7 CFR 4280.128 - Application and documentation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and Energy Efficiency Improvements Program Section B. Guaranteed Loans § 4280.128 Application and... the purchase of a renewable energy system (including making necessary capital improvements to an existing renewable energy system) or to make energy efficiency improvements. The response to § 4280.108(a...

Real World Data Driven Evolution of Volvo Cars’ Side Impact Protection Systems and their Effectiveness

PubMed Central

Jakobsson, Lotta; Lindman, Magdalena; Svanberg, Bo; Carlsson, Henrik

2010-01-01

This study analyses the outcome of the continuous improved occupant protection over the last two decades for front seat near side occupants in side impacts based on a real world driven working process. The effectiveness of four generations of improved side impact protection are calculated based on data from Volvo’s statistical accident database of Volvo Cars in Sweden. Generation I includes vehicles with a new structural and interior concept (SIPS). Generation II includes vehicles with structural improvements and a new chest airbag (SIPSbag). Generation III includes vehicles with further improved SIPS and SIPSbag as well as the new concept with a head protecting Inflatable Curtain (IC). Generation IV includes the most recent vehicles with further improvements of all the systems plus advanced sensors and seat belt pretensioner activation. Compared to baseline vehicles, vehicles of generation I reduce MAIS2+ injuries by 54%, generation II by 61% and generation III by 72%. For generation IV effectiveness figures cannot be calculated because of the lack of MAIS2+ injuries. A continuous improved performance is also seen when studying the AIS2+ pelvis, abdomen, chest and head injuries separately. By using the same real world driven working process, future improvements and possibly new passive as well as active safety systems, will be developed with the aim of further improved protection to near side occupants in side impacts. PMID:21050597

Upgrades to the International Space Station Water Recovery System

NASA Technical Reports Server (NTRS)

Kayatin, Matthew J.; Pruitt, Jennifer M.; Nur, Mononita; Takada, Kevin C.; Carter, Layne

2017-01-01

The International Space Station (ISS) Water Recovery System (WRS) includes the Water Processor Assembly (WPA) and the Urine Processor Assembly (UPA). The WRS produces potable water from a combination of crew urine (first processed through the UPA), crew latent, and Sabatier product water. Though the WRS has performed well since operations began in November 2008, several modifications have been identified to improve the overall system performance. These modifications aim to reduce resupply and improve overall system reliability, which is beneficial for the ongoing ISS mission as well as for future NASA manned missions. The following paper details efforts to improve the WPA through the use of reverse osmosis membrane technology to reduce the resupply mass of the WPA Multi-filtration Bed and improved catalyst for the WPA Catalytic Reactor to reduce the operational temperature and pressure. For the UPA, this paper discusses progress on various concepts for improving the reliability of the system, including the implementation of a more reliable drive belt, improved methods for managing condensate in the stationary bowl of the Distillation Assembly, and evaluating upgrades to the UPA vacuum pump.

Are university rankings useful to improve research? A systematic review.

PubMed

Vernon, Marlo M; Balas, E Andrew; Momani, Shaher

2018-01-01

Concerns about reproducibility and impact of research urge improvement initiatives. Current university ranking systems evaluate and compare universities on measures of academic and research performance. Although often useful for marketing purposes, the value of ranking systems when examining quality and outcomes is unclear. The purpose of this study was to evaluate usefulness of ranking systems and identify opportunities to support research quality and performance improvement. A systematic review of university ranking systems was conducted to investigate research performance and academic quality measures. Eligibility requirements included: inclusion of at least 100 doctoral granting institutions, be currently produced on an ongoing basis and include both global and US universities, publish rank calculation methodology in English and independently calculate ranks. Ranking systems must also include some measures of research outcomes. Indicators were abstracted and contrasted with basic quality improvement requirements. Exploration of aggregation methods, validity of research and academic quality indicators, and suitability for quality improvement within ranking systems were also conducted. A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Six of the 13 rankings are 100% focused on research performance. For those reporting weighting, 76% of the total ranks are attributed to research indicators, with 24% attributed to academic or teaching quality. Seven systems rely on reputation surveys and/or faculty and alumni awards. Rankings influence academic choice yet research performance measures are the most weighted indicators. There are no generally accepted academic quality indicators in ranking systems. No single ranking system provides a comprehensive evaluation of research and academic quality. Utilizing a combined approach of the Leiden, Thomson Reuters Most Innovative Universities, and the SCImago ranking systems may provide institutions with a more effective feedback for research improvement. Rankings which extensively rely on subjective reputation and "luxury" indicators, such as award winning faculty or alumni who are high ranking executives, are not well suited for academic or research performance improvement initiatives. Future efforts should better explore measurement of the university research performance through comprehensive and standardized indicators. This paper could serve as a general literature citation when one or more of university ranking systems are used in efforts to improve academic prominence and research performance.

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

A conceptual persistent healthcare quality improvement process for software development management.

PubMed

Lin, Jen-Chiun; Su, Mei-Ju; Cheng, Po-Hsun; Weng, Yung-Chien; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei

2007-01-01

This paper illustrates a sustained conceptual service quality improvement process for the management of software development within a healthcare enterprise. Our proposed process is revised from Niland's healthcare quality information system (HQIS). This process includes functions to survey the satisfaction of system functions, describe the operation bylaws on-line, and provide on-demand training. To achieve these goals, we integrate five information systems in National Taiwan University Hospital, including healthcare information systems, health quality information system, requirement management system, executive information system, and digital learning system, to form a full Deming cycle. A preliminary user satisfaction survey showed that our outpatient information system scored an average of 71.31 in 2006.

Why System Safety Professionals Should Read Accident Reports

NASA Technical Reports Server (NTRS)

Holloway, C. M.; Johnson, C. W.

2006-01-01

System safety professionals, both researchers and practitioners, who regularly read accident reports reap important benefits. These benefits include an improved ability to separate myths from reality, including both myths about specific accidents and ones concerning accidents in general; an increased understanding of the consequences of unlikely events, which can help inform future designs; a greater recognition of the limits of mathematical models; and guidance on potentially relevant research directions that may contribute to safety improvements in future systems.

Hybrid Power Management (HPM) Program Resulted in Several New Applications

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2003-01-01

Hybrid Power Management (HPM) is the innovative integration of diverse, state-of-the-art power devices in an optimal configuration for space and terrestrial applications. The appropriate application and control of the various power devices significantly improves overall system performance and efficiency. The advanced power devices include ultracapacitors, fuel cells, and photovoltaics. HPM has extremely wide potential with applications from nanowatts to megawatts. Applications include power generation, transportation systems, biotechnology systems, and space power systems. HPM has the potential to significantly alleviate global energy concerns, improve the environment, and stimulate the economy.

Improved operating scenarios of the DIII-D tokamak as a result of the addition of UNIX computer systems

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

Henline, P.A.

1995-12-31

The increased use of UNIX based computer systems for machine control, data handling and analysis has greatly enhanced the operating scenarios and operating efficiency of the DIII-D tokamak. This paper will describe some of these UNIX systems and their specific uses. These include the plasma control system, the electron cyclotron heating control system, the analysis of electron temperature and density measurements and the general data acquisition system (which is collecting over 130 Mbytes of data). The speed and total capability of these systems has dramatically affected the ability to operate DIII-D. The improved operating scenarios include better plasma shape controlmore » due to the more thorough MHD calculations done between shots and the new ability to see the time dependence of profile data as it relates across different spatial locations in the tokamak. Other analysis which engenders improved operating abilities will be described.« less

Improved operating scenarios of the DIII-D tokamak as a result of the addition of UNIX computer systems

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

Henline, P.A.

1995-10-01

The increased use of UNIX based computer systems for machine control, data handling and analysis has greatly enhanced the operating scenarios and operating efficiency of the DRI-D tokamak. This paper will describe some of these UNIX systems and their specific uses. These include the plasma control system, the electron cyclotron heating control system, the analysis of electron temperature and density measurements and the general data acquisition system (which is collecting over 130 Mbytes of data). The speed and total capability of these systems has dramatically affected the ability to operate DIII-D. The improved operating scenarios include better plasma shape controlmore » due to the more thorough MHD calculations done between shots and the new ability to see the time dependence of profile data as it relates across different spatial locations in the tokamak. Other analysis which engenders improved operating abilities will be described.« less

Investigating organizational quality improvement systems, patient empowerment, organizational culture, professional involvement and the quality of care in European hospitals: the 'Deepening our Understanding of Quality Improvement in Europe (DUQuE)' project.

PubMed

Groene, Oliver; Klazinga, Niek; Wagner, Cordula; Arah, Onyebuchi A; Thompson, Andrew; Bruneau, Charles; Suñol, Rosa

2010-09-24

Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. We propose to study the relationships among organisational quality improvement systems, patient empowerment, organisational culture, professionals' involvement with the quality of hospital care, including clinical effectiveness, patient safety and patient involvement. We will employ a cross-sectional, multi-level study design in which patient-level measurements are nested in hospital departments, which are in turn nested in hospitals in different EU countries. Mixed methods will be used for data collection, measurement and analysis. Hospital/care pathway level constructs that will be assessed include external pressure, hospital governance, quality improvement system, patient empowerment in quality improvement, organisational culture and professional involvement. These constructs will be assessed using questionnaires. Patient-level constructs include clinical effectiveness, patient safety and patient involvement, and will be assessed using audit of patient records, routine data and patient surveys. For the assessment of hospital and pathway level constructs we will collect data from randomly selected hospitals in eight countries. For a sample of hospitals in each country we will carry out additional data collection at patient-level related to four conditions (stroke, acute myocardial infarction, hip fracture and delivery). In addition, structural components of quality improvement systems will be assessed using visits by experienced external assessors. Data analysis will include descriptive statistics and graphical representations and methods for data reduction, classification techniques and psychometric analysis, before moving to bi-variate and multivariate analysis. The latter will be conducted at hospital and multilevel. In addition, we will apply sophisticated methodological elements such as the use of causal diagrams, outcome modelling, double robust estimation and detailed sensitivity analysis or multiple bias analyses to assess the impact of the various sources of bias. Products of the project will include a catalogue of instruments and tools that can be used to build departmental or hospital quality and safety programme and an appraisal scheme to assess the maturity of the quality improvement system for use by hospitals and by purchasers to contract hospitals.

Do Health Care Delivery System Reforms Improve Value? The Jury Is Still Out.

PubMed

Korenstein, Deborah; Duan, Kevin; Diaz, Manuel J; Ahn, Rosa; Keyhani, Salomeh

2016-01-01

Widespread restructuring of health delivery systems is underway in the United States to reduce costs and improve the quality of health care. To describe studies evaluating the impact of system-level interventions (incentives and delivery structures) on the value of US health care, defined as the balance between quality and cost. We identified articles in PubMed (2003 to July 2014) using keywords identified through an iterative process, with reference and author tracking. We searched tables of contents of relevant journals from August 2014 through 11 August 2015 to update our sample. We included prospective or retrospective studies of system-level changes, with a control, reporting both quality and either cost or utilization of resources. Data about study design, study quality, and outcomes was extracted by one reviewer and checked by a second. Thirty reports of 28 interventions were included. Interventions included patient-centered medical home implementations (n=12), pay-for-performance programs (n=10), and mixed interventions (n=6); no other intervention types were identified. Most reports (n=19) described both cost and utilization outcomes. Quality, cost, and utilization outcomes varied widely; many improvements were small and process outcomes predominated. Improved value (improved quality with stable or lower cost/utilization or stable quality with lower cost/utilization) was seen in 23 reports; 1 showed decreased value, and 6 showed unchanged, unclear, or mixed results.Study limitations included variability among specific endpoints reported, inconsistent methodologies, and lack of full adjustment in some observational trials. Lack of standardized MeSH terms was also a challenge in the search. On balance, the literature suggests that health system reforms can improve value. However, this finding is tempered by the varying outcomes evaluated across studies with little documented improvement in outcome quality measures. Standardized measures of value would facilitate assessment of the impact of interventions across studies and better estimates of the broad impact of system change.

Are Integrated Portfolio Systems the Answer? An Evaluation of a Web-Based Portfolio System to Improve Preservice Teachers' Reflective Thinking Skills

ERIC Educational Resources Information Center

Oner, Diler; Adadan, Emine

2016-01-01

This study investigated the effectiveness of an integrated web-based portfolio system, namely the BOUNCE System, which primarily focuses on improving preservice teachers' reflective thinking skills. BOUNCE©, the software component of the system, was designed and developed to support a teaching practice model including a cycle of activities to be…

A Measurement Feedback System (MFS) Is Necessary to Improve Mental Health Outcomes

ERIC Educational Resources Information Center

Bickman, Leonard

2008-01-01

The importance of measurement feedback system (MFS) for the improvement of mental health services for youths is discussed. As feedback obtained from clients and families is subject to distortions, a standardized MFS including clinical processes, contexts, outcomes, and feedback to clinicians and supervisors is necessary for improvement in quality…

Upgrades to the ISS Water Recovery System

NASA Technical Reports Server (NTRS)

Kayatin, Matthew; Takada, Kevin; Carter, Layne

2017-01-01

The ISS Water Recovery System (WRS) includes the Water Processor Assembly (WPA) and the Urine Processor Assembly (UPA). The WRS produces potable water from a combination of crew urine (first processed through the UPA), crew latent, and Sabatier product water. Though the WRS has performed well since operations began in November 2008, several modifications have been identified to improve the overall system performance. These modifications can reduce resupply and improve overall system reliability, which is beneficial for the ongoing ISS mission as well as for future NASA manned missions. The following paper details efforts to improve the WPA through the use of Reverse Osmosis technology to reduce the resupply mass of the WPA Multifiltration Bed and improved catalyst for the WPA Catalytic Reactor to reduce the operational temperature and pressure. For the UPA, this paper discusses progress on various concepts for improving the reliability of the UPA, including the implementation of a more reliable drive belt, improved methods for managing condensate in the stationary bowl of the Distillation Assembly, deleting the Separator Plumbing Assembly, and evaluating upgrades to the UPA vacuum pump.

Adding Value to the Health Care System: Identifying Value-Added Systems Roles for Medical Students.

PubMed

Gonzalo, Jed D; Graaf, Deanna; Johannes, Bobbie; Blatt, Barbara; Wolpaw, Daniel R

To catalyze learning in Health Systems Science and add value to health systems, education programs are seeking to incorporate students into systems roles, which are not well described. The authors sought to identify authentic roles for students within a range of clinical sites and explore site leaders' perceptions of the value of students performing these roles. From 2013 to 2015, site visits and interviews with leadership from an array of clinical sites (n = 30) were conducted. Thematic analysis was used to identify tasks and benefits of integrating students into interprofessional care teams. Types of systems roles included direct patient benefit activities, including monitoring patient progress with care plans and facilitating access to resources, and clinic benefit activities, including facilitating coordination and improving clinical processes. Perceived benefits included improved value of the clinical mission and enhanced student education. These results elucidate a framework for student roles that enhance learning and add value to health systems.

Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study

PubMed Central

Meyer, Johanna C.; Schellack, Natalie; Stokes, Jacobus; Lancaster, Ruth; Zeeman, Helecine; Defty, Douglas; Godman, Brian; Steel, Gavin

2017-01-01

Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance. Consequently, the objective of this paper is to review ongoing initiatives within the public healthcare sector in South Africa and their influence to provide future direction. Method: Principally a structured review of current and planned activities. Results: There have been a number of major activities and initiatives surrounding the availability and access to medicines in the public system in recent years in South Africa. This includes a National Surveillance Centre and an innovative early warning system for the supply of medicines as well as the development of a National Health Care Pricing Authority and initiatives to improve contracting. There have also been developments to improve the supply chain including instigating Medicine Procurement Units in the provinces and enhancing forecasting capabilities. Access to medicines is improving though the instigation of stable chronic disease management initiatives to increase the number of external pick-up points for medicines. There are also ongoing programmes to enhance adherence to medicines as well as enhance adherence to the Standard Treatment Guidelines and the Essential Medicines List with their increasing availability. In addition, there is a movement to enhance the role of health technology assessment in future decision making. Hospital initiatives include increased focus on reducing antimicrobial resistance through instigating stewardship programmes as well as improving adverse drug reaction reporting and associated activities. Conclusion: Overall, there are an appreciable number of ongoing activities within the public healthcare system in South Africa attempting to ensure and sustain universal healthcare. It is too early to assess their impact, which will be the subject of future research. PMID:29163151

Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study.

PubMed

Meyer, Johanna C; Schellack, Natalie; Stokes, Jacobus; Lancaster, Ruth; Zeeman, Helecine; Defty, Douglas; Godman, Brian; Steel, Gavin

2017-01-01

Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance. Consequently, the objective of this paper is to review ongoing initiatives within the public healthcare sector in South Africa and their influence to provide future direction. Method: Principally a structured review of current and planned activities. Results: There have been a number of major activities and initiatives surrounding the availability and access to medicines in the public system in recent years in South Africa. This includes a National Surveillance Centre and an innovative early warning system for the supply of medicines as well as the development of a National Health Care Pricing Authority and initiatives to improve contracting. There have also been developments to improve the supply chain including instigating Medicine Procurement Units in the provinces and enhancing forecasting capabilities. Access to medicines is improving though the instigation of stable chronic disease management initiatives to increase the number of external pick-up points for medicines. There are also ongoing programmes to enhance adherence to medicines as well as enhance adherence to the Standard Treatment Guidelines and the Essential Medicines List with their increasing availability. In addition, there is a movement to enhance the role of health technology assessment in future decision making. Hospital initiatives include increased focus on reducing antimicrobial resistance through instigating stewardship programmes as well as improving adverse drug reaction reporting and associated activities. Conclusion: Overall, there are an appreciable number of ongoing activities within the public healthcare system in South Africa attempting to ensure and sustain universal healthcare. It is too early to assess their impact, which will be the subject of future research.

Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

ERIC Educational Resources Information Center

National Center for Systemic Improvement at WestEd, 2015

2015-01-01

This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

Gamma ray spectroscopy employing divalent europium-doped alkaline earth halides and digital readout for accurate histogramming

DOEpatents

Cherepy, Nerine Jane; Payne, Stephen Anthony; Drury, Owen B; Sturm, Benjamin W

2014-11-11

A scintillator radiation detector system according to one embodiment includes a scintillator; and a processing device for processing pulse traces corresponding to light pulses from the scintillator, wherein pulse digitization is used to improve energy resolution of the system. A scintillator radiation detector system according to another embodiment includes a processing device for fitting digitized scintillation waveforms to an algorithm based on identifying rise and decay times and performing a direct integration of fit parameters. A method according to yet another embodiment includes processing pulse traces corresponding to light pulses from a scintillator, wherein pulse digitization is used to improve energy resolution of the system. A method in a further embodiment includes fitting digitized scintillation waveforms to an algorithm based on identifying rise and decay times; and performing a direct integration of fit parameters. Additional systems and methods are also presented.

Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps

PubMed Central

Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B.; Seguin, Rebecca A.

2015-01-01

A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers’ markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits. PMID:26613066

Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps.

PubMed

Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B; Seguin, Rebecca A

A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers' markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits.

Design of launch systems using continuous improvement process

NASA Technical Reports Server (NTRS)

Brown, Richard W.

1995-01-01

The purpose of this paper is to identify a systematic process for improving ground operations for future launch systems. This approach is based on the Total Quality Management (TQM) continuous improvement process. While the continuous improvement process is normally identified with making incremental changes to an existing system, it can be used on new systems if they use past experience as a knowledge base. In the case of the Reusable Launch Vehicle (RLV), the Space Shuttle operations provide many lessons. The TQM methodology used for this paper will be borrowed from the United States Air Force 'Quality Air Force' Program. There is a general overview of the continuous improvement process, with concentration on the formulation phase. During this phase critical analyses are conducted to determine the strategy and goals for the remaining development process. These analyses include analyzing the mission from the customers point of view, developing an operations concept for the future, assessing current capabilities and determining the gap to be closed between current capabilities and future needs and requirements. A brief analyses of the RLV, relative to the Space Shuttle, will be used to illustrate the concept. Using the continuous improvement design concept has many advantages. These include a customer oriented process which will develop a more marketable product and a better integration of operations and systems during the design phase. But, the use of TQM techniques will require changes, including more discipline in the design process and more emphasis on data gathering for operational systems. The benefits will far outweigh the additional effort.

Are university rankings useful to improve research? A systematic review

PubMed Central

Momani, Shaher

2018-01-01

Introduction Concerns about reproducibility and impact of research urge improvement initiatives. Current university ranking systems evaluate and compare universities on measures of academic and research performance. Although often useful for marketing purposes, the value of ranking systems when examining quality and outcomes is unclear. The purpose of this study was to evaluate usefulness of ranking systems and identify opportunities to support research quality and performance improvement. Methods A systematic review of university ranking systems was conducted to investigate research performance and academic quality measures. Eligibility requirements included: inclusion of at least 100 doctoral granting institutions, be currently produced on an ongoing basis and include both global and US universities, publish rank calculation methodology in English and independently calculate ranks. Ranking systems must also include some measures of research outcomes. Indicators were abstracted and contrasted with basic quality improvement requirements. Exploration of aggregation methods, validity of research and academic quality indicators, and suitability for quality improvement within ranking systems were also conducted. Results A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Six of the 13 rankings are 100% focused on research performance. For those reporting weighting, 76% of the total ranks are attributed to research indicators, with 24% attributed to academic or teaching quality. Seven systems rely on reputation surveys and/or faculty and alumni awards. Rankings influence academic choice yet research performance measures are the most weighted indicators. There are no generally accepted academic quality indicators in ranking systems. Discussion No single ranking system provides a comprehensive evaluation of research and academic quality. Utilizing a combined approach of the Leiden, Thomson Reuters Most Innovative Universities, and the SCImago ranking systems may provide institutions with a more effective feedback for research improvement. Rankings which extensively rely on subjective reputation and “luxury” indicators, such as award winning faculty or alumni who are high ranking executives, are not well suited for academic or research performance improvement initiatives. Future efforts should better explore measurement of the university research performance through comprehensive and standardized indicators. This paper could serve as a general literature citation when one or more of university ranking systems are used in efforts to improve academic prominence and research performance. PMID:29513762

Food and waste management biotechnology for the space shuttle

NASA Technical Reports Server (NTRS)

Murray, R. W.; Schelkopf, J. D.; Hunt, S. R.; Sauer, R. L.

1979-01-01

Space-crew facilities for preparation, eating, personal hygiene and waste management are contained in one small area of the Shuttle Orbiter Mid-Deck, all the functional systems being interconnected. The paper discusses three major systems: (1) the Galley, which includes the personal hygiene station and food packages; (2) the Waste Collector, which includes provisions for male and female users, urine, feces and emesis collection in both a normal and contigency mode of operation; and (3) Biowaste Monitoring, which includes mass measurement and sampling. The technology improvement continues by assuring that the Orbiter systems have sufficient design flexibility to permit later improvements in operation and in function.

Applying Toyota production system techniques for medication delivery: improving hospital safety and efficiency.

PubMed

Newell, Terry L; Steinmetz-Malato, Laura L; Van Dyke, Deborah L

2011-01-01

The inpatient medication delivery system used at a large regional acute care hospital in the Midwest had become antiquated and inefficient. The existing 24-hr medication cart-fill exchange process with delivery to the patients' bedside did not always provide ordered medications to the nursing units when they were needed. In 2007 the principles of the Toyota Production System (TPS) were applied to the system. Project objectives were to improve medication safety and reduce the time needed for nurses to retrieve patient medications. A multidisciplinary team was formed that included representatives from nursing, pharmacy, informatics, quality, and various operational support departments. Team members were educated and trained in the tools and techniques of TPS, and then designed and implemented a new pull system benchmarking the TPS Ideal State model. The newly installed process, providing just-in-time medication availability, has measurably improved delivery processes as well as patient safety and satisfaction. Other positive outcomes have included improved nursing satisfaction, reduced nursing wait time for delivered medications, and improved efficiency in the pharmacy. After a successful pilot on two nursing units, the system is being extended to the rest of the hospital. © 2010 National Association for Healthcare Quality.

Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

PubMed Central

2011-01-01

Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals) with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more developed quality improvement system is associated with lower rates of adjusted hospital complications. A number of methodological and logistic hurdles remain to link hospital quality improvement systems to outcomes. Further research should aim at identifying the latent dimensions of quality improvement systems that predict quality and safety outcomes. Such research would add pertinent knowledge regarding the implementation of organizational strategies related with quality of care outcomes. PMID:22185479

Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement.

PubMed

Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S

2010-11-30

The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific evaluation of physicians and other health staff (69.8%). Medical professionals were generally unsatisfied with the different aspects of the health system in Iraqi Kurdistan region. A number of problems and different priority needs for health system improvement have been recognized that require to be studied in more details.

Improving organisational systems for diabetes care in Australian Indigenous communities.

PubMed

Bailie, Ross; Si, Damin; Dowden, Michelle; O'Donoghue, Lynette; Connors, Christine; Robinson, Gary; Cunningham, Joan; Weeramanthri, Tarun

2007-05-06

Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from diabetes. There is an urgent need to understand how Indigenous primary care systems are organised to deliver diabetes services to those most in need, to monitor the quality of diabetes care received by Indigenous people, and to improve systems for better diabetes care. The intervention featured two annual cycles of assessment, feedback workshops, action planning, and implementation of system changes in 12 Indigenous community health centres. Assessment included a structured review of health service systems and audit of clinical records. Main process of care measures included adherence to guideline-scheduled services and medication adjustment. Main patient outcome measures were HbA1c, blood pressure and total cholesterol levels. There was good engagement of health centre staff, with significant improvements in system development over the study period. Adherence to guideline-scheduled processes improved, including increases in 6 monthly testing of HbA1c from 41% to 74% (Risk ratio 1.93, 95% CI 1.71-2.10), 3 monthly checking of blood pressure from 63% to 76% (1.27, 1.13-1.37), annual testing of total cholesterol from 56% to 74% (1.36, 1.20-1.49), biennial eye checking by a ophthalmologist from 34% to 54% (1.68, 1.39-1.95), and 3 monthly feet checking from 20% to 58% (3.01, 2.52-3.47). Medication adjustment rates following identification of elevated HbA1c and blood pressure were low, increasing from 10% to 24%, and from 13% to 21% respectively at year 1 audit. However, improvements in medication adjustment were not maintained at the year 2 follow-up. Mean HbA1c value improved from 9.3 to 8.9% (mean difference -0.4%, 95% CI -0.7;-0.1), but there was no improvement in blood pressure or cholesterol control. This quality improvement (QI) intervention has proved to be highly acceptable in the Indigenous Australian primary care setting and has been associated with significant improvements in systems and processes of care and some intermediate outcomes. However, improvements appear to be limited by inadequate attention to abnormal clinical findings and medication management. Greater improvement in intermediate outcomes may be achieved by specifically addressing system barriers to therapy intensification through more effective engagement of medical staff in QI activities and/or greater use of nurse-practitioners.

Optimal integral force feedback for active vibration control

NASA Astrophysics Data System (ADS)

Teo, Yik R.; Fleming, Andrew J.

2015-11-01

This paper proposes an improvement to Integral Force Feedback (IFF), which is a popular method for active vibration control of structures and mechanical systems. Benefits of IFF include robustness, guaranteed stability and simplicity. However, the maximum damping performance is dependent on the stiffness of the system; hence, some systems cannot be adequately controlled. In this paper, an improvement to the classical force feedback control scheme is proposed. The improved method achieves arbitrary damping for any mechanical system by introducing a feed-through term. The proposed improvement is experimentally demonstrated by actively damping an objective lens assembly for a high-speed confocal microscope.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

40 CFR 142.307 - What terms and conditions must be included in a small system variance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... improvements to comply with the small system variance technology, secure an alternative source of water, or... included in a small system variance? 142.307 Section 142.307 Protection of Environment ENVIRONMENTAL... IMPLEMENTATION Variances for Small System Review of Small System Variance Application § 142.307 What terms and...

40 CFR 142.307 - What terms and conditions must be included in a small system variance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... improvements to comply with the small system variance technology, secure an alternative source of water, or... included in a small system variance? 142.307 Section 142.307 Protection of Environment ENVIRONMENTAL... IMPLEMENTATION Variances for Small System Review of Small System Variance Application § 142.307 What terms and...

40 CFR 142.307 - What terms and conditions must be included in a small system variance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... improvements to comply with the small system variance technology, secure an alternative source of water, or... included in a small system variance? 142.307 Section 142.307 Protection of Environment ENVIRONMENTAL... IMPLEMENTATION Variances for Small System Review of Small System Variance Application § 142.307 What terms and...

40 CFR 142.307 - What terms and conditions must be included in a small system variance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... improvements to comply with the small system variance technology, secure an alternative source of water, or... included in a small system variance? 142.307 Section 142.307 Protection of Environment ENVIRONMENTAL... IMPLEMENTATION Variances for Small System Review of Small System Variance Application § 142.307 What terms and...

Precision Attitude Determination System (PADS) design and analysis. Two-axis gimbal star tracker

NASA Technical Reports Server (NTRS)

1973-01-01

Development of the Precision Attitude Determination System (PADS) focused chiefly on the two-axis gimballed star tracker and electronics design improved from that of Precision Pointing Control System (PPCS), and application of the improved tracker for PADS at geosynchronous altitude. System design, system analysis, software design, and hardware design activities are reported. The system design encompasses the PADS configuration, system performance characteristics, component design summaries, and interface considerations. The PADS design and performance analysis includes error analysis, performance analysis via attitude determination simulation, and star tracker servo design analysis. The design of the star tracker and electronics are discussed. Sensor electronics schematics are included. A detailed characterization of the application software algorithms and computer requirements is provided.

The Significance of the Understanding of Balance and Coordination in Self-Cognitive "Bio-Electro-Biblio/Info" Systems.

ERIC Educational Resources Information Center

Tsai, Bor-sheng

1991-01-01

Examines the information communication process and proposes a fuzzy commonality model for improving communication systems. Topics discussed include components of an electronic information programing and processing system and the flow of the formation and transfer of information, including DOS (disk operating system) commands, computer programing…

Terrorism in Argentina.

PubMed

Muro, Marcelo; Cohen, Roberto; Maffei, Daniel; Ballesteros, Marcelo; Espinosa, Luis

2003-01-01

Major terrorist attacks in Argentina since 1990 have been limited to two bombings in Buenos Aires, which together caused 115 deaths and left at least 555 injured. Following these attacks, national, regional, and local institutions responsible for emergency response in Argentina sought to improve their planning and preparedness for terrorism-related events. In 1996, the national government enacted legislation, which launched the Sistema Federal de Emergencias (SIFEM) or Federal Emergency System under the direction of the president. Since 1997, several of Argentina's major cities have developed emergency plans for terrorism-related events, including intentional biological and chemical releases. Institutional participants in emergency preparedness for terrorism-related events include Emergency Medical Services, hospitals, and the public health system. Remaining challenges include: (1) Improving intra-agency coordination; (2) Improving intra-agency communication; and (3) Improving and expanding emergency response training programs for responders and the general population.

National Airspace System Plan: Facilities, Equipment, Associated Development and Other Capital Needs

DTIC Science & Technology

1988-06-01

services will reflect a yes include: better balance between trip frequency and cost than would be the case under a closely regulated 0 Having an operating...terminal system). 0 Improved traffic flow planning and manage- ment, resulting in a more balanced workload. 0 A major improvement and integration of the...The AAS supervisors and specialists to assist them in will include AERA I functions and facilitate balancing sector staffing levels, later

Carrier-frequency synchronization system for improved amplitude modulation and television broadcast reception

DOEpatents

Smith, Stephen F.; Moore, James A.

2003-05-13

Systems and methods are described for carrier-frequency synchronization for improved AM and TV broadcast reception. A method includes synchronizing a carrier frequency of a broadcast signal with a remote reference frequency. An apparatus includes a reference signal receiver; a phase comparator coupled to the reference signal receiver; a voltage controlled oscillator coupled to the phase comparator; and a radio frequency output coupled to the voltage controlled oscillator.

Cockpit integration from a pilot's point of view

NASA Technical Reports Server (NTRS)

Green, D. L.

1982-01-01

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

Technology development of the Space Transportation System mission and terrestrial applications of satellite technology

NASA Technical Reports Server (NTRS)

1981-01-01

The Space Transportation System (STS) is discussed, including the launch processing system, the thermal protection subsystem, meteorological research, sound supression water system, rotating service structure, improved hypergol or removal systems, fiber optics research, precision positioning, remote controlled solid rocket booster nozzle plugs, ground operations for Centaur orbital transfer vehicle, parachute drying, STS hazardous waste disposal and recycle, toxic waste technology and control concepts, fast analytical densitometry study, shuttle inventory management system, operational intercommunications system improvement, and protective garment ensemble. Terrestrial applications are also covered, including LANDSAT applications to water resources, satellite freeze forecast system, application of ground penetrating radar to soil survey, turtle tracking, evaluating computer drawn ground cover maps, sparkless load pulsar, and coupling a microcomputer and computing integrator with a gas chromatograph.

Improvements in magnetic bearing performance for flywheel energy storage

NASA Technical Reports Server (NTRS)

Plant, David P.; Anand, Davinder K.; Kirk, James A.; Calomeris, Anthony J.; Romero, Robert L.

1988-01-01

The paper considers the development of a 500-Watt-hour magnetically suspended flywheel stack energy storage system. The work includes hardware testing results from a stack flywheel energy storage system, improvements in the area of noncontacting displacement transducers, and performance enhancements of magnetic bearings. Experimental results show that a stack flywheel energy storage system is feasible technology.

Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration

PubMed Central

Hynes, Denise M.; Perrin, Ruth A.; Rappaport, Steven; Stevens, Joanne M.; Demakis, John G.

2004-01-01

Information systems are increasingly important for measuring and improving health care quality. A number of integrated health care delivery systems use advanced information systems and integrated decision support to carry out quality assurance activities, but none as large as the Veterans Health Administration (VHA). The VHA's Quality Enhancement Research Initiative (QUERI) is a large-scale, multidisciplinary quality improvement initiative designed to ensure excellence in all areas where VHA provides health care services, including inpatient, outpatient, and long-term care settings. In this paper, we describe the role of information systems in the VHA QUERI process, highlight the major information systems critical to this quality improvement process, and discuss issues associated with the use of these systems. PMID:15187063

Demography of Principals' Work and School Improvement: Content Validity of Kentucky's Standards and Indicators for School Improvement (SISI)

ERIC Educational Resources Information Center

Lindle, Jane Clark; Stalion, Nancy; Young, Lu

2005-01-01

Kentucky's accountability system includes a school-processes audit known as Standards and Indicators for School Improvement (SISI), which is in a nascent stage of validation. Content validity methods include comparison to instruments measuring similar constructs as well as other techniques such as job analysis. This study used a two-phase process…

EHR strategy: top down, bottom up or middle out?

PubMed

Bowden, Thomas C

2011-01-01

Around the world a number of countries have made a concerted effort to embed Information and Communications Technology (ICT) within their health systems. It is widely acknowledged that the successful application of ICT to health systems can bring about significant benefits. A number of areas commonly singled out for improvement include: coordination of care; improved medication management; and streamlining the transfer of a patient's care from one healthcare provider to another. There are also perceived cost-benefits including reduced duplication of services and improved service utilization. Countries across the world have chosen many and varied paths to automating their health systems. Health systems are intrinsically very complicated and changing rapidly. Because they represent a high proportion of government expenditure, it is important to understand what is being achieved by each of the broad approaches that are being taken.

Robotics in Arthroplasty: A Comprehensive Review.

PubMed

Jacofsky, David J; Allen, Mark

2016-10-01

Robotic-assisted orthopedic surgery has been available clinically in some form for over 2 decades, claiming to improve total joint arthroplasty by enhancing the surgeon's ability to reproduce alignment and therefore better restore normal kinematics. Various current systems include a robotic arm, robotic-guided cutting jigs, and robotic milling systems with a diversity of different navigation strategies using active, semiactive, or passive control systems. Semiactive systems have become dominant, providing a haptic window through which the surgeon is able to consistently prepare an arthroplasty based on preoperative planning. A review of previous designs and clinical studies demonstrate that these robotic systems decrease variability and increase precision, primarily focusing on component positioning and alignment. Some early clinical results indicate decreased revision rates and improved patient satisfaction with robotic-assisted arthroplasty. The future design objectives include precise planning and even further improved consistent intraoperative execution. Despite this cautious optimism, many still wonder whether robotics will ultimately increase cost and operative time without objectively improving outcomes. Over the long term, every industry that has seen robotic technology be introduced, ultimately has shown an increase in production capacity, improved accuracy and precision, and lower cost. A new generation of robotic systems is now being introduced into the arthroplasty arena, and early results with unicompartmental knee arthroplasty and total hip arthroplasty have demonstrated improved accuracy of placement, improved satisfaction, and reduced complications. Further studies are needed to confirm the cost effectiveness of these technologies. Copyright © 2016 Elsevier Inc. All rights reserved.

Hybrid Power Management (HPM)

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2007-01-01

The NASA Glenn Research Center s Avionics, Power and Communications Branch of the Engineering and Systems Division initiated the Hybrid Power Management (HPM) Program for the GRC Technology Transfer and Partnership Office. HPM is the innovative integration of diverse, state-of-the-art power devices in an optimal configuration for space and terrestrial applications. The appropriate application and control of the various power devices significantly improves overall system performance and efficiency. The advanced power devices include ultracapacitors and fuel cells. HPM has extremely wide potential. Applications include power generation, transportation systems, biotechnology systems, and space power systems. HPM has the potential to significantly alleviate global energy concerns, improve the environment, and stimulate the economy. One of the unique power devices being utilized by HPM for energy storage is the ultracapacitor. An ultracapacitor is an electrochemical energy storage device, which has extremely high volumetric capacitance energy due to high surface area electrodes, and very small electrode separation. Ultracapacitors are a reliable, long life, maintenance free, energy storage system. This flexible operating system can be applied to all power systems to significantly improve system efficiency, reliability, and performance. There are many existing and conceptual applications of HPM.

Space Shuttle development update

NASA Technical Reports Server (NTRS)

Brand, V.

1984-01-01

The development efforts, since the STS-4 flight, in the Space Shuttle (SS) program are presented. The SS improvements introduced in the last two years include lower-weight loads, communication through the Tracking and Data Relay Satellite, expanded extravehicular activity capability, a maneuvering backpack and the manipulator foot restraint, the improvements in thermal projection system, the 'optional terminal area management targeting' guidance software, a rendezvous system with radar and star tracker sensors, and improved on-orbit living conditions. The flight demonstrations include advanced launch techniques (e.g., night launch and direct insertion to orbit); the on-orbit demonstrations; and added entry and launching capabilities. The entry aerodynamic analysis and entry flight control fine tuning are described. Reusability, improved ascent performance, intact abort and landing flexibility, rollout control, and 'smart speedbrakes' are among the many improvements planned for the future.

Air Quality Modeling Using the NASA GEOS-5 Multispecies Data Assimilation System

NASA Technical Reports Server (NTRS)

Keller, Christoph A.; Pawson, Steven; Wargan, Krzysztof; Weir, Brad

2018-01-01

The NASA Goddard Earth Observing System (GEOS) data assimilation system (DAS) has been expanded to include chemically reactive tropospheric trace gases including ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). This system combines model analyses from the GEOS-5 model with detailed atmospheric chemistry and observations from MLS (O3), OMI (O3 and NO2), and MOPITT (CO). We show results from a variety of assimilation test experiments, highlighting the improvements in the representation of model species concentrations by up to 50% compared to an assimilation-free control experiment. Taking into account the rapid chemical cycling of NO2 when applying the assimilation increments greatly improves assimilation skills for NO2 and provides large benefits for model concentrations near the surface. Analysis of the geospatial distribution of the assimilation increments suggest that the free-running model overestimates biomass burning emissions but underestimates lightning NOx emissions by 5-20%. We discuss the capability of the chemical data assimilation system to improve atmospheric composition forecasts through improved initial value and boundary condition inputs, particularly during air pollution events. We find that the current assimilation system meaningfully improves short-term forecasts (1-3 day). For longer-term forecasts more emphasis on updating the emissions instead of initial concentration fields is needed.

Measuring and improving quality of care in an academic medical center.

PubMed

Blayney, Douglas W

2013-05-01

The Donabedian definition of quality—structure, process, and outcome—provides a useful framework. A relentless focus on measuring process adherence and outcome is critical. Systemic improvements usually require teams to plan and to implement them. The lean or Toyota production system for process improvement is one useful method of organizing work, although different approaches are often necessary at the physician, practice unit, and statewide level. Challenges include scalability of the change (ie, rolling them out across the institution or system), tailoring the information technology tools, and building systems for sustainability.

A knowledge-based approach to improving optimization techniques in system planning

NASA Technical Reports Server (NTRS)

Momoh, J. A.; Zhang, Z. Z.

1990-01-01

A knowledge-based (KB) approach to improve mathematical programming techniques used in the system planning environment is presented. The KB system assists in selecting appropriate optimization algorithms, objective functions, constraints and parameters. The scheme is implemented by integrating symbolic computation of rules derived from operator and planner's experience and is used for generalized optimization packages. The KB optimization software package is capable of improving the overall planning process which includes correction of given violations. The method was demonstrated on a large scale power system discussed in the paper.

Hybrid Power Management Program Continued

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2002-01-01

Hybrid Power Management (HPM) is the innovative integration of diverse, state-of-the-art power devices in an optimal configuration for space and terrestrial applications. The appropriate application and control of the various power devices significantly improves overall system performance and efficiency. The advanced power devices include ultracapacitors and photovoltaics. HPM has extremely wide potential with applications including power-generation, transportation, biotechnology, and space power systems. It may significantly alleviate global energy concerns, improve the environment, and stimulate the economy.

A design for a new catalog manager and associated file management for the Land Analysis System (LAS)

NASA Technical Reports Server (NTRS)

Greenhagen, Cheryl

1986-01-01

Due to the larger number of different types of files used in an image processing system, a mechanism for file management beyond the bounds of typical operating systems is necessary. The Transportable Applications Executive (TAE) Catalog Manager was written to meet this need. Land Analysis System (LAS) users at the EROS Data Center (EDC) encountered some problems in using the TAE catalog manager, including catalog corruption, networking difficulties, and lack of a reliable tape storage and retrieval capability. These problems, coupled with the complexity of the TAE catalog manager, led to the decision to design a new file management system for LAS, tailored to the needs of the EDC user community. This design effort, which addressed catalog management, label services, associated data management, and enhancements to LAS applications, is described. The new file management design will provide many benefits including improved system integration, increased flexibility, enhanced reliability, enhanced portability, improved performance, and improved maintainability.

System Safety in an IT Service Organization

NASA Astrophysics Data System (ADS)

Parsons, Mike; Scutt, Simon

Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.

Observations to support adaptation: Principles, scales and decision-making

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.

2012-12-01

As has been long noted, a comprehensive, coordinated observing system is the backbone of any Earth information system. Demands are increasingly placed on earth observation and prediction systems and attendant services to address the needs of economically and environmentally vulnerable sectors and investments, including energy, water, human health, transportation, agriculture, fisheries, tourism, biodiversity, and national security. Climate services include building capacity to interpret information and recognize standards and limitations of data in the promotion of social and economic development in a changing climate. This includes improving the understanding of climate in the context of a variety of temporal and spatial scales (including the influence of decadal scale forcings and land surface feedbacks on seasonal forecast reliability). Climate data and information are central for developing decision options that are sensitive to climate-related uncertainties and the design of flexible adaptation pathways. Ideally monitoring should be action oriented to support climate risk assessment and adaptation including informing robust decision making to multiple risks over the long term. Based on the experience of global observations programs and empirical research we outline- Challenges in developing effective monitoring and climate information systems to support adaptation. The types of observations of critical importance needed for sector planning to enhance food, water and energy security, and to improve early warning for disaster risk reduction Observations needed for ecosystem-based adaptation including the identification of thresholds, maintenance of biological diversity and land degradation The benefits and limits of linking regional model output to local observations including analogs and verification for adaptation planning To support these goals a robust systems of integrated observations are needed to characterize the uncertainty surrounding emergent risks including overcoming unrealistically precise information demands. While monitoring systems design and operation should be guided by the standards and requirements of management, those who provide information to the system (e.g. hydromet services) should also derive benefits. Drawing on identified information needs to support climate risk management (in drought, water resources and other areas) we outline principles of effective monitoring and develop preliminary strategic guidance for information systems being developed through the GEO, GCOS and Global and national frameworks for climate services. The efficacy of such services are improved by a problem-solving orientation, participatory planning, extension management and improvements in the use and value of existing data to legitimize new investments.

