1 month. There were trends toward improvement in pain and sleep of the patients after therapeutic massage but not in patients in the control groups. There were no serious adverse events related to the interventions. Conclusions The study results showed that it is feasible to provide therapeutic massage at home for patients with advanced cancer, and to randomize patients to a no-touch intervention. Providing therapeutic massage improves the quality of life at the end of life for patients and may be associated with further beneficial effects, such as improvement in pain and sleep quality. Larger randomized controlled trials are needed to substantiate these findings. PMID:23368724

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

ERIC Educational Resources Information Center

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

2012-01-01

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

42 CFR 423.162 - Quality improvement organization activities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Quality improvement organization activities. 423... Cost Control and Quality Improvement Requirements § 423.162 Quality improvement organization activities. (a) General rule. Quality improvement organizations (QIOs) are required to offer providers...

42 CFR 423.162 - Quality improvement organization activities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Quality improvement organization activities. 423... Cost Control and Quality Improvement Requirements § 423.162 Quality improvement organization activities. (a) General rule. Quality improvement organizations (QIOs) are required to offer providers...

42 CFR 423.162 - Quality improvement organization activities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Quality improvement organization activities. 423... Cost Control and Quality Improvement Requirements § 423.162 Quality improvement organization activities. (a) General rule. Quality improvement organizations (QIOs) are required to offer providers...

Evaluating Internal Model Strength and Performance of Myoelectric Prosthesis Control Strategies.

PubMed

Shehata, Ahmed W; Scheme, Erik J; Sensinger, Jonathon W

2018-05-01

On-going developments in myoelectric prosthesis control have provided prosthesis users with an assortment of control strategies that vary in reliability and performance. Many studies have focused on improving performance by providing feedback to the user but have overlooked the effect of this feedback on internal model development, which is key to improve long-term performance. In this paper, the strength of internal models developed for two commonly used myoelectric control strategies: raw control with raw feedback (using a regression-based approach) and filtered control with filtered feedback (using a classifier-based approach), were evaluated using two psychometric measures: trial-by-trial adaptation and just-noticeable difference. The performance of both strategies was also evaluated using Schmidt's style target acquisition task. Results obtained from 24 able-bodied subjects showed that although filtered control with filtered feedback had better short-term performance in path efficiency ( ), raw control with raw feedback resulted in stronger internal model development ( ), which may lead to better long-term performance. Despite inherent noise in the control signals of the regression controller, these findings suggest that rich feedback associated with regression control may be used to improve human understanding of the myoelectric control system.

Quantifying Reporting Timeliness to Improve Outbreak Control

PubMed Central

Swaan, Corien; van Steenbergen, Jim; Kretzschmar, Mirjam

2015-01-01

The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated the proportion of infections produced by index and secondary cases until the index case is reported. We assumed interventions that immediately stop transmission. Reporting delays render useful only those interventions that stop transmission from index and secondary cases. We found that current reporting delays are adequate for hepatitis A and B control. However, reporting delays should be reduced by a few days to improve measles and mumps control, by at least 10 days to improve shigellosis control, and by at least 5 weeks to substantially improve pertussis control. Our method provides quantitative insight into the required reporting delay reductions needed to achieve outbreak control and other transmission prevention goals. PMID:25625374

System for controlling the operating temperature of a fuel cell

DOEpatents

Fabis, Thomas R.; Makiel, Joseph M.; Veyo, Stephen E.

2006-06-06

A method and system are provided for improved control of the operating temperature of a fuel cell (32) utilizing an improved temperature control system (30) that varies the flow rate of inlet air entering the fuel cell (32) in response to changes in the operating temperature of the fuel cell (32). Consistent with the invention an improved temperature control system (30) is provided that includes a controller (37) that receives an indication of the temperature of the inlet air from a temperature sensor (39) and varies the heat output by at least one heat source (34, 36) to maintain the temperature of the inlet air at a set-point T.sub.inset. The controller (37) also receives an indication of the operating temperature of the fuel cell (32) and varies the flow output by an adjustable air mover (33), within a predetermined range around a set-point F.sub.set, in order to maintain the operating temperature of the fuel cell (32) at a set-point T.sub.opset.

New Techniques for the Generation and Analysis of Tailored Microbial Systems on Surfaces.

PubMed

Furst, Ariel L; Smith, Matthew J; Francis, Matthew B

2018-05-17

The interactions between microbes and surfaces provide critically important cues that control the behavior and growth of the cells. As our understanding of complex microbial communities improves, there is a growing need for experimental tools that can establish and control the spatial arrangements of these cells in a range of contexts. Recent improvements in methods to attach bacteria and yeast to nonbiological substrates, combined with an expanding set of techniques available to study these cells, position this field for many new discoveries. Improving methods for controlling the immobilization of bacteria provides powerful experimental tools for testing hypotheses regarding microbiome interactions, studying the transfer of nutrients between bacterial species, and developing microbial communities for green energy production and pollution remediation.

Finite element based model predictive control for active vibration suppression of a one-link flexible manipulator.

PubMed

Dubay, Rickey; Hassan, Marwan; Li, Chunying; Charest, Meaghan

2014-09-01

This paper presents a unique approach for active vibration control of a one-link flexible manipulator. The method combines a finite element model of the manipulator and an advanced model predictive controller to suppress vibration at its tip. This hybrid methodology improves significantly over the standard application of a predictive controller for vibration control. The finite element model used in place of standard modelling in the control algorithm provides a more accurate prediction of dynamic behavior, resulting in enhanced control. Closed loop control experiments were performed using the flexible manipulator, instrumented with strain gauges and piezoelectric actuators. In all instances, experimental and simulation results demonstrate that the finite element based predictive controller provides improved active vibration suppression in comparison with using a standard predictive control strategy. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

A neural network controller for automated composite manufacturing

NASA Technical Reports Server (NTRS)

Lichtenwalner, Peter F.

1994-01-01

At McDonnell Douglas Aerospace (MDA), an artificial neural network based control system has been developed and implemented to control laser heating for the fiber placement composite manufacturing process. This neurocontroller learns an approximate inverse model of the process on-line to provide performance that improves with experience and exceeds that of conventional feedback control techniques. When untrained, the control system behaves as a proportional plus integral (PI) controller. However after learning from experience, the neural network feedforward control module provides control signals that greatly improve temperature tracking performance. Faster convergence to new temperature set points and reduced temperature deviation due to changing feed rate have been demonstrated on the machine. A Cerebellar Model Articulation Controller (CMAC) network is used for inverse modeling because of its rapid learning performance. This control system is implemented in an IBM compatible 386 PC with an A/D board interface to the machine.

Employee empowerment through team building and use of process control methods.

PubMed

Willems, S

1998-02-01

The article examines the use of statistical process control and performance improvement techniques in employee empowerment. The focus is how these techniques provide employees with information to improve their productivity and become involved in the decision-making process. Findings suggest that at one Mississippi hospital employee improvement has had a positive effect on employee productivity, morale, and quality of work.

Improved self-management skills in Chinese diabetes patients through a comprehensive health literacy strategy: study protocol of a cluster randomized controlled trial.

PubMed

Xu, Wang Hong; Rothman, Russell L; Li, Rui; Chen, Yingyao; Xia, Qinghua; Fang, Hong; Gao, Junling; Yan, Yujie; Zhou, Peng; Jiang, Yu; Liu, Yinan; Zhou, Fangjia; Wang, Wei; Chen, Minling; Liu, Xiao Yu; Liu, Xiao Na

2014-12-20

Diabetes self-management often involves the interpretation and application of oral, written, or quantitative information. Numerous diabetes patients in China have limited health literacy, which likely leads to poorer clinical outcomes. This study is designed to examine the efficacy and cost-effectiveness of addressing health literacy to improve self-management skills and glycemic control in Chinese diabetes patients. This is a cluster randomized controlled trial (RCT) conducted in 20 community healthcare sites in Shanghai, China. Overall, 800 diabetes patients will be randomized into intervention and control arms and will have a baseline hemoglobin A1c (HbA1c) assay and undergo a baseline survey which includes measures of health literacy and diabetes numeracy using revised Chinese versions of the Health Literacy Management Scale and Diabetes Numeracy Test Scale. During the 1-year period of intervention, while the control group will receive usual care, the intervention group will be supplemented with a comprehensive health literacy strategy which includes i) training healthcare providers in effective health communication skills that address issues related to low literacy, and ii) use of an interactive Diabetes Education Toolkit to improve patient understanding and behaviors. Assessments will be conducted at both patient and healthcare provider levels, and will take place upon admission and after 3, 6, 12, and 24 months of intervention. The primary outcome will be the improvement in HbA1c between Intervention group and Control group patients. Secondary outcomes at the patient level will include improvement in i) clinical outcomes (blood pressure, fasting lipids, body mass index, weight, smoking status), ii) patient reported self-management behaviors, and iii) patient-reported self-efficacy. Outcomes at the provider level will include: i) provider satisfaction and ii) intensity and type of care provided. The effects of the intervention will be examined in multivariable general linear models. Both cost-effectiveness and cost-utility analyses will be performed. The main strengths of this study are its large sample size and RCT design, involvement of both patients and healthcare providers, and the long term follow-up (24-months). This project will help to demonstrate the value of addressing health literacy and health communication to improve self-management and clinical outcomes among Chinese diabetes patients. ISRCTN76130594, Registration date: Sept 22, 2014.

Flight Test Comparison of Different Adaptive Augmentations for Fault Tolerant Control Laws for a Modified F-15 Aircraft

NASA Technical Reports Server (NTRS)

Burken, John J.; Hanson, Curtis E.; Lee, James A.; Kaneshige, John T.

2009-01-01

This report describes the improvements and enhancements to a neural network based approach for directly adapting to aerodynamic changes resulting from damage or failures. This research is a follow-on effort to flight tests performed on the NASA F-15 aircraft as part of the Intelligent Flight Control System research effort. Previous flight test results demonstrated the potential for performance improvement under destabilizing damage conditions. Little or no improvement was provided under simulated control surface failures, however, and the adaptive system was prone to pilot-induced oscillations. An improved controller was designed to reduce the occurrence of pilot-induced oscillations and increase robustness to failures in general. This report presents an analysis of the neural networks used in the previous flight test, the improved adaptive controller, and the baseline case with no adaptation. Flight test results demonstrate significant improvement in performance by using the new adaptive controller compared with the previous adaptive system and the baseline system for control surface failures.

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

PubMed

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

2016-12-01

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

Continuous Improvements to East Coast Abort Landings for Space Shuttle Aborts

NASA Technical Reports Server (NTRS)

Butler, Kevin D.

2003-01-01

Improvement initiatives in the areas of guidance, flight control, and mission operations provide increased capability for successful East Coast Abort Landings (ECAL). Automating manual crew procedures in the Space Shuttle's onboard guidance allows faster and more precise commanding of flight control parameters needed for successful ECALs. Automation also provides additional capability in areas not possible with manual control. Operational changes in the mission concept allow for the addition of new landing sites and different ascent trajectories that increase the regions of a successful landing. The larger regions of ECAL capability increase the safety of the crew and Orbiter.

Infection control in cystic fibrosis: barriers to implementation and ideas for improvement.

PubMed

Saiman, Lisa; Garber, Elizabeth

2009-11-01

This review will focus on recent research documenting baseline adherence to infection control recommendations and barriers to their implementation as experienced by multidisciplinary cystic fibrosis (CF) care providers. In addition, controversies regarding optimal infection control will be discussed. Finally, suggestions to improve infection control in CF will be proposed. Compliance with recent guidelines was assessed for clinical microbiology laboratories and for infection control policies at CF care centers in the United States. Unlike earlier reports, the vast majority of laboratories used selective media for Burkholderia cepacia complex and identified all species of nonlactose fermenting Gram-negative bacilli. Fewer used selective media for Staphylococcus aureus or used agar-based susceptibility testing assays for Pseudomonas aeruginosa. Only 103 (65%) of 158 CF care centers provided written infection control policies for review and these were more likely to address inpatient than outpatient settings. Surveys of healthcare professionals showed that access to a copy of the CF infection control guidelines reduced barriers to adherence to selected infection control practices. These data suggest that access to national infection control guidelines and written local policies are critically important to improving infection control for CF.

Significant improvements of electrical discharge machining performance by step-by-step updated adaptive control laws

NASA Astrophysics Data System (ADS)

Zhou, Ming; Wu, Jianyang; Xu, Xiaoyi; Mu, Xin; Dou, Yunping

2018-02-01

In order to obtain improved electrical discharge machining (EDM) performance, we have dedicated more than a decade to correcting one essential EDM defect, the weak stability of the machining, by developing adaptive control systems. The instabilities of machining are mainly caused by complicated disturbances in discharging. To counteract the effects from the disturbances on machining, we theoretically developed three control laws from minimum variance (MV) control law to minimum variance and pole placements coupled (MVPPC) control law and then to a two-step-ahead prediction (TP) control law. Based on real-time estimation of EDM process model parameters and measured ratio of arcing pulses which is also called gap state, electrode discharging cycle was directly and adaptively tuned so that a stable machining could be achieved. To this end, we not only theoretically provide three proved control laws for a developed EDM adaptive control system, but also practically proved the TP control law to be the best in dealing with machining instability and machining efficiency though the MVPPC control law provided much better EDM performance than the MV control law. It was also shown that the TP control law also provided a burn free machining.

A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol

PubMed Central

2013-01-01

Background Racial disparities in blood pressure control have been well documented in the United States. Research suggests that many factors contribute to this disparity, including barriers to care at patient, clinician, healthcare system, and community levels. To date, few interventions aimed at reducing hypertension disparities have addressed factors at all of these levels. This paper describes the design of Project ReD CHiP (Reducing Disparities and Controlling Hypertension in Primary Care), a multi-level system quality improvement project. By intervening on multiple levels, this project aims to reduce disparities in blood pressure control and improve guideline concordant hypertension care. Methods Using a pragmatic trial design, we are implementing three complementary multi-level interventions designed to improve blood pressure measurement, provide patient care management services and offer expanded provider education resources in six primary care clinics in Baltimore, Maryland. We are staggering the introduction of the interventions and will use Statistical Process Control (SPC) charting to determine if there are changes in outcomes at each clinic after implementation of each intervention. The main hypothesis is that each intervention will have an additive effect on improvements in guideline concordant care and reductions in hypertension disparities, but the combination of all three interventions will result in the greatest impact, followed by blood pressure measurement with care management support, blood pressure measurement with provider education, and blood pressure measurement only. This study also examines how organizational functioning and cultural competence affect the success of the interventions. Discussion As a quality improvement project, Project ReD CHiP employs a novel study design that specifically targets multi-level factors known to contribute to hypertension disparities. To facilitate its implementation and improve its sustainability, we have incorporated stakeholder input and tailored components of the interventions to meet the specific needs of the involved clinics and communities. Results from this study will provide knowledge about how integrated multi-level interventions can improve hypertension care and reduce disparities. Trial Registration ClinicalTrials.gov NCT01566864 PMID:23734703

A randomized controlled trial of the effect of participatory ergonomic low back pain training on workplace improvement

PubMed Central

Kajiki, Shigeyuki; Izumi, Hiroyuki; Hayashida, Kenshi; Kusumoto, Akira; Nagata, Tomohisa; Mori, Koji

2017-01-01

Objectives: This study aimed to determine the effects of participatory workplace improvement (PWI) -based provision of ergonomic training and ergonomic action checklists (ACLs) to on-site managers on workplace improvement activities for low back pain (LBP). Methods: A randomized controlled trial (RCT) was conducted at a manufacturing company in Japan. Teams entered in the study were randomly assigned to a control and an intervention group. A total of three interventional training sessions on methods of ergonomics were provided to on-site managers in the intervention group, with 1-month intervals between sessions. Ergonomic ACLs were provided at the same time. After completion of the training sessions, each team then provided a report of improvements each month for the next 10 months. Two people in charge of safety and health chose two major objectives of the implemented activities from the five categories. The reported number of improvements was analyzed using a Poisson regression model. Results: In the intervention group, although the incident rate ratio (IRR) of PWIs in countermeasures for the LBP category was significantly elevated after the training sessions, the IRR of improvements decreased over time during the 10-month follow-up period. No significant difference was observed in the IRR of total PWIs in either the control or intervention group. Conclusions: PWI-based provision of ergonomic training sessions and ergonomics ACLs to on-site managers was shown to be effective for workplace improvement activities targeted at LBP. However, because the effects decrease over time, efforts should be made to maintain the effects through regular interventions. PMID:28320978

A randomized controlled trial of the effect of participatory ergonomic low back pain training on workplace improvement.

PubMed

Kajiki, Shigeyuki; Izumi, Hiroyuki; Hayashida, Kenshi; Kusumoto, Akira; Nagata, Tomohisa; Mori, Koji

2017-05-25

This study aimed to determine the effects of participatory workplace improvement (PWI) -based provision of ergonomic training and ergonomic action checklists (ACLs) to on-site managers on workplace improvement activities for low back pain (LBP). A randomized controlled trial (RCT) was conducted at a manufacturing company in Japan. Teams entered in the study were randomly assigned to a control and an intervention group. A total of three interventional training sessions on methods of ergonomics were provided to on-site managers in the intervention group, with 1-month intervals between sessions. Ergonomic ACLs were provided at the same time. After completion of the training sessions, each team then provided a report of improvements each month for the next 10 months. Two people in charge of safety and health chose two major objectives of the implemented activities from the five categories. The reported number of improvements was analyzed using a Poisson regression model. In the intervention group, although the incident rate ratio (IRR) of PWIs in countermeasures for the LBP category was significantly elevated after the training sessions, the IRR of improvements decreased over time during the 10-month follow-up period. No significant difference was observed in the IRR of total PWIs in either the control or intervention group. PWI-based provision of ergonomic training sessions and ergonomics ACLs to on-site managers was shown to be effective for workplace improvement activities targeted at LBP. However, because the effects decrease over time, efforts should be made to maintain the effects through regular interventions.

Control Laws for a Dual-Spin Stabilized Platform

NASA Technical Reports Server (NTRS)

Lim, K. B.; Moerder, D. D.

2008-01-01

This paper describes two attitude control laws suitable for atmospheric flight vehicles with a steady angular momentum bias in the vehicle yaw axis. This bias is assumed to be provided by an internal flywheel, and is introduced to enhance roll and pitch stiffness. The first control law is based on Lyapunov stability theory, and stability proofs are given. The second control law, which assumes that the angular momentum bias is large, is based on a classical PID control. It is shown that the large yaw-axis bias requires that the PI feedback component on the roll and pitch angle errors be cross-fed. Both control laws are applied to a vehicle simulation in the presence of disturbances for several values of yaw-axis angular momentum bias. It is seen that both control laws provide a significant improvement in attitude performance when the bias is sufficiently large, but the nonlinear control law is also able to provide improved performance for a small value of bias. This is important because the smaller bias corresponds to a smaller requirement for mass to be dedicated to the flywheel.

Using Statistical Process Control to Drive Improvement in Neonatal Care: A Practical Introduction to Control Charts.

PubMed

Gupta, Munish; Kaplan, Heather C

2017-09-01

Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology. Copyright © 2017 Elsevier Inc. All rights reserved.

Development of a GA-Fuzzy-Immune PID Controller with Incomplete Derivation for Robot Dexterous Hand

PubMed Central

Liu, Xin-hua; Chen, Xiao-hu; Zheng, Xian-hua; Li, Sheng-peng; Wang, Zhong-bin

2014-01-01

In order to improve the performance of robot dexterous hand, a controller based on GA-fuzzy-immune PID was designed. The control system of a robot dexterous hand and mathematical model of an index finger were presented. Moreover, immune mechanism was applied to the controller design and an improved approach through integration of GA and fuzzy inference was proposed to realize parameters' optimization. Finally, a simulation example was provided and the designed controller was proved ideal. PMID:25097881

H-infinity based integrated flight-propulsion control design for a STOVL aircraft in transition flight

NASA Technical Reports Server (NTRS)

Garg, Sanjay; Mattern, Duane L.; Bright, Michelle M.; Ouzts, Peter J.

1990-01-01

Results are presented from an application of H-infinity control design methodology to a centralized integrated flight/propulsion control (IFPC) system design for a supersonic Short Take-Off and Vertical Landing (STOVL) fighter aircraft in transition flight. The overall design methodology consists of a centralized IFPC controller design with controller partitioning. Only the feedback controller design portion of the methodology is addressed. Design and evaluation vehicle models are summarized, and insight is provided into formulating the H-infinity control problem such that it reflects the IFPC design objectives. The H-infinity controller is shown to provide decoupled command tracking for the design model. The controller order could be significantly reduced by modal residualization of the fast controller modes without any deterioration in performance. A discussion is presented of the areas in which the controller performance needs to be improved, and ways in which these improvements can be achieved within the framework of an H-infinity based linear control design.

The Waukesha Turbocharger Control Module: A tool for improved engine efficiency and response

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

Zurlo, J.R.; Reinbold, E.O.; Mueller, J.

1996-12-31

The Waukesha Turbocharger Control Module allows optimum control of turbochargers on lean burn gaseous fueled engines. The Turbocharger Control Module is user programmed to provide either maximum engine efficiency or best engine response to load changes. In addition, the Turbocharger Control Module prevents undesirable turbocharger surge. The Turbocharger Control Module consists of an electronic control box, engine speed, intake manifold pressure, ambient temperature sensors, and electric actuators driving compressor bypass and wastegate valves. The Turbocharger Control Module expands the steady state operational environment of the Waukesha AT27GL natural gas engine from sea level to 1,525 m altitude with one turbochargermore » match and improves the engine speed turn down by 80 RPM. Finally, the Turbocharger Control Module improves engine response to load changes.« less

The Application of an Evidence-Based Clinical Nursing Path for Improving the Preoperative and Postoperative Quality of Care of Pediatric Retroperitoneal Neuroblastoma Patients: A Randomized Controlled Trial at a Tertiary Medical Institution.

PubMed

Liu, Yang; Mo, Lin; Tang, Yan; Wang, Qiuhong; Huang, Xiaoyan

A clinical nursing path (CNP) that encourages patients and their families to become actively involved in healthcare decision-making processes may improve outcomes of pediatric retroperitoneal neuroblastoma (NB) patients. The aim of this study was to evaluate the utility and value of an evidence-based CNP provided to pediatric retroperitoneal NB patients undergoing resection surgery. One hundred twenty NB cases were assigned to a control group or a CNP group. The control group was provided with standard nursing care. The CNP group was provided with nursing care in accordance with an evidence-based CNP. The utility and value of the CNP were compared with standard nursing care. Outcome measures included rates of postoperative complications, lengths of hospital stay, and cost of hospitalization, as well as preoperative and postoperative quality of care and patient satisfaction with care. The rates of postoperative complications, length of preoperative hospitalization, total length of hospital stay, and costs of hospitalization were significantly lower for patients receiving the CNP compared with the control group. Preoperative and postoperative quality of care and patient satisfaction with care were significantly higher in patients receiving the CNP compared with the control group. Adoption of a CNP for preoperative and postoperative care of pediatric retroperitoneal NB patients undergoing resection surgery improves clinical outcomes and patient satisfaction with care. A CNP can increase families' participation in a patient's recovery process, enhance nurses' understanding of the services they are providing, and improve the quality of healthcare received by patients.

Improving low-wage, midsized employers' health promotion practices: a randomized controlled trial.

PubMed

Hannon, Peggy A; Harris, Jeffrey R; Sopher, Carrie J; Kuniyuki, Alan; Ghosh, Donetta L; Henderson, Shelly; Martin, Diane P; Weaver, Marcia R; Williams, Barbara; Albano, Denise L; Meischke, Hendrika; Diehr, Paula; Lichiello, Patricia; Hammerback, Kristen E; Parks, Malcolm R; Forehand, Mark

2012-08-01

The Guide to Community Preventive Services (Community Guide) offers evidence-based intervention strategies to prevent chronic disease. The American Cancer Society (ACS) and the University of Washington Health Promotion Research Center co-developed ACS Workplace Solutions (WPS) to improve workplaces' implementation of Community Guide strategies. To test the effectiveness of WPS for midsized employers in low-wage industries. Two-arm RCT; workplaces were randomized to receive WPS during the study (intervention group) or at the end of the study (delayed control group). Forty-eight midsized employers (100-999 workers) in King County WA. WPS provides employers one-on-one consulting with an ACS interventionist via three meetings at the workplace. The interventionist recommends best practices to adopt based on the workplace's current practices, provides implementation toolkits for the best practices the employer chooses to adopt, conducts a follow-up visit at 6 months, and provides technical assistance. Employers' implementation of 16 best practices (in the categories of insurance benefits, health-related policies, programs, tracking, and health communications) at baseline (June 2007-June 2008) and 15-month follow-up (October 2008-December 2009). Data were analyzed in 2010-2011. Intervention employers demonstrated greater improvement from baseline than control employers in two of the five best-practice categories; implementing policies (baseline scores: 39% program, 43% control; follow-up scores: 49% program, 45% control; p=0.013) and communications (baseline scores: 42% program, 44% control; follow-up scores: 76% program, 55% control; p=0.007). Total best-practice implementation improvement did not differ between study groups (baseline scores: 32% intervention, 37% control; follow-up scores: 39% intervention, 42% control; p=0.328). WPS improved employers' health-related policies and communications but did not improve insurance benefits design, programs, or tracking. Many employers were unable to modify insurance benefits and reported that the time and costs of implementing best practices were major barriers. This study is registered at clinicaltrials.gov NCT00452816. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Ensemble-based uncertainty quantification for coordination and control of thermostatically controlled loads

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

Li, Weixuan; Lian, Jianming; Engel, Dave

2017-07-27

This paper presents a general uncertainty quantification (UQ) framework that provides a systematic analysis of the uncertainty involved in the modeling of a control system, and helps to improve the performance of a control strategy.

Aerial applications dispersal systems control requirements study. [agriculture

NASA Technical Reports Server (NTRS)

Bauchspies, J. S.; Cleary, W. L.; Rogers, W. F.; Simpson, W.; Sanders, G. S.

1980-01-01

Performance deficiencies in aerial liquid and dry dispersal systems are identified. Five control system concepts are explored: (1) end of field on/off control; (2) manual control of particle size and application rate from the aircraft; (3) manual control of deposit rate on the field; (4) automatic alarm and shut-off control; and (5) fully automatic control. Operational aspects of the concepts and specifications for improved control configurations are discussed in detail. A research plan to provide the technology needed to develop the proposed improvements is presented along with a flight program to verify the benefits achieved.

Using COPE To Improve Quality of Care: The Experience of the Family Planning Association of Kenya.

ERIC Educational Resources Information Center

Bradley, Janet

1998-01-01

COPE (Client-Oriented, Provider-Efficient) methodology, a self-assessment tool that has been used in 35 countries around the world, was used to improve the quality of care in family planning clinics in Kenya. COPE involves a process that legitimately invests power with providers and clinic-level staff. It gives providers more control over their…

Combined Space and Water Heating: Next Steps to Improved Performance

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

B. Schoenbauer; Bohac, D.; Huelman, P.

2016-07-13

A combined space- and water-heating (combi) system uses a high-efficiency direct-vent burner that eliminates safety issues associated with natural draft appliances. Past research with these systems shows that using condensing water heaters or boilers with hydronic air handling units can provide both space and water heating with efficiencies of 90% or higher. Improved controls have the potential to reduce complexity and improve upon the measured performance. This project demonstrates that controls can significantly benefit these first-generation systems. Laboratory tests and daily load/performance models showed that the set point temperature reset control produced a 2.1%–4.3% (20–40 therms/year) savings for storage andmore » hybrid water heater combi systems operated in moderate-load homes. The full modulation control showed additional savings over set point control (in high-load homes almost doubling the savings: 4%–5% over the no-control case). At the time of installation the reset control can be implemented for $200–$400, which would provide paybacks of 6–25 years for low-load houses and 3–15 years for high-load houses. Full modulation implementation costs would be similar to the outdoor reset and would provide paybacks of 5-½–20 years for low-load houses and 2-½–10 years for high-load houses.« less

New Vectorial Propulsion System and Trajectory Control Designs for Improved AUV Mission Autonomy.

PubMed

Masmitja, Ivan; Gonzalez, Julian; Galarza, Cesar; Gomariz, Spartacus; Aguzzi, Jacopo; Del Rio, Joaquin

2018-04-17

Autonomous Underwater Vehicles (AUV) are proving to be a promising platform design for multidisciplinary autonomous operability with a wide range of applications in marine ecology and geoscience. Here, two novel contributions towards increasing the autonomous navigation capability of a new AUV prototype (the Guanay II) as a mix between a propelled vehicle and a glider are presented. Firstly, a vectorial propulsion system has been designed to provide full vehicle maneuverability in both horizontal and vertical planes. Furthermore, two controllers have been designed, based on fuzzy controls, to provide the vehicle with autonomous navigation capabilities. Due to the decoupled system propriety, the controllers in the horizontal plane have been designed separately from the vertical plane. This class of non-linear controllers has been used to interpret linguistic laws into different zones of functionality. This method provided good performance, used as interpolation between different rules or linear controls. Both improvements have been validated through simulations and field tests, displaying good performance results. Finally, the conclusion of this work is that the Guanay II AUV has a solid controller to perform autonomous navigation and carry out vertical immersions.

Diabetes quality improvement in Department of Veterans Affairs Ambulatory Care Clinics: a group-randomized clinical trial.

PubMed

Reiber, Gayle E; Au, David; McDonell, Mary; Fihn, Stephan D

2004-05-01

To conduct a group-randomized clinical trial to determine whether regular feedback to primary care providers of synthesized information on patients' health, function, and satisfaction would demonstrate improved outcomes for their patients with diabetes. Patients in General Internal Medicine Clinics Department of Veterans Affairs (VA) Medical Centers were randomized into seven intervention or control firms. Patient self-reported information was collected by mail on general health, diabetes, and up to five other chronic conditions. Patients with diabetes received the Seattle Diabetes Questionnaire, the 36-item Medical Outcomes Study short form (SF-36), and a validated patient satisfaction questionnaire at regular intervals. Data from self-report, clinical, pharmacy, and laboratory sources were synthesized into patient-specific feedback reports that intervention providers received before patients' visits. The timely delivery to primary care providers of state-of-the-art patient-feedback reports that identified patient issues and areas for improvement did not result in significant improvements in patient outcomes between the intervention and control firms. Outcomes in diabetic patients whose providers received synthesized patient data before visits were no better than in those receiving care from control firms. Future studies may benefit from substantial involvement in patients discussing, problem solving, and goal setting in addition to use of timely synthesized patient data.

System and method for networking electrochemical devices

DOEpatents

Williams, Mark C.; Wimer, John G.; Archer, David H.

1995-01-01

An improved electrochemically active system and method including a plurality of electrochemical devices, such as fuel cells and fluid separation devices, in which the anode and cathode process-fluid flow chambers are connected in fluid-flow arrangements so that the operating parameters of each of said plurality of electrochemical devices which are dependent upon process-fluid parameters may be individually controlled to provide improved operating efficiency. The improvements in operation include improved power efficiency and improved fuel utilization in fuel cell power generating systems and reduced power consumption in fluid separation devices and the like through interstage process fluid parameter control for series networked electrochemical devices. The improved networking method includes recycling of various process flows to enhance the overall control scheme.

[System design of small intellectualized ultrasound hyperthermia instrument in the LabVIEW environment].

PubMed

Jiang, Feng; Bai, Jingfeng; Chen, Yazhu

2005-08-01

Small-scale intellectualized medical instrument has attracted great attention in the field of biomedical engineering, and LabVIEW (Laboratory Virtual Instrument Engineering Workbench) provides a convenient environment for this application due to its inherent advantages. The principle and system structure of the hyperthermia instrument are presented. Type T thermocouples are employed as thermotransducers, whose amplifier consists of two stages, providing built-in ice point compensation and thus improving work stability over temperature. Control signals produced by specially designed circuit drive the programmable counter/timer 8254 chip to generate PWM (Pulse width modulation) wave, which is used as ultrasound radiation energy control signal. Subroutine design topics such as inner-tissue real time feedback temperature control algorithm, water temperature control in the ultrasound applicator are also described. In the cancer tissue temperature control subroutine, the authors exert new improvments to PID (Proportional Integral Differential) algorithm according to the specific demands of the system and achieve strict temperature control to the target tissue region. The system design and PID algorithm improvement have experimentally proved to be reliable and excellent, meeting the requirements of the hyperthermia system.

Intermittent use of an "anchor system" improves postural control in healthy older adults.

PubMed

Freitas, Milena de Bem Zavanella; Mauerberg-deCastro, Eliane; Moraes, Renato

2013-07-01

Haptic information, provided by a non-rigid tool (i.e., an "anchor system"), can reduce body sway in individuals who perform a standing postural task. However, it was not known whether or not continuous use of the anchor system would improve postural control after its removal. Additionally, it was unclear as to whether or not frequency of use of the anchor system is related to improved control in older adults. The present study evaluated the effect of the prolonged use of the anchor system on postural control in healthy older individuals, at different frequencies of use, while they performed a postural control task (semi-tandem position). Participants were divided into three groups according to the frequency of the anchor system's use (0%, 50%, and 100%). Pre-practice phase (without anchor) was followed by a practice phase (they used the anchor system at the predefined frequency), and a post-practice phase (immediate and late-without anchor). All three groups showed a persistent effect 15min after the end of the practice phase (immediate post-practice phase). However, only the 50% group showed a persistent effect in the late post-practice phase (24h after finishing the practice phase). Older adults can improve their postural control by practicing the standing postural task, and use of the anchor system limited to half of their practice time can provide additional improvement in their postural control. Copyright © 2013 Elsevier B.V. All rights reserved.

Primary Care Providers Perceptions of Racial/Ethnic and Socioeconomic Disparities in Hypertension Control

PubMed Central

Nuccio, Eugene; Leiferman, Jenn A.; Sauaia, Angela

2015-01-01

OBJECTIVE To evaluate the attitudes and perceptions of primary care providers (PCPs) regarding the presence and underlying sources of racial/ethnic and socioeconomic disparities in hypertension control. METHODS We conducted a survey of 115 PCPs from 2 large academic centers in Colorado. We included physicians, nurse practitioners, and physician assistants. The survey assessed provider recognition and perceived contributors of disparities in hypertension control. RESULTS Respondents were primarily female (66%), non-Hispanic White (84%), and physicians (80%). Among respondents, 67% and 73% supported the collection of data on the patients’ race/ethnicity and socioeconomic status (SES), respectively. Eighty-six percent and 89% agreed that disparities in race/ethnicity and SES existed in hypertension care within the US health system. However, only 33% and 44% thought racial/ethnic and socioeconomic disparities existed in the care of their own patients. Providers were more likely to perceive patient factors rather than provider or health system factors as mediators of disparities. However, most supported interventions such as improving provider communication skills (87%) and cultural competency training (89%) to reduce disparities in hypertension control. CONCLUSIONS Most providers acknowledged that racial/ethnic and socioeconomic disparities in hypertension control exist in the US health system, but only a minority reported disparities in care among patients they personally treat. Our study highlights the need for testing an intervention aimed at increasing provider awareness of disparities within the local health setting to improve hypertension control for minority patients. PMID:25631381

Optimisation of active suspension control inputs for improved performance of active safety systems

NASA Astrophysics Data System (ADS)

Čorić, Mirko; Deur, Joško; Xu, Li; Tseng, H. Eric; Hrovat, Davor

2018-01-01

A collocation-type control variable optimisation method is used to investigate the extent to which the fully active suspension (FAS) can be applied to improve the vehicle electronic stability control (ESC) performance and reduce the braking distance. First, the optimisation approach is applied to the scenario of vehicle stabilisation during the sine-with-dwell manoeuvre. The results are used to provide insights into different FAS control mechanisms for vehicle performance improvements related to responsiveness and yaw rate error reduction indices. The FAS control performance is compared to performances of the standard ESC system, optimal active brake system and combined FAS and ESC configuration. Second, the optimisation approach is employed to the task of FAS-based braking distance reduction for straight-line vehicle motion. Here, the scenarios of uniform and longitudinally or laterally non-uniform tyre-road friction coefficient are considered. The influences of limited anti-lock braking system (ABS) actuator bandwidth and limit-cycle ABS behaviour are also analysed. The optimisation results indicate that the FAS can provide competitive stabilisation performance and improved agility when compared to the ESC system, and that it can reduce the braking distance by up to 5% for distinctively non-uniform friction conditions.

Quality control troubleshooting tools for the mill floor

Treesearch

John Dramm

2000-01-01

Statistical Process Control (SPC) provides effective tools for improving process quality in the forest products industry resulting in reduced costs and improved productivity. Implementing SPC helps identify and locate problems that occur in wood products manufacturing. SPC tools achieve their real value when applied on the mill floor for monitoring and troubleshooting...

Research Contributing to Improvements in Controlling Florida's Mosquitoes and Mosquito-borne Diseases.

PubMed

Tabachnick, Walter J

2016-09-28

Research on mosquitoes and mosquito-borne diseases has contributed to improvements in providing effective, efficient, and environmentally proper mosquito control. Florida has benefitted from several research accomplishments that have increased the state's mosquito control capabilities. Research with Florida's mosquitoes has resulted in the development of ecologically sound management of mosquito impoundments on Florida's east coast. This strategy, called Rotational Impoundment Management (RIM), has improved the ability to target the delivery of pesticides and has helped to reduce non-target effects and environmental damage. Research has led to the development of an arbovirus surveillance system which includes sentinel chicken surveillance, real time use of environmental contributing factors like meteorology and hydrology to target mosquito control, as well as public health efforts to mitigate disease outbreaks to areas with risk of disease. These research driven improvements have provided substantial benefits to all of Florida. More research is needed to meet the future challenges to reduce emerging pathogens like Zika virus and the consequences of environmental changes like global climate change that are likely to influence the effects of mosquito-borne pathogens on human health and well-being.

Ferroelectric Fluid Flow Control Valve

NASA Technical Reports Server (NTRS)

Jalink, Antony, Jr. (Inventor); Hellbaum, Richard F. (Inventor); Rohrbach, Wayne W. (Inventor)

1999-01-01

An active valve is controlled and driven by external electrical actuation of a ferroelectric actuator to provide for improved passage of the fluid during certain time periods and to provide positive closure of the valve during other time periods. The valve provides improved passage in the direction of flow and positive closure in the direction against the flow. The actuator is a dome shaped internally prestressed ferroelectric actuator having a curvature, said dome shaped actuator having a rim and an apex. and a dome height measured from a plane through said rim said apex that varies with an electric voltage applied between an inside and an outside surface of said dome shaped actuator.

Critical review of controlled release packaging to improve food safety and quality.

PubMed

Chen, Xi; Chen, Mo; Xu, Chenyi; Yam, Kit L

2018-03-19

Controlled release packaging (CRP) is an innovative technology that uses the package to release active compounds in a controlled manner to improve safety and quality for a wide range of food products during storage. This paper provides a critical review of the uniqueness, design considerations, and research gaps of CRP, with a focus on the kinetics and mechanism of active compounds releasing from the package. Literature data and practical examples are presented to illustrate how CRP controls what active compounds to release, when and how to release, how much and how fast to release, in order to improve food safety and quality.

Improving generalized inverted index lock wait times

NASA Astrophysics Data System (ADS)

Borodin, A.; Mirvoda, S.; Porshnev, S.; Ponomareva, O.

2018-01-01

Concurrent operations on tree like data structures is a cornerstone of any database system. Concurrent operations intended for improving read\\write performance and usually implemented via some way of locking. Deadlock-free methods of concurrency control are known as tree locking protocols. These protocols provide basic operations(verbs) and algorithm (ways of operation invocations) for applying it to any tree-like data structure. These algorithms operate on data, managed by storage engine which are very different among RDBMS implementations. In this paper, we discuss tree locking protocol implementation for General inverted index (Gin) applied to multiversion concurrency control (MVCC) storage engine inside PostgreSQL RDBMS. After that we introduce improvements to locking protocol and provide usage statistics about evaluation of our improvement in very high load environment in one of the world’s largest IT company.

Brief Report: Remotely Delivered Video Modeling for Improving Oral Hygiene in Children with ASD: A Pilot Study.

PubMed

Popple, Ben; Wall, Carla; Flink, Lilli; Powell, Kelly; Discepolo, Keri; Keck, Douglas; Mademtzi, Marilena; Volkmar, Fred; Shic, Frederick

2016-08-01

Children with autism have heightened risk of developing oral health problems. Interventions targeting at-home oral hygiene habits may be the most effective means of improving oral hygiene outcomes in this population. This randomized control trial examined the effectiveness of a 3-week video-modeling brushing intervention delivered to patients over the internet. Eighteen children with autism were assigned to an Intervention or Control video condition. Links to videos were delivered via email twice daily. Blind clinical examiners provided plaque index ratings at baseline, midpoint, and endpoint. Results show oral hygiene improvements in both groups, with larger effect sizes in the Intervention condition. The findings provide preliminary support for the use of internet-based interventions to improve oral hygiene for children with autism.

Improved Motor-Timing: Effects of Synchronized Metro-Nome Training on Golf Shot Accuracy

PubMed Central

Sommer, Marius; Rönnqvist, Louise

2009-01-01

This study investigates the effect of synchronized metronome training (SMT) on motor timing and how this training might affect golf shot accuracy. Twenty-six experienced male golfers participated (mean age 27 years; mean golf handicap 12.6) in this study. Pre- and post-test investigations of golf shots made by three different clubs were conducted by use of a golf simulator. The golfers were randomized into two groups: a SMT group and a Control group. After the pre-test, the golfers in the SMT group completed a 4-week SMT program designed to improve their motor timing, the golfers in the Control group were merely training their golf-swings during the same time period. No differences between the two groups were found from the pre-test outcomes, either for motor timing scores or for golf shot accuracy. However, the post-test results after the 4-weeks SMT showed evident motor timing improvements. Additionally, significant improvements for golf shot accuracy were found for the SMT group and with less variability in their performance. No such improvements were found for the golfers in the Control group. As with previous studies that used a SMT program, this study’s results provide further evidence that motor timing can be improved by SMT and that such timing improvement also improves golf accuracy. Key points This study investigates the effect of synchronized metronome training (SMT) on motor timing and how this training might affect golf shot accuracy. A randomized control group design was used. The 4 week SMT intervention showed significant improvements in motor timing, golf shot accuracy, and lead to less variability. We conclude that this study’s results provide further evidence that motor timing can be improved by SMT training and that such timing improvement also improves golf accuracy. PMID:24149608

EMISSION REDUCTIONS AIMED AT IMPROVING AIR QUALITY: UNINTENDED CLIMATIC CONSEQUENCES AND THE EFFECT OF CLIMATE CHANGE ON THEIR SUCCESS

EPA Science Inventory

This work will provide improved understanding of the role of climate change, both in the recent past and future, on the success of pollutant control strategies, allowing for better planning and accountability of emission reductions. This work will also provide a quantitative a...

Study on real-time force feedback for a master-slave interventional surgical robotic system.

PubMed

Guo, Shuxiang; Wang, Yuan; Xiao, Nan; Li, Youxiang; Jiang, Yuhua

2018-04-13

In robot-assisted catheterization, haptic feedback is important, but is currently lacking. In addition, conventional interventional surgical robotic systems typically employ a master-slave architecture with an open-loop force feedback, which results in inaccurate control. We develop herein a novel real-time master-slave (RTMS) interventional surgical robotic system with a closed-loop force feedback that allows a surgeon to sense the true force during remote operation, provide adequate haptic feedback, and improve control accuracy in robot-assisted catheterization. As part of this system, we also design a unique master control handle that measures the true force felt by a surgeon, providing the basis for the closed-loop control of the entire system. We use theoretical and empirical methods to demonstrate that the proposed RTMS system provides a surgeon (using the master control handle) with a more accurate and realistic force sensation, which subsequently improves the precision of the master-slave manipulation. The experimental results show a substantial increase in the control accuracy of the force feedback and an increase in operational efficiency during surgery.

Effects of a Patient-Provider, Collaborative, Medication-Planning Tool: A Randomized, Controlled Trial

PubMed Central

Wolf, Michael S.; Kaiser, Darren; Morrow, Daniel G.

2016-01-01

Among patients with various levels of health literacy, the effects of collaborative, patient-provider, medication-planning tools on outcomes relevant to self-management are uncertain. Objective. Among adult patients with type II diabetes mellitus, we tested the effectiveness of a medication-planning tool (Medtable™) implemented via an electronic medical record to improve patients' medication knowledge, adherence, and glycemic control compared to usual care. Design. A multicenter, randomized controlled trial in outpatient primary care clinics. 674 patients received either the Medtable tool or usual care and were followed up for up to 12 months. Results. Patients who received Medtable had greater knowledge about indications for medications in their regimens and were more satisfied with the information about their medications. Patients' knowledge of drug indication improved with Medtable regardless of their literacy status. However, Medtable did not improve patients' demonstrated medication use, regimen adherence, or glycemic control (HbA1c). Conclusion. The Medtable tool supported provider/patient collaboration related to medication use, as reflected in patient satisfaction with communication, but had limited impact on patient medication knowledge, adherence, and HbA1c outcomes. This trial is registered with ClinicalTrials.gov NCT01296633. PMID:27699179

Advances in Adaptive Control Methods

NASA Technical Reports Server (NTRS)

Nguyen, Nhan

2009-01-01

This poster presentation describes recent advances in adaptive control technology developed by NASA. Optimal Control Modification is a novel adaptive law that can improve performance and robustness of adaptive control systems. A new technique has been developed to provide an analytical method for computing time delay stability margin for adaptive control systems.

60 seconds to survival: A pilot study of a disaster triage video game for prehospital providers.

PubMed

Cicero, Mark X; Whitfill, Travis; Munjal, Kevin; Madhok, Manu; Diaz, Maria Carmen G; Scherzer, Daniel J; Walsh, Barbara M; Bowen, Angela; Redlener, Michael; Goldberg, Scott A; Symons, Nadine; Burkett, James; Santos, Joseph C; Kessler, David; Barnicle, Ryan N; Paesano, Geno; Auerbach, Marc A

2017-01-01

Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls. At baseline, all participants completed a live school-shooting simulation in which manikins and standardized patients depicted 10 adult and pediatric victims. The intervention group then played 60S at least three times over the course of 13 weeks (time 2). Players triaged 12 patients in three scenarios (school shooting, house fire, tornado), and received in-game performance feedback. At time 2, the same live simulation was conducted for all participants. Controls had no disaster training during the study. The main outcome was improvement in triage accuracy in live simulations from baseline to time 2. Physicians and EMS providers predetermined expected triage level (RED/YELLOW/GREEN/BLACK) via modified Delphi method. There were 26 participants in the intervention group and 21 in the control group. There was no difference in gender, level of training, or years of EMS experience (median 5.5 years intervention, 3.5 years control, p = 0.49) between the groups. At baseline, both groups demonstrated median triage accuracy of 80 percent (IQR 70-90 percent, p = 0.457). At time 2, the intervention group had a significant improvement from baseline (median accuracy = 90 percent [IQR: 80-90 percent], p = 0.005), while the control group did not (median accuracy = 80 percent [IQR:80-95], p = 0.174). However, the mean improvement from baseline was not significant between the two groups (difference = 6.5, p = 0.335). The intervention demonstrated a significant improvement in accuracy from baseline to time 2 while the control did not. However, there was no significant difference in the improvement between the intervention and control groups. These results may be due to small sample size. Future directions include assessment of the game's effect on triage accuracy with a larger, multisite site cohort and iterative development to improve 60S.

Software and electronic developments for TUG - T60 robotic telescope

NASA Astrophysics Data System (ADS)

Parmaksizoglu, M.; Dindar, M.; Kirbiyik, H.; Helhel, S.

2014-12-01

A robotic telescope is a telescope that can make observations without hands-on human control. Its low level behavior is automatic and computer-controlled. Robotic telescopes usually run under the control of a scheduler, which provides high-level control by selecting astronomical targets for observation. TUBITAK National Observatory (TUG) T60 Robotic Telescope is controlled by open source OCAAS software, formally named TALON. This study introduces the improvements on TALON software, new electronic and mechanic designs. The designs and software improvements were implemented in the T60 telescope control software and tested on the real system successfully.

Integrated flight/propulsion control design for a STOVL aircraft using H-infinity control design techniques

NASA Technical Reports Server (NTRS)

Garg, Sanjay; Ouzts, Peter J.

1991-01-01

Results are presented from an application of H-infinity control design methodology to a centralized integrated flight propulsion control (IFPC) system design for a supersonic Short Takeoff and Vertical Landing (STOVL) fighter aircraft in transition flight. The emphasis is on formulating the H-infinity control design problem such that the resulting controller provides robustness to modeling uncertainties and model parameter variations with flight condition. Experience gained from a preliminary H-infinity based IFPC design study performed earlier is used as the basis to formulate the robust H-infinity control design problem and improve upon the previous design. Detailed evaluation results are presented for a reduced order controller obtained from the improved H-infinity control design showing that the control design meets the specified nominal performance objectives as well as provides stability robustness for variations in plant system dynamics with changes in aircraft trim speed within the transition flight envelope. A controller scheduling technique which accounts for changes in plant control effectiveness with variation in trim conditions is developed and off design model performance results are presented.

Functional Assessment and Intervention by Nursing Assistants in Hospice and Palliative Care Inpatient Care Settings: A Quality Improvement Pilot Study.

PubMed

Mueller, Karen; Hamilton, Gillian; Rodden, Betheny; DeHeer, Hendrick D

2016-03-01

This study assessed the impact of a nursing assistant-led functional intervention in an urban hospice. Thirty-three patients participated. A physical therapist trained 4 nursing assistants to assess 4 basic functional activities at admission and discharge and to provide daily activity training to intervention group participants. Control group participants were assessed at admission and discharge and received the usual standard of care. Both groups improved. The intervention group participants demonstrated significant improvement in the Timed up and Go test as well as their self-reported ability to achieve goals on the Patient-Specific Functional Scale. Control group participants made significant improvements in the ability to move from supine to sit in bed. These findings suggest that nursing assistants can provide activity-based assessment and intervention leading to improved function among patients in hospice. © The Author(s) 2014.

A case study: application of statistical process control tool for determining process capability and sigma level.

PubMed

Chopra, Vikram; Bairagi, Mukesh; Trivedi, P; Nagar, Mona

2012-01-01

Statistical process control is the application of statistical methods to the measurement and analysis of variation process. Various regulatory authorities such as Validation Guidance for Industry (2011), International Conference on Harmonisation ICH Q10 (2009), the Health Canada guidelines (2009), Health Science Authority, Singapore: Guidance for Product Quality Review (2008), and International Organization for Standardization ISO-9000:2005 provide regulatory support for the application of statistical process control for better process control and understanding. In this study risk assessments, normal probability distributions, control charts, and capability charts are employed for selection of critical quality attributes, determination of normal probability distribution, statistical stability, and capability of production processes, respectively. The objective of this study is to determine tablet production process quality in the form of sigma process capability. By interpreting data and graph trends, forecasting of critical quality attributes, sigma process capability, and stability of process were studied. The overall study contributes to an assessment of process at the sigma level with respect to out-of-specification attributes produced. Finally, the study will point to an area where the application of quality improvement and quality risk assessment principles for achievement of six sigma-capable processes is possible. Statistical process control is the most advantageous tool for determination of the quality of any production process. This tool is new for the pharmaceutical tablet production process. In the case of pharmaceutical tablet production processes, the quality control parameters act as quality assessment parameters. Application of risk assessment provides selection of critical quality attributes among quality control parameters. Sequential application of normality distributions, control charts, and capability analyses provides a valid statistical process control study on process. Interpretation of such a study provides information about stability, process variability, changing of trends, and quantification of process ability against defective production. Comparative evaluation of critical quality attributes by Pareto charts provides the least capable and most variable process that is liable for improvement. Statistical process control thus proves to be an important tool for six sigma-capable process development and continuous quality improvement.

Aeroservoelastic wind-tunnel investigations using the Active Flexible Wing Model: Status and recent accomplishments

NASA Technical Reports Server (NTRS)

Noll, Thomas E.; Perry, Boyd, III; Tiffany, Sherwood H.; Cole, Stanley R.; Buttrill, Carey S.; Adams, William M., Jr.; Houck, Jacob A.; Srinathkumar, S.; Mukhopadhyay, Vivek; Pototzky, Anthony S.

1989-01-01

The status of the joint NASA/Rockwell Active Flexible Wing Wind-Tunnel Test Program is described. The objectives are to develop and validate the analysis, design, and test methodologies required to apply multifunction active control technology for improving aircraft performance and stability. Major tasks include designing digital multi-input/multi-output flutter-suppression and rolling-maneuver-load alleviation concepts for a flexible full-span wind-tunnel model, obtaining an experimental data base for the basic model and each control concept and providing comparisons between experimental and analytical results to validate the methodologies. The opportunity is provided to improve real-time simulation techniques and to gain practical experience with digital control law implementation procedures.

A randomized trial of automated electronic alerts demonstrating improved reimbursable anesthesia time documentation.

PubMed

Freundlich, Robert E; Barnet, Caryn S; Mathis, Michael R; Shanks, Amy M; Tremper, Kevin K; Kheterpal, Sachin

2013-03-01

To investigate whether alerting providers to errors results in improved documentation of reimbursable anesthesia care. Prospective randomized controlled trial. Operating room (OR) of a university hospital. Anesthesia cases were evaluated to determine whether they met the definition for appropriate anesthesia start time over 4 separate, 45-day calendar cycles: the pre-study period, study period, immediate post-study period, and 3-year follow-up period. During the study period, providers were randomly assigned to either a control or an alert group. Providers in the alert cohort received an automated alphanumeric page if the anesthesia start time occurred concurrently with the patient entering the OR, or more than 30 minutes before entering the OR. Three years after the intervention period, overall compliance was analyzed to assess learned behavior. Baseline compliance was 33% ± 5%. During the intervention period, providers in the alert group showed 87% ± 6% compliance compared with 41% ± 7% compliance in the control group (P < 0.001). Long-term follow-up after cessation of the alerts showed 85% ± 4% compliance. Automated electronic reminders for time-based billing charges are effective and result in improved ongoing reimbursement. Copyright © 2013 Elsevier Inc. All rights reserved.

Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD.

