A comparative assessment of solar thermal electric power plants in the 1-10 MWe range

The candidate power system technologies were ranked in terms of the cost of electric energy each system produces. In all cases, it was assumed that development programs would result in mature power plant systems that could be commercially manufactured. The results of the study, a brief description of the systems examined, and the methodologies used are presented

Verification Testing To Confirm VO2max Attainment in Inactive Women With Obesity

International Journal of Exercise Science 13(4): 1448-1458, 2020. Incidence of obesity is increasing worldwide which is deleterious to health due to its association with increased risk of cardiovascular disease, diabetes, and some cancers. Completion of regular physical activity in individuals with obesity increases maximal oxygen uptake (VO2max). However, whether individuals with obesity can exhibit ‘true’ VO2max is unresolved. This study examined efficacy of verification testing (VER) to identify ‘true’ VO2max in 17 inactive women with obesity (age, body fat, and VO2max = 37 ± 10 yr, 48.7 ± 3.5 %, and 19.4 ± 3.0 mL/kg/min, respectively). They performed ramp exercise (RAMP) to volitional fatigue followed by VER at 105 percent peak power output (%PPO) at baseline and after 3 and 6 wk of high intensity interval training. Results showed no difference in ramp and verification-derived VO2max (1.99 ± 0.37 L/min vs. 1.98 ± 0.32 L/min, 2.00 ± 0.40 L/min vs. 2.04 ± 0.38 L/min, and 2.08 ± 0.34 L/min vs. 2.08 ± 0.32 L/min at 0, 3 and 6 wk of training), although in 40 % of VER tests, VO2max was greater than the RAMP value. Overall, verification testing may be adopted as an additional approach to confirm ‘true’ VO2max attainment in obese women as ramp exercise frequently underestimates VO2max in this population

Does the process map influence the outcome of quality improvement work? A comparison of a sequential flow diagram and a hierarchical task analysis diagram

Background: Many quality and safety improvement methods in healthcare rely on a complete and accurate map of the process. Process mapping in healthcare is often achieved using a sequential flow diagram, but there is little guidance available in the literature about the most effective type of process map to use. Moreover there is evidence that the organisation of information in an external representation affects reasoning and decision making. This exploratory study examined whether the type of process map - sequential or hierarchical - affects healthcare practitioners' judgments.Methods: A sequential and a hierarchical process map of a community-based anti coagulation clinic were produced based on data obtained from interviews, talk-throughs, attendance at a training session and examination of protocols and policies. Clinic practitioners were asked to specify the parts of the process that they judged to contain quality and safety concerns. The process maps were then shown to them in counter-balanced order and they were asked to circle on the diagrams the parts of the process where they had the greatest quality and safety concerns. A structured interview was then conducted, in which they were asked about various aspects of the diagrams.Results: Quality and safety concerns cited by practitioners differed depending on whether they were or were not looking at a process map, and whether they were looking at a sequential diagram or a hierarchical diagram. More concerns were identified using the hierarchical diagram compared with the sequential diagram and more concerns were identified in relation to clinical work than administrative work. Participants' preference for the sequential or hierarchical diagram depended on the context in which they would be using it. The difficulties of determining the boundaries for the analysis and the granularity required were highlighted.Conclusions: The results indicated that the layout of a process map does influence perceptions of quality and safety problems in a process. In quality improvement work it is important to carefully consider the type of process map to be used and to consider using more than one map to ensure that different aspects of the process are captured

Quality management in heavy duty manufacturing industry: TQM vs. Six Sigma

‘Is TQM a management fad?’ This question has been extensively documented in the quality management literature; and will be tackled in this research though a critical literature review on the area. ‘TQM versus Six-Sigma’ debate, which has also been a fundamental challenge in this research filed, is addressed by a thematic and chronological review on the peer papers. To evaluate this challenge in practice, a primary research in heavy duty machinery production industry have been conducted using a case-study on, J C Bamford Excavators Ltd (JCB), the largest European construction machinery producer. The result highlights that TQM is a natural foundation to build up Six-Sigma upon; and not surprisingly the quality yield in a TQM approach complemented by Six-sigma is far higher and more stable than when TQM with no Six-Sigma focus is being put in place; thus presenting the overall finding that TQM and Six Sigma are compliments, not substitutes. The study will be concluded with an overview on quality management approaches in the heavy duty manufacturing industry to highlight the way forward for the industry

Chagas Disease in the New York City Metropolitan Area.

