889 resultados para Evaluation. Effectiveness. Efficacy. Efficiency. Participation


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The effectiveness of the Anisotropic Analytical Algorithm (AAA) implemented in the Eclipse treatment planning system (TPS) was evaluated using theRadiologicalPhysicsCenteranthropomorphic lung phantom using both flattened and flattening-filter-free high energy beams. Radiation treatment plans were developed following the Radiation Therapy Oncology Group and theRadiologicalPhysicsCenterguidelines for lung treatment using Stereotactic Radiation Body Therapy. The tumor was covered such that at least 95% of Planning Target Volume (PTV) received 100% of the prescribed dose while ensuring that normal tissue constraints were followed as well. Calculated doses were exported from the Eclipse TPS and compared with the experimental data as measured using thermoluminescence detectors (TLD) and radiochromic films that were placed inside the phantom. The results demonstrate that the AAA superposition-convolution algorithm is able to calculate SBRT treatment plans with all clinically used photon beams in the range from 6 MV to 18 MV. The measured dose distribution showed a good agreement with the calculated distribution using clinically acceptable criteria of ±5% dose or 3mm distance to agreement. These results show that in a heterogeneous environment a 3D pencil beam superposition-convolution algorithms with Monte Carlo pre-calculated scatter kernels, such as AAA, are able to reliably calculate dose, accounting for increased lateral scattering due to the loss of electronic equilibrium in low density medium. The data for high energy plans (15 MV and 18 MV) showed very good tumor coverage in contrast to findings by other investigators for less sophisticated dose calculation algorithms, which demonstrated less than expected tumor doses and generally worse tumor coverage for high energy plans compared to 6MV plans. This demonstrates that the modern superposition-convolution AAA algorithm is a significant improvement over previous algorithms and is able to calculate doses accurately for SBRT treatment plans in the highly heterogeneous environment of the thorax for both lower (≤12 MV) and higher (greater than 12 MV) beam energies.

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Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

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Background: The number of incarcerated women has increased dramatically over the past two decades. During their stay in prison, the medical and nutritional needs of these women are frequently ignored. Overweight or obesity related to poor dietary habits and low-income status are important risk factors for health inequities. Women in this population are at risk for dietary-related chronic diseases such as hypertension, diabetes, and cardiovascular diseases. This is an indication that there is a need for nutrition education in this population. ^ Purpose: The purpose of this study was to provide an evidence-based nutrition education program at a facility for previously incarcerated women in Downtown Houston, Texas (Brigid's Hope). This nutrition education program focused on promoting better health and prevention of chronic diseases by increasing fruit and vegetable (FV) intake and healthy eating on a limited budget. Constructs such as knowledge, skills, self-efficacy, and perceived barriers were evaluated as well as acceptability, feasibility, and sustainability of the program. ^ Methods: The Hope for Health Nutrition Education Program occurred in four weekly sessions at Brigid's Hope. The evaluation design was a one-group quasi-experimental design with pre- and post-test measures. Identical pre- and post-tests were administered before and after the intervention. A total of 11 residents and 2 staff members participated in the study. Results: After four nutrition education sessions, post-tests revealed an overall increase in knowledge, skills, and self-efficacy scores, and decrease in perceived barrier scores towards FV consumption. Changes in skills, self-efficacy, and perceived barriers scores were found to be statistically significant. Participant satisfaction surveys revealed overall high satisfaction of the program and that continuing the program in the future would be possible with support from staff member and mentors. ^ Conclusions: Results from this study show that a nutrition education program can have positive effects towards knowledge, skills, self-efficacy, and perceived barriers towards FV consumption for previously incarcerated women. The high satisfaction for this program shows that a health promotion program with focus on diet and nutrition can play an important role in helping this unique population of women re-enter society.^

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A review of literature related to appointment-keeping served as the basis for the development of an organizational paradigm for the study of appointment-keeping in the Beta-blocker Heart Attack Trial (BHAT). Features of the organizational environment, demographic characteristics of BHAT enrollees, organizational structure and processes and previous organizational performance variables were measured so as to provide exploratory information relating to the appointment-keeping behavior of 3,837 participants enrolled at thirty-two Clinical Centers. Results suggest that the social context of individual behavior is an important consideration for the understanding of patient compliance. In particular, the degree to which previous organizational performance--as measured by obtaining recruitment goals--and the ability to utilize resources had particularly strong bivariate associations with appointment-keeping. Implications for future theory development, research and practical implications were provided as was a suggestion for the development of multidisciplinary research efforts conducted within the context of Centers for the study and application of adherence behaviors. ^

