Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective.

PubMed

Sidek, Yusof Haji; Martins, Jorge Tiago

2017-11-01

Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Workflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

A graph-based system for network-vulnerability analysis

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

Swiler, L.P.; Phillips, C.

1998-06-01

This paper presents a graph-based approach to network vulnerability analysis. The method is flexible, allowing analysis of attacks from both outside and inside the network. It can analyze risks to a specific network asset, or examine the universe of possible consequences following a successful attack. The graph-based tool can identify the set of attack paths that have a high probability of success (or a low effort cost) for the attacker. The system could be used to test the effectiveness of making configuration changes, implementing an intrusion detection system, etc. The analysis system requires as input a database of common attacks,more » broken into atomic steps, specific network configuration and topology information, and an attacker profile. The attack information is matched with the network configuration information and an attacker profile to create a superset attack graph. Nodes identify a stage of attack, for example the class of machines the attacker has accessed and the user privilege level he or she has compromised. The arcs in the attack graph represent attacks or stages of attacks. By assigning probabilities of success on the arcs or costs representing level-of-effort for the attacker, various graph algorithms such as shortest-path algorithms can identify the attack paths with the highest probability of success.« less

Validating the Octave Allegro Information Systems Risk Assessment Methodology: A Case Study

ERIC Educational Resources Information Center

Keating, Corland G.

2014-01-01

An information system (IS) risk assessment is an important part of any successful security management strategy. Risk assessments help organizations to identify mission-critical IS assets and prioritize risk mitigation efforts. Many risk assessment methodologies, however, are complex and can only be completed successfully by highly qualified and…

Principals' Instructional Leadership within a Teacher Performance Appraisal System: Enhancing Students' Academic Success

ERIC Educational Resources Information Center

Ovando, Martha N.; Ramirez, Alfredo, Jr.

2007-01-01

The purpose of this study was to identify principals' instructional leadership actions within a comprehensive teacher evaluation system in successful schools rated as recognized or exemplary by the accountability measures in place. The study followed a multiple case study approach. Participants included six school administrators within the same…

Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

PubMed

deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

2018-03-01

Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Successful Educational Leadership at High Performing Schools

ERIC Educational Resources Information Center

Wilson, Doris L.

2011-01-01

Successful educational leadership is not a random phenomenon, but an executed success which leaves clues whereby one can discover them. These clues lead to a desired destination--higher student achievement. Essential, non-negotiable elements have been identified. That is, each element has been systemically embedded at schools that have turned from…

Ten key principles for successful health systems integration.

PubMed

Suter, Esther; Oelke, Nelly D; Adair, Carol E; Armitage, Gail D

2009-01-01

Integrated health systems are considered part of the solution to the challenge of sustaining Canada's healthcare system. This systematic literature review was undertaken to guide decision-makers and others to plan for and implement integrated health systems. This review identified 10 universal principles of successfully integrated healthcare systems that may be used by decision-makers to assist with integration efforts. These principles define key areas for restructuring and allow organizational flexibility and adaptation to local context. The literature does not contain a one-size-fits-all model or process for successful integration, nor is there a firm empirical foundation for specific integration strategies and processes.

A field study of the accuracy and reliability of a biometric iris recognition system.

PubMed

Latman, Neal S; Herb, Emily

2013-06-01

The iris of the eye appears to satisfy the criteria for a good anatomical characteristic for use in a biometric system. The purpose of this study was to evaluate a biometric iris recognition system: Mobile-Eyes™. The enrollment, verification, and identification applications were evaluated in a field study for accuracy and reliability using both irises of 277 subjects. Independent variables included a wide range of subject demographics, ambient light, and ambient temperature. A sub-set of 35 subjects had alcohol-induced nystagmus. There were 2710 identification and verification attempts, which resulted in 1,501,340 and 5540 iris comparisons respectively. In this study, the system successfully enrolled all subjects on the first attempt. All 277 subjects were successfully verified and identified on the first day of enrollment. None of the current or prior eye conditions prevented enrollment, verification, or identification. All 35 subjects with alcohol-induced nystagmus were successfully verified and identified. There were no false verifications or false identifications. Two conditions were identified that potentially could circumvent the use of iris recognitions systems in general. The Mobile-Eyes™ iris recognition system exhibited accurate and reliable enrollment, verification, and identification applications in this study. It may have special applications in subjects with nystagmus. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

The Case of Nuclear Propulsion

NASA Technical Reports Server (NTRS)

Koroteev, Anatoly S.; Ponomarev-Stepnoi, Nicolai N.; Smetannikov, Vladimir P.; Gafarov, Albert A.; Houts, Mike; VanDyke, Melissa; Godfroy, Tom; Martin, James; Bragg-Sitton, Shannon; Dickens, Ricky

2003-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. If fission propulsion systems are to be developed to their full potential; however, near-term customers must be identified and initial fission systems successfully developed, launched, and utilized. Successful utilization will simultaneously develop the infrastructure and experience necessary for developing even higher power and performance systems. To be successful, development programs must devise strategies for rapidly converting paper reactor concepts into actual flight hardware. One approach to accomplishing this is to design highly testable systems, and to structure the program to contain frequent, significant hardware milestones. This paper discusses ongoing efforts in Russia and the United States aimed at enabling near-term utilization of space fission systems.

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis

PubMed Central

Ziemann, Alexandra; Fouillet, Anne; Brand, Helmut; Krafft, Thomas

2016-01-01

Introduction Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. Materials and Methods We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. Results We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. Conclusions We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings. PMID:27182731

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis.

PubMed

Ziemann, Alexandra; Fouillet, Anne; Brand, Helmut; Krafft, Thomas

2016-01-01

Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings.

Rural and urban transit district benchmarking : effectiveness and efficiency guidance document.

DOT National Transportation Integrated Search

2011-05-01

Rural and urban transit systems have sought ways to compare performance across agencies, : identifying successful service delivery strategies and applying these concepts to achieve : successful results within their agency. Benchmarking is a method us...

Some correlates of electronic health information management system success in nigerian teaching hospitals.

PubMed

Ojo, Adebowale I; Popoola, Sunday O

2015-01-01

Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS's success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals.

Female Students and Denominational Affiliation: Sources of Success and Variation among Nineteenth-Century Academies.

ERIC Educational Resources Information Center

Beadie, Nancy

1999-01-01

Studies the institutional characteristics and strategic choices of successful academies operating under the New York Regents system from 1838 to 1850. Identifies single-sex education and denominational affiliation as important for success. Suggests frameworks for investigating variations among the 19th-century academies and discusses implications…

Clinical Decision Support Knowledge Management: Strategies for Success.

PubMed

Khalifa, Mohamed; Alswailem, Osama

2015-01-01

Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

E-referral Solutions: Successful Experiences, Key Features and Challenges- a Systematic Review.

PubMed

Naseriasl, Mansour; Adham, Davoud; Janati, Ali

2015-06-01

around the world health systems constantly face increasing pressures which arise from many factors, such as an ageing population, patients and providers demands for equipment's and services. In order to respond these challenges and reduction of health system's transactional costs, referral solutions are considered as a key factor. This study was carried out to identify referral solutions that have had successes. relevant studies identified using keywords of referrals, consultation, referral system, referral model, referral project, electronic referral, electronic booking, health system, healthcare, health service and medical care. These searches were conducted using PubMed, ProQuest, Google Scholar, Scopus, Emerald, Web of Knowledge, Springer, Science direct, Mosby's index, SID, Medlib and Iran Doc data bases. 4306 initial articles were obtained and refined step by step. Finally, 27 articles met the inclusion criteria. we identified seventeen e-referral systems developed in UK, Norway, Finland, Netherlands, Denmark, Scotland, New Zealand, Canada, Australia, and U.S. Implemented solutions had variant degrees of successes such as improved access to specialist care, reduced wait times, timeliness and quality of referral communication, accurate health information transfer and integration of health centers and services. each one of referral solutions has both positive and changeable aspects that should be addressed according to sociotechnical conditions. These solutions are mainly formed in a small and localized manner.

Organizational Factors' Effects on the Success of E-Learning Systems and Organizational Benefits: An Empirical Study in Taiwan

ERIC Educational Resources Information Center

Liu, Ying Chieh; Huang, Yu-An; Lin, Chad

2012-01-01

E-learning development for enterprises is still in its infancy in that scholars are still working on identifying the critical success factors for e-learning in organizational contexts. This study presents a framework considering how organizational factors affect the quality and service of e-learning systems and how these factors influence…

Leadership and effective succession planning in health-system pharmacy departments.

PubMed

Ellinger, Lara Kathryn; Trapskin, Philip J; Black, Raymond; Kotis, Despina; Alexander, Earnest

2014-04-01

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution's strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department's strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments.

Leadership and Effective Succession Planning in Health-System Pharmacy Departments

PubMed Central

Trapskin, Philip J.; Black, Raymond; Kotis, Despina; Alexander, Earnest

2014-01-01

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution’s strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department’s strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments. PMID:24958944

Facilitators and Barriers to Safe Medication Administration to Hospital Inpatients: A Mixed Methods Study of Nurses’ Medication Administration Processes and Systems (the MAPS Study)

PubMed Central

McLeod, Monsey; Barber, Nicholas; Franklin, Bryony Dean

2015-01-01

Context Research has documented the problem of medication administration errors and their causes. However, little is known about how nurses administer medications safely or how existing systems facilitate or hinder medication administration; this represents a missed opportunity for implementation of practical, effective, and low-cost strategies to increase safety. Aim To identify system factors that facilitate and/or hinder successful medication administration focused on three inter-related areas: nurse practices and workarounds, workflow, and interruptions and distractions. Methods We used a mixed-methods ethnographic approach involving observational fieldwork, field notes, participant narratives, photographs, and spaghetti diagrams to identify system factors that facilitate and/or hinder successful medication administration in three inpatient wards, each from a different English NHS trust. We supplemented this with quantitative data on interruptions and distractions among other established medication safety measures. Findings Overall, 43 nurses on 56 drug rounds were observed. We identified a median of 5.5 interruptions and 9.6 distractions per hour. We identified three interlinked themes that facilitated successful medication administration in some situations but which also acted as barriers in others: (1) system configurations and features, (2) behaviour types among nurses, and (3) patient interactions. Some system configurations and features acted as a physical constraint for parts of the drug round, however some system effects were partly dependent on nurses’ inherent behaviour; we grouped these behaviours into ‘task focused’, and ‘patient-interaction focused’. The former contributed to a more streamlined workflow with fewer interruptions while the latter seemed to empower patients to act as a defence barrier against medication errors by being: (1) an active resource of information, (2) a passive information resource, and/or (3) a ‘double-checker’. Conclusions We have identified practical examples of system effects on work optimisation and nurse behaviours that potentially increase medication safety, and conceptualized ways in which patient involvement can increase medication safety in hospitals. PMID:26098106

The Use of an Online Learning and Teaching System for Monitoring Computer Aided Design Student Participation and Predicting Student Success

ERIC Educational Resources Information Center

Akhtar, S.; Warburton, S.; Xu, W.

2017-01-01

In this paper we report on the use of a purpose built Computer Support Collaborative learning environment designed to support lab-based CAD teaching through the monitoring of student participation and identified predictors of success. This was carried out by analysing data from the interactive learning system and correlating student behaviour with…

A Longitudinal Study of the Relationship between User Attitudes and the Success of the MAJCOM and AFRCE Work Information Management System.

DTIC Science & Technology

1985-09-01

now focus on one of the most neglected and difficult to perform system strategies identified by Multinovich and Vlahovich ; the evaluation of the system...201). Multinovich and Vlahovich (33) have outlined several strategies which they feel will increase the probability of successfully implementing a...Management. Cincinnati: South-Western Publishing Company, 1975. 148 . . .2 * * T. 7° 33. Multinovich, Jugoslav S. and Vladimir Vlahovich . "A Strategy

Succession Planning in the Iranian Health System: A Case Study of the Ministry of Health and Medical Education

PubMed Central

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-01-01

Background: Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. Methods: In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Results: Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. Conclusion: lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization. PMID:25168998

Succession planning in the Iranian health system: a case study of the Ministry of Health and Medical Education.

PubMed

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-05-30

Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization.

Multimodal sensing strategies for detecting transparent barriers indoors from a mobile platform

NASA Astrophysics Data System (ADS)

Acevedo, Isaiah; Kleine, R. Kaleb; Kraus, Dustan; Mascareñas, David

2015-04-01

There is currently an interest in developing mobile sensing platforms that fly indoors. The primary goal for these platforms is to be able to successfully navigate a building under various lighting and environmental conditions. There are numerous research challenges associated with this goal, one of which is the platform's ability to detect and identify the presence of transparent barriers. Transparent barriers could include windows, glass partitions, or skylights. For example, in order to successfully navigate inside of a structure, these platforms will need to sense if a space contains a transparent barrier and whether or not this space can be traversed. This project's focus has been developing a multimodal sensing system that can successfully identify such transparent barriers under various lighting conditions while aboard a mobile platform. Along with detecting transparent barriers, this sensing platform is capable of distinguishing between reflective, opaque, and transparent barriers. It will be critical for this system to be able to identify transparent barriers in real-time in order for the navigation system to maneuver accordingly. The properties associated with the interaction between various frequencies of light and transparent materials were one of the techniques leveraged to solve this problem.

Some Correlates of Electronic Health Information Management System Success in Nigerian Teaching Hospitals

PubMed Central

Ojo, Adebowale I; Popoola, Sunday O

2015-01-01

Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS’s success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals. PMID:25983557

Computational Gene Expression Modeling Identifies Salivary Biomarker Analysis that Predict Oral Feeding Readiness in the Newborn

PubMed Central

Maron, Jill L.; Hwang, Jooyeon S.; Pathak, Subash; Ruthazer, Robin; Russell, Ruby L.; Alterovitz, Gil

2014-01-01

Objective To combine mathematical modeling of salivary gene expression microarray data and systems biology annotation with RT-qPCR amplification to identify (phase I) and validate (phase II) salivary biomarker analysis for the prediction of oral feeding readiness in preterm infants. Study design Comparative whole transcriptome microarray analysis from 12 preterm newborns pre- and post-oral feeding success was used for computational modeling and systems biology analysis to identify potential salivary transcripts associated with oral feeding success (phase I). Selected gene expression biomarkers (15 from computational modeling; 6 evidence-based; and 3 reference) were evaluated by RT-qPCR amplification on 400 salivary samples from successful (n=200) and unsuccessful (n=200) oral feeders (phase II). Genes, alone and in combination, were evaluated by a multivariate analysis controlling for sex and post-conceptional age (PCA) to determine the probability that newborns achieved successful oral feeding. Results Advancing post-conceptional age (p < 0.001) and female sex (p = 0.05) positively predicted an infant’s ability to feed orally. A combination of five genes, NPY2R (hunger signaling), AMPK (energy homeostasis), PLXNA1 (olfactory neurogenesis), NPHP4 (visual behavior) and WNT3 (facial development), in addition to PCA and sex, demonstrated good accuracy for determining feeding success (AUROC = 0.78). Conclusions We have identified objective and biologically relevant salivary biomarkers that noninvasively assess a newborn’s developing brain, sensory and facial development as they relate to oral feeding success. Understanding the mechanisms that underlie the development of oral feeding readiness through translational and computational methods may improve clinical decision making while decreasing morbidities and health care costs. PMID:25620512

View from the top: CEO perspectives on executive development and succession planning practices in healthcare organizations.

PubMed

Groves, Kevin S

2006-01-01

Many healthcare professionals question whether the industry's hospitals and multi-site systems are implementing the necessary executive development and succession planning systems to ensure that high potential managers are prepared and aptly selected to assume key executive roles. Survey data, case studies, and cross-industry comparisons suggest that healthcare organizations may face a leadership crisis as the current generation of chief executive officers (CEOs) nears retirement while traditional means of developing the leadership pipeline, including middle-management positions and graduate programs requiring formal residencies, continue to dissipate. Given the daunting challenges that accompany the healthcare industry's quest to identify, develop, and retain leadership talent, this article provides best practice findings from a qualitative study of 13 healthcare organizations with a record of exemplary executive development and succession planning practices. CEOs from six single-site hospitals, six healthcare systems, and one medical group were interviewed to identify industry best practices so that healthcare practitioners and educators may utilize the findings to enhance the industry's leadership capacity.

Technology in education: A guidebook for developing a science and math education support program

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

Wagner, C.L.

1992-09-01

Education is vital to survival and success in an increasingly technical world, and the quality of education is the responsibility of everyone students, teachers, parents, industry, and government. Any technical organization wanting to contribute to that success through its local education system can do so easily and effectively through careful planning. This report details that planning process and includes methods to (1) identify the interests, strengths, and resources of the technical organization; (2) identify the needs of the local education system; (3) interface with local school system administration, principals, and teachers; and (4) develop a unique plan to match themore » organization's strengths and resources with the needs of the school system. Following these getting started'' activities is the actual program that the Engineering Technology Division implemented in a local elementary school, including the curriculum, topics, and actual lesson plans used by technical personnel in the classroom. Finally, there are enrichment activities for teachers and students, suggestions for measuring the success of an education support program, and an overview of student responses to questions about the overall program.« less

Technology in education: A guidebook for developing a science and math education support program

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

Wagner, C.L.

1992-09-01

Education is vital to survival and success in an increasingly technical world, and the quality of education is the responsibility of everyone students, teachers, parents, industry, and government. Any technical organization wanting to contribute to that success through its local education system can do so easily and effectively through careful planning. This report details that planning process and includes methods to (1) identify the interests, strengths, and resources of the technical organization; (2) identify the needs of the local education system; (3) interface with local school system administration, principals, and teachers; and (4) develop a unique plan to match themore » organization`s strengths and resources with the needs of the school system. Following these ``getting started`` activities is the actual program that the Engineering Technology Division implemented in a local elementary school, including the curriculum, topics, and actual lesson plans used by technical personnel in the classroom. Finally, there are enrichment activities for teachers and students, suggestions for measuring the success of an education support program, and an overview of student responses to questions about the overall program.« less

Hardware Based Technology Assessment in Support of Near-Term Space Fission Missions

NASA Technical Reports Server (NTRS)

Houts, Mike; VanDyke, Melissa; Godfroy, Tom; Martin, James; BraggSitton, Shannon; Carter, Robert; Dickens, Ricky; Salvail, Pat; Williams, Eric; Harper, Roger

2003-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. If fission propulsion systems are to be developed to their full potential; however, near-term customers must be identified and initial fission systems successfully developed, launched, and utilized. Successful utilization will most likely occur if frequent, significant hardware-based milestones can be achieved throughout the program. Achieving these milestones will depend on the capability to perform highly realistic non-nuclear testing of nuclear systems. This paper discusses ongoing and potential research that could help achieve these milestones.

The Influence of Context on Quality Improvement Success in Health Care: A Systematic Review of the Literature

PubMed Central

Kaplan, Heather C; Brady, Patrick W; Dritz, Michele C; Hooper, David K; Linam, W Matthew; Froehle, Craig M; Margolis, Peter

2010-01-01

Context: The mixed results of success among QI initiatives may be due to differences in the context of these initiatives. Methods: The business and health care literature was systematically reviewed to identify contextual factors that might influence QI success; to categorize, summarize, and synthesize these factors; and to understand the current stage of development of this research field. Findings: Forty-seven articles were included in the final review. Consistent with current theories of implementation and organization change, leadership from top management, organizational culture, data infrastructure and information systems, and years involved in QI were suggested as important to QI success. Other potentially important factors identified in this review included: physician involvement in QI, microsystem motivation to change, resources for QI, and QI team leadership. Key limitations in the existing literature were the lack of a practical conceptual model, the lack of clear definitions of contextual factors, and the lack of well-specified measures. Conclusions: Several contextual factors were shown to be important to QI success, although the current body of literature lacks adequate definitions and is characterized by considerable variability in how contextual factors are measured across studies. Future research should focus on identifying and developing measures of context tied to a conceptual model that examines context across all levels of the health care system and explores the relationships among various aspects of context. PMID:21166868

The influence of context on quality improvement success in health care: a systematic review of the literature.

PubMed

Kaplan, Heather C; Brady, Patrick W; Dritz, Michele C; Hooper, David K; Linam, W Matthew; Froehle, Craig M; Margolis, Peter

2010-12-01

The mixed results of success among QI initiatives may be due to differences in the context of these initiatives. The business and health care literature was systematically reviewed to identify contextual factors that might influence QI success; to categorize, summarize, and synthesize these factors; and to understand the current stage of development of this research field. Forty-seven articles were included in the final review. Consistent with current theories of implementation and organization change, leadership from top management, organizational culture, data infrastructure and information systems, and years involved in QI were suggested as important to QI success. Other potentially important factors identified in this review included: physician involvement in QI, microsystem motivation to change, resources for QI, and QI team leadership. Key limitations in the existing literature were the lack of a practical conceptual model, the lack of clear definitions of contextual factors, and the lack of well-specified measures. Several contextual factors were shown to be important to QI success, although the current body of literature lacks adequate definitions and is characterized by considerable variability in how contextual factors are measured across studies. Future research should focus on identifying and developing measures of context tied to a conceptual model that examines context across all levels of the health care system and explores the relationships among various aspects of context. © 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

Performance evaluation of public hospital information systems by the information system success model.

PubMed

Cho, Kyoung Won; Bae, Sung-Kwon; Ryu, Ji-Hye; Kim, Kyeong Na; An, Chang-Ho; Chae, Young Moon

2015-01-01

This study was to evaluate the performance of the newly developed information system (IS) implemented on July 1, 2014 at three public hospitals in Korea. User satisfaction scores of twelve key performance indicators of six IS success factors based on the DeLone and McLean IS Success Model were utilized to evaluate IS performance before and after the newly developed system was introduced. All scores increased after system introduction except for the completeness of medical records and impact on the clinical environment. The relationships among six IS factors were also analyzed to identify the important factors influencing three IS success factors (Intention to Use, User Satisfaction, and Net Benefits). All relationships were significant except for the relationships among Service Quality, Intention to Use, and Net Benefits. The results suggest that hospitals should not only focus on systems and information quality; rather, they should also continuously improve service quality to improve user satisfaction and eventually reach full the potential of IS performance.

LANDSAT menhaden and thread herring resources investigation, Gulf of Mexico

NASA Technical Reports Server (NTRS)

Savastano, K. (Principal Investigator); Kemmerer, A. J.; Leming, T.; Holley, H.; Faller, K. H.

1977-01-01

The author has identified the following significant results. The most significant achievement thus far includes the successful charting of high probability fishing areas from LANDSAT MSS data and the successful simulation of an operational satellite system to provide tactical information for the commercial harvest of menhaden.

LANDSAT menhaden and thread herring resources investigation, Gulf of Mexico

NASA Technical Reports Server (NTRS)

Savastano, K. (Principal Investigator); Kemmerer, A. J.; Leming, T.; Holley, H.; Faller, K. H.

1976-01-01

The author has identified the following significant results. The most significant achievements thus far include the successful charting of high probability fishing areas from LANDSAT MSS data and the successful simulation of an operational satellite system to provide tactical information for the commercial harvest of menhaden.

Discipline--Still Number One on the Administrator's List of Problems.

ERIC Educational Resources Information Center

Bartosh, Fred, Jr.; Barilla, John

1985-01-01

Describes the components of a discipline record system that can improve understanding of where, when, and why problems occur and what methods prove successful for handling them. Also identifies a number of factors that affect the success of discipline conferences between administrators and the parents of misbehaving students. (PGD)

Japanese and United States Schooling: A Comparative Perspective.

ERIC Educational Resources Information Center

Shields, James J.

Scholars and educational policymakers are interested in identifying successful national school systems that might provide effective models of educational theory and practice for transfer to other nations. U.S. educators have been interested in the success Japan has had in a broad range of measures of academic achievement and school participation…

Successful approaches to deploying a Metropolitan Intelligent Transportation System.

DOT National Transportation Integrated Search

1999-03-01

To identify and evaluate the institutional structures and working relationships associated with the deployment and integration of Intelligent Transportation Systems (ITS) products and services at the Model Deployment Initiatives (MDIs), the Volpe Cen...

Efficacy of identifying neural components in the face and emotion processing system in schizophrenia using a dynamic functional localizer.

PubMed

Arnold, Aiden E G F; Iaria, Giuseppe; Goghari, Vina M

2016-02-28

Schizophrenia is associated with deficits in face perception and emotion recognition. Despite consistent behavioural results, the neural mechanisms underlying these cognitive abilities have been difficult to isolate, in part due to differences in neuroimaging methods used between studies for identifying regions in the face processing system. Given this problem, we aimed to validate a recently developed fMRI-based dynamic functional localizer task for use in studies of psychiatric populations and specifically schizophrenia. Previously, this functional localizer successfully identified each of the core face processing regions (i.e. fusiform face area, occipital face area, superior temporal sulcus), and regions within an extended system (e.g. amygdala) in healthy individuals. In this study, we tested the functional localizer success rate in 27 schizophrenia patients and in 24 community controls. Overall, the core face processing regions were localized equally between both the schizophrenia and control group. Additionally, the amygdala, a candidate brain region from the extended system, was identified in nearly half the participants from both groups. These results indicate the effectiveness of a dynamic functional localizer at identifying regions of interest associated with face perception and emotion recognition in schizophrenia. The use of dynamic functional localizers may help standardize the investigation of the facial and emotion processing system in this and other clinical populations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

An Assessment of Air Force Civil Engineering Officer Perceptions of Assignments to Career Broadening Positions.

DTIC Science & Technology

1986-09-01

opportunities will determine career success (7:9). Air Force Regulation (AFR) 36-23 states that the goals of the officer assignment system are to "fulfill present...goals" (4:3). In his AFIT thesis, Cady identifies some career profiles of successful civil engineering officers. He defines career success as an...single type of experience or prescribed plan that will guarantee career success . He found’that general officers have adaptive and innovative careers with

Key elements of successful care process of patients with heart symptoms in an emergency care - could an ERP system help?

PubMed

Kontio, Elina; Korvenranta, Heikki; Lundgren-Laine, Heljä; Salanterä, Sanna

2009-01-01

The aim of the study was to identify key elements of successful care process of patients with heart symptoms from the nursing management viewpoint in an emergency care. Through these descriptions, we aimed at identifying possibilities for using enterprise resource planning (ERP) systems to support decision making in emergency care. Hospitals are increasingly moving to process-based workings and at the same time new information system in healthcare are developed and therefore it is essential to understand the strengths and weaknesses of current processes better. A qualitative descriptive design using critical incident technique was employed. Critical Incidents were collected with an open-ended questionnaire. The sample (n=50), 13 head nurses and 37 registered nurses, was purposeful selected from three acute hospitals in southern Finland. The process of patients with heart symptoms in emergency care was described. We identified three competence categories where special focus should be placed to achieve successful process of patients with heart symptoms: process-oriented competencies, personal/management competencies and logistics oriented competencies. Improvement of decision making requires that the care processes are defined and modeled. The research showed that there are several happenings in emergency care where an ERP system could help and support decision making. These happenings can be categorized in two groups: 1) administrative related happenings and 2) patient processes related happenings.

All Seem to Need Immediate Attention--What Should I Do First? A Successful Principal in a New School Assignment at Secundaria Revolucion

ERIC Educational Resources Information Center

Torres-Arcadia, Celina; Flores-Kastanis, Eduardo

2012-01-01

This case provides emerging school administrators the opportunity to learn about the school system in Mexico. The case relates to a successful principal in her new school assignment. Martha Miramontes is an experienced and successful principal who quickly identified a number of challenges in her new campus. Even though each problem can be solved…

A qualitative assessment of a community pharmacy cognitive pharmaceutical services program, using a work system approach.

PubMed

Chui, Michelle A; Mott, David A; Maxwell, Leigh

2012-01-01

Although lack of time, trained personnel, and reimbursement have been identified as barriers to pharmacists providing cognitive pharmaceutical services (CPS) in community pharmacies, the underlying contributing factors of these barriers have not been explored. One approach to better understand barriers and facilitators to providing CPS is to use a work system approach to examine different components of a work system and how the components may impact care processes. The goals of this study were to identify and describe pharmacy work system characteristics that pharmacists identified and changed to provide CPS in a demonstration program. A qualitative approach was used for data collection. A purposive sample of 8 pharmacists at 6 community pharmacies participating in a demonstration program was selected to be interviewed. Each semistructured interview was audio recorded and transcribed, and the text was analyzed in a descriptive and interpretive manner by 3 analysts. Themes were identified in the text and aligned with 1 of 5 components of the Systems Engineering Initiative for Patient Safety (SEIPS) work system model (organization, tasks, tools/technology, people, and environment). A total of 21 themes were identified from the interviews, and 7 themes were identified across all 6 interviews. The organization component of the SEIPS model contained the most (n=10) themes. Numerous factors within a pharmacy work system appear important to enable pharmacists to provide CPS. Leadership and foresight by the organization to implement processes (communication, coordination, planning, etc.) to facilitate providing CPS was a key finding across the interviews. Expanding technician responsibilities was reported to be essential for successfully implementing CPS. To be successful in providing CPS, pharmacists must be cognizant of the different components of the pharmacy work system and how these components influence providing CPS. Copyright © 2012 Elsevier Inc. All rights reserved.

A qualitative assessment of a community pharmacy cognitive pharmaceutical services program, using a work system approach

PubMed Central

Chui, Michelle A.; Mott, David A.; Maxwell, Leigh

2012-01-01

Background Although lack of time, trained personnel, and reimbursement have been identified as barriers to pharmacists providing cognitive pharmaceutical services (CPS) in community pharmacies, the underlying contributing factors of these barriers have not been explored. One approach to better understand barriers and facilitators to providing CPS is to use a work system approach to examine different components of a work system and how the components may impact care processes. Objectives The goals of this study were to identify and describe pharmacy work system characteristics that pharmacists identified and changed to provide CPS in a demonstration program. Methods A qualitative approach was used for data collection. A purposive sample of 8 pharmacists at 6 community pharmacies participating in a demonstration program was selected to be interviewed. Each semistructured interview was audio recorded and transcribed, and the text was analyzed in a descriptive and interpretive manner by 3 analysts. Themes were identified in the text and aligned with 1 of 5 components of the Systems Engineering Initiative for Patient Safety (SEIPS) work system model (organization, tasks, tools/technology, people, and environment). Results A total of 21 themes were identified from the interviews, and 7 themes were identified across all 6 interviews. The organization component of the SEIPS model contained the most (n = 10) themes. Numerous factors within a pharmacy work system appear important to enable pharmacists to provide CPS. Leadership and foresight by the organization to implement processes (communication, coordination, planning, etc.) to facilitate providing CPS was a key finding across the interviews. Expanding technician responsibilities was reported to be essential for successfully implementing CPS. Conclusions To be successful in providing CPS, pharmacists must be cognizant of the different components of the pharmacy work system and how these components influence providing CPS. PMID:21824822

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

I Am Working for ___: Successfully Using Token Reward Systems

ERIC Educational Resources Information Center

Diamond, Gwendolyn P.; Da Fonte, M. Alexandra; Boesch, Miriam C.

2015-01-01

The use of these systems can enhance students' participation in instructional activities. However, to use token systems effectively, the system must be individualized and tailored to meet the needs of the child. In order to individualize the token system for each student, teachers should (1) identify an array of back-up reinforcers for the…

Chapter 636, Voluntary Integration in Massachusetts. Successful Programs of Choice.

ERIC Educational Resources Information Center

Spier, Adele W.; And Others

A statewide study was conducted to identify and describe successful voluntary school desegregation programs funded under Chapter 636, a 1974 amendment to Massachussets' Racial Imbalance Law. Programs selected were of four types: (1) school-based (elementary, middle, and high); (2) school system- or district-wide; (3) part-time and full-time…

ePortfolios in the Workplace for Human Capital Management: A Multiple Case Study

ERIC Educational Resources Information Center

Lievens, Ronald

2015-01-01

This study researches whether the ePortfolio is a suitable instrument for human capital management in the business environment. The implementation of ePortfolio systems in five different organizations is analyzed. It considers whether ePortfolio implementations were successful, and relevant critical success factors were identified. For the latter…

Factors Affecting Success of Training Companies

ERIC Educational Resources Information Center

Rogala, Piotr; Batko, Roman; Wawak, Slawomir

2017-01-01

This study aims to identify the key factors which influence the functioning quality and success of training companies. Based on an analysis of the requirements included in the quality management system standards for providers of education and training services, a set of twenty factors has been developed. This was followed by a survey for…

The Transition from Initial Education to Working Life: A Status Report on Australia's Progress.

ERIC Educational Resources Information Center

McDonald, Rod; Corbiere, Kathy; Doyle, Leonie; Field, Claire; Johnson, Lesley; Johnston, Paula; Kerr, Ella; Roberts, Anita

Australia's system for helping youths make a successful transition from initial vocational education and training (VET) to working life was assessed through an analysis that focused on the following features that were identified by the Organisation for Economic Cooperation and Development (OECD) as contributing to successful transitions: learning…

LANDSAT follow-on experiment: Gulf of Mexico menhaden and thread herring resources investigation. [Gulf of Mexico

NASA Technical Reports Server (NTRS)

Savastano, K. J. (Principal Investigator); Kemmerer, A. J.; Leming, T. D.; Holley, H.; Faller, K.

1976-01-01

The author has identified the following significant results. The most significant achievements realized thus far include the successful charting of high probability fishing areas from LANDSAT MSS data and the successful simulation of an operational satellite system to provide tactical information for the commercial harvest of menhaden.

An innovative Oklahoma program to coordinate interdisciplinary and interagency services for children with special healthcare needs at a county level.

PubMed

Wolraich, Mark; Lockhart, Jennifer; Worley, Louis

2013-03-01

Children and youth with special health care needs (CYSHCN) and their families often require multiple services from multiple providers in order to meet their needs. The Sooner SUCCESS (State Unified Children's Comprehensive Exemplary Services for Special Needs), was developed based on a complex adaptive systems approach allowing local coalitions to address their unique needs. Sooner SUCCESS provides support to families and service providers at the community level including a broad range of supports from simply helping a family identify and access a service that already exists to innovatively marshaling generic resources to meet a unique need. The program uses these family support activities coupled with the Community Needs Assessment to identify local service needs encouraging community capacity building by coordinating the efforts of the health, mental health, social and education systems to identify service gaps and develop community-based strategies to fill those gaps.

Predictors of operating room extubation in adult cardiac surgery.

PubMed

Subramaniam, Kathirvel; DeAndrade, Diana S; Mandell, Daniel R; Althouse, Andrew D; Manmohan, Rajan; Esper, Stephen A; Varga, Jeffrey M; Badhwar, Vinay

2017-11-01

The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. All 1518 patients in this retrospective cohort study underwent standardized fast-track cardiac anesthetic protocol during adult cardiac surgery. Perioperative variables between patients who had successful extubation in the operating room versus in the intensive care unit were retrospectively analyzed using both univariate and multivariable logistic regression analyses. A predictive score of successful operating room extubation was constructed from the multivariable results of 800 patients (derivation set), and the scoring system was further tested using a validation set of 398 patients. Younger age, lower body mass index, higher preoperative serum albumin, absence of chronic lung disease and diabetes, less-invasive surgical approach, isolated coronary bypass surgery, elective surgery, and lower doses of intraoperative intravenous fentanyl were independently associated with higher probability of operating room extubation. The extubation prediction score created in a derivation set of patients performed well in the validation set. Patient scores less than 0 had a minimal probability of successful operating room extubation. Operating room extubation was highly predicted with scores of 5 or greater. Perioperative factors that are independently associated with successful operating room extubation after adult cardiac operations were identified, and an operating room extubation prediction scoring system was validated. This scoring system may be used to guide safe operating room extubation after cardiac operations. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Development and initial evaluation of the Clinical Information Systems Success Model (CISSM).

PubMed

Garcia-Smith, Dianna; Effken, Judith A

2013-06-01

Most clinical information systems (CIS) today are technically sound, but the number of successful implementations of these systems is low. The purpose of this study was to develop and test a theoretically based integrated CIS Success Model (CISSM) from the nurse perspective. Model predictors of CIS success were taken from existing research on information systems acceptance, user satisfaction, use intention, user behavior and perceptions, as well as clinical research. Data collected online from 234 registered nurses in four hospitals were used to test the model. Each nurse had used the Cerner Power Chart Admission Health Profile for at least 3 months. Psychometric testing and factor analysis of the 23-item CISSM instrument established its construct validity and reliability. Initial analysis showed nurses' satisfaction with and dependency on CIS use predicted their perceived CIS use Net Benefit. Further analysis identified Social Influence and Facilitating Conditions as other predictors of CIS user Net Benefit. The level of hospital CIS integration may account for the role of CIS Use Dependency in the success of CIS. Based on our experience, CISSM provides a formative as well as summative tool for evaluating CIS success from the nurse's perspective. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Building health research systems: WHO is generating global perspectives, and who's celebrating national successes?

PubMed

Hanney, Stephen R; González-Block, Miguel A

2016-12-28

In 2016, England's National Institute for Health Research (NIHR) celebrated its tenth anniversary as an innovative national health research system with a focus on meeting patients' needs. This provides a good opportunity to reflect on how the creation of the NIHR has greatly enhanced important work, started in 1991, to develop a health research system in England that is embedded in the National Health Service.In 2004, WHO identified a range of functions that a national health research system should undertake to improve the health of populations. Health Research Policy and Systems (HRPS) has taken particular interest in the pioneering developments in the English health research system, where the comprehensive approach has covered most, if not all, of the functions identified by WHO. Furthermore, several significant recent developments in thinking about health research are relevant for the NIHR and have informed accounts of its achievements. These include recognition of the need to combat waste in health research, which had been identified as a global problem in successive papers in the Lancet, and an increasing emphasis on demonstrating impact. Here, pioneering evaluation of United Kingdom research, conducted through the impact case studies of the Research Excellence Framework, is particularly important. Analyses informed by these and other approaches identified many aspects of NIHR's progress in combating waste, building and sustaining research capacity, creating centres of research excellence linked to leading healthcare institutions, developing research networks, involving patients and others in identifying research needs, and producing and adopting research findings that are improving health outcomes.The NIHR's overall success, and an analysis of the remaining problems, might have lessons for other systems, notwithstanding important advances in many countries, as described in papers in HRPS and elsewhere. WHO's recently established Global Observatory for Health Research and Development provides an opportunity to promote some of these lessons. To inform its work, the Observatory is sponsoring a thematic series of papers in HRPS focusing on health research issues such as funding flows, priority setting, capacity building, utilisation and equity. While important papers on these have been published, this series is still open to new submissions.

The GUIDES checklist: development of a tool to improve the successful use of guideline-based computerised clinical decision support.

PubMed

Van de Velde, Stijn; Kunnamo, Ilkka; Roshanov, Pavel; Kortteisto, Tiina; Aertgeerts, Bert; Vandvik, Per Olav; Flottorp, Signe

2018-06-25

Computerised decision support (CDS) based on trustworthy clinical guidelines is a key component of a learning healthcare system. Research shows that the effectiveness of CDS is mixed. Multifaceted context, system, recommendation and implementation factors may potentially affect the success of CDS interventions. This paper describes the development of a checklist that is intended to support professionals to implement CDS successfully. We developed the checklist through an iterative process that involved a systematic review of evidence and frameworks, a synthesis of the success factors identified in the review, feedback from an international expert panel that evaluated the checklist in relation to a list of desirable framework attributes, consultations with patients and healthcare consumers and pilot testing of the checklist. We screened 5347 papers and selected 71 papers with relevant information on success factors for guideline-based CDS. From the selected papers, we developed a 16-factor checklist that is divided in four domains, i.e. the CDS context, content, system and implementation domains. The panel of experts evaluated the checklist positively as an instrument that could support people implementing guideline-based CDS across a wide range of settings globally. Patients and healthcare consumers identified guideline-based CDS as an important quality improvement intervention and perceived the GUIDES checklist as a suitable and useful strategy. The GUIDES checklist can support professionals in considering the factors that affect the success of CDS interventions. It may facilitate a deeper and more accurate understanding of the factors shaping CDS effectiveness. Relying on a structured approach may prevent that important factors are missed.

Identifying Strategies for Native American Student Success in Community Colleges: A Qualitative Study

ERIC Educational Resources Information Center

Baxter, Paula Jean

2009-01-01

This qualitative study attempted to analyze the educational goals and achievements of successful present and former Native American students at San Juan College (SJC) in Farmington, NM. It considered a systemic approach to educating Native American students by taking into account their suggestions of how to improve the educational framework to…

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2013-04-01

Intravital Microscopy was successfully employed for investigating EG shedding in hemorrhagic shock/resuscitation for the very first time; Contract... Intravital microscopy integrated with systemic hemodynamics evaluations may be essential and more accurate tools to identify changes and study...findings in concise form, utilizing key concepts/words. 1) Intravital Microscopy was successfully employed for investigating EG shedding in hemorrhagic

Successful Schools: How School-Level Factors Influence Success with Urban Advantage. Working Paper #01-14

ERIC Educational Resources Information Center

Weinstein, Meryle; Whitesell, Emilyn Ruble; Leardo, Michele

2014-01-01

Informal science education institutions have been identified as critical participants in helping students succeed in science by working in collaboration with school systems across the country. The results of one such collaboration, the Urban Advantage (UA) program found that participation in UA improved student achievement, on average, by 0.6…

Successful Secondary Principalship in Cyprus: What Have "Thucydides" and "Plato" Revealed to Us?

ERIC Educational Resources Information Center

Pashiardis, Petros; Kafa, Antonios; Marmara, Christiana

2012-01-01

Purpose: The purpose of this paper is to provide an insight into successful secondary school principals in Cyprus, focusing on identifying their actions and behaviours through the adoption of a systemic view of the quality of leadership in school organizations from multiple stakeholders (i.e. self, parents, students and teachers).…

Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

PubMed

Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

2015-07-01

Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

Heating systems to maximise efficiency.

PubMed

House, Jeff

2013-09-01

Jeff House, marketing and applications manager, Baxi Commercial, identifies some of the heating options available to the operators of healthcare facilities, and highlights practical examples of successful applications.

Hybrid neuro-fuzzy approach for automatic vehicle license plate recognition

NASA Astrophysics Data System (ADS)

Lee, Hsi-Chieh; Jong, Chung-Shi

1998-03-01

Most currently available vehicle identification systems use techniques such as R.F., microwave, or infrared to help identifying the vehicle. Transponders are usually installed in the vehicle in order to transmit the corresponding information to the sensory system. It is considered expensive to install a transponder in each vehicle and the malfunction of the transponder will result in the failure of the vehicle identification system. In this study, novel hybrid approach is proposed for automatic vehicle license plate recognition. A system prototype is built which can be used independently or cooperating with current vehicle identification system in identifying a vehicle. The prototype consists of four major modules including the module for license plate region identification, the module for character extraction from the license plate, the module for character recognition, and the module for the SimNet neuro-fuzzy system. To test the performance of the proposed system, three hundred and eighty vehicle image samples are taken by a digital camera. The license plate recognition success rate of the prototype is approximately 91% while the character recognition success rate of the prototype is approximately 97%.

Information system support as a critical success factor for chronic disease management: Necessary but not sufficient.

PubMed

Green, Carolyn J; Fortin, Patricia; Maclure, Malcolm; Macgregor, Art; Robinson, Sylvia

2006-12-01

Improvement of chronic disease management in primary care entails monitoring indicators of quality over time and across patients and practices. Informatics tools are needed, yet implementing them remains challenging. To identify critical success factors enabling the translation of clinical and operational knowledge about effective and efficient chronic care management into primary care practice. A prospective case study of positive deviants using key informant interviews, process observation, and document review. A chronic disease management (CDM) collaborative of primary care physicians with documented improvement in adherence to clinical practice guidelines using a web-based patient registry system with CDM guideline-based flow sheet. Thirty community-based physician participants using predominantly paper records, plus a project management team including the physician lead, project manager, evaluator and support team. A critical success factor (CSF) analysis of necessary and sufficient pathways to the translation of knowledge into clinical practice. A web-based CDM 'toolkit' was found to be a direct CSF that allowed this group of physicians to improve their practice by tracking patient care processes using evidence-based clinical practice guideline-based flow sheets. Moreover, the information and communication technology 'factor' was sufficient for success only as part of a set of seven direct CSF components including: health delivery system enhancements, organizational partnerships, funding mechanisms, project management, practice models, and formal knowledge translation practices. Indirect factors that orchestrated success through the direct factor components were also identified. A central insight of this analysis is that a comprehensive quality improvement model was the CSF that drew this set of factors into a functional framework for successful knowledge translation. In complex primary care settings environment where physicians have low adoption rates of electronic tools to support the care of patients with chronic conditions, successful implementation may require a set of interrelated system and technology factors.

Parameter Validation for Evaluation of Spaceflight Hardware Reusability

NASA Technical Reports Server (NTRS)

Childress-Thompson, Rhonda; Dale, Thomas L.; Farrington, Phillip

2017-01-01

Within recent years, there has been an influx of companies around the world pursuing reusable systems for space flight. Much like NASA, many of these new entrants are learning that reusable systems are complex and difficult to acheive. For instance, in its first attempts to retrieve spaceflight hardware for future reuse, SpaceX unsuccessfully tried to land on a barge at sea, resulting in a crash-landing. As this new generation of launch developers continues to develop concepts for reusable systems, having a systematic approach for determining the most effective systems for reuse is paramount. Three factors that influence the effective implementation of reusability are cost, operability and reliability. Therefore, a method that integrates these factors into the decision-making process must be utilized to adequately determine whether hardware used in space flight should be reused or discarded. Previous research has identified seven features that contribute to the successful implementation of reusability for space flight applications, defined reusability for space flight applications, highlighted the importance of reusability, and presented areas that hinder successful implementation of reusability. The next step is to ensure that the list of reusability parameters previously identified is comprehensive, and any duplication is either removed or consolidated. The characteristics to judge the seven features as good indicators for successful reuse are identified and then assessed using multiattribute decision making. Next, discriminators in the form of metrics or descriptors are assigned to each parameter. This paper explains the approach used to evaluate these parameters, define the Measures of Effectiveness (MOE) for reusability, and quantify these parameters. Using the MOEs, each parameter is assessed for its contribution to the reusability of the hardware. Potential data sources needed to validate the approach will be identified.

Setting Strategic Directions Using Critical Success Factors.

ERIC Educational Resources Information Center

Bourne, Bonnie; Gates, Larry; Cofer, James

2000-01-01

Describes implementation of a system-level planning model focused on institutional improvement and effectiveness at the University of Missouri. Details implementation of three phases of the strategic planning model (strategic analysis, strategic thinking/decision-making, and campus outreach/systems administration planning); identifies critical…

Models for At Risk Youth. Final Report.

ERIC Educational Resources Information Center

Woloszyk, Carl A.

Secondary data sources, including the ERIC and National Dropout Prevention Center databases, were reviewed to identify programs and strategies effective in keeping at-risk youth in school and helping them make successful school-to-work transitions. The dropout prevention model that was identified features a system of prevention, mediation,…

Transition of Incarcerated Youth With Disabilities Across Systems and Into Adulthood

ERIC Educational Resources Information Center

Baltodano, Heather M.; Mathur, Sarup R.; Rutherford, Robert B.

2005-01-01

Identifying factors that contribute to delinquency and recidivism is critical in predicting the success of incarcerated youth transitioning back to the community. The task of identifying these salient factors becomes increasingly complex when compounded by the disproportionate representation of youth with disabilities in juvenile corrections.…

Defining Administrative Tasks, Evaluating Performance, and Developing Skills.

ERIC Educational Resources Information Center

Herman, Janice L.; Herman, Jerry J.

1995-01-01

To ensure high performance, administrators should develop an articulated structure and process systems approach that identifies the critical success factors (CSFs) of performance for each position; appropriate indicators and scales; and a personal-improvement plan based on last year's evaluation. Once CSFs are identified and written into the…

A graph-based network-vulnerability analysis system

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

Swiler, L.P.; Phillips, C.; Gaylor, T.

1998-05-03

This paper presents a graph based approach to network vulnerability analysis. The method is flexible, allowing analysis of attacks from both outside and inside the network. It can analyze risks to a specific network asset, or examine the universe of possible consequences following a successful attack. The analysis system requires as input a database of common attacks, broken into atomic steps, specific network configuration and topology information, and an attacker profile. The attack information is matched with the network configuration information and an attacker profile to create a superset attack graph. Nodes identify a stage of attack, for example themore » class of machines the attacker has accessed and the user privilege level he or she has compromised. The arcs in the attack graph represent attacks or stages of attacks. By assigning probabilities of success on the arcs or costs representing level of effort for the attacker, various graph algorithms such as shortest path algorithms can identify the attack paths with the highest probability of success.« less

A graph-based network-vulnerability analysis system

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

Swiler, L.P.; Phillips, C.; Gaylor, T.

1998-01-01

This report presents a graph-based approach to network vulnerability analysis. The method is flexible, allowing analysis of attacks from both outside and inside the network. It can analyze risks to a specific network asset, or examine the universe of possible consequences following a successful attack. The analysis system requires as input a database of common attacks, broken into atomic steps, specific network configuration and topology information, and an attacker profile. The attack information is matched with the network configuration information and an attacker profile to create a superset attack graph. Nodes identify a stage of attack, for example the classmore » of machines the attacker has accessed and the user privilege level he or she has compromised. The arcs in the attack graph represent attacks or stages of attacks. By assigning probabilities of success on the arcs or costs representing level-of-effort for the attacker, various graph algorithms such as shortest-path algorithms can identify the attack paths with the highest probability of success.« less

Stakeholder requirements for commercially successful wave energy converter farms

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

Babarit, Aurélien; Bull, Diana; Dykes, Katherine

2017-12-01

In this study, systems engineering techniques are applied to wave energy to identify and specify stakeholders' requirements for a commercially successful wave energy farm. The focus is on the continental scale utility market. Lifecycle stages and stakeholders are identified. Stakeholders' needs across the whole lifecycle of the wave energy farm are analyzed. A list of 33 stakeholder requirements are identified and specified. This list of requirements should serve as components of a technology performance level metric that could be used by investors and funding agencies to make informed decisions when allocating resources. It is hoped that the technology performance levelmore » metric will accelerate wave energy conversion technology convergence.« less

Characteristics of health professions schools, public school systems, and community-based organizations in successful partnerships to increase the numbers of underrepresented minority students entering health professions education.

PubMed

Carline, Jan D; Patterson, Davis G

2003-05-01

To identify characteristics of health professions schools, public schools, and community-based organizations in successful partnerships to increase the number of underrepresented minority students entering health professions. The Robert Wood Johnson Foundation and the W. K. Kellogg Foundation funded the Health Professions Partnership Initiative program developed from Project 3000 by 2000 of the Association of American Medical Colleges. Semi-structured interviews were completed with awardees and representatives of the funding agencies, the national program office, and the national advisory committee between the fall of 2000 and the summer of 2002. Site visits were conducted at ten sites, with representatives of partner institutions, teachers, parents, and children. Characteristics that supported and hindered development of successful partnerships were identified using an iterative qualitative approach. Successful partnerships included professional schools that had a commitment to community service. Successful leaders could work in both cultures of the professional and public schools. Attitudes of respect and listening to the needs of partners were essential. Public school governance supported innovation. Happenstance and convergence of interests played significant roles in partnership development. The most telling statement was "We did it, together." This study identifies characteristics associated with smoothly working partnerships, and barriers to successful program development. Successful partnerships can form the basis on which educational interventions are built. The study is limited by the definition of success used, and its focus on one funded program. The authors were unable to identify outcomes in terms of numbers of children influenced by programs or instances in which lasting changes in health professions schools had occurred.

