The Veterans Affairs National Quality Scholars program: a model for interprofessional education in quality and safety.

PubMed

Patrician, Patricia A; Dolansky, Mary A; Pair, Vincent; Bates, Mekeshia; Moore, Shirley M; Splaine, Mark; Gilman, Stuart C

2013-01-01

The Quality and Safety Education for Nurses (QSEN) project is enhancing the emphasis on quality care and patient safety content in nursing schools. A partnership between QSEN and the Veterans Affairs National Quality Scholars program resulted in a unique experiential, interdisciplinary fellowship for both nurses and physicians. This article introduces the Veterans Affairs National Quality Scholars program and provides examples of learning activities and fellows' accomplishments. Interprofessional quality and safety education at the doctoral and postdoctoral levels is germane to improving the quality of health care.

National Water-Quality Assessment program: The Trinity River Basin

USGS Publications Warehouse

Land, Larry F.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels. A major design feature of the NAWQA program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which comprise the principal building blocks of the program on which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Trinity River basin study was among the first 20 NAWQA study units selected for study under the full-scale implementation plan.

National Water-Quality Assessment Program: The Sacramento River Basin

USGS Publications Warehouse

Domagalski, Joseph L.; Brown, Larry R.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status of and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to identify the major natural and human factors that affect the quality of those resources. In addressing these goals, the program will provide a wealth of water- quality information that will be useful to policy makers and managers at the national, State, and local levels. A major asset of the NAWQA program is that it will allow for the integration of water-quality information collected at several scales. A major component of the program is the study-unit investigation-the foundation of national- level assessment. The 60 study units of the NAWQA program are hydrologic systems that include parts of most major river basins and aquifer systems of the conterminous United States. These study units cover areas of 1,000 to more than 60,000 square miles and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Investigations of the first 20 study units began in 1991. In 1994, the Sacramento River Basin was among the second set of 20 NAWQA study units selected for investigation.

Nonpoint Source: National Water Quality Initiative

EPA Pesticide Factsheets

National Water Quality Initiative (NWQI) is a collaborative between EPA and Natural Resource Conservation Service ( NRCS) that began in 2012. NWQI provides a means to accelerate voluntary, private lands conservation practices

Child Reactivity Moderates the Over-Time Association between Mother-Child Conflict Quality and Externalizing Problems

ERIC Educational Resources Information Center

Nelson, Jackie A.

2015-01-01

Constructive parent-child conflict interactions that teach children to problem-solve and negotiate can enhance children's social adjustment. This paper identifies constructive and destructive qualities of mother-child conflict and explores whether child temperament moderated associations with changes in externalizing problems over time. One…

Quality management and accreditation of research tissue banks: experience of the National Center for Tumor Diseases (NCT) Heidelberg.

PubMed

Herpel, Esther; Röcken, Christoph; Manke, Heike; Schirmacher, Peter; Flechtenmacher, Christa

2010-12-01

Tissue banks are key resource and technology platforms in biomedical research that address the molecular pathogenesis of diseases as well as disease prevention, diagnosis, and treatment. Due to the central role of tissue banks in standardized collection, storage, and distribution of human tissues and their derivatives, quality management and its external assessment is becoming increasingly relevant for the maintenance, acceptance, and funding of tissue banks. Little experience exists regarding formalized external evaluation of tissue banks, especially regarding certification and accreditation. Based on the accreditation of the National Center of Tumor Diseases (NCT) tissue bank in Heidelberg (Germany), criteria, requirements, processes, and implications were compiled and evaluated. Accreditation formally approved professional competence and performance of the tissue bank in all steps involved in tissue collection, storage, handling as well as macroscopic and histologic examination and final (exit) examination of the tissue and transfer supervised by board-certified competent histopathologists. Thereby, accreditation provides a comprehensive measure to evaluate and document the quality standard of tissue research banks and may play a significant role in the future assessment of tissue banks. Furthermore, accreditation may support harmonization and standardization of tissue banking for biomedical research purposes.

External quality assurance of HER2 fluorescence in situ hybridisation testing: results of a UK NEQAS pilot scheme

PubMed Central

Bartlett, John M S; Ibrahim, Merdol; Jasani, Bharat; Morgan, John M; Ellis, Ian; Kay, Elaine; Magee, Hilary; Barnett, Sarah; Miller, Keith

2007-01-01

Background and Aims Trastuzumab provides clinical benefit for advanced and early breast cancer patients whose tumours over‐express or have gene amplification of the HER2 oncogene. The UK National External Quality Assessment Scheme (NEQAS) for immunohistochemical testing was established to assess and improve the quality of HER2 immunohistochemical testing. However, until recently, no provision was available for HER2 fluorescence in situ hybridisation (FISH) testing. A pilot scheme was set up to review the performance of FISH testing in clinical diagnostic laboratories. Methods FISH was performed in 6 reference and 31 participating laboratories using a cell line panel with known HER2 status. Results Using results from reference laboratories as a criterion for acceptable performance, 60% of all results returned by participants were appropriate and 78% either appropriate or acceptable. However, 22.4% of results returned were deemed inappropriate, including 13 cases (4.2%) where a misdiagnosis would have been made had these been clinical specimens. Conclusions The results of three consecutive runs show that both reference laboratories and a proportion of routine clinical diagnostic (about 25%) centres can consistently achieve acceptable quality control of HER2 testing. Data from a significant proportion of participating laboratories show that further steps are required, including those taken via review of performance under schemes such as NEQAS, to improve quality of HER2 testing by FISH in the “real world”. PMID:16963466

National water-quality assessment program : the Albemarle- Pamlico drainage

USGS Publications Warehouse

Lloyd, O.B.; Barnes, C.R.; Woodside, M.D.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. Long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water quality information that will be useful to policy makers and managers at the national, State, and local levels. Study-unit investigations constitute a major component of the NAWQA program, forming the principal building blocks on which national-level assessment activities are based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Albemarle-Pamlico drainage was among the first 20 NAWQA study units selected for study under the full-scale implementation plan. The Albemarle-Pamlico drainage study will examine the physical, chemical, and biological aspects of water quality issues in a coordinated investigation of surface water and ground water in the Albemarle-Pamlico drainage basin. The quantity and quality of discharge from the Albemarle-Pamlico drainage basin contribute to some water quality problems in the biologically sensitive waters of Albemarle and Pamlico Sounds. A retrospective analysis of existing water quality data will precede a 3-year period of intensive data-collection and analysis activities. The data resulting from this study and the improved understanding of important processes and issues in the upstream part of the study unit will enhance understanding of the quality of

Effects of equipment performance on data quality from the National Atmospheric Deposition Program/National Trends Network and the Mercury Deposition Network

USGS Publications Warehouse

Wetherbee, Gregory A.; Rhodes, Mark F.

2013-01-01

The U.S. Geological Survey Branch of Quality Systems operates the Precipitation Chemistry Quality Assurance project (PCQA) to provide independent, external quality-assurance for the National Atmospheric Deposition Program (NADP). NADP is composed of five monitoring networks that measure the chemical composition of precipitation and ambient air. PCQA and the NADP Program Office completed five short-term studies to investigate the effects of equipment performance with respect to the National Trends Network (NTN) and Mercury Deposition Network (MDN) data quality: sample evaporation from NTN collectors; sample volume and mercury loss from MDN collectors; mercury adsorption to MDN collector glassware, grid-type precipitation sensors for precipitation collectors, and the effects of an NTN collector wind shield on sample catch efficiency. Sample-volume evaporation from an NTN Aerochem Metrics (ACM) collector ranged between 1.1–33 percent with a median of 4.7 percent. The results suggest that weekly NTN sample evaporation is small relative to sample volume. MDN sample evaporation occurs predominantly in western and southern regions of the United States (U.S.) and more frequently with modified ACM collectors than with N-CON Systems Inc. collectors due to differences in airflow through the collectors. Variations in mercury concentrations, measured to be as high as 47.5 percent per week with a median of 5 percent, are associated with MDN sample-volume loss. Small amounts of mercury are also lost from MDN samples by adsorption to collector glassware irrespective of collector type. MDN 11-grid sensors were found to open collectors sooner, keep them open longer, and cause fewer lid cycles than NTN 7-grid sensors. Wind shielding an NTN ACM collector resulted in collection of larger quantities of precipitation while also preserving sample integrity.

First round of external quality assessment of dengue diagnostics in the WHO Western Pacific Region, 2013.

PubMed

Pok, Kwoon Yong; Squires, Raynal C; Tan, Li Kiang; Takasaki, Tomohiko; Abubakar, Sazaly; Hasebe, Futoshi; Partridge, Jeffrey; Lee, Chin Kei; Lo, Janice; Aaskov, John; Ng, Lee Ching; Konings, Frank

2015-01-01

Accurate laboratory testing is a critical component of dengue surveillance and control. The objective of this programme was to assess dengue diagnostic proficiency among national-level public health laboratories in the World Health Organization (WHO) Western Pacific Region. Nineteen national-level public health laboratories performed routine dengue diagnostic assays on a proficiency testing panel consisting of two modules: one containing commercial serum samples spiked with cultured dengue viruses for the detection of nucleic acid and non-structural protein 1 (NS1) (Module A) and one containing human serum samples for the detection of anti-dengue virus antibodies (Module B). A review of logistics arrangements was also conducted. All 16 laboratories testing Module A performed reverse transcriptase polymerase chain reaction (RT-PCR) for both RNA and serotype detection. Of these, 15 had correct results for RNA detection and all 16 correctly serotyped the viruses. All nine laboratories performing NS1 antigen detection obtained the correct results. Sixteen of the 18 laboratories using IgM assays in Module B obtained the correct results as did the 13 laboratories that performed IgG assays. Detection of ongoing/recent dengue virus infection by both molecular (RT-PCR) and serological methods (IgM) was available in 15/19 participating laboratories. This first round of external quality assessment of dengue diagnostics was successfully conducted in national-level public health laboratories in the WHO Western Pacific Region, revealing good proficiency in both molecular and serological testing. Further comprehensive diagnostic testing for dengue virus and other priority pathogens in the Region will be assessed during future rounds.

Guidelines for External Reviews of Quality Assurance Agencies in the European Higher Education Area. ENQA Occasional Papers 19

ERIC Educational Resources Information Center

ENQA (European Association for Quality Assurance in Higher Education), 2012

2012-01-01

In accordance with the ENQA (European Association for Quality Assurance in Higher Education) membership criteria laid down in the Statutes of ENQA, member agencies are required to undergo external reviews against the membership criteria, and thereby the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) as…

External quality assessment of dengue and chikungunya diagnostics in the Asia Pacific region, 2015

PubMed Central

Soh, Li Ting; Squires, Raynal C; Tan, Li Kiang; Pok, Kwoon Yong; Yang, HuiTing; Liew, Christina; Shah, Aparna Singh; Aaskov, John; Abubakar, Sazaly; Hasabe, Futoshi; Ng, Lee Ching

2016-01-01

Objective To conduct an external quality assessment (EQA) of dengue and chikungunya diagnostics among national-level public health laboratories in the Asia Pacific region following the first round of EQA for dengue diagnostics in 2013. Methods Twenty-four national-level public health laboratories performed routine diagnostic assays on a proficiency testing panel consisting of two modules. Module A contained serum samples spiked with cultured dengue virus (DENV) or chikungunya virus (CHIKV) for the detection of nucleic acid and DENV non-structural protein 1 (NS1) antigen. Module B contained human serum samples for the detection of anti-DENV antibodies. Results Among 20 laboratories testing Module A, 17 (85%) correctly detected DENV RNA by reverse transcription polymerase chain reaction (RT–PCR), 18 (90%) correctly determined serotype and 19 (95%) correctly identified CHIKV by RT–PCR. Ten of 15 (66.7%) laboratories performing NS1 antigen assays obtained the correct results. In Module B, 18/23 (78.3%) and 20/20 (100%) of laboratories correctly detected anti-DENV IgM and IgG, respectively. Detection of acute/recent DENV infection by both molecular (RT–PCR) and serological methods (IgM) was available in 19/24 (79.2%) participating laboratories. Discussion Accurate laboratory testing is a critical component of dengue and chikungunya surveillance and control. This second round of EQA reveals good proficiency in molecular and serological diagnostics of these diseases in the Asia Pacific region. Further comprehensive diagnostic testing, including testing for Zika virus, should comprise future iterations of the EQA. PMID:27508088

Groundwater quality data from the National Water-Quality Assessment Project, May 2012 through December 2013

USGS Publications Warehouse

Arnold, Terri L.; Desimone, Leslie A.; Bexfield, Laura M.; Lindsey, Bruce D.; Barlow, Jeannie R.; Kulongoski, Justin T.; Musgrove, MaryLynn; Kingsbury, James A.; Belitz, Kenneth

2016-06-20

Groundwater-quality data were collected from 748 wells as part of the National Water-Quality Assessment Project of the U.S. Geological Survey National Water-Quality Program from May 2012 through December 2013. The data were collected from four types of well networks: principal aquifer study networks, which assess the quality of groundwater used for public water supply; land-use study networks, which assess land-use effects on shallow groundwater quality; major aquifer study networks, which assess the quality of groundwater used for domestic supply; and enhanced trends networks, which evaluate the time scales during which groundwater quality changes. Groundwater samples were analyzed for a large number of water-quality indicators and constituents, including major ions, nutrients, trace elements, volatile organic compounds, pesticides, and radionuclides. These groundwater quality data are tabulated in this report. Quality-control samples also were collected; data from blank and replicate quality-control samples are included in this report.

[Extraction of management information from the national quality assurance program].

PubMed

Stausberg, Jürgen; Bartels, Claus; Bobrowski, Christoph

2007-07-15

Starting with clinically motivated projects, the national quality assurance program has established a legislative obligatory framework. Annual feedback of results is an important means of quality control. The annual reports cover quality-related information with high granularity. A synopsis for corporate management is missing, however. Therefore, the results of the University Clinics in Greifswald, Germany, have been analyzed and aggregated to support hospital management. Strengths were identified by the ranking of results within the state for each quality indicator, weaknesses by the comparison with national reference values. The assessment was aggregated per clinical discipline and per category (indication, process, and outcome). A composition of quality indicators was claimed multiple times. A coherent concept is still missing. The method presented establishes a plausible summary of strengths and weaknesses of a hospital from the point of view of the national quality assurance program. Nevertheless, further adaptation of the program is needed to better assist corporate management.

Water-quality trends in the nation's rivers

USGS Publications Warehouse

Smith, R.A.; Alexander, R.B.; Wolman, M.G.

1987-01-01

Water-quality records from two nationwide sampling networks now permit nationally consistent analysis of long-term water-quality trends at more than 300 locations on major U.S. rivers. Observed trends in 24 measures of water quality for the period from 1974 to 1981 provide new insight into changes in stream quality that occurred during a time of major changes in both terrestrial and atmospheric influences on surface waters. Particularly noteworthy are widespread decreases in fecal bacteria and lead concentrations and widespread increases in nitrate, chloride, arsenic, and cadmium concentrations. Recorded increases in municipal waste treatment, use of salt on highways, and nitrogen fertilizer application, along with decreases in leaded gasoline consumption and regionally variable trends in coal production and combustion during the period appear to be reflected in water-quality changes.Water-quality records from two nationwide sampling networks now permit nationally consistent analysis of long-term water-quality trends at more than 300 locations on major U. S. rivers. Observed trends in 24 measures of water quality for the period from 1974 to 1981 provide new insight into changes in stream quality that occurred during a time of major changes in both terrestrial and atmospheric influences on surface waters. Particularly noteworthy are widespread decreases in fecal bacteria and lead concentrations and widespread increases in nitrate, chloride, arsenic, and cadmium concentrations. Recorded increases in municipal waste treatment, use of salt on highways, and nitrogen fertilizer application, along with decreases in leaded gasoline consumption and regionally variable trends in coal production and combustion during the period appear to be reflected in water-quality changes.

External quality assessment of urine particle identification: a Northern European experience.

PubMed

Kouri, Timo T; Makkonen, Pirjo

2015-11-01

External quality assessment (EQA) schemes for urinalysis have been provided by Labquality Ltd, the publicly owned EQA service provider in Finland, since the 1980s. In 2014, the scheme on urine particle identification had 329 participating laboratories, out of which 60% from 19 countries were outside Finland. Each of the four annual web-based rounds were distributed with four Sternheimer-stained images from a single patient sample, as viewed both by bright-field and phase-contrast optics. Participants reported classified categories either at the basic or at the advanced level. Participating laboratories received assessment of their analytical performance as compared to their peers, including reflections from clinical data and preanalytical detail of the specimen. In general, reporting of basic urine particles succeeded in the eight schemes during the years 2013-2014 as follows: red blood cells 82%-92%, white blood cells 82%-97%, squamous epithelial cells 92%-98%, casts 84%-94%, and small epithelial cells 73%-83% (minimum and maximum of expected or accepted reports). This basic level of differentiation is used in routine laboratory reports, or as verification of results produced by automated instruments. Considerable effort is needed to standardise national procedures and reporting formats, in order to improve the shown figures internationally. Future technologies may help to alleviate limitations created by single digital images. Despite improvements, degenerating cells and casts always exhibit intermediate forms creating disputable classifications. That is why assessment of performance should encompass justified acceptable categories into the assessed outcomes. Preanalytical and clinical detail provide essential added value to morphological findings.

Does National Quality Monitoring Make a Difference?

ERIC Educational Resources Information Center

Wahlen, Staffan

2004-01-01

This article analyses the impact of national quality audit of Swedish higher education institutions between 1995 and 2002. It also looks at the programme and subject reviews that have succeeded the audits, in order to compare results. It is found that the audits have resulted in the development of policy and structure of institutional quality work…

77 FR 69795 - Malcolm Baldrige National Quality Award Board of Overseers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... Quality Award Board of Overseers AGENCY: National Institute of Standards and Technology, Department of... Quality Award (Board of Overseers) will meet in open session on Wednesday, December 12, 2012. The purpose... Standards and Technology and from the Chair of the Judges' Panel of the Malcolm Baldrige National Quality...

Methodological Quality of National Guidelines for Pediatric Inpatient Conditions

PubMed Central

Hester, Gabrielle; Nelson, Katherine; Mahant, Sanjay; Eresuma, Emily; Keren, Ron; Srivastava, Rajendu

2014-01-01

Background Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings (PRIS) network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children’s hospitals. The methodological quality of guidelines for priority conditions is unknown. Objective To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. Design We searched sources including PubMed for national guidelines published 2002–2012. Guidelines specific to one organism, test or treatment, or institution were excluded. Guidelines were rated by two raters using a validated tool (AGREE II) with an overall rating on a 7-point scale (7–highest). Inter-rater reliability was measured with a weighted kappa coefficient. Results 17 guidelines met inclusion criteria for 13 conditions, 7 conditions yielded no relevant national guidelines. The highest methodological quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5 and 6.5 respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3 respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78–0.87). Conclusions We identified a group of moderate to high methodological quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives. PMID:24677729

Standards and Quality in Higher Education. Higher Education Policy Series 37.

ERIC Educational Resources Information Center

Brennan, John, Ed.; de Vries, Peter, Ed.; Williams, Ruth, Ed.

The papers in this book reflect current debates on academic standards and quality assurance, and speak from the perspective of institutional leaders and national quality bodies and higher education researchers. Included are reports on the progress of several international quality initiatives and studies on the impact of external quality assurance…

Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study.

PubMed

Nicolaisen, Marianne; Müller, Stig; Patel, Hitendra R H; Hanssen, Tove Aminda

2014-12-01

To assess patients' symptoms, quality of life and satisfaction with information three to four years after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy and to analyse differences between treatment groups and the relationship between disease-specific, health-related and overall quality of life and satisfaction with information. Radical prostate cancer treatments are associated with changes in quality of life. Differences between patients undergoing different treatments in symptoms and quality of life have been reported, but there are limited long-term data comparing radical prostatectomy with radical external beam radiotherapy and postoperative radiotherapy. A cross-sectional survey design was used. The study sample included 143 men treated with radical prostatectomy and/or radical external beam radiotherapy. Quality of life was measured using the 12-item Short Form Health Survey and the 50-item Expanded Prostate Cancer Index Composite Instrument. Questions assessing overall Quality of life and satisfaction with information were included. Descriptive statistics and interference statistical methods were applied to analyse the data. Radical external beam radiotherapy was associated with less urinary incontinence and better urinary function. There were no differences between the groups for disease-specific quality of life sum scores. Sexual quality of life was reported very low in all groups. Disease-specific quality of life and health-related quality of life were associated with overall quality of life. Patients having undergone surgery were more satisfied with information, and there was a positive correlation between quality of life and patient satisfaction. Pretreatment information and patient education lead to better quality of life and satisfaction. This study indicates a need for structured, pretreatment information and follow-up for all men going through radical prostate cancer treatment. Long-term quality of life

EQUAL-quant: an international external quality assessment scheme for real-time PCR.

PubMed

Ramsden, Simon C; Daly, Sarah; Geilenkeuser, Wolf-Jochen; Duncan, Graeme; Hermitte, Fabienne; Marubini, Ettore; Neumaier, Michael; Orlando, Claudio; Palicka, Vladimir; Paradiso, Angelo; Pazzagli, Mario; Pizzamiglio, Sara; Verderio, Paolo

2006-08-01

Quantitative gene expression analysis by real-time PCR is important in several diagnostic areas, such as the detection of minimum residual disease in leukemia and the prognostic assessment of cancer patients. To address quality assurance in this technically challenging area, the European Union (EU) has funded the EQUAL project to develop methodologic external quality assessment (EQA) relevant to diagnostic and research laboratories among the EU member states. We report here the results of the EQUAL-quant program, which assesses standards in the use of TaqMan probes, one of the most widely used assays in the implementation of real-time PCR. The EQUAL-quant reagent set was developed to assess the technical execution of a standard TaqMan assay, including RNA extraction, reverse transcription, and real-time PCR quantification of target DNA copy number. The multidisciplinary EQA scheme included 137 participating laboratories from 29 countries. We demonstrated significant differences in performance among laboratories, with 20% of laboratories reporting at least one result lacking in precision and/or accuracy according to the statistical procedures described. No differences in performance were observed for the >10 different testing platforms used by the study participants. This EQA scheme demonstrated both the requirement and demand for external assessment of technical standards in real-time PCR. The reagent design and the statistical tools developed within this project will provide a benchmark for defining acceptable working standards in this emerging technology.

Quality Management Systems for the National Qualifications Framework. Quality Assurance in Education and Training.

ERIC Educational Resources Information Center

New Zealand Qualifications Authority, Wellington.

This booklet explores the idea of quality and its management as it applies to providers of education in particular, but also as it applies to national standards bodies and workplaces offering on-the-job training. It explores the focus on quality in industry and education and defines quality in terms of the features of quality and their…

77 FR 9651 - National Advisory Committee on Institutional Quality and Integrity (NACIQI) Teleconference

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-17

... DEPARTMENT OF EDUCATION National Advisory Committee on Institutional Quality and Integrity (NACIQI) Teleconference AGENCY: National Advisory Committee on Institutional Quality and Integrity, Office of... teleconference meeting of the National Advisory Committee on Institutional Quality and Integrity (NACIQI) and...

Overview of the National Water-Quality Assessment Program

USGS Publications Warehouse

Leahy, P.P.; Thompson, T.H.

1994-01-01

The Nation's water resources are the basis for life and our economic vitality. These resources support a complex web of human activities and fishery and wildlife needs that depend upon clean water. Demands for good-quality water for drinking, recreation, farming, and industry are rising, and as a result, the American public is concerned about the condition and sustainability of our water resources. The American public is asking: Is it safe to swim in and drink water from our rivers or lakes? Can we eat the fish that come from them? Is our ground water polluted? Is water quality degrading with time, and if so, why? Has all the money we've spent to clean up our waters, done any good? The U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program was designed to provide information that will help answer these questions. NAWQA is designed to assess historical, current, and future water-quality conditions in representative river basins and aquifers nationwide. One of the primary objectives of the program is to describe relations between natural factors, human activities, and water-quality conditions and to define those factors that most affect water quality in different parts of the Nation. The linkage of water quality to environmental processes is of fundamental importance to water-resource managers, planners, and policy makers. It provides a strong and unbiased basis for better decisionmaking by those responsible for making decisions that affect our water resources, including the United States Congress, Federal, State, and local agencies, environmental groups, and industry. Information from the NAWQA Program also will be useful for guiding research, monitoring, and regulatory activities in cost effective ways.