PubMed

Churchill, Shervin S; Leo, Michael C; Brennan, Eileen M; Sellmaier, Claudia; Kendall, Judy; Houck, Gail M

2018-02-23

Objective Evaluate the efficacy of a 12 month nursing case-management intervention over a period of 18 months, 6 months after the end of intervention, for families of children attention deficit hyperactivity disorder (ADHD). Methods Mother and child dyads were enrolled to participate in a randomized controlled clinical trial. Children were 4-18 years old. Data were collected at baseline, 6, 12, and 18 months or 6 months after the termination of direct intervention. Longitudinal analyses, using generalized estimating equations, were conducted to assess change in study outcomes relating to family function, maternal stress, and child behavior over the 18 month period. Results Compared to control families, some family function outcomes were moderately improved in the intervention group. In particular, intervention families demonstrated substantial improvement in implementing family behavior controls (p value = 0.038) and improvement in family satisfaction (not statistically significant p = 0.062). Although there was improvement in the overall family function measure there was not a statistically significant difference between groups. Maternal stress and child behavior outcomes were not significantly different between control and intervention groups by the end of the intervention. Conclusions for Practice Addressing ADHD is complex and requires the assessment of comorbidities that might exacerbate negative behavior. Our findings support the latest American Academy of Pediatrics guidelines to use behavioral therapy as the first line of treatment in young children. Nursing case-management interventions that provide direct family education and improve family function, especially with respect to providing structure and behavior control, may complement and facilitate behavioral therapy for treatment of ADHD and improving child behavior.

Trends in plant virus epidemiology: opportunities from new or improved technologies.

PubMed

Jones, R A C

2014-06-24

This review focuses on new or improved technologies currently being applied, or likely to be applied in the future, to worldwide research on plant virus epidemiology. Recent technological advances and innovations provide many opportunities to improve understanding of the way diverse types of plant virus epidemics develop and how to manage them. The review starts at the macro level by considering how recent innovations in remote sensing and precision agriculture can provide valuable information about (i) virus epidemics occurring at continental, regional or district scales (via satellites) and within individual crops (mostly via lightweight unmanned aerial vehicles), and (ii) exactly where to target control measures. It then considers recent improvements in information systems and innovations in modelling that improve (i) understanding of virus epidemics and ability to predict them, and (ii) delivery to end-users of critical advice on control measures, such as Internet-based Decision Support Systems. The review goes on to discuss how advances in analysis of spatiotemporal virus spread patterns within crops can help to enhance understanding of how virus epidemics develop and validate potentially useful virus control measures. At the micro level, the review then considers the many insights that advances in molecular epidemiology can provide about genetic variation within plant virus populations involved in epidemics, and how this variation drives what occurs at the macro level. Next, it describes how recent innovations in virus detection technologies are providing many opportunities to collect and analyse new types, and ever increasing amounts, of data about virus epidemics, and the genetic variability of the virus populations involved. Finally, the implications for plant virus epidemiology of technologies likely to be important in the future are considered. To address looming world food insecurity and threats to plant biodiversity resulting from climate change and rapid population growth, it is important that new and improved technologies that help understand and control epidemics of damaging plant viruses are adopted as smoothly and speedily as possible. Copyright © 2013 Elsevier B.V. All rights reserved.

Radar Performance Improvement. Angle Tracking Modification to Fire Control Radar System for Space Shuttle Rendezvous

NASA Technical Reports Server (NTRS)

Little, G. R.

1976-01-01

The AN/APQ-153 fire control radar modified to provide angle tracking was evaluated for improved performance. The frequency agile modifications are discussed along with the range-rate improvement modifications, and the radar to computer interface. A parametric design and comparison of noncoherent and coherent radar systems are presented. It is shown that the shuttle rendezvous range and range-rate requirements can be made by a Ku-Band noncoherent pulse radar.

Optimization of an Active Twist Rotor Blade Planform for Improved Active Response and Forward Flight Performance

NASA Technical Reports Server (NTRS)

Sekula, Martin K; Wilbur, Matthew L.

2014-01-01

A study was conducted to identify the optimum blade tip planform for a model-scale active twist rotor. The analysis identified blade tip design traits which simultaneously reduce rotor power of an unactuated rotor while leveraging aeromechanical couplings to tailor the active response of the blade. Optimizing the blade tip planform for minimum rotor power in forward flight provided a 5 percent improvement in performance compared to a rectangular blade tip, but reduced the vibration control authority of active twist actuation by 75 percent. Optimizing for maximum blade twist response increased the vibration control authority by 50 percent compared to the rectangular blade tip, with little effect on performance. Combined response and power optimization resulted in a blade tip design which provided similar vibration control authority to the rectangular blade tip, but with a 3.4 percent improvement in rotor performance in forward flight.

Introducing a new semi-active engine mount using force controlled variable stiffness

NASA Astrophysics Data System (ADS)

Azadi, Mojtaba; Behzadipour, Saeed; Faulkner, Gary

2013-05-01

This work introduces a new concept in designing semi-active engine mounts. Engine mounts are under continuous development to provide better and more cost-effective engine vibration control. Passive engine mounts do not provide satisfactory solution. Available semi-active and active mounts provide better solutions but they are more complex and expensive. The variable stiffness engine mount (VSEM) is a semi-active engine mount with a simple ON-OFF control strategy. However, unlike available semi-active engine mounts that work based on damping change, the VSEM works based on the static stiffness change by using a new fast response force controlled variable spring. The VSEM is an improved version of the vibration mount introduced by the authors in their previous work. The results showed significant performance improvements over a passive rubber mount. The VSEM also provides better vibration control than a hydromount at idle speed. Low hysteresis and the ability to be modelled by a linear model in low-frequency are the advantages of the VSEM over the vibration isolator introduced earlier and available hydromounts. These specifications facilitate the use of VSEM in the automotive industry, however, further evaluation and developments are needed for this purpose.

Analysis of Controller Communication in En Route Air Traffic Control.

ERIC Educational Resources Information Center

Seamster, Thomas L.; And Others

To contribute to an understanding of the elements of good air traffic controller communication with the objective of providing recommendations to improve controller communication training, two studies analyzed team communication, ground-air communication, and ground-line communication. The simulated and live traffic analyses examined established…

Progress in electrochemical storage for battery systems

NASA Technical Reports Server (NTRS)

Ford, F. E.; Hennigan, T. J.; Palandati, C. F.; Cohn, E.

1972-01-01

Efforts to improve electrochemical systems for space use relate to: (1) improvement of conventional systems; (2) development of fuel cells to practical power systems; and (3) a search for new systems that provide gains in energy density but offer comparable life and performance as conventional systems. Improvements in sealed conventional systems resulted in the areas of materials, charge control methods, cell operations and battery control, and specific process controls required during cell manufacture. Fuel-cell systems have been developed for spacecraft but the use of these power plants is limited. For present and planned flights, nickel-cadmium, silver-zinc, and silver-cadmium systems will be used. Improvements in nickel-cadmium batteries have been applied in medical and commercial areas.

New Vectorial Propulsion System and Trajectory Control Designs for Improved AUV Mission Autonomy

PubMed Central

Gonzalez, Julian; Galarza, Cesar; Aguzzi, Jacopo; del Rio, Joaquin

2018-01-01

Autonomous Underwater Vehicles (AUV) are proving to be a promising platform design for multidisciplinary autonomous operability with a wide range of applications in marine ecology and geoscience. Here, two novel contributions towards increasing the autonomous navigation capability of a new AUV prototype (the Guanay II) as a mix between a propelled vehicle and a glider are presented. Firstly, a vectorial propulsion system has been designed to provide full vehicle maneuverability in both horizontal and vertical planes. Furthermore, two controllers have been designed, based on fuzzy controls, to provide the vehicle with autonomous navigation capabilities. Due to the decoupled system propriety, the controllers in the horizontal plane have been designed separately from the vertical plane. This class of non-linear controllers has been used to interpret linguistic laws into different zones of functionality. This method provided good performance, used as interpolation between different rules or linear controls. Both improvements have been validated through simulations and field tests, displaying good performance results. Finally, the conclusion of this work is that the Guanay II AUV has a solid controller to perform autonomous navigation and carry out vertical immersions. PMID:29673224

A MPPT Algorithm Based PV System Connected to Single Phase Voltage Controlled Grid

NASA Astrophysics Data System (ADS)

Sreekanth, G.; Narender Reddy, N.; Durga Prasad, A.; Nagendrababu, V.

2012-10-01

Future ancillary services provided by photovoltaic (PV) systems could facilitate their penetration in power systems. In addition, low-power PV systems can be designed to improve the power quality. This paper presents a single-phase PV systemthat provides grid voltage support and compensation of harmonic distortion at the point of common coupling thanks to a repetitive controller. The power provided by the PV panels is controlled by a Maximum Power Point Tracking algorithm based on the incremental conductance method specifically modified to control the phase of the PV inverter voltage. Simulation and experimental results validate the presented solution.

Additional Development and Systems Analyses of Pneumatic Technology for High Speed Civil Transport Aircraft

NASA Technical Reports Server (NTRS)

Englar, Robert J.; Willie, F. Scott; Lee, Warren J.

1999-01-01

In the Task I portion of this NASA research grant, configuration development and experimental investigations have been conducted on a series of pneumatic high-lift and control surface devices applied to a generic High Speed Civil Transport (HSCT) model configuration to determine their potential for improved aerodynamic performance, plus stability and control of higher performance aircraft. These investigations were intended to optimize pneumatic lift and drag performance; provide adequate control and longitudinal stability; reduce separation flowfields at high angle of attack; increase takeoff/climbout lift-to-drag ratios; and reduce system complexity and weight. Experimental aerodynamic evaluations were performed on a semi-span HSCT generic model with improved fuselage fineness ratio and with interchangeable plain flaps, blown flaps, pneumatic Circulation Control Wing (CCW) high-lift configurations, plain and blown canards, a novel Circulation Control (CC) cylinder blown canard, and a clean cruise wing for reference. Conventional tail power was also investigated for longitudinal trim capability. Also evaluated was unsteady pulsed blowing of the wing high-lift system to determine if reduced pulsed mass flow rates and blowing requirements could be made to yield the same lift as that resulting from steady-state blowing. Depending on the pulsing frequency applied, reduced mass flow rates were indeed found able to provide lift augmentation at lesser blowing values than for the steady conditions. Significant improvements in the aerodynamic characteristics leading to improved performance and stability/control were identified, and the various components were compared to evaluate the pneumatic potential of each. Aerodynamic results were provided to the Georgia Tech Aerospace System Design Lab. to conduct the companion system analyses and feasibility study (Task 2) of theses concepts applied to an operational advanced HSCT aircraft. Results and conclusions from these experimental evaluations are presented herein, as are recommendations for further development and follow-on investigations. Also provided as an Appendix for reference are the basic results from the previous pneumatic HSCT investigations.

Research Contributing to Improvements in Controlling Florida’s Mosquitoes and Mosquito-Borne Diseases

PubMed Central

Tabachnick, Walter J.

2016-01-01

Research on mosquitoes and mosquito-borne diseases has contributed to improvements in providing effective, efficient, and environmentally proper mosquito control. Florida has benefitted from several research accomplishments that have increased the state’s mosquito control capabilities. Research with Florida’s mosquitoes has resulted in the development of ecologically sound management of mosquito impoundments on Florida’s east coast. This strategy, called Rotational Impoundment Management (RIM), has improved the ability to target the delivery of pesticides and has helped to reduce non-target effects and environmental damage. Research has led to the development of an arbovirus surveillance system which includes sentinel chicken surveillance, real time use of environmental contributing factors like meteorology and hydrology to target mosquito control, as well as public health efforts to mitigate disease outbreaks to areas with risk of disease. These research driven improvements have provided substantial benefits to all of Florida. More research is needed to meet the future challenges to reduce emerging pathogens like Zika virus and the consequences of environmental changes like global climate change that are likely to influence the effects of mosquito-borne pathogens on human health and well-being. PMID:27690112

Control of Flexible Structures (COFS) Flight Experiment Background and Description

NASA Technical Reports Server (NTRS)

Hanks, B. R.

1985-01-01

A fundamental problem in designing and delivering large space structures to orbit is to provide sufficient structural stiffness and static configuration precision to meet performance requirements. These requirements are directly related to control requirements and the degree of control system sophistication available to supplement the as-built structure. Background and rationale are presented for a research study in structures, structural dynamics, and controls using a relatively large, flexible beam as a focus. This experiment would address fundamental problems applicable to large, flexible space structures in general and would involve a combination of ground tests, flight behavior prediction, and instrumented orbital tests. Intended to be multidisciplinary but basic within each discipline, the experiment should provide improved understanding and confidence in making design trades between structural conservatism and control system sophistication for meeting static shape and dynamic response/stability requirements. Quantitative results should be obtained for use in improving the validity of ground tests for verifying flight performance analyses.

Control research in the NASA high-alpha technology program

NASA Technical Reports Server (NTRS)

Gilbert, William P.; Nguyen, Luat T.; Gera, Joseph

1990-01-01

NASA is conducting a focused technology program, known as the High-Angle-of-Attack Technology Program, to accelerate the development of flight-validated technology applicable to the design of fighters with superior stall and post-stall characteristics and agility. A carefully integrated effort is underway combining wind tunnel testing, analytical predictions, piloted simulation, and full-scale flight research. A modified F-18 aircraft has been extensively instrumented for use as the NASA High-Angle-of-Attack Research Vehicle used for flight verification of new methods and concepts. This program stresses the importance of providing improved aircraft control capabilities both by powered control (such as thrust-vectoring) and by innovative aerodynamic control concepts. The program is accomplishing extensive coordinated ground and flight testing to assess and improve available experimental and analytical methods and to develop new concepts for enhanced aerodynamics and for effective control, guidance, and cockpit displays essential for effective pilot utilization of the increased agility provided.

An intelligent position-specific training system for mission operations

NASA Technical Reports Server (NTRS)

Schneider, M. P.

1992-01-01

Marshall Space Flight Center's (MSFC's) payload ground controller training program provides very good generic training; however, ground controller position-specific training can be improved by including position-specific training systems in the training program. This report explains why MSFC needs to improve payload ground controller position-specific training. The report describes a generic syllabus for position-specific training systems, a range of system designs for position-specific training systems, and a generic development process for developing position-specific training systems. The report also describes a position-specific training system prototype that was developed for the crew interface coordinator payload operations control center ground controller position. The report concludes that MSFC can improve the payload ground controller training program by incorporating position-specific training systems for each ground controller position; however, MSFC should not develop position-specific training systems unless payload ground controller position experts will be available to participate in the development process.

The deployment of routing protocols in distributed control plane of SDN.

PubMed

Jingjing, Zhou; Di, Cheng; Weiming, Wang; Rong, Jin; Xiaochun, Wu

2014-01-01

Software defined network (SDN) provides a programmable network through decoupling the data plane, control plane, and application plane from the original closed system, thus revolutionizing the existing network architecture to improve the performance and scalability. In this paper, we learned about the distributed characteristics of Kandoo architecture and, meanwhile, improved and optimized Kandoo's two levels of controllers based on ideological inspiration of RCP (routing control platform). Finally, we analyzed the deployment strategies of BGP and OSPF protocol in a distributed control plane of SDN. The simulation results show that our deployment strategies are superior to the traditional routing strategies.

Improved carbon control in the sintering of structural PM parts

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

Nowotarski, M.; Gaines, G.

1981-12-01

The use of a nitrogen-methanol atmosphere and a system of control of the atmosphere in furnace zones to provide improved control of carbon in sintering of sprockets are described.A new process has been developed by the Linde Div. of Union Carbide for the sintering of structural PM parts. The process is based on a nitrogen/methanol sintering atmosphere and features superior carbon control (/plus or minus/.03%), elimination of sooting due to lubricant decomposition, and significantly reduced furnace atmosphere gas flows as compared to typical endothermic atmosphere gas consumption.

Targeted Muscle Reinnervation for Transradial Amputation: Description of Operative Technique.

PubMed

Morgan, Emily N; Kyle Potter, Benjamin; Souza, Jason M; Tintle, Scott M; Nanos, George P

2016-12-01

Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity for improvement in integrated prosthesis control and neuroma-related pain improvement in patients with transradial amputations. As there are no detailed descriptions of this technique in the literature to date, we provide our surgical technique for TMR in transradial amputations.

Integrated Flight-propulsion Control Concepts for Supersonic Transport Airplanes

NASA Technical Reports Server (NTRS)

Burcham, Frank W., Jr.; Gilyard, Glenn B.; Gelhausen, Paul A.

1990-01-01

Integration of propulsion and flight control systems will provide significant performance improvements for supersonic transport airplanes. Increased engine thrust and reduced fuel consumption can be obtained by controlling engine stall margin as a function of flight and engine operating conditions. Improved inlet pressure recovery and decreased inlet drag can result from inlet control system integration. Using propulsion system forces and moments to augment the flight control system and airplane stability can reduce the flight control surface and tail size, weight, and drag. Special control modes may also be desirable for minimizing community noise and for emergency procedures. The overall impact of integrated controls on the takeoff gross weight for a generic high speed civil transport is presented.

Study of mechanism improving target course traceability in G-Vectoring Control

NASA Astrophysics Data System (ADS)

Yamakado, Makoto; Abe, Masato; Kano, Yoshio; Umetsu, Daisuke; Yoshioka, Thoru

2018-05-01

Production-type G-Vectoring Control vehicles are now being put on the market. Customers and reviewers have praised the handling quality and course traceability of these vehicles. This paper clarifies the mechanism behind this improvement in handling quality using a simple bicycle model and driver model analysis. It focuses on the residual yaw angular acceleration when the steering speed is zero and shows that GVC reduces its value. This result provides evidence for improved handling quality in GVC vehicles.

Moisture Control Guidance for Commercial and Public Buildings (EPA 402-F-13053)

EPA Science Inventory

This document provides guidance to designers, construction mangers, and building operation/maintenance managers to improve IEQ and reduce risks of encountering IEQ problems due to insufficient moisture control. EPA will be producing a document entitled "Moisture Control Guida...

Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

PubMed

Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael

2012-01-01

Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.

Fine tuning GPS clock estimation in the MCS

NASA Technical Reports Server (NTRS)

Hutsell, Steven T.

1995-01-01

With the completion of a 24 operational satellite constellation, GPS is fast approaching the critical milestone, Full Operational Capability (FOC). Although GPS is well capable of providing the timing accuracy and stability figures required by system specifications, the GPS community will continue to strive for further improvements in performance. The GPS Master Control Station (MCS) recently demonstrated that timing improvements are always composite Clock, and hence, Kalman Filter state estimation, providing a small improvement to user accuracy.

Incentive spirometry combined with expiratory positive airway pressure improves asthma control and quality of life in asthma: a randomised controlled trial.

PubMed

Rondinel, Tatiana Zacarias; Corrêa, Isadora Faraco; Hoscheidt, Luíza Machado; Bueno, Mirelle Hugo; Da Silva, Luciano Muller Corrêa; Reppold, Caroline Tozzi; Dal Lago, Pedro

2015-03-01

The use of the incentive spirometer (IS) and expiratory positive airway pressure (EPAP) provides several benefits in patients with respiratory disorders. However, the effects of the use of these devices coupled (IS + EPAP) are still unknown in asthmatic patients. The aim of this study was to evaluate the effect of IS associated with EPAP on exercise tolerance (six-minute walk test - 6MWT), lung function (by spirometry), asthma control (Asthma Control Questionnaire - ACQ) and quality of life (Asthma Quality of Life Questionnaire - AQLQ) in patients with severe asthma. Patients were randomised into two groups: IS + EPAP (n = 8) and control (n = 6). The IS + EPAP group performed breathing exercises at home, twice daily for 20 min, over a period of 5 weeks. There was no significant difference in spirometric variables and in the distance walked in the 6MWT in both groups. However, the IS + EPAP group showed an improvement in asthma control (p = 0.002) and quality of life (p = 0.02). These findings demonstrate that the IS + EPAP protocol, when performed at home, provides an improvement in asthma control and quality of life for patients with severe asthma when evaluated by ACQ and AQLQ, respectively.

Improving Instruction Using Statistical Process Control.

ERIC Educational Resources Information Center

Higgins, Ronald C.; Messer, George H.

1990-01-01

Two applications of statistical process control to the process of education are described. Discussed are the use of prompt feedback to teachers and prompt feedback to students. A sample feedback form is provided. (CW)

Fault tolerant and lifetime control architecture for autonomous vehicles

NASA Astrophysics Data System (ADS)

Bogdanov, Alexander; Chen, Yi-Liang; Sundareswaran, Venkataraman; Altshuler, Thomas

2008-04-01

Increased vehicle autonomy, survivability and utility can provide an unprecedented impact on mission success and are one of the most desirable improvements for modern autonomous vehicles. We propose a general architecture of intelligent resource allocation, reconfigurable control and system restructuring for autonomous vehicles. The architecture is based on fault-tolerant control and lifetime prediction principles, and it provides improved vehicle survivability, extended service intervals, greater operational autonomy through lower rate of time-critical mission failures and lesser dependence on supplies and maintenance. The architecture enables mission distribution, adaptation and execution constrained on vehicle and payload faults and desirable lifetime. The proposed architecture will allow managing missions more efficiently by weighing vehicle capabilities versus mission objectives and replacing the vehicle only when it is necessary.

Microwave Temperature Profiler Mounted in a Standard Airborne Research Canister

NASA Technical Reports Server (NTRS)

Mahoney, Michael J.; Denning, Richard F.; Fox, Jack

2009-01-01

Many atmospheric research aircraft use a standard canister design to mount instruments, as this significantly facilitates their electrical and mechanical integration and thereby reduces cost. Based on more than 30 years of airborne science experience with the Microwave Temperature Profiler (MTP), the MTP has been repackaged with state-of-the-art electronics and other design improvements to fly in one of these standard canisters. All of the controlling electronics are integrated on a single 4 5-in. (.10 13- cm) multi-layer PCB (printed circuit board) with surface-mount hardware. Improved circuit design, including a self-calibrating RTD (resistive temperature detector) multiplexer, was implemented in order to reduce the size and mass of the electronics while providing increased capability. A new microcontroller-based temperature controller board was designed, providing better control with fewer components. Five such boards are used to provide local control of the temperature in various areas of the instrument, improving radiometric performance. The new stepper motor has an embedded controller eliminating the need for a separate controller board. The reference target is heated to avoid possible emissivity (and hence calibration) changes due to moisture contamination in humid environments, as well as avoiding issues with ambient targets during ascent and descent. The radiometer is a double-sideband heterodyne receiver tuned sequentially to individual oxygen emission lines near 60 GHz, with the line selection and intermediate frequency bandwidths chosen to accommodate the altitude range of the aircraft and mission.

Smart Inverter Control and Operation for Distributed Energy Resources

NASA Astrophysics Data System (ADS)

Tazay, Ahmad F.

The motivation of this research is to carry out the control and operation of smart inverters and voltage source converters (VSC) for distributed energy resources (DERs) such as photovoltaic (PV), battery, and plug-in hybrid electric vehicles (PHEV). The main contribution of the research includes solving a couple of issues for smart grids by controlling and implementing multifunctions of VSC and smart inverter as well as improving the operational scheme of the microgrid. The work is mainly focused on controlling and operating of smart inverter since it promises a new technology for the future microgrid. Two major applications of the smart inverter will be investigated in this work based on the connection modes: microgrid at grid-tied mode and autonomous mode. In grid-tied connection, the smart inverter and VSC are used to integrate DER such as Photovoltaic (PV) and battery to provide suitable power to the system by controlling the supplied real and reactive power. The role of a smart inverter at autonomous mode includes supplying a sufficient voltage and frequency, mitigate abnormal condition of the load as well as equally sharing the total load's power. However, the operational control of the microgrid still has a major issue on the operation of the microgrid. The dissertation is divided into two main sections which are: 1. Low-level control of a single smart Inverter. 2. High-level control of the microgrid. The first part investigates a comprehensive research for a smart inverter and VSC technology at the two major connections of the microgrid. This involves controlling and modeling single smart inverter and VSC to solve specific issues of microgrid as well as improve the operation of the system. The research provides developed features for smart inverter comparing with a conventional voltage sourced converter (VSC). The two main connections for a microgrid have been deeply investigated to analyze a better way to develop and improve the operational procedure of the microgrid as well as solve specific issues of connecting the microgrid to the system. A detailed procedure for controlling VSC and designing an optimal operation of the controller is also covered in the first part of the dissertation. This section provides an optimal operation for controlling motor drive and demonstrates issues when motor load exists at an autonomous microgrid. It also provides a solution for specific issues at operating a microgrid at autonomous mode as well as improving the structural design for the grid-tied microgrid. The solution for autonomous microgrid includes changing the operational state of the switching pattern of the smart inverter to solve the issue of a common mode voltage (CMV) that appears across the motor load. It also solves the issue of power supplying to large loads, such as induction motors. The last section of the low-level section involves an improvement of the performance and operation of the PV charging station for a plug-in hybrid electric vehicle (PHEV) at grid-tied mode. This section provides a novel structure and smart controller for PV charging station using three-phase hybrid boost converter topology. It also provides a form of applications of a multifunction smart inverter using PV charging station. The second part of the research is focusing on improving the performance of the microgrid by integrating several smart inverters to form a microgrid. It investigates the issue of connecting DER units with the microgrid at real applications. One of the common issues of the microgrid is the circulating current which is caused by poor reactive power sharing accuracy. When more than two DER units are connected in parallel, a microgrid is forming be generating required power for the load. When the microgrid is operated at autonomous mode, all DER units participate in generating voltage and frequency as well as share the load's power. This section provides a smart and novel controlling technique to solve the issue of unequal power sharing. The feature of the smart inverter is realized by the communication link between smart inverters and the main operator. The analysis and derivation of the problem are presented in this section. The dissertation has led to two accepted conference papers, one accepted transaction IEEE manuscript, and one submitted IET transaction manuscript. The future work aims to improve the current work by investigating the performance of the smart inverter at real applications.

Implementing GermWatcher, an enterprise infection control application.

PubMed

Doherty, Joshua; Noirot, Laura A; Mayfield, Jennie; Ramiah, Sridhar; Huang, Christine; Dunagan, Wm Claiborne; Bailey, Thomas C

2006-01-01

Automated surveillance tools can provide significant advantages to infection control practitioners. When stored in a relational database, the data collected can also be used to support numerous research and quality improvement opportunities. A previously described electronic infection control surveillance system was remodeled to provide multi-hospital support, an XML based rule set, and interoperability with an enterprise terminology server. This paper describes the new architecture being used at hospitals across BJC HealthCare.

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

PubMed

Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki

2011-02-14

Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on intervention effects, as well as on the validity and feasibility of the theoretical-domain approach. The empirical data collected within this trial will be useful in testing whether this theoretical-domain approach can improve our understanding of the implementation of TUPAC guidelines among dental providers. Current Controlled Trials ISRCTN15427433.

Can training in empathetic validation improve medical students' communication with patients suffering pain? A test of concept.

PubMed

Linton, Steven J; Flink, Ida K; Nilsson, Emma; Edlund, Sara

2017-05-01

Patient-centered, empathetic communication has been recommended as a means for improving the health care of patients suffering pain. However, a problem has been training health care providers since programs may be time-consuming and difficult to learn. Validation, a form of empathetic response that communicates that what a patient experiences is accepted as true, has been suggested as an appropriate method for improving communication with patients suffering pain. We study the immediate effects of providing medical students with a 2-session (45-minute duration each) program in validation skills on communication. A one group, pretest vs posttest design was employed with 22 volunteer medical students. To control patient variables, actors simulated 1 of 2 patient scenarios (randomly provided at pretest and posttest). Video recordings were blindly evaluated. Self-ratings of validation and satisfaction were also employed. Observed validation responses increased significantly after training and corresponded to significant reductions in invalidating responses. Both the patient simulators and the medical students were significantly more satisfied after the training. We demonstrated that training empathetic validation results in improved communication thus extending previous findings to a medical setting with patients suffering pain. Our results suggest that it would be feasible to provide validation training for health care providers and this warrants further investigation in controlled studies.

Implementation of Treat-to-Target in Rheumatoid Arthritis Through a Learning Collaborative: Results of a Randomized Controlled Trial.

PubMed

Solomon, Daniel H; Losina, Elena; Lu, Bing; Zak, Agnes; Corrigan, Cassandra; Lee, Sara B; Agosti, Jenifer; Bitton, Asaf; Harrold, Leslie R; Pincus, Theodore; Radner, Helga; Yu, Zhi; Smolen, Josef S; Fraenkel, Liana; Katz, Jeffrey N

2017-07-01

Treat-to-target (TTT) is an accepted paradigm for the management of rheumatoid arthritis (RA), but some evidence suggests poor adherence. The purpose of this study was to test the effects of a group-based multisite improvement learning collaborative on adherence to TTT. We conducted a cluster-randomized quality-improvement trial with waitlist control across 11 rheumatology sites in the US. The intervention entailed a 9-month group-based learning collaborative that incorporated rapid-cycle improvement methods. A composite TTT implementation score was calculated as the percentage of 4 required items documented in the visit notes for each patient at 2 time points, as evaluated by trained staff. The mean change in the implementation score for TTT across all patients for the intervention sites was compared with that for the control sites after accounting for intracluster correlation using linear mixed models. Five sites with a total of 23 participating rheumatology providers were randomized to intervention and 6 sites with 23 participating rheumatology providers were randomized to the waitlist control. The intervention included 320 patients, and the control included 321 patients. At baseline, the mean TTT implementation score was 11% in both arms; after the 9-month intervention, the mean TTT implementation score was 57% in the intervention group and 25% in the control group (change in score of 46% for intervention and 14% for control; P = 0.004). We did not observe excessive use of resources or excessive occurrence of adverse events in the intervention arm. A learning collaborative resulted in substantial improvements in adherence to TTT for the management of RA. This study supports the use of an educational collaborative to improve quality. © 2017, American College of Rheumatology.

Addressing Literacy and Numeracy to Improve Diabetes Care

PubMed Central

Cavanaugh, Kerri; Wallston, Kenneth A.; Gebretsadik, Tebeb; Shintani, Ayumi; Huizinga, Mary Margaret; Davis, Dianne; Gregory, Rebecca Pratt; Malone, Robb; Pignone, Michael; DeWalt, Darren; Elasy, Tom A.; Rothman, Russell L.

2009-01-01

OBJECTIVE Diabetic patients with lower literacy or numeracy skills are at greater risk for poor diabetes outcomes. This study evaluated the impact of providing literacy- and numeracy-sensitive diabetes care within an enhanced diabetes care program on A1C and other diabetes outcomes. RESEARCH DESIGN AND METHODS In two randomized controlled trials, we enrolled 198 adult diabetic patients with most recent A1C ≥7.0%, referred for participation in an enhanced diabetes care program. For 3 months, control patients received care from existing enhanced diabetes care programs, whereas intervention patients received enhanced programs that also addressed literacy and numeracy at each institution. Intervention providers received health communication training and used the interactive Diabetes Literacy and Numeracy Education Toolkit with patients. A1C was measured at 3 and 6 months follow-up. Secondary outcomes included self-efficacy, self-management behaviors, and treatment satisfaction. RESULTS At 3 months, both intervention and control patients had significant improvements in A1C from baseline (intervention −1.50 [95% CI −1.80 to −1.02]; control −0.80 [−1.10 to −0.30]). In adjusted analysis, there was greater improvement in A1C in the intervention group than in the control group (P = 0.03). At 6 months, there were no differences in A1C between intervention and control groups. Self-efficacy improved from baseline for both groups. No significant differences were found for self-management behaviors or satisfaction. CONCLUSIONS A literacy- and numeracy-focused diabetes care program modestly improved self-efficacy and glycemic control compared with standard enhanced diabetes care, but the difference attenuated after conclusion of the intervention. PMID:19741187

Ventilation equations for improved exothermic process control.

PubMed

McKernan, John L; Ellenbecker, Michael J

2007-04-01

Exothermic or heated processes create potentially unsafe work environments for an estimated 5-10 million American workers each year. Excessive heat and process contaminants have the potential to cause acute health effects such as heat stroke, and chronic effects such as manganism in welders. Although millions of workers are exposed to exothermic processes, insufficient attention has been given to continuously improving engineering technologies for these processes to provide effective and efficient control. Currently there is no specific occupational standard established by OSHA regarding exposure to heat from exothermic processes, therefore it is important to investigate techniques that can mitigate known and potential adverse occupational health effects. The current understanding of engineering controls for exothermic processes is primarily based on a book chapter written by W. C. L. Hemeon in 1955. Improvements in heat transfer and meteorological theory necessary to design improved process controls have occurred since this time. The research presented involved a review of the physical properties, heat transfer and meteorological theories governing buoyant air flow created by exothermic processes. These properties and theories were used to identify parameters and develop equations required for the determination of buoyant volumetric flow to assist in improving ventilation controls. Goals of this research were to develop and describe a new (i.e. proposed) flow equation, and compare it to currently accepted ones by Hemeon and the American Conference of Governmental Industrial Hygienists (ACGIH). Numerical assessments were conducted to compare solutions from the proposed equations for plume area, mean velocity and flow to those from the ACGIH and Hemeon. Parameters were varied for the dependent variables and solutions from the proposed, ACGIH, and Hemeon equations for plume area, mean velocity and flow were analyzed using a randomized complete block statistical design (ANOVA). Results indicate that the proposed plume mean velocity equation provides significantly greater means than either the ACGIH or Hemeon equations throughout the range of parameters investigated. The proposed equations for plume area and flow also provide significantly greater means than either the ACGIH or Hemeon equations at distances >1 m above exothermic processes. With an accurate solution for the total volumetric flow, ventilation engineers and practicing industrial hygienists are equipped with the necessary information to design and size hoods, as well as place them at an optimal distance from the source to provide adequate control of the rising plume. The equations developed will allow researchers and practitioners to determine the critical control parameters for exothermic processes, such as the exhaust flow necessary to improve efficacy and efficiency, while ensuring adequate worker protection.

Mobile-based blended learning for capacity building of health providers in rural Afghanistan.

PubMed

Tirmizi, Syeda Nateela; Khoja, Shariq; Patten, Scott; Yousafzai, Abdul Wahab; Scott, Richard E; Durrani, Hammad; Khoja, Wafa; Husyin, Nida

2017-01-01

Mobile-based blended learning initiative was launched in November 2014 in Badakshan province of Afghanistan by Tech4Life Enterprises, Aga Khan Health Service, Afghanistan (AKHS, A), and the University of Calgary, Canada. The goal of this initiative was to improve knowledge of health providers related to four major mental health problems, namely depression, psychosis, post-traumatic stress disorder (PTSD) and drug abuse. This paper presents the results of quasi-experimental study conducted in 4 intervention districts in Badakshan for improvement in the knowledge among health providers about depression. The results were compared with three control districts for the change in knowledge scores. Sixty-two health providers completed pre and post module questionnaires from case district, while 31 health providers did so from the control sites. Significant change was noticed in the case districts, where overall knowledge scores changed from 45% in pre-intervention test to 63% in post-intervention test. Overall background knowledge of pre to post module test scores changed from 30% to 40%, knowledge of symptoms showed correct responses raised from 25% to 44%, knowledge related to causes of depression from overall districts showed change from 22% to 51%, and treatment knowledge of depression improved from 29% to 35%. Average gain in scores among cases was 16.06, compared to 6.8 in controls. The study confirms that a blended Learning approach with multiple learning techniques for health providers in Badakshan, Afghanistan, enhanced their knowledge and offers an effective solution to overcome challenges in continuing education. Further research is needed to confirm that the gains in knowledge reported here translate into better practice and improved mental health.

Fast and robust control of nanopositioning systems: Performance limits enabled by field programmable analog arrays.

PubMed

Baranwal, Mayank; Gorugantu, Ram S; Salapaka, Srinivasa M

2015-08-01

This paper aims at control design and its implementation for robust high-bandwidth precision (nanoscale) positioning systems. Even though modern model-based control theoretic designs for robust broadband high-resolution positioning have enabled orders of magnitude improvement in performance over existing model independent designs, their scope is severely limited by the inefficacies of digital implementation of the control designs. High-order control laws that result from model-based designs typically have to be approximated with reduced-order systems to facilitate digital implementation. Digital systems, even those that have very high sampling frequencies, provide low effective control bandwidth when implementing high-order systems. In this context, field programmable analog arrays (FPAAs) provide a good alternative to the use of digital-logic based processors since they enable very high implementation speeds, moreover with cheaper resources. The superior flexibility of digital systems in terms of the implementable mathematical and logical functions does not give significant edge over FPAAs when implementing linear dynamic control laws. In this paper, we pose the control design objectives for positioning systems in different configurations as optimal control problems and demonstrate significant improvements in performance when the resulting control laws are applied using FPAAs as opposed to their digital counterparts. An improvement of over 200% in positioning bandwidth is achieved over an earlier digital signal processor (DSP) based implementation for the same system and same control design, even when for the DSP-based system, the sampling frequency is about 100 times the desired positioning bandwidth.

Patterned wafer geometry grouping for improved overlay control

NASA Astrophysics Data System (ADS)

Lee, Honggoo; Han, Sangjun; Woo, Jaeson; Park, Junbeom; Song, Changrock; Anis, Fatima; Vukkadala, Pradeep; Jeon, Sanghuck; Choi, DongSub; Huang, Kevin; Heo, Hoyoung; Smith, Mark D.; Robinson, John C.

2017-03-01

Process-induced overlay errors from outside the litho cell have become a significant contributor to the overlay error budget including non-uniform wafer stress. Previous studies have shown the correlation between process-induced stress and overlay and the opportunity for improvement in process control, including the use of patterned wafer geometry (PWG) metrology to reduce stress-induced overlay signatures. Key challenges of volume semiconductor manufacturing are how to improve not only the magnitude of these signatures, but also the wafer to wafer variability. This work involves a novel technique of using PWG metrology to provide improved litho-control by wafer-level grouping based on incoming process induced overlay, relevant for both 3D NAND and DRAM. Examples shown in this study are from 19 nm DRAM manufacturing.

Design and Control of Chemical Grouting : Volume 3 - Engineering Practice

DOT National Transportation Integrated Search

1983-04-01

Recent improvements in the engineering practice of chemical grouting have provided increased confidence in this method of ground modification. Designers can significantly improve the success of chemical grouting by defining their grouting program obj...

Organizational Wellness Program Implementation and Evaluation: A Holistic Approach to Improve the Wellbeing of Middle Managers.

PubMed

Medina, Maria Del Consuelo; Calderon, Angelica; Blunk, Dan I; Mills, Brandy W; Leiner, Marie

2018-06-01

: Employee wellness programs can provide benefits to institutions as well as employees and their families. Despite the attempts of some organizations to implement programs that take a holistic approach to improve physical, mental, and social wellness, the most common programs are exclusively comprised of physical and nutritional components. In this study, we implemented a wellness program intervention, including training using a holistic approach to improve the wellbeing of middle managers in several multinational organizations. We included control and experimental groups to measure wellness and teamwork with two repeated measures. Our results indicated that employees receiving the intervention had improved measures of wellness and teamwork. A positive relationship was found between wellness and teamwork in the experimental group when compared with the control group. Taken together, the data suggest that implementation of these programs would provide valuable outcomes for both employees and organizations.

The effect of massage on heart rate variability in preterm infants.

PubMed

Smith, S L; Lux, R; Haley, S; Slater, H; Beachy, J; Beechy, J; Moyer-Mileur, L J

2013-01-01

To test the hypothesis that massage would improve autonomic nervous system (ANS) function as measured by heart rate variability (HRV) in preterm infants. Medically stable, 29- to 32-week preterm infants (17 massage, 20 control) were enrolled in a masked, randomized longitudinal study. Licensed massage therapists provided the massage or control condition twice a day for 4 weeks. Weekly HRV, a measure of ANS development and function, was analyzed using SPSS generalized estimating equations. Infant characteristics were similar between groups. HRV improved in massaged infants but not in the control infants (P<0.05). Massaged males had a greater improvement in HRV than females (P<0.05). HRV in massaged infants was on a trajectory comparable to term-born infants by study completion. Massage-improved HRV in a homogeneous sample of hospitalized, medically stable, preterm male infants and may improve infant response to exogenous stressors. We speculate that massage improves ANS function in these infants.

Moisture Control Guidance for Commercial and Public ...

EPA Pesticide Factsheets

This document provides guidance to designers, construction mangers, and building operation/maintenance managers to improve IEQ and reduce risks of encountering IEQ problems due to insufficient moisture control. EPA will be producing a document entitled

Diabetes Self-management Quality Improvement Initiative for Medically Underserved Patients.

PubMed

Seol, Haesun; Thompson, Mark; Kreider, Kathryn Evans; Vorderstrasse, Allison

The burden of diabetes is greater for minorities and medically underserved populations in the United States. An evidence-based provider-delivered diabetes self-management education intervention was implemented in a federally qualified health center for medically underserved adult patients with type 2 diabetes. The findings provide support for the efficacy of the intervention on improvement in self-management behaviors and glycemic control among underserved patients with diabetes, while not substantially changing provider visit time or workload.

Injury depth control from combined wavelength and power tuning in scanned beam laser thermal therapy

NASA Astrophysics Data System (ADS)

Villiger, Martin; Soroka, Andrew; Tearney, Guillermo J.; Bouma, Brett E.; Vakoc, Benjamin J.

2011-11-01

Laser thermal therapy represents a possible method to treat premalignant epithelial lesions of the esophagus. Dynamically conforming the thermal injury profile to a specific lesion boundary is expected to improve the efficacy of such a treatment and avoid complications. In this work, we investigated wavelength tuning as a mechanism to achieve this aimed control over injury depth by using the strong variation of water absorption close to 1900 nm. We developed a numerical model simulating in steps the photon propagation in the tissue, the diffusion of the absorbed heat, and the resulting tissue damage. The model was compared with experimental results on porcine esophageal specimens ex vivo and showed good agreement. Combined with power tuning, the wavelength agility in the range of 1860 to 1895 nm extends the injury range compared to a fixed wavelength source beyond 1 mm, while at the same time improving control over shallow depths and avoiding vaporization at the tissue surface. The combination of two or three discrete wavelengths combined at variable ratios provides similar control, and may provide an improved strategy for the treatment of endothelial lesions.

Results of a Regional Effort to Improve Warfarin Management.

PubMed

Rose, Adam J; Park, Angela; Gillespie, Christopher; Van Deusen Lukas, Carol; Ozonoff, Al; Petrakis, Beth Ann; Reisman, Joel I; Borzecki, Ann M; Benedict, Ashley J; Lukesh, William N; Schmoke, Timothy J; Jones, Ellen A; Morreale, Anthony P; Ourth, Heather L; Schlosser, James E; Mayo-Smith, Michael F; Allen, Arthur L; Witt, Daniel M; Helfrich, Christian D; McCullough, Megan B

2017-05-01

Improved anticoagulation control with warfarin reduces adverse events and represents a target for quality improvement. No previous study has described an effort to improve anticoagulation control across a health system. To describe the results of an effort to improve anticoagulation control in the New England region of the Veterans Health Administration (VA). Our intervention encompassed 8 VA sites managing warfarin for more than 5000 patients in New England (Veterans Integrated Service Network 1 [VISN 1]). We provided sites with a system to measure processes of care, along with targeted audit and feedback. We focused on processes of care associated with site-level anticoagulation control, including prompt follow-up after out-of-range international normalized ratio (INR) values, minimizing loss to follow-up, and use of guideline-concordant INR target ranges. We used a difference-in-differences (DID) model to examine changes in anticoagulation control, measured as percentage time in therapeutic range (TTR), as well as process measures and compared VISN 1 sites with 116 VA sites located outside VISN 1. VISN 1 sites improved on TTR, our main indicator of quality, from 66.4% to 69.2%, whereas sites outside VISN 1 improved from 65.9% to 66.4% (DID 2.3%, P < 0.001). Improvement in TTR correlated strongly with the extent of improvement on process-of-care measures, which varied widely across VISN 1 sites. A regional quality improvement initiative, using performance measurement with audit and feedback, improved TTR by 2.3% more than control sites, which is a clinically important difference. Improving relevant processes of care can improve outcomes for patients receiving warfarin.

Archaeological Survey at Fort Hood, Texas Fiscal Years 1991 and 1992: Cantonment and Belton Lake Periphery Areas

DTIC Science & Technology

1993-12-01

is unable to adequately locate rockshelters. Improvement of the elevation data in the Fort Hood GIS would provide better estimates of slope and aspect...rockshelters. Improvement of the elevation data in the Fort Hood GIS would provide better estimates of slope and aspect and might be expected to improve the...could be chosen and used as a control (non-sites). The development of Geographic Information Systems ( GIS ) allows either or both approaches to be

Effect of Olympic and traditional resistance training on vertical jump improvement in high school boys.

PubMed

Channell, Brian T; Barfield, J P

2008-09-01

The purpose of this study was to compare the effects of a ballistic resistance training program of Olympic lifts with those of a traditional resistance training program of power lifts on vertical jump improvement in male high school athletes. Twenty-seven male student athletes were recruited from a high school football program at a small, rural school in the Southeast. The subjects were divided into an Olympic training group (OT, n = 11), a power training group (PT, n = 10), and a control group (n = 6). Analysis of variance was used to determine whether a significant mean difference existed among groups on vertical jump improvement after 8 weeks of group-specific training. Effect size of vertical jump improvement between groups, and correlations between strength and vertical jump performance, were also examined. There was no significant mean difference (p >or= 0.05) among OT, PT, and control groups, but large effect sizes between OT and control (d = 1.06) and PT and control (d = 0.94) demonstrate that both OT and PT are effective in improving vertical jump performance in male high school athletes. Moderate to high correlations were noted between squat score and vertical jump after adjusting for body weight (r = 0.42) and between power clean and vertical jump after adjusting for body weight (r = 0.75). Findings from the current study indicate that Olympic lifts as well as power lifts provide improvement in vertical jump performance and that Olympic lifts may provide a modest advantage over power lifts for vertical jump improvement in high school athletes.

Operational radiological support for the US manned space program

NASA Technical Reports Server (NTRS)

Golightly, Michael J.; Hardy, Alva C.; Atwell, William; Weyland, Mark D.; Kern, John; Cash, Bernard L.

1993-01-01

Radiological support for the manned space program is provided by the Space Radiation Analysis Group at NASA/JSC. This support ensures crew safety through mission design analysis, real-time space environment monitoring, and crew exposure measurements. Preflight crew exposure calculations using mission design information are used to ensure that crew exposures will remain within established limits. During missions, space environment conditions are continuously monitored from within the Mission Control Center. In the event of a radiation environment enhancement, the impact to crew exposure is assessed and recommendations are provided to flight management. Radiation dosimeters are placed throughout the spacecraft and provided to each crewmember. During a radiation contingency, the crew could be requested to provide dosimeter readings. This information would be used for projecting crew dose enhancements. New instrumentation and computer technology are being developed to improve the support. Improved instruments include tissue equivalent proportional counter (TEPC)-based dosimeters and charged particle telescopes. Data from these instruments will be telemetered and will provide flight controllers with unprecedented information regarding the radiation environment in and around the spacecraft. New software is being acquired and developed to provide 'smart' space environmental data displays for use by flight controllers.

The Deployment of Routing Protocols in Distributed Control Plane of SDN

PubMed Central

Jingjing, Zhou; Di, Cheng; Weiming, Wang; Rong, Jin; Xiaochun, Wu

2014-01-01

Software defined network (SDN) provides a programmable network through decoupling the data plane, control plane, and application plane from the original closed system, thus revolutionizing the existing network architecture to improve the performance and scalability. In this paper, we learned about the distributed characteristics of Kandoo architecture and, meanwhile, improved and optimized Kandoo's two levels of controllers based on ideological inspiration of RCP (routing control platform). Finally, we analyzed the deployment strategies of BGP and OSPF protocol in a distributed control plane of SDN. The simulation results show that our deployment strategies are superior to the traditional routing strategies. PMID:25250395

Exploratory low-speed wind-tunnel study of concepts designed to improve aircraft stability and control at high angles of attack. M.S. Thesis

NASA Technical Reports Server (NTRS)

Hahne, D. E.

1985-01-01

A wind tunnel investigation of concepts to improve the high angle-of-attack stability and control characteristics of a high performance aircraft was conducted. The effect of vertical tail geometry on stability and the effectiveness of several conventional and unusual control concepts was determined. These results were obtained over a large angle-of-attack range. Vertical tail location, cant angle and leading edge sweep could influence both longitudinal and lateral-directional stability. The control concepts tested were found to be effective and to provide control into the post stall angle-of-attack region.

Hypertension and hyperlipidemia management in patients treated at community health centers.

PubMed

Kirchhoff, Anne C; Drum, Melinda L; Zhang, James X; Schlichting, Jennifer; Levie, Jessica; Harrison, James F; Lippold, Susan A; Schaefer, Cynthia T; Chin, Marshall H

2008-01-01

OBJECTIVE: Community health centers (HCs) provide care for millions of medically underserved Americans with disproportionate burdens of hypertension and hyperlipidemia. For both conditions, treatment guidelines recently became more stringent and quality improvement (QI) efforts have intensified. We assessed hypertension and hyperlipidemia management in HCs during this time of guideline revision and increased QI efforts. DESIGN: Cross-sectional chart review. SETTING AND PARTICIPANTS: Eleven Midwestern HCs for 2000 and 9 for 2002 provided audit data from 2,976 randomly chosen patients with hypertension and/or hyperlipidemia. MEASUREMENT: Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI/VII) and National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) guidelines were used to assess management of these conditions. RESULTS: Hypertension (2000, N=808; 2002, N=692) and hyperlipidemia (2000, N=774; 2002, N=702) outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at <140/90 mm Hg, p=0.02). Hypertension control for persons with diabetes, renal failure and heart failure increased (16% vs. 28% controlled at <130/85 mm Hg, p=0.006). LDL control increased significantly for patients with 2 or more risk factors (39% vs. 58% controlled at <130 mg/dl, p=0.008). Other clinical subgroups showed trends toward better control, although there was insufficient power to detect significant differences for these groups. CONCLUSION: Hypertension and hyperlipidemia outcomes improved for some risk groups; however, ongoing QI is necessary.

Mirror therapy in chronic stroke survivors with severely impaired upper limb function: a randomized controlled trial.

PubMed

Colomer, Carolina; NOé, Enrique; Llorens, Roberto

2016-06-01

Mirror therapy (MT) has been proposed to improve the motor function of chronic individuals with stroke with mild to moderate impairment. With regards to severe upper limb paresis, MT has shown to provide limited motor improvement in the acute or sub-acute phase. However, no previous research has described the effects of MT in chronic individuals with stroke with severely impaired upper limb function. The aim of this study was to determine the effectiveness of MT on chronic stroke survivors with severe upper-limb impairment in comparison with passive mobilization. A randomized controlled trial. Rehabilitative outpatient unit. A total of 31 chronic subjects poststroke with severely impaired upper limb function were randomly assigned to either an experimental group (N.=15), or a control group (N.=16). Twenty-four intervention sessions were performed for both groups. Each session included 45-minute period of MT (experimental group) or passive mobilization (control group), administered three days a week. Participants were assessed before and after the intervention with the Wolf Motor Function Test, the Fugl-Meyer Assessment, and the Nottingham Sensory Assessment. Improvement in motor function was observed in both groups on the time (P=0.002) and ability (P=0.001) subscales of the Wolf Motor Function Test. No differences were detected in kinesthesis or stereognosis. However, the experimental group showed a significant improvement in tactile sensation that was mainly observed as an increased sensitivity to light touches. In comparison with passive mobilization, MT in chronic stroke survivors with severely impaired upper-limb function may provide a limited but positive effect on light touch sensitivity while providing similar motor improvement. MT is a therapeutic approach that can be used in the rehabilitation of severely impaired upper limb in chronic stroke survivors, specifically to address light touch sensitivity deficits.

Passive Thermal Control Challenges for Future Exploration Missions

NASA Technical Reports Server (NTRS)

Rickman, Steven L.

2004-01-01

This slide presentation reviews the importance of developing passive thermal control for the future exploration missions envisioned in President Bush's call for human exploration of the Moon and Mars. Included in the presentation is a review of the conditions that make the thermal control very challenging on the Moon and Mars. With the future miniaturization of electronics components, power density and the associated challenges of electronics heat dissipation will provide new challenges. There is a challenge for improvement in modeling and analysis of thermal control systems, and for improved facilities to support testing of thermal-vacuum systems.

A systematic review of studies of web portals for patients with diabetes mellitus.

PubMed

Coughlin, Steven S; Williams, Lovoria B; Hatzigeorgiou, Christos

2017-01-01

Patient web portals are password-protected online websites that offer patients 24-hour access to personal health information from anywhere with an Internet connection. Due to advances in health information technologies, there has been increasing interest among providers and researchers in patient web portals for use by patients with diabetes and other chronic conditions. This article, which is based upon bibliographic searches in PubMed, reviews web portals for patients with diabetes mellitus including patient web portals tethered to electronic medical records and web portals developed specifically for patients with diabetes. Twelve studies of the impact of patient web portals on the management of diabetes patients were identified. Three had a cross-sectional design, 1 employed mixed-methods, one had a matched-control design, 3 had a retrospective cohort design, and 5 were randomized controlled trials. Six (50%) of the studies examined web portals tethered to electronic medical records and the remainder were web portals developed specifically for diabetes patients. The results of this review suggest that secure messaging between adult diabetic patients and their clinician is associated with improved glycemic control. However, results from observational studies indicate that many diabetic patients do not take advantage of web portal features such as secure messaging, perhaps because of a lack of internet access or lack of experience in navigating web portal resources. Although results from randomized controlled trials provide stronger evidence of the efficacy of web portal use in improving glycemic control among diabetic patients, the number of trials is small and results from the trials have been mixed. Studies suggest that secure messaging between adult diabetic patients and their clinician is associated with improved glycemic control, but negative findings have also been reported. The number of randomized controlled trials that have examined the efficacy of web portal use in improving glycemic control among diabetic patients is still small. Additional research is needed to identify specific portal features that may impact quality of care or improve glycemic control.

A systematic review of studies of web portals for patients with diabetes mellitus

PubMed Central

Williams, Lovoria B.; Hatzigeorgiou, Christos

2017-01-01

Patient web portals are password-protected online websites that offer patients 24-hour access to personal health information from anywhere with an Internet connection. Due to advances in health information technologies, there has been increasing interest among providers and researchers in patient web portals for use by patients with diabetes and other chronic conditions. This article, which is based upon bibliographic searches in PubMed, reviews web portals for patients with diabetes mellitus including patient web portals tethered to electronic medical records and web portals developed specifically for patients with diabetes. Twelve studies of the impact of patient web portals on the management of diabetes patients were identified. Three had a cross-sectional design, 1 employed mixed-methods, one had a matched-control design, 3 had a retrospective cohort design, and 5 were randomized controlled trials. Six (50%) of the studies examined web portals tethered to electronic medical records and the remainder were web portals developed specifically for diabetes patients. The results of this review suggest that secure messaging between adult diabetic patients and their clinician is associated with improved glycemic control. However, results from observational studies indicate that many diabetic patients do not take advantage of web portal features such as secure messaging, perhaps because of a lack of internet access or lack of experience in navigating web portal resources. Although results from randomized controlled trials provide stronger evidence of the efficacy of web portal use in improving glycemic control among diabetic patients, the number of trials is small and results from the trials have been mixed. Studies suggest that secure messaging between adult diabetic patients and their clinician is associated with improved glycemic control, but negative findings have also been reported. The number of randomized controlled trials that have examined the efficacy of web portal use in improving glycemic control among diabetic patients is still small. Additional research is needed to identify specific portal features that may impact quality of care or improve glycemic control. PMID:28736732

The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial.

