Specific Benchmarks Research Articles

SOT at 50: A Proud Legacy, A Vibrant Future

SOT at 50: A Proud Legacy, A Vibrant Future

Body composition of Brazilian beach volleyball players

The development of a beach volleyball athlete is the result of highly planned training process, and should consider the specificity of this sport and the demands regarding body composition. The purpose of this study was to evaluate the values and distribution of fat mass among Brazilian beach volleyball players. The sample consisted of 16 male beach volleyball players from the Brazilian Circuit 2009. For the evaluation of body composition, the recommendations of FILHO, 2003, were applied: every measure was taken on the right side of the body, before the morning practice session; the reading took three seconds, to diminish reading errors; each measure was taken three times by the same researcher. Jackson and Pollock's seven-skinfolds model was utilised, since there are no protocols specific for volleyball. Subjects' mean age was 28 years, height 1.94 m, and they had played beach volleyball for approximately 8 years. The greatest average value of skin fat was found for the abdominal skinfold (12.5 mm), followed by the suprailiac (11.4 mm) and thigh (10.8 mm). The minimum percentage body fat found was 4.6%, with the maximum being 16.0%, and the average 8.7%, below the mean theoretical ideal percentage of 15%. Characterisation of the players' anthropometric profile helps in monitoring the training process, suggesting possible deficiencies and allowing specific intervention. It may also assist in selecting players with the adequate profile for the sport. In spite of a descriptive design having being applied in the study, the results provided some insights for training and competition. A more extensive data collection from beach volleyball players of different countries and levels of competitions will provide a database for characterisation of the beach volleyball player, allowing the setting of specific benchmarks for training.

Another Avenue for Anatomy of Income Comparisons: Evidence from Hypothetical Choice Experiments

We propose a new avenue for studying income comparisons effects, namely hypothetical discrete choice experiments in which respondents are presented with alternative combinations of hypothetical monthly income amounts, both for themselves and certain reference persons. With this experimental method we can avoid the problems associated with researcher-imposed reference persons’ incomes that are found in most of the happiness studies testing comparison effects. This approach allows investigation of the differences in comparison effects across types of reference groups as well as respondents’ individual characteristics, including specific comparison benchmarks, which are the main open questions in the literature. Some results from our original, large-scale, Internet-based survey are provided.

The Role of Interferon in Hepatitis B Therapy.

Despite the introduction of new nucleos(t)ide analogues in recent years, peginterferon is still recommended as a potential first-line treatment option by current practice guidelines for the management of chronic hepatitis B. Peginterferon offers the advantage of higher sustained off-treatment response rates compared to nucleos(t)ide analogues because of its immunomodulatory effects. Sustained transition to the inactive hepatitis B surface antigen (HBsAg) carrier state can be achieved in about 30% of hepatitis B e antigen (HBeAg)–positive patients and 20% of HBeAg-negative patients. Recent studies have focused on identification of pretreatment and on-treatment factors that allow the selection of patients who are likely to achieve a sustained response to peginterferon therapy in order to avoid the side-effects and costs associated with unnecessary treatment. Future studies need to address whether specific virologic benchmarks can guide individualized decisions concerning therapy continuation and whether peginterferon combined with new potent nucleos(t)ide analogues improves treatment outcomes.

Peginterferon for chronic hepatitis B: Predicting success with on‐treatment benchmarks

Peginterferon for chronic hepatitis B: Predicting success with on‐treatment benchmarks

Market timing and the determinants of performance of sector funds over the business cycle