Evolution of an International External Quality Assurance Model To Support Laboratory Investigation of Streptococcus pneumoniae, Developed for the SIREVA Project in Latin America, from 1993 to 2005▿

PubMed Central

Lovgren, Marguerite; Talbot, James A.; Brandileone, Maria Cristina; Casagrande, Silvana T.; Agudelo, Clara Inés; Castañeda, Elizabeth; Regueira, Mabel; Corso, Alejandra; Heitmann, Ingrid; Maldonado, Aurora; Echániz-Avilés, Gabriela; Soto-Noguerón, Araceli; Hortal, María; Camou, Teresa; Gabastou, Jean-Marc; Fabio, José Luis Di

2007-01-01

In 1993 the Pan American Health Organization initiated a laboratory-based surveillance system, called the SIREVA project, to learn about Streptococcus pneumoniae invasive disease in Latin American children. In 1994, National Laboratories in six countries were trained to perform serotyping and antibiotic susceptibility testing using broth microdilution to determine the MIC for specified antibiotics. An international External Quality Assurance (EQA) program was developed to monitor and support ongoing laboratory performance. The EQA program was coordinated by the National Centre for Streptococcus (NCS), Edmonton, Canada, and included external proficiency testing (EPT) and a validation process requiring regular submission of a sample of isolates from each laboratory to the NCS for verification of the serotype and MIC. In 1999, the EQA program was decentralized to use three of the original laboratories as regional quality control centers to address operational concerns and to accommodate the growth of the laboratory network to more than 20 countries including the Caribbean region. The overall EPT serotyping accuracies for phase I (1993 to 1998) and phase II (1999 to 2005) were 88.0 and 93.8%, respectively; the MIC correlations within ±1 log2 dilution of the expected result were 83.0 and 91.0% and the interpretive category agreements were 89.1 and 95.3%. Overall, the validation process serotyping accuracies for phases I and II were 81.9 and 88.1%, respectively, 80.4 and 90.5% for MIC agreement, and 85.8 and 94.3% for category agreement. These results indicate a high level of testing accuracy in participating National Laboratories and a sustained increase in EQA participation in Latin America and the Caribbean. PMID:17687007

National Quality Measures for Child Mental Health Care: Background, Progress, and Next Steps

PubMed Central

Murphy, J. Michael; Scholle, Sarah Hudson; Hoagwood, Kimberly Eaton; Sachdeva, Ramesh C.; Mangione-Smith, Rita; Woods, Donna; Kamin, Hayley S.; Jellinek, Michael

2013-01-01

OBJECTIVE: To review recent health policies related to measuring child health care quality, the selection processes of national child health quality measures, the nationally recommended quality measures for child mental health care and their evidence strength, the progress made toward developing new measures, and early lessons learned from these national efforts. METHODS: Methods used included description of the selection process of child health care quality measures from 2 independent national initiatives, the recommended quality measures for child mental health care, and the strength of scientific evidence supporting them. RESULTS: Of the child health quality measures recommended or endorsed during these national initiatives, only 9 unique measures were related to child mental health. CONCLUSIONS: The development of new child mental health quality measures poses methodologic challenges that will require a paradigm shift to align research with its accelerated pace. PMID:23457148

Advancing Our National Agenda. Proceedings of the National Conference on Adult and External Degree Programs (8th, Washington, D.C., October 12-14, 1988).

ERIC Educational Resources Information Center

American Council on Education, Washington, DC.

A comprehensive, interactive conference was designed to help improve the quality of external degree programs and adult education. Sixteen papers are presented as follows: (1) "Designing Self-Instructional Print Material for the Adult Learner" (Diane J. Davis); (2) "Degrees by Alternative Delivery for U.S. Soldiers and Sailors"…

Data Envelopment Analysis in the Presence of Measurement Error: Case Study from the National Database of Nursing Quality Indicators® (NDNQI®)

PubMed Central

Gajewski, Byron J.; Lee, Robert; Dunton, Nancy

2012-01-01

Data Envelopment Analysis (DEA) is the most commonly used approach for evaluating healthcare efficiency (Hollingsworth, 2008), but a long-standing concern is that DEA assumes that data are measured without error. This is quite unlikely, and DEA and other efficiency analysis techniques may yield biased efficiency estimates if it is not realized (Gajewski, Lee, Bott, Piamjariyakul and Taunton, 2009; Ruggiero, 2004). We propose to address measurement error systematically using a Bayesian method (Bayesian DEA). We will apply Bayesian DEA to data from the National Database of Nursing Quality Indicators® (NDNQI®) to estimate nursing units’ efficiency. Several external reliability studies inform the posterior distribution of the measurement error on the DEA variables. We will discuss the case of generalizing the approach to situations where an external reliability study is not feasible. PMID:23328796

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

PubMed

Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

2013-01-01

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of

Longitudinal Associations between Externalizing Problems and Student-Teacher Relationship Quality for Young Children with ASD

ERIC Educational Resources Information Center

Eisenhower, Abbey S.; Blacher, Jan; Bush Hurst, Hillary

2015-01-01

The associations between student-teacher relationship (STR) quality and externalizing behavior problems in school were examined among 166 children with ASD (82% boys, ages 4-7 years) across three assessments over a 1.5-year period; IQs in the sample range from 50 to 139 (M = 88.7). Unlike other non-ASD populations, the association between STR…

European consensus conference for external quality assessment in molecular pathology.

PubMed

van Krieken, J H; Siebers, A G; Normanno, N

2013-08-01

Molecular testing of tumor samples to guide treatment decisions is of increasing importance. Several drugs have been approved for treatment of molecularly defined subgroups of patients, and the number of agents requiring companion diagnostics for their prescription is expected to rapidly increase. The results of such testing directly influence the management of individual patients, with both false-negative and false-positive results being harmful for patients. In this respect, external quality assurance (EQA) programs are essential to guarantee optimal quality of testing. There are several EQA schemes available in Europe, but they vary in scope, size and execution. During a conference held in early 2012, medical oncologists, pathologists, geneticists, molecular biologists, EQA providers and representatives from pharmaceutical industries developed a guideline to harmonize the standards applied by EQA schemes in molecular pathology. The guideline comprises recommendations on the organization of an EQA scheme, defining the criteria for reference laboratories, requirements for EQA test samples and the number of samples that are needed for an EQA scheme. Furthermore, a scoring system is proposed and consequences of poor performance are formulated. Lastly, the contents of an EQA report, communication of the EQA results, EQA databases and participant manual are given.

National Water-Quality Assessment Program; the Allegheny-Monongahela River Basin

USGS Publications Warehouse

McAuley, Steven D.

1995-01-01

In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The three major objectives of the NAWQA program are to provide a consistent description of current water-quality conditions for a large part of the Nation's water resources, define long-term trends in water quality, and identify, describe, and explain the major factors that affect water-quality conditions and trends. The program produces water-quality information that is useful to policy makers and managers at the National, State, and local levels.The program will be implemented through 60 separate investigations of river basins and aquifer systems called study units. These study-unit investigations will be conducted at the State and local level and will form the foundation on which national- and regional-level assessments are based. The 60 study units are hydrologic systems that include parts of most major river basins and aquifer systems. The study-unit areas range from 1,000 to more than 60,000 square miles and include about 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty studyunit investigations were started in 1991, 20 started in 1994, and 20 more are planned to start in 1997. The Allegheny-Monongahela River Basin was selected to begin assessment activities as a NAWQA study unit in 1994. The study team will work from the office of the USGS in Pittsburgh, Pa.

National Water Quality Laboratory, 1995 services catalog

USGS Publications Warehouse

Timme, P.J.

1995-01-01

This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey. To assist personnel in the selection of analytical services, this catalog lists sample volume, required containers, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples.

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

National Standards for Quality Online Courses: Version 2

ERIC Educational Resources Information Center

International Association for K-12 Online Learning, 2011

2011-01-01

The mission of the International Association for K-12 Online Learning (iNACOL) is to ensure all students have access to world-class education and quality online learning opportunities that prepare them for a lifetime of success. "National Standards for Quality Online Courses" is designed to provide states, districts, online programs, and…

Quality of Life Effects of Automatic External Defibrillators in the Home: Results from the Home Automatic External Defibrillator Trial (HAT)

PubMed Central

Mark, Daniel B.; Anstrom, Kevin J.; McNulty, Steven E.; Flaker, Greg C.; Tonkin, Andrew M.; Smith, Warren M.; Toff, William D.; Dorian, Paul; Clapp-Channing, Nancy E.; Anderson, Jill; Johnson, George; Schron, Eleanor B.; Poole, Jeanne E.; Lee, Kerry L.; Bardy, Gust H.

2010-01-01

Background Public access automatic external defibrillators (AEDs) can save lives, but most deaths from out-of-hospital sudden cardiac arrest occur at home. The Home Automatic External Defibrillator Trial (HAT) found no survival advantage for adding a home AED to cardiopulmonary resuscitation (CPR) training for 7001 patients with a prior anterior wall myocardial infarction. Quality of life (QOL) outcomes for both the patient and spouse/companion were secondary endpoints. Methods A subset of 1007 study patients and their spouse/companions was randomly selected for ascertainment of QOL by structured interview at baseline and 12 and 24 months following enrollment. The primary QOL measures were the Medical Outcomes Study 36-Item Short-Form (SF-36) psychological well-being (reflecting anxiety and depression) and vitality (reflecting energy and fatigue) subscales. Results For patients and spouse/companions, the psychological well-being and vitality scales did not differ significantly between those randomly assigned an AED plus CPR training and controls who received CPR training only. None of the other QOL measures collected showed a clinically and statistically significant difference between treatment groups. Patients in the AED group were more likely to report being extremely or quite a bit reassured by their treatment assignment. Spouse/companions in the AED group reported being less often nervous about the possibility of using AED/CPR treatment than those in the CPR group. Conclusions Adding access to a home AED to CPR training did not affect quality of life either for patients with a prior anterior myocardial infarction or their spouse/companion but did provide more reassurance to the patients without increasing anxiety for spouse/companions. PMID:20362722

Impact of external haematology proficiency testing programme on quality of laboratories.

PubMed

Saxena, Renu; Katoch, S C; Srinivas, Upendra; Rao, Seema; Anand, Hema

2007-11-01

A reliable and reproducible report from a laboratory needs internal quality control within the laboratory and participation in external proficiency testing programmes (EPTP). This study conducted at the Department of Haematology, All India Institute of Medical Sciences (AIIMS), New Delhi, which has been conducting an EPTP since 1992, was undertaken to assess the efficacy of this programme in improving the performance of participating laboratories in reporting test samples sent for Hb, total leucocyte count (TLC), reticulocyte count and assessment of peripheral blood smear (PBS). The samples were prepared in our laboratory according to the International Standards Organization (ISO) guidelines. The performance of individual laboratories was assessed using robust Z score, which is an indicator of acceptability of the test result. An improvement in the overall percentage of laboratories with acceptable reports was seen during the study period. It has increased from 38,40,40 per cent in 1992 to 85, 90,94.7 per cent in 2006 for Hb, TLC, reticulocyte count, respectively. However, the results for peripheral smear assessment improved only marginally. The external haematology proficiency testing programme run by our department for Hb, TLC, reticulocyte count, and peripheral blood smear assessment, has helped in improving the reporting standards of these parameters in Indian laboratories.

Longitudinal links between spanking and children's externalizing behaviors in a national sample of White, Black, Hispanic, and Asian American families.

PubMed

Gershoff, Elizabeth T; Lansford, Jennifer E; Sexton, Holly R; Davis-Kean, Pamela; Sameroff, Arnold J

2012-01-01

This study examined whether the longitudinal links between mothers' use of spanking and children's externalizing behaviors are moderated by family race/ethnicity, as would be predicted by cultural normativeness theory, once mean differences in frequency of use are controlled. A nationally representative sample of White, Black, Hispanic, and Asian American families (n = 11,044) was used to test a cross-lagged path model from 5 to 8 years old. While race/ethnic differences were observed in the frequency of spanking, no differences were found in the associations of spanking and externalizing over time: Early spanking predicted increases in children's externalizing while early child externalizing elicited more spanking over time across all race/ethnic groups. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

National Water Quality Laboratory Profile

USGS Publications Warehouse

Raese, Jon W.

1994-01-01

The National Water Quality Laboratory determines organic and inorganic constituents in samples of surface and ground water, river and lake sediment, aquatic plant and animal material, and precipitation collected throughout the United States and its territories by the U.S. Geological Survey. In water year 1994, the Laboratory produced more than 900,000 analytical results for about 65,000 samples. The Laboratory also coordinates an extensive network of contract laboratories for the determination of radiochemical and stable isotopes and work for the U.S. Department of Defense Environmental Contamination Hydrology Program. Heightened concerns about water quality and about the possible effects of toxic chemicals at trace and ultratrace levels have contributed to an increased demand for impartial, objective, and independent data.

Overview of the new National Near-Road Air Quality Monitoring Network

EPA Science Inventory

In 2010, EPA promulgated new National Ambient Air Quality Standards (NAAQS) for nitrogen dioxide (NO2). As part of this new NAAQS, EPA required the establishment of a national near-road air quality monitoring network. This network will consist of one NO2 near-road monitoring st...

ADHD and the externalizing spectrum: direct comparison of categorical, continuous, and hybrid models of liability in a nationally representative sample.

PubMed

Carragher, Natacha; Krueger, Robert F; Eaton, Nicholas R; Markon, Kristian E; Keyes, Katherine M; Blanco, Carlos; Saha, Tulshi D; Hasin, Deborah S

2014-08-01

Alcohol use disorders, substance use disorders, and antisocial personality disorder share a common externalizing liability, which may also include attention-deficit hyperactivity disorder (ADHD). However, few studies have compared formal quantitative models of externalizing liability, with the aim of delineating the categorical and/or continuous nature of this liability in the community. This study compares categorical, continuous, and hybrid models of externalizing liability. Data were derived from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (N = 34,653). Seven disorders were modeled: childhood ADHD and lifetime diagnoses of antisocial personality disorder (ASPD), nicotine dependence, alcohol dependence, marijuana dependence, cocaine dependence, and other substance dependence. The continuous latent trait model provided the best fit to the data. Measurement invariance analyses supported the fit of the model across genders, with females displaying a significantly lower probability of experiencing externalizing disorders. Cocaine dependence, marijuana dependence, other substance dependence, alcohol dependence, ASPD, nicotine dependence, and ADHD provided the greatest information, respectively, about the underlying externalizing continuum. Liability to externalizing disorders is continuous and dimensional in severity. The findings have important implications for the organizational structure of externalizing psychopathology in psychiatric nomenclatures.

External quality assessment unravels interlaboratory differences in quality of RAS testing for anti-EGFR therapy in colorectal cancer.

PubMed

Tack, Véronique; Ligtenberg, Marjolijn J L; Tembuyser, Lien; Normanno, Nicola; Vander Borght, Sara; Han van Krieken, J; Dequeker, Elisabeth M C

2015-03-01

Regulations for the selection of patients with metastatic colorectal cancer for anti-EGFR treatment changed at the end of 2013. The set of mutations to be tested extended from KRAS codons 12 and 13 to KRAS and NRAS exons 2, 3, and 4. A European external quality assessment scheme monitored the performance of laboratories and evaluated the implementation of the new regulations. The 131 participating laboratories received 10 samples of formalin-fixed paraffin-embedded material, including RAS (exon 2, 3, 4) and BRAF mutations. Mock clinical data were provided for three cases. Using their routine methods, laboratories determined the genotypes and submitted three written reports. Assessors scored the results according to predefined evaluation criteria. Half of the participants (49.3%) had completely implemented the new test requirements (codons 12, 13, 59, 61, 117, and 146 of KRAS and NRAS), and 96 laboratories (73.3%) made no genotype mistakes. Correct nomenclature, according to the Human Genome Variation Society, was used by 82 laboratories (62.6%). Although regulations were effective for several months, many laboratories were not ready for full RAS testing in the context of anti-EGFR therapy. Nevertheless, in each participating country, there are laboratories that provide complete and correct testing. External quality assessments can be used to monitor implementation of new test regulations and to stimulate the laboratories to improve their testing procedures. Because the results of this program are available on the website of the European Society of Pathology, patients and clinicians can refer test samples to a reliable laboratory. ©AlphaMed Press.

The Benefits of Internalizing Air Quality and Greenhouse Gas Externalities in the US Energy System

NASA Astrophysics Data System (ADS)

Brown, Kristen E.

The emission of pollutants from energy use has effects on both local air quality and the global climate, but the price of energy does not reflect these externalities. This study aims to analyze the effect that internalizing these externalities in the cost of energy would have on the US energy system, emissions, and human health. In this study, we model different policy scenarios in which fees are added to emissions related to generation and use of energy. The fees are based on values of damages estimated in the literature and are applied to upstream and combustion emissions related to electricity generation, industrial energy use, transportation energy use, residential energy use, and commercial energy use. The energy sources and emissions are modeled through 2055 in five-year time steps. The emissions in 2045 are incorporated into a continental-scale atmospheric chemistry and transport model, CMAQ, to determine the change in air quality due to different emissions reduction scenarios. A benefit analysis tool, BenMAP, is used with the air quality results to determine the monetary benefit of emissions reductions related to the improved air quality. We apply fees to emissions associated with health impacts, climate change, and a combination of both. We find that the fees we consider lead to reductions in targeted emissions as well as co-reducing non-targeted emissions. For fees on the electric sector alone, health impacting pollutant (HIP) emissions reductions are achieved mainly through control devices while Greenhouse Gas (GHG) fees are addressed through changes in generation technologies. When sector specific fees are added, reductions come mainly from the industrial and electricity generation sectors, and are achieved through a mix of energy efficiency, increased use of renewables, and control devices. Air quality is improved in almost all areas of the country with fees, including when only GHG fees are applied. Air quality tends to improve more in regions with

Assessment of national dosimetry quality audits results for teletherapy machines from 1989 to 2015.

PubMed

Muhammad, Wazir; Ullah, Asad; Mahmood, Khalid; Matiullah

2016-01-01

The purpose of this study was to ensure accuracy in radiation dose delivery, external dosimetry quality audit has an equal importance with routine dosimetry performed at clinics. To do so, dosimetry quality audit was organized by the Secondary Standard Dosimetry Laboratory (SSDL) of Pakistan Institute of Nuclear Science and Technology (PINSTECH) at the national level to investigate and minimize uncertainties involved in the measurement of absorbed dose, and to improve the accuracy of dose measurement at different radiotherapy hospitals. A total of 181 dosimetry quality audits (i.e., 102 of Co-60 and 79 of linear accelerators) for teletherapy units installed at 22 different sites were performed from 1989 to 2015. The percent deviation between users’ calculated/stated dose and evaluated dose (in the result of on-site dosimetry visits) were calculated and the results were analyzed with respect to the limits of ± 2.5% (ICRU "optimal model") ± 3.0% (IAEA on-site dosimetry visits limit) and ± 5.0% (ICRU minimal or "lowest acceptable" model). The results showed that out of 181 total on-site dosimetry visits, 20.44%, 16.02%, and 4.42% were out of acceptable limits of ± 2.5% ± 3.0%, and ± 5.0%, respectively. The importance of a proper ongoing quality assurance program, recommendations of the followed protocols, and properly calibrated thermometers, pressure gauges, and humidity meters at radiotherapy hospitals are essential in maintaining consistency and uniformity of absorbed dose measurements for precision in dose delivery.

National Water Quality Inventory, 1975 Report to Congress.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Water Programs.

This document summarizes state submissions and provides a national overview of water quality as requested in Section 305(b) of the 1972 Federal Water Pollution Control Act Amendments (P.L. 92-500). This report provides the first opportunity for states to summarize their water quality and to report to EPA and Congress. Chapters of this report deal…

A summary of the U.S. Geological Survey National Water-Quality Assessment program

USGS Publications Warehouse

Hirsch, R.M.; Alley, W.M.; Wilber, W.G.

1988-01-01

Beginning in 1986, the Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water Quality Assessment Program. At present, the program is in a pilot phase with field studies occurring in seven areas around the Nation. In 1990, a committee of the National Academy of Sciences will complete an evaluation of the design and potential utility of the program. A decision about moving to full-scale implementation will be made upon completion of this evaluation. The program is intended to address a wide range of national water quality issues that include chemical contamination, acidification, eutrophication, salinity, sedimentation, and sanitary quality. The goals of the program are to: (1) provide nationally consistent descriptions of current water quality conditions for a large part of the Nation 's water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify and describe the relations of both current conditions and trends in water quality to natural and human factors. This information will be provided to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water quality management programs and for predicting the likely effects of contemplated changes in land- and water-management practices. (USGS)

How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

PubMed

Cho, Yu Kyung

2016-07-01

In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.

Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the Asia-Pacific.

PubMed

Ashraf, Sania; Kao, Angie; Hugo, Cecilia; Christophel, Eva M; Fatunmbi, Bayo; Luchavez, Jennifer; Lilley, Ken; Bell, David

2012-10-24

Malaria diagnosis has received renewed interest in recent years, associated with the increasing accessibility of accurate diagnosis through the introduction of rapid diagnostic tests and new World Health Organization guidelines recommending parasite-based diagnosis prior to anti-malarial therapy. However, light microscopy, established over 100 years ago and frequently considered the reference standard for clinical diagnosis, has been neglected in control programmes and in the malaria literature and evidence suggests field standards are commonly poor. Microscopy remains the most accessible method for parasite quantitation, for drug efficacy monitoring, and as a reference of assessing other diagnostic tools. This mismatch between quality and need highlights the importance of the establishment of reliable standards and procedures for assessing and assuring quality. This paper describes the development, function and impact of a multi-country microscopy external quality assurance network set up for this purpose in Asia. Surveys were used for key informants and past participants for feedback on the quality assurance programme. Competency scores for each country from 14 participating countries were compiled for analyses using paired sample t-tests. In-depth interviews were conducted with key informants including the programme facilitators and national level microscopists. External assessments and limited retraining through a formalized programme based on a reference slide bank has demonstrated an increase in standards of competence of senior microscopists over a relatively short period of time, at a potentially sustainable cost. The network involved in the programme now exceeds 14 countries in the Asia-Pacific, and the methods are extended to other regions. While the impact on national programmes varies, it has translated in some instances into a strengthening of national microscopy standards and offers a possibility both for supporting revival of national microcopy

Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the Asia-Pacific

PubMed Central

2012-01-01

Background Malaria diagnosis has received renewed interest in recent years, associated with the increasing accessibility of accurate diagnosis through the introduction of rapid diagnostic tests and new World Health Organization guidelines recommending parasite-based diagnosis prior to anti-malarial therapy. However, light microscopy, established over 100 years ago and frequently considered the reference standard for clinical diagnosis, has been neglected in control programmes and in the malaria literature and evidence suggests field standards are commonly poor. Microscopy remains the most accessible method for parasite quantitation, for drug efficacy monitoring, and as a reference of assessing other diagnostic tools. This mismatch between quality and need highlights the importance of the establishment of reliable standards and procedures for assessing and assuring quality. This paper describes the development, function and impact of a multi-country microscopy external quality assurance network set up for this purpose in Asia. Methods Surveys were used for key informants and past participants for feedback on the quality assurance programme. Competency scores for each country from 14 participating countries were compiled for analyses using paired sample t-tests. In-depth interviews were conducted with key informants including the programme facilitators and national level microscopists. Results External assessments and limited retraining through a formalized programme based on a reference slide bank has demonstrated an increase in standards of competence of senior microscopists over a relatively short period of time, at a potentially sustainable cost. The network involved in the programme now exceeds 14 countries in the Asia-Pacific, and the methods are extended to other regions. Conclusions While the impact on national programmes varies, it has translated in some instances into a strengthening of national microscopy standards and offers a possibility both for

Microbiological monitoring for the US Geological Survey National Water-Quality Assessment Program

USGS Publications Warehouse

Francy, Donna S.; Myers, Donna N.; Helsel, Dennis R.

2000-01-01

Data to characterize the microbiological quality of the Nation?s fresh, marine, and estuarine waters are usually collected for local purposes, most often to judge compliance with standards for protection of public health in swimmable or drinkable waters. Methods and procedures vary with the objectives and practices of the parties collecting data and are continuously being developed or modified. Therefore, it is difficult to provide a nationally consistent picture of the microbial quality of the Nation?s waters. Study objectives and guidelines for a national microbiological monitoring program are outlined in this report, using the framework of the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) program. A national program is designed to provide long-term data on the presence of microbiological pathogens and indicators in ground water and surface water to support effective water policy and management. Three major groups of waterborne pathogens affect the public health acceptability of waters in the United States?bacteria, protozoa, and viruses. Microbiological monitoring in NAWQA would be designed to assess the occurrence, distribution, and trends of pathogenic organisms and indicators in surface waters and ground waters; relate the patterns discerned to factors that help explain them; and improve our understanding of the processes that control microbiological water quality.

The Impact of Identifying a Specific Purpose and External Audience for Writing on Second Graders' Writing Quality

ERIC Educational Resources Information Center

Block, Meghan K.

2013-01-01

The Common Core State Standards for English Language Arts and Literacy in History/Social Studies, Science, and Technical Subjects (CCSS) emphasize the importance of writing and specify that students should write for external, and, at times, unfamiliar audiences. Given the relationship between audience specification and quality writing in older…

[External quality assurance in inpatient medical rehabilitation and prevention centers for mothers, fathers and children: development of instruments for assessing structural quality].

PubMed

Saupe-Heide, M; Gerlich, C; Lukasczik, M; Musekamp, G; Neuderth, S; Vogel, H

2013-12-01

As required by German law, inpatient institutions offering prevention and rehabilitation measures for mothers, fathers and children are obliged to implement external quality assurance measures. In 2 pilot projects funded by the German federal association of health insurance funds, external quality assurance procedures for in-hospital prevention and rehabilitation of mothers and fathers were analyzed with the aim of developing a set of instruments for the description of structural characteristics in this area of health care and to evaluate its appropriateness. Concerning structure-related quality, the project included a) designing and evaluating a questionnaire, b) the definition of assessment criteria for subsequent comparative data analyses, and c) the description and documentation of the current state in the field of rehabilitation and prevention for mothers, fathers and children. To document structural quality comprehensively, a modular questionnaire was developed and tested in a survey of 115 inpatient prevention and rehabilitation institutions for mothers, fathers and children. Involving an expert panel, preliminary basic and selection criteria were defined in order to assure a conducive assessment with regard to structural attributes. The majority of institutions had provider agreements for both prevention and rehabilitation. Measures for mothers/fathers with children were predominant; only 7 institutions exclusively treated mothers and fathers. Institution sizes varied strongly. Major indications included psychosomatics, dermatology, and pneumology. Overall, structural conditions of the institutions showed a high standard. Potential for development was found with regard to some aspects of the conceptual framework of institutional practice and the implementation of the International Classification of Functioning, Disability and Health (ICF) in diagnostics. In this article, the degrees of fulfillment with relation to the structural dimensions are presented

The effects of alterations in the osseous external auditory canal on perceived sound quality.