7 CFR 1777.21 - Use of funds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... reasonable costs for closing abandoned septic tanks and water wells when necessary to protect the health and...) Construct, enlarge, extend, or otherwise improve community water and/or waste disposal systems. Otherwise improve would include extending service lines to and/or connecting residence's plumbing to the system. (2...

7 CFR 1777.21 - Use of funds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... reasonable costs for closing abandoned septic tanks and water wells when necessary to protect the health and...) Construct, enlarge, extend, or otherwise improve community water and/or waste disposal systems. Otherwise improve would include extending service lines to and/or connecting residence's plumbing to the system. (2...

7 CFR 1777.21 - Use of funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reasonable costs for closing abandoned septic tanks and water wells when necessary to protect the health and...) Construct, enlarge, extend, or otherwise improve community water and/or waste disposal systems. Otherwise improve would include extending service lines to and/or connecting residence's plumbing to the system. (2...

7 CFR 1777.21 - Use of funds.

Code of Federal Regulations, 2013 CFR

2013-01-01

... reasonable costs for closing abandoned septic tanks and water wells when necessary to protect the health and...) Construct, enlarge, extend, or otherwise improve community water and/or waste disposal systems. Otherwise improve would include extending service lines to and/or connecting residence's plumbing to the system. (2...

A qualitative analysis of interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement.

PubMed

Powell, Rhea E; Doty, Amanda; Casten, Robin J; Rovner, Barry W; Rising, Kristin L

2016-09-20

Healthcare systems increasingly engage interprofessional healthcare team members such as case managers, social workers, and community health workers to work directly with patients and improve population health. This study elicited perspectives of interprofessional healthcare team members regarding patient barriers to health and suggestions to address these barriers. This is a qualitative study employing focus groups and semi-structured interviews with 39 interprofessional healthcare team members in Philadelphia to elicit perceptions of patients' needs and experiences with the health system, and suggestions for positioning health care systems to better serve patients. Themes were identified using a content analysis approach. Three focus groups and 21 interviews were conducted with 26 hospital-based and 13 ambulatory-based participants. Three domains emerged to characterize barriers to care: social determinants, health system factors, and patient trust in the health system. Social determinants included insurance and financial shortcomings, mental health and substance abuse issues, housing and transportation-related limitations, and unpredictability associated with living in poverty. Suggestions for addressing these barriers included increased financial assistance from the health system, and building a workforce to address these determinants directly. Health care system factors included poor care coordination, inadequate communication of hospital discharge instructions, and difficulty navigating complex systems. Suggestions for addressing these barriers included enhanced communication between care sites, patient-centered scheduling, and improved patient education especially in discharge planning. Finally, factors related to patient trust of the health system emerged. Participants reported that patients are often intimidated by the health system, mistrusting of physicians, and fearful of receiving a serious diagnosis or prognosis. A suggestion for mitigating these issues was increased visibility of the health system within communities to foster trust and help providers gain a better understanding of unique community needs. This work explored interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement. Participants identified barriers related to social determinants of health, complex system organization, and patient mistrust of the health system. Participants offered concrete suggestions to address these barriers, with suggestions supporting current healthcare reform efforts that aim at addressing social determinants and improving health system coordination and adding new insight into how systems might work to improve patient and community trust.

Optimization of the Switch Mechanism in a Circuit Breaker Using MBD Based Simulation

PubMed Central

Jang, Jin-Seok; Yoon, Chang-Gyu; Ryu, Chi-Young; Kim, Hyun-Woo; Bae, Byung-Tae; Yoo, Wan-Suk

2015-01-01

A circuit breaker is widely used to protect electric power system from fault currents or system errors; in particular, the opening mechanism in a circuit breaker is important to protect current overflow in the electric system. In this paper, multibody dynamic model of a circuit breaker including switch mechanism was developed including the electromagnetic actuator system. Since the opening mechanism operates sequentially, optimization of the switch mechanism was carried out to improve the current breaking time. In the optimization process, design parameters were selected from length and shape of each latch, which changes pivot points of bearings to shorten the breaking time. To validate optimization results, computational results were compared to physical tests with a high speed camera. Opening time of the optimized mechanism was decreased by 2.3 ms, which was proved by experiments. Switch mechanism design process can be improved including contact-latch system by using this process. PMID:25918740

The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

PubMed

Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

2014-05-01

Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries.

Li Anode Technology for Improved Performance

NASA Technical Reports Server (NTRS)

Chen, Tuqiang

2011-01-01

A novel, low-cost approach to stabilization of Li metal anodes for high-performance rechargeable batteries was developed. Electrolyte additives are selected and used in Li cell electrolyte systems, promoting formation of a protective coating on Li metal anodes for improved cycle and safety performance. Li batteries developed from the new system will show significantly improved battery performance characteristics, including energy/power density, cycle/ calendar life, cost, and safety.

Designing for resilience

NASA Astrophysics Data System (ADS)

Dwivedi, Anurag

2014-06-01

The motivation for this work comes from a desire to improve resilience of mission critical cyber enabled systems including those used in critical infrastructure domains such as cyber, power, water, fuel, financial, healthcare, agriculture, and manufacturing. Resilience can be defined as the ability of a system to persistently meet its performance requirements despite the occurrence of adverse events. Characterizing the resilience of a system requires a clear definition of the performance requirements of the system of interest and an ability to quantify the impact on performance by the adverse events of concern. A quantitative characterization of system resilience allows the resilience requirements to be included in the system design criteria. Resilience requirements of a system are derived from the service level agreements (SLAs), measures of effectiveness (MOEs), and measures of performance (MOPs) of the services or missions supported by the system. This paper describes a methodology for designing resilient systems. The components of the methodology include resilience characterization for threat models associated with various exposure modes, requirements mapping, subsystem ranking based on criticality, and selective implementation of mitigations to improve system resilience to a desired level.

Improved pulse laser ranging algorithm based on high speed sampling

NASA Astrophysics Data System (ADS)

Gao, Xuan-yi; Qian, Rui-hai; Zhang, Yan-mei; Li, Huan; Guo, Hai-chao; He, Shi-jie; Guo, Xiao-kang

2016-10-01

Narrow pulse laser ranging achieves long-range target detection using laser pulse with low divergent beams. Pulse laser ranging is widely used in military, industrial, civil, engineering and transportation field. In this paper, an improved narrow pulse laser ranging algorithm is studied based on the high speed sampling. Firstly, theoretical simulation models have been built and analyzed including the laser emission and pulse laser ranging algorithm. An improved pulse ranging algorithm is developed. This new algorithm combines the matched filter algorithm and the constant fraction discrimination (CFD) algorithm. After the algorithm simulation, a laser ranging hardware system is set up to implement the improved algorithm. The laser ranging hardware system includes a laser diode, a laser detector and a high sample rate data logging circuit. Subsequently, using Verilog HDL language, the improved algorithm is implemented in the FPGA chip based on fusion of the matched filter algorithm and the CFD algorithm. Finally, the laser ranging experiment is carried out to test the improved algorithm ranging performance comparing to the matched filter algorithm and the CFD algorithm using the laser ranging hardware system. The test analysis result demonstrates that the laser ranging hardware system realized the high speed processing and high speed sampling data transmission. The algorithm analysis result presents that the improved algorithm achieves 0.3m distance ranging precision. The improved algorithm analysis result meets the expected effect, which is consistent with the theoretical simulation.

Kaizen newspaper

NASA Technical Reports Server (NTRS)

Shearer, Scott C. (Inventor); Proferes, John Nicholas (Inventor); Baker, Sr., Mitchell D. (Inventor); Reilly, Kenneth B. (Inventor); Tiwari, Vijai K. (Inventor)

2013-01-01

Systems, computer program products, and methods are disclosed for tracking an improvement event. An embodiment includes an event interface configured to receive a plurality of entries related to each of a plurality of improvement events. The plurality of entries includes a project identifier for the improvement event, a creation date, an objective, an action related to reaching the objective, and a first deadline related to the improvement event. A database interface is configured to store the plurality of entries in an event database.

What Is Improvement Science? Do We Need It in Education?

ERIC Educational Resources Information Center

Lewis, Catherine

2015-01-01

The theory and tools of "improvement science" have produced performance improvements in many organizational sectors. This essay describes improvement science and explores its potential and challenges within education. Potential contributions include attention to the knowledge-building and motivational systems within schools, strategies…

Establishment, Present Condition, and Developmental Direction of the New Korean Healthcare Accreditation System

PubMed Central

Chang, Hoo-Sun

2012-01-01

On July 23rd, 2010 a revised medical law (Article 58) was passed to change existing evaluation system of medical institutions to an accreditation system. The new healthcare accreditation system was introduced to encourage medical institutions to work voluntarily and continuously to improve patient safety and medical service quality. Changes regarding the healthcare accreditation system included the establishment of an accreditation agency, the voluntary participation of medical institutions, accreditation standards centering on the treatment process and patient safety, tracing methodology, and the announcement of comprehensive results concerning accreditation. Despite varying views on the healthcare accreditation system, including some that are critical, it is meaningful that the voluntary nature of the system acknowledges that the medical institutions must be active agents in improving medical service quality. Healthcare quality is not improved instantaneously, but instead gradually through continuous communication within the clinical field. For this accreditation system to be successful, followings are essential: the accreditation agency becomes financially independent and is managed efficiently, the autonomy and regulation surrounding the system are balanced, the professionalism of the system is ensured, and the medical field plays an active role in the operation of the system. PMID:22661873

The MiPACQ clinical question answering system.

PubMed

Cairns, Brian L; Nielsen, Rodney D; Masanz, James J; Martin, James H; Palmer, Martha S; Ward, Wayne H; Savova, Guergana K

2011-01-01

The Multi-source Integrated Platform for Answering Clinical Questions (MiPACQ) is a QA pipeline that integrates a variety of information retrieval and natural language processing systems into an extensible question answering system. We present the system's architecture and an evaluation of MiPACQ on a human-annotated evaluation dataset based on the Medpedia health and medical encyclopedia. Compared with our baseline information retrieval system, the MiPACQ rule-based system demonstrates 84% improvement in Precision at One and the MiPACQ machine-learning-based system demonstrates 134% improvement. Other performance metrics including mean reciprocal rank and area under the precision/recall curves also showed significant improvement, validating the effectiveness of the MiPACQ design and implementation.

Improved Steam Turbine Leakage Control with a Brush Seal Design

NASA Astrophysics Data System (ADS)

Turnquist, Norman; Chupp, Raymond E.; Pastrana, Ryan; Wolfe, Chris; Burnett, Mark

2002-10-01

This paper presents an improved steam turbine leakage control system with a brush seal design. The contents include: 1) Typical Design Characteristics; 2) Typical Brush Seal Locations; 3) Reduced Leakage Rates; 4) Performance Benefits; 5) System Considerations; 6) Rotor Dynamics; 7) Laboratory Tests and 8) Field Experience.

Performance of a logging truck with a central tire inflation system.

Treesearch

John A. Sturos; Douglas B. Brumm; Andrew Lehto

1995-01-01

Describes the performance of an 11-axle logging truck with a central tire inflation system. Results included reduced damages to roads, improved ride of the truck, improved drawbar pull, and reduced rolling resistance. Road construction costs were reduced 62%, primarily due to using 33% less gravel.

Improving urban district heating systems and assessing the efficiency of the energy usage therein

NASA Astrophysics Data System (ADS)

Orlov, M. E.; Sharapov, V. I.

2017-11-01

The report describes issues in connection with improving urban district heating systems from combined heat power plants (CHPs), to propose the ways for improving the reliability and the efficiency of the energy usage (often referred to as “energy efficiency”) in such systems. The main direction of such urban district heating systems improvement suggests transition to combined heating systems that include structural elements of both centralized and decentralized systems. Such systems provide the basic part of thermal power via highly efficient methods for extracting thermal power plants turbines steam, while peak loads are covered by decentralized peak thermal power sources to be mounted at consumers’ locations, with the peak sources being also reserve thermal power sources. The methodology was developed for assessing energy efficiency of the combined district heating systems, implemented as a computer software product capable of comparatively calculating saving on reference fuel for the system.

Virtual reality and gaming systems to improve walking and mobility for people with musculoskeletal and neuromuscular conditions.

PubMed

Deutsch, Judith E

2009-01-01

Improving walking for individuals with musculoskeletal and neuromuscular conditions is an important aspect of rehabilitation. The capabilities of clinicians who address these rehabilitation issues could be augmented with innovations such as virtual reality gaming based technologies. The chapter provides an overview of virtual reality gaming based technologies currently being developed and tested to improve motor and cognitive elements required for ambulation and mobility in different patient populations. Included as well is a detailed description of a single VR system, consisting of the rationale for development and iterative refinement of the system based on clinical science. These concepts include: neural plasticity, part-task training, whole task training, task specific training, principles of exercise and motor learning, sensorimotor integration, and visual spatial processing.

Techniques for improving transients in learning control systems

NASA Technical Reports Server (NTRS)

Chang, C.-K.; Longman, Richard W.; Phan, Minh

1992-01-01

A discrete modern control formulation is used to study the nature of the transient behavior of the learning process during repetitions. Several alternative learning control schemes are developed to improve the transient performance. These include a new method using an alternating sign on the learning gain, which is very effective in limiting peak transients and also very useful in multiple-input, multiple-output systems. Other methods include learning at an increasing number of points progressing with time, or an increasing number of points of increasing density.

Injection locked oscillator system for pulsed metal vapor lasers

DOEpatents

Warner, Bruce E.; Ault, Earl R.

1988-01-01

An injection locked oscillator system for pulsed metal vapor lasers is disclosed. The invention includes the combination of a seeding oscillator with an injection locked oscillator (ILO) for improving the quality, particularly the intensity, of an output laser beam pulse. The present invention includes means for matching the first seeder laser pulses from the seeding oscillator to second laser pulses of a metal vapor laser to improve the quality, and particularly the intensity, of the output laser beam pulse.

Carrier phase synchronization system for improved amplitude modulation and television broadcast reception

DOEpatents

Smith, Stephen F [Loudon, TN; Moore, James A [Powell, TN

2011-02-01

Systems and methods are described for carrier phase synchronization for improved AM and TV broadcast reception. A method includes synchronizing the phase of a carrier frequency of a broadcast signal with the phase of a remote reference frequency. An apparatus includes a receiver to detect the phase of a reference signal; a phase comparator coupled to the reference signal-phase receiver; a voltage controlled oscillator coupled to the phase comparator; and a phase-controlled radio frequency output coupled to the voltage controlled oscillator.

Application of aircraft navigation sensors to enhanced vision systems

NASA Technical Reports Server (NTRS)

Sweet, Barbara T.

1993-01-01

In this presentation, the applicability of various aircraft navigation sensors to enhanced vision system design is discussed. First, the accuracy requirements of the FAA for precision landing systems are presented, followed by the current navigation systems and their characteristics. These systems include Instrument Landing System (ILS), Microwave Landing System (MLS), Inertial Navigation, Altimetry, and Global Positioning System (GPS). Finally, the use of navigation system data to improve enhanced vision systems is discussed. These applications include radar image rectification, motion compensation, and image registration.

Developing a clinical information system: the role of the chief information officer.

PubMed

Glaser, J

1994-11-01

Chief information officers (CIOs) must play a pivotal role in the formation and implementation of a clinical information system, the subset of an organizational information system that deals specifically with support of clinical care activities. Major elements include the applications software, technology and data architecture, databases, and analysis. The organizational structures and processes that manage the development of improvement activities, including the clinical information system itself, are just as vital to the design of an information system as the hardware and software. To develop, sustain, and advance an information infrastructure, the CIO must help establish certain organizational precursors, such as medical staff involvement, experience with quality improvement, and ability to meet data needs. The CIO must then work with the senior administrative and medical leadership in developing a vision for the information system. The CIO must also create new roles and knowledge for information system and medical staff members. Interaction between information services and medical staff is vitally important to the success of a clinical information system. Organizational committees and structures that Brigham and Women's Hospital in Boston put in place to formalize the relationship between information systems and medical staff include the Clinical Initiative Development Program and the Center for Applied Medical Information Systems Research. Improving the clinical management of care and the efficacy of care processes involves complex changes in organizational culture and processes, medical practice and information system applications, technologies, staff, and data.

Improving vaccine registries through mobile technologies: a vision for mobile enhanced Immunization information systems.

PubMed

Wilson, Kumanan; Atkinson, Katherine M; Deeks, Shelley L; Crowcroft, Natasha S

2016-01-01

Immunization registries or information systems are critical to improving the quality and evaluating the ongoing success of immunization programs. However, the completeness of these systems is challenged by a myriad of factors including the fragmentation of vaccine administration, increasing mobility of individuals, new vaccine development, use of multiple products, and increasingly frequent changes in recommendations. Mobile technologies could offer a solution, which mitigates some of these challenges. Engaging individuals to have more control of their own immunization information using their mobile devices could improve the timeliness and accuracy of data in central immunization information systems. Other opportunities presented by mobile technologies that could be exploited to improve immunization information systems include mobile reporting of adverse events following immunization, the capacity to scan 2D barcodes, and enabling bidirectional communication between individuals and public health officials. Challenges to utilizing mobile solutions include ensuring privacy of data, access, and equity concerns, obtaining consent and ensuring adoption of technology at sufficiently high rates. By empowering individuals with their own health information, mobile technologies can also serve as a mechanism to transfer immunization information as individuals cross local, regional, and national borders. Ultimately, mobile enhanced immunization information systems can help realize the goal of the individual, the healthcare provider, and public health officials always having access to the same immunization information. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

24 CFR 241.565 - Maximum loan amount.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... energy conserving improvements including the purchase thereof, cost of installation, architect's fees... of the energy conserving improvements. (b) An amount which, when added to the existing outstanding...

24 CFR 241.565 - Maximum loan amount.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... energy conserving improvements including the purchase thereof, cost of installation, architect's fees... of the energy conserving improvements. (b) An amount which, when added to the existing outstanding...

24 CFR 241.565 - Maximum loan amount.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... energy conserving improvements including the purchase thereof, cost of installation, architect's fees... of the energy conserving improvements. (b) An amount which, when added to the existing outstanding...

24 CFR 241.565 - Maximum loan amount.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... energy conserving improvements including the purchase thereof, cost of installation, architect's fees... of the energy conserving improvements. (b) An amount which, when added to the existing outstanding...

24 CFR 241.565 - Maximum loan amount.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... energy conserving improvements including the purchase thereof, cost of installation, architect's fees... of the energy conserving improvements. (b) An amount which, when added to the existing outstanding...

A novel energy recovery system for parallel hybrid hydraulic excavator.

PubMed

Li, Wei; Cao, Baoyu; Zhu, Zhencai; Chen, Guoan

2014-01-01

Hydraulic excavator energy saving is important to relieve source shortage and protect environment. This paper mainly discusses the energy saving for the hybrid hydraulic excavator. By analyzing the excess energy of three hydraulic cylinders in the conventional hydraulic excavator, a new boom potential energy recovery system is proposed. The mathematical models of the main components including boom cylinder, hydraulic motor, and hydraulic accumulator are built. The natural frequency of the proposed energy recovery system is calculated based on the mathematical models. Meanwhile, the simulation models of the proposed system and a conventional energy recovery system are built by AMESim software. The results show that the proposed system is more effective than the conventional energy saving system. At last, the main components of the proposed energy recovery system including accumulator and hydraulic motor are analyzed for improving the energy recovery efficiency. The measures to improve the energy recovery efficiency of the proposed system are presented.

A Novel Energy Recovery System for Parallel Hybrid Hydraulic Excavator

PubMed Central

Li, Wei; Cao, Baoyu; Zhu, Zhencai; Chen, Guoan

2014-01-01

Hydraulic excavator energy saving is important to relieve source shortage and protect environment. This paper mainly discusses the energy saving for the hybrid hydraulic excavator. By analyzing the excess energy of three hydraulic cylinders in the conventional hydraulic excavator, a new boom potential energy recovery system is proposed. The mathematical models of the main components including boom cylinder, hydraulic motor, and hydraulic accumulator are built. The natural frequency of the proposed energy recovery system is calculated based on the mathematical models. Meanwhile, the simulation models of the proposed system and a conventional energy recovery system are built by AMESim software. The results show that the proposed system is more effective than the conventional energy saving system. At last, the main components of the proposed energy recovery system including accumulator and hydraulic motor are analyzed for improving the energy recovery efficiency. The measures to improve the energy recovery efficiency of the proposed system are presented. PMID:25405215

24 CFR 241.605 - Contract requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... plus contract. Either form of contract shall include the cost of the energy conserving improvements...

24 CFR 241.605 - Contract requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... plus contract. Either form of contract shall include the cost of the energy conserving improvements...

24 CFR 241.605 - Contract requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... plus contract. Either form of contract shall include the cost of the energy conserving improvements...

24 CFR 241.605 - Contract requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... plus contract. Either form of contract shall include the cost of the energy conserving improvements...

24 CFR 241.605 - Contract requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Purchase and Installation of Energy Conserving Improvements, Solar Energy Systems, and Individual Utility... plus contract. Either form of contract shall include the cost of the energy conserving improvements...

Projected techno-economic improvements for advanced solar thermal power plants

NASA Technical Reports Server (NTRS)

Fujita, T.; Manvi, R.; Roschke, E. J.

1979-01-01

The projected characteristics of solar thermal power plants (with outputs up to 10 MWe) employing promising advanced technology subsystems/components are compared to current (or pre-1985) steam-Rankine systems. Improvements accruing to advanced technology development options are delineated. The improvements derived from advanced systems result primarily from achieving high efficiencies via solar collector systems which (1) capture a large portion of the available insolation and (2) concentrate this captured solar flux to attain high temperatures required for high heat engine/energy conversion performance. The most efficient solar collector systems employ two-axis tracking. Attractive systems include the central receiver/heliostat and the parabolic dish.

Strategic deployment plan : intelligent transportation system (ITS) : early deployment study, Kansas City metropolitan bi-state area

DOT National Transportation Integrated Search

1997-01-01

Intelligent transportation systems (ITS) are systems that utilize advanced technologies, including computer, communications and process control technologies, to improve the efficiency and safety of the transportation system. These systems encompass a...

Smart information system for gachon university gil hospital.

PubMed

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Smart Information System for Gachon University Gil Hospital

PubMed Central

Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-01-01

Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

PubMed

Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

2018-04-01

The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

Automated Developmental Disabilities Out-Patient Treatment Review System (ADDOPTRS)—Development and Automation of a Microcomputer Based Case Management System

PubMed Central

Fisch, Clifford B.; Fisch, Martin L.

1979-01-01

The Stanley S. Lamm Institute for Developmental Disabilities of The Long Island College Hospital, in conjunction with Micro-Med Systems has developed a low cost micro-computer based information system (ADDOP TRS) which monitors quality of care in outpatient settings rendering services to the developmentally disabled population. The process of conversion from paper record keeping systems to direct key-to-disk data capture at the point of service delivery is described. Data elements of the information system including identifying patient information, coded and English-grammar entry procedures for tracking elements of service as well as their delivery status are described. Project evaluation criteria are defined including improved quality of care, improved productivity for clerical and professional staff and enhanced decision making capability. These criteria are achieved in a cost effective manner as a function of more efficient information flow. Administrative applications including staff/budgeting procedures, submissions for third party reimbursement and case reporting to utilization review committees are considered.

Rapid response systems.

PubMed

Lyons, Patrick G; Edelson, Dana P; Churpek, Matthew M

2018-07-01

Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. Articles written in English and published in PubMed. Rapid response systems are heterogeneous, with important differences among afferent and efferent arms. Clinically meaningful outcomes may include unexpected mortality, in-hospital cardiac arrest, length of stay, cost, and processes of care at end of life. Both positive and negative interventional studies have been published, although the two largest randomized trials involving rapid response systems - the Medical Early Response and Intervention Trial (MERIT) and the Effect of a Pediatric Early Warning System on All-Cause Mortality in Hospitalized Pediatric Patients (EPOCH) trial - did not find a mortality benefit with these systems, albeit with important limitations. Advances in monitoring technologies, risk assessment strategies, and behavioral ergonomics may offer opportunities for improvement. Rapid responses may improve some meaningful outcomes, although these findings remain controversial. These systems may also improve care for patients at the end of life. Rapid response systems are expected to continue evolving with novel developments in monitoring technologies, risk prediction informatics, and work in human factors. Copyright © 2018 Elsevier B.V. All rights reserved.

Process Improvement Should Link to Security: SEPG 2007 Security Track Recap

DTIC Science & Technology

2007-09-01

the Systems Security Engineering Capability Maturity Model (SSE- CMM / ISO 21827) and its use in system software developments ...software development life cycle ( SDLC )? 6. In what ways should process improvement support security in the SDLC ? 1.2 10BPANEL RESOURCES For each... project management, and support practices through the use of the capability maturity models including the CMMI and the Systems Security

The MiPACQ Clinical Question Answering System

PubMed Central

Cairns, Brian L.; Nielsen, Rodney D.; Masanz, James J.; Martin, James H.; Palmer, Martha S.; Ward, Wayne H.; Savova, Guergana K.

2011-01-01

The Multi-source Integrated Platform for Answering Clinical Questions (MiPACQ) is a QA pipeline that integrates a variety of information retrieval and natural language processing systems into an extensible question answering system. We present the system’s architecture and an evaluation of MiPACQ on a human-annotated evaluation dataset based on the Medpedia health and medical encyclopedia. Compared with our baseline information retrieval system, the MiPACQ rule-based system demonstrates 84% improvement in Precision at One and the MiPACQ machine-learning-based system demonstrates 134% improvement. Other performance metrics including mean reciprocal rank and area under the precision/recall curves also showed significant improvement, validating the effectiveness of the MiPACQ design and implementation. PMID:22195068

Improved image quality in pinhole SPECT by accurate modeling of the point spread function in low magnification systems

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

Pino, Francisco; Roé, Nuria; Aguiar, Pablo, E-mail: pablo.aguiar.fernandez@sergas.es

2015-02-15

Purpose: Single photon emission computed tomography (SPECT) has become an important noninvasive imaging technique in small-animal research. Due to the high resolution required in small-animal SPECT systems, the spatially variant system response needs to be included in the reconstruction algorithm. Accurate modeling of the system response should result in a major improvement in the quality of reconstructed images. The aim of this study was to quantitatively assess the impact that an accurate modeling of spatially variant collimator/detector response has on image-quality parameters, using a low magnification SPECT system equipped with a pinhole collimator and a small gamma camera. Methods: Threemore » methods were used to model the point spread function (PSF). For the first, only the geometrical pinhole aperture was included in the PSF. For the second, the septal penetration through the pinhole collimator was added. In the third method, the measured intrinsic detector response was incorporated. Tomographic spatial resolution was evaluated and contrast, recovery coefficients, contrast-to-noise ratio, and noise were quantified using a custom-built NEMA NU 4–2008 image-quality phantom. Results: A high correlation was found between the experimental data corresponding to intrinsic detector response and the fitted values obtained by means of an asymmetric Gaussian distribution. For all PSF models, resolution improved as the distance from the point source to the center of the field of view increased and when the acquisition radius diminished. An improvement of resolution was observed after a minimum of five iterations when the PSF modeling included more corrections. Contrast, recovery coefficients, and contrast-to-noise ratio were better for the same level of noise in the image when more accurate models were included. Ring-type artifacts were observed when the number of iterations exceeded 12. Conclusions: Accurate modeling of the PSF improves resolution, contrast, and recovery coefficients in the reconstructed images. To avoid the appearance of ring-type artifacts, the number of iterations should be limited. In low magnification systems, the intrinsic detector PSF plays a major role in improvement of the image-quality parameters.« less

Extensions and improvements on XTRAN3S

NASA Technical Reports Server (NTRS)

Borland, C. J.

1989-01-01

Improvements to the XTRAN3S computer program are summarized. Work on this code, for steady and unsteady aerodynamic and aeroelastic analysis in the transonic flow regime has concentrated on the following areas: (1) Maintenance of the XTRAN3S code, including correction of errors, enhancement of operational capability, and installation on the Cray X-MP system; (2) Extension of the vectorization concepts in XTRAN3S to include additional areas of the code for improved execution speed; (3) Modification of the XTRAN3S algorithm for improved numerical stability for swept, tapered wing cases and improved computational efficiency; and (4) Extension of the wing-only version of XTRAN3S to include pylon and nacelle or external store capability.

Improved All-Terrain Suspension System

NASA Technical Reports Server (NTRS)

Bickler, Donald B.

1994-01-01

Redesigned suspension system for all-terrain vehicle exhibits enhanced ability to negotiate sand and rocks. Improved six-wheel suspension system includes only two links on each side. Bogie tends to pull rear wheels with it as it climbs. Designed for rover vehicle for exploration of Mars, also has potential application in off-road vehicles, military scout vehicles, robotic emergency vehicles, and toys. Predecessors of suspension system described in "Articulated Suspension Without Springs" (NPO-17354), "Four-Wheel Vehicle Suspension System" (NPO-17407), and "High-Clearance Six-Wheel Suspension" (NPO-17821).

Circulation Systems on Microcomputers.

ERIC Educational Resources Information Center

Carlson, Gary

1984-01-01

Reports on the use of microcomputers in comprehensive library circulation systems. Topics covered include system requirements (reliability, completeness); determining circulation system needs (saving money, improving service, modernization); limitations of microcomputers (capacity, kinds of data stored, number of stations or terminals); system…

Cast B2-phase iron-aluminum alloys with improved fluidity

DOEpatents

Maziasz, Philip J.; Paris, Alan M.; Vought, Joseph D.

2002-01-01

Systems and methods are described for iron aluminum alloys. A composition includes iron, aluminum and manganese. A method includes providing an alloy including iron, aluminum and manganese; and processing the alloy. The systems and methods provide advantages because additions of manganese to iron aluminum alloys dramatically increase the fluidity of the alloys prior to solidification during casting.

Efficacy of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP) Primary Version

ERIC Educational Resources Information Center

DiPerna, James Clyde; Lei, Puiwa; Bellinger, Jillian; Cheng, Weiyi

2015-01-01

A multisite cluster randomized trial was conducted to examine the effects of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007) on students' classroom social behavior. The final sample included 432 students across 38 second grade classrooms. Social skills and problem behaviors were measured…

Mechanisms of deterioration of nutrients. [of freeze dried foods

NASA Technical Reports Server (NTRS)

Karel, M.; Flink, J. M.

1976-01-01

Methods which produce freeze dried foods of improved quality were examined with emphasis on storage stability. Specific topics discussed include: microstructure of freeze dried systems, investigation of structural changes in freeze dried systems, artificial food matrices, osmotic preconcentration to yield improved quality freeze dried fruits, and storage stability of osmotically preconcentrated freeze dried fruits.

Mines Systems Safety Improvement Using an Integrated Event Tree and Fault Tree Analysis

NASA Astrophysics Data System (ADS)

Kumar, Ranjan; Ghosh, Achyuta Krishna

2017-04-01

Mines systems such as ventilation system, strata support system, flame proof safety equipment, are exposed to dynamic operational conditions such as stress, humidity, dust, temperature, etc., and safety improvement of such systems can be done preferably during planning and design stage. However, the existing safety analysis methods do not handle the accident initiation and progression of mine systems explicitly. To bridge this gap, this paper presents an integrated Event Tree (ET) and Fault Tree (FT) approach for safety analysis and improvement of mine systems design. This approach includes ET and FT modeling coupled with redundancy allocation technique. In this method, a concept of top hazard probability is introduced for identifying system failure probability and redundancy is allocated to the system either at component or system level. A case study on mine methane explosion safety with two initiating events is performed. The results demonstrate that the presented method can reveal the accident scenarios and improve the safety of complex mine systems simultaneously.

Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice

ERIC Educational Resources Information Center

Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

2010-01-01

Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

Flexible binding simulation by a novel and improved version of virtual-system coupled adaptive umbrella sampling

NASA Astrophysics Data System (ADS)

Dasgupta, Bhaskar; Nakamura, Haruki; Higo, Junichi

2016-10-01

Virtual-system coupled adaptive umbrella sampling (VAUS) enhances sampling along a reaction coordinate by using a virtual degree of freedom. However, VAUS and regular adaptive umbrella sampling (AUS) methods are yet computationally expensive. To decrease the computational burden further, improvements of VAUS for all-atom explicit solvent simulation are presented here. The improvements include probability distribution calculation by a Markov approximation; parameterization of biasing forces by iterative polynomial fitting; and force scaling. These when applied to study Ala-pentapeptide dimerization in explicit solvent showed advantage over regular AUS. By using improved VAUS larger biological systems are amenable.

Improved control strategy for wind-powered refrigerated storage of apples

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

Baldwin, J.D.C.; Vaughan, D.H.

1981-01-01

A refrigerated apple storage facility was constructed at the VPI and SU Horticultural Research Farm in Blacksburg, Virginia and began operation in March 1978. The system included a 10-kW electric wind generator, electrical battery storage, thermal (ice) storage, and auxiliary power. The need for an improved control system for the VPI and SU system was determined from tests on the individual components and in situ performance tests. The results of these tests formed the basis for an improved control strategy to improve the utilization of available wind energy and reduce the need for auxiliary power while maintaining an adequate applemore » storage environment.« less

Design Optimization of Innovative High-Level Waste Pipeline Unplugging Technologies - 13341

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

Pribanic, T.; Awwad, A.; Varona, J.

2013-07-01

Florida International University (FIU) is currently working on the development and optimization of two innovative pipeline unplugging methods: the asynchronous pulsing system (APS) and the peristaltic crawler system (PCS). Experiments were conducted on the APS to determine how air in the pipeline influences the system's performance as well as determine the effectiveness of air mitigation techniques in a pipeline. The results obtained during the experimental phase of the project, including data from pipeline pressure pulse tests along with air bubble compression tests are presented. Single-cycle pulse amplification caused by a fast-acting cylinder piston pump in 21.8, 30.5, and 43.6 mmore » pipelines were evaluated. Experiments were conducted on fully flooded pipelines as well as pipelines that contained various amounts of air to evaluate the system's performance when air is present in the pipeline. Also presented are details of the improvements implemented to the third generation crawler system (PCS). The improvements include the redesign of the rims of the unit to accommodate a camera system that provides visual feedback of the conditions inside the pipeline. Visual feedback allows the crawler to be used as a pipeline unplugging and inspection tool. Tests conducted previously demonstrated a significant reduction of the crawler speed with increasing length of tether. Current improvements include the positioning of a pneumatic valve manifold system that is located in close proximity to the crawler, rendering tether length independent of crawler speed. Additional improvements to increase the crawler's speed were also investigated and presented. Descriptions of the test beds, which were designed to emulate possible scenarios present on the Department of Energy (DOE) pipelines, are presented. Finally, conclusions and recommendations for the systems are provided. (authors)« less

Comprehensive Environmental Informatics System (CEIS) Integrating Crew and Vehicle Environmental Health

NASA Technical Reports Server (NTRS)

Nall, Mark E.

2006-01-01

Integrated Vehicle Health Management (IVHM) systems have been pursued as highly integrated systems that include smart sensors, diagnostic and prognostics software for assessments of real-time and life-cycle vehicle health information. Inclusive to such a system is the requirement to monitor the environmental health within the vehicle and the occupants of the vehicle. In this regard an enterprise approach to informatics is used to develop a methodology entitled, Comprehensive Environmental Informatics System (CEIS). The hardware and software technologies integrated into this system will be embedded in the vehicle subsystems, and maintenance operations, to provide both real-time and life-cycle health information of the environment within the vehicle cabin and of its occupants. This comprehensive information database will enable informed decision making and logistics management. One key element of the CEIS is interoperability for data acquisition and archive between environment and human system monitoring. With comprehensive components the data acquired in this system will use model based reasoning systems for subsystem and system level managers, advanced on-board and ground-based mission and maintenance planners to assess system functionality. Knowledge databases of the vehicle health state will be continuously updated and reported for critical failure modes, and routinely updated and reported for life cycle condition trending. Sufficient intelligence, including evidence-based engineering practices which are analogous to evidencebased medicine practices, will be included in the CEIS to result in more rapid recognition of off-nominal operation to enable quicker corrective actions. This will result from better information (rather than just data) for improved crew/operator situational awareness, which will produce significant vehicle and crew safety improvements, as well as increasing the chance for mission success, future mission planning as well as training. Other benefits include improved reliability, increase safety in operations and cost of operations. The cost benefits stem from significantly reduced processing and operations manpower, predictive maintenance for systems and subjects. The improvements in vehicle functionality and cost will result from increased prognostic and diagnostic capability due to the detailed total human exploration system health knowledge from CEIS. A collateral benefit is that there will be closer observations of the vehicle occupants as wrist watch sized devices are worn for continuous health monitoring. Additional database acquisition will stem from activities in countermeasure practices to ensure peak performance capability by occupants of the vehicle. The CEIS will provide data from advanced sensing technologies and informatics modeling which will be useful in problem troubleshooting, and improving NASA s awareness of systems during operation.

Rapid Deployment of Optimal Control for Building HVAC Systems using Innovative Software Tools and a Hybrid Heuristic/Model Based Control Approach

DTIC Science & Technology

2017-03-21

Energy and Water Projects March 21, 2017 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of...included reduced system energy use and cost as well as improved performance driven by autonomous commissioning and optimized system control. In the end...improve system performance and reduce energy use and cost. However, implementing these solutions into the extremely heterogeneous and often

Improved Photon-Emission-Microscope System

NASA Technical Reports Server (NTRS)

Vu, Duc

2006-01-01

An improved photon-emission-microscope (PEM) instrumentation system has been developed for use in diagnosing failure conditions in semiconductor devices, including complex integrated circuits. This system is designed primarily to image areas that emit photons, at wavelengths from 400 to 1,100 nm, associated with device failures caused by leakage of electric current through SiO2 and other dielectric materials used in multilayer semiconductor structures. In addition, the system is sensitive enough to image areas that emit photons during normal operation.

Framework for the Intelligent Transportation System (ITS) Evaluation : ITS Integration Activities

DOT National Transportation Integrated Search

2006-08-01

Intelligent Transportation Systems (ITS) represent a significant opportunity to improve the efficiency and safety of the surface transportation system. ITS includes technologies to support information processing, communications, surveillance and cont...

Patient safety - the role of human factors and systems engineering.

PubMed

Carayon, Pascale; Wood, Kenneth E

2010-01-01

Patient safety is a global challenge that requires knowledge and skills in multiple areas, including human factors and systems engineering. In this chapter, numerous conceptual approaches and methods for analyzing, preventing and mitigating medical errors are described. Given the complexity of healthcare work systems and processes, we emphasize the need for increasing partnerships between the health sciences and human factors and systems engineering to improve patient safety. Those partnerships will be able to develop and implement the system redesigns that are necessary to improve healthcare work systems and processes for patient safety.

Development of a Tool for Documenting, Tracking, Recording, and Analyzing Improvements to Intersection Sites and Roadway Departures in Curve Locations : Research Project Capsule

DOT National Transportation Integrated Search

2012-09-01

Intermodal transportation : system planning, design, : improvement, performance : evaluation, or economic : assessments include safety : improvements because they : lower the overall cost of : transportation. State Departments of Transportation (DOTs...

GEOS S2S-2_1: GMAO's New High Resolution Seasonal Prediction System

NASA Technical Reports Server (NTRS)

Molod, Andrea; Akella, Santha; Andrews, Lauren; Barahona, Donifan; Borovikov, Anna; Chang, Yehui; Cullather, Richard; Hackert, Eric; Kovach, Robin; Koster, Randal;

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.

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

PubMed

Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

2017-09-07

While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

Improved sensitivity high-definition interline CCD using the KODAK TRUESENSE color filter pattern

NASA Astrophysics Data System (ADS)

DiBella, James; Andreghetti, Marco; Enge, Amy; Chen, William; Stanka, Timothy; Kaser, Robert

2010-01-01

The KODAK TRUESENSE Color Filter Pattern has technology that for the first time is applied to a commercially available interline CCD. This 2/3" true-HD sensor will be described along with its performance attributes, including sensitivity improvement as compared to the Bayer CFA version of the same sensor. In addition, an overview of the system developed for demonstration and evaluation will be provided. Examples of the benefits of the new technology in specific applications including surveillance and intelligent traffic systems will be discussed.

Direct methanol feed fuel cell and system

NASA Technical Reports Server (NTRS)

Surampudi, Subbarao (Inventor); Kindler, Andrew (Inventor); Halpert, Gerald (Inventor); Frank, Harvey A. (Inventor); Narayanan, Sekharipuram R. (Inventor); Chun, William (Inventor); Jeffries-Nakamura, Barbara (Inventor)

2009-01-01

Improvements to non acid methanol fuel cells include new formulations for materials. The platinum and ruthenium are more exactly mixed together. Different materials are substituted for these materials. The backing material for the fuel cell electrode is specially treated to improve its characteristics. A special sputtered electrode is formed which is extremely porous. The fuel cell system also comprises a fuel supplying part including a meter which meters an amount of fuel which is used by the fuel cell, and controls the supply of fuel based on said metering.

Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

ERIC Educational Resources Information Center

Aluri, Rao

1993-01-01

Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

Innovation for maintenance technology improvements

NASA Technical Reports Server (NTRS)

Shives, T. R. (Editor); Willard, W. A. (Editor)

1982-01-01

A group of 34 submitted entries (32 papers and 2 abstracts) from the 33rd meeting of the Mechanical Failures Prevention Group whose subject was maintenance technology improvement through innovation. Areas of special emphasis included maintenance concepts, maintenance analysis systems, improved maintenance processes, innovative maintenance diagnostics and maintenance indicators, and technology improvements for power plant applications.

Continuous improvement in the Industrial and Management Systems Engineering programme at Kuwait University

NASA Astrophysics Data System (ADS)

Aldowaisan, Tariq; Allahverdi, Ali

2016-07-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.

RTSJ Memory Areas and Their Affects on the Performance of a Flight-Like Attitude Control System

NASA Technical Reports Server (NTRS)

Niessner, Albert F.; Benowitz, Edward G.

2003-01-01

The two most important factors in improving performance in any software system, but especially a real-time, embedded system, are knowing which components are the low performers and knowing what can be done to improve their performance. The word performance with respect to a real-time, embedded system does not necessarily mean fast execution, which is the common definition when discussing non real-time systems. It also includes meeting all of the specified execution dead-lines and executing at the correct time without sacrificing non real-time performance. Using a Java prototype of an existing control system used on Deep Space 1[1], the effects from adding memory areas are measured and evaluated with respect to improving performance.

Patient, Program, and System Barriers and Facilitators to Detoxification Services in the U.S. Veterans Health Administration: A Qualitative Study of Provider Perspectives.

PubMed

Schultz, Nicole R; Martinez, Rociel; Cucciare, Michael A; Timko, Christine

2016-08-23

Because substance use disorder (SUD) treatment is expanding, and detoxification (detox) is often the entry point to SUD treatment, it is critical to provide ready access to detox services. The purpose of the current study was to examine patient, program, and system barriers or facilitators to detox access within an integrated health care system with variable rates of detox utilization across facilities. Inpatient and outpatient providers from 31 different U.S. Veterans Health Administration detox programs were interviewed. Qualitative analyses identified six facilitators and 11 barriers to detox access. Facilitators included program staff and program characteristics such as encouragement and immediate access, as well as systemic cooperation and patient circumstances. Barriers to detox included programmatic and systemic problems, including lack of available detox services, program rules or admission requirements, funding shortages, stigma related to a SUD diagnosis or receiving detox services, and a deficiency of education and training. Other major barriers pertained to patients' lack of motivation and competing responsibilities. To improve detox access, health care settings should consider enhancing supportive relationships by emphasizing outreach, engagement, and rapport-building with patients, improving systemic communication and teamwork, educating patients on available detox services and the detox process, and addressing patient centered barriers such as resistance to detox or competing responsibilities. In addition, programs should consider open-door and immediate-admission policies. These approaches may improve detox access, which is important for increasing the likelihood of transitioning patients to SUD treatment, thus improving outcomes and reducing utilization of high-cost services.