Human factors considerations for the integration of unmanned aerial vehicles in the National Airspace System : an analysis of reports submitted to the Aviation Safety Reporting System (ASRS)

DOT National Transportation Integrated Search

2017-06-06

Successful integration of Unmanned Aerial Vehicle (UAV) operations into the National Airspace System requires the identification and mitigation of operational risks. This report reviews human factors issues that have been identified in operational as...

The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement.

PubMed

Kaplan, Heather C; Provost, Lloyd P; Froehle, Craig M; Margolis, Peter A

2012-01-01

BACKGROUND Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the variability seen. To develop a conceptual model that can be used by organisations and QI researchers to understand and optimise contextual factors affecting the success of a QI project. 10 QI experts were provided with the results of a systematic literature review and then participated in two rounds of opinion gathering to identify and define important contextual factors. The experts subsequently met in person to identify relationships among factors and to begin to build the model. The Model for Understanding Success in Quality (MUSIQ) is organised based on the level of the healthcare system and identifies 25 contextual factors likely to influence QI success. Contextual factors within microsystems and those related to the QI team are hypothesised to directly shape QI success, whereas factors within the organisation and external environment are believed to influence success indirectly. The MUSIQ framework has the potential to guide the application of QI methods in healthcare and focus research. The specificity of MUSIQ and the explicit delineation of relationships among factors allows a deeper understanding of the mechanism of action by which context influences QI success. MUSIQ also provides a foundation to support further studies to test and refine the theory and advance the field of QI science.

A global meta-analysis on the ecological drivers of forest restoration success

PubMed Central

Crouzeilles, Renato; Curran, Michael; Ferreira, Mariana S.; Lindenmayer, David B.; Grelle, Carlos E. V.; Rey Benayas, José M.

2016-01-01

Two billion ha have been identified globally for forest restoration. Our meta-analysis encompassing 221 study landscapes worldwide reveals forest restoration enhances biodiversity by 15–84% and vegetation structure by 36–77%, compared with degraded ecosystems. For the first time, we identify the main ecological drivers of forest restoration success (defined as a return to a reference condition, that is, old-growth forest) at both the local and landscape scale. These are as follows: the time elapsed since restoration began, disturbance type and landscape context. The time elapsed since restoration began strongly drives restoration success in secondary forests, but not in selectively logged forests (which are more ecologically similar to reference systems). Landscape restoration will be most successful when previous disturbance is less intensive and habitat is less fragmented in the landscape. Restoration does not result in full recovery of biodiversity and vegetation structure, but can complement old-growth forests if there is sufficient time for ecological succession. PMID:27193756

INFLUENCES OF HVAC DESIGN AND OPERATION ON RADON MITIGATION OF EXISTING SCHOOL BUILDINGS

EPA Science Inventory

The paper discusses various school building characteristics identified as influencing radon entry, the design and operation of installed mitigation systems in four Maryland schools, and the success of these systems in reducing school radon levels. Several public school buildings ...

Fault Tree Analysis: An Emerging Methodology for Instructional Science.

ERIC Educational Resources Information Center

Wood, R. Kent; And Others

1979-01-01

Describes Fault Tree Analysis, a tool for systems analysis which attempts to identify possible modes of failure in systems to increase the probability of success. The article defines the technique and presents the steps of FTA construction, focusing on its application to education. (RAO)

Use of Indocyanine Green for Sentinel Lymph Node Biopsy: Case Series and Methods Comparison.

PubMed

McGregor, Andrew; Pavri, Sabrina N; Tsay, Cynthia; Kim, Samuel; Narayan, Deepak

2017-11-01

Sentinel lymph node biopsy is indicated for patients with biopsy-proven thickness melanoma greater than 1.0 mm. Use of lymphoscintigraphy along with vital blue dyes is the gold standard for identifying sentinel lymph nodes intraoperatively. Indocyanine green (ICG) has recently been used as a method of identifying sentinel lymph nodes. We herein describe a case series of patients who have successfully undergone ICG-assisted sentinel lymph node biopsy for melanoma. We compare 2 imaging systems that are used for ICG-assisted sentinel lymph node biopsy. Fourteen patients underwent ICG-assisted sentinel lymph node biopsy for melanoma using the SPY Elite system (Novadaq, Mississigua, Canada) and the Hamamatsu PDE-Neo probe system (Mitaka USA, Park City, Utah). We analyzed costs for 2 systems that utilize ICG for sentinel lymph node biopsies. Intraoperative use of ICG for sentinel lymph node biopsies was successful in correctly identifying sentinel lymph nodes. There was no difference between the Hamamatsu PDE-Neo probe and SPY Elite systems in the ability to detect sentinel lymph nodes; however, the former was associated with a lower operating cost and ease of use compared with the latter. ICG-assisted sentinel lymph biopsy using the SPY Elite or the Hamamatsu PDE-Neo probe systems for melanoma are comparable in terms of sentinel node detection. The Neo probe system delivers pertinent clinical data with the advantages of lower cost and ease of operation.

Role of Educational Strategies for Human Resources in Green Infrastructure Operation and Maintenance

NASA Astrophysics Data System (ADS)

Ebrahimi, G.; Thurm, B.; Öberg, G.

2014-12-01

Rainwater harvesting and water reuse are receiving increasing attention as they hold the potential to effectively improve water conservation efforts. While many technical solutions have been developed, alternative water systems in built environments face significant challenges in the implementation and operational phases. The aim of this study is to examine obstacles to the implementation of alternative water systems in practice and identify criteria of feasible and sustainable solutions that allow bypassing of the identified obstacles. Interviews were conducted with planners, system designers and operators to find out which factors that central actors believe influence successful implementation of such systems. The results were analyzed in light of the literature. The actual performance of the water harvesting and reuse systems in four recently built green buildings in the Province of British Columbia, Canada was analyzed in light of the predicted outcome, according to the criteria identified in the interviews. It was found that the major obstacle to success is that the practical challenges involved in the implementation of alternative systems are underestimated. This, for example, leads to that education strategies for operational staff are not developed, and the staff is left floundering. This study highlights the importance of recognizing the need for strategic and directed educational programs for the human resources who are involved in operating and maintaining rainwater harvesting and water reuse systems.

Rigor in electronic health record knowledge representation: Lessons learned from a SNOMED CT clinical content encoding exercise.

PubMed

Monsen, Karen A; Finn, Robert S; Fleming, Thea E; Garner, Erin J; LaValla, Amy J; Riemer, Judith G

2016-01-01

Rigor in clinical knowledge representation is necessary foundation for meaningful interoperability, exchange and reuse of electronic health record (EHR) data. It is critical for clinicians to understand principles and implications of using clinical standards for knowledge representation within EHRs. To educate clinicians and students about knowledge representation and to evaluate their success of applying the manual lookups method for assigning Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) concept identifiers using formally mapped concepts from the Omaha System interface terminology. Clinicians who were students in a doctoral nursing program conducted 21 lookups for Omaha System terms in publicly available SNOMED CT browsers. Lookups were deemed successful if results matched exactly with the corresponding code from the January 2013 SNOMED CT-Omaha System terminology cross-map. Of the 21 manual lookups attempted, 12 (57.1%) were successful. Errors were due to semantic gaps differences in granularity and synonymy or partial term matching. Achieving rigor in clinical knowledge representation across settings, vendors and health systems is a globally recognized challenge. Cross-maps have potential to improve rigor in SNOMED CT encoding of clinical data. Further research is needed to evaluate outcomes of using of terminology cross-maps to encode clinical terms with SNOMED CT concept identifiers based on interface terminologies.

Task Force Report 5. Report of the Task Force on Family Medicine’s Role in Shaping the Future Health Care Delivery System

PubMed Central

Roberts, Richard G.; Snape, Pam S.; Burke, Kevin

2004-01-01

BACKGROUND Recognizing that the implementation of needed changes within family medicine will be enhanced through a concurrent effort to transform the broader health care system, this Future of Family Medicine task force was charged with determining family medicine’s leadership role in shaping the future health care delivery system. METHODS After reviewing the changes taking place within family medicine and the broader health care system, this task force identified 6 priorities for fostering necessary modifications in the health care system. In addressing the leadership challenge facing the discipline, the task force presents a 3-dimensional matrix that provides a useful framework for describing the audiences that should be targeted, the strategic priorities that should be pursued, and the specific recommendations that should be addressed. Noting that leadership is part of the heritage of family medicine, the task force reviewed past successes by the discipline as important lessons that can be instructive as family physicians begin advocating for needed changes. MAJOR FINDINGS Effective leadership is an essential ingredient that will determine, to a large extent, the success of family medicine in advocating for needed change in the health care system overall and in the specialty. It is vitally important to groom leaders within family medicine and to create venues where policy makers and influence leaders can look beyond their usual constituencies and horizons to a comprehensive view of health care. A central concept being proposed is that of a relationship-centered personal medical home. This medical home serves as the focal point through which all individuals—regardless of age, gender, race, ethnicity, or socioeconomic status—receive a basket of acute, chronic, and preventive medical care services that are accessible, accountable, comprehensive, integrated, patient-centered, safe, scientifically valid, and satisfying to both patients and their physicians. CONCLUSION Family medicine has and will continue to have an important leadership role in health system change. It has been most successful when it has been able to identify a high-priority goal through consensus within the discipline, to focus and coordinate local and national resources, and to use a multipronged approach in addressing the priority. Although the Future of Family Medicine project has provided an important impetus for the identification of key priorities across the discipline, for the FFM project ultimately to be a success, implementation steps will need to be identified and prioritized. The leadership matrix presented in this report can provide a useful structuring tool to identify, understand, and coordinate change efforts more effectively. Strategic alliances with primary care groups and others also will be critical to the success of change initiatives.

Health IT success and failure: recommendations from literature and an AMIA workshop.

PubMed

Kaplan, Bonnie; Harris-Salamone, Kimberly D

2009-01-01

With the United States joining other countries in national efforts to reap the many benefits that use of health information technology can bring for health care quality and savings, sobering reports recall the complexity and difficulties of implementing even smaller-scale systems. Despite best practice research that identified success factors for health information technology projects, a majority, in some sense, still fail. Similar problems plague a variety of different kinds of applications, and have done so for many years. Ten AMIA working groups sponsored a workshop at the AMIA Fall 2006 Symposium. It was entitled "Avoiding The F-Word: IT Project Morbidity, Mortality, and Immortality" and focused on this under-addressed problem. PARTICIPANTS discussed communication, workflow, and quality; the complexity of information technology undertakings; the need to integrate all aspects of projects, work environments, and regulatory and policy requirements; and the difficulty of getting all the parts and participants in harmony. While recognizing that there still are technical issues related to functionality and interoperability, discussion affirmed the emerging consensus that problems are due to sociological, cultural, and financial issues, and hence are more managerial than technical. Participants drew on lessons from experience and research in identifying important issues, action items, and recommendations to address the following: what "success" and "failure" mean, what contributes to making successful or unsuccessful systems, how to use failure as an enhanced learning opportunity for continued improvement, how system successes or failures should be studied, and what AMIA should do to enhance opportunities for successes. The workshop laid out a research agenda and recommended action items, reflecting the conviction that AMIA members and AMIA as an organization can take a leadership role to make projects more practical and likely to succeed in health care settings.

A Job Analysis for K-8 Principals in a Nationwide Charter School System

ERIC Educational Resources Information Center

Cumings, Laura; Coryn, Chris L. S.

2009-01-01

Background: Although no single technique on its own can predict job performance, a job analysis is a customary approach for identifying the relevant knowledge, skills, abilities, and other characteristics (KSAO) necessary to successfully complete the job tasks of a position. Once the position requirements are identified, the hiring process is…

Identification of Bearing Failure Using Signal Vibrations

NASA Astrophysics Data System (ADS)

Yani, Irsyadi; Resti, Yulia; Burlian, Firmansyah

2018-04-01

Vibration analysis can be used to identify damage to mechanical systems such as journal bearings. Identification of failure can be done by observing the resulting vibration spectrum by measuring the vibration signal occurring in a mechanical system Bearing is one of the engine elements commonly used in mechanical systems. The main purpose of this research is to monitor the bearing condition and to identify bearing failure on a mechanical system by observing the resulting vibration. Data collection techniques based on recordings of sound caused by the vibration of the mechanical system were used in this study, then created a database system based bearing failure due to vibration signal recording sounds on a mechanical system The next step is to group the bearing damage by type based on the databases obtained. The results show the percentage of success in identifying bearing damage is 98 %.

Rural ITS toolbox

DOT National Transportation Integrated Search

2001-11-01

This document identifies successful rural Intelligent Transportation Systems (ITS) projects and statewide applications. These applications are referred to as "tools" and include those in the process of being tested prior to full deployment. The tools...

Can We Identify a Successful Teacher Better, Faster, and Cheaper? Evidence for Innovating Teacher Observation Systems

ERIC Educational Resources Information Center

Gargani, John; Strong, Michael

2014-01-01

Teacher observations have become a national education phenomenon, mandated by federal policies and promoted by philanthropists. They are crucial components of teacher evaluation systems that often have high stakes for teachers and school systems, but have sparked little innovation. Recent calls to make teacher evaluations better, faster, and…

A Correlational Analysis of Strategic Information Systems Planning in K-12 Public Educational Organizations

ERIC Educational Resources Information Center

Martin, Christopher J.

2012-01-01

Three decades of research has indicated that strategic information systems planning is a vital component to business success. The purpose of this study was to identify the relationship strategic information systems planning and financial commitment has within the K-12 public education sector. Data for this study was obtained from top management of…

Evaluating and Celebrating PBIS Success: Development and Implementation of Ohio's PBIS Recognition System

ERIC Educational Resources Information Center

Noltemeyer, Amity; Petrasek, Michael; Stine, Karen; Palmer, Katelyn; Meehan, Cricket; Jordan, Emily

2018-01-01

With the increasing use of Positive Behavioral Interventions and Supports (PBIS) nationally, several states have developed systems to recognize exemplar schools that are implementing PBIS with fidelity. These systems serve the dual purpose of identifying model PBIS schools for other schools to emulate while also reinforcing schools' effective PBIS…

Economy and political ecology perspective of Indonesian food security at South Sulawesi

NASA Astrophysics Data System (ADS)

Fahmid, I. M.; Harun, H.; Fahmid, M. M.; Saadah; Busthanul, N.

2018-05-01

The purposes of this study are: firstly, to demonstrate the relations of agro-ecological function, agricultural innovation system, social-ecological system and political ecology to encourage production for Indonesian Food Security Program (PKP) in South Sulawesi. Secondly, to identify the most influential and interested stakeholders in the success of PKP program. The study conducted by applying an interdisciplinary analysis of triangulation method. The result showed, the success of PKP in South Sulawesi with the achievement of 2 million rice overstock mainly impacted by the application of agro-ecological concept, agricultural innovation system, and political ecology while disregarding the concept of social agroecology.

A Model to Improve the Success Rate of Students in Selected Health Career Programs in the North Carolina Community College System. Final Report.

ERIC Educational Resources Information Center

Petty, Norman H.; Todd, Anne

A project sought to identify variables that are associated with student success in allied health care programs in order to provide program directors with better admissions information. Forty-nine allied health programs provided data on over 1,800 students. One questionnaire generated these basic program data for each participating program: dropout…

Comparing three different passive RFID systems for behaviour monitoring in grow-finish pigs

USDA-ARS?s Scientific Manuscript database

Animal facilities are increasing in size making it difficult for animal caretakers to ensure the health and well-being of all animals under their care. Radio Frequency Identification (RFID) systems have been successfully used in animal facilities and research has identified potential applications in...

School Technology Leadership: Artifacts in Systems of Practice

ERIC Educational Resources Information Center

Dexter, Sara

2011-01-01

A cross-case analysis of five case studies of team-based technology leadership in middle schools with laptop programs identifies systems of practice that organize teams' distributed leadership. These cases suggest that successfully implementing a complex improvement effort warrants a team-based leadership approach, especially for an improvement…

A cognitive task analysis of information management strategies in a computerized provider order entry environment.

PubMed

Weir, Charlene R; Nebeker, Jonathan J R; Hicken, Bret L; Campo, Rebecca; Drews, Frank; Lebar, Beth

2007-01-01

Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system.

Success under duress: policies and practices managers view as keys to profitability in five California hospitals with challenging payer mix.

PubMed

Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina

2012-01-01

Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.

Identifying Structural Flow Defects in Disordered Solids Using Machine-Learning Methods

NASA Astrophysics Data System (ADS)

Cubuk, E. D.; Schoenholz, S. S.; Rieser, J. M.; Malone, B. D.; Rottler, J.; Durian, D. J.; Kaxiras, E.; Liu, A. J.

2015-03-01

We use machine-learning methods on local structure to identify flow defects—or particles susceptible to rearrangement—in jammed and glassy systems. We apply this method successfully to two very different systems: a two-dimensional experimental realization of a granular pillar under compression and a Lennard-Jones glass in both two and three dimensions above and below its glass transition temperature. We also identify characteristics of flow defects that differentiate them from the rest of the sample. Our results show it is possible to discern subtle structural features responsible for heterogeneous dynamics observed across a broad range of disordered materials.

User acceptability--a critical success factor for picture archiving and communication system implementation.

PubMed

Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

2000-05-01

The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

Challenges and Opportunities for School Improvement: Recommendations for Urban School Principals

ERIC Educational Resources Information Center

Dolph, David

2017-01-01

Insofar as urban school systems that are often identified as ineffective include such a large segment of U.S. P-12 students, it is vital to improve academic success. To provide context, the article first discusses key challenges facing urban schools. Second, the article identifies and briefly reviews a variety of approaches to reform models often…

DNA barcode-based molecular identification system for fish species.

PubMed

Kim, Sungmin; Eo, Hae-Seok; Koo, Hyeyoung; Choi, Jun-Kil; Kim, Won

2010-12-01

In this study, we applied DNA barcoding to identify species using short DNA sequence analysis. We examined the utility of DNA barcoding by identifying 53 Korean freshwater fish species, 233 other freshwater fish species, and 1339 saltwater fish species. We successfully developed a web-based molecular identification system for fish (MISF) using a profile hidden Markov model. MISF facilitates efficient and reliable species identification, overcoming the limitations of conventional taxonomic approaches. MISF is freely accessible at http://bioinfosys.snu.ac.kr:8080/MISF/misf.jsp .

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

PubMed

Kuo, Calvin C; Robb, William J

2013-06-01

The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

Phase 1 Space Fission Propulsion System Design Considerations

NASA Technical Reports Server (NTRS)

Houts, Mike; VanDyke, Melissa; Godfroy, Tom; Pedersen, Kevin; Martin, James; Carter, Robert; Dickens, Ricky; Salvail, Pat; Hrbud, Ivana; Rodgers, Stephen L. (Technical Monitor)

2001-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. If fission propulsion systems are to be developed to their full potential; however, near-term customers must be identified and initial fission systems successfully developed, launched, and operated. Studies conducted in fiscal year 2001 (IISTP, 2001) show that fission electric propulsion (FEP) systems operating at 80 kWe or above could enhance or enable numerous robotic outer solar system missions of interest. At these power levels it is possible to develop safe, affordable systems that meet mission performance requirements. In selecting the system design to pursue, seven evaluation criteria were identified: safety, reliability, testability, specific mass, cost, schedule, and programmatic risk. A top-level comparison of three potential concepts was performed: an SP-100 based pumped liquid lithium system, a direct gas cooled system, and a heatpipe cooled system. For power levels up to at least 500 kWt (enabling electric power levels of 125-175 kWe, given 25-35% power conversion efficiency) the heatpipe system has advantages related to several criteria and is competitive with respect to all. Hardware-based research and development has further increased confidence in the heatpipe approach. Successful development and utilization of a "Phase 1" fission electric propulsion system will enable advanced Phase 2 and Phase 3 systems capable of providing rapid, affordable access to any point in the solar system.

Phase 1 space fission propulsion system design considerations

NASA Astrophysics Data System (ADS)

Houts, Mike; van Dyke, Melissa; Godfroy, Tom; Pedersen, Kevin; Martin, James; Dickens, Ricky; Salvail, Pat; Hrbud, Ivana; Carter, Robert

2002-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. If fission propulsion systems are to be developed to their full potential; however, near-term customers must be identified and initial fission systems successfully developed, launched, and operated. Studies conducted in fiscal year 2001 (IISTP, 2001) show that fission electric propulsion (FEP) systems operating at 80 kWe or above could enhance or enable numerous robotic outer solar system missions of interest. At these power levels it is possible to develop safe, affordable systems that meet mission performance requirements. In selecting the system design to pursue, seven evaluation criteria were identified: safety, reliability, testability, specific mass, cost, schedule, and programmatic risk. A top-level comparison of three potential concepts was performed: an SP-100 based pumped liquid lithium system, a direct gas cooled system, and a heatpipe cooled system. For power levels up to at least 500 kWt (enabling electric power levels of 125-175 kWe, given 25-35% power conversion efficiency) the heatpipe system has advantages related to several criteria and is competitive with respect to all. Hardware-based research and development has further increased confidence in the heatpipe approach. Successful development and utilization of a ``Phase 1'' fission electric propulsion system will enable advanced Phase 2 and Phase 3 systems capable of providing rapid, affordable access to any point in the solar system. .

Integrating Information Systems in a Major Decentralized International Organization. Volume 7.

DTIC Science & Technology

1987-12-01

deployment of information technology. Three key conflicting organizational forces were found to significantly impact the technical strategies : 1... strategy was modulated by three key conflicting organizational forces - autonomy, integration and evolution. A conceptual system architecture has been... organizational needs. The second part, "Gaining Strategic Advantage Through Composite Tnformation Systems," identifies critical success factors for the

Two signs indicative of successful access in nuclear medicine cerebrospinal fluid diversionary shunt studies.

PubMed

Bermo, Mohammed S; Khalatbari, Hedieh; Parisi, Marguerite T

2018-05-08

Successful shunt access is the first step in a properly performed nuclear medicine cerebrospinal fluid (CSF) shunt study. To determine the significance of the radiotracer configuration at the injection site during initial nuclear medicine CSF shunt imaging and the lack of early systemic radiotracer activity as predictors of successful shunt access. With Institutional Review Board approval, three nuclear medicine physicians performed a retrospective review of all consecutive CSF shunt studies performed in children at our institution in 2015. Antecedent nuclear medicine CSF shunt studies in these patients were also assessed and included in the review. The appearance of the reservoir site immediately after radiotracer injection was classified as either figure-of-eight or round/ovoid configuration. The presence or absence of early systemic distribution of the tracer on the 5-min static images was noted and separately evaluated. A total of 98 nuclear medicine ventriculoperitoneal CSF shunt studies were evaluated. Figure-of-eight configuration was identified in 87% of studies and, when present, had 93% sensitivity, 78% specificity, 92% accuracy, 98% positive predictive value (PPV) and 54% negative predictive value (NPV) as a predictor of successful shunt access. Early systemic activity was absent in 89 of 98 studies. Lack of early systemic distribution of the radiotracer had 98% sensitivity, 78% specificity, 96% accuracy, 98% PPV and 78% NPV as a predictor of successful shunt access. Figure-of-eight configuration in conjunction with the absence of early systemic tracer activity had 99% PPV for successful shunt access. Figure-of-eight configuration at the injection site or lack of early systemic radiotracer activity had moderate specificity for successful shunt access. Specificity and PPV significantly improved when both signs were combined in assessment.

Identifying the Value of the ACT Score as a Predictor of Student Success in Respiratory Care, Radiography, and Nursing at Southeast Kentucky Community and Technical College

ERIC Educational Resources Information Center

Parrott-Robbins, Rebecca Jon

2010-01-01

The purpose of this study was to investigate--by utilizing data obtained from the Kentucky Community and Technical College System (KCTCS) PeopleSoft database-- whether the American College Testing (ACT) assessment was a predictor of student success for students who had graduated from respiratory, radiography, and nursing programs at Southeast…

Lessons from Elsewhere?: Comparative Music Education in Times of Globalization

ERIC Educational Resources Information Center

Kertz-Welzel, Alexandra

2015-01-01

In recent years, comparative education and comparative music education became important fields of research. Due to globalization, but also to international student assessments, it is most common to compare the outcomes of entire school systems or specific subject areas. The main goal is to identify the most successful systems and their best…

Collaborative Leadership for State Systems Building: New Mexico's Early Childhood Action Network

ERIC Educational Resources Information Center

Vermilya, Lois

2009-01-01

The Early Childhood Action Network (ECAN) provides an example of successful state systems building in New Mexico. The far-reaching scope of ECAN's coalition and accomplishments identifies promising collaborative leadership practices that have relevance for early childhood leaders in other states. The author describes the accomplishments of ECAN's…

The Impediments to the Successful Implementation of Change Initiatives in Special Education Settings

ERIC Educational Resources Information Center

Edwards, Erin

2012-01-01

As school systems in general and special education programming specifically come under increasing financial and ideological pressure to undergo reform, it is critically important to understand any resistance to change, to identify and describe the culture of resistance that exists within complexity that define our school systems today, and to…

PHYLOGENETIC AFFILIATION OF WATER DISTRIBUTION SYSTEM BACTERIAL ISOLATES USING 16S RDNA SEQUENCE ANALYSIS

EPA Science Inventory

In a previously described study, only 15% of the bacterial strains isolated from a water distribution system (WDS) grown on R2A agar were identifiable using fatty acid methyl esthers (FAME) profiling. The lack of success was attributed to the use of fatty acid databases of bacter...

Development of a data warehouse at an academic health system: knowing a place for the first time.

PubMed

Dewitt, Jocelyn G; Hampton, Philip M

2005-11-01

In 1998, the University of Michigan Health System embarked upon the design, development, and implementation of an enterprise-wide data warehouse, intending to use prioritized business questions to drive its design and implementation. Because of the decentralized nature of the academic health system and the development team's inability to identify and prioritize those institutional business questions, however, a bottom-up approach was used to develop the enterprise-wide data warehouse. Specific important data sets were identified for inclusion, and the technical team designed the system with an enterprise view and architecture rather than as a series of data marts. Using this incremental approach of adding data sets, institutional leaders were able to experience and then further define successful use of the integrated data made available to them. Even as requests for the use and expansion of the data warehouse outstrip the resources assigned for support, the data warehouse has become an integral component of the institution's information management strategy. The authors discuss the approach, process, current status, and successes and failures of the data warehouse.

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

Sudman, D.L.

For 17 years, the sensor-based IBM 1800 computer successfully fulfilled Sun's requirements for data acquisition and process control at its petroleum refinery in Toledo, Ohio. However, faltering reliability due to deterioration, coupled with IBM's announced withdrawal of contractual hardware maintenance, prompted Sun to approach IBM regarding potential solutions to the problem of economically maintaining the IBM 1800 as a viable system in the Toledo Refinery. In concert, IBM and Sun identified several options, but an IBM proposal which held the most promise for long term success was the direct replacement of the IBM 1800 processor and software systems with anmore » IBM 4300 running IBM's licensed program product ''Advanced Control System,'' i.e., ACS. Sun chose this solution. The intent of this paper is to chronicle the highlights of the project which successfully revitalized the process computer facilities in Sun's Toledo Refinery in only 10 months, under financial constraints, and using limited human resources.« less

Radiography simulation on single-shot dual-spectrum X-ray for cargo inspection system.

PubMed

Gil, Youngmi; Oh, Youngdo; Cho, Moohyun; Namkung, Won

2011-02-01

We propose a method to identify materials in the dual energy X-ray (DeX) inspection system. This method identifies materials by combining information on the relative proportions T of high-energy and low-energy X-rays transmitted through the material, and the ratio R of the attenuation coefficient of the material when high-energy are used to that when low energy X-rays are used. In Monte Carlo N-Particle Transport Code (MCNPX) simulations using the same geometry as that of the real container inspection system, this T vs. R method successfully identified tissue-equivalent plastic and several metals. In further simulations, the single-shot mode of operating the accelerator led to better distinguishing of materials than the dual-shot system. Copyright © 2010 Elsevier Ltd. All rights reserved.

The intellectual core of enterprise information systems: a co-citation analysis

NASA Astrophysics Data System (ADS)

Shiau, Wen-Lung

2016-10-01

Enterprise information systems (EISs) have evolved in the past 20 years, attracting the attention of international practitioners and scholars. Although literature reviews and analyses have been conducted to examine the multiple dimensions of EISs, no co-citation analysis has been conducted to examine the knowledge structures involved in EIS studies; thus, the current study fills this research gap. This study investigated the intellectual structures of EISs. All data source documents (1083 articles and 24,090 citations) were obtained from the Institute for Scientific Information Web of Knowledge database. A co-citation analysis was used to analyse EIS data. By using factor analysis, we identified eight critical factors: (a) factors affecting the implementation and success of information systems (ISs); (b) the successful implementation of enterprise resource planning (ERP); (c) IS evaluation and success, (d) system science studies; (e) factors influencing ERP success; (f) case research and theoretical models; (g) user acceptance of information technology; and (h) IS frameworks. Multidimensional scaling and cluster analysis were used to visually map the resultant EIS knowledge. It is difficult to implement an EIS in an enterprise and each organisation exhibits specific considerations. The current findings indicate that managers must focus on ameliorating inferior project performance levels, enabling a transition from 'vicious' to 'virtuous' projects. Successful EIS implementation yields substantial organisational advantages.

The (Un)Lonely Planet Guide: Formation and Evolution of Planetary Systems from a ``Blue Dots'' Perspective

NASA Astrophysics Data System (ADS)

Meyer, M. R.

2010-10-01

In this contribution I summarize some recent successes, and focus on remaining challenges, in understanding the formation and evolution of planetary systems in the context of the Blue Dots initiative. Because our understanding is incomplete, we cannot yet articulate a design reference mission engineering matrix suitable for an exploration mission where success is defined as obtaining a spectrum of a potentially habitable world around a nearby star. However, as progress accelerates, we can identify observational programs that would address fundamental scientific questions through hypothesis testing such that the null result is interesting.

Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

PubMed

Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

2017-05-01

Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

An exploration of the leadership attributes and methods associated with successful lean system deployments in acute care hospitals.

PubMed

Steed, Airica

2012-01-01

The lean system has been shown to be a viable and sustainable solution for the growing number of cost, quality, and efficiency issues in the health care industry. While there is a growing body of evidence to support the outcomes that can be achieved as a result of the successful application of the lean system in hospital organizations, there is not a complete understanding of the leadership attributes and methods that are necessary to achieve successful widespread mobilization and sustainment. This study was an exploration of leadership and its relevant association with successful lean system deployments in acute care hospitals. This research employed an exploratory qualitative research design encompassing a research questionnaire and telephonic interviews of 25 health care leaders in 8 hospital organizations across the United States. The results from this study identified the need to have a strong combination of personal characteristics, learned behaviors, strategies, tools, and tactics that evolved into a starting adaptable framework for health care leaders to leverage when starting their own transformational change journeys using the lean system. Health care leaders could utilize the outcomes reported in this study as a conduit to enhance the effective deployment, widespread adoption, and sustainment of the lean system in practice.

Telerobotic rendezvous and docking vision system architecture

NASA Technical Reports Server (NTRS)

Gravely, Ben; Myers, Donald; Moody, David

1992-01-01

This research program has successfully demonstrated a new target label architecture that allows a microcomputer to determine the position, orientation, and identity of an object. It contains a CAD-like database with specific geometric information about the object for approach, grasping, and docking maneuvers. Successful demonstrations were performed selecting and docking an ORU box with either of two ORU receptacles. Small, but significant differences were seen in the two camera types used in the program, and camera sensitive program elements have been identified. The software has been formatted into a new co-autonomy system which provides various levels of operator interaction and promises to allow effective application of telerobotic systems while code improvements are continuing.

Essential Ingredients for Successful Redesign of Addiction Treatment

PubMed Central

Gustafson, David H.

2013-01-01

Summary Since the passage of healthcare reform, there have been many discussions about how the mental health and substance use disorder (MH/SUD) system will need to change. Of the many components involved in a system redesign, the identification of essential ingredients is crucial to its success. In an effort to determine what essential ingredients the new MH/SUD system requires to optimally meet the needs of its customers, we convened a group of 16 multi-industrial experts who analyzed data collected from a string of 7 focus groups and 15 interviews with people dealing with or working in the SUD field. This paper summarizes the 11 essential ingredients our group identified. PMID:25243237

Exploring the Influence of 21st Century Skills in a Dual Language Program: A Case Study

ERIC Educational Resources Information Center

Heinrichs, Christine R.

2016-01-01

Preparing students as 21st century learners is a key reform in education. The Partnership for 21st Century Skills developed a framework that identifies outcomes needed for successful implementation of rigorous standards. The Dual Language (DL) program was identified as a structure for reform with systems and practices which can be used to prepare…

Recommendations for the Improved Effectiveness and Reporting of Telemedicine Programs in Developing Countries: Results of a Systematic Literature Review.

PubMed

Khanal, Sumesh; Burgon, Joseph; Leonard, Saoirse; Griffiths, Matthew; Eddowes, Lucy A

2015-11-01

A lack of decisive evidence on the impact of telemedicine on financial and clinical outcomes has not prohibited significant investment in developing countries. Understanding characteristics that facilitate effective telemedicine programs is required to allow telemedicine to be used to its full potential. This systematic review aimed to identify organizational, technological, and financial features of successful telemedicine programs providing direct clinical care in developing countries. Databases were searched, and the results were reviewed systematically according to predefined inclusion/exclusion criteria. Information on location(s), measure of success, and organizational, technological, and financial characteristics were extracted. This review was impeded by inadequate program reporting, and so a concise checklist was developed to aid improved reporting, enabling future reviews to identify key characteristics of effective programs. This systematic review identified 46 articles reporting 36 programs that fulfilled the inclusion/exclusion criteria. Programs were distributed globally, including regional, national, and international programs. Technological modalities included synchronous technology, real-time teleconsultations, and asynchronous technology. Program integration with existing systems and twinning of international institutions were identified as factors enabling program success. Other factors included simple and easy-to-use technology, ability to reduce the burden on healthcare professionals, and technology able to maintain functionality in challenging environmental circumstances. Reports describing effectiveness and costs were limited. This systematic review identified key factors associated with telemedicine program success. However, inconsistencies in reporting represent an obstacle to establishment of successful programs in developing countries by limiting the application of previous experiences. Adhering to the guidelines suggested here may allow more quantitative assessments of effectiveness and impact for future programs.

Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system.

PubMed

Kim, Pyeong Hwa; Song, Ho-Young; Park, Jung-Hoon; Zhou, Wei-Zhong; Na, Han Kyu; Cho, Young Chul; Jun, Eun Jung; Kim, Jun Ki; Kim, Guk Bae

2017-03-01

To evaluate clinical outcomes of fluoroscopic removal of retrievable self-expandable metal stents (SEMSs) for malignant oesophageal strictures, to compare clinical outcomes of three different removal techniques, and to identify predictive factors of successful removal by the standard technique (primary technical success). A total of 137 stents were removed from 128 patients with malignant oesophageal strictures. Primary overall technical success and removal-related complications were evaluated. Logistic regression models were constructed to identify predictive factors of primary technical success. Primary technical success rate was 78.8 % (108/137). Complications occurred in six (4.4 %) cases. Stent location in the upper oesophagus (P=0.004), stricture length over 8 cm (P=0.030), and proximal granulation tissue (P<0.001) were negative predictive factors of primary technical success. If granulation tissue was present at the proximal end, eversion technique was more frequently required (P=0.002). Fluoroscopic removal of retrievable SEMSs for malignant oesophageal strictures using three different removal techniques appeared to be safe and easy. The standard technique is safe and effective in the majority of patients. The presence of proximal granulation tissue, stent location in the upper oesophagus, and stricture length over 8 cm were negative predictive factors for primary technical success by standard extraction and may require a modified removal technique. • Fluoroscopic retrievable SEMS removal is safe and effective. • Standard removal technique by traction is effective in the majority of patients. • Three negative predictive factors of primary technical success were identified. • Caution should be exercised during the removal in those situations. • Eversion technique is effective in cases of proximal granulation tissue.

Development of a master health facility list in Nigeria.

PubMed

Makinde, Olusesan Ayodeji; Azeez, Aderemi; Bamidele, Samson; Oyemakinde, Akin; Oyediran, Kolawole Azeez; Adebayo, Wura; Fapohunda, Bolaji; Abioye, Abimbola; Mullen, Stephanie

2014-01-01

Abstract. Routine Health Information Systems (RHIS) are increasingly transitioning to electronic platforms in several developing countries. Establishment of a Master Facility List (MFL) to standardize the allocation of unique identifiers for health facilities can overcome identification issues and support health facility management. The Nigerian Federal Ministry of Health (FMOH) recently developed a MFL, and we present the process and outcome. The MFL was developed from the ground up, and includes a state code, a local government area (LGA) code, health facility ownership (public or private), the level of care, and an exclusive LGA level health facility serial number, as part of the unique identifier system in Nigeria. To develop the MFL, the LGAs sent the list of all health facilities in their jurisdiction to the state, which in turn collated for all LGAs under them before sending to the FMOH. At the FMOH, a group of RHIS experts verified the list and identifiers for each state. The national MFL consists of 34,423 health facilities uniquely identified. The list has been published and is available for worldwide access; it is currently used for planning and management of health services in Nigeria. Unique identifiers are a basic component of any information system. However, poor planning and execution of implementing this key standard can diminish the success of the RHIS. Development and adherence to standards is the hallmark for a national health information infrastructure. Explicit processes and multi-level stakeholder engagement is necessary to ensuring the success of the effort.

Recommended system of application and development

NASA Astrophysics Data System (ADS)

Wang, Wei

2018-04-01

A recommender system is a project that helps users identify their wishes and needs. The recommender system has been successfully applied to many e-commerce environments, such as news, film, music, books and other areas of recommendation. This paper mainly discusses the application of recommendation technology in software engineering, data and knowledge engineering, configurable projects and persuasion technology, and summarizes the development trend of recommendation technology in the future.

Object extraction in photogrammetric computer vision

NASA Astrophysics Data System (ADS)

Mayer, Helmut

This paper discusses state and promising directions of automated object extraction in photogrammetric computer vision considering also practical aspects arising for digital photogrammetric workstations (DPW). A review of the state of the art shows that there are only few practically successful systems on the market. Therefore, important issues for a practical success of automated object extraction are identified. A sound and most important powerful theoretical background is the basis. Here, we particularly point to statistical modeling. Testing makes clear which of the approaches are suited best and how useful they are for praxis. A key for commercial success of a practical system is efficient user interaction. As the means for data acquisition are changing, new promising application areas such as extremely detailed three-dimensional (3D) urban models for virtual television or mission rehearsal evolve.

[Factors associated with academic success of medical students at Buenos Aires University].

PubMed

Borracci, Raúl A; Pittaluga, Roberto D; Álvarez Rodríguez, Juan E; Arribalzaga, Eduardo B; Poveda Camargo, Ricardo L; Couto, Juan L; Provenzano, Sergio L

2014-01-01

The aim of this study was to identify common factors relating to the academic success of medical students who were distinguished with honors at the Buenos Aires University. In 2011, 142 graduates were surveyed; the questionnaire included 59 questions on their sociodemographic environment, living conditions and social integration, motivation to study, learning capacity and health quality during their career. Compared to other students, these distinguished students more often lived in the city, far from their families; had been educated at private or universitary high schools, their economic needs were financed by their parents, who were on the whole professionals. Most of them were single and childless. The possibility of future employment oportunities (work) did not influence their choice of a medical career, academic success was important to them and they believed that success depended largely on personal effort; they knew how to handle anxiety, were sociable but independent and preferred solid experience to abstract conceptuality in order to obtain information. Our conclusion, within the current system of candidate selection, these results serve to calculate the covert self-selection mechanisms during the career, or in a more restrictive regime, to select those likely to reach academic success due to their privileged ambience. The analysis of demographic factors indicates some degree of inequality for socially disadvantaged students. Perhaps, a selection system based only on intellectual abilities would help identify and support the best candidates regardless of their social context.

Making the Numbers Add up: A Guide for Using Data in College Access and Success Programs. Results and Reflections. An Evaluation Report

ERIC Educational Resources Information Center

Lumina Foundation for Education, 2009

2009-01-01

The purpose of this guide is to help readers clarify their roles in the college access and success system and to identify how they might use data to create change for students. This guide shows how data can strengthen current programs and support broader changes that ease the path to college for students. This guide illuminates how a long-term…

A portable freshwater closed-system fish egg incubation system

USGS Publications Warehouse

Sutherland, Jenny L.; Manny, Bruce A.; Kennedy, Gregory W.; Roseman, Edward F.; Allen, Jeffrey D.; Black, M. Glen

2014-01-01

To identify fish eggs collected in the field to species, a portable closed-system fish egg incubation system was designed and used to incubate and hatch the eggs in the laboratory. The system is portable, small in scale (2.54 × 1.52 × 2.03 m), and affordable, with the approximate cost of the system being US$8,300 (2012). The main tank is 678 L and holds a battery of up to 21 (egg) incubation jars. The system includes three independent water pumping systems to (1) provide aerated water to hatching jars, (2) filter and sterilize incubation water, and (3) provide temperature-controlled water in the main tank bath and the incubation jars. The system was successfully used to incubate freshwater fish eggs to raise resulting larvae to the post-yolk-sac stage for three seasons (spring 2012, spring 2013, and fall 2013) over two consecutive years, at two different locations, enabling us to identify fish eggs to species by providing identifiable fish larvae from incubated fish eggs.

A Cognitive Task Analysis of Information Management Strategies in a Computerized Provider Order Entry Environment

PubMed Central

Weir, Charlene R.; Nebeker, Jonathan J.R.; Hicken, Bret L.; Campo, Rebecca; Drews, Frank; LeBar, Beth

2007-01-01

Objective Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Design Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Measurements Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Results Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Conclusion Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system. PMID:17068345

System Identification for the Clipper Liberty C96 Wind Turbine

NASA Astrophysics Data System (ADS)

Showers, Daniel

System identification techniques are powerful tools that help improve modeling capabilities of real world dynamic systems. These techniques are well established and have been successfully used on countless systems in many areas. However, wind turbines provide a unique challenge for system identification because of the difficulty in measuring its primary input: wind. This thesis first motivates the problem by demonstrating the challenges with wind turbine system identification using both simulations and real data. It then suggests techniques toward successfully identifying a dynamic wind turbine model including the notion of an effective wind speed and how it might be measured. Various levels of simulation complexity are explored for insights into calculating an effective wind speed. In addition, measurements taken from the University of Minnesota's Clipper Liberty C96 research wind turbine are used for a preliminary investigation into the effective wind speed calculation and system identification of a real world wind turbine.

The Successful Development of an Automated Rendezvous and Capture (AR&C) System for the National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

Roe, Fred D.; Howard, Richard T.

2003-01-01

During the 1990's, the Marshall Space Flight Center (MSFC) conducted pioneering research in the development of an automated rendezvous and capture/docking (AR&C) system for U.S. space vehicles. Development and demonstration of a rendezvous sensor was identified early in the AR&C Program as the critical enabling technology that allows automated proximity operations and docking. A first generation rendezvous sensor, the Video Guidance Sensor (VGS), was developed and successfully flown on STS-87 and STS-95, proving the concept of a video- based sensor. A ground demonstration of the entire system and software was successfully tested. Advances in both video and signal processing technologies and the lessons learned from the two successful flight experiments provided a baseline for the development, by the MSFC, of a new generation of video based rendezvous sensor. The Advanced Video Guidance Sensor (AGS) has greatly increased performance and additional capability for longer-range operation with a new target designed as a direct replacement for existing ISS hemispherical reflectors.

Redesign and commissioning of sexual health services in England - a qualitative study.

PubMed

Walker, I F; Leigh-Hunt, N; Lee, A C K

2016-10-01

Responsibility for the commissioning of sexual and reproductive health (SRH) services transferred from the National Health Service to local authorities in England in 2013. This transfer prompted many local authorities to undertake new procurements of these SRH services. This study was undertaken to capture some of the lessons learnt in order to inform future commissioning and system redesign. A qualitative study was carried out involving semi-structured interviews. Interviews were conducted with 13 local authority sexual health commissioners in Yorkshire and the Humber from 11 interviews. Thematic analysis was used to identify themes from transcripts of the interviews with the 13 participants. Key themes identified were as follows: the challenge and complexity to those new to clinical commissioning; the prerequisites of robust infrastructural inputs to undertake the process, including technical expertise, a dependable project team, with clarity over the timescales and the budget; the requirement for good governance, stakeholder engagement and successful management of relationships with the latter; and the need to focus on the outcomes, aiming for value for money and improved system performance. Several key issues emerged from our study that significantly influenced the outcome of the redesign and commissioning process for sexual health services. An adapted model of the Donabedian evaluation framework was developed to provide a tool to inform future system redesign. Our model helps identify the key determinants for successful redesign in this context which is essential to both mitigate potential risks and maximize the likelihood of successful outcomes. Our model may have wider applications. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Lessons learned in the deployment of a HIV counseling and testing management information system on a new project.

PubMed

Makinde, Olusesan A; Ezomike, Chioma F; Lehmann, Harold P; Ibanga, Iko J

2011-11-28

To share our experience on how we used simple but detailed processes and deployed a management information system on a new HIV counseling and testing (HCT) project in Nigeria. The procedures used in this study were adopted for their strength in identifying areas of continuous improvement as the project was implemented. We used an iterative brainstorming technique among 30 participants (volunteer counselors and project management staff) as well as iterative quality audits to identify several limitations to the success of the project and to propose solutions. We then implemented the solutions and reevaluated for performance. Findings from the evaluations were then reintroduced into the brainstorming and planning sessions. Several limitations were identified with the most prominent being the poor documentation of records at the site and the lack of a document transfer trail for audit purposes. Communication, cohesion and team focus are necessary to achieve success on any new project. Institutionalizing routine HIV behavioral surveillance using data collected at HCT will help in streamlining interventions that will be evidence-based. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Business model design for a wearable biofeedback system.

PubMed

Hidefjäll, Patrik; Titkova, Dina

2015-01-01

Wearable sensor technologies used to track daily activities have become successful in the consumer market. In order for wearable sensor technology to offer added value in the more challenging areas of stress-rehab care and occupational health stress-related biofeedback parameters need to be monitored and more elaborate business models are needed. To identify probable success factors for a wearable biofeedback system (Affective Health) in the two mentioned market segments in a Swedish setting, we conducted literature studies and interviews with relevant representatives. Data were collected and used first to describe the two market segments and then to define likely feasible business model designs, according to the Business Model Canvas framework. Needs of stakeholders were identified as inputs to business model design. Value propositions, a key building block of a business model, were defined for each segment. The value proposition for occupational health was defined as "A tool that can both identify employees at risk of stress-related disorders and reinforce healthy sustainable behavior" and for healthcare as: "Providing therapists with objective data about the patient's emotional state and motivating patients to better engage in the treatment process".

The ABC's required for establishing a practical computerized plant engineering management data base system

NASA Technical Reports Server (NTRS)

Maiocco, F. R.; Hume, J. P.

1976-01-01

A system's approach is outlined in the paper to assist facility and Plant Engineers improve their organization's data management system. The six basic steps identified may appear somewhat simple; however, adequate planning, proper resources, and the involvement of management will determine the success of a computerized facility management data base. Helpful suggestions are noted throughout the paper to insure the development of a practical computerized data management system.

System Members at Odds: Managing Divergent Perspectives in the Higher Education Change Process

ERIC Educational Resources Information Center

Barnett, Kathy

2011-01-01

Achieving a shared vision is often cited as a prerequisite to successful organisational change. What change strategists do not take into consideration is how this concept applies to complex systems such as those found in higher education. This paper explores and identifies the divergent perspectives and meanings found among the multiplicity of…

The Development and Field Test of an Employment Interview System to Identify Successful School Principals

ERIC Educational Resources Information Center

Kobler, Angelique L.

2010-01-01

The purpose of the study was to examine the reliability and validity of the employment interview system for Principals (ICIS-Principal). This instrument attempts to predict the effectiveness of principal applicants as building leaders, determined through a set of employment interview questions aligned with the primary themes found within the…

Beyond the Paycheck: A Human Resources Management Guide for Leaders of Small Youth-Serving Organizations

ERIC Educational Resources Information Center

Casey, Thomas P.

2009-01-01

This guide aims to help organization leaders develop the tools and knowledge they need to create and use sound human resources management (HRM) systems and practices that support program success and sustainability. It identifies key components of HRM systems and discusses important considerations in designing HRM policies, procedures, and…

The Delaware River Basin Landsat-Data Collection System Experiment

NASA Technical Reports Server (NTRS)

Paulson, R. W. (Principal Investigator)

1975-01-01

The author has identified the following significant results. This experiment successfully demonstrated that standard U.S. Geological Survey field instrumentation could be easily interfaced with the LANDSAT-DCS and the data made to flow smoothly to water resources management agencies. The experiment was conducted in the Delaware River basin. A truly operational system could not be deployed.

Learner and Faculty Support

ERIC Educational Resources Information Center

Guan, Sharon; Stanford, Daniel

2016-01-01

This chapter identifies effective ways to address learner and faculty support. It introduces methods for building a successful learner support system by providing sufficient resources and proactively addressing learner motivation. It also addresses effective faculty support through institutional policies, resources, training, and course…

Candidate thermal energy storage technologies for solar industrial process heat applications

NASA Technical Reports Server (NTRS)

Furman, E. R.

1979-01-01

A number of candidate thermal energy storage system elements were identified as having the potential for the successful application of solar industrial process heat. These elements which include storage media, containment and heat exchange are shown.

On the identifiability of inertia parameters of planar Multi-Body Space Systems

NASA Astrophysics Data System (ADS)

Nabavi-Chashmi, Seyed Yaser; Malaek, Seyed Mohammad-Bagher

2018-04-01

This work describes a new formulation to study the identifiability characteristics of Serially Linked Multi-body Space Systems (SLMBSS). The process exploits the so called "Lagrange Formulation" to develop a linear form of Equations of Motion w.r.t the system Inertia Parameters (IPs). Having developed a specific form of regressor matrix, we aim to expedite the identification process. The new approach allows analytical as well as numerical identification and identifiability analysis for different SLMBSSs' configurations. Moreover, the explicit forms of SLMBSSs identifiable parameters are derived by analyzing the identifiability characteristics of the robot. We further show that any SLMBSS designed with Variable Configurations Joint allows all IPs to be identifiable through comparing two successive identification outcomes. This feature paves the way to design new class of SLMBSS for which accurate identification of all IPs is at hand. Different case studies reveal that proposed formulation provides fast and accurate results, as required by the space applications. Further studies might be necessary for cases where planar-body assumption becomes inaccurate.

Customer Discovery as the First Essential Step for Successful Health Information Technology System Development.

PubMed

Thamjamrassri, Punyotai; Song, YuJin; Tak, JaeHyun; Kang, HoYong; Kong, Hyoun-Joong; Hong, Jeeyoung

2018-01-01

Customer discovery (CD) is a method to determine if there are actual customers for a product/service and what they would want before actually developing the product/service. This concept, however, is rather new to health information technology (IT) systems. Therefore, the aim of this paper was to demonstrate how to use the CD method in developing a comprehensive health IT service for patients with knee/leg pain. We participated in a 6-week I-Corps program to perform CD, in which we interviewed 55 people in person, by phone, or by video conference within 6 weeks: 4 weeks in the United States and 2 weeks in Korea. The interviewees included orthopedic doctors, physical therapists, physical trainers, physicians, researchers, pharmacists, vendors, and patients. By analyzing the interview data, the aim was to revise our business model accordingly. Using the CD approach enabled us to understand the customer segments and identify value propositions. We concluded that a facilitating tele-rehabilitation system is needed the most and that the most suitable customer segment is early stage arthritis patients. We identified a new design concept for the customer segment. Furthermore, CD is required to identify value propositions in detail. CD is crucial to determine a more desirable direction in developing health IT systems, and it can be a powerful tool to increase the potential for successful commercialization in the health IT field.

