Developing a performance criteria model for school foodservice: an application of Analytic Hierarchy Process (AHP)

This study developed a performance criteria model in terms of achieving the overall Child Nutrition Program (CNP) goal for school foodservice and utilized it in comparing conventional and centralized food production systems. The development and comparison procedures were conducted using the Analytic Hierarchy Process (AHP). Current practices for monitoring performance criteria also were examined. Five questionnaires were developed to (a) identify a list of comprehensive performance criteria that were agreed upon by school foodservice experts; (b) evaluate two food production systems compared by school foodservice directors who have managed both systems in the same school district; and (c) investigate current practices for monitoring performance criteria reported by school foodservice directors managing large school districts.;Results indicated that customer satisfaction was the most important category in achieving the overall CNP goal, followed by financial management, meal quality, program management, and operations management. Two school foodservice directors, who responded and managed conventional and centralized food production systems in the same school district, suggested that the centralizing food production may be better in achieving the overall CNP goal. However, the optimum level of centralization in school foodservice operations is yet to be determined. Criteria related to food production, program management, and meal quality were monitored daily by most school foodservice directors. Although all performance criteria were monitored regularly by school foodservice managers, standards to determine whether current performance in various criteria were satisfactory or not were not consistent among school districts. Financial management was the area for which school foodservice directors needed the most assistance.;The performance criteria model developed can be used for strategic decision making in school foodservice. Priorities of criteria in the model can be customized to school districts with different goals by replicating the pairwise comparison process used in this study. Also, researchers need to identify levels of performance in each criterion by developing standards of performance for each criterion. This can assist school foodservice directors with evaluating performance in different criteria, especially for those criteria that directors have a difficult time monitoring

Validation of the Implementation Climate Scale (ICS) in substance use disorder treatment organizations.

BackgroundOne critical factor in the implementation of evidence-based practice (EBP) in substance use disorder treatment organizations is an inner organizational context that clearly supports implementation efforts. The Implementation Climate Scale (ICS) has been developed to allow researchers and organizations to assess climate for EBP implementation in health and allied health service organizations. The ICS consists of 18 items and measures six dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection for EBP, and selection for openness. The ICS was initially developed in a mental health context; thus, the goal of this study was to provide initial validation of the ICS in substance use disorder (SUD) treatment settings.MethodsConfirmatory factor analysis (CFA) was used to assess the psychometric functioning of the ICS using survey data from 326 providers in 65 teams in SUD treatment programs. Cronbach's alpha was examined to assess internal consistency of the ICS, and individual and team level construct-based validity was examined by comparing its correlations with service climate, molar climate, and organizational change.ResultsWe found evidence for the reliability, factor structure, and validity of the ICS in SUD services. The psychometric functioning of the ICS in SUD treatment settings was comparable to that found in mental health contexts.ConclusionsThe ICS is a brief and pragmatic tool for researchers to better understand a critical antecedent for implementation effectiveness in SUD treatment and for organizational leaders in SUD treatment organizations to evaluate the extent to which providers perceive that their organization supports EBP implementation

An Analysis of the 3D Sample Size Model Built by Individual Users

Current apparel CAD technology enables manufactures to develop products rapidly in an efficient way. In addition, 3D technologies with virtual models are considered for an advanced design process. This can help a technical designer visualize the entire process from 2D pattern creation to end product fit assessment on a 3D virtual model. The 3D virtual design tools are offered by several apparel CAD vendors. The 3D virtual design tools offer two ways to create 3D virtual models: 1) a manual 3D formation and 2) a 3D body scan. The manual 3D formation is an indirect virtual model that users can build from a built-in feature or a pre-existing 3D body template by manually inputting actual measurements

Curvaton reheating in tachyonic inflationary models

The curvaton reheating in a tachyonic inflationary universe model with an exponential potential is studied. We have found that the energy density in the kinetic epoch, has a complicated dependencies of the scale factor. For different scenarios, the temperature of reheating is computed. These temperature result to be analogous to those obtained in the standard case of the curvaton scenario.Comment: 9 pages, Accepted for publication in Phys. Letter