PubMed

van Spronsen, Erik; Brienesse, Patrick; Ebbens, Fenna A; Waterval, Jerome J; Dreschler, Wouter A

2015-10-01

To evaluate the perceptual effect of the altered shape of the osseous external auditory canal (OEAC) on sound quality. Prospective study. Twenty subjects with normal hearing were presented with six simulated sound conditions representing the acoustic properties of six different ear canals (three normal ears and three cavities). The six different real ear unaided responses of these ear canals were used to filter Dutch sentences, resulting in six simulated sound conditions. A seventh unfiltered reference condition was used for comparison. Sound quality was evaluated using paired comparison ratings and a visual analog scale (VAS). Significant differences in sound quality were found between the normal and cavity conditions (all P < .001) using both the seven-point paired comparison rating and the VAS. No significant differences were found between the reference and normal conditions. Sound quality deteriorates when the OEAC is altered into a cavity. This proof of concept study shows that the altered acoustic quality of the OEAC after radical cavity surgery may lead to a clearly perceived deterioration in sound quality. Nevertheless, some questions remain about the extent to which these changes are affected by habituation and by other changes in middle ear anatomy and functionality. 4 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Distributional benefit analysis of a national air quality rule.

PubMed

Post, Ellen S; Belova, Anna; Huang, Jin

2011-06-01

Under Executive Order 12898, the U.S. Environmental Protection Agency (EPA) must perform environmental justice (EJ) reviews of its rules and regulations. EJ analyses address the hypothesis that environmental disamenities are experienced disproportionately by poor and/or minority subgroups. Such analyses typically use communities as the unit of analysis. While community-based approaches make sense when considering where polluting sources locate, they are less appropriate for national air quality rules affecting many sources and pollutants that can travel thousands of miles. We compare exposures and health risks of EJ-identified individuals rather than communities to analyze EPA's Heavy Duty Diesel (HDD) rule as an example national air quality rule. Air pollutant exposures are estimated within grid cells by air quality models; all individuals in the same grid cell are assigned the same exposure. Using an inequality index, we find that inequality within racial/ethnic subgroups far outweighs inequality between them. We find, moreover, that the HDD rule leaves between-subgroup inequality essentially unchanged. Changes in health risks depend also on subgroups' baseline incidence rates, which differ across subgroups. Thus, health risk reductions may not follow the same pattern as reductions in exposure. These results are likely representative of other national air quality rules as well.

Development plan for the External Hazards Experimental Group. Light Water Reactor Sustainability Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coleman, Justin Leigh; Smith, Curtis Lee; Burns, Douglas Edward

This report describes the development plan for a new multi-partner External Hazards Experimental Group (EHEG) coordinated by Idaho National Laboratory (INL) within the Risk-Informed Safety Margin Characterization (RISMC) technical pathway of the Light Water Reactor Sustainability Program. Currently, there is limited data available for development and validation of the tools and methods being developed in the RISMC Toolkit. The EHEG is being developed to obtain high-quality, small- and large-scale experimental data validation of RISMC tools and methods in a timely and cost-effective way. The group of universities and national laboratories that will eventually form the EHEG (which is ultimately expectedmore » to include both the initial participants and other universities and national laboratories that have been identified) have the expertise and experimental capabilities needed to both obtain and compile existing data archives and perform additional seismic and flooding experiments. The data developed by EHEG will be stored in databases for use within RISMC. These databases will be used to validate the advanced external hazard tools and methods.« less

Experiences in the provision, fitting and supply of external breast prostheses: findings from a national survey.

PubMed

Gallagher, P; Buckmaster, A; O'Carroll, S; Kiernan, G; Geraghty, J

2009-11-01

A good-quality external breast prosthesis and prosthesis-fitting service is integral to recovery post-mastectomy. However, this area of care has minimal information or research available. The aim of this study was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. Three national surveys were undertaken with women (n = 527), breast care nurses (BCNs) (n = 32) and retail prosthesis fitters (n = 12). The findings identified the importance of the prosthesis for shape, appearance to self, appearance to others, sense of well-being, self-confidence and femininity. Dissatisfaction with weight, comfort and movement of the prosthesis was identified. Cost and travel distance were found to influence the replacement of the prosthesis. Dissatisfaction emerged with the display and choice of products, and brochure availability at the prosthesis fitting. Women preferred to be fitted for the first silicone prosthesis by a BCN in a hospital setting whereas for the replacement prosthesis they preferred a trained fitter at a specialized prosthesis supplier. BCNs and retail fitters identified the need for service guidelines and increased availability of professional development opportunities in prosthesis-fitting. These findings contributed to the development of standards of care for breast prosthesis-fitting services to benefit women and to provide guidelines for those providing the service.

[Analysis of the results of the 2010 External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Ruiz de Gopegui Bordes, Enrique; Serrano, M del Remedio Guna; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Cardona, Concepción Gimeno

2011-12-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most important conclusions and lessons of the 2010 controls. As a whole, the results obtained in 2010 confirm the excellent skill and good technical standards found in previous years. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls to ensure maximal quality of microbiological tests(1). Copyright © 2011 Elsevier España S.L. All rights reserved.

DEVELOPING A QUALITY SYSTEM FOR THE NATIONAL CHILDREN'S STUDY

EPA Science Inventory

A Quality Management Plan (QMP) is under development for a national, interagency, long-term study known as the National Children's Study (NCS). The NCS is a study to examine the effects of environmental influences on the health and development of more than 100,000 children acros...

77 FR 30280 - Final National Recommended Ambient Water Quality Criteria for Carbaryl-2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... national recommended water quality criteria for the protection of aquatic life from effects of carbaryl... developed the aquatic life criteria based on EPA's Guidelines for Deriving Numerical National Water Quality... quality standards for protecting aquatic life and human health. These criteria are intended to protect...

Influence of physical activity, sedentary behavior, and diet quality in childhood on the incidence of internalizing and externalizing disorders during adolescence: a population-based cohort study.

PubMed

Wu, XiuYun; Bastian, Kerry; Ohinmaa, Arto; Veugelers, Paul

2018-02-01

Studies among youth suggest that physical inactivity, sedentary behaviors, and poor diet quality are associated with poor mental health. Few population-based studies have investigated these relationships longitudinally. We examined the association between physical activity, sedentary behaviors, and diet quality in childhood and the incidence of internalizing and externalizing disorders throughout adolescence. We linked health behavior survey data from 2003 among 10- to 11-year-old children across Nova Scotia, Canada, with administrative health care data from 2003 to 2011. Students' diet quality was assessed using the Harvard Food Frequency Questionnaire. Physical activity and sedentary behaviors were self-reported, and internalizing and externalizing disorders were diagnosed by a physician. We applied Cox regression to examine the associations of the health behaviors with the incidence of internalizing and externalizing disorders between 2003 and 2011. Of the 4861 participating students, 23.7% and 9.4% had a diagnosis of internalizing and externalizing disorders, respectively. The incidences of internalizing and externalizing disorders were higher among students who were less physically active and spent more time using computers and video games. These findings suggest that promoting an active lifestyle in childhood may contribute to the prevention of both internalizing and externalizing disorders during adolescence. Copyright © 2017 Elsevier Inc. All rights reserved.

Data from selected U.S. Geological Survey National Stream Water-Quality Networks (WQN)

USGS Publications Warehouse

Alexander, Richard B.; Slack, J.R.; Ludtke, A.S.; Fitzgerald, K.K.; Schertz, T.L.; Briel, L.I.; Buttleman, K.P.

1996-01-01

This CD-ROM set contains data from two USGS national stream water-quality networks, the Hydrologic Benchmark Network (HBN) and the National Stream Quality Accounting Network (NASQAN), operated during the past 30 years. These networks were established to provide national and regional descriptions of stream water-quality conditions and trends, based on uniform monitoring of selected watersheds throughout the United States, and to improve our understanding of the effects of the natural environment and human activities on water quality. The HBN, consisting of 63 relatively small, minimally disturbed watersheds, provides data for investigating naturally induced changes in streamflow and water quality and the effects of airborne substances on water quality. NASQAN, consisting of 618 larger, more culturally influenced watersheds, provides information for tracking water-quality conditions in major U.S. rivers and streams.

Quality control in mutation analysis: the European Molecular Genetics Quality Network (EMQN).

PubMed

Müller, C R

2001-08-01

The demand for clinical molecular genetics testing has steadily grown since its introduction in the 1980s. In order to reach and maintain the agreed quality standards of laboratory medicine, the same internal and external quality assurance (IQA/EQA) criteria have to be applied as for "conventional" clinical chemistry or pathology. In 1996 the European Molecular Genetics Quality Network (EMQN) was established in order to spread QA standards across Europe and to harmonise the existing national activities. EMQN is operated by a central co-ordinator and 17 national partners from 15 EU countries; since 1998 it is being funded by the EU commission for a 3-year period. EMQN promotes QA by two tools: by providing disease-specific best practice meetings (BPM) and EQA schemes. A typical BPM is focussed on one disease or group of related disorders. International experts report on the latest news of gene characterisation and function and the state-of-the-art techniques for mutation detection. Disease-specific EQA schemes are provided by experts in the field. DNA samples are sent out together with mock clinical referrals and a diagnostic question is asked. Written reports must be returned which are marked for genotyping and interpretation. So far, three BPMs have been held and six EQA schemes are in operation at various stages. Although mutation types and diagnostic techniques varied considerably between schemes, the overall technical performance showed a high diagnostic standard. Nevertheless, serious genotyping errors have been occurred in some schemes which underline the necessity of quality assurance efforts. The European Molecular Genetics Quality Network provides a necessary platform for the internal and external quality assurance of molecular genetic testing.

Assessing the quality of the nation's water resources

USGS Publications Warehouse

Hamilton, Pixie A.

2002-01-01

This issue of IMPACT highlights findings from the first decade of studies (1991 to 2001) by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The articles also discuss the Program’s approaches and models designed to help understand and estimate the fate and transport of contaminants in different geographic areas and environmental settings and over different time frames. NAWQA was established by Congress in 1991 with a goal of developing long-term, consistent, and comparable science-based information on nationwide water-quality conditions. This information is used to support sound management and policy decisions by decision makers at all levels – local, state, and national – who, every day, face complex regulations and management issues related to water resources.

Water quality success stories: Integrated assessments from the IOOS regional associations and national water quality monitoring network

USGS Publications Warehouse

Ragsdale, Rob; Vowinkel, Eric; Porter, Dwayne; Hamilton, Pixie; Morrison, Ru; Kohut, Josh; Connell, Bob; Kelsey, Heath; Trowbridge, Phil

2011-01-01

The Integrated Ocean Observing System (IOOS®) Regional Associations and Interagency Partners hosted a water quality workshop in January 2010 to discuss issues of nutrient enrichment and dissolved oxygen depletion (hypoxia), harmful algal blooms (HABs), and beach water quality. In 2007, the National Water Quality Monitoring Council piloted demonstration projects as part of the National Water Quality Monitoring Network (Network) for U.S. Coastal Waters and their Tributaries in three IOOS Regional Associations, and these projects are ongoing. Examples of integrated science-based solutions to water quality issues of major concern from the IOOS regions and Network demonstration projects are explored in this article. These examples illustrate instances where management decisions have benefited from decision-support tools that make use of interoperable data. Gaps, challenges, and outcomes are identified, and a proposal is made for future work toward a multiregional water quality project for beach water quality.

76 FR 74777 - National Marine Protected Areas Center External Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-01

... through targeted science, information resources, coordination and policy development. An external review..., 1305 East-West Highway, Rm. 11401, Silver Spring, Maryland 20910. FOR FURTHER INFORMATION CONTACT....mpa.gov SUPPLEMENTARY INFORMATION: The MPA Center's external review will encompass program activities...

Introduction to the U.S. Geological Survey National Water-Quality Assessment (NAWQA) of ground-water quality trends and comparison to other national programs

USGS Publications Warehouse

Rosen, Michael R.; Lapham, W.W.

2008-01-01

Assessment of temporal trends in national ground-water quality networks are rarely published in scientific journals. This is partly due to the fact that long-term data from these types of networks are uncommon and because many national monitoring networks are not driven by hypotheses that can be easily incorporated into scientific research. The U.S. Geological Survey (USGS) National Water-Quality Assessment Program (NAWQA) since 1991 has to date (2006) concentrated on occurrence of contaminants because sufficient data for trend analysis is only just becoming available. This paper introduces the first set of trend assessments from NAWQA and provides an assessment of the success of the program. On a national scale, nitrate concentrations in ground water have generally increased from 1988 to 2004, but trends in pesticide concentrations are less apparent. Regionally, the studies showed high nitrate concentrations and frequent pesticide detections are linked to agricultural use of fertilizers and pesticides. Most of these areas showed increases in nitrate concentration within the last decade, and these increases are associated with oxic-geochemical conditions and well-drained soils. The current NAWQA plan for collecting data to define trends needs to be constantly reevaluated to determine if the approach fulfills the expected outcome. To assist this evaluation, a comparison of NAWQA to other national ground-water quality programs was undertaken. The design and spatial extent of each national program depend on many factors, including current and long-term budgets, purpose of the program, size of the country, and diversity of aquifer types. Comparison of NAWQA to nine other national programs shows a great diversity in program designs, but indicates that different approaches can achieve similar and equally important goals. Copyright ?? 2008 by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America. All rights reserved.

Infancy parenting and externalizing psychopathology from childhood through adulthood: developmental trends.

PubMed

Lorber, Michael F; Egeland, Byron

2009-07-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy parenting was associated with externalizing problems at kindergarten and first grade (mother report) as well as at 23 and 26 years (self report). Infancy parenting was not significantly associated with either mothers' or youths' reports of externalizing problems at 16 years. These findings are consistent with the notion that poor-quality infancy parenting is a risk factor for externalizing problems in developmental periods for which externalizing behavior is most deviant.

The Upper Colorado River; National Water-Quality Assessment Program; surface-water-monitoring network

USGS Publications Warehouse

Spahr, Norman E.; Driver, Nancy E.; Stephens, Verlin C.

1996-01-01

The U.S. Geological Survey began full implementation of the National Water-Quality Assessment (NAWQA) program in 1991. The long-term goals of the NAWQA program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams, rivers, and aquifers; (2) describe how water quality is changing over time; and (3) improve understanding of the primary natural and human factors that affect water-quality conditions (Leahy and others, 1990). To meet these goals, 60 study units representing the Nation's most important river basins and aquifers are being investigated. The program design balances the unique assessment requirements of individual study units with a nationally consistent design structure that incorporates a multiscale, interdisciplinary approach for assessment of surface and ground water.

40 CFR 50.16 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.16 National primary and secondary ambient air quality standards for lead. (a) The national primary and...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.12 National primary and secondary ambient air quality standards for lead. (a) National primary and secondary...

National Quality Improvement Center on Early Childhood

ERIC Educational Resources Information Center

Browne, Charlyn Harper

2014-01-01

The national Quality Improvement Center on early Childhood (QIC-eC) funded four research and demonstration projects that tested child maltreatment prevention approaches. The projects were guided by several key perspectives: the importance of increasing protective factors in addition to decreasing risk factors in child maltreatment prevention…

Water Quality in the Nation's Streams and Aquifers Overview of Selected Findings, 1991-2001

USGS Publications Warehouse

Hamilton, Pixie A.; Miller, Timothy L.; Myers, Donna N.

2004-01-01

This report accompanies the publication of the last 15 of 51 river basin and aquifer assessments by the USGS National Water-Quality Assessment (NAWQA) Program during 1991?2001. It highlights selected water-quality findings of regional and national interest through examples from river basins and aquifer systems across the Nation. Forthcoming reports in the USGS series ?The Quality of Our Nation?s Waters? will present comprehensive national syntheses of information collected in the 51 study units on pesticides in water, sediment, and fish; volatile organic compounds in major aquifers used for domestic and public supply; nutrients and trace elements in streams and ground water; and aquatic ecology. This report, summaries of the 51 water-quality assessments, and a 1999 national synthesis of information on nutrients and pesticides, are available free of charge as USGS Circulars and on the World Wide Web at http://water.usgs.gov/nawqa/nawqa_sumr.html.

Development of an evidence-based approach to external quality assurance for breast cancer hormone receptor immunohistochemistry: comparison of reference values.

PubMed

Makretsov, Nikita; Gilks, C Blake; Alaghehbandan, Reza; Garratt, John; Quenneville, Louise; Mercer, Joel; Palavdzic, Dragana; Torlakovic, Emina E

2011-07-01

External quality assurance and proficiency testing programs for breast cancer predictive biomarkers are based largely on traditional ad hoc design; at present there is no universal consensus on definition of a standard reference value for samples used in external quality assurance programs. To explore reference values for estrogen receptor and progesterone receptor immunohistochemistry in order to develop an evidence-based analytic platform for external quality assurance. There were 31 participating laboratories, 4 of which were previously designated as "expert" laboratories. Each participant tested a tissue microarray slide with 44 breast carcinomas for estrogen receptor and progesterone receptor and submitted it to the Canadian Immunohistochemistry Quality Control Program for analysis. Nuclear staining in 1% or more of the tumor cells was a positive score. Five methods for determining reference values were compared. All reference values showed 100% agreement for estrogen receptor and progesterone receptor scores, when indeterminate results were excluded. Individual laboratory performance (agreement rates, test sensitivity, test specificity, positive predictive value, negative predictive value, and κ value) was very similar for all reference values. Identification of suboptimal performance by all methods was identical for 30 of 31 laboratories. Estrogen receptor assessment of 1 laboratory was discordant: agreement was less than 90% for 3 of 5 reference values and greater than 90% with the use of 2 other reference values. Various reference values provide equivalent laboratory rating. In addition to descriptive feedback, our approach allows calculation of technical test sensitivity and specificity, positive and negative predictive values, agreement rates, and κ values to guide corrective actions.

[Quality of data on deaths from external causes in a medium-sized city in Minas Gerais State, Brazil].

PubMed

Melo, Cristiane Magalhães de; Bevilacqua, Paula Dias; Barletto, Marisa; França, Elisabeth Barboza

2014-09-01

This study aimed to assess the quality of data on deaths from external causes in Viçosa, Minas Gerais State, Brazil, from 2000 to 2009, and the completeness of the Mortality Information System (SIM). The data were obtained from the SIM of the Municipal Health Department, municipal police enquiries, and local newspaper articles, resulting in a databank with 495 deaths from external causes. The results showed a high proportion of deaths with indeterminate intent (21%) in the SIM, suggesting problems with quality of information. Comparison of data from the SIM and police department detected problems with coverage in the SIM (21%) and thus in the official statistics on mortality from accidents and violence. The results emphasize the importance of searches in other data sources to upgrade the SIM and expand its coverage, and especially the need for studies to identify and analyze problems faced by small and medium-sized cities in the production of mortality data.

[Guideline compliance in hip fracture: results of an external quality-assurance program in North Rhine Westphalia: 2003-2005].

PubMed

Schulze Raestrup, U; Grams, A; Smektala, R

2008-02-01

Whereas the Scottish guidelines are audited annually, nobody evaluates guideline compliance in Germany. Thus, can external quality assurance data pursuant to section 137 of the German Social Code Book V be suitable for auditing guideline compliance? From North Rhine Westphalia, a total of 48,831 cases of femoral fractures near the hip joint were evaluated. Compliance with the guidelines was determined based on preoperative hospital stay, thrombosis, and antibiotic prophylaxis. Guideline rationale was reviewed in terms of mortality and thromboembolism rate. Sixty-four percent of the interventions were performed in a timely manner. Thrombosis prophylaxis was given in 99% of cases. Antibiotics were given as a single shot. There was no connection between mortality and thromboembolism rates or time to surgery. Guideline compliance is similar in German and Scotland. The external quality assurance data are suitable for evaluating guideline compliance. The literature recommends a short time to surgery. Given the short observation period, it was not possible to demonstrate any improvement in outcomes.

External benefits of natural environments

Treesearch

Larry W. Tombaugh

1971-01-01

Existing methods of assessing economic benefits arising from certain physical environments left in a relatively natural condition do not include estimates of external benefits. Existence value is one such external benefit that accrues to individuals who have no intention of ever visiting the area in question. A partial measure of the existence value of National Parks...

National Wildlife's Eleventh Annual Environmental Quality Index 1980.

ERIC Educational Resources Information Center

National Wildlife, 1980

1980-01-01

Presented is the Eleventh Annual Environmental Quality Index, a subjective analysis of the state of the nation's natural resources. Resource trends are detailed for wildlife, minerals, air, water, soil living space, and forests. (BT)

Evaluation of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program.

PubMed

Sheils, Catherine R; Dahlke, Allison R; Kreutzer, Lindsey; Bilimoria, Karl Y; Yang, Anthony D

2016-11-01

The American College of Surgeons National Surgical Quality Improvement Program is well recognized in surgical quality measurement and is used widely in research. Recent calls to make it a platform for national public reporting and pay-for-performance initiatives highlight the importance of understanding which types of hospitals elect to participate in the program. Our objective was to compare characteristics of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program to characteristics of nonparticipating US hospitals. The 2013 American Hospital Association and Centers for Medicare & Medicaid Services Healthcare Cost Report Information System datasets were used to compare characteristics and operating margins of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program to those of nonparticipating hospitals. Of 3,872 general medical and surgical hospitals performing inpatient surgery in the United States, 475 (12.3%) participated in the American College of Surgeons National Surgical Quality Improvement Program. Participating hospitals performed 29.0% of all operations in the United States. Compared with nonparticipating hospitals, American College of Surgeons National Surgical Quality Improvement Program hospitals had a higher mean annual inpatient surgical case volume (6,426 vs 1,874; P < .001) and a larger mean number of hospital beds (420 vs 167; P < .001); participating hospitals were more often teaching hospitals (35.2% vs 4.1%; P < .001), had more quality-related accreditations (P < .001), and had higher mean operating margins (P < .05). States with the highest proportions of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program had established surgical quality improvement collaboratives. The American College of Surgeons National Surgical Quality Improvement Program hospitals are large teaching

National evaluation of multidisciplinary quality metrics for head and neck cancer.

PubMed

Cramer, John D; Speedy, Sedona E; Ferris, Robert L; Rademaker, Alfred W; Patel, Urjeet A; Samant, Sandeep

2017-11-15

The National Quality Forum has endorsed quality-improvement measures for multiple cancer types that are being developed into actionable tools to improve cancer care. No nationally endorsed quality metrics currently exist for head and neck cancer. The authors identified patients with surgically treated, invasive, head and neck squamous cell carcinoma in the National Cancer Data Base from 2004 to 2014 and compared the rate of adherence to 5 different quality metrics and whether compliance with these quality metrics impacted overall survival. The metrics examined included negative surgical margins, neck dissection lymph node (LN) yield ≥ 18, appropriate adjuvant radiation, appropriate adjuvant chemoradiation, adjuvant therapy within 6 weeks, as well as overall quality. In total, 76,853 eligible patients were identified. There was substantial variability in patient-level adherence, which was 80% for negative surgical margins, 73.1% for neck dissection LN yield, 69% for adjuvant radiation, 42.6% for adjuvant chemoradiation, and 44.5% for adjuvant therapy within 6 weeks. Risk-adjusted Cox proportional-hazard models indicated that all metrics were associated with a reduced risk of death: negative margins (hazard ratio [HR] 0.73; 95% confidence interval [CI], 0.71-0.76), LN yield ≥ 18 (HR, 0.93; 95% CI, 0.89-0.96), adjuvant radiation (HR, 0.67; 95% CI, 0.64-0.70), adjuvant chemoradiation (HR, 0.84; 95% CI, 0.79-0.88), and adjuvant therapy ≤6 weeks (HR, 0.92; 95% CI, 0.89-0.96). Patients who received high-quality care had a 19% reduced adjusted hazard of mortality (HR, 0.81; 95% CI, 0.79-0.83). Five head and neck cancer quality metrics were identified that have substantial variability in adherence and meaningfully impact overall survival. These metrics are appropriate candidates for national adoption. Cancer 2017;123:4372-81. © 2017 American Cancer Society. © 2017 American Cancer Society.

National quality improvement policies and strategies in European healthcare systems.

PubMed

Spencer, E; Walshe, K

2009-02-01

This survey provides an overview of the development of policies and strategies for quality improvement in European healthcare systems, by mapping quality improvement policies and strategies, progress in their implementation, and early indications of their impact. A survey of quality improvement policies and strategies in healthcare systems of the European Union was conducted in 2005 for the first phase of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The survey, completed by 68 key experts in quality improvement from 24 European Union member states, represents their views and accounts of quality improvement policies and strategies in their healthcare systems. There are substantial international and intra-national variations in the development of healthcare quality improvement. Legal requirements for quality improvement strategies are an important driver of progress, along with the activities of national governments and professional associations and societies. Patient and service user organisations appear to have less influence on quality improvement. Wide variation in voluntary and mandatory coverage of quality improvement policies and strategies across sectors can potentially lead to varying levels of progress in implementation. Many healthcare organisations lack basic infrastructure for quality improvement. Some convergence can be observed in policies on quality improvement in healthcare. Nevertheless, the growth of patient mobility across borders, along with the implications of free market provisions for the organisation and funding of healthcare systems in European Union member states, require policies for cooperation and learning transfer.

Performance management excellence among the Malcolm Baldrige National Quality Award Winners in Health Care.