Organizational resilience: Nonprofit organizations' response to change.

PubMed

Witmer, Hope; Mellinger, Marcela Sarmiento

2016-05-24

Organizational resilience refers to the ability to respond productively to significant disruptive change and transform challenges into opportunities. There is a gap in the literature about resilient nonprofit organizations and its application for identifying organizational conditions for successful adaption to external variables that threaten their existence. The aim of this study was to identify organizational characteristics that point to the resilience of nonprofit behavioral healthcare organizations as they successfully adapt to funding changes. A multiple case study of two behavioral health nonprofit organizations was conducted. Data was collected through interviews and focus groups, and analyzed through a qualitative content analysis. Using the framework of resilience, six themes that equipped these organizations to successfully adapt to funding changes were identified. They included: commitment to the mission, improvisation, community reciprocity, servant and transformational leadership, hope and optimism, and fiscal transparency. The findings suggest that incorporating these qualities into an organizational system equips it to systematically adapt to funding changes and other disruptive challenges. Using resilience as a process and not simply an outcome after recovery, nonprofit organizations can have the capacity to continuously respond to challenges and provide uninterrupted and valuable services to society.

Providing oxygen to children in hospitals: a realist review

PubMed Central

Tosif, Shidan; Gray, Amy; Qazi, Shamim; Campbell, Harry; Peel, David; McPake, Barbara; Duke, Trevor

2017-01-01

Abstract Objective To identify and describe interventions to improve oxygen therapy in hospitals in low-resource settings, and to determine the factors that contribute to success and failure in different contexts. Methods Using realist review methods, we scanned the literature and contacted experts in the field to identify possible mechanistic theories of how interventions to improve oxygen therapy systems might work. Then we systematically searched online databases for evaluations of improved oxygen systems in hospitals in low- or middle-income countries. We extracted data on the effectiveness, processes and underlying theory of selected projects, and used these data to test the candidate theories and identify the features of successful projects. Findings We included 20 improved oxygen therapy projects (45 papers) from 15 countries. These used various approaches to improving oxygen therapy, and reported clinical, quality of care and technical outcomes. Four effectiveness studies demonstrated positive clinical outcomes for childhood pneumonia, with large variation between programmes and hospitals. We identified factors that help or hinder success, and proposed a practical framework depicting the key requirements for hospitals to effectively provide oxygen therapy to children. To improve clinical outcomes, oxygen improvement programmes must achieve good access to oxygen and good use of oxygen, which should be facilitated by a broad quality improvement capacity, by a strong managerial and policy support and multidisciplinary teamwork. Conclusion Our findings can inform practitioners and policy-makers about how to improve oxygen therapy in low-resource settings, and may be relevant for other interventions involving the introduction of health technologies. PMID:28479624

Training Knowledge Bots for Physics-Based Simulations Using Artificial Neural Networks

NASA Technical Reports Server (NTRS)

Samareh, Jamshid A.; Wong, Jay Ming

2014-01-01

Millions of complex physics-based simulations are required for design of an aerospace vehicle. These simulations are usually performed by highly trained and skilled analysts, who execute, monitor, and steer each simulation. Analysts rely heavily on their broad experience that may have taken 20-30 years to accumulate. In addition, the simulation software is complex in nature, requiring significant computational resources. Simulations of system of systems become even more complex and are beyond human capacity to effectively learn their behavior. IBM has developed machines that can learn and compete successfully with a chess grandmaster and most successful jeopardy contestants. These machines are capable of learning some complex problems much faster than humans can learn. In this paper, we propose using artificial neural network to train knowledge bots to identify the idiosyncrasies of simulation software and recognize patterns that can lead to successful simulations. We examine the use of knowledge bots for applications of computational fluid dynamics (CFD), trajectory analysis, commercial finite-element analysis software, and slosh propellant dynamics. We will show that machine learning algorithms can be used to learn the idiosyncrasies of computational simulations and identify regions of instability without including any additional information about their mathematical form or applied discretization approaches.

Successful Business Intelligence System for SME: An Analytical Study in Malaysia

NASA Astrophysics Data System (ADS)

Qushem, Umar Bin; Zeki, Akram M.; Abubakar, Adamu

2017-08-01

While many larger organizations is adhering to a new level of competence by adoption of advanced Business Intelligence (BI) systems, in the same time there are other small-medium companies who are left behind in terms of updating them for better success in the industry. Thus the aim of the research is to identify Small and Medium Enterprise (SME) specific determinants for Business Intelligence efficiency which will lead those organizations a better understanding of development and testing of BI framework in the business world. In this study, it is therefore considered extensive literature reviews to measure the efficiently factors and proposed a holistic conceptual framework. In the same time, feedbacks of the Business Intelligent experts were taken into consideration to provide new insights for SME companies to ensure where to focus and which type of sector is crucial for an SME organization in order to be successful in parallel with Big organizations. Thus in this regard, Quantitative Survey research method is used and Statistical analysis were used for analyzing the data. The results revealed that SME Companies should focus on Environmental factor (EF) as it is the most identified factor lead BI efficiency in Business Organization.

Architectural Analysis of a LLNL LWIR Sensor System

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

Bond, Essex J.; Curry, Jim R.; LaFortune, Kai N.

The architecture of an LLNL airborne imaging and detection system is considered in this report. The purpose of the system is to find the location of substances of interest by detecting their chemical signatures using a long-wave infrared (LWIR) imager with geo-registration capability. The detection system consists of an LWIR imaging spectrometer as well as a network of computer hardware and analysis software for analyzing the images for the features of interest. The system has been in the operations phase now for well over a year, and as such, there is enough use data and feedback from the primary beneficiarymore » to assess the current successes and shortcomings of the LWIR system architecture. LWIR system has been successful in providing reliable data collection and the delivery of a report with results. The weakness of the architecture has been identified in two areas: with the network of computer hardware and software and with the feedback of the state of the system health. Regarding the former, the system computers and software that carry out the data acquisition are too complicated for routine operations and maintenance. With respect to the latter, the primary beneficiary of the instrument’s data does not have enough metrics to use to filter the large quantity of data to determine its utility. In addition to the needs in these two areas, a latent need of one of the stakeholders is identified. This report documents the strengths and weaknesses, as well as proposes a solution for enhancing the architecture that simultaneously addresses the two areas of weakness and leverages them to meet the newly identified latent need.« less

Systems biology and the quest for correlates of protection to guide the development of an HIV vaccine.

PubMed

Kuri-Cervantes, Leticia; Fourati, Slim; Canderan, Glenda; Sekaly, Rafick-Pierre

2016-08-01

Over the last three decades, a myriad of data has been generated regarding HIV/SIV evolution, immune evasion, immune response, and pathogenesis. Much of this data can be integrated and potentially used to generate a successful vaccine. Although individual approaches have begun to shed light on mechanisms involved in vaccine-conferred protection from infection, true correlates of protection have not yet been identified. The systems biology approach helps unify datasets generated using different techniques and broaden our understanding of HIV immunopathogenesis. Moreover, systems biology is a tool that can provide correlates of protection, which can be targeted for the production of a successful HIV vaccine. Copyright © 2016. Published by Elsevier Ltd.

Drug Delivery Research: The Invention Cycle.

PubMed

Park, Kinam

2016-07-05

Controlled drug delivery systems have been successful in introducing improved formulations for better use of existing drugs and novel delivery of biologicals. The initial success of producing many oral products and some injectable depot formulations, however, reached a plateau, and the progress over the past three decades has been slow. This is likely due to the difficulties of formulating hydrophilic, high molecular weight drugs, such as proteins and nucleic acids, for targeting specific cells, month-long sustained delivery, and pulsatile release. Since the approaches that have served well for delivery of small molecules are not applicable to large molecules, it is time to develop new methods for biologicals. The process of developing future drug delivery systems, termed as the invention cycle, is proposed, and it starts with clearly defining the problems for developing certain formulations. Once the problems are well-defined, creative imagination examines all potential options and selects the best answer and alternatives. Then, innovation takes over to generate unique solutions for developing new formulations that resolve the previously identified problems. Ultimately, the new delivery systems will have to go through a translational process to produce the final formulations for clinical use. The invention cycle also emphasizes examining the reasons for success of certain formulations, not just the reasons for failure of many systems. Implementation of the new invention cycle requires new mechanisms of funding the younger generation of scientists and a new way of identifying their achievements, thereby releasing them from the burden of short-termism.

Microbial Monitoring from the Frontlines to Space: A Successful Validation of a Department of Defense (DoD) Funded Small Business Innovation Research (SBIR) Technology on Board the International Space Station (ISS)

NASA Technical Reports Server (NTRS)

Oubre, Cherie; Khodadad, Christina; Castro, Victoria; Ott, Mark; Pollack, Lawrence; Roman, Monsi

2017-01-01

The RAZOR EX (Registered Trademark) PCR unit was initially developed by the DoD as part of an SBIR project to detect and identify biothreats during field deployment. The system was evaluated by NASA as a commercial technology for future microbial monitoring requirements and has been successfully demonstrated in microgravity on-board the International Space Station.

Central sensitization does not identify patients with carpal tunnel syndrome who are likely to achieve short-term success with physical therapy.

PubMed

Fernández-de-Las-Peñas, César; Cleland, Joshua A; Ortega-Santiago, Ricardo; de-la-Llave-Rincon, Ana Isabel; Martínez-Perez, Almudena; Pareja, Juan A

2010-11-01

The aim of the current study was to identify whether hyperexcitability of the central nervous system is a prognostic factor for individuals with carpal tunnel syndrome (CTS) likely to experience rapid and clinical self-reported improvement following a physical therapy program including soft tissue mobilization and nerve slider neurodynamic interventions. Women presenting with clinical and electrophysiological findings of CTS were involved in a prospective single-arm trial. Participants underwent a standardized examination and then a physical therapy session. The physical therapy sessions included both soft tissue mobilization directed at the anatomical sites of potential median nerve entrapment and a passive nerve slider neurodynamic technique targeted to the median nerve. Pressure pain thresholds (PPT) over the median, radial and ulnar nerves, C5-C6 zygapophyseal joint, carpal tunnel and tibialis anterior muscle were assessed bilaterally. Additionally, thermal detection and pain thresholds were measured over the carpal tunnel and thenar eminence bilaterally to evaluate central nervous system excitability. Subjects were classified as responders (having achieved a successful outcome) or non-responders based on self-perceived recovery. Variables were entered into a stepwise logistic regression model to determine the most accurate variables for determining prognosis. Data from 72 women were included in the analysis, of which 35 experienced a successful outcome (48.6%). Three variables including PPT over the C5-C6 joint affected side <137 kPa, HPT carpal tunnel affected side <39.6º and general health >66 points were identified. If 2 out of 3 variables were present (LR + 14.8), the likelihood of success increased from 48.6 to 93.3%. We identified 3 factors that may be associated with a rapid clinical response to both soft tissue mobilization and nerve slider neurodynamic techniques targeted to the median nerve in women presenting with CTS. Our results support that widespread central sensitization may not be present in women with CTS who are likely to achieve a successful outcome with physical therapy. Future studies are now necessary to validate these findings.

OSD CALS Architecture Master Plan Study. Concept Paper. Indexing. Volume 30

DOT National Transportation Integrated Search

1989-06-01

An index identifies and reference information which is exchanged between multiple users and systems. The increased automation that will take place as CALS evolves will dictate an increased use of indexes for the successful exchange of information. Th...

An integrated system for identifying the hidden assassins in traditional medicines containing aristolochic acids

NASA Astrophysics Data System (ADS)

Wu, Lan; Sun, Wei; Wang, Bo; Zhao, Haiyu; Li, Yaoli; Cai, Shaoqing; Xiang, Li; Zhu, Yingjie; Yao, Hui; Song, Jingyuan; Cheng, Yung-Chi; Chen, Shilin

2015-08-01

Traditional herbal medicines adulterated and contaminated with plant materials from the Aristolochiaceae family, which contain aristolochic acids (AAs), cause aristolochic acid nephropathy. Approximately 256 traditional Chinese patent medicines, containing Aristolochiaceous materials, are still being sold in Chinese markets today. In order to protect consumers from health risks due to AAs, the hidden assassins, efficient methods to differentiate Aristolochiaceous herbs from their putative substitutes need to be established. In this study, 158 Aristolochiaceous samples representing 46 species and four genera as well as 131 non-Aristolochiaceous samples representing 33 species, 20 genera and 12 families were analyzed using DNA barcodes based on the ITS2 and psbA-trnH sequences. Aristolochiaceous materials and their non-Aristolochiaceous substitutes were successfully identified using BLAST1, the nearest distance method and the neighbor-joining (NJ) tree. In addition, based on sequence information of ITS2, we developed a Real-Time PCR assay which successfully identified herbal material from the Aristolochiaceae family. Using Ultra High Performance Liquid Chromatography-Mass Spectrometer (UHPLC-HR-MS), we demonstrated that most representatives from the Aristolochiaceae family contain toxic AAs. Therefore, integrated DNA barcodes, Real-Time PCR assays using TaqMan probes and UHPLC-HR-MS system provides an efficient and reliable authentication system to protect consumers from health risks due to the hidden assassins (AAs).

Combining Theory-Driven Evaluation and Causal Loop Diagramming for Opening the 'Black Box' of an Intervention in the Health Sector: A Case of Performance-Based Financing in Western Uganda.

PubMed

Renmans, Dimitri; Holvoet, Nathalie; Criel, Bart

2017-09-03

Increased attention on "complexity" in health systems evaluation has resulted in many different methodological responses. Theory-driven evaluations and systems thinking are two such responses that aim for better understanding of the mechanisms underlying given outcomes. Here, we studied the implementation of a performance-based financing intervention by the Belgian Technical Cooperation in Western Uganda to illustrate a methodological strategy of combining these two approaches. We utilized a systems dynamics tool called causal loop diagramming (CLD) to generate hypotheses feeding into a theory-driven evaluation. Semi-structured interviews were conducted with 30 health workers from two districts (Kasese and Kyenjojo) and with 16 key informants. After CLD, we identified three relevant hypotheses: "success to the successful", "growth and underinvestment", and "supervision conundrum". The first hypothesis leads to increasing improvements in performance, as better performance leads to more incentives, which in turn leads to better performance. The latter two hypotheses point to potential bottlenecks. Thus, the proposed methodological strategy was a useful tool for identifying hypotheses that can inform a theory-driven evaluation. The hypotheses are represented in a comprehensible way while highlighting the underlying assumptions, and are more easily falsifiable than hypotheses identified without using CLD.

Results of a Research Study to Identify Historical RDTE (Research, Development, Test and Evaluation) Obligations and Expenditures on Major Army Materiel and Non-Materiel Systems,

DTIC Science & Technology

1983-10-01

SYSTEMS OBJECTIVES. This study was conducted as part of a continuing effort to obtain actual (historical) life cycle costs of major Army systems from...Procurement, AMS Code for RDTE, etc.). System life cycle costs cut across appropriation lines. A common architecture should be prerequisite to... life cycle costs of major Army systems have not been successful, but attention recently has been directed toward the possibility that a significant

A literature review for large-scale health information system project planning, implementation and evaluation.

PubMed

Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

2017-01-01

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Bat wing biometrics: using collagen-elastin bundles in bat wings as a unique individual identifier.

PubMed

Amelon, Sybill K; Hooper, Sarah E; Womack, Kathryn M

2017-05-29

The ability to recognize individuals within an animal population is fundamental to conservation and management. Identification of individual bats has relied on artificial marking techniques that may negatively affect the survival and alter the behavior of individuals. Biometric systems use biological characteristics to identify individuals. The field of animal biometrics has expanded to include recognition of individuals based upon various morphologies and phenotypic variations including pelage patterns, tail flukes, and whisker arrangement. Biometric systems use 4 biologic measurement criteria: universality, distinctiveness, permanence, and collectability. Additionally, the system should not violate assumptions of capture-recapture methods that include no increased mortality or alterations of behavior. We evaluated whether individual bats could be uniquely identified based upon the collagen-elastin bundles that are visible with gross examination of their wings. We examined little brown bats ( Myotis lucifugus ), northern long-eared bats ( M. septentrionalis ), big brown bats ( Eptesicus fuscus ), and tricolored bats ( Perimyotis subflavus ) to determine whether the "wing prints" from the bundle network would satisfy the biologic measurement criteria. We evaluated 1,212 photographs from 230 individual bats comparing week 0 photos with those taken at weeks 3 or 6 and were able to confirm identity of individuals over time. Two blinded evaluators were able to successfully match 170 individuals in hand to photographs taken at weeks 0, 3, and 6. This study suggests that bats can be successfully re-identified using photographs taken at previous times. We suggest further evaluation of this methodology for use in a standardized system that can be shared among bat conservationists.

Bat wing biometrics: using collagen–elastin bundles in bat wings as a unique individual identifier

PubMed Central

Hooper, Sarah E.; Womack, Kathryn M.

2017-01-01

Abstract The ability to recognize individuals within an animal population is fundamental to conservation and management. Identification of individual bats has relied on artificial marking techniques that may negatively affect the survival and alter the behavior of individuals. Biometric systems use biological characteristics to identify individuals. The field of animal biometrics has expanded to include recognition of individuals based upon various morphologies and phenotypic variations including pelage patterns, tail flukes, and whisker arrangement. Biometric systems use 4 biologic measurement criteria: universality, distinctiveness, permanence, and collectability. Additionally, the system should not violate assumptions of capture–recapture methods that include no increased mortality or alterations of behavior. We evaluated whether individual bats could be uniquely identified based upon the collagen–elastin bundles that are visible with gross examination of their wings. We examined little brown bats (Myotis lucifugus), northern long-eared bats (M. septentrionalis), big brown bats (Eptesicus fuscus), and tricolored bats (Perimyotis subflavus) to determine whether the “wing prints” from the bundle network would satisfy the biologic measurement criteria. We evaluated 1,212 photographs from 230 individual bats comparing week 0 photos with those taken at weeks 3 or 6 and were able to confirm identity of individuals over time. Two blinded evaluators were able to successfully match 170 individuals in hand to photographs taken at weeks 0, 3, and 6. This study suggests that bats can be successfully re-identified using photographs taken at previous times. We suggest further evaluation of this methodology for use in a standardized system that can be shared among bat conservationists. PMID:29674784

Communication-and-resolution programs: the challenges and lessons learned from six early adopters.

PubMed

Mello, Michelle M; Boothman, Richard C; McDonald, Timothy; Driver, Jeffrey; Lembitz, Alan; Bouwmeester, Darren; Dunlap, Benjamin; Gallagher, Thomas

2014-01-01

In communication-and-resolution programs (CRPs), health systems and liability insurers encourage the disclosure of unanticipated care outcomes to affected patients and proactively seek resolutions, including offering an apology, an explanation, and, where appropriate, reimbursement or compensation. Anecdotal reports from the University of Michigan Health System and other early adopters of CRPs suggest that these programs can substantially reduce liability costs and improve patient safety. But little is known about how these early programs achieved success. We studied six CRPs to identify the major challenges in and lessons learned from implementing these initiatives. The CRP participants we interviewed identified several factors that contributed to their programs' success, including the presence of a strong institutional champion, investing in building and marketing the program to skeptical clinicians, and making it clear that the results of such transformative change will take time. Many of the early CRP adopters we interviewed expressed support for broader experimentation with these programs even in settings that differ from their own, such as systems that do not own and control their liability insurer, and in states without strong tort reforms.

Community energy self-reliance

NASA Astrophysics Data System (ADS)

1980-07-01

Goals of a workshop/conference on community renewable energy systems are: (1) to encourage decentralization in attacking energy problems, (2) to show how renewable energy can meet community goals, (3) to present examples of successful projects, (4) to discuss the planning and management of renewable energy systems, (5) to identify sources of financial support, (6) to share legal strategies, and (7) to examine utility roles.

20 Years of persistent identifiers - Which systems are here to stay?

NASA Astrophysics Data System (ADS)

Klump, Jens; Huber, Robert; Lehnert, Kerstin

2016-04-01

Web-based persistent identifiers have been around for more than 20 years, a period long enough to start observing patterns of success and failure. Persistent identifiers were invented to address challenges arising from the distributed and disorganised nature of the internet, which not only allowed new technologies to emerge, it also made it difficult to maintain a persistent record of science. Persistent identifiers now allow unambiguous identification of resources on the net. The expectations were that persistent identifiers would lead to greater accessibility, transparency and reproducibility of research results. Over the past two decades a number of persistent identifier systems have been built, one of them being Digital Object Identifiers (DOI). While DOI were originally invented by the publishing industry, they quickly became an established way for the identification of research resources. At first, these resources referred to scholarly literature and related resources. Other identifier systems, some of them using DOI as an example, were developed as grass-roots efforts by the scientific community. The concept of using persistent identifiers has since been expanded to other, non-textual resources, like datasets (DOI, EPIC) and geological specimens (IGSN), and more recently to authors and contributors of scholarly works (ORCID), and to software and instruments. A common witticism states that "a great thing about standards is that there are so many to choose from." Setting up identifier systems is technically trivial. The real challenge lies in creating a governance system for the respective identifiers. Which systems will stand the test of time? Drawing on data from the Registry of Research Data Repositories (re3data.org) and our own experience in the field, this presentation looks at the history and adoption of existing identifier systems and how this gives us some indications towards factors influencing sustainability of these systems.

Development of Reliable Life Support Systems

NASA Technical Reports Server (NTRS)

Carter, Layne

2017-01-01

The life support systems on the International Space Station (ISS) are the culmination of an extensive effort encompassing development, design, and test to provide the highest possible confidence in their operation on ISS. Many years of development testing are initially performed to identify the optimum technology and the optimum operational approach. The success of this development program depends on the accuracy of the system interfaces. The critical interfaces include the specific operational environment, the composition of the waste stream to be processed and the quality of the product. Once the development program is complete, a detailed system schematic is built based on the specific design requirements, followed by component procurement, assembly, and acceptance testing. A successful acceptance test again depends on accurately simulating the anticipated environment on ISS. The ISS Water Recovery System (WRS) provides an excellent example of where this process worked, as well as lessons learned that can be applied to the success of future missions. More importantly, ISS has provided a test bed to identify these design issues. Mechanical design issues have included an unreliable harmonic drive train in the Urine Processor's fluids pump, and seals in the Water Processor's Catalytic Reactor with insufficient life at the operational temperature. Systems issues have included elevated calcium in crew urine (due to microgravity effect) that resulted in precipitation at the desired water recovery rate, and the presence of an organosilicon compound (dimethylsilanediol) in the condensate that is not well removed by the water treatment process. Modifications to the WRS to address these issues are either complete (and now being evaluated on ISS) or are currently in work to insure the WRS has the required reliability before embarking on a mission to Mars.

Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods.

PubMed

Khorrami, F; Ahmadi, M; Alizadeh, A; Roozbeh, N; Mohseni, S

2015-01-01

Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy in hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems.

Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods

PubMed Central

Khorrami, F; Ahmadi, M; Alizadeh, A; Roozbeh, N; Mohseni, S

2015-01-01

Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was “the number of bed and bed occupancy in hospitals”. Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems. PMID:28255389

Development of a Master Health Facility List in Nigeria

PubMed Central

Azeez, Aderemi; Bamidele, Samson; Oyemakinde, Akin; Oyediran, Kolawole Azeez; Adebayo, Wura; Fapohunda, Bolaji; Abioye, Abimbola; Mullen, Stephanie

2014-01-01

Abstract Introduction Routine Health Information Systems (RHIS) are increasingly transitioning to electronic platforms in several developing countries. Establishment of a Master Facility List (MFL) to standardize the allocation of unique identifiers for health facilities can overcome identification issues and support health facility management. The Nigerian Federal Ministry of Health (FMOH) recently developed a MFL, and we present the process and outcome. Methods The MFL was developed from the ground up, and includes a state code, a local government area (LGA) code, health facility ownership (public or private), the level of care, and an exclusive LGA level health facility serial number, as part of the unique identifier system in Nigeria. To develop the MFL, the LGAs sent the list of all health facilities in their jurisdiction to the state, which in turn collated for all LGAs under them before sending to the FMOH. At the FMOH, a group of RHIS experts verified the list and identifiers for each state. Results The national MFL consists of 34,423 health facilities uniquely identified. The list has been published and is available for worldwide access; it is currently used for planning and management of health services in Nigeria. Discussion Unique identifiers are a basic component of any information system. However, poor planning and execution of implementing this key standard can diminish the success of the RHIS. Conclusion Development and adherence to standards is the hallmark for a national health information infrastructure. Explicit processes and multi-level stakeholder engagement is necessary to ensuring the success of the effort. PMID:25422720

Oyster reef restoration in the northern Gulf of Mexico: extent, methods and outcomes

USGS Publications Warehouse

LaPeyre, Megan K.; Furlong, Jessica N.; Brown, Laura A.; Piazza, Bryan P.; Brown, Ken

2014-01-01

Shellfish reef restoration to support ecological services has become more common in recent decades, driven by increasing awareness of the functional decline of shellfish systems. Maximizing restoration benefits and increasing efficiency of shellfish restoration activities would greatly benefit from understanding and measurement of system responses to management activities. This project (1) compiles a database of northern Gulf of Mexico inshore artificial oyster reefs created for restoration purposes, and (2) quantitatively assesses a subset of reefs to determine project outcomes. We documented 259 artificial inshore reefs created for ecological restoration. Information on reef material, reef design and monitoring was located for 94, 43 and 20% of the reefs identified. To quantify restoration success, we used diver surveys to quantitatively sample oyster density and substrate volume of 11 created reefs across the coast (7 with rock; 4 with shell), paired with 7 historic reefs. Reefs were defined as fully successful if there were live oysters, and partially successful if there was hard substrate. Of these created reefs, 73% were fully successful, while 82% were partially successful. These data highlight that critical information related to reef design, cost, and success remain difficult to find and are generally inaccessible or lost, ultimately hindering efforts to maximize restoration success rates. Maintenance of reef creation information data, development of standard reef performance measures, and inclusion of material and reef design testing within reef creation projects would be highly beneficial in implementing adaptive management. Adaptive management protocols seek specifically to maximize short and long-term restoration success, but are critically dependent on tracking and measuring system responses to management activities.

Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers: A "Positive Deviance" Approach.

PubMed

Toscos, Tammy; Carpenter, Maria; Flanagan, Mindy; Kunjan, Kislaya; Doebbeling, Bradley N

2018-01-01

Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These "positive deviant" practices translate into organizational policies to improve health care access and patient experience. To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient-provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access.

Systems Engineering Technical Authority: A Path to Mission Success

NASA Technical Reports Server (NTRS)

Andary, James F.; So, Maria M.; Breindel, Barry

2008-01-01

The systems engineering of space missions to study planet Earth has been an important focus of the National Aeronautics and Space Administration (NASA) since its inception. But all space missions are becoming increasingly complex and this fact, reinforced by some major mishaps, has caused NASA to reevaluate their approach to achieving safety and mission success. A new approach ensures that there are adequate checks and balances in place to maximize the probability of safety and mission success. To this end the agency created the concept of Technical Authority which identifies a key individual accountable and responsible for the technical integrity of a flight mission as well as a project-independent reporting path. At the Goddard Space Flight Center (GSFC) this responsibility ultimately begins with the Mission Systems Engineer (MSE) for each satellite mission. This paper discusses the Technical Authority process and then describes some unique steps that are being taken at the GSFC to support these MSEs in meeting their responsibilities.

Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

PubMed

Giva, Karen R N; Duma, Sinegugu E

2015-08-31

Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

Contextual Learning Issues.

ERIC Educational Resources Information Center

1999

This document contains four symposium papers on contextual learning issues. "Learning to Learn Strategies of Successful Real Estate Professionals: Implications for Learning in the Workplace" (Margot B. Weinstein) describes a multicase study in which a model called the Individual Learning System was used to identify the strategies and…

Systems Engineering Provides Successful High Temperature Steam Electrolysis Project

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

Charles V. Park; Emmanuel Ohene Opare, Jr.

2011-06-01

This paper describes two Systems Engineering Studies completed at the Idaho National Laboratory (INL) to support development of the High Temperature Stream Electrolysis (HTSE) process. HTSE produces hydrogen from water using nuclear power and was selected by the Department of Energy (DOE) for integration with the Next Generation Nuclear Plant (NGNP). The first study was a reliability, availability and maintainability (RAM) analysis to identify critical areas for technology development based on available information regarding expected component performance. An HTSE process baseline flowsheet at commercial scale was used as a basis. The NGNP project also established a process and capability tomore » perform future RAM analyses. The analysis identified which components had the greatest impact on HTSE process availability and indicated that the HTSE process could achieve over 90% availability. The second study developed a series of life-cycle cost estimates for the various scale-ups required to demonstrate the HTSE process. Both studies were useful in identifying near- and long-term efforts necessary for successful HTSE process deployment. The size of demonstrations to support scale-up was refined, which is essential to estimate near- and long-term cost and schedule. The life-cycle funding profile, with high-level allocations, was identified as the program transitions from experiment scale R&D to engineering scale demonstration.« less

NASA's Solar Dynamics Observatory (SDO): A Systems Approach to a Complex Mission

NASA Technical Reports Server (NTRS)

Ruffa, John A.; Ward, David K.; Bartusek, LIsa M.; Bay, Michael; Gonzales, Peter J.; Pesnell, William D.

2012-01-01

The Solar Dynamics Observatory (SDO) includes three advanced instruments, massive science data volume, stringent science data completeness requirements, and a custom ground station to meet mission demands. The strict instrument science requirements imposed a number of challenging drivers on the overall mission system design, leading the SDO team to adopt an integrated systems engineering presence across all aspects of the mission to ensure that mission science requirements would be met. Key strategies were devised to address these system level drivers and mitigate identified threats to mission success. The global systems engineering team approach ensured that key drivers and risk areas were rigorously addressed through all phases of the mission, leading to the successful SDO launch and on-orbit operation. Since launch, SDO's on-orbit performance has met all mission science requirements and enabled groundbreaking science observations, expanding our understanding of the Sun and its dynamic processes.

NASA's Solar Dynamics Observatory (SDO): A Systems Approach to a Complex Mission

NASA Technical Reports Server (NTRS)

Ruffa, John A.; Ward, David K.; Bartusek, Lisa M.; Bay, Michael; Gonzales, Peter J.; Pesnell, William D.

2012-01-01

The Solar Dynamics Observatory (SDO) includes three advanced instruments, massive science data volume, stringent science data completeness requirements, and a custom ground station to meet mission demands. The strict instrument science requirements imposed a number of challenging drivers on the overall mission system design, leading the SDO team to adopt an integrated systems engineering presence across all aspects of the mission to ensure that mission science requirements would be met. Key strategies were devised to address these system level drivers and mitigate identified threats to mission success. The global systems engineering team approach ensured that key drivers and risk areas were rigorously addressed through all phases of the mission, leading to the successful SDO launch and on-orbit operation. Since launch, SDO s on-orbit performance has met all mission science requirements and enabled groundbreaking science observations, expanding our understanding of the Sun and its dynamic processes.

Holographic Recording Materials Development

NASA Technical Reports Server (NTRS)

Verber, C. M.; Schwerzel, R. E.; Perry, P. J.; Craig, R. A.

1976-01-01

Organic photorefractive materials were evaluated for application in a reversible holographic memory system. Representative indigo and thioindigo derivatives and several stilbene derivatives were studied as well as 15, 16-dialkyldihydropyrene derivatives the following goals were achieved: (1) the successful writing of phase holograms in a thioindigo/polymer gel system, (2) the successful writing and erasing of phase holograms in a variety of indigo/polymer gel and indigo/solid polymer systems, and (3) the identification of indigoid dyes and 15, 16-dialkyldihydropyrene derivatives as materials potentially suitable for utilization in an operational system. Photochemical studies of the stilbene, indigo, thioindigo, and dialkyldihydropyrene derivatives in solution and in a variety of polymer matrix materials were conducted with the goal of optimizing the photorefractive behavior of the chemical system as a whole. The spectroscopic properties required of optimal photorefractive materials were identified, and it was shown that both the indigoid dyes and the dialkyldihydropyrenes closely match the required properties.

Technology transfer: Transportation

NASA Technical Reports Server (NTRS)

Anyos, T.; Christy, L.; Lizak, R.; Wilhelm, J.

1978-01-01

The successful application of aerospace technology to problems related to highways and rail and rapid transit systems is described with emphasis on the use of corrosion resistant paints, fire retardant materials, and law enforcement. Possible areas for the use of spinoff from NASA technology by the California State Department of Corrections are identified. These include drug detection, security and warning systems, and the transportation and storage of food. A communication system for emergency services is also described.

The challenges and opportunities of supersonic transport propulsion technology

NASA Technical Reports Server (NTRS)

Strack, William C.; Morris, Shelby J., Jr.

1988-01-01

The major challenges confronting the propulsion community for civil supersonic transport applications are identified: high propulsion system efficiency at both supersonic and subsonic cruise conditions, low-cost fuel with adequate thermal stability at high temperatures, low noise cycles and exhaust systems, low emission combustion systems, and low drag installations. Both past progress and future opportunities are discussed in relation to perceived technology shortfalls for an economically successful airplane that satisfies environmental constraints.

Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.

PubMed

Ward, Marcia M; Baloh, Jure; Zhu, Xi; Stewart, Greg L

A particularly useful model for examining implementation of quality improvement interventions in health care settings is the PARIHS (Promoting Action on Research Implementation in Health Services) framework developed by Kitson and colleagues. The PARIHS framework proposes three elements (evidence, context, and facilitation) that are related to successful implementation. An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by the Agency for Healthcare Research and Quality, but research is needed to better understand its implementation. We apply the PARIHS framework in studying TeamSTEPPS implementation to identify elements that are most closely related to successful implementation. Quarterly interviews were conducted over a 9-month period in 13 small rural hospitals that implemented TeamSTEPPS. Interview quotes that were related to each of the PARIHS elements were identified using directed content analysis. Transcripts were also scored quantitatively, and bivariate regression analysis was employed to explore relationships between PARIHS elements and successful implementation related to planning activities. The current findings provide support for the PARIHS framework and identified two of the three PARIHS elements (context and facilitation) as important contributors to successful implementation. This study applies the PARIHS framework to TeamSTEPPS, a widely used quality initiative focused on improving health care quality and patient safety. By focusing on small rural hospitals that undertook this quality improvement activity of their own accord, our findings represent effectiveness research in an understudied segment of the health care delivery system. By identifying context and facilitation as the most important contributors to successful implementation, these analyses provide a focus for efficient and effective sustainment of TeamSTEPPS efforts.

Key Conditions for Successful Serial Entrepreneurship in Healthcare.

PubMed

Piron, Cameron

2017-01-01

As a serial entrepreneur in the medical device industry, the author embraces Snowdon's (2017) effort to create and stimulate dialogue among experts in health system innovation in an effort to define and support Canada's innovation agenda. In this paper, he outlines some of the attributes and skills that companies need to launch their products and scale their companies. He also identifies the main conditions of an innovation ecosystem that create the necessary infrastructure to enable and support highly successful companies while allowing them to accelerate their growth.

Analysis of ERTS-1 imagery and its application to evaluation of Wyoming's natural resources

NASA Technical Reports Server (NTRS)

Houston, R. S. (Principal Investigator); Marrs, R. W.

1973-01-01

The author has identified the following significant results. Significant results of the Wyoming ERTS-1 investigation during the first six months (July-December 1972) included: (1) successful segregation of Precambrian metasedimentary/metavolcanic rocks from igneous rocks, (2) discovery of iron formation within the metasedimentary sequence, (3) mapping of previously unreported tectonic elements of major significance, (4) successful mapping of large scale fracture systems of the Wind River Mountains, (5) successful distinction of some metamorphic, igneous, and sedimentary lithologies by color additive viewing, (6) mapping of large scale glacial features, and (7) development of techniques for mapping small urban areas.

Remote health monitoring: predicting outcome success based on contextual features for cardiovascular disease.

PubMed

Alshurafa, Nabil; Eastwood, Jo-Ann; Pourhomayoun, Mohammad; Liu, Jason J; Sarrafzadeh, Majid

2014-01-01

Current studies have produced a plethora of remote health monitoring (RHM) systems designed to enhance the care of patients with chronic diseases. Many RHM systems are designed to improve patient risk factors for cardiovascular disease, including physiological parameters such as body mass index (BMI) and waist circumference, and lipid profiles such as low density lipoprotein (LDL) and high density lipoprotein (HDL). There are several patient characteristics that could be determining factors for a patient's RHM outcome success, but these characteristics have been largely unidentified. In this paper, we analyze results from an RHM system deployed in a six month Women's Heart Health study of 90 patients, and apply advanced feature selection and machine learning algorithms to identify patients' key baseline contextual features and build effective prediction models that help determine RHM outcome success. We introduce Wanda-CVD, a smartphone-based RHM system designed to help participants with cardiovascular disease risk factors by motivating participants through wireless coaching using feedback and prompts as social support. We analyze key contextual features that secure positive patient outcomes in both physiological parameters and lipid profiles. Results from the Women's Heart Health study show that health threat of heart disease, quality of life, family history, stress factors, social support, and anxiety at baseline all help predict patient RHM outcome success.

A simple, inexpensive video camera setup for the study of avian nest activity

USGS Publications Warehouse

Sabine, J.B.; Meyers, J.M.; Schweitzer, Sara H.

2005-01-01

Time-lapse video photography has become a valuable tool for collecting data on avian nest activity and depredation; however, commercially available systems are expensive (>USA $4000/unit). We designed an inexpensive system to identify causes of nest failure of American Oystercatchers (Haematopus palliatus) and assessed its utility at Cumberland Island National Seashore, Georgia. We successfully identified raccoon (Procyon lotor), bobcat (Lynx rufus), American Crow (Corvus brachyrhynchos), and ghost crab (Ocypode quadrata) predation on oystercatcher nests. Other detected causes of nest failure included tidal overwash, horse trampling, abandonment, and human destruction. System failure rates were comparable with commercially available units. Our system's efficacy and low cost (<$800) provided useful data for the management and conservation of the American Oystercatcher.

Artificial intelligence technology assessment for the US Army Depot System Command

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

Pennock, K A

1991-07-01

This assessment of artificial intelligence (AI) has been prepared for the US Army's Depot System Command (DESCOM) by Pacific Northwest Laboratory. The report describes several of the more promising AI technologies, focusing primarily on knowledge-based systems because they have been more successful in commercial applications than any other AI technique. The report also identifies potential Depot applications in the areas of procedural support, scheduling and planning, automated inspection, training, diagnostics, and robotic systems. One of the principal objectives of the report is to help decisionmakers within DESCOM to evaluate AI as a possible tool for solving individual depot problems. Themore » report identifies a number of factors that should be considered in such evaluations. 22 refs.« less

Classification of antecedents towards safety use of health information technology: A systematic review.

PubMed

Salahuddin, Lizawati; Ismail, Zuraini

2015-11-01

This paper provides a systematic review of safety use of health information technology (IT). The first objective is to identify the antecedents towards safety use of health IT by conducting systematic literature review (SLR). The second objective is to classify the identified antecedents based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model and an extension of DeLone and McLean (D&M) information system (IS) success model. A systematic literature review (SLR) was conducted from peer-reviewed scholarly publications between January 2000 and July 2014. SLR was carried out and reported based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The related articles were identified by searching the articles published in Science Direct, Medline, EMBASE, and CINAHL databases. Data extracted from the resultant studies included are to be analysed based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model, and also from the extended DeLone and McLean (D&M) information system (IS) success model. 55 articles delineated to be antecedents that influenced the safety use of health IT were included for review. Antecedents were identified and then classified into five key categories. The categories are (1) person, (2) technology, (3) tasks, (4) organization, and (5) environment. Specifically, person is attributed by competence while technology is associated to system quality, information quality, and service quality. Tasks are attributed by task-related stressor. Organisation is related to training, organisation resources, and teamwork. Lastly, environment is attributed by physical layout, and noise. This review provides evidence that the antecedents for safety use of health IT originated from both social and technical aspects. However, inappropriate health IT usage potentially increases the incidence of errors and produces new safety risks. The review cautions future implementation and adoption of health IT to carefully consider the complex interactions between social and technical elements propound in healthcare settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

Stakeholder perspectives on implementing a universal Lynch syndrome screening program: a qualitative study of early barriers and facilitators.

PubMed

Schneider, Jennifer L; Davis, James; Kauffman, Tia L; Reiss, Jacob A; McGinley, Cheryl; Arnold, Kathleen; Zepp, Jamilyn; Gilmore, Marian; Muessig, Kristin R; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia L; Peterson, Susan K; Goddard, Katrina A B

2016-02-01

Evidence-based guidelines recommend that all newly diagnosed colon cancer be screened for Lynch syndrome (LS), but best practices for implementing universal tumor screening have not been extensively studied. We interviewed a range of stakeholders in an integrated health-care system to identify initial factors that might promote or hinder the successful implementation of a universal LS screening program. We conducted interviews with health-plan leaders, managers, and staff. Interviews were audio-recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). We completed 14 interviews with leaders/managers and staff representing involved clinical and health-plan departments. Although stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote or hinder implementation. Facilitating factors included perceived benefits of screening for patients and organization, collaboration between departments, and availability of organizational resources. Barriers were also identified, including: lack of awareness of guidelines, lack of guideline clarity, staffing and program "ownership" concerns, and cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication, patient and provider/staff education, and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.

Executive skills 21: a forecast of leadership skills and associated competencies required by naval hospital administrators into the 21st century.

PubMed

Sentell, J W; Finstuen, K

1998-01-01

Those in the Naval Medical Department are experiencing an exciting time of bridled chaos and creative change. Many mid-career officers are uncertain of the leadership behaviors and skills that will be necessary for successful managerial careers. Changes in the method of health care delivery of this nation combined with the reengineering of the armed forces' world-wide mission has driven military medical leaders to expand their professional skills, knowledge, and abilities beyond the clinical sciences. This research identifies the most critical domains in the science of health care administration and differentiates and ranks job skill, knowledge, and ability requirements that will be necessary for successful health care management into the 21st century. Top Naval hospital executives responded to two iterations of a Delphi inquiry. These medical leaders identified 106 unique issues that were content-analyzed into nine domains by a neutral, expert panel. Domains, in order of ranked importance, were leadership, health care delivery systems, cost-finance, technology, accessibility, professional staff relations, marketing, quality-risk management, and ethics. In the second Delphi iteration, hospital executives reviewed domain results and rated identified job requirements on their required job importance. The top-10 rated skills, knowledge, and abilities are reported. Results indicated that although a business orientation is needed for organizational survival, an emphasis on person-oriented skills, knowledge, and abilities is required for future success as a health care administrator in the Naval health care system.

External dacryocystorhinostomy for the treatment of epiphora in patients with patent but non-functioning lacrimal systems.

PubMed

Peter, Neena M; Pearson, Andrew R

2010-02-01

To assess the outcome of external dacryocystorhinostomies (DCRs) in patients with patent but non-functional lacrimal drainage systems and to identify any preoperative clinical or dacryocystography (DCG) and lacrimal scintigraphy (LS) factors associated with successful surgery. A retrospective study of 46 DCRs with silicone intubation performed for patients with epiphora associated with a clinically patent lacrimal drainage system. All patients underwent preoperative DCG and LS which were evaluated for presence, site and severity of delayed clearance. DCGs were also evaluated for reflux and anatomical abnormalities. Postoperative success was determined by subjective resolution of epiphora. Patients with persistent symptoms were offered Lester Jones Tube (LJT) insertion after establishment of a patent anastomosis to syringing and normal ostium on nasal endoscopy. Statistical analysis was performed using the chi2 and Fisher exact tests to determine whether there was any association between surgical outcome and preoperative resistance to lacrimal syringing, DCG and LS findings. 29 cases (63%) reported subjective surgical success after 11 months' average follow-up. There was a statistically significant association between increased resistance to syringing preoperatively and successful DCR (p=0.012). Of the 17 eyes that failed, all had patent anastomoses, and seven went on to have LJT insertion with complete resolution of symptoms. The majority of patients with patent but non-functional lacrimal drainage systems will be helped by DCR surgery, with greater success rates in those with significant reflux on preoperative syringing. For patients with residual epiphora, functional success can reach 100% with subsequent LJT insertion.

Combining System Safety and Reliability to Ensure NASA CoNNeCT's Success

NASA Technical Reports Server (NTRS)

Havenhill, Maria; Fernandez, Rene; Zampino, Edward

2012-01-01

Hazard Analysis, Failure Modes and Effects Analysis (FMEA), the Limited-Life Items List (LLIL), and the Single Point Failure (SPF) List were applied by System Safety and Reliability engineers on NASA's Communications, Navigation, and Networking reConfigurable Testbed (CoNNeCT) Project. The integrated approach involving cross reviews of these reports by System Safety, Reliability, and Design engineers resulted in the mitigation of all identified hazards. The outcome was that the system met all the safety requirements it was required to meet.

Biosphere reserves: Attributes for success.

PubMed

Van Cuong, Chu; Dart, Peter; Hockings, Marc

2017-03-01

Biosphere reserves established under the UNESCO Man and the Biosphere Program aim to harmonise biodiversity conservation and sustainable development. Concerns over the extent to which the reserve network was living up to this ideal led to the development of a new strategy in 1995 (the Seville Strategy) to enhance the operation of the network of reserves. An evaluation of effectiveness of management of the biosphere reserve network was called for as part of this strategy. Expert opinion was assembled through a Delphi Process to identify successful and less successful reserves and investigate common factors influencing success or failure. Ninety biosphere reserves including sixty successful and thirty less successful reserves in 42 countries across all five Man and the Biosphere Program regions were identified. Most successful sites are the post-Seville generation while the majority of unsuccessful sites are pre-Seville that are managed as national parks and have not been amended to conform to the characteristics that are meant to define a biosphere reserve. Stakeholder participation and collaboration, governance, finance and resources, management, and awareness and communication are the most influential factors in the success or failure of the biosphere reserves. For success, the biosphere reserve concept needs to be clearly understood and applied through landscape zoning. Designated reserves then need a management system with inclusive good governance, strong participation and collaboration, adequate finance and human resource allocation and stable and responsible management and implementation. All rather obvious but it is difficult to achieve without commitment to the biosphere reserve concept by the governance authorities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of the scientific underpinnings for identifying estrogenic chemicals in non-mammalian taxa using mammalian test systems

EPA Science Inventory

A major challenge in chemical risk assessment is extrapolation of toxicity data from tested to untested species. Successful cross-species extrapolation involves understanding similarities and differences in toxicokinetic and toxicodynamic processes among species. Herein we consi...

Variables Affecting Successful Reintegration as Perceived by Offenders and Professionals

ERIC Educational Resources Information Center

Graffam, Joe; Shinkfield, Alison; Lavelle, Barbara; McPherson, Wenda

2004-01-01

Six broad domains were identified as influencing reintegration of ex-offenders including personal conditions, social network/environment, accommodation, criminal justice system, rehabilitation and counselling support, and employment and training support. Semi-structured interviews were conducted with 12 offenders and 22 professionals from criminal…

Identification of Successive ``Unobservable'' Cyber Data Attacks in Power Systems Through Matrix Decomposition

NASA Astrophysics Data System (ADS)

Gao, Pengzhi; Wang, Meng; Chow, Joe H.; Ghiocel, Scott G.; Fardanesh, Bruce; Stefopoulos, George; Razanousky, Michael P.

2016-11-01

This paper presents a new framework of identifying a series of cyber data attacks on power system synchrophasor measurements. We focus on detecting "unobservable" cyber data attacks that cannot be detected by any existing method that purely relies on measurements received at one time instant. Leveraging the approximate low-rank property of phasor measurement unit (PMU) data, we formulate the identification problem of successive unobservable cyber attacks as a matrix decomposition problem of a low-rank matrix plus a transformed column-sparse matrix. We propose a convex-optimization-based method and provide its theoretical guarantee in the data identification. Numerical experiments on actual PMU data from the Central New York power system and synthetic data are conducted to verify the effectiveness of the proposed method.

Applying usability heuristics to radiotherapy systems.

PubMed

Chan, Alvita J; Islam, Mohammad K; Rosewall, Tara; Jaffray, David A; Easty, Anthony C; Cafazzo, Joseph A

2012-01-01

Heuristic evaluations have been used to evaluate safety of medical devices by identifying and assessing usability issues. Since radiotherapy treatment delivery systems often consist of multiple complex user-interfaces, a heuristic evaluation was conducted to assess the potential safety issues of such a system. A heuristic evaluation was conducted to evaluate the treatment delivery system at Princess Margaret Hospital (Toronto, Canada). Two independent evaluators identified usability issues with the user-interfaces and rated the severity of each issue. The evaluators identified 75 usability issues in total. Eighteen of them were rated as high severity, indicating the potential to have a major impact on patient safety. A majority of issues were found on the record and verify system, and many were associated with the patient setup process. While the hospital has processes in place to ensure patient safety, recommendations were developed to further mitigate the risks of potential consequences. Heuristic evaluation is an efficient and inexpensive method that can be successfully applied to radiotherapy delivery systems to identify usability issues and improve patient safety. Although this study was conducted only at one site, the findings may have broad implications for the design of these systems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Space station experiment definition: Advanced power system test bed

NASA Technical Reports Server (NTRS)

Pollard, H. E.; Neff, R. E.

1986-01-01

A conceptual design for an advanced photovoltaic power system test bed was provided and the requirements for advanced photovoltaic power system experiments better defined. Results of this study will be used in the design efforts conducted in phase B and phase C/D of the space station program so that the test bed capabilities will be responsive to user needs. Critical PV and energy storage technologies were identified and inputs were received from the idustry (government and commercial, U.S. and international) which identified experimental requirements. These inputs were used to develop a number of different conceptual designs. Pros and cons of each were discussed and a strawman candidate identified. A preliminary evolutionary plan, which included necessary precursor activities, was established and cost estimates presented which would allow for a successful implementation to the space station in the 1994 time frame.

Controlling tissue microenvironments: biomimetics, transport phenomena, and reacting systems.

PubMed

Fisher, Robert J; Peattie, Robert A

2007-01-01

The reconstruction of tissues ex vivo and production of cells capable of maintaining a stable performance for extended time periods in sufficient quantity for synthetic or therapeutic purposes are primary objectives of tissue engineering. The ability to characterize and manipulate the cellular microenvironment is critical for successful implementation of such cell-based bioengineered systems. As a result, knowledge of fundamental biomimetics, transport phenomena, and reaction engineering concepts is essential to system design and development. Once the requirements of a specific tissue microenvironment are understood, the biomimetic system specifications can be identified and a design implemented. Utilization of novel membrane systems that are engineered to possess unique transport and reactive features is one successful approach presented here. The limited availability of tissue or cells for these systems dictates the need for microscale reactors. A capstone illustration based on cellular therapy for type 1 diabetes mellitus via encapsulation techniques is presented as a representative example of this approach, to stress the importance of integrated systems.

Systematic review building a preceptor support system.

PubMed

Goss, Carol R

2015-01-01

This systematic review identifies the significance of the preceptor role in affecting new graduate nurse retention. Findings from 20 research studies provide support that nurse preceptors receiving continuing education and perceiving reward and recognition from the preceptor position positively affect new graduate nurse retention. Hospital administration, nurse managers, nurse educators, preceptors, and new graduate nurses each play a role in the successful implementation of a preceptor support system.

The other side of the safety coin. [aerospace operations

NASA Technical Reports Server (NTRS)

Roth, Gilbert L.