PubMed

Young, Kim-Wan; Ng, Petrus; Kwok, Timothy; Cheng, Daphne

2017-01-01

Persons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI. In a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants. The paired-samples t -test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status. This present RCT provides evidence to support the feasibility and effectiveness of the holistic health group intervention in improving the cognitive and short-term memory abilities of PwMCI.

Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children's body mass index.

PubMed

Alkon, Abbey; Crowley, Angela A; Neelon, Sara E Benjamin; Hill, Sherika; Pan, Yi; Nguyen, Viet; Rose, Roberta; Savage, Eric; Forestieri, Nina; Shipman, Linda; Kotch, Jonathan B

2014-03-01

To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention. Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic. National Clinical Trials Number NCT01921842.

Evaluation of traffic control devices : fifth-year activities.

DOT National Transportation Integrated Search

2009-02-01

This project was established to provide a means of conducting limited scope evaluations of numerous traffic : control device issues. During the fifth, and final, year of the project, researchers conducted four activities: : improving the interface fo...

A design procedure for the handling qualities optimization of the X-29A aircraft

NASA Technical Reports Server (NTRS)

Bosworth, John T.; Cox, Timothy H.

1989-01-01

A design technique for handling qualities improvement was developed for the X-29A aircraft. As with any new aircraft, the X-29A control law designers were presented with a relatively high degree of uncertainty in their mathematical models. The presence of uncertainties, and the high level of static instability of the X-29A caused the control law designers to stress stability and robustness over handling qualities. During flight test, the mathematical models of the vehicle were validated or corrected to match the vehicle dynamic behavior. The updated models were then used to fine tune the control system to provide fighter-like handling characteristics. A design methodology was developed which works within the existing control system architecture to provide improved handling qualities and acceptable stability with a minimum of cost in both implementation as well as software verification and validation.

Variable cycle engines for advanced supersonic transports

NASA Technical Reports Server (NTRS)

Howlett, R. A.; Kozlowski, H.

1975-01-01

Variable Cycle Engines being studied for advanced commercial supersonic transports show potential for significant environmental and economic improvements relative to 1st generation SST engines. The two most promising concepts are: a Variable Stream Control Engine and a Variable Cycle Engine with a rear flow-control valve. Each concept utilizes variable components and separate burners to provide independent temperature and velocity control for two coannular flow streams. Unique fuel control techniques are combined with cycle characteristics that provide low fuel consumption, similar to a turbojet engine, for supersonic operation. This is accomplished while retaining the good subsonic performance features of a turbofan engine. A two-stream coannular nozzle shows potential to reduce jet noise to below FAR Part 36 without suppressors. Advanced burner concepts have the potential for significant reductions in exhaust emissions. In total, these unique engine concepts have the potential for significant overall improvements to the environmental and economic characteristics of advanced supersonic transports.

Utilization of a patient-centered asthma passport tool in a subspecialty clinic

PubMed Central

Greenberg, Jonathan; Prushinskaya, Olga; Harris, Joshua D.; Guidetti-Myers, Giltian; Steiding, Jacqueline; Sawicki, Gregory S.; Gaffin, Jonathan M.

2018-01-01

Introduction Despite available and effective tools for asthma self-assessment (Asthma Control Test, ACT) and self-management (Asthma Action Plan, AAP), they are underutilized in outpatient specialty clinics. We evaluated the impact of a patient-centered checklist, the Asthma Passport, on improving ACT and AAP utilization in clinic. Methods This was a randomized, interventional quality-improvement project in which the Asthma Passport was distributed to 120 pediatric asthma patients over the duration of 16 weeks. The passport’s checklist consisted of tasks to be completed by the patient/family, including completion of the ACT and AAP. We compared rates of completion of the ACT and AAP for those who received the passport versus the control group, and assessed patient/caregiver and provider satisfaction. Results Based on electronic medical record data from 222 participants, the ACT completion rate was not significantly different between the passport and control groups, however, the AAP completion rate was significantly greater than control (30.0% vs. 17.7%, p = 0.04). When per-protocol analysis was limited to groups who completed and returned their passports, ACT and AAP completion rates were significantly greater than control (73.8% vs. 44.1% (p = 0.002) and 35.7% vs. 17.7% (p = 0.04), respectively). Nearly all participants reported high satisfaction with care, and surveyed providers viewed the passport favorably. Conclusions A patient-centered checklist significantly improved the completion rate of the AAP. For patient’s who completed and returned the asthma passport, the ACT completion rate was also improved. Participants and providers reported high satisfaction with the checklist, suggesting that it can effectively promote asthma self-management and self-assessment without burdening clinicians or clinic workfiow. PMID:28548904

Utilization of a patient-centered asthma passport tool in a subspecialty clinic.

PubMed

Greenberg, Jonathan; Prushinskaya, Olga; Harris, Joshua D; Guidetti-Myers, Gillian; Steiding, Jacqueline; Sawicki, Gregory S; Gaffin, Jonathan M

2018-02-01

Despite available and effective tools for asthma self-assessment (Asthma Control Test, ACT) and self-management (Asthma Action Plan, AAP), they are underutilized in outpatient specialty clinics. We evaluated the impact of a patient-centered checklist, the Asthma Passport, on improving ACT and AAP utilization in clinic. This was a randomized, interventional quality-improvement project in which the Asthma Passport was distributed to 120 pediatric asthma patients over the duration of 16 weeks. The passport's checklist consisted of tasks to be completed by the patient/family, including completion of the ACT and AAP. We compared rates of completion of the ACT and AAP for those who received the passport versus the control group, and assessed patient/caregiver and provider satisfaction. Based on electronic medical record data from 222 participants, the ACT completion rate was not significantly different between the passport and control groups, however, the AAP completion rate was significantly greater than control (30.0% vs. 17.7%, p = 0.04). When per-protocol analysis was limited to groups who completed and returned their passports, ACT and AAP completion rates were significantly greater than control (73.8% vs. 44.1% (p = 0.002) and 35.7% vs. 17.7% (p = 0.04), respectively). Nearly all participants reported high satisfaction with care, and surveyed providers viewed the passport favorably. A patient-centered checklist significantly improved the completion rate of the AAP. For patient's who completed and returned the asthma passport, the ACT completion rate was also improved. Participants and providers reported high satisfaction with the checklist, suggesting that it can effectively promote asthma self-management and self-assessment without burdening clinicians or clinic workflow.

SMART lunch box intervention to improve the food and nutrient content of children's packed lunches: UK wide cluster randomised controlled trial.

PubMed

Evans, C E L; Greenwood, D C; Thomas, J D; Cleghorn, C L; Kitchen, M S; Cade, J E

2010-11-01

Government standards are now in place for children's school meals but not for lunches prepared at home. The aim of this trial is to improve the content of children's packed lunches. A cluster randomised controlled trial in 89 primary schools across the UK involving 1291 children, age 8-9 years at baseline. Follow-up was 12 months after baseline. A "SMART" lunch box intervention programme consisted of food boxes, bag and supporting materials. The main outcome measures were weights of foods and proportion of children provided with sandwiches, fruit, vegetables, dairy food, savoury snacks and confectionery in each packed lunch. Levels of nutrients provided including energy, total fat, saturated fat, protein, non-milk extrinsic sugar, sodium, calcium, iron, folate, zinc, vitamin A and vitamin C. Moderately higher weights of fruit, vegetables, dairy and starchy food and lower weights of savoury snacks were provided to children in the intervention group. Children in the intervention group were provided with slightly higher levels of vitamin A and folate. 11% more children were provided with vegetables/salad in their packed lunch, and 13% fewer children were provided with savoury snacks (crisps). Children in the intervention group were more likely to be provided with packed lunches meeting the government school meal standards. The SMART lunch box intervention, targeting parents and children, led to small improvements in the food and nutrient content of children's packed lunches. Further interventions are required to bring packed lunches in line with the new government standards for school meals. Current controlled trials ISRCTN77710993.

Tests of a 1/7-Scale Semispan Model of the XB-35 Airplane in the Langley 19-Foot Pressure Tunnel

NASA Technical Reports Server (NTRS)

Teplitz, Jerome; Kayten, Gerald G.; Cancro, Patrick A.

1946-01-01

A 1/7 scale semispan model of the XB-35 airplane was tested in the Langley 10 foot pressure tunnel, primarily for the purpose of investigating the effectiveness of a leading-edge slot for alleviation of stick-fixed longitudinal instability at high angles of attack caused by early tip stalling and a device for relief of stick-free instability caused by elevon up-floating tendencies at high angles of attack. Results indicated that the slot was not adequate to provide the desired improvement in stick-fixed stability. The tab-flipper device provided improvement in stick-free stability abd two of the linkage combinations tested gave satisfactory variations of control force with airspeed for all conditions except that in which the wing-tip "pitch-control" flap was fully deflected. However, the improvement in control force characteristics was accompanied by a detrimental effect on stick-fixed stability because of the pitching moments produced by the elevon tab deflection.

Robust high-precision attitude control for flexible spacecraft with improved mixed H2/H∞ control strategy under poles assignment constraint

NASA Astrophysics Data System (ADS)

Liu, Chuang; Ye, Dong; Shi, Keke; Sun, Zhaowei

2017-07-01

A novel improved mixed H2/H∞ control technique combined with poles assignment theory is presented to achieve attitude stabilization and vibration suppression simultaneously for flexible spacecraft in this paper. The flexible spacecraft dynamics system is described and transformed into corresponding state space form. Based on linear matrix inequalities (LMIs) scheme and poles assignment theory, the improved mixed H2/H∞ controller does not restrict the equivalence of the two Lyapunov variables involved in H2 and H∞ performance, which can reduce conservatives compared with traditional mixed H2/H∞ controller. Moreover, it can eliminate the coupling of Lyapunov matrix variables and system matrices by introducing slack variable that provides additional degree of freedom. Several simulations are performed to demonstrate the effectiveness and feasibility of the proposed method in this paper.

School Improvement through Government Agencies: Loose or Tight Coupling?

ERIC Educational Resources Information Center

Bush, Tony

2017-01-01

In seeking to improve student outcomes, governments may choose to exercise direct control over schools, as in many centralised systems, or to provide frameworks for intermediate bodies to engage in improvement activities. One such body is the National College for School Leadership (NCSL), now the National College for Teaching and Leadership (NCTL)…

Virtual reality and cognitive rehabilitation: a review of current outcome research.

PubMed

Larson, Eric B; Feigon, Maia; Gagliardo, Pablo; Dvorkin, Assaf Y

2014-01-01

Recent advancement in the technology of virtual reality (VR) has allowed improved applications for cognitive rehabilitation. The aim of this review is to facilitate comparisons of therapeutic efficacy of different VR interventions. A systematic approach for the review of VR cognitive rehabilitation outcome research addressed the nature of each sample, treatment apparatus, experimental treatment protocol, control treatment protocol, statistical analysis and results. Using this approach, studies that provide valid evidence of efficacy of VR applications are summarized. Applications that have not yet undergone controlled outcome study but which have promise are introduced. Seventeen studies conducted over the past eight years are reviewed. The few randomized controlled trials that have been completed show that some applications are effective in treating cognitive deficits in people with neurological diagnoses although further study is needed. Innovations requiring further study include the use of enriched virtual environments that provide haptic sensory input in addition to visual and auditory inputs and the use of commercially available gaming systems to provide tele-rehabilitation services. Recommendations are offered to improve efficacy of rehabilitation, to improve scientific rigor of rehabilitation research and to broaden access to the evidence-based treatments that this research has identified.

Hall devices improve electric motor efficiency

NASA Technical Reports Server (NTRS)

Haeussermann, W.

1979-01-01

Efficiency of electric motors and generators is reduced by radial magnetic forces created by symmetric fields within device. Forces are sensed and counteracted by Hall devices on excitation or control windings. Hall generators directly measure and provide compensating control of anu asymmetry, eliminating additional measurements needed for calibration feedback control loop.

Improving household air, drinking water and hygiene in rural Peru: a community-randomized-controlled trial of an integrated environmental home-based intervention package to improve child health.

PubMed

Hartinger, S M; Lanata, C F; Hattendorf, J; Verastegui, H; Gil, A I; Wolf, J; Mäusezahl, D

2016-12-01

Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. We conducted a community-randomized-controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. We recorded 24 647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58-1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47-1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children's growth rates were observed. Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association

Improving household air, drinking water and hygiene in rural Peru: a community-randomized–controlled trial of an integrated environmental home-based intervention package to improve child health

PubMed Central

Hartinger, SM; Lanata, CF; Hattendorf, J; Verastegui, H; Gil, AI; Wolf, J; Mäusezahl, D

2016-01-01

Abstract Background: Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. Methods: We conducted a community-randomized–controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. Results: We recorded 24 647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58–1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47–1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children’s growth rates were observed. Conclusions: Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions. PMID:27818376

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

PubMed

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

2014-07-01

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

Effects of a social accountability approach, CARE's Community Score Card, on reproductive health-related outcomes in Malawi: A cluster-randomized controlled evaluation.

PubMed

Gullo, Sara; Galavotti, Christine; Sebert Kuhlmann, Anne; Msiska, Thumbiko; Hastings, Phil; Marti, C Nathan

2017-01-01

Social accountability approaches, which emphasize mutual responsibility and accountability by community members, health care workers, and local health officials for improving health outcomes in the community, are increasingly being employed in low-resource settings. We evaluated the effects of a social accountability approach, CARE's Community Score Card (CSC), on reproductive health outcomes in Ntcheu district, Malawi using a cluster-randomized control design. We matched 10 pairs of communities, randomly assigning one from each pair to intervention and control arms. We conducted two independent cross-sectional surveys of women who had given birth in the last 12 months, at baseline and at two years post-baseline. Using difference-in-difference (DiD) and local average treatment effect (LATE) estimates, we evaluated the effects on outcomes including modern contraceptive use, antenatal and postnatal care service utilization, and service satisfaction. We also evaluated changes in indicators developed by community members and service providers in the intervention areas. DiD analyses showed significantly greater improvements in the proportion of women receiving a home visit during pregnancy (B = 0.20, P < .01), receiving a postnatal visit (B = 0.06, P = .01), and overall service satisfaction (B = 0.16, P < .001) in intervention compared to control areas. LATE analyses estimated significant effects of the CSC intervention on home visits by health workers (114% higher in intervention compared to control) (B = 1.14, P < .001) and current use of modern contraceptives (57% higher) (B = 0.57, P < .01). All 13 community- and provider-developed indicators improved, with 6 of them showing significant improvements. By facilitating the relationship between community members, health service providers, and local government officials, the CSC contributed to important improvements in reproductive health-related outcomes. Further, the CSC builds mutual accountability, and ensures that solutions to problems are locally-relevant, locally-supported and feasible to implement.

Exciter switch

NASA Technical Reports Server (NTRS)

Mcpeak, W. L.

1975-01-01

A new exciter switch assembly has been installed at the three DSN 64-m deep space stations. This assembly provides for switching Block III and Block IV exciters to either the high-power or 20-kW transmitters in either dual-carrier or single-carrier mode. In the dual-carrier mode, it provides for balancing the two drive signals from a single control panel located in the transmitter local control and remote control consoles. In addition to the improved switching capabilities, extensive monitoring of both the exciter switch assembly and Transmitter Subsystem is provided by the exciter switch monitor and display assemblies.

Miniature Trailing Edge Effector for Aerodynamic Control

NASA Technical Reports Server (NTRS)

Lee, Hak-Tae (Inventor); Bieniawski, Stefan R. (Inventor); Kroo, Ilan M. (Inventor)

2008-01-01

Improved miniature trailing edge effectors for aerodynamic control are provided. Three types of devices having aerodynamic housings integrated to the trailing edge of an aerodynamic shape are presented, which vary in details of how the control surface can move. A bucket type device has a control surface which is the back part of a C-shaped member having two arms connected by the back section. The C-shaped section is attached to a housing at the ends of the arms, and is rotatable about an axis parallel to the wing trailing edge to provide up, down and neutral states. A flip-up type device has a control surface which rotates about an axis parallel to the wing trailing edge to provide up, down, neutral and brake states. A rotating type device has a control surface which rotates about an axis parallel to the chord line to provide up, down and neutral states.

A MULTI-CENTER CLUSTER-RANDOMIZED TRIAL OF A MULTI-FACTORIAL INTERVENTION TO IMPROVE ANTIHYPERTENSIVE MEDICATION ADHERENCE AND BLOOD PRESSURE CONTROL AMONG PATIENTS AT HIGH CARDIOVASCULAR RISK (The COM99 study)*

PubMed Central

Pladevall, Manel; Brotons, Carlos; Gabriel, Rafael; Arnau, Anna; Suarez, Carmen; de la Figuera, Mariano; Marquez, Emilio; Coca, Antonio; Sobrino, Javier; Divine, George; Heisler, Michele; Williams, L Keoki

2010-01-01

Background Medication non-adherence is common and results in preventable disease complications. This study assesses the effectiveness of a multifactorial intervention to improve both medication adherence and blood pressure control and to reduce cardiovascular events. Methods and Results In this multi-center, cluster-randomized trial, physicians from hospital-based hypertension clinics and primary care centers across Spain were randomized to receive and provide the intervention to their high-risk patients. Eligible patients were ≥50 years of age, had uncontrolled hypertension, and had an estimated 10-year cardiovascular risk greater than 30%. Physicians randomized to the intervention group counted patients’ pills, designated a family member to support adherence behavior, and provided educational information to patients. The primary outcome was blood pressure control at 6 months. Secondary outcomes included both medication adherence and a composite end-point of all cause mortality and cardiovascular-related hospitalizations. Seventy-nine physicians and 877 patients participated in the trial. The mean duration of follow-up was 39 months. Intervention patients were less likely to have an uncontrolled systolic blood pressure (odds ratio 0.62; 95% confidence interval [CI] 0.50–0.78) and were more likely to be adherent (OR 1.91; 95% CI 1.19–3.05) when compared with control group patients at 6 months. After five years 16% of the patients in the intervention group and 19% in the control group met the composite end-point (hazard ratio 0.97; 95% CI 0.67–1.39). Conclusions A multifactorial intervention to improve adherence to antihypertensive medication was effective in improving both adherence and blood pressure control, but it did not appear to improve long-term cardiovascular events. PMID:20823391

Design of the Lifestyle Improvement through Food and Exercise (LIFE) study: a randomized controlled trial of self-management of type 2 diabetes among African American patients from safety net health centers.

PubMed

Lynch, Elizabeth B; Liebman, Rebecca; Ventrelle, Jennifer; Keim, Kathryn; Appelhans, Bradley M; Avery, Elizabeth F; Tahsin, Bettina; Li, Hong; Shapera, Merle; Fogelfeld, Leon

2014-11-01

The Lifestyle Improvement through Food and Exercise (LIFE) study is a community-based randomized-controlled trial to measure the effectiveness of a lifestyle intervention to improve glycemic control among African Americans with type 2 diabetes attending safety net clinics. The study enrolled African American adults with a diagnosis of type 2 diabetes and HbA1c ≥ 7.0 who had attended specific safety net community clinics in the prior year. 210 patients will be enrolled and randomized to either the LIFE intervention or a standard of care control group, which consists of two dietitian-led diabetes self-management classes. The LIFE intervention was delivered in 28 group sessions over 12 months and focused on improving diet through dietitian-led culturally-tailored nutrition education, increasing physical activity through self-monitoring using an accelerometer, increasing ability to manage blood sugar through modifications to lifestyle, and providing social support for behavior change. In addition to the group sessions, peer supporters made regular telephone calls to participants to monitor progress toward behavioral goals and provide social support. The 12-month intervention phase was followed by a six-month maintenance phase consisting of two group sessions. The primary outcome of the study is change in A1C from baseline to 12 months, and an additional follow-up will occur at 18 months. The hypothesis of the study is that the participants in the LIFE intervention will show a greater improvement in glycemic control over 12 months than participants in the control group. Copyright © 2014 Elsevier Inc. All rights reserved.

Flow Control Research at NASA Langley in Support of High-Lift Augmentation

NASA Technical Reports Server (NTRS)

Sellers, William L., III; Jones, Gregory S.; Moore, Mark D.

2002-01-01

The paper describes the efforts at NASA Langley to apply active and passive flow control techniques for improved high-lift systems, and advanced vehicle concepts utilizing powered high-lift techniques. The development of simplified high-lift systems utilizing active flow control is shown to provide significant weight and drag reduction benefits based on system studies. Active flow control that focuses on separation, and the development of advanced circulation control wings (CCW) utilizing unsteady excitation techniques will be discussed. The advanced CCW airfoils can provide multifunctional controls throughout the flight envelope. Computational and experimental data are shown to illustrate the benefits and issues with implementation of the technology.

Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain.

PubMed

Paungmali, Aatit; Joseph, Leonard H; Sitilertpisan, Patraporn; Pirunsan, Ubon; Uthaikhup, Sureeporn

2017-11-01

Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain. A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions. Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident. Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain. © 2017 World Institute of Pain.

Development of a miniature motor-driven pulsatile LVAD driven by a fuzzy controller.

PubMed

Okamoto, Eiji; Makino, Tsutomu; Tanaka, Shuji; Yasuda, Takahiko; Akasaka, Yuta; Tani, Makiko; Inoue, Yusuke; Mitoh, Ayumu; Mitamura, Yoshinori

2007-01-01

We have been developing a small, lightweight motor-driven pulsatile left ventricular assist device (LVAD) with a ball screw. The motor-driven LVAD consists of a brushless DC motor and a ball screw. The attractive magnetic force between Nd-Fe-B magnets (with a diameter of 5 mm and a thickness of 1.5 mm) mounted in holes in a silicone rubber sheet (thickness 2 mm) and an iron plate adhered onto the a diaphragm of the blood pump can provide optimum active blood filling during the pump filling phase. The LVAD has a stroke volume of 55 ml and an overall volume of 285 ml; it weighs 360 g. The controller mainly consists of a fuzzy logic position and velocity controller to apply doctors' and engineers' knowledge to control the LVAD. Each unit of the controller consists of a functionally independent program module for easy improvement of the controller's performance. The LVAD was evaluated in in vitro experiments using a mock circulation. A maximum pump outflow of 5.1 l/min was obtained at a drive rate of 95 bpm against an afterload of 95 mmHg, and active filling using the attractive magnetic force provided a pump output of 3.6 l/min at a drive rate of 75 bpm under a preload of 0 mmHg. The operating efficiency of the LVAD was measured at between 8% and 10.5%. While the LVAD can provide adequate pump outflow for cardiac assistance, further upgrading of the software and improvement of the blood pump are required to improve pump performance and efficiency.

Upper-Limb Robotic Exoskeletons for Neurorehabilitation: A Review on Control Strategies.

PubMed

Proietti, Tommaso; Crocher, Vincent; Roby-Brami, Agnes; Jarrasse, Nathanael

2016-01-01

Since the late 1990s, there has been a burst of research on robotic devices for poststroke rehabilitation. Robot-mediated therapy produced improvements on recovery of motor capacity; however, so far, the use of robots has not shown qualitative benefit over classical therapist-led training sessions, performed on the same quantity of movements. Multidegree-of-freedom robots, like the modern upper-limb exoskeletons, enable a distributed interaction on the whole assisted limb and can exploit a large amount of sensory feedback data, potentially providing new capabilities within standard rehabilitation sessions. Surprisingly, most publications in the field of exoskeletons focused only on mechatronic design of the devices, while little details were given to the control aspects. On the contrary, we believe a paramount aspect for robots potentiality lies on the control side. Therefore, the aim of this review is to provide a taxonomy of currently available control strategies for exoskeletons for neurorehabilitation, in order to formulate appropriate questions toward the development of innovative and improved control strategies.

Automated agitation management accounting for saturation dynamics.

PubMed

Rudge, A D; Chase, J G; Shaw, G M; Lee, D

2004-01-01

Agitation-sedation cycling in critically ill is damaging to patient health and increases length of and cost. A physiologically representative model of the agitation-sedation system is used as a platform to evaluate feedback controllers offering improved agitation management. A heavy-derivative controller with upper and infusion rate bounds maintains minimum plasma concentrations through a low constant infusion, and minimizes outbursts of agitation through strong, timely boluses. controller provides improved agitation management using from 37 critically ill patients, given the saturation of effect at high concentration. Approval was obtained the Canterbury Ethics Board for this research.

Enhanced squeezing of a collective spin via control of its qudit subsystems.

PubMed

Norris, Leigh M; Trail, Collin M; Jessen, Poul S; Deutsch, Ivan H

2012-10-26

Unitary control of qudits can improve the collective spin squeezing of an atomic ensemble. Preparing the atoms in a state with large quantum fluctuations in magnetization strengthens the entangling Faraday interaction. The resulting increase in interatomic entanglement can be converted into metrologically useful spin squeezing. Further control can squeeze the internal atomic spin without compromising entanglement, providing an overall multiplicative factor in the collective squeezing. We model the effects of optical pumping and study the tradeoffs between enhanced entanglement and decoherence. For realistic parameters we see improvements of ~10 dB.

Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

PubMed Central

Forrester, Larry W.; Roy, Anindo; Krebs, Hermano Igo; Macko, Richard F.

2013-01-01

Background Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking. Objectives To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke. Methods This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function. Results Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased. Conclusions Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies. PMID:21115945

The impact of a multidisciplinary information technology-supported program on blood pressure control in primary care.

PubMed

Rinfret, Stéphane; Lussier, Marie-Thérèse; Peirce, Anthony; Duhamel, Fabie; Cossette, Sylvie; Lalonde, Lyne; Tremblay, Chantal; Guertin, Marie-Claude; LeLorier, Jacques; Turgeon, Jacques; Hamet, Pavel

2009-05-01

Hypertension is a leading mortality risk factor yet inadequately controlled in most affected subjects. Effective programs to address this problem are lacking. We hypothesized that an information technology-supported management program could help improve blood pressure (BP) control. This randomized controlled trial included 223 primary care hypertensive subjects with mean 24-hour BP >130/80 and daytime BP >135/85 mm Hg measured with ambulatory monitoring (ABPM). Intervention subjects received a BP monitor and access to an information technology-supported adherence and BP monitoring system providing nurses, pharmacists, and physicians with monthly reports. Control subjects received usual care. The mean (+/-SD) follow-up was 348 (+/-78) and 349 (+/-84) days in the intervention and control group, respectively. The primary end point of the change in the mean 24-hour ambulatory BP was consistently greater in intervention subjects for both systolic (-11.9 versus -7.1 mm Hg; P<0.001) and diastolic BP (-6.6 versus -4.5 mm Hg; P=0.007). The proportion of subjects that achieved Canadian Guideline target BP (46.0% versus 28.6%) was also greater in the intervention group (P=0.006). We observed similar BP declines for ABPM and self-recorded home BP suggesting the latter could be an alternative for confirming BP control. The intervention was associated with more physician-driven antihypertensive dose adjustments or changes in agents (P=0.03), more antihypertensive classes at study end (P=0.007), and a trend toward improved adherence measured by prescription refills (P=0.07). This multidisciplinary information technology-supported program that provided feedback to patients and healthcare providers significantly improved blood pressure levels in a primary care setting.

Current status of nanotechnology approaches for cardiovascular disease: a personal perspective.

PubMed

Buxton, Denis B

2009-01-01

Nanotechnology is poised to have an increasing impact on cardiovascular health in coming years. Diagnostically, multiplexed point-of-care devices will enable rapid genotyping and biomarker measurement to optimize and tailor therapies for the individual patient. Nanoparticle-based molecular imaging agents will take advantage of targeted agents to provide increased insight into disease pathways rather then simply providing structural and functional information. Drug delivery will be impacted by targeting of nanoparticle-encapsulated drugs to the site of action, increasing the effective concentration and decreasing systemic dosage and side effects. Controlled and tailored release of drugs from polymers will improve control of pharmacokinetics and bioavailability. The application of nanotechnology to tissue engineering will facilitate the fabrication of better tissue implants in vitro, and provide scaffolds to promote regeneration in vivo taking advantage of the body's own repair mechanisms. Medical devices will benefit from the development of nanostructured surfaces and coatings to provide better control of thrombogenicity and infection. Taken together, these new technologies have enormous potential for improving the diagnosis and treatment of cardiovascular diseases. (c) 2009 John Wiley & Sons, Inc.

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

PubMed

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

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

PubMed

Bingham, Geoffrey P; Snapp-Childs, Winona

2018-04-12

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

Do Work Condition Interventions Affect Quality and Errors in Primary Care? Results from the Healthy Work Place Study.

PubMed

Linzer, Mark; Poplau, Sara; Brown, Roger; Grossman, Ellie; Varkey, Anita; Yale, Steven; Williams, Eric S; Hicks, Lanis; Wallock, Jill; Kohnhorst, Diane; Barbouche, Michael

2017-01-01

While primary care work conditions are associated with adverse clinician outcomes, little is known about the effect of work condition interventions on quality or safety. A cluster randomized controlled trial of 34 clinics in the upper Midwest and New York City. Primary care clinicians and their diabetic and hypertensive patients. Quality improvement projects to improve communication between providers, workflow design, and chronic disease management. Intervention clinics received brief summaries of their clinician and patient outcome data at baseline. We measured work conditions and clinician and patient outcomes both at baseline and 6-12 months post-intervention. Multilevel regression analyses assessed the impact of work condition changes on outcomes. Subgroup analyses assessed impact by intervention category. There were no significant differences in error reduction (19 % vs. 11 %, OR of improvement 1.84, 95 % CI 0.70, 4.82, p = 0.21) or quality of care improvement (19 % improved vs. 44 %, OR 0.62, 95 % CI 0.58, 1.21, p = 0.42) between intervention and control clinics. The conceptual model linking work conditions, provider outcomes, and error reduction showed significant relationships between work conditions and provider outcomes (p ≤ 0.001) and a trend toward a reduced error rate in providers with lower burnout (OR 1.44, 95 % CI 0.94, 2.23, p = 0.09). Few quality metrics, short time span, fewer clinicians recruited than anticipated. Work-life interventions improving clinician satisfaction and well-being do not necessarily reduce errors or improve quality. Longer, more focused interventions may be needed to produce meaningful improvements in patient care. ClinicalTrials.gov # NCT02542995.

Formation Control of the MAXIM L2 Libration Orbit Mission

NASA Technical Reports Server (NTRS)

Folta, David; Hartman, Kate; Howell, Kathleen; Marchand, Belinda

2004-01-01

The Micro-Arcsecond Imaging Mission (MAXIM), a proposed concept for the Structure and Evolution of the Universe (SEU) Black Hole Imaging mission, is designed to make a ten million-fold improvement in X-ray image clarity of celestial objects by providing better than 0.1 microarcsecond imaging. To achieve mission requirements, MAXIM will have to improve on pointing by orders of magnitude. This pointing requirement impacts the control and design of the formation. Currently the architecture is comprised of 25 spacecraft, which will form the sparse apertures of a grazing incidence X-ray interferometer covering the 0.3-10 keV bandpass. This configuration will deploy 24 spacecraft as optics modules and one as the detector. The formation must allow for long duration continuous science observations and also for reconfiguration that permits re-pointing of the formation. In this paper, we provide analysis and trades of several control efforts that are dependent upon the pointing requirements and the configuration and dimensions of the MAXIM formation. We emphasize the utilization of natural motions in the Lagrangian regions that minimize the control efforts and we address both continuous and discrete control via LQR and feedback linearization. Results provide control cost, configuration options, and capabilities as guidelines for the development of this complex mission.

Modification of hemiplegic compensatory gait pattern by symmetry-based motion controller of HAL.

PubMed

Kawamoto, Hiroaki; Kadone, Hideki; Sakurai, Takeru; Sankai, Yoshiyuki

2015-01-01

As one of several characteristics of hemiplegic patients after stroke, compensatory gait caused by affected limb is often seen. The purpose of this research is to apply a symmetry-based controller of a wearable type lower limb robot, Hybrid Assistive Limb (HAL) to hemiplegic patients with compensatory gait, and to investigate improvement of gait symmetry. The controller is designed respectively for swing phase and support phase according to characteristics of hemiplegic gait pattern. The controller during swing phase stores the motion of the unaffected limb and then provides motion support on the affected limb during the subsequent swing using the stored pattern to realize symmetric gait based on spontaneous limb swing. Moreover, the controller during support phase provides motion to extend hip and knee joints to support wearer's body. Clinical tests were conducted in order to assess the modification of gait symmetry. Our case study involved participation of one chronic stroke patient who performs abnormally-compensatory gait for both of the affected and unaffected limbs. As a result, the patient's gait symmetry was improved by providing motion support during the swing phase on the affected side and motion constraint during the support phase on the unaffected side. The study showed promising basis for the effectiveness of the controller for the future clinical study.

Hardware-in-the-loop grid simulator system and method

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

Fox, John Curtiss; Collins, Edward Randolph; Rigas, Nikolaos

A hardware-in-the-loop (HIL) electrical grid simulation system and method that combines a reactive divider with a variable frequency converter to better mimic and control expected and unexpected parameters in an electrical grid. The invention provides grid simulation in a manner to allow improved testing of variable power generators, such as wind turbines, and their operation once interconnected with an electrical grid in multiple countries. The system further comprises an improved variable fault reactance (reactive divider) capable of providing a variable fault reactance power output to control a voltage profile, therein creating an arbitrary recovery voltage. The system further comprises anmore » improved isolation transformer designed to isolate zero-sequence current from either a primary or secondary winding in a transformer or pass the zero-sequence current from a primary to a secondary winding.« less

Trajectory control method of stratospheric airship based on the sliding mode control and prediction in wind field

NASA Astrophysics Data System (ADS)

Zhang, Jia-shi; Yang, Xi-xiang

2017-11-01

The stratospheric airship has the characteristics of large inertia, long time delay and large disturbance of wind field , so the trajectory control is very difficult .Build the lateral three degrees of freedom dynamic model which consider the wind interference , the dynamics equation is linearized by the small perturbation theory, propose a trajectory control method Combine with the sliding mode control and prediction, design the trajectory controller , takes the HAA airship as the reference to carry out simulation analysis. Results show that the improved sliding mode control with front-feedback method not only can solve well control problems of airship trajectory in wind field, but also can effectively improve the control accuracy of the traditional sliding mode control method, solved problems that using the traditional sliding mode control to control. It provides a useful reference for dynamic modeling and trajectory control of stratospheric airship.

Stable adaptive PI control for permanent magnet synchronous motor drive based on improved JITL technique.

PubMed

Zheng, Shiqi; Tang, Xiaoqi; Song, Bao; Lu, Shaowu; Ye, Bosheng

2013-07-01

In this paper, a stable adaptive PI control strategy based on the improved just-in-time learning (IJITL) technique is proposed for permanent magnet synchronous motor (PMSM) drive. Firstly, the traditional JITL technique is improved. The new IJITL technique has less computational burden and is more suitable for online identification of the PMSM drive system which is highly real-time compared to traditional JITL. In this way, the PMSM drive system is identified by IJITL technique, which provides information to an adaptive PI controller. Secondly, the adaptive PI controller is designed in discrete time domain which is composed of a PI controller and a supervisory controller. The PI controller is capable of automatically online tuning the control gains based on the gradient descent method and the supervisory controller is developed to eliminate the effect of the approximation error introduced by the PI controller upon the system stability in the Lyapunov sense. Finally, experimental results on the PMSM drive system show accurate identification and favorable tracking performance. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

Cryopreservation: Evolution of Molecular Based Strategies.

PubMed

Baust, John M; Corwin, William; Snyder, Kristi K; Van Buskirk, Robert; Baust, John G

2016-01-01

Cryopreservation (CP) is an enabling process providing for on-demand access to biological material (cells and tissues) which serve as a starting, intermediate or even final product. While a critical tool, CP protocols, approaches and technologies have evolved little over the last several decades. A lack of conversion of discoveries from the CP sciences into mainstream utilization has resulted in a bottleneck in technological progression in areas such as stem cell research and cell therapy. While the adoption has been slow, discoveries including molecular control and buffering of cell stress response to CP as well as the development of new devices for improved sample freezing and thawing are providing for improved CP from both the processing and sample quality perspectives. Numerous studies have described the impact, mechanisms and points of control of cryopreservation-induced delayed-onset cell death (CIDOCD). In an effort to limit CIDOCD, efforts have focused on CP agent and freeze media formulation to provide a solution path and have yielded improvements in survival over traditional approaches. Importantly, each of these areas, new technologies and cell stress modulation, both individually and in combination, are now providing a new foundation to accelerate new research, technology and product development for which CP serves as an integral component. This chapter provides an overview of the molecular stress responses of cells to cryopreservation, the impact of the hypothermic and cell death continuums and the targeted modulation of common and/or cell specific responses to CP in providing a path to improving cell quality.

A model of psychosocial and cultural antecedents of blood pressure control.

PubMed Central

Bosworth, Hayden B.; Oddone, Eugene Z.

2002-01-01

Hypertension is a major modifiable risk factor for stroke, congestive heart failure, and end-stage renal disease. Hypertension is particularly prevalent and deadly among African Americans. Effective treatment for hypertension has been available for decades, yet only one fourth of all individuals have their blood pressure under control. Despite the potential impact of hypertension, interventions to improve control have had limited success. We present a model of how to understand antecedents of blood pressure control according to three interrelated categories: patient characteristics, social and cultural environment, and medical environment. This theoretical paper was conducted using a literature review and a model to explain psychosocial antecedents of blood pressure control is presented. We conclude that improved understanding of important antecedents of blood pressure control coupled with technological advances, such as tailored interventions, provide clinicians with a tool that may lead to improved blood pressure control. These interventions will require the involvement of clinicians and consideration of sociocultural factors to be successful. PMID:11991336

School Improvement Plans and Student Learning in Jamaica

ERIC Educational Resources Information Center

Lockheed, Marlaine; Harris, Abigail; Jayasundera, Tamara

2010-01-01

A school improvement program that provided support to poor-performing schools on the basis of needs identified in a school improvement plan was implemented in 72 government schools in Jamaica, from 1998 to 2005. In this independent evaluation of the program, we use propensity score matching to create, post hoc, a control group of schools that were…

The Business Change Initiative: A Novel Approach to Improved Cost and Schedule Management

NASA Technical Reports Server (NTRS)

Shinn, Stephen A.; Bryson, Jonathan; Klein, Gerald; Lunz-Ruark, Val; Majerowicz, Walt; McKeever, J.; Nair, Param

2016-01-01

Goddard Space Flight Center's Flight Projects Directorate employed a Business Change Initiative (BCI) to infuse a series of activities coordinated to drive improved cost and schedule performance across Goddard's missions. This sustaining change framework provides a platform to manage and implement cost and schedule control techniques throughout the project portfolio. The BCI concluded in December 2014, deploying over 100 cost and schedule management changes including best practices, tools, methods, training, and knowledge sharing. The new business approach has driven the portfolio to improved programmatic performance. The last eight launched GSFC missions have optimized cost, schedule, and technical performance on a sustained basis to deliver on time and within budget, returning funds in many cases. While not every future mission will boast such strong performance, improved cost and schedule tools, management practices, and ongoing comprehensive evaluations of program planning and control methods to refine and implement best practices will continue to provide a framework for sustained performance. This paper will describe the tools, techniques, and processes developed during the BCI and the utilization of collaborative content management tools to disseminate project planning and control techniques to ensure continuous collaboration and optimization of cost and schedule management in the future.

Information and communication technology needs for distributed communication and coordination during expedition-class spaceflight.

PubMed

Caldwell, B S

2000-09-01

AO-lU. Expedition-class missions are distinct from historical human presence in space in ways that significantly affect information flow and information technology designs for such missions. The centrality of Mission Control in these missions is challenged by the distances, associated communication delays, and durations of expeditions, all of which require crews to have more local resources available to manage on-board situations. The author's current research investigates how ground controllers effectively allocate communications bandwidth, cognitive resources, and knowledge sharing skills during time critical routine and non-routine situations. The research focus is on team-based information and communication technology (ICT) use to provide recommendations for improvements to support adaptive bandwidth allocations and improved sharing of data and knowledge in Mission Control contexts. In order to further improve communication and coordination between controllers and crew, additional ICT support resources will be needed to provide shared context knowledge and dynamic assessment of costs and benefits for accessing local information vs. remote expertise. Crew members will have critical needs to understand the goals, intentions, and situational constraints associated with mission information resources in order to use them most effectively in conditions where ground-based expertise is insufficient or requires more time to access and coordinate than local task demands permit. Results of this research will serve to improve the design and implementation of ICT systems to improve human performance capabilities and system operating tolerances for exploration missions. (Specific research data were not available at the time of publication.)

Overview of Causes and Control of Nitrification in Chloraminated Drinking Water Distribution Systems

EPA Science Inventory

This chapter provides an integrated overview of nitrification causes and control in chloraminated drinking water distribution systems, leading to an in-depth discussion of nitrification microbiology, monitoring, prevention, response, and engineering improvements in subsequent man...

Process control charts in infection prevention: Make it simple to make it happen.

PubMed

Wiemken, Timothy L; Furmanek, Stephen P; Carrico, Ruth M; Mattingly, William A; Persaud, Annuradha K; Guinn, Brian E; Kelley, Robert R; Ramirez, Julio A

2017-03-01

Quality improvement is central to Infection Prevention and Control (IPC) programs. Challenges may occur when applying quality improvement methodologies like process control charts, often due to the limited exposure of typical IPs. Because of this, our team created an open-source database with a process control chart generator for IPC programs. The objectives of this report are to outline the development of the application and demonstrate application using simulated data. We used Research Electronic Data Capture (REDCap Consortium, Vanderbilt University, Nashville, TN), R (R Foundation for Statistical Computing, Vienna, Austria), and R Studio Shiny (R Foundation for Statistical Computing) to create an open source data collection system with automated process control chart generation. We used simulated data to test and visualize both in-control and out-of-control processes for commonly used metrics in IPC programs. The R code for implementing the control charts and Shiny application can be found on our Web site (https://github.com/ul-research-support/spcapp). Screen captures of the workflow and simulated data indicating both common cause and special cause variation are provided. Process control charts can be easily developed based on individual facility needs using freely available software. Through providing our work free to all interested parties, we hope that others will be able to harness the power and ease of use of the application for improving the quality of care and patient safety in their facilities. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Configuration-Control Scheme Copes With Singularities

NASA Technical Reports Server (NTRS)

Seraji, Homayoun; Colbaugh, Richard D.

1993-01-01

Improved configuration-control scheme for robotic manipulator having redundant degrees of freedom suppresses large joint velocities near singularities, at expense of small trajectory errors. Provides means to enforce order of priority of tasks assigned to robot. Basic concept of configuration control of redundant robot described in "Increasing The Dexterity Of Redundant Robots" (NPO-17801).

Remote kinematic training for patients with chronic neck pain: a randomised controlled trial.

PubMed

Sarig Bahat, Hilla; Croft, Kate; Carter, Courtney; Hoddinott, Anna; Sprecher, Elliot; Treleaven, Julia

2018-06-01

To evaluate short- and intermediate-term effects of kinematic training (KT) using virtual reality (VR) or laser in patients with chronic neck pain. A randomised controlled trial with three arms (laser, VR, control) to post-intervention (N = 90), and two arms (laser or VR) continuing to 3 months follow-up. Home training intervention was provided during 4 weeks to VR and laser groups while control group waited. Primary outcome measures included neck disability index (NDI), global perceived effect (GPE), and cervical motion velocity (mean and peak). Secondary outcome measures included pain intensity (VAS), health status (EQ5D), kinesiophobia (TSK), range, smoothness, and accuracy of neck motion as measured by the neck VR system. Measures were taken at baseline, immediately post-training, and 3 months later. Ninety patients with neck pain were randomised to the trial, of which 76 completed 1 month follow-up, and 56 the 3 months follow-up. Significant improvements were demonstrated in NDI and velocity with good effect sizes in intervention groups compared to control. No within-group changes were presented in the control group, compared to global improvements in intervention groups. Velocity significantly improved at both time points in both groups. NDI, VAS, EQ5D, TSK and accuracy significantly improved at both time points in VR and in laser at 3 months evaluation in all but TSK. GPE scores showed 74-84% of participants perceived improvement and/or were satisfied. Significant advantages to the VR group compared to laser were found in velocity, pain intensity, health status and accuracy at both time points. The results support home kinematic training using VR or laser for improving disability, neck pain and kinematics in the short and intermediate term with an advantage to the VR group. The results provide directions for future research, use and development. ACTRN12615000231549.

Synergistic Effects on the Elderly People's Motor Control by Wearable Skin-Stretch Device Combined with Haptic Joystick

PubMed Central

Yoon, Han U.; Anil Kumar, Namita; Hur, Pilwon

2017-01-01

Cutaneous sensory feedback can be used to provide additional sensory cues to a person performing a motor task where vision is a dominant feedback signal. A haptic joystick has been widely used to guide a user by providing force feedback. However, the benefit of providing force feedback is still debatable due to performance dependency on factors such as the user's skill-level, task difficulty. Meanwhile, recent studies have shown the feasibility of improving a motor task performance by providing skin-stretch feedback. Therefore, a combination of two aforementioned feedback types is deemed to be promising to promote synergistic effects to consistently improve the person's motor performance. In this study, we aimed at identifying the effect of the combined haptic and skin-stretch feedbacks on the aged person's driving motor performance. For the experiment, 15 healthy elderly subjects (age 72.8 ± 6.6 years) were recruited and were instructed to drive a virtual power-wheelchair through four different courses with obstacles. Four augmented sensory feedback conditions were tested: no feedback, force feedback, skin-stretch feedback, and a combination of both force and skin-stretch feedbacks. While the haptic force was provided to the hand by the joystick, the skin-stretch was provided to the steering forearm by a custom-designed wearable skin-stretch device. We tested two hypotheses: (i) an elderly individual's motor control would benefit from receiving information about a desired trajectory from multiple sensory feedback sources, and (ii) the benefit does not depend on task difficulty. Various metrics related to skills and safety were used to evaluate the control performance. Repeated measure ANOVA was performed for those metrics with two factors: task scenario and the type of the augmented sensory feedback. The results revealed that elderly subjects' control performance significantly improved when the combined feedback of both haptic force and skin-stretch feedback was applied. The proposed approach suggest the feasibility to improve people's task performance by the synergistic effects of multiple augmented sensory feedback modalities. PMID:28690514

Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

PubMed Central

2014-01-01

Background To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children’s body mass index (BMI). Methods A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center’s written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children’s nutritional intake, physical activity, and height and weight pre- and post-intervention. Results Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers’ and parents’ knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children’s zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. Conclusions The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic. Trial registration National Clinical Trials Number NCT01921842 PMID:24580983

Effect of audience response system technology on learning outcomes in health students and professionals: an updated systematic review.

PubMed

Atlantis, Evan; Cheema, Birinder S

2015-03-01

: Audience response system (ARS) technology is a recent innovation that is increasingly being used by health educators to improve learning outcomes. Equivocal results from previous systematic review research provide weak support for the use of ARS for improving learning outcomes at both short and long terms. This review sought to update and critically review the body of controlled experimental evidence on the use of ARS technology on learning outcomes in health students and professionals. This review searched using all identified keywords both electronic databases (CINAHL, Embase, ERIC, Medline, Science Direct, Scopus, and Web of Science) and reference lists of retrieved articles to find relevant published studies for review, from 2010 to April 2014. A descriptive synthesis of important study characteristics and effect estimates for learning outcomes was done. Three controlled trials in 321 participants from the United States were included for review. ARS knowledge retention scores were lower than the control group in one study, higher than control group provided that immediate feedback was given about each question in one study, and equivalent between intervention and control groups in another study. There is an absence of good quality evidence on effectiveness of ARS technologies for improving learning outcomes in health students and professionals.

Metallized coatings for corrosion control of Naval ship structures and components

NASA Technical Reports Server (NTRS)

1983-01-01

In attempting to improve corrosion control, the U.S. Navy has undertaken a program of coating corrosion-susceptible shipboard components with thermally sprayed aluminum. In this report the program is reviewed in depth, including examination of processes, process controls, the nature and properties of the coatings, nondestructive examination, and possible hazards to personnel. The performance of alternative metallic coating materials is also discussed. It is concluded that thermally sprayed aluminum can provide effective long-term protection against corrosion, thereby obviating the need for chipping of rust and repainting by ship personnel. Such coatings are providing excellent protection to below-deck components such as steam valves, but improvements are needed to realize the full potential of coatings for above-deck service. Several recommendations are made regarding processes, materials, and research and development aimed at upgrading further the performance of these coatings.

Improving Physical Task Performance with Counterfactual and Prefactual Thinking.

PubMed

Hammell, Cecilia; Chan, Amy Y C

2016-01-01

Counterfactual thinking (reflecting on "what might have been") has been shown to enhance future performance by translating information about past mistakes into plans for future action. Prefactual thinking (imagining "what might be if…") may serve a greater preparative function than counterfactual thinking as it is future-orientated and focuses on more controllable features, thus providing a practical script to prime future behaviour. However, whether or not this difference in hypothetical thought content may translate into a difference in actual task performance has been largely unexamined. In Experiment 1 (n = 42), participants performed trials of a computer-simulated physical task, in between which they engaged in either task-related hypothetical thinking (counterfactual or prefactual) or an unrelated filler task (control). As hypothesised, prefactuals contained more controllable features than counterfactuals. Moreover, participants who engaged in either form of hypothetical thinking improved significantly in task performance over trials compared to participants in the control group. The difference in thought content between counterfactuals and prefactuals, however, did not yield a significant difference in performance improvement. Experiment 2 (n = 42) replicated these findings in a dynamic balance task environment. Together, these findings provide further evidence for the preparatory function of counterfactuals, and demonstrate that prefactuals share this same functional characteristic.

Exubera® (inhaled insulin): an evidence-based review of its effectiveness in the management of diabetes

PubMed Central

Profit, Louise

2005-01-01

Introduction: Inadequate glycemic control contributes to the development and progression of complications, which are associated with a significant economic burden on healthcare systems. However, optimal glycemic control is difficult to sustain with oral antidiabetic agents and adherence to intensive insulin regimens is compromised by patient compliance to multiple daily injections. Therefore, alternative delivery systems are required to improve the acceptability of insulin therapy. Aims: This review assesses the evidence for the therapeutic value of inhaled insulin (Exubera®) in the management of type 1 and type 2 diabetes. Evidence review: Evidence indicates that glycemic control, as measured by plasma HbA1c levels, with Exubera is as effective as subcutaneous insulin in patients with type 1 or type 2 diabetes. There is also good evidence that Exubera provides improved patient satisfaction and ease of use compared with subcutaneous insulin. However, the cost effectiveness of Exubera and its place in therapy compared with other inhaled insulin delivery systems currently in development remain to be determined. Outcomes summary: Exubera is an alternative treatment option for the management of diabetes which provides effective glycemic control with improved patient satisfaction. PMID:22500147

Design and implementation of software for automated quality control and data analysis for a complex LC/MS/MS assay for urine opiates and metabolites.

PubMed

Dickerson, Jane A; Schmeling, Michael; Hoofnagle, Andrew N; Hoffman, Noah G

2013-01-16

Mass spectrometry provides a powerful platform for performing quantitative, multiplexed assays in the clinical laboratory, but at the cost of increased complexity of analysis and quality assurance calculations compared to other methodologies. Here we describe the design and implementation of a software application that performs quality control calculations for a complex, multiplexed, mass spectrometric analysis of opioids and opioid metabolites. The development and implementation of this application improved our data analysis and quality assurance processes in several ways. First, use of the software significantly improved the procedural consistency for performing quality control calculations. Second, it reduced the amount of time technologists spent preparing and reviewing the data, saving on average over four hours per run, and in some cases improving turnaround time by a day. Third, it provides a mechanism for coupling procedural and software changes with the results of each analysis. We describe several key details of the implementation including the use of version control software and automated unit tests. These generally useful software engineering principles should be considered for any software development project in the clinical lab. Copyright © 2012 Elsevier B.V. All rights reserved.

Injury depth control from combined wavelength and power tuning in scanned beam laser thermal therapy

PubMed Central

Villiger, Martin; Soroka, Andrew; Tearney, Guillermo J.; Bouma, Brett E.; Vakoc, Benjamin J.

2011-01-01

Laser thermal therapy represents a possible method to treat premalignant epithelial lesions of the esophagus. Dynamically conforming the thermal injury profile to a specific lesion boundary is expected to improve the efficacy of such a treatment and avoid complications. In this work, we investigated wavelength tuning as a mechanism to achieve this aimed control over injury depth by using the strong variation of water absorption close to 1900 nm. We developed a numerical model simulating in steps the photon propagation in the tissue, the diffusion of the absorbed heat, and the resulting tissue damage. The model was compared with experimental results on porcine esophageal specimens ex vivo and showed good agreement. Combined with power tuning, the wavelength agility in the range of 1860 to 1895 nm extends the injury range compared to a fixed wavelength source beyond 1 mm, while at the same time improving control over shallow depths and avoiding vaporization at the tissue surface. The combination of two or three discrete wavelengths combined at variable ratios provides similar control, and may provide an improved strategy for the treatment of endothelial lesions. PMID:22112139

Impact of a "No Mobile Device" Policy on Developmental Surveillance in a Pediatric Clinic.

PubMed

Regan, Paul A; Fogel, Benjamin S; Hicks, Steven D

2018-04-01

Children commonly use mobile devices at pediatric office visits. This practice may affect patient-provider interaction and undermine accuracy of developmental surveillance. A randomized, provider-blinded, controlled trial examined whether a policy prohibiting mobile device use in a pediatric clinic improved accuracy of pediatricians' developmental surveillance. Children, aged 18 to 36 months, were randomized to device-prohibited (intervention; n = 58) or device-allowed (control; n = 54) groups. After a 30-minute well-visit, development was evaluated as "normal," "borderline," or "delayed" in 5 categories using the Ages and Stages Questionnaire (ASQ-3). ASQ-3 results were compared with providers' clinical assessment in each category. Provider-ASQ discrepancies were more common for intervention participants ( P = .025). Providers "missed" more ASQ-3 "delayed" scores ( P = .005) in the intervention group, particularly in the fine motor domain ( P = .018). Prohibiting mobile device use at well-visits did not improve accuracy of providers' developmental surveillance. Mobile devices may entertain children at well-visits, allowing opportunities for parent-provider discussion, or observation of fine motor skills.