PubMed

Duarte, Neville T; Goodson, Jane R; Arnold, Edwin W

2013-01-01

When carefully constructed, performance management systems can help health care organizations direct their efforts toward strategic goals, high performance, and continuous improvement needed to ensure high-quality patient care and cost control. The effective management of performance is an integral component in hospital and health care systems that are recognized for excellence by the Malcolm Baldrige National Quality Award in Health Care. Using the framework in the 2011-2012 Health Care Criteria for Performance Excellence, this article identifies the best practices in performance management demonstrated by 15 Baldrige recipients. The results show that all of the recipients base their performance management systems on strategic goals, outcomes, or competencies that cascade from the organizational to the individual level. At the individual level, each hospital or health system reinforces the strategic direction with performance evaluations of leaders and employees, including the governing board, based on key outcomes and competencies. Leader evaluations consistently include feedback from internal and external stakeholders, creating a culture of information sharing and performance improvement. The hospitals or health care systems also align their reward systems to promote high performance by emphasizing merit and recognition for contributions. Best practices can provide a guide for leaders in other health systems in developing high-performance work systems.

75 FR 71033 - Air Quality Designations for the 2008 Lead (Pb) National Ambient Air Quality Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-22

.... These include damage to the central nervous system, cardiovascular function, kidneys, immune system, and... growth); (5) Meteorology (weather/transport patterns); (6) Geography/topography (mountain ranges or other... Air Quality Designations for the 2008 Lead (Pb) National Ambient Air Quality Standards AGENCY...

National patterns in wetland water quality from the 2001 NWCA

EPA Science Inventory

Water quality (WQ) is central to understanding ecological condition of lakes, streams, and coastal waters but less often assessed in wetlands. The utility of national-scale wetland WQ data was examined in the 2011 National Wetland Condition Assessment, which covered 48 USA state...

[Domestic and international trends concerning allowable limits of error in external quality assessment scheme].

PubMed

Hosogaya, Shigemi; Ozaki, Yukio

2005-06-01

Many external quality assessment schemes (EQAS) are performed to support quality improvement of the services provided by participating laboratories for the benefits of patients. The EQAS organizer shall be responsible for ensuring that the method of evaluation is appropriate for maintenance of the credibility of the schemes. Procedures to evaluate each participating laboratory are gradually being standardized. In most cases of EQAS, the peer group mean is used as a target of accuracy, and the peer group standard deviation is used as a criterion for inter-laboratory variation. On the other hand, Fraser CG, et al. proposed desirable quality specifications for any imprecision and inaccuracies, which were derived from inter- and intra-biologic variations. We also proposed allowable limits of analytical error, being less than one-half of the average intra-individual variation for evaluation of imprecision, and less than one-quarter of the inter- plus intra-individual variation for evaluation of inaccuracy. When expressed in coefficient of variation terms, these allowable limits may be applied at a wide range of levels of quantity.

The Czech External Quality Control system in medical microbiology and parasitology.

PubMed

Slosárek, M; Kríz, B

2000-11-01

The External Quality Control (EQC) system in activities of laboratories engaged in medical microbiology and parasitology was established in the Czech Republic in 1993 when to the first laboratories which applied coded serum samples were sent for diagnosis of viral hepatitis and bacterial strains for identification. In the course of years the number of control areas increased and in 2000 there were 31 and the number of those interested in participation in EQC increased from 79 in 1993 to 434 in 2000. This year a total of 13,239 samples will be sent to laboratories. Gradually thus almost all microbiological and parasitological laboratories concerned with examination of clinical material became involved. Seven-year experience with EQC in the Czech Republic revealed that gradually the results of various examinations became more accurate, that methods became standardized and the most suitable examination sets are used.

Internal versus External Quality Management

ERIC Educational Resources Information Center

Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

2008-01-01

This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

Application of visible/near-infrared reflectance spectroscopy for predicting internal and external quality in pepper.

PubMed

Toledo-Martín, Eva María; García-García, María Carmen; Font, Rafael; Moreno-Rojas, José Manuel; Gómez, Pedro; Salinas-Navarro, María; Del Río-Celestino, Mercedes

2016-07-01

The characterization of internal (°Brix, pH, malic acid, total phenolic compounds, ascorbic acid and total carotenoid content) and external (color, firmness and pericarp wall thickness) pepper quality is necessary to better understand its possible applications and increase consumer awareness of its benefits. The main aim of this work was to examine the feasibility of using visible/near-infrared reflectance spectroscopy (VIS-NIRS) to predict quality parameters in different pepper types. Commercially available spectrophotometers were evaluated for this purpose: a Polychromix Phazir spectrometer for intact raw pepper, and a scanning monochromator for freeze-dried pepper. The RPD values (ratio of the standard deviation of the reference data to the standard error of prediction) obtained from the external validation exceeded a value of 3 for chlorophyll a and total carotenoid content; values ranging between 2.5 < RPD < 3 for total phenolic compounds; between 1.5 < RPD <2.5 for °Brix, pH, color parameters a* and h* and chlorophyll b; and RPD values below 1.5 for fruit firmness, pericarp wall thickness, color parameters C*, b* and L*, vitamin C and malic acid content. The present work has led to the development of multi-type calibrations for pepper quality parameters in intact and freeze-dried peppers. The majority of NIRS equations obtained were suitable for screening purposes in pepper breeding programs. Components such as pigments (xanthophyll, carotenes and chlorophyll), glucides, lipids, cellulose and water were used by modified partial least-squares regression for modeling the predicting equations. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

National Stream Quality Accounting Network and National Monitoring Network Basin Boundary Geospatial Dataset, 2008–13

USGS Publications Warehouse

Baker, Nancy T.

2011-01-01

This report and the accompanying geospatial data were created to assist in analysis and interpretation of water-quality data provided by the U.S. Geological Survey's National Stream Quality Accounting Network (NASQAN) and by the U.S. Coastal Waters and Tributaries National Monitoring Network (NMN), which is a cooperative monitoring program of Federal, regional, and State agencies. The report describes the methods used to develop the geospatial data, which was primarily derived from the National Watershed Boundary Dataset. The geospatial data contains polygon shapefiles of basin boundaries for 33 NASQAN and 5 NMN streamflow and water-quality monitoring stations. In addition, 30 polygon shapefiles of the closed and noncontributing basins contained within the NASQAN or NMN boundaries are included. Also included is a point shapefile of the NASQAN and NMN monitoring stations and associated basin and station attributes. Geospatial data for basin delineations, associated closed and noncontributing basins, and monitoring station locations are available at http://water.usgs.gov/GIS/metadata/usgswrd/XML/ds641_nasqan_wbd12.xml.

National Water-Quality Assessment Program--Southern High Plains, Texas and New Mexico

USGS Publications Warehouse

Woodward, Dennis G.; Diniz, Cecilia G.

1994-01-01

BACKGROUND In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status of, and trends in, the quality of a large, representative part of the Nation's surface- and ground-water resources and to identify the major natural and human factors that affect the quality of these resources. In addressing these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the National, State, and local levels. The NAWQA program emphasis is on regional water-quality problems. The program will not diminish the need for smaller studies and monitoring designed and currently being conducted by Federal, State, and local agencies to meet their individual needs. The NAWQA program, however, will provide a large-scale framework for conducting many of these activities and an understanding about National and regional water-quality conditions that cannot be acquired from individual, small-scale programs and studies. Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the National assessment. The 60 study units range in size from 1,000 mi 2 (square miles) to more than 60,000 mi 2 and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional are starting in 1994, and 20 more are planned to start in 1997. The Southern High Plains study unit was selected as one of 20 study units to begin assessment activities in 1994. This study will be run from the New Mexico District office of the USGS in Albuquerque, New Mexico.

Friends' knowledge of youth internalizing and externalizing adjustment: accuracy, bias, and the influences of gender, grade, positive friendship quality, and self-disclosure.

PubMed

Swenson, Lance P; Rose, Amanda J

2009-08-01

Some evidence suggests that close friends may be knowledgeable of youth's psychological adjustment. However, friends are understudied as reporters of adjustment. The current study examines associations between self- and friend-reports of internalizing and externalizing adjustment in a community sample of fifth-, eighth-, and eleventh-grade youth. The study extends prior work by considering the degree to which friends' reports of youth adjustment are accurate (i.e., predicted by youths' actual adjustment) versus biased (i.e., predicted by the friend reporters' own adjustment). Findings indicated stronger bias effects than accuracy effects, but the accuracy effects were significant for both internalizing and externalizing adjustment. Additionally, friends who perceived their relationships as high in positive quality, friends in relationships high in disclosure, and girls perceived youths' internalizing symptoms most accurately. Knowledge of externalizing adjustment was not influenced by gender, grade, relationship quality, or self-disclosure. Findings suggest that friends could play an important role in prevention efforts.

Implementation of Quality Assurance and Quality Control Measures in the National Phenology Database

NASA Astrophysics Data System (ADS)

Gerst, K.; Rosemartin, A.; Denny, E. G.; Marsh, L.; Barnett, L.

2015-12-01

The USA National Phenology Network (USA-NPN; www.usanpn.org) serves science and society by promoting a broad understanding of plant and animal phenology and the relationships among phenological patterns and environmental change. The National Phenology Database has over 5.5 million observation records for plants and animals for the period 1954-2015. These data have been used in a number of science, conservation and resource management applications, including national assessments of historical and potential future trends in phenology, regional assessments of spatio-temporal variation in organismal activity, and local monitoring for invasive species detection. Customizable data downloads are freely available, and data are accompanied by FGDC-compliant metadata, data-use and data-attribution policies, and vetted documented methodologies and protocols. The USA-NPN has implemented a number of measures to ensure both quality assurance and quality control. Here we describe the resources that have been developed so that incoming data submitted by both citizen and professional scientists are reliable; these include training materials, such as a botanical primer and species profiles. We also describe a number of automated quality control processes applied to incoming data streams to optimize data output quality. Existing and planned quality control measures for output of raw and derived data include: (1) Validation of site locations, including latitude, longitude, and elevation; (2) Flagging of records that conflict for a given date for an individual plant; (3) Flagging where species occur outside known ranges; (4) Flagging of records when phenophases occur outside of the plausible order for a species; (5) Flagging of records when intensity measures do not follow a plausible progression for a phenophase; (6) Flagging of records when a phenophase occurs outside of the plausible season, and (7) Quantification of precision and uncertainty for estimation of phenological metrics

76 FR 67429 - National Advisory Committee on Institutional Quality and Integrity (NACIQI) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... DEPARTMENT OF EDUCATION National Advisory Committee on Institutional Quality and Integrity (NACIQI) Meeting AGENCY: National Advisory Committee on Institutional Quality and Integrity, Office of... submissions comply with the requirements of Section 508 of the Rehabilitation Act, or be submitted in an...

Methodologic European external quality assurance for DNA sequencing: the EQUALseq program.

PubMed

Ahmad-Nejad, Parviz; Dorn-Beineke, Alexandra; Pfeiffer, Ulrike; Brade, Joachim; Geilenkeuser, Wolf-Jochen; Ramsden, Simon; Pazzagli, Mario; Neumaier, Michael

2006-04-01

DNA sequencing is a key technique in molecular diagnostics, but to date no comprehensive methodologic external quality assessment (EQA) programs have been instituted. Between 2003 and 2005, the European Union funded, as specific support actions, the EQUAL initiative to develop methodologic EQA schemes for genotyping (EQUALqual), quantitative PCR (EQUALquant), and sequencing (EQUALseq). Here we report on the results of the EQUALseq program. The participating laboratories received a 4-sample set comprising 2 DNA plasmids, a PCR product, and a finished sequencing reaction to be analyzed. Data and information from detailed questionnaires were uploaded online and evaluated by use of a scoring system for technical skills and proficiency of data interpretation. Sixty laboratories from 21 European countries registered, and 43 participants (72%) returned data and samples. Capillary electrophoresis was the predominant platform (n = 39; 91%). The median contiguous correct sequence stretch was 527 nucleotides with considerable variation in quality of both primary data and data evaluation. The association between laboratory performance and the number of sequencing assays/year was statistically significant (P <0.05). Interestingly, more than 30% of participants neither added comments to their data nor made efforts to identify the gene sequences or mutational positions. Considerable variations exist even in a highly standardized methodology such as DNA sequencing. Methodologic EQAs are appropriate tools to uncover strengths and weaknesses in both technique and proficiency, and our results emphasize the need for mandatory EQAs. The results of EQUALseq should help improve the overall quality of molecular genetics findings obtained by DNA sequencing.

External Quality Assessment beyond the analytical phase: an Australian perspective.

PubMed

Badrick, Tony; Gay, Stephanie; McCaughey, Euan J; Georgiou, Andrew

2017-02-15

External Quality Assessment (EQA) is the verification, on a recurring basis, that laboratory results conform to expectations for the quality required for patient care. It is now widely recognised that both the pre- and post-laboratory phase of testing, termed the diagnostic phases, are a significant source of laboratory errors. These errors have a direct impact on both the effectiveness of the laboratory and patient safety. Despite this, Australian laboratories tend to be focussed on very narrow concepts of EQA, primarily surrounding test accuracy, with little in the way of EQA programs for the diagnostic phases. There is a wide range of possibilities for the development of EQA for the diagnostic phases in Australia, such as the utilisation of scenarios and health informatics. Such programs can also be supported through advances in health information and communications technology, including electronic test ordering and clinical decision support systems. While the development of such programs will require consultation and support from the referring doctors, and their format will need careful construction to ensure that the data collected is de-identified and provides education as well as useful and informative data, we believe that there is high value in the development of such programs. Therefore, it is our opinion that all pathology laboratories should strive to be involved in an EQA program in the diagnostic phases to both monitor the diagnostic process and to identify, learn from and reduce errors and near misses in these phases in a timely fashion.

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2013 CFR

2013-07-01

... air quality standards for lead. 50.12 Section 50.12 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) National primary and secondary ambient air quality standards for lead and its compounds, measured as elemental lead by a reference method...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2012 CFR

2012-07-01

... air quality standards for lead. 50.12 Section 50.12 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) National primary and secondary ambient air quality standards for lead and its compounds, measured as elemental lead by a reference method...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for lead. 50.12 Section 50.12 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) National primary and secondary ambient air quality standards for lead and its compounds, measured as elemental lead by a reference method...

External quality assessment for EGFR mutations in Italy: improvements in performances over the time.

PubMed

Normanno, Nicola; Fenizia, Francesca; Castiglione, Francesca; Barberis, Massimo; Taddei, Gian Luigi; Truini, Mauro; De Rosa, Gaetano; Pinto, Carmine; Marchetti, Antonio

2017-01-01

External quality assessment (EQA) schemes are essential procedures to assess the quality level of laboratories performing molecular testing of the epidermal growth factor receptor ( EGFR ) gene in non-small cell lung cancer. The Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology (SIAPEC-IAP) organise EGFR EQA programmes to ensure that the Italian laboratories achieve the quality standard levels required. Comparing the 2011, 2013 and 2015 EGFR EQA schemes, it was possible to observe improvements in the methodologies used and the outcomes. The use of direct sequencing was reduced from 78.7% in 2011 to only 14.1% in 2015, whereas the use of pyrosequencing and real-time PCR increased. The number of rounds in which centres using direct sequencing failed was significantly higher than the number of rounds that failed using other methods, both when analysing each single scheme and when combining the three EQAs together. In 2011 and 2013, about 29% of the participants failed the first phase of the programmes, compared with the 13% of centres failing in 2015, suggesting that the switch to more sensitive and robust methods could allow to increase the percentage of good performers. Although the molecular analyses are performed with good quality in Italy, the continuous education carried out by AIOM and SIAPEC-IAP remains a fundamental tool to maintain this quality level.

External quality assessment for EGFR mutations in Italy: improvements in performances over the time

PubMed Central

Normanno, Nicola; Fenizia, Francesca; Castiglione, Francesca; Barberis, Massimo; Taddei, Gian Luigi; Truini, Mauro; De Rosa, Gaetano; Pinto, Carmine; Marchetti, Antonio

2017-01-01

External quality assessment (EQA) schemes are essential procedures to assess the quality level of laboratories performing molecular testing of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer. The Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology (SIAPEC-IAP) organise EGFR EQA programmes to ensure that the Italian laboratories achieve the quality standard levels required. Comparing the 2011, 2013 and 2015 EGFR EQA schemes, it was possible to observe improvements in the methodologies used and the outcomes. The use of direct sequencing was reduced from 78.7% in 2011 to only 14.1% in 2015, whereas the use of pyrosequencing and real-time PCR increased. The number of rounds in which centres using direct sequencing failed was significantly higher than the number of rounds that failed using other methods, both when analysing each single scheme and when combining the three EQAs together. In 2011 and 2013, about 29% of the participants failed the first phase of the programmes, compared with the 13% of centres failing in 2015, suggesting that the switch to more sensitive and robust methods could allow to increase the percentage of good performers. Although the molecular analyses are performed with good quality in Italy, the continuous education carried out by AIOM and SIAPEC-IAP remains a fundamental tool to maintain this quality level. PMID:29181190

Valuing U.S. Water Quality at Regional and National Scales

EPA Science Inventory

Assessing and monetizing the benefits of water quality at a regional and/or national scale is a challenging problem. One of the biggest problems is a lack of consistency in the monitoring and assessment methods used by states to assess water quality. Despite this inconsistency,...

Methods for collecting algal samples as part of the National Water-Quality Assessment Program

USGS Publications Warehouse

Porter, Stephen D.; Cuffney, Thomas F.; Gurtz, Martin E.; Meador, Michael R.

1993-01-01

Benthic algae (periphyton) and phytoplankton communities are characterized in the U.S. Geological Survey's National Water-Quality Assessment Program as part of an integrated physical, chemical, and biological assessment of the Nation's water quality. This multidisciplinary approach provides multiple lines of evidence for evaluating water-quality status and trends, and for refining an understanding of the factors that affect water-quality conditions locally, regionally, and nationally. Water quality can be characterized by evaluating the results of qualitative and quantitative measurements of the algal community. Qualitative periphyton samples are collected to develop of list of taxa present in the sampling reach. Quantitative periphyton samples are collected to measure algal community structure within selected habitats. These samples of benthic algal communities are collected from natural substrates, using the sampling methods that are most appropriate for the habitat conditions. Phytoplankton samples may be collected in large nonwadeable streams and rivers to meet specific program objectives. Estimates of algal biomass (chlorophyll content and ash-free dry mass) also are optional measures that may be useful for interpreting water-quality conditions. A nationally consistent approach provides guidance on site, reach, and habitat selection, as well as information on methods and equipment for qualitative and quantitative sampling. Appropriate quality-assurance and quality-control guidelines are used to maximize the ability to analyze data locally, regionally, and nationally.

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.16 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for lead. 50.16 Section 50.16 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) The national primary and secondary ambient air quality standards for lead (Pb) and its compounds are 0.15 micrograms per cubic meter...

78 FR 47674 - Judges Panel of the Malcolm Baldrige National Quality Award

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

... DEPARTMENT OF COMMERCE National Institute of Standards and Technology Judges Panel of the Malcolm Baldrige National Quality Award AGENCY: National Institute of Standards and Technology, Department of.... ADDRESSES: The meeting will be held at the National Institute of Standards and Technology, 100 Bureau Drive...

The Quest for Strategic Malaysian Quality National Primary School Leaders

ERIC Educational Resources Information Center

Ali, Hairuddin Mohd

2012-01-01

Purpose: The purpose of this paper is to investigate the nine-point strategic leadership characteristics of Malaysian Quality National Primary School Leaders (QNPSL) and to indicate the implications of these findings for the current educational management and leadership practices in their quest for Malaysian quality education.…

Randomized control trial: evaluating aluminum-based antiperspirant use, axilla skin toxicity, and reported quality of life in women receiving external beam radiotherapy for treatment of Stage 0, I, and II breast cancer.

PubMed

Watson, Linda C; Gies, Donna; Thompson, Emmanuel; Thomas, Bejoy

2012-05-01

Standard skin care instructions regarding the use of antiperspirants during radiotherapy to the breast varies across North America. Women have articulated that when instructed to not use antiperspirant, the potential for body odor is distressing. Historical practices and individual opinions have often guided practice in this field. The present study had 2 purposes. To evaluate whether the use of aluminum-based antiperspirant while receiving external beam radiotherapy for stage 0, I, or II breast cancer will increase axilla skin toxicity and to evaluate whether the use of antiperspirant during external beam radiotherapy improves quality of life. A total of 198 participants were randomized to either the experimental group (antiperspirant) or control group (standard care-wash only). The skin reactions in both groups were measured weekly and 2 weeks after treatment using the National Cancer Institute Common Toxicity Criteria Adverse Events, version 3, toxicity grading criteria. Both groups completed the Functional Assessment for Chronic Illness Therapy's questionnaire for the breast population quality of life assessment tool, with additional questions evaluating the effect of underarm antiperspirant use on quality of life before treatment, immediately after treatment, and 2 weeks after treatment during the study. The skin reaction data were analyzed using the generalized estimating equation. No statistically significant difference was seen in the skin reaction between the 2 groups over time. The quality of life data also revealed no statistically significant difference between the 2 groups over time. Data analysis indicates that using antiperspirant routinely during external beam radiotherapy for Stage 0, I, or II breast cancer does not affect the intensity of the skin reaction or the self-reported quality of life. This evidence supports that in this particular population, there is no purpose to restrict these women from using antiperspirants during their treatment

Backcountry water quality in Grand Teton National Park

USGS Publications Warehouse

Tippets, N.; O'Ney, S.; Farag, A.M.

2001-01-01

Over the past several decades, visitor use of the backcountry areas of Grand Teton National Park (Wyoming) has dramatically increased. The water quality of clear, sparkling mountain streams and lakes is being impacted by concentrated recreational use where, because of the potential for future wilderness designation, no restroom facilities are available. Park officials are concerned about the impacts that these activities have on water quality, and that the consumption of untreated water from these areas may pose a hazard to human health.

40 CFR 50.6 - National primary and secondary ambient air quality standards for PM10.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.6 National primary and secondary ambient air quality standards for PM10. (a) The level of the national...

Longitudinal Links between Spanking and Children's Externalizing Behaviors in a National Sample of White, Black, Hispanic, and Asian American Families

ERIC Educational Resources Information Center

Gershoff, Elizabeth T.; Lansford, Jennifer E.; Sexton, Holly R.; Davis-Kean, Pamela; Sameroff, Arnold J.

2012-01-01

This study examined whether the longitudinal links between mothers' use of spanking and children's externalizing behaviors are moderated by family race/ethnicity, as would be predicted by cultural normativeness theory, once mean differences in frequency of use are controlled. A nationally representative sample of White, Black, Hispanic, and Asian…

The Water-Quality Partnership for National Parks—U.S. Geological Survey and National Park Service, 1998–2016

USGS Publications Warehouse

Nilles, Mark A.; Penoyer, Pete E; Ludtke, Amy S.; Ellsworth, Alan C.

2016-07-13

The U.S. Geological Survey (USGS) and the National Park Service (NPS) work together through the USGS–NPS Water-Quality Partnership to support a broad range of policy and management needs related to high-priority water-quality issues in national parks. The program was initiated in 1998 as part of the Clean Water Action Plan, a Presidential initiative to commemorate the 25th anniversary of the Clean Water Act. Partnership projects are developed jointly by the USGS and the NPS. Studies are conducted by the USGS and findings are used by the NPS to guide policy and management actions aimed at protecting and improving water quality.The National Park Service manages many of our Nation’s most highly valued aquatic systems across the country, including portions of the Great Lakes, ocean and coastal zones, historic canals, reservoirs, large rivers, high-elevation lakes and streams, geysers, springs, and wetlands. So far, the Water-Quality Partnership has undertaken 217 projects in 119 national parks. In each project, USGS studies and assessments (http://water.usgs.gov/nps_partnership/pubs.php) have supported science-based management by the NPS to protect and improve water quality in parks. Some of the current projects are highlighted in the NPS Call to Action Centennial initiative, Crystal Clear, which celebrates national park water-resource efforts to ensure clean water for the next century of park management (http://www.nature.nps.gov/water/crystalclear/).New projects are proposed each year by USGS scientists working in collaboration with NPS staff in specific parks. Project selection is highly competitive, with an average of only eight new projects funded each year out of approximately 75 proposals that are submitted. Since the beginning of the Partnership in 1998, 189 publications detailing project findings have been completed. The 217 studies have been conducted in 119 NPS-administered lands, extending from Denali National Park and Preserve in Alaska to Everglades

QADATA user's manual; an interactive computer program for the retrieval and analysis of the results from the external blind sample quality- assurance project of the U.S. Geological Survey

USGS Publications Warehouse

Lucey, K.J.

1990-01-01

The U.S. Geological Survey conducts an external blind sample quality assurance project for its National Water Quality Laboratory in Denver, Colorado, based on the analysis of reference water samples. Reference samples containing selected inorganic and nutrient constituents are disguised as environmental samples at the Survey 's office in Ocala, Florida, and are sent periodically through other Survey offices to the laboratory. The results of this blind sample project indicate the quality of analytical data produced by the laboratory. This report provides instructions on the use of QADATA, an interactive, menu-driven program that allows users to retrieve the results of the blind sample quality- assurance project. The QADATA program, which is available on the U.S. Geological Survey 's national computer network, accesses a blind sample data base that contains more than 50,000 determinations from the last five water years for approximately 40 constituents at various concentrations. The data can be retrieved from the database for any user- defined time period and for any or all available constituents. After the user defines the retrieval, the program prepares statistical tables, control charts, and precision plots and generates a report which can be transferred to the user 's office through the computer network. A discussion of the interpretation of the program output is also included. This quality assurance information will permit users to document the quality of the analytical results received from the laboratory. The blind sample data is entered into the database within weeks after being produced by the laboratory and can be retrieved to meet the needs of specific projects or programs. (USGS)

What is the experience of national quality campaigns? Views from the field.