1986-01-01

The development, inspection and testing requirements for successful production and launch and safe operation of spaceflight hardware are discussed. Emphasis is placed on paying acute attention to malfunctions, which could be caused by contaminants (particles in docking rings), insufficiently durable materials (Orbiter brakes), etc. Generic and specific problems which occur in propulsion, avionics, mechanical and computer systems and in configuration management, manufacturing and process control efforts are explored. Case histories of deficiencies found in LOX fuel lines, contaminated hydraulic control systems, the Solar Maximum Mission thermal insulation grommets, are summarized. Thorough inspection and testing procedures and design change recording during manufacture of spacecraft components are identified as requisites for successful space missions.

Space tug propulsion system failure mode, effects and criticality analysis

NASA Technical Reports Server (NTRS)

Boyd, J. W.; Hardison, E. P.; Heard, C. B.; Orourke, J. C.; Osborne, F.; Wakefield, L. T.

1972-01-01

For purposes of the study, the propulsion system was considered as consisting of the following: (1) main engine system, (2) auxiliary propulsion system, (3) pneumatic system, (4) hydrogen feed, fill, drain and vent system, (5) oxygen feed, fill, drain and vent system, and (6) helium reentry purge system. Each component was critically examined to identify possible failure modes and the subsequent effect on mission success. Each space tug mission consists of three phases: launch to separation from shuttle, separation to redocking, and redocking to landing. The analysis considered the results of failure of a component during each phase of the mission. After the failure modes of each component were tabulated, those components whose failure would result in possible or certain loss of mission or inability to return the Tug to ground were identified as critical components and a criticality number determined for each. The criticality number of a component denotes the number of mission failures in one million missions due to the loss of that component. A total of 68 components were identified as critical with criticality numbers ranging from 1 to 2990.

Customer Discovery as the First Essential Step for Successful Health Information Technology System Development

PubMed Central

Thamjamrassri, Punyotai; Song, YuJin; Tak, JaeHyun; Kang, HoYong; Hong, Jeeyoung

2018-01-01

Objectives Customer discovery (CD) is a method to determine if there are actual customers for a product/service and what they would want before actually developing the product/service. This concept, however, is rather new to health information technology (IT) systems. Therefore, the aim of this paper was to demonstrate how to use the CD method in developing a comprehensive health IT service for patients with knee/leg pain. Methods We participated in a 6-week I-Corps program to perform CD, in which we interviewed 55 people in person, by phone, or by video conference within 6 weeks: 4 weeks in the United States and 2 weeks in Korea. The interviewees included orthopedic doctors, physical therapists, physical trainers, physicians, researchers, pharmacists, vendors, and patients. By analyzing the interview data, the aim was to revise our business model accordingly. Results Using the CD approach enabled us to understand the customer segments and identify value propositions. We concluded that a facilitating tele-rehabilitation system is needed the most and that the most suitable customer segment is early stage arthritis patients. We identified a new design concept for the customer segment. Furthermore, CD is required to identify value propositions in detail. Conclusions CD is crucial to determine a more desirable direction in developing health IT systems, and it can be a powerful tool to increase the potential for successful commercialization in the health IT field. PMID:29503756

Assessing Teacher Quality: Understanding Teacher Effects on Instruction and Achievement

ERIC Educational Resources Information Center

Kelly, Sean, Ed.

2011-01-01

Recent educational reforms have promoted accountability systems which attempt to identify "teacher effects" on student outcomes and hold teachers accountable for producing learning gains. But in the complex world of classrooms, it may be difficult to attribute "success" or "failure" to teachers. In this timely…

Noncredit Instruction: Opportunity and Challenge

ERIC Educational Resources Information Center

Academic Senate for California Community Colleges, 2009

2009-01-01

This paper considers noncredit instruction in the California Community College System. It identifies three related concepts: a state need for increased levels of education that noncredit instruction is well placed to supply, several changes that begin to facilitate that response, and additional changes that are needed to ensure success. The…

Phase 1 Space Fission Propulsion Energy Source Design

NASA Technical Reports Server (NTRS)

Houts, Mike; VanDyke, Melissa; Godfroy, Tom; Pedersen, Kevin; Martin, James; Dickens, Ricky; Salvail, Pat; Hrbud, Ivana; Carter, Robert; Rodgers, Stephen L. (Technical Monitor)

2002-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. If fission propulsion systems are to be developed to their full potential; however, near-term customers must be identified and initial fission systems successfully developed, launched, and operated. Studies conducted in fiscal year 2001 (IISTP, 2001) show that fission electric propulsion (FEP) systems with a specific mass at or below 50 kg/kWjet could enhance or enable numerous robotic outer solar system missions of interest. At the required specific mass, it is possible to develop safe, affordable systems that meet mission requirements. To help select the system design to pursue, eight evaluation criteria were identified: system integration, safety, reliability, testability, specific mass, cost, schedule, and programmatic risk. A top-level comparison of four potential concepts was performed: a Testable, Passive, Redundant Reactor (TPRR), a Testable Multi-Cell In-Core Thermionic Reactor (TMCT), a Direct Gas Cooled Reactor (DGCR), and a Pumped Liquid Metal Reactor.(PLMR). Development of any of the four systems appears feasible. However, for power levels up to at least 500 kWt (enabling electric power levels of 125-175 kWe, given 25-35% power conversion efficiency) the TPRR has advantages related to several criteria and is competitive with respect to all. Hardware-based research and development has further increased confidence in the TPRR approach. Successful development and utilization of a "Phase I" fission electric propulsion system will enable advanced Phase 2 and Phase 3 systems capable of providing rapid, affordable access to any point in the solar system.

Seasonal influenza vaccination of healthcare employees: results of a 4-year campaign.

PubMed

Hirsch, Pamela; Hodgson, Michael; Davey, Victoria

2011-05-01

To document successful substantial increases in healthcare worker influenza vaccination rates and to identify reasons for success and failure. (1) Four-year longitudinal characterization of facility vaccination rates, (2) Web-based facility-level questionnaire for influenza coordinators to identify success factors in year 3, and (3) semistructured telephone interviews of influenza coordinators at facilities with substantial increases or declines in year 4. National single-payer hospital (healthcare) system with 153 hospitals in 5 levels of complexity. Facility leadership staff. (1) Vaccination data collected from management sources (doses from pharmacies, denominator data from payrolls); (2) a Web-based survey aligned with a previously administered instrument (Wisconsin Health Department), piloted in-house, modified to reflect national strategies and improvements; and (3) semistructured telephone interviews with influenza coordinators at facilities that improved or worsened by more than 20% between the 2007-2008 and 2008-2009 influenza seasons. Vaccination acceptance rates improved from 45% of healthcare workers in 2005-2006 to 66.5% in 2008-2009. Facilities with lower complexity had higher vaccination rates. No individual factors were associated with improved performance. Sustained management attention can lead to improvements in healthcare worker influenza vaccination rates. Wavering of attention, though, may lead to rapid loss of effectiveness. Declination statements in this system did not contribute to vaccine acceptance.

Workshop on Two-Phase Fluid Behavior in a Space Environment

NASA Technical Reports Server (NTRS)

Swanson, Theodore D. (Editor); Juhasz, AL (Editor); Long, W. Russ (Editor); Ottenstein, Laura (Editor)

1989-01-01

The Workshop was successful in achieving its main objective of identifying a large number of technical issues relating to the design of two-phase systems for space applications. The principal concern expressed was the need for verified analytical tools that will allow an engineer to confidently design a system to a known degree of accuracy. New and improved materials, for such applications as thermal storage and as heat transfer fluids, were also identified as major needs. In addition to these research efforts, a number of specific hardware needs were identified which will require development. These include heat pumps, low weight radiators, advanced heat pipes, stability enhancement devices, high heat flux evaporators, and liquid/vapor separators. Also identified was the need for a centralized source of reliable, up-to-date information on two-phase flow in a space environment.

Sedimentology and paleoenvironments of a new fossiliferous late Miocene-Pliocene sedimentary succession in the Rukwa Rift Basin, Tanzania

NASA Astrophysics Data System (ADS)

Mtelela, Cassy; Roberts, Eric M.; Hilbert-Wolf, Hannah L.; Downie, Robert; Hendrix, Marc S.; O'Connor, Patrick M.; Stevens, Nancy J.

2017-05-01

This paper presents a detailed sedimentologic investigation of a newly identified, fossiliferous Late Neogene sedimentary succession in the Rukwa Rift Basin, southwestern Tanzania. This synrift deposit is a rare and significant new example of a fossiliferous succession of this age in the Western Branch of East Africa Rift System. The unit, informally termed the lower Lake Beds succession, is late Miocene to Pliocene in age based on cross-cutting relationships, preliminary biostratigraphy, and U-Pb geochronology. An angular unconformity separates the lower Lake Beds from underlying Cretaceous and Oligocene strata. Deposition was controlled by rapid generation of accommodation space and increased sediment supply associated with late Cenozoic tectonic reactivation of the Rukwa Rift and synchronous initiation of the Rungwe Volcanic Centre. The lower Lake Beds, which have thus far only been identified in three localities throughout the Rukwa Rift Basin, are characterized by two discrete lithologic members (herein A and B). The lower Member A is a volcanic-rich succession composed mostly of devitrified volcanic tuffs, and volcaniclastic mudstones and sandstones with minor conglomerates. The upper Member B is a siliciclastic-dominated succession of conglomerates, sandstones, mudstones and minor volcanic tuffs. Detailed facies analysis of the lower Lake Beds reveals various distinctive depositional environments that can be grouped into three categories: 1) alluvial fan; 2) fluvial channel; and 3) flood basin environments, characterized by volcanoclastic-filled lakes and ponds, abandoned channel-fills and pedogenically modified floodplains. Member A represents a shallow lacustrine setting filled by tuffaceous sediments, which grade up into a system of alluvial fans and high-energy, proximal gravel-bed braided rivers. An unconformity marks the contact between the two members. Member B shows an upward transition from a high-energy, gravel-bed braided river system to a sandy braided river system with increasingly abundant floodplain deposits and well-developed paleosols. Vertebrate fossils are sparse in member A, but common in member B, preserved both within pedogenic soil horizons and as isolated elements and microsites within fluvial channel facies associations. Faunal remains include fishes, turtles and crocodylians, along with well-preserved mammal cranial and post-cranial remains. In addition, freshwater gastropod shells are locally present in member A and continental trace fossils, including abundant fossilized termite nests, are present in both members.

An evaluation of out-of-hospital advanced airway management in an urban setting.

PubMed

Colwell, Christopher B; McVaney, Kevin E; Haukoos, Jason S; Wiebe, David P; Gravitz, Craig S; Dunn, Will W; Bryan, Tamara

2005-05-01

To determine the success and complication rates associated with endotracheal intubation in an urban emergency medical services (EMS) system. This study evaluated consecutive airway interventions between March 2001 and May 2001 performed by paramedics from the Denver Health Paramedic Division in Denver, Colorado. Patients were identified and enrolled prospectively with the identification of all patients for whom intubation was attempted. A retrospective chart review of the emergency department (ED), intensive care unit, other hospital records, and the coroner's records was then conducted with the intent of identifying all complications related to attempted intubation, including the placement of each endotracheal tube. A total of 278 patients were included in this study. Of these, 154 (55%) had an initial nasal intubation attempt, and 124 (45%) had an initial oral intubation attempt. Of the 278 patients for whom an intubation was attempted, 234 (84%, 95% CI = 77% to 88%) were reported by paramedics to be successfully intubated. Of 114 nasal intubations reported as successful by paramedics, two (2%; 95% CI = 0.2% to 6%) were found to be misplaced. Of the 120 oral intubations reported as successful by paramedics, one (1%; 95% CI = 0.02% to 5%) was found to be misplaced. Of the 278 patients, 22 (8%; 95% CI = 5% to 12%) had complications; three (1%; 95% CI = 0.2% to 3%) endotracheal tubes were incorrectly positioned, two (0.7%; 95% CI = 0.08% to 3%) of which were undetected esophageal intubations and one (0.4%; 95% CI = 0 to 2%) of which was in the posterior pharynx. Reasonable success and complication rates of endotracheal intubation in the out-of-hospital setting can be achieved in a busy, urban EMS system without the assistance of medications.

Understanding requirements of novel healthcare information systems for management of advanced prostate cancer.

PubMed

Wagholikar, Amol S; Fung, Maggie; Nelson, Colleen C

2012-01-01

Effective management of chronic diseases is a global health priority. A healthcare information system offers opportunities to address challenges of chronic disease management. However, the requirements of health information systems are often not well understood. The accuracy of requirements has a direct impact on the successful design and implementation of a health information system. Our research describes methods used to understand the requirements of health information systems for advanced prostate cancer management. The research conducted a survey to identify heterogeneous sources of clinical records. Our research showed that the General Practitioner was the common source of patient's clinical records (41%) followed by the Urologist (14%) and other clinicians (14%). Our research describes a method to identify diverse data sources and proposes a novel patient journey browser prototype that integrates disparate data sources.

Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers

PubMed Central

Toscos, Tammy; Carpenter, Maria; Flanagan, Mindy; Kunjan, Kislaya; Doebbeling, Bradley N.

2018-01-01

Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access. PMID:29552599

Test Protocol for Room-to-Room Distribution of Outside Air by Residential Ventilation Systems

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

Barley, C. D.; Anderson, R.; Hendron, B.

2007-12-01

This test and analysis protocol has been developed as a practical approach for measuring outside air distribution in homes. It has been used successfully in field tests and has led to significant insights on ventilation design issues. Performance advantages of more sophisticated ventilation systems over simpler, less-costly designs have been verified, and specific problems, such as airflow short-circuiting, have been identified.

A systematic risk management approach employed on the CloudSat project

NASA Technical Reports Server (NTRS)

Basilio, R. R.; Plourde, K. S.; Lam, T.

2000-01-01

The CloudSat Project has developed a simplified approach for fault tree analysis and probabilistic risk assessment. A system-level fault tree has been constructed to identify credible fault scenarios and failure modes leading up to a potential failure to meet the nominal mission success criteria.

Mariner Venus-Mercury 1973 Project. Volume 1: Venus and Mercury 1 Encounters

NASA Technical Reports Server (NTRS)

1976-01-01

The primary mission report includes the Venus encounter and the first Mercury encounter. Plans and activities undertaken to successfully achieve the mission objectives are described. Operational activities are identified by mission operation system functions, providing a brief summary of each discipline. Spacecraft performance is summarized by subsystems.

Managing the Manpower Aspects of Applying Micro-Electronics Technology.

ERIC Educational Resources Information Center

Thornton, P.; Routledge, C.

1980-01-01

Outlines major effects that the application of micro-electronics devices in products/processes and in office systems will have on future manpower and skill requirements in manufacturing organizations. Identifies the type of problems these changes will pose for manpower managers. Provides general guidelines for the successful management of these…

Special Education Teacher Preparation in Kenya, Malawi, Zambia, and Zimbabwe

ERIC Educational Resources Information Center

Chitiyo, Morgan; Odongo, George; Itimu-Phiri, Ambumulire; Muwana, Florence; Lipemba, Mary

2015-01-01

Researchers have repeatedly identified special education teacher shortage as one of the factors that have stymied the development of special education in many African countries. Highly qualified special education teachers are an integral part of successful national educational systems. In order to ensure an optimum supply of qualified special…

Mandala Mornings: A Creative Approach for Elementary School Counselors

ERIC Educational Resources Information Center

Cook, Katrina; Mayorga, Mary G.; Ball, Veronica

2016-01-01

The American School Counselor Association (ASCA, 2012) has identified one of the ways elementary school counselors can assist students to become successful in school is to offer small group counseling through the responsive services delivery system. Expressive arts, such as creating mandalas, provide a non-threatening approach for school…

Winning in Time: Enabling Naturalistic Decision Making in Command and Control

DTIC Science & Technology

2000-11-01

non-linear with non-linearity defined as a condition master chess player , the NBA basketball player , the in which a system disobeys principles of great...are made up of basic others identified in the successive sectors, are feedback structures which have known behavioral points of leverage for policy

Expert Reflections on Effective Online Instruction: Importance of Course Content

ERIC Educational Resources Information Center

Ryan, Michael; Jonick, Christine; Langub, Lee Woodham

2015-01-01

This study seeks to identify common factors that leaders in online instruction consider most critical to successful teaching and learning at a distance. A quantitative and qualitative analysis of the teaching philosophy narratives of the nominees for the "University System of Georgia Regents' Teaching Excellence Award for Online…

Real-Time Analysis of a Sensor's Data for Automated Decision Making in an IoT-Based Smart Home.

PubMed

Khan, Nida Saddaf; Ghani, Sayeed; Haider, Sajjad

2018-05-25

IoT devices frequently generate large volumes of streaming data and in order to take advantage of this data, their temporal patterns must be learned and identified. Streaming data analysis has become popular after being successfully used in many applications including forecasting electricity load, stock market prices, weather conditions, etc. Artificial Neural Networks (ANNs) have been successfully utilized in understanding the embedded interesting patterns/behaviors in the data and forecasting the future values based on it. One such pattern is modelled and learned in the present study to identify the occurrence of a specific pattern in a Water Management System (WMS). This prediction aids in making an automatic decision support system, to switch OFF a hydraulic suction pump at the appropriate time. Three types of ANN, namely Multi-Input Multi-Output (MIMO), Multi-Input Single-Output (MISO), and Recurrent Neural Network (RNN) have been compared, for multi-step-ahead forecasting, on a sensor's streaming data. Experiments have shown that RNN has the best performance among three models and based on its prediction, a system can be implemented to make the best decision with 86% accuracy.

A Genetically Optimized Predictive System for Success in General Chemistry Using a Diagnostic Algebra Test

NASA Astrophysics Data System (ADS)

Cooper, Cameron I.; Pearson, Paul T.

2012-02-01

In higher education, many high-enrollment introductory courses have evolved into "gatekeeper" courses due to their high failure rates. These courses prevent many students from attaining their educational goals and often become graduation roadblocks. At the authors' home institution, general chemistry has become a gatekeeper course in which approximately 25% of students do not pass. This failure rate in chemistry is common, and often higher, at many other institutions of higher education, and mathematical deficiencies are perceived to be a large contributing factor. This paper details the development of a highly accurate predictive system that identifies students at the beginning of the semester who are "at-risk" for earning a grade of C- or below in chemistry. The predictive accuracy of this system is maximized by using a genetically optimized neural network to analyze the results of a diagnostic algebra test designed for a specific population. Once at-risk students have been identified, they can be helped to improve their chances of success using techniques such as concurrent support courses, online tutorials, "just-in-time" instructional aides, study skills, motivational interviewing, and/or peer mentoring.

Seven Key Principles of Program and Project Success: A Best Practices Survey

NASA Technical Reports Server (NTRS)

Bilardo, Vincent J.; Korte, John J.; Dankhoff, Walter; Langan, Kevin; Branscome, Darrell R.; Fragola, Joseph R.; Dugal, Dale J.; Gormley, Thomas J.; Hammond, Walter E.; Hollopeter, James J.;

Understanding local-scale drivers of biodiversity outcomes in terrestrial protected areas.

PubMed

Barnes, Megan D; Craigie, Ian D; Dudley, Nigel; Hockings, Marc

2017-07-01

Conservation relies heavily on protected areas (PAs) maintaining their key biodiversity features to meet global biodiversity conservation goals. However, PAs have had variable success, with many failing to fully maintain their biodiversity features. The current literature concerning what drives variability in PA performance is rapidly expanding but unclear, sometimes contradictory, and spread across multiple disciplines. A clear understanding of the drivers of successful biodiversity conservation in PAs is necessary to make them fully effective. Here, we conduct a comprehensive assessment of the current state of knowledge concerning the drivers of biological outcomes within PAs, focusing on those that can be addressed at local scales. We evaluate evidence in support of potential drivers to identify those that enable more successful outcomes and those that impede success and provide a synthetic review. Interactions are discussed where they are known, and we highlight gaps in understanding. We find that elements of PA design, management, and local and national governance challenges, species and system ecology, and sociopolitical context can all influence outcomes. Adjusting PA management to focus on actions and policies that influence the key drivers identified here could improve global biodiversity outcomes. © 2016 New York Academy of Sciences.

Obstacles to Successful Implementation of eHealth Applications into Clinical Practice.

PubMed

Voogt, Marianne P; Opmeer, Brent C; Kastelein, Arnoud W; Jaspers, Monique W M; Peute, Linda W

2018-01-01

eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.

The Seasat SAR Wind and Ocean Wave Monitoring Capabilities: A case study for pass 1339m

NASA Technical Reports Server (NTRS)

Beal, R. C.

1980-01-01

A well organized low energy 11 sec. swell system off the East Coast of the U.S. was detected with the Seasat Synthetic Aperture Radar and successfully tracked from deep water, across the continental shelf, and into shallow water. In addition, a less organized 7 sec. system was tentatively identified in the imagery. Both systems were independently confirmed with simultaneous wave spectral measurements from a research pier, aircraft laser profilometer data, and Fleet Numerical Spectral Ocean Wave Models.

Dominant resistance against plant viruses

PubMed Central

de Ronde, Dryas; Butterbach, Patrick; Kormelink, Richard

2014-01-01

To establish a successful infection plant viruses have to overcome a defense system composed of several layers. This review will overview the various strategies plants employ to combat viral infections with main emphasis on the current status of single dominant resistance (R) genes identified against plant viruses and the corresponding avirulence (Avr) genes identified so far. The most common models to explain the mode of action of dominant R genes will be presented. Finally, in brief the hypersensitive response (HR) and extreme resistance (ER), and the functional and structural similarity of R genes to sensors of innate immunity in mammalian cell systems will be described. PMID:25018765

Identification and impact of discoverers in online social systems

PubMed Central

Medo, Matúš; Mariani, Manuel S.; Zeng, An; Zhang, Yi-Cheng

2016-01-01

Understanding the behavior of users in online systems is of essential importance for sociology, system design, e-commerce, and beyond. Most existing models assume that individuals in diverse systems, ranging from social networks to e-commerce platforms, tend to what is already popular. We propose a statistical time-aware framework to identify the users who differ from the usual behavior by being repeatedly and persistently among the first to collect the items that later become hugely popular. Since these users effectively discover future hits, we refer them as discoverers. We use the proposed framework to demonstrate that discoverers are present in a wide range of real systems. Once identified, discoverers can be used to predict the future success of new items. We finally introduce a simple network model which reproduces the discovery patterns observed in the real data. Our results open the door to quantitative study of detailed temporal patterns in social systems. PMID:27687588

A multi-data source surveillance system to detect a bioterrorism attack during the G8 Summit in Scotland.

PubMed

Meyer, N; McMenamin, J; Robertson, C; Donaghy, M; Allardice, G; Cooper, D

2008-07-01

In 18 weeks, Health Protection Scotland (HPS) deployed a syndromic surveillance system to early-detect natural or intentional disease outbreaks during the G8 Summit 2005 at Gleneagles, Scotland. The system integrated clinical and non-clinical datasets. Clinical datasets included Accident & Emergency (A&E) syndromes, and General Practice (GPs) codes grouped into syndromes. Non-clinical data included telephone calls to a nurse helpline, laboratory test orders, and hotel staff absenteeism. A cumulative sum-based detection algorithm and a log-linear regression model identified signals in the data. The system had a fax-based track for real-time identification of unusual presentations. Ninety-five signals were triggered by the detection algorithms and four forms were faxed to HPS. Thirteen signals were investigated. The system successfully complemented a traditional surveillance system in identifying a small cluster of gastroenteritis among the police force and triggered interventions to prevent further cases.

Multicriteria decision-aid method to evaluate the performance of stormwater infiltration systems over the time.

PubMed

Moura, P; Barraud, S; Baptista, M B; Malard, F

2011-01-01

Nowadays, stormwater infiltration systems are frequently used because of their ability to reduce flows and volumes in downstream sewers, decrease overflows in surface waters and make it possible to recharge groundwater. Moreover, they come in various forms with different uses. Despite these advantages the long term sustainability of these systems is questionable and their real performances have to be assessed taking into account various and sometimes conflicting aspects. To address this problem a decision support system is proposed. It is based on a multicriteria method built to help managers to evaluate the performance of an existing infiltration system at different stages of its lifespan and identify whether it performs correctly or not, according to environmental, socio-economic, technical and sanitary aspects. The paper presents successively: the performance indicators and the way they were built, the multicriteria method to identify if the system works properly and a case study.

Identification and impact of discoverers in online social systems

NASA Astrophysics Data System (ADS)

Medo, Matúš; Mariani, Manuel S.; Zeng, An; Zhang, Yi-Cheng

2016-09-01

Understanding the behavior of users in online systems is of essential importance for sociology, system design, e-commerce, and beyond. Most existing models assume that individuals in diverse systems, ranging from social networks to e-commerce platforms, tend to what is already popular. We propose a statistical time-aware framework to identify the users who differ from the usual behavior by being repeatedly and persistently among the first to collect the items that later become hugely popular. Since these users effectively discover future hits, we refer them as discoverers. We use the proposed framework to demonstrate that discoverers are present in a wide range of real systems. Once identified, discoverers can be used to predict the future success of new items. We finally introduce a simple network model which reproduces the discovery patterns observed in the real data. Our results open the door to quantitative study of detailed temporal patterns in social systems.

Identification and impact of discoverers in online social systems.

PubMed

Medo, Matúš; Mariani, Manuel S; Zeng, An; Zhang, Yi-Cheng

2016-09-30

Understanding the behavior of users in online systems is of essential importance for sociology, system design, e-commerce, and beyond. Most existing models assume that individuals in diverse systems, ranging from social networks to e-commerce platforms, tend to what is already popular. We propose a statistical time-aware framework to identify the users who differ from the usual behavior by being repeatedly and persistently among the first to collect the items that later become hugely popular. Since these users effectively discover future hits, we refer them as discoverers. We use the proposed framework to demonstrate that discoverers are present in a wide range of real systems. Once identified, discoverers can be used to predict the future success of new items. We finally introduce a simple network model which reproduces the discovery patterns observed in the real data. Our results open the door to quantitative study of detailed temporal patterns in social systems.

An Actor-Network Theory Analysis of Policy Innovation for Smoke-Free Places: Understanding Change in Complex Systems

PubMed Central

Borland, Ron; Coghill, Ken

2010-01-01

Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems. PMID:20466949

An actor-network theory analysis of policy innovation for smoke-free places: understanding change in complex systems.

PubMed

Young, David; Borland, Ron; Coghill, Ken

2010-07-01

Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems.

Design and Multicentric Implementation of a Generic Software Architecture for Patient Recruitment Systems Re-Using Existing HIS Tools and Routine Patient Data

PubMed Central

Trinczek, B.; Köpcke, F.; Leusch, T.; Majeed, R.W.; Schreiweis, B.; Wenk, J.; Bergh, B.; Ohmann, C.; Röhrig, R.; Prokosch, H.U.; Dugas, M.

2014-01-01

Summary Objective (1) To define features and data items of a Patient Recruitment System (PRS); (2) to design a generic software architecture of such a system covering the requirements; (3) to identify implementation options available within different Hospital Information System (HIS) environments; (4) to implement five PRS following the architecture and utilizing the implementation options as proof of concept. Methods Existing PRS were reviewed and interviews with users and developers conducted. All reported PRS features were collected and prioritized according to their published success and user’s request. Common feature sets were combined into software modules of a generic software architecture. Data items to process and transfer were identified for each of the modules. Each site collected implementation options available within their respective HIS environment for each module, provided a prototypical implementation based on available implementation possibilities and supported the patient recruitment of a clinical trial as a proof of concept. Results 24 commonly reported and requested features of a PRS were identified, 13 of them prioritized as being mandatory. A UML version 2 based software architecture containing 5 software modules covering these features was developed. 13 data item groups processed by the modules, thus required to be available electronically, have been identified. Several implementation options could be identified for each module, most of them being available at multiple sites. Utilizing available tools, a PRS could be implemented in each of the five participating German university hospitals. Conclusion A set of required features and data items of a PRS has been described for the first time. The software architecture covers all features in a clear, well-defined way. The variety of implementation options and the prototypes show that it is possible to implement the given architecture in different HIS environments, thus enabling more sites to successfully support patient recruitment in clinical trials. PMID:24734138

Design and multicentric implementation of a generic software architecture for patient recruitment systems re-using existing HIS tools and routine patient data.

PubMed

Trinczek, B; Köpcke, F; Leusch, T; Majeed, R W; Schreiweis, B; Wenk, J; Bergh, B; Ohmann, C; Röhrig, R; Prokosch, H U; Dugas, M

2014-01-01

(1) To define features and data items of a Patient Recruitment System (PRS); (2) to design a generic software architecture of such a system covering the requirements; (3) to identify implementation options available within different Hospital Information System (HIS) environments; (4) to implement five PRS following the architecture and utilizing the implementation options as proof of concept. Existing PRS were reviewed and interviews with users and developers conducted. All reported PRS features were collected and prioritized according to their published success and user's request. Common feature sets were combined into software modules of a generic software architecture. Data items to process and transfer were identified for each of the modules. Each site collected implementation options available within their respective HIS environment for each module, provided a prototypical implementation based on available implementation possibilities and supported the patient recruitment of a clinical trial as a proof of concept. 24 commonly reported and requested features of a PRS were identified, 13 of them prioritized as being mandatory. A UML version 2 based software architecture containing 5 software modules covering these features was developed. 13 data item groups processed by the modules, thus required to be available electronically, have been identified. Several implementation options could be identified for each module, most of them being available at multiple sites. Utilizing available tools, a PRS could be implemented in each of the five participating German university hospitals. A set of required features and data items of a PRS has been described for the first time. The software architecture covers all features in a clear, well-defined way. The variety of implementation options and the prototypes show that it is possible to implement the given architecture in different HIS environments, thus enabling more sites to successfully support patient recruitment in clinical trials.

Simulation of hydrologic influences on wetland ecosystem succession. Master's thesis

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

Pompilio, R.A.

1994-09-01

This research focuses on the development of a simulation model to determine the affects of hydrological influences on a wetland ecosystem. The model allows perturbations to the inputs of various wetland data which in turn, influences the successional development of the ecosystem. This research consisted of converting a grassland ecosystem model to one which simulates wetland conditions. The critical factor in determining the success of wetland creation is the hydrology of the system. There are four of the areas of the original model which are affected by the hydrology. The model measures the health or success of the ecosystem throughmore » the measurement of the systems gross plant production, the respiration and the net primary production of biomass. Altering the auxiliary variables of water level and the rate of flow through the system explicitly details the affects hydrologic influences on those production rates. Ten case tests depicting exogenous perturbations of the hydrology were run to identify these affects. Although the tests dealt with the fluctuation of water through the system, any one of the auxiliary variables in the model could be changed to reflect site specific data. Productivity, Hazardous material management, Hazardous material pharmacy.« less

Identification of Major Outer Surface Proteins of Streptococcus agalactiae

PubMed Central

Hughes, Martin J. G.; Moore, Joanne C.; Lane, Jonathan D.; Wilson, Rebecca; Pribul, Philippa K.; Younes, Zabin N.; Dobson, Richard J.; Everest, Paul; Reason, Andrew J.; Redfern, Joanne M.; Greer, Fiona M.; Paxton, Thanai; Panico, Maria; Morris, Howard R.; Feldman, Robert G.; Santangelo, Joseph D.

2002-01-01

To identify the major outer surface proteins of Streptococcus agalactiae (group B streptococcus), a proteomic analysis was undertaken. An extract of the outer surface proteins was separated by two-dimensional electrophoresis. The visualized spots were identified through a combination of peptide sequencing and reverse genetic methodologies. Of the 30 major spots identified as S. agalactiae specific, 27 have been identified. Six of these proteins, previously unidentified in S. agalactiae, were sequenced and cloned. These were ornithine carbamoyltransferase, phosphoglycerate kinase, nonphosphorylating glyceraldehyde-3-phosphate dehydrogenase, purine nucleoside phosphorylase, enolase, and glucose-6-phosphate isomerase. Using a gram-positive expression system, we have overexpressed two of these proteins in an in vitro system. These recombinant, purified proteins were used to raise antisera. The identification of these proteins as residing on the outer surface was confirmed by the ability of the antisera to react against whole, live bacteria. Further, in a neonatal-animal model system, we demonstrate that some of these sera are protective against lethal doses of bacteria. These studies demonstrate the successful application of proteomics as a technique for identifying vaccine candidates. PMID:11854208

Automation of internal library operations in academic health sciences libraries: a state of the art report.

PubMed Central

Grefsheim, S F; Larson, R H; Bader, S A; Matheson, N W

1982-01-01

A survey of automated records management in the United States and Canada was developed to identify existing on-line library systems and technical expertise. Follow-up interviews were conducted with ten libraries. Tables compare the features and availability of four main frame and four minicomputer systems. Results showed: a trend toward vendor-supplied systems; little coordination of efforts among schools; current system developments generally on a universitywide basis; and the importance of having the cooperation of campus computer facilities to the success of automation efforts. PMID:7066571

Predictors of attitude and intention to use knowledge management system among Korean nurses.

PubMed

Yun, Eun Kyoung

2013-12-01

Knowledge sharing using Knowledge Management (KM) systems helps nurses to understand and acquire appropriate knowledge that influences the quality of healthcare service. The purpose of this study was to identify organizational and individual factors influencing attitude and intention to use KM systems among Korean nurses. A cross-sectional survey design was used to study a sample of 245 nurses employed at five hospitals in Seoul. A multiple hierarchical regression was used to examine predictors of nurses' attitude and intention to use. From an individual perspective, nurse's informatics competency was identified as a significant factor influencing attitudes toward knowledge management usage within adhocracy and clan cultures. However, from an organizational perspective, level of hospital information system was identified as a significant factor influencing KM system usage within adhocracy cultures. The findings of this study will be helpful in better understanding and assessing the impact of the factors affecting the implementation of nursing knowledge management systems and in further developing successful managerial strategies using knowledge resources in healthcare settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Overview of practice management in child and adolescent psychiatry.

PubMed

Schreter, Robert K

2010-01-01

The manager of a psychiatric practice must create and direct a clinical delivery system, design and oversee the administrative services necessary to support the system, and guide the business operations that contribute to its success. Regardless of the size of the practice, the psychiatrist administrator must handle seven core administrative responsibilities and oversee individual functions and capabilities within each domain. These responsibilities include practice development, clinical services management, medical office operations, clinical management, information management, business management, and risk management. This article provides a roadmap for creating and sustaining successful clinical and administrative endeavors. It can also be used by existing practices as an audit instrument to provide a snapshot of current capabilities so that strengths as well as opportunities for continued growth can be identified.

Exploration of indigenous bacteria in an intensive aquaculture system of African catfish (Clarias sp.) in Banyuwangi, Indonesia

NASA Astrophysics Data System (ADS)

Prayogo; Rahardja, B. S.; Asshanti, A. N.; Dewi, N. N.; Santanumurti, M. B.

2018-04-01

Intensive African catfish culture in tarpaulin pond was popular in Banyuwangi, Indonesia since the government supported the fisheries sector. Unfortunately, the failure of African catfish culture still occurred since the waste from fish metabolite process and feed residue decreased the water quality. Bacteria in the water could be the solution to increase the success rate of aquaculture by improving the water quality. This study purpose was to obtained indigenous bacteria in intensive aquaculture system of African catfish to improve water quality. This study successfully isolated bacteria contained with amylase, protease and lipase characteristic. Isolated bacteria in this study were identified as Pseudomonas pseudomallei (97.81%), Bacillus subtilis (95.81%) and Pseudomonas stutzeri (61.21%).

Participatory Design, User Involvement and Health IT Evaluation.

PubMed

Kushniruk, Andre; Nøhr, Christian

2016-01-01

End user involvement and input into the design and evaluation of information systems has been recognized as being a critical success factor in the adoption of information systems. Nowhere is this need more critical than in the design of health information systems. Consistent with evidence from the general software engineering literature, the degree of user input into design of complex systems has been identified as one of the most important factors in the success or failure of complex information systems. The participatory approach goes beyond user-centered design and co-operative design approaches to include end users as more active participants in design ideas and decision making. Proponents of participatory approaches argue for greater end user participation in both design and evaluative processes. Evidence regarding the effectiveness of increased user involvement in design is explored in this contribution in the context of health IT. The contribution will discuss several approaches to including users in design and evaluation. Challenges in IT evaluation during participatory design will be described and explored along with several case studies.

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

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

Singh, Ravindra; Reilly, James T.; Wang, Jianhui

Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to commonmore » barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.« less

Picture Archiving and Communication System (PACS) implementation, integration & benefits in an integrated health system.

PubMed

Mansoori, Bahar; Erhard, Karen K; Sunshine, Jeffrey L

2012-02-01

The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

CCD imaging technology and the war on crime

NASA Astrophysics Data System (ADS)

McNeill, Glenn E.

1992-08-01

Linear array based CCD technology has been successfully used in the development of an Automatic Currency Reader/Comparator (ACR/C) system. The ACR/C system is designed to provide a method for tracking US currency in the organized crime and drug trafficking environments where large amounts of cash are involved in illegal transactions and money laundering activities. United States currency notes can be uniquely identified by the combination of the denomination serial number and series year. The ACR/C system processes notes at five notes per second using a custom transport a stationary linear array and optical character recognition (OCR) techniques to make such identifications. In this way large sums of money can be " marked" (using the system to read and store their identifiers) and then circulated within various crime networks. The system can later be used to read and compare confiscated notes to the known sets of identifiers from the " marked" set to document a trail of criminal activities. With the ACR/C law enforcement agencies can efficiently identify currency without actually marking it. This provides an undetectable means for making each note individually traceable and facilitates record keeping for providing evidence in a court of law. In addition when multiple systems are used in conjunction with a central data base the system can be used to track currency geographically. 1.

Improvement in the technological feasibility of a web-based dietary survey system in local settings.

PubMed

Jung, Hyun Ju; Lee, Sang Eun; Kim, Dongwoo; Noh, Hwayoung; Song, Sujin; Kang, Minji; Song, Yoon Ju; Paik, Hee-Young

2015-01-01

The feasibility of a dietary survey tool is crucial for successful nutritional assessment via a community survey and for nutritional epidemiology. In 2012, we identified a newly developed computerized dietary survey system, the Diet Evaluation System (DES), which could be successfully applied to a community survey delivered during home visits using notebook computers when the internet environment was adequate, using either a WiBro modem or a smartphone as a tethered modem. In 2013, we retested DES feasibility using various mobile devices and in a larger number of subjects. We conducted a total of 430 interviews, representing two for each of 215 subjects of various ages, using tablet personal computers (PCs) and laptops. In addition, a group discussion with the interviewers was conducted. The interview success rate was improved to 84% (compared to 67% in 2012). Completing each interview took 14 min 1 s, and data processing was conducted automatically. The subjects' age, gender, and the type of mobile device used influenced the DES interview time. This study implies that the DES is an effective one-stop dietary survey system for use in a local setting. The interviewers' group discussion revealed that a one-stop system using the DES is convenient and that DES optimization for tablet PCs and continued database updating is needed.

Identifying the tobacco related free radicals by UPCC-QTOF-MS with radical trapping method in mainstream cigarette smoke.

PubMed

Wang, Ying; Liu, Misha; Zhu, Yingjing; Cheng, Kuan; Da Wu; Liu, Baizhan; Li, Fengting

2016-11-01

Tobacco related free radicals (TFRs) in the cigarette smoke are specific classes of hazardous compounds that merit concern. In this study, we developed a hybrid method to identify TFRs directly based on ultra-performance convergence chromatography with a quadrupole time-of-flight mass spectrometry (UPCC-QTOF MS) combined spin trapping technique. The short-lived TFRs were stabilized successfully in situ through spin trapping procedure and UPCC was applied to facilitate efficient separation of complex derivative products. Coupling of orthogonal partial least squares discriminant analysis (OPLS-DA), UPCC-QTOF MS system enabled us to identify specific potential TFRs with exact chemical formula. Moreover, computational stimulations have been carried out to evaluate the optimized stability of TFRs. This work is a successful demonstration for the application of an advanced hyphenated technique for separation of TFRs with short detection time (less than 7min) and high throughput. Copyright © 2016 Elsevier B.V. All rights reserved.

NASA's Software Bank (NETS)

NASA Technical Reports Server (NTRS)

1992-01-01

NETS (A Neural Network Development Tool) is a software system for mimicking the human brain. It is used in a University of Arkansas project in pattern matching of chemical systems. If successful, chemists would be able to identify mixtures of compounds without long and costly separation procedures. Using NETS, the group has trained the computer to recognize pattern relationships in a known compound and associate the results to an unknown compound. The research appears to be promising.

Effective Evaluation of Quality Rating and Improvement Systems for Early Care and Education and School-Age Care. Research-to-Policy, Research-to-Practice Brief OPRE 2011-11a

ERIC Educational Resources Information Center

Zellman, Gail L.; Brandon, Richard N.; Boller, Kimberly; Kreader, J. Lee

2011-01-01

It is important to evaluate Quality Rating and Improvement Systems (QRISs) so that policy makers and stakeholders can learn how well they are working and how they might be improved. Well-designed QRIS evaluations go beyond a "pass/fail" judgment to identify implementation successes and problems and assess what needs to be done to improve…

Application of Text Information Extraction System for Real-Time Cancer Case Identification in an Integrated Healthcare Organization.

PubMed

Xie, Fagen; Lee, Janet; Munoz-Plaza, Corrine E; Hahn, Erin E; Chen, Wansu

2017-01-01

Surgical pathology reports (SPR) contain rich clinical diagnosis information. The text information extraction system (TIES) is an end-to-end application leveraging natural language processing technologies and focused on the processing of pathology and/or radiology reports. We deployed the TIES system and integrated SPRs into the TIES system on a daily basis at Kaiser Permanente Southern California. The breast cancer cases diagnosed in December 2013 from the Cancer Registry (CANREG) were used to validate the performance of the TIES system. The National Cancer Institute Metathesaurus (NCIM) concept terms and codes to describe breast cancer were identified through the Unified Medical Language System Terminology Service (UTS) application. The identified NCIM codes were used to search for the coded SPRs in the back-end datastore directly. The identified cases were then compared with the breast cancer patients pulled from CANREG. A total of 437 breast cancer concept terms and 14 combinations of "breast"and "cancer" terms were identified from the UTS application. A total of 249 breast cancer cases diagnosed in December 2013 was pulled from CANREG. Out of these 249 cases, 241 were successfully identified by the TIES system from a total of 457 reports. The TIES system also identified an additional 277 cases that were not part of the validation sample. Out of the 277 cases, 11% were determined as highly likely to be cases after manual examinations, and 86% were in CANREG but were diagnosed in months other than December of 2013. The study demonstrated that the TIES system can effectively identify potential breast cancer cases in our care setting. Identified potential cases can be easily confirmed by reviewing the corresponding annotated reports through the front-end visualization interface. The TIES system is a great tool for identifying potential various cancer cases in a timely manner and on a regular basis in support of clinical research studies.

User-oriented evaluation of a medical image retrieval system for radiologists.

PubMed

Markonis, Dimitrios; Holzer, Markus; Baroz, Frederic; De Castaneda, Rafael Luis Ruiz; Boyer, Célia; Langs, Georg; Müller, Henning

2015-10-01

This article reports the user-oriented evaluation of a text- and content-based medical image retrieval system. User tests with radiologists using a search system for images in the medical literature are presented. The goal of the tests is to assess the usability of the system, identify system and interface aspects that need improvement and useful additions. Another objective is to investigate the system's added value to radiology information retrieval. The study provides an insight into required specifications and potential shortcomings of medical image retrieval systems through a concrete methodology for conducting user tests. User tests with a working image retrieval system of images from the biomedical literature were performed in an iterative manner, where each iteration had the participants perform radiology information seeking tasks and then refining the system as well as the user study design itself. During these tasks the interaction of the users with the system was monitored, usability aspects were measured, retrieval success rates recorded and feedback was collected through survey forms. In total, 16 radiologists participated in the user tests. The success rates in finding relevant information were on average 87% and 78% for image and case retrieval tasks, respectively. The average time for a successful search was below 3 min in both cases. Users felt quickly comfortable with the novel techniques and tools (after 5 to 15 min), such as content-based image retrieval and relevance feedback. User satisfaction measures show a very positive attitude toward the system's functionalities while the user feedback helped identifying the system's weak points. The participants proposed several potentially useful new functionalities, such as filtering by imaging modality and search for articles using image examples. The iterative character of the evaluation helped to obtain diverse and detailed feedback on all system aspects. Radiologists are quickly familiar with the functionalities but have several comments on desired functionalities. The analysis of the results can potentially assist system refinement for future medical information retrieval systems. Moreover, the methodology presented as well as the discussion on the limitations and challenges of such studies can be useful for user-oriented medical image retrieval evaluation, as user-oriented evaluation of interactive system is still only rarely performed. Such interactive evaluations can be limited in effort if done iteratively and can give many insights for developing better systems. Copyright © 2015. Published by Elsevier Ireland Ltd.

oPOSSUM: identification of over-represented transcription factor binding sites in co-expressed genes

PubMed Central

Ho Sui, Shannan J.; Mortimer, James R.; Arenillas, David J.; Brumm, Jochen; Walsh, Christopher J.; Kennedy, Brian P.; Wasserman, Wyeth W.

2005-01-01

Targeted transcript profiling studies can identify sets of co-expressed genes; however, identification of the underlying functional mechanism(s) is a significant challenge. Established methods for the analysis of gene annotations, particularly those based on the Gene Ontology, can identify functional linkages between genes. Similar methods for the identification of over-represented transcription factor binding sites (TFBSs) have been successful in yeast, but extension to human genomics has largely proved ineffective. Creation of a system for the efficient identification of common regulatory mechanisms in a subset of co-expressed human genes promises to break a roadblock in functional genomics research. We have developed an integrated system that searches for evidence of co-regulation by one or more transcription factors (TFs). oPOSSUM combines a pre-computed database of conserved TFBSs in human and mouse promoters with statistical methods for identification of sites over-represented in a set of co-expressed genes. The algorithm successfully identified mediating TFs in control sets of tissue-specific genes and in sets of co-expressed genes from three transcript profiling studies. Simulation studies indicate that oPOSSUM produces few false positives using empirically defined thresholds and can tolerate up to 50% noise in a set of co-expressed genes. PMID:15933209

The European Union Joint Procurement Agreement for cross-border health threats: what is the potential for this new mechanism of health system collaboration?

PubMed

Azzopardi-Muscat, Natasha; Schroder-Bäck, Peter; Brand, Helmut

2017-01-01

The Joint Procurement Agreement (JPA) is an innovative instrument for multi-country procurement of medical countermeasures against cross-border health threats. This paper aims to assess its potential performance. A literature review was conducted to identify key features of successful joint procurement programmes. Documentary analysis and a key informants' interview were carried out to analyse the European Union (EU) JPA. Ownership, equity, transparency, stable central financing, standardisation, flexibility and gradual development were identified as important prerequisites for successful establishment of multi-country joint procurement programmes in the literature while security of supply, favourable prices, reduction of operational costs and administrative burden and creation of professional expert networks were identified as desirable outcomes. The EU JPA appears to fulfil the criteria of ownership, transparency, equity, flexibility and gradual development. Standardisation is only partly fulfilled and central EU level financing is not provided. Security of supply is an important outcome for all EU Member States (MS). Price savings, reduction in administrative burden and creation of professional networks may be particularly attractive for the smaller MS. The JPA has the potential to increase health system collaboration and efficiency at EU level provided that the incentives for sustained commitment of larger MS are sufficiently attractive.

Characteristics of health care organizations associated with learning and development: lessons from a pilot study.

PubMed

Nyström, Monica

2009-01-01

Characteristics of health care organizations associated with an ability to learn from experiences and to develop and manage change were explored in this study. Understanding of these characteristics is necessary to identify factors influencing success in learning from the past and achieving future health care quality objectives. A literature review of the quality improvement, strategic organizational development and change management, organizational learning, and microsystems fields identified 20 organizational characteristics, grouped under (a) organizational systems, (b) key actors, and (c) change management processes. Qualitative methods, using interviews, focus group reports, and archival records, were applied to find associations between identified characteristics and 6 Swedish health care units externally evaluated as delivering high-quality care. Strong support for a characteristic was defined as units having more than 4 sources describing the characteristic as an important success factor. Eighteen characteristics had strong support from at least 2 units. The strongest evidence was found for the following: (i) key actors have long-term commitment, provide support, and make sense of ambiguous situations; (ii) organizational systems encourage employee commitment, participation, and involvement; and (iii) change management processes are employed systematically. Based on the results, a new model of "characteristics associated with learning and development in health care organizations" is proposed.

Convergent Adaptation in Small Groups: Understanding Professional Development Activities through a Complex Systems Lens

ERIC Educational Resources Information Center

Yoon, Susan; Liu, Lei; Goh, Sao-Ee

2010-01-01

Understanding the dynamics of individual or group adaptation can provide valuable information for constructing professional development strategies to increase chances of instructional success. This paper reports on an exploratory study that identifies indicators of convergent vs. non-convergent adaptation in two cases of teachers working together…

Student Achievement in Identified Workforce Clusters: Understanding Factors that Influence Student Success

ERIC Educational Resources Information Center

D'Amico, Mark M.; Morgan, Grant B.; Robertson, Thashundray C.

2011-01-01

This study blends elements from two South Carolina Technical College System initiatives--Achieving the Dream and a workforce cluster strategy. Achieving the Dream is a national non-profit organization created to help technical and community college students succeed, particularly low-income students and students of color. This initiative, combined…

The College Completion Agenda: State Policy Guide

ERIC Educational Resources Information Center

Stedron, Jennifer M.; Shah, Tajel; Bautsch, Brenda; Martin, Patricia; Deye, Sunny; Bailey, Lamar; Handel, Stephen J.; Vasavada, Natasha; Shen, Yilan; Exstrom, Michelle; Shelton, Sara; Santiago, Helen; Bell, Julie Davis; Quin, Bradley J.; Baum, Sandy; Bell, Julie Davis; Sturtevant, Anne; Bautsch, Brenda; Williams, Ronald; Kerouac, Pamela; Badolato, Vincent

2010-01-01

There are formidable challenges at every level of the system that confront students who aspire to enroll and succeed in college. In 2007, the College Board formed the Commission on Access, Admissions and Success in Higher Education to study the educational pipeline as a single continuum and identify solutions to increase the number of students who…

Education Business Plan 2008-11: Ministry Business Plan

ERIC Educational Resources Information Center

Alberta Education, 2008

2008-01-01

The Ministry of Education has identified one core business that is an ongoing key responsibility. It is called "Core Business One: Lead and Support the Education System So That All Students Are Successful at Learning." The core business includes three goals with specific outcomes that describe the end results the Ministry wants to…

Training for Efficiency: Work, Time, and Systems-Based Practice in Medical Residency

ERIC Educational Resources Information Center

Szymczak, Julia E.; Bosk, Charles L.

2012-01-01

Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these…

Recording Artists in Jamaica: Victims of the System.

ERIC Educational Resources Information Center

Cuthbert, Marlene

Despite the international success of reggae music, a survey of Jamaican recording artists revealed disillusionment, anger and frustration with the national recording industry. Various artists identified a lack of professional ethics and discipline, and above all, lack of an updated copyright law as being at the root of the problem. Since Jamaica…

The Circle of Evaluation in the Community Junior College.

ERIC Educational Resources Information Center

Trent, James W.

Community colleges need to evaluate, free from prejudice, the nature and impact of their whole system. Lack of effective programs for minority students is one of many discrepancies between objectives held and those actually implemented. The goals of a successful evaluation are to measure and identify a combination of input and process factors that…

Leading the Way: Access. Success. Impact. 2013-18 Master Plan

ERIC Educational Resources Information Center

West Virginia Higher Education Policy Commission, 2013

2013-01-01

The West Virginia Higher Education Policy Commission (Commission) has statutory responsibility for developing a five-year statewide master plan for higher education that sets forth system goals, objectives, and strategies and is aligned with meeting the goals of the state. The Legislature has identified in state code eight areas of special…

Definitions and codes for seral status and structure of vegetation.

