984 resultados para Driver improvement programs.


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In patients hospitalised with acute coronary syndromes (ACS) and congestive heart failure (CHF), evidence suggests opportunities for improving in-hospital and after hospital care, patient self-care, and hospital-community integration. A multidisciplinary quality improvement program was designed and instigated in Brisbane in October 2000 involving 250 clinicians at three teaching hospitals, 1080 general practitioners (GPs) from five Divisions of General Practice, 1594 patients with ACS and 904 patients with CHF. Quality improvement interventions were implemented over 17 months after a 6-month baseline period and included: clinical decision support (clinical practice guidelines, reminders, checklists, clinical pathways); educational interventions (seminars, academic detailing); regular performance feedback; patient self-management strategies; and hospital-community integration (discharge referral summaries; community pharmacist liaison; patient prompts to attend GPs). Using a before-after study design to assess program impact, significantly more program patients compared with historical controls received: ACS: Angiotensin-converting enzyme (ACE) inhibitors and lipid-lowering agents at discharge, aspirin and beta-blockers at 3 months after discharge, inpatient cardiac counselling, and referral to outpatient cardiac rehabilitation. CHF. Assessment for reversible precipitants, use of prophylaxis for deep-venous thrombosis, beta-blockers at discharge, ACE inhibitors at 6 months after discharge, imaging of left ventricular function, and optimal management of blood pressure levels. Risk-adjusted mortality rates at 6 and 12 months decreased, respectively, from 9.8% to 7.4% (P=0.06) and from 13.4% to 10.1% (P= 0.06) for patients with ACS and from 22.8% to 15.2% (P < 0.001) and from 32.8% to 22.4% (P= 0.005) for patients with CHF. Quality improvement programs that feature multifaceted interventions across the continuum of care can change clinical culture, optimise care and improve clinical outcomes.

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There is evidence that high-tillering, small-panicled pearl millet landraces are better adapted to the severe, unpredictable drought stress of the and zones of NW India than are low-tillering, large-panicled modern varieties, which significantly outyield the landraces under favourable conditions. In this paper, we analyse the relationship of and zone adaptation with the expression, under optimum conditions, of yield components that determine either the potential sink size or the ability to realise this potential. The objective is to test whether selection under optimal conditions for yield components can identify germplasm with adaptation to and zones in NW India, as this could potentially improve the efficiency of pearl millet improvement programs targeting and zones. We use data from an evaluation of over 100 landraces from NW India, conducted for two seasons under both severely drought-stressed and favourable conditions in northwest and south India. Trial average grain yields ranged from 14 g m(-2) to 182 g m(-2). The landraces were grouped into clusters, based on their phenology and yield components as measured under well-watered conditions in south India. In environments without pre-flowering drought stress, tillering type had no effect on potential sink size, but low-tillering, large-panicled landraces yielded significantly more grain, as they were better able to realise their potential sink size. By contrast, in two low-yielding and zone environments which experienced pre-anthesis drought stress, low-fillering, large-panicled landraces yielded significantly less grain than high-tillering ones with comparable phenology, because of both a reduced potential sink size and a reduced ability to realise this potential. The results indicate that the high grain yield of low-tillering, large-panicled landraces under favourable conditions is due to improved partitioning, rather than resource capture. However, under severe stress with restricted assimilate supply, high-tillering, small-panicled landraces are better able to produce a reproductive sink than are large-panicled ones. Selection under optimum conditions for yield components representing a resource allocation pattern favouring high yield under severe drought stress, combined with a capability to increase grain yield if assimilates are available, was more effective than direct selection for grain yield in identifying germplasm adapted to and zones. Incorporating such selection in early generations of variety testing could reduce the reliance on random stress environments. This should improve the efficiency of millet breeding programs targeting and zones. (c) 2005 Elsevier B.V. All rights reserved.