76 FR 5789 - Teaching American History Grant Program; Office of Innovation and Improvement; Overview...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... teachers, may include observations for determining teacher effectiveness (such as systems that meet the... student achievement by improving teachers' knowledge, understanding, and appreciation of traditional...--Improving the Effectiveness and Distribution of Effective Teachers or Principals (up to three additional...

A novel integrated cropping system for efficient grain production, improved soil quality, and enhanced beneficial arthropod communities

USDA-ARS?s Scientific Manuscript database

The solar corridor crop system (SCCS) is designed for improved crop productivity by using broad strips (corridors or skip rows) that promote highly efficient use of solar radiation and ambient carbon dioxide by C-4 plants including corn. Field trials in 2013 and 2014 showed that yields of selected c...

Implementing a Portfolio Assessment System for Chapter 1 Program Improvement: A Case Study.

ERIC Educational Resources Information Center

Leitner, David; Trevisan, Mike

This paper presents findings of a case study that documented the implementation of a portfolio assessment system in response to mandated program improvement and assessed its impact on teacher and student behaviors. The sample included elementary and middle school teachers and students from three Chapter 1 schools in a rural California school…

Improving Hospital Quality and Patient Safety an Examination of Organizational Culture and Information Systems

ERIC Educational Resources Information Center

Gardner, John Wallace

2012-01-01

This dissertation examines the effects of safety culture, including operational climate and practices, as well as the adoption and use of information systems for delivering high quality healthcare and improved patient experience. Chapter 2 studies the influence of both general and outcome-specific hospital climate and quality practices on process…

Experiences with establishing and implementing learning management system and computer-based test system in medical college.

PubMed

Park, Joo Hyun; Son, Ji Young; Kim, Sun

2012-09-01

The purpose of this study was to establish an e-learning system to support learning in medical education and identify solutions for improving the system. A learning management system (LMS) and computer-based test (CBT) system were established to support e-learning for medical students. A survey of 219 first- and second-grade medical students was administered. The questionnaire included 9 forced choice questions about the usability of system and 2 open-ended questions about necessary improvements to the system. The LMS consisted of a class management, class evaluation, and class attendance system. CBT consisted of a test management, item bank, and authoring tool system. The results of the survey showed a high level of satisfaction in all system usability items except for stability. Further, the advantages of the e-learning system were ensuring information accessibility, providing constant feedback, and designing an intuitive interface. Necessary improvements to the system were stability, user control, readability, and diverse device usage. Based on the findings, suggestions for developing an e-learning system to improve usability by medical students and support learning effectively are recommended.

78 FR 18974 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... bring together experts from diverse backgrounds and experiences including electric system operators... transmission switching; AC optimal power flow modeling; and use of active and dynamic transmission ratings. In... variability of the system, including forecast error? [cir] How can outage probability be captured in...

The School Climate Improvement "Process": Essential Elements. School Climate Brief, Number 4

ERIC Educational Resources Information Center

National School Climate Center, 2012

2012-01-01

Student learning and development are a function of both individual and systemic factors. Individual factors include students' motivation as well as their intellectual and social abilities. Systemic factors include teacher quality, administrative leadership, community engagement, and learning environments. The increasing numbers of children living…

Do we need a national incident reporting system for medical imaging?

PubMed

Itri, Jason N; Krishnaraj, Arun

2012-05-01

The essential role of an incident reporting system as a tool to improve safety and reliability has been described in high-risk industries such as aviation and nuclear power, with anesthesia being the first medical specialty to successfully integrate incident reporting into a comprehensive quality improvement strategy. Establishing an incident reporting system for medical imaging that effectively captures system errors and drives improvement in the delivery of imaging services is a key component of developing and evaluating national quality improvement initiatives in radiology. Such a national incident reporting system would be most effective if implemented as one piece of a comprehensive quality improvement strategy designed to enhance knowledge about safety, identify and learn from errors, raise standards and expectations for improvement, and create safer systems through implementation of safe practices. The potential benefits of a national incident reporting system for medical imaging include reduced morbidity and mortality, improved patient and referring physician satisfaction, reduced health care expenses and medical liability costs, and improved radiologist satisfaction. The purposes of this article are to highlight the positive impact of external reporting systems, discuss how similar advancements in quality and safety can be achieved with an incident reporting system for medical imaging in the United States, and describe current efforts within the imaging community toward achieving this goal. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Corporate Information Management and Business Process Improvement under the Unit Cost Program: An Analysis of a System for the Air Force Institute of Technology

DTIC Science & Technology

1992-12-01

rights or on management issues such as personnel and infrastructure investments are addresseud in the directive only at the broadest level, or in many...area with investments , including information systems. c. Functional processes improvements shall be accomplished though activity modeling and busi ass...an enterprise has invested considerable time, money and effort into the current system and has limited funds to upgrade the system (111:37). Software

Integrated Data & Analysis in Support of Informed and Transparent Decision Making

NASA Astrophysics Data System (ADS)

Guivetchi, K.

2012-12-01

The California Water Plan includes a framework for improving water reliability, environmental stewardship, and economic stability through two initiatives - integrated regional water management to make better use of local water sources by integrating multiple aspects of managing water and related resources; and maintaining and improving statewide water management systems. The Water Plan promotes ways to develop a common approach for data standards and for understanding, evaluating, and improving regional and statewide water management systems, and for common ways to evaluate and select from alternative management strategies and projects. The California Water Plan acknowledges that planning for the future is uncertain and that change will continue to occur. It is not possible to know for certain how population growth, land use decisions, water demand patterns, environmental conditions, the climate, and many other factors that affect water use and supply may change by 2050. To anticipate change, our approach to water management and planning for the future needs to consider and quantify uncertainty, risk, and sustainability. There is a critical need for information sharing and information management to support over-arching and long-term water policy decisions that cross-cut multiple programs across many organizations and provide a common and transparent understanding of water problems and solutions. Achieving integrated water management with multiple benefits requires a transparent description of dynamic linkages between water supply, flood management, water quality, land use, environmental water, and many other factors. Water Plan Update 2013 will include an analytical roadmap for improving data, analytical tools, and decision-support to advance integrated water management at statewide and regional scales. It will include recommendations for linking collaborative processes with technical enhancements, providing effective analytical tools, and improving and sharing data and information. Specifically, this includes achieving better integration and consistency with other planning activities; obtaining consensus on quantitative deliverables; building a common conceptual understanding of the water management system; developing common schematics of the water management system; establishing modeling protocols and standards; and improving transparency and exchange of Water Plan information.

Seeing the forests and the trees—innovative approaches to exploring heterogeneity in systematic reviews of complex interventions to enhance health system decision-making: a protocol

PubMed Central

2014-01-01

Background To improve quality of care and patient outcomes, health system decision-makers need to identify and implement effective interventions. An increasing number of systematic reviews document the effects of quality improvement programs to assist decision-makers in developing new initiatives. However, limitations in the reporting of primary studies and current meta-analysis methods (including approaches for exploring heterogeneity) reduce the utility of existing syntheses for health system decision-makers. This study will explore the role of innovative meta-analysis approaches and the added value of enriched and updated data for increasing the utility of systematic reviews of complex interventions. Methods/Design We will use the dataset from our recent systematic review of 142 randomized trials of diabetes quality improvement programs to evaluate novel approaches for exploring heterogeneity. These will include exploratory methods, such as multivariate meta-regression analyses and all-subsets combinatorial meta-analysis. We will then update our systematic review to include new trials and enrich the dataset by surveying authors of all included trials. In doing so, we will explore the impact of variables not, reported in previous publications, such as details of study context, on the effectiveness of the intervention. We will use innovative analytical methods on the enriched and updated dataset to identify key success factors in the implementation of quality improvement interventions for diabetes. Decision-makers will be involved throughout to help identify and prioritize variables to be explored and to aid in the interpretation and dissemination of results. Discussion This study will inform future systematic reviews of complex interventions and describe the value of enriching and updating data for exploring heterogeneity in meta-analysis. It will also result in an updated comprehensive systematic review of diabetes quality improvement interventions that will be useful to health system decision-makers in developing interventions to improve outcomes for people with diabetes. Systematic review registration PROSPERO registration no. CRD42013005165 PMID:25115289

Remote Sensing Image Quality Assessment Experiment with Post-Processing

NASA Astrophysics Data System (ADS)

Jiang, W.; Chen, S.; Wang, X.; Huang, Q.; Shi, H.; Man, Y.

2018-04-01

This paper briefly describes the post-processing influence assessment experiment, the experiment includes three steps: the physical simulation, image processing, and image quality assessment. The physical simulation models sampled imaging system in laboratory, the imaging system parameters are tested, the digital image serving as image processing input are produced by this imaging system with the same imaging system parameters. The gathered optical sampled images with the tested imaging parameters are processed by 3 digital image processes, including calibration pre-processing, lossy compression with different compression ratio and image post-processing with different core. Image quality assessment method used is just noticeable difference (JND) subject assessment based on ISO20462, through subject assessment of the gathered and processing images, the influence of different imaging parameters and post-processing to image quality can be found. The six JND subject assessment experimental data can be validated each other. Main conclusions include: image post-processing can improve image quality; image post-processing can improve image quality even with lossy compression, image quality with higher compression ratio improves less than lower ratio; with our image post-processing method, image quality is better, when camera MTF being within a small range.

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

PubMed

Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.

A framework for assessing the performance of health systems.

PubMed Central

Murray, C. J.; Frenk, J.

2000-01-01

Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges. PMID:10916909

A framework for assessing the performance of health systems.

PubMed

Murray, C J; Frenk, J

2000-01-01

Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges.

Systems metabolic engineering strategies for the production of amino acids.

PubMed

Ma, Qian; Zhang, Quanwei; Xu, Qingyang; Zhang, Chenglin; Li, Yanjun; Fan, Xiaoguang; Xie, Xixian; Chen, Ning

2017-06-01

Systems metabolic engineering is a multidisciplinary area that integrates systems biology, synthetic biology and evolutionary engineering. It is an efficient approach for strain improvement and process optimization, and has been successfully applied in the microbial production of various chemicals including amino acids. In this review, systems metabolic engineering strategies including pathway-focused approaches, systems biology-based approaches, evolutionary approaches and their applications in two major amino acid producing microorganisms: Corynebacterium glutamicum and Escherichia coli, are summarized.

Photographic and photometric enhancement of Lunar Orbiter products, projects A, B and C

NASA Technical Reports Server (NTRS)

1972-01-01

A detailed discussion is presented of the framelet joining, photometric data improvement, and statistical error analysis. The Lunar Orbiter film handling system, readout system, and the digitization are described, along with the technique of joining adjacent framelets by a using a digital computer. Time and cost estimates are given. The problems and techniques involved in improving the digitized data are discussed. It was found that spectacular improvements are possible. Program documentations are included.

Hybrid Power Management Program Evaluated Fuel Cell/Ultracapacitor Combinations and Developed Other New Applications

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2004-01-01

In fiscal year 2003, the continuation of the Hybrid Power Management (HPM) Program through NASA Glenn Research Center's Commercial Technology Office resulted in several new successful applications of this pioneering technology. HPM is the innovative integration of diverse, state-of-the-art power devices in an optimal configuration for space and terrestrial applications. The appropriate application and control of the various power devices significantly improves overall system performance and efficiency. The advanced power devices include ultracapacitors, fuel cells, and photovoltaics. HPM has extremely wide potential, with applications from nanowatts to megawatts--including power generation, transportation systems, biotechnology systems, and space power systems. HPM has the potential to significantly alleviate global energy concerns, improve the environment, and stimulate the economy. Fuel cells provide excellent efficiency and energy density, but do not have good power density. In contrast, ultracapacitors have excellent power density and virtually unlimited cycle life. To improve the power density of the fuel cell, the combination of fuel cells and ultracapacitors was evaluated.

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

Agalgaonkar, Yashodhan P.; Hammerstrom, Donald J.

The Pacific Northwest Smart Grid Demonstration (PNWSGD) was a smart grid technology performance evaluation project that included multiple U.S. states and cooperation from multiple electric utilities in the northwest region. One of the local objectives for the project was to achieve improved distribution system reliability. Toward this end, some PNWSGD utilities automated their distribution systems, including the application of fault detection, isolation, and restoration and advanced metering infrastructure. In light of this investment, a major challenge was to establish a correlation between implementation of these smart grid technologies and actual improvements of distribution system reliability. This paper proposes using Welch’smore » t-test to objectively determine and quantify whether distribution system reliability is improving over time. The proposed methodology is generic, and it can be implemented by any utility after calculation of the standard reliability indices. The effectiveness of the proposed hypothesis testing approach is demonstrated through comprehensive practical results. It is believed that wider adoption of the proposed approach can help utilities to evaluate a realistic long-term performance of smart grid technologies.« less

A Natural Language Processing System That Links Medical Terms in Electronic Health Record Notes to Lay Definitions: System Development Using Physician Reviews

PubMed Central

Druhl, Emily; Polepalli Ramesh, Balaji; Houston, Thomas K; Brandt, Cynthia A; Zulman, Donna M; Vimalananda, Varsha G; Malkani, Samir; Yu, Hong

2018-01-01

Background Many health care systems now allow patients to access their electronic health record (EHR) notes online through patient portals. Medical jargon in EHR notes can confuse patients, which may interfere with potential benefits of patient access to EHR notes. Objective The aim of this study was to develop and evaluate the usability and content quality of NoteAid, a Web-based natural language processing system that links medical terms in EHR notes to lay definitions, that is, definitions easily understood by lay people. Methods NoteAid incorporates two core components: CoDeMed, a lexical resource of lay definitions for medical terms, and MedLink, a computational unit that links medical terms to lay definitions. We developed innovative computational methods, including an adapted distant supervision algorithm to prioritize medical terms important for EHR comprehension to facilitate the effort of building CoDeMed. Ten physician domain experts evaluated the user interface and content quality of NoteAid. The evaluation protocol included a cognitive walkthrough session and a postsession questionnaire. Physician feedback sessions were audio-recorded. We used standard content analysis methods to analyze qualitative data from these sessions. Results Physician feedback was mixed. Positive feedback on NoteAid included (1) Easy to use, (2) Good visual display, (3) Satisfactory system speed, and (4) Adequate lay definitions. Opportunities for improvement arising from evaluation sessions and feedback included (1) improving the display of definitions for partially matched terms, (2) including more medical terms in CoDeMed, (3) improving the handling of terms whose definitions vary depending on different contexts, and (4) standardizing the scope of definitions for medicines. On the basis of these results, we have improved NoteAid’s user interface and a number of definitions, and added 4502 more definitions in CoDeMed. Conclusions Physician evaluation yielded useful feedback for content validation and refinement of this innovative tool that has the potential to improve patient EHR comprehension and experience using patient portals. Future ongoing work will develop algorithms to handle ambiguous medical terms and test and evaluate NoteAid with patients. PMID:29358159

Mission Data System Java Edition Version 7

NASA Technical Reports Server (NTRS)

Reinholtz, William K.; Wagner, David A.

2013-01-01

The Mission Data System framework defines closed-loop control system abstractions from State Analysis including interfaces for state variables, goals, estimators, and controllers that can be adapted to implement a goal-oriented control system. The framework further provides an execution environment that includes a goal scheduler, execution engine, and fault monitor that support the expression of goal network activity plans. Using these frameworks, adapters can build a goal-oriented control system where activity coordination is verified before execution begins (plan time), and continually during execution. Plan failures including violations of safety constraints expressed in the plan can be handled through automatic re-planning. This version optimizes a number of key interfaces and features to minimize dependencies, performance overhead, and improve reliability. Fault diagnosis and real-time projection capabilities are incorporated. This version enhances earlier versions primarily through optimizations and quality improvements that raise the technology readiness level. Goals explicitly constrain system states over explicit time intervals to eliminate ambiguity about intent, as compared to command-oriented control that only implies persistent intent until another command is sent. A goal network scheduling and verification process ensures that all goals in the plan are achievable before starting execution. Goal failures at runtime can be detected (including predicted failures) and handled by adapted response logic. Responses can include plan repairs (try an alternate tactic to achieve the same goal), goal shedding, ignoring the fault, cancelling the plan, or safing the system.

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

Quality care during labour and birth: a multi-country analysis of health system bottlenecks and potential solutions

PubMed Central

2015-01-01

Background Good outcomes during pregnancy and childbirth are related to availability, utilisation and effective implementation of essential interventions for labour and childbirth. The majority of the estimated 289,000 maternal deaths, 2.8 million neonatal deaths and 2.6 million stillbirths every year could be prevented by improving access to and scaling up quality care during labour and birth. Methods The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops engaged technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks", factors that hinder the scale up, of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for skilled birth attendance and basic and comprehensive emergency obstetric care. Results Across 12 countries the most critical bottlenecks identified by workshop participants for skilled birth attendance were health financing (10 out of 12 countries) and health workforce (9 out of 12 countries). Health service delivery bottlenecks were found to be the most critical for both basic and comprehensive emergency obstetric care (9 out of 12 countries); health financing was identified as having critical bottlenecks for comprehensive emergency obstetric care (9 out of 12 countries). Solutions to address health financing bottlenecks included strengthening national financing mechanisms and removing financial barriers to care seeking. For addressing health workforce bottlenecks, improved human resource planning is needed, including task shifting and improving training quality. For health service delivery, proposed solutions included improving quality of care and establishing public private partnerships. Conclusions Progress towards the 2030 targets for ending preventable maternal and newborn deaths is dependent on improving quality of care during birth and the immediate postnatal period. Strengthening national health systems to improve maternal and newborn health, as a cornerstone of universal health coverage, will only be possible by addressing specific health system bottlenecks during labour and birth, including those within health workforce, health financing and health service delivery. PMID:26390886

Health service changes to address diabetes in pregnancy in a complex setting: perspectives of health professionals.

PubMed

Kirkham, R; Boyle, J A; Whitbread, C; Dowden, M; Connors, C; Corpus, S; McCarthy, L; Oats, J; McIntyre, H D; Moore, E; O'Dea, K; Brown, A; Maple-Brown, L

2017-08-03

Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional's perceptions of models of care and related quality improvement activities since the implementation of the Partnership. Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A 'systems assessment tool' was used to guide six focus groups (49 healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology. Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes. The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population however improvements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.

Optical Automatic Car Identification (OACI) : Volume 1. Advanced System Specification.

DOT National Transportation Integrated Search

1978-12-01

A performance specification is provided in this report for an Optical Automatic Car Identification (OACI) scanner system which features 6% improved readability over existing industry scanner systems. It also includes the analysis and rationale which ...

The effectiveness of a mail reminder system for depot medroxyprogesterone injections.

PubMed

Madlon-Kay, D J

1996-04-01

To determine if a mail reminder system leads to an increase in the percentage of depot medroxyprogesterone acetate (Depo-Provera) injections administered on time, the charts of 184 women were reviewed. The reminder postcard included the due dates of both the next medroxyprogesterone injection and the next Papanicolaou test. Timeliness of injections improved with the reminder system from 64% administered on time to 76% (P < .02). Injections given late despite the reminders were late a mean of 8 days. Injections given late before the reminder system began were late a mean of 20 days (P < .05). If injections given during the injection's 14-day "grace" period are included, the on-time rate improved from 87% to 96% with the reminder system (P < .005). The reminder system was not effective in ensuring annual Papanicolaou testing. Vigilance is needed to ensure that women receiving medroxyprogesterone injections also receive timely Papanicolaou testing.

New Trends in Educational Lighting Systems.

ERIC Educational Resources Information Center

Murphy, Peter

2001-01-01

Explores technological trends for improving campus lighting, including the use of direct-indirect suspended fluorescent lighting, suspended linear lighting, high-efficiency optical systems, and occupancy and daylight sensors. (GR)

Titan I propulsion system modeling and possible performance improvements

NASA Astrophysics Data System (ADS)

Giusti, Oreste

This thesis features the Titan I propulsion systems and offers data-supported suggestions for improvements to increase performance. The original propulsion systems were modeled both graphically in CAD and via equations. Due to the limited availability of published information, it was necessary to create a more detailed, secondary set of models. Various engineering equations---pertinent to rocket engine design---were implemented in order to generate the desired extra detail. This study describes how these new models were then imported into the ESI CFD Suite. Various parameters are applied to these imported models as inputs that include, for example, bi-propellant combinations, pressure, temperatures, and mass flow rates. The results were then processed with ESI VIEW, which is visualization software. The output files were analyzed for forces in the nozzle, and various results were generated, including sea level thrust and ISP. Experimental data are provided to compare the original engine configuration models to the derivative suggested improvement models.

Cause-and-effect mapping of critical events.

PubMed

Graves, Krisanne; Simmons, Debora; Galley, Mark D

2010-06-01

Health care errors are routinely reported in the scientific and public press and have become a major concern for most Americans. In learning to identify and analyze errors health care can develop some of the skills of a learning organization, including the concept of systems thinking. Modern experts in improving quality have been working in other high-risk industries since the 1920s making structured organizational changes through various frameworks for quality methods including continuous quality improvement and total quality management. When using these tools, it is important to understand systems thinking and the concept of processes within organization. Within these frameworks of improvement, several tools can be used in the analysis of errors. This article introduces a robust tool with a broad analytical view consistent with systems thinking, called CauseMapping (ThinkReliability, Houston, TX, USA), which can be used to systematically analyze the process and the problem at the same time. Copyright 2010 Elsevier Inc. All rights reserved.

Quality improvement: the nurse's role.

PubMed

Moran, M J; Johnson, J E

1992-06-01

Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment. The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts. Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.

Tooth follicle extirpation and uvulectomy.

PubMed

Johnston, N L; Riordan, P J

2005-12-01

Migration is not only the movement of people, but also of their culture, customs and beliefs. As more people from developing countries in Africa migrate to industrialized countries, the more likely health professionals will find themselves providing care for people of whose customs and practices they have little knowledge. This review of the literature suggests that removal of deciduous canine follicles and uvulectomy are frequently practised in some African and neighbouring countries. Reasons given for deciduous canine extirpation include the prevention of vomiting, fever and diarrhoea. The indications for uvulectomy appear widespread, including treatment for persistent fever, coughing and growth retardation. The practices are usually performed by traditional healers. Risks for children who undergo these procedures are extensive, including septicaemia, potential for HIV transmission, numerous dental complications and death. With improved understanding between Western health teams and local, traditional people, an improved system may develop whereby the two systems can work together in providing improved health outcomes for the people.

Report on the lunar ranging at McDonald Observatory. [spark gap configuration and photomultiplier system

NASA Technical Reports Server (NTRS)

Silverberg, E. C.

1977-01-01

Range measurements to an accuracy of 5 cm were achieved following improvements in the laser oscillator configuration and the photomultiplier system. Modifications to the laser include a redesigned pockel cell mount to eliminate stressing of the cell crystal; an improved electrically triggered spark gap for sharpening the electrical pulse; the use of a brewster plate in the cavity to eliminate pre-pulsing; improved alignment for the oscillator system; and increased cavity lifetime through thin film polarizer technology. Laser calibration data are presented along with the lunar laser operations log for June to October 1977.

Energy Storage Technology Development for Space Exploration

NASA Technical Reports Server (NTRS)

Mercer, Carolyn R.; Jankovsky, Amy L.; Reid, Concha M.; Miller, Thomas B.; Hoberecht, Mark A.

2011-01-01

The National Aeronautics and Space Administration is developing battery and fuel cell technology to meet the expected energy storage needs of human exploration systems. Improving battery performance and safety for human missions enhances a number of exploration systems, including un-tethered extravehicular activity suits and transportation systems including landers and rovers. Similarly, improved fuel cell and electrolyzer systems can reduce mass and increase the reliability of electrical power, oxygen, and water generation for crewed vehicles, depots and outposts. To achieve this, NASA is developing non-flow-through proton-exchange-membrane fuel cell stacks, and electrolyzers coupled with low permeability membranes for high pressure operation. The primary advantage of this technology set is the reduction of ancillary parts in the balance-of-plant fewer pumps, separators and related components should result in fewer failure modes and hence a higher probability of achieving very reliable operation, and reduced parasitic power losses enable smaller reactant tanks and therefore systems with lower mass and volume. Key accomplishments over the past year include the fabrication and testing of several robust, small-scale non-flow-through fuel cell stacks that have demonstrated proof-of-concept. NASA is also developing advanced lithium-ion battery cells, targeting cell-level safety and very high specific energy and energy density. Key accomplishments include the development of silicon composite anodes, lithiatedmixed- metal-oxide cathodes, low-flammability electrolytes, and cell-incorporated safety devices that promise to substantially improve battery performance while providing a high level of safety.

Integrating ergonomics into production system development--the Volvo Powertrain case.

PubMed

Neumann, W Patrick; Ekman, Marianne; Winkel, Jørgen

2009-05-01

Understanding the barriers and assists to integrating ergonomics into production system design remains a research issue. An action research case study at Volvo Powertrain/Sweden was conducted. Researchers worked collaboratively with the firm in efforts to improve the company's ability to handle ergonomics in their daily work of improving and developing production systems. Researchers observed and reflected collectively on the change process using field notes and recordings to support their observations. Observed integration barriers included both individual level issues like life events, and organisational aspects such as communication barriers between groups or assignment of tasks to people not involved in decision-making. Observed assists included the 'political reflective navigation' (c.f. Broberg, O., Hermund, I., 2004. The OHS consultant as a 'political reflective navigator' in technological change processes. International Journal of Industrial Ergonomics 33 (4), 315-326) by the project owner to find new ways to overcome barriers and anchor ergonomics into the organisation. While special 'ergonomics' groups did not survive long, progress was observed in including ergonomics in regular design groups. A cross-functional workshop that fostered discussion across organisational boundaries helped shift focus from retrofitting systems to future production systems and improve engagement of engineering teams. Progress was marked by both success and setbacks and full integration appears to require more than 2 years time. It is concluded that support by senior managers should include succession planning for personnel that are key to the change effort.

Lean management systems: creating a culture of continuous quality improvement.

PubMed

Clark, David M; Silvester, Kate; Knowles, Simon

2013-08-01

This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

Enhanced technologies for unattended ground sensor systems

NASA Astrophysics Data System (ADS)

Hartup, David C.

2010-04-01

Progress in several technical areas is being leveraged to advantage in Unattended Ground Sensor (UGS) systems. This paper discusses advanced technologies that are appropriate for use in UGS systems. While some technologies provide evolutionary improvements, other technologies result in revolutionary performance advancements for UGS systems. Some specific technologies discussed include wireless cameras and viewers, commercial PDA-based system programmers and monitors, new materials and techniques for packaging improvements, low power cueing sensor radios, advanced long-haul terrestrial and SATCOM radios, and networked communications. Other technologies covered include advanced target detection algorithms, high pixel count cameras for license plate and facial recognition, small cameras that provide large stand-off distances, video transmissions of target activity instead of still images, sensor fusion algorithms, and control center hardware. The impact of each technology on the overall UGS system architecture is discussed, along with the advantages provided to UGS system users. Areas of analysis include required camera parameters as a function of stand-off distance for license plate and facial recognition applications, power consumption for wireless cameras and viewers, sensor fusion communication requirements, and requirements to practically implement video transmission through UGS systems. Examples of devices that have already been fielded using technology from several of these areas are given.

Patient Safety: The Role of Human Factors and Systems Engineering

PubMed Central

Carayon, Pascale; Wood, Kenneth E.

2011-01-01

Patient safety is a global challenge that requires knowledge and skills in multiple areas, including human factors and systems engineering. In this chapter, numerous conceptual approaches and methods for analyzing, preventing and mitigating medical errors are described. Given the complexity of healthcare work systems and processes, we emphasize the need for increasing partnerships between the health sciences and human factors and systems engineering to improve patient safety. Those partnerships will be able to develop and implement the system redesigns that are necessary to improve healthcare work systems and processes for patient safety. PMID:20543237

Autonomous Integrated Receive System (AIRS) requirements definition. Volume 2: Design and development

NASA Technical Reports Server (NTRS)

Chie, C. M.; White, M. A.; Lindsey, W. C.; Davarian, F.; Dixon, R. C.

1984-01-01

Functional requirements and specifications are defined for an autonomous integrated receive system (AIRS) to be used as an improvement in the current tracking and data relay satellite system (TDRSS), and as a receiving system in the future tracking and data acquisition system (TDAS). The AIRS provides improved acquisition, tracking, bit error rate (BER), RFI mitigation techniques, and data operations performance compared to the current TDRSS ground segment receive system. A computer model of the AIRS is used to provide simulation results predicting the performance of AIRS. Cost and technology assessments are included.

Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

PubMed

Seidman, Gabriel; Atun, Rifat

2017-04-13

Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

Antenna Calibration and Measurement Equipment

NASA Technical Reports Server (NTRS)

Rochblatt, David J.; Cortes, Manuel Vazquez

2012-01-01

A document describes the Antenna Calibration & Measurement Equipment (ACME) system that will provide the Deep Space Network (DSN) with instrumentation enabling a trained RF engineer at each complex to perform antenna calibration measurements and to generate antenna calibration data. This data includes continuous-scan auto-bore-based data acquisition with all-sky data gathering in support of 4th order pointing model generation requirements. Other data includes antenna subreflector focus, system noise temperature and tipping curves, antenna efficiency, reports system linearity, and instrument calibration. The ACME system design is based on the on-the-fly (OTF) mapping technique and architecture. ACME has contributed to the improved RF performance of the DSN by approximately a factor of two. It improved the pointing performances of the DSN antennas and productivity of its personnel and calibration engineers.

Organic solvents, electrolytes, and lithium ion cells with good low temperature performance

NASA Technical Reports Server (NTRS)

Huang, Chen-Kuo (Inventor); Smart, Marshall C. (Inventor); Surampudi, Subbarao (Inventor); Bugga, Ratnakumar V. (Inventor)

2002-01-01

Multi-component organic solvent systems, electrolytes and electrochemical cells characterized by good low temperature performance are provided. In one embodiment, an improved organic solvent system contains a ternary mixture of ethylene carbonate, dimethyl carbonate and diethyl carbonate. In other embodiments, quaternary systems include a fourth component, i.e, an aliphatic ester, an asymmetric alkyl carbonate or a compound of the formula LiOX, where X is R, COOR, or COR, where R is alkyl or fluoroalkyl. Electrolytes based on such organic solvent systems are also provided and contain therein a lithium salt of high ionic mobility, such as LiPF.sub.6. Reversible electrochemical cells, particularly lithium ion cells, are constructed with the improved electrolytes, and preferably include a carbonaceous anode, an insertion type cathode, and an electrolyte interspersed therebetween.

Control and communication co-design: analysis and practice on performance improvement in distributed measurement and control system based on fieldbus and Ethernet.

PubMed

Liang, Geng

2015-01-01

In this paper, improving control performance of a networked control system by reducing DTD in a different perspective was investigated. Two different network architectures for system implementation were presented. Analysis and improvement dealing with DTD for the experimental control system were expounded. Effects of control scheme configuration on DTD in the form of FB were investigated and corresponding improvements by reallocation of FB and re-arrangement of schedule table are proposed. Issues of DTD in hybrid network were investigated and corresponding approaches to improve performance including (1) reducing DTD in PLC or PAC by way of IEC61499 and (2) cascade Smith predictive control with BPNN-based identification were proposed and investigated. Control effects under the proposed methodologies were also given. Experimental and field practices validated these methodologies. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Isotope Brayton electric power system for the 500 to 2500 watt range

NASA Technical Reports Server (NTRS)

Macosko, R. P.; Barna, G. J.; Block, H. B.; Ingle, B. D.

1972-01-01

An extensive study was conducted at the Lewis Research Center to evaluate an isotope Brayton electric power system for use in the 500 to 2500 W power range. Overall system simplicity was emphasized in order to reduce parasitic power losses and improve system reliability. Detailed parametric cycle analysis, conceptual component designs, and evaluation of system packaging were included. A single-loop system (gas) with six major components including one rotating unit was selected. Calculated net system efficiency varies from 23 to 28 percent over the power range.

NOAA's National Air Quality Predictions and Development of Aerosol and Atmospheric Composition Prediction Components for the Next Generation Global Prediction System

NASA Astrophysics Data System (ADS)

Stajner, I.; Hou, Y. T.; McQueen, J.; Lee, P.; Stein, A. F.; Tong, D.; Pan, L.; Huang, J.; Huang, H. C.; Upadhayay, S.

2016-12-01

NOAA provides operational air quality predictions using the National Air Quality Forecast Capability (NAQFC): ozone and wildfire smoke for the United States and airborne dust for the contiguous 48 states at http://airquality.weather.gov. NOAA's predictions of fine particulate matter (PM2.5) became publicly available in February 2016. Ozone and PM2.5 predictions are produced using a system that operationally links the Community Multiscale Air Quality (CMAQ) model with meteorological inputs from the North American mesoscale forecast Model (NAM). Smoke and dust predictions are provided using the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model. Current NAQFC focus is on updating CMAQ to version 5.0.2, improving PM2.5 predictions, and updating emissions estimates, especially for NOx using recently observed trends. Wildfire smoke emissions from a newer version of the USFS BlueSky system are being included in a new configuration of the NAQFC NAM-CMAQ system, which is re-run for the previous 24 hours when the wildfires were observed from satellites, to better represent wildfire emissions prior to initiating predictions for the next 48 hours. In addition, NOAA is developing the Next Generation Global Prediction System (NGGPS) to represent the earth system for extended weather prediction. NGGPS will include a representation of atmospheric dynamics, physics, aerosols and atmospheric composition as well as coupling with ocean, wave, ice and land components. NGGPS is being developed with a broad community involvement, including community developed components and academic research to develop and test potential improvements for potentially inclusion in NGGPS. Several investigators at NOAA's research laboratories and in academia are working to improve the aerosol and gaseous chemistry representation for NGGPS, to develop and evaluate the representation of atmospheric composition, and to establish and improve the coupling with radiation and microphysics. Additional efforts may include the improved use of predicted atmospheric composition in assimilation of observations and the linkage of full global atmospheric composition predictions with national air quality predictions.

Social Validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) in the Primary Grades

ERIC Educational Resources Information Center

Wollersheim Shervey, Sarah; Sandilos, Lia E.; DiPerna, James C.; Lei, Pui-Wa

2017-01-01

The purpose of this study was to examine the social validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) for teachers in the primary grades. Participants included 45 first and second grade teachers who completed a 16-item social validity questionnaire during each year of the SSIS-CIP efficacy trial. Findings…

Social Validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) in the Primary Grades

ERIC Educational Resources Information Center

Wollersheim Shervey, Sarah; Sandilos, Lia E.; DiPerna, James C.; Lei, Pui-Wa

2017-01-01

The purpose of this study was to examine the social validity of the Social Skills Improvement System-Classwide Intervention Program (SSIS-CIP) for teachers in the primary grades. Participants included 45 first and second grade teachers who completed a 16-item social validity questionnaire during each year of the SSIS-CIP efficacy trial. Findings…

Technological Improvements for Digital Fire Control Systems

DTIC Science & Technology

2017-09-30

Final Technical Status Report For DOTC-12-01-INIT061 Technological Improvements for Digital Fire Control Systems Reporting Period: 30 Sep...Initiative Information Develop and fabricate next generation designs using advanced materials and processes. This will include but is not limited to...4.2 Develop manufacturing processes 100% 4.3 Develop manufacturing processes 100% 4.4 Develop manufacturing processes 100% 5 Design Tooling

A quality improvement project to improve the Medicare and Medicaid Services (CMS) sepsis bundle compliance rate in a large healthcare system.

PubMed

Raschke, Robert A; Groves, Robert H; Khurana, Hargobind S; Nikhanj, Nidhi; Utter, Ethel; Hartling, Didi; Stoffer, Brenda; Nunn, Kristina; Tryon, Shona; Bruner, Michelle; Calleja, Maria; Curry, Steven C

2017-01-01

Sepsis is a leading cause of mortality and morbidity in hospitalised patients. The Centers for Medicare and Medicaid Services (CMS) mandated that US hospitals report sepsis bundle compliance rate as a quality process measure in October 2015. The specific aim of our study was to improve the CMS sepsis bundle compliance rate from 30% to 40% across 20 acute care hospitals in our healthcare system within 1 year. The study included all adult inpatients with sepsis sampled according to CMS specifications from October 2015 to September 2016. The CMS sepsis bundle compliance rate was tracked monthly using statistical process control charting. A baseline rate of 28.5% with 99% control limits was established. We implemented multiple interventions including computerised decision support systems (CDSSs) to increase compliance with the most commonly missing bundle elements. Compliance reached 42% (99% statistical process control limits 18.4%-38.6%) as CDSS was implemented system-wide, but this improvement was not sustained after CMS changed specifications of the outcome measure. Difficulties encountered elucidate shortcomings of our study methodology and of the CMS sepsis bundle compliance rate as a quality process measure.

Overview and Evaluation of the Community Multiscale Air ...

EPA Pesticide Factsheets

The Community Multiscale Air Quality (CMAQ) model is a state-of-the-science air quality model that simulates the emission, transport and fate of numerous air pollutants, including ozone and particulate matter. The Computational Exposure Division (CED) of the U.S. Environmental Protection Agency develops the CMAQ model and periodically releases new versions of the model that include bug fixes and various other improvements to the modeling system. In late 2016 or early 2017, CMAQ version 5.2 will be released. This new version of CMAQ will contain important updates from the current CMAQv5.1 modeling system, along with several instrumented versions of the model (e.g. decoupled direct method and sulfur tracking). Some specific model updates include the implementation of a new wind-blown dust treatment in CMAQv5.2, a significant improvement over the treatment in v5.1 which can severely overestimate wind-blown dust under certain conditions. Several other major updates to the modeling system include an update to the calculation of aerosols; implementation of full halogen chemistry (CMAQv5.1 contains a partial implementation of halogen chemistry); the new carbon bond 6 (CB6) chemical mechanism; updates to cloud model in CMAQ; and a new lightning assimilation scheme for the WRF model which significant improves the placement and timing of convective precipitation in the WRF precipitation fields. Numerous other updates to the modeling system will also be available in v5.2.

Planning, Conducting, and Documenting Data Analysis for Program Improvement

ERIC Educational Resources Information Center

Winer, Abby; Taylor, Cornelia; Derrington, Taletha; Lucas, Anne

2015-01-01

This 2015 document was developed to help technical assistance (TA) providers and state staff define and limit the scope of data analysis for program improvement efforts, including the State Systemic Improvement Plan (SSIP); develop a plan for data analysis; document alternative hypotheses and additional analyses as they are generated; and…

Analysis of health trait data from on-farm computer systems in the U.S. II: Comparison of genomic analyses including two-stage and single-step methods

USDA-ARS?s Scientific Manuscript database

The development of genomic selection methodology, with accompanying substantial gains in reliability for low-heritability traits, may dramatically improve the feasibility of genetic improvement of dairy cow health. Many methods for genomic analysis have now been developed, including the “Bayesian Al...

75 FR 28035 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

..., Parent Company or Corporate Company, Name of Company Point of Contact (POC) for E-Verify Usage, POC Phone... information about user system usage. The information collected specifically on users includes: Name (last... improvement efforts and system enhancement planning, which may include conducting surveys, user interviews...

Social organization of self-management support of persons with diabetes: a health systems comparison.

PubMed

Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-09-01

Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

Developing a point-of-care electronic medical record system for TB/HIV co-infected patients: experiences from Lighthouse Trust, Lilongwe, Malawi.

PubMed

Tweya, Hannock; Feldacker, Caryl; Gadabu, Oliver Jintha; Ng'ambi, Wingston; Mumba, Soyapi L; Phiri, Dave; Kamvazina, Luke; Mwakilama, Shawo; Kanyerere, Henry; Keiser, Olivia; Mwafilaso, Johnbosco; Kamba, Chancy; Egger, Matthias; Jahn, Andreas; Simwaka, Bertha; Phiri, Sam

2016-03-05

Implementation of user-friendly, real-time, electronic medical records for patient management may lead to improved adherence to clinical guidelines and improved quality of patient care. We detail the systematic, iterative process that implementation partners, Lighthouse clinic and Baobab Health Trust, employed to develop and implement a point-of-care electronic medical records system in an integrated, public clinic in Malawi that serves HIV-infected and tuberculosis (TB) patients. Baobab Health Trust, the system developers, conducted a series of technical and clinical meetings with Lighthouse and Ministry of Health to determine specifications. Multiple pre-testing sessions assessed patient flow, question clarity, information sequencing, and verified compliance to national guidelines. Final components of the TB/HIV electronic medical records system include: patient demographics; anthropometric measurements; laboratory samples and results; HIV testing; WHO clinical staging; TB diagnosis; family planning; clinical review; and drug dispensing. Our experience suggests that an electronic medical records system can improve patient management, enhance integration of TB/HIV services, and improve provider decision-making. However, despite sufficient funding and motivation, several challenges delayed system launch including: expansion of system components to include of HIV testing and counseling services; changes in the national antiretroviral treatment guidelines that required system revision; and low confidence to use the system among new healthcare workers. To ensure a more robust and agile system that met all stakeholder and user needs, our electronic medical records launch was delayed more than a year. Open communication with stakeholders, careful consideration of ongoing provider input, and a well-functioning, backup, paper-based TB registry helped ensure successful implementation and sustainability of the system. Additional, on-site, technical support provided reassurance and swift problem-solving during the extended launch period. Even when system users are closely involved in the design and development of an electronic medical record system, it is critical to allow sufficient time for software development, solicitation of detailed feedback from both users and stakeholders, and iterative system revisions to successfully transition from paper to point-of-care electronic medical records. For those in low-resource settings, electronic medical records for integrated care is a possible and positive innovation.

Novel algorithm implementations in DARC: the Durham AO real-time controller

NASA Astrophysics Data System (ADS)

Basden, Alastair; Bitenc, Urban; Jenkins, David

2016-07-01

The Durham AO Real-time Controller has been used on-sky with the CANARY AO demonstrator instrument since 2010, and is also used to provide control for several AO test-benches, including DRAGON. Over this period, many new real-time algorithms have been developed, implemented and demonstrated, leading to performance improvements for CANARY. Additionally, the computational performance of this real-time system has continued to improve. Here, we provide details about recent updates and changes made to DARC, and the relevance of these updates, including new algorithms, to forthcoming AO systems. We present the computational performance of DARC when used on different hardware platforms, including hardware accelerators, and determine the relevance and potential for ELT scale systems. Recent updates to DARC have included algorithms to handle elongated laser guide star images, including correlation wavefront sensing, with options to automatically update references during AO loop operation. Additionally, sub-aperture masking options have been developed to increase signal to noise ratio when operating with non-symmetrical wavefront sensor images. The development of end-user tools has progressed with new options for configuration and control of the system. New wavefront sensor camera models and DM models have been integrated with the system, increasing the number of possible hardware configurations available, and a fully open-source AO system is now a reality, including drivers necessary for commercial cameras and DMs. The computational performance of DARC makes it suitable for ELT scale systems when implemented on suitable hardware. We present tests made on different hardware platforms, along with the strategies taken to optimise DARC for these systems.

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

PubMed

Cheng, Siu Mee; Thompson, Leslee J

2006-01-01

A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. The paper provides an outline of the CCO performance management system. These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Rural transportation emergency preparedness plans.

DOT National Transportation Integrated Search

2009-07-01

Improving the emergency preparedness of rural transportation systems is the overall goal of this research. Unique characteristics exist in rural transportation systems including widely dispersed and diverse populations and geographic areas. Exploring...

An intelligent position-specific training system for mission operations

NASA Technical Reports Server (NTRS)

Schneider, M. P.

1992-01-01

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

The Action Research Program: Experiential Learning in Systems-Based Practice for First-Year Medical Students.