PubMed

Bradley, Elizabeth H; Nembhard, Ingrid M; Yuan, Christina T; Stern, Amy F; Curtis, Jeptha P; Nallamothu, Brahmajee K; Brush, John E; Krumholz, Harlan M

2010-12-01

To identify key characteristics of a national quality campaign that participants viewed as effective, to understand mechanisms by which the campaign influenced hospital practices, and to elucidate contextual factors that modified the perceived influence of the campaign on hospital improvements. In-depth interviews, hospital surveys, and Health Quality Alliance data. We conducted a qualitative study using in-depth interviews with clinical and administrative staff (N = 99) at hospitals reporting strong influence (n = 6) as well as hospitals reporting limited influence (n = 6) of the Door-to-Balloon (D2B) Alliance, a national quality campaign to improve heart attack care. We analyzed these qualitative data as well as changes in hospital use of recommended strategies reported through a hospital survey and changes in treatment times using Health Quality Alliance data. In-depth, open-ended interviews; hospital survey. Key characteristics of the national quality campaign viewed as enhancing its effectiveness were as follows: credibility of the recommendations, perceived simplicity of the recommendations, alignment with hospitals' strategic goals, practical implementation tools, and breadth of the network of peer hospitals in the D2B Alliance. Perceived mechanisms of the campaign's influence included raising awareness and influencing goals, fostering strategy adoption, and influencing aspects of organizational culture. Modifying contextual factors included perceptions about current performance and internal championship for the recommended changes. The impact of national quality campaigns may depend on both campaign design features and on the internal environment of participating hospitals. © Health Research and Educational Trust.

History and challenges of national examination as a quality measurement for high school students in Indonesia

NASA Astrophysics Data System (ADS)

Rozamuri, Arif Murti; Suradi, Nur Riza Mohd

2015-02-01

Education in Indonesia has been established before the Indonesian state. Therefore, the history of Education in Indonesia is quite long. Education that has existed since ancient times, and then forwarded to the days of the Hindu and Buddhist religious influence, then the influence of Islamic religious era, the education in the colonial era until education in independence era. At Indonesia for senior high school students, the quality measured by national exam. The national examination has a long history and full of pros and cons in determining the quality of students. With different level social economic status, and teacher quality in each schools, the student quality would be assessed within a period of three years. The interesting part is whether the national examination, able to measure the quality of students?. Is the quality of students can only be measured through the national exam?. Then various fraud taint the education particularly in the implementation of national examination. This research would explain long history of national examination and various problems that occur in national examination.

Use of Air Quality Observations by the National Air Quality Forecast Capability

NASA Astrophysics Data System (ADS)

Stajner, I.; McQueen, J.; Lee, P.; Stein, A. F.; Kondragunta, S.; Ruminski, M.; Tong, D.; Pan, L.; Huang, J. P.; Shafran, P.; Huang, H. C.; Dickerson, P.; Upadhayay, S.

2015-12-01

The National Air Quality Forecast Capability (NAQFC) operational predictions of ozone and wildfire smoke for the United States (U.S.) and predictions of airborne dust for continental U.S. are available at http://airquality.weather.gov/. NOAA National Centers for Environmental Prediction (NCEP) operational North American Mesoscale (NAM) weather predictions are combined with the Community Multiscale Air Quality (CMAQ) model to produce the ozone predictions and test fine particulate matter (PM2.5) predictions. The Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model provides smoke and dust predictions. Air quality observations constrain emissions used by NAQFC predictions. NAQFC NOx emissions from mobile sources were updated using National Emissions Inventory (NEI) projections for year 2012. These updates were evaluated over large U.S. cities by comparing observed changes in OMI NO2 observations and NOx measured by surface monitors. The rate of decrease in NOx emission projections from year 2005 to year 2012 is in good agreement with the observed changes over the same period. Smoke emissions rely on the fire locations detected from satellite observations obtained from NESDIS Hazard Mapping System (HMS). Dust emissions rely on a climatology of areas with a potential for dust emissions based on MODIS Deep Blue aerosol retrievals. Verification of NAQFC predictions uses AIRNow compilation of surface measurements for ozone and PM2.5. Retrievals of smoke from GOES satellites are used for verification of smoke predictions. Retrievals of dust from MODIS are used for verification of dust predictions. In summary, observations are the basis for the emissions inputs for NAQFC, they are critical for evaluation of performance of NAQFC predictions, and furthermore they are used in real-time testing of bias correction of PM2.5 predictions, as we continue to work on improving modeling and emissions important for representation of PM2.5.

External quality assessment for laboratory testing of HLA-B*15:02 allele in relation to carbamazepine therapy.

PubMed

Lin, Guigao; Zhang, Kuo; Han, Yanxi; Xie, Jiehong; Li, Jinming

2018-02-01

Due to the significant risk of developing Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), the use of carbamazepine is not recommended in patients carrying the human leukocyte antigen B (HLA-B) *15:02 allele. In an effort to guarantee reliable community-based HLA-B*15:02 testing throughout China, a HLA-B*15:02 genotyping external quality assessment (EQA) program was set up. In 2016, 10 genomic DNA samples with known HLA-B*15:02 allele status were sent to 37 laboratories from 16 provinces with a request for routine HLA-B*15:02 screening. The samples were validated using Sanger sequencing by a reference laboratory. Both genotyping results and clinical written reports were evaluated. Thirty-six of the participating laboratories correctly identified the HLA-B*15:02 allele status for all EQA samples. However, one lab failed to identify any positive challenges. The overall analytical sensitivity was 97.3% (180/185 challenges; 95% confidence interval: 93.8%-99.1%) and the analytic specificity was 100% (185/185; 95% confidence interval: 98.0%-100%). A review of the written reports showed that the clinical reporting for HLA-B*15:02 detection should be improved. Some essential information was missing, most notably laboratory information/contact, therapeutic recommendations, and methodology. External quality assessment is valuable in assessing and improving the quality of laboratory testing of HLA-B*15:02 allele. © 2017 Wiley Periodicals, Inc.

Clinical governance: bridging the gap between managerial and clinical approaches to quality of care

PubMed Central

Buetow, S. A.; Roland, M.

1999-01-01

Clinical governance has been introduced as a new approach to quality improvement in the UK national health service. This article maps clinical governance against a discussion of the four main approaches to measuring and improving quality of care: quality assessment, quality assurance, clinical audit, and quality improvement (including continuous quality improvement). Quality assessment underpins each approach. Whereas clinical audit has, in general, been professionally led, managers have driven quality improvement initiatives. Quality assurance approaches have been perceived to be externally driven by managers or to involve professional inspection. It is discussed how clinical governance seeks to bridge these approaches. Clinical governance allows clinicians in the UK to lead a comprehensive strategy to improve quality within provider organisations, although with an expectation of greatly increased external accountability. Clinical governance aims to bring together managerial, organisational, and clinical approaches to improving quality of care. If successful, it will define a new type of professionalism for the next century. Failure by the professions to seize the opportunity is likely to result in increasingly detailed external control of clinical activity in the UK, as has occurred in some other countries. PMID:10847876

National trends in drinking water quality violations.

PubMed

Allaire, Maura; Wu, Haowei; Lall, Upmanu

2018-02-27

Ensuring safe water supply for communities across the United States is a growing challenge in the face of aging infrastructure, impaired source water, and strained community finances. In the aftermath of the Flint lead crisis, there is an urgent need to assess the current state of US drinking water. However, no nationwide assessment has yet been conducted on trends in drinking water quality violations across several decades. Efforts to reduce violations are of national concern given that, in 2015, nearly 21 million people relied on community water systems that violated health-based quality standards. In this paper, we evaluate spatial and temporal patterns in health-related violations of the Safe Drinking Water Act using a panel dataset of 17,900 community water systems over the period 1982-2015. We also identify vulnerability factors of communities and water systems through probit regression. Increasing time trends and violation hot spots are detected in several states, particularly in the Southwest region. Repeat violations are prevalent in locations of violation hot spots, indicating that water systems in these regions struggle with recurring issues. In terms of vulnerability factors, we find that violation incidence in rural areas is substantially higher than in urbanized areas. Meanwhile, private ownership and purchased water source are associated with compliance. These findings indicate the types of underperforming systems that might benefit from assistance in achieving consistent compliance. We discuss why certain violations might be clustered in some regions and strategies for improving national drinking water quality.

Nursing home consumer complaints and quality of care: a national view.

PubMed

Stevenson, David G

2006-06-01

This study uses 5 years of national data on investigated nursing home complaints (1998-2002) to evaluate whether complaints might be used to assess nursing home quality of care. On-Line Survey Certification and Reporting (OSCAR) data are used to evaluate the association between consumer complaints, facility and resident characteristics, and other nursing home quality measures. The analyses are undertaken in the context of considerable cross-state variation in nursing home complaint processes and rates. Complaints varied across facility characteristics in ways consistent with the nursing home quality literature. Complaints were significantly positively associated with survey deficiencies and the presence of serious survey deficiencies, and significantly negatively associated with nurse and nurse aide staffing. Complaints performance was significantly predictive of survey deficiencies at subsequent inspections. This study presents the first national evidence for using consumer complaints to assess nursing home quality of care. Despite limitations, nursing home complaints appear to offer a real-time signal of quality concerns.

76 FR 76048 - Air Quality Designations for the 2008 Lead (Pb) National Ambient Air Quality Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 81 [EPA-HQ-OAR-2009-0443; FRL-9492-3] RIN 2060-AR17 Air Quality Designations for the 2008 Lead (Pb) National Ambient Air Quality Standards Correction In rule document 2011-29460 appearing on pages 72097-72120 in the issues of Tuesday, November 22, 2011...

Making Quality Health Websites a National Public Health Priority: Toward Quality Standards.

PubMed

Devine, Theresa; Broderick, Jordan; Harris, Linda M; Wu, Huijuan; Hilfiker, Sandra Williams

2016-08-02

Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or

External Quality Assessment beyond the analytical phase: an Australian perspective

PubMed Central

Gay, Stephanie; McCaughey, Euan J.; Georgiou, Andrew

2017-01-01

External Quality Assessment (EQA) is the verification, on a recurring basis, that laboratory results conform to expectations for the quality required for patient care. It is now widely recognised that both the pre- and post-laboratory phase of testing, termed the diagnostic phases, are a significant source of laboratory errors. These errors have a direct impact on both the effectiveness of the laboratory and patient safety. Despite this, Australian laboratories tend to be focussed on very narrow concepts of EQA, primarily surrounding test accuracy, with little in the way of EQA programs for the diagnostic phases. There is a wide range of possibilities for the development of EQA for the diagnostic phases in Australia, such as the utilisation of scenarios and health informatics. Such programs can also be supported through advances in health information and communications technology, including electronic test ordering and clinical decision support systems. While the development of such programs will require consultation and support from the referring doctors, and their format will need careful construction to ensure that the data collected is de-identified and provides education as well as useful and informative data, we believe that there is high value in the development of such programs. Therefore, it is our opinion that all pathology laboratories should strive to be involved in an EQA program in the diagnostic phases to both monitor the diagnostic process and to identify, learn from and reduce errors and near misses in these phases in a timely fashion. PMID:28392728

Parasitic infections of the external eye.

PubMed

Pahuja, Shivani; Puranik, Charuta; Jelliti, Bechir; Khairallah, Moncef; Sangwan, Virender S

2013-08-01

To review the published literature on parasitic infections of external eye. Published articles and case reports on parasitic infections of external eye were reviewed and relevant information was collected. Parasitic infections of the eye are rare. However, being more commonly seen in developing nations, they require active measures for screening, diagnosis, and therapy. Parasites of importance causing external ocular disease are protozoan parasites, such as Leishmania; metazoans, such as nematodes (roundworms), cestodes (tapeworms), and trematodes (flatworms); or ectoparasites, such as Phthirus pubis and Demodex.

Does external evaluation of laboratories improve patient safety?

PubMed

Noble, Michael A

2007-01-01

Laboratory accreditation and External Quality Assessment (also called proficiency testing) are mainstays of laboratory quality assessment and performance. Both practices are associated with examples of improved laboratory performance. The relationship between laboratory performance and improved patient safety is more difficult to assess because of the many variables that are involved with patient outcome. Despite this difficulty, the argument to continue external evaluation of laboratories is too compelling to consider the alternative.

A Conceptualisation of Available Trust-Building Mechanisms for International Quality Assurance of Higher Education

ERIC Educational Resources Information Center

Stensaker, Bjørn; Maassen, Peter

2015-01-01

While external quality assurance in higher education was originally developed to cater for various domestic needs, recent decades have seen various attempts in the use of quality assurance also as a mechanism for creating more trust in cross-national higher education activities. In this article, a conceptual framework for analysing available…

Assessment of Health-Cost Externalities of Air Pollution at the National Level using the EVA Model System

NASA Astrophysics Data System (ADS)

Brandt, Jørgen; Silver, Jeremy David; Heile Christensen, Jesper; Skou Andersen, Mikael; Geels, Camilla; Gross, Allan; Buus Hansen, Ayoe; Mantzius Hansen, Kaj; Brandt Hedegaard, Gitte; Ambelas Skjøth, Carsten

2010-05-01

Air pollution has significant negative impacts on human health and well-being, which entail substantial economic consequences. We have developed an integrated model system, EVA (External Valuation of Air pollution), to assess health-related economic externalities of air pollution resulting from specific emission sources/sectors. The EVA system was initially developed to assess externalities from power production, but in this study it is extended to evaluate costs at the national level. The EVA system integrates a regional-scale atmospheric chemistry transport model (DEHM), address-level population data, exposure-response functions and monetary values applicable for Danish/European conditions. Traditionally, systems that assess economic costs of health impacts from air pollution assume linear approximations in the source-receptor relationships. However, atmospheric chemistry is non-linear and therefore the uncertainty involved in the linear assumption can be large. The EVA system has been developed to take into account the non-linear processes by using a comprehensive, state-of-the-art chemical transport model when calculating how specific changes to emissions affect air pollution levels and the subsequent impacts on human health and cost. Furthermore, we present a new "tagging" method, developed to examine how specific emission sources influence air pollution levels without assuming linearity of the non-linear behaviour of atmospheric chemistry. This method is more precise than the traditional approach based on taking the difference between two concentration fields. Using the EVA system, we have estimated the total external costs from the main emission sectors in Denmark, representing the ten major SNAP codes. Finally, we assess the impacts and external costs of emissions from international ship traffic around Denmark, since there is a high volume of ship traffic in the region.

QUALITY MANAGEMENT PLAN FOR THE NATIONAL CHILDREN'S STUDY

EPA Science Inventory

EPA has taken the lead, in consort with NIH, in developing the Quality Management Plan (QMP) for the National Children's Study (NCS); the QMP will delineate a systematic planning process for the implementation of the NCS. The QMP will state the goals and objectives of the NCS, th...

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia

2009-01-01

The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and themore » software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.« less

Field Methods and Quality-Assurance Plan for Quality-of-Water Activities, U.S. Geological Survey, Idaho National Laboratory, Idaho

USGS Publications Warehouse

Knobel, LeRoy L.; Tucker, Betty J.; Rousseau, Joseph P.

2008-01-01

Water-quality activities conducted by the staff of the U.S. Geological Survey (USGS) Idaho National Laboratory (INL) Project Office coincide with the USGS mission of appraising the quantity and quality of the Nation's water resources. The activities are conducted in cooperation with the U.S. Department of Energy's (DOE) Idaho Operations Office. Results of the water-quality investigations are presented in various USGS publications or in refereed scientific journals. The results of the studies are highly regarded, and they are used with confidence by researchers, regulatory and managerial agencies, and interested civic groups. In its broadest sense, quality assurance refers to doing the job right the first time. It includes the functions of planning for products, review and acceptance of the products, and an audit designed to evaluate the system that produces the products. Quality control and quality assurance differ in that quality control ensures that things are done correctly given the 'state-of-the-art' technology, and quality assurance ensures that quality control is maintained within specified limits.

National Survey on Internal Quality Control Practice for Lipid Parameters in Laboratories of China from 2014 to 2016.

PubMed

Ye, Yuanyuan; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-09-01

To investigate the situation of Internal Quality Control (IQC) practice for total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol from 2014 to 2016 in laboratories in China and provide improvement measurements. A web-based External Quality Assessment (EQA) system was used to collect IQC data of lipid parameters in laboratories which continuously participated in the national EQA programs in China from 2014 to 2016. Pass rate of the coefficients of variation (CVs) of two level quality controls in four lipid parameters were calculated according to six quality specifications for precision to evaluate the current status of precision level of the four lipid parameters and their change over time in China. 533, 512, 504, and 466 laboratories continuously reported the data of level one for total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol, and 212, 210, 208 and 198 laboratories reported the level two, respectively. The percentage of laboratories meeting the quality specification varied based on different criteria. Non-significant change can be found in the pass rate of CVs over time. The number of laboratories using a closed system increased over time, but still only accounted for a small proportion. There is no significant difference in the pass rate of CVs between closed and open systems. Triglycerides currently have a fairly good performance in China. While the performance of laboratories on total cholesterol, HDL-cholesterol and LDL-cholesterol has yet to be improved.

76 FR 51014 - National Advisory Committee on Institutional Quality and Integrity, Office of Postsecondary...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

... DEPARTMENT OF EDUCATION National Advisory Committee on Institutional Quality and Integrity, Office of Postsecondary Education; Meeting AGENCY: National Advisory Committee on Institutional Quality and Integrity, Office of Postsecondary Education, U.S. Department of Education. ACTION: Notice of December 14-16...

Design and implementation of an external quality assessment program for HIV viral load measurements using dried blood spots.

PubMed

Prach, Lisa M; Puren, Adrian; Lippman, Sheri A; Carmona, Sergio; Stephenson, Sophie; Cutler, Ewalde; Barnhart, Scott; Liegler, Teri

2015-03-01

An external quality assurance program was developed for HIV-1 RNA viral load measurements taken from dried blood spots using a reference panel and field-collected specimens. The program demonstrated that accurate and reproducible quantitation can be obtained from field-collected specimens. Residual proviral DNA may confound interpretation in virologically suppressed subjects. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide... of this document? III. What is sulfur dioxide? IV. What is the 2010 SO 2 NAAQS and what are the...

User’s manual to update the National Wildlife Refuge System Water Quality Information System (WQIS)

USGS Publications Warehouse

Chojnacki, Kimberly A.; Vishy, Chad J.; Hinck, Jo Ellen; Finger, Susan E.; Higgins, Michael J.; Kilbride, Kevin

2013-01-01

National Wildlife Refuges may have impaired water quality resulting from historic and current land uses, upstream sources, and aerial pollutant deposition. National Wildlife Refuge staff have limited time available to identify and evaluate potential water quality issues. As a result, water quality–related issues may not be resolved until a problem has already arisen. The National Wildlife Refuge System Water Quality Information System (WQIS) is a relational database developed for use by U.S. Fish and Wildlife Service staff to identify existing water quality issues on refuges in the United States. The WQIS database relies on a geospatial overlay analysis of data layers for ownership, streams and water quality. The WQIS provides summary statistics of 303(d) impaired waters and total maximum daily loads for the National Wildlife Refuge System at the national, regional, and refuge level. The WQIS allows U.S. Fish and Wildlife Service staff to be proactive in addressing water quality issues by identifying and understanding the current extent and nature of 303(d) impaired waters and subsequent total maximum daily loads. Water quality data are updated bi-annually, making it necessary to refresh the WQIS to maintain up-to-date information. This manual outlines the steps necessary to update the data and reports in the WQIS.

External breast prostheses in post-mastectomy care: women's qualitative accounts.

PubMed

Gallagher, P; Buckmaster, A; O'Carroll, S; Kiernan, G; Geraghty, J

2010-01-01

A good-quality external breast prosthesis and prosthesis-fitting service is an integral part of the recovery process post-mastectomy. However, this is an area of care that has minimal information or research available. The aim of this research was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. To ascertain women's own personal and subjective experiences, five focus groups with 47 women recruited through national cancer advocacy/support organizations and four Follow-up Breast Clinics throughout Ireland were conducted. As a result, five main themes emerged: (1) The fitting experience--Fitting? (2) Post-mastectomy products--Having? (3) Cost--Affording? (4) Information--Knowing? and (5) Adaptation--Accepting? The emerging themes pinpointed the impact of the fitting experience, fitting environment and the qualities of a prosthesis fitter on a woman's experience in obtaining a first or replacement breast prosthesis; the importance of the physical characteristics of the prosthesis and mastectomy bras; cost, affordability and entitlements; a lack of and perceived difficulty in getting information; and the myriad of personal and social impacts of a breast prosthesis for the woman. These findings are integral for the development of standards of practice in the fitting and supply of external breast prostheses in post-mastectomy care.

Using National Coastal Assessment Data to Model Estuarine Water Quality at Large Spatial Scales.

EPA Science Inventory

The water quality of the Nation’s estuaries is attracting scrutiny in light of population growth and enhanced nutrient delivery. The USEPA has evaluated water quality in the National Coastal Assessment (NCA) and National Aquatic Resource Surveys (NARS) programs. Here we rep...

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange

PubMed Central

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-01-01

Objectives The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. Setting NHS commissioning organisations and private and not-for-profit providers. Design Mixed methods case study of eight cases. Data collection 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Analysis Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. Results In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. Conclusions NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer

Groundwater-quality data from the National Water-Quality Assessment Project, January through December 2014 and select quality-control data from May 2012 through December 2014

USGS Publications Warehouse

Arnold, Terri L.; Bexfield, Laura M.; Musgrove, MaryLynn; Lindsey, Bruce D.; Stackelberg, Paul E.; Barlow, Jeannie R.; Desimone, Leslie A.; Kulongoski, Justin T.; Kingsbury, James A.; Ayotte, Joseph D.; Fleming, Brandon J.; Belitz, Kenneth

2017-10-05

Groundwater-quality data were collected from 559 wells as part of the National Water-Quality Assessment Project of the U.S. Geological Survey National Water-Quality Program from January through December 2014. The data were collected from four types of well networks: principal aquifer study networks, which are used to assess the quality of groundwater used for public water supply; land-use study networks, which are used to assess land-use effects on shallow groundwater quality; major aquifer study networks, which are used to assess the quality of groundwater used for domestic supply; and enhanced trends networks, which are used to evaluate the time scales during which groundwater quality changes. Groundwater samples were analyzed for a large number of water-quality indicators and constituents, including major ions, nutrients, trace elements, volatile organic compounds, pesticides, radionuclides, and some constituents of special interest (arsenic speciation, chromium [VI] and perchlorate). These groundwater-quality data, along with data from quality-control samples, are tabulated in this report and in an associated data release.

The pursuit of quality by business coalitions: a national survey.

PubMed

Fraser, I; McNamara, P; Lehman, G O; Isaacson, S; Moler, K

1999-01-01

The extent to which business coalitions and their employer members are catalysts for improving quality of care is of interest to policymakers, who need to know where and under what circumstances the marketplace succeeds on its own in assuring quality. Using data from the 1998 National Business Coalition on Health annual survey, this paper indicates that most coalitions have an infrastructure in place that could be tapped to advance quality goals. Although the survey data cannot tell us the extent to which coalitions are exercising their enhanced market influence specifically to improve quality, interviews with coalition leaders provide insights about how quality considerations can factor into coalition strategies.

40 CFR 50.7 - National primary and secondary ambient air quality standards for PM2.5.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.7 National primary and secondary ambient air quality standards for PM2.5. (a) The national primary and...

40 CFR 50.13 - National primary and secondary ambient air quality standards for PM2.5.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.13 National primary and secondary ambient air quality standards for PM2.5. (a) The national primary...

Developing a national framework of quality indicators for public hospitals.

PubMed

Simou, Effie; Pliatsika, Paraskevi; Koutsogeorgou, Eleni; Roumeliotou, Anastasia

2014-01-01

The current study describes the development of a preliminary set of quality indicators for public Greek National Health System (GNHS) hospitals, which were used in the "Health Monitoring Indicators System: Health Map" (Ygeionomikos Chartis) project, with the purpose that these quality indicators would assess the quality of all the aspects relevant to public hospital healthcare workforce and services provided. A literature review was conducted in the MEDLINE database to identify articles referring to international and national hospital quality assessment projects, together with an online search for relevant projects. Studies were included if they were published in English, from 1980 to 2010. A consensus panel took place afterwards with 40 experts in the field and tele-voting procedure. Twenty relevant projects and their 1698 indicators were selected through the literature search, and after the consensus panel process, a list of 67 indicators were selected to be implemented for the assessment of the public hospitals categorized under six distinct dimensions: Quality, Responsiveness, Efficiency, Utilization, Timeliness, and Resources and Capacity. Data gathered and analyzed in this manner provided a novel evaluation and monitoring system for Greece, which can assist decision-makers, healthcare professionals, and patients in Greece to retrieve relevant information, with the long-term goal to improve quality in care in the GNHS hospital sector. Copyright © 2014 John Wiley & Sons, Ltd.

1990 National Water Quality Laboratory Services Catalog

USGS Publications Warehouse

Pritt, Jeffrey; Jones, Berwyn E.