Treesearch

Frederick C. Hall; Larry Bryant; Rod Clausnitzer; Kathy Geier-Hayes; Robert Keane; Jane Kertis; Ayn Shlisky; Robert Steel

1995-01-01

Definitions and codes for identifying vegetation seral status and structure are desired for land management planning, appraising wildlife habitat, and prescribing vegetation treatment. Codes are only presented; they are not a system for determining seral status or stand structure. Terms defined are climax, potential natural community (PNC), succession, seral status,...

Barriers to Taking Massive Open Online Courses (MOOCs)

ERIC Educational Resources Information Center

Semenova, Tatiana Vadimovna; Rudakova, Lyudmila Mikhailovna

2016-01-01

Researchers of the traditional higher education system identify a number of factors affecting admission to a university (barriers to entry) and factors of its successful completion (barriers to exit). Massive open online courses (MOOCs), available to any Internet user, remove barriers to entry because anyone can study there. But do all students…

Connected Representations of Knowledge: Do Undergraduate Students Relate Algebraic Rational Expressions to Rational Numbers?

ERIC Educational Resources Information Center

Yantz. Jennifer

2013-01-01

The attainment and retention of later algebra skills in high school has been identified as a factor significantly impacting students' postsecondary success as STEM majors. Researchers maintain that learners develop meaning for algebraic procedures by forming connections to the basic number system properties. In the present study, the connections…

The New Basic Agenda: Public Policy Directions for Student Success.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Board of Governors.

Intended as a guide for policymakers in the California community colleges for the last half of the 1990s, this report describes four challenges facing the community college system and identifies major policy directions. Following an introduction, the following challenges are presented: (1) the delivery of high quality education in a manner that…

Rethinking School Bullying: Towards an Integrated Model

ERIC Educational Resources Information Center

Dixon, Roz; Smith, Peter K.

2011-01-01

What would make anti-bullying initiatives more successful? This book offers a new approach to the problem of school bullying. The question of what constitutes a useful theory of bullying is considered and suggestions are made as to how priorities for future research might be identified. The integrated, systemic model of school bullying introduced…

Beyond Search Technique and Strategy: Helping Students to Be Informed.

ERIC Educational Resources Information Center

Aversa, Elizabeth

1991-01-01

Suggests ways that the school library media specialist can help students become more successful as users of online information. Four types of barriers to becoming informed are described: (1) indicative access barriers (indexing systems and relevance); (2) physical access to documents identified in a search; (3) linguistic barriers; and (4)…

KELCH F-BOX protein positively influences Arabidopsis seed germination by targeting PHYTOCHROME-INTERACTING FACTOR1

USDA-ARS?s Scientific Manuscript database

Seeds employ sensory systems that assess various environmental cues over time to maximize the successful transition from embryo to seedling. Here, we show that the Arabidopsis F-Box protein Cold Temperature-Germinating (CTG)-10, identified by activation tagging, is a positive regulator during this p...

Evolution of the asexual queen succession system and its underlying mechanisms in termites.

PubMed

Matsuura, Kenji

2017-01-01

One major advantage of sexual reproduction over asexual reproduction is its promotion of genetic variation, although it reduces the genetic contribution to offspring. Queens of social insects double their contribution to the gene pool, while overuse of asexual reproduction may reduce the ability of the colony to adapt to environmental stress because of the loss of genetic diversity. Recent studies have revealed that queens of some termite species can solve this tradeoff by using parthenogenesis to produce the next generation of queens and sexual reproduction to produce other colony members. This reproductive system, known as asexual queen succession (AQS), has been identified in the subterranean termites Reticulitermes speratus, Reticulitermes virginicus and Reticulitermes lucifugus and in the Neotropical higher termites Embiratermes neotenicus and Cavitermes tuberosus The studies presented here have uncovered the unusual modes of reproduction in termites and have aimed to identify their underlying mechanisms. The study of AQS, the mixed use of sexual and asexual reproduction, is of fundamental importance as it may provide a key to solve the evolutionary paradox of sex. © 2017. Published by The Company of Biologists Ltd.

Biomimetics in Tribology

NASA Astrophysics Data System (ADS)

Gebeshuber, I. C.; Majlis, B. Y.; Stachelberger, H.

Science currently goes through a major change. Biology is evolving as new Leitwissenschaft, with more and more causation and natural laws being uncovered. The term `technoscience' denotes the field where science and technology are inseparably interconnected, the trend goes from papers to patents, and the scientific `search for truth' is increasingly replaced by search for applications with a potential economic value. Biomimetics, i.e. knowledge transfer from biology to technology, is a field that has the potential to drive major technical advances. The biomimetic approach might change the research landscape and the engineering culture dramatically, by the blending of disciplines. It might substantially support successful mastering of current tribological challenges: friction, adhesion, lubrication and wear in devices and systems from the meter to the nanometer scale. A highly successful method in biomimectics, the biomimicry innovation method, is applied in this chapter to identify nature's best practices regarding two key issues in tribology: maintenance of the physical integrity of a system, and permanent as well as temporary attachment. The best practices identified comprise highly diverse organisms and processes and are presented in a number of tables with detailed references.

Variability in vegetation effects on density and nesting success of grassland birds

USGS Publications Warehouse

Winter, Maiken; Johnson, Douglas H.; Shaffer, Jill A.

2005-01-01

The structure of vegetation in grassland systems, unlike that in forest systems, varies dramatically among years on the same sites, and among regions with similar vegetation. The role of this variation in vegetation structure on bird density and nesting success of grassland birds is poorly understood, primarily because few studies have included sufficiently large temporal and spatial scales to capture the variation in vegetation structure, bird density, or nesting success. To date, no large-scale study on grassland birds has been conducted to investigate whether grassland bird density and nesting success respond similarly to changes in vegetation structure. However, reliable management recommendations require investigations into the distribution and nesting success of grassland birds over larger temporal and spatial scales. In addition, studies need to examine whether bird density and nesting success respond similarly to changing environmental conditions. We investigated the effect of vegetation structure on the density and nesting success of 3 grassland-nesting birds: clay-colored sparrow (Spizella pallida), Savannah sparrow (Passerculus sandwichensis), and bobolink (Dolichonyx oryzivorus) in 3 regions of the northern tallgrass prairie in 1998-2001. Few vegetation features influenced the densities of our study species, and each species responded differently to those vegetation variables. We could identify only 1 variable that clearly influenced nesting success of 1 species: clay-colored sparrow nesting success increased with increasing percentage of nest cover from the surrounding vegetation. Because responses of avian density and nesting success to vegetation measures varied among regions, years, and species, land managers at all times need to provide grasslands with different types of vegetation structure. Management guidelines developed from small-scale, short-term studies may lead to misrepresentations of the needs of grassland-nesting birds.

Drug-induced sedation endoscopy (DISE) classification systems: a systematic review and meta-analysis.

PubMed

Dijemeni, Esuabom; D'Amone, Gabriele; Gbati, Israel

2017-12-01

Drug-induced sedation endoscopy (DISE) classification systems have been used to assess anatomical findings on upper airway obstruction, and decide and plan surgical treatments and act as a predictor for surgical treatment outcome for obstructive sleep apnoea management. The first objective is to identify if there is a universally accepted DISE grading and classification system for analysing DISE findings. The second objective is to identify if there is one DISE grading and classification treatment planning framework for deciding appropriate surgical treatment for obstructive sleep apnoea (OSA). The third objective is to identify if there is one DISE grading and classification treatment outcome framework for determining the likelihood of success for a given OSA surgical intervention. A systematic review was performed to identify new and significantly modified DISE classification systems: concept, advantages and disadvantages. Fourteen studies proposing a new DISE classification system and three studies proposing a significantly modified DISE classification were identified. None of the studies were based on randomised control trials. DISE is an objective method for visualising upper airway obstruction. The classification and assessment of clinical findings based on DISE is highly subjective due to the increasing number of DISE classification systems. Hence, this creates a growing divergence in surgical treatment planning and treatment outcome. Further research on a universally accepted objective DISE assessment is critically needed.

Optical Correlation

NASA Technical Reports Server (NTRS)

Cotariu, Steven S.

1991-01-01

Pattern recognition may supplement or replace certain navigational aids on spacecraft in docking or landing activities. The need to correctly identify terrain features remains critical in preparation of autonomous planetary landing. One technique that may solve this problem is optical correlation. Correlation has been successfully demonstrated under ideal conditions; however, noise significantly affects the ability of the correlator to accurately identify input signals. Optical correlation in the presence of noise must be successfully demonstrated before this technology can be incorporated into system design. An optical correlator is designed and constructed using a modified 2f configuration. Liquid crystal televisions (LCTV) are used as the spatial light modulators (SLM) for both the input and filter devices. The filter LCTV is characterized and an operating curve is developed. Determination of this operating curve is critical for reduction of input noise. Correlation of live input with a programmable filter is demonstrated.

Towards a typology of business process management professionals: identifying patterns of competences through latent semantic analysis

NASA Astrophysics Data System (ADS)

Müller, Oliver; Schmiedel, Theresa; Gorbacheva, Elena; vom Brocke, Jan

2016-01-01

While researchers have analysed the organisational competences that are required for successful Business Process Management (BPM) initiatives, individual BPM competences have not yet been studied in detail. In this study, latent semantic analysis is used to examine a collection of 1507 BPM-related job advertisements in order to develop a typology of BPM professionals. This empirical analysis reveals distinct ideal types and profiles of BPM professionals on several levels of abstraction. A closer look at these ideal types and profiles confirms that BPM is a boundary-spanning field that requires interdisciplinary sets of competence that range from technical competences to business and systems competences. Based on the study's findings, it is posited that individual and organisational alignment with the identified ideal types and profiles is likely to result in high employability and organisational BPM success.

A Framework for Business Process Change Requirements Analysis

NASA Astrophysics Data System (ADS)

Grover, Varun; Otim, Samuel

The ability to quickly and continually adapt business processes to accommodate evolving requirements and opportunities is critical for success in competitive environments. Without appropriate linkage between redesign decisions and strategic inputs, identifying processes that need to be modified will be difficult. In this paper, we draw attention to the analysis of business process change requirements in support of process change initiatives. Business process redesign is a multifaceted phenomenon involving processes, organizational structure, management systems, human resource architecture, and many other aspects of organizational life. To be successful, the business process initiative should focus not only on identifying the processes to be redesigned, but also pay attention to various enablers of change. Above all, a framework is just a blueprint; management must lead change. We hope our modest contribution will draw attention to the broader framing of requirements for business process change.

Optical correlation

NASA Astrophysics Data System (ADS)

Cotariu, Steven S.

1991-12-01

Pattern recognition may supplement or replace certain navigational aids on spacecraft in docking or landing activities. The need to correctly identify terrain features remains critical in preparation of autonomous planetary landing. One technique that may solve this problem is optical correlation. Correlation has been successfully demonstrated under ideal conditions; however, noise significantly affects the ability of the correlator to accurately identify input signals. Optical correlation in the presence of noise must be successfully demonstrated before this technology can be incorporated into system design. An optical correlator is designed and constructed using a modified 2f configuration. Liquid crystal televisions (LCTV) are used as the spatial light modulators (SLM) for both the input and filter devices. The filter LCTV is characterized and an operating curve is developed. Determination of this operating curve is critical for reduction of input noise. Correlation of live input with a programmable filter is demonstrated.

Analysis of interactions among the barriers to JIT production: interpretive structural modelling approach

NASA Astrophysics Data System (ADS)

Jadhav, J. R.; Mantha, S. S.; Rane, S. B.

2015-09-01

`Survival of the fittest' is the reality in modern global competition. Organizations around the globe are adopting or willing to embrace just-in-time (JIT) production to reinforce the competitiveness. Even though JIT is the most powerful inventory management methodologies it is not free from barriers. Barriers derail the implementation of JIT production system. One of the most significant tasks of top management is to identify and understand the relationship between the barriers to JIT production for alleviating its bad effects. The aims of this paper are to study the barriers hampering the implementation of successful JIT production and analysing the interactions among the barriers using interpretive structural modelling technique. Twelve barriers have been identified after reviewing literature. This paper offers a roadmap for preparing an action plan to tackle the barriers in successful implementation of JIT production.

Fiber Optic Experience with the Smart Actuation System on the F-18 Systems Research Aircraft

NASA Technical Reports Server (NTRS)

Zavala, Eddie

1997-01-01

High bandwidth, immunity to electromagnetic interference, and potential weight savings have led to the development of fiber optic technology for future aerospace vehicle systems. This technology has been incorporated in a new smart actuator as the primary communication interface. The use of fiber optics simplified system integration and significantly reduced wire count. Flight test results showed that fiber optics could be used in aircraft systems and identified critical areas of development of fly-by-light technology. This paper documents the fiber optic experience gained as a result of this program, and identifies general design considerations that could be used in a variety of specific applications of fiber optic technology. Environmental sensitivities of fiber optic system components that significantly contribute to optical power variation are discussed. Although a calibration procedure successfully minimized the effect of fiber optic sensitivities, more standardized calibration methods are needed to ensure system operation and reliability in future aerospace vehicle systems.

An Expert System for Diagnosis of Broiler Diseases using Certainty Factor

NASA Astrophysics Data System (ADS)

Setyohadi, D. P. S.; Octavia, R. A.; Puspitasari, T. D.

2018-01-01

Broilers are defined as chickens of meat-type strains raised specifically for meat production. Based on data production from the Ministry of the Republic of Indonesia raised 3.76% from 2015 - 2016. But in reality the price of chicken is expensive, because the amount of market demand is more than the amount of production. Harvest failure due to chicken disease is one of the causes. Detecting diseases at early stage can enable to overcome and treat them appropriately. Identifying the treatment accurately depends on the method that is used in diagnosing the diseases. A Diagnosis expert system can help a great deal in identifying those diseases and describing methods of treatment to be carried out taking into account the user capability in order to deal and interact with expert system easily and clearly. This system has 25 symptoms and 6 diseases using certainty factor method to solve the problem of uncertainty. The result of the research is that Broiler Expert System has been successfully identifying diseases that can solve the problem with accuracy 90%.

Independent component analysis (ICA) and self-organizing map (SOM) approach to multidetection system for network intruders

NASA Astrophysics Data System (ADS)

Abdi, Abdi M.; Szu, Harold H.

2003-04-01

With the growing rate of interconnection among computer systems, network security is becoming a real challenge. Intrusion Detection System (IDS) is designed to protect the availability, confidentiality and integrity of critical network information systems. Today"s approach to network intrusion detection involves the use of rule-based expert systems to identify an indication of known attack or anomalies. However, these techniques are less successful in identifying today"s attacks. Hackers are perpetually inventing new and previously unanticipated techniques to compromise information infrastructure. This paper proposes a dynamic way of detecting network intruders on time serious data. The proposed approach consists of a two-step process. Firstly, obtaining an efficient multi-user detection method, employing the recently introduced complexity minimization approach as a generalization of a standard ICA. Secondly, we identified unsupervised learning neural network architecture based on Kohonen"s Self-Organizing Map for potential functional clustering. These two steps working together adaptively will provide a pseudo-real time novelty detection attribute to supplement the current intrusion detection statistical methodology.

Patient safety: lessons learned.

PubMed

Bagian, James P

2006-04-01

The traditional approach to patient safety in health care has ranged from reticence to outward denial of serious flaws. This undermines the otherwise remarkable advances in technology and information that have characterized the specialty of medical practice. In addition, lessons learned in industries outside health care, such as in aviation, provide opportunities for improvements that successfully reduce mishaps and errors while maintaining a standard of excellence. This is precisely the call in medicine prompted by the 1999 Institute of Medicine report "To Err Is Human: Building a Safer Health System." However, to effect these changes, key components of a successful safety system must include: (1) communication, (2) a shift from a posture of reliance on human infallibility (hence "shame and blame") to checklists that recognize the contribution of the system and account for human limitations, and (3) a cultivation of non-punitive open and/or de-identified/anonymous reporting of safety concerns, including close calls, in addition to adverse events.

Evaluation of a nurse leadership development programme.

PubMed

West, Margaret; Smithgall, Lisa; Rosler, Greta; Winn, Erin

2016-03-01

The challenge for nursing leaders responsible for workforce planning is to predict the knowledge, skills and abilities required to lead future healthcare delivery systems effectively. Succession planning requires a constant, competitive pool of qualified nursing leader candidates, and retention of those interested in career growth. Formal nursing leadership education in the United States is available through graduate education and professional nursing organisation programmes, such as the Emerging Nurse Leader Institute of the American Organization of Nurse Executives. However, there is also a need for local development programmes tailored to the needs of individual organisations. Leaders at Geisinger Health System, one of the largest rural health systems in the US, identified the need for an internal professional development scheme for nurses. In 2013 the Nurses Emerging as Leaders programme was developed to prepare nurse leaders for effective leadership and successful role transition. This article describes the programme and an evaluation of its effectiveness.

Electronic health records: critical success factors in implementation.

PubMed

Safdari, Reza; Ghazisaeidi, Marjan; Jebraeily, Mohamad

2015-04-01

EHR implementation results in the improved quality of care, customer-orientation and timely access to complete information. Despite the potential benefits of EHR, its implementation is a difficult and complex task whose success depends on many factors. The purpose of this research is indeed to identify the key success factors of EHR. This is a cross-sectional survey conducted with participation of 340 work forces from different types of job from Hospitals of TUMS in 2014. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics. 58.2% of respondents were female and their mean age and work experience were 37.7 and 11.2 years, respectively and most respondents (52.5%) was bachelor. In terms of job, the maximum rate was related to nursing (33 %) and physician (21 %). the main category of critical success factors in Implementation EHRs, the highest rate related to Project Management (4.62) and lowest related to Organizational factors (3.98). success in implementation EHRs requirement more centralization to project management and human factors. Therefore must be Creating to EHR roadmap implementation, establishment teamwork to participation of end-users and select prepare leadership, users obtains sufficient training to use of system and also prepare support from maintain and promotion system.

Risk factors for technical failure of endoscopic double self-expandable metallic stent placement by partial stent-in-stent method.

PubMed

Kawakubo, Kazumichi; Kawakami, Hiroshi; Toyokawa, Yoshihide; Otani, Koichi; Kuwatani, Masaki; Abe, Yoko; Kawahata, Shuhei; Kubo, Kimitoshi; Kubota, Yoshimasa; Sakamoto, Naoya

2015-01-01

Endoscopic double self-expandable metallic stent (SEMS) placement by the partial stent-in-stent (PSIS) method has been reported to be useful for the management of unresectable hilar malignant biliary obstruction. However, it is technically challenging, and the optimal SEMS for the procedure remains unknown. The aim of this study was to identify the risk factors for technical failure of endoscopic double SEMS placement for unresectable malignant hilar biliary obstruction (MHBO). Between December 2009 and May 2013, 50 consecutive patients with MHBO underwent endoscopic double SEMS placement by the PSIS method. We retrospectively evaluated the rate of successful double SEMS placement and identified the risk factors for technical failure. The technical success rate for double SEMS placement was 82.0% (95% confidence interval [CI]: 69.2-90.2). On univariate analysis, the rate of technical failure was high in patients with metastatic disease and unilateral placement. Multivariate analysis revealed that metastatic disease was a significant risk factor for technical failure (odds ratio: 9.63, 95% CI: 1.11-105.5). The subgroup analysis after double guidewire insertion showed that the rate of technical success was higher in the laser-cut type SEMS with a large mesh and thick delivery system than in the braided type SEMS with a small mesh and thick delivery system. Metastatic disease was a significant risk factor for technical failure of double SEMS placement for unresectable MHBO. The laser-cut type SEMS with a large mesh and thin delivery system might be preferable for the PSIS procedure. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Systems Genetics as a Tool to Identify Master Genetic Regulators in Complex Disease.

PubMed

Moreno-Moral, Aida; Pesce, Francesco; Behmoaras, Jacques; Petretto, Enrico

2017-01-01

Systems genetics stems from systems biology and similarly employs integrative modeling approaches to describe the perturbations and phenotypic effects observed in a complex system. However, in the case of systems genetics the main source of perturbation is naturally occurring genetic variation, which can be analyzed at the systems-level to explain the observed variation in phenotypic traits. In contrast with conventional single-variant association approaches, the success of systems genetics has been in the identification of gene networks and molecular pathways that underlie complex disease. In addition, systems genetics has proven useful in the discovery of master trans-acting genetic regulators of functional networks and pathways, which in many cases revealed unexpected gene targets for disease. Here we detail the central components of a fully integrated systems genetics approach to complex disease, starting from assessment of genetic and gene expression variation, linking DNA sequence variation to mRNA (expression QTL mapping), gene regulatory network analysis and mapping the genetic control of regulatory networks. By summarizing a few illustrative (and successful) examples, we highlight how different data-modeling strategies can be effectively integrated in a systems genetics study.

Performance analysis of robust road sign identification

NASA Astrophysics Data System (ADS)

Ali, Nursabillilah M.; Mustafah, Y. M.; Rashid, N. K. A. M.

2013-12-01

This study describes performance analysis of a robust system for road sign identification that incorporated two stages of different algorithms. The proposed algorithms consist of HSV color filtering and PCA techniques respectively in detection and recognition stages. The proposed algorithms are able to detect the three standard types of colored images namely Red, Yellow and Blue. The hypothesis of the study is that road sign images can be used to detect and identify signs that are involved with the existence of occlusions and rotational changes. PCA is known as feature extraction technique that reduces dimensional size. The sign image can be easily recognized and identified by the PCA method as is has been used in many application areas. Based on the experimental result, it shows that the HSV is robust in road sign detection with minimum of 88% and 77% successful rate for non-partial and partial occlusions images. For successful recognition rates using PCA can be achieved in the range of 94-98%. The occurrences of all classes are recognized successfully is between 5% and 10% level of occlusions.

Performance of the Landsat-Data Collection System in a Total System Context

NASA Technical Reports Server (NTRS)

Paulson, R. W. (Principal Investigator); Merk, C. F.

1975-01-01

The author has identified the following significant results. This experiment was, and continues to be, an integration of the LANDSAT-DCS with the data collection and processing system of the Geological Survey. Although an experimental demonstration, it was a successful integration of a satellite relay system that is capable of continental data collection, and an existing governmental nationwide operational data processing and distributing networks. The Survey's data processing system uses a large general purpose computer with insufficient redundancy for 24-hour a day, 7 day a week operation. This is significant, but soluble obstacle to converting the experimental integration of the system to an operational integration.

Reliability/safety analysis of a fly-by-wire system

NASA Technical Reports Server (NTRS)

Brock, L. D.; Goddman, H. A.

1980-01-01

An analysis technique has been developed to estimate the reliability of a very complex, safety-critical system by constructing a diagram of the reliability equations for the total system. This diagram has many of the characteristics of a fault-tree or success-path diagram, but is much easier to construct for complex redundant systems. The diagram provides insight into system failure characteristics and identifies the most likely failure modes. A computer program aids in the construction of the diagram and the computation of reliability. Analysis of the NASA F-8 Digital Fly-by-Wire Flight Control System is used to illustrate the technique.

Implementing an Internet-based communication network for use during skilled nursing facility to emergency department care transitions: challenges and opportunities for improvement.

PubMed

Hustey, Fredric M; Palmer, Robert M

2012-03-01

To explore the feasibility of implementing an Internet-based communication network for communication of health care information during skilled nursing facility (SNF)-to-ED care transitions, and to identify potential barriers to system implementation. Qualitative. The largest SNF affiliated with the ED of an urban tertiary care center. Consecutive sample of all patients transferred from SNF to ED over 8 months between June 2007 and January 2008; ED and SNF care providers. The development and implementation of an Internet-based communication network for use during SNF-to-ED care transitions. This network was developed by adapting a preexisting Internet-based system that is widely used to facilitate placement of hospitalized patients into SNFs. Internet-based SNF and ED surveys were used to help identify barriers to implementation. There were 276/276 care transitions reviewed. The Internet-based communication network was used in 76 (28%) care transitions, with usage peaking at 40% near the end of the study. Barriers to success that were identified included lack of an electronic medical record (EMR) at the SNF; pervasive negative attitudes between ED and SNF personnel; time necessary for network use during care transitions; frustration by emergency physicians at low system usage rates by SNF personnel; and additional login requirements by ED personnel. Although implementing an Internet-based network for nursing home to ED communication may be feasible, significant barriers were identified in this study that are likely generalizable to other health care settings. Understanding such barriers is an essential first step toward building successful electronic communication networks in the future. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

A Review on Critical Success Factors of Governance towards Sustainable Campus Operations

NASA Astrophysics Data System (ADS)

Halid Abdullah, Abd; Razman, Ruzaimah; Muslim, Rahmat

2017-08-01

Campus Sustainability is an effort that integrates environmentally sustainable practices into institutional practices. A successful transition to a sustainable campus requires the involvement of the university community; the administration, academics departments (faculty and students), researchers and he local community. Our research seeks to identify Critical Success Factors (CSFs) of university governance that contribute to the success in implementing Sustainable Campus Operation (SCO) initiatives. The common CSFs have been identified from 22 published and unpublished articles, conference proceedings, university reports, books, and website documents. The CSFs are mapped and ranked based on the frequency of the identified CSFs. 23 CSFs of SCO have been identified through this research. This research revealed that the CSF that contributes the highest frequency as indicated by most researchers is “developing network with external parties for gaining consensus and commitment”. By identifying these CSFs, this research will help assist universities in successfully plan and implement their SCO initiatives.

[Development of a Surgical Navigation System with Beam Split and Fusion of the Visible and Near-Infrared Fluorescence].

PubMed

Yang, Xiaofeng; Wu, Wei; Wang, Guoan

2015-04-01

This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI. 2011 1 0292374. 1.

Special Anniversary Review: Twenty-five years of human immunodeficiency virus research: successes and challenges

PubMed Central

Weiss, R A

2008-01-01

During 25 years of research since HIV-1 was first identified in Paris, there have been great advances in our understanding of the virus and of the immune system. Practical advances include the early development of diagnostic tests of infection that made blood donation safe, and since 1996, combination anti-retroviral therapy that has great reduced incidence of AIDS in HIV-infected people who have access to the drugs. HIV prevention through behavioural change has been successful, and we do not yet have any safe and efficacious microbicides or vaccines. PMID:18373700

Successful treatment of HIV-1 infection increases the expression of a novel, short transcript for IL-18 receptor α chain.

PubMed

Nasi, Milena; Alboni, Silvia; Pinti, Marcello; Tascedda, Fabio; Benatti, Cristina; Benatti, Stefania; Gibellini, Lara; De Biasi, Sara; Borghi, Vanni; Brunello, Nicoletta; Mussini, Cristina; Cossarizza, Andrea

2014-11-01

: The importance of interleukin (IL)-18 in mediating immune activation during HIV infection has recently emerged. IL-18 activity is regulated by its receptor (IL-18R), formed by an α and a β chain, the IL-18-binding protein, and the newly identified shorter isoforms of both IL-18R chains. We evaluated gene expression of the IL-18/IL-18R system in peripheral blood mononuclear cells from HIV+ patients. Compared with healthy donors, IL-18 expression decreased in patients with primary infection. The IL-18Rα short transcript expression was strongly upregulated by successful highly active antiretroviral therapy. HIV progression and its treatment can influence the expression of different components of the complex IL-18/IL-18R system.

Web-Based Self-Service Systems for Managed IT Support: Service Provider Perspectives of Stakeholder-Based Issues

NASA Astrophysics Data System (ADS)

Cooper, Vanessa A.; Lichtenstein, Sharman; Smith, Ross

This chapter explores the provision of after-sales information technology (IT) support services using Web-based self-service systems (WSSs) in a business-to-business (B2B) context. A recent study conducted at six large multi-national IT support organisations revealed a number of critical success factors (CSFs) and stakeholder-based issues. To better identify and understand these important enablers and barriers, we explain how WSSs should be considered within a complex network of service providers, business partners and customer firms. The CSFs and stakeholder-based issues are discussed. The chapter highlights that for more successful service provision using WSSs, IT service providers should collaborate more effectively with enterprise customers and business partners and should better integrate their WSSs.

Using Social Media Data to Identify Potential Candidates for Drug Repurposing: A Feasibility Study.

PubMed

Rastegar-Mojarad, Majid; Liu, Hongfang; Nambisan, Priya

2016-06-16

Drug repurposing (defined as discovering new indications for existing drugs) could play a significant role in drug development, especially considering the declining success rates of developing novel drugs. Typically, new indications for existing medications are identified by accident. However, new technologies and a large number of available resources enable the development of systematic approaches to identify and validate drug-repurposing candidates. Patients today report their experiences with medications on social media and reveal side effects as well as beneficial effects of those medications. Our aim was to assess the feasibility of using patient reviews from social media to identify potential candidates for drug repurposing. We retrieved patient reviews of 180 medications from an online forum, WebMD. Using dictionary-based and machine learning approaches, we identified disease names in the reviews. Several publicly available resources were used to exclude comments containing known indications and adverse drug effects. After manually reviewing some of the remaining comments, we implemented a rule-based system to identify beneficial effects. The dictionary-based system and machine learning system identified 2178 and 6171 disease names respectively in 64,616 patient comments. We provided a list of 10 common patterns that patients used to report any beneficial effects or uses of medication. After manually reviewing the comments tagged by our rule-based system, we identified five potential drug repurposing candidates. To our knowledge, this is the first study to consider using social media data to identify drug-repurposing candidates. We found that even a rule-based system, with a limited number of rules, could identify beneficial effect mentions in patient comments. Our preliminary study shows that social media has the potential to be used in drug repurposing.

Neural Network Classifies Teleoperation Data

NASA Technical Reports Server (NTRS)

Fiorini, Paolo; Giancaspro, Antonio; Losito, Sergio; Pasquariello, Guido

1994-01-01

Prototype artificial neural network, implemented in software, identifies phases of telemanipulator tasks in real time by analyzing feedback signals from force sensors on manipulator hand. Prototype is early, subsystem-level product of continuing effort to develop automated system that assists in training and supervising human control operator: provides symbolic feedback (e.g., warnings of impending collisions or evaluations of performance) to operator in real time during successive executions of same task. Also simplifies transition between teleoperation and autonomous modes of telerobotic system.

The Application of Software Safety to the Constellation Program Launch Control System

NASA Technical Reports Server (NTRS)

Kania, James; Hill, Janice

2011-01-01

The application of software safety practices on the LCS project resulted in the successful implementation of the NASA Software Safety Standard NASA-STD-8719.138 and CxP software safety requirements. The GOP-GEN-GSW-011 Hazard Report was the first report developed at KSC to identify software hazard causes and their controls. This approach can be applied to similar large software - intensive systems where loss of control can lead to a hazard.

The immune system

PubMed Central

2016-01-01

All organisms are connected in a complex web of relationships. Although many of these are benign, not all are, and everything alive devotes significant resources to identifying and neutralizing threats from other species. From bacteria through to primates, the presence of some kind of effective immune system has gone hand in hand with evolutionary success. This article focuses on mammalian immunity, the challenges that it faces, the mechanisms by which these are addressed, and the consequences that arise when it malfunctions. PMID:27784777

Organizational change for services integration in public human service organizations: experiences in seven counties.

PubMed

Packard, Thomas; Patti, Rino; Daly, Donna; Tucker-Tatlow, Jennifer

2012-01-01

This is a study of organizational change strategies employed in seven county human service agencies to improve the coordination of services through the structural integration of previously free standing organizations or the development of voluntary interagency collaborative service delivery systems. The central question involves the identification of organizational change tactics which contributed to the success of the organizational change initiatives. The literature on organizational change is reviewed, with particular attention to a framework developed by Fernandez and Rainey based on their extensive review and synthesis of the research on successful change strategies in the public and business sectors. Qualitative and quantitative data were gathered from over 250 individuals and from agency documents. Findings are compared with the success factors identified by Fernandez and Rainey, and refinements to their propositions are suggested. More precise methods for measuring successful and unsuccessful change initiatives are suggested. Implications for practice and research are presented.

An exploratory review on critical factors of IBS formwork implementation for Malaysian construction stakeholders

NASA Astrophysics Data System (ADS)

Baharuddin, Mohd Nurfaisal; Bahardin, Nur Fadhilah; Zaidi, Mohd Azian; Lokman, Ikhwan; Nawi, Mohd Nasrun Mohd

2016-08-01

The goals of this paper is to analysed the critical factors of driving or hindering the used of Industrialised Building System (IBS) formwork system in the Malaysian construction industry. Based on the reviews of a previous research and related literature, this paper was identified four (4) critical factor that classified as a difficulties to the success of IBS formwork system application; The issues related to the lack of knowledge and awareness, high cost and financial barriers, lack of incentive and promotion and lack of enforcement for government policy were highlight as a key dimension for the uses of IBS formwork system to success. The objective of this paper is to determine the importance factors in implementing IBS formwork in Malaysia. A preliminary survey which qualitative research approach has been adopted for this study as to validate the factors which found in the literature study. Based on the result analysis, it can be confirmed that the entire factors in literature review are strongly related with challenges in construction industry.

The changing paradigm in surgery is system integration: How do we respond?

PubMed

Zenilman, Michael E; Freischlag, Julie-Ann

2017-12-08

With expansion of health care systems across the country, close relationships need to be developed between academic medical centers and their affiliated community hospitals. This creates opportunity to integrate surgical programs across different hospitals. Herein we describe a model of surgical integration at the system level of five large hospitals. We discuss utilizing advantages that both the academic and community hospital bring to the model. A close relationship between an interdisciplinary team, which includes the academic surgical chair, a regional director liaison who was embedded in the community, individual hospital leadership, and practice plan leaders was created. Three pillars as a foundation to success were physician leadership, the use of system infrastructure and development of new processes. This resulted in development of trust, leading to successful recruitments, models of employment and expansion into novel areas of patient safety. Once created, new opportunities for programming for surgical safety across the health care were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Diesel Fueled SOFC for Class 7/Class 8 On-Highway Truck Auxiliary Power

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

Vesely, Charles John-Paul; Fuchs, Benjamin S.; Booten, Chuck W.

2010-03-31

The following report documents the progress of the Cummins Power Generation (CPG) Diesel Fueled SOFC for Class 7/Class 8 On-Highway Truck Auxiliary Power (SOFC APU) development and final testing under the U.S. Department of Energy (DOE) Energy Efficiency and Renewable Energy (EERE) contract DE-FC36-04GO14318. This report overviews and summarizes CPG and partner development leading to successful demonstration of the SOFC APU objectives and significant progress towards SOFC commercialization. Significant SOFC APU Milestones: Demonstrated: Operation meeting SOFC APU requirements on commercial Ultra Low Sulfur Diesel (ULSD) fuel. SOFC systems operating on dry CPOX reformate. Successful start-up and shut-down of SOFC APUmore » system without inert gas purge. Developed: Low cost balance of plant concepts and compatible systems designs. Identified low cost, high volume components for balance of plant systems. Demonstrated efficient SOFC output power conditioning. Demonstrated SOFC control strategies and tuning methods.« less

Establishing treatment protocols for clinical mastitis.

PubMed

Roberson, Jerry R

2003-03-01

Each farm has a unique mix of mastitis pathogens and management procedures that have evolved over time. The herd veterinarian should work with the manager/owner to systematically develop treatment protocols that meet the needs and management of the farm. To establish a mastitis treatment protocol, it is necessary to develop a system to routinely identify clinical mastitis cases, develop a herd-specific severity level assessment system, manage the clinical mastitis cases based on severity level and culture result (when available), avoid antibiotic residues, and monitor the success of the system and alter the protocol as necessary.

Philanthropy in health professions education research: determinants of success.

PubMed

Paul, Robert; Hollenberg, Elisa; Hodges, Brian D

2017-05-01

Fund-raising is a new practice in medical education research. This qualitative study explores a cross-sectional analysis of philanthropy in medical education in Canada and Europe and identifies some common characteristics in the fund-raising system, key roles and characteristics of research sites that have had success. Medical education research sites that had received donations greater than Can$100 000 were identified by searching publicly available sources. Interviews were conducted with 25 individuals from these and other sites, in four categories: medical education leaders (n = 9); philanthropy-supported chairholders and researchers (n = 5); donors of over Can$100 000 (n = 7), and advancement professionals (n = 4). Interview transcripts were inductively coded to identify themes. Five factors associated with success in accessing philanthropic sources were identified in the sample: support of the organisation's senior leadership; a charismatic champion who motivates donors; access to an advancement office or foundation; impetus to find funds beyond traditional operating budgets, and understanding of the conceptual and practical dimensions of fund-raising. Three types of donor (medical education insider, donor collective and general philanthropist), four faculty roles (trailblazers, rock stars, 'Who? Me?' people and future fund-raisers) and six stages in the fund-raising cycle were also identified. Philanthropy is a source of funding with the potential to significantly advance education research. Yet competence in fund-raising is not widely developed among medical education research leaders. Successful accessing of philanthropic sources of funding requires the ability to articulate the impact of philanthropy in medical education research in a way that will interest donors. This appears to be challenging for medical education leaders, who tend to frame their work in academic terms and have trouble competing against other fund-raising domains. Medical education research institutes and centres will benefit from developing greater understanding of the conception and practices of fund-raising. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Investigation of metabolic objectives in cultured hepatocytes.

PubMed

Uygun, Korkut; Matthew, Howard W T; Huang, Yinlun

2007-06-15

Using optimization based methods to predict fluxes in metabolic flux balance models has been a successful approach for some microorganisms, enabling construction of in silico models and even inference of some regulatory motifs. However, this success has not been translated to mammalian cells. The lack of knowledge about metabolic objectives in mammalian cells is a major obstacle that prevents utilization of various metabolic engineering tools and methods for tissue engineering and biomedical purposes. In this work, we investigate and identify possible metabolic objectives for hepatocytes cultured in vitro. To achieve this goal, we present a special data-mining procedure for identifying metabolic objective functions in mammalian cells. This multi-level optimization based algorithm enables identifying the major fluxes in the metabolic objective from MFA data in the absence of information about critical active constraints of the system. Further, once the objective is determined, active flux constraints can also be identified and analyzed. This information can be potentially used in a predictive manner to improve cell culture results or clinical metabolic outcomes. As a result of the application of this method, it was found that in vitro cultured hepatocytes maximize oxygen uptake, coupling of urea and TCA cycles, and synthesis of serine and urea. Selection of these fluxes as the metabolic objective enables accurate prediction of the flux distribution in the system given a limited amount of flux data; thus presenting a workable in silico model for cultured hepatocytes. It is observed that an overall homeostasis picture is also emergent in the findings.

Development of X-TOOLSS: Preliminary Design of Space Systems Using Evolutionary Computation

NASA Technical Reports Server (NTRS)

Schnell, Andrew R.; Hull, Patrick V.; Turner, Mike L.; Dozier, Gerry; Alverson, Lauren; Garrett, Aaron; Reneau, Jarred

2008-01-01

Evolutionary computational (EC) techniques such as genetic algorithms (GA) have been identified as promising methods to explore the design space of mechanical and electrical systems at the earliest stages of design. In this paper the authors summarize their research in the use of evolutionary computation to develop preliminary designs for various space systems. An evolutionary computational solver developed over the course of the research, X-TOOLSS (Exploration Toolset for the Optimization of Launch and Space Systems) is discussed. With the success of early, low-fidelity example problems, an outline of work involving more computationally complex models is discussed.

A fiber-optic ice detection system for large-scale wind turbine blades

NASA Astrophysics Data System (ADS)

Kim, Dae-gil; Sampath, Umesh; Kim, Hyunjin; Song, Minho

2017-09-01

Icing causes substantial problems in the integrity of large-scale wind turbines. In this work, a fiber-optic sensor system for detection of icing with an arrayed waveguide grating is presented. The sensor system detects Fresnel reflections from the ends of the fibers. The transition in Fresnel reflection due to icing gives peculiar intensity variations, which categorizes the ice, the water, and the air medium on the wind turbine blades. From the experimental results, with the proposed sensor system, the formation of icing conditions and thickness of ice were identified successfully in real time.

Early Flight Fission Test Facilities (EFF-TF) and Concepts That Support Near-Term Space Fission Missions

NASA Technical Reports Server (NTRS)

VanDyke, Melissa; Houts, Mike; Godfroy, Thomas; Martin, James

2003-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. If fusion propulsion systems are to be developed to their full potential; however, near-term customers must be identified and initial fission systems successfully developed, launched, and utilized. Successful utilization will most likely occur if frequent, significant hardware-based milestones can be achieved throughout the program. If the system is designed to operate within established radiation damage and fuel burn up limits while simultaneously being designed to allow close simulation of heat from fission using resistance heaters, high confidence in fission system pe$ormance and lifetime can be attained through non-nuclear testing. Through demonstration of systems concepts (designed by DOE National Laboratories) in relevant environments, this philosophy has been demonstrated through hardware testing in the Early Flight Fission Test Facilities (EFF-TF) at the Marshall Space Flight Center. The EFF-TF is designed to enable very realistic non-nuclear testing of space fission systems. Ongoing research at the EFF-TF is geared towards facilitating research, development, system integration, and system utilization via cooperative efforts with DOE labs, industry, universities, and other NASA centers.

On-chip wavelength multiplexed detection of cancer DNA biomarkers in blood

PubMed Central

Cai, H.; Stott, M. A.; Ozcelik, D.; Parks, J. W.; Hawkins, A. R.; Schmidt, H.

2016-01-01

We have developed an optofluidic analysis system that processes biomolecular samples starting from whole blood and then analyzes and identifies multiple targets on a silicon-based molecular detection platform. We demonstrate blood filtration, sample extraction, target enrichment, and fluorescent labeling using programmable microfluidic circuits. We detect and identify multiple targets using a spectral multiplexing technique based on wavelength-dependent multi-spot excitation on an antiresonant reflecting optical waveguide chip. Specifically, we extract two types of melanoma biomarkers, mutated cell-free nucleic acids —BRAFV600E and NRAS, from whole blood. We detect and identify these two targets simultaneously using the spectral multiplexing approach with up to a 96% success rate. These results point the way toward a full front-to-back chip-based optofluidic compact system for high-performance analysis of complex biological samples. PMID:28058082

SU-E-T-218: The IHE-RO Helper Tool: Demonstrating the Connectivity Issues Solved by IHE-RO.

PubMed

Kapoor, Rishabh; Yeung, Daniel; Kumar, Sabari Ajay; Alex, Daley; Kapur, Priyanka; Palta, Jatinder

2012-06-01

To develop a Web-based application (IHE-RO Helper) to allow comprehensive review of the interconnectivity and interoperability of various radiotherapy devices established through testing sanctioned by the Integrating Healthcare Enterprise-Radiation Oncology (IHE-RO). IHE-RO is an initiative sponsored by ASTRO to improve the way computer based systems in radiation oncology share information using well-defined data exchange standards (DICOM / HL7). At the IHE-RO Connectathon events over the last 4 years, 11 vendors with 14 different products have successfully tested and identified solutions to connectivity problems in treatment planning, simulation and delivery. Because the test results are highly technical, the interconnectivity issues amongst the RT devices may get overlooked by the end users. The IHE-RO helper tool is designed to operate in simple clinical terms with queries and presentations organized based on treatment techniques and clinical features that are familiar to the practitioners. For example, if you are planning to purchase a treatment planning system capable of generating plans (e.g. Stereotactic treatments) and are concerned whether the TPS can successfully transfer such data to your treatment management system (TMS) and subsequently to your treatment delivery system (TDS), the IHE-RO Helper can identify the connectivity requirements and list vendors that have successfully passed an IHE-RO Connectathon and validated their solution to the specific requirements. The IHE-RO helper tool provides a graphical and textual user interface to effectively demonstrate the solved interconnectivity problems between TPS, TMS and TDS. A report is also provided that explains the interconnectivity problems and its solutions. The IHE-RO helper is an effective tool to clearly identify vendor products that are IHE-RO compliant, thereby encourages vendor participation in testing and validation. Such a tool will be invaluable in procurement of new equipment to ensure a priori interoperability with anticipated RT devices deployed in the clinic. This research and development project is supported by the Bankhead-Coley Cancer Research Program grant # RC1-09BW-09-26833. © 2012 American Association of Physicists in Medicine.

Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

NASA Astrophysics Data System (ADS)

Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

2016-03-01

Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

Integrating human health and environmental health into the DPSIR framework: a tool to identify research opportunities for sustainable and healthy communities.

PubMed

Yee, Susan H; Bradley, Patricia; Fisher, William S; Perreault, Sally D; Quackenboss, James; Johnson, Eric D; Bousquin, Justin; Murphy, Patricia A

2012-12-01

The U.S. Environmental Protection Agency has recently realigned its research enterprise around the concept of sustainability. Scientists from across multiple disciplines have a role to play in contributing the information, methods, and tools needed to more fully understand the long-term impacts of decisions on the social and economic sustainability of communities. Success will depend on a shift in thinking to integrate, organize, and prioritize research within a systems context. We used the Driving forces-Pressures-State-Impact-Response (DPSIR) framework as a basis for integrating social, cultural, and economic aspects of environmental and human health into a single framework. To make the framework broadly applicable to sustainability research planning, we provide a hierarchical system of DPSIR keywords and guidelines for use as a communication tool. The applicability of the integrated framework was first tested on a public health issue (asthma disparities) for purposes of discussion. We then applied the framework at a science planning meeting to identify opportunities for sustainable and healthy communities research. We conclude that an integrated systems framework has many potential roles in science planning, including identifying key issues, visualizing interactions within the system, identifying research gaps, organizing information, developing computational models, and identifying indicators.

Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success

PubMed Central

Rangachari, Pavani

2018-01-01

In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as “innovation implementation failure” in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on “innovation implementation” in hospitals and health systems over the last decade, since the spotlight was cast on “innovation implementation failure” in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the “what”), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the “how”). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health care innovations. This paper summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues. PMID:29546884

Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success.

PubMed

Rangachari, Pavani

2018-01-01

In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as "innovation implementation failure" in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the "what"), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the "how"). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health care innovations. This paper summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues.

A DNA Mini-Barcoding System for Authentication of Processed Fish Products.

PubMed

Shokralla, Shadi; Hellberg, Rosalee S; Handy, Sara M; King, Ian; Hajibabaei, Mehrdad

2015-10-30

Species substitution is a form of seafood fraud for the purpose of economic gain. DNA barcoding utilizes species-specific DNA sequence information for specimen identification. Previous work has established the usability of short DNA sequences-mini-barcodes-for identification of specimens harboring degraded DNA. This study aims at establishing a DNA mini-barcoding system for all fish species commonly used in processed fish products in North America. Six mini-barcode primer pairs targeting short (127-314 bp) fragments of the cytochrome c oxidase I (CO1) DNA barcode region were developed by examining over 8,000 DNA barcodes from species in the U.S. Food and Drug Administration (FDA) Seafood List. The mini-barcode primer pairs were then tested against 44 processed fish products representing a range of species and product types. Of the 44 products, 41 (93.2%) could be identified at the species or genus level. The greatest mini-barcoding success rate found with an individual primer pair was 88.6% compared to 20.5% success rate achieved by the full-length DNA barcode primers. Overall, this study presents a mini-barcoding system that can be used to identify a wide range of fish species in commercial products and may be utilized in high throughput DNA sequencing for authentication of heavily processed fish products.

Manager Perspectives on Communication and Public ...

EPA Pesticide Factsheets

We argue that public engagement is crucial to achieving lasting ecological success in aquatic restoration efforts, and that the most effective public engagement mechanisms are what we term iterative mechanisms. Here we look to a particular social-ecological system – the restoration community in Rhode Island, U.S.A. and the rivers, wetlands, marshes, and estuaries, and their related species, that they work to protect – to better understand land managers’ perspectives on public engagement in restoration processes. Adopting an inductive approach to critical discourse analysis of interviews with 27 local, state, and federal restoration managers and the forms of public interaction they described, we identify three distinct models of public engagement in natural resources management employed by managers: unidirectional; bidirectional; and iterative. While unidirectional and bidirectional mechanisms can help managers achieve short-term ecological successes, we suggest that adopting an iterative approach can improve the quality of stakeholder and learning interactions and, subsequently, foster lasting ecological successes. We argue that managers can design deliberately for public engagement mechanisms that are best suited to projects in particular social-ecological systems in order to create restoration projects that achieve ecological, learning, and stakeholder successes. We attempt to synthesize the lessons learned from efforts at public engagement in restoratio

Achieving excellence in veterans healthcare--a balanced scorecard approach.

PubMed

Biro, Lawrence A; Moreland, Michael E; Cowgill, David E

2003-01-01

This article provides healthcare administrators and managers with a framework and model for developing a balanced scorecard and demonstrates the remarkable success of this process, which brings focus to leadership decisions about the allocation of resources. This scorecard was developed as a top management tool designed to structure multiple priorities of a large, complex, integrated healthcare system and to establish benchmarks to measure success in achieving targets for performance in identified areas. Significant benefits and positive results were derived from the implementation of the balanced scorecard, based upon benchmarks considered to be critical success factors. The network's chief executive officer and top leadership team set and articulated the network's primary operating principles: quality and efficiency in the provision of comprehensive healthcare and support services. Under the weighted benchmarks of the balanced scorecard, the facilities in the network were mandated to adhere to one non-negotiable tenet: providing care that is second to none. The balanced scorecard approach to leadership continuously ensures that this is the primary goal and focal point for all activity within the network. To that end, systems are always in place to ensure that the network is fully successful on all performance measures relating to quality.

Optimizing Decision Support for Tailored Health Behavior Change Applications.

PubMed

Kukafka, Rita; Jeong, In cheol; Finkelstein, Joseph

2015-01-01

The Tailored Lifestyle Change Decision Aid (TLC DA) system was designed to provide support for a person to make an informed choice about which behavior change to work on when multiple unhealthy behaviors are present. TLC DA can be delivered via web, smartphones and tablets. The system collects a significant amount of information that is used to generate tailored messages to consumers to persuade them in certain healthy lifestyles. One limitation is the necessity to collect vast amounts of information from users who manually enter. By identifying an optimal set of self-reported parameters we will be able to minimize the data entry burden of the app users. The study was to identify primary determinants of health behavior choices made by patients after using the system. Using discriminant analysis an optimal set of predictors was identified. The resulting set included smoking status, smoking cessation success estimate, self-efficacy, body mass index and diet status. Predicting smoking cessation choice was the most accurate, followed by weight management. Physical activity and diet choices were better identified in a combined cluster.

Failure-free survival after second-line systemic treatment of chronic graft-versus-host disease

PubMed Central

Storer, Barry E.; Lee, Stephanie J.; Carpenter, Paul A.; Sandmaier, Brenda M.; Flowers, Mary E. D.; Martin, Paul J.

2013-01-01

This study attempted to characterize causes of treatment failure, identify associated prognostic factors, and develop shorter-term end points for trials testing investigational products or regimens for second-line systemic treatment of chronic graft-versus-host disease (GVHD). The study cohort (312 patients) received second-line systemic treatment of chronic GVHD. The primary end point was failure-free survival (FFS) defined by the absence of third-line treatment, nonrelapse mortality, and recurrent malignancy during second-line treatment. Treatment change was the major cause of treatment failure. FFS was 56% at 6 months after second-line treatment. Lower steroid doses at 6 months correlated with subsequent withdrawal of immunosuppressive treatment. Multivariate analysis showed that high-risk disease at transplantation, lower gastrointestinal involvement at second-line treatment, and severe NIH global score at second-line treatment were associated with increased risks of treatment failure. These three factors were used to define risk groups, and success rates at 6 months were calculated for each risk group either without or with various steroid dose limits at 6 months as an additional criterion of success. These success rates could be used as the basis for a clinically relevant and efficient shorter-term end point in clinical studies that evaluate agents for second-line systemic treatment of chronic GVHD. PMID:23321253

Design and Validation of a Web-Based System for Assigning Members to Teams Using Instructor-Specified Criteria

ERIC Educational Resources Information Center

Layton, Richard A.; Loughry, Misty L.; Ohland, Matthew W.; Ricco, George D.