PubMed

Ackerman, Sara L; Boscardin, Christy; Karliner, Leah; Handley, Margaret A; Cheng, Sarah; Gaither, Thomas W; Hagey, Jill; Hennein, Lauren; Malik, Faizan; Shaw, Brian; Trinidad, Norver; Zahner, Greg; Gonzales, Ralph

2016-01-01

Systems-based practice focuses on the organization, financing, and delivery of medical services. The American Association of Medical Colleges has recommended that systems-based practice be incorporated into medical schools' curricula. However, experiential learning in systems-based practice, including practical strategies to improve the quality and efficiency of clinical care, is often absent from or inconsistently included in medical education. A multidisciplinary clinician and nonclinician faculty team partnered with a cardiology outpatient clinic to design a 9-month clerkship for 1st-year medical students focused on systems-based practice, delivery of clinical care, and strategies to improve the quality and efficiency of clinical operations. The clerkship was called the Action Research Program. In 2013-2014, 8 trainees participated in educational seminars, research activities, and 9-week clinic rotations. A qualitative process and outcome evaluation drew on interviews with students, clinic staff, and supervising physicians, as well as students' detailed field notes. The Action Research Program was developed and implemented at the University of California, San Francisco, an academic medical center in the United States. All educational activities took place at the university's medical school and at the medical center's cardiology outpatient clinic. Students reported and demonstrated increased understanding of how care delivery systems work, improved clinical skills, growing confidence in interactions with patients, and appreciation for patients' experiences. Clinicians reported increased efficiency at the clinic level and improved performance and job satisfaction among medical assistants as a result of their unprecedented mentoring role with students. Some clinicians felt burdened when students shadowed them and asked questions during interactions with patients. Most student-led improvement projects were not fully implemented. The Action Research Program is a small pilot project that demonstrates an innovative pairing of experiential and didactic training in systems-based practice. Lessons learned include the need for dedicated time and faculty support for students' improvement projects, which were the least successful aspect of the program. We recommend that future projects aiming to combine clinical training and quality improvement projects designate distinct blocks of time for trainees to pursue each of these activities independently. In 2014-2015, the University of California, San Francisco School of Medicine incorporated key features of the Action Research Program into the standard curriculum, with plans to build upon this foundation in future curricular innovations.

Evaluation and Improvement of Eddy Current Position Sensors in Magnetically Suspended Flywheel Systems

NASA Technical Reports Server (NTRS)

Dever, Timothy P.; Palazzolo, Alan B.; Thomas, Erwin M., III; Jansen, Ralph H.; McLallin, Kerry (Technical Monitor); Soeder, James (Technical Monitor)

2001-01-01

Eddy current position sensor performance is evaluated for use in a high-speed flywheel development system. The flywheel utilizes a five axis active magnetic bearing system. The eddy current sensors are used for position feedback for the bearing controller. Measured characteristics include sensitivity to multiple target materials and susceptibility to noise from the magnetic bearings and from sensor-to-sensor crosstalk. Improvements in axial sensor configuration and techniques for noise reduction are described.

Evaluation of a Telerehabilitation System for Community-Based Rehabilitation

PubMed Central

Schutte, Jamie; Gales, Sara; Filippone, Ashlee; Saptono, Andi; Parmanto, Bambang; McCue, Michael

2012-01-01

The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs. A program within the Pennsylvania Office of Vocational Rehabilitation’s Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP), sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehabilitation system was developed consisting of (1) a web-based portal to support a variety of clinical activities, and (2) the Versatile Integrated System for Telerehabilitation (VISYTER) video-conferencing system to support the collaboration and delivery of rehabilitation services remotely. This descriptive evaluation examines the usability of the telerehabilitation system incorporating both the portal and VISYTER. Telerehabilitation system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ) and Post-Study System Usability Questionnaire (PSSUQ), the Telehealth Usability Questionnaire (TUQ), and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability. Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed. PMID:25945193

Projecting technology change to improve space technology planning and systems management

NASA Astrophysics Data System (ADS)

Walk, Steven Robert

2011-04-01

Projecting technology performance evolution has been improving over the years. Reliable quantitative forecasting methods have been developed that project the growth, diffusion, and performance of technology in time, including projecting technology substitutions, saturation levels, and performance improvements. These forecasts can be applied at the early stages of space technology planning to better predict available future technology performance, assure the successful selection of technology, and improve technology systems management strategy. Often what is published as a technology forecast is simply scenario planning, usually made by extrapolating current trends into the future, with perhaps some subjective insight added. Typically, the accuracy of such predictions falls rapidly with distance in time. Quantitative technology forecasting (QTF), on the other hand, includes the study of historic data to identify one of or a combination of several recognized universal technology diffusion or substitution patterns. In the same manner that quantitative models of physical phenomena provide excellent predictions of system behavior, so do QTF models provide reliable technological performance trajectories. In practice, a quantitative technology forecast is completed to ascertain with confidence when the projected performance of a technology or system of technologies will occur. Such projections provide reliable time-referenced information when considering cost and performance trade-offs in maintaining, replacing, or migrating a technology, component, or system. This paper introduces various quantitative technology forecasting techniques and illustrates their practical application in space technology and technology systems management.

A review of HIV/AIDS system-level interventions

PubMed Central

Bauermeister, José A.; Tross, Susan; Ehrhardt, Anke A.

2010-01-01

The escalating HIV/AIDS epidemic worldwide demands that on-going prevention efforts be strengthened, disseminated, and scaled-up. System-level interventions refer to programs aiming to improve the functioning of an agency as well as the delivery of its services to the community. System-level interventions are a promising approach to HIV/AIDS prevention because they focus on (a) improving the agency’s ability to adopt evidence-based HIV prevention and care programs; (b) develop and establish policies and procedures that maximize the sustainability of on-going prevention and care efforts; and (c) improve decision-making processes such as incorporating the needs of communities into their tailored services. We reviewed studies focusing on system-level interventions by searching multiple electronic abstracting indices, including PsycInfo, PubMed, and ProQuest. Twenty-three studies out of 624 peer-reviewed studies (published from January 1985 to February 2007) met study criteria. Most of the studies focused on strengthening agency infrastructure, while other studies included collaborative partnerships and technical assistance programs. Our findings suggest that system-level interventions are promising in strengthening HIV/AIDS prevention and treatment efforts. Based on our findings, we propose recommendations for future work in developing and evaluating system-level interventions. PMID:18369722

Differential absorption and Raman lidar for water vapor profile measurements - A review

NASA Technical Reports Server (NTRS)

Grant, William B.

1991-01-01

Differential absorption lidar and Raman lidar have been applied to the range-resolved measurements of water vapor density for more than 20 years. Results have been obtained using both lidar techniques that have led to improved understanding of water vapor distributions in the atmosphere. This paper reviews the theory of the measurements, including the sources of systematic and random error; the progress in lidar technology and techniques during that period, including a brief look at some of the lidar systems in development or proposed; and the steps being taken to improve such lidar systems.

Current state and future direction of computer systems at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Rogers, James L. (Editor); Tucker, Jerry H. (Editor)

1992-01-01

Computer systems have advanced at a rate unmatched by any other area of technology. As performance has dramatically increased there has been an equally dramatic reduction in cost. This constant cost performance improvement has precipitated the pervasiveness of computer systems into virtually all areas of technology. This improvement is due primarily to advances in microelectronics. Most people are now convinced that the new generation of supercomputers will be built using a large number (possibly thousands) of high performance microprocessors. Although the spectacular improvements in computer systems have come about because of these hardware advances, there has also been a steady improvement in software techniques. In an effort to understand how these hardware and software advances will effect research at NASA LaRC, the Computer Systems Technical Committee drafted this white paper to examine the current state and possible future directions of computer systems at the Center. This paper discusses selected important areas of computer systems including real-time systems, embedded systems, high performance computing, distributed computing networks, data acquisition systems, artificial intelligence, and visualization.

[Organizational capacity for continuous improvement of health services].

PubMed

Saturno-Hernández, Pedro J; Hernández-Avila, Mauricio; Magaña-Valladares, Laura; Garcia-Saisó, Sebastián; Vertiz-Ramírez, José de Jesús

2015-01-01

While the Mexican health system has achieved significant progress, as reflected in the growing improvement in population health, heterogeneity in the quality of services and its impact on health in different population groups is still a challenge. The costs or poor quality represent about 20 to 40% of the health system's expenditure. We need to develop organizational capacity to implement quality management systems in order to identify, evaluate, prevent and eventually overcome the health system's challenges. A competency-based comprehensive strategy for training human resources is proposed including undergraduate and graduate education as well as continuing education, which will contribute to improve the quality function at the various levels of responsibility in the health system. The proposed strategy responds to the context of the Mexican health system, but it could be adapted to other systems and contexts.

Methods for using groundwater model predictions to guide hydrogeologic data collection, with application to the Death Valley regional groundwater flow system

USGS Publications Warehouse

Tiedeman, C.R.; Hill, M.C.; D'Agnese, F. A.; Faunt, C.C.

2003-01-01

Calibrated models of groundwater systems can provide substantial information for guiding data collection. This work considers using such models to guide hydrogeologic data collection for improving model predictions by identifying model parameters that are most important to the predictions. Identification of these important parameters can help guide collection of field data about parameter values and associated flow system features and can lead to improved predictions. Methods for identifying parameters important to predictions include prediction scaled sensitivities (PSS), which account for uncertainty on individual parameters as well as prediction sensitivity to parameters, and a new "value of improved information" (VOII) method presented here, which includes the effects of parameter correlation in addition to individual parameter uncertainty and prediction sensitivity. In this work, the PSS and VOII methods are demonstrated and evaluated using a model of the Death Valley regional groundwater flow system. The predictions of interest are advective transport paths originating at sites of past underground nuclear testing. Results show that for two paths evaluated the most important parameters include a subset of five or six of the 23 defined model parameters. Some of the parameters identified as most important are associated with flow system attributes that do not lie in the immediate vicinity of the paths. Results also indicate that the PSS and VOII methods can identify different important parameters. Because the methods emphasize somewhat different criteria for parameter importance, it is suggested that parameters identified by both methods be carefully considered in subsequent data collection efforts aimed at improving model predictions.

Mobile mammography: An evaluation of organizational, process, and information systems challenges.

PubMed

Browder, Casey; Eberth, Jan M; Schooley, Benjamin; Porter, Nancy R

2015-03-01

The purpose of this case study was to evaluate the information systems, personnel, and processes involved in mobile mammography settings, and offer recommendations to improve efficiency and satisfaction among patients and staff. Data includes on-site observations, interviews, and an electronic medical record review of a hospital who offers both mobile and fixed facility mammography services to their community. The optimal expectations for the process of mobile mammography from multiple perspectives were defined as (1) patient receives mammogram the day of their visit, (2) patient has efficient intake process with little wait time, (3) follow-up is completed and timely, (4) site contact and van staff are satisfied with van visit and choose to schedule future visits, and (5) the MMU is able to assess its performance and set goals for improvement. Challenges that prevent the realization of those expectations include a low patient pre-registration rate, difficulty obtaining required physician orders, frequent information system downtime/Internet connectivity issues, ill-defined organizational communication/roles, insufficient site host/patient education, and disparate organizational and information systems. Our recommendations include employing a dedicated mobile mammography team for end-to-end oversight, mitigating for system connectivity issues, allowing for patient self-referrals, integrating scheduling and registration processes, and a focused approach to educating site hosts and respective patients about expectations for the day of the visit. The MMU is an important community resource; we recommend simple process improvements and information flow improvements to further enable the MMU׳s goals. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving transit equity, streamlining operations : technologies that benefit the transportation disadvantaged

DOT National Transportation Integrated Search

2006-01-01

This illustrates some of the ways in which technology has improved the ability of transportation disadvantaged individuals to use public transit. Some benefits offered include more efficient coordination among service providers, system flexibility, t...

The role of automation and artificial intelligence

NASA Astrophysics Data System (ADS)

Schappell, R. T.

1983-07-01

Consideration is given to emerging technologies that are not currently in common use, yet will be mature enough for implementation in a space station. Artificial intelligence (AI) will permit more autonomous operation and improve the man-machine interfaces. Technology goals include the development of expert systems, a natural language query system, automated planning systems, and AI image understanding systems. Intelligent robots and teleoperators will be needed, together with improved sensory systems for the robotics, housekeeping, vehicle control, and spacecraft housekeeping systems. Finally, NASA is developing the ROBSIM computer program to evaluate level of automation, perform parametric studies and error analyses, optimize trajectories and control systems, and assess AI technology.

A Report by the NEHA Air Pollution Committee

ERIC Educational Resources Information Center

Kirkpatrick, Lane

1972-01-01

Transportation controls to reduce air pollution are elaborated. These include: traffic control, parking restrictions, retrofit systems, testing and inspection, gaseous fuel systems, improved public transportation, and work schedule changes. (BL)

Hand hygiene monitoring technology: protocol for a systematic review

PubMed Central

2013-01-01

Background Healthcare worker hand hygiene is thought to be one of the most important strategies to prevent healthcare-associated infections, but compliance is generally poor. Hand hygiene improvement interventions must include audits of compliance (almost always with feedback), which are most often done by direct observation - a method that is expensive, subjective, and prone to bias. New technologies, including electronic and video hand hygiene monitoring systems, have the potential to provide continuous and objective monitoring of hand hygiene, regular feedback, and for some systems, real-time reminders. We propose a systematic review of the evidence supporting the effectiveness of these systems. The primary objective is to determine whether hand hygiene monitoring systems yield sustainable improvements in hand hygiene compliance when compared to usual care. Methods/Design MEDLINE, EMBASE, CINAHL, and other relevant databases will be searched for randomized control studies and quasi-experimental studies evaluating a video or electronic hand hygiene monitoring system. A standard data collection form will be used to abstract relevant information from included studies. Bias will be assessed using the Cochrane Effective Practice and Organization of Care Group Risk of Bias Assessment Tool. Studies will be reviewed independently by two reviewers, with disputes resolved by a third reviewer. The primary outcome is directly observed hand hygiene compliance. Secondary outcomes include healthcare-associated infection incidence and improvements in hand hygiene compliance as measured by alternative metrics. Results will be qualitatively summarized with comparisons made between study quality, the measured outcome, and study-specific factors that may be expected to affect outcome (for example, study duration, frequency of feedback, use of real-time reminders). Meta-analysis will be performed if there is more than one study of similar systems with comparable outcome definitions. Discussion Electronic and video monitoring systems have the potential to improve hand hygiene compliance and prevent healthcare-associated infection, but are expensive, difficult to install and maintain, and may not be accepted by all healthcare workers. This review will assess the current evidence of effectiveness of these systems before their widespread adoption. Study registration PROSPERO registration number: CRD42013004519 PMID:24219817

Hand hygiene monitoring technology: protocol for a systematic review.

PubMed

Srigley, Jocelyn A; Lightfoot, David; Fernie, Geoff; Gardam, Michael; Muller, Matthew P

2013-11-12

Healthcare worker hand hygiene is thought to be one of the most important strategies to prevent healthcare-associated infections, but compliance is generally poor. Hand hygiene improvement interventions must include audits of compliance (almost always with feedback), which are most often done by direct observation - a method that is expensive, subjective, and prone to bias. New technologies, including electronic and video hand hygiene monitoring systems, have the potential to provide continuous and objective monitoring of hand hygiene, regular feedback, and for some systems, real-time reminders. We propose a systematic review of the evidence supporting the effectiveness of these systems. The primary objective is to determine whether hand hygiene monitoring systems yield sustainable improvements in hand hygiene compliance when compared to usual care. MEDLINE, EMBASE, CINAHL, and other relevant databases will be searched for randomized control studies and quasi-experimental studies evaluating a video or electronic hand hygiene monitoring system. A standard data collection form will be used to abstract relevant information from included studies. Bias will be assessed using the Cochrane Effective Practice and Organization of Care Group Risk of Bias Assessment Tool. Studies will be reviewed independently by two reviewers, with disputes resolved by a third reviewer. The primary outcome is directly observed hand hygiene compliance. Secondary outcomes include healthcare-associated infection incidence and improvements in hand hygiene compliance as measured by alternative metrics. Results will be qualitatively summarized with comparisons made between study quality, the measured outcome, and study-specific factors that may be expected to affect outcome (for example, study duration, frequency of feedback, use of real-time reminders). Meta-analysis will be performed if there is more than one study of similar systems with comparable outcome definitions. Electronic and video monitoring systems have the potential to improve hand hygiene compliance and prevent healthcare-associated infection, but are expensive, difficult to install and maintain, and may not be accepted by all healthcare workers. This review will assess the current evidence of effectiveness of these systems before their widespread adoption. PROSPERO registration number: CRD42013004519.

ISO9000 and the quality management system in the digital hospital.

PubMed

Liu, Yalan; Yao, Bin; Zhang, Zigang

2002-01-01

ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.

Potential benefits of magnetic suspension and balance systems

NASA Technical Reports Server (NTRS)

Lawing, Pierce L.; Dress, David A.; Kilgore, Robert A.

1987-01-01

The potential of Magnetic Suspension and Balance Systems (MSBS) to improve conventional wind tunnel testing techniques is discussed. Topics include: elimination of model geometry distortion and support interference to improve the measurement accuracy of aerodynamic coefficients; removal of testing restrictions due to supports; improved dynamic stability data; and stores separation testing. Substantial increases in wind tunnel productivity are anticipated due to the coalescence of these improvements. Specific improvements in testing methods for missiles, helicopters, fighter aircraft, twin fuselage transports and bombers, state separation, water tunnels, and automobiles are also forecast. In a more speculative vein, new wind tunnel test techniques are envisioned as a result of applying MSBS, including free-flight computer trajectories in the test section, pilot-in-the-loop and designer-in-the-loop testing, shipboard missile launch simulation, and optimization of hybrid hypersonic configurations. Also addressed are potential applications of MSBS to such diverse technologies as medical research and practice, industrial robotics, space weaponry, and ore processing in space.

Multimodal system planning technique : an analytical approach to peak period operation

DOT National Transportation Integrated Search

1995-11-01

The multimodal system planning technique described in this report is an improvement of the methodology used in the Dallas System Planning Study. The technique includes a spreadsheet-based process to identify the costs of congestion, construction, and...

7 CFR 4280.110 - Grant funding.

Code of Federal Regulations, 2010 CFR

2010-01-01

...-party equity contributions are acceptable for renewable energy system projects, including those that are... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Renewable Energy Systems and Energy Efficiency... renewable energy system or energy efficiency improvement. (1) Post-application purchase and installation of...

7 CFR 4280.110 - Grant funding.

Code of Federal Regulations, 2011 CFR

2011-01-01

...-party equity contributions are acceptable for renewable energy system projects, including those that are... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Renewable Energy Systems and Energy Efficiency... renewable energy system or energy efficiency improvement. (1) Post-application purchase and installation of...

Improved Real-Time Monitoring Using Multiple Expert Systems

NASA Technical Reports Server (NTRS)

Schwuttke, Ursula M.; Angelino, Robert; Quan, Alan G.; Veregge, John; Childs, Cynthia

1993-01-01

Monitor/Analyzer of Real-Time Voyager Engineering Link (MARVEL) computer program implements combination of techniques of both conventional automation and artificial intelligence to improve monitoring of complicated engineering system. Designed to support ground-based operations of Voyager spacecraft, also adapted to other systems. Enables more-accurate monitoring and analysis of telemetry, enhances productivity of monitoring personnel, reduces required number of such personnel by performing routine monitoring tasks, and helps ensure consistency in face of turnover of personnel. Programmed in C language and includes commercial expert-system software shell also written in C.

Dry low combustion system with means for eliminating combustion noise

DOEpatents

Verdouw, Albert J.; Smith, Duane; McCormick, Keith; Razdan, Mohan K.

2004-02-17

A combustion system including a plurality of axially staged tubular premixers to control emissions and minimize combustion noise. The combustion system includes a radial inflow premixer that delivers the combustion mixture across a contoured dome into the combustion chamber. The axially staged premixers having a twist mixing apparatus to rotate the fluid flow and cause improved mixing without causing flow recirculation that could lead to pre-ignition or flashback.

Safety Analysis and Protection Measures of the Control System of the Pulsed High Magnetic Field Facility in WHMFC

NASA Astrophysics Data System (ADS)

Shi, J. T.; Han, X. T.; Xie, J. F.; Yao, L.; Huang, L. T.; Li, L.

2013-03-01

A Pulsed High Magnetic Field Facility (PHMFF) has been established in Wuhan National High Magnetic Field Center (WHMFC) and various protection measures are applied in its control system. In order to improve the reliability and robustness of the control system, the safety analysis of the PHMFF is carried out based on Fault Tree Analysis (FTA) technique. The function and realization of 5 protection systems, which include sequence experiment operation system, safety assistant system, emergency stop system, fault detecting and processing system and accident isolating protection system, are given. The tests and operation indicate that these measures improve the safety of the facility and ensure the safety of people.

Photovoltaic power for Space Station Freedom

NASA Technical Reports Server (NTRS)

Baraona, Cosmo R.

1990-01-01

Space Station Freedom is described with special attention given to its electric power system. The photovoltaic arrays, the battery energy storage system, and the power management, and distribution system are also discussed. The current design of Freedom's power system and the system requirements, trade studies, and competing factors which lead to system selections are referenced. This will be the largest power system ever flown in space. This system represents the culmination of many developments that have improved system performance, reduced cost, and improved reliability. Key developments and their evolution into the current space station solar array design are briefly described. The features of the solar cell and the array including the development, design, test, and flight hardware production status are given.

Photovoltaic power for Space Station Freedom

NASA Technical Reports Server (NTRS)

Baraona, Cosmo R.

1990-01-01

Space Station Freedom is described with special attention to its electric power system. The photovoltaic arrays, the battery energy storage system, and the power management and distribution system are also discussed. The current design of Freedom's power system and the system requirements, trade studies, and competing factors which lead to system selections are referenced. This will be the largest power system ever flown in space. This system represents the culmination of many developments that have improved system performance, reduced cost, and improved reliability. Key developments and their evolution into the current space station solar array design are briefly described. The features of the solar cell and the array including the development, design, test, and flight hardware production status are given.

Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: a systematic review

PubMed Central

Shanbhag, Deepti; Graham, Ian D; Harlos, Karen; Haynes, R. Brian; Gabizon, Itzhak; Connolly, Stuart J; Van Spall, Harriette Gillian Christine

2018-01-01

Background The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success. Methods We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines. We used the Cochrane Effective Practice and Organisation of Care and Process Redesign frameworks for data extraction. Primary outcomes included: proportion of eligible patients offered guideline-recommended pharmacotherapy, self-care education, left ventricular function assessment and/or intracardiac devices. We reported clinical outcomes when available. Results We included 38 studies. Provider-level interventions (n=13 studies) included audit and feedback, reminders and education. Organisation-level interventions (n=18) included medical records system changes, multidisciplinary teams, clinical pathways and continuity of care. System-level interventions (n=3) included provider/institutional incentives. Four studies assessed multi-level interventions. We could not perform meta-analyses due to statistical/conceptual heterogeneity. Thirty-two studies reported significant improvements in at least one primary outcome. Clinical pathways, multidisciplinary teams and multifaceted interventions were most consistently successful in increasing physician uptake of guidelines. Among randomised controlled trials (RCT) (n=10), pharmacist and nurse-led interventions improved target dose prescriptions. Eleven studies reported clinical outcomes; significant improvements were reported in three, including a clinical pathway, a multidisciplinary team and a multifaceted intervention. Baseline assessment of barriers, staff training, iterative intervention development, leadership commitment and policy/financial incentives were associated with intervention effectiveness. Most studies (n=20) had medium risk of bias; nine RCTs had low risk of bias. Conclusion Our study is limited by the quality and heterogeneity of the primary studies. Clinical pathways, multidisciplinary teams and multifaceted interventions appear to be most consistent in increasing guideline uptake. However, improvements in process outcomes were rarely accompanied by improvements in clinical outcomes. Our work highlights the need for improved research methodology to reliably assess the effectiveness of implementation interventions. PMID:29511005

Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: a systematic review.

PubMed

Shanbhag, Deepti; Graham, Ian D; Harlos, Karen; Haynes, R Brian; Gabizon, Itzhak; Connolly, Stuart J; Van Spall, Harriette Gillian Christine

2018-03-06

The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success. We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines. We used the Cochrane Effective Practice and Organisation of Care and Process Redesign frameworks for data extraction. Primary outcomes included: proportion of eligible patients offered guideline-recommended pharmacotherapy, self-care education, left ventricular function assessment and/or intracardiac devices. We reported clinical outcomes when available. We included 38 studies. Provider-level interventions (n=13 studies) included audit and feedback, reminders and education. Organisation-level interventions (n=18) included medical records system changes, multidisciplinary teams, clinical pathways and continuity of care. System-level interventions (n=3) included provider/institutional incentives. Four studies assessed multi-level interventions. We could not perform meta-analyses due to statistical/conceptual heterogeneity. Thirty-two studies reported significant improvements in at least one primary outcome. Clinical pathways, multidisciplinary teams and multifaceted interventions were most consistently successful in increasing physician uptake of guidelines. Among randomised controlled trials (RCT) (n=10), pharmacist and nurse-led interventions improved target dose prescriptions. Eleven studies reported clinical outcomes; significant improvements were reported in three, including a clinical pathway, a multidisciplinary team and a multifaceted intervention. Baseline assessment of barriers, staff training, iterative intervention development, leadership commitment and policy/financial incentives were associated with intervention effectiveness. Most studies (n=20) had medium risk of bias; nine RCTs had low risk of bias. Our study is limited by the quality and heterogeneity of the primary studies. Clinical pathways, multidisciplinary teams and multifaceted interventions appear to be most consistent in increasing guideline uptake. However, improvements in process outcomes were rarely accompanied by improvements in clinical outcomes. Our work highlights the need for improved research methodology to reliably assess the effectiveness of implementation interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Why differentiating between health system support and health system strengthening is needed

PubMed Central

Chee, Grace; Pielemeier, Nancy; Lion, Ann; Connor, Catherine

2013-01-01

There is increasing recognition that efforts to improve global health cannot be achieved without stronger health systems. Interpretation of health system strengthening (HSS) has varied widely however, with much of the focus to-date on alleviating input constraints, whereas less attention has been given to other performance drivers. It is important to distinguish activities that support the health system, from ones that strengthen the health system. Supporting the health system can include any activity that improves services, from distributing mosquito nets to procuring medicines. These activities improve outcomes primarily by increasing inputs. Strengthening the health system is accomplished by more comprehensive changes to performance drivers such as policies and regulations, organizational structures, and relationships across the health system to motivate changes in behavior and/or allow more effective use of resources to improve multiple health services. Even organizations that have made significant investments in health systems have not provided guidance on what HSS entails. While both supporting and strengthening are important and necessary, it is nonetheless important to make a distinction. If activities fail to produce improvements in system performance because they were incorrectly labeled as system strengthening, the value of HSS investments could quickly be discredited. Not distinguishing supportive activities from strengthening ones will lead to unmet expectations of stronger health systems, as well as neglect of critical system strengthening activities. Distinguishing between these two types of activities will improve programming impact. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22777839

Phasor Measurement Unit and Its Application in Modern Power Systems

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

Ma, Jian; Makarov, Yuri V.; Dong, Zhao Yang

2010-06-01

The introduction of phasor measuring units (PMUs) in power systems significantly improves the possibilities for monitoring and analyzing power system dynamics. Synchronized measurements make it possible to directly measure phase angles between corresponding phasors in different locations within the power system. Improved monitoring and remedial action capabilities allow network operators to utilize the existing power system in a more efficient way. Improved information allows fast and reliable emergency actions, which reduces the need for relatively high transmission margins required by potential power system disturbances. In this chapter, the applications of PMU in modern power systems are presented. Specifically, the topicsmore » touched in this chapter include state estimation, voltage and transient stability, oscillation monitoring, event and fault detection, situation awareness, and model validation. A case study using Characteristic Ellipsoid method based on PMU to monitor power system dynamic is presented.« less

Assessment and preliminary design of an energy buffer for regenerative braking in electric vehicles

NASA Technical Reports Server (NTRS)

Buchholz, R.; Mathur, A. K.

1979-01-01

Energy buffer systems, capable of storing the vehicle energy during braking and reusing this stored energy during acceleration, were examined. Some of these buffer systems when incorporated in an electric vehicle would result in an improvement in the performance and range under stop and go driving conditions. Buffer systems considered included flywheels, hydropneumatic, pneumatic, spring, and regenerative braking. Buffer ranking and rating criteria were established. Buffer systems were rated based on predicted range improvements, consumer acceptance, driveability, safety, reliability and durability, and initial and life cycle costs. A hydropneumatic buffer system was selected.

Some Solved Problems with the SLAC PEP-II B-Factory Beam-Position Monitor System

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

Johnson, Ronald G.

2000-05-05

The Beam-Position Monitor (BPM) system for the SLAC PEP-II B-Factory has been in operation for over two years. Although the BPM system has met all of its specifications, several problems with the system have been identified and solved. The problems include errors and limitations in both the hardware and software. Solutions of such problems have led to improved performance and reliability. In this paper the authors report on this experience. The process of identifying problems is not at an end and they expect continued improvement of the BPM system.

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation

PubMed Central

Alemnji, George; Edghill, Lisa; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Background Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. Objectives We report the development of a stepwise process for quality systems improvement in the Caribbean Region. Methods The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called ‘Laboratory Quality Management System – Stepwise Improvement Process (LQMS-SIP) Towards Accreditation’ to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. Results This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. Conclusion This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement. PMID:28879149

RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

NASA Astrophysics Data System (ADS)

Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

2008-08-01

RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

Batteries for electric and hybrid-electric vehicles.

PubMed

Cairns, Elton J; Albertus, Paul

2010-01-01

Batteries have powered vehicles for more than a century, but recent advances, especially in lithium-ion (Li-ion) batteries, are bringing a new generation of electric-powered vehicles to the market. Key barriers to progress include system cost and lifetime, and derive from the difficulty of making a high-energy, high-power, and reversible electrochemical system. Indeed, although humans produce many mechanical and electrical systems, the number of reversible electrochemical systems is very limited. System costs may be brought down by using cathode materials less expensive than those presently employed (e.g., sulfur or air), but reversibility will remain a key challenge. Continued improvements in the ability to synthesize and characterize materials at desired length scales, as well as to use computations to predict new structures and their properties, are facilitating the development of a better understanding and improved systems. Battery research is a fascinating area for development as well as a key enabler for future technologies, including advanced transportation systems with minimal environmental impact.

FOR Allocation to Distribution Systems based on Credible Improvement Potential (CIP)

NASA Astrophysics Data System (ADS)

Tiwary, Aditya; Arya, L. D.; Arya, Rajesh; Choube, S. C.

2017-02-01

This paper describes an algorithm for forced outage rate (FOR) allocation to each section of an electrical distribution system subject to satisfaction of reliability constraints at each load point. These constraints include threshold values of basic reliability indices, for example, failure rate, interruption duration and interruption duration per year at load points. Component improvement potential measure has been used for FOR allocation. Component with greatest magnitude of credible improvement potential (CIP) measure is selected for improving reliability performance. The approach adopted is a monovariable method where one component is selected for FOR allocation and in the next iteration another component is selected for FOR allocation based on the magnitude of CIP. The developed algorithm is implemented on sample radial distribution system.

Automated mixed traffic transit vehicle microprocessor controller

NASA Technical Reports Server (NTRS)

Marks, R. A.; Cassell, P.; Johnston, A. R.

1981-01-01

An improved Automated Mixed Traffic Vehicle (AMTV) speed control system employing a microprocessor and transistor chopper motor current controller is described and its performance is presented in terms of velocity versus time curves. The on board computer hardware and software systems are described as is the software development system. All of the programming used in this controller was implemented using FORTRAN. This microprocessor controller made possible a number of safety features and improved the comfort associated with starting and shopping. In addition, most of the vehicle's performance characteristics can be altered by simple program parameter changes. A failure analysis of the microprocessor controller was generated and the results are included. Flow diagrams for the speed control algorithms and complete FORTRAN code listings are also included.

Systems and methods for imaging using radiation from laser produced plasmas

DOEpatents

Renard-Le Galloudec, Nathalie; Cowan, Thomas E.; Sentoku, Yasuhiko; Rassuchine, Jennifer

2009-06-30

In particular embodiments, the present disclosure provides systems and methods for imaging a subject using radiation emitted from a laser produced plasma generating by irradiating a target with a laser. In particular examples, the target includes at least one radiation enhancing component, such as a fluor, cap, or wire. In further examples, the target has a metal layer and an internal surface defining an internal apex, the internal apex of less than about 15 .mu.m, such as less than about 1 .mu.m. The targets may take a variety of shapes, including cones, pyramids, and hemispheres. Certain aspects of the present disclosure provide improved imaging of a subject, such as improved medical images of a radiation dose than typical conventional methods and systems.

Benefits and drawbacks of electronic health record systems

PubMed Central

Menachemi, Nir; Collum, Taleah H

2011-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way. PMID:22312227

Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement.

PubMed

Shabila, Nazar P; Al-Tawil, Namir G; Al-Hadithi, Tariq S; Sondorp, Egbert; Vaughan, Kelsey

2012-09-27

As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq's Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and policy makers about the main problems affecting this system, though improvements to the health care system must be taken up at the national level and involve other key stakeholders.

CASPER Version 2.0

NASA Technical Reports Server (NTRS)

Chien, Steve; Rabideau, Gregg; Tran, Daniel; Knight, Russell; Chouinard, Caroline; Estlin, Tara; Gaines, Daniel; Clement, Bradley; Barrett, Anthony

2007-01-01

CASPER is designed to perform automated planning of interdependent activities within a system subject to requirements, constraints, and limitations on resources. In contradistinction to the traditional concept of batch planning followed by execution, CASPER implements a concept of continuous planning and replanning in response to unanticipated changes (including failures), integrated with execution. Improvements over other, similar software that have been incorporated into CASPER version 2.0 include an enhanced executable interface to facilitate integration with a wide range of execution software systems and supporting software libraries; features to support execution while reasoning about urgency, importance, and impending deadlines; features that enable accommodation to a wide range of computing environments that include various central processing units and random- access-memory capacities; and improved generic time-server and time-control features.

Implementing technology to improve medication safety in healthcare facilities: a literature review.

PubMed

Hidle, Unn

Medication errors remain one of the most common causes of patient injuries in the United States, with detrimental outcomes including adverse reactions and even death. By developing a better understanding of why and how medication errors occur, preventative measures may be implemented including technological advances. In this literature review, potential methods of reducing medication errors were explored. Furthermore, technology tools available for medication orders and administration are described, including advantages and disadvantages of each system. It was found that technology can be an excellent aid in improving safety of medication administration. However, computer technology cannot replace human intellect and intuition. Nurses should be involved when implementing any new computerized system in order to obtain the most appropriate and user-friendly structure.

Fostering the Development of Critical Thinking Skills, and Reading Comprehension of Undergraduates Using a Web 2.0 Tool Coupled with a Learning System

ERIC Educational Resources Information Center

Mendenhall, Anne; Johnson, Tristan E.

2010-01-01

A social annotation model learning system (SAM-LS) was created using multiple instructional strategies thereby supporting the student in improving in critical thinking, critical writing and related literacy. There are four mechanisms in which the SAM-LS methodology is believed to improve learning and performance. These mechanisms include providing…

The network of Shanghai Stroke Service System (4S): A public health-care web-based database using automatic extraction of electronic medical records.

PubMed

Dong, Yi; Fang, Kun; Wang, Xin; Chen, Shengdi; Liu, Xueyuan; Zhao, Yuwu; Guan, Yangtai; Cai, Dingfang; Li, Gang; Liu, Jianmin; Liu, Jianren; Zhuang, Jianhua; Wang, Panshi; Chen, Xin; Shen, Haipeng; Wang, David Z; Xian, Ying; Feng, Wuwei; Campbell, Bruce Cv; Parsons, Mark; Dong, Qiang

2018-07-01

Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area. The 4S registry uses a web-based database that automatically extracts data from structured electronic medical records. Site-specific education and training program will be designed and administrated according to their baseline characteristics. Both acute reperfusion therapies including thrombectomy and thrombolysis in the acute phase and subsequent care were measured and monitored with feedback. Primary outcome is to evaluate the differences in quality metrics between baseline characteristics (including rate of thrombolysis in acute stroke and key performance indicators in secondary prevention) and post-intervention. Conclusions The 4S system is a regional stroke network that monitors the ongoing stroke care quality in Shanghai. This project will provide the opportunity to evaluate the spectrum of acute stroke care and design quality improvement processes for better stroke care. A regional stroke network model for quality improvement will be explored and might be expanded to other large cities in China. Clinical Trial Registration-URL http://www.clinicaltrials.gov . Unique identifier: NCT02735226.

Development of improved injury criteria for the assessment of advanced automotive restraint systems : II

DOT National Transportation Integrated Search

1999-11-01

The National Highway Traffic Safety Administration's (NHTSA) plans for upgrading the Federal Motor Vehicle Safety Standard (FMVSS) No. 208, frontal crash protection safety standard, include improving protection requirements for the normally seated mi...

Development of improved injury criteria for the assessment of advanced automotive restraint systems

DOT National Transportation Integrated Search

1998-01-01

The National Highway Traffic Safety Administration's (NHTSA) plans for upgrading the Federal Motor Vehicle Safety Standard (FMVSS) No. 208, frontal crash protection safety standard, include improving protection requirements for the normally seated mi...

Improving the accuracy and usability of Iowa falling weight deflectometer data.

DOT National Transportation Integrated Search

2013-05-01

This study aims to improve the accuracy and usability of Iowa Falling Weight Deflectometer (FWD) data by incorporating significant : enhancements into the fully-automated software system for rapid processing of the FWD data. These enhancements includ...

Development of the improved helicopter icing spray system (IHISS)

NASA Technical Reports Server (NTRS)

Peterson, Andrew A.; Jenks, Mark D.; Gaitskill, William H.

1989-01-01

Boeing Helicopters has been awarded a contract by the U.S. Army to design, fabricate and test a replacement for the existing Helicopter Icing Spray System (HISS). The Improved Hiss (IHISS), capable of deployment from any CH-47D helicopter, will include new icing spray nozzles and pneumatic pressure source, and a significantly larger water tank and spray boom. Results are presented for extensive bench and icing tunnel test programs used to select and modify an improved spray nozzle and validate spray boom aerodynamic characteristics. The resulting system will provide a significantly larger icing cloud with droplet characteristics closely matching natural icing conditions.

Innovative technology conserves resources and generates savings: a case study from the Sunnybrook Regional Processing Centre.

PubMed

Karim, Abdool Z

2009-01-01

The regional processing centre at Sunnybrook Health Sciences Centre recently faced the substantial challenge of increasing cleaning capacity to meet the current workload and anticipated future demand without increasing its operating budget. The solution, upgrading its cleaning and decontamination system to a highly automated system, met both objectives. An analysis of the impact of the change found that the new system provided additional benefits, including improved productivity and cleaning quality; decreased costs; reduced water, electricity and chemical use; improved worker safety and morale; and decreased overtime. Investing in innovative technology improved key departmental outcomes while meeting institutional environmental and cost savings objectives.

Small rocket research and technology

NASA Technical Reports Server (NTRS)

Schneider, Steven; Biaglow, James

1993-01-01

Small chemical rockets are used on nearly all space missions. The small rocket program provides propulsion technology for civil and government space systems. Small rocket concepts are developed for systems which encompass reaction control for launch and orbit transfer systems, as well as on-board propulsion for large space systems and earth orbit and planetary spacecraft. Major roles for on-board propulsion include apogee kick, delta-V, de-orbit, drag makeup, final insertions, north-south stationkeeping, orbit change/trim, perigee kick, and reboost. The program encompasses efforts on earth-storable, space storable, and cryogenic propellants. The earth-storable propellants include nitrogen tetroxide (NTO) as an oxidizer with monomethylhydrazine (MMH) or anhydrous hydrazine (AH) as fuels. The space storable propellants include liquid oxygen (LOX) as an oxidizer with hydrazine or hydrocarbons such as liquid methane, ethane, and ethanol as fuels. Cryogenic propellants are LOX or gaseous oxygen (GOX) as oxidizers and liquid or gaseous hydrogen as fuels. Improved performance and lifetime for small chemical rockets are sought through the development of new predictive tools to understand the combustion and flow physics, the introduction of high temperature materials to eliminate fuel film cooling and its associated combustion inefficiency, and improved component designs to optimize performance. Improved predictive technology is sought through the comparison of both local and global predictions with experimental data. Results indicate that modeling of the injector and combustion process in small rockets needs improvement. High temperature materials require the development of fabrication processes, a durability data base in both laboratory and rocket environments, and basic engineering property data such as strength, creep, fatigue, and work hardening properties at both room and elevated temperature. Promising materials under development include iridium-coated rhenium and a ceramic composite of mixed hafnium carbide and tantalum carbide reinforced with graphite fibers.

Aviation system capacity improvements through technology

NASA Technical Reports Server (NTRS)

Harvey, W. Don

1995-01-01

A study was conducted with the primary objective of determining the impact of technology on capacity improvements in the U.S. air transportation system and, consequently, to assess the areas where NASA's expertise and technical contributions would be the most beneficial. The outlook of the study is considered both near- and long-term (5 to 25 years). The approach was that of actively working with the Massachusetts Institute of Technology (MIT) Flight Transportation Laboratory and included interactions with 'users' outside of both agencies as well as with organizations within. This report includes an overall survey of what are believed to be the causes of the capacity problems, ongoing work with the Federal Aviation Administration (FAA) to alleviate the problems, and identifies improvements in technology that would increase capacity and reduce delays.

Controllers, observers, and applications thereof

NASA Technical Reports Server (NTRS)

Gao, Zhiqiang (Inventor); Zhou, Wankun (Inventor); Miklosovic, Robert (Inventor); Radke, Aaron (Inventor); Zheng, Qing (Inventor)

2011-01-01

Controller scaling and parameterization are described. Techniques that can be improved by employing the scaling and parameterization include, but are not limited to, controller design, tuning and optimization. The scaling and parameterization methods described here apply to transfer function based controllers, including PID controllers. The parameterization methods also apply to state feedback and state observer based controllers, as well as linear active disturbance rejection (ADRC) controllers. Parameterization simplifies the use of ADRC. A discrete extended state observer (DESO) and a generalized extended state observer (GESO) are described. They improve the performance of the ESO and therefore ADRC. A tracking control algorithm is also described that improves the performance of the ADRC controller. A general algorithm is described for applying ADRC to multi-input multi-output systems. Several specific applications of the control systems and processes are disclosed.

Air Starters for Transit Buses

DOT National Transportation Integrated Search

1983-05-01

This study was conducted to familiarize transit agencies with the potential benefits gained by utilizing air starting systems as an alternative to electrical starting systems. The potential benefits include improved starting reliability under hot and...

Assessment of ADA Research and Development Needs

DOT National Transportation Integrated Search

1997-07-01

This report assesses the progress transit systems have made in improving the accessibility of their services and facilities. Specific objectives included the identification of innovative solutions developed by transit systems to meet the accessibilit...

Solar Technology Validation Project - USS Data, LLC: Cooperative Research and Development Final Report, CRADA Number CRD-09-367-04

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

Wilcox, S.

2013-08-01

Under this Agreement, NREL will work with Participant to improve concentrating solar power system performance characterizations. This work includes, but is not limited to, research and development of methods for acquiring renewable resource characterization information using site-specific measurements of solar radiation and meteorological conditions; collecting system performance data; and developing tools for improving the design, installation, operation, and maintenance of solar energy conversion systems. This work will be conducted at NREL and Participant facilities.

Solar Technology Validation Project - RES Americas: Cooperative Research and Development Final Report, CRADA Number CRD-09-367-11

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

Wilcox, S.

Under this Agreement, NREL will work with Participant to improve concentrating solar power system performance characterizations. This work includes, but is not limited to, research and development of methods for acquiring renewable resource characterization information using site-specific measurements of solar radiation and meteorological conditions; collecting system performance data; and developing tools for improving the design, installation, operation, and maintenance of solar energy conversion systems. This work will be conducted at NREL and Participant facilities.