Robot tracking system improvements and visual calibration of orbiter position for radiator inspection

NASA Technical Reports Server (NTRS)

Tonkay, Gregory

1990-01-01

The following separate topics are addressed: (1) improving a robotic tracking system; and (2) providing insights into orbiter position calibration for radiator inspection. The objective of the tracking system project was to provide the capability to track moving targets more accurately by adjusting parameters in the control system and implementing a predictive algorithm. A computer model was developed to emulate the tracking system. Using this model as a test bed, a self-tuning algorithm was developed to tune the system gains. The model yielded important findings concerning factors that affect the gains. The self-tuning algorithms will provide the concepts to write a program to automatically tune the gains in the real system. The section concerning orbiter position calibration provides a comparison to previous work that had been performed for plant growth. It provided the conceptualized routines required to visually determine the orbiter position and orientation. Furthermore, it identified the types of information which are required to flow between the robot controller and the vision system.

The effect of massage on heart rate variability in preterm infants

PubMed Central

Smith, SL.; Lux, R.; Haley, S.; Slater, H.; Beechy, J.; Moyer-Mileur, LJ.

2012-01-01

Objective To test the hypothesis that massage would improve autonomic nervous system (ANS) function as measured by heart rate variability (HRV) in preterm infants. Study Design Medically stable, 29- to 32-week preterm infants (17 massage, 20 control) were enrolled in a masked, randomized longitudinal study. Licensed massage therapists provided the massage or control condition twice a day for 4 weeks. Weekly HRV, a measure of ANS development and function, was analyzed using SPSS generalized estimating equations. Results Infant characteristics were similar between groups. HRV improved in massaged infants but not in the control infants (P<0.05). Massaged males had a greater improvement in HRV than females (P<0.05). HRV in massaged infants was on a trajectory comparable to term-born infants by study completion. Conclusion Massage-improved HRV in a homogeneous sample of hospitalized, medically stable, preterm male infants and may improve infant response to exogenous stressors. We speculate that massage improves ANS function in these infants. PMID:22538325

Migration strategies for service-enabling ground control stations for unmanned systems

NASA Astrophysics Data System (ADS)

Kroculick, Joseph B.

2011-06-01

Future unmanned systems will be integrated into the Global Information Grid (GIG) and support net-centric data sharing, where information in a domain is exposed to a wide variety of GIG stakeholders that can make use of the information provided. Adopting a Service-Oriented Architecture (SOA) approach to package reusable UAV control station functionality into common control services provides a number of benefits including enabling dynamic plug and play of components depending on changing mission requirements, supporting information sharing to the enterprise, and integrating information from authoritative sources such as mission planners with the UAV control stations data model. It also allows the wider enterprise community to use the services provided by unmanned systems and improve data quality to support more effective decision-making. We explore current challenges in migrating UAV control systems that manage multiple types of vehicles to a Service-Oriented Architecture (SOA). Service-oriented analysis involves reviewing legacy systems and determining which components can be made into a service. Existing UAV control stations provide audio/visual, navigation, and vehicle health and status information that are useful to C4I systems. However, many were designed to be closed systems with proprietary software and hardware implementations, message formats, and specific mission requirements. An architecture analysis can be performed that reviews legacy systems and determines which components can be made into a service. A phased SOA adoption approach can then be developed that improves system interoperability.

Control system to reduce the effects of friction in drive trains of continuous-path-positioning systems. [Patent application

DOEpatents

Green, W.L.

1980-12-01

An improved continuous-path-positioning servo-control system is provided for reducing the effects of friction arising at very low cutting speeds in the drive trains of numerically controlled cutting machines, and the like. The improvement comprises a feed forward network for altering the gain of the servo-control loop at low positioning velocities to prevent stick-slip movement of the cutting tool holder being positioned by the control system. The feed forward network shunts conventional lag-compensators in the control loop, or loops, so that the error signal used for positioning varies linearly when the value is small, but being limited for larger values. Thus, at higher positioning speeds there is little effect of the added component upon the control being achieved.

Blending of brain-machine interface and vision-guided autonomous robotics improves neuroprosthetic arm performance during grasping.

PubMed

Downey, John E; Weiss, Jeffrey M; Muelling, Katharina; Venkatraman, Arun; Valois, Jean-Sebastien; Hebert, Martial; Bagnell, J Andrew; Schwartz, Andrew B; Collinger, Jennifer L

2016-03-18

Recent studies have shown that brain-machine interfaces (BMIs) offer great potential for restoring upper limb function. However, grasping objects is a complicated task and the signals extracted from the brain may not always be capable of driving these movements reliably. Vision-guided robotic assistance is one possible way to improve BMI performance. We describe a method of shared control where the user controls a prosthetic arm using a BMI and receives assistance with positioning the hand when it approaches an object. Two human subjects with tetraplegia used a robotic arm to complete object transport tasks with and without shared control. The shared control system was designed to provide a balance between BMI-derived intention and computer assistance. An autonomous robotic grasping system identified and tracked objects and defined stable grasp positions for these objects. The system identified when the user intended to interact with an object based on the BMI-controlled movements of the robotic arm. Using shared control, BMI controlled movements and autonomous grasping commands were blended to ensure secure grasps. Both subjects were more successful on object transfer tasks when using shared control compared to BMI control alone. Movements made using shared control were more accurate, more efficient, and less difficult. One participant attempted a task with multiple objects and successfully lifted one of two closely spaced objects in 92 % of trials, demonstrating the potential for users to accurately execute their intention while using shared control. Integration of BMI control with vision-guided robotic assistance led to improved performance on object transfer tasks. Providing assistance while maintaining generalizability will make BMI systems more attractive to potential users. NCT01364480 and NCT01894802 .

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

PubMed Central

2011-01-01

Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on intervention effects, as well as on the validity and feasibility of the theoretical-domain approach. The empirical data collected within this trial will be useful in testing whether this theoretical-domain approach can improve our understanding of the implementation of TUPAC guidelines among dental providers. Trial registration Current Controlled Trials ISRCTN15427433 PMID:21320312

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

PubMed

Hanna, Timothy P; Kangolle, Alfred C T

2010-10-13

Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

Improving the transparency of a rehabilitation robot by exploiting the cyclic behaviour of walking.

PubMed

van Dijk, W; van der Kooij, H; Koopman, B; van Asseldonk, E H F; van der Kooij, H

2013-06-01

To promote active participation of neurological patients during robotic gait training, controllers, such as "assist as needed" or "cooperative control", are suggested. Apart from providing support, these controllers also require that the robot should be capable of resembling natural, unsupported, walking. This means that they should have a transparent mode, where the interaction forces between the human and the robot are minimal. Traditional feedback-control algorithms do not exploit the cyclic nature of walking to improve the transparency of the robot. The purpose of this study was to improve the transparent mode of robotic devices, by developing two controllers that use the rhythmic behavior of gait. Both controllers use adaptive frequency oscillators and kernel-based non-linear filters. Kernelbased non-linear filters can be used to estimate signals and their time derivatives, as a function of the gait phase. The first controller learns the motor angle, associated with a certain joint angle pattern, and acts as a feed-forward controller to improve the torque tracking (including the zero-torque mode). The second controller learns the state of the mechanical system and compensates for the dynamical effects (e.g. the acceleration of robot masses). Both controllers have been tested separately and in combination on a small subject population. Using the feedforward controller resulted in an improved torque tracking of at least 52 percent at the hip joint, and 61 percent at the knee joint. When both controllers were active simultaneously, the interaction power between the robot and the human leg was reduced by at least 40 percent at the thigh, and 43 percent at the shank. These results indicate that: if a robotic task is cyclic, the torque tracking and transparency can be improved by exploiting the predictions of adaptive frequency oscillator and kernel-based nonlinear filters.

Do workplace physical activity interventions improve mental health outcomes?

PubMed

Chu, A H Y; Koh, D; Moy, F M; Müller-Riemenschneider, F

2014-06-01

Mental health is an important issue in the working population. Interventions to improve mental health have included physical activity. To review evidence for the effectiveness of workplace physical activity interventions on mental health outcomes. A literature search was conducted for studies published between 1990 and August 2013. Inclusion criteria were physical activity trials, working populations and mental health outcomes. Study quality was assessed using the Jadad scale. Of 3684 unique articles identified, 17 met all selection criteria, including 13 randomized controlled trials, 2 comparison trials and 2 controlled trials. Studies were grouped into two key intervention areas: physical activity and yoga exercise. Of eight high-quality trials, two provided strong evidence for a reduction in anxiety, one reported moderate evidence for an improvement in depression symptoms and one provided limited evidence on relieving stress. The remaining trials did not provide evidence on improved mental well-being. Workplace physical activity and yoga programmes are associated with a significant reduction in depressive symptoms and anxiety, respectively. Their impact on stress relief is less conclusive. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Role of ankle foot orthoses in functional stability of individuals with stroke.

PubMed

Rao, N; Aruin, A S

2016-10-01

Ankle foot orthoses (AFOs) are frequently prescribed to improve ambulation in individuals with stroke. However, the role of AFOs in balance control is not completely understood. The aim of the study was to evaluate the contribution of the AFOs in functional stability of individuals with stroke. Twenty three individuals with unilateral hemiparesis due to stroke were assessed using the Functional Reach Test. The subjects performed reaches forward, left and right while standing with or without an AFO. When provided with AFO, individuals with stroke improved the maximal reaching distance in all the directions (p < 0.05). The study found that individuals with unilateral stroke clearly demonstrated improvements in functional stability when they were provided with AFOs. This outcome could be used in the optimization of balance rehabilitation of individuals with stroke. Implications for Rehabilitation Functional stability is impaired in individuals with stroke. Functional Reach Test (FRT) was used to assess the role of ankle foot orthoses (AFOs) in balance control. Individuals with stroke improved their functional stability while they were provided with AFOs. Functional Reach Test could assist clinicians in the evaluation of postural stability associated with the use of AFOs.

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes.

PubMed

Golden, Sherita Hill; Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia

2017-07-01

The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies.

Pulverized coal fuel injector

DOEpatents

Rini, Michael J.; Towle, David P.

1992-01-01

A pulverized coal fuel injector contains an acceleration section to improve the uniformity of a coal-air mixture to be burned. An integral splitter is provided which divides the coal-air mixture into a number separate streams or jets, and a center body directs the streams at a controlled angle into the primary zone of a burner. The injector provides for flame shaping and the control of NO/NO.sub.2 formation.

PNNL’s Building Operations Control Center

ScienceCinema

Belew, Shan

2018-01-16

PNNL's Building Operations Control Center (BOCC) video provides an overview of the center, its capabilities, and its objectives. The BOCC was relocated to PNNL's new 3820 Systems Engineering Building in 2015. Although a key focus of the BOCC is on monitoring and improving the operations of PNNL buildings, the center's state-of-the-art computational, software and visualization resources also have provided a platform for PNNL buildings-related research projects.

F-8C adaptive flight control extensions. [for maximum likelihood estimation

NASA Technical Reports Server (NTRS)

Stein, G.; Hartmann, G. L.

1977-01-01

An adaptive concept which combines gain-scheduled control laws with explicit maximum likelihood estimation (MLE) identification to provide the scheduling values is described. The MLE algorithm was improved by incorporating attitude data, estimating gust statistics for setting filter gains, and improving parameter tracking during changing flight conditions. A lateral MLE algorithm was designed to improve true air speed and angle of attack estimates during lateral maneuvers. Relationships between the pitch axis sensors inherent in the MLE design were examined and used for sensor failure detection. Design details and simulation performance are presented for each of the three areas investigated.

Improving air traffic control: Proving new tools or approving the joint human-machine system?

NASA Technical Reports Server (NTRS)

Gaillard, Irene; Leroux, Marcel

1994-01-01

From the description of a field problem (i.e., designing decision aids for air traffic controllers), this paper points out how a cognitive engineering approach provides the milestones for the evaluation of future joint human-machine systems.

[The improvement of mixed human serum-induced anaphylactic reaction death model in guinea pigs].

PubMed

Chen, Jiong-Yuan; Lai, Yue; Li, Dang-Ri; Yue, Xia; Wang, Hui-Jun

2012-12-01

To increase the death rate of fatal anaphylaxis in guinea pigs and the detectahie level of the tryptase of mast cell in hlood serum. Seventy-four guinea pigs were randomly divided into five groups: original model group, original model control group, improved model group, improved model control group, improved model with non-anaphylaxis group. Using mixed human serum as the allergen, the way of injection, sensitization and induction were improved. ELISA was used to detect the serum mast cell tryptase and total IgE in guinea pigs of each group. The death rate of fatal anaphylaxis in original model group was 54.2% with the different degree of hemopericardium. The severe pericardial tamponade appeared in 9 guinea pigs in original model group and original model control group. The death rate of fatal anaphylaxis in improved model group was 75% without pericardial tamponade. The concentration of the serum total IgE showed no statistically difference hetween original model group and original model control group (P > 0.05), hut the serum mast cell tryptase level was higher in the original model group than that in the original model control group (P > 0.05). The concentration of the serum total IgE and the serum mast cell tryptase level were significantly higher in improved model group than that in the improved model control group (P < 0.05). The death rate of the improved model significantly increases, which can provide effective animal model for the study of serum total IgE and mast cell tryptase.

An Angular Method with Position Control for Block Mesh Squareness Improvement

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

Yao, J.; Stillman, D.

We optimize a target function de ned by angular properties with a position control term for a basic stencil with a block-structured mesh, to improve element squareness in 2D and 3D. Comparison with the condition number method shows that besides a similar mesh quality regarding orthogonality can be achieved as the former does, the new method converges faster and provides a more uniform global mesh spacing in our numerical tests.

Walking on uneven terrain with a powered ankle prosthesis: A preliminary assessment.

PubMed

Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

2015-01-01

A successful walking gait with a powered prosthesis depends heavily on proper timing of power delivery, or push-off. This paper describes a control approach which provides improved walking on uneven terrain relative to previous work intended for use on even (level) terrain. This approach is motivated by an initial healthy subject study which demonstrated less variation in sagittal plane shank angle than sagittal plane ankle angle when walking on uneven terrain relative to even terrain. The latter therefore replaces the former as the control signal used to initiate push-off in the powered prosthesis described herein. The authors demonstrate improvement in consistency for several gait characteristics, relative to healthy, as well as controller characteristics with the new control approach, including a 50% improvement in the consistency of the percentage of stride at which push-off is initiated.

Use of probabilistic weights to enhance linear regression myoelectric control

NASA Astrophysics Data System (ADS)

Smith, Lauren H.; Kuiken, Todd A.; Hargrove, Levi J.

2015-12-01

Objective. Clinically available prostheses for transradial amputees do not allow simultaneous myoelectric control of degrees of freedom (DOFs). Linear regression methods can provide simultaneous myoelectric control, but frequently also result in difficulty with isolating individual DOFs when desired. This study evaluated the potential of using probabilistic estimates of categories of gross prosthesis movement, which are commonly used in classification-based myoelectric control, to enhance linear regression myoelectric control. Approach. Gaussian models were fit to electromyogram (EMG) feature distributions for three movement classes at each DOF (no movement, or movement in either direction) and used to weight the output of linear regression models by the probability that the user intended the movement. Eight able-bodied and two transradial amputee subjects worked in a virtual Fitts’ law task to evaluate differences in controllability between linear regression and probability-weighted regression for an intramuscular EMG-based three-DOF wrist and hand system. Main results. Real-time and offline analyses in able-bodied subjects demonstrated that probability weighting improved performance during single-DOF tasks (p < 0.05) by preventing extraneous movement at additional DOFs. Similar results were seen in experiments with two transradial amputees. Though goodness-of-fit evaluations suggested that the EMG feature distributions showed some deviations from the Gaussian, equal-covariance assumptions used in this experiment, the assumptions were sufficiently met to provide improved performance compared to linear regression control. Significance. Use of probability weights can improve the ability to isolate individual during linear regression myoelectric control, while maintaining the ability to simultaneously control multiple DOFs.

Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial

PubMed Central

Campbell, Melissa; Decker, Kathleen P.; Kruk, Kerry; Deaver, Sarah P.

2018-01-01

This randomized controlled trial was designed to determine if art therapy in conjunction with Cognitive Processing Therapy (CPT) was more effective for reducing symptoms of combat posttraumatic stress disorder (PTSD) than CPT alone. Veterans (N = 11) were randomized to receive either individual CPT, or individual CPT in conjunction with individual art therapy. PTSD Checklist–Military Version and Beck Depression Inventory–II scores improved with treatment in both groups with no significant difference in improvement between the experimental and control groups. Art therapy in conjunction with CPT was found to improve trauma processing and veterans considered it to be an important part of their treatment as it provided healthy distancing, enhanced trauma recall, and increased access to emotions. PMID:29332989

CWEST - COMMUNICATING WETLANDS EDUCATION FOR STUDENTS TODAY MX964011

EPA Science Inventory

Gulf Coastal wetlands provide flood control, improve water quality, reduce erosion and provide critically important habitat for many fish and wildlife species. This proposal Communicating Wetlands Education for Students Today (CWEST)was envisioned by the Bay/Waveland School Dist...

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

PubMed Central

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

2018-01-01

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

An electronic medical record-based intervention to improve quality of care for gastro-esophageal reflux disease (GERD) and atypical presentations of GERD.

PubMed

Player, Marty S; Gill, James M; Mainous, Arch G; Everett, Charles J; Koopman, Richelle J; Diamond, James J; Lieberman, Michael I; Chen, Ying Xia

2010-01-01

Gastro-esophageal reflux disease (GERD) is common in primary care but is often underdiagnosed and untreated. GERD can also present with atypical symptoms like chronic cough and asthma, and physicians may be unaware of this presentation. We aimed to implement and evaluate an intervention to improve diagnosis and treatment for GERD and atypical GERD in primary care. This was a randomised controlled trial in primary care office practice using a national network of US practices (the Medical Quality Improvement Consortium - MQIC) that share the same electronic medical record (EMR). Thirteen offices with 53 providers were randomised to the intervention of EMR-based prompts and education, and 14 offices with 66 providers were randomised to the control group totalling over 67 000 patients and examining outcomes of GERD diagnosis and appropriate treatment. Among patients who did not have GERD at baseline, new diagnoses of GERD increased significantly in the intervention group (3.1%) versus the control group (2.3%) (P<0.01). This remained significant after controlling for clustering with an odds of diagnosis of 1.33 (95% CI 1.13-1.56) for the intervention group. For patients with atypical symptoms, those in the intervention group had both higher odds of being diagnosed with GERD (OR 2.02, 95% CI 1.41-2.88) and of being treated for GERD (OR 1.40, 95% CI 1.08-1.83) than those in the control group. GERD diagnosis and treatment in primary care, particularly among patients with atypical symptoms, can be improved through the use of an EMR-based tool incorporating decision support and education. However, significant room for improvement exists in use of appropriate treatment.

Feasibility, safety and preliminary evidence of the effectiveness of a home-based exercise programme for older people with Alzheimer's disease: a pilot randomized controlled trial.

PubMed

Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Williams, Susan B; Byrne, Karin N; LoGiudice, Dina; Lautenschlager, Nicola T; Dodd, Karen J

2013-05-01

To evaluate the feasibility and safety of a home-based exercise programme for people with Alzheimer's disease, and to provide preliminary evidence of programme effectiveness in improving balance and mobility and reducing falls risk. A randomized controlled trial. Community. Forty people with mild to moderate Alzheimer's disease (mean age 81.9, SD 5.72; 62.5% female). Participants were randomized to a six-month home-based individually tailored balance, strengthening and walking exercise programme (physiotherapist) or a six-month home-based education programme (control) (occupational therapist). Both programmes provided six home-visits and five follow-up phone calls. Balance, mobility, falls and falls risk were measured at baseline and programme completion. Intention-to-treat analysis using a generalized linear model with group allocation as a predictor variable was performed to evaluate programme effectiveness. Feasibility and adverse events were systematically recorded at each contact. Fifty-eight per cent of the exercise group finished the programme, completing an average of 83% of prescribed sessions, with no adverse events reported. Functional Reach improved significantly (P = 0.002) in the exercise group (mean (SD), 2.28 (4.36)) compared to the control group (-2.99 (4.87)). Significant improvement was also observed for the Falls Risk for Older People - Community score (P = 0.008) and trends for improvement on several other balance, mobility, falls and falls risk measures for the exercise group compared to the control group. The exercise programme was feasible and safe and may help improve balance and mobility performance and reduce falls risk in people with Alzheimer's disease.

A controlled trial of web-based diabetes disease management: the MGH diabetes primary care improvement project.

PubMed

Meigs, James B; Cagliero, Enrico; Dubey, Anil; Murphy-Sheehy, Patricia; Gildesgame, Catharyn; Chueh, Henry; Barry, Michael J; Singer, Daniel E; Nathan, David M

2003-03-01

To test effects of a web-based decision support tool, the diabetes Disease Management Application (DMA), developed to improve evidence-based management of type 2 diabetes. We conducted a group randomized controlled trial of 12 intervention and 14 control staff providers and 307 intervention and 291 control patients with type 2 diabetes in a hospital-based internal medicine clinic. Providers were randomly assigned from May 1998 through April 1999 to have access to the DMA (intervention) or not to have access (control). The DMA displays interactive patient-specific clinical data, treatment advice, and links to other web-based care resources. We compared patients in the intervention and control groups for changes in processes and outcomes of care from the year preceding the study through the year of the study by intention-to-treat analysis. The DMA was used for 42% of scheduled patient visits. The number of HbA(1c) tests obtained per year increased significantly in the intervention group (+0.3 tests/year) compared with the control group (-0.04 tests/year, P = 0.008), as did the number of LDL cholesterol tests (intervention, +0.2 tests/year; control, +0.01 tests/year; P = 0.02) and the proportions of patients undergoing at least one foot examination per year (intervention, +9.8%; control, -0.7%; P = 0.003). Levels of HbA(1c) decreased by 0.2 in the intervention group and increased by 0.1 in the control group (P = 0.09); proportions of patients with LDL cholesterol levels <130 mg/dl increased by 20.3% in the intervention group and 10.5% in the control group (P = 0.5). Web-based patient-specific decision support has the potential to improve evidence-based parameters of diabetes care.

Cognitive control in the self-regulation of physical activity and sedentary behavior

PubMed Central

Buckley, Jude; Cohen, Jason D.; Kramer, Arthur F.; McAuley, Edward; Mullen, Sean P.

2014-01-01

Cognitive control of physical activity and sedentary behavior is receiving increased attention in the neuroscientific and behavioral medicine literature as a means of better understanding and improving the self-regulation of physical activity. Enhancing individuals’ cognitive control capacities may provide a means to increase physical activity and reduce sedentary behavior. First, this paper reviews emerging evidence of the antecedence of cognitive control abilities in successful self-regulation of physical activity, and in precipitating self-regulation failure that predisposes to sedentary behavior. We then highlight the brain networks that may underpin the cognitive control and self-regulation of physical activity, including the default mode network, prefrontal cortical networks and brain regions and pathways associated with reward. We then discuss research on cognitive training interventions that document improved cognitive control and that suggest promise of influencing physical activity regulation. Key cognitive training components likely to be the most effective at improving self-regulation are also highlighted. The review concludes with suggestions for future research. PMID:25324754

Performance improvements of a highly integrated digital electronic control system for an F-15 airplane

NASA Technical Reports Server (NTRS)

Putnam, T. W.; Burcham, F. W., Jr.; Andries, M. G.; Kelly, J. B.

1985-01-01

The NASA highly integrated digital electronic control (HIDEC) program is structured to conduct flight research into the benefits of integrating an aircraft flight control system with the engine control system. A brief description of the HIDEC system installed on an F-15 aircraft is provided. The adaptive engine control system (ADECS) mode is described in detail, together with simulation results and analyses that show the significant excess thrust improvements achievable with the ADECS mode. It was found that this increased thrust capability is accompanied by reduced fan stall margin and can be realized during flight conditions where engine face distortion is low. The results of analyses and simulations also show that engine thrust response is improved and that fuel consumption can be reduced. Although the performance benefits that accrue because of airframe and engine control integration are being demonstrated on an F-15 aircraft, the principles are applicable to advanced aircraft such as the advanced tactical fighter and advanced tactical aircraft.

An investigation of improved airbag performance by vent control and gas injection

NASA Astrophysics Data System (ADS)

Lee, Calvin; Rosato, Nick; Lai, Francis

Airbags are currently being investigated as an impact energy absorber for U.S. Army airdrop. Simple airbags with constant vent areas have been found to be unsatisfactory in yielding high G forces. In this paper, a method of controlling the vent area and a method of injecting gas into the airbag during its compression stroke to improve airbag performance are presented. Theoretical analysis of complex airbags using these two methods show that they provide lower G forces than simple airbags. Vertical drop tests of a vent-control airbag confirm this result. Gas-injection airbags are currently being tested.

Short- and Long-Term Learning of Feedforward Control of a Myoelectric Prosthesis with Sensory Feedback by Amputees.

PubMed

Strbac, Matija; Isakovic, Milica; Belic, Minja; Popovic, Igor; Simanic, Igor; Farina, Dario; Keller, Thierry; Dosen, Strahinja

2017-11-01

Human motor control relies on a combination of feedback and feedforward strategies. The aim of this study was to longitudinally investigate artificial somatosensory feedback and feedforward control in the context of grasping with myoelectric prosthesis. Nine amputee subjects performed routine grasping trials, with the aim to produce four levels of force during four blocks of 60 trials across five days. The electrotactile force feedback was provided in the second and third block using multipad electrode and spatial coding. The first baseline and last validation block (open-loop control) evaluated the effects of long- (across sessions) and short-term (within session) learning, respectively. The outcome measures were the absolute error between the generated and target force, and the number of force saturations. The results demonstrated that the electrotactile feedback improved the performance both within and across sessions. In the validation block, the performance did not significantly decrease and the quality of open-loop control (baseline) improved across days, converging to the performance characterizing closed-loop control. This paper provides important insights into the feedback and feedforward processes in prosthesis control, contributing to the better understanding of the role and design of feedback in prosthetic systems.

Virtual solar field - An opportunity to optimize transient processes in line-focus CSP power plants

NASA Astrophysics Data System (ADS)

Noureldin, Kareem; Hirsch, Tobias; Pitz-Paal, Robert

2017-06-01

Optimizing solar field operation and control is a key factor to improve the competitiveness of line-focus solar thermal power plants. However, the risks of assessing new and innovative control strategies on operational power plants hinder such optimizations and result in applying more conservative control schemes. In this paper, we describe some applications for a whole solar field transient in-house simulation tool developed at the German Aerospace Centre (DLR), the Virtual Solar Field (VSF). The tool offers a virtual platform to simulate real solar fields while coupling the thermal and hydraulic conditions of the field with high computational efficiency. Using the tool, developers and operator can probe their control strategies and assess the potential benefits while avoiding the high risks and costs. In this paper, we study the benefits gained from controlling the loop valves and of using direct normal irradiance maps and forecasts for the field control. Loop valve control is interesting for many solar field operators since it provides a high degree of flexibility to the control of the solar field through regulating the flow rate in each loop. This improves the reaction to transient condition, such as passing clouds and field start-up in the morning. Nevertheless, due to the large number of loops and the sensitivity of the field control to the valve settings, this process needs to be automated and the effect of changing the setting of each valve on the whole field control needs to be taken into account. We used VSF to implement simple control algorithms to control the loop valves and to study the benefits that could be gained from using active loop valve control during transient conditions. Secondly, we study how using short-term highly spatially-resolved DNI forecasts provided by cloud cameras could improve the plant energy yield. Both cases show an improvement in the plant efficiency and outlet temperature stability. This paves the road for further investigations of new control strategies or for optimizations of the currently implemented ones.

Waste Water Treatment Apparatus and Methods

NASA Technical Reports Server (NTRS)

Plawsky, Joel L. (Inventor); Paccione, John D. (Inventor); Littman, Howard (Inventor)

2014-01-01

An improved draft tube spout fluid bed (DTSFB) mixing, handling, conveying, and treating apparatus and systems, and methods for operating are provided. The apparatus and systems can accept particulate material and pneumatically or hydraulically conveying the material to mix and/or treat the material. In addition to conveying apparatus, a collection and separation apparatus adapted to receive the conveyed particulate material is also provided. The collection apparatus may include an impaction plate against which the conveyed material is directed to improve mixing and/or treatment. The improved apparatus are characterized by means of controlling the operation of the pneumatic or hydraulic transfer to enhance the mixing and/or reacting by controlling the flow of fluids, for example, air, into and out of the apparatus. The disclosed apparatus may be used to mix particulate material, for example, mortar; react fluids with particulate material; coat particulate material, or simply convey particulate material.

Methods and apparatus for handling or treating particulate material

NASA Technical Reports Server (NTRS)

Littman, Howard (Inventor); Plawsky, Joel L. (Inventor); Paccione, John D. (Inventor)

2009-01-01

An improved draft tube spout fluid bed (DTSFB) mixing, handling, conveying, and treating apparatus and systems, and methods for operating are provided. The apparatus and systems can accept particulate material and pneumatically or hydraulically conveying the material to mix and/or treat the material. In addition to conveying apparatus, a collection and separation apparatus adapted to receive the conveyed particulate material is also provided. The collection apparatus may include an impaction plate against which the conveyed material is directed to improve mixing and/or treatment. The improved apparatus are characterized by means of controlling the operation of the pneumatic or hydraulic transfer to enhance the mixing and/or reacting by controlling the flow of fluids, for example, air, into and out of the apparatus. The disclosed apparatus may be used to mix particulate material, for example, mortar; react fluids with particulate material; coat particulate material, or simply convey particulate material.

Simulation development and evaluation of an improved longitudinal velocity vector control wheel steering mode and electronic display format

NASA Technical Reports Server (NTRS)

Steinmetz, G. G.

1980-01-01

Using simulation, an improved longitudinal velocity vector control wheel steering mode and an improved electronic display format for an advanced flight system were developed and tested. Guidelines for the development phase were provided by test pilot critique summaries of the previous system. The results include performances from computer generated step column inputs across the full airplane speed and configuration envelope, as well as piloted performance results taken from a reference line tracking task and an approach to landing task conducted under various environmental conditions. The analysis of the results for the reference line tracking and approach to landing tasks indicates clearly detectable improvement in pilot tracking accuracy with a reduction in physical workload. The original objectives of upgrading the longitudinal axis of the velocity vector control wheel steering mode were successfully met when measured against the test pilot critique summaries and the original purpose outlined for this type of augment control mode.

Improving IAQ Via Air Filtration.

ERIC Educational Resources Information Center

Monk, Brian

1999-01-01

Provides tips on using air filtration to control indoor air quality in educational facilities, including dedicated spaces with unique air quality conditions such as in libraries, museums and archival storage areas, kitchens and dining areas, and laboratories. The control of particulate contaminants, gaseous contaminants, and moisture buildup are…

Pumping Insulin during Exercise: What Healthcare Providers and Diabetic Patients Need To Know.

ERIC Educational Resources Information Center

Colberg, Sheri R.; Walsh, John

2002-01-01

Exercise can decrease insulin resistance. Insulin pumps deliver precise insulin adjustments that improve fuel availability and provide glycemic control to help people with diabetes overcome obstacles to exercise. Physicians, patients, and healthcare providers should be familiar with the features and nuances of specific pump models and follow basic…

Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs

ERIC Educational Resources Information Center

Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

2009-01-01

The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

Novel switching method for single-phase NPC three-level inverter with neutral-point voltage control

NASA Astrophysics Data System (ADS)

Lee, June-Seok; Lee, Seung-Joo; Lee, Kyo-Beum

2018-02-01

This paper proposes a novel switching method with the neutral-point voltage control in a single-phase neutral-point-clamped three-level inverter (SP-NPCI) used in photovoltaic systems. A proposed novel switching method for the SP-NPCI improves the efficiency. The main concept is to fix the switching state of one leg. As a result, the switching loss decreases and the total efficiency is improved. In addition, it enables the maximum power-point-tracking operation to be performed by applying the proposed neutral-point voltage control algorithm. This control is implemented by modifying the reference signal. Simulation and experimental results provide verification of the performance of a novel switching method with the neutral-point voltage control.

Active Power Control of Waked Wind Farms: Preprint

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

Fleming, Paul A; van Wingerden, Jan-Willem; Pao, Lucy

Active power control can be used to balance the total power generated by wind farms with the power consumed on the electricity grid. With the increasing penetration levels of wind energy, there is an increasing need for this ancillary service. In this paper, we show that the tracking of a certain power reference signal provided by the transmission system operator can be significantly improved by using feedback control at the wind farm level. We propose a simple feedback control law that significantly improves the tracking behavior of the total power output of the farm, resulting in higher performance scores. Themore » effectiveness of the proposed feedback controller is demonstrated using high-fidelity computational fluid dynamics simulations of a small wind farm.« less

The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial

PubMed Central

Young, Kim-wan; Ng, Petrus; Kwok, Timothy; Cheng, Daphne

2017-01-01

Purpose Persons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI. Research methods In a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants. Results The paired-samples t-test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status. Conclusion This present RCT provides evidence to support the feasibility and effectiveness of the holistic health group intervention in improving the cognitive and short-term memory abilities of PwMCI. PMID:29026292

A randomized trial of a primary care-based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes.

PubMed

Rothman, Russell L; Malone, Robb; Bryant, Betsy; Shintani, Ayumi K; Crigler, Britton; Dewalt, Darren A; Dittus, Robert S; Weinberger, Morris; Pignone, Michael P

2005-03-01

To assess the efficacy of a pharmacist-led, primary care-based, disease management program to improve cardiovascular risk factors and glycated hemoglobin (A(1C)) levels in vulnerable patients with poorly controlled diabetes. A randomized controlled trial of 217 patients with type 2 diabetes and poor glycemic control (A(1C) level >or=8.0%) was conducted at an academic general medicine practice from February 2001 to April 2003. Intervention patients received intensive management from clinical pharmacists, as well as from a diabetes care coordinator who provided diabetes education, applied algorithms for managing glucose control and decreasing cardiovascular risk factors, and addressed barriers to care. Control patients received a one-time management session from a pharmacist followed by usual care from their primary care provider. Outcomes were recorded at baseline and at 6 and 12 months. Primary outcomes included blood pressure, A(1C) level, cholesterol level, and aspirin use. Secondary outcomes included diabetes knowledge, satisfaction, use of clinical services, and adverse events. For the 194 patients (89%) with 12-month data, the intervention group had significantly greater improvement than did the control group for systolic blood pressure (-9 mm Hg; 95% confidence interval [CI]: -16 to -3 mm Hg) and A(1C) level (-0.8%; 95% CI: -1.7% to 0%). Change in total cholesterol level was not significant. At 12 months, aspirin use was 91% in the intervention group versus 58% among controls (P <0.0001). Intervention patients had greater improvements in diabetes knowledge and satisfaction than did control patients. There were no significant differences in use of clinical services or adverse events. Our comprehensive disease management program reduced cardiovascular risk factors and A(1C) levels among vulnerable patients with type 2 diabetes and poor glycemic control.

Developmental improvements in dynamic control of fingertip forces last throughout childhood and into adolescence

PubMed Central

Dayanidhi, Sudarshan; Hedberg, Åsa; Forssberg, Hans

2013-01-01

While it is clear that the development of dexterous manipulation in children exhibits dramatic improvements over an extended period, it is difficult to separate musculoskeletal from neural contributors to these important functional gains. This is in part due to the inability of current methods to disambiguate improvements in hand strength from gains in finger dexterity (i.e., the dynamic control of fingertip force vectors at low magnitudes). We adapted our novel instrumentation to evaluate finger dexterity in 130 typically developing children between the ages of 4 and 16 yr. We find that finger dexterity continues to develop well into late adolescence and musculoskeletal growth and strength are poorly correlated with the improvements in dexterity. Importantly, because these behavioral results seem to mirror the known timelines of neuroanatomical development up to adolescence, we speculate that they reflect the functional benefits of such continual neural maturation. This novel perspective now enables the systematic study of the functional roles of specific neuroanatomical structures and their connectivity, maturity, and plasticity. Moreover, the temporal dynamics of the fingertip force vectors shows improvements in stability that provide a novel way to look at the maturation of finger control. From a clinical perspective, our results provide a practical means to chart functional development of dexterous manipulation in typically developing children and could be adapted for clinical use and for use in children with developmental disorders. PMID:23864371

Assessment and Optimization of Lidar Measurement Availability for Wind Turbine Control (Poster)

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

Scholbrock, F. A.; Fleming, P.; Wright, A.

2014-02-01

Integrating Lidar to improve wind turbine controls is a potential breakthrough for reducing the cost of wind energy. By providing undisturbed wind measurements up to 400m in front of the rotor, Lidar may provide an accurate update of the turbine inflow with a preview time of several seconds. Focusing on loads, several studies have evaluated potential reductions using integrated Lidar, either by simulation or full scale field testing.

Improving Well-being and Health for People with Dementia (WHELD): study protocol for a randomised controlled trial

PubMed Central

2014-01-01

Background People with dementia living in care homes often have complex mental health problems, disabilities and social needs. Providing more comprehensive training for staff working in care home environments is a high national priority. It is important that this training is evidence based and delivers improvement for people with dementia residing in these environments. Well-being and Health for People with Dementia (WHELD) combines the most effective elements of existing approaches to develop a comprehensive but practical staff training intervention. This optimised intervention is based on a factorial study and qualitative evaluation, to combine: training on person-centred care, promoting person-centred activities and interactions, and providing care home staff and general practitioners with updated knowledge regarding the optimal use of psychotropic medications for persons with dementia in care homes. Design The trial will be a randomised controlled two-arm cluster single blind trial that will take place for nine months across 80 care homes in the United Kingdom. Discussion The overarching goal of this trial is to determine whether this optimised WHELD intervention is more effective in improving the quality of life and mental health than the usual care provided to people with dementia living in nursing homes. This study will be the largest and best powered randomised controlled trial (RCT) evaluating the benefits of an augmented person-centred care training intervention in care homes worldwide. Trial registration Current controlled trials ISRCTN62237498 Date registered: 5 September 2013 PMID:25016303

Assessment of Closed-Loop Control Using Multi-Mode Sensor Fusion For a High Reynolds Number Transonic Jet

NASA Astrophysics Data System (ADS)

Low, Kerwin; Elhadidi, Basman; Glauser, Mark

2009-11-01

Understanding the different noise production mechanisms caused by the free shear flows in a turbulent jet flow provides insight to improve ``intelligent'' feedback mechanisms to control the noise. Towards this effort, a control scheme is based on feedback of azimuthal pressure measurements in the near field of the jet at two streamwise locations. Previous studies suggested that noise reduction can be achieved by azimuthal actuators perturbing the shear layer at the jet lip. The closed-loop actuation will be based on a low-dimensional Fourier representation of the hydrodynamic pressure measurements. Preliminary results show that control authority and reduction in the overall sound pressure level was possible. These results provide motivation to move forward with the overall vision of developing innovative multi-mode sensing methods to improve state estimation and derive dynamical systems. It is envisioned that estimating velocity-field and dynamic pressure information from various locations both local and in the far-field regions, sensor fusion techniques can be utilized to ascertain greater overall control authority.

Can sensory attention focused exercise facilitate the utilization of proprioception for improved balance control in PD?

PubMed

Lefaivre, Shannon C; Almeida, Quincy J

2015-02-01

Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits. Copyright © 2015. Published by Elsevier B.V.

Mitigating the Impact of Nurse Manager Large Spans of Control.

PubMed

Simpson, Brenda Baird; Dearmon, Valorie; Graves, Rebecca

Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.

Convergent method of and apparatus for distributed control of robotic systems using fuzzy logic

DOEpatents

Feddema, John T.; Driessen, Brian J.; Kwok, Kwan S.

2002-01-01

A decentralized fuzzy logic control system for one vehicle or for multiple robotic vehicles provides a way to control each vehicle to converge on a goal without collisions between vehicles or collisions with other obstacles, in the presence of noisy input measurements and a limited amount of compute-power and memory on board each robotic vehicle. The fuzzy controller demonstrates improved robustness to noise relative to an exact controller.

Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial.

PubMed

Vlemmix, Floortje; Rosman, Ageeth N; Rijnders, Marlies E; Beuckens, Antje; Opmeer, Brent C; Mol, Ben W J; Kok, Marjolein; Fleuren, Margot A H

2015-05-01

To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech presentation from 32 weeks of gestation onwards. We randomized clusters to a client strategy (written information leaflets and decision aid), a care-provider strategy (1-day counseling course focused on knowledge and counseling skills), a combined client and care-provider strategy and care-as-usual strategy. We performed an intention-to-treat analysis. Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt. The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8-95%. Neither the client strategy (OR 0.8, 95% CI 0.4-1.5) nor the care-provider strategy (OR 1.2, 95% CI 0.6-2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3-1.4 and OR 2.0, 95% CI 0.7-4.5). Neither a client nor a care-provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Situation analysis of the National Comprehensive Cancer Control Program (2013) in the I. R. of Iran; assessment and recommendations based on the IAEA imPACT mission.

PubMed

Rouhollahi, Mohammad Reza; Mohagheghi, Mohammad Ali; Mohammadrezai, Narges; Ghiasvand, Reza; Ghanbari Motlagh, Ali; Harirchi, Iraj; Zendehdel, Kazem

2014-04-01

Iran was engaged in the Program of Action for Cancer Therapy (PACT) in 2012, and delegates from the International Atomic Energy Agency (IAEA), and the World Health Organization (WHO) evaluated the National Cancer Control Program (NCCP) status (the imPACT mission), based on which they provided recommendations for improvements of NCCP in the I.R. of Iran. We reported the results of this situational analysis and discussed the recommendations and their implication in the promotion of NCCP in the I.R. of Iran.  International delegates visited the I.R. of Iran and evaluated different aspects and capacities of NCCP in Iran. In addition, a Farsi version of the WHO/IAEA self-assessment tool was completed by local experts and stakeholders, including experts from different departments of the Ministry of Health and Medical Education (MOHME) and representatives from the National Cancer Research Network (NCRN). Following these evaluations, the PACT office provided recommendations for improving the NCCP in Iran. Almost all the recommendations were endorsed by MOHME. The PACT program provided 31 recommendations for improvement of NCCP in Iran in six categories, including planning, cancer registration and information, prevention, early detection, diagnosis and treatment, and palliative care. The most important recommendation was to establish a strong, multi-sectoral NCCP committee and develop an updated national cancer control program. The imPACT mission report provided a comprehensive view about the NCCP status in Iran. An appropriate response to these recommendations and filing the observed gaps will improve the NCCP status in the I.R. of Iran.

Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts.

PubMed

Duncan, Fiona; Haigh, Carol

2013-10-01

To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools. Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief. Process control and quality improvement Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain. The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty-seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions. Statistical Process Control is a useful tool for measuring and improving the quality of pain management. The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that has led to the establishment of a national pain registry. © 2013 Blackwell Publishing Ltd.

Methods, systems and apparatus for adjusting modulation index to improve linearity of phase voltage commands

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

Gallegos-Lopez, Gabriel; Perisic, Milun; Kinoshita, Michael H.

2017-03-14

Embodiments of the present invention relate to methods, systems and apparatus for controlling operation of a multi-phase machine in a motor drive system. The disclosed embodiments provide a mechanism for adjusting modulation index of voltage commands to improve linearity of the voltage commands.

Potential Impacts of Climate Change on Vegetative Ecosystem Services of Soil Retention [US-IALE 04/08/18

EPA Science Inventory

Planning for a sustainable future should include an accounting of services currently provided by ecosystems such as erosion control. Retention of soil not only maintains but improves soil fertility, improves water retention, and decreases sedimentation in streams and rivers ther...

Reciprocating Linear Electric Motor

NASA Technical Reports Server (NTRS)

Goldowsky, M. P.

1984-01-01

Features include structural simplicity and good force/displacement characteristics. Reciprocating motor has simple, rugged construction, relatively low reciprocating weight, improved power delivery, and improved force control. Wear reduced by use of magnetic bearings. Intended to provide drivers for long-lived Stirling-cycle cryogenic refrigerators, concept has less exotic applications, such as fuel pumps.

Future long-range transports - Prospects for improved fuel efficiency

NASA Technical Reports Server (NTRS)

Nagel, A. L.; Alford, W. J., Jr.; Dugan, J. F., Jr.

1975-01-01

A status report is provided on current thinking concerning potential improvements in fuel efficiency and possible alternate fuels. Topics reviewed are: historical trends in airplane efficiency; technological opportunities including supercritical aerodynamics, vortex diffusers, composite materials, propulsion systems, active controls, and terminal-area operations; unconventional design concepts, and hydrogen-fueled airplane.

Positive beliefs and privacy concerns shape the future for the Personally Controlled Electronic Health Record.

PubMed

Lehnbom, E C; Douglas, H E; Makeham, M A B

2016-01-01

The uptake of the Personally Controlled Electronic Health Record (PCEHR) has been slowly building momentum in Australia. The purpose of the PCEHR is to collect clinically important information from multiple healthcare providers to provide a secure electronic record to patients and their authorised healthcare providers that will ultimately enhance the efficiency and effectiveness of healthcare delivery. Reasons for the slow uptake of the PCEHR and future directions to improve its usefulness is discussed later. © 2016 Royal Australasian College of Physicians.

Global Tobacco Control: An integrated approach to global health policy

PubMed Central

RUGER, JENNIFER PRAH

2014-01-01

Following the development discussion in the last volume on the ‘politics of health’, Jennifer Prah Ruger argues that the Framework Convention on Tobacco Control (FCTC) represents a shift in global health policy that recognizes the importance of addressing health needs on multiple fronts and integrating public policies into a comprehensive set of health improvement strategies. She argues that the FCTC provides a model for multifaceted approaches to health improvement that require simultaneous progress on various dimensions. PMID:25598648

Proton beam therapy control system

DOEpatents

Baumann, Michael A [Riverside, CA; Beloussov, Alexandre V [Bernardino, CA; Bakir, Julide [Alta Loma, CA; Armon, Deganit [Redlands, CA; Olsen, Howard B [Colton, CA; Salem, Dana [Riverside, CA

2008-07-08

A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.

Proton beam therapy control system

DOEpatents

Baumann, Michael A.; Beloussov, Alexandre V.; Bakir, Julide; Armon, Deganit; Olsen, Howard B.; Salem, Dana

2010-09-21

A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.

Proton beam therapy control system

DOEpatents

Baumann, Michael A; Beloussov, Alexandre V; Bakir, Julide; Armon, Deganit; Olsen, Howard B; Salem, Dana

2013-06-25

A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.

Proton beam therapy control system

DOEpatents

Baumann, Michael A; Beloussov, Alexandre V; Bakir, Julide; Armon, Deganit; Olsen, Howard B; Salem, Dana

2013-12-03

A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.

Chinese Calligraphy Writing for Augmenting Attentional Control and Working Memory of Older Adults at Risk of Mild Cognitive Impairment: A Randomized Controlled Trial.

PubMed

Chan, Sam C C; Chan, Chetwyn C H; Derbie, Abiot Y; Hui, Irene; Tan, Davynn G H; Pang, Marco Y C; Lau, Stephen C L; Fong, Kenneth N K

2017-01-01

Nonpharmacological intervention for individuals with mild cognitive impairment (MCI) needs further investigation. Test efficacy of an eight-week Chinese calligraphy writing training course in improving attentional control and working memory. Ninety-nine participants with MCI were randomized into the eight-week calligraphy writing (n = 48) or control (tablet computer) training (n = 51). Outcomes of the interventions were attentional control, working memory, visual scan and processing speed. They were measured at baseline, post-training, and six-month follow-up. Calligraphy writing, when compared with control, significantly improved working memory as reflected from DST-Backward sequence (p = 0.009) and span scores (p = 0.002), and divided attention as reflected from CTT2 (p < 0.001), and at the post-training. The unique improvement in working memory (span: p < 0.001; sequence: p = 0.008) of the intervention group was also found at follow-up when comparing with those at baseline. Changes in the other outcome measures were not statistically significant. The findings provide support that Chinese calligraphy writing training for eight weeks using a cognitive approach would improve working memory and to a lesser extent attentional control functions of patients with early MCI. They also demonstrate the usefulness of using mind-and-body practice for improving specific cognitive functions.

Training to Improve Hearing Speech in Noise: Biological Mechanisms

PubMed Central

Song, Judy H.; Skoe, Erika; Banai, Karen

2012-01-01

We investigated training-related improvements in listening in noise and the biological mechanisms mediating these improvements. Training-related malleability was examined using a program that incorporates cognitively based listening exercises to improve speech-in-noise perception. Before and after training, auditory brainstem responses to a speech syllable were recorded in quiet and multitalker noise from adults who ranged in their speech-in-noise perceptual ability. Controls did not undergo training but were tested at intervals equivalent to the trained subjects. Trained subjects exhibited significant improvements in speech-in-noise perception that were retained 6 months later. Subcortical responses in noise demonstrated training-related enhancements in the encoding of pitch-related cues (the fundamental frequency and the second harmonic), particularly for the time-varying portion of the syllable that is most vulnerable to perceptual disruption (the formant transition region). Subjects with the largest strength of pitch encoding at pretest showed the greatest perceptual improvement. Controls exhibited neither neurophysiological nor perceptual changes. We provide the first demonstration that short-term training can improve the neural representation of cues important for speech-in-noise perception. These results implicate and delineate biological mechanisms contributing to learning success, and they provide a conceptual advance to our understanding of the kind of training experiences that can influence sensory processing in adulthood. PMID:21799207

[Establishment of industry promotion technology system in Chinese medicine secondary exploitation based on "component structure theory"].

PubMed

Cheng, Xu-Dong; Feng, Liang; Zhang, Ming-Hua; Gu, Jun-Fei; Jia, Xiao-Bin

2014-10-01

The purpose of the secondary exploitation of Chinese medicine is to improve the quality of Chinese medicine products, enhance core competitiveness, for better use in clinical practice, and more effectively solve the patient suffering. Herbs, extraction, separation, refreshing, preparation and quality control are all involved in the industry promotion of Chinese medicine secondary exploitation of industrial production. The Chinese medicine quality improvement and industry promotion could be realized with the whole process of process optimization, quality control, overall processes improvement. Based on the "component structure theory", "multi-dimensional structure & process dynamic quality control system" and systematic and holistic character of Chinese medicine, impacts of whole process were discussed. Technology systems of Chinese medicine industry promotion was built to provide theoretical basis for improving the quality and efficacy of the secondary development of traditional Chinese medicine products.

Method and apparatus for improved melt flow during continuous strip casting

DOEpatents

Follstaedt, Donald W.; King, Edward L.; Schneider, Ken C.

1991-11-12

The continuous casting of metal strip using the melt overflow process is improved by controlling the weir conditions in the nozzle to provide a more uniform flow of molten metal across the width of the nozzle and reducing the tendency for freezing of metal along the interface with refractory surfaces. A weir design having a sloped rear wall and tapered sidewalls and critical gap controls beneath the weir has resulted in the drastic reduction in edge tearing and a significant improvement in strip uniformity. The floor of the container vessel is preferably sloped and the gap between the nozzle and the rotating substrate is critically controlled. The resulting flow patterns observed with the improved casting process have reduced thermal gradients in the bath, contained surface slag and eliminated undesirable solidification near the discharge area by increasing the flow rates at those points.

Method and apparatus for improved melt flow during continuous strip casting

DOEpatents

Follstaedt, D.W.; King, E.L.; Schneider, K.C.

1991-11-12

The continuous casting of metal strip using the melt overflow process is improved by controlling the weir conditions in the nozzle to provide a more uniform flow of molten metal across the width of the nozzle and reducing the tendency for freezing of metal along the interface with refractory surfaces. A weir design having a sloped rear wall and tapered sidewalls and critical gap controls beneath the weir has resulted in the drastic reduction in edge tearing and a significant improvement in strip uniformity. The floor of the container vessel is preferably sloped and the gap between the nozzle and the rotating substrate is critically controlled. The resulting flow patterns observed with the improved casting process have reduced thermal gradients in the bath, contained surface slag and eliminated undesirable solidification near the discharge area by increasing the flow rates at those points. 8 figures.

Therapeutics of diabetes mellitus: focus on insulin analogues and insulin pumps.

PubMed

Valla, Vasiliki

2010-01-01

Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas. Intensive insulin therapy with multiple daily injections (MDI) allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII) provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM) systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial "closed-loop" systems mimicking the pancreatic activity have been also developed. Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

Good to Great: Quality-Improvement Initiative Increases and Sustains Pediatric Health Care Worker Hand Hygiene Compliance.

PubMed

McLean, Heather S; Carriker, Charlene; Bordley, William Clay

2017-04-01

The Joint Commission, the Centers for Disease Control and Prevention, and the World Health Organization challenge hospitals to achieve and sustain compliance with effective hand hygiene (HH) practice; however, many inpatient units fail to achieve a high level of reliability. The aim of the project was to increase and sustain health care worker (HCW) compliance with HH protocols from 87% (level of reliability [LOR] 1) to ≥95% (LOR 2) within 9 months on 2 pediatric inpatient units in an academic children's hospital. This study was a time-series, quality-improvement project. Interventions were tested through multiple plan-do-study-act cycles on 2 pediatric inpatient units. HH compliance audits of HCWs on these units were performed randomly each week by the hospital infection prevention program. Control charts of percentages of HCW HH compliance were constructed with 3-σ (data within 3 SDs from a mean) control limits. These control limits were adjusted after achieving significant improvements in performance over time. Charts were annotated with interventions including (1) increasing awareness, (2) providing timely feedback, (3) empowering patients and families to participate in mitigation, (4) providing focused education, and (5) developing interdisciplinary HH champions. HH compliance rates improved from an average of 87% (LOR 1) to ≥95% (LOR 2) within 9 months, and this improvement has been sustained for >2 years on both pediatric inpatient units. Significant and sustained gains in HH compliance rates of ≥95% (LOR 2) can be achieved by applying high-reliability human-factor interventions. Copyright © 2017 by the American Academy of Pediatrics.

Robust integrated flight/propulsion control design for a STOVL aircraft using H-infinity control design techniques

NASA Technical Reports Server (NTRS)

Garg, Sanjay

1993-01-01

Results are presented from an application of H-infinity control design methodology to a centralized integrated flight/propulsion control (IFPC) system design for a supersonic STOVL fighter aircraft in transition flight. The emphasis is on formulating the H-infinity optimal control synthesis problem such that the critical requirements for the flight and propulsion systems are adequately reflected within the linear, centralized control problem formulation and the resulting controller provides robustness to modeling uncertainties and model parameter variations with flight condition. Detailed evaluation results are presented for a reduced order controller obtained from the improved H-infinity control design showing that the control design meets the specified nominal performance objective as well as provides stability robustness for variations in plant system dynamics with changes in aircraft trim speed within the transition flight envelope.

