Setting Performance Standards Research Articles

Lifestyle Medicine Performance Measures: An Expert Consensus Statement Defining Metrics to Identify Remission or Long-Term Progress Following Lifestyle Medicine Treatment.

The objective of this expert consensus process was to define performance measures that can be used to document remission or long-term progress following lifestyle medicine (LM) treatment. Expert panel members with experience in intensive, therapeutic lifestyle change (ITLC) developed a list of performance measures for key disease states, using an established process for developing consensus statements adapted for the topic. Proposed performance measures were assessed for consensus using a modified Delphi process. After a series of meetings and an iterative Delphi process of voting and revision, a final set of 32 performance measures achieved consensus. These were grouped in 10 domains of diseases, conditions, or risk factors, including (1) Cardiac function, (2) Cardiac risk factors, (3) Cardiac medications and procedures, (4) Patient-centered cardiac health, (5) Hypertension, (6) Type 2 diabetes and prediabetes, (7) Metabolic syndrome, (8) Inflammatory conditions, (9) Inflammatory condition patient-centered measures, and (10) Chronic kidney disease. These measures compose a set of performance standards that can be used to evaluate the effectiveness of LM treatment for these conditions.

Principal’s Strategies in Improving Employee’s Performance (Study at SMA Negeri South Bengkulu)

This study aims to determine the Principal's Strategy in Improving Employee Performance (Study at SMA Negeri 1 Bengkulu Selatan). This research is qualitative research which is presented descriptively. There were 6 informants in this study consisting of: 2 key informants and 4 key informants. Methods of data collection through interviews, observation, and documentation. The data analysis techniques used are data reduction, data presentation, and drawing conclusions. Based on the results of the research and discussion, it is known that employee performance (a study at SMA Negeri 1 Bengkulu Selatan has been carried out). This can be seen from the indicators discussed earlier, namely: (1) Positive Encouragement: there is an award given by the school principal to TU employees and the teacher council who have achieved achievements assessed by the school principal, in the form of a charter. (2) Perform a Performance Audit: Every year the principal conducts an audit both in terms of finance and performance checks of employees, both the teacher council and TU staff to assess performance results. (3) Set Performance Standards and Goals: The principal assigns duties and responsibilities to the teacher council and TU staff in accordance with their respective duties in carrying out their duties. (4) Give Feedback: To Employees Regarding Their Performance The principal can see from the absence of teachers and TU staff to check the attendance of early or late employees whether or not the tasks assigned are carried out. (5) Give Employees Compliments or Other Rewards Related to Performance. The existence of praise given or carried out by the principal to the staff of the teacher council, TU and students who excel by giving some kind of reward can be in the form of money that has been budgeted by the school committee.

Applying a Mixture Rasch Model‐Based Approach to Standard Setting

AbstractThe subjective aspect of standard‐setting is often criticized, yet data‐driven standard‐setting methods are rarely applied. Therefore, we applied a mixture Rasch model approach to setting performance standards across several testing programs of various sizes and compared the results to existing passing standards derived from traditional standard‐setting methods. We found that heterogeneity of the sample is clearly necessary for the mixture Rasch model approach to standard setting to be useful. While possibly not sufficient to determine passing standards on their own, there may be value in these data‐driven models for providing additional validity evidence to support decision‐making bodies entrusted with establishing cut scores. They may also provide a useful tool for evaluating existing cut scores and determining if they continue to be supported or if a new study is warranted.

Public–Private Partnership Contract Framework Development for Highway Projects: A Delphi Approach