2010-01-01

A significant body of research identifies a large number of team composition characteristics that affect the success of individuals and teams in cooperative learning and project-based team environments. Controlling these factors when assigning students to teams should result in improved learning experiences. However, it is very difficult for…

Education Business Plan 2010-13. Budget 2010: Striking the Right Balance

ERIC Educational Resources Information Center

Alberta Education, 2010

2010-01-01

The ministry has identified one core business that is an ongoing key responsibility. It is called "Core Business One: Lead and Support the Education System So That All Students Are Successful at Learning." The core business includes four goals with specific outcomes that describe the end results the ministry wants to achieve in…

On-Entry Assessment of School Competencies and Academic Achievement: A Comparison between Slovenia and Germany

ERIC Educational Resources Information Center

Vidmar, Maša; Niklas, Frank; Schneider, Wolfgang; Hasselhorn, Marcus

2017-01-01

The foundation of school success is laid early in children's lives. Consequently, assessments of academic precursors may help to identify children in need of additional support. Such early assessments could also be interesting from an international perspective when educational systems are compared. This analysis is used to inform on the…

Toward Addressing the Issues of Site Selection in District Effectiveness Research: A Two-Level Hierarchical Linear Growth Model

ERIC Educational Resources Information Center

Bowers, Alex J.

2010-01-01

Purpose: District effectiveness research (DER) is an emerging field concerned with identifying the organizational structures, administration, and leadership practices at the school district level that help districts find success with all of their students across the schools within the system. This work has mirrored much of the early school…

Managing the Organizational Vision, Mission, and Planning: Five Steps toward a Successful Leadership Strategy

ERIC Educational Resources Information Center

Ricci, Frederick A.

2011-01-01

The vision of academic and business leaders often sets a pattern for all activities to follow. Organizational objectives, tasks, performance, and uses of resources are needed to obtain and reach current and future society trends influencing organizational goals. This paper identifies 5 steps leaders need to create a systems approach toward…

Shining a Light on Alport Syndrome.

PubMed

Hale, Lorna J; Little, Melissa H

2018-05-17

In this issue of Cell Chemical Biology, Omachi et al. (2018) present a split Nanoluciferase system to identify successful protein trimerization in Alport syndrome. This elegant proof of concept suggests opportunities for drug screening for Alport syndrome and may be transferable to the study of other diseases affecting protein-protein interactions. Copyright © 2018 Elsevier Ltd. All rights reserved.

urCF: An Approach to Integrating User Reviews into Memory-Based Collaborative Filtering

ERIC Educational Resources Information Center

Zhang, Zhenxue

2013-01-01

Blessed by the Internet age, many online retailers (e.g., Amazon.com) have deployed recommender systems to help their customers identify products that may be of their interest in order to improve cross-selling and enhance customer loyalty. Collaborative Filtering (CF) is the most successful technique among different approaches to generating…

Teaching as a Career Choice: Attractors and Deterrents Identified by Grade 11 Learners

ERIC Educational Resources Information Center

Park, Thomas

2006-01-01

Any strategic plan to address the predicted shortage of teachers will have to include the promotion of the teaching profession as an attractive career. This will, however, depend largely on how successfully the campaign takes into account the favourable and less favourable opinions and perceptions of learners about the education system as a whole…

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2013-03-01

l) Intravital Microscopy was successfully employed for investigating EG sheddÍng in hemorrhagic shock/resuscitation for the very first time; 2... Intravital microscopy integrated with systemic hemodynamics evaluations may be essential and more accurate tools to identify changes and study mechanisms...Glycocalyx during Hemorrhagic Shock in Rats using Intravital Microscopy. Submitted to Microvascular Research, 2012 (under review). FINAL REPORT Laboratory

Better than Expected: Using Learning Analytics to Promote Student Success in Gateway Science

ERIC Educational Resources Information Center

Wright, Mary C.; McKay, Timothy; Hershock, Chad; Miller, Kate; Tritz, Jared

2014-01-01

Learning Analytics (LA) has been identified as one of the top technology trends in higher education today (Johnson et al., 2013). LA is based on the idea that datasets generated through normal administrative, teaching, or learning activities--such as registrar data or interactions with learning management systems--can be analyzed to enhance…

Early Childhood Education in Europe. Achievements: Challenges and Possibilities

ERIC Educational Resources Information Center

Urban, Mathias

2009-01-01

This document is the report of a study commissioned by Education International. The aim of this study is to present key characteristics of ECE systems, to highlight strengths and successful approaches and to identify major challenges and areas where urgent action is needed. To achieve this aim, the report comprises two main sections. The first…

Tribal Colleges Reach Out to Future Students, Pre-K through 12.

ERIC Educational Resources Information Center

Ambler, Marjane

1998-01-01

Identifies the problems faced by the Indian education system and lists the goals of the Indian Nations at Risk Task Force, which was created in 1991 to improve tribal education by the year 2000. Addresses the need for further change in K-12 schooling, stressing partnerships and research as necessary proponents of educational success. (YKH)

The Impact of the Digital Divide on First-Year Community College Students

ERIC Educational Resources Information Center

Mansfield, Malinda

2017-01-01

Some students do not possess the learning management system (LMS) and basic computer skills needed for success in first-year experience (FYE) courses. The purpose of this quantitative study, based on the Integrative Learning Design Framework and theory of transactional distance, was to identify what basic computer skills and LMS skills are needed…

Factors and Conditions Promoting Academic Resilience: A TIMSS-Based Analysis of Five Asian Education Systems

ERIC Educational Resources Information Center

Sandoval-Hernández, Andrés; Bialowolski, Piotr

2016-01-01

It is well documented that academic achievement of students from families of low socioeconomic status (SES) tends to be below their more socially advantaged peers. Several studies have identified factors and conditions that facilitate academic success for disadvantaged students (i.e., promote academic resilience). However, one of the main…

Depot Maintenance Transformation: Successful Strategies in Capital Investing

DTIC Science & Technology

2010-06-01

parking areas, increased property, sales and wage taxes from higher economic activity downtown, etc. Societal Benefits: Reduced unemployment ...raw materials and wages ) and fixed-capital (factories and machinery) which quickly identifies the DMT projects as fixed-capital investments since...and establishes the necessary international coordination to provide a seamless global aviation system. (FAA, 2010) According to its 2003-2007

A Systematic Literature Review of Funding for Higher Education Institutions in Developed Countries

ERIC Educational Resources Information Center

Zhang, Qilong; Ning, Kang; Barnes, Ruth

2016-01-01

Resource allocation and funding in higher education is crucial to the success of reform and transformation of our higher education system. With a view to identifying trends and best practices in the area, utilizing a method of systematic literature review, we have critically reviewed relevant theories and practices from developed counties that are…

Identification of "At Risk" Students Using Learning Analytics: The Ethical Dilemmas of Intervention Strategies in a Higher Education Institution

ERIC Educational Resources Information Center

Lawson, Celeste; Beer, Colin; Rossi, Dolene; Moore, Teresa; Fleming, Julie

2016-01-01

Learning analytics is an emerging field in which sophisticated analytic tools are used to inform and improve learning and teaching. Researchers within a regional university in Australia identified an association between interaction and student success in online courses and subsequently developed a learning analytics system aimed at informing…

Influence of flue gas desulfurization gypsum on reducing soluble phosphorus in successive runoff events from a coastal plain bermudagrass pasture

USDA-ARS?s Scientific Manuscript database

Controlling the potential threat that pasture systems which have been intensively fertilized with poultry litter (PL) pose to accelerate eutrophication of surface waters has become a major issue in the southeastern U.S. Gypsum has been identified as a promising management tool for ameliorating the ...

A Dynamic Programming Approach to Identifying the Shortest Path in Virtual Learning Environments

ERIC Educational Resources Information Center

Fazlollahtabar, Hamed

2008-01-01

E-learning has been widely adopted as a promising solution by many organizations to offer learning-on-demand opportunities to individual employees (learners) in order to reduce training time and cost. While successful information systems models have received much attention among researchers, little research has been conducted to assess the success…

Distal turbidite fan/lobe succession of the Late Oligocene Zuberec Fm. - architecture and hierarchy (Central Western Carpathians, Orava-Podhale basin)

NASA Astrophysics Data System (ADS)

Starek, Dušan; Fuksi, Tomáš

2017-08-01

A part of the Upper Oligocene sand-rich turbidite systems of the Central Carpathian Basin is represented by the Zuberec Formation. Sand/mud-mixed deposits of this formation are well exposed in the northern part of the basin, allowing us to interpret the turbidite succession as terminal lobe deposits of a submarine fan. This interpretation is based on the discrimination of three facies associations that are comparable to different components of distributive lobe deposits in deep-water fan systems. They correspond to the lobe off-axis, lobe fringe and lobe distal fringe depositional subenvironments, respectively. The inferences about the depositional paleoenvironment based on sedimentological observations are verified by statistical analyses. The bed-thickness frequency distributions and vertical organization of the facies associations show cyclic trends at different hierarchical levels that enable us to reconstruct architectural elements of a turbidite fan. First, small-scale trends correspond with shift in the lobe element centroid between successive elements. Differences in the distribution and frequency of sandstone bed thicknesses as well as differences in the shape of bed-thickness frequency distributions between individual facies associations reflect a gradual fining and thinning in a down-dip direction. Second, meso-scale trends are identified within lobes and they generally correspond to the significant periodicity identified by the time series analysis of the bed thicknesses. The meso-scale trends demonstrate shifts in the position of the lobe centroid within the lobe system. Both types of trends have a character of a compensational stacking pattern and could be linked to autogenic processes. Third, a largescale trend documented by generally thickening-upward stacking pattern of beds, accompanied by a general increase of the sandstones/mudstones ratio and by a gradual change of percentage of individual facies, could be comparable to lobe-system scale. This trend probably indicates a gradual basinward progradation of lobe system controlled by allogenic processes related to tectonic activity of sources and sea-level fluctuations.

Characteristics and Conditions of a Successful Community College Foundation. Resource Paper No. 23.

ERIC Educational Resources Information Center

Duffy, Edward F.

In 1978-79 a study was conducted to identify the characteristics of a successful community college foundation and the conditions that foster foundation success. A review of the literature and a panel of experts were used to identify seven characteristics and 22 conditions associated with a successful foundation, and presidents and development…

Success Factors of E-Learning Projects: A Technical Perspective

ERIC Educational Resources Information Center

Alhomod, Sami; Shafi, Mohd Mudasir

2013-01-01

The aim of this study is to identify the success factors of e learning programs in King Saud University from an engineer and technician's point of view. An extensive study of existing literature was done to determine the 11 success factors of e learning program. The factors identified as success factors are: Sufficient Users Training,…

Predicting Success in an Online Course Using Expectancies, Values, and Typical Mode of Instruction

ERIC Educational Resources Information Center

Zimmerman, Whitney Alicia

2017-01-01

Expectancies of success and values were used to predict success in an online undergraduate-level introductory statistics course. Students who identified as primarily face-to-face learners were compared to students who identified as primarily online learners. Expectancy value theory served as a model. Expectancies of success were operationalized as…

Postcrisis redevelopment of sustainable healthcare systems.

PubMed

Kanadanian, Koren V; Haan, Constance K

2014-01-01

Research and field experience have identified a global gap in postdisaster rebuilding of healthcare systems due to the current primary focus on returning devastated community infrastructures to predisaster conditions. Disasters, natural or man-made, present an opportunity for communities to rebuild, restructure, and redefine their predisaster states, creating more resilient and sustainable healthcare systems. A model for sustainable postdisaster healthcare rebuilding was developed by bridging identified gaps in the literature on the processes of developing healthcare systems postdisaster and utilizing evidence from the literature on postdisaster community reconstruction. The proposed model-the Sustainable Healthcare Redevelopment Model-is designed to guide communities through the process of recovery, and identifies four stages for rebuilding healthcare systems: (1) response, (2) recovery, (3) redevelopment, and (4) sustainable development. Implementing sustainable healthcare redevelopment involves a bottom-up approach, where community stakeholders have the ability to influence policy decisions. Relationships within internal government agencies and with public-private partnerships are necessary for successful recovery. The Sustainable Healthcare Redevelopment Model can serve as a guideline for delivery of healthcare services following disaster or conflict and use of crisis as a window of opportunity to improve the healthcare delivery system and incorporate resilience into the healthcare infrastructure.

Entry, Descent and Landing Systems Analysis Study: Phase 2 Report on Exploration Feed-Forward Systems

NASA Technical Reports Server (NTRS)

Dwyer Ciancolo, Alicia M.; Davis, Jody L.; Engelund, Walter C.; Komar, D. R.; Queen, Eric M.; Samareh, Jamshid A.; Way, David W.; Zang, Thomas A.; Murch, Jeff G.; Krizan, Shawn A.;

Algorithmic structural segmentation of defective particle systems: a lithium-ion battery study.

PubMed

Westhoff, D; Finegan, D P; Shearing, P R; Schmidt, V

2018-04-01

We describe a segmentation algorithm that is able to identify defects (cracks, holes and breakages) in particle systems. This information is used to segment image data into individual particles, where each particle and its defects are identified accordingly. We apply the method to particle systems that appear in Li-ion battery electrodes. First, the algorithm is validated using simulated data from a stochastic 3D microstructure model, where we have full information about defects. This allows us to quantify the accuracy of the segmentation result. Then we show that the algorithm can successfully be applied to tomographic image data from real battery anodes and cathodes, which are composed of particle systems with very different morpohological properties. Finally, we show how the results of the segmentation algorithm can be used for structural analysis. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.

Thermal energy storage systems using fluidized bed heat exchangers

NASA Technical Reports Server (NTRS)

Ramanathan, V.; Weast, T. E.; Ananth, K. P.

1980-01-01

The viability of using fluidized bed heat exchangers (FBHX) for thermal energy storage (TES) in applications with potential for waste heat recovery was investigated. Of the candidate applications screened, cement plant rotary kilns and steel plant electric arc furnaces were identified, via the chosen selection criteria, as having the best potential for successful use of FBHX/TES system. A computer model of the FBHX/TES systems was developed and the technical feasibility of the two selected applications was verified. Economic and tradeoff evaluations in progress for final optimization of the systems and selection of the most promising system for further concept validation are described.

MCNP calculations for container inspection with tagged neutrons

NASA Astrophysics Data System (ADS)

Boghen, G.; Donzella, A.; Filippini, V.; Fontana, A.; Lunardon, M.; Moretto, S.; Pesente, S.; Zenoni, A.

2005-12-01

We are developing an innovative tagged neutrons inspection system (TNIS) for cargo containers: the system will allow us to assay the chemical composition of suspect objects, previously identified by a standard X-ray radiography. The operation of the system is extensively being simulated by using the MCNP Monte Carlo code to study different inspection geometries, cargo loads and hidden threat materials. Preliminary simulations evaluating the signal and the signal over background ratio expected as a function of the system parameters are presented. The results for a selection of cases are briefly discussed and demonstrate that the system can operate successfully in different filling conditions.

Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology: the need for retention as well as transition.

PubMed

Bohun, Claudine M; Woods, Patricia; Winter, Christiane; Mitchell, Julie; McLarry, Joel; Weiss, Joseph; Broberg, Craig S

2016-02-01

Transferring patients with CHD from paediatric to adult care has been challenging, especially across institutions. Within a single institution, some issues such as provider interaction, information exchange, or administrative directives should not play a significant role, and should favour successful transfer. We studied patients who were eligible for transfer to the adult congenital heart disease service within our institution in order to identify factors associated with successful transfer to adult care providers versus failure to transfer. Patients above18 years of age with CHD who were seen by paediatric cardiologists before January, 2008 were identified through a patient-care database. Records were reviewed to determine follow-up between 2008 and 2011 and to determine whether the patient was seen in the adult congenital cardiology clinic, paediatric cardiology clinic, or had no follow-up, and statistical comparisons were made between groups. After reviewing 916 records, 229 patients were considered eligible for transition to adult congenital cardiology. Of these, 77 (34%) were transferred successfully to adult congenital cardiology, 47 (21%) continued to be seen by paediatric cardiologists, and 105 (46%) were lost to follow-up. Those who transferred successfully differed with regard to complexity of diagnosis, insurance, and whether a formal referral was made by a paediatric care provider. Only a small fraction of the patients who were lost to follow-up could be contacted. Within a single institution, with shared information systems, administrations, and care providers, successful transfer from paediatric to adult congenital cardiology was still poor. Efforts for successful retention are just as vital as those for transfer.

Identification of Human Factors in Unmanned Aviation Via Pilot Incident Reports

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

2015-01-01

There is a need for incident data relevant to the operation of civilian unmanned aircraft systems (UAS) in the National Air Space (NAS). Currently, very limited incident and accident data are available from military sources, and the tightly-restricted civilian UAS industry has produced very few incident reports that could shed light on design issues relevant to human factors. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from UAS pilots, and using the information to identify areas where human factors guidelines will be of assistance. Experienced UAS pilots are participating in small focus groups in which they are prompted to describe critical incidents that either reveal a system flaw, or highlight a case where the human operator contributed to system resilience or mission success. The de-identified incidents are being analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot in dealing with the incident. Preliminary findings will be described.

Causal inference in nonlinear systems: Granger causality versus time-delayed mutual information

NASA Astrophysics Data System (ADS)

Li, Songting; Xiao, Yanyang; Zhou, Douglas; Cai, David

2018-05-01

The Granger causality (GC) analysis has been extensively applied to infer causal interactions in dynamical systems arising from economy and finance, physics, bioinformatics, neuroscience, social science, and many other fields. In the presence of potential nonlinearity in these systems, the validity of the GC analysis in general is questionable. To illustrate this, here we first construct minimal nonlinear systems and show that the GC analysis fails to infer causal relations in these systems—it gives rise to all types of incorrect causal directions. In contrast, we show that the time-delayed mutual information (TDMI) analysis is able to successfully identify the direction of interactions underlying these nonlinear systems. We then apply both methods to neuroscience data collected from experiments and demonstrate that the TDMI analysis but not the GC analysis can identify the direction of interactions among neuronal signals. Our work exemplifies inference hazards in the GC analysis in nonlinear systems and suggests that the TDMI analysis can be an appropriate tool in such a case.

Neural Network Target Identification System for False Alarm Reduction

NASA Technical Reports Server (NTRS)

Ye, David; Edens, Weston; Lu, Thomas T.; Chao, Tien-Hsin

2009-01-01

A multi-stage automated target recognition (ATR) system has been designed to perform computer vision tasks with adequate proficiency in mimicking human vision. The system is able to detect, identify, and track targets of interest. Potential regions of interest (ROIs) are first identified by the detection stage using an Optimum Trade-off Maximum Average Correlation Height (OT-MACH) filter combined with a wavelet transform. False positives are then eliminated by the verification stage using feature extraction methods in conjunction with neural networks. Feature extraction transforms the ROIs using filtering and binning algorithms to create feature vectors. A feed forward back propagation neural network (NN) is then trained to classify each feature vector and remove false positives. This paper discusses the test of the system performance and parameter optimizations process which adapts the system to various targets and datasets. The test results show that the system was successful in substantially reducing the false positive rate when tested on a sonar image dataset.

Using A Model-Based Systems Engineering Approach For Exploration Medical System Development

NASA Technical Reports Server (NTRS)

Hanson, A.; Mindock, J.; McGuire, K.; Reilly, J.; Cerro, J.; Othon, W.; Rubin, D.; Urbina, M.; Canga, M.

2017-01-01

NASA's Human Research Program's Exploration Medical Capabilities (ExMC) element is defining the medical system needs for exploration class missions. ExMC's Systems Engineering (SE) team will play a critical role in successful design and implementation of the medical system into exploration vehicles. The team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." Development of the medical system is being conducted in parallel with exploration mission architecture and vehicle design development. Successful implementation of the medical system in this environment will require a robust systems engineering approach to enable technical communication across communities to create a common mental model of the emergent engineering and medical systems. Model-Based Systems Engineering (MBSE) improves shared understanding of system needs and constraints between stakeholders and offers a common language for analysis. The ExMC SE team is using MBSE techniques to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. Systems Modeling Language (SysML) is the specific language the SE team is utilizing, within an MBSE approach, to model the medical system functional needs, requirements, and architecture. Modeling methods are being developed through the practice of MBSE within the team, and tools are being selected to support meta-data exchange as integration points to other system models are identified. Use of MBSE is supporting the development of relationships across disciplines and NASA Centers to build trust and enable teamwork, enhance visibility of team goals, foster a culture of unbiased learning and serving, and be responsive to customer needs. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. Here, we describe the methods and approach to building this integrated model.

Structural Identifiability of Dynamic Systems Biology Models

PubMed Central

Villaverde, Alejandro F.

2016-01-01

A powerful way of gaining insight into biological systems is by creating a nonlinear differential equation model, which usually contains many unknown parameters. Such a model is called structurally identifiable if it is possible to determine the values of its parameters from measurements of the model outputs. Structural identifiability is a prerequisite for parameter estimation, and should be assessed before exploiting a model. However, this analysis is seldom performed due to the high computational cost involved in the necessary symbolic calculations, which quickly becomes prohibitive as the problem size increases. In this paper we show how to analyse the structural identifiability of a very general class of nonlinear models by extending methods originally developed for studying observability. We present results about models whose identifiability had not been previously determined, report unidentifiabilities that had not been found before, and show how to modify those unidentifiable models to make them identifiable. This method helps prevent problems caused by lack of identifiability analysis, which can compromise the success of tasks such as experiment design, parameter estimation, and model-based optimization. The procedure is called STRIKE-GOLDD (STRuctural Identifiability taKen as Extended-Generalized Observability with Lie Derivatives and Decomposition), and it is implemented in a MATLAB toolbox which is available as open source software. The broad applicability of this approach facilitates the analysis of the increasingly complex models used in systems biology and other areas. PMID:27792726

Improving Our Odds: Success through Continuous Risk Management

NASA Technical Reports Server (NTRS)

Greenhalgh, Phillip O.

2009-01-01

Launching a rocket, running a business, driving to work and even day-to-day living all involve some degree of risk. Risk is ever present yet not always recognized, adequately assessed and appropriately mitigated. Identification, assessment and mitigation of risk are elements of the risk management component of the "continuous improvement" way of life that has become a hallmark of successful and progressive enterprises. While the application of risk management techniques to provide continuous improvement may be detailed and extensive, the philosophy, ideals and tools can be beneficially applied to all situations. Experiences with the use of risk identification, assessment and mitigation techniques for complex systems and processes are described. System safety efforts and tools used to examine potential risks of the Ares I First Stage of NASA s new Constellation Crew Launch Vehicle (CLV) presently being designed are noted as examples. Recommendations from lessons learned are provided for the application of risk management during the development of new systems as well as for the improvement of existing systems. Lessons learned and suggestions given are also examined for applicability to simple systems, uncomplicated processes and routine personal daily tasks. This paper informs the reader of varied uses of risk management efforts and techniques to identify, assess and mitigate risk for improvement of products, success of business, protection of people and enhancement of personal life.

A Cross-site Qualitative Study of Physician Order Entry

PubMed Central

Ash, Joan S.; Gorman, Paul N.; Lavelle, Mary; Payne, Thomas H.; Massaro, Thomas A.; Frantz, Gerri L.; Lyman, Jason A.

2003-01-01

Objective: To describe the perceptions of diverse professionals involved in computerized physician order entry (POE) at sites where POE has been successfully implemented and to identify differences between teaching and nonteaching hospitals. Design: A multidisciplinary team used observation, focus groups, and interviews with clinical, administrative, and information technology staff to gather data at three sites. Field notes and transcripts were coded using an inductive approach to identify patterns and themes in the data. Measurements: Patterns and themes concerning perceptions of POE were identified. Results: Four high-level themes were identified: (1) organizational issues such as collaboration, pride, culture, power, politics, and control; (2) clinical and professional issues involving adaptation to local practices, preferences, and policies; (3) technical/implementation issues, including usability, time, training and support; and (4) issues related to the organization of information and knowledge, such as system rigidity and integration. Relevant differences between teaching and nonteaching hospitals include extent of collaboration, staff longevity, and organizational missions. Conclusion: An organizational culture characterized by collaboration and trust and an ongoing process that includes active clinician engagement in adaptation of the technology were important elements in successful implementation of physician order entry at the institutions that we studied. PMID:12595408

Beyond health information technology: critical factors necessary for effective diabetes disease management.

PubMed

Ciemins, Elizabeth L; Coon, Patricia J; Fowles, Jinnet Briggs; Min, Sung-joon

2009-05-01

Electronic health records (EHRs) have been implemented throughout the United States with varying degrees of success. Past EHR implementation experiences can inform health systems planning to initiate new or expand existing EHR systems. Key "critical success factors," e.g., use of disease registries, workflow integration, and real-time clinical guideline support, have been identified but not fully tested in practice. A pre/postintervention cohort analysis was conducted on 495 adult patients selected randomly from a diabetes registry and followed for 6 years. Two intervention phases were evaluated: a "low-dose" period targeting primary care provider (PCP) and patient education followed by a "high-dose" EHR diabetes management implementation period, including a diabetes disease registry and office workflow changes, e.g., diabetes patient preidentification to facilitate real-time diabetes preventive care, disease management, and patient education. Across baseline, "low-dose," and "high-dose" postintervention periods, a significantly greater proportion of patients (a) achieved American Diabetes Association (ADA) guidelines for control of blood pressure (26.9 to 33.1 to 43.9%), glycosylated hemoglobin (48.5 to 57.5 to 66.8%), and low-density lipoprotein cholesterol (33.1 to 44.4 to 56.6%) and (b) received recommended preventive eye (26.2 to 36.4 to 58%), foot (23.4 to 40.3 to 66.9%), and renal (38.5 to 53.9 to 71%) examinations or screens. Implementation of a fully functional, specialized EHR combined with tailored office workflow process changes was associated with increased adherence to ADA guidelines, including risk factor control, by PCPs and their patients with diabetes. Incorporation of previously identified "critical success factors" potentially contributed to the success of the program, as did use of a two-phase approach. 2009 Diabetes Technology Society.

Managing Risk for Cassini During Mission Operations and Data Analysis (MOandDA)

NASA Technical Reports Server (NTRS)

Witkowski, Mona M.

2002-01-01

A Risk Management Process has been tailored for Cassini that not only satisfies the requirements of NASA and JPL, but also allows the Program to proactively identify and assess risks that threaten mission objectives. Cassini Risk Management is a team effort that involves both management and engineering staff. The process is managed and facilitated by the Mission Assurance Manager (MAM), but requires regular interactions with Program Staff and team members to instill the risk management philosophy into the day to day mission operations. While Risk Management is well defined for projects in the development phase, it is a relatively new concept for Mission Operations. The Cassini team has embraced this process and has begun using it in an effective, proactive manner, to ensure mission success. It is hoped that the Cassini Risk Management Process will form the basis by which risk management is conducted during MO&DA on future projects. proactive in identifying, assessing and mitigating risks before they become problems. Cost ehtiveness is achieved by: Comprehensively identifying risks Rapidly assessing which risks require the expenditure of pruject cewums Taking early actions to mitigate these risks Iterating the process frequently, to be responsive to the dynamic internal and external environments The Cassini Program has successfully implemented a Risk Management Process for mission operations, The initial SRL has been developed and input into he online tool. The Risk Management webbased system has been rolled out for use by the flight team and risk owners we working proactive in identifying, assessing and mitigating risks before they become problems. Cost ehtiveness is achieved by: Comprehensively identifying risks Rapidly assessing which risks require the expenditure of pruject cewums Taking early actions to mitigate these risks Iterating the process frequently, to be responsive to the dynamic internal and external environments The Cassini Program has successfully implemented a Risk Management Process for mission operations, The initial SRL has been developed and input into he online tool. The Risk Management webbased system has been rolled out for use by the flight team and risk owners we working put into place will become visible and will be illusmted in future papers.

Expansion of the neuropeptidome of the globally invasive marine crab Carcinus maenas.

PubMed

Christie, Andrew E

2016-09-01

Carcinus maenas is widely recognized as one of the world's most successful marine invasive species; its success as an invader is due largely to its ability to thrive under varied environmental conditions. The physiological/behavioral control systems that allow C. maenas to adapt to new environments are undoubtedly under hormonal control, the largest single class of hormones being peptides. While numerous studies have focused on identifying native C. maenas peptides, none has taken advantage of mining transcriptome shotgun assembly (TSA) sequence data, a strategy proven highly successful for peptide discovery in other crustaceans. Here, a C. maenas peptidome was predicted via in silico transcriptome mining. Thirty-seven peptide families were searched for in the extant TSA database, with transcripts encoding precursors for 29 groups identified. The pre/preprohormones deduced from the identified sequences allowed for the prediction of 263 distinct mature peptides, 193 of which are new discoveries for C. maenas. The predicted peptides include isoforms of adipokinetic hormone-corazonin-like peptide, allatostatin A, allatostatin B, allatostatin C, bursicon, CCHamide, corazonin, crustacean cardioactive peptide, crustacean hyperglycemic hormone, diuretic hormone 31, diuretic hormone 44, eclosion hormone, FMRFamide-like peptide, HIGSLYRamide, intocin, leucokinin, myosuppressin, neuroparsin, neuropeptide F, orcokinin, pigment dispersing hormone, proctolin, pyrokinin, red pigment concentrating hormone, RYamide, short neuropeptide F, SIFamide, and tachykinin-related peptide. This peptidome is the largest predicted from any single crustacean using the in silico approach, and provides a platform for investigating peptidergic signaling in C. maenas, including control of the processes that allow for its success as a global marine invader. Copyright © 2016 Elsevier Inc. All rights reserved.

A qualitative study of contextual factors' impact on measures to reduce surgery cancellations.

PubMed

Hovlid, Einar; Bukve, Oddbjørn

2014-05-13

Contextual factors influence quality improvement outcomes. Understanding this influence is important when adapting and implementing interventions and translating improvements into new settings. To date, there is limited knowledge about how contextual factors influence quality improvement processes. In this study, we explore how contextual factors affected measures to reduce surgery cancellations, which are a persistent problem in healthcare. We discuss the usefulness of the theoretical framework provided by the model for understanding success in quality (MUSIQ) for this kind of research. We performed a qualitative case study at Førde Hospital, Norway, where we had previously demonstrated a reduction in surgery cancellations. We interviewed 20 clinicians and performed content analysis to explore how contextual factors affected measures to reduce cancellations of planned surgeries. We identified three common themes concerning how contextual factors influenced the change process: 1) identifying a need to change, 2) facilitating system-wide improvement, and 3) leader involvement and support. Input from patients helped identify a need to change and contributed to the consensus that change was necessary. Reducing cancellations required improving the clinical system. This improvement process was based on a strategy that emphasized the involvement of frontline clinicians in detecting and improving system problems. Clinicians shared information about their work by participating in improvement teams to develop a more complete understanding of the clinical system and its interdependencies. This new understanding allowed clinicians to detect system problems and design adequate interventions. Middle managers' participation in the improvement teams and in regular work processes was important for successfully implementing and adapting interventions. Contextual factors interacted with one another and with the interventions to facilitate changes in the clinical system, reducing surgery cancellations. The MUSIQ framework is useful for exploring how contextual factors influence the improvement process and how they influence one another. Discussing data in relation to a theoretical framework can promote greater uniformity in reporting findings, facilitating knowledge-building across studies.

A qualitative evaluation of medication management services in six Minnesota health systems.

PubMed

Sorensen, Todd D; Pestka, Deborah; Sorge, Lindsay A; Wallace, Margaret L; Schommer, Jon

2016-03-01

The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described. Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes. A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies. A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Progress in computer vision.

NASA Astrophysics Data System (ADS)

Jain, A. K.; Dorai, C.

Computer vision has emerged as a challenging and important area of research, both as an engineering and a scientific discipline. The growing importance of computer vision is evident from the fact that it was identified as one of the "Grand Challenges" and also from its prominent role in the National Information Infrastructure. While the design of a general-purpose vision system continues to be elusive machine vision systems are being used successfully in specific application elusive, machine vision systems are being used successfully in specific application domains. Building a practical vision system requires a careful selection of appropriate sensors, extraction and integration of information from available cues in the sensed data, and evaluation of system robustness and performance. The authors discuss and demonstrate advantages of (1) multi-sensor fusion, (2) combination of features and classifiers, (3) integration of visual modules, and (IV) admissibility and goal-directed evaluation of vision algorithms. The requirements of several prominent real world applications such as biometry, document image analysis, image and video database retrieval, and automatic object model construction offer exciting problems and new opportunities to design and evaluate vision algorithms.

Electrochemical air revitalization system optimization investigation

NASA Technical Reports Server (NTRS)

Woods, R. R.; Schubert, F. H.; Hallick, T. M.

1975-01-01

A program to characterize a Breadboard of an Electrochemical Air Revitalization System (BEARS) was successfully completed. The BEARS is composed of three components: (1) a water vapor electrolysis module (WVEM) for O2 production and partial humidity control, (2) an electrochemical depolarized carbon dioxide concentrator module (EDCM) for CO2 control, and (3) a power-sharing controller, designed to utilize the power produced by the EDCM to partially offset the WVEM power requirements. It is concluded from the results of this work that the concept of electrochemical air revitalization with power-sharing is a viable solution to the problem of providing a localized topping force for O2 generation, CO2 removal and partial humidity control aboard manned spacecraft. Continued development of the EARS concept is recommended, applying the operational experience and limits identified during the BEARS program to testing of a one-man capacity system and toward the development of advanced system controls to optimize EARS operation for given interfaces and requirements. Successful completion of this development will produce timely technology necessary to plan future advanced environmental control and life support system programs and experiments.

System Analysis Applied to Autonomy: Application to Human-Rated Lunar/Mars Landers

NASA Technical Reports Server (NTRS)

Young, Larry A.

2006-01-01

System analysis is an essential technical discipline for the modern design of spacecraft and their associated missions. Specifically, system analysis is a powerful aid in identifying and prioritizing the required technologies needed for mission and/or vehicle development efforts. Maturation of intelligent systems technologies, and their incorporation into spacecraft systems, are dictating the development of new analysis tools, and incorporation of such tools into existing system analysis methodologies, in order to fully capture the trade-offs of autonomy on vehicle and mission success. A "system analysis of autonomy" methodology will be outlined and applied to a set of notional human-rated lunar/Mars lander missions toward answering these questions: 1. what is the optimum level of vehicle autonomy and intelligence required? and 2. what are the specific attributes of an autonomous system implementation essential for a given surface lander mission/application in order to maximize mission success? Future human-rated lunar/Mars landers, though nominally under the control of their crew, will, nonetheless, be highly automated systems. These automated systems will range from mission/flight control functions, to vehicle health monitoring and prognostication, to life-support and other "housekeeping" functions. The optimum degree of autonomy afforded to these spacecraft systems/functions has profound implications from an exploration system architecture standpoint.

Extending and implementing the Persistent ID pillars

NASA Astrophysics Data System (ADS)

Car, Nicholas; Golodoniuc, Pavel; Klump, Jens

2017-04-01

The recent double decade anniversary of scholarly persistent identifier use has triggered journal special editions such as "20 Years of Persistent Identifiers". For such a publication, it is apt to consider the longevity of some persistent identifier (PID) mechanisms (Digital Object Identifiers) and the partial disappearance of others (Life Sciences IDs). We have previously postulated a set of "PID Pillars" [1] which are design principles aimed at ensuring PIDs can survive technology and social change and thus persist for the long term that we have drawn from our observations of PIDs at work over many years. The principles: describe how to ensure identifiers' system and organisation independence; codify the delivery of essential PID system functions; mandate a separation of PID functions from data delivery mechanisms; and require generation of policies detailing how change is handled. In this presentation, first we extend on our previous work of introducing the pillars by refining their descriptions, giving specific suggestions for each and presenting some work that addresses them. Second, we propose a baseline data model for persistent identifiers that, if used, would assist the separation of PID metadata and PID system functioning. This would allow PID system function specifics to change over time (e.g. resolver services or even resolution protocols) and yet preserve the PIDs themselves. Third, we detail our existing PID system — the PID Service [2] — that partially implements the pillars and describe both its successes and shortcomings. Finally, we describe our planned next-generation system that will aim to use the baseline data model and fully implement the pillars.

Numerical Aerodynamic Simulation (NAS)

NASA Technical Reports Server (NTRS)

Peterson, V. L.; Ballhaus, W. F., Jr.; Bailey, F. R.

1983-01-01

The history of the Numerical Aerodynamic Simulation Program, which is designed to provide a leading-edge capability to computational aerodynamicists, is traced back to its origin in 1975. Factors motivating its development and examples of solutions to successively refined forms of the governing equations are presented. The NAS Processing System Network and each of its eight subsystems are described in terms of function and initial performance goals. A proposed usage allocation policy is discussed and some initial problems being readied for solution on the NAS system are identified.

A Product Development Decision Model for Cockpit Weather Information System

NASA Technical Reports Server (NTRS)

Sireli, Yesim; Kauffmann, Paul; Gupta, Surabhi; Kachroo, Pushkin; Johnson, Edward J., Jr. (Technical Monitor)

2003-01-01

There is a significant market demand for advanced cockpit weather information products. However, it is unclear how to identify the most promising technological options that provide the desired mix of consumer requirements by employing feasible technical systems at a price that achieves market success. This study develops a unique product development decision model that employs Quality Function Deployment (QFD) and Kano's model of consumer choice. This model is specifically designed for exploration and resolution of this and similar information technology related product development problems.

Rare Orbital Infections ~ State of the Art ~ Part II

PubMed Central

Hamed-Azzam, Shirin; AlHashash, Islam; Briscoe, Daniel; Rose, Geoffrey E; Verity, David H.

2018-01-01

Infections of the orbit and periorbita are relatively frequent. Identifying unusual organisms is crucial because they can cause severe local and systemic morbidity, despite their rarity. Opportunistic infections of the orbit should be considered mainly in debilitated or immunocompromised patients. The key to successful management includes a high index of suspicion, prompt diagnosis, and addressing the underlying systemic disease. This review summarizes unusual infectious processes of the orbit, including mycobacterial, fungal, and parasitic infections, as well as their pathophysiology, symptoms, signs, and treatment. PMID:29719648

A Product Development Decision Model for Cockpit Weather Information Systems

NASA Technical Reports Server (NTRS)

Sireli, Yesim; Kauffmann, Paul; Gupta, Surabhi; Kachroo, Pushkin

2003-01-01

There is a significant market demand for advanced cockpit weather information products. However, it is unclear how to identify the most promising technological options that provide the desired mix of consumer requirements by employing feasible technical systems at a price that achieves market success. This study develops a unique product development decision model that employs Quality Function Deployment (QFD) and Kano's model of consumer choice. This model is specifically designed for exploration and resolution of this and similar information technology related product development problems.

Study and design of cryogenic propellant acquisition systems. Volume 2: Supporting experimental program

NASA Technical Reports Server (NTRS)

Burge, G. W.; Blackmon, J. B.

1973-01-01

Areas of cryogenic fuel systems were identified where critical experimental information was needed either to define a design criteria or to establish the feasibility of a design concept or a critical aspect of a particular design. Such data requirements fell into three broad categories: (1) basic surface tension screen characteristics; (2) screen acquisition device fabrication problems; and (3) screen surface tension device operational failure modes. To explore these problems and to establish design criteria where possible, extensive laboratory or bench test scale experiments were conducted. In general, these proved to be quite successful and, in many instances, the test results were directly used in the system design analyses and development. In some cases, particularly those relating to operational-type problems, areas requiring future research were identified, especially screen heat transfer and vibrational effects.

What determines successful implementation of inpatient information technology systems?

PubMed

Spetz, Joanne; Burgess, James F; Phibbs, Ciaran S

2012-03-01

To identify the factors and strategies that were associated with successful implementation of hospital-based information technology (IT) systems in US Department of Veterans Affairs (VA) hospitals, and how these might apply to other hospitals. Qualitative analysis of 118 interviews conducted at 7 VA hospitals. The study focused on the inpatient setting, where nurses are the main patient-care providers; thus, the research emphasized the impact of Computerized Patient Record System and Bar Code Medication Administration on nurses. Hospitals were selected to represent a range of IT implementation dates, facility sizes, and geography. The subjects included nurses, pharmacists, physicians, IT staff, and managers. Interviews were guided by a semi-structured interview protocol, and a thematic analysis was conducted, with initial codes drawn from the content of the interview guides. Additional themes were proposed as the coding was conducted. Five broad themes arose as factors which affected the process and success of implementation: (1) organizational stability and implementation team leadership, (2) implementation timelines, (3) equipment availability and reliability, (4) staff training, and (5) changes in work flow Overall IT implementation success in the VA depended on: (1) whether there was support for change from both leaders and staff, (2) development of a gradual and flexible implementation approach, (3) allocation of adequate resources for equipment and infrastructure, hands-on support, and deployment of additional staff, and (4) how the implementation team planned for setbacks, and continued the process to achieve success. Problems that developed in the early stages of implementation tended to become persistent, and poor implementation can lead to patient harm.

Outstanding School Administrators: Their Keys to Success.

ERIC Educational Resources Information Center

Wendel, Frederick C.; And Others

Project Success was initiated to identify the good things that happen in American public education. One thousand administrators nationwide, identified by their peers as successful were asked to describe their leadership characteristics and beliefs about education. Responses were received from 491 administrators. Chapter 1 presents sample…

English-as-a-Second Language (ESL) nursing student success: a critical review of the literature.

PubMed

Olson, Mary Angela

2012-01-01

Many English-as-a-Second Language (ESL) nursing students struggle in nursing school for a multitude of reasons. The purpose of this critical review of the literature is to identify barriers and discover bridges to ESL nursing student success. Twenty-five articles were identified for the review. Language barriers were identified as the single most significant obstacle facing the ESL nursing student. Bridges to ESL nursing student success include enhancing language development and acculturation into the American mainstream culture. A broad range of strategies to promote student success are outlined and the role of the nurse educator in ESL nursing student success is also addressed.

Strategic Assessment of Trauma Care Capacity in Ghana.

PubMed

Stewart, Barclay T; Quansah, Robert; Gyedu, Adam; Ankomah, James; Donkor, Peter; Mock, Charles

2015-10-01

This study aimed to assess availability of trauma care technology in Ghana. In addition, factors contributing to deficiencies were evaluated. By doing so, potential solutions to inefficient aspects of health systems management and maladapted technology for trauma care in low- and middle-income countries (LMICs) could be identified. Thirty-two items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with administrative, clinical, and biomedical engineering staff were used to assess the challenges and successes of item availability at 40 purposively sampled district, regional, and tertiary hospitals. Hospital assessments demonstrated marked deficiencies. Some of these were low cost, such as basic airway supplies, chest tubes, and cervical collars. Item non-availability resulted from several contributing factors, namely equipment absence, lack of training, frequent stock-outs, and technology breakage. A number of root causes for these factors were identified, including ineffective healthcare financing by way of untimely national insurance reimbursements, procurement and stock-management practices, and critical gaps in local biomedical engineering and trauma care training. Nonetheless, local examples of successfully overcoming deficiencies were identified (e.g., public-private partnering, ensuring company engineers trained technicians on-the-job during technology installation or servicing). While availability of several low-cost items could be better supplied by improvements in stock-management and procurement policies, there is a critical need for redress of the national insurance reimbursement system and trauma care training of district hospital staff. Further, developing local service and technical support capabilities is more and more pressing as technology plays an increasingly important role in LMIC healthcare systems.

Dimensions of Entrepreneurial Success: A Multilevel Study on Stakeholders of Micro-Enterprises

PubMed Central

Razmus, Wiktor; Laguna, Mariola

2018-01-01

The study provides an insight into the indicators and dimensions of entrepreneurial success as evaluated from the external stockholders’ perspective. As each firm is embedded in a network of relations with stakeholders (business partners), understanding how they evaluate entrepreneurial success is important. The initial qualitative study in the form of in-depth interviews allowed us to identify the indicators of entrepreneurial success that are identified by external stakeholders of micro-firms. In the quantitative study on 475 stakeholders of 57 micro-firms, we identified the dimensions of entrepreneurial success. Using a multilevel approach, we found six dimensions of entrepreneurial success at the individual stakeholder level and four dimensions at the firm level. The results show that stakeholders perceive entrepreneurial success in terms of many dimensions, not focusing solely on economic indicators. This knowledge may inform micro-firm management and the strategies employed by practitioners supporting entrepreneurs. PMID:29892242

[Levers in Primary Health Care - Identifying Strategic Success Factors for Improved Primary Care in Upper Austria].

PubMed

Kriegel, J; Rebhandl, E; Reckwitz, N; Hockl, W

2016-12-01

Current and projected general practitioner (GP) and primary care in Austria shows structural and process inadequacies in the quality as well as assurance of healthcare supply. The aim is therefore to develop solution- and patient-oriented measures that take patient-related requirements and medical perspectives into account. Using an effect matrix, subjective expert and user priorities were ascertained, cause and effect relationships were examined, and an expanded circle of success for the optimization of GP and primary care in Upper Austria was developed. Through this, the relevant levers for target-oriented development and optimization of the complex system of GP and primary care in Upper Austria were identified; these are training to become general practitioners, entrepreneurs as well as management and coordination. It is necessary to further adapt the identified levers conceptually and operationally in a targeted approach. This is to be achieved by means of the primary health care (PHC) concept as well as management tools and information and communication technologies (ICT) associated with it. © Georg Thieme Verlag KG Stuttgart · New York.

White paper on guidelines concerning enteric nervous system stem cell therapy for enteric neuropathies⋆

PubMed Central

Burns, Alan J.; Goldstein, Allan M.; Newgreen, Donald F.; Stamp, Lincon; Schäfer, Karl-Herbert; Metzger, Marco; Hotta, Ryo; Young, Heather M.; Andrews, Peter W.; Thapar, Nikhil; Belkind-Gerson, Jaime; Bondurand, Nadege; Bornstein, Joel C.; Chan, Wood Yee; Cheah, Kathryn; Gershon, Michael D.; Heuckeroth, Robert O.; Hofstra, Robert M.W.; Just, Lothar; Kapur, Raj P.; King, Sebastian K.; McCann, Conor J.; Nagy, Nandor; Ngan, Elly; Obermayr, Florian; Pachnis, Vassilis; Pasricha, Pankaj J.; Sham, Mai Har; Tam, Paul; Berghe, Pieter Vanden

2016-01-01

Over the last 20 years, there has been increasing focus on the development of novel stem cell based therapies for the treatment of disorders and diseases affecting the enteric nervous system (ENS) of the gastrointestinal tract (so-called enteric neuropathies). Here, the idea is that ENS progenitor/stem cells could be transplanted into the gut wall to replace the damaged or absent neurons and glia of the ENS. This White Paper sets out experts’ views on the commonly used methods and approaches to identify, isolate, purify, expand and optimize ENS stem cells, transplant them into the bowel, and assess transplant success, including restoration of gut function. We also highlight obstacles that must be overcome in order to progress from successful preclinical studies in animal models to ENS stem cell therapies in the clinic. PMID:27059883

Smart RTI: A Next-Generation Approach to Multilevel Prevention

PubMed Central

FUCHS, DOUGLAS; FUCHS, LYNN S.; COMPTON, DONALD L.

2012-01-01

During the past decade, responsiveness to intervention (RTI) has become popular among many practitioners as a means of transforming schooling into a multilevel prevention system. Popularity aside, its successful implementation requires ambitious intent, a comprehensive structure, and coordinated service delivery. An effective RTI also depends on building-based personnel with specialized expertise at all levels of the prevention system. Most agree on both its potential for strengthening schooling and its heavy demand on practitioners. In this article, we describe Smart RTI, which we define as making efficient use of school resources while maximizing students' opportunities for success. In light of findings from recent research, we discuss three important features of Smart RTI: (a) multistage screening to identify risk, (b) multistage assessment to determine appropriate levels of instruction, and (c) a role for special education that supports prevention. PMID:22736805

Early warning systems and rapid response to the deteriorating patient in hospital: A realist evaluation.

PubMed

McGaughey, Jennifer; O'Halloran, Peter; Porter, Sam; Trinder, John; Blackwood, Bronagh

2017-12-01

To test the Rapid Response Systems programme theory against actual practice components of the Rapid Response Systems implemented to identify those contexts and mechanisms which have an impact on the successful achievement of desired outcomes in practice. Rapid Response Systems allow deteriorating patients to be recognized using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. Realist evaluation. The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation. We used various mixed methods including individual and focus group interviews, observation of nursing practice between June-November 2010 and document analysis of Early Warning Systems audit data between May-October 2010 and hospital acute care training records over 4.5 years from 2003-2008. Data were analysed using NiVivo8 and SPPS. A cross-case analysis highlighted similar patterns of factors which enabled or constrained successful recognition, referral and response to deteriorating patients in practice. Key enabling factors were the use of clinical judgement by experienced nurses and the empowerment of nurses as a result of organizational change associated with implementation of Early Warning System protocols. Key constraining factors were low staffing and inappropriate skill mix levels, rigid implementation of protocols and culturally embedded suboptimal communication processes. Successful implementation of Rapid Response Systems was dependent on adopting organizational and cultural changes that facilitated staff empowerment, flexible implementation of protocols and ongoing experiential learning. © 2017 John Wiley & Sons Ltd.

Combination of microautoradiography and fluorescence in situ hybridization for identification of microorganisms degrading xenobiotic contaminants.

PubMed

Yang, Yanru; Zarda, Annatina; Zeyer, Josef

2003-12-01

One of the central topics in environmental bioremediation research is to identify microorganisms that are capable of degrading the contaminants of interest. Here we report application of combined microautoradiography (MAR) and fluorescence in situ hybridization (FISH). The method has previously been used in a number of systems; however, here we demonstrate its feasibility in studying the degradation of xenobiotic compounds. With a model system (coculture of Pseudomonas putida B2 and Sphingomonas stygia incubated with [14C] o-nitrophenol), combination of MAR and FISH was shown to be able to successfully identify the microorganisms degrading o-nitrophenol. Compared with the conventional techniques, MAR-FISH allows fast and accurate identification of the microorganisms involved in environmental contaminant degradation.

Design of a submillimeter laser Thomson scattering system for measurement of ion temperature in SUMMA

NASA Technical Reports Server (NTRS)

Praddaude, H. C.; Woskoboinikow, P.

1978-01-01

A thorough discussion of submillimeter laser Thomson scattering for the measurement of ion temperature in plasmas is presented. This technique is very promising and work is being actively pursued on the high power lasers and receivers necessary for its implementation. In this report we perform an overall system analysis of the Thomson scattering technique aimed to: (1) identify problem areas; (2) establish specifications for the main components of the apparatus; (3) study signal processing alternatives and identify the optimum signal handling procedure. Because of its importance for the successful implementation of this technique, we also review the work presently being carried out on the optically pumped submillimeter CH3F and D2O lasers.