PurposeMarket‐timing skills of fund managers are an important issue for both mutual fund investors and researchers. The purpose of this paper is to analyze the market‐timing skills and determinants of performance of sector funds across business cycles to see whether sector fund managers exhibit different market‐timing abilities across business cycle.Design/methodology/approachSingle factor, five‐factor conditional and five‐factor unconditional models were used to estimate the initial results for market timing of sector funds across the business cycle. Monthly data such as returns, Fama and French factors, and fund specific variables of sector funds from January 1990 to December 2005 were used to estimate initial and cross‐sectional results. Cross‐sectional analyses were done using two approaches: the traditional approach where alpha, the dependent variable, is estimated assuming that betas of predicting variables remain constant over time, and where alpha is estimated assuming that betas do change over time. Estimated alpha was estimated as a function of fund specific variables to examine which fund specific variables influence fund abnormal performance across the overall, recessionary, and expansionary periods.FindingsThe benchmark used in the analysis (S&P vs sector specific) was shown to greatly influence the results. Sector funds demonstrate positive timing ability during recessions and negative timing ability during expansions when using the S&P 500 as the benchmark, but this timing ability disappears when sector specific benchmarks are used. As a whole, sector funds exhibit significant negative timing ability across all stages of the business cycle. When using the more appropriate industry specific benchmarks, only the utility sector demonstrates significant timing ability over both stages of the business cycle.Research limitations/implicationsOnly two recessions are observed over the period of study. More recession periods would have given a clearer picture of findings across business cycle.Practical implicationsThis paper offers readers an insight into the market‐timing abilities of sector fund managers across the business cycles. Investors can use the findings of this paper to develop hedging strategies especially when the economy is going through recession.Originality/valueThis paper covers the longest period of sector funds market timing and is the only one that evaluates sector funds across business cycle.

HEP specific benchmarks of virtual machines on multi-core CPU architectures

Virtualization technologies such as Xen can be used in order to satisfy the disparate and often incompatible system requirements of different user groups in shared-use computing facilities. This capability is particularly important for HEP applications, which often have restrictive requirements. The use of virtualization adds flexibility, however, it is essential that the virtualization technology place little overhead on the HEP application. We present an evaluation of the practicality of running HEP applications in multiple Virtual Machines (VMs) on a single multi-core Linux system. We use the benchmark suite used by the HEPiX CPU Benchmarking Working Group to give a quantitative evaluation relevant to the HEP community. Benchmarks are packaged inside VMs and then the VMs are booted onto a single multi-core system. Benchmarks are then simultaneously executed on each VM to simulate highly loaded VMs running HEP applications. These techniques are applied to a variety of multi-core CPU architectures and VM configurations.

Cancer's Next Frontier

Cancer's Next Frontier

Nursing-Sensitive Benchmarks for Hospitals to Gauge High-Reliability Performance

Benchmarking expedites the quest for best practices and is crucial to hospitals' effective, reliable, and superior performance. Comparative performance data are used by accrediting and regulatory bodies to evaluate performance and by consumers in making decisions on where to seek healthcare. Nursing-sensitive quality measures affirmed by the National Quality Forum are now used in public reporting and pay-for-performance in addition to traditional medical outcome metrics. This report provides hospital nursing-sensitive benchmarks from medical/surgical, critical care, and step-down units drawn from 196 hospitals during six quarters in 2007 and 2008. Outcome measures include pressure ulcer prevalence rates and fall/falls with injury rates. Additional indicators that describe nursing care (nurse staffing care hours, skill mix, nurse/patient ratios, workload intensity, voluntary turnover, and use of sitters) and patient descriptors (age, gender, and diagnosis description) were also included. Specific benchmarks are provided using the 10th and the 90th percentiles, as well as quartiles to allow hospitals an opportunity to understand comparative performance with specificity. The purpose of this article is to provide hospitals not currently participating in comparative benchmarking databases with nursing-sensitive data from the Collaborative Alliance for Nursing Outcomes for use in performance improvement processes.

Gateway: New high performance computing facility for EFDA task force on integrated Tokamak modelling

The EFDA task force on Integrated Tokamak Modelling (ITM-TF) is providing the EU fusion community with a complete and flexible suite of reliable software tools and codes able to simulate the next ITER and DEMO plasma discharges. EFDA has launched the Gateway project as the first computing facility to be jointly used by EU fusion associations. The Gateway has been designed to allow the ITM-TF members to work together on a common platform and share their codes, developments tools and technologies as well as to make able the inter-operation with tera-scale supercomputer facilities. Technically the Gateway is a rather small high computing facility in operation since 2008, with 1 Teraflops of theoretical peak and 100 Terabytes shared storage area for experimental and simulation data. This paper describes the information technologies involved in the Gateway facility, particularly as regards the low latency interconnect network for multi-core platform as well as fast I/O solutions implemented with storage over Infiniband and high performance parallel file systems. The solutions adopted on the Gateway facility had undergone to specific benchmarks showing excellent performances in typical fusion data handling issues. Finally the interoperability between Gateway and ENEA CRESCO supercomputer will be described showing the access solutions that allow the exploitation of tera-scale supercomputer facilities.