1989-01-01

PREFACE This catalog provides information about analytical services available from the National Water Quality Laboratory (NWQL) to support programs of the Water Resources Division of the U.S. Geological Survey. To assist personnel in the selection of analytical services, the catalog lists cost, sample volume, applicable concentration range, detection level, precision of analysis, and preservation techniques for samples to be submitted for analysis. Prices for services reflect operationa1 costs, the complexity of each analytical procedure, and the costs to ensure analytical quality control. The catalog consists of five parts. Part 1 is a glossary of terminology; Part 2 lists the bottles, containers, solutions, and other materials that are available through the NWQL; Part 3 describes the field processing of samples to be submitted for analysis; Part 4 describes analytical services that are available; and Part 5 contains indices of analytical methodology and Chemical Abstract Services (CAS) numbers. Nomenclature used in the catalog is consistent with WATSTORE and STORET. The user is provided with laboratory codes and schedules that consist of groupings of parameters which are measured together in the NWQL. In cases where more than one analytical range is offered for a single element or compound, different laboratory codes are given. Book 5 of the series 'Techniques of Water Resources Investigations of the U.S. Geological Survey' should be consulted for more information about the analytical procedures included in the tabulations. This catalog supersedes U.S. Geological Survey Open-File Report 86-232 '1986-87-88 National Water Quality Laboratory Services Catalog', October 1985.

Making Quality Health Websites a National Public Health Priority: Toward Quality Standards

PubMed Central

2016-01-01

Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out

National Water Quality Inventory, 1976 Report to Congress.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Water Programs.

This report summarizes the state submissions and provides a national overview of water quality as required in Section 305(b) of the 1972 Federal Water Pollution Control Act Amendments (P.L. 92-500). Topics receiving the greatest coverage include toxic substances, quantitative assessments of the percentage of waters currently meeting the goals of…

External quality assessment of malaria microscopy diagnosis in selected health facilities in Western Oromia, Ethiopia.

PubMed

Sori, Getachew; Zewdie, Olifan; Tadele, Geletta; Samuel, Abdi

2018-06-18

Accurate early diagnosis and prompt treatment are one of the key strategies to control and prevent malaria disease. External quality assessment is the most effective method for evaluation of the quality of malaria microscopy diagnosis. The aim of this study was to assess the quality of malaria microscopy diagnosis and its associated factors in selected public health facility laboratories in East Wollega Zone, Western Ethiopia. Facility-based cross-sectional study design was conducted in 30 randomly selected public health facility laboratories from November 2014 to January 2015 in East Wollega Zone, Western Ethiopia. Ten validated stained malaria panel slides with known Plasmodium species, developmental stage and parasite density were distributed. Data were captured; cleaned and analyzed using SPSS version 20 statistical software-multivariate logistic regressions and the agreement in reading between the peripheral diagnostic centers and the reference laboratory were done using kappa statistics. A total of 30 health facility laboratories were involved in the study and the overall quality of malaria microscopy diagnosis was poor (62.3%). The associated predictors of quality in this diagnosis were in-service training [(AOR = 16, 95% CI (1.3, 1.96)], smearing quality [(AOR = 24, 95% CI (1.8, 3.13)], staining quality [(AOR = 15, 95% CI (2.35, 8.61), parasite detection [(AOR = 9, 95% CI (1.1, 8.52)] and identification skills [(AOR = 8.6, 95% CI (1.21, 1.63)]. Eighteen (60%) of health facility laboratories had in-service trained laboratory professionals on malaria microscopy diagnosis. Overall quality of malaria microscopy diagnosis was poor and a significant gap in this service was observed that could impact on its diagnostic services.

Quality of antenatal care in Zambia: a national assessment

PubMed Central

2012-01-01

Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601

Quality-assurance plan and field methods for quality-of-water activities, U.S. Geological Survey, Idaho National Engineering Laboratory, Idaho

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mann, L.J.

1996-10-01

Water-quality activities at the Idaho National Engineering Laboratory (INEL) Project Office are part of the US Geological Survey`s (USGS) Water Resources Division (WRD) mission of appraising the quantity and quality of the Nation`s water resources. The purpose of the Quality Assurance Plan (QAP) for water-quality activities performed by the INEL Project Office is to maintain and improve the quality of technical products, and to provide a formal standardization, documentation, and review of the activities that lead to these products. The principles of this plan are as follows: (1) water-quality programs will be planned in a competent manner and activities willmore » be monitored for compliance with stated objectives and approaches; (2) field, laboratory, and office activities will be performed in a conscientious and professional manner in accordance with specified WRD practices and procedures by qualified and experienced employees who are well trained and supervised, if or when, WRD practices and procedures are inadequate, data will be collected in a manner that its quality will be documented; (3) all water-quality activities will be reviewed for completeness, reliability, credibility, and conformance to specified standards and guidelines; (4) a record of actions will be kept to document the activity and the assigned responsibility; (5) remedial action will be taken to correct activities that are deficient.« less

Differential Susceptibility to Long-Term Effects of Quality of Child Care on Externalizing Behavior in Adolescence?

ERIC Educational Resources Information Center

Belsky, Jay; Pluess, Michael

2012-01-01

Much research on the quality of child care reveals it--in the case of low-quality child care--to be related to poorer child functioning, net of confounding factors, perhaps especially in the case of cognitive-linguistic performance. Recent work using data from the National Institute of Child Health and Human Development (NICHD) Study of Early…

Can the national surgical quality improvement program provide surgeon-specific outcomes?

PubMed

Kuhnen, Angela H; Marcello, Peter W; Roberts, Patricia L; Read, Thomas E; Schoetz, David J; Rusin, Lawrence C; Hall, Jason F; Ricciardi, Rocco

2015-02-01

Efforts to improve the quality of surgical care and reduce morbidity and mortality have resulted in outcomes reporting at the service and institutional level. Surgeon-specific outcomes are not readily available. The aim of this study is to compare surgeon-specific outcomes from the National Surgical Quality Improvement Program and 100% capture institutional quality data. We conducted a cohort study evaluating institutional and surgeon-specific outcomes following colorectal surgery procedures at 1 institution over 5 years. All patients who underwent an operation by a colorectal surgeon at Lahey Hospital & Medical Center from January 1, 2008 through December 31, 2012 were identified. Thirty-day mortality, reoperation, urinary tract infection, deep vein thrombosis, pneumonia, superficial surgical site infection, and organ space infection were the primary outcomes measured. We compared annual and 5-year institutional and surgeon-specific adverse event rates between the data sets. In addition, we categorized individual surgeons as low-outlier, average, or high-outlier in relation to aggregate averages and determined the concordance between the data sets in identifying outliers. Concordance was designated if the 2 databases classified outlier status similarly for the same adverse event category. In the 100% capture institutional data, 6459 operative encounters were identified in comparison with 1786 National Surgical Quality Improvement Program encounters (28% sampled). Annual aggregate adverse event rates were similar between the institutional data and the National Surgical Quality Improvement Program. For annual surgeon-specific comparisons, concordance in identifying outliers between the 2 data sets was 51.4%, and gross discordance between outlier status was in 8.2%. Five-year surgeon-specific comparisons demonstrated 59% concordance in identifying outlier status with 8.2% gross discordance for the group. The inclusion of data from only 1 academic referral center is a

Variation in marital quality in a national sample of divorced women.

PubMed

James, Spencer L

2015-06-01

Previous work has compared marital quality between stably married and divorced individuals. Less work has examined the possibility of variation among divorcés in trajectories of marital quality as divorce approaches. This study addressed that hole by first examining whether distinct trajectories of marital quality can be discerned among women whose marriages ended in divorce and, second, the profile of women who experienced each trajectory. Latent class growth analyses with longitudinal data from a nationally representative sample were used to "look backward" from the time of divorce. Although demographic and socioeconomic variables from this national sample did not predict the trajectories well, nearly 66% of divorced women reported relatively high levels of both happiness and communication and either low or moderate levels of conflict. Future research including personality or interactional patterns may lead to theoretical insights about patterns of marital quality in the years leading to divorce. (c) 2015 APA, all rights reserved).

Education for All in South Africa: Developing a National System for Quality Assurance.

ERIC Educational Resources Information Center

Smith, William J.; Ngoma-Maema, Wendy Yolisa

2003-01-01

Draws on international research, policy, and practice relevant to quality assurance systems to analyze the development of a national framework for educational quality assurance in South Africa. Describes an emerging framework for quality assurance that encompasses evaluation of student achievement, quality audits and reviews, program and service…

National Coal Quality Inventory (NACQI)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robert Finkelman

2005-09-30

The U.S. Geological Survey (USGS) conducted the National Coal Quality Inventory (NaCQI) between 1999 and 2005 to address a need for quality information on coals that will be mined during the next 20-30 years. Collaboration between the USGS, State geological surveys, universities, coal burning utilities, and the coal mining industry plus funding support from the Electric Power Research Institute (EPRI) and the U.S. Department of Energy (DOE) permitted collection and submittal of coal samples for analysis. The chemical data (proximate and ultimate analyses; major, minor and trace element concentrations) for 729 samples of raw or prepared coal, coal associated shale,more » and coal combustion products (fly ash, hopper ash, bottom ash and gypsum) from nine coal producing States are included. In addition, the project identified a new coal reference analytical standard, to be designated CWE-1 (West Elk Mine, Gunnison County, Colorado) that is a high-volatile-B or high-volatile-A bituminous coal with low contents of ash yield and sulfur, and very low, but detectable contents of chlorine, mercury and other trace elements.« less

ENQA: 10 Years (2000-2010): A Decade of European Co-Operation in Quality Assurance in Higher Education

ERIC Educational Resources Information Center

Crozier, Fiona, Ed.; Costes, Nathalie, Ed.; Ranne, Paula, Ed.; Stalter, Maria, Ed.

2010-01-01

The history of ENQA (European Association for Quality Assurance in Higher Education) arises in the late 1990s when the first formal procedures for quality assurance begun to stabilize on a national level. As a result of the European Pilot Projects in the field of external quality assurance during the nineties, participants felt the need for…

78 FR 34964 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

...] Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan... Ambient Air Quality Standards for Ozone: State Implementation Plan Requirements'' which published in the... the 2008 ozone national ambient air quality standards (NAAQS) (the ``2008 ozone NAAQS'') that were...

Data Delivery and Mapping Over the Web: National Water-Quality Assessment Data Warehouse

USGS Publications Warehouse

Bell, Richard W.; Williamson, Alex K.

2006-01-01

The U.S. Geological Survey began its National Water-Quality Assessment (NAWQA) Program in 1991, systematically collecting chemical, biological, and physical water-quality data from study units (basins) across the Nation. In 1999, the NAWQA Program developed a data warehouse to better facilitate national and regional analysis of data from 36 study units started in 1991 and 1994. Data from 15 study units started in 1997 were added to the warehouse in 2001. The warehouse currently contains and links the following data: -- Chemical concentrations in water, sediment, and aquatic-organism tissues and related quality-control data from the USGS National Water Information System (NWIS), -- Biological data for stream-habitat and ecological-community data on fish, algae, and benthic invertebrates, -- Site, well, and basin information associated with thousands of descriptive variables derived from spatial analysis, like land use, soil, and population density, and -- Daily streamflow and temperature information from NWIS for selected sampling sites.

Infancy Parenting and Externalizing Psychopathology from Childhood through Adulthood: Developmental Trends

ERIC Educational Resources Information Center

Lorber, Michael F.; Egeland, Byron

2009-01-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy…

[Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre].

PubMed

Guinement, L; Marchesi, V; Veres, A; Lacornerie, T; Buchheit, I; Peiffert, D

2013-01-01

To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γ<1). These parameters should be independent of the film analysis software. This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Final Report from the External Peer Review of the IRIS ...

EPA Pesticide Factsheets

This document is the final report for the 2004 external peer review for the EPA IRIS Reassessment of the Inhalation Carcinogenicity of Naphthalene, prepared by the Office of Research and Development's National Center for Environmental Assessment (NCEA), for the Integrated Risk Information System (IRIS) Database. A panel of external peer reviewers met to discuss the IRIS report and their responses to the charge questions on July 30, 2004. This document contains the final written comments of the external peer reviewers. This document is the final report for the 2004 external peer review for the IRIS Reassessment of the Inhalation Carcinogenicity of Naphthalene, prepared by the U.S. Environmental Protection Agency (EPA), National Center for Environmental Assessment (NCEA), for the Integrated Risk Information System (IRIS). A panel of external peer reviewers met to discuss their responses to the charge questions on July 30, 2004. This document contains the final written comments of the external peer reviewers.

Canadian National Dairy Study: Herd-level milk quality.

PubMed

Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

2018-03-01

The objective of this study was to estimate Canadian national milk quality parameters and estimate the bulk tank milk (BTM) prevalence of 4 mastitis pathogens, Staphylococcus aureus, Streptococcus agalactiae, Mycoplasma bovis, and Prototheca spp., on Canadian dairy farms. A questionnaire was sent to all Canadian dairy producers. Of the 1,062 producers who completed the questionnaire, 374 producers from across the country were visited and milking hygiene was assessed. Farm-level milk quality data for all Canadian dairy producers was collected from the provincial marketing boards and combined with the questionnaire and farm visit data. In addition, a BTM sample was collected either during the farm visit or by the marketing board in November of 2015 and was tested for 4 major mastitis pathogens using the PathoProof Mastitis Major 4 PCR Assay (Thermo Fisher Scientific Inc., Waltham, MA). Apparent herd-level prevalence was 46% for S. aureus, 6% for Prototheca spp., 0% for M. bovis, and 0% for Strep. agalactiae. Due to the low prevalence of M. bovis and Strep. agalactiae and a lack of significant factors associated with farms testing positive for Prototheca spp., an association analysis could only be carried out for Staph. aureus-positive farms. Factors associated with Staph. aureus-positive farms were not fore-stripping cows before milking (odds ratio = 1.87), milking with a pipeline system (odds ratio = 2.21), and stall bases made of a rubberized surface (mats and mattresses), whereas protective factors were using blanket dry cow therapy (odds ratio = 0.49) and applying a tag or visible mark on cows known to have chronic mastitis infections (odds ratio = 0.45). The Canadian national production-weighted geometric mean somatic cell count was determined to be 208,000 cells/mL. This is the first national dairy study conducted in Canada. Participating farms had higher milk yield; were more likely to have a loose housing system, parlor, or automated milking system; and had

The use of CellaVision competency software for external quality assessment and continuing professional development.

PubMed

Horiuchi, Yuki; Tabe, Yoko; Idei, Mayumi; Bengtsson, Hans-Inge; Ishii, Kiyoshi; Horii, Takashi; Miyake, Kazunori; Satoh, Naotake; Miida, Takashi; Ohsaka, Akimichi

2011-07-01

Quality assessment of blood cell morphological testing, such as white blood cell (WBC) differential and its interpretation, is one of the most important and difficult assignments in haematology laboratories. A monthly survey was performed to assess the possible role of the proficiency testing program produced by CellaVision competency software (CCS) in external quality assessment (EQA) of the clinical laboratories of affiliated university hospitals and the effective utilisation of this program in continuing professional development (CPD). Four monthly proficiency surveys were conducted in collaboration with four clinical laboratories affiliated with the teaching hospitals of Juntendo University of Medicine in Japan. EQA results by the CCS proficiency testing program revealed a difference of performance levels of WBC differential and morphological interpretation and a discrepancy in the WBC differential criteria among laboratories. With regard to the utilisation of this proficiency program as a tool for CPD, this program successfully improved the performance of the low-scoring laboratories and less experienced individuals. The CCS proficiency testing program was useful for the quality assessment of laboratory performance, for education, and for the storage and distribution of cell images to be utilised for further standardisation and education.

External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

PubMed Central

Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Atua, Benjamin; Sheshe, Nicole; Kanza, Albert; Mayunda, Jean Bosco; Mongita, Briston; Senga, Raphaël; Ngoyi, John; Muyembe, Jean-Jacques; Jacobs, Jan

2013-01-01

Abstract Objective To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. Methods A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113 530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. Findings Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment. Conclusion The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern. PMID:24052681

External quality assurance of malaria nucleic acid testing for clinical trials and eradication surveillance.

PubMed

Murphy, Sean C; Hermsen, Cornelus C; Douglas, Alexander D; Edwards, Nick J; Petersen, Ines; Fahle, Gary A; Adams, Matthew; Berry, Andrea A; Billman, Zachary P; Gilbert, Sarah C; Laurens, Matthew B; Leroy, Odile; Lyke, Kristen E; Plowe, Christopher V; Seilie, Annette M; Strauss, Kathleen A; Teelen, Karina; Hill, Adrian V S; Sauerwein, Robert W

2014-01-01

Nucleic acid testing (NAT) for malaria parasites is an increasingly recommended diagnostic endpoint in clinical trials of vaccine and drug candidates and is also important in surveillance of malaria control and elimination efforts. A variety of reported NAT assays have been described, yet no formal external quality assurance (EQA) program provides validation for the assays in use. Here, we report results of an EQA exercise for malaria NAT assays. Among five centers conducting controlled human malaria infection trials, all centers achieved 100% specificity and demonstrated limits of detection consistent with each laboratory's pre-stated expectations. Quantitative bias of reported results compared to expected results was generally <0.5 log10 parasites/mL except for one laboratory where the EQA effort identified likely reasons for a general quantitative shift. The within-laboratory variation for all assays was low at <10% coefficient of variation across a range of parasite densities. Based on this study, we propose to create a Molecular Malaria Quality Assessment program that fulfills the need for EQA of malaria NAT assays worldwide.

Examining the Assessment Literacy of External Examiners

ERIC Educational Resources Information Center

Medland, Emma

2015-01-01

External scrutiny of higher education courses is evident globally, but the use of an external examiner from another institution for the purposes of quality assurance has been a distinguishing feature of UK higher education since the 1830s. However, the changing higher education context has led to mounting criticism of the system and the…

Disasters and Impact of Sleep Quality and Quantity on National Guard Medical Personnel

DTIC Science & Technology

2018-04-30

Impact of Sleep Quality & Quantity on National Guard Medical Personnel Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Sd. PROJECT NUMBER...Std. 239.18 Adobe Professional 7 .0 Approved for Public Release ~••Unlmlted Disasters & Impact of Sleep Quality & Quantity on National Guard...College of Nursing 4/11/2018 6 Methods • Measures • Critical skills questions • Medication calculations +Licensed • Basic Life Support (BLS

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

Improving guideline adherence through intensive quality improvement and the use of a National Quality Register in Sweden for acute myocardial infarction.

PubMed

Peterson, Anette; Carlhed, Rickard; Lindahl, Bertil; Lindström, Gunilla; Aberg, Christina; Andersson-Gäre, Boel; Bojestig, Mats

2007-01-01

Data from the Swedish National Register in Cardiac Care have shown over the last 10 years an enduring gap between optimal treatment of acute myocardial infarction (AMI) according to current guidelines and the treatment actually given. We performed a controlled, prospective study in order to evaluate the effects of applying a multidisciplinary team-based improvement methodology to the use of evidence-based treatments in AMI, together with the use of a modified National Quality Register. The project engaged 25% of the Swedish hospitals. Multidisciplinary teams from 20 hospitals participating in the National Register in Cardiac Care, ranging from small to large hospitals, were trained in continuous quality improvement methodology. Twenty matched hospitals served as controls. Our efforts were focused on finding and applying tools and methods to increase adherence to the national guidelines for 5 different treatments for AMI. For measurement, specially designed quality control charts were made available in the National Register for Cardiac Care. To close the gap, an important issue for the teams was to get all 5 treatments in place. Ten of the hospitals in the study group reduced the gap in 5 of 5 treatments by 50%, while none of the control hospitals did so. This first, controlled prospective study of a registry supported by multidisciplinary team-based improvement methodology showed that this approach led to rapidly improved adherence to AMI guidelines in a broad spectrum of hospitals and that National Quality Registers can be helpful tools.

National Assessment of Quality Programs in Emergency Medical Services.

PubMed

Redlener, Michael; Olivieri, Patrick; Loo, George T; Munjal, Kevin; Hilton, Michael T; Potkin, Katya Trudeau; Levy, Michael; Rabrich, Jeffrey; Gunderson, Michael R; Braithwaite, Sabina A

2018-01-01

This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS. A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement. The survey was distributed nationally via State EMS Offices to EMS agencies nation-wide using Surveymonkey©. A convenience sample of respondents was enrolled between August and November, 2015. Univariate, bivariate and multiple logistic regression analyses were conducted to describe demographics and relationships between outcomes of interest and their covariates using SAS 9.3©. A total of 1,733 surveys were initiated and 1,060 surveys had complete or near-complete responses. This includes agencies from 45 states representing over 6.23 million 9-1-1 responses annually. Totals of 70.5% (747) agencies reported dedicated QI personnel, 62.5% (663) follow clinical metrics and 33.3% (353) participate in outside quality or research program. Medical director hours varied, notably, 61.5% (649) of EMS agencies had <5 hours of medical director time per month. Presence of medical director time was correlated with tracking of QI measures. Air medical [OR 9.64 (1.13, 82.16)] and hospital-based EMS agencies [OR 2.49 (1.36, 4.59)] were more likely to track quality measures compared to fire-based agencies. Agencies in rural only environments were less likely to follow clinical quality metrics. (OR 0.47 CI 0.31 -0.72 p < 0.0004). For those that track QI measures, the most common are; Response Time (Emergency) (68.3%), On-Scene Time (66.4%), prehospital stroke screen (64.6%), aspirin administration (64.5%), and 12 lead ECG in chest pain patients (63.0%). EMS agencies in the United States have significant practice variability with regard to quality

Classification management plan of groundwater quality in Taiwan

NASA Astrophysics Data System (ADS)

Chen, Chun Ming; Chen, Yu Ying; Pan, Shih Cheng; Li, Hui Jun; Hsiao, Fang Ke

2017-04-01

Taiwan Environmental Protection Administration has been monitoring regional water quality for 14 years. Since the beginning of 2002 till now, there are 453 regional groundwater monitoring wells in ten groundwater subregions in Taiwan, and the monitoring of groundwater quality has been carried out for a long time. Currently, water quality monitoring project has reached 50 items, while the number of water quality monitoring data has reached more than 20,000. In order to use the monitoring data efficiently, this study constructed the localized groundwater quality indicators of Taiwan. This indicator takes into account the different users' point of view, incorporating the Taiwan groundwater pollution monitoring standards (Category II), irrigation water quality standard and drinking water source water quality standard. 50 items of water quality monitoring projects were simplified and classified. The groundwater quality parameters were divided into five items, such as potability for drinking water, salting, external influence, health influences and toxicity hazard. The weight of the five items of groundwater was calculated comprehensively, and the groundwater quality of each monitoring well was evaluated with three grades of good, ordinary, and poor. According to the monitoring results of the groundwater monitoring wells in October to December of 2016, about 70% of groundwater quality in Taiwan is in good to ordinary grades. The areas with poor groundwater quality were mostly distributed in coastal, agriculture and part of the urban areas. The conductivity or ammonia nitrogen concentration was higher in those regions, showing that groundwater may be salinized or affected by external influences. Groundwater quality indicators can clearly show the current comprehensive situation of the groundwater environment in Taiwan and can be used as a tool for groundwater quality classification management. The indicators can coordinate with the Taiwan land planning policy in the

Successful integration efforts in water quality from the integrated Ocean Observing System Regional Associations and the National Water Quality Monitoring Network

USGS Publications Warehouse

Ragsdale, R.; Vowinkel, E.; Porter, D.; Hamilton, P.; Morrison, R.; Kohut, J.; Connell, B.; Kelsey, H.; Trowbridge, P.

2011-01-01

The Integrated Ocean Observing System (IOOS??) Regional Associations and Interagency Partners hosted a water quality workshop in January 2010 to discuss issues of nutrient enrichment and dissolved oxygen depletion (hypoxia), harmful algal blooms (HABs), and beach water quality. In 2007, the National Water Quality Monitoring Council piloted demonstration projects as part of the National Water Quality Monitoring Network (Network) for U.S. Coastal Waters and their Tributaries in three IOOS Regional Associations, and these projects are ongoing. Examples of integrated science-based solutions to water quality issues of major concern from the IOOS regions and Network demonstration projects are explored in this article. These examples illustrate instances where management decisions have benefited from decision-support tools that make use of interoperable data. Gaps, challenges, and outcomes are identified, and a proposal is made for future work toward a multiregional water quality project for beach water quality.

Revised Methods for Characterizing Stream Habitat in the National Water-Quality Assessment Program

USGS Publications Warehouse

Fitzpatrick, Faith A.; Waite, Ian R.; D'Arconte, Patricia J.; Meador, Michael R.; Maupin, Molly A.; Gurtz, Martin E.

1998-01-01

Stream habitat is characterized in the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program as part of an integrated physical, chemical, and biological assessment of the Nation's water quality. The goal of stream habitat characterization is to relate habitat to other physical, chemical, and biological factors that describe water-quality conditions. To accomplish this goal, environmental settings are described at sites selected for water-quality assessment. In addition, spatial and temporal patterns in habitat are examined at local, regional, and national scales. This habitat protocol contains updated methods for evaluating habitat in NAWQA Study Units. Revisions are based on lessons learned after 6 years of applying the original NAWQA habitat protocol to NAWQA Study Unit ecological surveys. Similar to the original protocol, these revised methods for evaluating stream habitat are based on a spatially hierarchical framework that incorporates habitat data at basin, segment, reach, and microhabitat scales. This framework provides a basis for national consistency in collection techniques while allowing flexibility in habitat assessment within individual Study Units. Procedures are described for collecting habitat data at basin and segment scales; these procedures include use of geographic information system data bases, topographic maps, and aerial photographs. Data collected at the reach scale include channel, bank, and riparian characteristics.

The relevance of external quality assessment for molecular testing for ALK positive non-small cell lung cancer: results from two pilot rounds show room for optimization.