Root architecture simulation improves the inference from seedling root phenotyping towards mature root systems

PubMed Central

Zhao, Jiangsan; Rewald, Boris; Leitner, Daniel; Nagel, Kerstin A.; Nakhforoosh, Alireza

2017-01-01

Abstract Root phenotyping provides trait information for plant breeding. A shortcoming of high-throughput root phenotyping is the limitation to seedling plants and failure to make inferences on mature root systems. We suggest root system architecture (RSA) models to predict mature root traits and overcome the inference problem. Sixteen pea genotypes were phenotyped in (i) seedling (Petri dishes) and (ii) mature (sand-filled columns) root phenotyping platforms. The RSA model RootBox was parameterized with seedling traits to simulate the fully developed root systems. Measured and modelled root length, first-order lateral number, and root distribution were compared to determine key traits for model-based prediction. No direct relationship in root traits (tap, lateral length, interbranch distance) was evident between phenotyping systems. RootBox significantly improved the inference over phenotyping platforms. Seedling plant tap and lateral root elongation rates and interbranch distance were sufficient model parameters to predict genotype ranking in total root length with an RSpearman of 0.83. Parameterization including uneven lateral spacing via a scaling function substantially improved the prediction of architectures underlying the differently sized root systems. We conclude that RSA models can solve the inference problem of seedling root phenotyping. RSA models should be included in the phenotyping pipeline to provide reliable information on mature root systems to breeding research. PMID:28168270

Computational Models of Neuron-Astrocyte Interactions Lead to Improved Efficacy in the Performance of Neural Networks

PubMed Central

Alvarellos-González, Alberto; Pazos, Alejandro; Porto-Pazos, Ana B.

2012-01-01

The importance of astrocytes, one part of the glial system, for information processing in the brain has recently been demonstrated. Regarding information processing in multilayer connectionist systems, it has been shown that systems which include artificial neurons and astrocytes (Artificial Neuron-Glia Networks) have well-known advantages over identical systems including only artificial neurons. Since the actual impact of astrocytes in neural network function is unknown, we have investigated, using computational models, different astrocyte-neuron interactions for information processing; different neuron-glia algorithms have been implemented for training and validation of multilayer Artificial Neuron-Glia Networks oriented toward classification problem resolution. The results of the tests performed suggest that all the algorithms modelling astrocyte-induced synaptic potentiation improved artificial neural network performance, but their efficacy depended on the complexity of the problem. PMID:22649480

Computational models of neuron-astrocyte interactions lead to improved efficacy in the performance of neural networks.

PubMed

Alvarellos-González, Alberto; Pazos, Alejandro; Porto-Pazos, Ana B

2012-01-01

The importance of astrocytes, one part of the glial system, for information processing in the brain has recently been demonstrated. Regarding information processing in multilayer connectionist systems, it has been shown that systems which include artificial neurons and astrocytes (Artificial Neuron-Glia Networks) have well-known advantages over identical systems including only artificial neurons. Since the actual impact of astrocytes in neural network function is unknown, we have investigated, using computational models, different astrocyte-neuron interactions for information processing; different neuron-glia algorithms have been implemented for training and validation of multilayer Artificial Neuron-Glia Networks oriented toward classification problem resolution. The results of the tests performed suggest that all the algorithms modelling astrocyte-induced synaptic potentiation improved artificial neural network performance, but their efficacy depended on the complexity of the problem.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects.

PubMed

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-09-27

To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades-while not inexpensive-contributed to greater system efficiency and modest savings. © Mwencha et al.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

PubMed Central

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-01-01

ABSTRACT Background: To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. Methods: We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. Results: The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Conclusion: Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades—while not inexpensive—contributed to greater system efficiency and modest savings. PMID:28877933

Early Warning/Track-and-Trigger Systems to Detect Deterioration and Improve Outcomes in Hospitalized Patients.

PubMed

Shiloh, Ariel L; Lominadze, George; Gong, Michelle N; Savel, Richard H

2016-02-01

As a global effort toward improving patient safety, a specific area of focus has been the early recognition and rapid intervention in deteriorating ward patients. This focus on "failure to rescue" has led to the construction of early warning/track-and-trigger systems. In this review article, we present a description of the data behind the creation and implementation of such systems, including multiple algorithms and strategies for deployment. Additionally, the strengths and weaknesses of the various systems and their evaluation in the literature are emphasized. Despite the limitations of the current literature, the potential benefit of these early warning/track-and-trigger systems to improve patient outcomes remains significant. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

United States benefits of improved worldwide wheat crop information from a LANDSAT system

NASA Technical Reports Server (NTRS)

Heiss, K. P.; Sand, F.; Seidel, A.; Warner, D.; Sheflin, N.; Bhattacharyya, R.; Andrews, J.

1975-01-01

The value of worldwide information improvements on wheat crops, promised by LANDSAT, is measured in the context of world wheat markets. These benefits are based on current LANDSAT technical goals and assume that information is made available to all (United States and other countries) at the same time. A detailed empirical sample demonstration of the effect of improved information is given; the history of wheat commodity prices for 1971-72 is reconstructed and the price changes from improved vs. historical information are compared. The improved crop forecasting from a LANDSAT system assumed include wheat crop estimates of 90 percent accuracy for each major wheat producing region. Accurate, objective worldwide wheat crop information using space systems may have a very stabilizing influence on world commodity markets, in part making possible the establishment of long-term, stable trade relationships.

Idaho National Laboratory Integrated Safety Management System FY 2013 Effectiveness Review and Declaration Report

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

Hunt, Farren

2013-12-01

Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in themore » past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.« less

Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

PubMed

Trebble, Timothy M; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M

2014-11-21

Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. The current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken. Six themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM. There is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and performance management of individual clinicians may be possible but requires an alternative approach for the NHS.

Integrating MRP (materiel requirements planning) into modern business.

PubMed

Lunn, T

1994-05-01

Time is the commodity of the '90s. Therefore, we all must learn how to use our manufacturing systems to shorten lead time and increase customer satisfaction. The objective of this article is to discuss practical ways people integrate the techniques of materiel requirements planning (MRP) systems with just-in-time (JIT) execution systems to increase customer satisfaction. Included are examples of new ways people use MRP systems to exemplify the process of continuous improvement--multiple items on work orders, consolidated routings, flexing capacity, and other new developments. Ways that successful companies use MRP II for planning and JIT for execution are discussed. There are many examples of how to apply theory to real life situations and a discussion of techniques that work to keep companies in the mode of continuous improvement. Also included is a look at hands-on, practical methods people use to achieve lead time reduction and simplify bills of material. Total quality management concepts can be applied to the MRP process itself. This in turn helps people improve schedule adherence, which leads to customer satisfaction.

High-precision radiometric tracking for planetary approach and encounter in the inner solar system

NASA Technical Reports Server (NTRS)

Christensen, C. S.; Thurman, S. W.; Davidson, J. M.; Finger, M. H.; Folkner, W. M.

1989-01-01

The benefits of improved radiometric tracking data have been studied for planetary approach within the inner Solar System using the Mars Rover Sample Return trajectory as a model. It was found that the benefit of improved data to approach and encounter navigation was highly dependent on the a priori uncertainties assumed for several non-estimated parameters, including those for frame-tie, Earth orientation, troposphere delay, and station locations. With these errors at their current levels, navigational performance was found to be insensitive to enhancements in data accuracy. However, when expected improvements in these errors are modeled, performance with current-accuracy data significantly improves, with substantial further improvements possible with enhancements in data accuracy.

Upgrades to the ISS Water Recovery System

NASA Technical Reports Server (NTRS)

Pruitt, Jennifer M.; Carter, Layne; Bagdigian, Robert M.; Kayatin, Mattthew J.

2015-01-01

The ISS Water Recovery System (WRS) includes the Water Processor Assembly (WPA) and the Urine Processor Assembly (UPA). The WRS produces potable water from a combination of crew urine (first processed through the UPA), crew latent, and Sabatier product water. The WRS has been operational on ISS since November 2008, producing over 21,000 L of potable water during that time. Though the WRS has performed well during this time, several modifications have been identified to improve the overall system performance. These modifications can reduce resupply and improve overall system reliability, which is beneficial for the ongoing ISS mission as well as for future NASA manned missions. The following paper lists these modifications, how they improve WRS performance, and a status on the ongoing development effort.

Method and apparatus of parallel computing with simultaneously operating stream prefetching and list prefetching engines

DOEpatents

Boyle, Peter A.; Christ, Norman H.; Gara, Alan; Mawhinney, Robert D.; Ohmacht, Martin; Sugavanam, Krishnan

2012-12-11

A prefetch system improves a performance of a parallel computing system. The parallel computing system includes a plurality of computing nodes. A computing node includes at least one processor and at least one memory device. The prefetch system includes at least one stream prefetch engine and at least one list prefetch engine. The prefetch system operates those engines simultaneously. After the at least one processor issues a command, the prefetch system passes the command to a stream prefetch engine and a list prefetch engine. The prefetch system operates the stream prefetch engine and the list prefetch engine to prefetch data to be needed in subsequent clock cycles in the processor in response to the passed command.

Combining Systems and Teamwork Approaches to Enhance the Effectiveness of Safety Improvement Interventions in Surgery: The Safer Delivery of Surgical Services (S3) Program.

PubMed

McCulloch, Peter; Morgan, Lauren; New, Steve; Catchpole, Ken; Roberston, Eleanor; Hadi, Mohammed; Pickering, Sharon; Collins, Gary; Griffin, Damian

2017-01-01

Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies. Operating theatres in 5 UK hospitals performing elective orthopedic, plastic, or vascular surgery PARTICIPANTS:: All operating theatres staff, including surgeons, nurses, anaesthetists, and others INTERVENTIONS:: 4-month safety improvement interventions, using teamwork training (TT), systems redesign and standardization (SOP), Lean quality improvement, SOP + TT combination, or Lean + TT combination. Team technical and nontechnical performance and World Health Organization (WHO) checklist compliance, measured for 3 months before and after intervention using validated scales. Pooled data analysis of before-after change in active and control groups, comparing combined versus single and systems versus teamwork interventions, using 2-way ANOVA. We studied 453 operations, (255 intervention, 198 control). TT improved nontechnical skills and WHO compliance (P < 0.001), but not technical performance; systems interventions (Lean & SOP, 2 & 3) improved nontechnical skills and technical performance (P < 0.001) but improved WHO compliance less. Combined interventions (4 & 5) improved all performance measures except WHO time-out attempts, whereas single approaches (1 & 2 & 3) improved WHO compliance less (P < 0.001) and failed to improve technical performance. Safety interventions combining teamwork training and systems rationalization are more effective than those adopting either approach alone. This has important implications for safety improvement strategies in hospitals.

Meteorological support for space operations: Review and recommendations

NASA Technical Reports Server (NTRS)

1988-01-01

The current meteorological support provided to NASA by NOAA, Air Weather Service, and other contractors is reviewed and suggestions are offered for its improvement. These recommendations include improvement in NASA's internal management organizational structure that would accommodate continued improvement in operational weather support, installation of new observing systems, improvement in analysis and forecasting procedures, and the establishment of an Applied Research and Forecasting Facility.

Panelized wall system with foam core insulation

DOEpatents

Kosny, Jan [Oak Ridge, TN; Gaskin, Sally [Houston, TX

2009-10-20

A wall system includes a plurality of wall members, the wall members having a first metal panel, a second metal panel, and an insulating core between the first panel and the second panel. At least one of the first panel and the second panel include ridge portions. The insulating core can be a foam, such as a polyurethane foam. The foam can include at least one opacifier to improve the k-factor of the foam.

EDUCATIONAL CASE REPORTS

PubMed Central

Ackerman, Sara L.; Boscardin, Christy; Karliner, Leah; Handley, Margaret A.; Cheng, Sarah; Gaither, Tom; Hagey, Jill; Hennein, Lauren; Malik, Faizan; Shaw, Brian; Trinidad, Norver; Zahner, Greg; Gonzales, Ralph

2016-01-01

Problem Systems-based practice focuses on the organization, financing, and delivery of medical services. The American Association of Medical Colleges has recommended that systems-based practice be incorporated into medical schools’ curricula. However, experiential learning in systems-based practice, including practical strategies to improve the quality and efficiency of clinical care, is often absent from or inconsistently included in medical education. Intervention A multidisciplinary clinician and non-clinician faculty team partnered with a cardiology outpatient clinic to design a nine-month clerkship for first-year medical students focused on systems-based practice, delivery of clinical care, and strategies to improve the quality and efficiency of clinical operations. The clerkship was called the Action Research Program. In 2013–2014, eight trainees participated in educational seminars, research activities, and nine-week clinic rotations. A qualitative process and outcome evaluation drew on interviews with students, clinic staff, and supervising physicians, as well as students’ detailed field notes. Context The Action Research Program was developed and implemented at the University of California, San Francisco, an academic medical center in the U.S. All educational activities took place at the university’s medical school and at the medical center’s cardiology outpatient clinic. Outcome Students reported and demonstrated increased understanding of how care delivery systems work, improved clinical skills, growing confidence in interactions with patients, and appreciation for patients’ experiences. Clinicians reported increased efficiency at the clinic level and improved performance and job satisfaction among medical assistants as a result of their unprecedented mentoring role with students. Some clinicians felt burdened when students shadowed them and asked questions during interactions with patients. Most student-led improvement projects were not fully implemented. Lessons Learned The Action Research Program is a small pilot project that demonstrates an innovative pairing of experiential and didactic training in systems-based practice. Lessons learned include the need for dedicated time and faculty support for students’ improvement projects, which were the least successful aspect of the program. We recommend that future projects aiming to combine clinical training and quality improvement projects designate distinct blocks of time for trainees to pursue each of these activities independently. In 2014–2015, the University of California, San Francisco School of Medicine incorporated key features of the Action Research Program into the standard curriculum, with plans to build upon this foundation in future curricular innovations. PMID:27064720

Surveying Florida MPO readiness to incorporate innovative technologies into long range transportation plans : draft final report.

DOT National Transportation Integrated Search

2016-08-01

There is optimism that Automated Vehicles (AVs) can improve the safety of the transportation system, : reduce congestion, increase reliability, offer improved mobility solutions to all segments of the population : including the transportation-disadva...

The People Side of Performance Improvement.

ERIC Educational Resources Information Center

Gerson, Richard F.

1999-01-01

Discusses 11 keys to the personal side of performance improvement, including positive attitude, high self esteem and positive self-image, communication skills, lifelong learning, caring about other people, health and well-being, motivation, goal setting, relaxation, visualization, and personal value system. (LRW)

ISPI's Value Proposition: Two Examples.

ERIC Educational Resources Information Center

Swinney, John

2003-01-01

Describes two experiences that illustrate the value of the International Society for Performance Improvement (ISPI). Highlights include measuring organizational results; identifying opportunities to improve performance; training as part of the solution; the role of ISD (instructional systems design); HPT (human performance technology) issues; and…

The Local Ensemble Transform Kalman Filter with the Weather Research and Forecasting Model: Experiments with Real Observations

NASA Astrophysics Data System (ADS)

Miyoshi, Takemasa; Kunii, Masaru

2012-03-01

The local ensemble transform Kalman filter (LETKF) is implemented with the Weather Research and Forecasting (WRF) model, and real observations are assimilated to assess the newly-developed WRF-LETKF system. The WRF model is a widely-used mesoscale numerical weather prediction model, and the LETKF is an ensemble Kalman filter (EnKF) algorithm particularly efficient in parallel computer architecture. This study aims to provide the basis of future research on mesoscale data assimilation using the WRF-LETKF system, an additional testbed to the existing EnKF systems with the WRF model used in the previous studies. The particular LETKF system adopted in this study is based on the system initially developed in 2004 and has been continuously improved through theoretical studies and wide applications to many kinds of dynamical models including realistic geophysical models. Most recent and important improvements include an adaptive covariance inflation scheme which considers the spatial and temporal inhomogeneity of inflation parameters. Experiments show that the LETKF successfully assimilates real observations and that adaptive inflation is advantageous. Additional experiments with various ensemble sizes show that using more ensemble members improves the analyses consistently.

Intelligent Transportation Systems (ITS) plan for Canada : en route to intelligent mobility

DOT National Transportation Integrated Search

1999-11-01

Intelligent Transportation Systems (ITS) include the application of advanced information processing, communications, sensor and control technologies and management strategies in an integrated manner to improve the functioning of the transportation sy...

Designing Bioretention Systems to Improve Nitrogen Removal

EPA Science Inventory

Bioretention systems effectively remove many stormwater stressors, including oil/grease, heavy metals, phosphorus, and ammonium. However, reported nitrate removal performance is highly variable. Bioretention media is typically coarse-grained with low organic matter content, which...

Initial Development of a Spatially Separated Speech-in-Noise and Localization Training Program

PubMed Central

Tyler, Richard S.; Witt, Shelley A.; Dunn, Camille C.; Wang, Wenjun

2010-01-01

Objective This article describes the initial development of a novel approach for training hearing-impaired listeners to improve their ability to understand speech in the presence of background noise and to also improve their ability to localize sounds. Design Most people with hearing loss, even those well fit with hearing devices, still experience significant problems understanding speech in noise. Prior research suggests that at least some subjects can experience improved speech understanding with training. However, all training systems that we are aware of have one basic, critical limitation. They do not provide spatial separation of the speech and noise, therefore ignoring the potential benefits of training binaural hearing. In this paper we describe our initial experience with a home-based training system that includes spatially separated speech-in-noise and localization training. Results Throughout the development of this system patient input, training and preliminary pilot data from individuals with bilateral cochlear implants were utilized. Positive feedback from subjective reports indicated that some individuals were engaged in the treatment, and formal testing showed benefit. Feedback and practical issues resulted from the reduction of an eight-loudspeaker to a two-loudspeaker system. Conclusions These preliminary findings suggest we have successfully developed a viable spatial hearing training system that can improve binaural hearing in noise and localization. Applications include, but are not limited to, hearing with hearing aids and cochlear implants. PMID:20701836

Complex adaptive systems: a tool for interpreting responses and behaviours.

PubMed

Ellis, Beverley

2011-01-01

Quality improvement is a priority for health services worldwide. There are many barriers to implementing change at the locality level and misinterpreting responses and behaviours can effectively block change. Electronic health records will influence the means by which knowledge and information are generated and sustained among those operating quality improvement programmes. To explain how complex adaptive system (CAS) theory provides a useful tool and new insight into the responses and behaviours that relate to quality improvement programmes in primary care enabled by informatics. Case studies in two English localities who participated in the implementation and development of quality improvement programmes. The research strategy included purposefully sampled case studies, conducted within a social constructionist ontological perspective. Responses and behaviours of quality improvement programmes in the two localities include both positive and negative influences associated with a networked model of governance. Pressures of time, resources and workload are common issues, along with the need for education and training about capturing, coding, recording and sharing information held within electronic health records to support various information requirements. Primary care informatics enables information symmetry among those operating quality improvement programmes by making some aspects of care explicit, allowing consensus about quality improvement priorities and implementable solutions.

Analysis of signal to noise enhancement using a highly selective modulation tracking filter

NASA Technical Reports Server (NTRS)

Haden, C. R.; Alworth, C. W.

1972-01-01

Experiments are reported which utilize photodielectric effects in semiconductor loaded superconducting resonant circuits for suppressing noise in RF communication systems. The superconducting tunable cavity acts as a narrow band tracking filter for detecting conventional RF signals. Analytical techniques were developed which lead to prediction of signal-to-noise improvements. Progress is reported in optimization of the experimental variables. These include improved Q, new semiconductors, improved optics, and simplification of the electronics. Information bearing signals were passed through the system, and noise was introduced into the computer model.

Development and test fuel cell powered on-site integrated total energy systems. Phase 3: Full-scale power plant development

NASA Technical Reports Server (NTRS)

Kaufman, A.

1982-01-01

The on-site system application analysis is summarized. Preparations were completed for the first test of a full-sized single cell. Emphasis of the methanol fuel processor development program shifted toward the use of commercial shell-and-tube heat exchangers. An improved method for predicting the carbon-monoxide tolerance of anode catalysts is described. Other stack support areas reported include improved ABA bipolar plate bonding technology, improved electrical measurement techniques for specification-testing of stack components, and anodic corrosion behavior of carbon materials.

23 CFR 972.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... management strategies; (v) Determine methods to monitor and evaluate the performance of the multi-modal... means the level at which transportation system performance is no longer acceptable due to traffic... improve existing transportation system efficiency. Approaches may include the use of alternate mode...

23 CFR 972.214 - Federal lands congestion management system (CMS).

Code of Federal Regulations, 2010 CFR

2010-04-01

... management strategies; (v) Determine methods to monitor and evaluate the performance of the multi-modal... means the level at which transportation system performance is no longer acceptable due to traffic... improve existing transportation system efficiency. Approaches may include the use of alternate mode...

Third International Symposium on Space Mission Operations and Ground Data Systems, part 1

NASA Technical Reports Server (NTRS)

Rash, James L. (Editor)

1994-01-01

Under the theme of 'Opportunities in Ground Data Systems for High Efficiency Operations of Space Missions,' the SpaceOps '94 symposium included presentations of more than 150 technical papers spanning five topic areas: Mission Management, Operations, Data Management, System Development, and Systems Engineering. The papers focus on improvements in the efficiency, effectiveness, productivity, and quality of data acquisition, ground systems, and mission operations. New technology, techniques, methods, and human systems are discussed. Accomplishments are also reported in the application of information systems to improve data retrieval, reporting, and archiving; the management of human factors; the use of telescience and teleoperations; and the design and implementation of logistics support for mission operations.

A Natural Language Processing System That Links Medical Terms in Electronic Health Record Notes to Lay Definitions: System Development Using Physician Reviews.

PubMed

Chen, Jinying; Druhl, Emily; Polepalli Ramesh, Balaji; Houston, Thomas K; Brandt, Cynthia A; Zulman, Donna M; Vimalananda, Varsha G; Malkani, Samir; Yu, Hong

2018-01-22

Many health care systems now allow patients to access their electronic health record (EHR) notes online through patient portals. Medical jargon in EHR notes can confuse patients, which may interfere with potential benefits of patient access to EHR notes. The aim of this study was to develop and evaluate the usability and content quality of NoteAid, a Web-based natural language processing system that links medical terms in EHR notes to lay definitions, that is, definitions easily understood by lay people. NoteAid incorporates two core components: CoDeMed, a lexical resource of lay definitions for medical terms, and MedLink, a computational unit that links medical terms to lay definitions. We developed innovative computational methods, including an adapted distant supervision algorithm to prioritize medical terms important for EHR comprehension to facilitate the effort of building CoDeMed. Ten physician domain experts evaluated the user interface and content quality of NoteAid. The evaluation protocol included a cognitive walkthrough session and a postsession questionnaire. Physician feedback sessions were audio-recorded. We used standard content analysis methods to analyze qualitative data from these sessions. Physician feedback was mixed. Positive feedback on NoteAid included (1) Easy to use, (2) Good visual display, (3) Satisfactory system speed, and (4) Adequate lay definitions. Opportunities for improvement arising from evaluation sessions and feedback included (1) improving the display of definitions for partially matched terms, (2) including more medical terms in CoDeMed, (3) improving the handling of terms whose definitions vary depending on different contexts, and (4) standardizing the scope of definitions for medicines. On the basis of these results, we have improved NoteAid's user interface and a number of definitions, and added 4502 more definitions in CoDeMed. Physician evaluation yielded useful feedback for content validation and refinement of this innovative tool that has the potential to improve patient EHR comprehension and experience using patient portals. Future ongoing work will develop algorithms to handle ambiguous medical terms and test and evaluate NoteAid with patients. ©Jinying Chen, Emily Druhl, Balaji Polepalli Ramesh, Thomas K Houston, Cynthia A Brandt, Donna M Zulman, Varsha G Vimalananda, Samir Malkani, Hong Yu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.01.2018.

How can routine health information systems improve health systems functioning in low- and middle-income countries? Assessing the evidence base.

PubMed

Hotchkiss, David R; Diana, Mark L; Foreit, Karen G Fleischman

2012-01-01

Health system performance depends on production and use of quality health data and information. Routine health information systems (RHIS) are defined as systems that provide information at regular intervals of a year or less to meet predictable information needs. These include paper-based or electronic health records and facility- and district-level management information systems. RHIS are receiving increasing attention as an essential component of efficient, country-owned, integrated national systems. To guide investment decisions on RHIS, evidence is needed on which types of RHIS interventions work and which do not. This chapter is a systematic review of the literature on the evaluation of RHIS interventions in low- and middle-income countries, starting from the premise that investments in RHIS could be better understood and so produce greater benefits than they currently do. We describe the conceptual literature on the determinants of RHIS performance and its role in improving health systems functioning, discuss the evidence base on the effectiveness of strategies to improve RHIS performance, provide an overview of RHIS evaluation challenges, and make suggestions to improve the evidence base. The goal is to help ensure that (a) RHIS interventions are appropriately designed and implemented to improve health systems functioning and (b) resulting RHIS information is used more effectively.

Free-Mass and Interface Configurations of Hammering Mechanisms

NASA Technical Reports Server (NTRS)

Bao, Xiaoqi (Inventor); Sherrit, Stewart (Inventor); Badescu, Mircea (Inventor); Bar-Cohen, Yoseph (Inventor); Askins, Steve (Inventor); Ostlund, Patrick (Inventor)

2015-01-01

The design of the free-mass in an ultrasonic driller/corer (USDC) has been refined in order to improve the performance and operational reliability of the system. In one embodiment, the improvements in performance and operational reliability include decreasing the impact surface area of the free-mass to increase the transfer of impact energy from the piezoelectric transducer and reductions in the likelihood that the system will jam.

Quality and Safety in Health Care, Part XIV: The External Environment and Research for Diagnostic Processes.

PubMed

Harolds, Jay A

2016-09-01

The work system in which diagnosis takes place is affected by the external environment, which includes requirements such as certification, accreditation, and regulations. How errors are reported, malpractice, and the system for payment are some other aspects of the external environment. Improving the external environment is expected to decrease errors in diagnosis. More research on improving the diagnostic process is needed.

VHF Air/Ground Communications for Air Traffic Control: A Decision Tree Approach to System Innovations. Volume 2

DTIC Science & Technology

1993-07-01

GROUND RADIO ISSUES Multiple transmitters and receivers at a common site has been a dfficult integration issue for many communicaton systems...lower data rate vocoders become available. 10. Compatibility of modulation with channel availability and message integrity improvements, including...overrides can use in- frequency and path diversity, integrity improvements band signaling, busy channel overrides, and Frequency diversity and ARQ ARQ is

Potential clinical impact of advanced imaging and computer-aided diagnosis in chest radiology: importance of radiologist's role and successful observer study.

PubMed

Li, Feng

2015-07-01

This review paper is based on our research experience in the past 30 years. The importance of radiologists' role is discussed in the development or evaluation of new medical images and of computer-aided detection (CAD) schemes in chest radiology. The four main topics include (1) introducing what diseases can be included in a research database for different imaging techniques or CAD systems and what imaging database can be built by radiologists, (2) understanding how radiologists' subjective judgment can be combined with technical objective features to improve CAD performance, (3) sharing our experience in the design of successful observer performance studies, and (4) finally, discussing whether the new images and CAD systems can improve radiologists' diagnostic ability in chest radiology. In conclusion, advanced imaging techniques and detection/classification of CAD systems have a potential clinical impact on improvement of radiologists' diagnostic ability, for both the detection and the differential diagnosis of various lung diseases, in chest radiology.

Development of health policy and systems research in Nigeria: lessons for developing countries' evidence-based health policy making process and practice.

PubMed

Uneke, Chigozie J; Ezeoha, Abel E; Ndukwe, Chinwendu D; Oyibo, Patrick G; Onwe, Friday

2010-08-01

Health policy and systems research (HPSR), which aims to produce reliable and rigorous evidence to inform the many critical decisions that must be made about health systems, is a new concept in Nigeria. In this study, policy makers and other stakeholders in the health sector identified the challenges and the potential intervention strategies to HPSR evidence use in policy making in Nigeria. The major challenges identified included capacity constraints at individual and organizational levels, communication gaps and poor networking between policy makers and researchers, and the non-involvement of healthcare recipients in identifying and planning care delivery needs. The main solutions suggested included promotion of strategies to encourage partnership between researchers and policy makers, improvement of staff incentives and facilities for research activities, improved budgetary provision for research, and sustainable institutional capacity development. These strategies have been shown to improve evidence-based policy making in developed countries and are likely to produce better outcomes in the developing world.

Development of Health Policy and Systems Research in Nigeria: Lessons for Developing Countries' Evidence-Based Health Policy Making Process and Practice

PubMed Central

Uneke, Chigozie J.; Ezeoha, Abel E.; Ndukwe, Chinwendu D.; Oyibo, Patrick G.; Onwe, Friday

2010-01-01

Health policy and systems research (HPSR), which aims to produce reliable and rigorous evidence to inform the many critical decisions that must be made about health systems, is a new concept in Nigeria. In this study, policy makers and other stakeholders in the health sector identified the challenges and the potential intervention strategies to HPSR evidence use in policy making in Nigeria. The major challenges identified included capacity constraints at individual and organizational levels, communication gaps and poor networking between policy makers and researchers, and the non-involvement of healthcare recipients in identifying and planning care delivery needs. The main solutions suggested included promotion of strategies to encourage partnership between researchers and policy makers, improvement of staff incentives and facilities for research activities, improved budgetary provision for research, and sustainable institutional capacity development. These strategies have been shown to improve evidence-based policy making in developed countries and are likely to produce better outcomes in the developing world. PMID:21804832

Building knowledge development and exchange capacity in Canada: lessons from Youth Excel.

PubMed

Riley, B; Wong, K; Manske, S

2014-07-01

Youth Excel was a 3-year pan-Canadian initiative to advance youth health through improving knowledge development and exchange (KDE) capacity. KDE capacity refers to an improvement cycle linking evidence and action. Capacities include local surveillance of youth behaviours; knowledge exchange; skills, resources and a supportive environment to use knowledge; and evaluation. Interviews were conducted with Youth Excel members, including 7 provincial teams and 2 national organizations. Interviews explored participant experiences with building KDE capacity. Local surveillance systems were considered the backbone to KDE capacity, strengthened by co-ordinating surveys within and across jurisdictions and using common indicators and measures. The most effective knowledge exchange included tailored products and opportunities for dialogue and action planning. Evaluation is the least developed KDE component. Building KDE capacity requires frequent dialogue, mutually beneficial partnerships and trust. It also requires attention to language, vision, strategic leadership and funding. Youth Excel reinforces the need for a KDE system to improve youth health that will require new perspectives and sustained commitment from individual champions and relevant organizations.

WheatGenome.info: an integrated database and portal for wheat genome information.

PubMed

Lai, Kaitao; Berkman, Paul J; Lorenc, Michal Tadeusz; Duran, Chris; Smits, Lars; Manoli, Sahana; Stiller, Jiri; Edwards, David

2012-02-01

Bread wheat (Triticum aestivum) is one of the most important crop plants, globally providing staple food for a large proportion of the human population. However, improvement of this crop has been limited due to its large and complex genome. Advances in genomics are supporting wheat crop improvement. We provide a variety of web-based systems hosting wheat genome and genomic data to support wheat research and crop improvement. WheatGenome.info is an integrated database resource which includes multiple web-based applications. These include a GBrowse2-based wheat genome viewer with BLAST search portal, TAGdb for searching wheat second-generation genome sequence data, wheat autoSNPdb, links to wheat genetic maps using CMap and CMap3D, and a wheat genome Wiki to allow interaction between diverse wheat genome sequencing activities. This system includes links to a variety of wheat genome resources hosted at other research organizations. This integrated database aims to accelerate wheat genome research and is freely accessible via the web interface at http://www.wheatgenome.info/.

Civil propulsion technology for the next twenty-five years

NASA Technical Reports Server (NTRS)

Rosen, Robert; Facey, John R.

1987-01-01

The next twenty-five years will see major advances in civil propulsion technology that will result in completely new aircraft systems for domestic, international, commuter and high-speed transports. These aircraft will include advanced aerodynamic, structural, and avionic technologies resulting in major new system capabilities and economic improvements. Propulsion technologies will include high-speed turboprops in the near term, very high bypass ratio turbofans, high efficiency small engines and advanced cycles utilizing high temperature materials for high-speed propulsion. Key fundamental enabling technologies include increased temperature capability and advanced design methods. Increased temperature capability will be based on improved composite materials such as metal matrix, intermetallics, ceramics, and carbon/carbon as well as advanced heat transfer techniques. Advanced design methods will make use of advances in internal computational fluid mechanics, reacting flow computation, computational structural mechanics and computational chemistry. The combination of advanced enabling technologies, new propulsion concepts and advanced control approaches will provide major improvements in civil aircraft.

Got (the Right) Milk? How a Blended Quality Improvement Approach Catalyzed Change.

PubMed

Luton, Alexandra; Bondurant, Patricia G; Campbell, Amy; Conkin, Claudia; Hernandez, Jae; Hurst, Nancy

2015-10-01

The expression, storage, preparation, fortification, and feeding of breast milk are common ongoing activities in many neonatal intensive care units (NICUs) today. Errors in breast milk administration are a serious issue that should be prevented to preserve the health and well-being of NICU babies and their families. This paper describes how a program to improve processes surrounding infant feeding was developed, implemented, and evaluated. The project team used a blended quality improvement approach that included the Model for Improvement, Lean and Six Sigma methodologies, and principles of High Reliability Organizations to identify and drive short-term, medium-term, and long-term improvement strategies. Through its blended quality improvement approach, the team strengthened the entire dispensation system for both human milk and formula and outlined a clear vision and plan for further improvements as well. The NICU reduced feeding errors by 83%. Be systematic in the quality improvement approach, and apply proven methods to improving processes surrounding infant feeding. Involve expert project managers with nonclinical perspective to guide work in a systematic way and provide unbiased feedback. Create multidisciplinary, cross-departmental teams that include a vast array of stakeholders in NICU feeding processes to ensure comprehensive examination of current state, identification of potential risks, and "outside the box" potential solutions. As in the realm of pharmacy, the processes involved in preparing feedings for critically ill infants should be carried out via predictable, reliable means including robust automated verification that integrates seamlessly into existing processes. The use of systems employed in pharmacy for medication preparation should be considered in the human milk and formula preparation setting.

SimCenter Hawaii Technology Enabled Learning and Intervention Systems

DTIC Science & Technology

2008-01-01

manikin training in acquiring triage skills and self -efficacy. Phase II includes the development of the VR training scenarios, which includes iterative...Task A5. Skills acquisition relative to self -efficacy study See Appendix F, Mass Casualty Triage Training using Human Patient Simulators Improves...relative to self -efficacy study • See Appendix F, Mass Casualty Triage Training using Human Patient Simulators Improves Speed and Accuracy of First

Geotechnical Centrifuge Experiments to Evaluate Piping in Foundation Soils

DTIC Science & Technology

2014-05-01

verifiable results. These tests were successful in design , construction, and execution of a realistic simulation of internal erosion leading to failure...possible “scale effects,” “modeling of models” testing protocol should be included in the test program. Also, the model design should minimize the scale...recommendations for improving the centrifuge tests include the following: • Design improved system for reservoir control to provide definitive and

Audio-Visual Situational Awareness for General Aviation Pilots

NASA Technical Reports Server (NTRS)

Spirkovska, Lilly; Lodha, Suresh K.; Clancy, Daniel (Technical Monitor)

2001-01-01

Weather is one of the major causes of general aviation accidents. Researchers are addressing this problem from various perspectives including improving meteorological forecasting techniques, collecting additional weather data automatically via on-board sensors and "flight" modems, and improving weather data dissemination and presentation. We approach the problem from the improved presentation perspective and propose weather visualization and interaction methods tailored for general aviation pilots. Our system, Aviation Weather Data Visualization Environment (AWE), utilizes information visualization techniques, a direct manipulation graphical interface, and a speech-based interface to improve a pilot's situational awareness of relevant weather data. The system design is based on a user study and feedback from pilots.

Shuttle waste management system design improvements and flight evaluation

NASA Technical Reports Server (NTRS)

Winkler, H. Eugene; Goodman, Jerry R.; Murray, Robert W.; Mcintosh, Mathew E.

1986-01-01

The Space Shuttle waste management system has undergone a variety of design changes to improve performance and man-machine interface. These design improvements have resulted in more reliable operation and hygienic usage. Design enhancements include individual urinals, increased urine collection airflows, increased solids storage capacity, easier access to personal hygiene items, and additional wet trash stowage. The development and flight evaluation of these improvements are described herein. The Space Shuttle Orbiter has proved to be an invaluable test bed for development and in-flight evaluation of life support and habitability concepts which involve transport or separation of solids, liquids, and gases in a zero-g environment.

Management of local economic and ecological system of coal processing company

NASA Astrophysics Data System (ADS)

Kiseleva, T. V.; Mikhailov, V. G.; Karasev, V. A.

2016-10-01

The management issues of local ecological and economic system of coal processing company - coal processing plant - are considered in the article. The objectives of the research are the identification and the analysis of local ecological and economic system (coal processing company) performance and the proposals for improving the mechanism to support the management decision aimed at improving its environmental safety. The data on the structure of run-of-mine coal processing products are shown. The analysis of main ecological and economic indicators of coal processing enterprises, characterizing the state of its environmental safety, is done. The main result of the study is the development of proposals to improve the efficiency of local enterprise ecological and economic system management, including technical, technological and business measures. The results of the study can be recommended to industrial enterprises to improve their ecological and economic efficiency.

Systems, Stakeholders, and Students: Including Students in School Reform

ERIC Educational Resources Information Center

Zion, Shelley D.

2009-01-01

The education system in the United States is under pressure from a variety of sources to reform and improve the delivery of educational services to students. Change across a system as complex and dynamic as the educational system requires a systemic approach and requires the participation or buy-in of all participants and stakeholders. This…

Family Systems Theory in the Workplace.

ERIC Educational Resources Information Center

Rogers, Vivian

This paper presents a summary of Murray Brown's family systems theory as it applies to the workplace, lists some indicators of when a system is working well, and cites some other guidelines for gauging and improving one's own functioning in the work system. Major concepts of Bowen's theory include: (1) the family and the workplace are systems; (2)…

Better Off with or without Your CMS? 5 Kinds of Assessment That Can Really Help.

ERIC Educational Resources Information Center

Ehrmann, Stephen C.; Gilbert, Steven W.

2003-01-01

Presents five areas to consider to help establish the value and improve the effectiveness of a course management system (CMS). Highlights include faculty use to improve teaching effectiveness; changes in support strategies to improve the value of a CMS; increasing enrollment or retention; controlling costs; and identifying barriers to desired…

Linking the Teacher Appraisal Process to the School Improvement Plan

ERIC Educational Resources Information Center

Reddekopp, Therese

2007-01-01

If a school improvement plan includes input from all stakeholders and focuses on data-driven processes that are linked to teacher appraisal, it can be powerful in leading the school toward the common mission of achieving student success. Linking the school improvement plan to the teacher appraisal process creates a system whereby all individuals…

Financial sustainability of academic health centers: identifying challenges and strategic responses.

PubMed

Stimpson, Jim P; Li, Tao; Shiyanbola, Oyewale O; Jacobson, Janelle J

2014-06-01

Academic health centers (AHCs) play a vital role in the health care system. The training of health care personnel and delivery of health care services, especially to the most complex and financially challenged patients, has been a responsibility increasingly shouldered by AHCs over the years. Additionally, AHCs play a significant role in researching and developing new treatment protocols, including discovering and validating new health technologies. However, AHCs face unique financial challenges in fulfilling their social mission in the health care system. Reforms being implemented under the Affordable Care Act and shifting economic patterns are threatening the financial sustainability of AHCs.The authors review challenges facing AHCs, including training new health care professionals with fewer funding resources, disproportionate clinical care of complex and costly patients, charity care to uninsured and underinsured, and reduced research funding opportunities. Then, they provide a review of some potential solutions to these challenges, including new reimbursement methods, improvements in operational efficiency, price regulation, subsidization of education, improved decision making and communication, utilization of industrial management tools, and increasing internal and external cooperation. Devising solutions to the evolving problems of AHCs is crucial to improving health care delivery in the United States. Most likely, a combination of market, government, and system reforms will be needed to improve the viability of AHCs and assist them in fulfilling their social and organizational missions.

Improved NASTRAN plotting

NASA Technical Reports Server (NTRS)

Chan, Gordon C.

1991-01-01

The new 1991 COSMIC/NASTRAN version, compatible with the older versions, tries to remove some old constraints and make it easier to extract information from the plot file. It also includes some useful improvements and new enhancements. New features available in the 1991 version are described. They include a new PLT1 tape with simplified ASCII plot commands and short records, combined hidden and shrunk plot, an x-y-z coordinate system on all structural plots, element offset plot, improved character size control, improved FIND and NOFIND logic, a new NASPLOT post-prosessor to perform screen plotting or generate PostScript files, and a BASIC/NASTPLOT program for PC.

A Hybrid Approach to Detect Driver Drowsiness Utilizing Physiological Signals to Improve System Performance and Wearability.

PubMed

Awais, Muhammad; Badruddin, Nasreen; Drieberg, Micheal

2017-08-31

Driver drowsiness is a major cause of fatal accidents, injury, and property damage, and has become an area of substantial research attention in recent years. The present study proposes a method to detect drowsiness in drivers which integrates features of electrocardiography (ECG) and electroencephalography (EEG) to improve detection performance. The study measures differences between the alert and drowsy states from physiological data collected from 22 healthy subjects in a driving simulator-based study. A monotonous driving environment is used to induce drowsiness in the participants. Various time and frequency domain feature were extracted from EEG including time domain statistical descriptors, complexity measures and power spectral measures. Features extracted from the ECG signal included heart rate (HR) and heart rate variability (HRV), including low frequency (LF), high frequency (HF) and LF/HF ratio. Furthermore, subjective sleepiness scale is also assessed to study its relationship with drowsiness. We used paired t -tests to select only statistically significant features ( p < 0.05), that can differentiate between the alert and drowsy states effectively. Significant features of both modalities (EEG and ECG) are then combined to investigate the improvement in performance using support vector machine (SVM) classifier. The other main contribution of this paper is the study on channel reduction and its impact to the performance of detection. The proposed method demonstrated that combining EEG and ECG has improved the system's performance in discriminating between alert and drowsy states, instead of using them alone. Our channel reduction analysis revealed that an acceptable level of accuracy (80%) could be achieved by combining just two electrodes (one EEG and one ECG), indicating the feasibility of a system with improved wearability compared with existing systems involving many electrodes. Overall, our results demonstrate that the proposed method can be a viable solution for a practical driver drowsiness system that is both accurate and comfortable to wear.

Wind Turbine Optimization with WISDEM

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

Dykes, Katherine L; Damiani, Rick R; Graf, Peter A

This presentation for the Fourth Wind Energy Systems Engineering Workshop explains the NREL wind energy systems engineering initiative-developed analysis platform and research capability to capture important system interactions to achieve a better understanding of how to improve system-level performance and achieve system-level cost reductions. Topics include Wind-Plant Integrated System Design and Engineering Model (WISDEM) and multidisciplinary design analysis and optimization.

Traffic management centers : the state-of-the-practice : task A : final working paper for design of support systems for advanced traffic management systems

DOT National Transportation Integrated Search

1999-02-01

The goal of the Federal Highway Administration (FHWA) Expert Systems for Crash Data Collection Program was to use expert system technology to improve the accuracy and consistency of police-reported data. The program included the development and evalu...

Refractory Pain Management in Amyloid-Associated Peripheral Neuropathy.

PubMed

Warner, Nafisseh S; Watson, James C; Bendel, Markus A; Moeschler, Susan M

2018-05-01

Systemic amyloidosis is a disease that often involves multiple organ systems, including the peripheral nervous system. Patients may present with severe, refractory neuropathic pain; however, the optimal treatment approach for pain for these patients remains unclear. A man with severe, refractory neuropathic pain in his bilateral upper and lower extremities and the trunk secondary to amyloid neuropathy is presented. Multiple medication trials, including neuropathic and opioid agents, produced considerable adverse effects and minimal relief. Scrambler therapy, a novel electrical stimulation modality, was used and was associated with substantial short-term but nonsustained benefit. Spinal cord stimulation was considered, but given his diffuse symptoms, it was deemed a less-than-optimal approach. Ultimately, an intrathecal drug delivery system was placed with infusion of hydromorphone, resulting in substantial pain reduction in all involved areas and with an improved adverse effect profile. This intervention resulted in immense improvement in the patient's quality of life, despite progression of his systemic amyloidosis. Severe pain in the setting of amyloid neuropathy is often difficult to treat. To our knowledge, this represents the first report of Scrambler therapy or an implanted intrathecal drug delivery system used for a patient with refractory amyloidosis-related neuropathic pain, resulting in substantial analgesic benefit and improved quality of life.