Anesthesia Stipends – 2010: Performance Metrics Increasingly a Part of Stipend Agreements

Properly constructed stipend agreements between hospitals and anesthesia groups can produce important benefits for both parties. Anesthesia practices gain additional revenue which, among other things, can help defray costs associated with expanded coverage requirements. Hospitals, meanwhile, are assured of reliable, continuous and high-quality coverage. Establishing an appropriate stipend amount is the key to a successful stipend arrangement. Yet this process can be timeconsuming and complex. A detailed understanding of the physician group’s expenses, staffing patterns and collection capabilities along with data about the hospital’s current and future anesthesia service requirements are just some of the elements required to calculate an equitable stipend amount. As stipend arrangements have become increasingly prevalent, they’ve continued to evolve and today, a growing number of agreements include provisions requiring practices to meet or exceed specific performance benchmarks to receive new or continued financial support. Anesthesia groups need to be aware of this trend and be prepared to play a proactive role in developing mutually agreed-upon performance metrics, should their hospital partner seek to impose them.

Assessing the long-term supply risks for mineral raw materials—a combined evaluation of past and future trends

This paper develops a method for identifying and assessing long-term supply risks for mineral raw materials. The method is based on a combined evaluation of past and future supply and demand trends. By analysing raw material boom and bust cycles over the past 50 years, we have quantified indicators and defined benchmarks for identifying critical market situations. By applying the method, risks for supply shortage may be identified at an early stage. In addition, a numerical evaluation model has been developed for better comparison between various mineral raw materials. Compared to other assessment methods this method uses specific benchmarks for each raw material to better assess supply risks. The method is embedded within a systematic and comprehensive analytical approach. Based on this model, companies can make better informed decisions for their market assessment and may use suitable risk mitigation instruments to counteract problematic developments. Understanding future supply conditions is especially useful when selecting new technologies for products which require an intensive use of raw materials. As an example, the method is applied to the copper market as of 2006. It is important to emphasise that nobody can foresee the future of raw material prices. But we may aim to better understand the weaknesses of these markets which may lead to future supply shortages thus influencing price.

A Re-Examination of the Factors That Influence Productivity in Hotels: A Study of the Housekeeping Function

Evidence from a number of studies suggests that productivity in hotels is largely driven by factors outside the control of the manager. This paper questions this assumption by examining the level of productivity in the housekeeping departments in a chain of 45 hotels. The paper reviews the concept of productivity and the issues relating to its measurement, before reviewing previous studies of productivity in the hotel sector. A number of factors are identified that appear to affect productivity performance. These are then investigated through analysing one year's data from a web-based labour scheduling system that records every hour worked by every employee in a chain of hotels. This kind of data has not been used in any previous published study, which unlike studies based on Data Envelopment Analysis, enables specific performance indices or benchmarks to be identified. The paper concludes that there is no significant difference in productivity levels according to the size, location, demand variability or age of the hotel, thereby refuting evidence from some prior studies. It concludes that managers have much more control over productivity performance than previously thought.

Sustainable value assessment of farms using frontier efficiency benchmarks

Appropriate assessment of firm sustainability facilitates actor-driven processes towards sustainable development. The methodology in this paper builds further on two proven methodologies for the assessment of sustainability performance: it combines the sustainable value approach with frontier efficiency benchmarks. The sustainable value methodology tries to relate firm performance to the use of different resources. This approach assesses contributions to corporate sustainability by comparing firm resource productivity with the resource productivity of a benchmark, and this for all resources considered. The efficiency is calculated by estimating the production frontier indicating the maximum feasible production possibilities. In this research, the sustainable value approach is combined with efficiency analysis methods to benchmark sustainability assessment. In this way, the production theoretical underpinnings of efficiency analysis enrich the sustainable value approach. The methodology is presented using two different functional forms: the Cobb–Douglas and the translog functional forms. The simplicity of the Cobb–Douglas functional form as benchmark is very attractive but it lacks flexibility. The translog functional form is more flexible but has the disadvantage that it requires a lot of data to avoid estimation problems. Using frontier methods for deriving firm specific benchmarks has the advantage that the particular situation of each company is taken into account when assessing sustainability. Finally, we showed that the methodology can be used as an integrative sustainability assessment tool for policy measures.