Construction projects can be delivered through various approaches; nevertheless, all practitioners and involved parties have a mutual goal, which is completing the project within the original scope, defined budget, and schedule. Reviewing the literature on public–private partnerships (PPPs) showed that many efforts have been made to cover different research areas, including policies, risks, roles and responsibilities, and finance. The existing literature lacks studies involving the comprehensive process of preparing and implementing PPP contracts associated with highway projects in the US. This research, therefore, fills this noticeable gap in the body of knowledge on the PPP delivery method. The main objective of this research was to develop a framework for PPP contracts focusing on highway projects. To meet this objective, the authors conducted a Delphi study with highway professionals to identify the major issues that they should carefully deal with during contract document preparation, contract procurement, and contract implementation phases to make PPP highway projects successful. The Delphi study consisted of two rounds, with 25 open-ended interview questions over three phases. The study found that highway agencies must fix the scope of a project before a PPP project starts. They should also choose a lump sum contract type and a design-build-finance-operate-maintenance PPP type with a 35 to 40-year concession period for highway projects. Contracts should consist of incentive and disincentive clauses along with availability payments as the mode of compensating concessioners for their work. Before initiating a PPP contract, agencies should make sure that their state legislation allows this type of contract. The study also found that during the contract procurement phase, owners should use the best-value selection method to choose a PPP contractor; the competition should be fair and transparent, and the owner must have expertise in order to successfully procure PPP contracts. The experts recommended setting performance standards for PPP concessioners, performing inspections using independent third parties, and handing over condition data to maintenance personnel at the end of construction. The primary contribution of this research to the body of knowledge was to highlight the fact that each country, with the help of professional expertise and key stakeholders, background, and/or lessons learned, needs to develop a framework that lists the main issues and processes to be considered in implementing PPP highway contracts. This study presents a framework that can work nationwide, something that is missing in previous research studies. This framework can guide professionals in the transportation industry toward effective contract document preparation, procurement, and implementation of PPP highway projects in addition to giving academicians better insights to understand PPP highway projects in the US.

Optimal Use of Advanced Practice Providers at an Academic Medical Center: A First-Year Retrospective Review.

Background Physician assistants/associates (PAs) and nurse practitioners (NPs), together known as advanced practice providers (APPs), practice with a high degree of clinical autonomy and professional respect, and play a critical role in team-based care. Aligning APPcaredeliverymodels to promote top-of-license practice is essential to improving ambulatory capacity and bottom-line expectations at academic medical centers (AMCs) in the 21stcentury and beyond. This administrativequality improvementstudy assesses the downstream impact of restructuring our APP care models to promote independent practice sessions. Methods Our AMC formed an APP oversight committee in April 2021 to optimize the ambulatory care model, realign APP funds flow, and set performance standardsto whichPAs and NPsare being held accountable. We conducted a one-year retrospective review of internal data from July 2021 to June 30, 2022. Certified registered nurse anesthetists (CRNAs) were excluded from this analysis. Results APP productivity year-over-year (YOY) aggregate data across all School of Medicine (SOM) departments, demonstrated a 53% increase inwork relativevalueunits (wRVUs), 84% increase in payments, and 79% increase in charges from the prior fiscal year (July to June). Regarding APP ambulatory clinical effort (YOY), there was a 45% increase in the number of APP completed visits (92% return patient visits, 8% new visits). An increase in APP productivitydid not adversely impact patient satisfaction, physician-generated wRVUs, or delay programmatic expansion efforts. Lastly, in a recent engagement survey, the majority of PA and NP respondents (78%) reported working either "most of the time" or "always" at the top-of-license. Conclusion This quality improvement study demonstrates that enhancement of PA and NP utilization through top-of-license initiatives can be achieved without jeopardizing physician wRVUs or performance. While we acknowledge, there are differencesbetween healthcare institutions in terms of care delivery and compensation models, organizational culture, and distribution of clinical resources, there remains an opportunity among hospitals and health systems to optimize this critical and essential APP workforce.

Managerial performance in the conditions of selected local government offices

The development and execution of employees in a modern public administration organisation are subject to specific management forms. Performance management is about setting performance standards, monitoring progress, and building relevant plans. Managerial performance and its management are presented as beneficial for employee development. Addressing the interaction between performance management and administrative authority is appropriate given the empirical result of performance management reform. The public sector's adoption of performance management systems has long focused on creating more advanced performance information systems while neglecting to increase managerial authority. Therefore, understanding how this partial acceptance affects public service performance is particularly important. However, our knowledge of how they interact remains limited despite the central role of management authority over standard performance management regulations. According to the analysis of the current situation, the main goal of the presented article is to derive propositions and propose measures to streamline the managerial performance of the offices in Trnava, Nitra and Trenčín. In the study, we use the benchmarking method to analyse and subsequent evolution of the state of managerial performance in selected bodies. We identify individual factors in the form of the Saaty matrix and characterise the systematic steps of the methodological procedure. In this process, we faced certain limitations related to limited data access. The main benefits of this study are suggestions for improving the level of managerial performance that can be applied in public administration. Among the primary areas where change is needed, we identified ambiguity in the strategy and plan, delayed feedback processes and limited behavioural incentives.

EFFECTS OF PERFORMANCE MANAGEMENT SYSTEM ON EMPLOYEE PERFORMANCE AND THE MODERATING ROLE OF STAFF DEVELOPMENT: THE CASE OF MINISTRY OF MINES AND MINERALS DEVELOPMENT IN ZAMBIA.