Light-controlled resistors provide quadrature signal rejection for high-gain servo systems

NASA Technical Reports Server (NTRS)

Mc Cauley, D. D.

1967-01-01

Servo amplifier feedback system, in which the phase sensitive detection, low pass filtering, and multiplication functions required for quadrature rejection, are preformed by light-controlled photoresistors, eliminates complex circuitry. System increases gain, improves signal-to-noise ratio, and eliminates the necessity for compensation.

78 FR 22332 - Notice of Quarterly Report (October 1, 2012-December 31, 2012)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... applied improved techniques. Agro-sylvo-pastoral groups that receive technical assistance. Loans provided... Administration \\3\\ and $56,138,545 $34,820,809 Control, Monitoring and Evaluation. Pending Subsequent Report \\4...,435 Control, Monitoring and Evaluation. Pending Subsequent Report \\4\\ Cumulative Projects Obligated...

Locomotor training through a novel robotic platform for gait rehabilitation in pediatric population: short report.

PubMed

Bayón, C; Lerma, S; Ramírez, O; Serrano, J I; Del Castillo, M D; Raya, R; Belda-Lois, J M; Martínez, I; Rocon, E

2016-11-14

Cerebral Palsy (CP) is a disorder of posture and movement due to a defect in the immature brain. The use of robotic devices as alternative treatment to improve the gait function in patients with CP has increased. Nevertheless, current gait trainers are focused on controlling complete joint trajectories, avoiding postural control and the adaptation of the therapy to a specific patient. This paper presents the applicability of a new robotic platform called CPWalker in children with spastic diplegia. CPWalker consists of a smart walker with body weight and autonomous locomotion support and an exoskeleton for joint motion support. Likewise, CPWalker enables strategies to improve postural control during walking. The integrated robotic platform provides means for testing novel gait rehabilitation therapies in subjects with CP and similar motor disorders. Patient-tailored therapies were programmed in the device for its evaluation in three children with spastic diplegia for 5 weeks. After ten sessions of personalized training with CPWalker, the children improved the mean velocity (51.94 ± 41.97 %), cadence (29.19 ± 33.36 %) and step length (26.49 ± 19.58 %) in each leg. Post-3D gait assessments provided kinematic outcomes closer to normal values than Pre-3D assessments. The results show the potential of the novel robotic platform to serve as a rehabilitation tool. The autonomous locomotion and impedance control enhanced the children's participation during therapies. Moreover, participants' postural control was substantially improved, which indicates the usefulness of the approach based on promoting the patient's trunk control while the locomotion therapy is executed. Although results are promising, further studies with bigger sample size are required.

A systematic review of interventions to improve diabetes care in socially disadvantaged populations.

PubMed

Glazier, Richard H; Bajcar, Jana; Kennie, Natalie R; Willson, Kristie

2006-07-01

To identify and synthesize evidence about the effectiveness of patient, provider, and health system interventions to improve diabetes care among socially disadvantaged populations. Studies that were included targeted interventions toward socially disadvantaged adults with type 1 or type 2 diabetes; were conducted in industrialized countries; were measured outcomes of self-management, provider management, or clinical outcomes; and were randomized controlled trials, controlled trials, or before-and-after studies with a contemporaneous control group. Seven databases were searched for articles published in any language between January 1986 and December 2004. Twenty-six intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions. Eleven of 17 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included cultural tailoring of the intervention, community educators or lay people leading the intervention, one-on-one interventions with individualized assessment and reassessment, incorporating treatment algorithms, focusing on behavior-related tasks, providing feedback, and high-intensity interventions (>10 contact times) delivered over a long duration (>or=6 months). Interventions that were consistently associated with the largest negative outcomes included those that used mainly didactic teaching or that focused only on diabetes knowledge. This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success. These types of interventions would require additional resources for needs assessment, leader training, community and family outreach, and follow-up.

Acceptance, Benefits, and Challenges of Public Health-Oriented Pet Business Regulations in King County, Washington.

PubMed

Wierenga, Janelle; Thiede, Hanne; Helms, Leah; Hopkins, Sharon

2016-01-01

New regulations were implemented in King County, Washington, in 2010 requiring pet businesses to obtain a permit from Public Health-Seattle & King County (Public Health) and undergo annual inspections to provide education and ensure compliance with regulatory standards. The regulations were developed as a tool for zoonotic disease control and prevention education for businesses and their customers, as well as for environmental protection. To assess the acceptance, benefits, and challenges of the new regulations and identify ways for Public Health to improve educational efforts and assist businesses with compliance. Cross-sectional survey. King County, Washington. Pet businesses with Public Health permits in 2013. Self-administered survey responses. The response rate was 40.5%. The majority of respondents provided grooming, pet day care, and kennel/boarding services from small, independent businesses. Sixty-one percent reported Public Health inspections as beneficial, especially concerning disinfection procedures and using an infection control plan. Almost three-fourths of respondents used the Public Health template to develop the infection control plan. Forty-four percent reported using the educational materials provided by Public Health, and 62% used educational materials from other sources. Most respondents reported that they gained benefits from the pet business permit, although fewer agreed that they obtained a good value from the permit and fee. The most common benefits reported were protection of animal and human health and establishing the credibility of the pet business. Major challenges with the implementation of the pet business regulations were not generally reported by respondents. Most respondents reported a collaborative relationship between Public Health and the pet businesses. Improvements in infection control practices and positive responses to the inspections were reported by pet businesses. Survey results were used to improve infection control plan templates, increase the use of educational materials, and improve the Web site and business portal performance.

Phase formation polycrystalline vanadium oxide via thermal annealing process under controlled nitrogen pressure

NASA Astrophysics Data System (ADS)

Jessadaluk, S.; Khemasiri, N.; Rahong, S.; Rangkasikorn, A.; Kayunkid, N.; Wirunchit, S.; Horprathum, M.; Chananonnawathron, C.; Klamchuen, A.; Nukeaw, J.

2017-09-01

This article provides an approach to improve and control crystal phases of the sputtering vanadium oxide (VxOy) thin films by post-thermal annealing process. Usually, as-deposited VxOy thin films at room temperature are amorphous phase: post-thermal annealing processes (400 °C, 2 hrs) under the various nitrogen (N2) pressures are applied to improve and control the crystal phase of VxOy thin films. The crystallinity of VxOy thin films changes from amorphous to α-V2O5 phase or V9O17 polycrystalline, which depend on the pressure of N2 carrier during annealing process. Moreover, the electrical resistivity of the VxOy thin films decrease from 105 Ω cm (amorphous) to 6×10-1 Ω cm (V9O17). Base on the results, our study show a simply method to improve and control phase formation of VxOy thin films.

Asthma in pregnancy: management strategies.

PubMed

McCallister, Jennifer W

2013-01-01

Asthma is one of the most prevalent chronic medical conditions to complicate pregnancy. With approximately one-third of women experiencing a worsening of control during the course of their pregnancy, identifying those at greatest risk has the potential to improve maternal and fetal outcomes for a large number of pregnancies. Similarly, active management strategies that prioritize asthma control in this vulnerable population can have a far-reaching impact. Demographic characteristics and patient noncompliance place certain populations of pregnant women at increased risk of poor asthma control during pregnancy. In addition, undertreatment and disparities in care of acute exacerbations during pregnancy likely contribute. Targeted educational interventions and treatment algorithms using objective markers of disease activity have shown improved outcomes in asthma control. Active management strategies which focus on identifying patient-specific risk factors, patient and provider education, and targeted treatment interventions can improve asthma care for women during pregnancy.

The UK Stem Cell Bank: a UK government-funded, international resource center for stem cell research.

PubMed

Stacey, Glyn; Hunt, Charles J

2006-01-01

The UK Stem Cell Bank is a UK Research Council-funded initiative that aims to provide ethically sourced and quality controlled stocks of cells for researchers and also establish seed stocks of cell lines for clinical trials. Whilst the Bank is prohibited from carrying out basic stem cell research (to avoid conflicts of interest) it is working to improve stem cell banking procedures including cryopreservation, characterization and quality control. The Bank also supports training activities and has provided the hub for the International Stem Cell Initiative, which includes 17 expert stem cell centers aiming to characterize a large number of human embryonic stem cell lines in a standardized way to improve our understanding of the characteristics of these cells.

Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines

PubMed Central

Kim, Yeesuk; Cho, Hong-Man; Park, Kyung-Soon; Yoon, Pil Whan; Nho, Jae-Hwi; Kim, Sang-Min; Lee, Kyung-Jae; Moon, Kyong-Ho

2016-01-01

Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty. PMID:27536639

Compact vehicle drive module having improved thermal control

DOEpatents

Meyer, Andreas A.; Radosevich, Lawrence D.; Beihoff, Bruce C.; Kehl, Dennis L.; Kannenberg, Daniel G.

2006-01-03

An electric vehicle drive includes a thermal support may receive one or more power electronic circuits. The support may aid in removing heat from the circuits through fluid circulating through the support, which may be controlled in a closed-loop manner. Interfacing between circuits, circuit mounting structure, and the support provide for greatly enhanced cooling. The support may form a shield from both external EMI/RFI and from interference generated by operation of the power electronic circuits. Features may be provided to permit and enhance connection of the circuitry to external circuitry, such as improved terminal configurations. Modular units may be assembled that may be coupled to electronic circuitry via plug-in arrangements or through interface with a backplane or similar mounting and interconnecting structures.

Real-Time Charging Strategies for an Electric Vehicle Aggregator to Provide Ancillary Services

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

Wenzel, George; Negrete-Pincetic, Matias; Olivares, Daniel E.

Real-time charging strategies, in the context of vehicle to grid (V2G) technology, are needed to enable the use of electric vehicle (EV) fleets batteries to provide ancillary services (AS). Here, we develop tools to manage charging and discharging in a fleet to track an Automatic Generation Control (AGC) signal when aggregated. We also propose a real-time controller that considers bidirectional charging efficiency and extend it to study the effect of looking ahead when implementing Model Predictive Control (MPC). Simulations show that the controller improves tracking error as compared with benchmark scheduling algorithms, as well as regulation capacity and battery cycling.

Real-Time Charging Strategies for an Electric Vehicle Aggregator to Provide Ancillary Services

DOE PAGES

Wenzel, George; Negrete-Pincetic, Matias; Olivares, Daniel E.; ...

2017-03-13

Real-time charging strategies, in the context of vehicle to grid (V2G) technology, are needed to enable the use of electric vehicle (EV) fleets batteries to provide ancillary services (AS). Here, we develop tools to manage charging and discharging in a fleet to track an Automatic Generation Control (AGC) signal when aggregated. We also propose a real-time controller that considers bidirectional charging efficiency and extend it to study the effect of looking ahead when implementing Model Predictive Control (MPC). Simulations show that the controller improves tracking error as compared with benchmark scheduling algorithms, as well as regulation capacity and battery cycling.

Oxygen-controlled automated neural differentiation of mouse embryonic stem cells.

PubMed

Mondragon-Teran, Paul; Tostoes, Rui; Mason, Chris; Lye, Gary J; Veraitch, Farlan S

2013-03-01

Automation and oxygen tension control are two tools that provide significant improvements to the reproducibility and efficiency of stem cell production processes. the aim of this study was to establish a novel automation platform capable of controlling oxygen tension during both the cell-culture and liquid-handling steps of neural differentiation processes. We built a bespoke automation platform, which enclosed a liquid-handling platform in a sterile, oxygen-controlled environment. An airtight connection was used to transfer cell culture plates to and from an automated oxygen-controlled incubator. Our results demonstrate that our system yielded comparable cell numbers, viabilities, metabolism profiles and differentiation efficiencies when compared with traditional manual processes. Interestingly, eliminating exposure to ambient conditions during the liquid-handling stage resulted in significant improvements in the yield of MAP2-positive neural cells, indicating that this level of control can improve differentiation processes. This article describes, for the first time, an automation platform capable of maintaining oxygen tension control during both the cell-culture and liquid-handling stages of a 2D embryonic stem cell differentiation process.

An improved predictive functional control method with application to PMSM systems

NASA Astrophysics Data System (ADS)

Li, Shihua; Liu, Huixian; Fu, Wenshu

2017-01-01

In common design of prediction model-based control method, usually disturbances are not considered in the prediction model as well as the control design. For the control systems with large amplitude or strong disturbances, it is difficult to precisely predict the future outputs according to the conventional prediction model, and thus the desired optimal closed-loop performance will be degraded to some extent. To this end, an improved predictive functional control (PFC) method is developed in this paper by embedding disturbance information into the system model. Here, a composite prediction model is thus obtained by embedding the estimated value of disturbances, where disturbance observer (DOB) is employed to estimate the lumped disturbances. So the influence of disturbances on system is taken into account in optimisation procedure. Finally, considering the speed control problem for permanent magnet synchronous motor (PMSM) servo system, a control scheme based on the improved PFC method is designed to ensure an optimal closed-loop performance even in the presence of disturbances. Simulation and experimental results based on a hardware platform are provided to confirm the effectiveness of the proposed algorithm.

Simulation of talking faces in the human brain improves auditory speech recognition

PubMed Central

von Kriegstein, Katharina; Dogan, Özgür; Grüter, Martina; Giraud, Anne-Lise; Kell, Christian A.; Grüter, Thomas; Kleinschmidt, Andreas; Kiebel, Stefan J.

2008-01-01

Human face-to-face communication is essentially audiovisual. Typically, people talk to us face-to-face, providing concurrent auditory and visual input. Understanding someone is easier when there is visual input, because visual cues like mouth and tongue movements provide complementary information about speech content. Here, we hypothesized that, even in the absence of visual input, the brain optimizes both auditory-only speech and speaker recognition by harvesting speaker-specific predictions and constraints from distinct visual face-processing areas. To test this hypothesis, we performed behavioral and neuroimaging experiments in two groups: subjects with a face recognition deficit (prosopagnosia) and matched controls. The results show that observing a specific person talking for 2 min improves subsequent auditory-only speech and speaker recognition for this person. In both prosopagnosics and controls, behavioral improvement in auditory-only speech recognition was based on an area typically involved in face-movement processing. Improvement in speaker recognition was only present in controls and was based on an area involved in face-identity processing. These findings challenge current unisensory models of speech processing, because they show that, in auditory-only speech, the brain exploits previously encoded audiovisual correlations to optimize communication. We suggest that this optimization is based on speaker-specific audiovisual internal models, which are used to simulate a talking face. PMID:18436648

Spirometry as a motivational tool to improve smoking cessation rates: a systematic review of the literature.

PubMed

Wilt, Timothy J; Niewoehner, Dennis; Kane, Robert L; MacDonald, Roderick; Joseph, Anne M

2007-01-01

Obtaining spirometric testing and providing those results to individuals who smoke has been advocated as a motivational tool to improve smoking cessation. However, its effectiveness is not known. We conducted a systematic review to determine if this approach improves rates of smoking cessation. Data sources included MEDLINE (1966 to October 2005), the Cochrane Library, and experts in the field. Eligible randomized controlled trials (RCTs) enrolled at least 25 smokers per arm, evaluated spirometry with associated counseling or in combination with other treatments, followed subjects at least 6 months, and provided smoking abstinence rates. Results from nonrandomized studies also were summarized. The primary outcome was patient-reported long-term (at least 6 months) sustained abstinence with biological validation. Additional outcomes included self-reported abstinence and point-prevalence abstinence. Seven RCTs (N = 6,052 subjects) met eligibility criteria. Follow-up duration ranged from 9 to 36 months. In six trials, the intervention group received concomitant treatments previously demonstrated to increase cessation independently. The range of abstinence was 3%-14% for control subjects and 7%-39% among intervention groups, statistically significantly in favor of intervention in four studies. The only RCT that assessed the independent contribution of spirometry in combination with counseling demonstrated a nonsignificant 1% improvement in patient-reported point-prevalence abstinence at 12 months in the group that received spirometry plus counseling versus counseling alone (6.5% versus 5.5%). Findings from observational studies were mixed, and the lack of controls makes interpretation problematic. Available evidence is insufficient to determine whether obtaining spirometric values and providing that information to patients improves smoking cessation compared with other smoking cessation methods. Spirometric values are of limited benefit as a predictor of smoking cessation or as a tool to "customize" smoking cessation strategies.

A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence.

PubMed

Pakpour, Amir H; Gholami, Maryam; Esmaeili, Ravanbakhsh; Naghibi, Seyed Abolhasan; Updegraff, John A; Molloy, Gerard J; Dombrowski, Stephan U

2015-11-01

Medication nonadherence is one of the most important reasons for treatment failure in patients with epilepsy. The present study investigated the effectiveness of a multicomponent intervention to improve adherence to antiepileptic drug (AED) medication in patients with epilepsy. In a prospective, randomized multicenter trial, three sessions of face-to-face motivational interviewing (MI) in combination with complementary behavior change techniques were compared with standard care. Motivational interviewing prompted change talk and self-motivated statements from the patients, planning their own medication intake regimen and also identifying and overcoming barriers that may prevent adherence. Participants were provided with calendars to self-monitor their medication taking behavior. A family member and the health-care team were invited to attend the last session of MI in order to improve the collaboration and communication between patients, their caregiver or family member, and their health-care provider. At baseline and 6-month follow-up, psychosocial variables and medical adherence were assessed. In total, 275 participants were included in the study. Compared with the active control group, patients in the intervention group reported significantly higher medication adherence, as well as stronger intention and perceptions of control for taking medication regularly. The intervention group also reported higher levels of action planning, coping planning, self-monitoring, and lower medication concerns. This study shows that MI can be effective in clinical practice to improve medication adherence in patients with epilepsy. It also provides evidence that combining volitional interventions, including action planning, coping planning, and self-monitoring with motivational interviewing can promote the effectiveness of the medical treatments for epilepsy by improving adherence. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving the effectiveness of nighttime temporary traffic control warning devices, volume 2 : evaluation of nighttime mobile warning lights.

DOT National Transportation Integrated Search

2013-11-01

Vehicle-mounted warning lights for nighttime mobile highway operations provide critical protection to workers and the driving : public. Alerting the traveling public of the approaching work activity and providing guidance is vital to maintaining safe...

The millennium development goals and tobacco control.

PubMed

Collishaw, Neil E

2010-03-01

The eight Millennium Development Goals were proposed by the UN Secretary-General in 2001. They are goals with measurable targets to be achieved by 2015 or earlier. The Goals were distilled from the 2000 United Nations Millennium Declaration, a sweeping statement of development values, principles, objectives and proposed actions. The Framework Convention on Tobacco Control (FCTC) is a demonstrable translation of some of the ideas in the Millennium Declaration into reality. With 165(i) Parties, the FCTC does more than just improve global tobacco control: * The FCTC contributes to achievement of many of the Millennium Development Goals, and benefits from success in implementation of the Goals in other sectors. * The treaty itself is a demonstration of strengthened international and national rule of law, central tenets of the Millennium Declaration. * The FCTC expands international law into the health sector and provides better balance of international law among economic, environmental, social and health sectors. The Millennium Declaration calls for a more equitable distribution of the benefits of globalization, and the FCTC delivers this result. * The FCTC provides a model for addressing other unsolved global problems through greater use of international law. Alcohol control and dietary improvements including greater control of empty calories in manufactured foods are examples of problems that may benefit from greater governance by international law. Were that to come to pass, those new treaties would also improve implementation of the Millennium Declaration and the Millennium Development Goals.

Platelet-rich plasma to improve the bio-functionality of biomaterials.

PubMed

Anitua, Eduardo; Tejero, Ricardo; Alkhraisat, Mohammad H; Orive, Gorka

2013-04-01

Growth factors and cytokines are active players in controlling the different stages of wound healing and tissue regeneration. Recent trends in personalized regenerative medicine involve using patient's own platelet-rich plasma for stimulating wound healing and tissue regeneration. This technology provides a complex cocktail of growth factors and even a fibrin scaffold with multiple biologic effects. In the last few years, an increasing number of studies provide evidence of the potential of combining platelet-rich plasma with different biomaterials in order to improve their properties, including handling, administration, bioactivity, and level of osseointegration, among others. In this review, we discuss the use of platelet-rich plasma as an alternative, easy, cost-effective, and controllable strategy for the release of high concentrations of many endogenous growth factors. Additionally, we provide an overview of the current progress and future directions of research combining different types of biomaterials with platelet-rich plasma in tissue engineering and regenerative medicine.

Topical Prophylaxis for HIV Prevention in Women: Becoming a Reality

PubMed Central

Verma, Natasha A.; Lee, Anna C.; Herold, Betsy C.

2011-01-01

Strategies to protect against sexual transmission of HIV include the development of products formulated for topical application, which limit the toxicities associated with systemic oral pre-exposure prophylaxis. Following several clinical trial failures, attention is now focused on antiretroviral (ARV) agents. Highly potent ARV topical formulations provide a female-controlled, targeted, and feasible option for HIV prevention. A recently completed tenofovir gel trial was the first to demonstrate significant protection against HIV acquisition. Topical ARVs have the advantage of delivering high concentration of drug at the site of transmission of HIV, with low systemic absorption. Sustained-release formulations, such as intravaginal rings, will likely improve adherence and can be designed to provide controlled and continuous delivery of ARV combinations. Further studies to test alternative dosing strategies and pharmacokinetic/pharmacodynamic relationships in the genital tract will provide valuable information as the field strives to improve upon the promising tenofovir gel trial results. PMID:21424725

Real-time economic nonlinear model predictive control for wind turbine control

NASA Astrophysics Data System (ADS)

Gros, Sebastien; Schild, Axel

2017-12-01

Nonlinear model predictive control (NMPC) is a strong candidate to handle the control challenges emerging in the modern wind energy industry. Recent research suggested that wind turbine (WT) control based on economic NMPC (ENMPC) can improve the closed-loop performance and simplify the task of controller design when compared to a classical NMPC approach. This paper establishes a formal relationship between the ENMPC controller and the classic NMPC approach, and compares empirically their closed-loop nominal behaviour and performance. The robustness of the performance is assessed for an inaccurate modelling of the tower fore-aft main frequency. Additionally, though a perfect wind preview is assumed here, the effect of having a limited horizon of preview of the wind speed via the LIght Detection And Ranging (LIDAR) sensor is investigated. Finally, this paper provides new algorithmic solutions for deploying ENMPC for WT control, and report improved computational times.

JT9D-70/59 Improved High Pressure Turbine Active Clearance Control System. [for specific fuel consumption improvement

NASA Technical Reports Server (NTRS)

Gaffin, W. O.

1979-01-01

The JT9D-70/59 high pressure turbine active clearance control system was modified to provide reduction of blade tip clearance when the system is activated during cruise operation. The modification increased the flow capacity and air impingement effectiveness of the cooling air manifold to augment turbine case shrinkage capability, and increased responsiveness of the airseal clearance to case shrinkage. The simulated altitude engine testing indicated a significant improvement in specific fuel consumption with the modified system. A 1000 cycle engine endurance test showed no unusual wear or performance deterioration effects on the engine or the clearance control system. Rig tests indicated that the air impingement and seal support configurations used in the engine tests are near optimum.

Autonomous learning in humanoid robotics through mental imagery.

PubMed

Di Nuovo, Alessandro G; Marocco, Davide; Di Nuovo, Santo; Cangelosi, Angelo

2013-05-01

In this paper we focus on modeling autonomous learning to improve performance of a humanoid robot through a modular artificial neural networks architecture. A model of a neural controller is presented, which allows a humanoid robot iCub to autonomously improve its sensorimotor skills. This is achieved by endowing the neural controller with a secondary neural system that, by exploiting the sensorimotor skills already acquired by the robot, is able to generate additional imaginary examples that can be used by the controller itself to improve the performance through a simulated mental training. Results and analysis presented in the paper provide evidence of the viability of the approach proposed and help to clarify the rational behind the chosen model and its implementation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Energy efficient model based algorithm for control of building HVAC systems.

PubMed

Kirubakaran, V; Sahu, Chinmay; Radhakrishnan, T K; Sivakumaran, N

2015-11-01

Energy efficient designs are receiving increasing attention in various fields of engineering. Heating ventilation and air conditioning (HVAC) control system designs involve improved energy usage with an acceptable relaxation in thermal comfort. In this paper, real time data from a building HVAC system provided by BuildingLAB is considered. A resistor-capacitor (RC) framework for representing thermal dynamics of the building is estimated using particle swarm optimization (PSO) algorithm. With objective costs as thermal comfort (deviation of room temperature from required temperature) and energy measure (Ecm) explicit MPC design for this building model is executed based on its state space representation of the supply water temperature (input)/room temperature (output) dynamics. The controllers are subjected to servo tracking and external disturbance (ambient temperature) is provided from the real time data during closed loop control. The control strategies are ported on a PIC32mx series microcontroller platform. The building model is implemented in MATLAB and hardware in loop (HIL) testing of the strategies is executed over a USB port. Results indicate that compared to traditional proportional integral (PI) controllers, the explicit MPC's improve both energy efficiency and thermal comfort significantly. Copyright © 2015 Elsevier Inc. All rights reserved.

Recent activities within the Aeroservoelasticity Branch at the NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Noll, Thomas E.; Perry, Boyd, III; Gilbert, Michael G.

1989-01-01

The objective of research in aeroservoelasticity at the NASA Langley Research Center is to enhance the modeling, analysis, and multidisciplinary design methodologies for obtaining multifunction digital control systems for application to flexible flight vehicles. Recent accomplishments are discussed, and a status report on current activities within the Aeroservoelasticity Branch is presented. In the area of modeling, improvements to the Minimum-State Method of approximating unsteady aerodynamics are shown to provide precise, low-order aeroservoelastic models for design and simulation activities. Analytical methods based on Matched Filter Theory and Random Process Theory to provide efficient and direct predictions of the critical gust profile and the time-correlated gust loads for linear structural design considerations are also discussed. Two research projects leading towards improved design methodology are summarized. The first program is developing an integrated structure/control design capability based on hierarchical problem decomposition, multilevel optimization and analytical sensitivities. The second program provides procedures for obtaining low-order, robust digital control laws for aeroelastic applications. In terms of methodology validation and application the current activities associated with the Active Flexible Wing project are reviewed.

Design and characterization of a torque-controllable actuator for knee assistance during sit-to-stand.

PubMed

Shepherd, Max K; Rouse, Elliott J

2016-08-01

Individuals with post-stroke hemiparesis often have difficulty standing out of a chair. One way to potentially improve sit-to-stand is to provide knee extension assistance using a powered knee exoskeleton. An exoskeleton providing unilateral, partial assistance during sit-to-stand would need to be torque-controllable. There are no knee exoskeletons on the market suitable for conducting experiments assisting stroke patients with sit-to-stand, so to enable such experiments a research device was developed. The purpose of this report is to present the design of a novel knee exoskeleton actuator that uses a fiberglass leaf spring in series to improve torque-controllability, and present a characterization of the actuator performance. The actuator is capable of the required torque and speed for sit-to-stand, has high bandwidth (25 Hz), low output impedance at low frequencies (<;0.5 Nm), and excellent torque tracking. An orthotic brace built upon this actuator will enable an in-depth study on the biomechanical effects of providing stroke subjects with knee extension assistance during sit-to-stand.

Assessing administrative costs of mental health and substance abuse services.

PubMed

Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

2004-05-01

Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

Literature Review and Meta-Analysis of Transcutaneous Electrical Nerve Stimulation in Treating Chronic Back Pain

PubMed Central

Wu, Lien-Chen; Weng, Pei-Wei; Chen, Chia-Hsien; Huang, Yi-You; Tsuang, Yang-Hwei; Chiang, Chang-Jung

2018-01-01

Background and Objectives This study is a meta-analysis of randomized controlled trials comparing the efficacy of transcutaneous electrical nerve stimulation (TENS) to a control and to other nerve stimulation therapies (NSTs) for the treatment of chronic back pain. Methods Citations were identified in MEDLINE, the Cochrane Library, Google Scholar, and ClinicalTrials.gov through June 2014 using the following keywords: nerve stimulation therapy, transcutaneous electrical nerve stimulation, back pain, chronic pain. Control treatments included sham, placebo, or medication only. Other NSTs included electroacupuncture, percutaneous electrical nerve stimulation, and percutaneous neuromodulation therapy. Results Twelve randomized controlled trials including 700 patients were included in the analysis. The efficacy of TENS was similar to that of control treatment for providing pain relief (standardized difference in means [SDM] = −0.20; 95% confidence interval [CI], −0.58 to 0.18; P = 0.293). Other types of NSTs were more effective than TENS in providing pain relief (SDM = 0.86; 95% CI, 0.15–1.57; P = 0.017). Transcutaneous electrical nerve stimulation was more effective than control treatment in improving functional disability only in patients with follow-up of less than 6 weeks (SDM = −1.24; 95% CI, −1.83 to −0.65; P < 0.001). There was no difference in functional disability outcomes between TENS and other NSTs. Conclusions These results suggest that TENS does not improve symptoms of lower back pain, but may offer short-term improvement of functional disability. PMID:29394211

"They're younger… it's harder." Primary providers' perspectives on hypertension management in young adults: a multicenter qualitative study.

PubMed

Johnson, Heather M; Warner, Ryan C; Bartels, Christie M; LaMantia, Jamie N

2017-01-03

Young adults (18-39 year-olds) have the lowest hypertension control rates among adults with hypertension in the United States. Unique barriers to hypertension management in young adults with primary care access compared to older adults have not been evaluated. Understanding these differences will inform the development of hypertension interventions tailored to young adults. The goals of this multicenter study were to explore primary care providers' perspectives on barriers to diagnosing, treating, and controlling hypertension among young adults with regular primary care. Primary care providers (physicians and advanced practice providers) actively managing young adults with uncontrolled hypertension were recruited by the Wisconsin Research & Education Network (WREN), a statewide practice-based research network. Semi-structured qualitative interviews were conducted in three diverse Midwestern clinical practices (academic, rural, and urban clinics) using a semi-structured interview guide, and content analysis was performed. Primary care providers identified unique barriers across standard hypertension healthcare delivery practices for young adults. Altered self-identity, greater blood pressure variability, and unintended consequences of medication initiation were critical hypertension control barriers among young adults. Gender differences among young adults were also noted as barriers to hypertension follow-up and antihypertensive medication initiation. Tailored interventions addressing the unique barriers of young adults are needed to improve population hypertension control. Augmenting traditional clinic structure to support the "health identity" of young adults and self-management skills are promising next steps to improve hypertension healthcare delivery.

The combined action of a passive exoskeleton and an EMG-controlled neuroprosthesis for upper limb stroke rehabilitation: First results of the RETRAINER project.

PubMed

Ambrosini, E; Ferrante, S; Zajc, J; Bulgheroni, M; Baccinelli, W; d'Amico, E; Schauer, T; Wiesener, C; Russold, M; Gfoehler, M; Puchinger, M; Weber, M; Becker, S; Krakow, K; Rossini, M; Proserpio, D; Gasperini, G; Molteni, F; Ferrigno, G; Pedrocchi, A

2017-07-01

The combined use of Functional Electrical Stimulation (FES) and robotic technologies is advocated to improve rehabilitation outcomes after stroke. This work describes an arm rehabilitation system developed within the European project RETRAINER. The system consists of a passive 4-degrees-of-freedom exoskeleton equipped with springs to provide gravity compensation and electromagnetic brakes to hold target positions. FES is integrated in the system to provide additional support to the most impaired muscles. FES is triggered based on the volitional EMG signal of the same stimulated muscle; in order to encourage the active involvement of the patient the volitional EMG is also monitored throughout the task execution and based on it a happy or sad emoji is visualized at the end of each task. The control interface control of the system provides a GUI and multiple software tools to organize rehabilitation exercises and monitor rehabilitation progress. The functionality and the usability of the system was evaluated on four stroke patients. All patients were able to use the system and judged positively its wearability and the provided support. They were able to trigger the stimulation based on their residual muscle activity and provided different levels of active involvement in the exercise, in agreement with their level of impairment. A randomized controlled trial aimed at evaluating the effectiveness of the RETRAINER system to improve arm function after stroke is currently ongoing.

Improving Physical Task Performance with Counterfactual and Prefactual Thinking

PubMed Central

Hammell, Cecilia; Chan, Amy Y. C.

2016-01-01

Counterfactual thinking (reflecting on “what might have been”) has been shown to enhance future performance by translating information about past mistakes into plans for future action. Prefactual thinking (imagining “what might be if…”) may serve a greater preparative function than counterfactual thinking as it is future-orientated and focuses on more controllable features, thus providing a practical script to prime future behaviour. However, whether or not this difference in hypothetical thought content may translate into a difference in actual task performance has been largely unexamined. In Experiment 1 (n = 42), participants performed trials of a computer-simulated physical task, in between which they engaged in either task-related hypothetical thinking (counterfactual or prefactual) or an unrelated filler task (control). As hypothesised, prefactuals contained more controllable features than counterfactuals. Moreover, participants who engaged in either form of hypothetical thinking improved significantly in task performance over trials compared to participants in the control group. The difference in thought content between counterfactuals and prefactuals, however, did not yield a significant difference in performance improvement. Experiment 2 (n = 42) replicated these findings in a dynamic balance task environment. Together, these findings provide further evidence for the preparatory function of counterfactuals, and demonstrate that prefactuals share this same functional characteristic. PMID:27942041

Understanding the Components of Quality Improvement Collaboratives: A Systematic Literature Review

PubMed Central

Nadeem, Erum; Olin, S Serene; Hill, Laura Campbell; Hoagwood, Kimberly Eaton; Horwitz, Sarah McCue

2013-01-01

Context In response to national efforts to improve quality of care, policymakers and health care leaders have increasingly turned to quality improvement collaboratives (QICs) as an efficient approach to improving provider practices and patient outcomes through the dissemination of evidence-based practices. This article presents findings from a systematic review of the literature on QICs, focusing on the identification of common components of QICs in health care and exploring, when possible, relations between QIC components and outcomes at the patient or provider level. Methods A systematic search of five major health care databases generated 294 unique articles, twenty-four of which met our criteria for inclusion in our final analysis. These articles pertained to either randomized controlled trials or quasi-experimental studies with comparison groups, and they reported the findings from twenty different studies of QICs in health care. We coded the articles to identify the components reported for each collaborative. Findings We found fourteen crosscutting components as common ingredients in health care QICs (e.g., in-person learning sessions, phone meetings, data reporting, leadership involvement, and training in QI methods). The collaboratives reported included, on average, six to seven of these components. The most common were in-person learning sessions, plan-do-study-act (PDSA) cycles, multidisciplinary QI teams, and data collection for QI. The outcomes data from these studies indicate the greatest impact of QICs at the provider level; patient-level findings were less robust. Conclusions Reporting on specific components of the collaborative was imprecise across articles, rendering it impossible to identify active QIC ingredients linked to improved care. Although QICs appear to have some promise in improving the process of care, there is great need for further controlled research examining the core components of these collaboratives related to patient- and provider-level outcomes. PMID:23758514

Comparative Effectiveness of Plantar-Massage Techniques on Postural Control in Those With Chronic Ankle Instability.

PubMed

Wikstrom, Erik A; Song, Kyeongtak; Lea, Ashley; Brown, Nastassia

2017-07-01

  One of the major concerns after an acute lateral ankle sprain is the potential for development of chronic ankle instability (CAI). The existing research has determined that clinician-delivered plantar massage improves postural control in those with CAI. However, the effectiveness of self-administered treatments and the underlying cause of any improvements remain unclear.   To determine (1) the effectiveness of a self-administered plantar-massage treatment in those with CAI and (2) whether the postural-control improvements were due to the stimulation of the plantar cutaneous receptors.   Crossover study.   University setting.   A total of 20 physically active individuals (6 men and 14 women) with self-reported CAI.   All participants completed 3 test sessions involving 3 treatments: a clinician-delivered manual plantar massage, a patient-delivered self-massage with a ball, and a clinician-delivered sensory brush massage.   Postural control was assessed using single-legged balance with eyes open and the Star Excursion Balance Test.   Static postural control improved (P ≤ .014) after each of the interventions. However, no changes in dynamic postural control after any of the interventions were observed (P > .05). No differences were observed between a clinician-delivered manual plantar massage and either a patient-delivered self-massage with a ball or a clinician-delivered sensory brush massage in any postural-control outcome.   In those with CAI, single 5-minute sessions of traditional plantar massage, self-administered massage, and sensory brush massage each resulted in comparable static postural-control improvements. The results also provide empirical evidence suggesting that the mechanism for the postural-control improvements is the stimulation of the plantar cutaneous receptors.

A Mixed-Methods Research Framework for Healthcare Process Improvement.

PubMed

Bastian, Nathaniel D; Munoz, David; Ventura, Marta

2016-01-01

The healthcare system in the United States is spiraling out of control due to ever-increasing costs without significant improvements in quality, access to care, satisfaction, and efficiency. Efficient workflow is paramount to improving healthcare value while maintaining the utmost standards of patient care and provider satisfaction in high stress environments. This article provides healthcare managers and quality engineers with a practical healthcare process improvement framework to assess, measure and improve clinical workflow processes. The proposed mixed-methods research framework integrates qualitative and quantitative tools to foster the improvement of processes and workflow in a systematic way. The framework consists of three distinct phases: 1) stakeholder analysis, 2a) survey design, 2b) time-motion study, and 3) process improvement. The proposed framework is applied to the pediatric intensive care unit of the Penn State Hershey Children's Hospital. The implementation of this methodology led to identification and categorization of different workflow tasks and activities into both value-added and non-value added in an effort to provide more valuable and higher quality patient care. Based upon the lessons learned from the case study, the three-phase methodology provides a better, broader, leaner, and holistic assessment of clinical workflow. The proposed framework can be implemented in various healthcare settings to support continuous improvement efforts in which complexity is a daily element that impacts workflow. We proffer a general methodology for process improvement in a healthcare setting, providing decision makers and stakeholders with a useful framework to help their organizations improve efficiency. Published by Elsevier Inc.

Improving adaptive/responsive signal control performance : implications of non-invasive detection and legacy timing practices : final report.

DOT National Transportation Integrated Search

2017-02-01

This project collected and analyzed event based vehicle detection data from multiple technologies at four different sites across Oregon to provide guidance for deployment of non-invasive detection for use in adaptive control, as well as develop a tru...

77 FR 25484 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-30

... Prevention (D provides national leadership and support for capacity building assistance (CBA) to help improve... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [60Day-12-12IN... on proposed data collection projects, the Centers for Disease Control and Prevention (CDC) will...

Robotic Thumb Assembly

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor); Goza, S. Michael (Inventor)

2013-01-01

An improved robotic thumb for a robotic hand assembly is provided. According to one aspect of the disclosure, improved tendon routing in the robotic thumb provides control of four degrees of freedom with only five tendons. According to another aspect of the disclosure, one of the five degrees of freedom of a human thumb is replaced in the robotic thumb with a permanent twist in the shape of a phalange. According to yet another aspect of the disclosure, a position sensor includes a magnet having two portions shaped as circle segments with different center points. The magnet provides a linearized output from a Hall effect sensor.

Effect of Extended State Observer and Automatic Voltage Regulator on Synchronous Machine Connected to Infinite Bus Power System

NASA Astrophysics Data System (ADS)

Angu, Rittu; Mehta, R. K.

2018-04-01

This paper presents a robust controller known as Extended State Observer (ESO) in order to improve the stability and voltage regulation of a synchronous machine connected to an infinite bus power system through a transmission line. The ESO-based control scheme is implemented with an automatic voltage regulator in conjunction with an excitation system to enhance the damping of low frequency power system oscillations, as the Power System Stabilizer (PSS) does. The implementation of PSS excitation control techniques however requires reliable information about the entire states, though they are not always directly measureable. To address this issue, the proposed ESO provides the estimate of system states as well as disturbance state together in order to improve not only the damping but also compensates system efficiently in presence of parameter uncertainties and external disturbances. The Closed-Loop Poles (CLPs) of the system have been assigned by the symmetric root locus technique, with the desired level of system damping provided by the dominant CLPs. The performance of the system is analyzed through simulating at different operating conditions. The control method is not only capable of providing zero estimation error in steady-state, but also shows robustness in tracking the reference command under parametric variations and external disturbances. Illustrative examples have been provided to demonstrate the effectiveness of the developed methodology.

Misoprostol in the treatment of tinnitus: a double-blind study.

PubMed

Yilmaz, Ismail; Akkuzu, Babür; Cakmak, Ozcan; Ozlüoglu, Levent N

2004-05-01

To test the efficacy of misoprostol as a treatment for tinnitus. A prospective, placebo-controlled, double-blind study. Başkent University Otolaryngology Clinic. Forty adult patients who had had tinnitus for a minimum of 6 months and were free of systemic or otolaryngologic disease. Twenty-eight patients were randomly assigned to the experimental group (group I) and 12 to the control group (group II). The respective groups received active drug and placebo in increasing doses for 4 months. The effect of medications on tinnitus were evaluated by determining improvement rates in tinnitus loudness and subjective tinnitus scoring. In the experimental group, 18 of 28 patients showed improvement in tinnitus loudness, representing an improvement rate of 64%. The improvement rate based on subjective tinnitus scoring was 36% (10 of 28 patients). In the control group, the improvement rate for tinnitus loudness was 33% (n = 4), and the rate for subjective tinnitus scoring was 17% (n = 2). The difference between improvement rate for tinnitus loudness of the experimental group and control group was found to be statistically significant (P = 0.039), but difference between improvement rate based on subjective tinnitus scoring was insignificant (P = 0.119). When results in the experimental group were analyzed according to etiological factors, the improvement rate was highest in the sudden-onset subgroup (77%). Misoprostol provided therapeutic relief for some patients with tinnitus we studied, but further investigation of larger groups is needed.

Safety-factor profile tailoring by improved electron cyclotron system for sawtooth control and reverse shear scenarios in ITER

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

Zucca, C.; Sauter, O.; Fable, E.

2008-11-01

The effect of the predicted local electron cyclotron current driven by the optimized electron cyclotron system on ITER is discussed. A design variant was recently proposed to enlarge the physics program covered by the upper and equatorial launchers. By extending the functionality range of the upper launcher, significant control capabilities of the sawtooth period can be obtained. The upper launcher improvement still allows enough margin to exceed the requirements for neoclassical tearing mode stabilization, for which it was originally designed. The analysis of the sawtooth control is carried on with the ASTRA transport code, coupled with the threshold model bymore » Por-celli, to study the control capabilities of the improved upper launcher on the sawtooth instability. The simulations take into account the significant stabilizing effect of the fusion alpha particles. The sawtooth period can be increased by a factor of 1.5 with co-ECCD outside the q = 1 surface, and decreased by at least 30% with co-ECCD inside q = 1. The present ITER base-line design has the electron cyclotron launchers providing only co-ECCD. The variant for the equatorial launcher proposes the possibility to drive counter-ECCD with 1 of the 3 rows of mirrors: the counter-ECCD can then be balanced with co-ECCD and provide pure ECH with no net driven current. The difference between full co-ECCD off-axis using all 20MW from the equatorial launcher and 20MW co-ECCD driven by 2/3 from the equatorial launcher and 1/3 from the upper launcher is shown to be negligible. Cnt-ECCD also offers greater control of the plasma current density, therefore this analysis addresses the performance of the equatorial launcher to control the central q profile. The equatorial launcher is shown to control very efficiently the value of q{sub 0.2}-q{sub min} in advanced scenarios, if one row provides counter-ECCD.« less

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - The Pegasus launch vehicle is moved back to its hangar at Vandenberg Air Force Base, Calif. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - The Pegasus launch vehicle is moved back to its hangar at Vandenberg Air Force Base, Calif. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is revealed after being uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is revealed after being uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - Workers at Vandenberg Air Force Base, Calif., prepare to move the SciSat-1 spacecraft. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

KENNEDY SPACE CENTER, FLA. - Workers at Vandenberg Air Force Base, Calif., prepare to move the SciSat-1 spacecraft. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved into its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved into its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Interface evaluation for soft robotic manipulators

NASA Astrophysics Data System (ADS)

Moore, Kristin S.; Rodes, William M.; Csencsits, Matthew A.; Kwoka, Martha J.; Gomer, Joshua A.; Pagano, Christopher C.

2006-05-01

The results of two usability experiments evaluating an interface for the operation of OctArm, a biologically inspired robotic arm modeled after an octopus tentacle, are reported. Due to the many degrees-of-freedom (DOF) for the operator to control, such 'continuum' robotic limbs provide unique challenges for human operators because they do not map intuitively. Two modes have been developed to control the arm and reduce the DOF under the explicit direction of the operator. In coupled velocity (CV) mode, a joystick controls changes in arm curvature. In end-effector (EE) mode, a joystick controls the arm by moving the position of an endpoint along a straight line. In Experiment 1, participants used the two modes to grasp objects placed at different locations in a virtual reality modeling language (VRML). Objective measures of performance and subjective preferences were recorded. Results revealed lower grasp times and a subjective preference for the CV mode. Recommendations for improving the interface included providing additional feedback and implementation of an error recovery function. In Experiment 2, only the CV mode was tested with improved training of participants and several changes to the interface. The error recovery function was implemented, allowing participants to reverse through previously attained positions. The mean time to complete the trials in the second usability test was reduced by more than 4 minutes compared with the first usability test, confirming the interface changes improved performance. The results of these tests will be incorporated into future versions of the arm and improve future usability tests.

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

PubMed Central

Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia

2017-01-01

Purpose of Review The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent Findings Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Summary Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies. PMID:28567711

Health management and controls for earth to orbit propulsion systems

NASA Technical Reports Server (NTRS)

Bickford, R. L.

1992-01-01

Fault detection and isolation for advanced rocket engine controllers are discussed focusing on advanced sensing systems and software which significantly improve component failure detection for engine safety and health management. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Health management systems provide high levels of automated fault coverage and significantly improve vehicle delivered reliability and lower preflight operations costs. Key technologies, including the sensor data validation algorithms and flight capable spectrometers, have been demonstrated in ground applications and are found to be suitable for bridging programs into flight applications.

Improving Decision Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial

PubMed Central

Hanson, Laura C.; Carey, Timothy S.; Caprio, Anthony J.; Lee, Tae Joon; Ersek, Mary; Garrett, Joanne; Jackman, Anne; Gilliam, Robin; Wessell, Kathryn; Mitchell, Susan L.

2011-01-01

Background Feeding problems are common in dementia, and decision-makers have limited understanding of treatment options. Objectives To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. Design Cluster randomized controlled trial. Setting 24 nursing homes in North Carolina Participants Residents with advanced dementia and feeding problems and their surrogates. Intervention Intervention surrogates received an audio or print decision aid on feeding options in advanced dementia. Controls received usual care. Measurements Primary outcome was the Decisional Conflict Scale (range 1–5) measured at 3 months; other main outcomes were surrogate knowledge, frequency of communication with providers, and feeding treatment use. Results 256 residents and surrogate decision-makers were recruited. Residents’ average age was 85; 67% were Caucasian and 79% were women. Surrogates’ average age was 59; 67% were Caucasian, and 70% were residents’ children. The intervention improved knowledge scores (16.8 vs 15.1, p<0.001). After 3 months, intervention surrogates had lower Decisional Conflict Scale scores than controls (1.65 vs. 1.90, p<0.001) and more often discussed feeding options with a health care provider (46% vs. 33%, p=0.04). Residents in the intervention group were more likely to receive a dysphagia diet (89% vs.76%, p=0.04), and showed a trend toward increased staff eating assistance (20% vs.10%, p=0.08). Tube feeding was rare in both groups even after 9 months (1 intervention vs. 3 control, p=0.34). Limitations Cluster randomization was necessary to avoid contamination, but limits blinding and may introduce bias by site effect. Conclusion A decision aid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers. PMID:22091750

Study protocol: The Technology-Enhanced Coaching (TEC) program to improve diabetes outcomes – A randomized controlled trial

PubMed Central

Heisler, Michele; Mase, Rebecca; Brown, Brianne; Wilson, Shayla; Reeves, Pamela J.

2017-01-01

Background Racial and ethnic minority adults with diabetes living in under-resourced communities face multiple barriers to sustaining self-management behaviors necessary to improve diabetes outcomes. Peer support and decision support tools each have been associated with improved diabetes outcomes. Methods 289 primarily African American adults with poor glycemic control will be recruited from the Detroit Veteran’s Administration Hospital and randomized to Technology-Enhanced Coaching (TEC) or Peer Coaching alone. Participants in both arms will be assigned a peer coach trained in autonomy-supportive approaches. Coaches are diabetes patients with prior poor glycemic control who now have good control. All participants meet face-to-face initially with their coach to review diabetes education materials and develop an action plan. Educational materials in the TEC arm are delivered via a web-based, educational tool tailored with each participant’s personalized health data (iDecide). Over the next six months, Coaches call their assigned participants once a week to provide support for weekly action steps. Data are also collected on an Observational Control group with no contact with study staff. Changes in A1c, blood pressure, other patient-centered outcomes and mediators and moderators of intervention effects will be assessed. Discussion Tailored e-Health tools with educational content may enhance the effectiveness of peer coaching programs to better prepare patients to set self-management goals, identify action plans, and discuss treatment options with their health care providers. The study will provide insights for scalable self-management support programs for diabetes and chronic illnesses that require high levels of sustained patient self-management. PMID:28132876

Robust lateral blended-wing-body aircraft feedback control design using a parameterized LFR model and DGK-iteration

NASA Astrophysics Data System (ADS)

Schirrer, A.; Westermayer, C.; Hemedi, M.; Kozek, M.

2013-12-01

This paper shows control design results, performance, and limitations of robust lateral control law designs based on the DGK-iteration mixed-μ-synthesis procedure for a large, flexible blended wing body (BWB) passenger aircraft. The aircraft dynamics is preshaped by a low-complexity inner loop control law providing stabilization, basic response shaping, and flexible mode damping. The μ controllers are designed to further improve vibration damping of the main flexible modes by exploiting the structure of the arising significant parameter-dependent plant variations. This is achieved by utilizing parameterized Linear Fractional Representations (LFR) of the aircraft rigid and flexible dynamics. Designs with various levels of LFR complexity are carried out and discussed, showing the achieved performance improvement over the initial controller and their robustness and complexity properties.

Westinghouse Hanford Company health and safety performance report. Fourth quarter calendar year 1994

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

Lansing, K.A.

1995-03-01

Detailed information pertaining to As Low As Reasonably Achievable/Contamination Control Improvement Project (ALARA/CCIP) activities are outlined. Improved commitment to the WHC ALARA/CCIP Program was experienced throughout FY 1994. During CY 1994, 17 of 19 sitewide ALARA performance goals were completed on or ahead of schedule. Estimated total exposure by facility for CY 1994 is listed in tables by organization code for each dosimeter frequency. Facilities/areas continue to utilize the capabilities of the RPR tracking system in conjunction with the present site management action-tracking system to manage deficiencies, trend performance, and develop improved preventive efforts. Detailed information pertaining to occupational injuries/illnessesmore » are provided. The Industrial Safety and Hygiene programs are described which have generated several key initiatives that are believed responsible for improved safety performance. A breakdown of CY 1994 occupational injuries/illnesses by type, affected body group, cause, job type, age/gender, and facility is provided. The contributing experience of each WHC division/department in attaining this significant improvement is described along with tables charting specific trends. The Radiological Control Program is on schedule to meet all RL Site Management System milestones and program commitments.« less

The aerodynamics of some guided projectiles

NASA Technical Reports Server (NTRS)

Spearman, M. L.

1984-01-01

Some characteristic projectile shapes are considered with various added components intended to provide lift, stability, and control. The intent of the additions is to provide some means for altering the normal ballistic flight path of a projectile for various purposes such as: achieving greater accuracy at the impact point, selecting alternate impact points, extending range, improved evasion, and so on. The configurations presented illustrate the effects of a flare, wings, and tails for providing stability and lift, and the effects of aft-tails, a close-coupled flap, and all-moving forward wings for control. The relative merits of the various configurations, all of which provided for flight path alterations are discussed.

The aerodynamics of some guided projectiles

NASA Technical Reports Server (NTRS)

Spearman, M. L.

1984-01-01

Some characteristic projectile shapes are considered with various added components intended to provide lift, stability, and control. The intent of the additions is to provide some means for altering the normal ballistic flight path of a projectile for various purposes such as: achieving greater accuracy at the impact point, selecting alternate impact points, extending range, improved evasion, and so on. The configurations presented illustrate the effects of a flare, wings, and tails for providing stability and lift, and the effects of aft-tails, a close-coupled flap, and all-moving forward wings for control. The relative merits of the various configurations, all of which provided for flight path alterations, are discussed.

Advanced process control framework initiative

NASA Astrophysics Data System (ADS)

Hill, Tom; Nettles, Steve

1997-01-01

The semiconductor industry, one the world's most fiercely competitive industries, is driven by increasingly complex process technologies and global competition to improve cycle time, quality, and process flexibility. Due to the complexity of these problems, current process control techniques are generally nonautomated, time-consuming, reactive, nonadaptive, and focused on individual fabrication tools and processes. As the semiconductor industry moves into higher density processes, radical new approaches are required. To address the need for advanced factory-level process control in this environment, Honeywell, Advanced Micro Devices (AMD), and SEMATECH formed the Advanced Process Control Framework Initiative (APCFI) joint research project. The project defines and demonstrates an Advanced Process Control (APC) approach based on SEMATECH's Computer Integrated Manufacturing (CIM) Framework. Its scope includes the coordination of Manufacturing Execution Systems, process control tools, and wafer fabrication equipment to provide necessary process control capabilities. Moreover, it takes advantage of the CIM Framework to integrate and coordinate applications from other suppliers that provide services necessary for the overall system to function. This presentation discusses the key concept of model-based process control that differentiates the APC Framework. This major improvement over current methods enables new systematic process control by linking the knowledge of key process settings to desired product characteristics that reside in models created with commercial model development tools The unique framework-based approach facilitates integration of commercial tools and reuse of their data by tying them together in an object-based structure. The presentation also explores the perspective of each organization's involvement in the APCFI project. Each has complementary goals and expertise to contribute; Honeywell represents the supplier viewpoint, AMD represents the user with 'real customer requirements', and SEMATECH provides a consensus-building organization that widely disseminates technology to suppliers and users in the semiconductor industry that face similar equipment and factory control systems challenges.

Energy efficiency technologies in cement and steel industry

NASA Astrophysics Data System (ADS)

Zanoli, Silvia Maria; Cocchioni, Francesco; Pepe, Crescenzo

2018-02-01

In this paper, Advanced Process Control strategies aimed at energy efficiency achievement and improvement in cement and steel industry are proposed. A flexible and smart control structure constituted by several functional modules and blocks has been developed. The designed control strategy is based on Model Predictive Control techniques, formulated on linear models. Two industrial control solutions have been developed, oriented to energy efficiency and process control improvement in cement industry clinker rotary kilns (clinker production phase) and in steel industry billets reheating furnaces. Tailored customization procedures for the design of ad hoc control systems have been executed, based on the specific needs and specifications of the analysed processes. The installation of the developed controllers on cement and steel plants produced significant benefits in terms of process control which resulted in working closer to the imposed operating limits. With respect to the previous control systems, based on local controllers and/or operators manual conduction, more profitable configurations of the crucial process variables have been provided.