The role of the hospital registry in achieving outcome benchmarks in cancer care

The hospital registry is a valuable tool for evaluating quality benchmarks in cancer care. As payment for performance standards are adopted, the registry will assume a more dynamic and economically important role in the hospital setting. At Carolinas Medical Center, the registry has been a key instrument in the comparison of state and national benchmarks and for program improvement in meeting standards in the care of breast and colon cancer. One of the significant successes of the American College of Surgeons Commission on Cancer (CoC) Hospital Approvals Program is the support of hospital registries, especially in small and midsized community hospitals throughout the United States. To become a member of the Hospital Approvals Program, a registry must be staffed appropriately and include analytic data for patients who have their primary diagnosis or treatment at the facility 1. The current challenge for most hospitals is to prove that the registry has specific worth when many facets of care are not compensated. Unfortunately a small number of hospitals have disbanded their registries because of the short-sighted decision that the registry and its personnel are a drain on the hospital system and do not generate revenue. In the present era of meeting benchmarks for care as a prelude to being paid by third party and governmental agencies 2,3, a primary argument is that the registry can be revenue-enhancing by quantifying specific outcomes in cancer care. Without having appropriate registry and abstract capability, the hospital leadership cannot measure the specific outcome benchmarks required in the era of "pay for performance" or "pay for participation".

Benefits and risks of interferon therapy for hepatitis B #

Alpha interferon is the only licensed drug for hepatitis B with immunomodulatory as well as viral inhibitory properties. Potential advantages of interferon compared to nucleoside analogs include a lack of drug resistance, a finite and defined treatment course, and a higher likelihood for hepatitis B surface antigen (HBsAg) clearance. Approximately 30% of hepatitis B e antigen (HBeAg)-positive and 40% of HBeAg-negative cases have a sustained virological response (when defined as HBeAg seroconversion and/or hepatitis B virus (HBV) DNA levels below 20,000 copies/mL, respectively) 6 months after completion of a 48-week course of peginterferon alfa-2a These responses remain durable in 80% and 50% of cases, respectively, when evaluated several years later. Recent studies have shown that changes in HBsAg and HBeAg concentration during treatment predict sustained virological response and serial monitoring of HBsAg is helpful in predicting HBsAg clearance. HBeAg-positive patients with genotype A have higher rates of HBeAg and HBsAg clearance, whereas HBeAg-negative patients with genotype D have the lowest rate of response to interferon therapy. Long-term follow-up of virological responders to either standard alpha interferon or peginterferon has demonstrated a progressive increase in the rate of HBsAg clearance, particularly in patients who were initially HBeAg-positive. Future studies need to address if specific virological benchmarks during therapy can be used to tailor treatment duration. Peginterferon alfa has a place as first-line therapy of hepatitis B in patients who are carefully selected on the basis of pretreatment serum HBV DNA and aminotransferase levels, safety considerations, and viral genotype.

Howling Wolves: Active Experiential Learning in Event Management

Active learning is described as educational exercises that involve students completing an activity and then reflecting on that activity. This type of learning is ideal for many recreation, parks, and tourism classes because of its hands-on nature. The purpose of this paper is to describe an event management course that is designed around an active learning activity. The activity is the planning, development and implementation of a class event. The event, Wolf Awareness Day, was treated as a semester long project with students achieving specific benchmarks during the semester. This paper describes the process for conducting this learning activity, followed by a discussion of how to modify the activity for other events.