The main aim of this paper is to investigate the effects of Performance Management System on Employee Performance in the Civil Service, specifically the Ministry of Mines and Minerals Development (MMMD) in Zambia. The research consists of four main parts: The effects of Performance Management System on Employee Performance; The effects of Performance Management System on Staff Development; The relationship between Staff Development and Employee Performance; and the mediating role of Staff Development on the effects of Performance Management System on Employee Performance. A quantitative approach was adopted in this study, with the population of interest consisting 250 employees who were randomly selected from six Departments under MMMD in Lusaka. The data was collected with the aid of structured questionnaires, and analysed using the Statistical Package for Social Sciences (SPSS) and excel. The findings of the research study indicates that Performance Management System: improves employee performance, efficiency and attitude towards work; identifies employee individual strengths and weaknesses; helps in identifying training needs and employee competencies; and also helps align employee qualifications/skills to the job requirements (job specifications). The research concludes that, Performance Management System has effects on Employee Performance and Staff Development. It also concludes that the relationship that exists between Staff Development and Employee Performance is that Staff Development enhances Employee Performance, which in turn improves career progression of employees as they acquire new knowledge and skills of doing their job. Further, the study concludes that Staff Development plays a reconciling role between Performance Management System and Employee Performance. The role played include: assisting employees gain knowledge and understanding of the job requirements, to enable them achieve the set performance standards and goals; facilitates for effective monitoring of employee performance; and helps to bridges gaps between identified employee incompetence and performance requirements.

Validating Performance Standards via Latent Class Analysis

AbstractValidity of performance standards is a key element for the defensibility of standard setting results, and validating performance standards requires collecting multiple pieces of evidence at every step during the standard setting process. This study employs a statistical procedure, latent class analysis, to set performance standards and compares latent class analysis results with previously established performance standards via the modified‐Angoff method for cross‐validation. The context of the study is an operational large‐scale science assessment administered in one of the southern states in the United States. Results show that the number of classes that emerged in the latent class analysis concurs with the number of existing performance levels. In addition, there is a substantial level of agreement between latent class analysis results and modified‐Angoff method in terms of classifying students into the same performance levels. Overall, the findings establish evidence for the validity of the performance standards identified via the modified‐Angoff method. Practical implications of the study findings are discussed.

Modal-based FE model updating via genetic algorithms: Exploiting artificial intelligence to build realistic numerical models of historical structures

Cultural Heritage preservation requires the combination of in situ investigations and accurate Finite Elements models in order to correctly interpret the empirical evidence and successfully apply advanced structural analyses for health assessment purposes, allowing to infer about the future evolution of the structural response and timely detect deviations from the expected behaviour.In this paper the actual dynamic behaviour of the Civic Tower of Ostra, Italy, is thoroughly investigated by means of a detailed numerical model built and calibrated using the experimental modal features estimated through field dynamic testing. To this end, a fully automated Finite Element Model Updating procedure based on genetic algorithms and machine learning is conceived and employed, allowing the successful estimation of the unknown material properties of the tower, considering both isotropic and orthotropic behavioural models for masonry. The results enabled to establish baseline information on the current structural condition of the heritage and to set performance standards that will serve to optimise the control of the structural integrity over time.

Proposed Design Criteria for a Bilge Pumping System for Large Container Ships

The IMO’s Goal-Based Standards (GBS) in the Safety of Life at Sea Convention (SOLAS) sets the high-level goals (GBS Tier 1 and 2) and classification societies acting as recognized organizations (ROs) should develop detailed rules and regulations in order to meet the goals (GBS Tier 4). Even though the GBS requirements are applicable to new build construction standards of bulk carriers and oil tankers at present, given that IMO may develop goal-based standards for other safety areas, it will be meaningful to examine the bilge pumping system requirements in the context of principles of Goal-Based Standards. The bilge pumping system is one of the most important systems in ships but there is no requirement for its performance except for the 2 m/s speed of water requirement and the internal diameter of bilge main prescribed in SOLAS. The purpose of this study is to quantitatively evaluate bilge pumping performance of actual ships in service and to propose an alternative set of performance standards. The rules of Classification Societies were investigated, and the bilge pumping performance was quantitatively evaluated using specifications of a 14,000 TEU class container ship. As a result of the investigation, it was found that satisfying the 2 m/s requirement under many operating conditions was impossible, and the rules and regulations to determine the internal diameter of bilge main and the capacity of bilge pump did not meet intended purpose of the 2 m/s speed of water requirement. Finally, a set of design criteria are proposed to fulfil the intended purpose of the 2 m/s requirement of SOLAS.