Distributed design approach in persistent identifiers systems

NASA Astrophysics Data System (ADS)

Golodoniuc, Pavel; Car, Nicholas; Klump, Jens

2017-04-01

The need to identify both digital and physical objects is ubiquitous in our society. Past and present persistent identifier (PID) systems, of which there is a great variety in terms of technical and social implementations, have evolved with the advent of the Internet, which has allowed for globally unique and globally resolvable identifiers. PID systems have catered for identifier uniqueness, integrity, persistence, and trustworthiness, regardless of the identifier's application domain, the scope of which has expanded significantly in the past two decades. Since many PID systems have been largely conceived and developed by small communities, or even a single organisation, they have faced challenges in gaining widespread adoption and, most importantly, the ability to survive change of technology. This has left a legacy of identifiers that still exist and are being used but which have lost their resolution service. We believe that one of the causes of once successful PID systems fading is their reliance on a centralised technical infrastructure or a governing authority. Golodoniuc et al. (2016) proposed an approach to the development of PID systems that combines the use of (a) the Handle system, as a distributed system for the registration and first-degree resolution of persistent identifiers, and (b) the PID Service (Golodoniuc et al., 2015), to enable fine-grained resolution to different information object representations. The proposed approach solved the problem of guaranteed first-degree resolution of identifiers, but left fine-grained resolution and information delivery under the control of a single authoritative source, posing risk to the long-term availability of information resources. Herein, we develop these approaches further and explore the potential of large-scale decentralisation at all levels: (i) persistent identifiers and information resources registration; (ii) identifier resolution; and (iii) data delivery. To achieve large-scale decentralisation, we propose using Distributed Hash Tables (DHT), Peer Exchange networks (PEX), Magnet Links, and peer-to-peer (P2P) file sharing networks - the technologies that enable applications such as BitTorrent (Wu et al., 2010). The proposed approach introduces reliable information replication and caching mechanisms, eliminating the need for a central PID data store, and increases overall system fault tolerance due to the lack of a single point of failure. The proposed PID system's design aims to ensure trustworthiness of the system and incorporates important aspects of governance, such as the notion of the authoritative source, data integrity, caching, and data replication control.

Development of dog-like retrieving capability in a ground robot

NASA Astrophysics Data System (ADS)

MacKenzie, Douglas C.; Ashok, Rahul; Rehg, James M.; Witus, Gary

2013-01-01

This paper presents the Mobile Intelligence Team's approach to addressing the CANINE outdoor ground robot competition. The competition required developing a robot that provided retrieving capabilities similar to a dog, while operating fully autonomously in unstructured environments. The vision team consisted of Mobile Intelligence, the Georgia Institute of Technology, and Wayne State University. Important computer vision aspects of the project were the ability to quickly learn the distinguishing characteristics of novel objects, searching images for the object as the robot drove a search pattern, identifying people near the robot for safe operations, correctly identify the object among distractors, and localizing the object for retrieval. The classifier used to identify the objects will be discussed, including an analysis of its performance, and an overview of the entire system architecture presented. A discussion of the robot's performance in the competition will demonstrate the system's successes in real-world testing.

Identifying Perceptions That Contribute to the Development of Successful Project Lead the Way Pre-Engineering Programs in Utah

ERIC Educational Resources Information Center

McMullin, Keith

2013-01-01

Many secondary schools in Utah have adopted the Project Lead the Way (PLTW) pre-engineering program. Little research has been conducted in Utah to show how successful these programs are or what factors are perceived to contribute to that success. This research is about defining PLTW program success and identifying factors perceived to improve…

Developing Meaning for Algebraic Procedures: An Exploration of the Connections Undergraduate Students Make between Algebraic Rational Expressions and Basic Number Properties

ERIC Educational Resources Information Center

Yantz, Jennifer

2013-01-01

The attainment and retention of later algebra skills in high school has been identified as a factor significantly impacting the postsecondary success of students majoring in STEM fields. Researchers maintain that learners develop meaning for algebraic procedures by forming connections to the basic number system properties. The present study…

Machine intelligence and robotics: Report of the NASA study group

NASA Technical Reports Server (NTRS)

1980-01-01

Opportunities for the application of machine intelligence and robotics in NASA missions and systems were identified. The benefits of successful adoption of machine intelligence and robotics techniques were estimated and forecasts were prepared to show their growth potential. Program options for research, advanced development, and implementation of machine intelligence and robot technology for use in program planning are presented.

Learning from Experience: A Cross-Case Comparison of School-to-Work Transition Reform Initiatives.

ERIC Educational Resources Information Center

Rogers, Anne M.; And Others

A cross-case study approach was used to determine how school-to-work reform affects clients and participants and to identify elements critical to the success of school-to-work systems. Fourteen school-to-work reform initiatives in communities across the United States were examined by using a research protocol that included individual interviews,…

Cervical spondylodiscitis with spinal epidural abscess caused by Aggregatibacter aphrophilus.

PubMed

Pasqualini, Leonella; Mencacci, Antonella; Scarponi, Anna Maria; Leli, Christian; Fabbriciani, Gianluigi; Callarelli, Laura; Schillaci, Giuseppe; Bistoni, Francesco; Mannarino, Elmo

2008-05-01

Spondylodiscitis caused by Aggregatibacter aphrophilus, formerly known as Haemophilus paraphrophilus, is an unusual condition and can be very difficult to diagnose. We report a case of cervical spondylodiscitis complicated by spinal epidural abscess in a 63-year-old woman, without underlying predisposing conditions. The source of infection was identified as a periodontal infection. The patient was successfully treated with systemic antibiotics.

Successfully Automating Library Consortia: Procedures To Facilitate Governance, Management and Cooperation. DataResearch Automation Guide Series, Number Three.

ERIC Educational Resources Information Center

Data Research Associates, Inc., St. Louis, MO.

Sharing a local automated library system will generally reduce the costs of automation for each participating library and will facilitate the sharing of resources. To set up a consortium, libraries must first identify and agree on governance issues and methods for dealing with these issues. Issues range from ownership, management, and location of…

Let's Find the Special People: Identifying and Locating the Special Needs Learners. "It Isn't Easy Being Special." Research & Development Series No. 176.

ERIC Educational Resources Information Center

Campbell-Thrane, Lucille, Ed.

This publication presents a data collection system useful in measuring the success of vocational programs for special needs populations as well as current descriptive/demographic information on special needs populations nationwide. The first of four chapters provides a general characterization of special populations and specific definitions for…

Summary of States' Strategies and Consequences for ESEA Focus Schools. Solutions. Issue No. 2

ERIC Educational Resources Information Center

Perlman, Carole

2013-01-01

As of January 1, 2013, 34 states and the District of Columbia have been granted waivers from certain provisions of the Elementary and Secondary Education Act (ESEA). Part of each successful flexibility application was a state accountability system that could identify priority schools (the lowest performing 5% of Title 1 schools) and focus schools…

In Care, Aftercare and Caring for Those in Care: My Successful Care Journey

ERIC Educational Resources Information Center

Morrison, Shelley

2016-01-01

Coyle and Pinkerton identify gaps in the care leaving system in Northern Ireland regarding social work training and meeting the challenges of transitioning from care. The primary focus of this article is to provide a perspective of care and leaving care which could contribute to social work education and practice in these areas. Framed within a…

Community Monitoring Systems: Tracking and Improving the Well-Being of America's Children and Adolescents. NIH Publication No. 07-5852

ERIC Educational Resources Information Center

National Institute on Drug Abuse (NIDA), 2007

2007-01-01

Monitoring the well-being of children and adolescents is a critical component of efforts to prevent psychological, behavioral, and health problems and to promote their successful development. Research during the past 40 years has helped identify aspects of child and adolescent functioning that are important to monitor. These aspects, which…

Identifying the Criteria for Planning the Selection and Succession of a CIO: A Phenomenological Study

ERIC Educational Resources Information Center

Williamson, Charles E.

2010-01-01

Many challenges face CIOs in their management of IT systems; yet, very little research is available regarding the issues and constraints associated with their role. CIO leadership is still a subject of inquiry for those with aspirations to pursue such a position. The specific problem of the current qualitative phenomenological study concerned the…

Summary of States' Strategies and Consequences for ESEA Focus Schools. Solutions. Issue Number 2

ERIC Educational Resources Information Center

Perlman, Carole

2013-01-01

As of January 1, 2013, 34 states and the District of Columbia have been granted waivers from certain provisions of the Elementary and Secondary Education Act (ESEA). Part of each successful flexibility application was a state accountability system that could identify priority schools (the lowest performing 5% of Title 1 schools) and focus schools…

Public Education in the Russian Empire at the End of the 19th Century

ERIC Educational Resources Information Center

Shevchenko, Natal'ya A.; Kucherkov, Ivan A.; Shirev, Denis A.; Miku, Natal'ya V.

2018-01-01

The paper reviews primary education in the Russian Empire at the end of the 19th century. It focuses on describing the successes and shortcomings of the public education system, as well as identifying the causes of its poor efficiency. As a summary, the authors concluded that the government of the Russian Empire consolidated major efforts to…

The Role of 21st Century Skills in Two Rural Regional Areas of Public Education

ERIC Educational Resources Information Center

Fox, Sean B.; McDermott, Carrie L.

2015-01-01

Budgetary shortfalls and excessive layoffs have left public schools with a deficiency of professional innovation as well as modern theory and practice. It is imperative that educators identify the exemplary school systems that are engaging students and adults in 21st century education, and broadcast those patterns of success to schools in need of…

Optimal coherent control of dissipative N -level systems

NASA Astrophysics Data System (ADS)

Jirari, H.; Pötz, W.

2005-07-01

General optimal coherent control of dissipative N -level systems in the Markovian time regime is formulated within Pointryagin’s principle and the Lindblad equation. In the present paper, we study feasibility and limitations of steering of dissipative two-, three-, and four-level systems from a given initial pure or mixed state into a desired final state under the influence of an external electric field. The time evolution of the system is computed within the Lindblad equation and a conjugate gradient method is used to identify optimal control fields. The influence of both field-independent population and polarization decay on achieving the objective is investigated in systematic fashion. It is shown that, for realistic dephasing times, optimum control fields can be identified which drive the system into the target state with very high success rate and in economical fashion, even when starting from a poor initial guess. Furthermore, the optimal fields obtained give insight into the system dynamics. However, if decay rates of the system cannot be subjected to electromagnetic control, the dissipative system cannot be maintained in a specific pure or mixed state, in general.

Ghost Imaging of Space Objects

NASA Technical Reports Server (NTRS)

Strekalov, Dmitry V.; Erkmen, Baris I.; Yu, Nan

2016-01-01

Development of innovative aerospace technologies is critical for our nation to meet its goals to explore and under-stand the Earth, our solar system, and the universe. The spectacular success of many recent NASA missions hinges on the extensive technological innovations that NASA has been supporting for the past decades. To sustain this successful tradition it is very important to identify and stimulate the scientific research that may turn into a viable technology in the decades yet to come. Investment in innovative low-TRL research stimulates the growth of the scientific knowledge and enhances the technical capabilities in a way that answers the new questions and responds to new requirements.

Keys to career success in managed care.

PubMed

Sandrick, K

1996-04-01

Given the prominence that managed care will have in the future U.S. healthcare system, financial managers who want to advance their careers must take steps to hone their managed care knowledge and skills, become accomplished managed care strategists, and identify opportunities to gain expertise in the managed care field. Healthcare Financial Management interviewed a number of managed care experts to obtain their views on how healthcare financial managers can prepare for a career in managed care organizations. The experts agree that one of the keys to future success lies in financial managers' willingness to assume more and different types of responsibility than before as the shift to managed care continues.

Systemic Artery to Pulmonary Artery Fistula Associated with Mitral Regurgitation: Successful Treatment with Endovascular Embolization

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

Iwazawa, Jin, E-mail: iwazawa.jin@nissay-hp.or.j; Nakamura, Kenji; Hamuro, Masao

We present the case of a 60-year-old woman with symptomatic mitral regurgitation caused by a left-to-right shunt via anastomoses consisting of microfistulae, most likely of inflammatory origin, between the right subclavian artery and the right pulmonary artery. The three arteries responsible for fistulous formation, including the internal mammary, thyrocervical, and lateral thoracic arteries, were successfully occluded by transcatheter embolization using superabsorbent polymer microsphere (SAP-MS) particles combined with metallic coils. No complications have been identified following treatment with SAP-MS particles. This approach significantly reduced the patient's mitral regurgitation and she has remained asymptomatic for more than 4 years.

Hepatitis C Care in the Department of Veterans Affairs: Building a Foundation for Success.

PubMed

Belperio, Pamela S; Chartier, Maggie; Gonzalez, Rachel I; Park, Angela M; Ross, David B; Morgan, Tim R; Backus, Lisa I

2018-06-01

The Department of Veterans Affairs (VA) has made significant progress in treating hepatitis C virus, experiencing more than a 75% reduction in veterans remaining to be treated since the availability of oral direct-acting antivirals. Hepatitis C Innovation Teams use lean process improvement and system redesign, resulting in practice models that address gaps in care. The key to success is creative improvements in veteran access to providers, including expanded use of nonphysician providers, video telehealth, and electronic technologies. Population health management tools monitor and identify trends in care, helping the VA tailor care and address barriers. Published by Elsevier Inc.

Imaging pancreatobiliary ductal system with optical coherence tomography: A review

PubMed Central

Mahmud, Mohammad S; May, Gray R; Kamal, Mohammad M; Khwaja, Ahmed S; Sun, Carry; Vitkin, Alex; Yang, Victor XD

2013-01-01

An accurate, noninvasive and cost-effective method of in situ tissue evaluation during endoscopy would be highly advantageous for the detection of dysplasia or early cancer and for identifying different disease stages. Optical coherence tomography (OCT) is a noninvasive, high-resolution (1-10 μm) emerging optical imaging method with potential for identifying microscopic subsurface features in the pancreatic and biliary ductal system. Tissue microstructure of pancreaticobiliary ductal system has been successfully imaged by inserting an OCT probe through a standard endoscope operative channel. High-resolution OCT images and the technique’s endoscopic compatibility have allowed for the microstructural diagnostic of the pancreatobiliary diseases. In this review, we discussed currently available pancreaticobiliary ductal imaging systems to assess the pancreatobiliary tissue microstructure and to evaluate varieties of pancreaticobiliary disorders and diseases. Results show that OCT can improve the quality of images of pancreatobiliary system during endoscopic retrograde cholangiopancheatography procedure, which may be important in distinguishing between the neoplastic and non-neoplastic lesions. PMID:24255746

A methodology for global-sensitivity analysis of time-dependent outputs in systems biology modelling.

PubMed

Sumner, T; Shephard, E; Bogle, I D L

2012-09-07

One of the main challenges in the development of mathematical and computational models of biological systems is the precise estimation of parameter values. Understanding the effects of uncertainties in parameter values on model behaviour is crucial to the successful use of these models. Global sensitivity analysis (SA) can be used to quantify the variability in model predictions resulting from the uncertainty in multiple parameters and to shed light on the biological mechanisms driving system behaviour. We present a new methodology for global SA in systems biology which is computationally efficient and can be used to identify the key parameters and their interactions which drive the dynamic behaviour of a complex biological model. The approach combines functional principal component analysis with established global SA techniques. The methodology is applied to a model of the insulin signalling pathway, defects of which are a major cause of type 2 diabetes and a number of key features of the system are identified.

Australian health system restructuring - what problem is being solved?

PubMed

Dwyer, Judith M

2004-11-19

BACKGROUND: In recent years, Australian state and territory governments have reviewed and restructured the health systems they lead and regulate. This paper examines the outcomes of the most recent official published reviews of systems and structures; identifies the common themes; and addresses two questions: what problems are being addressed? And how would we know if the changes were successful? RESULTS: In all the broad, systemic reviews, the main health system problems identified were money, hospital utilisation and a weak primary health care system. The solutions are various, but there is a common trend towards centralisation of governance, often at state health authority level, and stronger accountability measures. Other common themes are hospital substitution (services to avoid the need for admission); calls for cooperation across the Commonwealth:state divide, or for its abolition; and the expected range of current efficiency and effectiveness measures (eg amalgamate pathology and support services) and ideas in good currency (eg call centres). The top-down nature of the public review process is noted, along with the political nature of the immediate catalysts for calling on a review. CONCLUSION: The long-standing tension between the pull to centralisation of authority and the need for innovation in care models is heightened by recent changes, which may be counterproductive in an era dominated by the burden of chronic disease. I argue that the current reforms will not succeed in achieving the stated goals unless they make a difference for people with chronic illness. And if this is correct, the most useful focus for evaluation of the success of the reforms may be their impact on the system's ability to develop and deliver better models of care for this growing group of patients.

Decision support at home (DS@HOME) – system architectures and requirements

PubMed Central

2012-01-01

Background Demographic change with its consequences of an aging society and an increase in the demand for care in the home environment has triggered intensive research activities in sensor devices and smart home technologies. While many advanced technologies are already available, there is still a lack of decision support systems (DSS) for the interpretation of data generated in home environments. The aim of the research for this paper is to present the state-of-the-art in DSS for these data, to define characteristic properties of such systems, and to define the requirements for successful home care DSS implementations. Methods A literature review was performed along with the analysis of cross-references. Characteristic properties are proposed and requirements are derived from the available body of literature. Results 79 papers were identified and analyzed, of which 20 describe implementations of decision components. Most authors mention server-based decision support components, but only few papers provide details about the system architecture or the knowledge base. A list of requirements derived from the analysis is presented. Among the primary drawbacks of current systems are the missing integration of DSS in current health information system architectures including interfaces, the missing agreement among developers with regard to the formalization and customization of medical knowledge and a lack of intelligent algorithms to interpret data from multiple sources including clinical application systems. Conclusions Future research needs to address these issues in order to provide useful information – and not only large amounts of data – for both the patient and the caregiver. Furthermore, there is a need for outcome studies allowing for identifying successful implementation concepts. PMID:22640470

Conversion from Tree to Graph Representation of Requirements

NASA Technical Reports Server (NTRS)

Mayank, Vimal; Everett, David Frank; Shmunis, Natalya; Austin, Mark

2009-01-01

A procedure and software to implement the procedure have been devised to enable conversion from a tree representation to a graph representation of the requirements governing the development and design of an engineering system. The need for this procedure and software and for other requirements-management tools arises as follows: In systems-engineering circles, it is well known that requirements- management capability improves the likelihood of success in the team-based development of complex systems involving multiple technological disciplines. It is especially desirable to be able to visualize (in order to identify and manage) requirements early in the system- design process, when errors can be corrected most easily and inexpensively.

On inconsistency in frictional granular systems

NASA Astrophysics Data System (ADS)

Alart, Pierre; Renouf, Mathieu

2018-04-01

Numerical simulation of granular systems is often based on a discrete element method. The nonsmooth contact dynamics approach can be used to solve a broad range of granular problems, especially involving rigid bodies. However, difficulties could be encountered and hamper successful completion of some simulations. The slow convergence of the nonsmooth solver may sometimes be attributed to an ill-conditioned system, but the convergence may also fail. The prime aim of the present study was to identify situations that hamper the consistency of the mathematical problem to solve. Some simple granular systems were investigated in detail while reviewing and applying the related theoretical results. A practical alternative is briefly analyzed and tested.

Knowledge management: implications for human service organizations.

PubMed

Austin, Michael J; Claassen, Jennette; Vu, Catherine M; Mizrahi, Paola

2008-01-01

Knowledge management has recently taken a more prominent role in the management of organizations as worker knowledge and intellectual capital are recognized as critical to organizational success. This analysis explores the literature of knowledge management including the individual level of tacit and explicit knowledge, the networks and social interactions utilized by workers to create and share new knowledge, and the multiple organizational and managerial factors associated with effective knowledge management systems. Based on the role of organizational culture, structure, leadership, and reward systems, six strategies are identified to assist human service organizations with implementing new knowledge management systems.

a Continuous Health Monitoring Guided Wave Fmd System for Retrofit to Existing Offshore Oilrigs

NASA Astrophysics Data System (ADS)

Mijarez, R.; Solis, L.; Martinez, F.

2010-02-01

An automatic health monitoring guided wave flood member detection (FMD) system, for retrofit to existing offshore oilrigs is presented. The system employs a microcontroller piezoelectric (PZT) based transmitter and a receiver instrumentation package composed of a PZT 40 kHz ultrasound transducer and a digital signal processor (DSP) module connected to a PC via USB for monitoring purposes. The transmitter and receiver were attached, non-intrusively, to the external wall of a steel tube; 1 m×27 cm×2 mm. Experiments performed in the laboratory have successfully identified automatically flooded tubes.

APGEN Scheduling: 15 Years of Experience in Planning Automation

NASA Technical Reports Server (NTRS)

Maldague, Pierre F.; Wissler, Steve; Lenda, Matthew; Finnerty, Daniel

2014-01-01

In this paper, we discuss the scheduling capability of APGEN (Activity Plan Generator), a multi-mission planning application that is part of the NASA AMMOS (Advanced Multi- Mission Operations System), and how APGEN scheduling evolved over its applications to specific Space Missions. Our analysis identifies two major reasons for the successful application of APGEN scheduling to real problems: an expressive DSL (Domain-Specific Language) for formulating scheduling algorithms, and a well-defined process for enlisting the help of auxiliary modeling tools in providing high-fidelity, system-level simulations of the combined spacecraft and ground support system.

ART/Ada design project, phase 1. Task 2 report: Detailed design

NASA Technical Reports Server (NTRS)

Allen, Bradley P.

1988-01-01

Various issues are studied in the context of the design of an Ada based expert system building tool. Using an existing successful design as a starting point, the impact is analyzed of the Ada language and Ada development methodologies on that design, the Ada system is redesigned, and its performance is analyzed using both complexity-theoretic and empirical techniques. The algorithms specified in the overall design are refined, resolving and documenting any open design issues, identifying each system module, documenting the internal architecture and control logic, and describing the primary data structures involved in the module.

Influence Map Methodology for Evaluating Systemic Safety Issues

NASA Technical Reports Server (NTRS)

2008-01-01

"Raising the bar" in safety performance is a critical challenge for many organizations, including Kennedy Space Center. Contributing-factor taxonomies organize information about the reasons accidents occur and therefore are essential elements of accident investigations and safety reporting systems. Organizations must balance efforts to identify causes of specific accidents with efforts to evaluate systemic safety issues in order to become more proactive about improving safety. This project successfully addressed the following two problems: (1) methods and metrics to support the design of effective taxonomies are limited and (2) influence relationships among contributing factors are not explicitly modeled within a taxonomy.

Statistical analysis of microgravity experiment performance using the degrees of success scale

NASA Technical Reports Server (NTRS)

Upshaw, Bernadette; Liou, Ying-Hsin Andrew; Morilak, Daniel P.

1994-01-01

This paper describes an approach to identify factors that significantly influence microgravity experiment performance. Investigators developed the 'degrees of success' scale to provide a numerical representation of success. A degree of success was assigned to 293 microgravity experiments. Experiment information including the degree of success rankings and factors for analysis was compiled into a database. Through an analysis of variance, nine significant factors in microgravity experiment performance were identified. The frequencies of these factors are presented along with the average degree of success at each level. A preliminary discussion of the relationship between the significant factors and the degree of success is presented.

Identifying Noncognitive Skills That Contribute to Dental Students' Success: Dental Faculty Perspectives.

PubMed

Virtue, Shannon Myers; Pendergast, Laura; Tellez, Marisol; Waldron, Elizabeth; Ismail, Amid

2017-03-01

The aims of this study were to identify noncognitive factors that dental faculty members perceived to contribute to dental students' success and to assess dental faculty members' ratings of the relative importance of these factors to academic performance, clinical performance, and overall success. Out of 184 eligible faculty members at one U.S. dental school, 43 respondents (23.3%) completed a survey in 2015-16. The survey asked respondents to rank the importance of seven noncognitive factors to academic performance, clinical performance, and overall success. Descriptive analysis was conducted to determine the ratings on importance of each noncognitive factor. Two additional open-ended questions asked faculty members to 1) think of dental students who performed very well and list the noncognitive factors they believed contributed to those students' success and 2) identify the two most important of those factors that contributed to success. Qualitative analysis was conducted to identify themes in the open-ended responses. The respondents rated professionalism and preparedness highest in importance for overall success. Preparedness was rated highest in importance for academic performance, and communication was highest in importance for clinical performance. Six themes were identified in the open-ended responses: communication/interpersonal skills, approach to learning, personal characteristics, professionalism, diverse experiences, and technical abilities. On both open-ended items, the most frequently cited noncognitive skill was communication/interpersonal skills followed by approach to learning. In this study, dental faculty members perceived communication, preparedness, and professionalism as important skills contributing to dental students' success.

Evaluation Criteria for Implementation of a Sustainable Sanitation and Wastewater Treatment System at Jiuzhaigou National Park, Sichuan Province, China

NASA Astrophysics Data System (ADS)

Gaulke, Linda S.; Weiyang, Xiao; Scanlon, Andrew; Henck, Amanda; Hinckley, Tom

2010-01-01

The administration of Jiuzhaigou National Park in Sichuan Province, China, is in the process of considering a range of upgrades to their sanitation and wastewater treatment systems. Their case history involves an ongoing series of engineering design flaws and management failures. The administration of the Park identified sustainability, environmental protection, and education goals for their sanitation and wastewater treatment system. To meet the goal of sustainability, environmental and economic concerns of the Park’s administration had to be balanced with socio-cultural needs. An advanced reconnaissance method was developed that identified reasons for previous failures, conducted stakeholder analysis and interviews, determined evaluation criteria, and introduced innovative alternatives with records of successful global implementations. This evaluation also helped the Park to better define their goals . To prevent future failures, the administration of the Park must commit to a balanced and thorough evaluation process for selection of a final alternative and institute effective long-term management and monitoring of systems. In addition, to meet goals and achieve energy efficient, cost-effective use of resources, the Park must shift their thinking from one of waste disposal to resource recovery. The method and criteria developed for this case study provides a framework to aid in the successful implementation of sanitation projects in both underdeveloped and developed areas of the world, incorporating socio-cultural values and resource recovery for a complex group of stakeholders.

Development of an Interactive, Web-Delivered System to Increase Provider–Patient Engagement in Smoking Cessation

PubMed Central

Delaughter, Kathryn; Crenshaw, Katie; Sobko, Heather J; Williams, Jessica H; Coley, Heather L; Ray, Midge N; Ford, Daniel E; Allison, Jeroan J; Houston, Thomas K

2011-01-01

Background Patient self-management interventions for smoking cessation are effective but underused. Health care providers do not routinely refer smokers to these interventions. Objective The objective of our study was to uncover barriers and facilitators to the use of an e-referral system that will be evaluated in a community-based randomized trial. The e-referral system will allow providers to refer smokers to an online smoking intervention during routine clinical care. Methods We devised a four-step development and pilot testing process: (1) system conceptualization using Delphi to identify key functionalities that would overcome barriers in provider referrals for smoking cessation, (2) Web system programming using agile software development and best programming practices with usability refinement using think-aloud testing, (3) implementation planning using the nominal group technique for the effective integration of the system into the workflow of practices, and (4) pilot testing to identify practice recruitment and system-use barriers in real-world settings. Results Our Delphi process (step 1) conceptualized three key e-referral functions: (1) Refer Your Smokers, allowing providers to e-refer patients at the point of care by entering their emails directly into the system, (2) practice reports, providing feedback regarding referrals and impact of smoking-cessation counseling, and (3) secure messaging, facilitating provider–patient communication. Usability testing (step 2) suggested the system was easy to use, but implementation planning (step 3) suggested several important approaches to encourage use (eg, proactive email cues to encourage practices to participate). Pilot testing (step 4) in 5 practices had limited success, with only 2 patients referred; we uncovered important recruitment and system-use barriers (eg, lack of study champion, training, and motivation, registration difficulties, and forgetting to refer). Conclusions Implementing a system to be used in a clinical setting is complex, as several issues can affect system use. In our ongoing large randomized trial, preliminary analysis with the first 50 practices using the system for 3 months demonstrated that our rigorous preimplementation evaluation helped us successfully identify and overcome these barriers before the main trial. Trial Clinicaltrials.gov NCT00797628; http://clinicaltrials.gov/ct2/show/NCT00797628 (Archived by WebCite at http://www.webcitation.org/61feCfjCy) PMID:22011394

Patient Safety Learning Systems: A Systematic Review and Qualitative Synthesis.

PubMed

2017-01-01

A patient safety learning system (sometimes called a critical incident reporting system) refers to structured reporting, collation, and analysis of critical incidents. To inform a provincial working group's recommendations for an Ontario Patient Safety Event Learning System, a systematic review was undertaken to determine design features that would optimize its adoption into the health care system and would inform implementation strategies. The objective of this review was to address two research questions: (a) what are the barriers to and facilitators of successful adoption of a patient safety learning system reported by health professionals and (b) what design components maximize successful adoption and implementation? To answer the first question, we used a published systematic review. To answer the second question, we used scoping study methodology. Common barriers reported in the literature by health care professionals included fear of blame, legal penalties, the perception that incident reporting does not improve patient safety, lack of organizational support, inadequate feedback, lack of knowledge about incident reporting systems, and lack of understanding about what constitutes an error. Common facilitators included a non-accusatory environment, the perception that incident reporting improves safety, clarification of the route of reporting and of how the system uses reports, enhanced feedback, role models (such as managers) using and promoting reporting, legislated protection of those who report, ability to report anonymously, education and training opportunities, and clear guidelines on what to report. Components of a patient safety learning system that increased successful adoption and implementation were emphasis on a blame-free culture that encourages reporting and learning, clear guidelines on how and what to report, making sure the system is user-friendly, organizational development support for data analysis to generate meaningful learning outcomes, and multiple mechanisms to provide feedback through routes to reporters and the wider community (local meetings, email alerts, bulletins, paper contributions, etc.). The design of a patient safety learning system can be optimized by an awareness of the barriers to and facilitators of successful adoption and implementation identified by health care professionals. Evaluation of the effectiveness of a patient safety learning system is needed to refine its design.

Nitrogen removal performance and loading capacity of a novel single-stage nitritation-anammox system with syntrophic micro-granules.

PubMed

Wang, Shaopo; Liu, Yuan; Niu, Qigui; Ji, Jiayuan; Hojo, Toshimasa; Li, Yu-You

2017-07-01

The operation performance of a novel micro-granule based syntrophic system of nitritation and anammox was studied by controlling the oxygen concentration and maintaining a constant temperature of 25°C. With the oxygen concentration of around 0.11 (<0.15)mg/L, the single-stage nitritation-anammox system was startup successfully at a nitrogen loading rate (NLR) of 1.5kgN/m 3 /d. The reactor was successfully operated at volumetric N loadings ranging from 0.5 to 2.5kgN/m 3 /d with a high nitrogen removal of 82%. The microbial community was composed by ammonia oxidizing bacteria (AOB) and anammox bacteria forming micro-granules with an average diameter of 0.8mm and good settleability. Results from pyrosequencing analysis revealed that Ca. Kuenenia and Nitrosomonas were selected and enriched in the community over the startup period, and these were identified as the dominant anammox bacteria and AOB species, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using technology to prevent adverse drug events in the intensive care unit.

PubMed

Hassan, Erkan; Badawi, Omar; Weber, Robert J; Cohen, Henry

2010-06-01

Critically ill patients are particularly susceptible to adverse drug events (ADEs) due to their rapidly changing and unstable physiology, complex therapeutic regimens, and large percentage of medications administered intravenously. There are a wide variety of technologies that can help prevent the points of failure commonly associated with ADEs (i.e., the five "Rights": right patient; right drug; right route; right dose; right frequency). These technologies are often categorized by their degree of complexity to design and engineer and the type of error they are designed to prevent. Focusing solely on the software and hardware design of technology may over- or underestimate the degree of difficulty to avoid ADEs at the bedside. Alternatively, we propose categorizing technological solutions by identifying the factors essential for success. The two major critical success factors are: 1) the degree of clinical assessment required by the clinician to appropriately evaluate and disposition the issue identified by a technology; and 2) the complexity associated with effective implementation. This classification provides a way of determining how ADE-preventing technologies in the intensive care unit can be successfully integrated into clinical practice. Although there are limited data on the effectiveness of many technologies in reducing ADEs, we will review the technologies currently available in the intensive care unit environment. We will also discuss critical success factors for implementation, common errors made during implementation, and the potential errors using these systems.

Research in software allocation for advanced manned mission communications and tracking systems

NASA Technical Reports Server (NTRS)

Warnagiris, Tom; Wolff, Bill; Kusmanoff, Antone

1990-01-01

An assessment of the planned processing hardware and software/firmware for the Communications and Tracking System of the Space Station Freedom (SSF) was performed. The intent of the assessment was to determine the optimum distribution of software/firmware in the processing hardware for maximum throughput with minimum required memory. As a product of the assessment process an assessment methodology was to be developed that could be used for similar assessments of future manned spacecraft system designs. The assessment process was hampered by changing requirements for the Space Station. As a result, the initial objective of determining the optimum software/firmware allocation was not fulfilled, but several useful conclusions and recommendations resulted from the assessment. It was concluded that the assessment process would not be completely successful for a system with changing requirements. It was also concluded that memory requirements and hardware requirements were being modified to fit as a consequence of the change process, and although throughput could not be quantitized, potential problem areas could be identified. Finally, inherent flexibility of the system design was essential for the success of a system design with changing requirements. Recommendations resulting from the assessment included development of common software for some embedded controller functions, reduction of embedded processor requirements by hardwiring some Orbital Replacement Units (ORUs) to make better use of processor capabilities, and improvement in communications between software development personnel to enhance the integration process. Lastly, a critical observation was made regarding the software integration tasks did not appear to be addressed in the design process to the degree necessary for successful satisfaction of the system requirements.

The Integrated Hazard Analysis Integrator

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Massie, Michael J.

2009-01-01

Hazard analysis addresses hazards that arise in the design, development, manufacturing, construction, facilities, transportation, operations and disposal activities associated with hardware, software, maintenance, operations and environments. An integrated hazard is an event or condition that is caused by or controlled by multiple systems, elements, or subsystems. Integrated hazard analysis (IHA) is especially daunting and ambitious for large, complex systems such as NASA s Constellation program which incorporates program, systems and element components that impact others (International Space Station, public, International Partners, etc.). An appropriate IHA should identify all hazards, causes, controls and verifications used to mitigate the risk of catastrophic loss of crew, vehicle and/or mission. Unfortunately, in the current age of increased technology dependence, there is the tendency to sometimes overlook the necessary and sufficient qualifications of the integrator, that is, the person/team that identifies the parts, analyzes the architectural structure, aligns the analysis with the program plan and then communicates/coordinates with large and small components, each contributing necessary hardware, software and/or information to prevent catastrophic loss. As viewed from both Challenger and Columbia accidents, lack of appropriate communication, management errors and lack of resources dedicated to safety were cited as major contributors to these fatalities. From the accident reports, it would appear that the organizational impact of managers, integrators and safety personnel contributes more significantly to mission success and mission failure than purely technological components. If this is so, then organizations who sincerely desire mission success must put as much effort in selecting managers and integrators as they do when designing the hardware, writing the software code and analyzing competitive proposals. This paper will discuss the necessary and sufficient requirements of one of the significant contributors to mission success, the IHA integrator. Discussions will be provided to describe both the mindset required as well as deleterious assumptions/behaviors to avoid when integrating within a large scale system.

Automated tracking of the Florida manatee (Trichechus manatus)

NASA Technical Reports Server (NTRS)

Michelson, R. C.; Breedlove, J.; Jenkins, H. H.

1978-01-01

The electronic, physical, biological and environmental factors involved in the automated remote tracking of the Florida manatee (Trichechus manatus) are identified. The current status of the manatee as an endangered species is provided. Brief descriptions of existing tracking and position locating systems are presented to identify the state of the art in these fields. An analysis of energy media is conducted to identify those with the highest probability of success for this application. Logistic questions such as the means of attachment and position of any equipment to be placed on the manatee are also investigated. Power sources and manateeborne electronics encapsulation techniques are studied and the results of a compter generated DF network analysis are summarized.

C-reactive protein and familial risk for dementia: a phenotype for successful cognitive aging.

PubMed

Silverman, Jeremy M; Schmeidler, James; Beeri, Michal S; Rosendorff, Clive; Sano, Mary; Grossman, Hillel T; Carrión-Baralt, José R; Bespalova, Irina N; West, Rebecca; Haroutunian, Vahram

2012-09-11

Identifying phenotypes for successful cognitive aging, intact cognition into late-old age (>age 75), can help identify genes and neurobiological systems that may lead to interventions against and prevention of late-life cognitive impairment. The association of C-reactive protein (CRP) with cognitive impairment and dementia, observed primarily in young-elderly samples, appears diminished or reversed in late-old age (75+ years). A family history study determined if high CRP levels in late-old aged cognitively intact probands are associated with a reduced risk of dementia in their first-degree family members, suggesting a familial successful cognitive aging phenotype. The primary sample was 1,329 parents and siblings of 277 cognitively intact male veteran probands at least 75 years old. The replication sample was 202 relatives of 51 cognitively intact community-ascertained probands at least 85 years old. Relatives were assessed for dementia by proband informant interview. Their hazard ratio (HR) for dementia as a function of the proband's log-transformed CRP was calculated using the proportional hazards model. Covarying for key demographics, higher CRP in probands was strongly associated with lower risk of dementia in relatives (HR = 0.55 [95% confidence interval (CI) 0.41, 0.74], p < 0.02). The replication sample relationship was in the same direction, stronger in magnitude, and also significant (HR = 0.15 [95% CI 0.06, 0.37], p < 0.0001). Relatives of successful cognitive aging individuals with high levels of CRP are relatively likely to remain free of dementia. High CRP in successful cognitive aging individuals may constitute a phenotype for familial-and thus possibly genetic-successful cognitive aging.

An Exploratory Analysis of Network Characteristics and Quality of Interactions among Public Health Collaboratives

PubMed Central

Varda, Danielle M.; Retrum, Jessica H.

2012-01-01

While the benefits of collaboration have become widely accepted and the practice of collaboration is growing within the public health system, a paucity of research exists that examines factors and mechanisms related to effective collaboration between public health and their partner organizations. The purpose of this paper is to address this gap by exploring the structural and organizational characteristics of public health collaboratives. Design and Methods. Using both social network analysis and traditional statistical methods, we conduct an exploratory secondary data analysis of 11 public health collaboratives chosen from across the United States. All collaboratives are part of the PARTNER (www.partnertool.net) database. We analyze data to identify relational patterns by exploring the structure (the way that organizations connect and exchange relationships), in relation to perceptions of value and trust, explanations for varying reports of success, and factors related to outcomes. We describe the characteristics of the collaboratives, types of resource contributions, outcomes of the collaboratives, perceptions of success, and reasons for success. We found high variation and significant differences within and between these collaboratives including perceptions of success. There were significant relationships among various factors such as resource contributions, reasons cited for success, and trust and value perceived by organizations. We find that although the unique structure of each collaborative makes it challenging to identify a specific set of factors to determine when a collaborative will be successful, the organizational characteristics and interorganizational dynamics do appear to impact outcomes. We recommend a quality improvement process that suggests matching assessment to goals and developing action steps for performance improvement. Acknowledgements the authors would like to thank the Robert Wood Johnson Foundation’s Public Health Program for funding for this research. PMID:25170462

An Exploratory Analysis of Network Characteristics and Quality of Interactions among Public Health Collaboratives.

PubMed

Varda, Danielle M; Retrum, Jessica H

2012-06-15

While the benefits of collaboration have become widely accepted and the practice of collaboration is growing within the public health system, a paucity of research exists that examines factors and mechanisms related to effective collaboration between public health and their partner organizations. The purpose of this paper is to address this gap by exploring the structural and organizational characteristics of public health collaboratives. Design and Methods. Using both social network analysis and traditional statistical methods, we conduct an exploratory secondary data analysis of 11 public health collaboratives chosen from across the United States. All collaboratives are part of the PARTNER (www.partnertool.net) database. We analyze data to identify relational patterns by exploring the structure (the way that organizations connect and exchange relationships), in relation to perceptions of value and trust, explanations for varying reports of success, and factors related to outcomes. We describe the characteristics of the collaboratives, types of resource contributions, outcomes of the collaboratives, perceptions of success, and reasons for success. We found high variation and significant differences within and between these collaboratives including perceptions of success. There were significant relationships among various factors such as resource contributions, reasons cited for success, and trust and value perceived by organizations. We find that although the unique structure of each collaborative makes it challenging to identify a specific set of factors to determine when a collaborative will be successful, the organizational characteristics and interorganizational dynamics do appear to impact outcomes. We recommend a quality improvement process that suggests matching assessment to goals and developing action steps for performance improvement. the authors would like to thank the Robert Wood Johnson Foundation's Public Health Program for funding for this research.

Male mate choice influences female promiscuity in Soay sheep

PubMed Central

Preston, B.T.; Stevenson, I.R.; Pemberton, J.M.; Coltman, D.W.; Wilson, K.

2005-01-01

In most animal species, males are predicted to compete for reproductive opportunities, while females are expected to choose between potential mates. However, when males’ rate of reproduction is constrained, or females vary widely in ‘quality’, male mate choice is also predicted to occur. Such conditions exist in the promiscuous mating system of feral Soay sheep on St Kilda, Scotland, where a highly synchronized mating season, intense sperm competition and limitations on sperm production constrain males’ potential reproductive rate, and females vary substantially in their ability to produce successful offspring. We show that, consistent with predictions, competitive rams focus their mating activity and siring success towards heavier females with higher inclusive fitness. To our knowledge, this is the first time that male mate choice has been identified and shown to lead to assortative patterns of parentage in a natural mammalian system, and occurs despite fierce male–male competition for mates. An additional consequence of assortative mating in this population is that lighter females experience a series of unstable consorts with less adept rams, and hence are mated by a greater number of males during their oestrus. We have thus also identified a novel male-driven mechanism that generates variation in female promiscuity, which suggests that the high levels of female promiscuity in this system are not part of an adaptive female tactic to intensify post-copulatory competition between males. PMID:15734690

Male mate choice influences female promiscuity in Soay sheep.

PubMed

Preston, B T; Stevenson, I R; Pemberton, J M; Coltman, D W; Wilson, K

2005-02-22

In most animal species, males are predicted to compete for reproductive opportunities, while females are expected to choose between potential mates. However, when males' rate of reproduction is constrained, or females vary widely in 'quality', male mate choice is also predicted to occur. Such conditions exist in the promiscuous mating system of feral Soay sheep on St Kilda, Scotland, where a highly synchronized mating season, intense sperm competition and limitations on sperm production constrain males' potential reproductive rate, and females vary substantially in their ability to produce successful offspring. We show that, consistent with predictions, competitive rams focus their mating activity and siring success towards heavier females with higher inclusive fitness. To our knowledge, this is the first time that male mate choice has been identified and shown to lead to assortative patterns of parentage in a natural mammalian system, and occurs despite fierce male-male competition for mates. An additional consequence of assortative mating in this population is that lighter females experience a series of unstable consorts with less adept rams, and hence are mated by a greater number of males during their oestrus. We have thus also identified a novel male-driven mechanism that generates variation in female promiscuity, which suggests that the high levels of female promiscuity in this system are not part of an adaptive female tactic to intensify post-copulatory competition between males.

Managing change in the nursing handover from traditional to bedside handover – a case study from Mauritius

PubMed Central

Kassean, Hemant K; Jagoo, Zaheda B

2005-01-01

Background The shift handover forms an important part of the communication process that takes place twice within the nurses' working day in the gynaecological ward. This paper addresses the topic of implementing a new system of bedside handover, which puts patients central to the whole process of managing care and also addresses some of the shortcomings of the traditional handover system. Methods A force field analysis in terms of the driving forces had shown that there was dissatisfaction with the traditional method of handover which had led to an increase in the number of critical incidents and complaints from patients, relatives and doctors. The restraining forces identified were a fear of accountability, lack of confidence and that this change would lead to more work. A 3 – step planned change model consisting of unfreezing, moving and refreezing was used to guide us through the change process. Resistance to change was managed by creating a climate of open communication where stakeholders were allowed to voice opinions, share concerns, insights, and ideas thereby actively participating in decision making. Results An evaluation had shown that this process was successfully implemented to the satisfaction of patients, and staff in general. Conclusion This successful change should encourage other nurses to become more proactive in identifying areas for change management in order to improve our health care system. PMID:15676078

Tracking microbial colonization in fecal microbiota transplantation experiments via genome-resolved metagenomics

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

Lee, Sonny T. M.; Kahn, Stacy A.; Delmont, Tom O.

Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. However, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of FMT experiments fail to provide enough resolution to identify populations that are likely responsible for FMT-derived benefits. Here, we used shotgun metagenomics together with assembly and binning strategies to reconstruct metagenome-assembled genomes (MAGs) from fecal samples of a single FMT donor. We then used metagenomic mapping to track themore » occurrence and distribution patterns of donor MAGs in two FMT recipients. Our analyses revealed that 22% of the 92 highly complete bacterial MAGs that we identified from the donor successfully colonized and remained abundant in two recipients for at least 8 weeks. Most MAGs with a high colonization rate belonged to the order Bacteroidales. The vast majority of those that lacked evidence of colonization belonged to the order Clostridiales, and colonization success was negatively correlated with the number of genes related to sporulation. Our analysis of 151 publicly available gut metagenomes showed that the donor MAGs that colonized both recipients were prevalent, and the ones that colonized neither were rare across the participants of the Human Microbiome Project. Although our dataset showed a link between taxonomy and the colonization ability of a given MAG, we also identified MAGs that belong to the same taxon with different colonization properties, highlighting the importance of an appropriate level of resolution to explore the functional basis of colonization and to identify targets for cultivation, hypothesis generation, and testing in model systems. Lastly, the analytical strategy adopted in our study can provide genomic insights into bacterial populations that may be critical to the efficacy of FMT due to their success in gut colonization and metabolic properties, and guide cultivation efforts to investigate mechanistic underpinnings of this procedure beyond associations.« less

Tracking microbial colonization in fecal microbiota transplantation experiments via genome-resolved metagenomics

DOE PAGES

Lee, Sonny T. M.; Kahn, Stacy A.; Delmont, Tom O.; ...

2017-05-04

Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. However, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of FMT experiments fail to provide enough resolution to identify populations that are likely responsible for FMT-derived benefits. Here, we used shotgun metagenomics together with assembly and binning strategies to reconstruct metagenome-assembled genomes (MAGs) from fecal samples of a single FMT donor. We then used metagenomic mapping to track themore » occurrence and distribution patterns of donor MAGs in two FMT recipients. Our analyses revealed that 22% of the 92 highly complete bacterial MAGs that we identified from the donor successfully colonized and remained abundant in two recipients for at least 8 weeks. Most MAGs with a high colonization rate belonged to the order Bacteroidales. The vast majority of those that lacked evidence of colonization belonged to the order Clostridiales, and colonization success was negatively correlated with the number of genes related to sporulation. Our analysis of 151 publicly available gut metagenomes showed that the donor MAGs that colonized both recipients were prevalent, and the ones that colonized neither were rare across the participants of the Human Microbiome Project. Although our dataset showed a link between taxonomy and the colonization ability of a given MAG, we also identified MAGs that belong to the same taxon with different colonization properties, highlighting the importance of an appropriate level of resolution to explore the functional basis of colonization and to identify targets for cultivation, hypothesis generation, and testing in model systems. Lastly, the analytical strategy adopted in our study can provide genomic insights into bacterial populations that may be critical to the efficacy of FMT due to their success in gut colonization and metabolic properties, and guide cultivation efforts to investigate mechanistic underpinnings of this procedure beyond associations.« less

Reliability Issues in Stirling Radioisotope Power Systems

NASA Technical Reports Server (NTRS)

Schreiber, Jeffrey; Shah, Ashwin

2005-01-01

Stirling power conversion is a potential candidate for use in a Radioisotope Power System (RPS) for space science missions because it offers a multifold increase in the conversion efficiency of heat to electric power and reduced requirement of radioactive material. Reliability of an RPS that utilizes Stirling power conversion technology is important in order to ascertain long term successful performance. Owing to long life time requirement (14 years), it is difficult to perform long-term tests that encompass all the uncertainties involved in the design variables of components and subsystems comprising the RPS. The requirement for uninterrupted performance reliability and related issues are discussed, and some of the critical areas of concern are identified. An overview of the current on-going efforts to understand component life, design variables at the component and system levels, and related sources and nature of uncertainties are also discussed. Current status of the 110 watt Stirling Radioisotope Generator (SRG110) reliability efforts is described. Additionally, an approach showing the use of past experience on other successfully used power systems to develop a reliability plan for the SRG110 design is outlined.

Reliability Issues in Stirling Radioisotope Power Systems

NASA Technical Reports Server (NTRS)

Shah, Ashwin R.; Schreiber, Jeffrey G.

2004-01-01

Stirling power conversion is a potential candidate for use in a Radioisotope Power System (RPS) for space science missions because it offers a multifold increase in the conversion efficiency of heat to electric power and reduced requirement of radioactive material. Reliability of an RPS that utilizes Stirling power conversion technology is important in order to ascertain long term successful performance. Owing to long life time requirement (14 years), it is difficult to perform long-term tests that encompass all the uncertainties involved in the design variables of components and subsystems comprising the RPS. The requirement for uninterrupted performance reliability and related issues are discussed, and some of the critical areas of concern are identified. An overview of the current on-going efforts to understand component life, design variables at the component and system levels, and related sources and nature of uncertainties are also discussed. Current status of the 110 watt Stirling Radioisotope Generator (SRG110) reliability efforts is described. Additionally, an approach showing the use of past experience on other successfully used power systems to develop a reliability plan for the SRG110 design is outlined.

Retired Adults: Perceptions on Successful Retirement

ERIC Educational Resources Information Center

Rausch, Suzanne

2013-01-01

This dissertation is an examination of the perceptions offered by adults who self-identify as being successfully retired. The increase in the percentage of the retiring population in the United States in the immediate future alerts us to the need to identify strategies that have been reported by retirees to successfully transition into retirement.…

From complexity to reality: providing useful frameworks for defining systems of care.

PubMed

Levison-Johnson, Jody; Wenz-Gross, Melodie

2010-02-01

Because systems of care are not uniform across communities, there is a need to better document the process of system development, define the complexity, and describe the development of the structures, processes, and relationships within communities engaged in system transformation. By doing so, we begin to identify the necessary and sufficient components that, at minimum, move us from usual care within a naturally occurring system to a true system of care. Further, by documenting and measuring the degree to which key components are operating, we may be able to identify the most successful strategies in creating system reform. The theory of change and logic model offer a useful framework for communities to begin the adaptive work necessary to effect true transformation. Using the experience of two system of care communities, this new definition and the utility of a theory of change and logic model framework for defining local system transformation efforts will be discussed. Implications for the field, including the need to further examine the natural progression of systems change and to create quantifiable measures of transformation, will be raised as new challenges for the evolving system of care movement.

A web-based information system for a regional public mental healthcare service network in Brazil.

PubMed

Yoshiura, Vinicius Tohoru; de Azevedo-Marques, João Mazzoncini; Rzewuska, Magdalena; Vinci, André Luiz Teixeira; Sasso, Ariane Morassi; Miyoshi, Newton Shydeo Brandão; Furegato, Antonia Regina Ferreira; Rijo, Rui Pedro Charters Lopes; Del-Ben, Cristina Marta; Alves, Domingos

2017-01-01

Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.

A comprehensive strategy for identifying long-distance mobile peptides in xylem sap.

PubMed

Okamoto, Satoru; Suzuki, Takamasa; Kawaguchi, Masayoshi; Higashiyama, Tetsuya; Matsubayashi, Yoshikatsu

2015-11-01

There is a growing awareness that secreted pemediate organ-to-organ communication in higher plants. Xylem sap peptidomics is an effective but challenging approach for identifying long-distance mobile peptides. In this study we developed a simple, gel-free purification system that combines o-chlorophenol extraction with HPLC separation. Using this system, we successfully identified seven oligopeptides from soybean xylem sap exudate that had one or more post-transcriptional modifications: glycosylation, sulfation and/or hydroxylation. RNA sequencing and quantitative PCR analyses showed that the peptide-encoding genes are expressed in multiple tissues. We further analyzed the long-distance translocation of four of the seven peptides using gene-encoding peptides with single amino acid substitutions, and identified these four peptides as potential root-to-shoot mobile oligopeptides. Promoter-GUS analysis showed that all four peptide-encoding genes were expressed in the inner tissues of the root endodermis. Moreover, we found that some of these peptide-encoding genes responded to biotic and/or abiotic factors. These results indicate that our purification system provides a comprehensive approach for effectively identifying endogenous small peptides and reinforce the concept that higher plants employ various peptides in root-to-shoot signaling. © 2015 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.