Improved Airborne System for Sensing Wildfires

NASA Technical Reports Server (NTRS)

McKeown, Donald; Richardson, Michael

2008-01-01

The Wildfire Airborne Sensing Program (WASP) is engaged in a continuing effort to develop an improved airborne instrumentation system for sensing wildfires. The system could also be used for other aerial-imaging applications, including mapping and military surveillance. Unlike prior airborne fire-detection instrumentation systems, the WASP system would not be based on custom-made multispectral line scanners and associated custom- made complex optomechanical servomechanisms, sensors, readout circuitry, and packaging. Instead, the WASP system would be based on commercial off-the-shelf (COTS) equipment that would include (1) three or four electronic cameras (one for each of three or four wavelength bands) instead of a multispectral line scanner; (2) all associated drive and readout electronics; (3) a camera-pointing gimbal; (4) an inertial measurement unit (IMU) and a Global Positioning System (GPS) receiver for measuring the position, velocity, and orientation of the aircraft; and (5) a data-acquisition subsystem. It would be necessary to custom-develop an integrated sensor optical-bench assembly, a sensor-management subsystem, and software. The use of mostly COTS equipment is intended to reduce development time and cost, relative to those of prior systems.

airborne data analysis/monitor system

NASA Technical Reports Server (NTRS)

Stephison, D. B.

1981-01-01

An Airborne Data Analysis/Monitor System (ADAMS), a ROLM 1666 computer based system installed onboard test airplanes used during experimental testing is evaluated. In addition to the 1666 computer, the ADAMS hardware includes a DDC System 90 fixed head disk and a Miltape DD400 floppy disk. Boeing designed a DMA interface to the data acquisition system and an intelligent terminal to reduce system overhead and simplify operator commands. The ADAMS software includes RMX/RTOS and both ROLM FORTRAN and assembly language are used. The ADAMS provides real time displays that enable onboard test engineers to make rapid decisions about test conduct thus reducing the cost and time required to certify new model airplanes, and improved the quality of data derived from the test, leading to more rapid development of improvements resulting in quieter, safer, and more efficient airplanes. The availability of airborne data processing removes most of the weather and geographical restrictions imposed by telemetered flight test data systems. A data base is maintained to describe the airplane, the data acquisition system, the type of testing, and the conditions under which the test is performed.

An improved lateral control wheel steering law for the Transport Systems Research Vehicle (TSRV)

NASA Technical Reports Server (NTRS)

Ragsdale, W. A.

1992-01-01

A lateral control wheel steering law with improved performance was developed for the Transport Systems Research Vehicle (TSRV) simulation and used in the Microwave Landing System research project. The control law converted rotational hand controller inputs into roll rate commands, manipulated ailerons, spoilers, and the rudder to achieve the desired roll rates. The system included automatic turn coordination, track angle hold, and autopilot/autoland modes. The resulting control law produced faster roll rates (15 degrees/sec), quicker response to command reversals, and safer bank angle limits, while using a more concise program code.

Development of public science archive system of Subaro Telescope. 2

NASA Astrophysics Data System (ADS)

Yamamoto, Naotaka; Noda, Sachiyo; Taga, Masatoshi; Ozawa, Tomohiko; Horaguchi, Toshihiro; Okumura, Shin-Ichiro; Furusho, Reiko; Baba, Hajime; Yagi, Masafumi; Yasuda, Naoki; Takata, Tadafumi; Ichikawa, Shin-Ichi

2003-09-01

We report various improvements in a public science archive system, SMOKA (Subaru-Mitaka-Okayama-Kiso Archive system). We have developed a new interface to search observational data of minor bodies in the solar system. In addition, the other improvements (1) to search frames by specifying wavelength directly, (2) to find out calibration data set automatically, (3) to browse data on weather, humidity, and temperature, which provide information of image quality, (4) to provide quick-look images of OHS/CISCO and IRCS, and (5) to include the data from OAO HIDES (HIgh Dispersion Echelle Spectrograph), are also summarized.

Investigation of erosion rates of field samples using FDOT's enhanced sediment erosion rate flume (SERF).

DOT National Transportation Integrated Search

2013-09-01

The first part of this project was to enhance and improve the Florida Department of Transportations : Sediment Erosion Rate Flume (SERF) device. Notable improvements include a pump repair, laser : system enhancement, installation of a digital vide...

Methods for Improving Fine-Scale Applications of the WRF-CMAQ Modeling System

EPA Science Inventory

Presentation on the work in AMAD to improve fine-scale (e.g. 4km and 1km) WRF-CMAQ simulations. Includes iterative analysis, updated sea surface temperature and snow cover fields, and inclusion of impervious surface information (urban parameterization).

Recommendations for Highway Construction, Maintenance, and Service Equipment Warning Lights and Pavement Data Collection System Safety

DOT National Transportation Integrated Search

1998-10-01

This report presents the recommendations to improve the vehicle and equipment warning light policy for the Texas Department of Transportation, and improve the safety of the Department's pavement data collection activities. Research efforts include a ...

Using human factors engineering to improve patient safety in the cardiovascular operating room.

PubMed

Gurses, Ayse P; Martinez, Elizabeth A; Bauer, Laura; Kim, George; Lubomski, Lisa H; Marsteller, Jill A; Pennathur, Priyadarshini R; Goeschel, Chris; Pronovost, Peter J; Thompson, David

2012-01-01

Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.

Improving access in gastroenterology: The single point of entry model for referrals

PubMed Central

Novak, Kerri L; Van Zanten, Sander Veldhuyzen; Pendharkar, Sachin R

2013-01-01

In 2005, a group of academic gastroenterologists in Calgary (Alberta) adopted a centralized referral intake system known as central triage. This system provided a single point of entry model (SEM) for referrals rather than the traditional system of individual practitioners managing their own referrals and queues. The goal of central triage was to improve wait times and referral management. In 2008, a similar system was developed in Edmonton at the University of Alberta Hospital (Edmonton, Alberta). SEMs have subsequently been adopted by numerous subspecialties throughout Alberta. There are many benefits of SEMs including improved access and reduced wait times. Understanding and measuring complex patient flow systems is key to improving access, and centralized intake systems provide an opportunity to better understand total demand and system bottlenecks. This knowledge is particularly important for specialties such as gastroenterology (GI), in which demand exceeds supply. While it is anticipated that SEMs will reduce wait times for GI care in Canada, the lack of sufficient resources to meet the demand for GI care necessitates additional strategies. PMID:24040629

Improving access in gastroenterology: the single point of entry model for referrals.

PubMed

Novak, Kerri; Veldhuyzen Van Zanten, Sander; Pendharkar, Sachin R

2013-11-01

In 2005, a group of academic gastroenterologists in Calgary (Alberta) adopted a centralized referral intake system known as central triage. This system provided a single point of entry model (SEM) for referrals rather than the traditional system of individual practitioners managing their own referrals and queues. The goal of central triage was to improve wait times and referral management. In 2008, a similar system was developed in Edmonton at the University of Alberta Hospital (Edmonton, Alberta). SEMs have subsequently been adopted by numerous subspecialties throughout Alberta. There are many benefits of SEMs including improved access and reduced wait times. Understanding and measuring complex patient flow systems is key to improving access, and centralized intake systems provide an opportunity to better understand total demand and system bottlenecks. This knowledge is particularly important for specialties such as gastroenterology (GI), in which demand exceeds supply. While it is anticipated that SEMs will reduce wait times for GI care in Canada, the lack of sufficient resources to meet the demand for GI care necessitates additional strategies.

Analysis of initial performance of Solergy's HCPV/T system at Rome-Fiumicino International Airport

NASA Astrophysics Data System (ADS)

Micheli, Leonardo; Femia, Giuseppe; Liani, Martina; Poli, Ruggero; Banin, Yoav; Lanzara, Giovanni; Kurtz, Sarah

2017-09-01

A commercial HCPV/T system, developed by Solergy, is installed at the airport of Rome, in Italy, as part of a prototype smart grid. The system is rated at 15 kW AC electric and 20 kW thermal and is used to provide both electricity for charging electric vehicles and heat for a conventional thermal power plant. This paper presents an analysis of the performance of the system, operating since March 2017, which achieves a combined peak efficiency of 48%. This study incorporates also an investigation on the improvements that can benefit the system, including a new type of receiver with improved heat dissipation.

The impact of emerging technologies on an advanced supersonic transport

NASA Technical Reports Server (NTRS)

Driver, C.; Maglieri, D. J.

1986-01-01

The effects of advances in propulsion systems, structure and materials, aerodynamics, and systems on the design and development of supersonic transport aircraft are analyzed. Efficient propulsion systems with variable-cycle engines provide the basis for improved propulsion systems; the propulsion efficienies of supersonic and subsonic engines are compared. Material advances consist of long-life damage-tolerant structures, advanced material development, aeroelastic tailoring, and low-cost fabrication. Improvements in the areas of aerodynamics and systems are examined. The environmental problems caused by engine emissions, airport noise, and sonic boom are studied. The characteristics of the aircraft designed to include these technical advances are described.

V-shaped resonators for addition of broad-area laser diode arrays

DOEpatents

Liu, Bo; Liu, Yun; Braiman, Yehuda Y.

2012-12-25

A system and method for addition of broad-area semiconductor laser diode arrays are described. The system can include an array of laser diodes, a V-shaped external cavity, and grating systems to provide feedback for phase-locking of the laser diode array. A V-shaped mirror used to couple the laser diode emissions along two optical paths can be a V-shaped prism mirror, a V-shaped stepped mirror or include multiple V-shaped micro-mirrors. The V-shaped external cavity can be a ring cavity. The system can include an external injection laser to further improve coherence and phase-locking.

36 CFR 251.56 - Terms and conditions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... authorizing noncommercial group uses of National Forest System lands. Section 251.56(a)(1)(ii)(G) provides... include the protection of resources and improvements on National Forest System lands, the allocation of.... (2) Authorizations for use of National Forest System lands may be conditioned to require State...

36 CFR 251.56 - Terms and conditions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... authorizing noncommercial group uses of National Forest System lands. Section 251.56(a)(1)(ii)(G) provides... include the protection of resources and improvements on National Forest System lands, the allocation of.... (2) Authorizations for use of National Forest System lands may be conditioned to require State...

Theory of constraints for publicly funded health systems.

PubMed

Sadat, Somayeh; Carter, Michael W; Golden, Brian

2013-03-01

Originally developed in the context of publicly traded for-profit companies, theory of constraints (TOC) improves system performance through leveraging the constraint(s). While the theory seems to be a natural fit for resource-constrained publicly funded health systems, there is a lack of literature addressing the modifications required to adopt TOC and define the goal and performance measures. This paper develops a system dynamics representation of the classical TOC's system-wide goal and performance measures for publicly traded for-profit companies, which forms the basis for developing a similar model for publicly funded health systems. The model is then expanded to include some of the factors that affect system performance, providing a framework to apply TOC's process of ongoing improvement in publicly funded health systems. Future research is required to more accurately define the factors affecting system performance and populate the model with evidence-based estimates for various parameters in order to use the model to guide TOC's process of ongoing improvement.

Developing Drought Outlook Forums in Support of a Regional Drought Early Warning Information System

NASA Astrophysics Data System (ADS)

Mcnutt, C. A.; Pulwarty, R. S.; Darby, L. S.; Verdin, J. P.; Webb, R. S.

2011-12-01

The National Integrated Drought Information System (NIDIS) Act of 2006 (P.L. 109-430) charged NIDIS with developing the leadership and partnerships necessary to implement an integrated national drought monitoring and forecasting system that creates a drought "early warning system". The drought early warning information system should be capable of providing accurate, timely and integrated information on drought conditions at the relevant spatial scale to facilitate proactive decisions aimed at minimizing the economic, social and ecosystem losses associated with drought. As part of this effort, NIDIS has held Regional Drought Outlook Forums in several regions of the U.S. The purpose of the Forums is to inform practices that reduce vulnerability to drought through an interactive and collaborative process that includes the users of the information. The Forums have focused on providing detailed assessments of present conditions and impacts, comparisons with past drought events, and seasonal predictions including discussion of the state and expected evolution of the El Niño Southern Oscillation phenomena. Regional Climate Outlook Forums (RCOFs) that include close interaction between information providers and users are not a new concept, however. RCOFs started in Africa in the 1990s in response to the 1997-98 El Niño and have since expanded to South America, Asia, the Pacific islands, and the Caribbean. As a result of feedback from the RCOFs a large body of research has gone into improving seasonal forecasts and the capacity of the users to apply the information in a way that improves their decision-making. Over time, it has become clear that more is involved than just improving the interaction between the climate forecasters and decision-makers. NIDIS is using the RCOF approach as one component in a larger effort to develop Regional Drought Early Warning Information Systems (RDEWS) around the U.S. Using what has been learned over the past decade in the RCOF process, NIDIS is working with existing regional and local networks to develop outlook forums as part of an integrated process that involves closer coordination of drought monitoring among federal, state, and local groups; a research component that can address gaps in understanding that are identified in the outlook forum process; a drought information portal (www.drought.gov) for improving communication; an education and outreach component that improves understanding to apply the information; and close coordination with the preparedness community that includes state and local planners for improved mainstreaming of the information into decisions and policies. These components allow for a mutual learning process that encourages critical assessment of the information, builds trust and identifies how information is used to reduce vulnerability and risk associated with the impacts of drought. This process also identifies the key contacts in the region that can maximize dissemination of the information including local media, and provides an ongoing dialogue that allows for feedback and improvement of the process.

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

Widergren, Steven E.; Knight, Mark R.; Melton, Ronald B.

The Interoperability Strategic Vision whitepaper aims to promote a common understanding of the meaning and characteristics of interoperability and to provide a strategy to advance the state of interoperability as applied to integration challenges facing grid modernization. This includes addressing the quality of integrating devices and systems and the discipline to improve the process of successfully integrating these components as business models and information technology improve over time. The strategic vision for interoperability described in this document applies throughout the electric energy generation, delivery, and end-use supply chain. Its scope includes interactive technologies and business processes from bulk energy levelsmore » to lower voltage level equipment and the millions of appliances that are becoming equipped with processing power and communication interfaces. A transformational aspect of a vision for interoperability in the future electric system is the coordinated operation of intelligent devices and systems at the edges of grid infrastructure. This challenge offers an example for addressing interoperability concerns throughout the electric system.« less

Promoting Conceptual Change for Complex Systems Understanding: Outcomes of an Agent-Based Participatory Simulation

NASA Astrophysics Data System (ADS)

Rates, Christopher A.; Mulvey, Bridget K.; Feldon, David F.

2016-08-01

Components of complex systems apply across multiple subject areas, and teaching these components may help students build unifying conceptual links. Students, however, often have difficulty learning these components, and limited research exists to understand what types of interventions may best help improve understanding. We investigated 32 high school students' understandings of complex systems components and whether an agent-based simulation could improve their understandings. Pretest and posttest essays were coded for changes in six components to determine whether students showed more expert thinking about the complex system of the Chesapeake Bay watershed. Results showed significant improvement for the components Emergence ( r = .26, p = .03), Order ( r = .37, p = .002), and Tradeoffs ( r = .44, p = .001). Implications include that the experiential nature of the simulation has the potential to support conceptual change for some complex systems components, presenting a promising option for complex systems instruction.

A Real-Time System for Lane Detection Based on FPGA and DSP

NASA Astrophysics Data System (ADS)

Xiao, Jing; Li, Shutao; Sun, Bin

2016-12-01

This paper presents a real-time lane detection system including edge detection and improved Hough Transform based lane detection algorithm and its hardware implementation with field programmable gate array (FPGA) and digital signal processor (DSP). Firstly, gradient amplitude and direction information are combined to extract lane edge information. Then, the information is used to determine the region of interest. Finally, the lanes are extracted by using improved Hough Transform. The image processing module of the system consists of FPGA and DSP. Particularly, the algorithms implemented in FPGA are working in pipeline and processing in parallel so that the system can run in real-time. In addition, DSP realizes lane line extraction and display function with an improved Hough Transform. The experimental results show that the proposed system is able to detect lanes under different road situations efficiently and effectively.

Improvements and Extensions for Joint Polar Satellite System Algorithms

NASA Astrophysics Data System (ADS)

Grant, K. D.

2016-12-01

The National Oceanic and Atmospheric Administration (NOAA) and National Aeronautics and Space Administration (NASA) are jointly acquiring the next-generation civilian weather satellite system: the Joint Polar Satellite System (JPSS). JPSS replaced the afternoon orbit component and ground processing of the old POES system managed by NOAA. JPSS satellites carry sensors designed to collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The ground processing system for JPSS is the Common Ground System (CGS), and provides command, control, and communications (C3), data processing and product delivery. CGS's data processing capability provides environmental data products (Sensor Data Records (SDRs) and Environmental Data Records (EDRs)) to the NOAA Satellite Operations Facility. The first satellite in the JPSS constellation, S-NPP, was launched in October 2011. The second satellite, JPSS-1, is scheduled for launch in January 2017. During a satellite's calibration and validation (Cal/Val) campaign, numerous algorithm updates occur. Changes identified during Cal/Val become available for implementation into the operational system for both S-NPP and JPSS-1. In addition, new capabilities, such as higher spectral and spatial resolution, will be exercised on JPSS-1. This paper will describe changes to current algorithms and products as a result of S-NPP Cal/Val and related initiatives for improved capabilities. Improvements include Cross Track Infrared Sounder high spectral processing, extended spectral and spatial ranges for Ozone Mapping and Profiler Suite ozone Total Column and Nadir Profiles, and updates to Vegetation Index, Snow Cover, Active Fires, Suspended Matter, and Ocean Color. Updates will include Sea Surface Temperature, Cloud Mask, Cloud Properties, and other improvements.

48 CFR 2.101 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... support or improve: organizational policy development; decision-making; management and administration... organizations, activities (including management and support services for R&D activities), or systems. These..., decision-making, management, or administration. Included are studies in support of R&D activities. Also...

48 CFR 2.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... support or improve: organizational policy development; decision-making; management and administration... organizations, activities (including management and support services for R&D activities), or systems. These..., decision-making, management, or administration. Included are studies in support of R&D activities. Also...

Vehicle trust management for connected vehicles : final research report.

DOT National Transportation Integrated Search

2016-01-01

The goal of this project is to research a wide range of transportation-related issues : including: improving health and safety for all users of the transportation system, including : bicycles, pedestrians and transit modes; reducing carbon emissions ...

Robotics in Cardiac Surgery: Past, Present, and Future

PubMed Central

Bush, Bryan; Nifong, L. Wiley; Chitwood, W. Randolph

2013-01-01

Robotic cardiac operations evolved from minimally invasive operations and offer similar theoretical benefits, including less pain, shorter length of stay, improved cosmesis, and quicker return to preoperative level of functional activity. The additional benefits offered by robotic surgical systems include improved dexterity and degrees of freedom, tremor-free movements, ambidexterity, and the avoidance of the fulcrum effect that is intrinsic when using long-shaft endoscopic instruments. Also, optics and operative visualization are vastly improved compared with direct vision and traditional videoscopes. Robotic systems have been utilized successfully to perform complex mitral valve repairs, coronary revascularization, atrial fibrillation ablation, intracardiac tumor resections, atrial septal defect closures, and left ventricular lead implantation. The history and evolution of these procedures, as well as the present status and future directions of robotic cardiac surgery, are presented in this review. PMID:23908867

Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.

PubMed

Hemens, Brian J; Holbrook, Anne; Tonkin, Marita; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

Computerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit. We conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements. CCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.

An experimental investigation of the flow physics of high-lift systems

NASA Technical Reports Server (NTRS)

Thomas, Flint O.; Nelson, R. C.

1995-01-01

This progress report, a series of viewgraphs, outlines experiments on the flow physics of confluent boundary layers for high lift systems. The design objective is to design high lift systems with improved C(sub Lmax) for landing approach and improved take-off L/D and simultaneously reduce acquisition and maintenance costs. In effect, achieve improved performance with simpler designs. The research objectives include: establish the role of confluent boundary layer flow physics in high-lift production; contrast confluent boundary layer structure for optimum and non-optimum C(sub L) cases; formation of a high quality, detailed archival data base for CFD/modeling; and examination of the role of relaminarization and streamline curvature.

Comparative health systems research among Kaiser Permanente and other integrated delivery systems: a systematic literature review.

PubMed

Maeda, Jared Lane K; Lee, Karen M; Horberg, Michael

2014-01-01

Because of rising health care costs, wide variations in quality, and increased patient complexity, the US health care system is undergoing rapid changes that include payment reform and movement toward integrated delivery systems. Well-established integrated delivery systems, such as Kaiser Permanente (KP), should work to identify the specific system-level factors that result in superior patient outcomes in response to policymakers' concerns. Comparative health systems research can provide insights into which particular aspects of the integrated delivery system result in improved care delivery. To provide a baseline understanding of comparative health systems research related to integrated delivery systems and KP. Systematic literature review. We conducted a literature search on PubMed and the KP Publications Library. Studies that compared KP as a system or organization with other health care systems or across KP facilities internally were included. The literature search identified 1605 articles, of which 65 met the study inclusion criteria and were examined by 3 reviewers. Most comparative health systems studies focused on intra-KP comparisons (n = 42). Fewer studies compared KP with other US (n = 15) or international (n = 12) health care systems. Several themes emerged from the literature as possible factors that may contribute to improved care delivery in integrated delivery systems. Of all studies published by or about KP, only a small proportion of articles (4%) was identified as being comparative health systems research. Additional empirical studies that compare the specific factors of the integrated delivery system model with other systems of care are needed to better understand the "system-level" factors that result in improved and/or diminished care delivery.

Molecular Signatures in Skin Associated with Clinical Improvement During Mycophenolate Treatment in Systemic Sclerosis

PubMed Central

Hinchcliff, Monique; Huang, Chiang-Ching; Wood, Tammara A.; Mahoney, J. Matthew; Martyanov, Viktor; Bhattacharyya, Swati; Tamaki, Zenshiro; Lee, Jungwha; Carns, Mary; Podlusky, Sofia; Sirajuddin, Arlene; Shah, Sanjiv J; Chang, Rowland W.; Lafyatis, Robert; Varga, John; Whitfield, Michael L.

2013-01-01

Heterogeneity in systemic sclerosis/SSc confounds clinical trials. We previously identified ‘intrinsic’ gene expression subsets by analysis of SSc skin. Here we test the hypotheses that skin gene expression signatures including intrinsic subset are associated with skin score/MRSS improvement during mycophenolate mofetil (MMF) treatment. Gene expression and intrinsic subset assignment were measured in 12 SSc patients’ biopsies and ten controls at baseline, and from serial biopsies of one cyclophosphamide-treated patient, and nine MMF-treated patients. Gene expression changes during treatment were determined using paired t-tests corrected for multiple hypothesis testing. MRSS improved in four of seven MMF-treated patients classified as the inflammatory intrinsic subset. Three patients without MRSS improvement were classified as normal-like or fibroproliferative intrinsic subsets. 321 genes (FDR <5%) were differentially expressed at baseline between patients with and without MRSS improvement during treatment. Expression of 571 genes (FDR <10%) changed between pre- and post-MMF treatment biopsies for patients demonstrating MRSS improvement. Gene expression changes in skin are only seen in patients with MRSS improvement. Baseline gene expression in skin, including intrinsic subset assignment, may identify SSc patients whose MRSS will improve during MMF treatment, suggesting that gene expression in skin may allow targeted treatment in SSc. PMID:23677167

Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

PubMed

Samuel, Cleo A; Turner, Kea; Donovan, Heidi A S; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

2017-12-01

Adjuvant endocrine therapy (AET) utilization is linked to improved clinical outcomes among breast cancer survivors (BCS); yet, AET adherence rates remain suboptimal. Little is known about provider perspectives regarding barriers and facilitators to AET-related symptom management (SM). In this study, we examined provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. We conducted three focus groups (FGs) with a multidisciplinary group of healthcare providers (n = 13) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM. FGs were audiotaped, transcribed, and analyzed using qualitative software to identify key themes. Providers described patient-, provider-, and system-level barriers and facilitators to AET-related SM. At the patient-level, barriers included competing demands, limited time/resources, and possible misattribution of some symptoms to AET, while family/social relationships and insurance emerged as important facilitators. Discomfort with SM, limited time, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Provider-level facilitators included routine symptom documentation and strong provider relationships. Care fragmentation and complexity of the cancer care delivery system were described as system-level barriers; however, survivor clinics were endorsed by providers. Provider perspectives on AET-related SM can shed light on SM barriers and facilitators spanning multiple levels of the cancer care delivery system. Strategies for improving AET-related SM in BCS include increasing patients' knowledge and engagement in SM, equipping providers with efficient SM strategies, and improving coordination of symptom-related services through survivorship programs.

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004-2012.

PubMed

Hamel, Donald J; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T; Okonkwo, Prosper; Kanki, Phyllis J

From 2004-2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President's Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings.

An improved method for design of expansion-chamber mufflers with application to an operational helicopter

NASA Technical Reports Server (NTRS)

Parrott, T. L.

1973-01-01

An improved method for the design of expansion-chamber mufflers is described and applied to the task of reducing exhaust noise generated by a helicopter. The method is an improvement of standard transmission-line theory in that it accounts for the effect of the mean exhaust-gas flow on the acoustic-transmission properties of a muffler system, including the termination boundary condition. The method has been computerized, and the computer program includes an optimization procedure that adjusts muffler component lengths to achieve a minimum specified desired transmission loss over a specified frequency range. A printout of the program is included together with a user-oriented description.

Final Technical Report for GO15056 Millennium Cell: Development of an Advanced Chemical Hydrogen Storage and Generation System

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

Moreno, Oscar

The objectives of this project are to increase system storage capacity by improving hydrogen generation from concentrated sodium borohydride, with emphasis on reactor and system engineering; to complete a conceptual system design based on sodium borohydride that will include key technology improvements to enable a hydrogen fuel system that will meet the systembased storage capacity of 1.2 kWh/L (36 g H2/L) and 1.5 kWh/kg (45 g H2/kg), by the end of FY 2007; and to utilize engineering expertise to guide Center research in both off-board chemical hydride regeneration and on-board hydrogen generation systems.

Direct modeling parameter signature analysis and failure mode prediction of physical systems using hybrid computer optimization

NASA Technical Reports Server (NTRS)

Drake, R. L.; Duvoisin, P. F.; Asthana, A.; Mather, T. W.

1971-01-01

High speed automated identification and design of dynamic systems, both linear and nonlinear, are discussed. Special emphasis is placed on developing hardware and techniques which are applicable to practical problems. The basic modeling experiment and new results are described. Using the improvements developed successful identification of several systems, including a physical example as well as simulated systems, was obtained. The advantages of parameter signature analysis over signal signature analysis in go-no go testing of operational systems were demonstrated. The feasibility of using these ideas in failure mode prediction in operating systems was also investigated. An improved digital controlled nonlinear function generator was developed, de-bugged, and completely documented.

Li-Ion Electrolytes with Improved Safety and Tolerance to High-Voltage Systems

NASA Technical Reports Server (NTRS)

Smart, Marshall C.; Bugga, Ratnakumar V.; Prakash, Surya; Krause, Frederick C.

2013-01-01

Given that lithium-ion (Li-ion) technology is the most viable rechargeable energy storage device for near-term applications, effort has been devoted to improving the safety characteristics of this system. Therefore, extensive effort has been devoted to developing nonflammable electrolytes to reduce the flammability of the cells/battery. A number of promising electrolytes have been developed incorporating flame-retardant additives, and have been shown to have good performance in a number of systems. However, these electrolyte formulations did not perform well when utilizing carbonaceous anodes with the high-voltage materials. Thus, further development was required to improve the compatibility. A number of Li-ion battery electrolyte formulations containing a flame-retardant additive [i.e., triphenyl phosphate (TPP)] were developed and demonstrated in high-voltage systems. These electrolytes include: (1) formulations that incorporate varying concentrations of the flame-retardant additive (from 5 to 15%), (2) the use of mono-fluoroethylene carbonate (FEC) as a co-solvent, and (3) the use of LiBOB as an electrolyte additive intended to improve the compatibility with high-voltage systems. Thus, improved safety has been provided without loss of performance in the high-voltage, high-energy system.

Solar collector mounting and support apparatus

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

Hutchison, J.A.

1981-12-22

A solar collector system is described of the type having a movable surface for receiving solar radiation having improved means for rotatably supporting the movable surface and for rotating the collector surface. A support axle for the collector includes a ball at one end which is carried within a cylindrical sleeve in the solar collector to support the weight of the collector. A torque transmitting arm comprising a flexible flat strip is connected at one end to the axle and at the other end to the collector surface. An improved rotational drive mechanism includes a first sprocket wheel carried onmore » the axle and a second sprocket wheel supported on a support pylon with a drive chain engaging both sprockets. A double acting piston also supported by the pylon is coupled to the chain so that the chain may be driven by a hydraulic control system to rotate the collector surfaces as required. An improved receiver tube support ring is also provided for use with the improved mounting and support apparatus to improve overall efficiency by reducing thermal losses.« less

Near-misses are an opportunity to improve patient safety: adapting strategies of high reliability organizations to healthcare.

PubMed

Van Spall, Harriette; Kassam, Alisha; Tollefson, Travis T

2015-08-01

Near-miss investigations in high reliability organizations (HROs) aim to mitigate risk and improve system safety. Healthcare settings have a higher rate of near-misses and subsequent adverse events than most high-risk industries, but near-misses are not systematically reported or analyzed. In this review, we will describe the strategies for near-miss analysis that have facilitated a culture of safety and continuous quality improvement in HROs. Near-miss analysis is routine and systematic in HROs such as aviation. Strategies implemented in aviation include the Commercial Aviation Safety Team, which undertakes systematic analyses of near-misses, so that findings can be incorporated into Standard Operating Procedures (SOPs). Other strategies resulting from incident analyses include Crew Resource Management (CRM) for enhanced communication, situational awareness training, adoption of checklists during operations, and built-in redundancy within systems. Health care organizations should consider near-misses as opportunities for quality improvement. The systematic reporting and analysis of near-misses, commonplace in HROs, can be adapted to health care settings to prevent adverse events and improve clinical outcomes.

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

PubMed

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

2017-07-01

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

Spray nozzle investigation for the Improved Helicopter Icing Spray System (IHISS)

NASA Technical Reports Server (NTRS)

Peterson, Andrew A.; Oldenburg, John R.

1990-01-01

A contract has been awarded by the U.S. Army to design, fabricate and test a replacement for the existing Helicopter Icing Spray System. Data are shown for extensive bench and icing tunnel test programs used to select and modify an improved spray nozzle. The IHISS, capable of deployment from any CH-47 helicopter, will include new icing spray nozzles and pneumatic pressure source, and a significantly larger water tank and spray boom. The resulting system will provide a significantly larger icing cloud with droplet characteristics closely matching natural icing conditions.

A Framework for Measurement Feedback to Improve Decision-Making in Mental Health

PubMed Central

Chorpita, Bruce F.; Reay, William E.; Stelk, Wayne; Garland, Ann F.; Kutash, Krista; Mullican, Charlotte; Ringeisen, Heather

2009-01-01

The authors present a multi-level framework for conceptualizing and designing measurement systems to improve decision-making in the treatment and prevention of child and adolescent mental health problems as well as the promotion of well-being. Also included is a description of the recommended drivers of the development and refinement of these measurement systems and the importance of the architecture upon which these measurement systems are built. The authors conclude with a set of recommendations for the next steps for the field. PMID:20041342

Systems Engineering Education Development(SEED)Case Study

NASA Technical Reports Server (NTRS)

Bagg, Thomas C., III; Brumfield, Mark D.; Jamison, Donald E.; Granata, Raymond L.; Casey, Carolyn A.

2003-01-01

The Systems Engineering Development Program (SEED) was initiated to help Goddard resolve a Systems Engineering skill shortage. The chronology of events and the experiences of the pilot program are outlined to describe the development of the present program. The program goals are included in order to give a focus on what the developers saw as the program drivers. Lessons learned from a pilot program were incorporated into the present program. This program is constantly learning from its past efforts and looks for continuous improvement. We list several future ideas for improvement and change.

Third International Symposium on Space Mission Operations and Ground Data Systems, part 2

NASA Technical Reports Server (NTRS)

Rash, James L. (Editor)

1994-01-01

Under the theme of 'Opportunities in Ground Data Systems for High Efficiency Operations of Space Missions,' the SpaceOps '94 symposium included presentations of more than 150 technical papers spanning five topic areas: Mission Management, Operations, Data Management, System Development, and Systems Engineering. The symposium papers focus on improvements in the efficiency, effectiveness, and quality of data acquisition, ground systems, and mission operations. New technology, methods, and human systems are discussed. Accomplishments are also reported in the application of information systems to improve data retrieval, reporting, and archiving; the management of human factors; the use of telescience and teleoperations; and the design and implementation of logistics support for mission operations. This volume covers expert systems, systems development tools and approaches, and systems engineering issues.

Efficacy of Local and Systemic Antimicrobials in the Non-Surgical Treatment of Smokers With Chronic Periodontitis: A Systematic Review.

PubMed

Chambrone, Leandro; Vargas, Miguel; Arboleda, Silie; Serna, Maritza; Guerrero, Marcela; de Sousa, Jose; Lafaurie, Gloria Inés

2016-11-01

The aim of this systematic review is to evaluate whether use of local or systemic antimicrobials would improve clinical results of non-surgical periodontal therapy for smokers with chronic periodontitis (CP). Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, and The Cochrane Central Register of Controlled Trials were searched up to and including March 2016. Randomized clinical trials of duration of at least 6 months were included if they reported on treatment of smokers (≥10 cigarettes per day for minimum 12 months) with CP with non-surgical periodontal therapy either alone or associated with local or systemic antimicrobials. Random-effects meta-analyses were undertaken to evaluate mean differences in probing depth (PD) and clinical attachment level (CAL). Of 108 potentially eligible articles, seven were included. Most individual studies (75%) testing locally delivered antibiotics reported that smokers benefited from this treatment approach. Pooled estimates found additional PD reduction of 0.81 mm (P = 0.01) and CAL gain of 0.91 mm (P = 0.01) at sites with baseline PD ≥5 mm. Conversely, meta-analysis on systemic use of antimicrobials failed to detect significant differences in mean changes from baseline, and only one trial supported their use. In smokers with CP, adjunctive use of local antimicrobials improved efficacy of non-surgical periodontal therapy in reducing PD and improving CAL at sites presenting PD ≥5 mm before treatment. Current evidence does not demonstrate similar gains when scaling and root planing plus systemic antimicrobial/antibiotics were associated with therapy.

Measure Guideline. Steam System Balancing and Tuning for Multifamily Residential Buildings

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

Choi, Jayne; Ludwig, Peter; Brand, Larry

2013-04-01

This guideline provides building owners, professionals involved in multifamily audits, and contractors insights for improving the balance and tuning of steam systems. It provides readers an overview of one-pipe steam heating systems, guidelines for evaluating steam systems, typical costs and savings, and guidelines for ensuring quality installations. It also directs readers to additional resources for details not included here. Measures for balancing a distribution system that are covered include replacing main line vents and upgrading radiator vents. Also included is a discussion on upgrading boiler controls and the importance of tuning the settings on new or existing boiler controls. Themore » guideline focuses on one-pipe steam systems, though many of the assessment methods can be generalized to two-pipe steam systems.« less

Improving feed efficiency in dairy production systems – challenges and possibilities

USDA-ARS?s Scientific Manuscript database

Improving production efficiency has always been a goal of animal agriculture to ensure an abundant food and fiber supply, and to maintain producer profitability. In recent decades, the concept of sustainable agriculture emerged, which includes the additional goals of safeguarding natural resources, ...

The Business of Art Education: A Fairytale Adventure

ERIC Educational Resources Information Center

Buda, Sharon; Fedorenko, Jan; Sheridan, Mary A.

2012-01-01

School reform initiatives designed to improve school quality require strong leadership, strategic planning, data analysis, and systemized performance accountability. Utilizing school reforms includes rethinking curriculum and instruction to improve quality and promote equality, restructuring school operations with a focus on both the students and…

Reengineering the laboratory: strategic process and systems innovation to improve performance. Recreating our role on the health-care team.

PubMed

Johnson, E

1995-01-01

The author describes reengineering efforts in the laboratory of a 550-bed hospital. Key benefits include reduced costs, improved turnaround time, and redirection of staff into new roles in information management and outreach.

Biomass district heating methodology and pilot installations for public buildings groups

NASA Astrophysics Data System (ADS)

Chatzistougianni, N.; Giagozoglou, E.; Sentzas, K.; Karastergios, E.; Tsiamitros, D.; Stimoniaris, D.; Stomoniaris, A.; Maropoulos, S.

2016-11-01

The objective of the paper is to show how locally available biomass can support a small-scale district heating system of public buildings, especially when taking into account energy audit in-situ measurements and energy efficiency improvement measures. The step-by-step methodology is presented, including the research for local biomass availability, the thermal needs study and the study for the biomass district heating system, with and without energy efficiency improvement measures.

Improving Students' Chinese Writing Abilities in Taiwan with the "Conditioned Writing System"

ERIC Educational Resources Information Center

Liu, Yuan-Chen; Lee, Wan-Chun; Huang, Tzu-Hua; Hsieh, Hsiao-Mei

2012-01-01

This research investigates students' performance while writing Chinese essays using an interactive online writing system. Participants include students from two seventh-grade classes of a junior high school in Taoyuan County, Taiwan. The experimental group uses the conditioned writing interactive online system, while the control group receives…

7 CFR 4280.115 - RES and EEI grant funding.

Code of Federal Regulations, 2014 CFR

2014-01-01

... contributions are acceptable for renewable energy system projects, including those that are eligible for Federal... General Renewable Energy System and Energy Efficiency Improvement Grants § 4280.115 RES and EEI grant... this section, as long as the items are an integral and necessary part of the renewable energy system or...

7 CFR 4280.115 - RES and EEI grant funding.

Code of Federal Regulations, 2012 CFR

2012-01-01

... contributions are acceptable for renewable energy system projects, including those that are eligible for Federal... General Renewable Energy System and Energy Efficiency Improvement Grants § 4280.115 RES and EEI grant... this section, as long as the items are an integral and necessary part of the renewable energy system or...

7 CFR 4280.115 - RES and EEI grant funding.

Code of Federal Regulations, 2013 CFR

2013-01-01

... contributions are acceptable for renewable energy system projects, including those that are eligible for Federal... General Renewable Energy System and Energy Efficiency Improvement Grants § 4280.115 RES and EEI grant... this section, as long as the items are an integral and necessary part of the renewable energy system or...

Methodologies For Evaluating The Impact On Safety Of Intelligent Vehicle Highway Systems

DOT National Transportation Integrated Search

1994-01-01

THE IVHS PROGRAM INCLUDES A WIDE VARIETY OF TYPES OF SYSTEMS ALL OF WHICH ARE INTENDED TO IMPROVE SOME ASPECT OF HIGHWAY TRAVEL. AS THESE SYSTEMS EVOLVE, IT IS IMPORTANT TO KNOW IF THEY ARE ACCOMPLISHING THEIR DESIGN GOALS; AND IT IS ALSO IMPORTANT T...

An Expert System for On-Site Instructional Advice.

ERIC Educational Resources Information Center

Martindale, Elizabeth S.; Hofmeister, Alan M.

1988-01-01

Describes Written Language Consultant, an expert system designed to help teachers teach special education students how to write business letters. Three main components of the system are described, including entry of students' test scores; analysis of teachers' uses of classroom time and management techniques; and suggestions for improving test…

Process Improvement Through Tool Integration in Aero-Mechanical Design

NASA Technical Reports Server (NTRS)

Briggs, Clark

2010-01-01

Emerging capabilities in commercial design tools promise to significantly improve the multi-disciplinary and inter-disciplinary design and analysis coverage for aerospace mechanical engineers. This paper explores the analysis process for two example problems of a wing and flap mechanical drive system and an aircraft landing gear door panel. The examples begin with the design solid models and include various analysis disciplines such as structural stress and aerodynamic loads. Analytical methods include CFD, multi-body dynamics with flexible bodies and structural analysis. Elements of analysis data management, data visualization and collaboration are also included.

Integrated heart failure telemonitoring system for homecare.

PubMed

Lobodzinski, S Suave; Jadalla, Ahlam A

2010-01-01

The integrated telemonitoring system (ITS) for homecare has been designed to improve quality of care as measured by increased nursing productivity, improved patients' clinical and behavioral outcomes and reduction of cost. The system incorporates managerial, organizational, operational and clinical tasks optimized for delivery of quality care through telemonitoring. A secure, multi-modal computer network that integrates homecare nurses, patients and those who care into one seamless environment has been developed. The network brings together a new generation of small, hand-held, wireless terminals used by nurses and patients with a HIPPA-compliant electronic patient record system at the caregiver's site. Wireless terminals use Gobi multi-standard networking technology for connectivity to any available wireless network. The unique features of ITS include a) picture recognition technology capable of extracting numeric data from in-home physiological signal monitor displays that include blood pressure, weight, oxygen saturation, transmission of lung sounds, and capturing echocardiography and electrocardiography data from mobile units; b) in-home caregiver-assisted interactive examinations of signs and symptoms that include visual impressions of ankle swelling, jugular vein distension measurement, and weight gain; c) video-conference capability, facilitating face-to-face two-way communication of nursing personnel with the patients. The ITS network has been designed to improve patients' clinical and behavioral outcomes, increase nursing productivity, and reduce the cost of homecare. Patients' co-operation and compliance has been achieved through use of easy-to-use videoconferencing terminals.

The Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2)

NASA Technical Reports Server (NTRS)

Gelaro, Ronald; McCarty, Will; Randles, Cynthia; Darmenov, Anton; Bosilovich, Michael G.; Cullather, Richard; Buchard, Virginie; Gu, Wei; Putman, William; Schubert, Siegfried D.;

Root architecture simulation improves the inference from seedling root phenotyping towards mature root systems.

PubMed

Zhao, Jiangsan; Bodner, Gernot; Rewald, Boris; Leitner, Daniel; Nagel, Kerstin A; Nakhforoosh, Alireza

2017-02-01

Root phenotyping provides trait information for plant breeding. A shortcoming of high-throughput root phenotyping is the limitation to seedling plants and failure to make inferences on mature root systems. We suggest root system architecture (RSA) models to predict mature root traits and overcome the inference problem. Sixteen pea genotypes were phenotyped in (i) seedling (Petri dishes) and (ii) mature (sand-filled columns) root phenotyping platforms. The RSA model RootBox was parameterized with seedling traits to simulate the fully developed root systems. Measured and modelled root length, first-order lateral number, and root distribution were compared to determine key traits for model-based prediction. No direct relationship in root traits (tap, lateral length, interbranch distance) was evident between phenotyping systems. RootBox significantly improved the inference over phenotyping platforms. Seedling plant tap and lateral root elongation rates and interbranch distance were sufficient model parameters to predict genotype ranking in total root length with an RSpearman of 0.83. Parameterization including uneven lateral spacing via a scaling function substantially improved the prediction of architectures underlying the differently sized root systems. We conclude that RSA models can solve the inference problem of seedling root phenotyping. RSA models should be included in the phenotyping pipeline to provide reliable information on mature root systems to breeding research. © The Author 2017. Published by Oxford University Press on behalf of the Society for Experimental Biology.

Energy manager design for microgrids

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

Firestone, Ryan; Marnay, Chris

2005-01-01

On-site energy production, known as distributed energy resources (DER), offers consumers many benefits, such as bill savings and predictability, improved system efficiency, improved reliability, control over power quality, and in many cases, greener electricity. Additionally, DER systems can benefit electric utilities by reducing congestion on the grid, reducing the need for new generation and transmission capacity, and offering ancillary services such as voltage support and emergency demand response. Local aggregations of distributed energy resources (DER) that may include active control of on-site end-use energy devices can be called microgrids. Microgrids require control to ensure safe operation and to make dispatchmore » decisions that achieve system objectives such as cost minimization, reliability, efficiency and emissions requirements, while abiding by system constraints and regulatory rules. This control is performed by an energy manager (EM). Preferably, an EM will achieve operation reasonably close to the attainable optimum, it will do this by means robust to deviations from expected conditions, and it will not itself incur insupportable capital or operation and maintenance costs. Also, microgrids can include supervision over end-uses, such as curtailing or rescheduling certain loads. By viewing a unified microgrid as a system of supply and demand, rather than simply a system of on-site generation devices, the benefits of integrated supply and demand control can be exploited, such as economic savings and improved system energy efficiency.« less

Implementation and impact of ICD-10 (Part II).