Benefits and Sustainability of a Learning Collaborative for Implementation of Treat to Target in Rheumatoid Arthritis: Results of the TRACTION Trial Phase II.

PubMed

Solomon, Daniel H; Lu, Bing; Yu, Zhi; Corrigan, Cassandra; Harrold, Leslie R; Smolen, Josef S; Fraenkel, Liana; Katz, Jeffrey N; Losina, Elena

2018-01-05

We conducted a two-phase randomized controlled trial of a Learning Collaborative (LC) to facilitate implementation of treat to target (TTT) to manage rheumatoid arthritis (RA). We found substantial improvement in implementation of TTT in Phase I. Herein, we report on a second 9 months (Phase II) where we examined maintenance of response in Phase I and predictors of greater improvement in TTT adherence. We recruited 11 rheumatology sites and randomized them to either receive the LC during Phase I or to a wait-list control group that received the LC intervention during Phase II. The outcome was change in TTT implementation score (0 to 100, 100 is best) from pre- to post-intervention. TTT implementation score is defined as a percent of components documented in visit notes. Analyses examined: 1) the extent that the Phase I intervention teams sustained improvement in TTT; and, 2) predictors of TTT improvement. The analysis included 636 RA patients. At baseline, mean TTT implementation score was 11% in Phase I intervention sites and 13% in Phase II sites. After the intervention, TTT implementation score improved to 57% in the Phase I intervention sites and to 58% in the Phase II sites. Intervention sites from Phase I sustained the improvement during the Phase II (52%). Predictors of greater TTT improvement included only having rheumatologist providers at the site, academic affiliation of the site, fewer providers per site, and the rheumatologist provider being a trainee. Improvement in TTT remained relatively stable over a post-intervention period. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

78 FR 72860 - White River National Forest; Summit County, CO; 2013 Arapahoe Basin Improvements EIS

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... experience that A-Basin provides; improve access to Montezuma Bowl; upgrade or remove existing lifts, as... Gullies and one in Beaver Bowl. Currently, The Beavers can be accessed legally through backcountry access... exit the controlled/patrolled portions of A-Basin's operational boundary to access adjacent backcountry...

75 FR 18238 - United States Section; Final Environmental Impact Statement, Flood Control Improvements and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... engineering alternatives for long-term improvement of the Presidio FCP flood containment capacity. The EIS... Federal Register on February 26, 2010 for a 30-day wait period. Finding: Based on engineering, economic... existing levee and provide protection to the City of Presidio and adjacent agricultural areas from a 25...

A Comparison of Web Resource Access Experiments: Planning for the New Millennium.

ERIC Educational Resources Information Center

Greenberg, Jane

This paper reports on research that compared five leading experiments that aim to improve access to the growing number of information resources on the World Wide Web. The objective was to identify characteristics of success and considerations for improvement in experiments providing access to Web resources via bibliographic control methods. The…

Social Judgment Analysis: Methodology for Improving Interpersonal Communication and Understanding.

ERIC Educational Resources Information Center

Rohrbaugh, John; Harmon, Joel

Research has found the Social Judgment Analysis (SJA) approach, with its focus on judgment policy and cognitive feedback, to be a significant factor in developing group member agreement and improving member performance. A controlled experiment was designed to assess the relative quality of the judgment making process provided by SJA.…

77 FR 21541 - Notice of Submission for OMB Review; Office of Innovation and Improvement; Transition to Teaching...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Office of Innovation and Improvement; Transition to Teaching Evaluation SUMMARY: The Transition to Teaching (TTT) grant program provides five- year... records. Title of Collection: Transition to Teaching Evaluation. OMB Control Number: 1855-0018. Type of...

Performance seeking control program overview

NASA Technical Reports Server (NTRS)

Orme, John S.

1995-01-01

The Performance Seeking Control (PSC) program evolved from a series of integrated propulsion-flight control research programs flown at NASA Dryden Flight Research Center (DFRC) on an F-15. The first of these was the Digital Electronic Engine Control (DEEC) program and provided digital engine controls suitable for integration. The DEEC and digital electronic flight control system of the NASA F-15 were ideally suited for integrated controls research. The Advanced Engine Control System (ADECS) program proved that integrated engine and aircraft control could improve overall system performance. The objective of the PSC program was to advance the technology for a fully integrated propulsion flight control system. Whereas ADECS provided single variable control for an average engine, PSC controlled multiple propulsion system variables while adapting to the measured engine performance. PSC was developed as a model-based, adaptive control algorithm and included four optimization modes: minimum fuel flow at constant thrust, minimum turbine temperature at constant thrust, maximum thrust, and minimum thrust. Subsonic and supersonic flight testing were conducted at NASA Dryden covering the four PSC optimization modes and over the full throttle range. Flight testing of the PSC algorithm, conducted in a series of five flight test phases, has been concluded at NASA Dryden covering all four of the PSC optimization modes. Over a three year period and five flight test phases 72 research flights were conducted. The primary objective of flight testing was to exercise each PSC optimization mode and quantify the resulting performance improvements.

Infection control in the operating room: is it more than a clean dish?

PubMed

Loftus, Randy W

2016-04-01

Healthcare-associated infections (HCAIs) are driven by a complex interplay between host defenses, pathogen traits, and pathogen transmission. A better understanding of each of these factors is required to extend infection control beyond antibiotic therapy to improvements in basic preventive measures that can achieve sustained HCAI reductions. The purpose of this article is to review recent advancements in our understanding of these issues for the operating room environment. The importance and implications of intraoperative bacterial transmission have been solidified, and hyper transmissible, virulent, and antibiotic resistant bacterial strains have been characterized. As a result, a best practice for improved intraoperative infection control has been delineated. Little advancement has been made in our understanding of the efficacy of higher inspired oxygen concentrations, improved postoperative glucose control, perioperative normothermia, and prophylactic antibiotic selection, timing, and dose for HCAI prevention. Recent work has led to the development of evidence-based hand hygiene, environmental cleaning, patient decolonization, and intravascular catheter design and handling improvement strategies. Evidence suggests that a best practice for postoperative infection control is a multimodal program that utilizes these interventions to target patient, provider, and environmental reservoirs in parallel. The development of novel diagnostic tools for targeted attenuation of hyper virulent, transmissible and resistant strains/strain characteristics is indicated to improve patient decolonization efforts.

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

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

PubMed

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

2014-06-01

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

Simulation results of automatic restructurable flight control system concepts

NASA Technical Reports Server (NTRS)

Weiss, J. L.; Looze, D. P.; Eterno, J. S.; Ostroff, A.

1986-01-01

The restructurable flight control system (RFCS) described by Weiss et al. (1986) is reviewed, and several results of an extensive six degrees of freedom nonlinear simulation of several aspects of this system are reported. It is concluded that the nontraditional use of standard control surfaces in a nominal feedback control system to spread control authority among many redundant control elements provides a significant amount of fault tolerance without any use of restructuring techniques. The use of new feedback gains alone following a failure can provide significantly improved recovery as long as the control elements remain within their travel limits and as long as uncertainty about the failure identity is properly handled. The use of the feed-forward trim solution in conjunction with redesigned feedback gains allows recovery to take place even when significant control saturation occurs.

Repurposing historical control clinical trial data to provide safety context.

PubMed

Bhuyan, Prakash; Desai, Jigar; Louis, Matthew St; Carlsson, Martin; Bowen, Edward; Danielson, Mark; Cantor, Michael N

2016-02-01

Billions of dollars spent, millions of subject-hours of clinical trial experience and an abundance of archived study-level data, yet why are historical data underutilized? We propose that historical data can be aggregated to provide safety, background incidence rate and context to improve the evaluation of new medicinal products. Here, we describe the development and application of the eControls database, which is derived from the control arms of studies of licensed products, and discuss the challenges and potential solutions to the proper application of historical data to help interpret product safety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinical evaluation of a confocal microendoscope system for imaging the ovary

NASA Astrophysics Data System (ADS)

Tanbakuchi, Anthony A.; Rouse, Andrew R.; Hatch, Kenneth D.; Sampliner, Richard E.; Udovich, Josh A.; Gmitro, Arthur F.

2008-02-01

We have developed a mobile confocal microendoscope system that provides live cellular imaging during surgery to aid in diagnosing microscopic abnormalities including cancer. We present initial clinical trial results using the device to image ovaries in-vivo using fluorescein and ex-vivo results using acridine orange. The imaging catheter has improved depth control and localized dye delivery mechanisms than previously presented. A manual control now provides a simple way for the surgeon to adjust and optimize imaging depth during the procedure while a tiny piezo valve in the imaging catheter controls the dye delivery.

The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial.

PubMed

Ghorob, Amireh; Vivas, Maria Mercedes; De Vore, Diana; Ngo, Victoria; Bodenheimer, Thomas; Chen, Ellen; Thom, David H

2011-04-01

Although self-management support improves diabetes outcomes, it is not consistently provided in health care settings strained for time and resources. One proposed solution to personnel and funding shortages is to utilize peer coaches, patients trained to provide diabetes education and support to other patients. Coaches share similar experiences about living with diabetes and are able to reach patients within and beyond the health care setting. Given the limited body of evidence that demonstrates peer coaching significantly improves chronic disease care, this present study examines the impact of peer coaching delivered in a primary care setting on diabetes outcomes. The aim of this multicenter, randomized control trial is to evaluate the effectiveness of utilizing peer coaches to improve clinical outcomes and self-management skills in low-income patients with poorly controlled diabetes. A total of 400 patients from six primary health centers based in San Francisco that serve primarily low-income populations will be randomized to receive peer coaching (n = 200) or usual care (n = 200) over 6 months. Patients in the peer coach group receive coaching from patients with diabetes who are trained and mentored as peer coaches. The primary outcome is change in HbA1c. Secondary outcomes include change in: systolic blood pressure, body mass index (BMI), LDL cholesterol, diabetes self-care activities, medication adherence, diabetes-related quality of life, diabetes self-efficacy, and depression. Clinical values (HbA1c, LDL cholesterol and blood pressure) and self-reported diabetes self-efficacy and self-care activities are measured at baseline and after 6 months for patients and coaches. Peer coaches are also assessed at 12 months. Patients with diabetes, who are trained as peer health coaches, are uniquely poised to provide diabetes self management support and education to patients. This study is designed to investigate the impact of peer health coaching in patients with poorly controlled diabetes. Additionally, we will assess disease outcomes in patients with well controlled diabetes who are trained and work as peer health coaches. ClinicalTrials.gov identifier: NCT01040806.

Air-Breathing Hypersonic Vehicle Tracking Control Based on Adaptive Dynamic Programming.

PubMed

Mu, Chaoxu; Ni, Zhen; Sun, Changyin; He, Haibo

2017-03-01

In this paper, we propose a data-driven supplementary control approach with adaptive learning capability for air-breathing hypersonic vehicle tracking control based on action-dependent heuristic dynamic programming (ADHDP). The control action is generated by the combination of sliding mode control (SMC) and the ADHDP controller to track the desired velocity and the desired altitude. In particular, the ADHDP controller observes the differences between the actual velocity/altitude and the desired velocity/altitude, and then provides a supplementary control action accordingly. The ADHDP controller does not rely on the accurate mathematical model function and is data driven. Meanwhile, it is capable to adjust its parameters online over time under various working conditions, which is very suitable for hypersonic vehicle system with parameter uncertainties and disturbances. We verify the adaptive supplementary control approach versus the traditional SMC in the cruising flight, and provide three simulation studies to illustrate the improved performance with the proposed approach.

Continuous improvement and TQM in health care: an emerging operational paradigm becomes a strategic imperative.

PubMed

Swinehart, K; Green, R F

1995-01-01

Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health-care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health-care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health-care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

Evaluating an Art-Based Intervention to Improve Practicing Nurses' Observation, Description, and Problem Identification Skills.

PubMed

Nease, Beth M; Haney, Tina S

Astute observation, description, and problem identification skills provide the underpinning for nursing assessment, surveillance, and prevention of failure to rescue events. Art-based education has been effective in nursing schools for improving observation, description, and problem identification. The authors describe a randomized controlled pilot study testing the effectiveness of an art-based educational intervention aimed at improving these skills in practicing nurses.

Steric stabilization of nonaqueous silicon slips. I - Control of particle agglomeration and packing. II - Pressure casting of powder compacts

NASA Technical Reports Server (NTRS)

Kerkar, Awdhoot V.; Henderson, Robert J. M.; Feke, Donald L.

1990-01-01

The application of steric stabilization to control particle agglomeration and packing of silicon powder in benzene and trichloroethylene is reported. The results provide useful guidelines for controlling unfavorable particle-particle interactions during nonaqueous processing of silicon-based ceramic materials. The application of steric stabilization to the control and improvement of green processing of nonaqueous silicon slips in pressure consolidation is also demonstrated.

Motorized control for mirror mount apparatus

DOEpatents

Cutburth, Ronald W.

1989-01-01

A motorized control and automatic braking system for adjusting mirror mount apparatus is disclosed. The motor control includes a planetary gear arrangement to provide improved pitch adjustment capability while permitting a small packaged design. The motor control for mirror mount adjustment is suitable for laser beam propagation applications. The brake is a system of constant contact, floating detents which engage the planetary gear at selected between-teeth increments to stop rotation instantaneously when the drive motor stops.

Comparison of flight results with digital simulation for a digital electronic engine control in an F-15 airplane

NASA Technical Reports Server (NTRS)

Myers, L. P.; Burcham, F. W., Jr.

1983-01-01

Substantial benefits of a full authority digital electronic engine control on an air breathing engine were demonstrated repeatedly in simulation studies, ground engine tests, and engine altitude test facilities. A digital engine electronic control system showed improvements in efficiency, performance, and operation. An additional benefit of full authority digital controls is the capability of detecting and correcting failures and providing engine health diagnostics.

Predictive displays for a process-control schematic interface.

PubMed

Yin, Shanqing; Wickens, Christopher D; Helander, Martin; Laberge, Jason C

2015-02-01

Our objective was to examine the extent to which increasing precision of predictive (rate of change) information in process control will improve performance on a simulated process-control task. Predictive displays have been found to be useful in process control (as well as aviation and maritime industries). However, authors of prior research have not examined the extent to which predictive value is increased by increasing predictor resolution, nor has such research tied potential improvements to changes in process control strategy. Fifty nonprofessional participants each controlled a simulated chemical mixture process (honey mixer simulation) that simulated the operations found in process control. Participants in each of five groups controlled with either no predictor or a predictor ranging in the resolution of prediction of the process. Increasing detail resolution generally increased the benefit of prediction over the control condition although not monotonically so. The best overall performance, combining quality and predictive ability, was obtained by the display of intermediate resolution. The two displays with the lowest resolution were clearly inferior. Predictors with higher resolution are of value but may trade off enhanced sensitivity to variable change (lower-resolution discrete state predictor) with smoother control action (higher-resolution continuous predictors). The research provides guidelines to the process-control industry regarding displays that can most improve operator performance.

A cluster-randomized effectiveness trial of a physician-pharmacist collaborative model to improve blood pressure control.

PubMed

Carter, Barry L; Clarke, William; Ardery, Gail; Weber, Cynthia A; James, Paul A; Vander Weg, Mark; Chrischilles, Elizabeth A; Vaughn, Thomas; Egan, Brent M

2010-07-01

Numerous studies have demonstrated the value of team-based care to improve blood pressure (BP) control, but there is limited information on whether these models would be adopted in diverse populations. The purpose of this study was to evaluate whether a collaborative model between physicians and pharmacists can improve BP control in multiple primary care medical offices with diverse geographic and patient characteristics and whether long-term BP control can be sustained. This study is a randomized prospective trial in 27 primary care offices first stratified by the percentage of underrepresented minorities and the level of clinical pharmacy services within the office. Each office is then randomized to either a 9- or 24-month intervention or a control group. Patients will be enrolled in this study until 2012. The results of this study should provide information on whether this model can be implemented in large numbers of diverse offices, if it is effective in diverse populations, and whether BP control can be sustained long term. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00935077.

Interventions to improve child-parent-medical provider communication: A systematic review.

PubMed

Kodjebacheva, Gergana Damianova; Sabo, Tina; Xiong, Janet

2016-10-01

Research related to effective communication between children/parents and medical providers is limited. To review interventions seeking to improve communication between children/parents and medical providers. The inclusion criteria were interventions in peer-reviewed articles and dissertations in English. Because of the limited availability of pediatric communication research, no restrictions were placed on the year, design, and length of follow-up of the interventions. Out of 4163 articles in the CINAHL, Cochrane, EMBASE, ERIC, MEDLINE, and PsycINFO databases, 34 met the inclusion criteria. The design, strategies, measurement tools, results, and conflicts of interest of the interventions were reviewed. Most interventions were conducted in the United States, had a small sample size, and used a pre-posttest design. Fifteen were randomized controlled trials (RCTs). The most frequent intervention strategies were role-playing sessions and seminars for medical providers. Standardized children (i.e., fictitious child patients) were frequently used to help train physicians. Most interventions improved providers' interpersonal, patient-centered interviewing skills. Interventions that targeted parents involved booklets and role-playing to encourage questions. They improved parents' satisfaction and communication. An intervention that targeted youth used a video portraying how children can communicate better with physicians. Once the children aged 5-15 years watched the video, they wrote questions for their physicians prior to the medical visit. The experimental group of children had better rapport with physicians and could recall recommendations about medications more often than the control group. More RCTs involving children as active participants are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of a primary care intervention on physician practice and patient and family behavior: keep ME Healthy---the Maine Youth Overweight Collaborative.

PubMed

Polacsek, Michele; Orr, Joan; Letourneau, Lisa; Rogers, Victoria; Holmberg, Robert; O'Rourke, Karen; Hannon, Cindy; Lombard, Kenneth A; Gortmaker, Steven L

2009-06-01

To evaluate the effect of a pediatric primary care-based intervention, on improved clinical decision support and family management of risk behaviors for childhood overweight. An experimental field trial was conducted with 12 intervention sites in urban and rural areas of Maine and nonrandomized control sites. Change was assessed by using clinical and parent measures from 9 intervention and 10 control sites before and during the Maine Youth Overweight Collaborative intervention. Longitudinal information was collected from chart audits of patients aged 5-18 years (n = 600), systematic samples of parents collected before (n = 346) and during (n = 386) the intervention in 12 sites, and systematic samples of parents in 9 intervention (n = 235) and 10 control (n = 304) sites collected during the intervention. Surveys of health care providers (n = 14 and 17) before and during the intervention were also collected. Teams worked over 18 months to implement improvements in clinical decision support, including tracking BMI percentiles, identification of overweight patients, appropriate laboratory tests, counseling of families and patients use of a behavioral screening tool, and other improvements following the chronic-care model targeting patients aged 5 to 18 and their families. Large changes occurred in clinical practice from before to during the Maine Youth Overweight Collaborative: increases in assessment of BMI (38%-94%), BMI percentile for age and gender (25%-89%), use of the 5-2-1-0 behavioral screening tool (0%-82%), and weight classification (19%-75%). Parent surveys indicated improvements in providers' behavior and rates of counseling. Intervention providers reported improvements in knowledge, attitudes, self-efficacy, and practice. The Maine Youth Overweight Collaborative intervention improved clinical decision support and family management of risk behaviors, indicating a promising primary care-based approach to address overweight risk among children and youth.

Interactive training improves workplace climate, knowledge, and support towards domestic violence.

PubMed

Glass, Nancy; Hanson, Ginger C; Laharnar, Naima; Anger, W Kent; Perrin, Nancy

2016-07-01

As Intimate Partner Violence (IPV) affects the workplace, a supportive workplace climate is important. The study evaluated the effectiveness of an "IPV and the Workplace" training on workplace climate towards IPV. IPV training was provided to 14 intervention counties and 13 control counties (receiving training 6 months delayed). Measures included workplace climate surveys, IPV knowledge test, and workplace observations. (i) Training significantly improved supervisor knowledge on IPV and received positive evaluations, (ii) training improved workplace climate towards IPV significantly which was maintained over time, and (iii) after the training, supervisors provided more IPV information to employees and more IPV postings were available in the workplace. The study provides evidence to support on-site interactive, computer based training as a means for improved workplace safety. IPV and the Workplace training effectively increased knowledge and positively changed workplace climate. Am. J. Ind. Med. 59:538-548, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Development of an improved GTA (gas tungsten arc) weld temperature monitor fixture

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

Hollar, D.L.

1990-05-01

An initial design weld temperature control fixture was implemented into final closure of an electronic assembly in November 1986. Use of this fixture indicated several areas that could be improved. Review of these areas with the process engineer and the weld operator provided the ideas to be incorporated into the new design Phase 2 fixture. Some primary areas of change and improvement included fixture mobility to provide better accessibility to the weld joint area, automatic timed blow cooling of the weld joint, and a feature to assure proper thermocouple placement. The resulting Phase 2 fixture design provided all of themore » essential weld temperature monitoring features in addition to several significant improvements. Technology developed during this project will pave the way to similar process monitoring of other manual gas tungsten arc (GTA) welding applications. 9 figs.« less

Optimal Control Allocation with Load Sensor Feedback for Active Load Suppression, Experiment Development

NASA Technical Reports Server (NTRS)

Miller, Christopher J.; Goodrick, Dan

2017-01-01

The problem of control command and maneuver induced structural loads is an important aspect of any control system design. The aircraft structure and the control architecture must be designed to achieve desired piloted control responses while limiting the imparted structural loads. The classical approach is to utilize high structural margins, restrict control surface commands to a limited set of analyzed combinations, and train pilots to follow procedural maneuvering limitations. With recent advances in structural sensing and the continued desire to improve safety and vehicle fuel efficiency, it is both possible and desirable to develop control architectures that enable lighter vehicle weights while maintaining and improving protection against structural damage. An optimal control technique has been explored and shown to achieve desirable vehicle control performance while limiting sensed structural loads. The subject of this paper is the design of the optimal control architecture, and provides the reader with some techniques for tailoring the architecture, along with detailed simulation results.

A dissociation of objective and subjective workload measures in assessing the impact of speech controls in advanced helicopters

NASA Technical Reports Server (NTRS)

Vidulich, Michael A.; Bortolussi, Michael R.

1988-01-01

Among the new technologies that are expected to aid helicopter designers are speech controls. Proponents suggest that speech controls could reduce the potential for manual control overloads and improve time-sharing performance in environments that have heavy demands for manual control. This was tested in a simulation of an advanced single-pilot, scout/attack helicopter. Objective performance indicated that the speech controls were effective in decreasing the interference of discrete responses during moments of heavy flight control activity. However, subjective ratings indicated that the use of speech controls required extra effort to speak precisely and to attend to feedback. Although the operational reliability of speech controls must be improved, the present results indicate that reliable speech controls could enhance the time-sharing efficiency of helicopter pilots. Furthermore, the results demonstrated the importance of using multiple assessment techniques to completely assess a task. Neither the objective nor the subjective measures alone provided complete information. It was the contrast between the measures that was most informative.

NASA Workshop on Distributed Parameter Modeling and Control of Flexible Aerospace Systems

NASA Technical Reports Server (NTRS)

Marks, Virginia B. (Compiler); Keckler, Claude R. (Compiler)

1994-01-01

Although significant advances have been made in modeling and controlling flexible systems, there remains a need for improvements in model accuracy and in control performance. The finite element models of flexible systems are unduly complex and are almost intractable to optimum parameter estimation for refinement using experimental data. Distributed parameter or continuum modeling offers some advantages and some challenges in both modeling and control. Continuum models often result in a significantly reduced number of model parameters, thereby enabling optimum parameter estimation. The dynamic equations of motion of continuum models provide the advantage of allowing the embedding of the control system dynamics, thus forming a complete set of system dynamics. There is also increased insight provided by the continuum model approach.

[An object-oriented intelligent engineering design approach for lake pollution control].

PubMed

Zou, Rui; Zhou, Jing; Liu, Yong; Zhu, Xiang; Zhao, Lei; Yang, Ping-Jian; Guo, Huai-Cheng

2013-03-01

Regarding the shortage and deficiency of traditional lake pollution control engineering techniques, a new lake pollution control engineering approach was proposed in this study, based on object-oriented intelligent design (OOID) from the perspective of intelligence. It can provide a new methodology and framework for effectively controlling lake pollution and improving water quality. The differences between the traditional engineering techniques and the OOID approach were compared. The key points for OOID were described as object perspective, cause and effect foundation, set points into surface, and temporal and spatial optimization. The blue algae control in lake was taken as an example in this study. The effect of algae control and water quality improvement were analyzed in details from the perspective of object-oriented intelligent design based on two engineering techniques (vertical hydrodynamic mixer and pumping algaecide recharge). The modeling results showed that the traditional engineering design paradigm cannot provide scientific and effective guidance for engineering design and decision-making regarding lake pollution. Intelligent design approach is based on the object perspective and quantitative causal analysis in this case. This approach identified that the efficiency of mixers was much higher than pumps in achieving the goal of low to moderate water quality improvement. However, when the objective of water quality exceeded a certain value (such as the control objective of peak Chla concentration exceeded 100 microg x L(-1) in this experimental water), the mixer cannot achieve this goal. The pump technique can achieve the goal but with higher cost. The efficiency of combining the two techniques was higher than using one of the two techniques alone. Moreover, the quantitative scale control of the two engineering techniques has a significant impact on the actual project benefits and costs.

Improved Electronic Control for Electrostatic Precipitators

NASA Technical Reports Server (NTRS)

Johnston, D. F.

1986-01-01

Electrostatic precipitators remove particulate matter from smoke created by burning refuse. Smoke exposed to electrostatic field, and particles become electrically charged and migrate to electrically charged collecting surfaces. New microprocessor-based electronic control maintains precipitator power at maximum particulate-collection level. Control automatically senses changes in smoke composition due to variations in fuel or combustion and adjusts precipitator voltage and current accordingly. Also, sensitive yet stable fault detection provided.

Interface control in BaTiO3 based supercapacitors

NASA Astrophysics Data System (ADS)

Maglione, Mario; Elissalde, Catherine; Chung, U.-Chan

2010-03-01

Core shell BaTiO3 based particles sintered using advanced processes provide a high control of grain boundaries in bulk composites. As a result, supercapacitor behavior was evidenced which came from the balance between inner grain conductivity and grain boundary dielectric barrier. Thanks to the core-shell structure of the starting particles, improved control of the effective dielectric parameters can be achieved.

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

Improving Blood Pressure Control Using Smart Technology.

PubMed

Ciemins, Elizabeth L; Arora, Anupama; Coombs, Nicholas C; Holloway, Barbara; Mullette, Elizabeth J; Garland, Robin; Walsh Bishop-Green, Shannon; Penso, Jerry; Coon, Patricia J

2018-03-01

The authors sought to determine if wireless oscillometric home blood pressure monitoring (HBPM) that integrates with smartphone technology improves blood pressure (BP) control among patients with new or existing uncontrolled hypertension (HTN). A prospective observational cohort study monitored BP control before and after an educational intervention and introduction to HBPM. Patients in the intervention group were instructed to track their BP using a smartphone device three to seven times per week. Cases were matched to controls at a 1:3 allocation ratio on several clinical characteristics over the same period and received usual care. The proportion of patients with controlled BP was compared between groups at pre- and postintervention, ∼9 months later. Results and Materials: The total study population included 484 patients with mean age 60 years (range 23-102 years), 47.7% female, and 84.6% Caucasian. Mean preintervention BP was 137.8 mm Hg systolic and 81.4 mm Hg diastolic. Mean BP control rates improved for patients who received HBPM from 42% to 67% compared with matched control patients who improved from 59% to 67% (p < 0.01). HBPM with smartphone technology has the potential to improve HTN management among patients with uncontrolled or newly diagnosed HTN. Technology needs to be easy to use and operate and would work best when integrated into local electronic health record systems. In systems without this capability, medical assistants or other personnel may be trained to facilitate the process. Nurse navigator involvement was instrumental in bridging communication between the patients and provider.

Providing security for automated process control systems at hydropower engineering facilities

NASA Astrophysics Data System (ADS)

Vasiliev, Y. S.; Zegzhda, P. D.; Zegzhda, D. P.

2016-12-01

This article suggests the concept of a cyberphysical system to manage computer security of automated process control systems at hydropower engineering facilities. According to the authors, this system consists of a set of information processing tools and computer-controlled physical devices. Examples of cyber attacks on power engineering facilities are provided, and a strategy of improving cybersecurity of hydropower engineering systems is suggested. The architecture of the multilevel protection of the automated process control system (APCS) of power engineering facilities is given, including security systems, control systems, access control, encryption, secure virtual private network of subsystems for monitoring and analysis of security events. The distinctive aspect of the approach is consideration of interrelations and cyber threats, arising when SCADA is integrated with the unified enterprise information system.

The NASA Langley Research Center 0.3-meter transonic cryogenic tunnel microcomputer controller source code

NASA Technical Reports Server (NTRS)

Kilgore, W. Allen; Balakrishna, S.

1991-01-01

The 0.3 m Transonic Cryogenic Tunnel (TCT) microcomputer based controller has been operating for several thousand hours in a safe and efficient manner. A complete listing is provided of the source codes for the tunnel controller and tunnel simulator. Included also is a listing of all the variables used in these programs. Several changes made to the controller are described. These changes are to improve the controller ease of use and safety.

Non-adherence in children with asthma reviewed: The need for improvement of asthma care and medical education.

PubMed

Klok, Ted; Kaptein, Adrian A; Brand, Paul L P

2015-05-01

Adherence to daily inhaled corticosteroid therapy is a key determinant of asthma control. Therefore, improving adherence to inhaled corticosteroids is the most effective method through which healthcare providers can help children with uncontrolled asthma. However, identifying non-adherent patients is difficult, and electronic monitoring is the only reliable method to assess adherence. (Non-)adherence is a complex behavioural process influenced by many interacting factors. Intentional barriers to adherence are common; driven by illness perceptions and medication beliefs, patients and parents deliberately choose not to follow the doctor's recommendations. Common non-intentional barriers are related to family routines, child-raising issues, and to social issues such as poverty. Effective interventions improving adherence are complex, because they take intentional and non-intentional barriers to adherence into account. There is evidence that comprehensive, guideline-based asthma self-management programmes can be successful, with excellent adherence and good asthma control. Patient-centred care focused on healthcare provider-patient/parent collaboration is the key factor determining the success of guided self-management programmes. Such care should focus on shared decision-making as this has been shown to improve adherence and healthcare outcomes. Current asthma care falls short because many physicians fail to adhere to asthma guidelines in their diagnostic approach and therapeutic prescriptions, and because of the lack of application of patient-centred health care. Increased awareness of the importance of patient-centred communication and increased training in patient-centred communication skills of undergraduates and experienced attending physicians are needed to improve adherence to daily controller therapy and asthma control in children with asthma. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Save medical personnel's time by improved user interfaces.

PubMed

Kindler, H

1997-01-01

Common objectives in the industrial countries are the improvement of quality of care, clinical effectiveness, and cost control. Cost control, in particular, has been addressed through the introduction of case mix systems for reimbursement by social-security institutions. More data is required to enable quality improvement, increases in clinical effectiveness and for juridical reasons. At first glance, this documentation effort is contradictory to cost reduction. However, integrated services for resource management based on better documentation should help to reduce costs. The clerical effort for documentation should be decreased by providing a co-operative working environment for healthcare professionals applying sophisticated human-computer interface technology. Additional services, e.g., automatic report generation, increase the efficiency of healthcare personnel. Modelling the medical work flow forms an essential prerequisite for integrated resource management services and for co-operative user interfaces. A user interface aware of the work flow provides intelligent assistance by offering the appropriate tools at the right moment. Nowadays there is a trend to client/server systems with relational databases or object-oriented databases as repository. The work flows used for controlling purposes and to steer the user interfaces must be represented in the repository.

Control and eradication of invasive mammals in Great Britain.

PubMed

Baker, S J

2010-08-01

This paper provides a 'long view' of the eradication and control of invasive mammals by reviewing the management of 24 mammalian species that have been introduced into Great Britain since the Neolithic period and have subsequently established free-living populations in the wild. The approach provides examples of the issues faced when managing populations and examines some of the lessons that can be learned from successes and failures. The species are covered in the order of introduction, with the control/eradication of rabbit (Oryctolagus cuniculus), muskrat (Ondatra zibethicus), coypu (Myocastor coypus) and American mink (Mustela vison) considered in more detail. The species accounts are set within the context of commitments for the control of invasive alien species made by parties to the Convention on Biological Diversity and guidance provided by the International Union for Conservation of Nature and the Council of Europe. These have led to improvements in the process for assessing risks and co-ordinating action. However, despite some notable cases documented here, there have been few successful eradication programmes carried out in Europe. This paper argues that there is a case for building on the improved frameworks that are being developed in the United Kingdom and elsewhere and for being more ambitious with goals for the management of invasive alien species.

A facility specialist model for improving retention of nursing home staff: results from a randomized, controlled study.

PubMed

Pillemer, Karl; Meador, Rhoda; Henderson, Charles; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

2008-07-01

This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and Connecticut and randomly assigned to treatment and control conditions. Staff outcomes were measured through certified nursing assistant interviews, and turnover rates were measured over the course of the year. In the intervention condition, a staff member was selected to be the facility retention specialist, who would advocate for and implement programs to improve staff retention and commitment throughout the facility. Retention specialists received an intensive 3-day training in retention leadership and in a number of evidence-based retention programs. Ongoing support was provided throughout the project. Treatment facilities experienced significant declines in turnover rates compared to control facilities. As predicted, we found positive effects on certified nursing assistant assessments of the quality of retention efforts and of care provided in the facility; we did not find effects for job satisfaction or stress. The study provides evidence for the effectiveness of the retention specialist model. Findings from a detailed process evaluation suggest modifications of the program that may increase program effects.

Acquisition-Management Program

NASA Technical Reports Server (NTRS)

Avery, Don E.; Vann, A. Vernon; Jones, Richard H.; Rew, William E.

1987-01-01

NASA Acquisition Management Subsystem (AMS) program integrated NASA-wide standard automated-procurement-system program developed in 1985. Designed to provide each NASA installation with procurement data-base concept with on-line terminals for managing, tracking, reporting, and controlling contractual actions and associated procurement data. Subsystem provides control, status, and reporting for various procurement areas. Purpose of standardization is to decrease costs of procurement and operation of automatic data processing; increases procurement productivity; furnishes accurate, on-line management information and improves customer support. Written in the ADABAS NATURAL.

Precision control of high temperature furnaces using an auxiliary power supply and charged practice current flow

DOEpatents

Pollock, George G.

1997-01-01

Two power supplies are combined to control a furnace. A main power supply heats the furnace in the traditional manner, while the power from the auxiliary supply is introduced as a current flow through charged particles existing due to ionized gas or thermionic emission. The main power supply provides the bulk heating power and the auxiliary supply provides a precise and fast power source such that the precision of the total power delivered to the furnace is improved.

Mineback Stimulation Research Experiments

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

Warpinski, N.R.

The objective of the Mineback Stimulation Research Experiments is to improve hydraulic fracture stimulation technology by providing an in situ laboratory where basic processes and mechanisms that control and influence fracture propagation can be observed, measured and understood. While previous tests have been instrumental in providing an understanding of the mechanisms controlling fracture height, current experiments are focused on fluid flow through the created fracture and the associated pressure drops and crack widths. Work performed, accomplishments and future plans are presented. 7 refs., 2 figs.

A Concept and Implementation of Optimized Operations of Airport Surface Traffic

NASA Technical Reports Server (NTRS)

Jung, Yoon C.; Hoang, Ty; Montoya, Justin; Gupta, Gautam; Malik, Waqar; Tobias, Leonard

2010-01-01

This paper presents a new concept of optimized surface operations at busy airports to improve the efficiency of taxi operations, as well as reduce environmental impacts. The suggested system architecture consists of the integration of two decoupled optimization algorithms. The Spot Release Planner provides sequence and timing advisories to tower controllers for releasing departure aircraft into the movement area to reduce taxi delay while achieving maximum throughput. The Runway Scheduler provides take-off sequence and arrival runway crossing sequence to the controllers to maximize the runway usage. The description of a prototype implementation of this integrated decision support tool for the airport control tower controllers is also provided. The prototype decision support tool was evaluated through a human-in-the-loop experiment, where both the Spot Release Planner and Runway Scheduler provided advisories to the Ground and Local Controllers. Initial results indicate the average number of stops made by each departure aircraft in the departure runway queue was reduced by more than half when the controllers were using the advisories, which resulted in reduced taxi times in the departure queue.

Artificial mismatch hybridization

DOEpatents

Guo, Zhen; Smith, Lloyd M.

1998-01-01

An improved nucleic acid hybridization process is provided which employs a modified oligonucleotide and improves the ability to discriminate a control nucleic acid target from a variant nucleic acid target containing a sequence variation. The modified probe contains at least one artificial mismatch relative to the control nucleic acid target in addition to any mismatch(es) arising from the sequence variation. The invention has direct and advantageous application to numerous existing hybridization methods, including, applications that employ, for example, the Polymerase Chain Reaction, allele-specific nucleic acid sequencing methods, and diagnostic hybridization methods.

A pilot randomized controlled trial comparing prenatal yoga to perinatal health education for antenatal depression.

PubMed

Uebelacker, Lisa A; Battle, Cynthia L; Sutton, Kaeli A; Magee, Susanna R; Miller, Ivan W

2016-06-01

We conducted a pilot randomized controlled trial (RCT) comparing a prenatal yoga intervention to perinatal-focused health education in pregnant women with depression. Findings document acceptability and feasibility of the yoga intervention: no yoga-related injuries were observed, instructors showed fidelity to the yoga manual, and women rated interventions as acceptable. Although improvements in depression were not statistically different between groups, they favored yoga. This study provides support for a larger scale RCT examining prenatal yoga to improve mood during pregnancy.

Use of a control chart to monitor diarrhoea admissions: a quality improvement exercise in West Kalimantan Provincial Hospital, Pontianak, Indonesia.

PubMed

Purba, M

1999-09-01

Data on the number of admissions for diarrhoea each week to the West Kalimantan Provincial Hospital, Pontianak, Indonesia over a 5 year period, 1992-1996, were collected. After cleaning and exclusion of extreme values, transformation was then performed to ensure that the data were free of special cause variation and normally distributed. A control chart was then constructed to provide an 'early warning' system for hospital authorities in order to facilitate the management of the epidemic and to improve patient care.

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial

PubMed Central

Llewellyn-Jones, Robert H; Baikie, Karen A; Smithers, Heather; Cohen, Jasmine; Snowdon, John; Tennant, Chris C

1999-01-01

Objective To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Design Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Setting Population of residential facility in Sydney living in self care units and hostels. Participants 220 depressed residents aged ⩾65 without severe cognitive impairment. Intervention The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Main outcome measure Geriatric depression scale. Results Intention to treat analysis was used. There was significantly more movement to “less depressed” levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). Conclusions The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents. Key messagesLarge numbers of depressed elderly people live in residential care but few receive appropriate managementA population based, multifaceted shared care intervention for late life depression was more effective than routine care in improving depression outcomeThe outcome of late life depression can be improved by enhancing the clinical skills of general practitioners and care staff and by providing depression related health education and activity programmes for residentsThe intervention needs further refining and evaluation to improve its effectiveness and to determine how best to implement it in other residential care settings PMID:10480824

Do multiple micronutrient interventions improve child health, growth, and development?

PubMed

Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H

2011-11-01

Micronutrient deficiencies are common and often co-occur in many developing countries. Several studies have examined the benefits of providing multiple micronutrient (MMN) interventions during pregnancy and childhood, but the implications for programs remain unclear. The key objective of this review is to summarize what is known about the efficacy of MMN interventions during early childhood on functional outcomes, namely, child health, survival, growth, and development, to guide policy and identify gaps for future research. We identified review articles including meta-analyses and intervention studies that evaluated the benefits of MMN interventions (3 or more micronutrients) in children (<5 y of age) using Pubmed and EMBASE. Several controlled trials (n = 45) and meta-analyses (n = 6) have evaluated the effects of MMN interventions primarily for child morbidity, anemia, and growth. Two studies found no effects on child mortality. The findings for respiratory illness and diarrhea are mixed, although suggestive of benefit when provided as fortified foods. There is evidence from several controlled trials (>25) and 2 meta-analyses that MMN interventions improve hemoglobin concentrations and reduce anemia, but the effects were small compared to providing only iron or iron with folic acid. Two recent meta-analyses and several intervention trials also indicated that MMN interventions improve linear growth compared to providing a placebo or single nutrients. Much less is known about the effects on MMN interventions during early childhood on motor and mental development. In summary, MMN interventions may result in improved outcomes for children in settings where micronutrient deficiencies are widespread.

An ICT and mobile health integrated approach to optimize patients' education on hypertension and its management by physicians: The Patients Optimal Strategy of Treatment(POST) pilot study.

PubMed

Albini, Fabio; Xiaoqiu Liu; Torlasco, Camilla; Soranna, Davide; Faini, Andrea; Ciminaghi, Renata; Celsi, Ada; Benedetti, Matteo; Zambon, Antonella; di Rienzo, Marco; Parati, Gianfranco

2016-08-01

Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy. In a pilot study, we have included 690 treated hypertensive patients with uncontrolled office blood pressure (BP), consecutively recruited by 9 general practitioners over 3 months. Patients were alternatively assigned to routine management based on repeated office visits or to an integrated ICT-based Patients Optimal Strategy for Treatment (POST) system including Home BP monitoring teletransmission, a dedicated web-based platform for patients' management by physicians (Misuriamo platform), and a smartphone mobile application (Eurohypertension APP, E-APP), over a follow-up of 6 months. BP values, demographic and clinical data were collected at baseline and at all follow-up visits (at least two). BP control and cardiovascular risk level have been evaluated at the beginning and at the end of the study. 89 patients did not complete the follow-up, thus data analysis was carried out in 601 of them (303 patients in the POST group and 298 in the control group). Office BP control (<;149/90 mmHg) was 40.0% in control group, and 72.3% in POST group at 6 month follow-up. At the same time Home BP control (<;135/85 mmHg average of 6 days) in POST group was 87.5%. this pilot study suggests that ICT based tools might be effective in improving hypertension management, implementing positive patients' involvement with better adherence to treatment prescriptions and providing the physicians with dynamic control of patients' home BP measurements, resulting in lesser clinical inertia.

CDC's 6|18 Initiative: A Cross-Sector Approach to Translating Evidence Into Practice.

PubMed

Seeff, Laura C; McGinnis, Tricia; Heishman, Hilary

2018-02-22

As the US health care system continues to undergo dynamic change, the increased alignment between health care quality and payment has provided new opportunities for public health and health care sectors to work together. The Centers for Disease Control and Prevention's 6|18 Initiative accelerates cross-sector collaboration between public health and health care purchasers, payers, and providers and highlights 6 high-burden conditions and 18 associated interventions with evidence of cost reduction/neutrality and improved health outcomes. This evidence can inform payment, utilization, and quality of prevention and control interventions. The Centers for Disease Control and Prevention focused initially on public payer health insurance interventions for asthma control, unintended pregnancy prevention, and tobacco cessation. Nine state Medicaid and public health agency teams-in Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina-participated in the initiative because they had previously prioritized the health condition(s) and specific intervention(s) and had secured state-level leadership support for state agency collaboration. The Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Center for Health Care Strategies, the Robert Wood Johnson Foundation, and other partners supported state implementation and dissemination of early lessons learned. The Centers for Disease Control and Prevention conducted exploratory interviews to guide improvement of the 6|18 Initiative and to understand facilitators, barriers, and complementary roles played by each sector. Monthly technical assistance calls conducted with state teams documented collaborative activities between state Medicaid agencies and health departments and state processes to increase coverage and utilization. The 6|18 Initiative is strengthening partnerships between state health departments and Medicaid agencies and contributing to state progress in helping improve Medicaid coverage and utilization of effective prevention and control interventions. This initiative highlights early successes for others interested in strengthening collaboration between state agencies and between public and private sectors to improve payment, utilization, and quality of evidence-based interventions.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

PubMed Central

2010-01-01

Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important. PMID:20942937

Online analysis and process control in recombinant protein production (review).

PubMed

Palmer, Shane M; Kunji, Edmund R S

2012-01-01

Online analysis and control is essential for efficient and reproducible bioprocesses. A key factor in real-time control is the ability to measure critical variables rapidly. Online in situ measurements are the preferred option and minimize the potential loss of sterility. The challenge is to provide sensors with a good lifespan that withstand harsh bioprocess conditions, remain stable for the duration of a process without the need for recalibration, and offer a suitable working range. In recent decades, many new techniques that promise to extend the possibilities of analysis and control, not only by providing new parameters for analysis, but also through the improvement of accepted, well practiced, measurements have arisen.

Five Climate Control Techniques for Schools.

ERIC Educational Resources Information Center

Wilson, Maurice J.

1963-01-01

There are many reasons for air-conditioning schools and among them are--(1) the improvement of learning and teaching efficiency, (2) effective use of the educational plant for a greater part of the year, and (3) more efficient use of space through compact building design. Five climate control techniques are cited as providing optimum…

Aviation safety/automation program overview

NASA Technical Reports Server (NTRS)

Morello, Samuel A.

1990-01-01

The goal is to provide a technology base leading to improved safety of the national airspace system through the development and integration of human-centered automation technologies for aircraft crews and air traffic controllers. Information on the problems, specific objectives, human-automation interaction, intelligent error-tolerant systems, and air traffic control/cockpit integration is given in viewgraph form.

QTL meta-analysis provides a comprehensive view of loci controlling partial resistance to Aphanomyces euteiches in four sources of resistance in pea

USDA-ARS?s Scientific Manuscript database

More knowledge about diversity of Quantitative Trait Loci (QTL) controlling polygenic disease resistance in natural genetic variation of crop species is required for durably improving plant genetic resistances to pathogens. Polygenic partial resistance to Aphanomyces root rot, due to Aphanomcyces eu...

Tools for Schools: Filtration for Improved Air Quality. Technical Services Bulletin.

ERIC Educational Resources Information Center

2001

This product bulletin addresses air pollution control in educational facilities to enhance educational performance, provides air quality recommendations for schools, and examines the filtration needs of various school areas. The types of air particles typically present are highlighted, and the use of proper filtration to control gases and vapors…

Jurisdictional Control: The Regulation of Nurses' Aides.

ERIC Educational Resources Information Center

Reinhard, Susan C.

1988-01-01

The future of health care depends on a more unified nursing hierarchy. It makes sense to place the regulation of nurses' aides within the jurisdiction of the state nursing board, the agency charged with providing safe nursing care. Strengthening nursing's jurisdictional control will not only improve the quality of care, it will increase the…

Electrokinetic high pressure hydraulic system

DOEpatents

Paul, Phillip H.; Rakestraw, David J.; Arnold, Don W.; Hencken, Kenneth R.; Schoeniger, Joseph S.; Neyer, David W.

2001-01-01

An electrokinetic high pressure hydraulic pump for manipulating fluids in capillary-based systems. The pump uses electro-osmotic flow to provide a high pressure hydraulic system, having no moving mechanical parts, for pumping and/or compressing fluids, for providing valve means and means for opening and closing valves, for controlling fluid flow rate, and manipulating fluid flow generally and in capillary-based systems (Microsystems), in particular. The compact nature of the inventive high pressure hydraulic pump provides the ability to construct a micro-scale or capillary-based HPLC system that fulfills the desire for small sample quantity, low solvent consumption, improved efficiency, the ability to run samples in parallel, and field portability. Control of pressure and solvent flow rate is achieved by controlling the voltage applied to an electrokinetic pump.

Electrokinetic high pressure hydraulic system

DOEpatents

Paul, Phillip H.; Rakestraw, David J.; Arnold, Don W.; Hencken, Kenneth R.; Schoeniger, Joseph S.; Neyer, David W.

2003-06-03

An electrokinetic high pressure hydraulic pump for manipulating fluids in capillary-based system. The pump uses electro-osmotic flow to provide a high pressure hydraulic system, having no moving mechanical parts, for pumping and/or compressing fluids, for providing valve means and means for opening and closing valves, for controlling fluid flow rate, and manipulating fluid flow generally and in capillary-based systems (microsystems), in particular. The compact nature of the inventive high pressure hydraulic pump provides the ability to construct a micro-scale or capillary-based HPLC system that fulfills the desire for small sample quantity, low solvent consumption, improved efficiency, the ability to run samples in parallel, and field portability. Control of pressure and solvent flow rate is achieved by controlling the voltage applied to an electrokinetic pump.

Dynamic control of ERG20 expression combined with minimized endogenous downstream metabolism contributes to the improvement of geraniol production in Saccharomyces cerevisiae.

PubMed

Zhao, Jianzhi; Li, Chen; Zhang, Yan; Shen, Yu; Hou, Jin; Bao, Xiaoming

2017-01-31

Microbial production of monoterpenes provides a promising substitute for traditional chemical-based methods, but their production is lagging compared with sesquiterpenes. Geraniol, a valuable monoterpene alcohol, is widely used in cosmetic, perfume, pharmaceutical and it is also a potential gasoline alternative. Previously, we constructed a geraniol production strain by engineering the mevalonate pathway together with the expression of a high-activity geraniol synthase. In this study, we further improved the geraniol production through reducing the endogenous metabolism of geraniol and controlling the precursor geranyl diphosphate flux distribution. The deletion of OYE2 (encoding an NADPH oxidoreductase) or ATF1 (encoding an alcohol acetyltransferase) both involving endogenous conversion of geraniol to other terpenoids, improved geraniol production by 1.7-fold or 1.6-fold in batch fermentation, respectively. In addition, we found that direct down-regulation of ERG20 expression, the branch point regulating geranyl diphosphate flux, does not improve geraniol production. Therefore, we explored dynamic control of ERG20 expression to redistribute the precursor geranyl diphosphate flux and achieved a 3.4-fold increase in geraniol production after optimizing carbon source feeding. Furthermore, the combination of dynamic control of ERG20 expression and OYE2 deletion in LEU2 prototrophic strain increased geraniol production up to 1.69 g/L with pure ethanol feeding in fed-batch fermentation, which is the highest reported production in engineered yeast. An efficient geraniol production platform was established by reducing the endogenous metabolism of geraniol and by controlling the flux distribution of the precursor geranyl diphosphate. The present work also provides a production basis to synthesis geraniol-derived chemicals, such as monoterpene indole alkaloids.

Assessing the impact of a school-based safe water intervention on household adoption of point-of-use water treatment practices in southern India.

PubMed

Freeman, Matthew C; Clasen, Thomas

2011-03-01

We assessed a pilot project by UNICEF and Hindustan Unilever Limited to improve the quality of drinking water for children in schools through adoption of improved drinking water practices among households in southern India. The intervention consisted of providing classrooms of 200 schools a commercial water purifier, and providing basic hygiene and water treatment information to students, parents, and teachers. We found no evidence that the intervention was effective in improving awareness or uptake of effective water treatment practices at home. A similar proportion of household members in the intervention and control groups boiled their water (P = 0.60), used a ceramic filtration system (P = 0.33), and used a cloth filter (P = 0.89). One year after the launch of the campaign, household ownership of the commercial purifier promoted at schools was higher in the intervention group (26%) than the control group (19%), but this difference was not statistically significant (P = 0.53).

Enhancing Surveillance and Diagnostics in Anthrax-Endemic Countries

PubMed Central

Salzer, Johanna S.; Traxler, Rita M.; Hendricks, Katherine A.; Kadzik, Melissa E.; Marston, Chung K.; Kolton, Cari B.; Stoddard, Robyn A.; Hoffmaster, Alex R.; Bower, William A.; Walke, Henry T.

2017-01-01

Naturally occurring anthrax disproportionately affects the health and economic welfare of poor, rural communities in anthrax-endemic countries. However, many of these countries have limited anthrax prevention and control programs. Effective prevention of anthrax outbreaks among humans is accomplished through routine livestock vaccination programs and prompt response to animal outbreaks. The Centers for Disease Control and Prevention uses a 2-phase framework when providing technical assistance to partners in anthrax-endemic countries. The first phase assesses and identifies areas for improvement in existing human and animal surveillance, laboratory diagnostics, and outbreak response. The second phase provides steps to implement improvements to these areas. We describe examples of implementing this framework in anthrax-endemic countries. These activities are at varying stages of completion; however, the public health impact of these initiatives has been encouraging. The anthrax framework can be extended to other zoonotic diseases to build on these efforts, improve human and animal health, and enhance global health security. PMID:29155651

Use Cases for Combining Web Services with ArcPython Tools for Enabling Quality Control of Land Remote Sensing Data Products.

NASA Astrophysics Data System (ADS)

Krehbiel, C.; Maiersperger, T.; Friesz, A.; Harriman, L.; Quenzer, R.; Impecoven, K.

2016-12-01

Three major obstacles facing big Earth data users include data storage, management, and analysis. As the amount of satellite remote sensing data increases, so does the need for better data storage and management strategies to exploit the plethora of data now available. Standard GIS tools can help big Earth data users whom interact with and analyze increasingly large and diverse datasets. In this presentation we highlight how NASA's Land Processes Distributed Active Archive Center (LP DAAC) is tackling these big Earth data challenges. We provide a real life use case example to describe three tools and services provided by the LP DAAC to more efficiently exploit big Earth data in a GIS environment. First, we describe the Open-source Project for a Network Data Access Protocol (OPeNDAP), which calls to specific data, minimizing the amount of data that a user downloads and improves the efficiency of data downloading and processing. Next, we cover the LP DAAC's Application for Extracting and Exploring Analysis Ready Samples (AppEEARS), a web application interface for extracting and analyzing land remote sensing data. From there, we review an ArcPython toolbox that was developed to provide quality control services to land remote sensing data products. Locating and extracting specific subsets of larger big Earth datasets improves data storage and management efficiency for the end user, and quality control services provides a straightforward interpretation of big Earth data. These tools and services are beneficial to the GIS user community in terms of standardizing workflows and improving data storage, management, and analysis tactics.

Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial.

PubMed

Johnson, Aimee K; Johnson, Alisa J; Barton, Debra; Elkins, Gary

2016-01-01

Sexual dysfunction is a common problem for postmenopausal women. This study, as part of a larger randomized controlled trial, examined the effect of hypnotic relaxation therapy on sexual dysfunction, a secondary study outcome, in postmenopausal women. Sexual function was assessed using the Sexual Activity Questionnaire (SAQ). Significant improvement in sexual pleasure and discomfort were reported following 5 weekly sessions of hypnotic relaxation therapy, compared with those receiving an attention control. Total SAQ scores showed significant improvement in the hypnotic relaxation therapy treatment group while holding baseline SAQ scores constant. Improvements showed a slight increase at the Week 12 follow-up. The results of this analysis provide initial support for the use of hypnotic relaxation therapy to improve sexual function in postmenopausal women.