Strategies to reduce energy and metalworking fluid consumption for the sustainability of turning operation: A review

The industrial sector is responsible for over 50% of the global energy utilization and out of which non-OECD countries account for 67%. The energy and resources utilization of the manufacturing sector are 40% and 25% of the global consumption respectively. The concept of sustainable manufacturing has gained traction in recent times with the realisation of this significant ecological footprint. The machining sector, in particular, creates a significant environmental footprint due to energy and resource use. In order to identify the true environmental costs and find means to mitigate the said impacts, holistic life cycle thinking is necessary. Particularly in countries with rapidly emerging industrial sectors, setting performance standards and regulations to guide the sustainability of the industrial activities is necessary. The industrial sector uses different machining operations in which turning operation is significant due to its higher energy consumption among other machining operations. Furthermore, there is a research gap of assessing the contributors of environmental impact of turning operation. Therefore, this review focuses on turning operations and the major contributors to environmental impacts during turning operations, to identify effective strategies to reduce them. The information ascertained from the review was thematically coded and analysed to establish the current status of the topic. Out of reviewed articles, 34% and 37% of papers respectively have identified energy and metalworking fluid (MWF) as key sources of environmental impact. Based on the literature analysis results, the paper proposes several strategies to achieve more sustainable turning operations. The findings are expected to be of use to the machining industry in improving its sustainability, as well as to policy makers in defining performance standards to regulate industrial activities. • Energy and metalworking fluid are the key contributors to environmental impact during turning. • Identification of multiple strategies leads to effective environmental performances of turning. • Life cycle assessment can be used to obtain a holistic approach to the sustainable machining process.

Result-Based Management System: A Mediating Factor for Employees’ Performance

In any organization, human resources stand as vital assets for success; these are to be highly valued in order to achieve the competitive edge. Therefore, human capital policies and practices should be tied to organizational goals. The impact of practices of HRM can be the channel that fuels sustained competitive advantage; therefore, enhancement of organizational performance should be the focus for an organization. Performance management comprises setting expectations, assessing behaviors and results of the employee, giving coaching and feedback, and performance evaluation over time to use in decision making. The aim is to line up individual efforts to achieve organizational goals. To this end, this study attempts to examine result-based management which is synonymous with performance management system, and how it drives employees’ productivity. Utilising the purposive sampling technique, staff within an educational institution were selected in Lagos. It was revealed that setting targets and performance standards would engender the desired productivity in employees. The study therefore recommends a comprehensive performance management system which should also be automated in order to capture key performance indicators of employees.

APPRAISAL OF PERFORMANCE MANAGEMENT PRACTICES AND EXCELLENT PERFORMANCE INDICATORS IN PUBLIC HIGHER EDUCATIONAL INSTITUTIONS

The excessive attention on performance evaluation in tertiary education in current times should be viewed in consonance with globalization. Globalization has had a complete makeover effect on advanced academic establishments as a consequence of its widening, deepening and speeding up of worldwide connectedness. Performance is in essence the amount of effort a worker puts in to help an establishment achieve its targets. A comparative analysis of the resemblances and variations in PM practices were highlighted to ascertain best practices in academic institutions. The study aims at ascertaining performance management (PM) practices as well as excellent performance indicators in public higher educational institutions (HEIs) of Ghana. The study takes the form of a case study where the University of Cape Coast (UCC) in the Central region and the Takoradi Technical University (TTU) in the Western region were selected as units of analysis. Using the simple random technique, 141 respondents were selected from the total population of 173 using the Yamane (1967) formula. Data was analyzed using a quantitative approach. Setting performance objectives, setting performance standards and setting performance targets were the variables studied for performance Management practices. Conformity to standards and service quality were the variables studied for excellent performance indicators. The findings of the study reveal that most of the respondents confirm to the observant of performance practices as well as excellent performance indicators in their institutions

Unification of Calculating the Performance of Vehicles and Transport-Technological Facilities