PubMed

Tembuyser, Lien; Tack, Véronique; Zwaenepoel, Karen; Pauwels, Patrick; Miller, Keith; Bubendorf, Lukas; Kerr, Keith; Schuuring, Ed; Thunnissen, Erik; Dequeker, Elisabeth M C

2014-01-01

Molecular profiling should be performed on all advanced non-small cell lung cancer with non-squamous histology to allow treatment selection. Currently, this should include EGFR mutation testing and testing for ALK rearrangements. ROS1 is another emerging target. ALK rearrangement status is a critical biomarker to predict response to tyrosine kinase inhibitors such as crizotinib. To promote high quality testing in non-small cell lung cancer, the European Society of Pathology has introduced an external quality assessment scheme. This article summarizes the results of the first two pilot rounds organized in 2012-2013. Tissue microarray slides consisting of cell-lines and resection specimens were distributed with the request for routine ALK testing using IHC or FISH. Participation in ALK FISH testing included the interpretation of four digital FISH images. Data from 173 different laboratories was obtained. Results demonstrate decreased error rates in the second round for both ALK FISH and ALK IHC, although the error rates were still high and the need for external quality assessment in laboratories performing ALK testing is evident. Error rates obtained by FISH were lower than by IHC. The lowest error rates were observed for the interpretation of digital FISH images. There was a large variety in FISH enumeration practices. Based on the results from this study, recommendations for the methodology, analysis, interpretation and result reporting were issued. External quality assessment is a crucial element to improve the quality of molecular testing.

Systemic inaccuracies in the National Surgical Quality Improvement Program database: Implications for accuracy and validity for neurosurgery outcomes research.

PubMed

Rolston, John D; Han, Seunggu J; Chang, Edward F

2017-03-01

The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides a rich database of North American surgical procedures and their complications. Yet no external source has validated the accuracy of the information within this database. Using records from the 2006 to 2013 NSQIP database, we used two methods to identify errors: (1) mismatches between the Current Procedural Terminology (CPT) code that was used to identify the surgical procedure, and the International Classification of Diseases (ICD-9) post-operative diagnosis: i.e., a diagnosis that is incompatible with a certain procedure. (2) Primary anesthetic and CPT code mismatching: i.e., anesthesia not indicated for a particular procedure. Analyzing data for movement disorders, epilepsy, and tumor resection, we found evidence of CPT code and postoperative diagnosis mismatches in 0.4-100% of cases, depending on the CPT code examined. When analyzing anesthetic data from brain tumor, epilepsy, trauma, and spine surgery, we found evidence of miscoded anesthesia in 0.1-0.8% of cases. National databases like NSQIP are an important tool for quality improvement. Yet all databases are subject to errors, and measures of internal consistency show that errors affect up to 100% of case records for certain procedures in NSQIP. Steps should be taken to improve data collection on the frontend of NSQIP, and also to ensure that future studies with NSQIP take steps to exclude erroneous cases from analysis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interpreting biomarker data from the COPHES/DEMOCOPHES twin projects: Using external exposure data to understand biomarker differences among countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smolders, R., E-mail: roel.smolders@vito.be; Den Hond, E.; Koppen, G.

In 2011 and 2012, the COPHES/DEMOCOPHES twin projects performed the first ever harmonized human biomonitoring survey in 17 European countries. In more than 1800 mother–child pairs, individual lifestyle data were collected and cadmium, cotinine and certain phthalate metabolites were measured in urine. Total mercury was determined in hair samples. While the main goal of the COPHES/DEMOCOPHES twin projects was to develop and test harmonized protocols and procedures, the goal of the current paper is to investigate whether the observed differences in biomarker values among the countries implementing DEMOCOPHES can be interpreted using information from external databases on environmental quality andmore » lifestyle. In general, 13 countries having implemented DEMOCOPHES provided high-quality data from external sources that were relevant for interpretation purposes. However, some data were not available for reporting or were not in line with predefined specifications. Therefore, only part of the external information could be included in the statistical analyses. Nonetheless, there was a highly significant correlation between national levels of fish consumption and mercury in hair, the strength of antismoking legislation was significantly related to urinary cotinine levels, and we were able to show indications that also urinary cadmium levels were associated with environmental quality and food quality. These results again show the potential of biomonitoring data to provide added value for (the evaluation of) evidence-informed policy making. - Highlights: • External data was collected to interpret HBM data from DEMOCOPHES. • Hg in hair could be related to fish consumption across different countries. • Urinary cotinine was related to strictness of anti-smoking legislation. • Urinary Cd was borderline significantly related to air and food quality. • Lack of comparable data among countries hampered the analysis.« less

Developing a national quality registry for hand surgery: challenges and opportunities

PubMed Central

Arner, Marianne

2016-01-01

The Scandinavian National Healthcare Quality Registries (NQRs) have brought about considerable improvements since their introduction in the 1970s. One such registry – HAKIR (‘hand surgery’) – was established in 2010 and was likely the first NQR for hand surgery. Patient-reported outcome and reoperations due to post-operative complications are registered in HAKIR, as well as hand function in selected groups of surgical procedures. Creating simple logistics for collecting data and careful planning are important factors when establishing a new NQR. Continuous surveillance of data validity and coverage are crucial for success. With perseverance, large databases for clinical research can be created, along with the establishment of national multi-professional collaboration in healthcare improvement work. Cite this article: Arner, M. Developing a national quality registry for hand surgery: challenges and opportunities. EFORT Open Rev 2016;1:100-106. DOI: 10.1302/2058-5241.1.000045. PMID:28461935

Quality Assurance in Engineering Education on a National and European Scale

ERIC Educational Resources Information Center

Gola, Muzio M.

2005-01-01

Activity 2 of project E4, "Quality Assessment and Transparency for Enhanced Mobility and Trans-European Recognition", included the working group on "Quality Assurance in Engineering on a National and European Scale". Its report can be found in Part 2 of Volume D, final report of the E4 Thematic Network (Firenze University Press 2003). The Report…

External Quality Assessment Scheme for reference laboratories - review of 8 years' experience.

PubMed

Kessler, Anja; Siekmann, Lothar; Weykamp, Cas; Geilenkeuser, Wolf Jochen; Dreazen, Orna; Middle, Jonathan; Schumann, Gerhard

2013-05-01

We describe an External Quality Assessment Scheme (EQAS) intended for reference (calibration) laboratories in laboratory medicine and supervised by the Scientific Division of the International Federation of Clinical Chemistry and Laboratory Medicine and the responsible Committee on Traceability in Laboratory Medicine. The official EQAS website, RELA (www.dgkl-rfb.de:81), is open to interested parties. Information on all requirements for participation and results of surveys are published annually. As an additional feature, the identity of every participant in relation to the respective results is disclosed. The results of various groups of measurands (metabolites and substrates, enzymes, electrolytes, glycated hemoglobins, proteins, hormones, thyroid hormones, therapeutic drugs) are discussed in detail. The RELA system supports reference measurement laboratories preparing for accreditation according to ISO 17025 and ISO 15195. Participation in a scheme such as RELA is one of the requirements for listing of the services of a calibration laboratory by the Joint Committee on Traceability in Laboratory Medicine.

Reliability and agreement on embryo assessment: 5 years of an external quality control programme.

PubMed

Martínez-Granados, Luis; Serrano, María; González-Utor, Antonio; Ortiz, Nereyda; Badajoz, Vicente; López-Regalado, María Luisa; Boada, Montserrat; Castilla, Jose A

2018-03-01

An external quality-control programme for morphology-based embryo quality assessment, incorporating a standardized embryo grading scheme, was evaluated over a period of 5 years to determine levels of inter-observer reliability and agreement between practising clinical embryologists at IVF centres and the opinions of a panel of experts. Following Guidelines for Reporting Reliability and Agreement Studies, the Gwet index and proportion of positive (Ppos) and negative agreement were calculated. For embryo morphology assessment, a substantial degree of reliability was measured between the centres and the panel of experts (Gwet index: 0.76; 95% CI 0.70 to 0.84). The agreement was higher for good- versus poor-quality embryos. When multinucleation or vacuoles were observed, low levels of reliability were obtained (Ppos: 0.56 and 0.43, respectively). In blastocysts, the characteristic that presented the largest discrepancy was that related to the inner cell mass. In decisions about the final disposition of the embryo, reliability between centre and the panel of experts was moderate (Gwet index: 0.51; 95% CI 0.41 to 0.60). In conclusion, the ability of clinical embryologists to evaluate the presence of multinucleation and vacuoles in the early cleavage embryo, and to determine the category of the inner cell mass in blastocysts, needs to be improved. Copyright © 2017 Reproductive Healthcare Ltd. All rights reserved.

A rapid communication from the AAPM Task Group 201: recommendations for the QA of external beam radiotherapy data transfer. AAPM TG 201: quality assurance of external beam radiotherapy data transfer.

PubMed

Siochi, R Alfredo; Balter, Peter; Bloch, Charles D; Santanam, Lakshmi; Blodgett, Kurt; Curran, Bruce H; Engelsman, Martijn; Feng, Wenzheng; Mechalakos, Jim; Pavord, Dan; Simon, Tom; Sutlieff, Steven; Zhu, X Ronald

2010-12-04

The transfer of radiation therapy data among the various subsystems required for external beam treatments is subject to error. Hence, the establishment and management of a data transfer quality assurance program is strongly recommended. It should cover the QA of data transfers of patient specific treatments, imaging data, manually handled data and historical treatment records. QA of the database state (logical consistency and information integrity) is also addressed to ensure that accurate data are transferred.

External quality assurance for HIV point-of-care testing in Africa: A collaborative country-partner approach to strengthen diagnostic services

PubMed Central

2016-01-01

It is important to consider the role of diagnostics and the critical need for quality diagnostics services in resource-limited settings. Accurate diagnostic tests play a key role in patient management and the prevention and control of most infectious diseases. As countries plan for implementation of HIV early infant diagnosis and viral load point-of-care testing, the London School of Hygiene & Tropical Medicine has worked with countries and partners with an interest in external quality assurance to support quality point-of-care testing on the continent. Through a series of collaborative consultations and workshops, the London School of Hygiene & Tropical Medicine has gathered lessons learned, tools, and resources and developed quality assurance models that will support point-of-care testing. The London School of Hygiene & Tropical Medicine is committed to the continued advancement of laboratory diagnostics in Africa and quality laboratory services and point-of-care testing. PMID:28879132

Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings.

PubMed

Van Rie, A; Fitzgerald, D; Kabuya, G; Van Deun, A; Tabala, M; Jarret, N; Behets, F; Bahati, E

2008-03-01

Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories.

National Water-Quality Assessment (NAWQA) Program, Long Island-New Jersey (LINJ) Coastal Drainages Study Unit

USGS Publications Warehouse

Stackelberg, Paul E.; Ayers, Mark A.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began its National Water-Quality Assessment (NAWQA ) program to (1) document the quality of a large, representative part of the Nation's water resources; (2) define water-quality trends; and (3) identify major factors that affect water quality. In addressing these goals, the program will produce information that will be useful to water policy makers and managers at National, State, and local levels.Studies of 60 hydrologic systems that include parts of most major river and aquifer systems form the building blocks of the NAWQA program. Study units range in size from about 1,000 mi ² (square miles) to more than 60,000 mi² and represent 60 to 70 percent of the Nation's water use and population served by public water supply. The first 20 studies were begun in 1991; 20 more were begun in 1994, and the remaining 20 are to begin in 1997.

National Water-Quality Assessment (NAWQA) Area-Characterization Toolbox

USGS Publications Warehouse

Price, Curtis

2010-01-01

This is release 1.0 of the National Water-Quality Assessment (NAWQA) Area-Characterization Toolbox. These tools are designed to be accessed using ArcGIS Desktop software (versions 9.3 and 9.3.1). The toolbox is composed of a collection of custom tools that implement geographic information system (GIS) techniques used by the NAWQA Program to characterize aquifer areas, drainage basins, and sampled wells.

[External quality control system in medical microbiology and parasitology in the Czech Republic].

PubMed

Slosárek, M; Petrás, P; Kríz, B

2004-11-01

The External Quality Control System (EQAS) of laboratory activities in medical microbiology and parasitology was implemented in the Czech Republic in 1993 with coded sera samples for diagnosis of viral hepatitis and bacterial strains for identification distributed to first participating laboratories. The number of sample types reached 31 in 2003 and the number of participating laboratories rised from 79 in 1993 to 421 in 2003. As many as 15.130 samples were distributed to the participating laboratories in 2003. Currently, almost all microbiology and parasitology laboratories in the Czech Republic involved in examination of clinical material participate in the EQAS. Based on the 11-year experience gained with the EQAS in the Czech Republic, the following benefits were observed: higher accuracy of results in different tests, standardisation of methods and the use of most suitable test kits.

Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

PubMed

Vasikaran, Samuel D

2015-05-01

The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2011 CFR

2011-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2012 CFR

2012-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2010 CFR

2010-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2013 CFR

2013-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2014 CFR

2014-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

Methods for collecting benthic invertebrate samples as part of the National Water-Quality Assessment Program

USGS Publications Warehouse

Cuffney, Thomas F.; Gurtz, Martin E.; Meador, Michael R.

1993-01-01

Benthic invertebrate communities are evaluated as part of the ecological survey component of the U.S. Geological Survey's National Water-Quality Assessment Program. These biological data are collected along with physical and chemical data to assess water-quality conditions and to develop an understanding of the factors that affect water-quality conditions locally, regionally, and nationally. The objectives of benthic invertebrate community characterizations are to (1) develop for each site a list of tax a within the associated stream reach and (2) determine the structure of benthic invertebrate communities within selected habitats of that reach. A nationally consistent approach is used to achieve these objectives. This approach provides guidance on site, reach, and habitat selection and methods and equipment for qualitative multihabitat sampling and semi-quantitative single habitat sampling. Appropriate quality-assurance and quality-control guidelines are used to maximize the ability to analyze data within and among study units.

External Link Policy | Division of Cancer Prevention

Cancer.gov

The following graphic notice means that you are leaving the DCP Web site: (link is external)This external link provides additional information that is consistent with the intended purpose of DCP.The National Cancer Institute (NCI) cannot attest to the accuracy of a non-federal site.Linking to a non-federal site does not constitute an endorsement by HHS or any of its employees

Standard procedures and quality-control practices for the U.S. Geological Survey National Field Quality Assurance Program from 1982 through 1993

USGS Publications Warehouse

Stanley, D.L.

1995-01-01

The U.S. Geological Survey operates the National Field Quality Assurance Program to provide quality- assurance reference samples to field personnel who make water-quality field measurements. The program monitors the accuracy and precision of pH, specific conductance, and alkalinity field measurements. This report documents the operational procedures and quality-control techniques used in operating the quality-assurance program.

Factors facilitating a national quality registry to aid clinical quality improvement: findings of a national survey.

PubMed

Eldh, Ann Catrine; Wallin, Lars; Fredriksson, Mio; Vengberg, Sofie; Winblad, Ulrika; Halford, Christina; Dahlström, Tobias

2016-11-09

While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstroke, investigating what aspects of the registry and healthcare organisations facilitate or hinder the use of registry data in clinical quality improvement. Following particular qualitative studies, we performed a quantitative survey in an exploratory sequential design. The survey, including 50 items on context, processes and the registry, was sent to managers, physicians and nurses engaged in Riksstroke in all 72 Swedish stroke units. Altogether, 242 individuals were presented with the survey; 163 responded, representing all but two units. Data were analysed descriptively and through multiple linear regression. A majority (88%) considered Riksstroke data to facilitate detection of stroke care improvement needs and acknowledged that their data motivated quality improvements (78%). The use of Riksstroke for quality improvement initiatives was associated (R 2 =0.76) with 'Colleagues' call for local results' (p=<0.001), 'Management Request of Registry data' (p=<0.001), and it was said to be 'Simple to explain the results to colleagues' (p=0.02). Using stepwise regression, 'Colleagues' call for local results' was identified as the most influential factor. Yet, while 73% reported that managers request registry data, only 39% reported that their colleagues call for the unit's Riksstroke results. While an NQR like Riksstroke demonstrates improvement needs and motivates stakeholders to make progress, local stroke care staff and managers need to engage to keep the momentum going in terms of applying registry data when planning, performing and evaluating quality initiatives. Published by the BMJ Publishing Group Limited. For permission to use

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange.

PubMed

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-02-25

The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. NHS commissioning organisations and private and not-for-profit providers. Mixed methods case study of eight cases. 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital

Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.

PubMed

Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M

2015-10-01

The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to

The Department of Veterans Affairs National Quality Scholars Fellowship Program

PubMed Central

Splaine, Mark E.; Ogrinc, Greg; Gilman, Stuart C.; Aron, David C.; Estrada, Carlos; Rosenthal, Gary E.; Lee, Sei; Dittus, Robert S.; Batalden, Paul B.

2013-01-01

The Department of Veterans Affairs National Quality Scholars Fellowship Program (VAQS) was established in 1998 as a post-graduate medical education fellowship to train physicians in new methods of improving the quality and safety of health care for Veterans and the nation. The VAQS curriculum is based on adult learning theory, with a national core curriculum of face-to-face components, technologically mediated distance learning components, and a unique local curriculum that draws from the strengths of regional resources. VAQS has established strong ties with other VA programs. Fellows’ research and projects are integrated with local and regional VA leaders’ priorities, enhancing the relevance and visibility of the fellows’ efforts and promoting recruitment of fellows to VA positions. VAQS has enrolled 96 fellows from 1999 to 2008; 75 have completed the program and 11 are currently enrolled. Fellowship graduates have pursued a variety of career paths: 20% are continuing training (most in VA); 32% hold a VA faculty/staff position; 63% are academic faculty; and 80% conduct clinical or research work related to health care improvement. Graduates have held leadership positions in VA, Department of Defense, and public health. Combining knowledge about the improvement of health care with adult learning strategies, distance learning technologies, face-to-face meetings, local mentorship, and experiential projects has been successful in improving care in VA and preparing physicians to participate in, study, and lead the improvement of health care quality and safety. PMID:19940583

A stitch in time saves nine: external quality assessment rounds demonstrate improved quality of biomarker analysis in lung cancer

PubMed Central

Keppens, Cleo; Tack, Véronique; Hart, Nils ‘t; Tembuyser, Lien; Ryska, Ales; Pauwels, Patrick; Zwaenepoel, Karen; Schuuring, Ed; Cabillic, Florian; Tornillo, Luigi; Warth, Arne; Weichert, Wilko; Dequeker, Elisabeth

2018-01-01

Biomarker analysis has become routine practice in the treatment of non-small cell lung cancer (NSCLC). To ensure high quality testing, participation to external quality assessment (EQA) schemes is essential. This article provides a longitudinal overview of the EQA performance for EGFR, ALK, and ROS1 analyses in NSCLC between 2012 and 2015. The four scheme years were organized by the European Society of Pathology according to the ISO 17043 standard. Participants were asked to analyze the provided tissue using their routine procedures. Analysis scores improved for individual laboratories upon participation to more EQA schemes, except for ROS1 immunohistochemistry (IHC). For EGFR analysis, scheme error rates were 18.8%, 14.1% and 7.5% in 2013, 2014 and 2015 respectively. For ALK testing, error rates decreased between 2012 and 2015 by 5.2%, 3.2% and 11.8% for the fluorescence in situ hybridization (FISH), FISH digital, and IHC subschemes, respectively. In contrast, for ROS1 error rates increased between 2014 and 2015 for FISH and IHC by 3.2% and 9.3%. Technical failures decreased over the years for all three markers. Results show that EQA contributes to an ameliorated performance for most predictive biomarkers in NSCLC. Room for improvement is still present, especially for ROS1 analysis. PMID:29755669

External inspection of compliance with standards for improved healthcare outcomes.

PubMed

Flodgren, Gerd; Gonçalves-Bradley, Daniela C; Pomey, Marie-Pascale

2016-12-02

risk of bias of each included study. Since meta-analysis was not possible, we produced a narrative results summary. We used the GRADE tool to assess the certainty of the evidence. We did not identify any new eligible studies in this update. One cluster RCT involving 20 South African public hospitals and one ITS involving all acute hospital trusts in England, met the inclusion criteria. A trust is a National Health Service hospital which has opted to withdraw from local authority control and be managed by a trust instead.The cluster RCT reported mixed effects of external inspection on compliance with COHSASA (Council for Health Services Accreditation for South Africa) accreditation standards and eight indicators of hospital quality. Improved total compliance score with COHSASA accreditation standards was reported for 21/28 service elements: mean intervention effect was 30% (95% confidence interval (CI) 23% to 37%) (P < 0.001). The score increased from 48% to 78% in intervention hospitals, while remaining the same in control hospitals (43%). The median intervention effect for the indicators of hospital quality of care was 2.4% (range -1.9% to +11.8%).The ITS study evaluated compliance with policies to address healthcare-acquired infections and reported a mean reduction in MRSA (methicillin-resistant Staphylococcus aureus) infection rates of 100 cases per quarter (95% CI -221.0 to 21.5, P = 0.096) at three months' follow-up and an increase of 70 cases per quarter (95% CI -250.5 to 391.0; P = 0.632) at 24 months' follow-up. Regression analysis showed similar MRSA rates before and after the external inspection (difference in slope 24.27, 95% CI -10.4 to 58.9; P = 0.147).Neither included study reported data on unanticipated/adverse consequences or economic outcomes. The cluster RCT reported mainly outcomes related to healthcare organisation change, and no patient reported outcomes other than patient satisfaction.The certainty of the included evidence from both studies was

ASSESSING BIOACCUMULATION FOR DERIVING NATIONAL HUMAN HEALTH WATER QUALITY CRITERIA

EPA Science Inventory

The United States Environmental Protection Agency is revising its methodology for deriving national ambient water quality criteria (AWQC) to protect human health. A component of this guidance involves assessing the potential for chemical bioaccumulation in commonly consumed fish ...

Toward a US National Air Quality Forecast Capability: Current and Planned Capabilities

EPA Science Inventory

As mandated by Congress, NOAA is establishing a US national air quality forecast capability. This capability is being built with EPA, to provide air quality forecast information with enough accuracy and lead-time so that people can take actions to limit harmful effects of poor a...

External quality assurance programs as a tool for verifying standardization of measurement procedures: Pilot collaboration in Europe.

PubMed

Perich, C; Ricós, C; Alvarez, V; Biosca, C; Boned, B; Cava, F; Doménech, M V; Fernández-Calle, P; Fernández-Fernández, P; García-Lario, J V; Minchinela, J; Simón, M; Jansen, R

2014-05-15

Current external quality assurance schemes have been classified into six categories, according to their ability to verify the degree of standardization of the participating measurement procedures. SKML (Netherlands) is a Category 1 EQA scheme (commutable EQA materials with values assigned by reference methods), whereas SEQC (Spain) is a Category 5 scheme (replicate analyses of non-commutable materials with no values assigned by reference methods). The results obtained by a group of Spanish laboratories participating in a pilot study organized by SKML are examined, with the aim of pointing out the improvements over our current scheme that a Category 1 program could provide. Imprecision and bias are calculated for each analyte and laboratory, and compared with quality specifications derived from biological variation. Of the 26 analytes studied, 9 had results comparable with those from reference methods, and 10 analytes did not have comparable results. The remaining 7 analytes measured did not have available reference method values, and in these cases, comparison with the peer group showed comparable results. The reasons for disagreement in the second group can be summarized as: use of non-standard methods (IFCC without exogenous pyridoxal phosphate for AST and ALT, Jaffé kinetic at low-normal creatinine concentrations and with eGFR); non-commutability of the reference material used to assign values to the routine calibrator (calcium, magnesium and sodium); use of reference materials without established commutability instead of reference methods for AST and GGT, and lack of a systematic effort by manufacturers to harmonize results. Results obtained in this work demonstrate the important role of external quality assurance programs using commutable materials with values assigned by reference methods to correctly monitor the standardization of laboratory tests with consequent minimization of risk to patients. Copyright © 2013 Elsevier B.V. All rights reserved.

Biology as an integrated component of the U.S. Geological Survey's National Water-Quality Assessment Program

USGS Publications Warehouse

Meador, Michael R.; Gurtz, Martin E.

1994-01-01

The U.S. Geological Survey?s (USGS) National Water-Quality Assessment (NAWQA) Program is designed to integrate chemical, physical, and biological data to assess the status of and trends in the Nation?s water quality at local, regional, and national levels. The Program consists of 60 study units (major river basins and large parts of aquifers) located throughout the Nation (fig. 1). Data are collected at stream, river, and ground-water sites that represent the Nation?s mix of major natural and human factors that influence water quality. Biological data are collected from streams and rivers, and include (1) fish and other aquatic organisms whose tissues are analyzed for a wide array of chemical contaminants; (2) characterizations of algal, benthic invertebrate, and fish communities; and (3) characterizations of vegetation growing in streams and along streambanks. These biological data are collected in conjunction with physical (streamflow, characterizations of instream, bank, and flood-plain habitats) and chemical data.

Assessment of Reference Height Models on Quality of Tandem-X dem

NASA Astrophysics Data System (ADS)

Mirzaee, S.; Motagh, M.; Arefi, H.

2015-12-01

The aim of this study is to investigate the effect of various Global Digital Elevation Models (GDEMs) in producing high-resolution topography model using TanDEM-X (TDX) Coregistered Single Look Slant Range Complex (CoSSC) images. We selected an image acquired on Jun 12th, 2012 over Doroud region in Lorestan, west of Iran and used 4 external digital elevation models in our processing including DLR/ASI X-SAR DEM (SRTM-X, 30m resolution), ASTER GDEM Version 2 (ASTER-GDEMV2, 30m resolution), NASA SRTM Version 4 (SRTM-V4, 90m resolution), and a local photogrammetry-based DEM prepared by National Cartographic Center (NCC DEM, 10m resolution) of Iran. InSAR procedure for DEM generation was repeated four times with each of the four external height references. The quality of each external DEM was initially assessed using ICESat filtered points. Then, the quality of, each TDX-based DEM was assessed using the more precise external DEM selected in the previous step. Results showed that both local (NCC) DEM and SRTM X-band performed the best (RMSE< 9m) for TDX-DEM generation. In contrast, ASTER GDEM v2 and SRTM C-band v4 showed poorer quality.