Simulation comparison of a decoupled longitudinal control system and a velocity vector control wheel steering system during landings in wind shear

NASA Technical Reports Server (NTRS)

Kimball, G., Jr.

1980-01-01

A simulator comparison of the velocity vector control wheel steering (VCWS) system and a decoupled longitudinal control system is presented. The piloting task was to use the electronic attitude direction indicator (EADI) to capture and maintain a 3 degree glide slope in the presence of wind shear and to complete the landing using the perspective runway included on the EADI. The decoupled control system used constant prefilter and feedback gains to provide steady state decoupling of flight path angle, pitch angle, and forward velocity. The decoupled control system improved the pilots' ability to control airspeed and flight path angle during the final stages of an approach made in severe wind shear. The system also improved their ability to complete safe landings. The pilots preferred the decoupled control system in severe winds and, on a pilot rating scale, rated the approach and landing task with the decoupled control system as much as 3 to 4 increments better than use of the VCWS system.

Improving Urban African Americans’ Blood Pressure Control through Multi-level Interventions in the Achieving Blood Pressure Control Together (ACT) Study: A Randomized Clinical Trial

PubMed Central

Ephraim, Patti L.; Hill-Briggs, Felicia; Roter, Debra; Bone, Lee; Wolff, Jennifer; Lewis-Boyer, LaPricia; Levine, David; Aboumatar, Hanan; Cooper, Lisa A; Fitzpatrick, Stephanie; Gudzune, Kimberly; Albert, Michael; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary; Fagan, Peter; Ramamurthi, Hema; Ameling, Jessica; Charlston, Jeanne; Sam, Tanyka; Carson, Kathryn A.; Wang, Nae-Yuh; Crews, Deidra; Greer, Raquel; Sneed, Valerie; Flynn, Sarah J.; DePasquale, Nicole; Boulware, L. Ebony

2014-01-01

Background Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients’ management of a variety of chronic illnesses. However, studies of multilevel interventions designed specifically to improve urban African American patients’ blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. Methods/Design We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients’ improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients’ blood pressure control at 12 months. Discussion Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients’ hypertension control. PMID:24956323

Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: a randomized clinical trial.

PubMed

Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra L; Bone, Lee R; Wolff, Jennifer L; Lewis-Boyer, LaPricia; Levine, David M; Aboumatar, Hanan J; Cooper, Lisa A; Fitzpatrick, Stephanie J; Gudzune, Kimberly A; Albert, Michael C; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J; Fagan, Peter J; Ramamurthi, Hema C; Ameling, Jessica M; Charlston, Jeanne; Sam, Tanyka S; Carson, Kathryn A; Wang, Nae-Yuh; Crews, Deidra C; Greer, Raquel C; Sneed, Valerie; Flynn, Sarah J; DePasquale, Nicole; Boulware, L Ebony

2014-07-01

Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12months. Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control. Copyright © 2014 Elsevier Inc. All rights reserved.

Freon, T-B1 cutting fluid

NASA Technical Reports Server (NTRS)

Peters, R. L.

1969-01-01

Improved cutting fluid completely controls the heat generated from machining operations, thus providing longer tool life. Fluid is especially useful in the working of plastics and replaces less efficient contaminating oils.

Improving hospital cost accounting with activity-based costing.

PubMed

Chan, Y C

1993-01-01

In this article, activity-based costing, an approach that has proved to be an improvement over the conventional costing system in product costing, is introduced. By combining activity-based costing with standard costing, health care administrators can better plan and control the costs of health services provided while ensuring that the organization's bottom line is healthy.

Improving the Spelling Ability among Speakers of African American English through Explicit Instruction

ERIC Educational Resources Information Center

Pittman, Ramona T.; Joshi, R. Malatesha; Carreker, Suzanne

2014-01-01

The purpose of this eight week study was to provide explicit instruction to improve spelling to 124 sixth grade students who are speakers of African American English (AAE). Two classroom teachers taught 14 different language arts class sections. The research design was a pretest/posttest/posttest design using wait-list-control. The treatment group…

The status of tree improvement programs for northern tree species

Treesearch

David S. Canavera

1977-01-01

Forest tree improvement research and application in the Northeast is reviewed in the perspective of past development and future needs. Control over provenance selection can provide the best quality seed for today's reforestation programs. Future supplies of seed must come from seed orchards if forest land owners are to attain the maximum production per unit area...

A technique for improved maxillary record base adaptation through controlled polymerization of light-activated dental resins.

PubMed

Hopkins, D S; Phoenix, R D; Abrahamsen, T C

1997-09-01

A technique for the fabrication of light-activated maxillary record bases is described. The use of a segmental polymerization process provides improved palatal adaptation by minimizing the effects of polymerization shrinkage. Utilization of this technique results in record bases that are well adapted to the corresponding master casts.

Improving Preschoolers' Language and Literacy Skills through Web-Mediated Professional Development

ERIC Educational Resources Information Center

Cabell, Sonia Q.; Downer, Jason T.

2011-01-01

MyTeachingPartner (MTP) is a Web-mediated approach that provides ongoing support for teachers to improve the quality of their interactions with children. This study examined the effects of MTP on the preschool language and literacy development of children who are at risk for later academic difficulties. Results of this randomized controlled trial…

Future long-range transports: Prospects for improved fuel efficiency

NASA Technical Reports Server (NTRS)

Nagel, A. L.; Alford, W. J., Jr.; Dugan, J. F., Jr.

1975-01-01

A status report is provided on current thinking concerning potential improvements in fuel efficiency and possible alternate fuels. Topics reviewed are: (1) historical trends in airplane efficiency; (2) technological opportunities including supercritical aerodynamics, (3) vortex diffusers, (4) composite materials, (5) propulsion systems, (6) active controls, and terminal-area operations; (7) unconventional design concepts, and (8) hydrogen-fueled airplane.

The employment of a spoken language computer applied to an air traffic control task.

NASA Technical Reports Server (NTRS)

Laveson, J. I.; Silver, C. A.

1972-01-01

Assessment of the merits of a limited spoken language (56 words) computer in a simulated air traffic control (ATC) task. An airport zone approximately 60 miles in diameter with a traffic flow simulation ranging from single-engine to commercial jet aircraft provided the workload for the controllers. This research determined that, under the circumstances of the experiments carried out, the use of a spoken-language computer would not improve the controller performance.

Controlling rotary desiccant wheels for dehumidification and cooling

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

Crooks, K.W.; Banks, N.J.

With greater focus on indoor air quality (IAQ) and ventilation, humidity control within spaces such as office buildings, hotels, schools, ice-skating rinks, nursing homes, and operating rooms has become paramount during the past decade. Control of relative humidity (RH) has been linked to increased comfort and the improved health of building occupants. The desiccant wheel process can be utilized in these applications to provide increased dehumidification while introducing minimal additional control parameters, often at lower cost.

Flight Results of the NF-15B Intelligent Flight Control System (IFCS) Aircraft with Adaptation to a Longitudinally Destabilized Plant

NASA Technical Reports Server (NTRS)

Bosworth, John T.

2008-01-01

Adaptive flight control systems have the potential to be resilient to extreme changes in airplane behavior. Extreme changes could be a result of a system failure or of damage to the airplane. The goal for the adaptive system is to provide an increase in survivability in the event that these extreme changes occur. A direct adaptive neural-network-based flight control system was developed for the National Aeronautics and Space Administration NF-15B Intelligent Flight Control System airplane. The adaptive element was incorporated into a dynamic inversion controller with explicit reference model-following. As a test the system was subjected to an abrupt change in plant stability simulating a destabilizing failure. Flight evaluations were performed with and without neural network adaptation. The results of these flight tests are presented. Comparison with simulation predictions and analysis of the performance of the adaptation system are discussed. The performance of the adaptation system is assessed in terms of its ability to stabilize the vehicle and reestablish good onboard reference model-following. Flight evaluation with the simulated destabilizing failure and adaptation engaged showed improvement in the vehicle stability margins. The convergent properties of this initial system warrant additional improvement since continued maneuvering caused continued adaptation change. Compared to the non-adaptive system the adaptive system provided better closed-loop behavior with improved matching of the onboard reference model. A detailed discussion of the flight results is presented.

Test Rig for Evaluating Active Turbine Blade Tip Clearance Control Concepts

NASA Technical Reports Server (NTRS)

Lattime, Scott B.; Steinetz, Bruce M.; Robbie, Malcolm G.

2003-01-01

Improved blade tip sealing in the high pressure compressor and high pressure turbine can provide dramatic improvements in specific fuel consumption, time-on-wing, compressor stall margin and engine efficiency as well as increased payload and mission range capabilities of both military and commercial gas turbine engines. The preliminary design of a mechanically actuated active clearance control (ACC) system for turbine blade tip clearance management is presented along with the design of a bench top test rig in which the system is to be evaluated. The ACC system utilizes mechanically actuated seal carrier segments and clearance measurement feedback to provide fast and precise active clearance control throughout engine operation. The purpose of this active clearance control system is to improve upon current case cooling methods. These systems have relatively slow response and do not use clearance measurement, thereby forcing cold build clearances to set the minimum clearances at extreme operating conditions (e.g., takeoff, re-burst) and not allowing cruise clearances to be minimized due to the possibility of throttle transients (e.g., step change in altitude). The active turbine blade tip clearance control system design presented herein will be evaluated to ensure that proper response and positional accuracy is achievable under simulated high-pressure turbine conditions. The test rig will simulate proper seal carrier pressure and temperature loading as well as the magnitudes and rates of blade tip clearance changes of an actual gas turbine engine. The results of these evaluations will be presented in future works.

Impact of oral health education on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city.

PubMed

D'Cruz, A M; Aradhya, S

2013-05-01

To assess effectiveness of an oral health education (OHE) programme on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city. Three schools were randomly selected and assigned to experimental I, experimental II and control groups. At baseline, a 20-item questionnaire was used to assess the oral hygiene knowledge and practices. Clinical examinations (Turesky-Gilmore-Glickman modification of Quigley Hein plaque index; Loe-Silness gingival index) were performed by 2 examiners. OHE was provided by the investigator for experimental groups I (lecture using a PowerPoint presentation) and II (lecture using a PowerPoint presentation with toothbrushing demonstration). Control group did not receive any intervention. Reinforcement was provided for experimental groups at 3 and 6 months. At end of 9 months, questionnaire was administered and clinical examinations were performed. Data were analysed using chi-square, anova and post hoc Tukey's tests. Nine months post-intervention, there was significant improvement in oral hygiene knowledge and practices in experimental groups. There were significant reductions in mean plaque index and gingival index scores in the experimental groups. The control group did not show any significant improvement. Active involvement of school children with reinforcement of OHE can improve oral hygiene knowledge, practices and gingival health and decrease plaque levels. © 2012 John Wiley & Sons A/S.

Effectiveness of cognitive behavioral therapy on health-related quality of life: An evaluation of therapies provided by trainee therapists.

PubMed

Henriksson, Sophie; Anclair, Malin; Hiltunen, Arto J

2016-06-01

The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health-related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Research on Precision Tracking on Fast Steering Mirror and Control Strategy

NASA Astrophysics Data System (ADS)

Di, Lin; Yi-ming, Wu; Fan, Zhu

2018-01-01

Fast steering mirror is a device used for controlling the beam direction precisely. Due to the short travel of the push-pull FSM, a compound fast steering mirror system driven by both limited-angle voice coil motor and push-pull FSM together is proposed. In the compound FSM system, limited-angle voice coil motor quickly swings at wide angle, while the push-pull FSM do high frequency movement in a small range, which provides the system with the high bandwidth and long travel. In the control strategy, the method of combining feed-forward control in Kalman filtering with auto-disturbance rejection control is used to improve trajectory tracking accuracy. The simulation result shows that tracking accuracy measured by the compound method can be improved by more than 5 times than that of the conventional PID.

Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.

PubMed

Ellmers, Toby J; Paraskevopoulos, Ioannis Th; Williams, A Mark; Young, William R

2018-03-22

Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.

Impact of pharmaceutical care on knowledge, quality of life and satisfaction of postmenopausal women with osteoporosis.

PubMed

Lai, Pauline Siew Mei; Chua, Siew Siang; Chan, Siew Pheng

2013-08-01

This study describes the analysis of secondary outcomes from a previously published randomised controlled trial, which assessed the effects of pharmaceutical care on medication adherence, persistence and bone turnover markers. The main focus of this manuscript is the effect of the provision of pharmaceutical care on these secondary outcomes, and details on the design of the intervention provided, the osteoporosis care plan and materials used to deliver the intervention. To evaluate the effects of pharmaceutical care on knowledge, quality of life (QOL) and satisfaction of postmenopausal osteoporotic women prescribed bisphosphonates, and their associating factors. Randomised controlled trial, performed at an osteoporosis clinic of a tertiary hospital in Malaysia. Postmenopausal women diagnosed with osteoporosis (T-score ≤-2.5/lowtrauma fracture), just been prescribed weekly alendronate/risedronate were randomly allocated to receive intervention or standard care (controls). Intervention participants received a medication review, education on osteoporosis, risk factors, lifestyle modifications, goals of therapy, side effects and the importance of medication adherence at months 0, 3, 6 and 12. Knowledge, QOL and satisfaction. A total of 198 postmenopausal osteoporotic women were recruited: intervention = 100 and control = 98. Intervention participants reported significantly higher knowledge scores at months 3 (72.50 vs. 62.50 %), 6 (75.00 vs. 65.00 %) and 12 (78.75 vs. 68.75 %) compared to control participants. QOL scores were also lower (which indicates better QOL) at months 3 (29.33 vs. 38.41), 6 (27.50 vs. 36.56) and 12 (27.53 vs. 37.56) compared to control participants. Similarly, satisfaction score was higher in intervention participants (93.67 vs. 84.83 %). More educated women, with back pain, who were provided pharmaceutical care had better knowledge levels. Similarly, older, more educated women, with previous falls and back pain tend to have poorer QOL, whilst women who exercised more frequently and were provided pharmaceutical care had better QOL. Satisfaction also increased as QOL increases and when provided pharmaceutical care. The provision of pharmaceutical care improved knowledge, QOL and satisfaction in Malaysian postmenopausal osteoporotic women, showing that pharmacists have the potential to improve patients' overall bone health. Policymakers should consider placing a clinical pharmacist in the osteoporosis clinic to provide counselling to improve these outcomes.

Straight Talk About Birth Control: A Contraceptive Education Protocol for Home Care.

PubMed

Schoenberg, Leslie

Home healthcare providers play a critical role in the prevention of unintended pregnancies by providing evidence-based contraception education during home visits. This article describes an innovative and comprehensive contraception protocol that was developed for Nurse-Family Partnership to improve contraception education for home healthcare patients. The protocol focused on increasing uptake of long-acting reversible contraception (LARC) for high-risk prenatal and postpartum home healthcare patients. The protocol was designed to reduce early subsequent pregnancies and thereby improve outcomes for mothers and their infants. An evidence-based translation project was designed and piloted in three California counties. The protocol consisted of a contraception education module for nurses and a patient education toolkit. The toolkit included an interactive patient education workbook emphasizing LARC methods for nurses to complete with their patients along with other teaching tools. The project was evaluated using pre- and posttest surveys that measured changes in nurses' knowledge, attitudes, and practice before, after, and 2 months after implementation. Outcomes revealed the following statistically significant results: (a) nurses' knowledge doubled at the first posttest and persisted at 2 months, (b) nurses' attitudes improved on two of the three measures, and (c) there was a 17.7% increase in the frequency of LARC birth control education 2 months after implementation. An evidence-based contraception protocol can promote acceptance of LARC methods and improve home healthcare clinician comfort with and frequency of birth control education.

Advanced air distribution: improving health and comfort while reducing energy use.

PubMed

Melikov, A K

2016-02-01

Indoor environment affects the health, comfort, and performance of building occupants. The energy used for heating, cooling, ventilating, and air conditioning of buildings is substantial. Ventilation based on total volume air distribution in spaces is not always an efficient way to provide high-quality indoor environments at the same time as low-energy consumption. Advanced air distribution, designed to supply clean air where, when, and as much as needed, makes it possible to efficiently achieve thermal comfort, control exposure to contaminants, provide high-quality air for breathing and minimizing the risk of airborne cross-infection while reducing energy use. This study justifies the need for improving the present air distribution design in occupied spaces, and in general the need for a paradigm shift from the design of collective environments to the design of individually controlled environments. The focus is on advanced air distribution in spaces, its guiding principles and its advantages and disadvantages. Examples of advanced air distribution solutions in spaces for different use, such as offices, hospital rooms, vehicle compartments, are presented. The potential of advanced air distribution, and individually controlled macro-environment in general, for achieving shared values, that is, improved health, comfort, and performance, energy saving, reduction of healthcare costs and improved well-being is demonstrated. Performance criteria are defined and further research in the field is outlined. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Genetic mouse embryo assay: improving performance and quality testing for assisted reproductive technology (ART) with a functional bioassay.

PubMed

Gilbert, Rebecca S; Nunez, Brandy; Sakurai, Kumi; Fielder, Thomas; Ni, Hsiao-Tzu

2016-03-24

Growing concerns about safety of ART on human gametes, embryos, clinical outcomes and long-term health of offspring require improved methods of risk assessment to provide functionally relevant assays for quality control testing and pre-clinical studies prior to clinical implementation. The one-cell mouse embryo assay (MEA) is the most widely used for development and quality testing of human ART products; however, concerns exist due to the insensitivity/variability of this bioassay which lacks standardization and involves subjective analysis by morphology alone rather than functional analysis of the developing embryos. We hypothesized that improvements to MEA by the use of functional molecular biomarkers could enhance sensitivity and improve detection of suboptimal materials/conditions. Fresh one-cell transgenic mouse embryos with green fluorescent protein (GFP) expression driven by Pou6f1 or Cdx2 control elements were harvested and cultured to blastocysts in varied test and control conditions to compare assessment by standard morphology alone versus the added dynamic expression of GFP for screening and selection of critical raw materials and detection of suboptimal culture conditions. Transgenic mouse embryos expressing functionally relevant biomarkers of normal early embryo development can be used to monitor the developmental impact of culture conditions. This novel approach provides a superior MEA that is more meaningful and sensitive for detection of embryotoxicity than morphological assessment alone.

Development of technology for creating intelligent control systems for power plants and propulsion systems for marine robotic systems

NASA Astrophysics Data System (ADS)

Iakovleva, E. V.; Momot, B. A.

2017-10-01

The object of this study is to develop a power plant and an electric propulsion control system for autonomous remotely controlled vessels. The tasks of the study are as follows: to assess remotely controlled vessels usage reasonability, to define the requirements for this type of vessel navigation. In addition, the paper presents the analysis of technical diagnostics systems. The developed electric propulsion control systems for vessels should provide improved reliability and efficiency of the propulsion complex to ensure the profitability of remotely controlled vessels.

Dual-Arm Generalized Compliant Motion With Shared Control

NASA Technical Reports Server (NTRS)

Backes, Paul G.

1994-01-01

Dual-Arm Generalized Compliant Motion (DAGCM) primitive computer program implementing improved unified control scheme for two manipulator arms cooperating in task in which both grasp same object. Provides capabilities for autonomous, teleoperation, and shared control of two robot arms. Unifies cooperative dual-arm control with multi-sensor-based task control and makes complete task-control capability available to higher-level task-planning computer system via large set of input parameters used to describe desired force and position trajectories followed by manipulator arms. Some concepts discussed in "A Generalized-Compliant-Motion Primitive" (NPO-18134).

[Controlling instruments in radiology].

PubMed

Maurer, M

2013-10-01

Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

Mobile Health Technology for Improving Symptom Management in Low Income Persons Living with HIV.

PubMed

Schnall, Rebecca; Cho, Hwayoung; Mangone, Alexander; Pichon, Adrienne; Jia, Haomiao

2018-01-03

Persons living with HIV (PLWH) are living longer but experiencing more adverse symptoms associated with the disease and its treatment. This study aimed to examine the impact of a mHealth application (app) comprised of evidence-based self-care strategies on the symptom experience of PLWH. We conducted a 12-week feasibility study with 80 PLWH who were randomized (1:1) to a mHealth app, mobile Video Information Provider (mVIP), with self-care strategies for improving 13 commonly experienced symptoms in PLWH or to a control app. Intervention group participants showed a significantly greater improvement than the control group in 5 symptoms: anxiety (p = 0.001), depression (p = 0.001), neuropathy (p = 0.002), fever/chills/sweat (p = 0.037), and weight loss/wasting (p = 0.020). Participants in the intervention group showed greater improvement in adherence to their antiretroviral medications (p = 0.017) as compared to those in the control group. In this 12-week trial, mVIP was associated with improved symptom burden and increased medication adherence in PLWH.

ASDTIC: A feedback control innovation

NASA Technical Reports Server (NTRS)

Lalli, V. R.; Schoenfeld, A. D.

1972-01-01

The ASDTIC (Analog Signal to Discrete Time Interval Converter) control subsystem provides precise output control of high performance aerospace power supplies. The key to ASDTIC operation is that it stably controls output by sensing output energy change as well as output magnitude. The ASDTIC control subsystem and control module were developed to improve power supply performance during static and dynamic input voltage and output load variations, to reduce output voltage or current regulation due to component variations or aging, to maintain a stable feedback control with variations in the loop gain or loop time constants, and to standardize the feedback control subsystem for power conditioning equipment.

ASDTIC - A feedback control innovation.

NASA Technical Reports Server (NTRS)

Lalli, V. R.; Schoenfeld, A. D.

1972-01-01

The ASDTIC (analog signal to discrete time interval converter) control subsystem provides precise output control of high performance aerospace power supplies. The key to ASDTIC operation is that it stably controls output by sensing output energy change as well as output magnitude. The ASDTIC control subsystem and control module were developed to improve power supply performance during static and dynamic input voltage and output load variations, to reduce output voltage or current regulation due to component variations or aging, to maintain a stable feedback control with variations in the loop gain or loop time constants, and to standardize the feedback control subsystem for power conditioning equipment.

Successful Outcomes of a Clinical Decision Support System in an HIV Practice: A Randomized Controlled Trial

PubMed Central

Robbins, Gregory K.; Lester, William; Johnson, Kristin L.; Chang, Yuchiao; Estey, Gregory; Surrao, Dominic; Zachary, Kimon; Lammert, Sara M.; Chueh, Henry; Meigs, James B.; Freedberg, Kenneth A.

2013-01-01

Background Data to support improved patient outcomes from clinical decision support systems (CDSS) are lacking in HIV care. Objective To conduct a randomized controlled trial testing the efficacy of a CDSS to improve HIV outcomes in an outpatient clinic. Design We conducted a randomized controlled trial where half of each provider’s patients were randomized to interactive or static computer alerts (ClinicalTrials.gov #NCT00678600). Setting The study was conducted at the Massachusetts General Hospital HIV Clinic. Subjects Participants were HIV providers and their HIV-infected patients. Intervention Computer alerts were generated for virologic failure (HIV RNA >400 c/mL after HIV RNA ≤400 c/mL), evidence of suboptimal follow-up, and 11 abnormal laboratory tests. Providers received interactive computer alerts, facilitating appointment rescheduling and repeat laboratory testing, for half of their patients and static alerts for the other half. Measurements The primary endpoint was change in CD4 count. Other endpoints included time-to-clinical event, 6-month suboptimal follow-up, and severe laboratory toxicity. Results Thirty-three HIV providers followed 1,011 HIV-infected patients. For the intervention arm, the mean CD4 count increase was greater (5.3 versus 3.2 cells/mm3/month; difference = 2.0 cells/mm3/month 95% CI [0.1, 4.0], p=0.040) and the rate of 6-month suboptimal follow-up was lower (20.6 versus 30.1 events per 100 patient-years, p=0.022). Median time-to-next scheduled appointment was shorter in the intervention arm after a suboptimal follow-up alert (1.71 versus 3.48 months; p<0.001) and after a toxicity alert (2.79 versus >6 months for control); p=0.072). Ninety-six percent of providers supported adopting the CDSS as part of standard care. Limitations This was a one-year informatics study conducted at a single hospital sub-specialty clinic. Conclusion A CDSS using interactive provider alerts improved CD4 counts and clinic follow-up for HIV-infected patients. Wider implementation of such systems can provide important clinical benefits. PMID:23208165

Robotic excavator trajectory control using an improved GA based PID controller

NASA Astrophysics Data System (ADS)

Feng, Hao; Yin, Chen-Bo; Weng, Wen-wen; Ma, Wei; Zhou, Jun-jing; Jia, Wen-hua; Zhang, Zi-li

2018-05-01

In order to achieve excellent trajectory tracking performances, an improved genetic algorithm (IGA) is presented to search for the optimal proportional-integral-derivative (PID) controller parameters for the robotic excavator. Firstly, the mathematical model of kinematic and electro-hydraulic proportional control system of the excavator are analyzed based on the mechanism modeling method. On this basis, the actual model of the electro-hydraulic proportional system are established by the identification experiment. Furthermore, the population, the fitness function, the crossover probability and mutation probability of the SGA are improved: the initial PID parameters are calculated by the Ziegler-Nichols (Z-N) tuning method and the initial population is generated near it; the fitness function is transformed to maintain the diversity of the population; the probability of crossover and mutation are adjusted automatically to avoid premature convergence. Moreover, a simulation study is carried out to evaluate the time response performance of the proposed controller, i.e., IGA based PID against the SGA and Z-N based PID controllers with a step signal. It was shown from the simulation study that the proposed controller provides the least rise time and settling time of 1.23 s and 1.81 s, respectively against the other tested controllers. Finally, two types of trajectories are designed to validate the performances of the control algorithms, and experiments are performed on the excavator trajectory control experimental platform. It was demonstrated from the experimental work that the proposed IGA based PID controller improves the trajectory accuracy of the horizontal line and slope line trajectories by 23.98% and 23.64%, respectively in comparison to the SGA tuned PID controller. The results further indicate that the proposed IGA tuning based PID controller is effective for improving the tracking accuracy, which may be employed in the trajectory control of an actual excavator.

Recent developments for the Large Binocular Telescope Guiding Control Subsystem

NASA Astrophysics Data System (ADS)

Golota, T.; De La Peña, M. D.; Biddick, C.; Lesser, M.; Leibold, T.; Miller, D.; Meeks, R.; Hahn, T.; Storm, J.; Sargent, T.; Summers, D.; Hill, J.; Kraus, J.; Hooper, S.; Fisher, D.

2014-07-01

The Large Binocular Telescope (LBT) has eight Acquisition, Guiding, and wavefront Sensing Units (AGw units). They provide guiding and wavefront sensing capability at eight different locations at both direct and bent Gregorian focal stations. Recent additions of focal stations for PEPSI and MODS instruments doubled the number of focal stations in use including respective motion, camera controller server computers, and software infrastructure communicating with Guiding Control Subsystem (GCS). This paper describes the improvements made to the LBT GCS and explains how these changes have led to better maintainability and contributed to increased reliability. This paper also discusses the current GCS status and reviews potential upgrades to further improve its performance.

Adaptive control schemes for improving dynamic performance of efficiency-optimized induction motor drives.

PubMed

Kumar, Navneet; Raj Chelliah, Thanga; Srivastava, S P

2015-07-01

Model Based Control (MBC) is one of the energy optimal controllers used in vector-controlled Induction Motor (IM) for controlling the excitation of motor in accordance with torque and speed. MBC offers energy conservation especially at part-load operation, but it creates ripples in torque and speed during load transition, leading to poor dynamic performance of the drive. This study investigates the opportunity for improving dynamic performance of a three-phase IM operating with MBC and proposes three control schemes: (i) MBC with a low pass filter (ii) torque producing current (iqs) injection in the output of speed controller (iii) Variable Structure Speed Controller (VSSC). The pre and post operation of MBC during load transition is also analyzed. The dynamic performance of a 1-hp, three-phase squirrel-cage IM with mine-hoist load diagram is tested. Test results are provided for the conventional field-oriented (constant flux) control and MBC (adjustable excitation) with proposed schemes. The effectiveness of proposed schemes is also illustrated for parametric variations. The test results and subsequent analysis confer that the motor dynamics improves significantly with all three proposed schemes in terms of overshoot/undershoot peak amplitude of torque and DC link power in addition to energy saving during load transitions. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Adaptive glide slope control for parafoil and payload aircraft

NASA Astrophysics Data System (ADS)

Ward, Michael

Airdrop systems provide a unique capability of delivering large payloads to undeveloped and inaccessible locations. Traditionally, these systems have been unguided, requiring large landing zones and drops from low altitude. The invention of the steerable, gliding, ram-air parafoil enabled the possibility of precision aerial payload delivery. In practice, the gliding ability of the ram-air parafoil can actually create major problems for airdrop systems by making them more susceptible to winds and allowing them to achieve far greater miss distances than were previously possible. Research and development work on guided airdrop systems has focused primarily on evolutionary improvements to the guidance algorithm, while the navigation and control algorithms have changed little since the initial autnomous systems were developed. Furthermore, the control mechanisms have not changed since the invention of the ram-air canopy in the 1960’s. The primary contributions of this dissertation are: (1) the development of a reliable and robust method to identify a flight dynamic model for a parafoil and payload aircraft using minimal sensor data; (2) the first demonstration in flight test of the ability to achieve large changes in glide slope over ground using coupled incidence angle variation and trailing edge brake deflection; (3) the first development of a control law to implement glide slope control on an autonomous system; (4) the first flight tests of autonomous landing with a glide slope control mechanism demonstrating an improvement in landing accuracy by a factor of 2 or more in especially windy conditions, and (5) the first demonstrations in both simulation and flight test of the ability to perform in-flight system identification to adapt the internal control mappings to flight data and provide dramatic improvements in landing accuracy when there is a significant discrepancy between the assumed and actual flight characteristics.

Rapid control and feedback rates enhance neuroprosthetic control

PubMed Central

Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

2017-01-01

Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms. PMID:28059065

Rapid control and feedback rates enhance neuroprosthetic control

NASA Astrophysics Data System (ADS)

Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

2017-01-01

Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms.

Impact of Computerized Decision Support on Blood Pressure Management and Control: A Randomized Controlled Trial

PubMed Central

Sequist, Thomas D.; Ayanian, John Z.; Shaykevich, Shimon; Fairchild, David G.; Orav, E. John; Bates, David W.

2008-01-01

BACKGROUND We conducted a cluster randomized controlled trial to examine the effectiveness of computerized decision support (CDS) designed to improve hypertension care and outcomes in a racially diverse sample of primary care patients. METHODS We randomized 2,027 adult patients receiving hypertension care in 14 primary care practices to either 18 months of their physicians receiving CDS for each hypertensive patient or to usual care without computerized support for the control group. We assessed prescribing of guideline-recommended drug therapy and levels of blood pressure control for patients in each group and examined if the effects of the intervention differed by patients’ race/ethnicity using interaction terms. MEASUREMENTS AND MAIN RESULTS Rates of blood pressure control were 42% at baseline and 46% at the outcome visit with no significant differences between groups. After adjustment for patients’ demographic and clinical characteristics, number of prior visits, and levels of baseline blood pressure control, there were no differences between intervention groups in the odds of outcome blood pressure control. The use of CDS to providers significantly improved Joint National Committee (JNC) guideline adherent medication prescribing compared to usual care (7% versus 5%, P < 0.001); the effects of the intervention remained after multivariable adjustment (odds ratio [OR] 1.39 [CI, 1.13–1.72]) and the effects of the intervention did not differ by patients’ race and ethnicity. CONCLUSIONS CDS improved appropriate medication prescribing with no improvement in disparities in care and overall blood pressure control. Future work focusing on improvement of these interventions and the study of other practical interventions to reduce disparities in hypertension-related outcomes is needed. PMID:18373141

The efficacy of early language intervention in mainstream school settings: a randomized controlled trial.

PubMed

Fricke, Silke; Burgoyne, Kelly; Bowyer-Crane, Claudine; Kyriacou, Maria; Zosimidou, Alexandra; Maxwell, Liam; Lervåg, Arne; Snowling, Margaret J; Hulme, Charles

2017-10-01

Oral language skills are a critical foundation for literacy and more generally for educational success. The current study shows that oral language skills can be improved by providing suitable additional help to children with language difficulties in the early stages of formal education. We conducted a randomized controlled trial with 394 children in England, comparing a 30-week oral language intervention programme starting in nursery (N = 132) with a 20-week version of the same programme starting in Reception (N = 133). The intervention groups were compared to an untreated waiting control group (N = 129). The programmes were delivered by trained teaching assistants (TAs) working in the children's schools/nurseries. All testers were blind to group allocation. Both the 20- and 30-week programmes produced improvements on primary outcome measures of oral language skill compared to the untreated control group. Effect sizes were small to moderate (20-week programme: d = .21; 30-week programme: d = .30) immediately following the intervention and were maintained at follow-up 6 months later. The difference in improvement between the 20-week and 30-week programmes was not statistically significant. Neither programme produced statistically significant improvements in children's early word reading or reading comprehension skills (secondary outcome measures). This study provides further evidence that oral language interventions can be delivered successfully by trained TAs to children with oral language difficulties in nursery and Reception classes. The methods evaluated have potentially important policy implications for early education. © 2017 Association for Child and Adolescent Mental Health.

KENNEDY SPACE CENTER, FLA. - Inside the hangar at Vandenberg Air Force Base, Calif., workers wait for the Pegasus launch vehicle to be moved inside. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - Inside the hangar at Vandenberg Air Force Base, Calif., workers wait for the Pegasus launch vehicle to be moved inside. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

An automated telephone nutrition support system for Spanish-speaking patients with diabetes.

PubMed

Khanna, Raman; Stoddard, Pamela J; Gonzales, Elizabeth N; Villagran-Flores, Mariana; Thomson, Joan; Bayard, Paul; Palos Lucio, Ana Gabriela; Schillinger, Dean; Bertozzi, Stefano; Gonzales, Ralph

2014-11-01

In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (-0.3% in the control arm, -0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland. © 2014 Diabetes Technology Society.

[Healthcare-Associated Infection Control with Awareness of Patient Safety].

PubMed

Murakami, Nobuo

2016-03-01

In order to provide safe and secure medical care for patients, health care-associated infections (HAI) must not occur. HAI should be considered as incidents, and countermeasures should be viewed as a patient safety management itself. Healthcare-associated infection control (HAIC) is practiced by the infection control team (ICT), which is based on multidisciplinary cooperation. Team members have to recognize that it is the most important to make use of the expertise of each discipline. In addition, all members must try to respond quickly, to help the clinic staff. Visualized rapid information provision and sharing, environmental improvement, outbreak factor analysis, hand hygiene compliance rate improvement, proper antibiotic use (Antimicrobial Stewardship Program: ASP), and regional cooperation & leadership comprise the role of the ICT in the flagship hospital. Regarding this role, we present our hospital's efforts and the outcomes. In conclusion, for medical practice quality improvement, healthcare-associated infection control should be conducted thoroughly along with an awareness of patient safety.

Evaluation of the Terminal Precision Scheduling and Spacing System for Near-Term NAS Application

NASA Technical Reports Server (NTRS)

Thipphavong, Jane; Martin, Lynne Hazel; Swenson, Harry N.; Lin, Paul; Nguyen, Jimmy

2012-01-01

NASA has developed a capability for terminal area precision scheduling and spacing (TAPSS) to provide higher capacity and more efficiently manage arrivals during peak demand periods. This advanced technology is NASA's vision for the NextGen terminal metering capability. A set of human-in-the-loop experiments was conducted to evaluate the performance of the TAPSS system for near-term implementation. The experiments evaluated the TAPSS system under the current terminal routing infrastructure to validate operational feasibility. A second goal of the study was to measure the benefit of the Center and TRACON advisory tools to help prioritize the requirements for controller radar display enhancements. Simulation results indicate that using the TAPSS system provides benefits under current operations, supporting a 10% increase in airport throughput. Enhancements to Center decision support tools had limited impact on improving the efficiency of terminal operations, but did provide more fuel-efficient advisories to achieve scheduling conformance within 20 seconds. The TRACON controller decision support tools were found to provide the most benefit, by improving the precision in schedule conformance to within 20 seconds, reducing the number of arrivals having lateral path deviations by 50% and lowering subjective controller workload. Overall, the TAPSS system was found to successfully develop an achievable terminal arrival metering plan that was sustainable under heavy traffic demand levels and reduce the complexity of terminal operations when coupled with the use of the terminal controller advisory tools.

Additional development of the XTRAN3S computer program

NASA Technical Reports Server (NTRS)

Borland, C. J.

1989-01-01

Additional developments and enhancements to the XTRAN3S computer program, a code for calculation of steady and unsteady aerodynamics, and associated aeroelastic solutions, for 3-D wings in the transonic flow regime are described. Algorithm improvements for the XTRAN3S program were provided including an implicit finite difference scheme to enhance the allowable time step and vectorization for improved computational efficiency. The code was modified to treat configurations with a fuselage, multiple stores/nacelles/pylons, and winglets. Computer program changes (updates) for error corrections and updates for version control are provided.

Artificial intelligence-based computer modeling tools for controlling slag foaming in electric arc furnaces

NASA Astrophysics Data System (ADS)

Wilson, Eric Lee

Due to increased competition in a world economy, steel companies are currently interested in developing techniques that will allow for the improvement of the steelmaking process, either by increasing output efficiency or by improving the quality of their product, or both. Slag foaming is one practice that has been shown to contribute to both these goals. However, slag foaming is highly dynamic and difficult to model or control. This dissertation describes an effort to use artificial intelligence-based tools (genetic algorithms, fuzzy logic, and neural networks) to both model and control the slag foaming process. Specifically, a neural network is trained and tested on slag foaming data provided by a steel plant. This neural network model is then controlled by a fuzzy logic controller, which in turn is optimized by a genetic algorithm. This tuned controller is then installed at a steel plant and given control be a more efficient slag foaming controller than what was previously used by the steel plant.

[Challenges and countermeasures of forestry schistosomiasis control programs in ecological priority of Yangtze River economic belt development].

PubMed

Ning, Su; Yong-Jie, Xu

2016-12-13

Relevant projects carried out within the Yangtze River economic belt on the impact of schistosomiasis epidemic and transmission are important issues for "ecological priority" in the process of implementing the strategy. The key problems of schistosomiasis epidemic risk, epidemic happening repeatedly, difficulty of rehabilitating Oncomelania hupensis snail control and schistosomiasis prevention forest, lag of evaluation system and platform construction, lack of basic research, et al. were analyzed in the Yangtze River economic belt taking "ecological priority" as the basis in this paper. Then corresponding countermeasures to these challenges were put forward so as to provide the reference for the national forestry schistosomiasis control programs, which include: execution of the comprehensive prevention and control strategy, scheming of the new round of forestry schistosomiasis control programs, strengthening schistosomiasis prevention and control, promoting productivity in existing forestry to consolidate and improve the achievements of previous forestry schistosomiasis control programs, and promoting the intensity of technological innovation to improve the technological level of forestry schistosomiasis control programs.

Improving Vocabulary and Pre-Literacy Skills of At-Risk Preschoolers through Teacher Professional Development

ERIC Educational Resources Information Center

Wasik, Barbara A.; Hindman, Annemarie H.

2011-01-01

In a randomized control study, Head Start teachers were assigned to either an intervention group that received intensive, ongoing professional development (PD) or to a comparison group that received the "business as usual" PD provided by Head Start. The PD intervention provided teachers with conceptual knowledge and instructional…

The March to Accountable Care Organizations--How Will Rural Fare?

ERIC Educational Resources Information Center

MacKinney, A. Clinton; Mueller, Keith J.; McBride, Timothy D.

2011-01-01

Purpose: This article describes a strategy for rural providers, communities, and policy makers to support or establish accountable care organizations (ACOs). Methods: ACOs represent a new health care delivery and provider payment system designed to improve clinical quality and control costs. The Patient Protection and Affordable Care Act (ACA)…

A survey of life support system automation and control

NASA Technical Reports Server (NTRS)

Finn, Cory K.

1993-01-01

The level of automation and control necessary to support advanced life support systems for use in the manned space program is steadily increasing. As the length and complexity of manned missions increase, life support systems must be able to meet new space challenges. Longer, more complex missions create new demands for increased automation, improved sensors, and improved control systems. It is imperative that research in these key areas keep pace with current and future developments in regenerative life support technology. This paper provides an overview of past and present research in the areas of sensor development, automation, and control of life support systems for the manned space program, and it discusses the impact continued research in several key areas will have on the feasibility, operation, and design of future life support systems.

[Evaluation of a medication self-management education program for elders with hypertension living in the community].

PubMed

Lee, Jong Kyung

2013-04-01

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension. The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program. There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure. The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

Hydropyrolysis process

DOEpatents

Ullman, Alan Z.; Silverman, Jacob; Friedman, Joseph

1986-01-01

An improved process for producing a methane-enriched gas wherein a hydrogen-deficient carbonaceous material is treated with a hydrogen-containing pyrolysis gas at an elevated temperature and pressure to produce a product gas mixture including methane, carbon monoxide and hydrogen. The improvement comprises passing the product gas mixture sequentially through a water-gas shift reaction zone and a gas separation zone to provide separate gas streams of methane and of a recycle gas comprising hydrogen, carbon monoxide and methane for recycle to the process. A controlled amount of steam also is provided which when combined with the recycle gas provides a pyrolysis gas for treatment of additional hydrogen-deficient carbonaceous material. The amount of steam used and the conditions within the water-gas shift reaction zone and gas separation zone are controlled to obtain a steady-state composition of pyrolysis gas which will comprise hydrogen as the principal constituent and a minor amount of carbon monoxide, steam and methane so that no external source of hydrogen is needed to supply the hydrogen requirements of the process. In accordance with a particularly preferred embodiment, conditions are controlled such that there also is produced a significant quantity of benzene as a valuable coproduct.

Polycythemia Vera Management and Challenges in the Community Health Setting

PubMed Central

Gerds, Aaron T.; Dao, Kim-Hien

2017-01-01

Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms. For many patients, PV is managed in a community health setting, and it is important that community hematologists, oncologists, and internists are familiar with the contemporary management of PV to improve patient outcomes, including management for patients who present with unique health-care needs. This review provides an overview of current treatment options for patients with PV and discusses challenging circumstances encountered by community providers in the management of PV, including symptom assessment, identification of hydroxyurea resistance/intolerance, pregnancy, elective surgeries, concomitant immunosuppressants, and managing patients in areas with limited access to specialized hematologic care. PMID:28095380

A low power medium access control protocol for wireless medical sensor networks.

PubMed

Lamprinos, I; Prentza, A; Sakka, E; Koutsouris, D

2004-01-01

The concept of a wireless integrated network of sensors, already applied in several sectors of our everyday life, such as security, transportation and environment monitoring, can as well provide an advanced monitor and control resource for healthcare services. By networking medical sensors wirelessly, attaching them in patient's body, we create the appropriate infrastructure for continuous and real-time monitoring of patient without discomforting him. This infrastructure can improve healthcare by providing the means for flexible acquisition of vital signs, while at the same time it provides more convenience to the patient. Given the type of wireless network, traditional medium access control (MAC) protocols cannot take advantage of the application specific requirements and information characteristics occurring in medical sensor networks, such as the demand for low power consumption and the rather limited and asymmetric data traffic. In this paper, we present the architecture of a low power MAC protocol, designated to support wireless networks of medical sensors. This protocol aims to improve energy efficiency by exploiting the inherent application features and requirements. It is oriented towards the avoidance of main energy wastage sources, such as idle listening, collision and power outspending.

Cognitive control under contingencies in anxious and depressed adolescents: an antisaccade task.

PubMed

Jazbec, Sandra; McClure, Erin; Hardin, Michael; Pine, Daniel S; Ernst, Monique

2005-10-15

Emotion-related perturbations in cognitive control characterize adult mood and anxiety disorders. Fewer data are available to confirm such deficits in youth. Studies of cognitive control and error processing can provide an ideal template to examine these perturbations. Antisaccade paradigms are particularly well suited for this endeavor because they provide exquisite behavioral measures of modulation of response errors. A new monetary reward antisaccade task was used with 28 healthy, 11 anxious, and 12 depressed adolescents. Performance accuracy, saccade latency, and peak velocity of incorrect responses were analyzed. Performance accuracy across all groups was improved by incentives (obtain reward, avoid punishment). However, modulation of saccade errors by incentives differed by groups. In incentive trials relative to neutral trials, inhibitory efficiency (saccade latency) was enhanced in healthy, unaffected in depressed, and diminished in anxious adolescents. Modulation of errant actions (saccade peak velocity) was improved in the healthy group and unchanged in both the anxious and depressed groups. These findings provide grounds for testing hypotheses related to the impact of motivation deficits and emotional interference on directed action in adolescents with mood and anxiety disorders. Furthermore, neural mechanisms can now be examined by using this task paired with functional neuroimaging.

Improved Gout Outcomes in Primary Care Using a Novel Disease Management Program: A Pilot Study.

PubMed

Bulbin, David; Denio, Alfred E; Berger, Andrea; Brown, Jason; Maynard, Carson; Sharma, Tarun; Kirchner, H Lester; Ayoub, William T

2018-02-13

To pilot a primary care gout management improvement intervention. Two large primary care sites were selected: one underwent the intervention, the other, a control, underwent no intervention. The intervention consisted of: engagement of intervention site staff, surveys of provider performance improvement preferences, and onsite live and enduring online education. Electronic Health Record reminders were constructed. Both the intervention and control sites had 3 quality measures assessed monthly: percent of gout patients treated with urate lowering therapy, percent of treated patients monitored with serum urate, and percent of treated patients at target serum urate ≤ 6.0 mg/dl. The intervention site providers received monthly reports comparing their measures against their peers. By 6 months, the intervention site significantly improved all 3 gout performance measures. Percentage treated increased from 54.4 to 61.1%, OR 1.19 (95% CI 1.08, 1.31 and p-value <0.001); percentage monitored increased from 56.1 to 79.2% OR 1.52 (95% CI 1.24, 1.87 and P-value <0.001); and percentage at goal increased from 26.8 to 43.3% OR 1.43 (95% CI 1.16, 1.77 and p-value <0.001. At 6 months after intervention, gout patients at the intervention site were more likely to be monitored (79.2% vs. 53.4%, OR 3.54 (95% CI: 2.30, 5.45 and p-value < 0.001)) and at goal (43.3% vs. 28.3%; OR 1.99 (95% CI: 1.33, 2.96 and p-value <0.001) than control site patients. Numbers treated did not significantly improve over the control site. A pilot multifaceted gout management program can significantly improve primary care gout management performance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The research and realization of multi-platform real-time message-oriented middleware in large-scale air traffic control system

NASA Astrophysics Data System (ADS)

Liang, Haijun; Ren, Jialong; Song, Tao

2017-05-01

Operating requirement of air traffic control system, the multi-platform real-time message-oriented middleware was studied and realized, which is composed of CDCC and CDCS. The former provides application process interface, while the latter realizes data synchronism of CDCC and data exchange. MQM, as one important part of it, provides message queue management and, encrypt and compress data during transmitting procedure. The practical system application verifies that the middleware can simplify the development of air traffic control system, enhance its stability, improve its systematic function and make it convenient for maintenance and reuse.

Schistosomiasis control through rural health units.

PubMed

el Katsha, S; Watts, S

1995-01-01

In Egypt the main effort in the campaign against schistosomiasis involves providing free diagnosis and treatment through primary care facilities, especially rural health units. The prospects for improving these services are considered below.

Dramatic pretend play games uniquely improve emotional control in young children.

PubMed

Goldstein, Thalia R; Lerner, Matthew D

2017-09-15

Pretense is a naturally occurring, apparently universal activity for typically developing children. Yet its function and effects remain unclear. One theorized possibility is that pretense activities, such as dramatic pretend play games, are a possible causal path to improve children's emotional development. Social and emotional skills, particularly emotional control, are critically important for social development, as well as academic performance and later life success. However, the study of such approaches has been criticized for potential bias and lack of rigor, precluding the ability to make strong causal claims. We conducted a randomized, component control (dismantling) trial of dramatic pretend play games with a low-SES group of 4-year-old children (N = 97) to test whether such practice yields generalized improvements in multiple social and emotional outcomes. We found specific effects of dramatic play games only on emotional self-control. Results suggest that dramatic pretend play games involving physicalizing emotional states and traits, pretending to be animals and human characters, and engaging in pretend scenarios in a small group may improve children's emotional control. These findings have implications for the function of pretense and design of interventions to improve emotional control in typical and atypical populations. Further, they provide support for the unique role of dramatic pretend play games for young children, particularly those from low-income backgrounds. A video abstract of this article can be viewed at: https://youtu.be/2GVNcWKRHPk. © 2017 John Wiley & Sons Ltd.

Statistical process control: separating signal from noise in emergency department operations.

PubMed

Pimentel, Laura; Barrueto, Fermin

2015-05-01

Statistical process control (SPC) is a visually appealing and statistically rigorous methodology very suitable to the analysis of emergency department (ED) operations. We demonstrate that the control chart is the primary tool of SPC; it is constructed by plotting data measuring the key quality indicators of operational processes in rationally ordered subgroups such as units of time. Control limits are calculated using formulas reflecting the variation in the data points from one another and from the mean. SPC allows managers to determine whether operational processes are controlled and predictable. We review why the moving range chart is most appropriate for use in the complex ED milieu, how to apply SPC to ED operations, and how to determine when performance improvement is needed. SPC is an excellent tool for operational analysis and quality improvement for these reasons: 1) control charts make large data sets intuitively coherent by integrating statistical and visual descriptions; 2) SPC provides analysis of process stability and capability rather than simple comparison with a benchmark; 3) SPC allows distinction between special cause variation (signal), indicating an unstable process requiring action, and common cause variation (noise), reflecting a stable process; and 4) SPC keeps the focus of quality improvement on process rather than individual performance. Because data have no meaning apart from their context, and every process generates information that can be used to improve it, we contend that SPC should be seriously considered for driving quality improvement in emergency medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

Control-enhanced multiparameter quantum estimation

NASA Astrophysics Data System (ADS)

Liu, Jing; Yuan, Haidong

2017-10-01

Most studies in multiparameter estimation assume the dynamics is fixed and focus on identifying the optimal probe state and the optimal measurements. In practice, however, controls are usually available to alter the dynamics, which provides another degree of freedom. In this paper we employ optimal control methods, particularly the gradient ascent pulse engineering (GRAPE), to design optimal controls for the improvement of the precision limit in multiparameter estimation. We show that the controlled schemes are not only capable to provide a higher precision limit, but also have a higher stability to the inaccuracy of the time point performing the measurements. This high time stability will benefit the practical metrology, where it is hard to perform the measurement at a very accurate time point due to the response time of the measurement apparatus.

Flight evaluation of a digital electronic engine control system in an F-15 airplane

NASA Technical Reports Server (NTRS)

Myers, L. P.; Mackall, K. G.; Burcham, F. W., Jr.; Walter, W. A.

1982-01-01

Benefits provided by a full-authority digital engine control are related to improvements in engine efficiency, performance, and operations. An additional benefit is the capability of detecting and accommodating failures in real time and providing engine-health diagnostics. The digital electronic engine control (DEEC), is a full-authority digital engine control developed for the F100-PW-100 turbofan engine. The DEEC has been flight tested on an F-15 aircraft. The flight tests had the objective to evaluate the DEEC hardware and software over the F-15 flight envelope. A description is presented of the results of the flight tests, which consisted of nonaugmented and augmented throttle transients, airstarts, and backup control operations. The aircraft, engine, DEEC system, and data acquisition and reduction system are discussed.

Progress in research, control and elimination of helminth infections in Asia.

PubMed

Utzinger, Jürg; Brattig, Norbert W; Leonardo, Lydia; Zhou, Xiao-Nong; Bergquist, Robert

2015-01-01

Global health has substantially improved over the past 20 years. In low- and middle-income countries, in particular, great strives have been made in the control of communicable diseases, including helminth infections. Nevertheless, the most marginalised communities still suffer from infectious diseases that are intimately connected with poverty and lack of access to essential commodities and services, such as clean water, improved sanitation and sufficient food. A two-pronged approach is thus necessary: (i) intensifying control in remaining high-endemicity areas and pockets of high transmission; and (ii) moving from morbidity control to interruption of disease transmission in low-endemicity areas with the goal of local elimination. The latter will require new tools and strategies, going hand-in-hand with strong partnerships and new strategic alliances. In this special issue of Acta Tropica, 35 articles are featured that, together, provide an up-to-date overview of the latest progress made in research, control and elimination of helminth infections in East and Southeast Asia. The first 12 articles expound tools and approaches for improved detection, surveillance and monitoring of helminth infections. Control and elimination approaches for the most important helminth infections are revisited in the next 20 articles. The three remaining articles are cross-cutting pieces examining the interface of agriculture, environment and helminth infections and providing a rationale for integrated, multi-sectorial control approaches that are necessary for sustaining helminthiasis control and progressively moving towards elimination. An interesting aspect revealed through an in-depth analysis of the provenance of the 35 contributions is that the People's Republic of China emerges as a key player in global health, which is documented through its prominent role in research and control of helminth infection and networking throughout Asia. Policy implications are discussed and will hopefully shape the future agenda for the control and elimination of helminth infections the world over. Copyright © 2014. Published by Elsevier B.V.

Improving fundamental movement skills in Hong Kong students through an assessment for learning intervention that emphasizes fun, mastery, and support: the A + FMS randomized controlled trial study protocol.

PubMed

Chan, Cecilia; Ha, Amy; Ng, Johan Y Y

2016-01-01

Assessment for learning has been identified as an effective strategy to help children learn more effectively. Developing children to master basic movement skills in primary school requires formative assessments to inform instruction and learning. This study reports the rationale and methods for an assessment-based intervention that emphasizes fun, mastery and support (A + FMS) designed to improve fundamental movement skill (FMS) proficiency of primary schoolchildren. Utilizing a cluster randomized controlled trial, the A + FMS intervention was designed to improve FMS proficiency of Hong Kong Chinese schoolchildren. A target sample of 282 students or more from 10 Grade 3 classes (from five schools) will be recruited and randomly assigned into an experimental group or a wait-list control group. Competence motivation theory provided a framework for the intervention that emphasizes fun activities to develop basic fundamentals, improving mastery of movement, and providing support for teaching and learning skills. Primary outcome measures are the raw scores of six objectively measured FMS (i.e., jump, hop, skip, dribble, catch, and overhand throw). Secondary outcomes include self-reported measures: enjoyment in physical education, perceived physical competence, perceived skill competence, and perceived social support. Teachers in the experimental group are required to attend a six-h training workshop and integrate 550 min of assessment for learning strategies into their physical education lessons. Resources such as videos, skills checklists, and equipment will also be provided to support children to accumulate extra learning and practice time after school. The rate of changes in primary and secondary outcomes across the experimental and control groups will be compared to determine the effectiveness of the program. The A + FMS is an innovative school-based intervention targeting improvements in movement mastery by supporting physical education teachers in FMS instruction and assessment practices. The findings from the study may be used to guide pre-service teacher education and continuous professional development in FMS teaching and assessment. Trial registration CUHK_CCRB00479.