PubMed

Rahmathulla, Gazanfar; Deen, H Gordon; Dokken, Judith A; Pirris, Stephen M; Pichelmann, Mark A; Nottmeier, Eric W; Reimer, Ronald; Wharen, Robert E

2014-01-01

The transition from the International Classification of Disease-9(th) clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices.

Strengthening global health security capacity--Vietnam demonstration project, 2013.

PubMed

Tran, Phu Dac; Vu, Long Ngoc; Nguyen, Hien Tran; Phan, Lan Trong; Lowe, Wayne; McConnell, Michelle S; Iademarco, Michael F; Partridge, Jeffrey M; Kile, James C; Do, Trang; Nadol, Patrick J; Bui, Hien; Vu, Diep; Bond, Kyle; Nelson, David B; Anderson, Lauren; Hunt, Kenneth V; Smith, Nicole; Giannone, Paul; Klena, John; Beauvais, Denise; Becknell, Kristi; Tappero, Jordan W; Dowell, Scott F; Rzeszotarski, Peter; Chu, May; Kinkade, Carl

2014-01-31

Over the past decade, Vietnam has successfully responded to global health security (GHS) challenges, including domestic elimination of severe acute respiratory syndrome (SARS) and rapid public health responses to human infections with influenza A(H5N1) virus. However, new threats such as Middle East respiratory syndrome coronavirus (MERS-CoV) and influenza A(H7N9) present continued challenges, reinforcing the need to improve the global capacity to prevent, detect, and respond to public health threats. In June 2012, Vietnam, along with many other nations, obtained a 2-year extension for meeting core surveillance and response requirements of the 2005 International Health Regulations (IHR). During March-September 2013, CDC and the Vietnamese Ministry of Health (MoH) collaborated on a GHS demonstration project to improve public health emergency detection and response capacity. The project aimed to demonstrate, in a short period, that enhancements to Vietnam's health system in surveillance and early detection of and response to diseases and outbreaks could contribute to meeting the IHR core capacities, consistent with the Asia Pacific Strategy for Emerging Diseases. Work focused on enhancements to three interrelated priority areas and included achievements in 1) establishing an emergency operations center (EOC) at the General Department of Preventive Medicine with training of personnel for public health emergency management; 2) improving the nationwide laboratory system, including enhanced testing capability for several priority pathogens (i.e., those in Vietnam most likely to contribute to public health emergencies of international concern); and 3) creating an emergency response information systems platform, including a demonstration of real-time reporting capability. Lessons learned included awareness that integrated functions within the health system for GHS require careful planning, stakeholder buy-in, and intradepartmental and interdepartmental coordination and communication.

[The health system of El Salvador].

PubMed

Acosta, Mónica; Sáenz, María del Rocío; Gutiérrez, Blanca; Bermúdez, Juan Luis

2011-01-01

This paper describes the health conditions in El Salvador and the main característics of the Salvadoran health system, including its structure and coverage, its financial sources, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health, and the participation of health care users in the evaluation of the system. It also discusses the most recent policy innovations including the approval of the Law for the Creation of the National Health System, which intends to expand coverage, reduce health inequalities and improve the coordination of public health institutions.

EVA Roadmap: New Space Suit for the 21st Century

NASA Technical Reports Server (NTRS)

Yowell, Robert

1998-01-01

New spacesuit design considerations for the extra vehicular activity (EVA) of a manned Martian exploration mission are discussed. Considerations of the design includes:(1) regenerable CO2 removal, (2) a portable life support system (PLSS) which would include cryogenic oxygen produced from in-situ manufacture, (3) a power supply for the EVA, (4) the thermal control systems, (5) systems engineering, (5) space suit systems (materials, and mobility), (6) human considerations, such as improved biomedical sensors and astronaut comfort, (7) displays and controls, and robotic interfaces, such as rovers, and telerobotic commands.

An expert system as applied to bridges : testing phase : final report.

DOT National Transportation Integrated Search

1991-01-01

This project concludes a four part study regarding the development of an expert system called DOBES, to form conclusions as to the disposition of older bridges. The options include replacement, rehabilitation, improvement, abandonment and routine mai...

Development of a precast bent cap system

DOT National Transportation Integrated Search

2001-01-01

Improved speed of construction and economy can be achieved through the use of precast bridge substructures. As a step in the advancement of precast bridge substructures, a precast bent cap system is developed for nonseismic regions, including a desig...

Case studies in collecting highway inventory data with the Global Positioning System.

DOT National Transportation Integrated Search

1996-01-01

A number of state departments of transportation, including the Virginia Department of Transportation (VDOT), are developing a geographic information system (GIS) to integrate data and to conduct more elaborate analyses which will improve their decisi...

PRN 87-1: Label Improvement Program for Pesticides Applied through Irrigation Systems (Chemigation)

EPA Pesticide Factsheets

This Notice requires registrants of pesticide products registered under FIFRA and applied through irrigation systems to revise the labeling for such products to include additional use directions and other statements described in this Notice.

Nonlinear predictive control for durability enhancement and efficiency improvement in a fuel cell power system

NASA Astrophysics Data System (ADS)

Luna, Julio; Jemei, Samir; Yousfi-Steiner, Nadia; Husar, Attila; Serra, Maria; Hissel, Daniel

2016-10-01

In this work, a nonlinear model predictive control (NMPC) strategy is proposed to improve the efficiency and enhance the durability of a proton exchange membrane fuel cell (PEMFC) power system. The PEMFC controller is based on a distributed parameters model that describes the nonlinear dynamics of the system, considering spatial variations along the gas channels. Parasitic power from different system auxiliaries is considered, including the main parasitic losses which are those of the compressor. A nonlinear observer is implemented, based on the discretised model of the PEMFC, to estimate the internal states. This information is included in the cost function of the controller to enhance the durability of the system by means of avoiding local starvation and inappropriate water vapour concentrations. Simulation results are presented to show the performance of the proposed controller over a given case study in an automotive application (New European Driving Cycle). With the aim of representing the most relevant phenomena that affects the PEMFC voltage, the simulation model includes a two-phase water model and the effects of liquid water on the catalyst active area. The control model is a simplified version that does not consider two-phase water dynamics.

Space Shuttle Main Engine: Advanced Health Monitoring System

NASA Technical Reports Server (NTRS)

Singer, Chirs

1999-01-01

The main gola of the Space Shuttle Main Engine (SSME) Advanced Health Management system is to improve flight safety. To this end the new SSME has robust new components to improve the operating margen and operability. The features of the current SSME health monitoring system, include automated checkouts, closed loop redundant control system, catastropic failure mitigation, fail operational/ fail-safe algorithms, and post flight data and inspection trend analysis. The features of the advanced health monitoring system include: a real time vibration monitor system, a linear engine model, and an optical plume anomaly detection system. Since vibration is a fundamental measure of SSME turbopump health, it stands to reason that monitoring the vibration, will give some idea of the health of the turbopumps. However, how is it possible to avoid shutdown, when it is not necessary. A sensor algorithm has been developed which has been exposed to over 400 test cases in order to evaluate the logic. The optical plume anomaly detection (OPAD) has been developed to be a sensitive monitor of engine wear, erosion, and breakage.

Using wide area differential GPS to improve total system error for precision flight operations

NASA Astrophysics Data System (ADS)

Alter, Keith Warren

Total System Error (TSE) refers to an aircraft's total deviation from the desired flight path. TSE can be divided into Navigational System Error (NSE), the error attributable to the aircraft's navigation system, and Flight Technical Error (FTE), the error attributable to pilot or autopilot control. Improvement in either NSE or FTE reduces TSE and leads to the capability to fly more precise flight trajectories. The Federal Aviation Administration's Wide Area Augmentation System (WAAS) became operational for non-safety critical applications in 2000 and will become operational for safety critical applications in 2002. This navigation service will provide precise 3-D positioning (demonstrated to better than 5 meters horizontal and vertical accuracy) for civil aircraft in the United States. Perhaps more importantly, this navigation system, which provides continuous operation across large regions, enables new flight instrumentation concepts which allow pilots to fly aircraft significantly more precisely, both for straight and curved flight paths. This research investigates the capabilities of some of these new concepts, including the Highway-In-The Sky (HITS) display, which not only improves FTE but also reduces pilot workload when compared to conventional flight instrumentation. Augmentation to the HITS display, including perspective terrain and terrain alerting, improves pilot situational awareness. Flight test results from demonstrations in Juneau, AK, and Lake Tahoe, CA, provide evidence of the overall feasibility of integrated, low-cost flight navigation systems based on these concepts. These systems, requiring no more computational power than current-generation low-end desktop computers, have immediate applicability to general aviation flight from Cessnas to business jets and can support safer and ultimately more economical flight operations. Commercial airlines may also, over time, benefit from these new technologies.

Improving Health Care Workers for Seasonal Influenza Vaccination at University Health System: A Paradigm for Closing the Quality Chasm

PubMed Central

Patterson, Jan E.; Cadena, Jose; Prigmore, Teresa; Bowling, Jason; Ayala, Beth Ann; Kirkman, Leni; Parekh, Amruta; Scepanski, Theresa

2011-01-01

Significant gaps in quality and patient safety in the US health-care system have been identified and were reported in the past decade by the Institute of Medicine. Despite recognition of these gaps in “knowing versus doing,” change in health care is slow and difficult. The quality improvement and clinical safety movement is increasing among US medical centers. Our health science center implemented the UT System Clinical Safety and Effectiveness course, providing project-based teaching of quality-improvement tools and principles of patient safety. A quality-improvement project that increased healthcare workers' influenza vaccination rate by 17.8% from that in 2008 to a rate of 76.6% in 2009 serves as a paradigm of how physicians can lead quality-improvement project teams to narrow the quality chasm (1). Local efforts to narrow the chasm are discussed in the present paper, including inter-professional education in quality improvement and clinical safety. PMID:21686222

Intermediate water recovery system

NASA Technical Reports Server (NTRS)

Deckman, G.; Anderson, A. R. (Editor)

1973-01-01

A water recovery system for collecting, storing, and processing urine, wash water, and humidity condensates from a crew of three aboard a spacecraft is described. The results of a 30-day test performed on a breadboard system are presented. The intermediate water recovery system produced clear, sterile, water with a 96.4 percent recovery rate from the processed urine. Recommendations for improving the system are included.

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

Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.

The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less

Why the Eurocontrol Safety Regulation Commission Policy on Safety Nets and Risk Assessment is Wrong

NASA Astrophysics Data System (ADS)

Brooker, Peter

2004-05-01

Current Eurocontrol Safety Regulation Commission (SRC) policy says that the Air Traffic Management (ATM) system (including safety minima) must be demonstrated through risk assessments to meet the Target Level of Safety (TLS) without needing to take safety nets (such as Short Term Conflict Alert) into account. This policy is wrong. The policy is invalid because it does not build rationally and consistently from ATM's firm foundations of TLS and hazard analysis. The policy is bad because it would tend to retard safety improvements. Safety net policy must rest on a clear and rational treatment of integrated ATM system safety defences. A new safety net policy, appropriate to safe ATM system improvements, is needed, which recognizes that safety nets are an integrated part of ATM system defences. The effects of safety nets in reducing deaths from mid-air collisions should be fully included in hazard analysis and safety audits in the context of the TLS for total system design.

Three-Dimensional Optical Coherence Tomography

NASA Technical Reports Server (NTRS)

Gutin, Mikhail; Wang, Xu-Ming; Gutin, Olga

2009-01-01

Three-dimensional (3D) optical coherence tomography (OCT) is an advanced method of noninvasive infrared imaging of tissues in depth. Heretofore, commercial OCT systems for 3D imaging have been designed principally for external ophthalmological examination. As explained below, such systems have been based on a one-dimensional OCT principle, and in the operation of such a system, 3D imaging is accomplished partly by means of a combination of electronic scanning along the optical (Z) axis and mechanical scanning along the two axes (X and Y) orthogonal to the optical axis. In 3D OCT, 3D imaging involves a form of electronic scanning (without mechanical scanning) along all three axes. Consequently, the need for mechanical adjustment is minimal and the mechanism used to position the OCT probe can be correspondingly more compact. A 3D OCT system also includes a probe of improved design and utilizes advanced signal- processing techniques. Improvements in performance over prior OCT systems include finer resolution, greater speed, and greater depth of field.

Nuclear Engine System Simulation (NESS). Version 2.0: Program user's guide

NASA Technical Reports Server (NTRS)

Pelaccio, Dennis G.; Scheil, Christine M.; Petrosky, Lyman

1993-01-01

This Program User's Guide discusses the Nuclear Thermal Propulsion (NTP) engine system design features and capabilities modeled in the Nuclear Engine System Simulation (NESS): Version 2.0 program (referred to as NESS throughout the remainder of this document), as well as its operation. NESS was upgraded to include many new modeling capabilities not available in the original version delivered to NASA LeRC in Dec. 1991, NESS's new features include the following: (1) an improved input format; (2) an advanced solid-core NERVA-type reactor system model (ENABLER 2); (3) a bleed-cycle engine system option; (4) an axial-turbopump design option; (5) an automated pump-out turbopump assembly sizing option; (6) an off-design gas generator engine cycle design option; (7) updated hydrogen properties; (8) an improved output format; and (9) personal computer operation capability. Sample design cases are presented in the user's guide that demonstrate many of the new features associated with this upgraded version of NESS, as well as design modeling features associated with the original version of NESS.

Developing a Continuous Improvement System

DTIC Science & Technology

2016-09-16

disagree that continuous improvement is critical to an organization’s suc-cess, since conducting business using a status quo philosophy will not work...for implementing one of these processes include: better operational efficiency, increased customer satisfaction, improved employee morale ...when a problem in reliability or maintenance may become the greatest opportunity. As described in the January-February 2011 issue of Defense AT&L

The 1999 ICSI/IHI colloquium on clinical quality improvement--"quality: settling the frontier".

PubMed

Palmersheim, T M

1999-12-01

A Colloquium on Clinical Quality Improvement, "Quality: Setting the Frontier," held in May 1999, covered methods and programs in clinical quality improvement. Leadership and organizational behavior were the main themes of the breakout sessions; specific topics included implementing guidelines, applying continuous quality improvement (CQI) methods in preventive services and primary care, and using systems thinking to improve clinical outcomes. Three keynote addresses were presented. James L. Reinertsen, MD (CareGroup, Boston), characterized the financial challenges faced by many health care organizations as a "clarion call" for leadership on quality. "The leadership imperative is to establish an environment in which quality can thrive, despite unprecedented, severe economic pressures on our health systems." How do we make improvement more effective? G. Ross Baker, PhD (University of Toronto), reviewed what organizational literature says about making teams more effective, understanding the organizational context to enable improvement work, and augmenting existing methods for creating sustainable improvement. For example, he noted the increasing interest among may organizations in rapid-cycle improvement but cautioned that such efforts may work best where problems can be addressed by existing clinical teams (not cross-functional work groups) and where there are available solutions that have worked in other settings. Mark Chassin, MD (Mount Sinai School of Medicine, New York), stated that critical tasks for improving quality include increasing public awareness, engaging clinicians in improvement, increasing the investment in producing measures and improvement tools, and reinventing health care delivery, clinical education and training, and QI.

Pretest analysis of Semiscale Mod-3 baseline test S-07-8 and S-07-9

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

Fineman, C.P.; Steiner, J.L.; Snider, D.M.

This document contains a pretest analysis of the Semiscale Mod-3 system thermal-hydraulic response for the second and third integral tests in Test Series 7 (Tests S-07-8 and S-07-9). Test Series 7 is the first test series to be conducted with the Semiscale Mod-3 system. The design of the Mod-3 system includes an improved representation of certain portions of a pressurized water reactor (PWR) when compared to the previously operated Semiscale Mod-1 system. The improvements include a new vessel which contains a full length (3.66 m) core, a full length upper plenum and upper head, and an external downcomer. An activemore » pump and active steam generator scaled to their pressurized water reactor (PWR) counterparts have been added to the broken loop. The upper head design includes the capability to simulate emergency core coolant (ECC) injection into this region. Test Series 7 is divided into three groups of tests that emphasize the evaluation of the Mod-3 system performance during different phases of the loss-of-coolant experiment (LOCE) transient. The last test group, which includes Tests S-07-8 and S-07-9, will be used to evaluate the integral behavior of the system. The previous two test groups were used to evaluate the blowdown behavior and the reflood behavior of the system. 3 refs., 35 figs., 12 tabs.« less

Reliability model generator

NASA Technical Reports Server (NTRS)

Cohen, Gerald C. (Inventor); McMann, Catherine M. (Inventor)

1991-01-01

An improved method and system for automatically generating reliability models for use with a reliability evaluation tool is described. The reliability model generator of the present invention includes means for storing a plurality of low level reliability models which represent the reliability characteristics for low level system components. In addition, the present invention includes means for defining the interconnection of the low level reliability models via a system architecture description. In accordance with the principles of the present invention, a reliability model for the entire system is automatically generated by aggregating the low level reliability models based on the system architecture description.

Vulnerability Analysis and Evaluation of Urban Road System in Tianjin

NASA Astrophysics Data System (ADS)

Liu, Y. Q.; Wu, X.

In recent years, with the development of economy, the road construction of our country has entered into a period of rapid growth. The road transportation network has been expanding and the risk of disasters is increasing. In this paper we study the vulnerability of urban road system in Tianjin. After analyzed many risk factors of the urban road system security, including road construction, road traffic and the natural environment, we proposed an evaluation index of vulnerability of urban road system and established the corresponding evaluation index system. Based on the results of analysis and comprehensive evaluation, appropriate improvement measures and suggestions which may reduce the vulnerability of the road system and improve the safety and reliability of the road system are proposed.

Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review

PubMed Central

Brand, Sarah L.; Thompson Coon, Jo; Fleming, Lora E.; Carroll, Lauren; Bethel, Alison; Wyatt, Katrina

2017-01-01

Background Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and “burnout” at work than staff in other sectors. There is a growing call for the ‘triple aim’ of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom’s (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. Objectives This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. Methods A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. Results Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours. Conclusions This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff. PMID:29200422

Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

PubMed

Brand, Sarah L; Thompson Coon, Jo; Fleming, Lora E; Carroll, Lauren; Bethel, Alison; Wyatt, Katrina

2017-01-01

Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours. This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff.

Improvement of TOPEX/POSEIDON and Jason-1 Geophysical Data Record for Global Change Studies and Coastal Applications

NASA Technical Reports Server (NTRS)

Shum, C. K.

1999-01-01

The Earth's modem climate change has been characterized by interlinked changes in temperature, CO2, ice sheets and sea level. Global sea level change is a critical indicator for study of contemporary climate change. Sea level rise appears to have accelerated since the ice sheet retreats have stopped some 5000 years ago and it is estimated that the sea level rise has been approx. 15 cm over the last century. Contemporary radar altimeters represent the only technique capable of monitoring global sea level change with accuracy approaching 1 mm/yr and with a temporal scale of days and a spatial scale of 100 km or longer. This report highlights the major accomplishments of the TOPEX/POSEIDON (T/P) Extended Mission and Jason-1 science investigation. The primary objectives of the investigation include the calibration and improvement of T/P and Jason-1 altimeter data for global sea level change and coastal tide and circulation studies. The scientific objectives of the investigation include: (1) the calibration and improvement of T/P and Jason-1 data as a reference measurement system for the accurate cross-linking with other altimeter systems (Seasat, Geosat, ERS-1, ERS-2, GFO-1, and Envisat), (2) the improved determination and the associated uncertainties of the long-term (15-year) global mean sea level change using multiple altimeters, (3) the characterization of the sea level change by analyses of independent data, including tide gauges, sea surface temperature, and (4) the improvement coastal radar altimetry for studies including coastal ocean tide modeling and coastal circulation. Major accomplishments of the investigation include the development of techniques for low-cost radar altimeter absolute calibration (including the associated GPS-buoy technology), coastal ocean tide modeling, and the linking of multiple altimeter systems and the resulting determination of the 15-year (1985-1999) global mean sea level variations. The current rate of 15-year sea level rise observed by multiple satellite altimetry is +2.3 +/- 1.2 mm/yr, which is in general agreement with the analysis of sparsely distributed tide gauge measurements for the same data span, and represents the first such determination of sea level change in its kind.

Global ablation techniques.

PubMed

Woods, Sarah; Taylor, Betsy

2013-12-01

Global endometrial ablation techniques are a relatively new surgical technology for the treatment of heavy menstrual bleeding that can now be used even in an outpatient clinic setting. A comparison of global ablation versus earlier ablation technologies notes no significant differences in success rates and some improvement in patient satisfaction. The advantages of the newer global endometrial ablation systems include less operative time, improved recovery time, and decreased anesthetic risk. Ablation procedures performed in an outpatient surgical or clinic setting provide advantages both of potential cost savings for patients and the health care system and improved patient convenience. Copyright © 2013. Published by Elsevier Inc.

Meeting the Challenge of Chronic Conditions in a Sustainable Manner: Building on the AHC Learning.

PubMed

Delgado, Pedro

2016-01-01

The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) set out to achieve three aims: to create a patient- and family-centred approach to manage chronic diseases; to build a network of organizational, regional and provincial teams to share evidence-informed, systems-level solutions and work together to develop, implement and sustain improvement initiatives; and to promote the sustainability of the participating health systems. Important elements of all three aims were achieved and the synthesis provides a meaningful contribution to systems working to improve chronic care. This paper explores those achievements as well as some of the areas for improvement, including replicability, expanded outcome measurement, greater detail around patient and family engagement, increased focus on specific outcomes and processes, and further articulation of lessons learned and recommendations.

Response to comments by Adam Smiarowski and Shane Mulè on: Christensen, N., and Lawrie, K., 2012. Resolution analyses for selecting an appropriate airborne electromagnetic (AEM) system, Exploration Geophysics, 43, 213-227

NASA Astrophysics Data System (ADS)

Christensen, Niels B.; Lawrie, Ken

2015-06-01

We analyse and compare the resolution improvement that can be obtained from including x-component data in the inversion of AEM data from the SkyTEM and TEMPEST systems. Except for the resistivity of the bottom layer, the SkyTEM system, even without including x-component data, has the better resolution of the parameters of the analysed models.

Perceptual Training Strongly Improves Visual Motion Perception in Schizophrenia

ERIC Educational Resources Information Center

Norton, Daniel J.; McBain, Ryan K.; Ongur, Dost; Chen, Yue

2011-01-01

Schizophrenia patients exhibit perceptual and cognitive deficits, including in visual motion processing. Given that cognitive systems depend upon perceptual inputs, improving patients' perceptual abilities may be an effective means of cognitive intervention. In healthy people, motion perception can be enhanced through perceptual learning, but it…

SPAR improved structure-fluid dynamic analysis capability, phase 2

NASA Technical Reports Server (NTRS)

Pearson, M. L.

1984-01-01

An efficient and general method of analyzing a coupled dynamic system of fluid flow and elastic structures is investigated. The improvement of Structural Performance Analysis and Redesign (SPAR) code is summarized. All error codes are documented and the SPAR processor/subroutine cross reference is included.

Development and validation of techniques for improving software dependability

NASA Technical Reports Server (NTRS)

Knight, John C.

1992-01-01

A collection of document abstracts are presented on the topic of improving software dependability through NASA grant NAG-1-1123. Specific topics include: modeling of error detection; software inspection; test cases; Magnetic Stereotaxis System safety specifications and fault trees; and injection of synthetic faults into software.

Identifying pathways for improving household food self-sufficiency outcomes in the hills of Nepal

USDA-ARS?s Scientific Manuscript database

Maintaining and improving food security in mountain regions is an ongoing challenge. There are many facets to the problem, including comparatively high levels of system diversity and crop-livestock integration, challenging terrain and transportation bottlenecks, declining labor availability due to o...

The Older Woman: Increased Psychosocial Benefits from Physical Activity.

ERIC Educational Resources Information Center

Wakat, Diane; Odom, Sarah

1982-01-01

Older women who participate in physical activity programs find physical benefits in the improvement of cardiovascular and musculoskeletal systems. The psychosocial benefits which result from physical activity include an increase in self-esteem, increased social contacts, a counteraction to depression, and improved stress management. Suggestions…

Solar thermal program summary. Volume 1: Overview, fiscal year 1988

NASA Astrophysics Data System (ADS)

1989-02-01

The goal of the solar thermal program is to improve overall solar thermal systems performance and provide cost-effective energy options that are strategically secure and environmentally benign. Major research activities include energy collection technology, energy conversion technology, and systems and applications technology for both CR and DR systems. This research is being conducted through research laboratories in close coordination with the solar thermal industry, utilities companies, and universities. The Solar Thermal Technology Program is pursuing the development of critical components and subsystems for improved energy collection and conversion devices. This development follows two basic paths: for CR systems, critical components include stretched membrane heliostats, direct absorption receivers (DARs), and transport subsystems for molten salt heat transfer fluids. These components offer the potential for a significant reduction in system costs; and for DR systems, critical components include stretched membrane dishes, reflux receivers, and Stirling engines. These components will significantly increase system reliability and efficiency, which will reduce costs. The major thrust of the program is to provide electric power. However, there is an increasing interest in the use of concentrated solar energy for applications such as detoxifying hazardous wastes and developing high-value transportable fuels. These potential uses of highly concentrated solar energy still require additional experiments to prove concept feasibility. The program goal of economically competitive energy reduction from solar thermal systems is being cooperatively addressed by industry and government.

Atmospheric Electrical Activity and the Prospects for Improving Short-Term, Weather Forcasting

NASA Technical Reports Server (NTRS)

Goodman, Steven J.

2003-01-01

How might lightning measurements be used to improve short-term (0-24 hr) weather forecasting? We examine this question under two different prediction strategies. These include integration of lightning data into short-term forecasts (nowcasts) of convective (including severe) weather hazards and the assimilation of lightning data into cloud-resolving numerical weather prediction models. In each strategy we define specific metrics of forecast improvement and a progress assessment. We also address the conventional observing system deficiencies and potential gap-filling information that can be addressed through the use of the lightning measurement.

Energy Division annual progress report for period ending September 30, 1983

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

Not Available

This report covers work done during FY 1983 by the staff of the Energy Division and its subcontractors and by colleagues in other Oak Ridge National Laboratory divisions working on Energy Division projects. The work can be divided into four areas: (1) analysis and assessment, (2) models and data systems, (3) research to improve the efficiency of energy use and to improve electric power transmission and distribution, and (4) research utilization. Support came principally from the US Department of Energy (DOE), the US Nuclear Regulatory Commission, and the US Department of Defense, but also from a number of other agenciesmore » and organizations. Analysis and assessment included work on (a) environmental issues, including those deriving from the preparation of environmental impact statements; (b) energy and resource analysis; and (c) emergency preparedness. The models and data systems area involved research on evaluating and developing energy, environment, and engineering simulation models and on devising large data management systems, evaluating user data requirements, and compiling data bases. Research on improving the efficiency of energy use was focused primarily on the buildings and electricity sectors. A major effort on heat pump technology, which includes both heat-activated and electrically driven systems, continues. An important aspect of all the work was research utilization. Since the Energy Division is doing applied research, results are, by definition, intended to solve problems or answer questions of DOE and other sponsors. However, there are other users, and research utilization activities include technology transfer, commercialization efforts, outreach to state and regional organizations, and, of course, information dissemination.« less

Affordable non-traditional source data mining for context assessment to improve distributed fusion system robustness

NASA Astrophysics Data System (ADS)

Bowman, Christopher; Haith, Gary; Steinberg, Alan; Morefield, Charles; Morefield, Michael

2013-05-01

This paper describes methods to affordably improve the robustness of distributed fusion systems by opportunistically leveraging non-traditional data sources. Adaptive methods help find relevant data, create models, and characterize the model quality. These methods also can measure the conformity of this non-traditional data with fusion system products including situation modeling and mission impact prediction. Non-traditional data can improve the quantity, quality, availability, timeliness, and diversity of the baseline fusion system sources and therefore can improve prediction and estimation accuracy and robustness at all levels of fusion. Techniques are described that automatically learn to characterize and search non-traditional contextual data to enable operators integrate the data with the high-level fusion systems and ontologies. These techniques apply the extension of the Data Fusion & Resource Management Dual Node Network (DNN) technical architecture at Level 4. The DNN architecture supports effectively assessment and management of the expanded portfolio of data sources, entities of interest, models, and algorithms including data pattern discovery and context conformity. Affordable model-driven and data-driven data mining methods to discover unknown models from non-traditional and `big data' sources are used to automatically learn entity behaviors and correlations with fusion products, [14 and 15]. This paper describes our context assessment software development, and the demonstration of context assessment of non-traditional data to compare to an intelligence surveillance and reconnaissance fusion product based upon an IED POIs workflow.

Interventions for hiring, retaining and training district health systems managers in low- and middle-income countries.

PubMed

Rockers, Peter C; Bärnighausen, Till

2013-04-30

District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. To assess the effectiveness of interventions to hire, retain and train district health systems managers in low- and middle-income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We also searched online resources of international agencies, including the World Bank, to find relevant grey literature. Searches were conducted in December 2011. District health systems managers are those persons who are responsible for overseeing the operations of the health system within a defined, subnational geographical area that is designated as a district. Hiring and retention interventions include those that aim to increase the attractiveness of district management positions, as well as those related to hiring and retention processes, such as private contracting. Training interventions include education programs to develop future managers and on-the-job training programs for current managers. To be included, studies needed to use one of the following study designs: randomized controlled trial, nonrandomized controlled trial, controlled before-and-after study, and interrupted time series analysis. We report measures of effect in the same way that the primary study authors have reported them. Due to the varied nature of interventions included in this review we could not pool data across studies. Two studies met our inclusion criteria. The findings of one study conducted in Cambodia provide low quality evidence that private contracts with international nongovernmental organizations (NGOs) for district health systems management ('contracting-in') may improve health care access and utilization. Contracting-in increased use of antenatal care by 28% and use of public facilities by 14%. However, contracting-in was not found to have an effect on population health outcomes. The findings of the other study provide low quality evidence that intermittent training courses over 18 months may improve district health system managers' performance. In three countries in Latin America, managers who did not receive the intermittent training courses had between 2.4 and 8.3 times more management deficiencies than managers who received the training courses. No studies that aimed to investigate interventions for retaining district health systems managers met our study selection criteria for inclusion in this review. There is low quality evidence that contracting-in may improve health care accessibility and utilization and that intermittent training courses may improve district health systems managers' performance. More evidence is required before firm conclusions can be drawn regarding the effectiveness of these interventions in diverse settings. Other interventions that might be promising candidates for hiring and retaining (e.g., government regulations, professional support programs) as well as training district health systems managers (e.g., in-service workshops with on-site support) have not been adequately investigated.

Advanced endoscopic imaging to improve adenoma detection

PubMed Central

Neumann, Helmut; Nägel, Andreas; Buda, Andrea

2015-01-01

Advanced endoscopic imaging is revolutionizing our way on how to diagnose and treat colorectal lesions. Within recent years a variety of modern endoscopic imaging techniques was introduced to improve adenoma detection rates. Those include high-definition imaging, dye-less chromoendoscopy techniques and novel, highly flexible endoscopes, some of them equipped with balloons or multiple lenses in order to improve adenoma detection rates. In this review we will focus on the newest developments in the field of colonoscopic imaging to improve adenoma detection rates. Described techniques include high-definition imaging, optical chromoendoscopy techniques, virtual chromoendoscopy techniques, the Third Eye Retroscope and other retroviewing devices, the G-EYE endoscope and the Full Spectrum Endoscopy-system. PMID:25789092

Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.

PubMed

Wysham, Nicholas G; Abernethy, Amy P; Cox, Christopher E

2014-10-01

Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare practice, potentially limiting their value over time. Improved prognostication of patient-centered outcomes in critical illness could enhance decision-making quality in the ICU. Patient-reported outcomes have emerged as precise methodological measures of patient-centered variables and have been successfully employed using diverse platforms and technologies, enhancing the value of research in critical illness survivorship and in direct patient care. The learning health system is an emerging ideal characterized by integration of multiple data sources into a smart and interconnected health information technology infrastructure with the goal of rapidly optimizing patient care. We propose a vision of a smart, interconnected learning health system with integrated electronic patient-reported outcomes to optimize patient-centered care, including critical care outcome prediction. A learning health system infrastructure integrating electronic patient-reported outcomes may aid in the management of critical illness-associated conditions and yield tools to improve prognostication of patient-centered outcomes in critical illness.

Designing Bioretention Systems to Improve Nitrogen Removal - poster

EPA Science Inventory

Rain gardens, also referred to as bioretention systems, are designed primarily to infiltrate stormwater flow and reduce surface runoff and peak flows to receiving streams. Additionally, they are known to remove stressors from urban stormwater runoff, including oil and grease, pho...

NOVEL CERAMIC MEMBRANE BIOREACTOR FOR LOW-FLOW SYSTEMS - PHASE I

EPA Science Inventory

Improved low-flow (50,000 gallons per day) sanitary wastewater treatment systems are needed. CeraMem Corporation's proposed approach includes a membrane bioreactor (MBR) using fully proven biological processes for biological oxygen demand oxidation and (optionally) fo...

77 FR 4060 - Notice of Lodging of Second Agreement and Order Regarding Modification of the Consent Decree...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... improve its sewage collection system including addressing Unauthorized Discharges such as sanitary sewer... used in the sewage collection system. The Department of Justice will receive for a period of thirty (30...

In-Vehicle Information Systems Demand Model (Research Update)

DOT National Transportation Integrated Search

2000-04-01

The goal of in-vehicle information system (IVIS) technologies is to increase the mobility, improve the efficiency, and increase the safety and/or convenience of the motoring public. To achieve this goal, IVISs must be designed to include good human f...

Management Design Theories

NASA Astrophysics Data System (ADS)

Pries-Heje, Jan; Baskerville, Richard L.

This paper elaborates a design science approach for management planning anchored to the concept of a management design theory. Unlike the notions of design theories arising from information systems, management design theories can appear as a system of technological rules, much as a system of hypotheses or propositions can embody scientific theories. The paper illus trates this form of management design theories with three grounded cases. These grounded cases include a software process improvement study, a user involvement study, and an organizational change study. Collectively these studies demonstrate how design theories founded on technological rules can not only improve the design of information systems, but that these concepts have great practical value for improving the framing of strategic organi zational design decisions about such systems. Each case is either grounded in an empirical sense, that is to say, actual practice, or it is grounded to practices described extensively in the practical literature. Such design theories will help managers more easily approach complex, strategic decisions.

Storage media pipelining: Making good use of fine-grained media

NASA Technical Reports Server (NTRS)

Vanmeter, Rodney

1993-01-01

This paper proposes a new high-performance paradigm for accessing removable media such as tapes and especially magneto-optical disks. In high-performance computing the striping of data across multiple devices is a common means of improving data transfer rates. Striping has been used very successfully for fixed magnetic disks improving overall system reliability as well as throughput. It has also been proposed as a solution for providing improved bandwidth for tape and magneto-optical subsystems. However, striping of removable media has shortcomings, particularly in the areas of latency to data and restricted system configurations, and is suitable primarily for very large I/Os. We propose that for fine-grained media, an alternative access method, media pipelining, may be used to provide high bandwidth for large requests while retaining the flexibility to support concurrent small requests and different system configurations. Its principal drawback is high buffering requirements in the host computer or file server. This paper discusses the possible organization of such a system including the hardware conditions under which it may be effective, and the flexibility of configuration. Its expected performance is discussed under varying workloads including large single I/O's and numerous smaller ones. Finally, a specific system incorporating a high-transfer-rate magneto-optical disk drive and autochanger is discussed.

Thermostatic system of sensor in NIR spectrometer based on PID control

NASA Astrophysics Data System (ADS)

Wang, Zhihong; Qiao, Liwei; Ji, Xufei

2016-11-01

Aiming at the shortcomings of the primary sensor thermostatic control system in the near infrared (NIR) spectrometer, a novel thermostatic control system based on proportional-integral-derivative (PID) control technology was developed to improve the detection precision of the NIR spectrometer. There were five parts including bridge amplifier circuit, analog-digital conversion (ADC) circuit, microcontroller, digital-analog conversion (DAC) circuit and drive circuit in the system. The five parts formed a closed-loop control system based on PID algorithm that was used to control the error between the temperature calculated by the sampling data of ADC and the designed temperature to ensure the stability of the spectrometer's sensor. The experimental results show that, when the operating temperature of sensor is -11°, compared with the original system, the temperature control precision of the new control system is improved from ±0.64° to ±0.04° and the spectrum signal to noise ratio (SNR) is improved from 4891 to 5967.

Model Based Mission Assurance: Emerging Opportunities for Robotic Systems

NASA Technical Reports Server (NTRS)

Evans, John W.; DiVenti, Tony

2016-01-01

The emergence of Model Based Systems Engineering (MBSE) in a Model Based Engineering framework has created new opportunities to improve effectiveness and efficiencies across the assurance functions. The MBSE environment supports not only system architecture development, but provides for support of Systems Safety, Reliability and Risk Analysis concurrently in the same framework. Linking to detailed design will further improve assurance capabilities to support failures avoidance and mitigation in flight systems. This also is leading new assurance functions including model assurance and management of uncertainty in the modeling environment. Further, the assurance cases, a structured hierarchal argument or model, are emerging as a basis for supporting a comprehensive viewpoint in which to support Model Based Mission Assurance (MBMA).

Preparing for a decision support system.

PubMed

Callan, K

2000-08-01

The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments. This article reviews decision support system characteristics and describes a process to assess the preparedness of an organization to implement and use decision support systems to achieve a more effective, information-based decision process. Decision support tools included in this article range from reports to data mining.

Control technology for future aircraft propulsion systems

NASA Technical Reports Server (NTRS)

Zeller, J. R.; Szuch, J. R.; Merrill, W. C.; Lehtinen, B.; Soeder, J. F.

1984-01-01

The need for a more sophisticated engine control system is discussed. The improvements in better thrust-to-weight ratios demand the manipulation of more control inputs. New technological solutions to the engine control problem are practiced. The digital electronic engine control (DEEC) system is a step in the evolution to digital electronic engine control. Technology issues are addressed to ensure a growth in confidence in sophisticated electronic controls for aircraft turbine engines. The need of a control system architecture which permits propulsion controls to be functionally integrated with other aircraft systems is established. Areas of technology studied include: (1) control design methodology; (2) improved modeling and simulation methods; and (3) implementation technologies. Objectives, results and future thrusts are summarized.

Appointment systems are essential for improving chronic disease care in resource-poor settings: learning from experiences with HIV patients in Africa.

PubMed

Chalker, John C; Wagner, Anita K; Tomson, Göran; Johnson, Keith; Wahlström, Rolf; Ross-Degnan, Dennis

2013-09-01

Lessons learned from treating patients with HIV infection can inform care systems for other chronic conditions. For antiretroviral treatment, attending appointments on time correlates with medication adherence; however, HIV clinics in East Africa, where attendance rates vary widely, rarely include systems to schedule appointments or to track missed appointments or patient follow-up. An introduction of low-cost, paper-based patient appointment and tracking systems led to an improvement in timely clinic attendance rates and tracking missing patients. An effective appointment system is critical to managing patients with chronic conditions and can be introduced in resource-limited settings, possibly without having to add staff.

System for improving measurement accuracy of transducer by measuring transducer temperature and resistance change using thermoelectric voltages

NASA Technical Reports Server (NTRS)

Anderson, Karl F. (Inventor); Parker, Allen R., Jr. (Inventor)

1993-01-01

A constant current loop measuring system measures a property including the temperature of a sensor responsive to an external condition being measured. The measuring system includes thermocouple conductors connected to the sensor, sensing first and second induced voltages responsive to the external condition. In addition, the measuring system includes a current generator and reverser generating a constant current, and supplying the constant current to the thermocouple conductors in forward and reverse directions generating first and second measured voltages, and a determining unit receiving the first and second measured voltages from the current generator and reverser, and determining the temperature of the sensor responsive to the first and second measured voltages.

Health management and controls for earth to orbit propulsion systems

NASA Technical Reports Server (NTRS)

Bickford, R. L.

1992-01-01

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

Apollo food technology

NASA Technical Reports Server (NTRS)

Smith, M. C., Jr.; Heidelbaugh, N. D.; Rambaut, P. C.; Rapp, R. M.; Wheeler, H. O.; Huber, C. S.; Bourland, C. T.

1975-01-01

Large improvements and advances in space food systems achieved during the Apollo food program are discussed. Modifications of the Apollo food system were directed primarily toward improving delivery of adequate nutrition to the astronaut. Individual food items and flight menus were modified as nutritional countermeasures to the effects of weightlessness. Unique food items were developed, including some that provided nutritional completeness, high acceptability, and ready-to-eat, shelf-stable convenience. Specialized food packages were also developed. The Apollo program experience clearly showed that future space food systems will require well-directed efforts to achieve the optimum potential of food systems in support of the physiological and psychological well-being of astronauts and crews.

Nonlinear Control of Large Disturbances in Magnetic Bearing Systems

NASA Technical Reports Server (NTRS)

Jiang, Yuhong; Zmood, R. B.

1996-01-01

In this paper, the nonlinear operation of magnetic bearing control methods is reviewed. For large disturbances, the effects of displacement constraints and power amplifier current and di/dt limits on bearing control system performance are analyzed. The operation of magnetic bearings exhibiting self-excited large scale oscillations have been studied both experimentally and by simulation. The simulation of the bearing system has been extended to include the effects of eddy currents in the actuators, so as to improve the accuracy of the simulation results. The results of these experiments and simulations are compared, and some useful conclusions are drawn for improving bearing system robustness.

OpenIPSL: Open-Instance Power System Library - Update 1.5 to "iTesla Power Systems Library (iPSL): A Modelica library for phasor time-domain simulations"

NASA Astrophysics Data System (ADS)

Baudette, Maxime; Castro, Marcelo; Rabuzin, Tin; Lavenius, Jan; Bogodorova, Tetiana; Vanfretti, Luigi

2018-01-01

This paper presents the latest improvements implemented in the Open-Instance Power System Library (OpenIPSL). The OpenIPSL is a fork from the original iTesla Power Systems Library (iPSL) by some of the original developers of the iPSL. This fork's motivation comes from the will of the authors to further develop the library with additional features tailored to research and teaching purposes. The enhancements include improvements to existing models, the addition of a new package of three phase models, and the implementation of automated tests through continuous integration.

Improving patient safety: patient-focused, high-reliability team training.

PubMed

McKeon, Leslie M; Cunningham, Patricia D; Oswaks, Jill S Detty

2009-01-01

Healthcare systems are recognizing "human factor" flaws that result in adverse outcomes. Nurses work around system failures, although increasing healthcare complexity makes this harder to do without risk of error. Aviation and military organizations achieve ultrasafe outcomes through high-reliability practice. We describe how reliability principles were used to teach nurses to improve patient safety at the front line of care. Outcomes include safety-oriented, teamwork communication competency; reflections on safety culture and clinical leadership are discussed.

System-Level Action Required for Wide-Scale Improvement in Quality of Primary Health Care: Synthesis of Feedback from an Interactive Process to Promote Dissemination and Use of Aggregated Quality of Care Data.