Background:Chagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor. Methods:We review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment. Results:The most common country of origin of our patients was El Salvador (n = 24, 40%), and the most common detection method was by routine blood donor screening (n = 21, 35%). Nearly half of the patients were asymptomatic (n = 29, 48%). Twenty-seven patients were treated with either benznidazole or nifurtimox, of whom 7 did not complete therapy due to side effects or were lost to follow-up. Ten patients had advanced heart failure requiring device implantation or organ transplantation. Conclusions:Based on our experience, we recommend that targeted screening be used to identify at-risk, asymptomatic patients before progression to clinical disease. Evaluation should include an electrocardiogram, echocardiogram, and chest x-ray, as well as gastrointestinal imaging if relevant symptoms are present. Patients should be treated if appropriate, but providers should be aware of adverse effects that may prevent patients from completing treatment

Overcoming the novelty effect in online gamified learning systems: an empirical evaluation of student engagement and performance

Learners in the Higher Education context who engage with computer-based gamified learning systems often experience the novelty effect: a pattern of high activity during the gamified system’s introduction followed by a drop in activity a few weeks later, once its novelty has worn off. We applied a two-tiered motivational, online gamified learning system over two years to a total number of 333 students. In a mixed methods research design, we used three-years’ worth of longitudinal data (333 students for the treatment group and 175 in the control group) to assess students’ engagement and performance in that period. Quantitative results established that students engaged and performed better in the gamified condition vis-à-vis the non- gamified. Furthermore, students exhibited higher levels of engagement in the second year compared to the first year of the gamified condition. Our qualitative data suggests that students in the second year of the gamified delivery exhibited sustained engagement, overcoming the novelty effect. Thus, our main contribution is in suggesting ways of making the engagement meaningful and useful for the students thus sustaining their engagement with computer-based gamified learning systems and overcoming the novelty effect

Public Health Emergency Preparedness and Response Communications with Health Care Providers: A Literature Review

<p>Abstract</p> <p>Background</p> <p>Health care providers (HCPs) play an important role in public health emergency preparedness and response (PHEPR) so need to be aware of public health threats and emergencies. To inform HCPs, public health issues PHEPR messages that provide guidelines and updates, and facilitate surveillance so HCPs will recognize and control communicable diseases, prevent excess deaths and mitigate suffering. Public health agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. Public health agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. We conducted a literature review to investigate the systems and tools used by public health to generate PHEPR communications to HCPs, and to identify specific characteristics of message delivery mechanisms and formats that may be associated with effective PHEPR communications.</p> <p>Methods</p> <p>A systematic review of peer- and non-peer-reviewed literature focused on the following questions: 1) What public health systems exist for communicating PHEPR messages from public health agencies to HCPs? 2) Have these systems been evaluated and, if yes, what criteria were used to evaluate these systems? 3) What have these evaluations discovered about characterizations of the most effective ways for public health agencies to communicate PHEPR messages to HCPs?</p> <p>Results</p> <p>We identified 25 systems or tools for communicating PHEPR messages from public health agencies to HCPs. Few articles assessed PHEPR communication systems or messaging methods or outcomes. Only one study compared the effectiveness of the delivery format, device or message itself. We also discovered that the potential is high for HCPs to experience "message overload" given redundancy of PHEPR messaging in multiple formats and/or through different delivery systems.</p> <p>Conclusions</p> <p>We found that detailed descriptions of PHEPR messaging from public health to HCPs are scarce in the literature and, even when available are rarely evaluated in any systematic fashion. To meet present-day and future information needs for emergency preparedness, more attention needs to be given to evaluating the effectiveness of these systems in a scientifically rigorous manner.</p

Web‐based Weight Management Programs in an Integrated Health Care Setting: A Randomized, Controlled Trial

Objective : To assess the efficacy of a Web‐based tailored behavioral weight management program compared with Web‐based information‐only weight management materials. Research Methods and Procedures : Participants, 2862 eligible overweight and obese (BMI = 27 to 40 kg/m 2 ) members from four regions of Kaiser Permanente's integrated health care delivery system, were randomized to receive either a tailored expert system or information‐only Web‐based weight management materials. Weight change and program satisfaction were assessed by self‐report through an Internet‐based survey at 3‐ and 6‐month follow‐up periods. Results : Significantly greater weight loss at follow‐up was found among participants assigned to the tailored expert system than among those assigned to the information‐only condition. Subjects in the tailored expert system lost a mean of 3 ± 0.3% of their baseline weight, whereas subjects in the information‐only condition lost a mean of 1.2 ± 0.4% ( p < 0.0004). Participants were also more likely to report that the tailored expert system was personally relevant, helpful, and easy to understand. Notably, 36% of enrollees were African‐American, with enrollment rates higher than the general proportion of African Americans in any of the study regions. Discussion : The results of this large, randomized control trial show the potential benefit of the Web‐based tailored expert system for weight management compared with a Web‐based information‐only weight management program.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93691/1/oby.2006.34.pd