Development of a statewide trauma registry using multiple linked sources of data.

PubMed Central

Clark, D. E.

1993-01-01

In order to develop a cost-effective method of injury surveillance and trauma system evaluation in a rural state, computer programs were written linking records from two major hospital trauma registries, a statewide trauma tracking study, hospital discharge abstracts, death certificates, and ambulance run reports. A general-purpose database management system, programming language, and operating system were used. Data from 1991 appeared to be successfully linked using only indirect identifying information. Familiarity with local geography and the idiosyncracies of each data source were helpful in programming for effective matching of records. For each individual case identified in this way, data from all available sources were then merged and imported into a standard database format. This inexpensive, population-based approach, maintaining flexibility for end-users with some database training, may be adaptable for other regions. There is a need for further improvement and simplification of the record-linkage process for this and similar purposes. PMID:8130556

Entry, Descent and Landing Systems Analysis: Exploration Feed Forward Internal Peer Review Slide Package

NASA Technical Reports Server (NTRS)

Dwyer Cianciolo, Alicia M. (Editor)

2011-01-01

NASA senior management commissioned the Entry, Descent and Landing Systems Analysis (EDL-SA) Study in 2008 to identify and roadmap the Entry, Descent and Landing (EDL) technology investments that the agency needed to successfully land large payloads at Mars for both robotic and human-scale missions. Year 1 of the study focused on technologies required for Exploration-class missions to land payloads of 10 to 50 mt. Inflatable decelerators, rigid aeroshell and supersonic retro-propulsion emerged as the top candidate technologies. In Year 2 of the study, low TRL technologies identified in Year 1, inflatables aeroshells and supersonic retropropulsion, were combined to create a demonstration precursor robotic mission. This part of the EDL-SA Year 2 effort, called Exploration Feed Forward (EFF), took much of the systems analysis simulation and component model development from Year 1 to the next level of detail.

SP-100 system thaw and start-up strategies

NASA Astrophysics Data System (ADS)

Kirpich, A.; Choe, H.

The authors review several strategies that have been considered during calendar year 1990 for SP-100 system start-up and thaw, and provide results of screening analyses. Screening studies have identified three concepts which are capable of thawing the SP-100 system: (1) a heat pipe approach in which reactor-heated heat pipes are routed to equipment enclosed within a thaw cavity; (2) a bleed-tube approach in which perforated tubes routed through ducting and components achieve thaw progressively as the result of successively thawing bleed-holes; and (3) a NaK traceline approach in which reactor-heated NaK is routed along ducting and components and achieves lithium thaw by both radiative and conductive coupling methods. Key issues have been identified in connection with pump start-up, reactor and power converter transient behavior, and hydraulic circuit stability. Pump start-up stability is accomplished by a linked-pump hydraulic arrangement.

Barriers to Remote Health Interventions for Type 2 Diabetes: A Systematic Review and Proposed Classification Scheme

PubMed Central

Kum, Hye-Chung; Gonzalez Coronado, Karla; Foster, Margaret J; Ortega, Pearl; Lawley, Mark A

2017-01-01

Background Diabetes self-management involves adherence to healthy daily habits typically involving blood glucose monitoring, medication, exercise, and diet. To support self-management, some providers have begun testing remote interventions for monitoring and assisting patients between clinic visits. Although some studies have shown success, there are barriers to widespread adoption. Objective The objective of our study was to identify and classify barriers to adoption of remote health for management of type 2 diabetes. Methods The following 6 electronic databases were searched for articles published from 2010 to 2015: MEDLINE (Ovid), Embase (Ovid), CINAHL, Cochrane Central, Northern Light Life Sciences Conference Abstracts, and Scopus (Elsevier). The search identified studies involving remote technologies for type 2 diabetes self-management. Reviewers worked in teams of 2 to review and extract data from identified papers. Information collected included study characteristics, outcomes, dropout rates, technologies used, and barriers identified. Results A total of 53 publications on 41 studies met the specified criteria. Lack of data accuracy due to input bias (32%, 13/41), limitations on scalability (24%, 10/41), and technology illiteracy (24%, 10/41) were the most commonly cited barriers. Technology illiteracy was most prominent in low-income populations, whereas limitations on scalability were more prominent in mid-income populations. Barriers identified were applied to a conceptual model of successful remote health, which includes patient engagement, patient technology accessibility, quality of care, system technology cost, and provider productivity. In total, 40.5% (60/148) of identified barrier instances impeded patient engagement, which is manifest in the large dropout rates cited (up to 57%). Conclusions The barriers identified represent major challenges in the design of remote health interventions for diabetes. Breakthrough technologies and systems are needed to alleviate the barriers identified so far, particularly those associated with patient engagement. Monitoring devices that provide objective and reliable data streams on medication, exercise, diet, and glucose monitoring will be essential for widespread effectiveness. Additional work is needed to understand root causes of high dropout rates, and new interventions are needed to identify and assist those at the greatest risk of dropout. Finally, future studies must quantify costs and benefits to determine financial sustainability. PMID:28193598

Innovations in non-communicable diseases management in ASEAN: a case series.

PubMed

Lim, Jeremy; Chan, Melissa M H; Alsagoff, Fatimah Z; Ha, Duc

2014-01-01

Non-communicable diseases (NCDs) are reaching epidemic proportions worldwide and present an unprecedented challenge to economic and social development globally. In Southeast Asia, the challenges are exacerbated by vastly differing levels of health systems development and funding availability. In addressing the burden of NCDs, ASEAN nations need to fundamentally re-examine how health care services are structured and delivered and discover new models as undiscerning application of models from other geographies with different cultures and resources will be problematic. We sought to examine cases of innovation and identify critical success factors in NCD management in ASEAN. A qualitative design, focusing on in-depth interviews and site visits to explore the meanings and perceptions of participants regarding innovations in NCD against the backdrop of the overall context of delivering health care within the country's context was adopted. In total 12 case studies in six ASEAN countries were analysed. Primary interventions accounted for five of the total cases, whereas secondary interventions comprised four, and tertiary interventions three. Five core themes contributing to successful innovation for NCD management were identified. They include: 1) encourage better outcomes through leadership and support, 2) strengthen inter-disciplinary partnership, 3) community ownership is key, 4) recognise the needs of the people and what appeals to them, and 5) raise awareness through capacity building and increasing health literacy. Innovation is vital in enabling ASEAN nations to successfully address the growing crisis of NCDs. More of the same or wholesale transfers of developed world models will be ineffective and lead to financially unsustainable programmes or programmes lacking appropriate human capital. The case studies have demonstrated the transformative impact of innovation and identified key factors in successful implementation. Beyond pilot success, the bigger challenge is scaling up. Medical technologies are crucial but insufficient; passionate and engaged leaders and communities enabled by enlightened policy makers and funding agencies matter more.

Innovations in non-communicable diseases management in ASEAN: a case series

PubMed Central

Lim, Jeremy; Chan, Melissa M. H.; Alsagoff, Fatimah Z.; Ha, Duc

2014-01-01

Background Non-communicable diseases (NCDs) are reaching epidemic proportions worldwide and present an unprecedented challenge to economic and social development globally. In Southeast Asia, the challenges are exacerbated by vastly differing levels of health systems development and funding availability. In addressing the burden of NCDs, ASEAN nations need to fundamentally re-examine how health care services are structured and delivered and discover new models as undiscerning application of models from other geographies with different cultures and resources will be problematic. Objective We sought to examine cases of innovation and identify critical success factors in NCD management in ASEAN. Design A qualitative design, focusing on in-depth interviews and site visits to explore the meanings and perceptions of participants regarding innovations in NCD against the backdrop of the overall context of delivering health care within the country's context was adopted. Results In total 12 case studies in six ASEAN countries were analysed. Primary interventions accounted for five of the total cases, whereas secondary interventions comprised four, and tertiary interventions three. Five core themes contributing to successful innovation for NCD management were identified. They include: 1) encourage better outcomes through leadership and support, 2) strengthen inter-disciplinary partnership, 3) community ownership is key, 4) recognise the needs of the people and what appeals to them, and 5) raise awareness through capacity building and increasing health literacy. Conclusions Innovation is vital in enabling ASEAN nations to successfully address the growing crisis of NCDs. More of the same or wholesale transfers of developed world models will be ineffective and lead to financially unsustainable programmes or programmes lacking appropriate human capital. The case studies have demonstrated the transformative impact of innovation and identified key factors in successful implementation. Beyond pilot success, the bigger challenge is scaling up. Medical technologies are crucial but insufficient; passionate and engaged leaders and communities enabled by enlightened policy makers and funding agencies matter more. PMID:25249061

Work System Assessment to Facilitate the Dissemination of a Quality Improvement Program for Optimizing Blood Culture Use: A Case Study Using a Human Factors Engineering Approach.

PubMed

Xie, Anping; Woods-Hill, Charlotte Z; King, Anne F; Enos-Graves, Heather; Ascenzi, Judy; Gurses, Ayse P; Klaus, Sybil A; Fackler, James C; Milstone, Aaron M

2017-11-20

Work system assessments can facilitate successful implementation of quality improvement programs. Using a human factors engineering approach, we conducted a work system assessment to facilitate the dissemination of a quality improvement program for optimizing blood culture use in pediatric intensive care units at 2 hospitals. Semistructured face-to-face interviews were conducted with clinicians from Johns Hopkins All Children's Hospital and University of Virginia Medical Center. Interview data were analyzed using qualitative content analysis. Blood culture-ordering practices are influenced by various work system factors, including people, tasks, tools and technologies, the physical environment, organizational conditions, and the external environment. A clinical decision-support tool could facilitate implementation by (1) standardizing blood culture-ordering practices, (2) ensuring that prescribing clinicians review the patient's condition before ordering a blood culture, (3) facilitating critical thinking, and (4) empowering nurses to communicate with physicians and advocate for adherence to blood culture-ordering guidelines. The success of interventions for optimizing blood culture use relies heavily on the local context. A work system analysis using a human factors engineering approach can identify key areas to be addressed for the successful dissemination of quality improvement interventions. © The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation.

PubMed

Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

2017-08-14

Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Using a mixed-method, qualitative approach, we observed training of service providers who were required to switch from telephone to video, and conducted pre- and post-training interviews with 15 service providers and their trainers on the challenges associated with transitioning to video. Two full days of simulation training were observed. Data were transcribed and analysed using an inductive approach; a modified constant comparative method was employed to identify common themes. We found three broad categories of issues likely to affect implementation of the video service: social, professional, and technical. Within these categories, eight sub-themes were identified; they were: enhanced delivery of the health service, improved health advice for people living in remote areas, safety concerns, professional risks, poor uptake of video service, system design issues, use of simulation for system testing, and use of simulation for system training. This study identified a number of unexpected potential barriers to successful transition from telephone to the video system. Most prominent were technical and training issues, and personal safety concerns about transitioning from telephone to video media. Addressing identified issues prior to implementation of a new video telehealth system is likely to improve effectiveness and uptake.

Human Factors Engineering: Current and Emerging Dual-Use Applications

NASA Technical Reports Server (NTRS)

Chandlee, G. O.; Goldsberry, B. S.

1994-01-01

Human Factors Engineering is a multidisciplinary endeavor in which information pertaining to human characteristics is used in the development of systems and machines. Six representatives considered to be experts from the public and private sectors were surveyed in an effort to identify the potential dual-use of human factors technology. Each individual was asked to provide a rating as to the dual-use of 85 identified NASA technologies. Results of the survey were as follows: nearly 75 percent of the technologies were identified at least once as high dual-use by one of the six survey respondents, and nearly 25 percent of the identified NASA technologies were identified as high dual-use technologies by a majority of the respondents. The perceived level of dual-use appeared to be independent of the technology category. Successful identification of dual-use technology requires expanded input from industry. As an adjunct, cost-benefit analysis should be conducted to identify the feasibility of the dual-use technology. Concurrent with this effort should be an examination of precedents established by other technologies in other industrial settings. Advances in human factors and systems engineering are critical to reduce risk in any workplace and to enhance industrial competitiveness.

Determinants of successful clinical networks: the conceptual framework and study protocol.

PubMed

Haines, Mary; Brown, Bernadette; Craig, Jonathan; D'Este, Catherine; Elliott, Elizabeth; Klineberg, Emily; McInnes, Elizabeth; Middleton, Sandy; Paul, Christine; Redman, Sally; Yano, Elizabeth M

2012-03-13

Clinical networks are increasingly being viewed as an important strategy for increasing evidence-based practice and improving models of care, but success is variable and characteristics of networks with high impact are uncertain. This study takes advantage of the variability in the functioning and outcomes of networks supported by the Australian New South Wales (NSW) Agency for Clinical Innovation's non-mandatory model of clinical networks to investigate the factors that contribute to the success of clinical networks. The objective of this retrospective study is to examine the association between external support, organisational and program factors, and indicators of success among 19 clinical networks over a three-year period (2006-2008). The outcomes (health impact, system impact, programs implemented, engagement, user perception, and financial leverage) and explanatory factors will be collected using a web-based survey, interviews, and record review. An independent expert panel will provide judgements about the impact or extent of each network's initiatives on health and system impacts. The ratings of the expert panel will be the outcome used in multivariable analyses. Following the rating of network success, a qualitative study will be conducted to provide a more in-depth examination of the most successful networks. This is the first study to combine quantitative and qualitative methods to examine the factors that contribute to the success of clinical networks and, more generally, is the largest study of clinical networks undertaken. The adaptation of expert panel methods to rate the impacts of networks is the methodological innovation of this study. The proposed project will identify the conditions that should be established or encouraged by agencies developing clinical networks and will be of immediate use in forming strategies and programs to maximise the effectiveness of such networks.

A complex magma reservoir system for a large volume intra- to extra-caldera ignimbrite: Mineralogical and chemical architecture of the VEI8, Permian Ora ignimbrite (Italy)

NASA Astrophysics Data System (ADS)

Willcock, M. A. W.; Bargossi, G. M.; Weinberg, R. F.; Gasparotto, G.; Cas, R. A. F.; Giordano, G.; Marocchi, M.

2015-11-01

Intra-caldera settings record a wealth of information on caldera-forming processes, yet field study is rarely possible due to lack of access and exposure. The Permian Ora Formation, Italy, preserves > 1000 m of vertical section through its intra-caldera succession. This provides an excellent opportunity to detail its mineralogical and geochemical architecture and gain understanding of the eruption evolution and insight into the pre-eruptive magma system. Detailed juvenile clast phenocryst and matrix crystal fragment point count and image analysis data, coupled with bulk-rock chemistry and single mineral compositional data, show that the Ora ignimbrite succession is rhyolitic (72.5-77.7% SiO2), crystal-rich (~ 25-57%; average 43%) and has a constant main mineral population (volcanic quartz + sanidine + plagioclase + biotite). Although a seemingly homogeneous ignimbrite succession, important subtle but detectable lateral and vertical variations in modal mineralogy and bulk-rock major and trace elements are identified here. The Ora Formation is comprised of multiple lithofacies, dominated by four densely welded ignimbrite lithofacies. They are crystal-rich, typically lithic-poor (< 2%), and juvenile clast-bearing (average 20%). The ignimbrite lithofacies are distinguished by variation in crystal fragment size and abundance and total lithic content. The intra-caldera stratigraphic architecture shows both localised and some large-scale lithofacies correlation, however, it does not conform to a 'layer-cake' stratigraphy. The intra-caldera succession is divided into two depo-centres: Southern and Northern, with proximal extra-caldera deposits preserved to the south and north of the system. The Southern and Northern intra-caldera ignimbrite successions are discriminated by variations in total biotite crystal abundance. Detailed mineralogical and chemical data records decreases across the caldera system from south to north in biotite phenocrysts in the groundmass of juvenile clasts (average 12-2%), matrix biotite (average 7.5-2%) and plagioclase crystal fragments (average 18-6%), and total crystal fragment abundance in the matrix (average 47-37%); a biotite compositional change to iron-rich (0.57-0.78 Fe); and bulk-rock element decreases in Fe2O3, MgO, P2O5, Ce, Hf, V, La and Zr, and increases in SiO2, Y and Nb, with TiO2. Together, the changes enable subtle distinction of the Southern and Northern successions, indicating that the Northern deposits are more evolved. Furthermore, the data reveals discrimination within the Northern succession, with the northwestern extra-caldera fine-crystal-rich lithofacies, having a distinct texture, componentry and composition. The componentry variation, mineralogical and chemical ranges identified here are consistent with an eruption from a heterogeneous magma system. Our results suggest that the Ora magma was likely stored in multiple chambers within a genetically related magma reservoir network. The mineralogical and chemical architecture together with stratigraphic relationships, enable interpretation of eruption sequence. Caldera eruption is proposed to have commenced in the south and progressed to the north, forming the two pene-contemporaneous caldera depressions. Moreover, this data illustrates heterogeneity and local zonation from base-to-top of the main intra-caldera and extra-caldera successions. These variations together with crystal fragment size variations between ignimbrite lithofacies support the hypothesis of a multi-vent eruption process, incremental caldera in-filling by subtly compositionally different pyroclastic flow pulses, and a lower intensity eruption style (Willcock et al., 2013, 2014).

How to Improve Integrated Care for People with Chronic Conditions: Key Findings from EU FP-7 Project INTEGRATE and Beyond.

PubMed

Borgermans, Liesbeth; Marchal, Yannick; Busetto, Loraine; Kalseth, Jorid; Kasteng, Frida; Suija, Kadri; Oona, Marje; Tigova, Olena; Rösenmuller, Magda; Devroey, Dirk

2017-09-25

Political and public health leaders increasingly recognize the need to take urgent action to address the problem of chronic diseases and multi-morbidity. European countries are facing unprecedented demand to find new ways to deliver care to improve patient-centredness and personalization, and to avoid unnecessary time in hospitals. People-centred and integrated care has become a central part of policy initiatives to improve the access, quality, continuity, effectiveness and sustainability of healthcare systems and are thus preconditions for the economic sustainability of the EU health and social care systems. This study presents an overview of lessons learned and critical success factors to policy making on integrated care based on findings from the EU FP-7 Project Integrate, a literature review, other EU projects with relevance to this study, a number of best practices on integrated care and our own experiences with research and policy making in integrated care at the national and international level. Seven lessons learned and critical success factors to policy making on integrated care were identified. The lessons learned and critical success factors to policy making on integrated care show that a comprehensive systems perspective should guide the development of integrated care towards better health practices, education, research and policy.

How to Improve Integrated Care for People with Chronic Conditions: Key Findings from EU FP-7 Project INTEGRATE and Beyond

PubMed Central

Marchal, Yannick; Busetto, Loraine; Kalseth, Jorid; Kasteng, Frida; Suija, Kadri; Oona, Marje; Tigova, Olena; Rösenmuller, Magda; Devroey, Dirk

2017-01-01

Background: Political and public health leaders increasingly recognize the need to take urgent action to address the problem of chronic diseases and multi-morbidity. European countries are facing unprecedented demand to find new ways to deliver care to improve patient-centredness and personalization, and to avoid unnecessary time in hospitals. People-centred and integrated care has become a central part of policy initiatives to improve the access, quality, continuity, effectiveness and sustainability of healthcare systems and are thus preconditions for the economic sustainability of the EU health and social care systems. Purpose: This study presents an overview of lessons learned and critical success factors to policy making on integrated care based on findings from the EU FP-7 Project Integrate, a literature review, other EU projects with relevance to this study, a number of best practices on integrated care and our own experiences with research and policy making in integrated care at the national and international level. Results: Seven lessons learned and critical success factors to policy making on integrated care were identified. Conclusion: The lessons learned and critical success factors to policy making on integrated care show that a comprehensive systems perspective should guide the development of integrated care towards better health practices, education, research and policy. PMID:29588630

What Type of Teachers Do We Intend to Train? An Analysis of Teacher Profiles in MERCOSUR Curricula

ERIC Educational Resources Information Center

Alliaud, Andrea; Feeney, Silvina María

2015-01-01

Over the last decades, teachers have often been identified as 'key' players for the improvement of education systems. The successive waves of reform taking place in Latin America since the 1990s have aimed at initial and continuous teacher training. The main changes intended to improve the quality and lengthen the duration of initial teacher…

Designing Teacher Evaluation Systems: New Guidance from the Measures of Effective Teaching Project

ERIC Educational Resources Information Center

Kane, Thomas J., Ed.; Kerr, Kerri A., Ed.; Pianta, Robert C., Ed.

2014-01-01

What is effective teaching? It is not enough to say "I know it when I see it"--not when we are expecting so much more from students and teachers than in the past. To help teachers achieve greater success with their students we need new and better ways to identify and develop effective teaching. The Measures of Effective Teaching (MET)…

An ecological process model of systems change.

PubMed

Peirson, Leslea J; Boydell, Katherine M; Ferguson, H Bruce; Ferris, Lorraine E

2011-06-01

In June 2007 the American Journal of Community Psychology published a special issue focused on theories, methods and interventions for systems change which included calls from the editors and authors for theoretical advancement in this field. We propose a conceptual model of systems change that integrates familiar and fundamental community psychology principles (succession, interdependence, cycling of resources, adaptation) and accentuates a process orientation. To situate our framework we offer a definition of systems change and a brief review of the ecological perspective and principles. The Ecological Process Model of Systems Change is depicted, described and applied to a case example of policy driven systems level change in publicly funded social programs. We conclude by identifying salient implications for thinking and action which flow from the Model.

Performance-Shaping Factors Affecting Older Adults' Hospital-to-Home Transition Success: A Systems Approach.

PubMed

Werner, Nicole E; Tong, Michelle; Borkenhagen, Amy; Holden, Richard J

2018-01-03

Facilitating older adults' successful hospital-to-home transitions remains a persistent challenge. To address this challenge, we applied a systems lens to identify and understand the performance-shaping factors (PSFs) related older adults' hospital-to-home transition success. This study was a secondary analysis of semi-structured interviews from older adults (N = 31) recently discharged from a hospital and their informal caregivers (N = 13). We used a Human Factors Engineering approach to guide qualitative thematic analysis to develop four themes concerning the system conditions shaping hospital-to-home transition success. The four themes concerning PSFs were: (a) the hospital-to-home transition was a complex multiphase process-the process unfolded over several months and required substantial, persistent investment/effort; (b) there were unmet needs for specialized tools-information and resources provided at hospital discharge were not aligned with requirements for transition success; (c) alignment of self-care routines with transition needs-pre-hospitalization routines could be supportive/disruptive and could deteriorate/be re-established; and (d) changing levels of work demand and capacity during the transition-demand often exceeded capacity leading to work overload. Our findings highlight that the transition is not an episodic event, but rather a longitudinal process extending beyond the days just after hospital discharge. Transition interventions to improve older adults' hospital-to-home transitions need to account for this complex multiphase process. Future interventions must be developed to support older adults and informal caregivers in navigating the establishment and re-establishment of routines and managing work demands and capacity during the transition process. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Health Care Transformation: The Role of Academic Health Centers and Their Psychologists.

PubMed

Kirch, Darrell G; Ast, Cori E

2017-06-01

The health care system of the United States has been in a period of dramatic transformation since the passage of the Affordable Care Act in 2010, and the rate of change is accelerating. Historically, health care delivery was focused on the efforts of independent individual providers related to single patients, but the future will require interprofessional teamwork to achieve successful transformation. Academic health centers must identify nimble leaders who can harness the expertise of every team member to succeed in yielding the triple aim-better care for individuals, better health for populations, and lower overall cost. To create this change, there are several critical success factors for academic health center leaders, including creating a culture of collaboration, becoming "multipliers," embracing innovation, adhering to core professional ethics, and working to promote resilience. Given their extensive training and predisposition to these skills, psychologists are well-positioned to serve as leaders in today's academic health systems.

A Multi-Decadal Sample Return Campaign Will Advance Lunar and Solar System Science and Exploration by 2050

NASA Technical Reports Server (NTRS)

Neal, C. R.; Lawrence, S. J.

2017-01-01

There have been 11 missions to the Moon this century, 10 of which have been orbital, from 5 different space agencies. China became the third country to successfully soft-land on the Moon in 2013, and the second to successfully remotely operate a rover on the lunar surface. We now have significant global datasets that, coupled with the 1990s Clementine and Lunar Prospector missions, show that the sample collection is not representative of the lithologies present on the Moon. The M3 data from the Indian Chandrayaan-1 mission have identified lithologies that are not present/under-represented in the sample collection. LRO datasets show that volcanism could be as young as 100 Ma and that significant felsic complexes exist within the lunar crust. A multi-decadal sample return campaign is the next logical step in advancing our understanding of lunar origin and evolution and Solar System processes.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING.

PubMed

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-10-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING

PubMed Central

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-01-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly. PMID:26783512

Early detection and longitudinal imaging of cancer micrometastases using biofunctionalized rare-earth albumin nanocomposites

NASA Astrophysics Data System (ADS)

Zevon, M.; Kantamneni, H.; Ganapathy, V.; Higgins, L.; Mingozzi, M.; Pierce, M.; Riman, R.; Roth, C. M.; Moghe, P. V.

2016-05-01

Success of personalized medicine in cancer therapy depends on the ability to identify and molecularly phenotype tumors. Current clinical imaging techniques cannot be integrated with precision molecular medicine at the level of single cells or microlesions due to limited resolution. In this work we use molecularly targeted infrared emitting optical probes to identify and characterize metastatic microlesions prior to their detection with clinically relevant imaging modalities. These contrast agents form the basis of an in vivo optical imaging system capable of resolving internal microlesions, filling a critical unmet need in cancer imaging.

Exact transition probabilities in a 6-state Landau–Zener system with path interference

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

Sinitsyn, Nikolai A.

2015-04-23

In this paper, we identify a nontrivial multistate Landau–Zener (LZ) model for which transition probabilities between any pair of diabatic states can be determined analytically and exactly. In the semiclassical picture, this model features the possibility of interference of different trajectories that connect the same initial and final states. Hence, transition probabilities are generally not described by the incoherent successive application of the LZ formula. Finally, we discuss reasons for integrability of this system and provide numerical tests of the suggested expression for the transition probability matrix.

Activating Cell Death Ligand Signaling Through Proteasome Inhibition

DTIC Science & Technology

2009-05-01

cell system would work and, if not, identify a new system. First, wild-type caspase-8 was stably expressed in the SH -SY-5Y line . SH -SY-5Y caspase-8...little success with the SH -SY-5Y cells we sought to use the I9.2 caspase-8 deficient Jurkat cell line . Our initial data confirmed that the caspase-8...shown that TRAIL can induce apop- tosis in a variety of human tumor cell lines .3,12,13 However, a large number of prostate cancer cells exhibit a

REopt Lite Web Tool Evaluates Photovoltaics and Battery Storage

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

Building on the success of the REopt renewable energy integration and optimization platform, NREL has developed a free, publicly available web version of REopt called REopt Lite. REopt Lite evaluates the economics of grid-connected photovoltaics (PV) and battery storage at a site. It allows building owners to identify the system sizes and battery dispatch strategy that minimize their life cycle cost of energy. This web tool also estimates the amount of time a PV and storage system can sustain the site's critical load during a grid outage.

The underestimated potential of solar energy to mitigate climate change

NASA Astrophysics Data System (ADS)

Creutzig, Felix; Agoston, Peter; Goldschmidt, Jan Christoph; Luderer, Gunnar; Nemet, Gregory; Pietzcker, Robert C.

2017-09-01

The Intergovernmental Panel on Climate Change's fifth assessment report emphasizes the importance of bioenergy and carbon capture and storage for achieving climate goals, but it does not identify solar energy as a strategically important technology option. That is surprising given the strong growth, large resource, and low environmental footprint of photovoltaics (PV). Here we explore how models have consistently underestimated PV deployment and identify the reasons for underlying bias in models. Our analysis reveals that rapid technological learning and technology-specific policy support were crucial to PV deployment in the past, but that future success will depend on adequate financing instruments and the management of system integration. We propose that with coordinated advances in multiple components of the energy system, PV could supply 30-50% of electricity in competitive markets.

Micro-attenuated total reflection spectral imaging in archaeology: application to Maya paint and plaster wall decorations.

PubMed

Goodall, Rosemary A; Hall, Jay; Sharer, Robert J; Traxler, Loa; Rintoul, Llew; Fredericks, Peter M

2008-01-01

Fourier transform infrared (FT-IR) attenuated total reflection (ATR) imaging has been successfully used to identify individual mineral components of ancient Maya paint. The high spatial resolution of a micro FT-IR-ATR system in combination with a focal plane array detector has allowed individual particles in the paint to be resolved and identified from their spectra. This system has been used in combination with micro-Raman spectroscopy to characterize the paint, which was found to be a mixture of hematite and silicate particles with minor amounts of calcite, carbon, and magnetite particles in a sub-micrometer hematite and calcite matrix. The underlying stucco was also investigated and found to be a combination of calcite with fine carbon particles, making a dark sub-ground for the paint.

Using the principle of entropy maximization to infer genetic interaction networks from gene expression patterns.

PubMed

Lezon, Timothy R; Banavar, Jayanth R; Cieplak, Marek; Maritan, Amos; Fedoroff, Nina V

2006-12-12

We describe a method based on the principle of entropy maximization to identify the gene interaction network with the highest probability of giving rise to experimentally observed transcript profiles. In its simplest form, the method yields the pairwise gene interaction network, but it can also be extended to deduce higher-order interactions. Analysis of microarray data from genes in Saccharomyces cerevisiae chemostat cultures exhibiting energy metabolic oscillations identifies a gene interaction network that reflects the intracellular communication pathways that adjust cellular metabolic activity and cell division to the limiting nutrient conditions that trigger metabolic oscillations. The success of the present approach in extracting meaningful genetic connections suggests that the maximum entropy principle is a useful concept for understanding living systems, as it is for other complex, nonequilibrium systems.

WE-G-BRA-07: Analyzing the Safety Implications of a Brachytherapy Process Improvement Project Utilizing a Novel System-Theory-Based Hazard-Analysis Technique

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

Tang, A; Samost, A; Viswanathan, A

Purpose: To investigate the hazards in cervical-cancer HDR brachytherapy using a novel hazard-analysis technique, System Theoretic Process Analysis (STPA). The applicability and benefit of STPA to the field of radiation oncology is demonstrated. Methods: We analyzed the tandem and ring HDR procedure through observations, discussions with physicists and physicians, and the use of a previously developed process map. Controllers and their respective control actions were identified and arranged into a hierarchical control model of the system, modeling the workflow from applicator insertion through initiating treatment delivery. We then used the STPA process to identify potentially unsafe control actions. Scenarios weremore » then generated from the identified unsafe control actions and used to develop recommendations for system safety constraints. Results: 10 controllers were identified and included in the final model. From these controllers 32 potentially unsafe control actions were identified, leading to more than 120 potential accident scenarios, including both clinical errors (e.g., using outdated imaging studies for planning), and managerial-based incidents (e.g., unsafe equipment, budget, or staffing decisions). Constraints identified from those scenarios include common themes, such as the need for appropriate feedback to give the controllers an adequate mental model to maintain safe boundaries of operations. As an example, one finding was that the likelihood of the potential accident scenario of the applicator breaking during insertion might be reduced by establishing a feedback loop of equipment-usage metrics and equipment-failure reports to the management controller. Conclusion: The utility of STPA in analyzing system hazards in a clinical brachytherapy system was demonstrated. This technique, rooted in system theory, identified scenarios both technical/clinical and managerial in nature. These results suggest that STPA can be successfully used to analyze safety in brachytherapy and may prove to be an alternative to other hazard analysis techniques.« less

Integrated diagenetic and sequence stratigraphy of a late Oligocene-early Miocene, mixed-sediment platform (Austral Basin, southern Patagonia): Resolving base-level and paleoceanographic changes, and paleoaquifer characteristics

NASA Astrophysics Data System (ADS)

Dix, George R.; Parras, Ana

2014-06-01

A condensed (~ 20-m-thick) marine transgressive-highstand succession comprises the upper San Julián Formation (upper Oligocene-lower Miocene) of the northern retroarc Austral Basin, southern Patagonia. Mixed-sediment facies identify a shelf-interior setting, part of an overall warm-temperate regional platform of moderate energy. Giant oyster-dominated skeletal-hiatal accumulations along the maximum flooding surface and forming high-energy event beds in the highstand succession preserve relict micrite in protected shelter porosity, and identify periods of reduced sediment accumulation. The stratigraphic distribution of marine-derived glaucony and diagenetic carbonates is spatially related to sequence development. Depositional siderite coincides with prominent marine transgression, defining transient mixing of marine and meteoric waters across coastal-plain deposits. Chemically evolved autochthonous glaucony coincides with periods of extended seafloor exposure and transgressions that bracket the marine succession, and within the oyster-dominated skeletal accumulations. Seafloor cement, likely once magnesian calcite, formed in association with an encrusting/boring biota along the maximum flooding surface in concert with incursion of cool (11-13 °C) water. The cement is present locally in skeletal event beds in the highstand succession suggesting a possible association with high-order base-level change and cooler water. As the highstand succession coincides with elevated global sea level in the late Oligocene-early Miocene, the locally marine-cemented glauconitic skeletal event beds in the highstand succession may identify higher order glacio-eustatic control. Local stratal condensation, however, is best explained by regional differences in basement subsidence. In the burial realm, carbonate diagenesis produced layers of phreatic calcrete coincident with skeletal-rich deposits. Zeolite (clinoptilolite-K) cement is restricted to the lowermost marine transgressive interval probably due to initial elevated metastability of reworked weathered silicates. Clay (illite)-cement is restricted to siliciclastic-rich intervals wherein skeletal carbonate did not buffer pore-water pH. Diagenetic carbonate geochemistry (Sr, Na, and δ18O and δ13C) shows that, with burial, the transgressive and highstand system tracts developed as distinct paleoaquifers resulting from different proximities to meteoric recharge zones.

Undergraduate African American females in the sciences: A qualitative study of student experiences affecting academic success and persistence

NASA Astrophysics Data System (ADS)

Essien-Wood, Idara R.

Given the lack of literature on Undergraduate African American females in the sciences (UAAFS), this study sought to explicate their experiences at one large, predominantly White, Research I institution in the southwestern United States. In particular, the purpose of this study was to identify factors that affect the academic success and persistence of Black females in the natural and physical sciences. Data was collected via in-depth, semi-structured interviews with 15 Black female science majors. Findings from this study identified several supportive mechanisms for academic success: family, religion, teaching assistants and friends. Also identified were seven barriers to academic success: employment, lack of diversity, cultural dissonance, unwelcoming Research I environment, faculty, advisors, classmates, and lab groups. Further, an analysis of students' responses revealed numerous instances of racial and gender micro-aggressions. Recommendations are provided to address factors identified as affecting student academic success and persistence as well as a culture of micro-aggressive behavior.

[Success factors in public healthy eating campaigns: a case study].

PubMed

Aschemann-Witzel, J; Pérez-Cueto, F J A; Strand, M; Verbeke, W; Bech-Larsen, T

2012-01-01

Public campaigns and interventions are rarely fully evaluated regarding their effectiveness. The analysis of past, successful activities can contribute to the future development of public campaigns and interventions for healthier eating. The study of public campaigns and interventions for healthier eating aimed at identifying the underlying success factors and describing their relation. Interviews were conducted with representatives of 11 cases that had been identified as especially successful in an earlier research step. The interviews were analysed with regard to possible success factors and the latter used to develop a model of success factor interrelation. It was found that success of the cases was first, attributed to characteristics of the macro environment or to public private partnerships in the initiation of campaigns, second, to the engagement of social communities, elements of empowerment of the target group and the implementation of social marketing measures, and thirdly, in citizens adoption of the campaign and in accompanying structural changes. The model and identified success factors underline that success can stem from three crucial phases: the set up of a campaign, the conduction and finally, the interrelation with the citizen. The model can serve as a guide in the future development of campaigns.

Operational environments for electrical power wiring on NASA space systems

NASA Technical Reports Server (NTRS)

Stavnes, Mark W.; Hammoud, Ahmad N.; Bercaw, Robert W.

1994-01-01

Electrical wiring systems are used extensively on NASA space systems for power management and distribution, control and command, and data transmission. The reliability of these systems when exposed to the harsh environments of space is very critical to mission success and crew safety. Failures have been reported both on the ground and in flight due to arc tracking in the wiring harnesses, made possible by insulation degradation. This report was written as part of a NASA Office of Safety and Mission Assurance (Code Q) program to identify and characterize wiring systems in terms of their potential use in aerospace vehicles. The goal of the program is to provide the information and guidance needed to develop and qualify reliable, safe, lightweight wiring systems, which are resistant to arc tracking and suitable for use in space power applications. This report identifies the environments in which NASA spacecraft will operate, and determines the specific NASA testing requirements. A summary of related test programs is also given in this report. This data will be valuable to spacecraft designers in determining the best wiring constructions for the various NASA applications.

Misalignment in Gas Foil Journal Bearings: An Experimental Study

NASA Technical Reports Server (NTRS)

Howard, Samuel A.

2008-01-01

As gas foil journal bearings become more prevalent in production machines, such as small gas turbine propulsion systems and microturbines, system-level performance issues must be identified and quantified in order to provide for successful design practices. Several examples of system-level design parameters that are not fully understood in foil bearing systems are thermal management schemes, alignment requirements, balance requirements, thrust load balancing, and others. In order to address some of these deficiencies and begin to develop guidelines, this paper presents a preliminary experimental investigation of the misalignment tolerance of gas foil journal bearing systems. Using a notional gas foil bearing supported rotor and a laser-based shaft alignment system, increasing levels of misalignment are imparted to the bearing supports while monitoring temperature at the bearing edges. The amount of misalignment that induces bearing failure is identified and compared to other conventional bearing types such as cylindrical roller bearings and angular contact ball bearings. Additionally, the dynamic response of the rotor indicates that the gas foil bearing force coefficients may be affected by misalignment.

Identifying Successful Advancement Approaches in Four Catholic Universities: The Effectiveness of the Four Advancement Models of Communication

ERIC Educational Resources Information Center

Bonglia, Jean-Pierre K.

2010-01-01

The current longitudinal study of the most successful Catholic universities in the United States identifies the prevalence of four advancement models of communication that have contributed to make those institutions successful in their philanthropic efforts. While research by Grunig and Kelly maintained that the two-way symmetrical model of…

The MSFC Systems Engineering Guide: An Overview and Plan

NASA Technical Reports Server (NTRS)

Shelby, Jerry A.; Thomas, L. Dale

2007-01-01

As systems and subsystems requirements become more complex in the pursuit of the exploration of space, advanced technology will demand and require an integrated approach to the design and development of safe and successful space vehicles and there products. System engineers play a vital and key role in transforming mission needs into vehicle requirements that can be verified and validated. This will result in a safe and cost effective design that will satisfy the mission schedule. A key to successful vehicle design within systems engineering is communication. Communication, through a systems engineering infrastructure, will not only ensure that customers and stakeholders are satisfied but will also assist in identifying vehicle requirements; i.e. identification, integration and management. This vehicle design will produce a system that is verifiable, traceable, and effectively satisfies cost, schedule, performance, and risk throughout the life-cycle of the product. A communication infrastructure will bring about the integration of different engineering disciplines within vehicle design. A system utilizing these aspects will enhance system engineering performance and improve upon required activities such as Development of Requirements, Requirements Management, Functional Analysis, Test, Synthesis, Trade Studies, Documentation, and Lessons Learned to produce a successful final product. This paper will describe the guiding vision, progress to date and the plan forward for development of the Marshall Space Flight Center (MSFC) Systems Engineering Guide (SEG), a virtual systems engineering handbook and archive that will describe the system engineering processes that are used by MSFC in the development of complex systems such as the Ares launch vehicle. It is the intent of this website to be a "One Stop Shop" for our systems engineers that will provide tutorial information, an overview of processes and procedures and links to assist system engineering with guidance and references, and provide an archive of systems engineering artifacts produced by the many NASA projects developed and managed by MSFC over the years.

Boundary Control of Linear Uncertain 1-D Parabolic PDE Using Approximate Dynamic Programming.

PubMed

Talaei, Behzad; Jagannathan, Sarangapani; Singler, John

2018-04-01

This paper develops a near optimal boundary control method for distributed parameter systems governed by uncertain linear 1-D parabolic partial differential equations (PDE) by using approximate dynamic programming. A quadratic surface integral is proposed to express the optimal cost functional for the infinite-dimensional state space. Accordingly, the Hamilton-Jacobi-Bellman (HJB) equation is formulated in the infinite-dimensional domain without using any model reduction. Subsequently, a neural network identifier is developed to estimate the unknown spatially varying coefficient in PDE dynamics. Novel tuning law is proposed to guarantee the boundedness of identifier approximation error in the PDE domain. A radial basis network (RBN) is subsequently proposed to generate an approximate solution for the optimal surface kernel function online. The tuning law for near optimal RBN weights is created, such that the HJB equation error is minimized while the dynamics are identified and closed-loop system remains stable. Ultimate boundedness (UB) of the closed-loop system is verified by using the Lyapunov theory. The performance of the proposed controller is successfully confirmed by simulation on an unstable diffusion-reaction process.

Evaluation of Active Mortality Surveillance System Data for Monitoring Hurricane-Related Deaths—Texas, 2008

PubMed Central

Choudhary, Ekta; Zane, David F.; Beasley, Crystal; Jones, Russell; Rey, Araceli; Noe, Rebecca S.; Martin, Colleen; Wolkin, Amy F.; Bayleyegn, Tesfaye M.

2015-01-01

Introduction The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike. Objective The objective of this study was to evaluate Texas DSHS’ active mortality surveillance system using US Centers for Disease Control and Prevention’s (CDC) surveillance system evaluation guidelines. Methods Using CDC’s Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths. Results From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively. Conclusions Texas’s active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates. PMID:22800916

Evaluation of active mortality surveillance system data for monitoring hurricane-related deaths-Texas, 2008.

PubMed

Choudhary, Ekta; Zane, David F; Beasley, Crystal; Jones, Russell; Rey, Araceli; Noe, Rebecca S; Martin, Colleen; Wolkin, Amy F; Bayleyegn, Tesfaye M

2012-08-01

The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike. The objective of this study was to evaluate Texas DSHS' active mortality surveillance system using US Centers for Disease Control and Prevention's (CDC) surveillance system evaluation guidelines. Using CDC's Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths. From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively. Texas's active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates.

High-performance computing with quantum processing units

DOE PAGES

Britt, Keith A.; Oak Ridge National Lab.; Humble, Travis S.; ...

2017-03-01

The prospects of quantum computing have driven efforts to realize fully functional quantum processing units (QPUs). Recent success in developing proof-of-principle QPUs has prompted the question of how to integrate these emerging processors into modern high-performance computing (HPC) systems. We examine how QPUs can be integrated into current and future HPC system architectures by accounting for func- tional and physical design requirements. We identify two integration pathways that are differentiated by infrastructure constraints on the QPU and the use cases expected for the HPC system. This includes a tight integration that assumes infrastructure bottlenecks can be overcome as well asmore » a loose integration that as- sumes they cannot. We find that the performance of both approaches is likely to depend on the quantum interconnect that serves to entangle multiple QPUs. As a result, we also identify several challenges in assessing QPU performance for HPC, and we consider new metrics that capture the interplay between system architecture and the quantum parallelism underlying computational performance.« less

High-performance computing with quantum processing units

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

Britt, Keith A.; Oak Ridge National Lab.; Humble, Travis S.

The prospects of quantum computing have driven efforts to realize fully functional quantum processing units (QPUs). Recent success in developing proof-of-principle QPUs has prompted the question of how to integrate these emerging processors into modern high-performance computing (HPC) systems. We examine how QPUs can be integrated into current and future HPC system architectures by accounting for func- tional and physical design requirements. We identify two integration pathways that are differentiated by infrastructure constraints on the QPU and the use cases expected for the HPC system. This includes a tight integration that assumes infrastructure bottlenecks can be overcome as well asmore » a loose integration that as- sumes they cannot. We find that the performance of both approaches is likely to depend on the quantum interconnect that serves to entangle multiple QPUs. As a result, we also identify several challenges in assessing QPU performance for HPC, and we consider new metrics that capture the interplay between system architecture and the quantum parallelism underlying computational performance.« less

Easily configured real-time CPOE Pick Off Tool supporting focused clinical research and quality improvement.

PubMed

Rosenbaum, Benjamin P; Silkin, Nikolay; Miller, Randolph A

2014-01-01

Real-time alerting systems typically warn providers about abnormal laboratory results or medication interactions. For more complex tasks, institutions create site-wide 'data warehouses' to support quality audits and longitudinal research. Sophisticated systems like i2b2 or Stanford's STRIDE utilize data warehouses to identify cohorts for research and quality monitoring. However, substantial resources are required to install and maintain such systems. For more modest goals, an organization desiring merely to identify patients with 'isolation' orders, or to determine patients' eligibility for clinical trials, may adopt a simpler, limited approach based on processing the output of one clinical system, and not a data warehouse. We describe a limited, order-entry-based, real-time 'pick off' tool, utilizing public domain software (PHP, MySQL). Through a web interface the tool assists users in constructing complex order-related queries and auto-generates corresponding database queries that can be executed at recurring intervals. We describe successful application of the tool for research and quality monitoring.

A novel Minimalist Cell-Free MHC Class II Antigen Processing System Identifies Immunodominant Epitopes

PubMed Central

Hartman, Isamu Z.; Kim, AeRyon; Cotter, Robert J.; Walter, Kimberly; Dalai, Sarat K.; Boronina, Tatiana; Griffith, Wendell; Schwenk, Robert; Lanar, David E.; Krzych, Urszula; Cole, Robert N.; Sadegh-Nasseri, Scheherazade

2010-01-01

Immunodominance is defined as restricted responsiveness of T cells to a few selected epitopes from complex antigens. Strategies currently used for elucidating CD4+ T cell epitopes are inadequate. To understand the mechanism of epitope selection for helper T cells, we established a cell-free antigen processing system composed of defined proteins: MHC class II, cathepsins, and HLA-DM. Our minimalist system successfully identified the physiologically selected immunodominant epitopes of model antigens, HA1 from influenza virus (A/Texas/1/77) and type II collagen. When applied for de novo epitope identification to a malaria antigen, or HA1 from H5N1 virus (Avian Flu), the system selected a single epitope from each protein that were confirmed to be immunodominant by their capacity to activate CD4+ T cells in HLA-DR1 positive human volunteers or transgenic mice immunized with the corresponding proteins. Thus, we provide a powerful new tool for the identification of physiologically relevant helper T cell epitopes from antigens. PMID:21037588

Priority Areas and Potential Solutions for Successful Integration and Sustainment of Health Systems Science in Undergraduate Medical Education.

PubMed

Gonzalo, Jed D; Baxley, Elizabeth; Borkan, Jeffrey; Dekhtyar, Michael; Hawkins, Richard; Lawson, Luan; Starr, Stephanie R; Skochelak, Susan

2017-01-01

Educators, policy makers, and health systems leaders are calling for significant reform of undergraduate medical education (UME) and graduate medical education (GME) programs to meet the evolving needs of the health care system. Nationally, several schools have initiated innovative curricula in both classroom and workplace learning experiences to promote education in health systems science (HSS), which includes topics such as value-based care, health system improvement, and population and public health. However, the successful implementation of HSS curricula across schools is challenged by issues of curriculum design, assessment, culture, and accreditation, among others. In this report of a working conference using thematic analysis of workshop recommendations and experiences from 11 U.S. medical schools, the authors describe seven priority areas for the successful integration and sustainment of HSS in educational programs, and associated challenges and potential solutions. In 2015, following regular HSS workgroup phone calls and an Accelerating Change in Medical Education consortium-wide meeting, the authors identified the priority areas: partner with licensing, certifying, and accrediting bodies; develop comprehensive, standardized, and integrated curricula; develop, standardize, and align assessments; improve the UME to GME transition; enhance teachers' knowledge and skills, and incentives for teachers; demonstrate value added to the health system; and address the hidden curriculum. These priority areas and their potential solutions can be used by individual schools and HSS education collaboratives to further outline and delineate the steps needed to create, deliver, study, and sustain effective HSS curricula with an eye toward integration with the basic and clinical sciences curricula.

Weak Polygyny in California Sea Lions and the Potential for Alternative Mating Tactics

PubMed Central

Flatz, Ramona; González-Suárez, Manuela; Young, Julie K.; Hernández-Camacho, Claudia J.; Immel, Aaron J.; Gerber, Leah R.

2012-01-01

Female aggregation and male territoriality are considered to be hallmarks of polygynous mating systems. The development of genetic parentage assignment has called into question the accuracy of behavioral traits in predicting true mating systems. In this study we use 14 microsatellite markers to explore the mating system of one of the most behaviorally polygynous species, the California sea lion (Zalophus californianus). We sampled a total of 158 female-pup pairs and 99 territorial males across two breeding rookeries (San Jorge and Los Islotes) in the Gulf of California, Mexico. Fathers could be identified for 30% of pups sampled at San Jorge across three breeding seasons and 15% of sampled pups at Los Islotes across two breeding seasons. Analysis of paternal relatedness between the pups for which no fathers were identified (sampled over four breeding seasons at San Jorge and two at Los Islotes) revealed that few pups were likely to share a father. Thirty-one percent of the sampled males on San Jorge and 15% of the sampled males on Los Islotes were assigned at least one paternity. With one exception, no male was identified as the father of more than two pups. Furthermore, at Los Islotes rookery there were significantly fewer pups assigned paternity than expected given the pool of sampled males (p<0.0001). Overall, we found considerably lower variation in male reproductive success than expected in a species that exhibits behavior associated with strongly polygynous mating. Low variation in male reproductive success may result from heightened mobility among receptive females in the Gulf of California, which reduces the ability of males to monopolize groups of females. Our results raise important questions regarding the adaptive role of territoriality and the potential for alternative mating tactics in this species. PMID:22432039

A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success.

PubMed

Wright, Adam; Ash, Joan S; Erickson, Jessica L; Wasserman, Joe; Bunce, Arwen; Stanescu, Ana; St Hilaire, Daniel; Panzenhagen, Morgan; Gebhardt, Eric; McMullen, Carmit; Middleton, Blackford; Sittig, Dean F

2014-01-01

To describe the activities performed by people involved in clinical decision support (CDS) at leading sites. We conducted ethnographic observations at seven diverse sites with a history of excellence in CDS using the Rapid Assessment Process and analyzed the data using a series of card sorts, informed by Linstone's Multiple Perspectives Model. We identified 18 activities and grouped them into four areas. Area 1: Fostering relationships across the organization, with activities (a) training and support, (b) visibility/presence on the floor, (c) liaising between people, (d) administration and leadership, (e) project management, (f) cheerleading/buy-in/sponsorship, (g) preparing for CDS implementation. Area 2: Assembling the system with activities (a) providing technical support, (b) CDS content development, (c) purchasing products from vendors (d) knowledge management, (e) system integration. Area 3: Using CDS to achieve the organization's goals with activities (a) reporting, (b) requirements-gathering/specifications, (c) monitoring CDS, (d) linking CDS to goals, (e) managing data. Area 4: Participation in external policy and standards activities (this area consists of only a single activity). We also identified a set of recommendations associated with these 18 activities. All 18 activities we identified were performed at all sites, although the way they were organized into roles differed substantially. We consider these activities critical to the success of a CDS program. A series of activities are performed by sites strong in CDS, and sites adopting CDS should ensure they incorporate these activities into their efforts.