National water summary 1986; Hydrologic events and ground-water quality

USGS Publications Warehouse

Moody, David W.; Carr, Jerry E.; Chase, Edith B.; Paulson, Richard W.

1988-01-01

Ground water is one of the most important natural resources of the United States and degradation of its quality could have a major effect on the welfare of the Nation. Currently (1985), ground water is the source of drinking water for 53 percent of the Nation's population and for more than 97 percent of its rural population. It is the source of about 40 percent of the Nation's public water supply, 33 percent of water for irrigation, and 17 percent of freshwater for selfsupplied industries.Ground water also is the source of about 40 percent of the average annual streamflow in the United States, although during long periods of little or no precipitation, ground-water discharges provide nearly all of the base streamflow. This hydraulic connection between aquifers and streams implies that if a persistent pollutant gets into an aquifer, it eventually could discharge into a stream.Information presented in the 1986 National Water Summary clearly shows that the United States has very large amounts of potable ground water available for use. Although naturally occurring constituents, such as nitrate, and human-induced substances, such as synthetic organic chemicals, frequently are detected in ground water, their concentrations usually do not exceed existing Federal or State standards or guidelines for maximum concentrations in drinking water.Troublesome contamination of ground water falls into two basic categories related to the source or sources of the contamination. Locally, high concentrations of a variety of toxic metals, organic chemicals, and petroleum products have been detected in ground water associated with point sources such as wastedisposal sites, storage-tank leaks, and hazardous chemical spills. These types of local problems commonly occur in densely populated urban areas and industrialized areas. Larger, multicounty areas also have been identified where contamination frequently is found in shallow wells. These areas generally are associated with broad

75 FR 62550 - Meeting of a Subcommittee of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of a Subcommittee of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare... Subcommittee of the National Advisory Council for Healthcare Research and Quality. DATES: The meeting will be...

The Riks-Stroke story: building a sustainable national register for quality assessment of stroke care.

PubMed

Asplund, Kjell; Hulter Åsberg, Kerstin; Appelros, Peter; Bjarne, Daniela; Eriksson, Marie; Johansson, Asa; Jonsson, Fredrik; Norrving, Bo; Stegmayr, Birgitta; Terént, Andreas; Wallin, Sari; Wester, Per-Olov

2011-04-01

Riks-Stroke, the Swedish Stroke Register, is the world's longest-running national stroke quality register (established in 1994) and includes all 76 hospitals in Sweden admitting acute stroke patients. The development and maintenance of this sustainable national register is described. Riks-Stroke includes information on the quality of care during the acute phase, rehabilitation and secondary prevention of stroke, as well as data on community support. Riks-Stroke is unique among stroke quality registers in that patients are followed during the first year after stroke. The data collected describe processes, and medical and patient-reported outcome measurements. The register embraces most of the dimensions of health-care quality (evidence-based, safe, provided in time, distributed fairly and patient oriented). Annually, approximately 25,000 patients are included. In 2009, approximately 320,000 patients had been accumulated (mean age 76-years). The register is estimated to cover 82% of all stroke patients treated in Swedish hospitals. Among critical issues when building a national stroke quality register, the delicate balance between simplicity and comprehensiveness is emphasised. Future developments include direct transfer of data from digital medical records to Riks-Stroke and comprehensive strategies to use the information collected to rapidly implement new evidence-based techniques and to eliminate outdated methods in stroke care. It is possible to establish a sustainable quality register for stroke at the national level covering all hospitals admitting acute stroke patients. Riks-Stroke is fulfilling its main goals to support continuous quality improvement of Swedish stroke services and serve as an instrument for following up national stroke guidelines. © 2010 The Authors. International Journal of Stroke © 2010 World Stroke Organization.

The Relevance of External Quality Assessment for Molecular Testing for ALK Positive Non-Small Cell Lung Cancer: Results from Two Pilot Rounds Show Room for Optimization

PubMed Central

Tembuyser, Lien; Tack, Véronique; Zwaenepoel, Karen; Pauwels, Patrick; Miller, Keith; Bubendorf, Lukas; Kerr, Keith; Schuuring, Ed; Thunnissen, Erik; Dequeker, Elisabeth M. C.

2014-01-01

Background and Purpose Molecular profiling should be performed on all advanced non-small cell lung cancer with non-squamous histology to allow treatment selection. Currently, this should include EGFR mutation testing and testing for ALK rearrangements. ROS1 is another emerging target. ALK rearrangement status is a critical biomarker to predict response to tyrosine kinase inhibitors such as crizotinib. To promote high quality testing in non-small cell lung cancer, the European Society of Pathology has introduced an external quality assessment scheme. This article summarizes the results of the first two pilot rounds organized in 2012–2013. Materials and Methods Tissue microarray slides consisting of cell-lines and resection specimens were distributed with the request for routine ALK testing using IHC or FISH. Participation in ALK FISH testing included the interpretation of four digital FISH images. Results Data from 173 different laboratories was obtained. Results demonstrate decreased error rates in the second round for both ALK FISH and ALK IHC, although the error rates were still high and the need for external quality assessment in laboratories performing ALK testing is evident. Error rates obtained by FISH were lower than by IHC. The lowest error rates were observed for the interpretation of digital FISH images. Conclusion There was a large variety in FISH enumeration practices. Based on the results from this study, recommendations for the methodology, analysis, interpretation and result reporting were issued. External quality assessment is a crucial element to improve the quality of molecular testing. PMID:25386659

Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

PubMed

Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

2014-10-01

We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

Floristic Quality Assessment Across the Nation: Status, Opportunities, and Challenges

EPA Science Inventory

Floristic Quality Assessment (FQA) will be considered in the USEPA National Wetland Condition Assessment (NWCA). FQA is a powerful tool to describe wetland ecological condition, and is based on Coefficients of Conservatism (CC) of individual native plant species. CCs rank sensiti...

How to conduct External Quality Assessment Schemes for the pre-analytical phase?

PubMed

Kristensen, Gunn B B; Aakre, Kristin Moberg; Kristoffersen, Ann Helen; Sandberg, Sverre

2014-01-01

In laboratory medicine, several studies have described the most frequent errors in the different phases of the total testing process, and a large proportion of these errors occur in the pre-analytical phase. Schemes for registration of errors and subsequent feedback to the participants have been conducted for decades concerning the analytical phase by External Quality Assessment (EQA) organizations operating in most countries. The aim of the paper is to present an overview of different types of EQA schemes for the pre-analytical phase, and give examples of some existing schemes. So far, very few EQA organizations have focused on the pre-analytical phase, and most EQA organizations do not offer pre-analytical EQA schemes (EQAS). It is more difficult to perform and standardize pre-analytical EQAS and also, accreditation bodies do not ask the laboratories for results from such schemes. However, some ongoing EQA programs for the pre-analytical phase do exist, and some examples are given in this paper. The methods used can be divided into three different types; collecting information about pre-analytical laboratory procedures, circulating real samples to collect information about interferences that might affect the measurement procedure, or register actual laboratory errors and relate these to quality indicators. These three types have different focus and different challenges regarding implementation, and a combination of the three is probably necessary to be able to detect and monitor the wide range of errors occurring in the pre-analytical phase.

An examination of the hexokinase method for serum glucose assay using external quality assessment data.

PubMed

Westwood, A; Bullock, D G; Whitehead, T P

1986-01-01

Hexokinase methods for serum glucose assay appeared to give slightly but consistently higher inter-laboratory coefficients of variation than all methods combined in the UK External Quality Assessment Scheme; their performance over a two-year period was therefore compared with that for three groups of glucose oxidase methods. This assessment showed no intrinsic inferiority in the hexokinase method. The greater variation may be due to the more heterogeneous group of instruments, particularly discrete analysers, on which the method is used. The Beckman Glucose Analyzer and Astra group (using a glucose oxidase method) showed the least inter-laboratory variability but also the lowest mean value. No comment is offered on the absolute accuracy of any of the methods.

77 FR 8197 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

...-AR32 Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area Classifications Approach, Attainment Deadlines and Revocation of the 1997 Ozone Standards for Transportation... proposing thresholds for classifying nonattainment areas for the 2008 ozone National Ambient Air Quality...

77 FR 30160 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

...-AR32 Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area Classifications Approach, Attainment Deadlines and Revocation of the 1997 Ozone Standards for Transportation... all nonattainment areas for the 2008 ozone national ambient air quality standards (NAAQS) (the ``2008...

Development and Application of the Key Technologies for the Quality Control and Inspection of National Geographical Conditions Survey Products

NASA Astrophysics Data System (ADS)

Zhao, Y.; Zhang, L.; Ma, W.; Zhang, P.; Zhao, T.

2018-04-01

The First National Geographical Condition Survey is a predecessor task to dynamically master basic situations of the nature, ecology and human activities on the earth's surface and it is the brand-new mapping geographic information engineering. In order to ensure comprehensive, real and accurate survey results and achieve the quality management target which the qualified rate is 100 % and the yield is more than 80 %, it is necessary to carry out the quality control and result inspection for national geographical conditions survey on a national scale. To ensure that achievement quality meets quality target requirements, this paper develops the key technology method of "five-in-one" quality control that is constituted by "quality control system of national geographical condition survey, quality inspection technology system, quality evaluation system, quality inspection information management system and national linked quality control institutions" by aiming at large scale, wide coverage range, more undertaking units, more management levels, technical updating, more production process and obvious regional differences in the national geographical condition survey and combining with novel achievement manifestation, complicated dependency, more special reference data, and large data size. This project fully considering the domestic and foreign related research results and production practice experience, combined with the technology development and the needs of the production, it stipulates the inspection methods and technical requirements of each stage in the quality inspection of the geographical condition survey results, and extends the traditional inspection and acceptance technology, and solves the key technologies that are badly needed in the first national geographic survey.

Multicenter External Quality Assessment Program for PCR Detection of Mycobacterium ulcerans in Clinical and Environmental Specimens

PubMed Central

Eddyani, Miriam; Lavender, Caroline; de Rijk, Willem Bram; Bomans, Pieter; Fyfe, Janet; de Jong, Bouke; Portaels, Françoise

2014-01-01

Background Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU), a necrotizing disease of the skin, soft tissue and bone. PCR is increasingly used in the diagnosis of BU and in research on the mode of transmission and environmental reservoir of M. ulcerans. Methodology/Principal Findings The aim of this study was to evaluate the performance of laboratories in detecting M. ulcerans using molecular tests in clinical and environmental samples by implementing sequential multicenter external quality assessment (EQA) programs. The second round of the clinical EQA program revealed somewhat improved performance. Conclusions/Significance Ongoing EQA programs remain essential and continued participation in future EQA programs by laboratories involved in the molecular testing of clinical and environmental samples for M. ulcerans for diagnostic and research purposes is strongly encouraged. Broad participation in such EQA programs also benefits the harmonization of quality in the BU research community and enhances the credibility of advances made in solving the transmission enigma of M. ulcerans. PMID:24586755

77 FR 30087 - Air Quality Designations for the 2008 Ozone National Ambient Air Quality Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

...This rule establishes initial air quality designations for most areas in the United States, including areas of Indian country, for the 2008 primary and secondary national ambient air quality standards (NAAQS) for ozone. The designations for several counties in Illinois, Indiana, and Wisconsin that the EPA is considering for inclusion in the Chicago nonattainment area will be designated in a subsequent action, no later than May 31, 2012. Areas designated as nonattainment are also being classified by operation of law according to the severity of their air quality problems. The classification categories are Marginal, Moderate, Serious, Severe, and Extreme. The EPA is establishing the air quality thresholds that define the classifications in a separate rule that the EPA is signing and publishing in the Federal Register on the same schedule as these designations. In accordance with that separate rule, six nonattainment areas in California are being reclassified to a higher classification.

76 FR 6056 - Additional Air Quality Designations for the 2006 24-Hour Fine Particle National Ambient Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

...-9261-3] RIN 2060-AQ30 Additional Air Quality Designations for the 2006 24-Hour Fine Particle National..., and Decisions Related to the 1997 Air Quality Designations and Classifications for the Annual Fine... nationwide for all but three areas for the 2006 24-hour fine particle (PM 2.5 ) National Ambient Air Quality...

DSM-IV personality disorders and associations with externalizing and internalizing disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Harford, Thomas C; Chen, Chiung M; Saha, Tulshi D; Smith, Sharon M; Ruan, W June; Grant, Bridget F

2013-11-01

Although associations between personality disorders and psychiatric disorders are well established in general population studies, their association with liability dimensions for externalizing and internalizing disorders has not been fully assessed. The purpose of this study is to examine associations between personality disorders (PDs) and lifetime externalizing and internalizing Axis I disorders. Data were obtained from the total sample of 34,653 respondents from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drawing on the literature, a 3-factor exploratory structural equation model was selected to simultaneously assess the measurement relations among DSM-IV Axis I substance use and mood and anxiety disorders and the structural relations between the latent internalizing-externalizing dimensions and DSM-IV PDs, adjusting for gender, age, race/ethnicity, and marital status. Antisocial, histrionic, and borderline PDs were strong predictors for the externalizing factor, while schizotypal, borderline, avoidant, and obsessive-compulsive PDs had significantly larger effects on the internalizing fear factor when compared to the internalizing misery factor. Paranoid, schizoid, narcissistic, and dependent PDs provided limited discrimination between and among the three factors. An overarching latent factor representing general personality dysfunction was significantly greater on the internalizing fear factor followed by the externalizing factor, and weakest for the internalizing misery factor. Personality disorders offer important opportunities for studies on the externalizing-internalizing spectrum of common psychiatric disorders. Future studies based on panic, anxiety, and depressive symptoms may elucidate PD associations with the internalizing spectrum of disorders. Published by Elsevier Ltd.

DSM-IV Personality Disorders and Associations with Externalizing and Internalizing Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Harford, Thomas C.; Chen, Chiung M.; Saha, Tulshi D.; Smith, Sharon M.; Ruan, W. June; Grant, Bridget F.

2013-01-01

Background Although associations between personality disorders and psychiatric disorders are well established in general population studies, their association with liability dimensions for externalizing and internalizing disorders has not been fully assessed. The purpose of this study is to examine associations between personality disorders (PDs) and lifetime externalizing and internalizing Axis I disorders. Methods Data were obtained from the total sample of 34,653 respondents from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drawing on the literature, a 3-factor exploratory structural equation model was selected to simultaneously assess the measurement relations among DSM-IV Axis I substance use and mood and anxiety disorders and the structural relations between the latent internalizing-externalizing dimensions and DSM-IV PDs, adjusting for gender, age, race/ethnicity, and marital status. Results Antisocial, histrionic, and borderline PDs were strong predictors for the externalizing factor, while schizotypal, borderline, avoidant, and obsessive-compulsive PDs had significantly larger effects on the internalizing fear factor when compared to the internalizing misery factor. Paranoid, schizoid, narcissistic, and dependent PDs provided limited discrimination between and among the three factors. An overarching latent factor representing general personality dysfunction was significantly greater on the internalizing fear factor followed by the externalizing factor, and weakest for the internalizing misery factor. Conclusion Personality disorders offer important opportunities for studies on the externalizing-internalizing spectrum of common psychiatric disorders. Future studies based on panic, anxiety, and depressive symptoms may elucidate PD associations with the internalizing spectrum of disorders. PMID:23932575

Relating Child Care during Infancy to Externalizing and Internalizing Behaviors in Toddlerhood: How Specific Features of Child Care Quality Matter Depending on a Child's Gender and Temperament

ERIC Educational Resources Information Center

Lemay, Lise; Bigras, Nathalie; Bouchard, Caroline

2014-01-01

This study explored whether the relationships between specific features of child care quality and externalizing and internalizing behaviors in 24-month-old children are moderated by gender and temperament. Questionnaires were used to record children's gender and measure their temperament. Child care quality was observed with the "Échelles…

Water quality data for national-scale aquatic research: The Water Quality Portal

USGS Publications Warehouse

Read, Emily K.; Carr, Lindsay; DeCicco, Laura; Dugan, Hilary; Hanson, Paul C.; Hart, Julia A.; Kreft, James; Read, Jordan S.; Winslow, Luke

2017-01-01

Aquatic systems are critical to food, security, and society. But, water data are collected by hundreds of research groups and organizations, many of which use nonstandard or inconsistent data descriptions and dissemination, and disparities across different types of water observation systems represent a major challenge for freshwater research. To address this issue, the Water Quality Portal (WQP) was developed by the U.S. Environmental Protection Agency, the U.S. Geological Survey, and the National Water Quality Monitoring Council to be a single point of access for water quality data dating back more than a century. The WQP is the largest standardized water quality data set available at the time of this writing, with more than 290 million records from more than 2.7 million sites in groundwater, inland, and coastal waters. The number of data contributors, data consumers, and third-party application developers making use of the WQP is growing rapidly. Here we introduce the WQP, including an overview of data, the standardized data model, and data access and services; and we describe challenges and opportunities associated with using WQP data. We also demonstrate through an example the value of the WQP data by characterizing seasonal variation in lake water clarity for regions of the continental U.S. The code used to access, download, analyze, and display these WQP data as shown in the figures is included as supporting information.

Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators.

PubMed

Shumba, Edwin; Nzombe, Phoebe; Mbinda, Absolom; Simbi, Raiva; Mangwanya, Douglas; Kilmarx, Peter H; Luman, Elizabeth T; Zimuto, Sibongile N

2014-01-01

In 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening. To evaluate the financial costs of SLMTA implementation using two models (external facilitators; and internal local or MoHCW facilitators) from the perspective of the implementing partner and to estimate resources needed to scale up the programme nationally in all 10 provinces. The average expenditure per laboratory was calculated based on accounting records; calculations included implementing partner expenses but excluded in-kind contributions and salaries of local facilitators and trainees. We also estimated theoretical financial costs, keeping all contextual variables constant across the two models. Resource needs for future national expansion were estimated based on a two-phase implementation plan, in which 12 laboratories in each of five provinces would implement SLMTA per phase; for the internal facilitator model, 20 facilitators would be trained at the beginning of each phase. The average expenditure to implement SLMTA in 11 laboratories using external facilitators was approximately US$5800 per laboratory; expenditure in 19 laboratories using internal facilitators was approximately $6000 per laboratory. The theoretical financial cost of implementing a 12-laboratory SLMTA cohort keeping all contextual variables constant would be approximately $58 000 using external facilitators; or $15 000 using internal facilitators, plus $86 000 to train 20 facilitators. The financial cost for subsequent SLMTA cohorts using the previously-trained internal facilitators would be approximately $15 000, yielding a break-even point of 2 cohorts, at $116 000 for either model. Estimated resources required for national implementation in 120 laboratories would therefore be $580 000 using external facilitators ($58 000 per province) and $322 000 using internal facilitators ($86

78 FR 44485 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

...] Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan... Rule Regarding ``Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State... ground-level ozone formation. B. What should I consider as I prepare my comments for the EPA? 1...

National Beef Quality Audit-2011: Survey of instrument grading assessments of beef carcass characteristics

USDA-ARS?s Scientific Manuscript database

The instrument grading assessments for the 2011 National Beef Quality Audit evaluated seasonal trends of beef carcass quality and yield attributes over the course of the year. One week of instrument grading data, HCW, gender, USDA quality grade (QG), and yield grade (YG) factors, were collected ever...

75 FR 63497 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, November 5, 2010...

78 FR 65321 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, November 15, 2013...

75 FR 38110 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, July 23, 2010...

78 FR 12319 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, April 12, 2013...

77 FR 61000 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, November 9, 2012...

76 FR 14668 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, April 8, 2011...

77 FR 38633 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, July 13, 2012...

77 FR 13607 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... for Healthcare Research and Quality. DATES: The meeting will be held on Friday, April 13, 2012, from 8...

78 FR 41799 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, July 26, 2013...

76 FR 62068 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, November 4, 2011...

76 FR 40733 - Meeting of the National Advisory Council for Healthcare Research and Quality

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Meeting of the National Advisory Council for Healthcare Research and Quality AGENCY: Agency for Healthcare Research and... Council for Healthcare Research and Quality. DATES: The meeting will be held on Friday, July 22 2011, from...

General introduction for the “National Field Manual for the Collection of Water-Quality Data”

USGS Publications Warehouse

,

2018-02-28

BackgroundAs part of its mission, the U.S. Geological Survey (USGS) collects data to assess the quality of our Nation’s water resources. A high degree of reliability and standardization of these data are paramount to fulfilling this mission. Documentation of nationally accepted methods used by USGS personnel serves to maintain consistency and technical quality in data-collection activities. “The National Field Manual for the Collection of Water-Quality Data” (NFM) provides documented guidelines and protocols for USGS field personnel who collect water-quality data. The NFM provides detailed, comprehensive, and citable procedures for monitoring the quality of surface water and groundwater. Topics in the NFM include (1) methods and protocols for sampling water resources, (2) methods for processing samples for analysis of water quality, (3) methods for measuring field parameters, and (4) specialized procedures, such as sampling water for low levels of mercury and organic wastewater chemicals, measuring biological indicators, and sampling bottom sediment for chemistry. Personnel who collect water-quality data for national USGS programs and projects, including projects supported by USGS cooperative programs, are mandated to use protocols provided in the NFM per USGS Office of Water Quality Technical Memorandum 2002.13. Formal training, for example, as provided in the USGS class, “Field Water-Quality Methods for Groundwater and Surface Water,” and field apprenticeships supplement the guidance provided in the NFM and ensure that the data collected are high quality, accurate, and scientifically defensible.

Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alvarez R, J T; Tovar M, V M

2008-08-11

A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described--for eleven {sup 60}Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 deg. C plus 24 hrs 80 deg. C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal D{sub W} = 2 Gy{center_dot}c) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gymore » in terms of absorbed dose to water D{sub W} for {sup 60}Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.« less

How the national healthcare quality and disparities reports can catalyze quality improvement.

PubMed

McNeill, Dwight; Kelley, Ed

2005-03-01

The purpose of the National Reports on Healthcare Quality and Disparities is to enhance awareness of quality and health care disparities, track progress, understand variations, and catalyze improvements in health care. The objective of this paper is to propose a model that will facilitate a user's progression from knowledge to action and to show how the reports, its data warehouse, associated products, and Agency for Healthcare Research and Quality resources are integrated and focused on a comprehensive campaign to improve health care quality. The design of the paper is to present a conceptual model and to show how implementation strategies for the reports fit the model. The authors propose a quality improvement supply chain model to help elucidate the links of the process, corresponding developmental stages that potential users need to master and progress through, and "just-in-time" supply chain inputs at each of the corresponding stages, and populate the model with examples. The traditional ways of disseminating knowledge derived from science through reports and conferences are inadequate to the humbling need for vast improvements in the US health care system. Our model suggests the need for a wide variety of information, packaged in a diverse ways, and delivered just in time and on demand. It encourages the alignment of decision makers and researchers, along with information intermediaries and innovation brokers, to make the information production cycle more efficient and effective. Future iterations of the reports will improve relevance, meaning, and distribution of information to facilitate its uptake by potential users.

Apparent Quality-of-Life in Nations: How Long and Happy People Live

ERIC Educational Resources Information Center

Veenhoven, Ruut

2005-01-01

Quality-of-life in nations can be measured by how long and happy people live. This is assessed by combining data on life expectancy drawn from civil registration with survey data on subjective enjoyment of life as a whole. This measure of "apparent" quality-of-life is a good alternative to current indexes of "assumed"…

Global Influences on National Definitions of Quality Education: Examples from Spain and Italy

ERIC Educational Resources Information Center

Engel, Laura C.; Rutkowski, David

2014-01-01

There is increasing attention worldwide to advancing quality education. Beyond a rhetorical aim, many international organizations and national education systems have articulated a commitment to promoting measures of quality education through the development of educational indicators. This article broadly explores the global influences on national…

Preface; Water quality of large U.S. rivers; results from the U.S. Geological Survey's National Stream Quality Accounting Network

USGS Publications Warehouse

Hirsch, Robert M.; Hooper, Richard P.; Kelly, Valerie J.

2001-01-01

The mission of the US Geological Survey (USGS) is to assess the quantity and quality of the earth resources of the USA and to provide information that will assist resource managers and policymakers at federal, state and local levels in making sound decisions. Characterizing the water quality of the largest rivers of the USA is a daunting prospect, especially given the resources available for the task. The most effective approach is uncertain and is legitimately a research topic. The National Stream Quality Accounting Network (NASQAN) was redesigned in 1995 to estimate the annual mass flux of constituents at a network of fixed stations in the Mississippi, Rio Grande, Colorado, and Columbia River basins. This special volume of Hydrological Processes contains a series of papers evaluating the data collected by NASQAN during its first 3 years of operation under this design. The NASQAN network complements other USGS national programs that are designed to address water quality at different scales. The National Water-Quality Assessment Program (Hirsch et al., 1988) is designed around river basins of 10 000 to 100 000 km2 (versus these NASQAN basins, which are 650 000 to 3 100 000 km2 at their most downstream stations). The USGS also operates the Hydrologic Benchmark Network that is focused on relatively pristine basins of only 10 to 100 km2 (Mast and Turk, 1999a,b; Clark et al., 2000; Mast et al., 2000).