Introduction. In agricultural production during transportation of goods it is accepted to allocate transport and transport-technological processes with the corresponding methods of rationing works. The peculiarity of the processes is the sequential execution of cyclic operations, providing transportation of technological material to the destination directly or with preliminary collection (subsequent distribution) on the field. At the same time, if the goods are moved directly between points, excluding technological (field) operations, this process can be considered a purely transport one, a special case of the transport and technological process. In this regard, it is proposed to consider this process as a component of the transport and technological process, which in turn requires correcting the applied methods for setting performance standards. The aim of the study is to develop a mathematical model and algorithm for standardizing the calculation of the performance of different vehicles and transport and technological facilities through formulating the dependence of the performance components on the power of the said facilities as their main classifier. Materials and Methods. The performance standards were identified by the extrapolation, interpolation or approximation methods based on their estimated performance. The classical method of differentiating functions was used to find the extrema. Результаты исследования.At length of fertilizer transportation by direct-flow technology LГ = 9 km and application dose U = 0.06 kg/m2, the following values of transport and technological facilities performance have been obtained: a) for vehicles to deliver fertilizers to fertilizer storehouses by Ural-432065 truck (body) W = 9.1 t/h, W = 6.3 t/h for tractor with MTZ-82 trailer. 1+2PTS-6; b) for transport and technological facilities to transport and distribute fertilizers by Ural-432065 (Amazone spreader) W = 5.5 t/h, W = 3.9 t/h for tractor with MTZ-82.1+RUM-6 trailer. Discussion and Conclusion. Based on the analysis of methods, the authors have made the case for the unification of calculating the standardized volumes of works, choice of composition, and comparison of the effectiveness of using vehicles, if they are used as transport and transport-technological facilities. A mathematical model and algorithm for a uniform calculation of the performance of different transport and technological facilities are presented. The way to determine the approximate rate of generation of funds that do not have standard indicators of work. The explanation of the innovations is accompanied by a formula device, which is based on the conclusion of the dependencies of out- and in-cycle components of the shift time balance on the engine power of the mobile device. The block diagram of the algorithm to calculate performance standards for vehicles is illustrated. The implementation of the algorithm is given by the example of using a specialized vehicle for transport and transport-technological operations.

Evaluating the effect of strengthening nurse midwifery pre-service education in two Indian states: A single group pre – and post – intervention study

BackgroundThe high focus states of India have higher maternal and neonatal mortality rates as compared to the national average. The quality of pre-service education (PSE) in nursing midwifery institutions in these states was found to be suboptimal. In 2013, Government of India implemented the PSE strengthening program across all public sector nursing midwifery institutions. The program focused on strengthening educational processes, training infrastructure, institutional management and clinical site practices by implementing a set of performance standards. ObjectiveTo evaluate the effect of PSE strengthening program on institutional performance and maternal neonatal health (MNH) related competences of nursing midwifery students and faculty. DesignSingle group pre-post intervention study. Settings15 sampled public sector nursing midwifery institutions in the states of Madhya Pradesh and Odisha, India. ParticipantsFinal-year students and faculty involved in teaching MNH subjects. MethodsPerformance of 15 sampled institutions was assessed at baseline, midline and endline using the performance standards. Additionally, competences of 232, 295 and 298 students and 64, 62 and 63 faculty members at baseline, midline and endline respectively were assessed on six MNH related practices using objective structured clinical examination (OSCE). ResultsNone of the institutions met 70% standards during baseline. At endline, 13 of the 15 institutions met these standards. The mean OSCE scores of students and faculty at baseline was 17.1 (SD: 8.0) and 23.5 (SD: 14.3) out of 76 respectively. It significantly increased to 66.4 (SD: 8.0) and 71.1 (SD: 5.2) during the endline. The proportion of students and faculty found competent (achieved 75% in OSCE) also significantly increased from none at baseline to 91% and 98% respectively, at endline. ConclusionThe combination of attributes included in the PSE strengthening program may have contributed to improvements in institutional performance as well as MNH related competences of nursing midwifery students and faculty.

Performance management perception in Kenya

Purpose This paper aims to present an analysis of the perception of performance management practices and transformations by investigating what devolved governments of Kenya are doing and ought to do after which the approaches of performance and performance management are evaluated. Design/methodology/approach A descriptive assessment of five devolved governments of Kenya is carried out. This study covered 518 respondents across the above-sampled governments. Findings The outcomes demonstrated that there are guidelines established by the counties to measure the performance of workers where tested variables about setting performance standards and performance review information against their effect on performance improvement and performance measurement, respectively, are statistically significant, and therefore have a positive impact on the eventual performance of devolved governments. Practical implications The results support scholars, practitioners and social scientists in development studies for the planning and management of public organizations. The thought of factors that enhance or impede devolved government workers’ performance can be explored in future research. Originality/value The thought of performance management perception, especially in a developing country, is a theoretical milestone.