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Road traffic accident involvement rates show that younger males are over represented in accidents. A number of studies have shown individual differences in accident involvement. Questionnaire-based methods to investigate individual and group differences in driver stress and risk perceptions reported in chapter 2 and 3 revealed that neuroticism was associated with; heightened perception of personal risk, driver stress, and inefficient coping strategies. Younger drivers and female drivers reported higher levels of stress. Young male drivers assessed their personal risk and driving abilities less realistically than did other age and sex groups. Driving simulator-based methods reported in chapter 4 revealed that young drivers and male drivers; drive faster, overtake more often, and commit more `high risk' overtakes than do other age and sex groups. Middle-aged and elderly drivers were poorer at maintaining a fixed distance from a lead `vehicle'. Older drivers adopt a slower, more cautious driving style, but appear to be worse at controlling distance from a `lead' vehicle. Results are consistent with individual and group differences in accident involvement rates. Findings are discussed with reference to the implementation of driver education programs to reduce stress, the adoption of more realistic perceptions of risk among younger drivers, and the training of compensation strategies to counteract age-related changes in older drivers.

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This paper outlines, using evidence from several case studies, the use of alternative forms of manufacturing strategy processes. Our investigation shows that the manufacturing strategy development practices of manufacturers are evolving in many directions; we found several alternatives to the formal top-down planning process. Manufacturers use one or more of the following alternatives with or without the top-down manufacturing strategy process: a coherent pattern of actions; manufacturing/process improvement programs; or the pursuit of core manufacturing capabilities. It appears that the various manufacturing strategy development processes may be tied to the strategic role of manufacturing in a company. This paper offers a framework that captures the relationship between the strategic role of manufacturing and the process of manufacturing strategy development. An in-depth case from a UK company illustrates the evolving forms of manufacturing strategy development processes.

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County engineers in Iowa face the dual problems of rapidly escalating costs and a decreasing rate of growth of revenues. Various priority systems are in use, ranking projects for inclusion in road improvement programs, but they generally have weaknesses when used to compare one project with another in a different location. The sufficiency rating system has proven to be a useful tool in developing a priority list of projects for primary road systems, but there are none currently in use for secondary road systems. Some elements of an existing system used for primary roads could be modified for use with secondary roads, but would require extensive changes. The research reported here, sponsored by the Iowa Department of Transportation, was undertaken to develop a sufficiency rating system which could be used for secondary roads in Iowa and to produce the necessary forms and instructions to aid county engineering personnel in their efforts to complete the ratings for roads within their county. If a usable system were available that would yield reasonable results, county engineers would have an additional tool available to assist them in arriving at a defensible road improvement program.

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Im Verlauf einer universitätsweiten Förderinitiative wurde für die Lehrveranstaltung Betonbau ein Projekt durchgeführt, das mithilfe Neuer Medien versucht, die Lehre an der Hochschule nachhaltig zu verbessern. In dieser Veröffentlichung wird über die Entwicklung von interaktiven Lernobjekten (ILO) berichtet, die streng nach den Gesichtspunkten des 3-2-1 Modells didaktischer Elemente nach Kerres (2001) aufgebaut wurden. Die Umsetzung, sowohl in technischer als auch didaktischer Hinsicht, sowie die Implementierung im Curriculum wird detailliert beschrieben. Eine Diskussion über eine mögliche Effizienzsteigerung in der Lehre rundet diese Veröffentlichung ab.(DIPF/Orig.)

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This newsletter from the South Carolina School Improvement Council presents articles on news from the Council for members including new staff, conference information, and award winners.

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This newsletter from the South Carolina School Improvement Council presents articles on news from the Council for members including new staff, conference information, and award winners.

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This newsletter from the South Carolina School Improvement Council presents articles on news from the Council for members including new staff, conference information, and award winners.

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This newsletter from the South Carolina School Improvement Council presents articles on news from the Council for members including new staff, conference information, and award winners.

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This newsletter from the South Carolina School Improvement Council presents articles on news from the Council for members including new staff, conference information, and award winners.

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This newsletter from the South Carolina School Improvement Council presents articles on news from the Council for members including new staff, conference information, and award winners.