Memory feedback PID control for exponential synchronisation of chaotic Lur'e systems

NASA Astrophysics Data System (ADS)

Zhang, Ruimei; Zeng, Deqiang; Zhong, Shouming; Shi, Kaibo

2017-09-01

This paper studies the problem of exponential synchronisation of chaotic Lur'e systems (CLSs) via memory feedback proportional-integral-derivative (PID) control scheme. First, a novel augmented Lyapunov-Krasovskii functional (LKF) is constructed, which can make full use of the information on time delay and activation function. Second, improved synchronisation criteria are obtained by using new integral inequalities, which can provide much tighter bounds than what the existing integral inequalities can produce. In comparison with existing results, in which only proportional control or proportional derivative (PD) control is used, less conservative results are derived for CLSs by PID control. Third, the desired memory feedback controllers are designed in terms of the solution to linear matrix inequalities. Finally, numerical simulations of Chua's circuit and neural network are provided to show the effectiveness and advantages of the proposed results.

Optimization and Control of Acoustic Liner Impedance with Bias Flow

NASA Technical Reports Server (NTRS)

Wood, Houston; Follet, Jesse

2000-01-01

Because communities are impacted by steady increases in aircraft traffic, aircraft noise continues to be a growing problem for the growth of commercial aviation. Research has focused on improving the design of specific high noise source areas of aircraft and on noise control measures to alleviate noise radiated from aircraft to the surrounding environment. Engine duct liners have long been a principal means of attenuating engine noise. The ability to control in-situ the acoustic impedance of a liner would provide a valuable tool to improve the performance of liners. The acoustic impedance of a liner is directly related to the sound absorption qualities of that liner. Increased attenuation rates, the ability to change liner acoustic impedance to match various operating conditions, or the ability to tune a liner to more precisely match design impedance represent some ways that in-situ impedance control could be useful. With this in mind, the research to be investigated will focus on improvements in the ability to control liner impedance using a mean flow through the liner which is referred to as bias flow.

Liquid human milk fortifier significantly improves docosahexaenoic and arachidonic acid status in preterm infants.

PubMed

Berseth, C L; Harris, C L; Wampler, J L; Hoffman, D R; Diersen-Schade, D A

2014-09-01

We report the fatty acid composition of mother׳s own human milk from one of the largest US cohorts of lactating mothers of preterm infants. Milk fatty acid data were used as a proxy for intake at enrollment in infants (n=150) who received human milk with a powder human milk fortifier (HMF; Control) or liquid HMF [LHMF; provided additional 12mg docosahexaenoic acid (DHA), 20mg arachidonic acid (ARA)/100mL human milk]. Mothers provided milk samples (n=129) and reported maternal DHA consumption (n=128). Infant blood samples were drawn at study completion (Study Day 28). Human milk and infant PPL fatty acids were analyzed using capillary column gas chromatography. DHA and ARA were within ranges previously published for US term and preterm human milk. Compared to Control HMF (providing no DHA or ARA), human milk fortified with LHMF significantly increased infant PPL DHA and ARA and improved preterm infant DHA and ARA status. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Economic Value of Environmental Services on Indigenous-Held Lands in Australia

PubMed Central

Zander, Kerstin K.; Garnett, Stephen T.

2011-01-01

Australians could be willing to pay from $878m to $2b per year for Indigenous people to provide environmental services. This is up to 50 times the amount currently invested by government. This result was derived from a nationwide survey that included a choice experiment in which 70% of the 927 respondents were willing to contribute to a conservation fund that directly pays Indigenous people to carry out conservation activities. Of these the highest values were found for benefits that are likely to improve biodiversity outcomes, carbon emission reductions and improved recreational values. Of the activities that could be undertaken to provide the services, feral animal control attracted the highest level of support followed by coastal surveillance, weed control and fire management. Respondents' decisions to pay were not greatly influenced by the additional social benefits that can arise for Indigenous people spending time on country and providing the services, although there was approval for reduced welfare payments that might arise. PMID:21826234

SUPPORTING PHYSICIANS' PRACTICE-BASED LEARNING AND IMPROVEMENT (PBLI) AND QUALITY IMPROVEMENT THROUGH EXPLORATION OF POPULATION-BASED MEDICAL DATA.

PubMed

Baumgart, Leigh A; Bass, Ellen J; Lyman, Jason A; Springs, Sherry; Voss, John; Hayden, Gregory F; Hellems, Martha A; Hoke, Tracey R; Schlag, Katharine A; Schorling, John B

2010-01-01

Participating in self-assessment activities may stimulate improvement in practice behaviors. However, it is unclear how best to support the development of self-assessment skills, particularly in the health care domain. Exploration of population-based data is one method to enable health care providers to identify deficiencies in overall practice behavior that can motivate quality improvement initiatives. At the University of Virginia, we are developing a decision support tool to integrate and present population-based patient data to health care providers related to both clinical outcomes and non-clinical measures (e.g., demographic information). By enabling users to separate their direct impact on clinical outcomes from other factors out of their control, we may enhance the self-assessment process.

SUPPORTING PHYSICIANS’ PRACTICE-BASED LEARNING AND IMPROVEMENT (PBLI) AND QUALITY IMPROVEMENT THROUGH EXPLORATION OF POPULATION-BASED MEDICAL DATA

PubMed Central

Baumgart, Leigh A.; Bass, Ellen J.; Lyman, Jason A.; Springs, Sherry; Voss, John; Hayden, Gregory F.; Hellems, Martha A.; Hoke, Tracey R.; Schlag, Katharine A.; Schorling, John B.

2011-01-01

Participating in self-assessment activities may stimulate improvement in practice behaviors. However, it is unclear how best to support the development of self-assessment skills, particularly in the health care domain. Exploration of population-based data is one method to enable health care providers to identify deficiencies in overall practice behavior that can motivate quality improvement initiatives. At the University of Virginia, we are developing a decision support tool to integrate and present population-based patient data to health care providers related to both clinical outcomes and non-clinical measures (e.g., demographic information). By enabling users to separate their direct impact on clinical outcomes from other factors out of their control, we may enhance the self-assessment process. PMID:21874123

A memory and organizational aid improves Alzheimer disease research consent capacity: results of a randomized, controlled trial.

PubMed

Rubright, Jonathan; Sankar, Pamela; Casarett, David J; Gur, Ruben; Xie, Sharon X; Karlawish, Jason

2010-12-01

Early and progressive cognitive impairments of patients with Alzheimer disease (AD) hinder their capacity to provide informed consent. Unfortunately, the limited research on techniques to improve capacity has shown mixed results. Therefore, the authors tested whether a memory and organizational aid improves the performance of patients with AD on measures of capacity and competency to give informed consent. Patients with AD randomly assigned to standard consent or standard plus a memory and organizational aid. Memory and organizational aid summarized the content of information mandated under the informed consent disclosure requirements of the Common Rule at a sixth grade reading level. Three psychiatrists without access to patient data independently reviewed MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) interview transcripts to judge whether the patient was capable of providing informed consent. The agreement of at least two of the three experts defined a participant as capable of providing informed consent. Secondary outcomes are MacCAT-CR measures of understanding, appreciation and reasoning, and comparison with cognitively normal older adult norms. AD intervention and control groups were similar in terms of age, education, and cognitive status. The intervention group was more likely to be judged competent than control group and had higher scores on MacCAT-CR measure of understanding. The intervention had no effect on the measures of appreciation or reasoning. A consent process that addresses the deficits in memory and attention of a patient with AD can improve capacity to give informed consent for early phase AD research. The results also validate the MacCAT-CR as an instrument to measure capacity, especially the understanding subscale. ClinicalTrials.Gov#NCT00105612, http://clinicaltrials.gov/show/NCT00105612.

A memory and organizational aid improves AD research consent capacity: Results of a randomized, controlled trial

PubMed Central

Rubright, Jonathan; Sankar, Pamela; Casarett, David J; Gur, Ruben; Xie, Sharon X; Karlawish, Jason

2010-01-01

Objectives AD patients' early and progressive cognitive impairments hinder their capacity to provide informed consent. Unfortunately, the limited research on techniques to improve capacity has shown mixed results. Therefore, we tested whether a memory and organizational aid improves AD patient performance on measures of capacity and competency to give informed consent. Design, Setting, and Participants AD patients randomly assigned to standard consent, or standard plus a memory and organizational aid. Intervention Memory and organizational aid summarized at a 6th grade reading level the content of information mandated under the Common Rule's informed consent disclosure requirements. Measurements Three psychiatrists without access to patient data independently reviewed MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) interview transcripts to judge whether the patient was capable of providing informed consent. The agreement of at least two of three experts defined a participant as capable of providing informed consent. Secondary outcomes are MacCAT-CR measures of understanding, appreciation and reasoning, and comparison to cognitively normal older adult norms. Results AD intervention and control groups were similar in terms of age, education, and cognitive status. The intervention group was more likely to be judged competent than control group and had higher scores on MacCAT-CR measure of understanding. The intervention had no effect on measures of appreciation or reasoning. Conclusions A consent process that addresses an AD patients' deficits in memory and attention can improve capacity to give informed consent for early phase AD research. The results also validate the MacCAT-CR as an instrument to measure capacity, especially the understanding subscale. PMID:20808101

HIAD Advancements and Extension of Mission Applications

NASA Technical Reports Server (NTRS)

Johnson, R. Keith; Cheatwood, F. McNeil; Calomino, Anthony M.; Hughes, Stephen J.; Korzun, Ashley M.; DiNonno, John M.; Lindell, Mike C.; Swanson, Greg T.

2016-01-01

The Hypersonic Inflatable Aerodynamic Decelerator (HIAD) technology has made significant advancements over the last decade with flight test demonstrations and ground development campaigns. The first generation (Gen-1) design and materials were flight tested with the successful third Inflatable Reentry Vehicle Experiment flight test of a 3-m HIAD (IRVE-3). Ground development efforts incorporated materials with higher thermal capabilities for the inflatable structure (IS) and flexible thermal protection system (F-TPS) as a second generation (Gen-2) system. Current efforts and plans are focused on extending capabilities to improve overall system performance and reduce areal weight, as well as expand mission applicability. F-TPS materials that offer greater thermal resistance, and ability to be packed to greater density, for a given thickness are being tested to demonstrated thermal performance benefits and manufacturability at flight-relevant scale. IS materials and construction methods are being investigated to reduce mass, increase load capacities, and improve durability for packing. Previous HIAD systems focused on symmetric geometries using stacked torus construction. Flight simulations and trajectory analysis show that symmetrical HIADs may provide L/D up to 0.25 via movable center of gravity (CG) offsets. HIAD capabilities can be greatly expanded to suit a broader range of mission applications with asymmetric shapes and/or modulating L/D. Various HIAD concepts are being developed to provide greater control to improve landing accuracy and reduce dependency upon propulsion systems during descent and landing. Concepts being studied include a canted stack torus design, control surfaces, and morphing configurations that allow the shape to be actively manipulated for flight control. This paper provides a summary of recent HIAD development activities, and plans for future HIAD developments including advanced materials, improved construction techniques, and alternate geometry concepts that will greatly expand HIAD mission applications.

A Course in English for Air Traffic Controllers.

ERIC Educational Resources Information Center

McCann, Paul; Thompson, Lesley

A description is provided of a course, developed by the British Council in Madrid, Spain, to improve the English language training for trainee air traffic services personnel as a result of an increased demand for trained controllers over the next few years. The course aims to teach students in the areas of standard radiotelephony, non-routine…

The Association between Funding for Statewide Programs and Enactment of Obesity Legislation

ERIC Educational Resources Information Center

Hersey, James; Lynch, Christina; Williams-Piehota, Pamela; Rooks, Adrienne; Hamre, Robin; Chappelle, Eileen F.; Roussel, Amy; O'Toole, Terry; Grasso, Tamara; Hannan, Casey

2010-01-01

Objective: As part of a national effort to prevent and control obesity, the Centers for Disease Control and Prevention's (CDC's) Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases (NPAO) provides funding to states to improve access to healthful food and increase opportunities for physical activity. The CDC also…

Improving Pain Care with Project ECHO in Community Health Centers.

PubMed

Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

2017-10-01

Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

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

NASA Technical Reports Server (NTRS)

Orme, John S.; Schkolnik, Gerard S.

1995-01-01

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

Improving service delivery of water, sanitation, and hygiene in primary schools: a cluster-randomized trial in western Kenya.

PubMed

Alexander, Kelly T; Dreibelbis, Robert; Freeman, Matthew C; Ojeny, Betty; Rheingans, Richard

2013-09-01

Water, sanitation, and hygiene (WASH) programs in schools have been shown to improve health and reduce absence. In resource-poor settings, barriers such as inadequate budgets, lack of oversight, and competing priorities limit effective and sustained WASH service delivery in schools. We employed a cluster-randomized trial to examine if schools could improve WASH conditions within existing administrative structures. Seventy schools were divided into a control group and three intervention groups. All intervention schools received a budget for purchasing WASH-related items. One group received no further intervention. A second group received additional funding for hiring a WASH attendant and making repairs to WASH infrastructure, and a third group was given guides for student and community monitoring of conditions. Intervention schools made significant improvements in provision of soap and handwashing water, treated drinking water, and clean latrines compared with controls. Teachers reported benefits of monitoring, repairs, and a WASH attendant, but quantitative data of WASH conditions did not determine whether expanded interventions out-performed our budget-only intervention. Providing schools with budgets for WASH operational costs improved access to necessary supplies, but did not ensure consistent service delivery to students. Further work is needed to clarify how schools can provide WASH services daily.

Positive Imagery-Based Cognitive Bias Modification as a Web-Based Treatment Tool for Depressed Adults

PubMed Central

Blackwell, Simon E.; Browning, Michael; Mathews, Andrew; Pictet, Arnaud; Welch, James; Davies, Jim; Watson, Peter; Geddes, John R.

2015-01-01

Depression is a global health problem requiring treatment innovation. Targeting neglected cognitive aspects may provide a useful route. We tested a cognitive-training paradigm using positive mental imagery (imagery cognitive bias modification, imagery CBM), developed via experimental psychopathology studies, in a randomized controlled trial. Training was delivered via the Internet to 150 individuals with current major depression. Unexpectedly, there was no significant advantage for imagery CBM compared with a closely matched control for depression symptoms as a whole in the full sample. In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery. Results suggest avenues for improving imagery CBM to inform low-intensity treatment tools for depression. Anhedonia may be a useful treatment target for future work. PMID:25984421

Controlled release in transdermal pressure sensitive adhesives using organosilicate nanocomposites.

PubMed

Shaikh, Sohel; Birdi, Anil; Qutubuddin, Syed; Lakatosh, Eric; Baskaran, Harihara

2007-12-01

Polydimethyl siloxane (PDMS) based pressure sensitive adhesives (PSA) incorporating organo-clays at different loadings were fabricated via solution casting. Partially exfoliated nanocomposites were obtained for the hydroxyl terminated PDMS in ethyl acetate solvent as determined by X-ray diffraction and atomic force microscopy. Drug release studies showed that the initial burst release was substantially reduced and the drug release could be controlled by the addition of organo-clay. Shear strength and shear adhesion failure temperature (SAFT) measurements indicated substantial improvement in adhesive properties of the PSA nanocomposite adhesives. Shear strength showed more than 200% improvement at the lower clay loadings and the SAFT increased by about 21% due to the reinforcement provided by the nano-dispersed clay platelets. It was found that by optimizing the level of the organosilicate additive to the polymer matrix, superior control over drug release kinetics and simultaneous improvements in adhesive properties could be attained for a transdermal PSA formulation.

Improving attention control in dysphoria through cognitive training: transfer effects on working memory capacity and filtering efficiency.

PubMed

Owens, Max; Koster, Ernst H W; Derakshan, Nazanin

2013-03-01

Impaired filtering of irrelevant information from working memory is thought to underlie reduced working memory capacity for relevant information in dysphoria. The current study investigated whether training-related gains in working memory performance on the adaptive dual n-back task could result in improved inhibitory function. Efficacy of training was monitored in a change detection paradigm allowing measurement of a sustained event-related potential asymmetry sensitive to working memory capacity and the efficient filtering of irrelevant information. Dysphoric participants in the training group showed training-related gains in working memory that were accompanied by gains in working memory capacity and filtering efficiency compared to an active control group. Results provide important initial evidence that behavioral performance and neural function in dysphoria can be improved by facilitating greater attentional control. Copyright © 2013 Society for Psychophysiological Research.

Effectiveness of Parent-Child Mediation in Improving Family Functioning and Reducing Adolescent Problem Behavior: Results from a Pilot Randomized Controlled Trial.

PubMed

Tucker, Joan S; Edelen, Maria Orlando; Huang, Wenjing

2017-03-01

Parent-child mediation programs are intended to resolve or manage disputes and improve family functioning, but rigorous evaluations of their effectiveness are lacking. Families referred to a community-based mediation program (N = 111) were randomized to an intervention or wait-list control group, and completed three surveys over a 12-week period. With the exception of parent-reported child delinquency (which decreased more in the intervention group), this evaluation provides little support for the short-term effectiveness of parent-child mediation for improving family functioning and reducing child problem behaviors in general. Given that this is the first randomized controlled trial of a parent-child mediation program, additional evaluations involving larger samples and longer follow-ups are needed before firm conclusions can be drawn about the effectiveness of this intervention.

Control Structures for VSC-based FACTS Devices under Normal and Faulted AC-systems

NASA Astrophysics Data System (ADS)

Babaei, Saman

This thesis is concerned with improving the Flexible AC Transmission Systems (FACTS) devices performance under the normal and fault AC-system conditions by proposing new control structures and also converter topologies. The combination of the increasing electricity demand and restrictions in expanding the power system infrastructures has urged the utility owners to deploy the utility-scaled power electronics in the power system. Basically, FACTS is referred to the application of the power electronics in the power systems. Voltage Source Converter (VSC) is the preferred building block of the FACTS devices and many other utility-scale power electronics applications. Despite of advances in the semiconductor technology and ultra-fast microprocessor based controllers, there are still many issues to address and room to improve[25]. An attempt is made in this thesis to address these important issues of the VSC-based FACTS devices and provide solutions to improve them.

Effectiveness of Parent-Child Mediation in Improving Family Functioning and Reducing Adolescent Problem Behavior: Results from a Pilot Randomized Controlled Trial

PubMed Central

Tucker, Joan S.; Edelen, Maria Orlando; Huang, Wenjing

2016-01-01

Parent-child mediation programs are intended to resolve or manage disputes and improve family functioning, but rigorous evaluations of their effectiveness are lacking. Families referred to a community-based mediation program (N=111) were randomized to an intervention or wait-list control group, and completed three surveys over a 12-week period. With the exception of parent-reported child delinquency (which decreased more in the intervention group), this evaluation provides little support for the short-term effectiveness of parent-child mediation for improving family functioning and reducing child problem behaviors in general. Given that this is the first randomized controlled trial of a parent-child mediation program, additional evaluations involving larger samples and longer follow-ups are needed before firm conclusions can be drawn about the effectiveness of this intervention. PMID:26762375

Architectures for mission control at the Jet Propulsion Laboratory

NASA Technical Reports Server (NTRS)

Davidson, Reger A.; Murphy, Susan C.

1992-01-01

JPL is currently converting to an innovative control center data system which is a distributed, open architecture for telemetry delivery and which is enabling advancement towards improved automation and operability, as well as new technology, in mission operations at JPL. The scope of mission control within mission operations is examined. The concepts of a mission control center and how operability can affect the design of a control center data system are discussed. Examples of JPL's mission control architecture, data system development, and prototype efforts at the JPL Operations Engineering Laboratory are provided. Strategies for the future of mission control architectures are outlined.

National plan to enhance aviation safety through human factors improvements

NASA Technical Reports Server (NTRS)

Foushee, Clay

1990-01-01

The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.

Closed-loop control of anesthesia: a primer for anesthesiologists.

PubMed

Dumont, Guy A; Ansermino, J Mark

2013-11-01

Feedback control is ubiquitous in nature and engineering and has revolutionized safety in fields from space travel to the automobile. In anesthesia, automated feedback control holds the promise of limiting the effects on performance of individual patient variability, optimizing the workload of the anesthesiologist, increasing the time spent in a more desirable clinical state, and ultimately improving the safety and quality of anesthesia care. The benefits of control systems will not be realized without widespread support from the health care team in close collaboration with industrial partners. In this review, we provide an introduction to the established field of control systems research for the everyday anesthesiologist. We introduce important concepts such as feedback and modeling specific to control problems and provide insight into design requirements for guaranteeing the safety and performance of feedback control systems. We focus our discussion on the optimization of anesthetic drug administration.

Development and flight test experiences with a flight-crucial digital control system

NASA Technical Reports Server (NTRS)

Mackall, Dale A.

1988-01-01

Engineers and scientists in the advanced fighter technology integration (AFTI) F-16 program investigated the integration of emerging technologies into an advanced fighter aircraft. AFTI's three major technologies included: flight-crucial digital control, decoupled aircraft flight control, and integration of avionics, flight control, and pilot displays. In addition to investigating improvements in fighter performance, researchers studied the generic problems confronting the designers of highly integrated flight-crucial digital control. An overview is provided of both the advantages and problems of integration digital control systems. Also, an examination of the specification, design, qualification, and flight test life-cycle phase is provided. An overview is given of the fault-tolerant design, multimoded decoupled flight control laws, and integrated avionics design. The approach to qualifying the software and system designs is discussed, and the effects of design choices on system qualification are highlighted.

Effects of lifestyle education program for type 2 diabetes patients in clinics: study design of a cluster randomized trial.

PubMed

Adachi, Misa; Yamaoka, Kazue; Watanabe, Mariko; Nishikawa, Masako; Hida, Eisuke; Kobayashi, Itsuro; Tango, Toshiro

2010-11-30

The number of patients with type 2 diabetes is drastically increasing worldwide. It is a serious health problem in Japan as well. Lifestyle interventions can reduce progression from impaired glucose tolerance to type 2 diabetes, and glycemic control has been shown to improve postprandial plasma glucose levels. Moreover, several studies have suggested that continuous interventions (combined diet and exercise) can improve the plasma glucose level and reduce dosage of hypoglycemic agents.Although many interventional studies of lifestyle education for persons with diabetes in hospitals have been reported, only a few have been clinic-based studies employing an evidence-based lifestyle education program. This article describes the design of a cluster randomized controlled trial of the effectiveness of lifestyle education for patients with type 2 diabetes in clinics by registered dietitians. In Japan, general practitioners generally have their own medical clinics to provide medical care for outpatients in the community, including those with type 2 diabetes. With the collaboration of such general practitioners, the study patients were enrolled in the present study. Twenty general practitioners were randomly allocated to each provide patients for entry into either an intervention group (10) or a control group (10). In total, 200 participants will be included in the study. The intervention group will receive intensive education on lifestyle improvement related to type 2 diabetes by registered dietitians in clinics. Lifestyle education will be conducted several times during the study period. The control group will receive information on dietary intake and standard advice on glycemic control by registered dietitians. The primary endpoint is the change from the baseline value of HbA1c at 6 months. Data on health behavior and related issues will be gathered continuously over a 6-month period. This is the first study to evaluate lifestyle education in clinics by a cluster randomization trial in Japan. The proposed study will provide practical information about the usefulness of the intensive lifestyle improvement education program in primary care settings. The study was started in September 2007 and entry of subjects was completed in December 2010. Data on the effect evaluation will be available in 2011. UMIN000004049.

A Wind Tunnel Model to Explore Unsteady Circulation Control for General Aviation Applications

NASA Technical Reports Server (NTRS)

Cagle, Christopher M.; Jones, Gregory S.

2002-01-01

Circulation Control airfoils have been demonstrated to provide substantial improvements in lift over conventional airfoils. The General Aviation Circular Control model is an attempt to address some of the concerns of this technique. The primary focus is to substantially reduce the amount of air mass flow by implementing unsteady flow. This paper describes a wind tunnel model that implements unsteady circulation control by pulsing internal pneumatic valves and details some preliminary results from the first test entry.

Volttron version 5.0

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

VOLTTRON is an agent execution platform providing services to its agents that allow them to easily communicate with physical devices and other resources. VOLTTRON delivers an innovative distributed control and sensing software platform that supports modern control strategies, including agent-based and transaction-based controls. It enables mobile and stationary software agents to perform information gathering, processing, and control actions. VOLTTRON can independently manage a wide range of applications, such as HVAC systems, electric vehicles, distributed energy or entire building loads, leading to improved operational efficiency.

Cybersecurity and Resilience | Energy Systems Integration Facility | NREL

Science.gov Websites

, and offer prioritized action items to improve organizational protocols. The team is also helping and provide a prioritized list of action items for gaps in security controls. Security architectures

The Nose Knows.

ERIC Educational Resources Information Center

Brown, Doug

2000-01-01

Discusses the following considerations when using restroom air fresheners: the types available, timing and frequency of fragrance delivery, and dispenser placement. An example is provided of one school's success at improving restroom hygiene and controlling odor. (GR)

Optimal clustering of MGs based on droop controller for improving reliability using a hybrid of harmony search and genetic algorithms.

PubMed

Abedini, Mohammad; Moradi, Mohammad H; Hosseinian, S M

2016-03-01

This paper proposes a novel method to address reliability and technical problems of microgrids (MGs) based on designing a number of self-adequate autonomous sub-MGs via adopting MGs clustering thinking. In doing so, a multi-objective optimization problem is developed where power losses reduction, voltage profile improvement and reliability enhancement are considered as the objective functions. To solve the optimization problem a hybrid algorithm, named HS-GA, is provided, based on genetic and harmony search algorithms, and a load flow method is given to model different types of DGs as droop controller. The performance of the proposed method is evaluated in two case studies. The results provide support for the performance of the proposed method. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Adaptive controller for volumetric display of neuroimaging studies

NASA Astrophysics Data System (ADS)

Bleiberg, Ben; Senseney, Justin; Caban, Jesus

2014-03-01

Volumetric display of medical images is an increasingly relevant method for examining an imaging acquisition as the prevalence of thin-slice imaging increases in clinical studies. Current mouse and keyboard implementations for volumetric control provide neither the sensitivity nor specificity required to manipulate a volumetric display for efficient reading in a clinical setting. Solutions to efficient volumetric manipulation provide more sensitivity by removing the binary nature of actions controlled by keyboard clicks, but specificity is lost because a single action may change display in several directions. When specificity is then further addressed by re-implementing hardware binary functions through the introduction of mode control, the result is a cumbersome interface that fails to achieve the revolutionary benefit required for adoption of a new technology. We address the specificity versus sensitivity problem of volumetric interfaces by providing adaptive positional awareness to the volumetric control device by manipulating communication between hardware driver and existing software methods for volumetric display of medical images. This creates a tethered effect for volumetric display, providing a smooth interface that improves on existing hardware approaches to volumetric scene manipulation.

The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis.

PubMed

Jewiss, D; Ostman, C; Smart, N A

2016-10-15

To quantify the change in effect sizes, for selected clinical outcome measures, in people with heart failure, from resistance exercise, either in isolation, or in combination with aerobic training. Most exercise training data in heart failure, relates to aerobic exercise, we sought to provide current evidence for the benefits of resistance training in this population. We conducted a MEDLINE search (1985 to May 1, 2016), for exercise based rehabilitation trials in heart failure, using search terms 'resistance training, combined training, left ventricular dysfunction, peak VO2, cardio-myopathy and systolic heart dysfunction'. The 27 included studies provided a total of 2321 participants, 1172 in an intervention and 1149 in either sedentary controls or aerobic exercise only groups, producing over 31,263 patient-hours of training. Mortality, hospitalization, resting blood pressure and Left ventricular fraction were all unchanged with resistance or combined aerobic and resistance training. Peak VO2 was improved in combined exercise vs. control MD of 1.43ml·kg(-1)·min(-1) (95% CI 0.63, 2.23, p=0.0004; and in resistance vs. control MD 3.99ml·kg(-1)·min(-1) (95% CI 1.47, 6.51, p=0.002). Quality of Life (MLwHFQ) was improved in combined vs. control MD -8.31 (95% CI -14.3, -2.33, p=0.006). Six-minute walk distance was improved combined exercise vs. control, MD 13.49m (95% CI 1.13, 25.84, p=0.03); and resistance vs. control MD 41.77m (95% CI 21.90, 61.64, p<0.0001): SMD 1.25 (95%CI 0.53, 1.98, p=0.0007). Resistance only or combined training improves peak VO2, quality of life and walking performance in heart failure patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pediatric endurance and limb strengthening (PEDALS) for children with cerebral palsy using stationary cycling: a randomized controlled trial.

PubMed

Fowler, Eileen G; Knutson, Loretta M; Demuth, Sharon K; Siebert, Kara L; Simms, Victoria D; Sugi, Mia H; Souza, Richard B; Karim, Roksana; Azen, Stanley P

2010-03-01

Effective interventions to improve and maintain strength (force-generating capacity) and endurance are needed for children with cerebral palsy (CP). This study was performed to examine the effects of a stationary cycling intervention on muscle strength, locomotor endurance, preferred walking speed, and gross motor function in children with spastic diplegic CP. This was a phase I randomized controlled trial with single blinding. The interventions were performed in community-based outpatient physical therapy clinics. Outcome assessments were performed in university laboratories. Sixty-two ambulatory children aged 7 to 18 years with spastic diplegic CP and Gross Motor Function Classification System levels I to III participated in this study. Participants were randomly assigned to cycling or control (no-intervention) groups. Thirty intervention sessions occurred over 12 weeks. Primary outcomes were peak knee extensor and flexor moments, the 600-Yard Walk-Run Test, the Thirty-Second Walk Test, and the Gross Motor Function Measure sections D and E (GMFM-66). Significant baseline-postintervention improvements were found for the 600-Yard Walk-Run Test, the GMFM-66, peak knee extensor moments at 120 degrees /s, and peak knee flexor moments at 30 degrees /s for the cycling group. Improved peak knee flexor moments at 120 degrees/s were found for the control group only, although not all participants could complete this speed of testing. Significant differences between the cycling and control groups based on change scores were not found for any outcomes. Limitations Heterogeneity of the patient population and intrasubject variability were limitations of the study. Significant improvements in locomotor endurance, gross motor function, and some measures of strength were found for the cycling group but not the control group, providing preliminary support for this intervention. As statistical differences were not found in baseline-postintervention change scores between the 2 groups; the results did not demonstrate that stationary cycling was more effective than no intervention. The results of this phase I study provide guidance for future research.

Locus of control, quality of life, anxiety, and depression among Malaysian breast cancer patients: The mediating role of uncertainty.

PubMed

Pahlevan Sharif, Saeed

2017-04-01

The main objective of this study was to investigate the mediating role of uncertainty in the relationship between locus of control with quality of life, anxiety, and depression. A descriptive and correlational survey was conducted in a private hospital in Kuala Lumpur, Malaysia. A convenience sample of 118 Malaysian breast cancer patients voluntarily participated in the study and responded to a set of questionnaires including: socio-demographic questionnaire, the short form of Locus of Control Scale, the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Hospital Anxiety and Depression Scale (HADS), and the Short-Form Mishel Uncertainty in Illness Scale (SF-MUIS). The results revealed that breast cancer patients with higher internal locus of control and lower external locus of control experience a higher quality of life, lower anxiety, and lower depression. Also, uncertainty mediated the relationship between locus of control with quality of life and depression (quasi-significant). The findings indicated the need for early, targeted psychological interventions seeking to gradually shift cancer patients' locus of control from external to internal in order to improve their quality of life and reduce their depression and anxiety. Moreover, health care providers by providing relevant information to cancer patients, especially for externally oriented patients, can reduce their uncertainty which in turn would improve their quality of life. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vacuum Powder Injector

NASA Technical Reports Server (NTRS)

Working, Dennis C.

1991-01-01

Method developed to provide uniform impregnation of bundles of carbon-fiber tow with low-solubility, high-melt-flow polymer powder materials to produce composite prepregs. Vacuum powder injector expands bundle of fiber tow, applies polymer to it, then compresses bundle to hold powder. System provides for control of amount of polymer on bundle. Crystallinity of polymer maintained by controlled melt on takeup system. All powder entrapped, and most collected for reuse. Process provides inexpensive and efficient method for making composite materials. Allows for coating of any bundle of fine fibers with powders. Shows high potential for making prepregs of improved materials and for preparation of high-temperature, high-modulus, reinforced thermoplastics.

Techniques for grid manipulation and adaptation. [computational fluid dynamics

NASA Technical Reports Server (NTRS)

Choo, Yung K.; Eisemann, Peter R.; Lee, Ki D.

1992-01-01

Two approaches have been taken to provide systematic grid manipulation for improved grid quality. One is the control point form (CPF) of algebraic grid generation. It provides explicit control of the physical grid shape and grid spacing through the movement of the control points. It works well in the interactive computer graphics environment and hence can be a good candidate for integration with other emerging technologies. The other approach is grid adaptation using a numerical mapping between the physical space and a parametric space. Grid adaptation is achieved by modifying the mapping functions through the effects of grid control sources. The adaptation process can be repeated in a cyclic manner if satisfactory results are not achieved after a single application.

Nurse-led hypnotherapy: an innovative approach to Irritable Bowel Syndrome.

PubMed

Bremner, Helen

2013-08-01

Irritable Bowel Syndrome (IBS) is a common, chronic functional illness, which can greatly reduce patients' quality of life, and consumes healthcare resources. Standard treatments include dietary changes and medication, though these are often ineffective. Clinical studies of hypnotherapy demonstrate improvement in symptoms and quality of life in over 80% of subjects with intractable IBS. Our experience of a nurse-led hypnotherapy service for IBS in a community setting provides evidence of comparable efficacy for symptom control, improved quality of life, reduced dependence on medication and improved general health measures. We address the challenges of setting up and maintaining the service in a changing healthcare environment. This model of care could act as a template for providers of gastroenterology and functional disease services wishing to provide IBS care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Strange Bedfellows: A Local Insurer/Physician Practice Partnership to Fund Innovation.

PubMed

Kraft, Sally; Strutz, Elizabeth; Kay, Lawrence; Welnick, Richard; Pandhi, Nancy

2015-01-01

Despite an unprecedented urgency to control healthcare costs while simultaneously improving quality, there are many barriers to investing in quality improvement. Traditional fee-for-service reimbursement models fail to reward providers whose improved processes lead to decreases in billable clinical activity. In addition, providers may lack the necessary skills for improvement, or the organizational infrastructure to conduct these activities. Insurance firms lack incentives to invest in healthcare delivery system improvements that lead to benefits for all patients, even those covered by competitors. In this article, we describe a novel program in its sixth year of existence that funds ambulatory care improvements through a collaborative partnership between a local academic healthcare delivery system and an insurance firm. The program is designed as a competitive grant program and the payer and healthcare organization jointly benefit from completed improvement projects. Factors contributing to the ongoing success of the program and lessons learned are discussed in order to inform the potential development of similar programs in other markets.

Identifying Procurement Fraud in Defense Agencies: An Analysis of the Government Purchase Card Program

DTIC Science & Technology

2011-04-30

fielding, contracting, interoperability, organizational behavior, risk management , cost estimating, and many others. Approaches range from... COSO ), (Whittington & Pany, 2012). In addition, the Federal Financial Management Improvement Act of 1996 identified internal control as an...fraud indicators within the DoD Government Purchase Card Programs and provides recommendations for improving the management of Government Purchase

Using School Staff to Establish a Preventive Network of Care to Improve Elementary School Students' Control of Asthma

ERIC Educational Resources Information Center

Bruzzese, Jean-Marie; Evans, David; Wiesemann, Sandra; Pinkett-Heller, Marcia; Levison, Moshe J.; Du, Yunling; Fitzpatrick, Cecilia; Krigsman, Gary; Ramos-Bonoan, Carmen; Turner, Levonne; Mellins, Robert B.

2006-01-01

School-based asthma interventions delivered by nonschool staff have been successful but are limited in their reach because of the cost and effort of bringing in outside educators and their inability to establish improved communication about asthma between schools, families, and primary care providers (PCPs). To address these problems, Columbia…

The NASA Aircraft Energy Efficiency program

NASA Technical Reports Server (NTRS)

Klineberg, J. M.

1979-01-01

A review is provided of the goals, objectives, and recent progress in each of six aircraft energy efficiency programs aimed at improved propulsive, aerodynamic and structural efficiency for future transport aircraft. Attention is given to engine component improvement, an energy efficient turbofan engine, advanced turboprops, revolutionary gains in aerodynamic efficiency for aircraft of the late 1990s, laminar flow control, and composite primary aircraft structures.

On the Minimum Induced Drag of Wings

NASA Technical Reports Server (NTRS)

Bowers, Albion H.

2015-01-01

Birds do not require the use of vertical tails. They do not appear to have any mechanism by which to control their yaw. As an example the albatross is notable in this regard. The authors believe this is possible because of a unique adaptation by which there exists a triple-optimal solution that provides the maximum aerodynamic efficiency, the minimum structural weight, and it provides for coordination of control in roll and yaw. Until now, this solution has eluded researchers, and remained unknown. Here it is shown that the correct specification of spanload provides for all three solutions at once, maximum aerodynamic efficiency, minimum structural weight, and coordinated control. The implications of this result has far reaching effects on the design of aircraft, as well as dramatic efficiency improvement.

VANDENBERG AIR FORCE BASE, CALIF. - Workers mate the Pegasus , with its cargo of the SciSat-1 payload to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - Workers mate the Pegasus , with its cargo of the SciSat-1 payload to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is tested before installing on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is tested before installing on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is installed on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is installed on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload and Pegasus launch vehicle are lifted and mated to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload and Pegasus launch vehicle are lifted and mated to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Temporal and spatial control of gene expression in horticultural crops

PubMed Central

Dutt, Manjul; Dhekney, Sadanand A; Soriano, Leonardo; Kandel, Raju; Grosser, Jude W

2014-01-01

Biotechnology provides plant breeders an additional tool to improve various traits desired by growers and consumers of horticultural crops. It also provides genetic solutions to major problems affecting horticultural crops and can be a means for rapid improvement of a cultivar. With the availability of a number of horticultural genome sequences, it has become relatively easier to utilize these resources to identify DNA sequences for both basic and applied research. Promoters play a key role in plant gene expression and the regulation of gene expression. In recent years, rapid progress has been made on the isolation and evaluation of plant-derived promoters and their use in horticultural crops, as more and more species become amenable to genetic transformation. Our understanding of the tools and techniques of horticultural plant biotechnology has now evolved from a discovery phase to an implementation phase. The availability of a large number of promoters derived from horticultural plants opens up the field for utilization of native sequences and improving crops using precision breeding. In this review, we look at the temporal and spatial control of gene expression in horticultural crops and the usage of a variety of promoters either isolated from horticultural crops or used in horticultural crop improvement. PMID:26504550

Neuro-fuzzy decoding of sensory information from ensembles of simultaneously recorded dorsal root ganglion neurons for functional electrical stimulation applications

NASA Astrophysics Data System (ADS)

Rigosa, J.; Weber, D. J.; Prochazka, A.; Stein, R. B.; Micera, S.

2011-08-01

Functional electrical stimulation (FES) is used to improve motor function after injury to the central nervous system. Some FES systems use artificial sensors to switch between finite control states. To optimize FES control of the complex behavior of the musculo-skeletal system in activities of daily life, it is highly desirable to implement feedback control. In theory, sensory neural signals could provide the required control signals. Recent studies have demonstrated the feasibility of deriving limb-state estimates from the firing rates of primary afferent neurons recorded in dorsal root ganglia (DRG). These studies used multiple linear regression (MLR) methods to generate estimates of limb position and velocity based on a weighted sum of firing rates in an ensemble of simultaneously recorded DRG neurons. The aim of this study was to test whether the use of a neuro-fuzzy (NF) algorithm (the generalized dynamic fuzzy neural networks (GD-FNN)) could improve the performance, robustness and ability to generalize from training to test sets compared to the MLR technique. NF and MLR decoding methods were applied to ensemble DRG recordings obtained during passive and active limb movements in anesthetized and freely moving cats. The GD-FNN model provided more accurate estimates of limb state and generalized better to novel movement patterns. Future efforts will focus on implementing these neural recording and decoding methods in real time to provide closed-loop control of FES using the information extracted from sensory neurons.

Brain-computer interfaces for post-stroke motor rehabilitation: a meta-analysis.

PubMed

Cervera, María A; Soekadar, Surjo R; Ushiba, Junichi; Millán, José Del R; Liu, Meigen; Birbaumer, Niels; Garipelli, Gangadhar

2018-05-01

Brain-computer interfaces (BCIs) can provide sensory feedback of ongoing brain oscillations, enabling stroke survivors to modulate their sensorimotor rhythms purposefully. A number of recent clinical studies indicate that repeated use of such BCIs might trigger neurological recovery and hence improvement in motor function. Here, we provide a first meta-analysis evaluating the clinical effectiveness of BCI-based post-stroke motor rehabilitation. Trials were identified using MEDLINE, CENTRAL, PEDro and by inspection of references in several review articles. We selected randomized controlled trials that used BCIs for post-stroke motor rehabilitation and provided motor impairment scores before and after the intervention. A random-effects inverse variance method was used to calculate the summary effect size. We initially identified 524 articles and, after removing duplicates, we screened titles and abstracts of 473 articles. We found 26 articles corresponding to BCI clinical trials, of these, there were nine studies that involved a total of 235 post-stroke survivors that fulfilled the inclusion criterion (randomized controlled trials that examined motor performance as an outcome measure) for the meta-analysis. Motor improvements, mostly quantified by the upper limb Fugl-Meyer Assessment (FMA-UE), exceeded the minimal clinically important difference (MCID=5.25) in six BCI studies, while such improvement was reached only in three control groups. Overall, the BCI training was associated with a standardized mean difference of 0.79 (95% CI: 0.37 to 1.20) in FMA-UE compared to control conditions, which is in the range of medium to large summary effect size. In addition, several studies indicated BCI-induced functional and structural neuroplasticity at a subclinical level. This suggests that BCI technology could be an effective intervention for post-stroke upper limb rehabilitation. However, more studies with larger sample size are required to increase the reliability of these results.

A Controlled Pilot Trial of PainTracker Self-Manager, a Web-Based Platform Combined With Patient Coaching, to Support Patients' Self-Management of Chronic Pain.

PubMed

Sullivan, Mark; Langford, Dale J; Davies, Pamela Stitzlein; Tran, Christine; Vilardaga, Roger; Cheung, Gifford; Yoo, Daisy; McReynolds, Justin; Lober, William B; Tauben, David; Vowles, Kevin E

2018-03-29

The objective of this study was to develop and pilot test a chronic pain empowerment and self-management platform, derived from acceptance and commitment therapy, in a pain specialty setting. A controlled, sequential, nonrandomized study design was used to accommodate intervention development and to test the efficacy of the PainTracker Self-Manager (PTSM) intervention (Web-based educational modules and outcome tracking combined with tailored patient coaching sessions and provider guidance). Generalized estimating equations evaluated changes over time (baseline, 3 months, 6 months) in pain self-efficacy (primary outcome), chronic pain acceptance (activity engagement and pain willingness), perceived efficacy in patient-provider interactions, pain intensity and interference, and overall satisfaction with pain treatment (secondary outcomes) between intervention (n = 48) and usual care control groups (n = 51). The full study sample (N = 99) showed greater improvements over time (significant Group × Time interactions) in pain self-efficacy and satisfaction with pain treatment. Among study completers (n = 82), greater improvement in activity engagement as well as pain intensity and interference were also observed. These preliminary findings support the efficacy of the PTSM intervention in a pain specialty setting. Further research is needed to refine and expand the PTSM intervention and to test it in a randomized trial in primary care settings. We developed a Web-based patient empowerment platform that combined acceptance and commitment therapy-based educational modules and tailored coaching sessions with longitudinal tracking of treatments and patient-reported outcomes, named PTSM. Pilot controlled trial results provide preliminary support for its efficacy in improving pain self-efficacy, activity engagement, pain intensity and interference, and satisfaction with pain treatment. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

Improving Quality of Shoe Soles Product using Six Sigma

NASA Astrophysics Data System (ADS)

Jesslyn Wijaya, Athalia; Trusaji, Wildan; Akbar, Muhammad; Ma’ruf, Anas; Irianto, Dradjad

2018-03-01

A manufacture in Bandung produce kind of rubber-based product i.e. trim, rice rollers, shoe soles, etc. After penetrating the shoe soles market, the manufacture has met customer with tight quality control. Based on the past data, defect level of this product was 18.08% that caused the manufacture’s loss of time and money. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control (DMAIC). In the design phase, the object’s problem and definition were defined. Delphi method was also used in this phase to identify critical factors. In the measure phase, the existing process stability and sigma quality level were measured. Fishbone diagram and failure mode and effect analysis (FMEA) were used in the next phase to analyse the root cause and determine the priority issues. Improve phase was done by designing alternative improvement strategy using 5W1H method. Some improvement efforts were identified, i.e. (i) modifying design of the hanging rack, (ii) create pantone colour book and check sheet, (iii) provide pedestrian line at compound department, (iv) buying stop watch, and (v) modifying shoe soles dies. Some control strategies for continuous improvement were proposed such as SOP or reward and punishment system.

Structured output-feedback controller synthesis with design specifications

NASA Astrophysics Data System (ADS)

Hao, Yuqing; Duan, Zhisheng

2017-03-01

This paper considers the problem of structured output-feedback controller synthesis with finite frequency specifications. Based on the orthogonal space information of input matrix, an improved parameter-dependent Lyapunov function method is first proposed. Then, a two-stage construction method is designed, which depends on an initial centralised controller. Corresponding design conditions for three types of output-feedback controllers are presented in terms of unified representations. Moreover, heuristic algorithms are provided to explore the desirable controllers. Finally, the effectiveness of these proposed methods is illustrated via some practical examples.

Research of vibration controlling based on programmable logic controller for electrostatic precipitator

NASA Astrophysics Data System (ADS)

Zhang, Zisheng; Li, Yanhu; Li, Jiaojiao; Liu, Zhiqiang; Li, Qing

2013-03-01

In order to improve the reliability, stability and automation of electrostatic precipitator, circuits of vibration motor for ESP and vibration control ladder diagram program are investigated using Schneider PLC with high performance and programming software of Twidosoft. Operational results show that after adopting PLC, vibration motor can run automatically; compared with traditional control system of vibration based on single-chip microcomputer, it has higher reliability, better stability and higher dust removal rate, when dust emission concentrations <= 50 mg m-3, providing a new method for vibration controlling of ESP.

Beam wavefront and farfield control for ICF laser driver

NASA Astrophysics Data System (ADS)

Dai, Wanjun; Deng, Wu; Zhang, Xin; Jiang, Xuejun; Zhang, Kun; Zhou, Wei; Zhao, Junpu; Hu, Dongxia

2010-10-01

Five main problems of beam wavefront and farfield control in ICF laser driver are synthetically discussed, including control requirements, beam propagation principle, distortions source control, system design and adjustment optimization, active wavefront correction technology. We demonstrate that beam can be propagated well and the divergence angle of the TIL pulses can be improved to less than 60μrad with solving these problems, which meets the requirements of TIL. The results can provide theoretical and experimental support for wavefront and farfield control designing requirements of the next large scale ICF driver.

The Cancer Prevention and Control Research Network: An Interactive Systems Approach to Advancing Cancer Control Implementation Research and Practice

PubMed Central

Fernández, María E.; Melvin, Cathy L.; Leeman, Jennifer; Ribisl, Kurt M.; Allen, Jennifer D.; Kegler, Michelle C.; Bastani, Roshan; Ory, Marcia G.; Risendal, Betsy C.; Hannon, Peggy A.; Kreuter, Matthew W.; Hebert, James R.

2018-01-01

Background Although cancer research has advanced at a rapid pace, a gap remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within health care systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with more than 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. Methods The collective work of the CPCRN has facilitated the analysis and categorization of research and implementation efforts according to the Interactive Systems Framework for Dissemination and Implementation (ISF), providing a useful heuristic for bridging the gap between prevention research and practice. The ISF authors have called for examples of its application as input to help refine the model. Results We provide examples of how the collaborative activities supported by the CPCRN, using community-engaged processes, accelerated the synthesis and translation of evidence, built both general and innovation-specific capacity, and worked with delivery systems to advance cancer control research and practice. Conclusions The work of the CPCRN has provided real-world examples of the application of the ISF and demonstrated that synthesizing and translating evidence can increase the potential that evidence-based CPC programs will be used and that capacity building for both the support system and the delivery system is crucial for the successful implementation and maintenance of evidence-based cancer control. Impact Adoption and implementation of CPC can be enhanced by better understanding ISF systems and intervening to improve them. PMID:25155759

Cascade generalized predictive control strategy for boiler drum level.

PubMed

Xu, Min; Li, Shaoyuan; Cai, Wenjian

2005-07-01

This paper proposes a cascade model predictive control scheme for boiler drum level control. By employing generalized predictive control structures for both inner and outer loops, measured and unmeasured disturbances can be effectively rejected, and drum level at constant load is maintained. In addition, nonminimum phase characteristic and system constraints in both loops can be handled effectively by generalized predictive control algorithms. Simulation results are provided to show that cascade generalized predictive control results in better performance than that of well tuned cascade proportional integral differential controllers. The algorithm has also been implemented to control a 75-MW boiler plant, and the results show an improvement over conventional control schemes.

Heart failure disease management: implementation and outcomes.

PubMed

Whellan, David J

2005-01-01

Millions of dollars are being spent to identify new therapies to improve mortality and morbidity for the growing epidemic of patients sustaining heart failure. However, in clinical practice, these therapies are currently underused. To bridge the gap between proven therapies and clinical practice, the medical community has turned to disease management. Heart failure disease management interventions vary from vital-sign monitoring to multidisciplinary approaches involving a pharmacist, nutritionist, nurse practitioner, and physician. This review attempts to categorize these inventions based on location. We compared the published results from randomized, controlled trials of the following types of heart failure disease management interventions: inpatient, clinic visits, home visits, and telephone follow up. Although research shows an improvement in the quality of care and a decrease in hospitalizations for patients sustaining heart failure, the economic impact of disease management is still unclear. The current reimbursement structure is a disincentive to providers wanting to offer disease management services to patients sustaining heart failure. Additionally, the cost of providing disease management services such as additional clinical visits, patient education materials, or additional personnel time has not been well documented. Most heart failure disease management studies do confirm the concept that providing increased access to healthcare providers for an at-risk group of patients sustaining heart failure does improve outcomes. However, a large-scale randomized, controlled clinical trial based in the United States is needed to prove that this concept can be implemented beyond a single center and to determine how much it will cost patients, providers, healthcare systems, and payers.

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina.

PubMed

González, Lorena; Elgart, Jorge F; Calvo, Héctor; Gagliardino, Juan J

2013-01-01

To measure the impact of a diabetes and cardiovascular risk factors program implemented in a social security institution upon short- and long-term clinical/metabolic outcomes and costs of care. Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female program participants with diabetes before (baseline) and 1 and 3 years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration's database. The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRFs), as well as a decrease of events related to chronic complications. This improvement was associated with an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRFs. The implementation of a diabetes program in real-world conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRFs, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing costs, our results suggest the need to include management-control strategies in these programs for appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.

SDN Project

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

Smith, Rhett

The SDN Project completed on time and on budget and successfully accomplished 100% of the scope of work outlined in the original Statement of Project Objective (SOPO). The SDN Project formed an alliance between Ameren Corporation, University of Illinois Urbana- Champaign (UIUC), Pacific Northwest National Laboratories (PNNL), and Schweitzer Engineering Laboratories, Inc. (SEL). The objective of the SDN Project is to address Topic Area of Interest 2: Sustain critical energy delivery functions while responding to a cyber-intrusion under Funding Opportunity Announcement DE-FOA-0000797. The goal of the project is to design and commercially release technology that provides a method to sustainmore » critical energy delivery functions during a cyber intrusion and to do this control system operators need the ability to quickly identify and isolate the affected network areas, and re-route critical information and control flows around. The objective of the SDN Project is to develop a Flow Controller that monitors, configures, and maintains the safe, reliable network traffic flows of all the local area networks (LANs) on a control system in the Energy sector. The SDN team identified the core attributes of a control system and produced an SDN flow controller that has the same core attributes enabling networks to be designed, configured and deployed that maximize the whitelisted, deny-bydefault and purpose built networks. This project researched, developed and commercially released technology that: Enables all field networks be to configured and monitored as if they are a single asset to be protected; Enables greatly improved and even precalculated response actions to reliability and cyber events; Supports pre-configured localized response actions tailored to provide resilience against failures and centralized response to cyber-attacks that improve network reliability and availability; Architecturally enables the right subject matter experts, who are usually the information technology and operational technology engineers, to be the ones centrally administering the technology and responding to events; Simplifies network configuration, improving deterministic Ethernet transport times, and providing instant visualization on where the communication circuits are and how all circuits are impacted when changes (e.g., configuration changes, failures or intrusions) happen, allowing operators to minimize downtime; and Improves the ability to identify deviations in network behavior resulting in detection and analysis of potential cyber intrusions and faster response times Results: This project has forever changed the way critical infrastructure networks are designed, secured, deployed and maintained. The cybersecurity and performance advantages achieved are significant, simply put traditional networking has been obsoleted while the team maintained Ethernet interoperability avoiding any legacy concerns. The team commercially released technology that accomplished all the cybersecurity goals outlined in the SOPO and completed it by executing the project management plan approved in the initial contract. The resulting Energy sector SDN flow controller model number is SEL-5056 and can be freely downloaded from the www.SELinc.com website. This technology not only improves the cybersecurity of control systems but has measured results that it improves the performance and reliability of the control system as well. This means the system owners can confidently apply it to their systems knowing that it will, “first do no harm” but actually improve the system as well. Success of the project is best measured by the sales and deployment of the technology. System owners in industrial, electric, defense, and oil and gas only months after commercial release have approved plans for deployment.« less

Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).

PubMed

Schleyer, Anneliese M; Best, Jennifer A; McIntyre, Lisa K; Ehrmantraut, Ross; Calver, Patty; Goss, J Richard

2013-01-01

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study.