The Stern Review: A deconstruction

Using a simple model designed for transparency but nonetheless calibrated to support the much-quoted damage estimates of the Stern Review of the Economics of Climate Change, we demonstrate significant sensitivity of those results to assumptions about the pure rate of time preference, the time horizon, and the rates of risk and equity aversion used to compute certainty- and equity-equivalent annuities. Most importantly, we demonstrate enormous sensitivity to presumed constant regional vulnerability and underlying assumptions about adaptive capacity. Manipulation of any of these parameters one at a time across reasonable ranges can diminish damage estimates by as much as 84% or, in the case of extending the time horizon with the Review's low discount rate, increase damage estimates by 900%. We also confirm the usual result that limiting atmospheric concentrations to specific benchmarks above 400 ppm cannot eliminate all damages. Nonetheless, we applaud the Stern Review author team for reconfirming that the climate problem can be approached productively as an economic problem whose solutions can be explored with the tools of decision analysis.

End‐Stage Renal Disease Reform Moves into the Regulatory Process

Now that the Medicare legislation has become law, the center of activity has moved from Congress to the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). The broad language of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) gives the HHS secretary discretion over many of its provisions, including the design and implementation of the bundled payment system of reimbursement for the treatment of end-stage renal disease (ESRD). MIPPA, which became law on July 15, 2008, creates a bundled payment that covers items and services included in the composite rate as of December 31, 2010; erythropoiesis-stimulating agents and their oral equivalents; and laboratory tests. Under the law, the secretary of the HHS has the discretion to include in the “bundle” other drugs, biologics, and their oral equivalents as well as other items and services furnished to individuals for the specific treatment of ESRD. The case-mix adjusters specified in the law are patient weight, body mass index, comorbidities, length of time on dialysis, age, race and ethnicity. However, the law gives the HHS secretary discretion to include additional adjustments, such as those relating to geographic factors and for pediatric and rural facilities. There is also an adjustment for high-cost outliers to be decided by the secretary. MIPPA requires that low-volume, high-cost facilities receive a minimum add-on adjustment of 10 percent during the 4-year phase-in of the bundle. The secretary has discretion in determining the facilities that qualify for the add-on and the amount, if any, over 10 percent. The unit of payment under the bundle is also left to the discretion of the secretary, who may set it on a per-treatment, weekly or monthly basis. Developing the ESRD regulations will be a multiyear process; even though CMS may be starting the process now, the ultimate decisions will be made under a new administration. MIPPA requires CMS to initiate a pay-for-performance program. According to the law, the bundled payment rate will be reduced by up to 2 percent for facilities that do not achieve or make progress toward specified quality measures starting January 1, 2012. Anemia management, patient satisfaction, iron management, bone mineral metabolism, and vascular access are specified in the law as quality measures. The secretary will establish the specific benchmarks used in measuring quality, the design of the overall system, the implementation process, and the details of the public notice requirements. The secretary will also develop the criteria for participation and selection in the five-year chronic kidney disease demonstration project required by MIPPA and the content of the chronic kidney disease education sessions and material that will now be reimbursed by Medicare. MIPPA includes specific language that precludes judicial or administrative review of any of the secretary's decisions. In essence, the secretary and the administration have broad unilateral authority in developing the specific policies for implementing the statutory ESRD requirements. Although the law gives the secretary broad authority in the design of the reimbursement, quality and demonstration programs, CMS will play a crucial role in their development. The implementation decisions will be made through the regulatory process, which begins with CMS. The path for the development of regulations is that the initial decisions are made by CMS, reviewed by the secretary of the HHS, forwarded to the Office of Management and Budget (OMB) for analysis and concurrence, and published as proposed regulations with a public comment period. The comments are reviewed, and changes can be made in the proposed regulations, which must then be reviewed again by the secretary of the HHS and the OMB before being published as final regulations. Once the final regulations are published, there is normally a 60- to 90-day period before implementation. Developing the ESRD regulations will be a multiyear process. Even though CMS may be starting the process now, the ultimate decisions will be made under a new administration. This means that a new secretary of the HHS, administrator of CMS, and director of the OMB, along with other top officials, will have a direct impact on the regulations. The regulatory process is where the action will be focused for the next year.

Professionalizing psychiatry: from ‘amateur’ psychiatry to ‘a mature’ profession

Professionalizing psychiatry: from ‘amateur’ psychiatry to ‘a mature’ profession