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The purpose of this study was to evaluate the effectiveness of an HIV-screening program at a private health-care institution where the providers were trained to counsel pregnant women about the HIV-antibody test according to the latest recommendations made by the U.S. Public Health Service (PHS) and the Texas legislature. A before-and-after study design was selected for the study. The participants were OB/GYN nurses who attended an educational program and the patients they counseled about the HIV test. Training improved the nurses' overall knowledge about the content of the program and nurses were more likely to offer the HIV test to all pregnant women regardless of their risk of infection. Still, contrary to what was predicted, the nurses did not give more information to increase the knowledge pregnant women had about HIV infection, transmission, and available treatments. Consequently, many women were not given the chance to correctly assess their risk during the counseling session and there was no evidence that knowledge would reduce the propensity of many women to deny being at risk for HIV. On the other hand, pregnant women who received prenatal care after the implementation of the HIV-screening program were more likely to be tested than women who received prenatal care before its implementation (96% vs. 48%); in turn, the likelihood that more high-risk women would be tested for HIV also increased (94% vs. 60%). There was no evidence that mandatory testing with right of refusal would deter women from being tested for HIV. When the moment comes for a woman to make her decision, other concerns are more important to her than whether the option to be tested is mandatory or not. The majority of pregnant women indicated that their main reasons for being tested were: (a) the recommendation of their health-care provider; and (b) concern about the risks to their babies. Recommending that all pregnant women be tested regardless of their risk of infection, together with making the HIV test readily available to all women, are probably the two best ways of increasing the patients' participation in an HIV-screening program for pregnant women. ^

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The Two State model describes how drugs activate receptors by inducing or supporting a conformational change in the receptor from “off” to “on”. The beta 2 adrenergic receptor system is the model system which was used to formalize the concept of two states, and the mechanism of hormone agonist stimulation of this receptor is similar to ligand activation of other seven transmembrane receptors. Hormone binding to beta 2 adrenergic receptors stimulates the intracellular production of cyclic adenosine monophosphate (cAMP), which is mediated through the stimulatory guanyl nucleotide binding protein (Gs) interacting with the membrane bound enzyme adenylylcyclase (AC). ^ The effects of cAMP include protein phosphorylation, metabolic regulation and transcriptional regulation. The beta 2 adrenergic receptor system is the most well known of its family of G protein coupled receptors. Ligands have been scrutinized extensively in search of more effective therapeutic agents at this receptor as well as for insight into the biochemical mechanism of receptor activation. Hormone binding to receptor is thought to induce a conformational change in the receptor that increases its affinity for inactive Gs, catalyzes the release of GDP and subsequent binding of GTP and activation of Gs. ^ However, some beta 2 ligands are more efficient at this transformation than others, and the underlying mechanism for this drug specificity is not fully understood. The central problem in pharmacology is the characterization of drugs in their effect on physiological systems, and consequently, the search for a rational scale of drug effectiveness has been the effort of many investigators, which continues to the present time as models are proposed, tested and modified. ^ The major results of this thesis show that for many b2 -adrenergic ligands, the Two State model is quite adequate to explain their activity, but dobutamine (+/−3,4-dihydroxy-N-[3-(4-hydroxyphenyl)-1-methylpropyl]- b -phenethylamine) fails to conform to the predictions of the Two State model. It is a weak partial agonist, but it forms a large amount of high affinity complexes, and these complexes are formed at low concentrations much better than at higher concentrations. Finally, dobutamine causes the beta 2 adrenergic receptor to form high affinity complexes at a much faster rate than can be accounted for by its low efficiency activating AC. Because the Two State model fails to predict the activity of dobutamine in three different ways, it has been disproven in its strictest form. ^

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Soybean (Glycine max), grown in Iowa and most of the north central region of the United States, has not required regular insecticide use. The soybean aphid, Aphis glycines (Hemiptera: Aphididae), causes yield losses from direct plant feeding, and has been shown to transmit several plant viruses. In Iowa, soybean aphid can colonize soybean fields in June and has developed into outbreaks in July and August capable of reducing yields by nearly 40 percent.