Competence in Decision Making: Setting Performance Standards for Critical Care.

Health care professionals must be able to make frequent and timely decisions that can alter the illness trajectory of intensive care patients. A competence standard for this ability is difficult to establish yet assuring practitioners can make appropriate judgments is an important step in advancing patient safety. We hypothesized that simulation can be used effectively to assess decision-making competence. To test our hypothesis, we used a "standard-setting" method to derive cut scores (standards) for 16 simulated ICU scenarios targeted at decision-making skills and applied them to a cohort of critical care trainees. Panelists (critical care experts) reviewed digital audio-video performances of critical care trainees managing simulated critical care scenarios. Based on their collectively agreed-upon definition of "readiness" to make decisions in an ICU setting, each panelist made an independent judgment (ready, not ready) for a large number of recorded performances. The association between the panelists' judgments and the assessment scores was used to derive scenario-specific performance standards. For all 16 scenarios, the aggregate panelists' ratings (ready/not ready for independent decision making) were positively associated with the performance scores, permitting derivation of performance standards for each scenario. Minimum competence standards for high-stakes decision making can be established through standard-setting techniques. We effectively identified "front-line" providers who are, or are not, ready to make independent decisions in an ICU setting. Our approach may be used to assure stakeholders that clinicians are competent to make appropriate judgments. Further work is needed to determine whether our approach is effective in simulation-based assessments in other domains.

Quality standards, implementation autonomy, and citizen satisfaction with public services: cross-national evidence

ABSTRACT This article investigates whether citizens’ evaluations of service performance are related to archival measures of performance, and how institutional context shapes this relationship contingent on administrative autonomy – standards, human resources, and financial autonomy. Using cross-national education data, this study finds that student performance is positively associated with parental evaluations of schools. Perceptions are more closely aligned with performance when agencies have greater autonomy in managing employees, and when national-level bureaucracies set performance standards. This research advances our understanding of the role of administrative autonomy in citizen satisfaction and provides implications for the institutional designs that can benefit performance assessment.

Development and Validation of an Assessment Tool for Technical Skills in Handheld Otoscopy.

Handheld otoscopy requires both technical and diagnostic skills, and is often reported to be insufficient after medical training. We aimed to develop and gather validity evidence for an assessment tool for handheld otoscopy using contemporary medical educational standards. Educational study. University/teaching hospital. A structured Delphi methodology was used to develop the assessment tool: nine key opinion leaders (otologists) in undergraduate training of otoscopy iteratively achieved consensus on the content. Next, validity evidence was gathered by the videotaped assessment of two handheld otoscopy performances of 15 medical students (novices) and 11 specialists in otorhinolaryngology using two raters. Standard setting (pass/fail criteria) was explored using the contrasting groups and Angoff methods. The developed Copenhagen Assessment Tool of Handheld Otoscopy Skills (CATHOS) consists 10 items rated using a 5-point Likert scale with descriptive anchors. Validity evidence was collected and structured according to Messick's framework: for example the CATHOS had excellent discriminative validity (mean difference in performance between novices and experts 20.4 out of 50 points, P < .001); and high internal consistency (Cronbach's alpha = 0.94). Finally, a pass/fail score was established at 30 points for medical students and 42 points for specialists in ORL. We have developed and gathered validity evidence for an assessment tool of technical skills of handheld otoscopy and set standards of performance. Standardized assessment allows for individualized learning to the level of proficiency and could be implemented in under- and postgraduate handheld otoscopy training curricula, and is also useful in evaluating training interventions. NA.

Leak frequency analysis for hydrogen-based technology using bayesian and frequentist methods

Dealing with hazardous environments such as hydrogen poses considerable risks to property, people, and the environment. Leak frequency analysis is a method of understanding the characteristics of risks at hydrogen refueling stations (HRSs). This paper proposes leak rate estimation using time-based evaluation methods that utilize historical HRS accident information. In addition, leak frequency estimates from another two methods (non-parametric and leak-hole-size) were examined. In the non-parametric approach, the leak frequency is estimated based on a Bayesian update. The results from these three approaches are summarized to understand the trend of leak rate data. The leak rate data from the time-based method displays a similar trend to the leak size based method. However, the non-parametric method tends to be conservative due to high failure observations (new evidences) during the Bayesian update. Finally, the unrevealed leak time was calculated as a function of the leak frequency. The quantitative insights of this study can be used to set performance standards for the availability and reliability in the operation and maintenance of HRSs.