PubMed

Bailie, Jodie; Laycock, Alison; Matthews, Veronica; Bailie, Ross

2016-01-01

There is an enduring gap between recommended practice and care that is actually delivered; and there is wide variation between primary health care (PHC) centers in delivery of care. Where aspects of care are not being done well across a range of PHC centers, this is likely due to inadequacies in the broader system. This paper aims to describe stakeholders' perceptions of the barriers and enablers to addressing gaps in Australian Aboriginal and Torres Strait Islander chronic illness care and child health, and to identify key drivers for improvement. This paper draws on data collected as part of a large-scale continuous quality improvement project in Australian Indigenous PHC settings. We undertook a qualitative assessment of stakeholder feedback on the main barriers and enablers to addressing gaps in care for Aboriginal and Torres Strait Islander children and in chronic illness care. Themes on barriers and enablers were further analyzed to develop a "driver diagram," an improvement tool used to locate barriers and enablers within causal pathways (as primary and secondary drivers), enabling them to be targeted by tailored interventions. We identified 5 primary drivers and 11 secondary drivers of high-quality care, and associated strategies that have potential for wide-scale implementation to address barriers and enablers for improving care. Perceived barriers to addressing gaps in care included both health system and staff attributes. Primary drivers were: staff capability to deliver high-quality care; availability and use of clinical information systems and decision support tools; embedding of quality improvement processes and data-driven decision-making; appropriate and effective recruitment and retention of staff; and community capacity, engagement and mobilization for health. Suggested strategies included mechanisms for increasing clinical supervision and support, staff retention, reorientation of service delivery, use of information systems and community health literacy. The findings identify areas of focus for development of barrier-driven, tailored interventions to improve health outcomes. They reinforce the importance of system-level action to improve health center performance and health outcomes, and of developing strategies to address system-wide challenges that can be adapted to local contexts.

Solar receiver heliostat reflector having a linear drive and position information system

DOEpatents

Horton, Richard H.

1980-01-01

A heliostat for a solar receiver system comprises an improved drive and control system for the heliostat reflector assembly. The heliostat reflector assembly is controllably driven in a predetermined way by a light-weight drive system so as to be angularly adjustable in both elevation and azimuth to track the sun and efficiently continuously reflect the sun's rays to a focal zone, i.e., heat receiver, which forms part of a solar energy utilization system, such as a solar energy fueled electrical power generation system. The improved drive system includes linear stepping motors which comprise low weight, low cost, electronic pulse driven components. One embodiment comprises linear stepping motors controlled by a programmed, electronic microprocessor. Another embodiment comprises a tape driven system controlled by a position control magnetic tape.

A qualitative study of health information technology in the Canadian public health system.

PubMed

Zinszer, Kate; Tamblyn, Robyn; Bates, David W; Buckeridge, David L

2013-05-25

Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technology (HIT) policy related to public health in Canada that have succeeded, to identify remaining challenges, and to suggest future directions to improve the adoption and use of HIT in the public health system. A qualitative case study was performed with 24 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Identified benefits of HIT in public health included improved communication among jurisdictions, increased awareness of the need for interoperable systems, and improvement in data standardization. Identified barriers included a lack of national vision and leadership, insufficient investment, and poor conceptualization of the priority areas for implementing HIT in public health. The application of HIT in public health should focus on automating core processes and identifying innovative applications of HIT to advance public health outcomes. The Public Health Agency of Canada should develop the expertise to lead public health HIT policy and should establish a mechanism for coordinating public health stakeholder input on HIT policy.

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

Melton, Ron

The Pacific Northwest Smart Grid Demonstration (PNWSGD), a $179 million project that was co-funded by the U.S. Department of Energy (DOE) in late 2009, was one of the largest and most comprehensive demonstrations of electricity grid modernization ever completed. The project was one of 16 regional smart grid demonstrations funded by the American Recovery and Reinvestment Act. It was the only demonstration that included multiple states and cooperation from multiple electric utilities, including rural electric co-ops, investor-owned, municipal, and other public utilities. No fewer than 55 unique instantiations of distinct smart grid systems were demonstrated at the projects’ sites. Themore » local objectives for these systems included improved reliability, energy conservation, improved efficiency, and demand responsiveness. The demonstration developed and deployed an innovative transactive system, unique in the world, that coordinated many of the project’s distributed energy resources and demand-responsive components. With the transactive system, additional regional objectives were also addressed, including the mitigation of renewable energy intermittency and the flattening of system load. Using the transactive system, the project coordinated a regional response across the 11 utilities. This region-wide connection from the transmission system down to individual premises equipment was one of the major successes of the project. The project showed that this can be done and assets at the end points can respond dynamically on a wide scale. In principle, a transactive system of this type might eventually help coordinate electricity supply, transmission, distribution, and end uses by distributing mostly automated control responsibilities among the many distributed smart grid domain members and their smart devices.« less

Leveraging information technology to drive improvement in patient satisfaction.

PubMed

Nash, Mary; Pestrue, Justin; Geier, Peter; Sharp, Karen; Helder, Amy; McAlearney, Ann Scheck

2010-01-01

A healthcare organization's commitment to quality and the patient experience requires senior leader involvement in improvement strategies, and accountability for goals. Further, improvement strategies are most effective when driven by data, and in the world of patient satisfaction, evidence is growing that nurse leader rounding and discharge calls are strategic tactics that can improve patient satisfaction. This article describes how The Ohio State University Medical Center (OSUMC) leveraged health information technology (IT) to apply a data-driven strategy execution to improve the patient experience. Specifically, two IT-driven approaches were used: (1) business intelligence reporting tools were used to create a meaningful reporting system including dashboards, scorecards, and tracking reports and (2) an improvement plan was implemented that focused on two high-impact tactics and data to hardwire accountability. Targeted information from the IT systems enabled clinicians and administrators to execute these strategic tactics, and senior leaders to monitor achievement of strategic goals. As a result, OSUMC's inpatient satisfaction scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey improved from 56% nines and tens in 2006 to 71% in 2009. © 2010 National Association for Healthcare Quality.

Clinical Information Systems - From Yesterday to Tomorrow.

PubMed

Gardner, R M

2016-06-30

To review the history of clinical information systems over the past twenty-five years and project anticipated changes to those systems over the next twenty-five years. Over 250 Medline references about clinical information systems, quality of patient care, and patient safety were reviewed. Books, Web resources, and the author's personal experience with developing the HELP system were also used. There have been dramatic improvements in the use and acceptance of clinical computing systems and Electronic Health Records (EHRs), especially in the United States. Although there are still challenges with the implementation of such systems, the rate of progress has been remarkable. Over the next twenty-five years, there will remain many important opportunities and challenges. These opportunities include understanding complex clinical computing issues that must be studied, understood and optimized. Dramatic improvements in quality of care and patient safety must be anticipated as a result of the use of clinical information systems. These improvements will result from a closer involvement of clinical informaticians in the optimization of patient care processes. Clinical information systems and computerized clinical decision support have made contributions to medicine in the past. Therefore, by using better medical knowledge, optimized clinical information systems, and computerized clinical decision, we will enable dramatic improvements in both the quality and safety of patient care in the next twenty-five years.

A plan for application system verification tests: The value of improved meteorological information, volume 1. [economic consequences of improved meteorological information

NASA Technical Reports Server (NTRS)

1976-01-01

The framework within which the Applications Systems Verification Tests (ASVTs) are performed and the economic consequences of improved meteorological information demonstrated is described. This framework considers the impact of improved information on decision processes, the data needs to demonstrate the economic impact of the improved information, the data availability, the methodology for determining and analyzing the collected data and demonstrating the economic impact of the improved information, and the possible methods of data collection. Three ASVTs are considered and program outlines and plans are developed for performing experiments to demonstrate the economic consequences of improved meteorological information. The ASVTs are concerned with the citrus crop in Florida, the cotton crop in Mississippi and a group of diverse crops in Oregon. The program outlines and plans include schedules, manpower estimates and funding requirements.

An improved adaptive weighting function method for State Estimation in Power Systems with VSC-MTDC

NASA Astrophysics Data System (ADS)

Zhao, Kun; Yang, Xiaonan; Lang, Yansheng; Song, Xuri; Wang, Minkun; Luo, Yadi; Wu, Lingyun; Liu, Peng

2017-04-01

This paper presents an effective approach for state estimation in power systems that include multi-terminal voltage source converter based high voltage direct current (VSC-MTDC), called improved adaptive weighting function method. The proposed approach is simplified in which the VSC-MTDC system is solved followed by the AC system. Because the new state estimation method only changes the weight and keeps the matrix dimension unchanged. Accurate and fast convergence of AC/DC system can be realized by adaptive weight function method. This method also provides the technical support for the simulation analysis and accurate regulation of AC/DC system. Both the oretical analysis and numerical tests verify practicability, validity and convergence of new method.

Optimization of absorption air-conditioning for solar energy applications

NASA Technical Reports Server (NTRS)

Perry, E. H.

1976-01-01

Improved performance of solar cooling systems using the lithium bromide water absorption cycle is investigated. Included are computer simulations of a solar-cooled house, analyses and measurements of heat transfer rates in absorption system components, and design and fabrication of various system components. A survey of solar collector convection suppression methods is presented.

NASIS data base management system: IBM 360 TSS implementation. Volume 1: Installation standards

NASA Technical Reports Server (NTRS)

1973-01-01

The installation standards for the (NASIS) data base management system are presented. The standard approach to preparing systems documentation and the program design and coding rules and conventions are outlines. Included are instructions for preparing all major specifications and suggestions for improving the quality and efficency of the programming task.

76 FR 42052 - National Emission Standards for Hazardous Air Pollutants From Petroleum Refineries

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... under CAA sections 112(d)(2) and (3) for heat exchange systems, which the EPA had not addressed in the... rule addressed residual risk for all Refinery MACT 1 sources, including heat exchange systems. Third... continue to make improvements in emissions reductions, and the heat exchange system standards will reduce...

Integrating Resources and Strategies into an Emerging System of Professional Development: The Case of PITC in California

ERIC Educational Resources Information Center

Mangione, Peter L.; Lally, J. Ronald; Poole, Janet L.; Tuesta, Alicia; Paxton, Arlene R.

2011-01-01

States have placed high priority on developing early care and education systems that include early learning guidelines, curriculum, program guidelines or standards, and early childhood educator competencies. To explore how professional development and quality improvement initiatives are being integrated into emerging infant-toddler care systems,…

Educator Evaluation: A Case Study of Massachusetts' Approach

ERIC Educational Resources Information Center

Brown, Catherine; Partelow, Lisette; Konoske-Graf, Annette

2016-01-01

There has been a sea change in teacher evaluation over the past eight years. Inspired in part by President Barack Obama's policies, schools have instituted teacher evaluation systems that include multiple measures of teacher impact. Model systems are aligned to systems of continuous improvement, helping teachers identify areas of weakness in their…

Human Systems Integration at NASA Ames Research Center

NASA Technical Reports Server (NTRS)

McCandless, Jeffrey

2017-01-01

The Human Systems Integration Division focuses on the design and operations of complex aerospace systems through analysis, experimentation and modeling. With over a dozen labs and over 120 people, the division conducts research to improve safety, efficiency and mission success. Areas of investigation include applied vision research which will be discussed during this seminar.

Oceanic Area System Improvement Study (OASIS). Volume IV. Caribbean Region Air Traffic Services System Description.

DTIC Science & Technology

1981-09-01

OASIS) U Final Report This report i.s one of a set of companion documents which includes the following volumes: Volume I Executive Summary and...Northern Coastal Region of 4 the Directorate of Engineering and Systems (Direccion de Ingenieria y Sistemas ), which is responsible for maintenance of the

Social Science Data Bases and Data Banks in the United States and Canada.

ERIC Educational Resources Information Center

Black, John B.

This overview of North American social science databases, including scope and services, identifies five trends: (1) growth--in the number of databases, subjects covered, and system availability; (2) increased competition in the retrieval systems marketplace with more databases being offered on multiple systems, improvements being made to the…

The Promise of Education Information Systems: How Technology Can Improve School Management and Success

ERIC Educational Resources Information Center

Levenson, Nathan; Boser, Ulrich

2014-01-01

Many school district strategic plans and education conferences are aggressively embracing technology to improve teaching and learning. Classroom technology typically includes blended learning, personalized learning, online courses for students, and professional development for teachers, among many other things. As districts wrestle with tighter…

TQM in Rural Education: Managing Schools from a Business Perspective.

ERIC Educational Resources Information Center

Nelson, William

1994-01-01

Outlines the 14 points of Deming's business philosophy of Total Quality Management in terms of rural education, including adoption of a common mission, movement from mass inspection (standardized testing) to individualized assessment, constant system improvement, training for those involved in the process, improved communication, employee rewards…

Ten Ways To Provide a High-Quality Acoustical Environment in Schools.

ERIC Educational Resources Information Center

Siebein, Gary W.; Gold, Martin A.; Siebein, Glenn W.; Ermann, Michael G.

2000-01-01

A study used impulse response measures and observations in 10 Florida classrooms to develop 10 recommendations for improving the acoustical environment in schools. Recommendations include improving air-conditioning systems, limiting room volume, providing sound-absorbing surfaces, using carpeting, reducing distance between teachers and students,…

Future long-range transports - Prospects for improved fuel efficiency

NASA Technical Reports Server (NTRS)

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

1975-01-01

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

Maturing Weapon Systems for Improved Availability at Lower Costs

DTIC Science & Technology

1994-01-01

development of new measures of R&M performance and improved data collection and analysis capabilities . Innovations in automated data collection, including the...45 Capabilities Required to Implement Maturation Development ...... 45 Assess R&M Performance Accurately ....................... 46 Identify...Requirements Determination ...................................... 49 Capabilities of the Best Existing Databases ..................... 49 Data Elements Needed

Audit filters for improving processes of care and clinical outcomes in trauma systems.

PubMed

Evans, Christopher; Howes, Daniel; Pickett, William; Dagnone, Luigi

2009-10-07

Traumatic injuries represent a considerable public health burden with significant personal and societal costs. The care of the severely injured patient in a trauma system progresses along a continuum that includes numerous interventions being provided by a multidisciplinary group of healthcare personnel. Despite the recent emphasis on quality of care in medicine, there has been little research to direct trauma clinicians and administrators on how optimally to monitor and improve upon the quality of care delivered within a trauma system. Audit filters are one mechanism for improving quality of care and are defined as specific clinical processes or outcomes of care that, when they occur, represent unfavorable deviations from an established norm and which prompt review and feedback. Although audit filters are widely utilized for performance improvement in trauma systems they have not been subjected to systematic review of their effectiveness. To determine the effectiveness of using audit filters for improving processes of care and clinical outcomes in trauma systems. Our search strategy included an electronic search of the Cochrane Injuries Group Specialized Register, the Cochrane EPOC Group Specialized Register, CENTRAL (The Cochrane Library 2008, Issue 4), MEDLINE, PubMed, EMBASE, CINAHL, and ISI Web of Science: (SCI-EXPANDED and CPCI-S). We handsearched the Journal of Trauma, Injury, Annals of Emergency Medicine, Academic Emergency Medicine, and Injury Prevention. We searched two clinical trial registries: 1) The World Health Organization International Clinical Trials Registry Platform and, 2) Clinical Trials.gov. We also contacted content experts for further articles. The most recent electronic search was completed in December 2008 and the handsearch was completed up to February 2009. We searched for randomized controlled trials, controlled clinical trials, controlled before-and-after studies, and interrupted time series studies that used audit filters as an intervention for improving processes of care, morbidity, or mortality for severely injured patients. Two authors independently screened the search results, applied inclusion criteria, and extracted data. There were no studies identified that met the inclusion criteria for this review. We were unable to identify any studies of sufficient methodological quality to draw conclusions regarding the effectiveness of audit filters as a performance improvement intervention in trauma systems. Future research using rigorous study designs should focus on the relative effectiveness of audit filters in comparison to alternative quality improvement strategies at improving processes of care, functional outcomes, and mortality for injured patients.

Conceptual design study for an advanced cab and visual system, volume 2

NASA Technical Reports Server (NTRS)

Rue, R. J.; Cyrus, M. L.; Garnett, T. A.; Nachbor, J. W.; Seery, J. A.; Starr, R. L.

1980-01-01

The performance, design, construction and testing requirements are defined for developing an advanced cab and visual system. The rotorcraft system integration simulator is composed of the advanced cab and visual system and the rotorcraft system motion generator, and is part of an existing simulation facility. User's applications for the simulator include rotorcraft design development, product improvement, threat assessment, and accident investigation.

Real time data acquisition for expert systems in Unix workstations at Space Shuttle Mission Control

NASA Technical Reports Server (NTRS)

Muratore, John F.; Heindel, Troy A.; Murphy, Terri B.; Rasmussen, Arthur N.; Gnabasik, Mark; Mcfarland, Robert Z.; Bailey, Samuel A.

1990-01-01

A distributed system of proprietary engineering-class workstations is incorporated into NASA's Space Shuttle Mission-Control Center to increase the automation of mission control. The Real-Time Data System (RTDS) allows the operator to utilize expert knowledge in the display program for system modeling and evaluation. RTDS applications are reviewed including: (1) telemetry-animated communications schematics; (2) workstation displays of systems such as the Space Shuttle remote manipulator; and (3) a workstation emulation of shuttle flight instrumentation. The hard and soft real-time constraints are described including computer data acquisition, and the support techniques for the real-time expert systems include major frame buffers for logging and distribution as well as noise filtering. The incorporation of the workstations allows smaller programming teams to implement real-time telemetry systems that can improve operations and flight testing.

Satellite services system overview

NASA Technical Reports Server (NTRS)

Rysavy, G.

1982-01-01

The benefits of a satellite services system and the basic needs of the Space Transportation System to have improved satellite service capability are identified. Specific required servicing equipment are discussed in terms of their technology development status and their operative functions. Concepts include maneuverable television systems, extravehicular maneuvering unit, orbiter exterior lighting, satellite holding and positioning aid, fluid transfer equipment, end effectors for the remote manipulator system, teleoperator maneuvering system, and hand and power tools.

Medicaid Program; Mechanized Claims Processing and Information Retrieval Systems (90/10). Final rule.

PubMed

2015-12-04

This final rule will extend enhanced funding for Medicaid eligibility systems as part of a state's mechanized claims processing system, and will update conditions and standards for such systems, including adding to and updating current Medicaid Management Information Systems (MMIS) conditions and standards. These changes will allow states to improve customer service and support the dynamic nature of Medicaid eligibility, enrollment, and delivery systems.

Graphics Processing Unit (GPU) implementation of image processing algorithms to improve system performance of the Control, Acquisition, Processing, and Image Display System (CAPIDS) of the Micro-Angiographic Fluoroscope (MAF).

PubMed

Vasan, S N Swetadri; Ionita, Ciprian N; Titus, A H; Cartwright, A N; Bednarek, D R; Rudin, S

2012-02-23

We present the image processing upgrades implemented on a Graphics Processing Unit (GPU) in the Control, Acquisition, Processing, and Image Display System (CAPIDS) for the custom Micro-Angiographic Fluoroscope (MAF) detector. Most of the image processing currently implemented in the CAPIDS system is pixel independent; that is, the operation on each pixel is the same and the operation on one does not depend upon the result from the operation on the other, allowing the entire image to be processed in parallel. GPU hardware was developed for this kind of massive parallel processing implementation. Thus for an algorithm which has a high amount of parallelism, a GPU implementation is much faster than a CPU implementation. The image processing algorithm upgrades implemented on the CAPIDS system include flat field correction, temporal filtering, image subtraction, roadmap mask generation and display window and leveling. A comparison between the previous and the upgraded version of CAPIDS has been presented, to demonstrate how the improvement is achieved. By performing the image processing on a GPU, significant improvements (with respect to timing or frame rate) have been achieved, including stable operation of the system at 30 fps during a fluoroscopy run, a DSA run, a roadmap procedure and automatic image windowing and leveling during each frame.

Study of space shuttle orbiter system management computer function. Volume 1: Analysis, baseline design

NASA Technical Reports Server (NTRS)

1975-01-01

A system analysis of the shuttle orbiter baseline system management (SM) computer function is performed. This analysis results in an alternative SM design which is also described. The alternative design exhibits several improvements over the baseline, some of which are increased crew usability, improved flexibility, and improved growth potential. The analysis consists of two parts: an application assessment and an implementation assessment. The former is concerned with the SM user needs and design functional aspects. The latter is concerned with design flexibility, reliability, growth potential, and technical risk. The system analysis is supported by several topical investigations. These include: treatment of false alarms, treatment of off-line items, significant interface parameters, and a design evaluation checklist. An in-depth formulation of techniques, concepts, and guidelines for design of automated performance verification is discussed.

Cost analysis of new and retrofit hot-air type solar assisted heating systems

NASA Technical Reports Server (NTRS)

Stewart, R. D.; Hawkins, B. J.

1978-01-01

A detailed cost analysis/cost improvement study was performed on two Department of Energy/National Aeronautics and Space Administration operational test sites to determine actual costs and potential cost improvements of new and retrofit hot air type, solar assisted heating and hot water systems for single family sized structures. This analysis concentrated on the first cost of a system which included procurement, installation, and integration of a solar assisted heating and hot water system on a new or retrofit basis; it also provided several cost projections which can be used as inputs to payback analyses, depending upon the degree of optimism or future improvements assumed. Cost definitions were developed for five categories of cost, and preliminary estimates were developed for each. The costing methodology, approach, and results together with several candidate low cost designs are described.

Final Technical Report. Project Boeing SGS

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

Bell, Thomas E.

Boeing and its partner, PJM Interconnection, teamed to bring advanced “defense-grade” technologies for cyber security to the US regional power grid through demonstration in PJM’s energy management environment. Under this cooperative project with the Department of Energy, Boeing and PJM have developed and demonstrated a host of technologies specifically tailored to the needs of PJM and the electric sector as a whole. The team has demonstrated to the energy industry a combination of processes, techniques and technologies that have been successfully implemented in the commercial, defense, and intelligence communities to identify, mitigate and continuously monitor the cyber security of criticalmore » systems. Guided by the results of a Cyber Security Risk-Based Assessment completed in Phase I, the Boeing-PJM team has completed multiple iterations through the Phase II Development and Phase III Deployment phases. Multiple cyber security solutions have been completed across a variety of controls including: Application Security, Enhanced Malware Detection, Security Incident and Event Management (SIEM) Optimization, Continuous Vulnerability Monitoring, SCADA Monitoring/Intrusion Detection, Operational Resiliency, Cyber Range simulations and hands on cyber security personnel training. All of the developed and demonstrated solutions are suitable for replication across the electric sector and/or the energy sector as a whole. Benefits identified include; Improved malware and intrusion detection capability on critical SCADA networks including behavioral-based alerts resulting in improved zero-day threat protection; Improved Security Incident and Event Management system resulting in better threat visibility, thus increasing the likelihood of detecting a serious event; Improved malware detection and zero-day threat response capability; Improved ability to systematically evaluate and secure in house and vendor sourced software applications; Improved ability to continuously monitor and maintain secure configuration of network devices resulting in reduced vulnerabilities for potential exploitation; Improved overall cyber security situational awareness through the integration of multiple discrete security technologies into a single cyber security reporting console; Improved ability to maintain the resiliency of critical systems in the face of a targeted cyber attack of other significant event; Improved ability to model complex networks for penetration testing and advanced training of cyber security personnel« less

Smart Adaptive Socket to Improve Fit and Relieve Pain in Wounded Warriors

DTIC Science & Technology

2016-10-01

applications were developed for wireless interaction with the socket system firmware. A control algorithm was designed and tested. Clinical trial...interface, Dynamic segmental volume control, Wireless connection, Pressure control system. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...charging jack, and power button are included in the design. A Bluetooth 4 radio is also included to allow for advanced user control via smartphone. The

Alpha-Linolenic Acid Confers Neuroprotection and Improves Behavioral Deficits After Soman Exposure: Involvement of Neurogenesis Through an mTOR-Mediated Pathway

DTIC Science & Technology

2015-01-15

chemical warfare agent that irreversibly inhibits acetylcholinesterase in the periphery and central nervous system. Soman induces status epilepticus ...of signs and symptoms including status epilepticus and death. The neuropathology leads to severe cognitive performance, including long-term cognitive... status epilepticus and excessive synaptic accumulation of acetylcholine affects other organ systems beside the brain causing hypersecretions

Improvement in Context: Exploring Aims, Improvement Priorities, and Environmental Considerations in a National Sample of Programs Using "Small Data".

PubMed

Philibert, Ingrid; Beernink, John H; Bush, Barbara H; Caniano, Donna A; Chow, Andrea; Coyle, John J; Gilhooly, Joseph; Kraybill, Donald E; Larson, David; Moran, Sarah; Nace, Mary Catherine; Robertson, William W; Rubin, Judith D; Sanford, Theodore

2017-12-01

In 2013, the Accreditation Council for Graduate Medical Education (ACGME) transitioned into a new accreditation system to reduce burden, focus on outcomes, and promote innovation and improvement. One component is a self-study that includes aims, an environmental assessment, and setting improvement priorities. The ACGME initiated voluntary site visits following the self-study. We explored common themes in program aims and assessment of their environment. Using grounded theory, inductive and deductive qualitative methods, and truth grounding, we analyzed data from voluntary site visits of 396 core and subspecialty programs between June 2015 and September 2017, with a focus on common themes. We report common themes for aims and the dimensions of the environmental assessment. Themes for strengths include a collegial, supportive learning environment; responsive leaders; and experiences that prepare residents for unsupervised practice. Improvement priorities encompass low learner engagement and "content mismatch" in didactic education, balancing education and service at a time of growing clinical volumes, and improving the utility of assessment systems. Common opportunities encompass collaborations that improve education, involving alumni and harnessing technology to enrich education, while threats include an unsustainable effort for many program leaders, clinical pressures on faculty, and loss of external sites important for education. Linked dimensions of the environmental assessment suggest benefit in a growing focus on learners, and approaches to ensure a humanistic learning environment that allows for growth, self-determination, and inclusion. The findings highlight actionable themes for the environmental assessment. We discuss implications for programs, institutions, and the ACGME.

Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

PubMed

Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

PubMed Central

2011-01-01

Background The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Results Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. Conclusions A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes. PMID:21824386

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

PubMed Central

Hamel, Donald J.; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D.; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T.; Okonkwo, Prosper; Kanki, Phyllis J.

2015-01-01

Introduction From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Methods Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Results Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Conclusions Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings. PMID:26900573

Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

PubMed

Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

2015-04-04

In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

Isotope Brayton electric power system for the 500 to 2500 watt range.

NASA Technical Reports Server (NTRS)

Macosko, R. P.; Barna, G. J.; Block, H. B.; Ingle, B. D.

1972-01-01

An extensive study was conducted at the Lewis Research Center to evaluate an isotope Brayton electric power system for use in the 500 to 2500 W power range. The study emphasized overall system simplicity in order to reduce parasitic power losses and improve system reliability. The study included detailed parametric cycle analysis, conceptual component designs, and evaluation of system packaging. The study has resulted in the selection of a single-loop system (gas) with six major components including one rotating unit. Calculated net system efficiency varies from 23 to 28% over the power range. The use of the Pu-238 heat source being developed for the Multi-Hundred-Watt Radioisotope Thermoelectric Generator program was assumed.

DECISION-SUPPORT TOOLS FOR MANAGING WASTEWATER PIPELINE PERFORMANCE IMPROVEMENTS

EPA Science Inventory

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

DECISION SUPPORT TOOLS FOR MANAGING WASTEWATER PIPELINE PERFORMANCE IMPROVEMENTS

EPA Science Inventory

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

Midwest regional rail system : a transportation network for the 21 century : executive report

DOT National Transportation Integrated Search

2000-02-01

The Midwest Regional Rail Initiative is an ongoing effort to develop an improved and expanded passenger rail system in the Midwest. Since 1996, the Midwest Regional Rail Initiative (MWRRI) advanced from a series of service concepts, including increas...

Improving the freight transportation roadway system during snow events : a performance evaluation of deicing chemicals.

DOT National Transportation Integrated Search

2012-05-01

The ability of state DOTs to adequately clear roadways during winter weather conditions is critical for a safe and effective : freight transportation system. Variables affecting winter maintenance operations include the type of precipitation, air and...

NASA firefighters breathing system program report

NASA Technical Reports Server (NTRS)

Wood, W. B.

1977-01-01

Because of the rising incidence of respiratory injury to firefighters, local governments expressed the need for improved breathing apparatus. A review of the NASA firefighters breathing system program, including concept definition, design, development, regulatory agency approval, in-house testing, and program conclusion is presented.

Can health care organizations improve health behavior and treatment adherence?

PubMed

Bender, Bruce G

2014-04-01

Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions.

NASIS data base management system - IBM 360/370 OS MVT implementation. 1: Installation standards

NASA Technical Reports Server (NTRS)

1973-01-01

The installation standards for the NASA Aerospace Safety Information System (NASIS) data base management system are presented. The standard approach to preparing systems documentation and the program design and coding rules and conventions are outlined. Included are instructions for preparing all major specifications and suggestions for improving the quality and efficiency of the programming task.

Reliability Validation and Improvement Framework

DTIC Science & Technology

2012-11-01

systems . Steps in that direction include the use of the Architec- ture Tradeoff Analysis Method ® (ATAM®) developed at the Carnegie Mellon...embedded software • cyber - physical systems (CPSs) to indicate that the embedded software interacts with, manag - es, and controls a physical system [Lee...the use of formal static analysis methods to increase our confidence in system operation beyond testing. However, analysis results

Consultant Input in Acute Medical Admissions and Patient Outcomes in Hospitals in England: A Multivariate Analysis

PubMed Central

Bell, Derek; Lambourne, Adrian; Percival, Frances; Laverty, Anthony A.; Ward, David K.

2013-01-01

Recent recommendations for physicians in the UK outline key aspects of care that should improve patient outcomes and experience in acute hospital care. Included in these recommendations are Consultant patterns of work to improve timeliness of clinical review and improve continuity of care. This study used a contemporaneous validated survey compared with clinical outcomes derived from Hospital Episode Statistics, between April 2009 and March 2010 from 91 acute hospital sites in England to evaluate systems of consultant cover for acute medical admissions. Clinical outcomes studied included adjusted case fatality rates (aCFR), including the ratio of weekend to weekday mortality, length of stay and readmission rates. Hospitals that had an admitting Consultant presence within the Acute Medicine Unit (AMU, or equivalent) for a minimum of 4 hours per day (65% of study group) had a lower aCFR compared with hospitals that had Consultant presence for less than 4 hours per day (p<0.01) and also had a lower 28 day re-admission rate (p<0.01). An ‘all inclusive’ pattern of Consultant working, incorporating all the guideline recommendations and which included the minimum Consultant presence of 4 hours per day (29%) was associated with reduced excess weekend mortality (p<0.05). Hospitals with >40 acute medical admissions per day had a lower aCFR compared to hospitals with fewer than 40 admissions per day (p<0.03) and had a lower 7 day re-admission rate (p<0.02). This study is the first large study to explore the potential relationships between systems of providing acute medical care and clinical outcomes. The results show an association between well-designed systems of Consultant working practices, which promote increased patient contact, and improved patient outcomes in the acute hospital setting. PMID:23613858

Consultant input in acute medical admissions and patient outcomes in hospitals in England: a multivariate analysis.

PubMed

Bell, Derek; Lambourne, Adrian; Percival, Frances; Laverty, Anthony A; Ward, David K

2013-01-01

Recent recommendations for physicians in the UK outline key aspects of care that should improve patient outcomes and experience in acute hospital care. Included in these recommendations are Consultant patterns of work to improve timeliness of clinical review and improve continuity of care. This study used a contemporaneous validated survey compared with clinical outcomes derived from Hospital Episode Statistics, between April 2009 and March 2010 from 91 acute hospital sites in England to evaluate systems of consultant cover for acute medical admissions. Clinical outcomes studied included adjusted case fatality rates (aCFR), including the ratio of weekend to weekday mortality, length of stay and readmission rates. Hospitals that had an admitting Consultant presence within the Acute Medicine Unit (AMU, or equivalent) for a minimum of 4 hours per day (65% of study group) had a lower aCFR compared with hospitals that had Consultant presence for less than 4 hours per day (p<0.01) and also had a lower 28 day re-admission rate (p<0.01). An 'all inclusive' pattern of Consultant working, incorporating all the guideline recommendations and which included the minimum Consultant presence of 4 hours per day (29%) was associated with reduced excess weekend mortality (p<0.05). Hospitals with >40 acute medical admissions per day had a lower aCFR compared to hospitals with fewer than 40 admissions per day (p<0.03) and had a lower 7 day re-admission rate (p<0.02). This study is the first large study to explore the potential relationships between systems of providing acute medical care and clinical outcomes. The results show an association between well-designed systems of Consultant working practices, which promote increased patient contact, and improved patient outcomes in the acute hospital setting.

Crowdsourced Contributions to the Nation's Geodetic Elevation Infrastructure

NASA Astrophysics Data System (ADS)

Stone, W. A.

2014-12-01

NOAA's National Geodetic Survey (NGS), a United States Department of Commerce agency, is engaged in providing the nation's fundamental positioning infrastructure - the National Spatial Reference System (NSRS) - which includes the framework for latitude, longitude, and elevation determination as well as various geodetic models, tools, and data. Capitalizing on Global Navigation Satellite System (GNSS) technology for improved access to the nation's precise geodetic elevation infrastructure requires use of a geoid model, which relates GNSS-derived heights (ellipsoid heights) with traditional elevations (orthometric heights). NGS is facilitating the use of crowdsourced GNSS observations collected at published elevation control stations by the professional surveying, geospatial, and scientific communities to help improve NGS' geoid modeling capability. This collocation of published elevation data and newly collected GNSS data integrates together the two height systems. This effort in turn supports enhanced access to accurate elevation information across the nation, thereby benefiting all users of geospatial data. By partnering with the public in this collaborative effort, NGS is not only helping facilitate improvements to the elevation infrastructure for all users but also empowering users of NSRS with the capability to do their own high-accuracy positioning. The educational outreach facet of this effort helps inform the public, including the scientific community, about the utility of various NGS tools, including the widely used Online Positioning User Service (OPUS). OPUS plays a key role in providing user-friendly and high accuracy access to NSRS, with optional sharing of results with NGS and the public. All who are interested in helping evolve and improve the nationwide elevation determination capability are invited to participate in this nationwide partnership and to learn more about the geodetic infrastructure which is a vital component of viable spatial data for many disciplines, including the geosciences.

Living Design Memory: Framework, Implementation, Lessons Learned.

ERIC Educational Resources Information Center

Terveen, Loren G.; And Others

1995-01-01

Discusses large-scale software development and describes the development of the Designer Assistant to improve software development effectiveness. Highlights include the knowledge management problem; related work, including artificial intelligence and expert systems, software process modeling research, and other approaches to organizational memory;…

Assistive and Autonomous Breast Ultrasound Screening: Improving PPV and Reducing RSI

DTIC Science & Technology

imaging with quantitative elastography. Major objectives achieved in this period included development of a research platform including a compliant...This report details our first year of research activity on technologies that support sonographer-supervised robotic systems for breast ultrasound

RTEMS CENTRE- RTEMS Improvement

NASA Astrophysics Data System (ADS)

Silva, Helder; Constantino, Alexandre; Freitas, Daniel; Coutinho, Manuel; Faustino, Sergio; Sousa, Jose; Dias, Luis; Zulianello, Marco

2010-08-01

During the last two years, EDISOFT's RTEMS CENTRE team [1], jointly with the European Space Agency and with the support of the worldwide RTEMS community [2], have been developing an activity to facilitate the qualification of the real-time operating system RTEMS (Real-Time Operating System for Multiprocessor Systems). This paper intends to give a high level visibility of the progress and the results obtained in the RTEMS Improvement [3] activity. The primary objective [4] of the project is to improve the RTEMS product, its documentation and to facilitate the qualification of RTEMS for future space missions, taking into consideration the specific operational requirements. The sections below provide a brief overview of the RTEMS operating system and the activities performed in the RTEMS Improvement project, which includes the selection of API managers to be qualified, the tailoring process, the requirements analysis, the reverse engineering and design of the RTEMS, the quality assurance process, the ISVV activities, the test campaign, the results obtained, the criticality analysis and the facilitation of qualification process.

Some economic benefits of a synchronous earth observatory satellite

NASA Technical Reports Server (NTRS)

Battacharyya, R. K.; Greenberg, J. S.; Lowe, D. S.; Sattinger, I. J.

1974-01-01

An analysis was made of the economic benefits which might be derived from reduced forecasting errors made possible by data obtained from a synchronous satellite system which can collect earth observation and meteorological data continuously and on demand. User costs directly associated with achieving benefits are included. In the analysis, benefits were evaluated which might be obtained as a result of improved thunderstorm forecasting, frost warning, and grain harvest forecasting capabilities. The anticipated system capabilities were used to arrive at realistic estimates of system performance on which to base the benefit analysis. Emphasis was placed on the benefits which result from system forecasting accuracies. Benefits from improved thunderstorm forecasts are indicated for the construction, air transportation, and agricultural industries. The effects of improved frost warning capability on the citrus crop are determined. The benefits from improved grain forecasting capability are evaluated in terms of both U.S. benefits resulting from domestic grain distribution and U.S. benefits from international grain distribution.

Are well functioning civil registration and vital statistics systems associated with better health outcomes?

PubMed

Phillips, David E; AbouZahr, Carla; Lopez, Alan D; Mikkelsen, Lene; de Savigny, Don; Lozano, Rafael; Wilmoth, John; Setel, Philip W

2015-10-03

In this Series paper, we examine whether well functioning civil registration and vital statistics (CRVS) systems are associated with improved population health outcomes. We present a conceptual model connecting CRVS to wellbeing, and describe an ecological association between CRVS and health outcomes. The conceptual model posits that the legal identity that civil registration provides to individuals is key to access entitlements and services. Vital statistics produced by CRVS systems provide essential information for public health policy and prevention. These outcomes benefit individuals and societies, including improved health. We use marginal linear models and lag-lead analysis to measure ecological associations between a composite metric of CRVS performance and three health outcomes. Results are consistent with the conceptual model: improved CRVS performance coincides with improved health outcomes worldwide in a temporally consistent manner. Investment to strengthen CRVS systems is not only an important goal for individuals and societies, but also a development imperative that is good for health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluating Options for Improving California's Drought Resilience

NASA Astrophysics Data System (ADS)

Ray, P. A.; Schwarz, A.; Wi, S.; Correa, M.; Brown, C.

2015-12-01

Through a unique collaborative arrangement, the University of Massachusetts (UMass) and the California Department of Water Resources (DWR) have together performed a baseline climate change analysis of the California state (State Water Project) and federal (Central Valley Project) water systems. The first step in the baseline analysis was development of an improved basinwide hydrologic model covering a large area of California including all major tributaries to the state and federal water systems. The CalLite modeling system used by DWR for planning purposes allowed simulation of the system of reservoirs, rivers, control points, and deliveries which are then used to create performance metrics that quantify a wide range of system characteristics including water deliveries, water quality, and environmental/ecological factors. A baseline climate stress test was conducted to identify current vulnerabilities to climate change through the linking of the modeling chain with Decision Scaling concepts through the UMass bottom-up climate stress-testing algorithm. This procedure allowed the first comprehensive climate stress analysis of the California state and federal water systems not constrained by observed historical variability and wet-dry year sequences. A forward-looking drought vulnerability and adaptation assessment of the water systems based on this workflow is ongoing and preliminary results will be presented. Presentation of results will include discussion of the collaborative arrangement between DWR and UMass, which is instrumental to both the success of the research and the education of policy makers.

Strengthening health system to improve immunization for migrants in China.

PubMed

Fang, Hai; Yang, Li; Zhang, Huyang; Li, Chenyang; Wen, Liankui; Sun, Li; Hanson, Kara; Meng, Qingyue

2017-07-01

Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.

Force Measurement Improvements to the National Transonic Facility Sidewall Model Support System

NASA Technical Reports Server (NTRS)

Goodliff, Scott L.; Balakrishna, Sundareswara; Butler, David; Cagle, C. Mark; Chan, David; Jones, Gregory S.; Milholen, William E., II

2016-01-01

The National Transonic Facility is a transonic pressurized cryogenic facility. The development of the high Reynolds number semi-span capability has advanced over the years to include transonic active flow control and powered testing using the sidewall model support system. While this system can be used in total temperatures down to -250Â F for conventional unpowered configurations, it is limited to temperatures above -60Â F when used with powered models that require the use of the high-pressure air delivery system. Thermal instabilities and non-repeatable mechanical arrangements revealed several data quality shortfalls by the force and moment measurement system. Recent modifications to the balance cavity recirculation system have improved the temperature stability of the balance and metric model-to-balance hardware. Changes to the mechanical assembly of the high-pressure air delivery system, particularly hardware that interfaces directly with the model and balance, have improved the repeatability of the force and moment measurement system. Drag comparisons with the high-pressure air system removed will also be presented in this paper.

Note: Work function change measurement via improved Anderson method

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

Sabik, A., E-mail: sabik@ifd.uni.wroc.pl; Gołek, F.; Antczak, G.

We propose the modification to the Anderson method of work function change (Δϕ) measurements. In this technique, the kinetic energy of the probing electrons is already low enough for non-destructive investigation of delicate molecular systems. However, in our implementation, all electrodes including filament of the electron gun are polarized positively. As a consequence, electron bombardment of any elements of experimental system is eliminated. Our modification improves cleanliness of the ultra-high vacuum system. As an illustration of the solution capabilities, we present Δϕ of the Ag(100) surface induced by cobalt phthalocyanine layers.

Gelcasting compositions having improved drying characteristics and machinability

DOEpatents

Janney, Mark A.; Walls, Claudia A. H.

2001-01-01

A gelcasting composition has improved drying behavior, machinability and shelf life in the dried and unfired state. The composition includes an inorganic powder, solvent, monomer system soluble in the solvent, an initiator system for polymerizing the monomer system, and a plasticizer soluble in the solvent. Dispersants and other processing aides to control slurry properties can be added. The plasticizer imparts an ability to dry thick section parts, to store samples in the dried state without cracking under conditions of varying relative humidity, and to machine dry gelcast parts without cracking or chipping. A method of making gelcast parts is also disclosed.

A Hybrid Approach to Detect Driver Drowsiness Utilizing Physiological Signals to Improve System Performance and Wearability

PubMed Central

Badruddin, Nasreen

2017-01-01

Driver drowsiness is a major cause of fatal accidents, injury, and property damage, and has become an area of substantial research attention in recent years. The present study proposes a method to detect drowsiness in drivers which integrates features of electrocardiography (ECG) and electroencephalography (EEG) to improve detection performance. The study measures differences between the alert and drowsy states from physiological data collected from 22 healthy subjects in a driving simulator-based study. A monotonous driving environment is used to induce drowsiness in the participants. Various time and frequency domain feature were extracted from EEG including time domain statistical descriptors, complexity measures and power spectral measures. Features extracted from the ECG signal included heart rate (HR) and heart rate variability (HRV), including low frequency (LF), high frequency (HF) and LF/HF ratio. Furthermore, subjective sleepiness scale is also assessed to study its relationship with drowsiness. We used paired t-tests to select only statistically significant features (p < 0.05), that can differentiate between the alert and drowsy states effectively. Significant features of both modalities (EEG and ECG) are then combined to investigate the improvement in performance using support vector machine (SVM) classifier. The other main contribution of this paper is the study on channel reduction and its impact to the performance of detection. The proposed method demonstrated that combining EEG and ECG has improved the system’s performance in discriminating between alert and drowsy states, instead of using them alone. Our channel reduction analysis revealed that an acceptable level of accuracy (80%) could be achieved by combining just two electrodes (one EEG and one ECG), indicating the feasibility of a system with improved wearability compared with existing systems involving many electrodes. Overall, our results demonstrate that the proposed method can be a viable solution for a practical driver drowsiness system that is both accurate and comfortable to wear. PMID:28858220

Application of Calspan pitch rate control system to the Space Shuttle for approach and landing

NASA Technical Reports Server (NTRS)

Weingarten, N. C.; Chalk, C. R.

1983-01-01

A pitch rate control system designed for use in the shuttle during approach and landing was analyzed and compared with a revised control system developed by NASA and the existing OFT control system. The design concept control system uses filtered pitch rate feedback with proportional plus integral paths in the forward loop. Control system parameters were designed as a function of flight configuration. Analysis included time and frequency domain techniques. Results indicate that both the Calspan and NASA systems significantly improve the flying qualities of the shuttle over the OFT. Better attitude and flight path control and less time delay are the primary reasons. The Calspan system is preferred because of reduced time delay and simpler mechanization. Further testing of the improved flight control systems in an in-flight simulator is recommended.