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Soybean, Glycine max (L.), grown in Iowa and most of the north central region of the United States, has not required regular insecticide usage. The soybean aphid, Aphis glycines (Hemiptera: Aphididae), causes yield losses from direct plant feeding, and has been shown to transmit several plant viruses. In Iowa, soybean aphid can colonize soybean fields in June and has developed into outbreaks in July and August capable of reducing yields by nearly 40 percent.

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This paper aims to identify the magnitude of energy efficiency improvement, which has been promoted through energy efficiency labeling and the Minimum Energy Performance Standard, and to compare this against the increase in the number of products and the average increase in cooling capacity. Air conditioners (ACs) are one of the major contributors to energy consumption in a household. To assess the magnitude of this factor, we developed a formula to decompose total energy consumption from ACs into the number of ACs, their average cooling capacity, and energy efficiency. In the case of ACs in Thailand, energy efficiency improvement has offset the increase in the average AC cooling capacity. However, energy consumption from ACs increases with the number of ACs.

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A system to evaluate nanoparticles efficiency in hyperthermia applications is presented. The method allows a direct measurement of the power dissipated by the nanoparticles through the determination of the first harmonic component of the in quadrature magnetic moment induced by the applied field. The magnetic moment is measured by using an induction method. To avoid errors and reduce the noise signal a double in phase demodulation technique is used. To test the system viability we have measured nanowires, nanoparticles and copper samples of different volumes to prove by comparing experimental and modeled results

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An accepted fact in software engineering is that software must undergo verification and validation process during development to ascertain and improve its quality level. But there are too many techniques than a single developer could master, yet, it is impossible to be certain that software is free of defects. So, it is crucial for developers to be able to choose from available evaluation techniques, the one most suitable and likely to yield optimum quality results for different products. Though, some knowledge is available on the strengths and weaknesses of the available software quality assurance techniques but not much is known yet on the relationship between different techniques and contextual behavior of the techniques. Objective: This research investigates the effectiveness of two testing techniques ? equivalence class partitioning and decision coverage and one review technique ? code review by abstraction, in terms of their fault detection capability. This will be used to strengthen the practical knowledge available on these techniques.

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In order to show the choice of transparency as the guiding principle of the accreditation process, the article evaluates its influence on the fundamental subprocess of self-evaluation, thereby confirming that transparency is an essential tool for continuous improvement of academic processes and those of educational quality management. It fosters educational innovation and permits the sustainability of the continuous accreditation process over time, resulting in greater probabilities of university self-regulation through systemization of the process, with the objective of continuous improvement of university degree programs. The article analyzes the influence of transparency on each activity of the self-evaluation process according to the Peruvian accreditation model prepared under the total quality approach, as a reference for other accreditation models, proposing concrete transparency actions and evaluating its influence on the stakeholder groups in the self-evaluation process, as well as on the efficiency and effectiveness of the process. It is concluded that transparency has a positive influence on the training of human capital and the formation of the university?s organizational culture, facilitating dissemination, understanding and involvement of the stakeholder groups in the continuous improvement of accreditation activities and increasing their acceptance of change and commitment to the process. It is confirmed that transparency contributes toward increasing the efficiency index of the self-evaluation process by reducing operating costs through adequate, accessible, timely contribution of information by the stakeholders and through the optimization of the time spent gathering relevant information. In addition, it is concluded that transparency contributes toward increasing the effectiveness index of self-evaluation by facilitating the achievement of its objectives through synthetic, useful, reliable interpretation of the education situation and the formulation of feasible improvement plans based on the adequacy, relevance, visibility, pertinence and truthfulness of the information analyzed.

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Given the global energy and environmental situation, the European Union has been issuing directives with increasingly demanding requirements in term of the energy efficiency in buildings. The international competition of sustainable houses, Solar Decathlon Europe (SDE), is aligned with these European objectives. SDE houses are low energy solar buildings that must reach the near to zero energy houses’ goal. In the 2012 edition, in order to emphasize its significance, the Energy Efficiency Contest was added. SDE houses’ interior comfort, functioning and energy performance is monitored. The monitoring data can give an idea about the efficiency of the houses. However, a jury comprised by international experts is responsible for carrying out the houses energy efficiency evaluation. Passive strategies and houses services are analyzed. Additionally, the jury's assessment has been compared with the behavior of the houses during the monitoring period. Comparative studies make emphasis on the energy aspects, houses functioning and their interior comfort. Conclusions include thoughts related with the evaluation process, the results of the comparative studies and suggestions for the next competitions.