Dark energy and dark matter from an inhomogeneous dilaton

A cosmological scenario is proposed where the dark matter (DM) and dark energy (DE) of the universe are two simultaneous manifestations of an inhomogenous dilaton. The equation of state of the field is scale-dependent and pressureless at galactic and larger scales and it has negative pressure as a DE at very large scales. The dilaton drives an inflationary phase followed by a kinetic energy-dominated one, as in the "quintessential inflation" model introduced by Peebles & Vilenkin, and soon after the end of inflation particle production seeds the first inhomogeneities that lead to galaxy formation. The dilaton is trapped near the minimum of the potential where it oscillates like a massive field, and the excess of kinetic energy is dissipated via the mechanism of "gravitational cooling" first introduced by Seidel & Suen. The inhomogeneities therefore behave like solitonic oscillations around the minimum of the potential, known as "oscillatons", that we propose account for most DM in galaxies. Those regions where the dilaton does not transform enough kinetic energy into reheating or carry an excess of it from regions that have cooled, evolve to the tail of the potential as DE, driving the acceleration of the universe.Comment: 9 pages, 8 figures, uses revtex, submitted PR

Evaluating the Impact of a Critical Time Intervention Adaptation on Health Care Utilization among Homeless Adults with Mental Health Needs in a Large Urban Center

OBJECTIVE: This study evaluated the impact of a critical time intervention (CTI) adaptation on health care utilization outcomes among adults experiencing homelessness and mental health needs in a large urban center. METHODS: Provincial population-based administrative data from Ontario, Canada, were used in a pre-post design for a cohort of 197 individuals who received the intervention between January 2013 and May 2014 and were matched to a cohort of adults experiencing homelessness who did not receive the intervention over the same time period. Changes in health care utilization outcomes in the year pre- and postintervention were evaluated using generalized estimating equations, and post hoc analyses evaluated differences between groups. RESULTS: Pre-post analyses revealed statistically significant changes in health care utilization patterns among intervention recipients, including reduced inpatient service use and increased outpatient service use in the year following the intervention compared to the year prior. However, the matched cohort analysis found nonsignificant differences in health service use changes between a subgroup of intervention recipients and their matched counterparts. CONCLUSIONS: An adapted CTI model was associated with changes in health care utilization among people experiencing homelessness and mental health needs. However, changes were not different from those observed in a matched cohort. Rigorous study designs with adequate samples are needed to examine the effectiveness of CTI and local adaptations in diverse health care contexts

Design, implementation and evaluation of a national campaign to distribute nine million free LLINs to children under five years of age in Tanzania.

BACKGROUND\ud \ud After a national voucher scheme in 2004 provided pregnant women and infants with highly subsidized insecticide-treated nets (ITNs), use among children under five years (U5s) in mainland Tanzania increased from 16% in 2004 to 26.2% in 2007. In 2008, the Ministry of Health and Social Welfare planned a catch-up campaign to rapidly and equitably deliver a free long-lasting insecticidal net (LLIN) to every child under five years in Tanzania.\ud \ud METHODS\ud \ud The ITN Cell, a unit within the National Malaria Control Programme (NMCP), coordinated the campaign on behalf of the Ministry of Health and Social Welfare. Government contractors trained and facilitated local government officials to supervise village-level volunteers on a registration of all U5s and the distribution and issuing of LLINs. The registration results formed the basis for the LLIN order and delivery to village level. Caregivers brought their registration coupons to village issuing posts during a three-day period where they received LLINs for their U5s. Household surveys in five districts assessed ITN ownership and use immediately after the campaign.\ud \ud RESULTS\ud \ud Nine donors contributed to the national campaign that purchased and distributed 9.0 million LLINs at an average cost of $7.07 per LLIN, including all campaign-associated activities. The campaign covered all eight zones of mainland Tanzania, the first region being covered separately during an integrated measles immunization/malaria LLIN distribution in August 2008, and was implemented one zone at a time from March 2009 until May 2010. ITN ownership at household level increased from Tanzania's 2008 national average of 45.7% to 63.4%, with significant regional variations. ITN use among U5s increased from 28.8% to 64.1%, a 2.2-fold increase, with increases ranging from 22.1-38.3% percentage points in different regions.\ud \ud CONCLUSION\ud \ud A national-level LLIN distribution strategy that fully engaged local government authorities helped avoid additional burden on the healthcare system. Distribution costs per net were comparable to other public health interventions. Particularly among rural residents, ITN ownership and use increased significantly for the intended beneficiaries. The upcoming universal LLIN distribution and further behaviour change communication will further improve ITN ownership and use in 2010-2011

Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for uveitis (focus) initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic reviewof the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE,CINAHL,SCOPUS,BIOSIS, andWeb of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review.Atotal of 44 globally representativegroupmembersmet in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents