Science.gov

Sample records for accessibility quality guidelines

  1. Web Accessibility and Guidelines

    NASA Astrophysics Data System (ADS)

    Harper, Simon; Yesilada, Yeliz

    Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

  2. [Vascular access guidelines for hemodialysis].

    PubMed

    Rodríguez Hernández, J A; González Parra, E; Julián Gutiérrez, J M; Segarra Medrano, A; Almirante, B; Martínez, M T; Arrieta, J; Fernández Rivera, C; Galera, A; Gallego Beuter, J; Górriz, J L; Herrero, J A; López Menchero, R; Ochando, A; Pérez Bañasco, V; Polo, J R; Pueyo, J; Ruiz, Camps I; Segura Iglesias, R

    2005-01-01

    Quality of vascular access (VA) has a remarkable influence in hemodialysis patients outcomes. Dysfunction of VA represents a capital cause of morbi-mortality of these patients as well an increase in economical. Spanish Society of Neprhology, aware of the problem, has decided to carry out a revision of the issue with the aim of providing help in comprehensión and treatment related with VA problems, and achieving an homogenization of practices in three mayor aspects: to increase arteriovenous fistula utilization as first vascular access, to increment vascular access monitoring practice and rationalise central catheters use. We present a consensus document elaborated by a multidisciplinar group composed by nephrologists, vascular surgeons, interventional radiologysts, infectious diseases specialists and nephrological nurses. Along six chapters that cover patient education, creation of VA, care, monitoring, complications and central catheters, we present the state of the art and propose guidelines for the best practice, according different evidence based degrees, with the intention to provide help at the professionals in order to make aproppiate decissions. Several quality standars are also included.

  3. 78 FR 38101 - Passenger Vessels Accessibility Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ...We, the Architectural and Transportation Barriers Compliance Board (Access Board), are proposing accessibility guidelines for the construction and alteration of passenger vessels covered by the Americans with Disabilities Act (ADA) to ensure that the vessels are readily accessible to and usable by passengers with disabilities. The guidelines would apply to passenger vessels, other than ferries......

  4. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 1191.1 Section 1191.1 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS...; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES § 1191.1 Accessibility guidelines. (a) The... facilities covered by the Architectural Barriers Act are set forth in Appendices C and D to this part....

  5. Total quality management implementation guidelines

    SciTech Connect

    Not Available

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  6. 78 FR 49248 - Passenger Vessels Accessibility Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1196 RIN 3014-AA11 Passenger Vessels Accessibility Guidelines AGENCY: Architectural and Transportation Barriers Compliance Board. ACTION: Notice of proposed rulemaking; extension of comment period. SUMMARY: The Architectural and Transportation Barriers...

  7. Guidelines for Outsourcing Remote Access.

    ERIC Educational Resources Information Center

    Hassler, Ardoth; Neuman, Michael

    1996-01-01

    Discusses the advantages and disadvantages of outsourcing remote access to campus computer networks and the Internet, focusing on improved service, cost-sharing, partnerships with vendors, supported protocols, bandwidth, scope of access, implementation, support, network security, and pricing. Includes a checklist for a request for proposals on…

  8. Removing the Barriers: Accessibility Guidelines and Specifications.

    ERIC Educational Resources Information Center

    Cotler, Stephen R.

    This guide provides guidelines for meeting the accessibility requirements of the Americans with Disabilities (ADA) Act in college and university buildings. The publication is divided into 10 chapters, the first 7 of which present construction drawings, evaluation criteria, and specifications for: (1) site accessibility (external path of travel,…

  9. 78 FR 39649 - Passenger Vessels Accessibility Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ... From the Federal Register Online via the Government Publishing Office ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1196 RIN 3014-AA11 Passenger Vessels Accessibility Guidelines Correction In proposed rule document 2013-14367, appearing on pages 38102- 38159 in the issue...

  10. Guidelines for Making Web Content Accessible to All Users

    ERIC Educational Resources Information Center

    Thompson, Terrill; Primlani, Saroj; Fiedor, Lisa

    2009-01-01

    The main goal of accessibility standards and guidelines is to design websites everyone can use. The "IT Accessibility Constituent Group" developed this set of draft guidelines to help EQ authors, reviewers, and staff and the larger EDUCAUSE community ensure that web content is accessible to all users, including those with disabilities. This…

  11. Chiropractic quality assurance: standards and guidelines

    PubMed Central

    Gatterman, Meridel I; Dobson, Thomas P; LeFevbre, Ron

    2001-01-01

    Chiropractic quality assurance involves development of both clinical guidelines and standards. Confusion generated by poor differentiation of guidelines from standards contributes to mistrust of the guideline development process. Guidelines are considered to be recommendations that allow for flexibility and individual patient differences. Standards are more binding and require a high level of supporting evidence. While guidelines serve as educational tools to improve the quality of practice, standards that outline minimum competency are used more as administrative tools on which to base policy. Barriers to development of clinical guidelines and standards include fear that they will create prescriptive “cookbook” practice, and the distrust that guidelines are developed primarily for cost containment. Clinicians also criticize guidelines developed by academics that don't relate to practice, and those based on evidence that lacks clinical relevance. Conflicting guidelines perceived to be based on strong bias or conflict of interest are also suspect. To reduce barriers to acceptance and implementation, guidelines should be inclusive, patient-centered, and based on a variety of evidence and clinical experience.

  12. 76 FR 8753 - Final Information Quality Guidelines Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... SECURITY Final Information Quality Guidelines Policy AGENCY: Department of Homeland Security. ACTION: Notice and request for public comment on Final Information Quality Guidelines. SUMMARY: These guidelines should be used to ensure and maximize the quality of disseminated information. The...

  13. Indoor Air Quality Guidelines for Pennsylvania Schools.

    ERIC Educational Resources Information Center

    Zimmerman, Robert S., Jr.

    This report provides information and practical guidance on how to prevent indoor air quality (IAQ) problems in schools, and it describes how to implement a practical plan of action using a minimal amount of resources. It includes general guidelines to prevent or help resolve IAQ problems, guidelines on specific indoor contaminants, recommendations…

  14. Quality Control Guidelines for SAM Radiochemical Methods

    EPA Pesticide Factsheets

    Learn more about quality control guidelines and recommendations for the analysis of samples using the radiochemistry methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

  15. Quality Control Guidelines for SAM Biotoxin Methods

    EPA Pesticide Factsheets

    Learn more about quality control guidelines and recommendations for the analysis of samples using the pathogen methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

  16. Quality Control Guidelines for SAM Pathogen Methods

    EPA Pesticide Factsheets

    Learn more about quality control guidelines and recommendations for the analysis of samples using the biotoxin methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

  17. Quality Control Guidelines for SAM Chemical Methods

    EPA Pesticide Factsheets

    Learn more about quality control guidelines and recommendations for the analysis of samples using the chemistry methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

  18. Sandia software guidelines: Software quality planning

    SciTech Connect

    Not Available

    1987-08-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. In consonance with the IEEE Standard for Software Quality Assurance Plans, this volume identifies procedures to follow in producing a Software Quality Assurance Plan for an organization or a project, and provides an example project SQA plan. 2 figs., 4 tabs.

  19. Quality of clinical practice guidelines in delirium: a systematic appraisal

    PubMed Central

    Marchington, Katie L; Agar, Meera; Davis, Daniel H J; Sikora, Lindsey; Tsang, Tammy W Y

    2017-01-01

    Objective To determine the accessibility and currency of delirium guidelines, guideline summary papers and evaluation studies, and critically appraise guideline quality. Design Systematic literature search for formal guidelines (in English or French) with focus on delirium assessment and/or management in adults (≥18 years), guideline summary papers and evaluation studies. Full appraisal of delirium guidelines published between 2008 and 2013 and obtaining a ‘Rigour of Development’ domain screening score cut-off of >40% using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Data sources Multiple bibliographic databases, guideline organisation databases, complemented by a grey literature search. Results 3327 database citations and 83 grey literature links were identified. A total of 118 retrieved delirium guidelines and related documents underwent full-text screening. A final 21 delirium guidelines (with 10 being >5 years old), 12 guideline summary papers and 3 evaluation studies were included. For 11 delirium guidelines published between 2008 and 2013, the screening AGREE II ‘Rigour’ scores ranged from 3% to 91%, with seven meeting the cut-off score of >40%. Overall, the highest rating AGREE II domains were ‘Scope and Purpose’ (mean 80.1%, range 64–100%) and ‘Clarity and Presentation’ (mean 76.7%, range 38–97%). The lowest rating domains were ‘Applicability’ (mean 48.7%, range 8–81%) and ‘Editorial Independence’ (mean 53%, range 2–90%). The three highest rating guidelines in the ‘Applicability’ domain incorporated monitoring criteria or audit and costing templates, and/or implementation strategies. Conclusions Delirium guidelines are best sourced by a systematic grey literature search. Delirium guideline quality varied across all six AGREE II domains, demonstrating the importance of using a formal appraisal tool prior to guideline adaptation and implementation into clinical settings. Adding more

  20. 76 FR 17064 - Shared Use Path Accessibility Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-28

    ... pedestrians, bicyclists, skaters, equestrians, and other users. The guidelines will include technical... Urban Development, and United States Postal Service are authorized to issue enforceable accessibility... Facilities'' (July 2004) and the ``Guide for the Development of Bicycle Facilities'' (1999)....

  1. 75 FR 37819 - Proposed Information Quality Guidelines Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... SECURITY Proposed Information Quality Guidelines Policy ACTION: Notice and request for public comment on Proposed Information Quality Guidelines. SUMMARY: These guidelines should be used to ensure and maximize the quality of disseminated information. The Department's guidelines are based on the guidelines...

  2. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Department of Justice adopted the 2010 ADA Standards for Accessible Design (2010 Standards) as the regulatory.... Complete copies of the 2010 Standards can be obtained from the Department of Justice's ADA Web site...

  3. MedlinePlus: Quality Guidelines

    MedlinePlus

    ... reviewed/quality-filtered. The primary purpose of the Web page is educational and not to sell a ... in the directories. Availability and maintenance of the Web page The Web site is available consistently and ...

  4. [Guidelines for quality management of dialysis solutions].

    PubMed

    Pérez García, R; González Parra, E; Ceballos, F; Escallada Cotero, R; Gómez-Reino, Ma I; Martín-Rabadán, P; Pérez García, A; Ramírez Chamond, R; Sobrino, P E; Solozábal, C

    2004-01-01

    A Best Practice Guideline about Dialysis fluid purity has been developed under the leadership of the Spanish Society of Nephrology. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. The Guideline was based on the European pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis (Section IV), literature reviews, according to their level of evidence, and the opinion of the expert spanish group. Two levels of quality of water were defined: purified water and high purified water (Ultra pure) and for dialysate: standard dialysate and ultra pure dialysate. Regular use of ultra pure dialysate is necessary for hemofiltration and hemodiafiltration on-line and desirable for high-flux hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anemia and amyloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (1.1.2), microbial and endotoxins: [table: see text] Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (Anexos). For microbiological monitoring, TSA or R2A medium are recommended, incubated during 5 days at a temperature of 30-35 degrees C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org

  5. Canadian water quality guidelines. Appendix 22: Interim marine and estuarine water quality guidelines for general variables

    SciTech Connect

    1996-12-31

    This document has been prepared in response to the need for marine water quality guidelines for general water quality variables. It presents interim guidelines, summaries of existing guidelines if any, the rationale for the guidelines, and variable-specific background information, and notes gaps in data, for the following variables: Debris, including floating or submerged litter, and settleable matter; dissolved oxygen; pH; salinity; temperature; and suspended solids and turbidity. For the purpose of this document, the marine environment includes shorelines, estuaries up to the freshwater limit, and nearshore and offshore waters.

  6. 76 FR 77738 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... Accessibility Guidelines; Electronic and Information Technology Accessibility Standards AGENCY: Architectural... Guidelines and its Electronic and Information Technology Accessibility Standards. DATES: The hearings will be... information technology covered by Section 508 of the Rehabilitation Act Amendments of 1998. 76 FR...

  7. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Fair Housing Accessibility Guidelines. 200.929a Section 200.929a Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT...

  8. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Fair Housing Accessibility Guidelines. 200.929a Section 200.929a Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT...

  9. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Fair Housing Accessibility Guidelines. 200.929a Section 200.929a Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT...

  10. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Fair Housing Accessibility Guidelines. 200.929a Section 200.929a Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT...

  11. 75 FR 43747 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ...The Architectural and Transportation Barriers Compliance Board (Access Board) is proposing to revise and update its accessibility guidelines for buses, over-the-road buses, and vans. The guidelines ensure that transportation vehicles are readily accessible to and usable by individuals with disabilities. The guidelines apply to the acquisition of new, used, and remanufactured transportation......

  12. 13 point video tape quality guidelines

    SciTech Connect

    Gaunt, R.

    1997-05-01

    Until high definition television (ATV) arrives, in the U.S. we must still contend with the National Television Systems Committee (NTSC) video standard (or PAL or SECAM-depending on your country). NTSC, a 40-year old standard designed for transmission of color video camera images over a small bandwidth, is not well suited for the sharp, full-color images that todays computers are capable of producing. PAL and SECAM also suffers from many of NTSC`s problems, but to varying degrees. Video professionals, when working with computer graphic (CG) images, use two monitors: a computer monitor for producing CGs and an NTSC monitor to view how a CG will look on video. More often than not, the NTSC image will differ significantly from the CG image, and outputting it to NTSC as an artist works enables the him or her to see the images as others will see it. Below are thirteen guidelines designed to increase the quality of computer graphics recorded onto video tape. Viewing your work in NTSC and attempting to follow the below tips will enable you to create higher quality videos. No video is perfect, so don`t expect to abide by every guideline every time.

  13. 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

  14. General Quality Control (QC) Guidelines for SAM Methods

    EPA Pesticide Factsheets

    Learn more about quality control guidelines and recommendations for the analysis of samples using the methods listed in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

  15. Methodological Quality of Consensus Guidelines in Implant Dentistry

    PubMed Central

    Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

    2017-01-01

    Background Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. Objective To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. Methods The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Results Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Conclusions Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions. PMID:28107405

  16. 75 FR 16088 - Proposed Information Quality Guidelines Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... COMMISSION Proposed Information Quality Guidelines Policy AGENCY: U.S. Election Assistance Commission (EAC). ACTION: Notice and request for public comment on Proposed Information Quality Guidelines Policy. SUMMARY: The U.S. Election Assistance Commission (EAC) seeks public comment on the Proposed Information...

  17. Web Content Accessibility Guidelines 2.0: A Further Step towards Accessible Digital Information

    ERIC Educational Resources Information Center

    Ribera, Mireia; Porras, Merce; Boldu, Marc; Termens, Miquel; Sule, Andreu; Paris, Pilar

    2009-01-01

    Purpose: The purpose of this paper is to explain the changes in the Web Content Accessibility Guidelines (WCAG) 2.0 compared with WCAG 1.0 within the context of its historical development. Design/methodology/approach: In order to compare WCAG 2.0 with WCAG 1.0 a diachronic analysis of the evolution of these standards is done. Known authors and…

  18. Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality

    PubMed Central

    Kirby, Joslyn S.; Scharnitz, Thomas; Seiverling, Elizabeth V.; Ahrns, Hadjh; Ferguson, Sara

    2015-01-01

    Actinic keratosis (AK) is a common precancerous skin lesion and many AK management guidelines exist, but there has been limited investigation into the quality of these documents. The objective of this study was to assess the strengths and weaknesses of guidelines that address AK management. A systematic search for guidelines with recommendations for AK was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE II) was used to appraise the quality of guidelines. Multiple raters independently reviewed each of the guidelines and applied the AGREE II tool and scores were calculated. Overall, 2,307 citations were identified and 7 fulfilled the study criteria. The Cancer Council of Australia/Australian Cancer Network guideline had the highest mean scores and was the only guideline to include a systematic review, include an evidence rating for recommendations, and report conflicts of interest and funding sources. High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated. Features such as concise tables, pictorial diagrams, and explicit links to evidence are helpful. However, the rigor and validity of some guidelines were weak. So, it is important for providers to be aware of the features that contribute to a high-quality, practical document. PMID:26451140

  19. Guidelines for appraisal and publication of PDSA quality improvement.

    PubMed

    Speroff, Theodore; James, Brent C; Nelson, Eugene C; Headrick, Linda A; Brommels, Mats

    2004-01-01

    Plan-do-study-act (PDSA) quality improvement is the application of the scientific method to implement and test the effects of change ideas on the performance of the health care system. Users of quality improvement could benefit with markers to gauge the "best" science. Four core questions can determine the value of a quality improvement study: Is the quality improvement study pertinent and relevant? Are the results valid? Are appropriate criteria used to interpret the results? Will the study help you with your practice or organization of care? A set of guidelines is provided to help answer these questions. Similar guidelines exist for randomized clinical trials and clinical-epidemiologic observational studies. Analogous to these existing research guidelines, the PDSA quality improvement guidelines will provide researchers and reviewers with succinct standards of methodological rigor to assist in critical appraisal of quality improvement protocols and publications.

  20. EFFECTIVE USE OF SEDIMENT QUALITY GUIDELINES: WHICH GUIDELINE IS RIGHT FOR ME?

    EPA Science Inventory

    A bewildering array of sediment quality guidelines have been developed, but fortunately they mostly fall into two families: empirically-derived and theoretically-derived. The empirically-derived guidelines use large data bases of concurrent sediment chemistry and biological effe...

  1. 78 FR 67303 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... From the Federal Register Online via the Government Publishing Office ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1191 RIN 3014-AA22 Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities; Architectural Barriers Act (ABA) Accessibility...

  2. 77 FR 50068 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-20

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1192 RIN 3014-AA38 Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles AGENCY: Architectural and Transportation Barriers... Architectural and Transportation Barriers Compliance Board (Access Board) is holding a public...

  3. 75 FR 54543 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... accessibility guidelines for buses, over-the-road buses, and vans. DATES: The first public hearing will be held...) in the Federal Register to revise and update its accessibility guidelines for buses, over-the-road buses, and vans. 75 FR 43748 (July 26, 2010). The comment period on the proposed rule ends on...

  4. Guidelines for Inclusion: Ensuring Access to Education for All

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization (UNESCO), 2005

    2005-01-01

    These guidelines were created by UNESCO to assist countries in making National Plans for Education more inclusive, recognizing that there was a lack of guidelines to assist in this important process. This document thus provides guidelines and concepts for rendering National Education Plans / Education for All (EFA) more inclusive, with the…

  5. 75 FR 13457 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... Accessibility Guidelines; Electronic and Information Technology Accessibility Standards AGENCY: Architectural... Notice of Proposed Rulemaking (ANPRM) to begin the process of updating its standards for electronic and... (voice); 202- 272-0082 (TTY). Electronic mail address: board.gov ">creagan@access-...

  6. 78 FR 59475 - Architectural Barriers Act Accessibility Guidelines; Outdoor Developed Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ...We, the Architectural and Transportation Barriers Compliance Board (Access Board), are issuing a final rule that amends the Architectural Barriers Act Accessibility Guidelines by adding scoping and technical requirements for camping facilities, picnic facilities, viewing areas, trails, and beach access routes constructed or altered by or on behalf of federal agencies. The final rule ensures......

  7. An evaluation of the Essential Medicines List, Standard Treatment Guidelines and prescribing restrictions, as an integrated strategy to enhance quality, efficacy and safety of and improve access to essential medicines in Papua New Guinea.

    PubMed

    Joshua, Isaac B; Passmore, Phillip R; Sunderland, Bruce V

    2016-05-01

    The World Health Organization (WHO) has advocated the development and use of country specific Standard Treatment Guidelines (STGs) and Essential Medicines Lists (EML) as strategies to promote the rational use of medicines. When implemented effectively STGs offer many health advantages. Papua New Guinea (PNG) has official STGs and a Medical and Dental Catalogue (MDC) which serves as a national EML for use at different levels of health facilities. This study evaluated consistency between the PNG Adult STGs (2003 and 2012) and those for children (2005 and 2011) with respect to the MDCs (2002, 2012) for six chronic and/or acute diseases: asthma, arthritis, diabetes, hypertension, pneumonia and psychosis. Additionally, the potential impact of prescriber level restrictions on rational medicines use for patient's living in rural areas, where no medical officer is present, was evaluated. Almost all drugs included in the STGs for each disease state evaluated were listed in the MDCs. However, significant discrepancies occurred between the recommended treatments in the STGs with the range of related medicines listed in the MDCs. Many medicines recommended in the STGs for chronic diseases had prescriber level restrictions hindering access for most of the PNG population who live in rural and remote areas. In addition many more medicines were listed in the MDCs which are commonly used to treat arthritis, high blood pressure and psychosis than were recommended in the STGs contributing to inappropriate prescribing. We recommend the public health and rational use of medicines deficiencies associated with these findings are addressed requiring: reviewing prescriber level restrictions; updating the STGs; aligning the MDC to reflect recommendations in the STGs; establishing the process where the MDC would automatically be updated based on any changes made to the STGs; and developing STGs for higher levels of care.

  8. Practical guidelines for radiographers to improve computed radiography image quality.

    PubMed

    Pongnapang, N

    2005-10-01

    Computed Radiography (CR) has become a major digital imaging modality in a modern radiological department. CR system changes workflow from the conventional way of using film/screen by employing photostimulable phosphor plate technology. This results in the changing perspectives of technical, artefacts and quality control issues in radiology departments. Guidelines for better image quality in digital medical enterprise include professional guidelines for users and the quality control programme specifically designed to serve the best quality of clinical images. Radiographers who understand technological shift of the CR from conventional method can employ optimization of CR images. Proper anatomic collimation and exposure techniques for each radiographic projection are crucial steps in producing quality digital images. Matching image processing with specific anatomy is also important factor that radiographers should realise. Successful shift from conventional to fully digitised radiology department requires skilful radiographers who utilise the technology and a successful quality control program from teamwork in the department.

  9. Rethinking equal access: agency, quality, and norms.

    PubMed

    Ruger, J P

    2007-01-01

    In 2005 the Global Health Council convened healthcare providers, community organizers, policymakers and researchers at Health Systems: Putting Pieces Together to discuss health from a systems perspective. Its report and others have established healthcare access and quality as two of the most important issues in health policy today. Still, there is little agreement about what equal access and quality mean for health system development. At the philosophical level, few have sought to understand why differences in healthcare quality are morally so troubling. While there has been considerable work in medical ethics on equal access, these efforts have neglected health agency (individuals' ability to work toward health goals they value) and health norms, both of which influence individuals' ability to be healthy. This paper argues for rethinking equal access in terms of an alternative ethical aim: to ensure the social conditions in which all individuals have the capability to be healthy. This perspective requires that we examine injustices not just by the level of healthcare resources, but by the: (1) quality of those resources and their capacity to enable effective health functioning; (2) extent to which society supports health agency so that individuals can convert healthcare resources into health functioning; and (3) nature of health norms, which affect individuals' efforts to achieve functioning.

  10. RTOG quality assurance guidelines for interstitial hyperthermia.

    PubMed

    Emami, B; Stauffer, P; Dewhirst, M W; Prionas, S; Ryan, T; Corry, P; Herman, T; Kapp, D S; Myerson, R J; Samulski, T

    1991-05-01

    This document specifies the current recommendations for quality assurance for hyperthermia administration with interstitial techniques as specified by the Radiation Therapy Oncology Group (RTOG). The document begins by providing a brief description of the physical principles behind the use of the three most commonly used methods of interstitial hyperthermia: radiofrequency (RF-LCF), microwave antennas, and ferromagnetic seeds. Emphasis is placed on features that effect quality assurance. Specific recommendations are provided for: a) Pretreatment planning and equipment performance checks, b) Implant considerations and documentation, c) Thermometry, and d) Safety procedures. Specific details regarding quality assurance issues that are common to all local and regional hyperthermia methods are outlined in previous documents sponsored by the RTOG. It is anticipated that technological advances may lead to future modifications of this document.

  11. Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles. Final rule.

    PubMed

    2016-12-14

    The Architectural and Transportation Barriers Compliance Board (Access Board or Board) is issuing a final rule that revises its existing accessibility guidelines for non-rail vehicles--namely, buses, over-the-road buses, and vans--acquired or remanufactured by entities covered by the Americans with Disabilities Act. The revised guidelines ensure that such vehicles are readily accessible to, and usable by, individuals with disabilities. The U.S. Department of Transportation (DOT) is required to revise its accessibility standards for transportation vehicles acquired or remanufactured by entities covered by the Americans with Disabilities Act (ADA) to be consistent with the final rule.

  12. How to Develop State Guidelines for Access Assistants: Scribes, Readers, and Sign Language Interpreters

    ERIC Educational Resources Information Center

    Clapper, Ann T.; Morse, Amanda B.; Thurlow, Martha L.; Thompson, Sandra J.

    2006-01-01

    This manual offers states a tool to assist in the development or enhancement of guidelines for access assistants. Whether a state already has guidelines or is just in the process of establishing them, this manual will provide structure to the process and many examples of criteria already included by states. This manual was developed to accompany…

  13. Americans with Disabilities Act: Accessibility Guidelines for Buildings and Facilities, Transportation Facilities, Transportation Vehicles.

    ERIC Educational Resources Information Center

    Architectural and Transportation Barriers Compliance Board, Washington, DC.

    Guidelines are presented regarding accessibility to buildings and facilities, transportation facilities, and transportation vehicles by individuals with disabilities, under the Americans with Disabilities Act of 1990. These guidelines are to be applied during building design, construction, and alteration. Part 1 offers detailed facility…

  14. Formulating Independent School K-12 Quality Physical Education Program Guidelines

    ERIC Educational Resources Information Center

    Currie, Stuart M.; Phillips, Michael B.; Jubenville, Colby B.

    2012-01-01

    The purpose of this study was to formulate Tennessee independent school K-12 quality physical education program guidelines. A panel of 18 physical education representatives from Tennessee independent schools K-12 participated in a three-phase Delphi study and completed three opinionnaires via e-mail. In Phase One, Opinionnaire One solicited panel…

  15. 77 FR 56590 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... 56590-56591] [FR Doc No: 2012-22554] ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR...) Accessibility Guidelines for Transportation Vehicles AGENCY: Architectural and Transportation Barriers... Barriers Compliance Board (Access Board) is holding an information meeting in Seattle, WA on October...

  16. Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

    SciTech Connect

    Taggart, J.; Sikora, J.; Wiehagen, J.; Wood, A.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling and quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.

  17. 76 FR 51060 - Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... Commission has disseminated elsewhere. Archival records, including library holdings. Archival information... Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity of Information AGENCY... guidelines to ensure and maximize the quality, objectivity, utility, and integrity of...

  18. Impact of air quality guidelines on COPD sufferers

    PubMed Central

    Liu, Youcheng; Yan, Shuang; Poh, Karen; Liu, Suyang; Iyioriobhe, Emanehi; Sterling, David A

    2016-01-01

    Background COPD is one of the leading causes of morbidity and mortality in both high- and low-income countries and a major public health burden worldwide. While cigarette smoking remains the main cause of COPD, outdoor and indoor air pollution are important risk factors to its etiology. Although studies over the last 30 years helped reduce the values, it is not very clear if the current air quality guidelines are adequately protective for COPD sufferers. Objective This systematic review was to summarize the up-to-date literature on the impact of air pollution on the COPD sufferers. Methods PubMed and Google Scholar were utilized to search for articles related to our study’s focus. Search terms included “COPD exacerbation”, “air pollution”, “air quality guidelines”, “air quality standards”, “COPD morbidity and mortality”, “chronic bronchitis”, and “air pollution control” separately and in combination. We focused on articles from 1990 to 2015. We also used articles prior to 1990 if they contained relevant information. We focused on articles written in English or with an English abstract. We also used the articles in the reference lists of the identified articles. Results Both short-term and long-term exposures to outdoor air pollution around the world are associated with the mortality and morbidity of COPD sufferers even at levels below the current air quality guidelines. Biomass cooking in low-income countries was clearly associated with COPD morbidity in adult nonsmoking females. Conclusion There is a need to continue to improve the air quality guidelines. A range of intervention measures could be selected at different levels based on countries’ socioeconomic conditions to reduce the air pollution exposure and COPD burden. PMID:27143874

  19. Canadian soil quality guidelines for copper: Environmental and human health

    SciTech Connect

    1997-12-31

    This report begins with background information on the physical and chemical properties of copper, the production and use of copper in Canada, its levels in the Canadian environment, and existing guidelines and criteria regarding copper concentrations in various media. It then reviews the environmental fate and behaviour of copper, notably in the soil; the behavior and effects of copper in biota, including soil microbial processes, terrestrial plants and invertebrates, livestock and wildlife, and bioaccumulation; and the pharmacokinetics and toxicology of copper in mammals and humans, concluding with an overall toxicological evaluation and human exposure estimates. This information is used to derive environmental and human health soil quality guidelines for copper to protect environmental and human health receptors, for agricultural, residential/parkland, commercial, and industrial land uses.

  20. Guidelines for the microbiological quality of treated wastewater used in agriculture: recommendations for revising WHO guidelines.

    PubMed Central

    Blumenthal, U. J.; Mara, D. D.; Peasey, A.; Ruiz-Palacios, G.; Stott, R.

    2000-01-01

    Three different approaches for establishing guidelines for the microbiological quality of treated wastewater that is reused for agriculture are reviewed. These approaches have different objectives as their outcomes: the absence of faecal indicator organisms in the wastewater, the absence of a measurable excess of cases of enteric disease in the exposed population and a model-generated estimated risk below a defined acceptable risk. If the second approach (using empirical epidemiological studies supplemented by microbiological studies of the transmission of pathogens) is used in conjunction with the third approach (using a model-based quantitative risk assessment for selected pathogens) a powerful tool is produced that aids the development of regulations. This combined approach is more cost-effective than the first approach and adequately protects public health. The guideline limit for faecal coliform bacteria in unrestricted irrigation (< or = 1000 faecal coliform bacteria/ 100 ml) is valid, but for restricted irrigation < or = 10(5) faecal coliform bacteria/100 ml is recommended when adult farmworkers are exposed to spray irrigation. A limit of < or = 10(3) faecal coliform bacteria/100 ml is recommended if flood irrigation is used or children are exposed. The guideline limit for nematode eggs for both types of irrigation is adequate except when conditions favour the survival of nematode eggs and where children are exposed; in these cases it should be reduced from < or = 1 egg/l to < or = 0.1 egg/l. PMID:11019459

  1. Access, quality and costs of prenatal diagnosis.

    PubMed

    Izquierdo, Luis A; Berkshire, Steven

    2010-01-01

    The background risk of birth defects ranges from 2 to 5%. These birth defects are responsible for 30% of all admissions to pediatric hospitals and are responsible for a large proportion of neonatal and infant deaths. Medicine and Genetics have taken giant steps in their ability to detect and treat genetic disorders in utero. Screening tests for prenatal diagnosis should be offered to all pregnant women to assess their risk of having a baby with a birth defect or genetic disorder. Psychosocial and financial factors, inadequate insurance coverage, and the inability to pay for health care services are some of the known barriers to healthcare. These barriers are particularly magnified when there is a language barrier. From an economical standpoint it has been demonstrated that prenatal diagnosis has the potential of saving millions of dollars to our healthcare system. But when patients do not have the resources to access prenatal care and prenatal diagnosis cost shifting occurs, escalating healthcare costs. Our current healthcare system promotes inequalities in its delivery. With the existing barriers to access, quality, and costs of prenatal diagnosis we are confronted with an inefficient and flawed system.

  2. Consensus sediment quality guidelines for polycyclic aromatic hydrocarbon mixtures

    SciTech Connect

    Swartz, R.C.

    1999-04-01

    Sediment quality guidelines (SQGs) for polycyclic aromatic hydrocarbons (PAHs) have been derived from a variety of laboratory, field, and theoretical foundations. They include the screening level concentration, effects ranges-low and -median, equilibrium partitioning concentrations, apparent effects threshold, {Sigma}PAH model, and threshold and probable effects levels. The resolution of controversial differences among the PAH SQGs lies in an understanding of the effects of mixtures. Polycyclic aromatic hydrocarbons virtually always occur in field-collected sediment as a complex mixture of covarying compounds. When expressed as a mixture concentration, that is, total PAH (TPAH), the guidelines form three clusters that were intended in their original derivations to represent threshold (TEC = 290 {micro}g/g organic carbon [OC]), median (MEC = 1,800 {micro}g/g OC), and extreme (EEC = 10,000 {micro}g/g OC) effects concentrations. The TEC/MEC/EEC consensus guidelines provide a unifying synthesis of other SQGs, reflect causal rather than correlative effects, account for mixtures, and predict sediment toxicity and benthic community perturbations at sites of PAH contamination. The TEC offers the most useful SQG because PAH mixtures are unlikely to cause adverse effects on benthic ecosystems below the TEC.

  3. The cost of implementing the Dialysis Outcomes Quality Initiative Clinical Practice Guidelines.

    PubMed

    Wish, J; Roberts, J; Besarab, A; Owen, W F

    1999-01-01

    For a clinical practice guideline to be accepted by the end-user, the system of reimbursement for the targeted service must be favorable. The National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) Guideline recommendations were developed without primary concern for the costs of their execution. Arguably, an unfavorable financial environment and excessive mercantile behavior by providers and payers would offer a considerable hindrance to their implementation. Toward addressing these concerns, three leaders in the development of the DOQI Guidelines for the Treatment of Anemia of Chronic Renal Failure, Hemodialysis Adequacy, and Vascular Access, have evaluated the hypothesis that implementing the recommendations of the DOQI Guidelines will increase the treatment costs for dialysis providers but will effect savings in the entire end-stage renal disease (ESRD) program. Their analyses suggest that under the current reimbursement system, this assumption may be true. However, restructured global reimbursement in the ESRD program will permit financial incentives for dialysis providers and the payer to coincide.

  4. [Quality indicators for National Disease Management Guidelines using the example of the National Disease Management Guideline for "Chronic Heart Failure"].

    PubMed

    Nothacker, Monika Judith; Langer, Thomas; Weinbrenner, Susanne

    2011-01-01

    Together with an expert committee a structured approach to determining quality indicators for National Disease Management Guidelines has been developed. The key steps of this approach include: introducing guideline authors to the methodology at an early stage of the process of guideline development, pre-selecting recommendations of the guideline which are potentially measurable by means of quality indicators, assessing the potentially measurable quality indicators in written form using five criteria (including their importance for the health care system and clarity of definitions) and approving them in a formal consensus process. For lack of a database these quality indicators must be regarded as preliminary. For the National Disease Management Guideline "Chronic Heart Failure" nine rate-based indicators have been chosen. The indicators correspond to important strong recommendations (grade of recommendation: A) from the fields of diagnosis (two), general therapeutic strategy (two), specific treatment (three), clinical monitoring (one) and co-ordination of care (one). In a second step, the quality indicators have to be validated within a pilot project. The determination and assessment of the potential quality indicators have revealed room for improvement of guideline development. In particular, there is a need for more health care data and for specification of recommendations.

  5. The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration

    PubMed Central

    Ogrinc, G; Mooney, S E; Estrada, C; Foster, T; Goldmann, D; Hall, L W; Huizinga, M M; Liu, S K; Mills, P; Neily, J; Nelson, W; Pronovost, P J; Provost, L; Rubenstein, L V; Speroff, T; Splaine, M; Thomson, R; Tomolo, A M; Watts, B

    2008-01-01

    As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This “Explanation and Elaboration” document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org. PMID:18836062

  6. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Guideline on Air Quality Models W... 51—Guideline on Air Quality Models Preface a. Industry and control agencies have long expressed a need for consistency in the application of air quality models for regulatory purposes. In the...

  7. The Impact Factor: Implications of Open Access on Quality

    ERIC Educational Resources Information Center

    Grozanick, Sara E.

    2010-01-01

    There has been debate about the extent to which open access affects the quality of scholarly work. At the same time, researchers have begun to look for ways to evaluate the quality of open access publications. Dating back to the growth of citation indexes during the 1960s and 1970s, citation analysis--examining citation statistics--has since been…

  8. Inequity in Access to Guideline-Recommended Colorectal Cancer Treatment in Nova Scotia, Canada

    PubMed Central

    Maddison, André R.; Asada, Yukiko; Urquhart, Robin; Johnston, Grace; Burge, Frederick; Porter, Geoff

    2012-01-01

    Cancer continues to be one of the heaviest burdens of disease in Canada, and assessing potential inequities in access to cancer care may serve as a barometer of the health of Canadian health systems. This study tackled three limitations of the current literature by clearly differentiating between inequality and inequity, by assessing inequity in receipt of care and wait times for care, and by taking advantage of inequity indices to enhance comparability of inequities between studies and populations. We measured income-, age-, sex- and distance-related inequities among colorectal cancer (CRC) patients in Nova Scotia by accounting for clinical guidelines and patient need. Results reveal statistically significant inequity in access to chemotherapy and radiotherapy for CRC by age, sex and distance, but not income. This study demonstrates the importance of carefully examining inequity in access to cancer care and highlights one method to report and compare inequities with conceptual clarity. PMID:23968617

  9. QUALITY ASSURANCE GUIDELINES FOR LABORATORIES PERFORMING FORENSIC ANALYSIS OF CHEMICAL TERRORISM

    EPA Science Inventory

    The Scientific Working Group on Forensic Analysis of Chemical Terrorism (SWGFACT) has developed the following quality assurance guidelines to provide laboratories engaged in forensic analysis of chemical evidence associated with terrorism a framework to implement a quality assura...

  10. Inequality in Preschool Quality? Community-Level Disparities in Access to High-Quality Learning Environments

    ERIC Educational Resources Information Center

    Bassok, Daphna; Galdo, Eva

    2016-01-01

    In recent years, unequal access to high-quality preschool has emerged as a growing public policy concern. Because of data limitations, it is notoriously difficult to measure disparities in access to early learning opportunities across communities and particularly challenging to quantify gaps in access to "high-quality" programs. Research…

  11. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2007-07-01

    ... 40 Protection of Environment 2 2007-07-01 2007-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  12. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2008-07-01

    ... 40 Protection of Environment 2 2008-07-01 2008-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  13. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2004-07-01

    ... 40 Protection of Environment 2 2004-07-01 2004-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  14. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2009-07-01

    ... 40 Protection of Environment 2 2009-07-01 2009-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  15. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2015-07-01

    ... 40 Protection of Environment 2 2015-07-01 2015-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  16. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2005-07-01

    ... 40 Protection of Environment 2 2005-07-01 2005-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  17. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2016-07-01

    ... 40 Protection of Environment 2 2016-07-01 2016-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  18. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  19. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality...

  20. Distance Education: Access, Quality, Cautions, and Opportunities

    ERIC Educational Resources Information Center

    Edelson, Paul Jay

    2013-01-01

    Assessing the impact of widely distributed learning opportunities now accessible through distance education must take into account the re-imposition of values and motives long associated with traditional education. The expectations of new higher education consumers should be tempered by institutional acknowledgement of pre-existing value…

  1. Quality Improvement Guidelines for Radiofrequency Ablation of Liver Tumours

    SciTech Connect

    Crocetti, Laura; Baere, Thierry de; Lencioni, Riccardo

    2010-02-15

    The development of image-guided percutaneous techniques for local tumour ablation has been one of the major advances in the treatment of liver malignancies. Among these methods, radiofrequency ablation (RFA) is currently established as the primary ablative modality at most institutions. RFA is accepted as the best therapeutic choice for patients with early-stage hepatocellular carcinoma (HCC) when liver transplantation or surgical resection are not suitable options [1, 2]. In addition, RFA is considered a viable alternate to surgery (1) for inoperable patients with limited hepatic metastatic disease, especially from colorectal cancer, and (2) for patients deemed ineligible for surgical resection because of extent and location of the disease or concurrent medical conditions [3]. These guidelines were written to be used in quality-improvement programs to assess RFA of HCC and liver metastases. The most important processes of care are (1) patient selection, (2) performing the procedure, and (3) monitoring the patient. The outcome measures or indicators for these processes are indications, success rates, and complication rates.

  2. Quality of internet access: barrier behind internet use statistics.

    PubMed

    Skinner, Harvey; Biscope, Sherry; Poland, Blake

    2003-09-01

    The rapid growth of the Internet is increasingly international with young people being the early adopters in most countries. However, the quality of Internet access looms as a major barrier hidden behind Internet use statistics. The goal of this study was to provide an in-depth evaluation of young people's perspectives on using the Internet to obtain health information and resources (e-health). Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 young participants were selected to reflect diversity in age, sex, geographic location, cultural identity and risk. A major finding was how the quality of Internet access influenced young people's ability to obtain health information and resources. Quality of Internet access was affected by four key factors: 1. Privacy, 2. Gate-keeping, 3. Timeliness and 4. Functionality. Privacy was particularly relevant to these young people in getting access to sensitive health information (e.g. sexual activities). Variations in access quality also impacted participation in mutual support, fostering social networks and getting specific health questions answered. These results serve as a warning about using Internet penetration statistics alone as a measure of access. Concerted attention is needed on improving the quality of Internet access for achieving the potential of e-health. This is imperative for addressing the digital divide affecting populations both within countries and globally between countries.

  3. 76 FR 75844 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way; Reopening of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-05

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1190 RIN 3014-AA26 Accessibility Guidelines for Pedestrian... Barriers Compliance Board. ACTION: Notice of proposed rulemaking; reopening of comment period. SUMMARY: The Architectural and Transportation Barriers Compliance Board (Access Board) is reopening until February 2,...

  4. Strategy Guideline: Quality Management in Existing Homes - Cantilever Floor Example

    SciTech Connect

    Taggart, J.; Sikora, J.; Wiehagen, J.; Wood, A.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented.

  5. Quality Improvement Strategies and Best Practices in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Casey, Michelle M.; Moscovice, Ira

    2004-01-01

    Critical access hospitals (CAHs) face many challenges in implementing quality improvement (QI) initiatives, which include limited resources, low volume of patients, small staffs, and inadequate information technology. A primary goal of the Medicare Rural Hospital Flexibility Program is to improve the quality of care provided by CAHs. This article…

  6. Dilated eye examination screening guideline compliance among patients with diabetes without a diabetic retinopathy diagnosis: the role of geographic access

    PubMed Central

    Lee, David J; Kumar, Naresh; Feuer, William J; Chou, Chiu-Fang; Rosa, Potyra R; Schiffman, Joyce C; Morante, Alexis; Aldahan, Adam; Staropoli, Patrick; Fernandez, Cristina A; Tannenbaum, Stacey L; Lam, Byron L

    2014-01-01

    Objective To estimate the prevalence of, and factors associated with, dilated eye examination guideline compliance among patients with diabetes mellitus (DM), but without diabetic retinopathy. Research design and methods Utilizing the computerized billing records database, we identified patients with International Classification of Diseases (ICD)-9 diagnoses of DM, but without any ocular diagnoses. The available medical records of patients in 2007–2008 were reviewed for demographic and ocular information, including visits through 2010 (n=200). Patients were considered guideline compliant if they returned at least every 15 months for screening. Participant street addresses were assigned latitude and longitude coordinates to assess their neighborhood socioeconomic status (using the 2000 US census data), distance to the screening facility, and public transportation access. Patients not compliant, based on the medical record review, were contacted by phone or mail and asked to complete a follow-up survey to determine if screening took place at other locations. Results The overall screening compliance rate was 31%. Patient sociodemographic characteristics, insurance status, and neighborhood socioeconomic measures were not significantly associated with compliance. However, in separate multivariable logistic regression models, those living eight or more miles from the screening facility were significantly less likely to be compliant relative to those living within eight miles (OR=0.36 (95% CI 0.14 to 0.86)), while public transit access quality was positively associated with screening compliance (1.34 (1.07 to 1.68)). Conclusions Less than one-third of patients returned for diabetic retinopathy screening at least every 15 months, with transportation challenges associated with noncompliance. Our results suggest that reducing transportation barriers or utilizing community-based screening strategies may improve compliance. PMID:25452871

  7. [Tools to enhance the quality and transparency of health research reports: reporting guidelines].

    PubMed

    Galvão, Taís Freire; Silva, Marcus Tolentino; Garcia, Leila Posenato

    2016-01-01

    Scientific writing is the cornestone for publishing the results of research. Reporting guidelines are important tools for all those involved in the process of research production and report writing. These guidelines detail what is expected to be found in each section of a report for a given study design. The EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research) is an international initiative that seeks to improve the reliability and the value of health research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines. The use of reporting guidelines has contributed to improved reports as well as increased quality of research methods. Reporting guidelines need to be publicized in order to increase knowledge about these essential tools among health researchers. Encouraging their use by journals is key to enhancing the quality of scientific publications.

  8. ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

    PubMed

    Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

    2010-09-01

    Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.

  9. ITC Guidelines on Quality Control in Scoring, Test Analysis, and Reporting of Test Scores

    ERIC Educational Resources Information Center

    Allalouf, Avi

    2014-01-01

    The Quality Control (QC) Guidelines are intended to increase the efficiency, precision, and accuracy of the scoring, analysis, and reporting process of testing. The QC Guidelines focus on large-scale testing operations where multiple forms of tests are created for use on set dates. However, they may also be used for a wide variety of other testing…

  10. George M. Low Trophy NASA's Quality and Excellence Award, 1992. Application guidelines: Small business

    NASA Technical Reports Server (NTRS)

    1992-01-01

    Guidelines are given for the selection of small business candidates for the George M. Low Trophy, NASA's Quality and Excellence Award, 1992. Topics covered include candidate eligibility, the selection process milestone schedule, the nomination letter, and the application report.

  11. RFC: EPA's Action Plan for Bisphenol A Pursuant to EPA's Data Quality Guidelines

    EPA Pesticide Factsheets

    The American Chemistry Council (ACC) submits this Request for Correction to the U.S. Environmental Protection Agency under the Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity of Information Disseminated by the Environmental Protection Agency

  12. Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project

    PubMed Central

    Batalden, Paul; Stevens, David; Ogrinc, Greg; Mooney, Susan E

    2009-01-01

    In 2005 we published draft guidelines for reporting studies of quality improvement, as the initial step in a consensus process for development of a more definitive version. The current article contains the revised version, which we refer to as standards for quality improvement reporting excellence (SQUIRE). This narrative progress report summarises the special features of improvement that are reflected in SQUIRE, and describes major differences between SQUIRE and the initial draft guidelines. It also briefly describes the guideline development process; considers the limitations of and unresolved questions about SQUIRE; describes ancillary supporting documents and alternative versions under development; and discusses plans for dissemination, testing, and further development of SQUIRE. PMID:19153129

  13. Is open access sufficient? A review of the quality of open-access nursing journals.

    PubMed

    Crowe, Marie; Carlyle, Dave

    2015-02-01

    The present study aims to review the quality of open-access nursing journals listed in the Directory of Open Access Journals that published papers in 2013 with a nursing focus, written in English, and were freely accessible. Each journal was reviewed in relation to their publisher, year of commencement, number of papers published in 2013, fee for publication, indexing, impact factor, and evidence of requirements for ethics and disclosure statements. The quality of the journals was assessed by impact factors and the requirements for indexing in PubMed. A total of 552 were published in 2013 in the 19 open-access nursing journals that met the inclusion criteria. No journals had impact factors listed in Web of Knowledge, but three had low Scopus impact factors. Only five journals were indexed with PubMed. The quality of the 19 journals included in the review was evaluated as inferior to most subscription-fee journals. Mental health nursing has some responsibility to the general public, and in particular, consumers of mental health services and their families, for the quality of papers published in open-access journals. The way forward might involve dual-platform publication or a process that enables assessment of how research has improved clinical outcomes.

  14. An international study of the quality of national-level guidelines on driving with medical illness

    PubMed Central

    Rapoport, M.J.; Weegar, K.; Kadulina, Y.; Bédard, M.; Carr, D.; Charlton, J.L.; Dow, J.; Gillespie, I.A.; Hawley, C.A.; Koppel, S.; McCullagh, S.; Molnar, F.; Murie-Fernández, M.; Naglie, G.; Shortt, S.; Simpson, C.; Tuokko, H.A.; Vrkljan, B.H.; Marshall, S.

    2015-01-01

    Background: Medical illnesses are associated with a modest increase in crash risk, although many individuals with acute or chronic conditions may remain safe to drive, or pose only temporary risks. Despite the extensive use of national guidelines about driving with medical illness, the quality of these guidelines has not been formally appraised. Aim: To systematically evaluate the quality of selected national guidelines about driving with medical illness. Design: A literature search of bibliographic databases and Internet resources was conducted to identify the guidelines, each of which was formally appraised. Methods: Eighteen physicians or researchers from Canada, Australia, Ireland, USA and UK appraised nine national guidelines, applying the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Results: Relative strengths were found in AGREE II scores for the domains of scope and purpose, stakeholder involvement and clarity of presentation. However, all guidelines were given low ratings on rigour of development, applicability and documentation of editorial independence. Overall quality ratings ranged from 2.25 to 5.00 out of 7.00, with modifications recommended for 7 of the guidelines. Intra-class coefficients demonstrated fair to excellent appraiser agreement (0.57–0.79). Conclusions: This study represents the first systematic evaluation of national-level guidelines for determining medical fitness to drive. There is substantive variability in the quality of these guidelines, and rigour of development was a relative weakness. There is a need for rigorous, empirically derived guidance for physicians and licensing authorities when assessing driving in the medically ill. PMID:25660605

  15. Efficient clinical evaluation of guideline quality: development and testing of a new tool

    PubMed Central

    2014-01-01

    Background Evaluating the methodological quality of clinical practice guidelines is essential before deciding which ones which could best inform policy or practice. One current method of evaluating clinical guideline quality is the research-focused AGREE II instrument. This uses 23 questions scored 1–7, arranged in six domains, which requires at least two independent testers, and uses a formulaic weighted domain scoring system. Following feedback from time-poor clinicians, policy-makers and managers that this instrument did not suit clinical need, we developed and tested a simpler, shorter, binary scored instrument (the iCAHE Guideline Quality Checklist) designed for single users. Methods Content and construct validity, inter-tester reliability and clinical utility were tested by comparing the new iCAHE Guideline Quality Checklist with the AGREE II instrument. Firstly the questions and domains in both instruments were compared. Six randomly-selected guidelines on a similar theme were then assessed by three independent testers with different experience in guideline quality assessment, using both instruments. Per guideline, weighted domain and total AGREE II scores were calculated, using the scoring rubric for three testers. Total iCAHE scores were calculated per guideline, per tester. The linear relationship between iCAHE and AGREE II scores was assessed using Pearson r correlation coefficients. Score differences between testers were assessed for the iCAHE Guideline Quality Checklist. Results There were congruent questions in each instrument in four domains (Scope & Purpose, Stakeholder involvement, Underlying evidence/Rigour, Clarity). The iCAHE and AGREE II scores were moderate to strongly correlated for the six guidelines. There was generally good agreement between testers for iCAHE scores, irrespective of their experience. The iCAHE instrument was preferred by all testers, and took significantly less time to administer than the AGREE II instrument. However

  16. Lateral-Directional Eigenvector Flying Qualities Guidelines for High Performance Aircraft

    NASA Technical Reports Server (NTRS)

    Davidson, John B.; Andrisani, Dominick, II

    1996-01-01

    This report presents the development of lateral-directional flying qualities guidelines with application to eigenspace (eigenstructure) assignment methods. These guidelines will assist designers in choosing eigenvectors to achieve desired closed-loop flying qualities or performing trade-offs between flying qualities and other important design requirements, such as achieving realizable gain magnitudes or desired system robustness. This has been accomplished by developing relationships between the system's eigenvectors and the roll rate and sideslip transfer functions. Using these relationships, along with constraints imposed by system dynamics, key eigenvector elements are identified and guidelines for choosing values of these elements to yield desirable flying qualities have been developed. Two guidelines are developed - one for low roll-to-sideslip ratio and one for moderate-to-high roll-to-sideslip ratio. These flying qualities guidelines are based upon the Military Standard lateral-directional coupling criteria for high performance aircraft - the roll rate oscillation criteria and the sideslip excursion criteria. Example guidelines are generated for a moderate-to-large, an intermediate, and low value of roll-to-sideslip ratio.

  17. Guidelines for the quality control of population pharmacokinetic-pharmacodynamic analyses: an industry perspective.

    PubMed

    Bonate, P L; Strougo, A; Desai, A; Roy, M; Yassen, A; van der Walt, J S; Kaibara, A; Tannenbaum, S

    2012-12-01

    Quality population modeling and simulation analyses and reports are something every modeler desires. However, little attention in the literature has been paid to what constitutes quality regarding population analyses. Very rarely do published manuscripts contain any statement about quality assurance of the modeling results contained therein. The purpose of this manuscript is to present guidelines for the quality assurance of population analyses, particularly with regards to the use of NONMEM from an industrial perspective. Quality guidelines are developed for the NONMEM installation itself, NONMEM data sets, control streams, output listings, output data files and resultant post-processing, reporting of results, and the review processes. These guidelines were developed to be thorough yet practical, though are not meant to be completely comprehensive. It is our desire to ensure that what is reported accurately reflects the collected data, the modeling process, and model outputs for a modeling project.

  18. Guideline for dialysate quality of Spanish Society of Nephrology (second edition, 2015).

    PubMed

    Pérez-García, Rafael; García Maset, Rafael; Gonzalez Parra, Emilio; Solozábal Campos, Carlos; Ramírez Chamond, Rafael; Martín-Rabadán, Pablo; Sobrino Pérez, Pedro Enrique; Gallego Pereira, Ovidio; Dominguez, Jon; de la Cueva Matute, Enrique; Ferllen, Ricardo

    2016-01-01

    A Best Practice Guideline about Dialysis fluid purity was developed under the leadership of the Spanish Society of Nephrology in 2004. The second edition revised Guideline considered new evidences and International Standard. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. This Guideline is based on the ISO13959, European Pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis, literature reviews, according to their level of evidence, and the opinion of the expert Spanish group. Two levels of quality of water were defined: purified water and high purified water (ultra pure) and for dialysate: ultra pure dialysate. Regular use of ultra pure dialysate is recommended for all type of hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anaemia and amiloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (4.1.2), conductivity, microbial and endotoxins (4.1.1): Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (anexos). For microbiological monitoring, R2A medium is recommended, incubated during 7-14 days at a temperature of 17-23°C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org.

  19. A Critical Analysis of the INQAAHE Guidelines of Good Practice for Higher Education Quality Assurance Agencies

    ERIC Educational Resources Information Center

    Blackmur, Douglas

    2008-01-01

    The International Network of Quality Assurance Agencies in Higher Education's Guidelines of Good Practice by higher education quality assurance agencies need substantial revision before they can be considered adequate by stakeholders in any national higher education system. Various revisions are proposed in this article. But the International…

  20. Elevating the quality of disability and rehabilitation research: mandatory use of the reporting guidelines.

    PubMed

    Chan, Leighton; Heinemann, Allen W; Roberts, Jason

    2014-01-01

    Note from the AJOT Editor-in-Chief: Since 2010, the American Journal of Occupational Therapy (AJOT) has adopted reporting standards based on the Consolidated Standards of Reporting Trials (CONSORT) Statement and American Psychological Association (APA) guidelines in an effort to publish transparent clinical research that can be easily evaluated for methodological and analytical rigor (APA Publications and Communications Board Working Group on Journal Article Reporting Standards, 2008; Moher, Schulz, & Altman, 2001). AJOT has now joined 28 other major rehabilitation and disability journals in a collaborative initiative to enhance clinical research reporting standards through adoption of the EQUATOR Network reporting guidelines, described below. Authors will now be required to use these guidelines in the preparation of manuscripts that will be submitted to AJOT. Reviewers will also use these guidelines to evaluate the quality and rigor of all AJOT submissions. By adopting these standards we hope to further enhance the quality and clinical applicability of articles to our readers.

  1. EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health-related quality of life measures.

    PubMed

    Muraro, A; Dubois, A E J; DunnGalvin, A; Hourihane, J O'B; de Jong, N W; Meyer, R; Panesar, S S; Roberts, G; Salvilla, S; Sheikh, A; Worth, A; Flokstra-de Blok, B M J

    2014-07-01

    Instruments have been developed and validated for the measurement of health-related quality of life in patients with food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group. It draws on a systematic review of the literature on quality of life instruments for food allergy and the Appraisal of Guidelines for Research & Evaluation (AGREE II) guideline development process. Guidance is provided on the use of such instruments in research, and the current limitations of their use in clinical practice are described. Gaps in current knowledge as well as areas of future interest are also discussed. This document is relevant to healthcare workers dealing with food-allergic patients, scientists engaging in food allergy research and policy makers involved in regulatory aspects concerning food allergy and safety.

  2. GENERAL GUIDELINES FOR USING THE SEDIMENT QUALITY TRIAD

    EPA Science Inventory

    The Sediment Quality Triad(Fig. 1),developed in the mid-1980s (Long and Chapman, 1985), is now widely used for conducting integrated assessments of sediment quality based on measures of chemistry,toxicity and benthos(e.g.,Canfield et al., 1994,1996,submitted; Carr et al., 1996;Ch...

  3. A comparison of inpatient glucose management guidelines: implications for patient safety and quality.

    PubMed

    Mathioudakis, Nestoras; Golden, Sherita Hill

    2015-03-01

    Inpatient glucose management guidelines and consensus statements play an important role in helping to keep hospitalized patients with diabetes and hyperglycemia safe and in optimizing the quality of their glycemic control. In this review article, we compare and contrast seven prominent US guidelines on recommended glycemic outcome measures and processes of care, with the goal of highlighting how variation among them might influence patient safety and quality. The outcome measures of interest include definitions of glucose abnormalities and glycemic targets. The relevant process measures include detection and documentation of diabetes/hyperglycemia, methods of and indications for insulin therapy, management of non-insulin agents, blood glucose monitoring, management of special situations (e.g., parenteral/enteral nutrition, glucocorticoids, surgery, insulin pumps), and appropriate transitions of care. In addition, we address elements of quality improvement, such as glycemic control program infrastructure, glucometrics, insulin safety, and professional education. While most of these guidelines align with respect to outcome measures such as glycemic targets, there is significant heterogeneity among process measures, which we propose might introduce variation or even confusion in clinical practice and possibly affect quality of care. Guideline-related factors, such as rigor of development, clarity, and presentation, may also affect provider trust in and adherence to guidelines. There is a need for high-quality research to address knowledge gaps in optimal glucose management practice approaches in the hospital setting.

  4. Design Guidelines: Study of Handicapped Accessibility in South Carolina State Parks.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Parks, Recreation, and Tourism, Columbia. Div. of Engineering and Planning.

    The publication provides guidelines for the design of new facilities or rehabilitation of existing facilities to accommodate physically handicapped persons in the South Carolina State Parks system. The guidelines are also recommended for use in regional, special district, county, and municipal parks within the state. The guidelines were developed…

  5. Clinical practice guideline development manual: A quality-driven approach for translating evidence into action

    PubMed Central

    Rosenfeld, Richard M.; Shiffman, Richard N.

    2010-01-01

    Background Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing healthcare variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective – or potentially harmful – interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. Purpose This manual describes the principles and practices used successfully by the American Academy of Otolaryngology – Head and Neck Surgery to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for action-ready recommendations with multi-disciplinary applicability. The development process, which allows moving from conception to completion in twelve months, emphasizes a logical sequence of key action statements supported by amplifying text, evidence profiles, and recommendation grades that link action to evidence. Conclusions As clinical practice guidelines become more prominent as a key metric of quality healthcare, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are – and are not – and how they are best utilized to improve care. The information in this manual should help clinicians and organizations achieve these goals. PMID:19464525

  6. [ISO 9000: guidelines for a total quality system in health].

    PubMed

    Pasini, E; Opasich, C; Scherillo, M

    1998-04-01

    The Italian National Health System has recently been revised and reorganized. In the new scenario, the quality of the service being provided is considered extremely important. The international ISO 9000 standard has made it possible to implement a total-quality management system that can be documented and certified independently by a third party. Several hospitals in Italy and abroad have implemented a total-quality system according to ISO 9000 standards in order to provide a service that can satisfy the expectations of the patients in a controlled and efficient way. This article describes ISO 9000, proposes its application to ensure quality in the structures and organizations involved in the national health system and reports several examples of how the standard has been implemented in hospitals.

  7. Guidelines for use of water-quality monitors

    USGS Publications Warehouse

    Gordon, A. Brice; Katzenbach, Max S.

    1983-01-01

    This manual contains methods and procedures used by the U.S. Geological Survey (USGS) for collecting specific conductance, dissolved oxygen, water temperature, and pH data for ground water, streams, lakes, reservoirs, and estuaries by means of permanently installed, continuously recording, water quality monitors. The topics discussed include the selection of monitoring sites, selection and installation of shelters and equipment, and standard methods of calibration, operation and maintenance of water-quality monitors.

  8. Guidelines of the International Federation of Red Cross and Red Crescent Societies: an overview and quality appraisal using AGREE II

    PubMed Central

    Vande veegaete, Axel; Borra, Vere; De Buck, Emmy; Vandekerckhove, Philippe

    2016-01-01

    Objectives To appraise the quality of guidelines developed by the International Federation of Red Cross and Red Crescent Societies (IFRC) between 2001 and 2015. Study design Cross-sectional. Methods 2 authors independently assessed the quality of IFRC guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Average domain scores were calculated and overall quality scores and recommendation for use were determined. Results Out of 77 identified guidelines, 27 met the inclusion criteria and were assessed. The domains with the highest average scores across guidelines were ‘scope and purpose’, ‘clarity of presentation’ and ‘applicability’. The lowest scoring domains were ‘rigour of development’ and ‘editorial independence’. No guideline can be ‘recommended for immediate use’, 23 guidelines are ‘recommended with modifications’ and 4 guidelines are ‘not recommended’. Conclusions The IFRC produces guidelines that should be adhered to by millions of staff and volunteers in 190 countries. These guidelines should therefore be of high quality. Up until now, the IFRC had no uniform guideline development process. The results of the AGREE II appraisal indicate that the quality of the guidelines needs to be improved. PMID:27678534

  9. Quality of Life and its Measurement: Important Principles and Guidelines

    ERIC Educational Resources Information Center

    Verdugo, M. A.; Schalock, R. L.; Keith, K. D.; Stancliffe, R. J.

    2005-01-01

    Background: The importance of the valid assessment of quality of life (QOL) is heightened with the increased use of the QOL construct as a basis for policies and practices in the field of intellectual disability (ID). Method: This article discusses the principles that should guide the measurement process, the major interrogatories (i.e. who, what,…

  10. A quality assessment tool for markup-based clinical guidelines.

    PubMed

    Shalom, Erez; Shahar, Yuval; Taieb-Maimon, Meirav; Lunenfeld, Eitan

    2008-11-06

    We introduce a tool for quality assessment of procedural and declarative knowledge. We developed this tool for evaluating the specification of mark-up-based clinical GLs. Using this graphical tool, the expert physician and knowledge engineer collaborate to perform scoring, using pre-defined scoring scale, each of the knowledge roles of the mark-ups, comparing it to a gold standard. The tool enables scoring the mark-ups simultaneously at different sites by different users at different locations.

  11. Drinking water sources, availability, quality, access and utilization for goats in the Karak Governorate, Jordan.

    PubMed

    Al-Khaza'leh, Ja'far Mansur; Reiber, Christoph; Al Baqain, Raid; Valle Zárate, Anne

    2015-01-01

    Goat production is an important agricultural activity in Jordan. The country is one of the poorest countries in the world in terms of water scarcity. Provision of sufficient quantity of good quality drinking water is important for goats to maintain feed intake and production. This study aimed to evaluate the seasonal availability and quality of goats' drinking water sources, accessibility, and utilization in different zones in the Karak Governorate in southern Jordan. Data collection methods comprised interviews with purposively selected farmers and quality assessment of water sources. The provision of drinking water was considered as one of the major constraints for goat production, particularly during the dry season (DS). Long travel distances to the water sources, waiting time at watering points, and high fuel and labor costs were the key reasons associated with the problem. All the values of water quality (WQ) parameters were within acceptable limits of the guidelines for livestock drinking WQ with exception of iron, which showed slightly elevated concentration in one borehole source in the DS. These findings show that water shortage is an important problem leading to consequences for goat keepers. To alleviate the water shortage constraint and in view of the depleted groundwater sources, alternative water sources at reasonable distance have to be tapped and monitored for water quality and more efficient use of rainwater harvesting systems in the study area is recommended.

  12. REVISING EPA'S GUIDELINES FOR THE DERIVATIONS OF AQUATIC LIFE AMBIENT WATER QUALITY CRITERIA

    EPA Science Inventory

    Henry, T.R., H.E. Bell, C.G. Delos, R.J. Erickson, K.M. Kubena and F.L. Mayer. In press. Revising EPA's Guidelines for the Derivation of Aquatic Life Ambient Water Quality Criteria (Abstract). To be presented at the SETAC Fourth World Congress, 14-18 November 2004, Portland, OR. ...

  13. THE UNITED STATES EPA CONCEPT FOR DERIVING WATER QUALITY GUIDELINES FOR RECREATIONAL WATERS

    EPA Science Inventory

    The guidelines developed by the US EPA for controlling the quality of recreational waters are based on protecting the health of swimmers and other recreationists who may be exposed to waters contaminated by human and animal excreta. Risks to swimmers were determined through a se...

  14. Preventing Indoor Air Quality Problems in Educational Facilities: Guidelines for Hot, Humid Climates. Revised.

    ERIC Educational Resources Information Center

    Odom, J. David; DuBose, George

    This manual addresses the errors that occur during new construction that subsequently contribute to indoor air quality (IAQ) problems in newly constructed buildings in hot and humid climates, and offers guidelines for preventing them during the design and construction phases. It defines the roles and responsibilities of the design team, the…

  15. ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

    PubMed

    Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

    2015-12-01

    The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included.

  16. Chronic toxicity of chloride to freshwater species: effects of hardness and implications for water quality guidelines.

    PubMed

    Elphick, James R F; Bergh, Kelli D; Bailey, Howard C

    2011-01-01

    Toxicity tests using nine freshwater species (Ceriodaphnia dubia, Daphnia magna, Oncorhynchus mykiss, Pimephales promelas, Lumbriculus variegatus, Tubifex tubifex, Chironomus dilutus, Hyallela azteca, and Brachionus calyciflorus) were conducted to evaluate their sensitivity to chloride. Acute-to-chronic ratios (ACRs) from these tests indicate the ACR of 7.59 employed by the United States Environmental Protection Agency (U.S. EPA) in deriving its water quality guideline for chloride may be conservative; a revised ACR of 3.50 is presented here. The endpoints used to calculate the ACR included 24-h to 96-h median lethal concentrations (LC50s) for acute tests, and 48-h to 54-d inhibition concentration (ICx) values for growth or reproduction for chronic exposures. Data from the present chronic toxicity tests, and other investigators, were used to propose a water quality guideline for long-term exposure to chloride using a species sensitivity distribution (SSD) approach. The 5th percentile from the SSD was calculated as 307 mg/L and proposed as the water quality guideline. Cladocerans were the most sensitive species in the dataset. Ceriodaphnia dubia was used to evaluate the relationship between water hardness and sensitivity to chloride. A strong relationship was observed and was used to establish a hardness-related equation to modify the proposed water quality guideline on the basis of water hardness, resulting in values ranging from 64 mg/L chloride at 10 mg/L hardness to 388 mg/L chloride at 160 mg/L hardness (as CaCO₃). These data suggest that current water quality guidelines for chloride may be overly conservative in water with moderate-to-high hardness, and may not be sufficiently protective under soft-water conditions.

  17. Facilitating access to laboratory guidelines by modeling their contents and designing a computerized user interface.

    PubMed

    Yasini, Mobin; Duclos, Catherine; Lamy, Jean-Baptiste; Venot, Alain

    2011-01-01

    Laboratory tests are not always prescribed appropriately. Guidelines for some important laboratory tests have been developed by expert panels in the Parisian region to maximize the appropriateness of laboratory medicine. However; these recommendations are not frequently consulted by physicians and nurses. We developed a system facilitating consultation of these guidelines, to increase their usability. Elements of information contained in these documents were identified and included in recommendations of different categories. UML modeling was used to represent these categories and their relationships to each other in the guidelines. We used the generated model to implement a computerized interface. The prototype interface, based on web-based technology was found to be rapid and easy to use. By clicking on provided keywords, information about the subject sought is highlighted whilst retaining the entire text of the guideline on-screen.

  18. [From library to clinical decision support systems: access of general practitioner to quality information].

    PubMed

    Fauquert, B

    2012-09-01

    Since 2003, the following tools have been implemented in Belgium for improving the access of general practioners to the EBM literature: the Digital Library for Health and the evidence-linker of the CEBAM, the portal EBMPracticeNet.be and the multidimensional electronic clinical decision support EBMeDS. The aim of this article is to show the progress achieved in the information dissemination toward the belgian general practioners, particularly the access from the electronic health record. From the literature published these last years, the opportunities cited by the users are for using EBM and the strong willingness for using these literature access in the future; the limits are the medical data coding, the irrelevance of the search results, the alerts fatigue induced by EBMeDS. The achievements done and planned for the new EBMPracticeNet guidelines portal and the EBMeDS system are explained in the aim of informing belgian healthcare professionals. These projects are claiming for lauching a participatory process in the production and dissemination of EBM information. The discussion is focused on the belgian healthcare system advantages, the solutions for a reasonable implementation of these projects and for increasing the place of an evidence-based information in the healthcare decision process. Finally the input of these projects to the continuing medical education and to the healthcare quality are discussed, in a context of multifactorial interaction healthcare design (complexity design).

  19. Seeking value in pharmaceutical care: balancing quality, access and efficiency.

    PubMed

    Montague, Terrence; Cavanaugh, Siobhan

    2004-01-01

    Healthcare remains a dominant issue for Canadians. Central to the debate is the dynamic tension among the value, accessibility and affordability of drugs. Simply put, innovative drugs improve health and economic outcomes for individuals and populations. As a result, providers and patients increasingly demand, and expect, these benefits; utilization and expenditures increase. The management challenge is finding the best balance of quality, access and costs. Supply-side strategies, such as restricting access with the intention of controlling isolated costs of drug budgets, are not optimal from a population health view because they have the adverse impact of limiting the system benefits of innovative drugs. Management strategies emphasizing the demand side of the market are more empowering to providers and patients and, given the increasing knowledge and accountability of these stakeholders, are increasingly feasible. Population health outcomes and efficient resource use may be better served by a combination of strategies. The partnership-measurement model of disease management is a practical example of this approach at the community level; timely and repeated feedback of real-world practices, as well as provider and patient education, drive accountable, cost-efficient and continuously improved outcomes. As we seek the optimal societal strategy for innovative drug therapy, resource allocation decisions have to be made. Widening the debate and informing the debaters will enhance the chances of making choices that achieve the best health for the most people at the best cost.

  20. Evaluation of the Quality of Guidelines for Myasthenia Gravis with the AGREE II Instrument

    PubMed Central

    Zhang, Zhenchang; Guo, Jia; Su, Gang; Li, Jiong; Wu, Hua; Xie, Xiaodong

    2014-01-01

    Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners in making decisions about appropriate healthcare in specific clinical circumstances. The methodological quality of CPGs for myasthenia gravis (MG) are unclear. Objective To critically evaluate the methodological quality of CPGs for MG using AGREE II instrument. Method A systematical search strategy on PubMed, EMBASE, DynaMed, the National Guideline Clearinghouse (NGC) and the Chinese Biomedical Literature database (CBM) was performed on September 20th 2013. All guidelines related to MG were evaluated with AGREE II. The software used for analysis was SPSS 17.0. Results A total of 15 CPGs for MG met the inclusion criteria (12 CPGs in English, 3 CPGs in Chinese). The overall agreement among reviews was moderate or high (ICC >0.70). The mean scores (mean ± SD) for al six domains were presented as follows: scope and purpose (60.93% ±16.62%), stakeholder involvement (40.93% ±20.04%), rigor of development (37.22% ±30.46%), clarity of presentation (64.26% ±16.36%), applicability (28.19% ±20.56%) and editorial independence (27.78% ±28.28%). Compared with non-evidence-based CPGs, evidence-based CPGs had statistically significant higher quality scores for all AGREE II domains (P<0.05). All domain scores appear slightly higher for CPGs published after AGREE II instrument development and validation (P>0.05). The quality scores of CPGs developed by NGC/AAN were higher than the quality scores of CPGs developed by other organizations for all domains. The difference was statistically significant for all domains with the exception of clarity of presentation (P = 0.07). Conclusions The qualities of CPGs on MG were generally acceptable with several flaws. The AGREE II instrument should be adopted by guideline developers, particularly in China. PMID:25402504

  1. Access to fracture risk assessment by FRAX and linked National Osteoporosis Guideline Group (NOGG) guidance in the UK-an analysis of anonymous website activity.

    PubMed

    McCloskey, E V; Johansson, H; Harvey, N C; Compston, J; Kanis, J A

    2017-01-01

    In the UK, fracture risk guidance is provided by the National Osteoporosis Guideline Group (NOGG). NOGG usage showed widespread access through direct web-based linkage to FRAX. The facilitated interaction between fracture risk assessment and clinical guidelines could usefully be adopted in other countries.

  2. Clinical guidelines in pediatric headache: evaluation of quality using the AGREE II instrument

    PubMed Central

    2014-01-01

    Background The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool is a validated questionnaire used to assess the methodological quality of clinical guidelines (CGs). We used the AGREE II tool to assess the development process, the methodological quality, and the quality of reporting of available pediatric CGs for the management of headache in children. We also studied the variability in responses related to the characteristics of eleven Italian neuropediatric centers, showing similarities and differences in the main recommendations reported in CGs. Methods A systematic literature search was conducted from January 2002 to June 2013 on Mediline, the Cochrane database, the National Guideline Clearinghouse website and the NHS evidence search tool, using the following terms: headache, cephalalgia, guidelines and children (MESH or text words). Six CGs providing information on the diagnosis and management of headache and specific recommendations for children were selected. Eleven neuropediatric centers assessed the overall quality and the appropriateness of all available CGs using of the AGREE II instrument. Results Six CGs meeting the inclusion and exclusion criteria were identified and assessed by 11 reviewers. Our study showed that the NICE CGs was “strongly recommended” while the French and Danish CGs were mainly “not recommended”. The comparison between the overall quality score of the French CGs and the NICE CGs was statistically significant (6.54 ± 0.69 vs 4.18 ± 1.08; p =0.001). The correlation analysis between quality domain score and guideline publication date showed a statistically significant association only for the “editorial independence” domain (r = 0.842 p = 0.035). The intra-class coefficients showed that the 11 reviewers had the highest agreement for the Lewis CGs (r = 0.857), and the lowest one for the NICE CGs (r = 0.656). Statistical analyses showed that professionals from outpatient services

  3. Water quality and health in the new millennium: the role of the World Health Organization Guidelines for Drinking-Water Quality.

    PubMed

    Sobsey, Mark D; Bartram, S

    2003-01-01

    In this report the role of the WHO Guidelines for Drinking Water Quality in promoting safe drinking water for the world's population is briefly described. The guidelines are being revised in a third edition to emphasize an integrated approach to water quality assessment and management from source to consumer. The forthcoming guidelines will: be risk-based and quantitative, emphasize quality protection and prevention of contamination, be proactive and participatory, and address the needs of those in developing countries who have no access to piped community water supplies. The guidelines emphasize the maintenance of microbial quality to prevent waterborne infectious disease as an essential goal. In addition, they address protection from chemical toxicants and other contaminants of public health concern. The forthcoming 3rd edition of the WHO GDWQ intend to be responsive to the under-served in developing countries by inclusion of non-piped supplies and addressing practical systems for their collection, treatment and storage at household level to provide safe water. Beyond the inclusion of these and possibly additional household water collection, treatment and storage systems, what is needed is to achieve their widespread use is an education and dissemination campaign that promotes and explains them and their benefits. Such a communication and marketing campaign is best done by including as many different sectors and stakeholders as possible in the process. It will be important to acknowledge that safe water is one of essential components or needs for healthy living, along with adequate sanitation and proper nutrition. Together, these are the essential health needs to be met in the developing and the developed world. All three contribute to reduced disease and increased health, and the lack of one can degrade the beneficial impact of the others. The importance of safe water, sanitation and nutrition to human health and well-being can be stated no better than it was by

  4. Recent Advances in Point-of-Access Water Quality Monitoring

    NASA Astrophysics Data System (ADS)

    Korostynska, O.; Arshak, K.; Velusamy, V.; Arshak, A.; Vaseashta, Ashok

    Clean water is one of our most valuable natural resources. In addition to providing safe drinking water it assures functional ecosystems that support fisheries and recreation. Human population growth and its associated increased demands on water pose risks to maintaining acceptable water quality. It is vital to assess source waters and the aquatic systems that receive inputs from industrial waste and sewage treatment plants, storm water systems, and runoff from urban and agricultural lands. Rapid and confident assessments of aquatic resources form the basis for sound environmental management. Current methods engaged in tracing the presence of various bacteria in water employ bulky laboratory equipment and are time consuming. Thus, real-time water quality monitoring is essential for National and International Health and Safety. Environmental water monitoring includes measurements of physical characteristics (e.g. pH, temperature, conductivity), chemical parameters (e.g. oxygen, alkalinity, nitrogen and phosphorus compounds), and abundance of certain biological taxa. Monitoring could also include assays of biological activity such as alkaline phosphatase, tests for toxins such as microcystins and direct measurements of pollutants such as heavy metals or hydrocarbons. Real time detection can significantly reduce the level of damage and also the cost to remedy the problem. This paper presents overview of state-of-the-art methods and devices used for point-of-access water quality monitoring and suggest further developments in this area.

  5. [The German program for disease management guidelines: evaluation by use of quality indicators].

    PubMed

    Kopp, Ina B; Geraedts, Max; Jäckel, Wilfried H; Altenhofen, Lutz; Thomeczek, Christian; Ollenschläger, Günter

    2007-08-15

    The Program for National Disease Management Guidelines (German DM-CPG Program) in Germany aims at the implementation of best-practice recommendations for prevention, acute care, rehabilitation and chronic care in the setting of disease management programs and integrated health-care systems. Like other guidelines, DM-CPG need to be assessed regarding their influence on structures, processes and outcomes of care. However, quality assessment in integrated health-care systems is challenging. On the one hand, a multitude of potential domains for measurement, actors and perspectives need to be considered. On the other hand, measures need to be identified that assess the function of the diagnostic and therapeutic chain in terms of cooperation and coordination of care. The article reviews methods and use of quality indicators in the context of the German DM-CPG Program.

  6. Internet pharmacy: issues of access, quality, costs, and regulation.

    PubMed

    Crawford, Stephanie Y

    2003-02-01

    Internet pharmacy has been the focus of heightened interest over the past 3 years since the first major Web site was introduced in the United States. This paper addresses issues pertaining to Internet pharmacies that sell prescriptions and other products to consumers at the retail level. The Internet pharmacy industry has shifted rapidly in the short time span. This paper begins with a summary of historical considerations and the shifting organization of Internet pharmacy. The advantages and disadvantages of online pharmacy practice are listed. Issues of access, quality, and cost are described. The challenges in regulation at the state and federal levels are presented. Advice to consumers is offered regarding the use of Internet pharmacy sites for purchasing prescription drug products.

  7. ARM User Survey Report: Data Access, Quality, and Delivery

    SciTech Connect

    Mather, JH; Roeder, LR; Sivaraman, C

    2012-06-28

    The objective of this survey was to obtain user feedback to determine how users of the Atmospheric Radiation Measurement (ARM) Climate Research Facility Data Archive interact with the more than 2000 available types of datastreams. The survey also gathered information about data discovery and data quality. The Market and Competitive Analysis group at Pacific Northwest National Laboratory worked with web administrators to develop a landing page from which users could access the survey. A survey invitation was sent by ARM via email to about 6100 users on February 22, 2012. The invitation was also posted on the ARM website and Facebook page. Reminders were sent via e-mail and posted on Facebook while the survey was open, February 22-March 23, 2012.

  8. 38 CFR 17.508 - Access to quality assurance records and documents within the agency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans... Records § 17.508 Access to quality assurance records and documents within the agency. (a) Access...

  9. 38 CFR 17.508 - Access to quality assurance records and documents within the agency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans... Records § 17.508 Access to quality assurance records and documents within the agency. (a) Access...

  10. 38 CFR 17.508 - Access to quality assurance records and documents within the agency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans... Records § 17.508 Access to quality assurance records and documents within the agency. (a) Access...

  11. 38 CFR 17.508 - Access to quality assurance records and documents within the agency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans... Records § 17.508 Access to quality assurance records and documents within the agency. (a) Access...

  12. 38 CFR 17.508 - Access to quality assurance records and documents within the agency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Access to quality assurance records and documents within the agency. 17.508 Section 17.508 Pensions, Bonuses, and Veterans... Records § 17.508 Access to quality assurance records and documents within the agency. (a) Access...

  13. How To Promote Data Quality And Access? Publish It!

    NASA Astrophysics Data System (ADS)

    Carlson, D. J.; Pfeiffenberger, H.

    2011-12-01

    Started during IPY 2007-2008, the Earth System Science Data journal (Copernicus) has now 'tested the waters' of earth system data publishing for approximately 2 years with some success. The journal has published more than 30 data sets, of remarkable breadth and variety, all under a Creative Commons Attribution license. Users can now find well-described, quality-controlled and freely accessible data on soils, permafrost, sediment transport, ice sheets, surface radiation, ocean-atmosphere fluxes, ocean chemistry, gravity fields, and combined radar and web cam observations of the Eyjafjallajökull eruption plume. Several of the data sets derive specifically from IPY or from polar regions, but a large portion, including a substantial special issue on ocean carbon, cover broad temporal and geographic domains; the contributors themselves come from leading science institutions around the world. ESSD has attracted the particular interest of international research teams, particularly those who, as in the case of ocean carbon data, have spent many years gathering, collating and calibrating global data sets under long-term named programs, but who lack within those programs the mechanisms to distribute those data sets widely outside their specialist teams and to ensure proper citation credit for those remarkable collaborative data processing efforts. An in-progress special issue on global ocean plankton function types, again representing years of international data collaboration, provides a further example of ESSD utility to large research programs. We anticipate an interesting test case of parallel special issues with companion science journals - data sets in ESSD to accompany science publications in a prominent research journal. We see the ESSD practices and products as useful steps to increase quality of and access to important data sets.

  14. [Consideration of Rehabilitation within High Class Quality Guidelines, Registered by the German Association of the Scientific Medical Professional Societies (AWMF)].

    PubMed

    Jäckel, W H; Beindorf, G; Glattacker, M

    2013-10-01

    Clinical practice guidelines are systematically developed documents aiming at guiding decisions in specific areas of health care. Therefore, incorporating rehabilitation in guidelines adressing chronic diseases is of major importance. As information regarding consideration of rehabilitation in guidelines is lacking, the intention of our study was to analyse to what degree rehabilitation experts participated in guideline development and whether guidelines for chronic diseases include relevant information and recommendations concerning rehabilitation.In order to answer these questions we investigated 97 guidelines of high class quality, registered by the German Association of the Scientific Medical Professional Societies (AWMF). 36 out of these guidelines addressed chronic health conditions in which rehabilitation may be of relevance. Guidelines identified were analysed using a set of defined criteria.In 11 out of the 36 guidelines one or more medical rehabilitation societies participated in the development process, 17 include a chapter on rehabilitation issues, and 20 information concerning indication for rehabilitation processes. 24 guidelines consider rehabilitation in their recommendations.There is substantial variance concerning inclusion of rehabilitation in German guidelines on chronic diseases. Rehabilitation societies are encouraged to strive for stronger integration of rehabilitation into guidelines of other societies.

  15. ASVCP guidelines: quality assurance for point-of-care testing in veterinary medicine.

    PubMed

    Flatland, Bente; Freeman, Kathleen P; Vap, Linda M; Harr, Kendal E

    2013-12-01

    Point-of-care testing (POCT) refers to any laboratory testing performed outside the conventional reference laboratory and implies close proximity to patients. Instrumental POCT systems consist of small, handheld or benchtop analyzers. These have potential utility in many veterinary settings, including private clinics, academic veterinary medical centers, the community (eg, remote area veterinary medical teams), and for research applications in academia, government, and industry. Concern about the quality of veterinary in-clinic testing has been expressed in published veterinary literature; however, little guidance focusing on POCT is available. Recognizing this void, the ASVCP formed a subcommittee in 2009 charged with developing quality assurance (QA) guidelines for veterinary POCT. Guidelines were developed through literature review and a consensus process. Major recommendations include (1) taking a formalized approach to POCT within the facility, (2) use of written policies, standard operating procedures, forms, and logs, (3) operator training, including periodic assessment of skills, (4) assessment of instrument analytical performance and use of both statistical quality control and external quality assessment programs, (5) use of properly established or validated reference intervals, (6) and ensuring accurate patient results reporting. Where possible, given instrument analytical performance, use of a validated 13s control rule for interpretation of control data is recommended. These guidelines are aimed at veterinarians and veterinary technicians seeking to improve management of POCT in their clinical or research setting, and address QA of small chemistry and hematology instruments. These guidelines are not intended to be all-inclusive; rather, they provide a minimum standard for maintenance of POCT instruments in the veterinary setting.

  16. Developing Guidelines for Evaluating the Adaptation of Accessible Web-Based Learning Materials

    ERIC Educational Resources Information Center

    Radovan, Marko; Perdih, Mojca

    2016-01-01

    E-learning is a rapidly developing form of education. One of the key characteristics of e-learning is flexibility, which enables easier access to knowledge for everyone. Information and communications technology (ICT), which is e-learning's main component, enables alternative means of accessing the web-based learning materials that comprise the…

  17. Improving accessibility of trust guidelines and protocols at the Great Western Hospital, Swindon.

    PubMed

    Robertson, Ian; Smith, Abigail; Tucker, Jennifer; Cilia, Erica; Chen, Kangni; Marion, Rose; Nesbitt, Julian; Ramcharitar, Steve; Cathiavadi Greamspet, Mala

    2014-01-01

    Trust guidelines and policies outline recommendations for the management of common clinical and non-clinical situations, serving to standardise best practice. Prior to this project, there was no consolidated location for these documents. Lack of organisational structure and inadequate search functionality within the trust intranet led to time wasted locating information, acting outside of recognised best practice, and ultimately potentially compromising patient safety. We surveyed 55 junior doctors, 95% of respondents were dependent on guidelines on a daily basis. 20% spending greater than 5 minutes to locate protocols and 38% unable to locate some relevant documents at all. We analysed the time taken for junior doctors to locate six randomly selected protocols. Pre-intervention mean time was 133 seconds (on six occasions doctors were unable to locate the guideline). All trust guidelines and protocols currently available on the intranet were collated, consolidated, and renamed according to content. These were then re-alphabetised and new search terms linked to each document. Existing links were then uploaded and a single web page made available via the trust intranet homepage. The new page was publicised by email, posters and interdepartmental presentations. In our post intervention survey, 97% of respondents were aware of the project and had made use of the page. All protocols were located during re-testing with 90% of those resurveyed stating it was easier to locate protocols. Overall, a reduction in the time and number of clicks required to locate protocols was demonstrated: mean time 16 seconds vs 133 seconds pre-intervention (n=60). 53% of guidelines located in <30s and 86% <2 minutes.

  18. Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment.

    PubMed

    Nielsen, Gunnar Damgård; Larsen, Søren Thor; Wolkoff, Peder

    2017-01-01

    In 2010, the World Health Organization (WHO) established an indoor air quality guideline for short- and long-term exposures to formaldehyde (FA) of 0.1 mg/m(3) (0.08 ppm) for all 30-min periods at lifelong exposure. This guideline was supported by studies from 2010 to 2013. Since 2013, new key studies have been published and key cancer cohorts have been updated, which we have evaluated and compared with the WHO guideline. FA is genotoxic, causing DNA adduct formation, and has a clastogenic effect; exposure-response relationships were nonlinear. Relevant genetic polymorphisms were not identified. Normal indoor air FA concentrations do not pass beyond the respiratory epithelium, and therefore FA's direct effects are limited to portal-of-entry effects. However, systemic effects have been observed in rats and mice, which may be due to secondary effects as airway inflammation and (sensory) irritation of eyes and the upper airways, which inter alia decreases respiratory ventilation. Both secondary effects are prevented at the guideline level. Nasopharyngeal cancer and leukaemia were observed inconsistently among studies; new updates of the US National Cancer Institute (NCI) cohort confirmed that the relative risk was not increased with mean FA exposures below 1 ppm and peak exposures below 4 ppm. Hodgkin's lymphoma, not observed in the other studies reviewed and not considered FA dependent, was increased in the NCI cohort at a mean concentration ≥0.6 mg/m(3) and at peak exposures ≥2.5 mg/m(3); both levels are above the WHO guideline. Overall, the credibility of the WHO guideline has not been challenged by new studies.

  19. Standards of Practice: Quality Assurance Guidelines for Percutaneous Treatments of Intervertebral Discs

    SciTech Connect

    Kelekis, Alexis D. Filippiadis, Dimitris K.; Martin, Jean-Baptiste; Brountzos, Elias

    2010-10-15

    Percutaneous treatments are used in the therapy of small- to medium-sized hernias of intervertebral discs to reduce the intradiscal pressure in the nucleus and theoretically create space for the herniated fragment to implode inward, thus reducing pain and improving mobility and quality of life. These techniques involve the percutaneous removal of the nucleus pulposus by using a variety of chemical, thermal, or mechanical techniques and consist of removal of all or part of nucleus pulposus to induce more rapid healing of the abnormal lumbar disc. These guidelines are written to be used in quality improvement programs for assessing fluoroscopy- and/or computed tomography-guided percutaneous intervertebral disc ablative techniques.

  20. Software Quality-Control Guidelines for Codes Developed for the NWTC

    SciTech Connect

    H. James Green.

    1999-06-16

    Members in the wind-energy research, develop-ment, deployment, and production communities use computer codes for many things. They base important decisions on the results from the codes. It is important that the developers of these codes scrutinize them to assure an appropriate level for quality. The National Wind Technology Center (NWTC) and its subcontractors have developed many computer codes now in use in the United States and around the world. This document will present some guidelines for ensuring the quality of programs that are developed for the NWTC.

  1. Improving food composition data quality: Three new FAO/INFOODS guidelines on conversions, data evaluation and food matching.

    PubMed

    Charrondiere, U Ruth; Rittenschober, Doris; Nowak, Verena; Stadlmayr, Barbara; Wijesinha-Bettoni, Ramani; Haytowitz, David

    2016-02-15

    Food composition data play a key role in many sectors and the availability of quality data is critically important. Since 1984, the International Network of Food Data Systems (INFOODS) has been working towards improving food composition data quality and availability, including the development and updating of standards, guidelines and tools for food composition. FAO/INFOODS has recently published three comprehensive guidelines to improve and harmonise the compilation of data: (1) Guidelines for Food Matching, (2) Guidelines for Checking Food Composition Data prior to Publication of a User Table/Database, and (3) Guidelines for Converting Units, Denominators and Expressions. This article describes their content and development processes. Their adoption, along with additional ones planned for the future by FAO/INFOODS, should further improve the quality of published food composition data, which in turn can lead to more accurate nutrient intake estimates and more precise food labels, as well as better-targeted programs and policies.

  2. [European community guidelines and standards in indoor air quality: what proposals for Italy].

    PubMed

    Settimo, Gaetano; D'Alessandro, Daniela

    2014-01-01

    Indoor air quality is an issue on which to focus because of the increasing number of exposed population and in view of the strong public feeling on this issue. This paper reports the rules of EU and several European countries about indoor air quality, focusing on the initiatives performed in Italy to respond to WHO recommendations. Several EU countries have introduced in their legislation rules relating to indoor air quality. At the moment, in Italy, a reference rule has not been issued. For this reason, up to date main informations concerning some guidelines or reference values in indoor air, to be used for a first comparison, are those obtained by the scientific literature, or by the guidelines issued by other European countries or, for analogy, by other standard values such as limit or reference values regarding outdoor air. Even the EU, while reaffirming the priority of energy efficiency measures, recommends healthier indoor environments and the development of a specific European strategy on the issue of indoor air quality. The National Study Group on indoor pollution of the Italian National Health Institute (ISS), is working for the development of shared technical and scientific documents, in order to provide greater uniformity of actions at national level, waiting for a legal framework for indoor air quality, in the light of the indication already produced by the WHO.

  3. KRAS Mutations Testing in Colorectal Carcinoma Patients in Italy: From Guidelines to External Quality Assessment

    PubMed Central

    Normanno, Nicola; Pinto, Carmine; Castiglione, Francesca; Bardelli, Alberto; Gambacorta, Marcello; Botti, Gerardo; Nappi, Oscar; Siena, Salvatore; Ciardiello, Fortunato; Taddei, GianLuigi; Marchetti, Antonio

    2011-01-01

    Background Monoclonal antibodies directed against the epidermal growth factor receptor (EGFR) have been approved for the treatment of patients with metastatic colorectal carcinoma (mCRC) that do not carry KRAS mutations. Therefore, KRAS testing has become mandatory to chose the most appropriate therapy for these patients. Methodology/Principal Findings In order to guarantee the possibility for mCRC patients to receive an high quality KRAS testing in every Italian region, the Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology and Cytopathology -Italian division of the International Academy of Pathology (SIAPEC-IAP) started a program to improve KRAS testing. AIOM and SIAPEC identified a large panel of Italian medical oncologists, pathologists and molecular biologists that outlined guidelines for KRAS testing in mCRC patients. These guidelines include specific information on the target patient population, the biological material for molecular analysis, the extraction of DNA, and the methods for the mutational analysis that are summarized in this paper. Following the publication of the guidelines, the scientific societies started an external quality assessment scheme for KRAS testing. Five CRC specimens with known KRAS mutation status were sent to the 59 centers that participated to the program. The samples were validated by three referral laboratories. The participating laboratories were allowed to use their own preferred method for DNA extraction and mutational analysis and were asked to report the results within 4 weeks. The limit to pass the quality assessment was set at 100% of true responses. In the first round, only two centers did not pass (3%). The two centers were offered to participate to a second round and both centers failed again to pass. Conclusions The results of this first Italian quality assessment for KRAS testing suggest that KRAS mutational analysis is performed with good quality in the majority of Italian centers

  4. Hepatitis C Virus: A Review of Treatment Guidelines, Cost-effectiveness, and Access to Therapy

    PubMed Central

    Lynch, Shaina M.; Wu, George Y.

    2016-01-01

    Abstract Hepatitis C virus (HCV) infection remains a significant medical concern in the United States and around the world. It is still one of the leading causes of chronic liver disease, and, for more than 20 years, there has been little progress in the treatment of HCV infection. The advent of direct-acting antivirals (DAAs) initiated the era of high efficacy and well-tolerated medications with high cure rates. The efficacy of these medications has prompted many professional societies around the world to update their treatment guidelines to include DAAs as first-line treatment. Guidelines by the American Association for the Study of Liver Disease/Infectious Disease Society of America, World Health Organization, Asian-Pacific Association for the Study of Liver and the European Association for the Study of Liver have all incorporated DAAs into their treatment guidelines. Despite the promising data supporting these medications, however, their cost represents a limiting factor to their use, even though studies have shown DAAs to be cost-effective. In addition to the expense of these medications and limited resources, there are many barriers preventing patients from receiving this potentially life-saving treatment. In order to overcome these barriers, these issues need to be recognized and addressed. PMID:28097100

  5. Clinical practice guidelines in dentistry: opinions of dental practitioners on their contribution to the quality of dental care

    PubMed Central

    van der Sanden, W J M; Mettes, D; Plasschaert, A; van't, H; Grol, R; Verdonschot, E

    2003-01-01

    Objectives: To assess the opinions of general dental practitioners regarding the development and importance of clinical practice guidelines and their contribution to the quality of dental care. Methods: A questionnaire was sent to a representative sample of 1656 dentists in the Netherlands. Factor analysis was conducted to identify scales of variables, and a reliability analysis was conducted to verify the reliability of the identified scales. The effect of the independent variables is expressed as odds ratio per scale part (standard deviation, SD). Regression analyses were conducted to study determinants of the opinions on clinical guidelines. Results: The response rate was 73%; 54% of the respondents supported the development of clinical practice guidelines for dentists. Most respondents indicated that clinical practice guidelines could be used as a checklist, as a support in daily clinical decision making, and as a basis for continuing dental education. The factor analyses yielded four scale factors—contribution of guidelines to effectiveness of care (OR 1.95/SD), contribution of guidelines to professional autonomy (OR 1.70/SD), contribution of guidelines to quality of care (OR 2.52/SD), and contribution of guidelines to collaboration (OR 1.49/SD)—which complied with the criterion of Cronbach's alpha >0.60. Multiple regression analysis with the four scale factors as dependent variables yielded only extremely low correlations for practice and dentist characteristics (R2=0.01–0.04). Conclusions: Only about 50% of dentists support the development and implementation of clinical guidelines. Guidelines are seen as helpful in the provision of continuing dental education and as a support in daily clinical decision making. The most important barrier to successful implementation of clinical practice guidelines is the fear of dental practitioners that guidelines will reduce their professional autonomy. Practice and dentist characteristics are unrelated to dentists

  6. Development and evaluation of sediment quality guidelines for Florida coastal waters

    USGS Publications Warehouse

    MacDonald, Donald D.; Carr, R. Scott; Calder, Fred D.; Long, Edward R.; Ingersoll, Christopher G.

    1996-01-01

    The weight-of-evidence approach to the development of sediment quality guidelines (SQGs) was modified to support the derivation of biological effects-based SQGs for Florida coastal waters. Numerical SQGs were derived for 34 substances, including nine trace metals, 13 individual polycyclic aromatic hydrocarbons (PAHs), three groups of PAHs, total polychlorinated biphenyls (PCBs), seven pesticides and one phthalate ester. For each substance, a threshold effects level (TEL) and a probable effects level (PEL) was calculated. These two values defined three ranges of chemical concentrations, including those that were (1) rarely, (2) occasionally or (3) frequently associated with adverse effects. The SQGs were then evaluated to determine their degree of agreement with other guidelines (an indicator of comparability) and the percent incidence of adverse effects within each concentration range (an indicator of reliability). The guidelines also were used to classify (using a dichotomous system: toxic, with one or more exceedances of the PELs or non-toxic, with no exceedances of the TELs) sediment samples collected from various locations in Florida and the Gulf of Mexico. The accuracy of these predictions was then evaluated using the results of the biological tests that were performed on the same sediment samples. The resultant SQGs were demonstrated to provide practical, reliable and predictive tools for assessing sediment quality in Florida and elsewhere in the southeastern portion of the United States.

  7. Assessment of heavy metals contamination in Mamut river sediments using sediment quality guidelines and geochemical indices.

    PubMed

    Mohammad Ali, Bibi Noorarlijannah; Lin, Chin Yik; Cleophas, Fera; Abdullah, Mohd Harun; Musta, Baba

    2015-01-01

    This paper describes the concentration of selected heavy metals (Co, Cu, Ni, Pb, and Zn) in the Mamut river sediments and evaluate the degree of contamination of the river polluted by a disused copper mine. Based on the analytical results, copper showed the highest concentration in most of the river samples. A comparison with Interim Canadian Sediment Quality Guidelines (ICSQG) and Germany Sediment Quality Guidelines (GSQG) indicated that the sediment samples in all the sampling stations, except Mamut river control site (M1), exceeded the limit established for Cu, Ni, and Pb. On the contrary, Zn concentrations were reported well below the guidelines limit (ICSQG and GSQG). Mineralogical analysis indicated that the Mamut river sediments were primarily composed of quartz and accessory minerals such as chalcopyrite, pyrite, edenite, kaolinite, mica, and muscovite, reflected by the geological character of the study area. Enrichment factor (EF) and geoaccumulation index (Igeo) were calculated to evaluate the heavy metal pollution in river sediments. Igeo values indicated that all the sites were strongly polluted with the studied metals in most sampling stations, specifically those located along the Mamut main stream. The enrichment factor with value greater than 1.5 suggested that the source of heavy metals was mainly derived from anthropogenic activity such as mining. The degree of metal changes (δfold) revealed that Cu concentration in the river sediments has increased as much as 20 to 38 folds since the preliminary investigation conducted in year 2004.

  8. Effects of Guideline-Based Training on the Quality of Formal Ontologies: A Randomized Controlled Trial

    PubMed Central

    Boeker, Martin; Jansen, Ludger; Grewe, Niels; Röhl, Johannes; Schober, Daniel; Seddig-Raufie, Djamila; Schulz, Stefan

    2013-01-01

    Background The importance of ontologies in the biomedical domain is generally recognized. However, their quality is often too poor for large-scale use in critical applications, at least partially due to insufficient training of ontology developers. Objective To show the efficacy of guideline-based ontology development training on the performance of ontology developers. The hypothesis was that students who received training on top-level ontologies and design patterns perform better than those who only received training in the basic principles of formal ontology engineering. Methods A curriculum was implemented based on a guideline for ontology design. A randomized controlled trial on the efficacy of this curriculum was performed with 24 students from bioinformatics and related fields. After joint training on the fundamentals of ontology development the students were randomly allocated to two groups. During the intervention, each group received training on different topics in ontology development. In the assessment phase, all students were asked to solve modeling problems on topics taught differentially in the intervention phase. Primary outcome was the similarity of the students’ ontology artefacts compared with gold standard ontologies developed by the authors before the experiment; secondary outcome was the intra-group similarity of group members’ ontologies. Results The experiment showed no significant effect of the guideline-based training on the performance of ontology developers (a) the ontologies developed after specific training were only slightly but not significantly closer to the gold standard ontologies than the ontologies developed without prior specific training; (b) although significant differences for certain ontologies were detected, the intra-group similarity was not consistently influenced in one direction by the differential training. Conclusion Methodologically limited, this study cannot be interpreted as a general failure of a guideline

  9. Republication of: Elevating the quality of disability and rehabilitation research: Mandatory use of the reporting guidelines.

    PubMed

    Chan, Leighton; Heinemann, Allen W; Roberts, Jason

    2015-08-01

    Journal of NeuroEngineering and Rehabilitation advocates the complete and transparent reporting of research and methods, and is pleased to be part of an initiative to mandate the use of reporting guidelines. This Editorial is a republication of a previously published Editorial in Archives of Physical Medicine and Rehabilitation ( http://dx.doi.org/10.1016/j.apmr.2013.12.010 ), and is republished here under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License ( http://creativecommons.org/licenses/by-nc-nd/3.0/ ). For citation purposes, please use the original publication details: Chan L, Heinemann AW, Roberts J. Elevating the Quality of Disability and Rehabilitation Research: Mandatory use of the Reporting Guidelines. Arch Phys Med Rehabil. 2014;95:415-7.

  10. Development and evaluation of sediment quality guidelines based on benthic macrofauna responses.

    PubMed

    Ritter, Kerry J; Bay, Steven M; Smith, Robert W; Vidal-Dorsch, Doris E; Field, L Jay

    2012-10-01

    Toxicity-based sediment quality guidelines (SQGs) are often used to assess the potential of sediment contamination to adversely affect benthic macrofauna, yet the correspondence of these guidelines to benthic community condition is poorly documented. This study compares the performance of 5 toxicity-based SQG approaches to a new benthos-based SQG approach relative to changes in benthic community condition. Four of the toxicity-based SQG approaches--effects range median, logistic regression modeling (LRM), sediment quality guideline quotient 1 (SQGQ1), and consensus--were derived in previous national studies in the United States, and one was developed as a regional variation of LRM calibrated to California data. The new benthos-based SQG approach, chemical score index, was derived from Southern California benthic community data. The chemical-specific guidelines for each approach were applied to matched chemical concentration, amphipod mortality, and benthic macrofauna abundance data for Southern California. Respective results for each SQG approach were then combined into a summary metric describing the overall contamination magnitude (e.g., mean quotient) and assessed in accordance with a set of thresholds in order to classify stations into 4 categories of expected biological effect. Results for each SQG approach were significantly correlated with changes in sediment toxicity and benthic community condition. Cumulative frequency plots and effect category thresholds for toxicity and benthic community condition were similar, indicating that both types of effect measures had similar sensitivity and specificity of response to contamination level. In terms of discriminating among multiple levels of benthic community condition, the toxicity-based SQG indices illustrated moderate capabilities, similar to those for multiple levels of toxicity. The National LRM, California LRM, and the chemical score index had the highest overall agreement with benthic categories. However

  11. The significance of water quality guidelines in environmental decision making: Ethylene glycol -- A case example

    SciTech Connect

    Craig, G.R.; Gilron, G.L.; Bishop, J.; Cerf, J.; Williams, J.

    1995-12-31

    Ethylene glycol is a principal component of deicing and anti-icing products commonly applied to aircraft in winter prior to take-off. Many airports do not have efficient collection systems in place surrounding aquatic environments and biota are often exposed to ethylene glycol contained in direct runoff and snowmelt. This study was designed to fulfill the minimum ecotoxicity data requirements for the development of a water quality guideline for ethylene glycol. Ecotoxicity testing was conducted using reagent-grade ethylene glycol and exposure concentrations were confirmed by GC/FID direct aqueous injection, or based on spectrophotometric measurement of the purpene-glycol reaction. The highest ethylene glycol NOEC values for the organisms tested included rainbow trout fry growth 14,692 mg/L, fathead minnow fry growth 12,531 mg/l, Ceriodaphnia dubia reproduction 3,469 mg/L, the ciliate Colpidium campylum 28,090 mg/L, and the rotifer Brachionus calyciflorus 12,800 mg/L. The highest non-lethal level for rainbow trout and the for the frog Xenopus laevis was 12,500 mg/L. Results indicated that the 48-hr LC50 for Xenopus laevis reported in an earlier study (and which was used in the derivation of some interim guidelines) could not be reproduced. However, results of the fish and invertebrate tests compared favorably with other literature values for similar species and with QSAR estimates. A number of water quality derivation protocols (CCME, Ontario MOE, and US EPA) were applied to the data set for the comparison of generated guideline values. Differences in values demonstrate the economic need for using a common approach in developing guidelines that are used to assess hazard to similar ecosystems in different jurisdictions within a global marketplace.

  12. Quality of the Development of Traumatic Brain Injury Clinical Practice Guidelines: A Systematic Review

    PubMed Central

    Patel, Anjni; Vieira, Mateus Mazorra Coelho; Abraham, John; Reid, Nick; Tran, Tu; Tomecsek, Kevin; Vissoci, João Ricardo N.; Eucker, Stephanie; Gerardo, Charles J.; Staton, Catherine A.

    2016-01-01

    Traumatic brain injury (TBI) is a leading cause of death worldwide and is increasing exponentially particularly in low and middle income countries (LMIC). To inform the development of a standard Clinical Practice Guideline (CPG) for the acute management of TBI that can be implemented specifically for limited resource settings, we conducted a systematic review to identify and assess the quality of all currently available CPGs on acute TBI using the AGREE II instrument. In accordance with PRISMA guidelines, from April 2013 to December 2015 we searched MEDLINE, EMBASE, Google Scholar and the Duke University Medical Center Library Guidelines for peer-reviewed published Clinical Practice Guidelines on the acute management of TBI (less than 24 hours), for any level of traumatic brain injury in both high and low income settings. A comprehensive reference and citation analysis was performed. CPGs found were assessed using the AGREE II instrument by five independent reviewers and scores were aggregated and reported in percentage of total possible score. An initial 2742 articles were evaluated with an additional 98 articles from the citation and reference analysis, yielding 273 full texts examined. A total of 24 final CPGs were included, of which 23 were from high income countries (HIC) and 1 from LMIC. Based on the AGREE II instrument, the best score on overall assessment was 100.0 for the CPG from the National Institute for Health and Clinical Excellence (NIHCE, 2007), followed by the New Zealand Guidelines Group (NZ, 2006) and the National Clinical Guideline (SIGN, 2009) both with a score of 96.7. The CPG from a LMIC had lower scores than CPGs from higher income settings. Our study identified and evaluated 24 CPGs with the highest scores in clarity and presentation, scope and purpose, and rigor of development. Most of these CPGs were developed in HICs, with limited applicability or utility for resource limited settings. Stakeholder involvement, Applicability, and

  13. 75 FR 18781 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Parts 1191, 1193, and 1194 RIN 3014-AA37 Americans With... and Transportation Barriers Compliance Board. ACTION: Notice of hearing. SUMMARY: The Architectural and Transportation Barriers Compliance Board (Access Board) will hold a public hearing on its...

  14. A Working Model for Complying with Accessibility Guidelines for Online Learning

    ERIC Educational Resources Information Center

    Cifuentes, Lauren; Janney, Alexandra; Guerra, Lauran; Weir, Jennifer

    2016-01-01

    We describe our activities that emerged in the context of an Office of Distance Education and Learning Technologies' efforts to systematically and systemically address accessibility for online learning in order to comply with ethical principles, best practices, and laws. The activities include three overarching continuous tasks: strategically…

  15. Access technique and its problems in parenteral nutrition – Guidelines on Parenteral Nutrition, Chapter 9

    PubMed Central

    Jauch, K. W.; Schregel, W.; Stanga, Z.; Bischoff, S. C.; Braß, P.; Hartl, W.; Muehlebach, S.; Pscheidl, E.; Thul, P.; Volk, O.

    2009-01-01

    Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7–10 days) parenteral nutrition (PN) requires central venous access whereas for PN <3 weeks percutaneously inserted catheters and for PN >3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7–10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site. PMID:20049083

  16. Construction Guidelines and Specifications. Modifying the Existing Campus Building for Accessibility.

    ERIC Educational Resources Information Center

    Cotler, Stephen Richard

    To address problems that the campus faces when attempting to make facility modifications that meet federal handicap accessibility requirements, this guidebook gives guidance on requirements and methods of "retrofitting" that meet the mobility needs of the disabled. Seven chapters discuss modifications to site, entrance, doors, interior…

  17. Guidelines for preparing a quality assurance plan for district offices of the U.S. Geological Survey

    USGS Publications Warehouse

    Schroder, L.J.; Shampine, W.J.

    1992-01-01

    The U.S. Geological Survey has a policy that requires each District office to prepare a Quality Assurance Plan. This plan is a combination of a District's management principles and quality assurance processes. The guidelines presented in this report provide a framework or expanded outline that a District can use to prepare a plan. Parti- cular emphasis is given to a District's: (1) quality assurance policies; (2) organization and staff responsibilities; and (3) program and project planning. The guidelines address the 'how', 'what', and 'who' questions that need to be answered when a District Quality Assurance Plan is prepared.

  18. [Quality guidelines for presurgical epilepsy diagnosis and operative epilepsy therapy: 1st revised version].

    PubMed

    Rosenow, F; Bast, T; Czech, T; Hans, V; Helmstaedter, C; Huppertz, H-J; Seeck, M; Trinka, E; Wagner, K

    2014-06-01

    In patients with pharmacorefractory epilepsy, preoperative epilepsy evaluation and subsequent epilepsy surgery lead to a significant improvement of seizure control, proportion of seizure-free patients, quality of life and social participation. The aims of preoperative epilepsy evaluation are to define the chance of complete seizure freedom and the likelihood of inducing new neurological deficits in a given patient. As epilepsy surgery is an elective procedure quality standards are particularly high. As detailed in the first edition of these practice guidelines, quality control relates to seven different domains: (1) establishing centres with a sufficient number of sufficiently and specifically trained personnel, (2) minimum technical standards and equipment, (3) continuing medical education of employees, (4) surveillance by trained personnel during the video electroencephalography (EEG) monitoring (VEM), (5) systematic acquisition of clinical and outcome data, (6) the minimum number of preoperative evaluations and epilepsy surgery procedures and (7) cooperation of epilepsy centres. In the first edition of these practice guidelines published in 2000 it was defined which standards were desirable and that their implementation should be aimed for. These standards related especially to the certification required for different groups of medical doctors involved and to the minimum numbers of procedures required. In the subsequent decade quite a number of colleagues have been certified by the trinational Working Group (Arbeitsgemeinschaft, AG) for Presurgical Epilepsy Diagnosis and Operative Epilepsy Treatment (http://www.ag-epilepsiechirurgie.de) and therefore, on 8 May 2013 the executive board of the AG decided to now make these standards obligatory.

  19. ESPEN Guidelines on Parenteral Nutrition: central venous catheters (access, care, diagnosis and therapy of complications).

    PubMed

    Pittiruti, Mauro; Hamilton, Helen; Biffi, Roberto; MacFie, John; Pertkiewicz, Marek

    2009-08-01

    When planning parenteral nutrition (PN), the proper choice, insertion, and nursing of the venous access are of paramount importance. In hospitalized patients, PN can be delivered through short-term, non-tunneled central venous catheters, through peripherally inserted central catheters (PICC), or - for limited period of time and with limitation in the osmolarity and composition of the solution - through peripheral venous access devices (short cannulas and midline catheters). Home PN usually requires PICCs or - if planned for an extended or unlimited time - long-term venous access devices (tunneled catheters and totally implantable ports). The most appropriate site for central venous access will take into account many factors, including the patient's conditions and the relative risk of infective and non-infective complications associated with each site. Ultrasound-guided venepuncture is strongly recommended for access to all central veins. For parenteral nutrition, the ideal position of the catheter tip is between the lower third of the superior cava vein and the upper third of the right atrium; this should preferably be checked during the procedure. Catheter-related bloodstream infection is an important and still too common complication of parenteral nutrition. The risk of infection can be reduced by adopting cost-effective, evidence-based interventions such as proper education and specific training of the staff, an adequate hand washing policy, proper choices of the type of device and the site of insertion, use of maximal barrier protection during insertion, use of chlorhexidine as antiseptic prior to insertion and for disinfecting the exit site thereafter, appropriate policies for the dressing of the exit site, routine changes of administration sets, and removal of central lines as soon as they are no longer necessary. Most non-infective complications of central venous access devices can also be prevented by appropriate, standardized protocols for line insertion

  20. The SQUIRE guidelines and how can they help you report on quality in health.

    PubMed

    Davidoff, Frank

    2014-03-07

    Published in 2008, the SQUIRE guidelines are a set of 19 descriptive items that identify the information readers want and need to know about making and studying improvements in healthcare delivery. They were created over a period of several years, largely in response to earlier concerns about the limited quantity and inadequate quality of published reports of work in this new discipline. They have proven useful in writing about improvement interventions, as well as in designing and implementing them. As improvement concepts and methods continue to develop, SQUIRE is also evolving as part of its continuing effort to contribute to the advancement of the "science of improvement."

  1. The process of reconciliation: evaluation of guidelines for translating quality-of-life questionnaires.

    PubMed

    Koller, Michael; Kantzer, Valeska; Mear, Isabelle; Zarzar, Katie; Martin, Mona; Greimel, Eva; Bottomley, Andrew; Arnott, Maria; Kuliś, Dagmara

    2012-04-01

    Reconciliation refers to the process through which two or more independent forward translations are merged into one single translation. This critical step in the translation process is difficult to formalize. The purpose of this review is to analyze how reconciliation is specified in leading guidelines for the translation of quality-of-life questionnaires and other patient-reported outcome forms with regard to the number and qualifications of individuals involved, the processes followed, as well as the criteria applied. In general, relatively little attention has been paid to characterizing the process in detail. Based on these findings, we specify criteria to be followed.

  2. Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation

    PubMed Central

    Radwan, Mahmoud; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

    2017-01-01

    Objectives To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Design Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Setting Palestinian Primary Healthcare Centres. Participants Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Main outcome measures Methodological quality of diabetic guideline. Results The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach’s α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains ‘Scope and Purpose’ and ‘Clarity of Presentation’ had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for ‘Applicability’, ‘Stakeholder Involvement’, ‘Rigour of Development’ and ‘Editorial Independence’ were the lowest (27%, 35%, 36.5%, and 40%, respectively). Conclusions The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group. PMID:28203385

  3. Managing Both Quality and Access at Higher Educational Institutions in Tobago

    ERIC Educational Resources Information Center

    Julien Sealey, Beverley

    2011-01-01

    This paper will focus on the island of Tobago and indicate what practical solutions are best suited for administrators to manage quality and access at higher educational institutions on the island. The key areas to managing quality identified are the inclusiveness of a quality plan, administrators desire to see quality as an institutional culture…

  4. Derivation of a water quality guideline for aluminium in marine waters.

    PubMed

    Golding, Lisa A; Angel, Brad M; Batley, Graeme E; Apte, Simon C; Krassoi, Rick; Doyle, Chris J

    2015-01-01

    Metal risk assessment of industrialized harbors and coastal marine waters requires the application of robust water quality guidelines to determine the likelihood of biological impacts. Currently there is no such guideline available for aluminium in marine waters. A water quality guideline of 24 µg total Al/L has been developed for aluminium in marine waters based on chronic 10% inhibition or effect concentrations (IC10 or EC10) and no-observed-effect concentrations (NOECs) from 11 species (2 literature values and 9 species tested including temperate and tropical species) representing 6 taxonomic groups. The 3 most sensitive species tested were a diatom Ceratoneis closterium (formerly Nitzschia closterium; IC10 = 18 µg Al/L, 72-h growth rate inhibition) < mussel Mytilus edulis plannulatus (EC10 = 250 µg Al/L, 72-h embryo development) < oyster Saccostrea echinata (EC10 = 410 µg Al/L, 48-h embryo development). Toxicity to these species was the result of the dissolved aluminium forms of aluminate (Al(OH4 (-) ) and aluminium hydroxide (Al(OH)3 (0) ) although both dissolved, and particulate aluminium contributed to toxicity in the diatom Minutocellus polymorphus and green alga Dunaliella tertiolecta. In contrast, aluminium toxicity to the green flagellate alga Tetraselmis sp. was the result of particulate aluminium only. Four species, a brown macroalga (Hormosira banksii), sea urchin embryo (Heliocidaris tuberculata), and 2 juvenile fish species (Lates calcarifer and Acanthochromis polyacanthus), were not adversely affected at the highest test concentration used.

  5. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Quality assurance in endoscopy in colorectal cancer screening and diagnosis.

    PubMed

    Valori, R; Rey, J-F; Atkin, W S; Bretthauer, M; Senore, C; Hoff, G; Kuipers, E J; Altenhofen, L; Lambert, R; Minoli, G

    2012-09-01

    Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in endoscopy includes 50 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of endoscopy and other elements in the screening process, including multidisciplinary diagnosis and management of the disease.

  6. ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories.

    PubMed

    Gunn-Christie, Rebekah G; Flatland, Bente; Friedrichs, Kristen R; Szladovits, Balazs; Harr, Kendal E; Ruotsalo, Kristiina; Knoll, Joyce S; Wamsley, Heather L; Freeman, Kathy P

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and documents recommendations for control of preanalytical, analytical, and postanalytical factors related to urinalysis, cytology, and clinical chemistry in veterinary laboratories and is adapted from sections 1.1 and 2.2 (clinical chemistry), 1.3 and 2.5 (urinalysis), 1.4 and 2.6 (cytology), and 3 (postanalytical factors important in veterinary clinical pathology) of these guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.

  7. Improving Quality and Access to Radiation Therapy-An IAEA Perspective.

    PubMed

    Abdel-Wahab, May; Zubizarreta, Eduardo; Polo, Alfredo; Meghzifene, Ahmed

    2017-04-01

    The International Atomic Energy Agency (IAEA) has been involved in radiation therapy since soon after its creation in 1957. In response to the demands of Member States, the IAEA׳s activities relating to radiation therapy have focused on supporting low- and middle-income countries to set up radiation therapy facilities, expand the scope of treatments, or gradually transition to new technologies. In addition, the IAEA has been very active in providing internationally harmonized guidelines on clinical, dosimetry, medical physics, and safety aspects of radiation therapy. IAEA clinical research has provided evidence for treatment improvement as well as highly effective resource-sparing interventions. In the process, training of researchers occurs through this program. To provide this support, the IAEA works with its Member States and multiple partners worldwide through several mechanisms. In this article, we review the main activities conducted by the IAEA in support to radiation therapy. IAEA support has been crucial for achieving tangible results in many low- and middle-income countries. However, long-term sustainability of projects can present a challenge, especially when considering health budget constraints and the brain drain of skilled professionals. The need for support remains, with more than 90% of patients in low-income countries lacking access to radiotherapy. Thus, the IAEA is expected to continue its support and strengthen quality radiation therapy treatment of patients with cancer.

  8. 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…

  9. The service context for clinical guidelines: supporting guideline implementation by assuring and improving the quality of service in which clinicians work.

    PubMed

    Worrall, Adrian

    2011-08-01

    This paper argues that accreditation schemes and quality networks promote good contexts for the implementation of clinical guidelines. It raises questions about how organizational standards should be developed, structured and focused, how clinical guidelines and organizational standards should connect, how to practically increase the number of such schemes and their scope, and the role of professional bodies in this. There is a considerable amount of administration involved in running an accreditation scheme or quality network and there are risks involved in starting in new areas. One way forward is for professional bodies to partner to share risks and to build a common operating platform for the administration of the work across the professional bodies. This platform could be guided by topic experts within the bodies.

  10. The Water Quality Portal: a single point of access for water quality data

    NASA Astrophysics Data System (ADS)

    Kreft, J.

    2015-12-01

    The Water Quality Portal (WQP) is a cooperative project between the U.S. Geological Survey (USGS) and the U.S. Environmental Protection Agency (EPA) overseen by the National Water Quality Monitoring Council (NWQMC). It was launched in April of 2012 as a single point of access for discrete water quality samples stored in the USGS NWIS and EPA STORET systems. Since launch thousands of users have visited the Water Quality Portal to download billions of results that are pertinent to their interests. Numerous tools have also been developed that use WQP web services as a source of data for further analysis. Since the launch of the Portal, the WQP development team at the USGS Center for Integrated Data Analytics has worked with USGS and EPA stakeholders as well as the wider user community to add significant new features to the WQP. WQP users can now directly plot sites of interest on a web map based on any of the 164 WQP query parameters, and then download data of interest directly from that map. In addition, the WQP has expanded beyond just serving out NWIS and STORET data, and provides data from the US Department of Agriculture's Agricultural Research Service STEWARDS system, the USGS BioData system and is working with others to bring in additional data. Finally, the WQP is linked to another NWQMC-supported project, the National Environmental Methods Index (NEMI), so WQP users can easily find the method behind the data that they are using. Future work is focused on incorporating additional biological data from the USGS BioData system, broadening the scope of discrete water quality sample types from STORET, and developing approaches to make the data in the WQP more visible and usable. The WQP team is also exploring ways to further integrate with other systems, such as those operated the U.S. Department of Agriculture Forest Service and other federal agencies to facilitate the overarching goal of improving access to water quality data for all users.

  11. Production and quality of clinical practice guidelines in Argentina (1994–2004): a cross-sectional study

    PubMed Central

    Esandi, María Eugenia; Ortiz, Zulma; Chapman, Evelina; Dieguez, Marcelo García; Mejía, Raúl; Bernztein, Ricardo

    2008-01-01

    Background In the last decades, a sustained increment of Clinical Practice Guidelines (CPG) production in the world has been accompanied by a growing concern about their quality. Many studies related to quality assessment of guidelines produced in High Income Countries were published; however, evidence on this topic is scarce in Low and Middle Income Countries (LMIC). The objectives of this research were: a) to describe guideline production in Argentina at different levels of the health system (macro, meso and micro) from 1994 to 2004; and b) to assess their quality by using the AGREE instrument. Methods A cross-sectional study was undertaken to describe guidelines production in Argentina between 1994 and 2004. CPG were identified through Internet and electronic databases (MEDLINE and LILACS). Explicit inclusion and exclusion criteria were used to select guidelines. Each CPG was independently assessed by two reviewers using the AGREE instrument. Domain scores were calculated as recommended by the AGREE Collaboration. The internal consistency of each domain was evaluated using Cronbach's alpha and inter-observer agreement by the Intraclass Correlation Coefficient (ICC). Results A total amount of 431 potential CPG were identified, but only 144 were considered CPG. At the end, 101 CPG were included for further assessment. Median standardized score for each domain were: scope = 39%; stakeholder involvement = 13%; rigour of development = 10%; clarity = 42%; applicability = 6%; editorial independence = 0%. Only 22 CPG were recommended with modifications by both appraisers. ICC and Cronbach's alpha for each domain were in all cases moderate or high (greater than 0.40), except for editorial independence. Conclusion This study has systematically employed the AGREE instrument for the critical assessment of guidelines produced in a LMIC. Guideline development and diffusion in Argentina from 1994 to 2004 shows a constant increment, although quality of reporting did not improve

  12. Quality assurance: recommended guidelines for safe heating by capacitive-type heating technique to treat patients with metallic implants.

    PubMed

    Kato, Hirokazu; Kondo, Motoharu; Imada, Hajime; Kuroda, Masahiro; Kamimura, Yoshitsugu; Saito, Kazuyuki; Kuroda, Kagayaki; Ito, Koichi; Takahashi, Hideaki; Matsuki, Hidetoshi

    2013-05-01

    This article is a redissemination of the previous Japanese Quality Assurance Guide guidelines. Specific absorption rate and temperature distribution were investigated with respect to various aspects including metallic implant size and shape, insertion site, insertion direction, blood flow and heating power, and simulated results were compared with adverse reactions of patients treated by radio frequency capacitive-type heating. Recommended guidelines for safe heating methods for patients with metallic implants are presented based on our findings.

  13. National standards and guidelines for pesticides in water, sediment, and aquatic organisms: application to water-quality assessments.

    PubMed

    Nowell, L H; Resek, E A

    1994-01-01

    National standards and guidelines for pesticides can be useful tools in water-quality assessment for evaluating potential human health or ecological effects of measured pesticide residues in water, bed sediment, or aquatic organisms. However, valid use of a given standard or guideline requires an understanding of its technical basis and underlying assumptions. Each type of standard or guideline is specific for one sampling medium (water, bed sediment, and fish and shellfish tissue) and is aimed at protection of one or more beneficial uses of the hydrologic system (drinking water, fish and shellfish consumption, aquatic organisms, and wildlife). These characteristics can be used to identify which standards and guidelines are appropriate for comparison with measured pesticide concentrations in environmental samples from a given hydrologic system. A review of standards and guidelines can be restricted to the applicable sampling medium. Then, the beneficial uses of the hydrologic system need to be identified and the measured pesticide concentrations compared with standards and guidelines for all beneficial uses that apply to that system. Several key factors that must be considered when applying this general process to water-quality assessment are summarized below. Two precautions need to be considered regarding sampling media: 1. Standards and guidelines for water distinguish between finished drinking water (potable water, often treated) and ambient surface water. If standards and guidelines for drinking water (EPA primary drinking-water regulations and drinking-water health advisories) are applied to measured pesticide concentrations in ambient water samples, the effects of water treatment (such as filtration) need to be considered. 2. Standards and guidelines for fish and shellfish tissue distinguish between edible fish and shellfish tissue and whole fish tissue. Comparison of pesticide concentrations in whole fish tissue with standards or guidelines for edible fish

  14. The Quality of Teaching Staff: Higher Education Institutions' Compliance with the European Standards and Guidelines for Quality Assurance--The Case of Portugal

    ERIC Educational Resources Information Center

    Cardoso, Sónia; Tavares, Orlanda; Sin, Cristina

    2015-01-01

    In recent years, initiatives for the improvement of teaching quality have been pursued both at European and national levels. Such is the case of the European Standards and Guidelines for Quality Assurance (ESG) and of legislation passed by several European countries, including Portugal, in response to European policy developments driven by the…

  15. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Qualified Health Maintenance Organizations: Services § 417.106 Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. (a) Quality assurance program. Each HMO or CMP must have an ongoing quality assurance program for its health services that meets...

  16. Dilemma of Access and Provision of Quality Basic Education in Central Region, Ghana

    ERIC Educational Resources Information Center

    Amakyi, Michael; Ampah-Mensah, Alfred

    2016-01-01

    A survey research was conducted to find out if reported improvements in access to education in Ghana are reflected in comparable improvements in delivery of quality education. The study examined theoretical constructs on adequacy and quality assurance in education to ascertain the state of quality provision in education, and whether there is a…

  17. Brazil's National Program for Improving Primary Care Access and Quality (PMAQ)

    PubMed Central

    Harris, Matthew J.; Rocha, Marcia Gomes

    2017-01-01

    Despite some remarkable achievements, there are several challenges facing Brazil's Family Health Strategy (FHS), including expanding access to primary care and improving its quality. These concerns motivated the development of the National Program for Improving Primary Care Access and Quality (PMAQ). Although voluntary, the program now includes nearly 39 000 FHS teams in the country and has led to a near doubling of the federal investment in primary care in its first 2 rounds. In this article, we introduce the PMAQ and advance several recommendations to ensure that it continues to improve primary care access and quality in Brazil. PMID:28252498

  18. Disk diffusion quality control guidelines for NVP-PDF 713: a novel peptide deformylase inhibitor.

    PubMed

    Anderegg, Tamara R; Jones, Ronald N

    2004-01-01

    NVP-PDF713 is a peptide deformylase inhibitor that has emerged as a candidate for treating Gram-positive infections and selected Gram-negative species that commonly cause community-acquired respiratory tract infections. This report summarizes the results of a multi-center (seven participants) disk diffusion quality control (QC) investigation for NVP PDF-713 using guidelines of the National Committee for Clinical Laboratory Standards and the standardized disk diffusion method. A total of 420 NVP-PDF 713 zone diameter values were generated for each QC organism. The proposed zone diameter ranges contained 97.6-99.8% of the reported participant results and were: Staphylococcus aureus ATCC 25923 (25-35 mm), Streptococcus pneumoniae ATCC 49619 (30-37 mm), and Haemophilus influenzae ATCC 49247 (24-32 mm). These QC criteria for the disk diffusion method should be applied during the NVP-PDF 713 clinical trials to maximize test accuracy.

  19. Response of the freshwater bivalve Anodonta grandis to Cd near the Canadian Water Quality Guideline

    SciTech Connect

    Stewart, A.R.; Malley, D.F. |

    1994-12-31

    The bivalve population inhabiting Lake 382 in the Experimental Lakes Area, northwestern Ontario, receiving experimental additions of cadmium (Cd) near the Canadian Water Quality Guideline (CWQG) was monitored for effects during 1987 to 1992. the purpose of the study was to determine if the CWQG of 0.2 {mu}g Cd/L would adequately protect the biota of the Precambrian Shield Lakes. Mussels accumulated Cd to whole body levels 30X background. Cd levels in the mussels did not plateau by the end of 1992 and continues to increase. Metal-binding proteins metallothioneins (MTs) were induced in all tissues to levels significantly higher than in tissues of mussels from a pristine lake. Although mussel growth rates differed from site to site within Lake 382, there was no change in growth rates with the addition of Cd.

  20. Using sediment quality guidelines for dredged material management in commercial ports from Spain.

    PubMed

    Casado-Martínez, M C; Buceta, J L; Belzunce, M J; Delvalls, T A

    2006-04-01

    Dredged material contamination was assessed in different commercial ports from Spain: Port of Cádiz and Huelva, South West; Bilbao and Pasajes, North; Cartagena and Barcelona, East; Coruña, North West. Sediment from different locations of these ports was sampled and was characterized following the Spanish recommendations for dredged material management. This characterization included grain size distribution, organic matter content and concentration of the chemical compounds included in the list of pollutants and hazardous substances (As, Cd, Cu, Cr, Hg, Ni, Pb and Zn; PCB congeners IUPAC number 28, 52, 101, 118, 138, 153 and 180; PAHs were also analyzed). The results were compared to the limit values of Spanish Action Levels that define the different categories for assessment and management. A set of empirically derived sediment quality guidelines (SQG) was used to assess the possible toxicity of the dredged materials and to improve the use of the chemical approach to characterize dredged material for its management.

  1. Applying sediment quality guidelines on soft sediments of the Gulf of Finland, Baltic Sea.

    PubMed

    Vallius, Henry

    2015-09-15

    The Gulf of Finland is known to have been rather largely contaminated by heavy metals during the last half of the 20th century, but indications of recovery have been reported. In order to investigate the recent levels of heavy metals and arsenic in the uppermost soft sediments of the off-shore Gulf of Finland coring of altogether 23 sites were performed. The subsamples of the cores are 605 in total and thus give a good picture of heavy metal levels in the surface sediments during the first decade of this century. In order to evaluate methods and predict sediment toxicity the sediment concentrations are compared to American SQG:s. Majority of the subsamples exceeded the threshold levels of both used SQG:s, but some exceeded also the midrange effects quality guidelines. As, Cd, Hg, and Zn concentrations still occur at unacceptably high levels in sediments of the off-shore Gulf of Finland.

  2. Transportation Accessibility and Quality of Life for the Urban Elderly.

    ERIC Educational Resources Information Center

    Belnap, Judith A.

    The barriers to physical mobility of the elderly are explained in this study which concentrated on spatial-temporal accessibility, and the use of mass transit to urban services and resources. The first area of concern dealt with the amount and extent of free time available to the elderly who are perceived as having large blocks of descretionary…

  3. Matching Students to Opportunity: Expanding College Choice, Access, and Quality

    ERIC Educational Resources Information Center

    Kelly, Andrew P., Ed.; Howell, Jessica S., Ed.; Sattin-Bajaj, Carolyn, Ed.

    2016-01-01

    "Matching Students to Opportunity" expands on the discussion of a critical issue in college access and success: the match between prospective students and the colleges in which they enroll. Research indicates that ensuring a good match significantly increases a student's chance of graduating. The contributors to this volume argue that…

  4. Using research metrics to evaluate the International Atomic Energy Agency guidelines on quality assurance for R&D

    SciTech Connect

    Bodnarczuk, M.

    1994-06-01

    The objective of the International Atomic Energy Agency (IAEA) Guidelines on Quality Assurance for R&D is to provide guidance for developing quality assurance (QA) programs for R&D work on items, services, and processes important to safety, and to support the siting, design, construction, commissioning, operation, and decommissioning of nuclear facilities. The standard approach to writing papers describing new quality guidelines documents is to present a descriptive overview of the contents of the document. I will depart from this approach. Instead, I will first discuss a conceptual framework of metrics for evaluating and improving basic and applied experimental science as well as the associated role that quality management should play in understanding and implementing these metrics. I will conclude by evaluating how well the IAEA document addresses the metrics from this conceptual framework and the broader principles of quality management.

  5. Peer Review Quality and Transparency of the Peer-Review Process in Open Access and Subscription Journals

    PubMed Central

    Wicherts, Jelte M.

    2016-01-01

    Background Recent controversies highlighting substandard peer review in Open Access (OA) and traditional (subscription) journals have increased the need for authors, funders, publishers, and institutions to assure quality of peer-review in academic journals. I propose that transparency of the peer-review process may be seen as an indicator of the quality of peer-review, and develop and validate a tool enabling different stakeholders to assess transparency of the peer-review process. Methods and Findings Based on editorial guidelines and best practices, I developed a 14-item tool to rate transparency of the peer-review process on the basis of journals’ websites. In Study 1, a random sample of 231 authors of papers in 92 subscription journals in different fields rated transparency of the journals that published their work. Authors’ ratings of the transparency were positively associated with quality of the peer-review process but unrelated to journal’s impact factors. In Study 2, 20 experts on OA publishing assessed the transparency of established (non-OA) journals, OA journals categorized as being published by potential predatory publishers, and journals from the Directory of Open Access Journals (DOAJ). Results show high reliability across items (α = .91) and sufficient reliability across raters. Ratings differentiated the three types of journals well. In Study 3, academic librarians rated a random sample of 140 DOAJ journals and another 54 journals that had received a hoax paper written by Bohannon to test peer-review quality. Journals with higher transparency ratings were less likely to accept the flawed paper and showed higher impact as measured by the h5 index from Google Scholar. Conclusions The tool to assess transparency of the peer-review process at academic journals shows promising reliability and validity. The transparency of the peer-review process can be seen as an indicator of peer-review quality allowing the tool to be used to predict academic

  6. The use of automated external defibrillators and public access defibrillators in the mountains: official guidelines of the international commission for mountain emergency medicine ICAR-MEDCOM.

    PubMed

    Elsensohn, Fidel; Agazzi, Giancelso; Syme, David; Swangard, Michael; Facchetti, Gianluca; Brugger, Hermann

    2006-01-01

    In this article we propose guidelines for rational use of automated external defibrillators and public access defibrillators in the mountains. In cases of ventricular fibrillation and pulseless ventricular tachycardia, early defibrillation is the most effective therapy. Easy access to mountainous areas permits visitation by persons with high risks for sudden cardiac death, and medical trials show the benefit of exercising in moderate altitude. The introduction of public access defibrillators in popular areas in the mountains may lead to a reduction of fatal outcome of cardiac arrest. Public access defibrillators should be placed with priority in popular ski areas, in busy mountain huts and restaurants, at mass-participation events, and in remote but often-visited locations that do not have medical coverage. Automated external defibrillators should be available to first-responder groups and mountain-rescue teams. It is important that people know how to perform cardiopulmonary resuscitation and how to use public access defibrillators and automated external defibrillators.

  7. Canadian experiences in telehealth: equalizing access to quality care.

    PubMed

    Jennett, P A; Person, V L; Watson, M; Watanabe, M

    2000-01-01

    The Canadian Conference "TExpo'98: Interactive Health" focused on four telehealth themes: community needs, Canadian experiences, industry perspectives, and access/security/interoperability issues. Health and socioeconomic needs have been the driving force behind telehealth initiatives; telelearning is one of the major Canadian initiatives. To encourage Canadian telehealth initiatives, the federal government is building a national health infrastructure. One element in this framework is concerned with empowering the public, strengthening health care services, and ensuring accountability. Technological advancements and innovative partnerships among health communities, government, users, professional bodies, and industry are critical to continued growth. Key issues including access, evaluation, implementation, privacy, confidentiality, security, and interoperability are of universal concern to participants. Research that examines the benefits and costs of telehealth is needed.

  8. Comparison of test specific sediment effect concentrations with marine sediment quality assessment guidelines

    SciTech Connect

    Carr, R.S.; Biedenbach, J.M.; Long, E.R.; MacDonald, D.D.

    1995-12-31

    As part of NOAA`s National Status and Trends (NS and T) Bioeffects Assessment program and studies conducted by the National Biological Service, numerous sediment quality assessment surveys have recently been conducted along the Atlantic and Gulf coasts of the US using the sea urchin (Arbacia punctulata) fertilization and embryological development tests with pore water. Additional toxicity tests were also conducted in conjunction with most of these studies. The areas that have been sampled include Boston harbor, Massachusetts; Charleston Harbor, Winyah Bay, and Savannah River, South Carolina; St. Simon Sound, Georgia; Biscayne Bay, Tampa Bay, Choctawhatchee Bay, Apalachicola Bay, St. Andrew Bay, and Pensacola Bay, Florida; Galveston Bay, Lavaca Bay, and Sabine Lake, Texas, and 200 stations in the vicinity of offshore oil and gas production platforms in the Gulf of Mexico. Sufficient data are now available from this series of surveys to calculate test specific sediment effect concentrations (SECs). Based on these recent studies, SECs were developed for the sea urchin porewater and amphipod tests and compared with existing marine sediment quality assessment guidelines.

  9. Gestational Diabetes and Preeclampsia in Association with Air Pollution at Levels below Current Air Quality Guidelines

    PubMed Central

    Jakobsson, Kristina; Tinnerberg, Håkan; Rignell-Hydbom, Anna; Rylander, Lars

    2013-01-01

    Background: Several studies have estimated associations between air pollution and birth outcomes, but few have evaluated potential effects on pregnancy complications. Objective: We investigated whether low-level exposure to air pollution is associated with gestational diabetes and preeclampsia. Methods: High-quality registry information on 81,110 singleton pregnancy outcomes in southern Sweden during 1999–2005 was linked to individual-level exposure estimates with high spatial resolution. Modeled exposure to nitrogen oxides (NOx), expressed as mean concentrations per trimester, and proximity to roads of different traffic densities were used as proxy indicators of exposure to combustion-related air pollution. The data were analyzed by logistic regression, with and without adjusting for potential confounders. Results: The prevalence of gestational diabetes increased with each NOx quartile, with an adjusted odds ratio (OR) of 1.69 (95% CI: 1.41, 2.03) for the highest (> 22.7 µg/m3) compared with the lowest quartile (2.5–8.9 µg/m3) of exposure during the second trimester. The adjusted OR for acquiring preeclampsia after exposure during the third trimester was 1.51 (1.32, 1.73) in the highest quartile of NOx compared with the lowest. Both outcomes were associated with high traffic density, but ORs were significant for gestational diabetes only. Conclusion: NOx exposure during pregnancy was associated with gestational diabetes and preeclampsia in an area with air pollution levels below current air quality guidelines. PMID:23563048

  10. Variation in cooking and eating quality traits in Japanese rice germplasm accessions

    PubMed Central

    Hori, Kiyosumi; Suzuki, Keitaro; Iijima, Ken; Ebana, Kaworu

    2016-01-01

    The eating quality of cooked rice is important and determines its market price and consumer acceptance. To comprehensively describe the variation of eating quality in 183 rice germplasm accessions, we evaluated 33 eating-quality traits including amylose and protein contents, pasting properties of rice flour, and texture of cooked rice grains. All eating-quality traits varied widely in the germplasm accessions. Principal-components analysis (PCA) revealed that allelic differences in the Wx gene explained the largest proportion of phenotypic variation of the eating-quality traits. In 146 accessions of non-glutinous temperate japonica rice, PCA revealed that protein content and surface texture of the cooked rice grains significantly explained phenotypic variations of the eating-quality traits. An allelic difference based on simple sequence repeats, which was located near a quantitative trait locus (QTL) on the short arm of chromosome 3, was associated with differences in the eating quality of non-glutinous temperate japonica rice. These results suggest that eating quality is controlled by genetic factors, including the Wx gene and the QTL on chromosome 3, in Japanese rice accessions. These genetic factors have been consciously selected for eating quality during rice breeding programs in Japan. PMID:27162502

  11. Variation in cooking and eating quality traits in Japanese rice germplasm accessions.

    PubMed

    Hori, Kiyosumi; Suzuki, Keitaro; Iijima, Ken; Ebana, Kaworu

    2016-03-01

    The eating quality of cooked rice is important and determines its market price and consumer acceptance. To comprehensively describe the variation of eating quality in 183 rice germplasm accessions, we evaluated 33 eating-quality traits including amylose and protein contents, pasting properties of rice flour, and texture of cooked rice grains. All eating-quality traits varied widely in the germplasm accessions. Principal-components analysis (PCA) revealed that allelic differences in the Wx gene explained the largest proportion of phenotypic variation of the eating-quality traits. In 146 accessions of non-glutinous temperate japonica rice, PCA revealed that protein content and surface texture of the cooked rice grains significantly explained phenotypic variations of the eating-quality traits. An allelic difference based on simple sequence repeats, which was located near a quantitative trait locus (QTL) on the short arm of chromosome 3, was associated with differences in the eating quality of non-glutinous temperate japonica rice. These results suggest that eating quality is controlled by genetic factors, including the Wx gene and the QTL on chromosome 3, in Japanese rice accessions. These genetic factors have been consciously selected for eating quality during rice breeding programs in Japan.

  12. Application of phytotoxicity data to a new Australian soil quality guideline framework for biosolids.

    PubMed

    Heemsbergen, Diane A; Warne, Michael St J; Broos, Kris; Bell, Mike; Nash, David; McLaughlin, Mike; Whatmuff, Mark; Barry, Glenn; Pritchard, Deb; Penney, Nancy

    2009-04-01

    To protect terrestrial ecosystems and humans from contaminants many countries and jurisdictions have developed soil quality guidelines (SQGs). This study proposes a new framework to derive SQGs and guidelines for amended soils and uses a case study based on phytotoxicity data of copper (Cu) and zinc (Zn) from field studies to illustrate how the framework could be applied. The proposed framework uses normalisation relationships to account for the effects of soil properties on toxicity data followed by a species sensitivity distribution (SSD) method to calculate a soil added contaminant limit (soil ACL) for a standard soil. The normalisation equations are then used to calculate soil ACLs for other soils. A soil amendment availability factor (SAAF) is then calculated as the toxicity and bioavailability of pure contaminants and contaminants in amendments can be different. The SAAF is used to modify soil ACLs to ACLs for amended soils. The framework was then used to calculate soil ACLs for copper (Cu) and zinc (Zn). For soils with pH of 4-8 and OC content of 1-6%, the ACLs range from 8 mg/kg to 970 mg/kg added Cu. The SAAF for Cu was pH dependant and varied from 1.44 at pH 4 to 2.15 at pH 8. For soils with pH of 4-8 and OC content of 1-6%, the ACLs for amended soils range from 11 mg/kg to 2080 mg/kg added Cu. For soils with pH of 4-8 and a CEC from 5-60, the ACLs for Zn ranged from 21 to 1470 mg/kg added Zn. A SAAF of one was used for Zn as it concentrations in plant tissue and soil to water partitioning showed no difference between biosolids and soluble Zn salt treatments, indicating that Zn from biosolids and Zn salts are equally bioavailable to plants.

  13. Guidelines for Controlling Indoor Air Quality Problems Associated with Kilns, Copiers, and Welding in Schools. Technical Bulletin.

    ERIC Educational Resources Information Center

    Turner, Ronald W.; And Others

    Guidelines for controlling indoor air quality problems associated with kilns, copiers, and welding in schools are provided in this document. Individual sections on kilns, duplicating equipment, and welding operations contain information on the following: sources of contaminants; health effects; methods of control; ventilation strategies; and…

  14. Methodological quality of English-language genetic guidelines on hereditary breast-cancer screening and management: an evaluation using the AGREE instrument

    PubMed Central

    2012-01-01

    Background We examined the methodological quality of guidelines on syndromes conferring genetic susceptibility to breast cancer. Methods PubMed, EMBASE, and Google were searched for guidelines published up to October 2010. All guidelines in English were included. The Appraisal of Guidelines, Research and Evaluation (AGREE) instrument was used to assess the quality of the guidelines, and their reported evidence base was evaluated. Results Thirteen guidelines were deemed eligible: seven had been developed by independent associations, and the other six had national/state endorsements. Four guidelines performed satisfactorily, achieving a score of greater than 50% in all six AGREE domains. Mean ± SD standardized scores for the six AGREE domains were: 90 ± 9% for 'scope and purpose', 51 ± 18% for 'stakeholder involvement', 55 ± 27% for 'rigour of development', 80 ± 11% for 'clarity and presentation', 37 ± 32% for 'applicability', and 47 ± 38% for 'editorial independence'. Ten of the thirteen guidelines were found to be based on research evidence. Conclusions Given the ethical implications and the high costs of genetic testing for hereditary breast cancer, guidelines on this topic should provide clear and evidence-based recommendations. Our analysis shows that there is scope for improving many aspects of the methodological quality of current guidelines. The AGREE instrument is a useful tool, and could be used profitably by guidelines developers to improve the quality of recommendations. PMID:23171648

  15. Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality.

    PubMed

    Hinds, Richard M; Danna, Natalie R; Capo, John T; Mroczek, Kenneth J

    2016-11-10

    Background The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. Methods The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Results Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. Conclusions There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Clinical Relevance Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online.

  16. Getting (Along) With the Guidelines: Reconciling Patient Autonomy and Quality Improvement Through Shared Decision Making.

    PubMed

    Xu, Yan; Wells, Philip S

    2016-07-01

    In past decades, stark differences in practice pattern, cost, and outcomes of care across regions with similar health demographics have prompted calls for reform. As health systems answer the growing call for accountability in the form of quality indices, while responding to increased scrutiny on practice variation in the form of pay for performance (P4P), a rift is widening between the system and individual patients. Currently, three areas are inadequately considered by P4P structures based largely on physician adherence to guidelines: diversity of patient values and preferences; time and financial burden of therapy in the context of multimorbidity; and narrow focus on quantitative measures that distract clinicians from providing optimal care. As health care reform efforts place greater emphasis on value-for-money of care delivered, they provide an opportunity to consider the other "value"-the values of each patient and care delivery that aligns with them.The inherent balance of risks and benefits in every treatment, especially those involving chronic conditions, calls for engagement of patients in decision-making processes, recognizing the diversity of preferences at the individual level. Shared decision making (SDM) is an attractive option and should be an essential component of quality health care rather than its adjunct. Four interwoven steps toward the meaningful implementation of SDM in clinical practice-embedding SDM as a health care quality measure, "real-world" evaluation of SDM effectiveness, pursuit of an SDM-favorable health system, and patient-centered medical education-are proposed to bring focus back to the beneficiary of health care accountability, the patient.

  17. Selecting pesticides for inclusion in drinking water quality guidelines on the basis of detection probability and ranking.

    PubMed

    Narita, Kentaro; Matsui, Yoshihiko; Iwao, Kensuke; Kamata, Motoyuki; Matsushita, Taku; Shirasaki, Nobutaka

    2014-02-01

    Pesticides released into the environment may pose both ecological and human health risks. Governments set the regulations and guidelines for the allowable levels of active components of pesticides in various exposure sources, including drinking water. Several pesticide risk indicators have been developed using various methodologies, but such indicators are seldom used for the selection of pesticides to be included in national regulations and guidelines. The aim of the current study was to use risk indicators for the selection of pesticides to be included in regulations and guidelines. Twenty-four risk indicators were created, and a detection rate was defined to judge which indicators were the best for selection. The combination of two indicators (local sales of a pesticide for the purposes of either rice farming or other farming, divided by the guideline value and annual precipitation, and amended with the scores from the physical and chemical properties of the pesticide) gave the highest detection rates. In this case study, this procedure was used to evaluate 134 pesticides that are currently unregulated in the Japanese Drinking Water Quality Guidelines, from which 44 were selected as pesticides to be added to the primary group in the guidelines. The detection probability of the 44 pesticides was more than 72%. Among the 102 pesticides currently in the primary group, 17 were selected for withdrawal from the group.

  18. Expanding Access to Quality Pre-K Is Sound Public Policy

    ERIC Educational Resources Information Center

    Barnett, W. Steven

    2013-01-01

    In 2013, preschool education received more attention in the media and public policy circles than it has for some time, in part because of a series of high-profile proposals to expand access to quality pre-K. The scientific basis for these proposed expansions of quality pre-K is impressive. This paper brings to bear the full weight of the evidence…

  19. Hearing Parents' and Carers' Voices: Experiences of Accessing Quality Long Day Care in Northern Regional Australia

    ERIC Educational Resources Information Center

    Harris, Nonie; Tinning, Beth

    2012-01-01

    This article explores parents' and carers' experiences of accessing quality long day care in northern regional Australia. The data was gathered in 2009, after the collapse of ABC Developmental Learning Centres (herein referred to as ABC Learning) and before the implementation of the "National Quality Framework," and provides a snapshot…

  20. Access High Quality Imagery from the NOAA View Portal

    NASA Astrophysics Data System (ADS)

    Pisut, D.; Powell, A. M.; Loomis, T.; Goel, V.; Mills, B.; Cowan, D.

    2013-12-01

    NOAA curates a vast treasure trove of environmental data, but one that is sometimes not easily accessed, especially for education, outreach, and media purposes. Traditional data portals in NOAA require extensive knowledge of the specific names of observation platforms, models, and analyses, along with nomenclature for variable outputs. A new website and web mapping service (WMS) from NOAA attempts to remedy such issues. The NOAA View data imagery portal provides a seamless entry point into data from across the agency: satellite, models, in-situ analysis, etc. The system provides the user with ability to browse, animate, and download high resolution (e.g., 4,000 x 2,000 pixel) imagery, Google Earth, and even proxy data files. The WMS architecture also allows the resources to be ingested into other software systems or applications.

  1. Application of water quality guidelines and water quantity calculations to decisions for beneficial use of treated water

    NASA Astrophysics Data System (ADS)

    Pham, Minh Phung T.; Castle, James W.; Rodgers, John H.

    2011-12-01

    Water reuse guidelines were compiled as a decision-analysis screening tool for application to potential water reuse for irrigation, livestock watering, aquaculture, and drinking. Data compiled from the literature for water reuses yielded guideline values for over 50 water quality parameters, including concentrations of inorganic and organic constituents as well as general water chemistry parameters. These water quality guidelines can be used to identify constituents of concern in water, to determine the levels to which the constituents must be treated for water reuse applications, and assess the suitability of treated water for reuse. An example is provided to illustrate the application of water quality guidelines for decision analysis. Water quantity analysis was also investigated, and water volumes required for producing 16 different crops in 15 countries were estimated as an example of applying water quantity in the decision-making process regarding the potential of water reuse. For each of the countries investigated, the crop that produces the greatest yield in terms of weight per water volume is tomatoes in Australia, Brazil, Italy, Japan, Saudi Arabia, Turkey, USA; sugarcane in Chad, India, Indonesia, Sudan; watermelons in China; lettuce in Egypt, Mexico; and onions (dry) in Russia.

  2. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    PubMed Central

    Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

    2016-01-01

    Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

  3. Access to orphan drugs despite poor quality of clinical evidence

    PubMed Central

    Dupont, Alain G; Van Wilder, Philippe B

    2011-01-01

    AIM We analysed the Belgian reimbursement decisions of orphan drugs as compared with those of innovative drugs for more common but equally severe diseases, with special emphasis on the quality of clinical evidence. METHODS Using the National Health Insurance Agency administrative database, we evaluated all submitted orphan drug files between 2002 and 2007. A quality analysis of the clinical evidence in the orphan reimbursement files was performed. The evaluation reports of the French ‘Haute Autorité de Santé’, including the five-point scale parameter ‘Service Médical Rendu (SMR), were examined to compare disease severity. Chi-squared tests (at P < 0.05 significance level) were used to compare the outcome of the reimbursement decisions between orphan and non-orphan innovative medicines. RESULTS Twenty-five files of orphan drugs and 117 files of non-orphan drugs were evaluated. Twenty-two of 25 (88%) submissions of orphan drugs were granted reimbursement as opposed to 74 of the 117 (63%) non-orphan innovative medicines (P = 0.02). Only 52% of the 25 orphan drug files included a randomized controlled trial as opposed to 84% in a random control sample of 25 non-orphan innovative submissions (P < 0.01). The duration of drug exposure was in most cases far too short in relation to the natural history of the disease. CONCLUSIONS Orphan drug designation predicts reimbursement despite poor quality of clinical evidence. The evidence gap at market authorization should be reduced by post-marketing programmes, in which the centralized regulatory and the local reimbursement authorities collaborate in an efficient way across the European Union member states. PMID:21395641

  4. The role of yogurt in improving the quality of the American diet and meeting dietary guidelines.

    PubMed

    Webb, Densie; Donovan, Sharon M; Meydani, Simin Nikbin

    2014-03-01

    The Dietary Guidelines for Americans (DGA) recommend three daily servings of low- or nonfat dairy products, yet two-thirds of individuals in the United States do not meet that goal. Including low- or nonfat yogurt as part of an overall healthful diet can be a positive step toward meeting the DGA recommendations. Yogurt naturally contains calcium and potassium, and some products are fortified with vitamin D. All of these nutrients were identified in the DGA as "nutrients of concern," because typical intake falls far short of recommended intakes. Yogurt can also be an excellent source of high-quality protein, which promotes satiety, helps in maintaining a healthy body weight, and aids muscle and bone growth. In addition, yogurt is low in sodium and contributes 1.0% or less of added sugars to the diets of most individuals in the United States; however, 90% of children and adults consume less than 8 ounces (1 cup) of yogurt per week. Thus, consuming 1 serving of yogurt per day would help to meet the DGA-recommended dairy servings and would provide nutrients of concern.

  5. Adherence to Guidelines for Cancer Survivors and Health-Related Quality of Life among Korean Breast Cancer Survivors

    PubMed Central

    Song, Sihan; Hwang, Eunkyung; Moon, Hyeong-Gon; Noh, Dong-Young; Lee, Jung Eun

    2015-01-01

    There is limited evidence on the association between adherence to guidelines for cancer survivors and health-related quality of life (HRQoL). In a cross-sectional study of Korean breast cancer survivors, we examined whether adherence to the guidelines of the American Cancer Society (ACS) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) for cancer survivors was related to levels of HRQoL, assessed by the Korean version of Core 30 (C30) and Breast cancer module 23 (BR23) of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ). We included a total of 160 women aged 21 to 79 years who had been diagnosed with breast cancer according to American Joint Committee on Cancer (AJCC) stages I to III and had breast cancer surgery at least six months before the interview. Increasing adherence to ACS guidelines was associated with higher scores of social functioning (p for trend = 0.05), whereas increasing adherence to WCRF/AICR recommendations was associated with higher scores of arm symptoms (p for trend = 0.01). These associations were limited to those with stage II or III cancer. Diet may be an important factor in relation to quality of life among Korean breast cancer survivors, however our findings warrant further prospective studies to evaluate whether healthy diet improves survivors’ quality of life. PMID:26690215

  6. School Segregation, Charter Schools, and Access to Quality Education.

    PubMed

    Logan, John R; Burdick-Will, Julia

    2016-08-01

    Race, class, neighborhood, and school quality are all highly inter-related in the American educational system. In the last decade a new factor has come into play, the option of attending a charter school. We offer a comprehensive analysis of the disparities among public schools attended by white, black, Hispanic, Asian, and Native American children in 2010-2011, including all districts in which charter schools existed. We compare schools in terms of poverty concentration, racial composition, and standardized test scores, and we also examine how attending a charter or non-charter school affects these differences. Black and Hispanic (and to a lesser extent Native American and Asian) students attend elementary and high schools with higher rates of poverty than white students. Especially for whites and Asians, attending a charter school means lower exposure to poverty. Children's own race and the poverty and charter status of their schools affect the test scores and racial isolation of schools that children attend in complex combinations. Most intriguing, attending a charter school means attending a better performing school in high-poverty areas but a lower performing school in low-poverty areas. Yet even in the best case the positive effect of attending a charter school only slightly offsets the disadvantages of black and Hispanic students.

  7. Assessment of the quality and content of national and international guidelines on hypertensive disorders of pregnancy using the AGREE II instrument

    PubMed Central

    Bazzano, Alessandra N; Madison, Anita; Barton, Andrew; Gillispie, Veronica; Bazzano, Lydia A L

    2016-01-01

    Objectives High-quality evidence-based clinical practice guidelines can guide diagnosis and treatment to optimise outcomes. The purpose of this study was to evaluate the quality and content of national and international guidelines on hypertensive disorders of pregnancy. Data Sources: The MEDLINE database, the National Guideline Clearinghouse and several international databases were searched for appropriate guidelines from the past 10 years. Study Appraisal and Synthesis Methods: Six guidelines met inclusion and exclusion criteria and were evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Results A total of 695 records were identified and screened by two authors. Disorder definitions, classifications, preventive measures and treatment recommendations were evaluated and compared among guidelines. AGREE II results varied widely across domains and categories. Only two guidelines received consistently high ratings across domains and few demonstrated a high level of methodological rigour. Recommendations regarding classification and treatment were similar across guidelines, while assessment of preventive measures varied widely. Conclusions Clinical practice guidelines for hypertensive disorders of pregnancy vary significantly in quality and with respect to assessment of preventive measures. PMID:26781503

  8. Guidelines for quality assurance and quality control of fish taxonomic data collected as part of the National Water-Quality Assessment Program

    USGS Publications Warehouse

    Walsh, Stephen Joseph; Meador, Michael R.

    1998-01-01

    Fish community structure is characterized by the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program as part of a perennial, multidisciplinary approach to evaluating the physical, chemical, and biological conditions of the Nation's water resources. The objective of quality assurance and quality control of fish taxonomic data that are collected as part of the NAWQA Program is to establish uniform guidelines and protocols for the identification, processing, and archiving of fish specimens to ensure that accurate and reliable data are collected. Study unit biologists, collaborating with regional biologists and fish taxonomic specialists, prepare a pre-sampling study plan that includes a preliminary faunal list and identification of an ichthyological curation center for receiving preserved fish specimens. Problematic taxonomic issues and protected taxa also are identified in the study plan, and collecting permits are obtained in advance of sampling activities. Taxonomic specialists are selected to identify fish specimens in the field and to assist in determining what fish specimens should be sacrificed, fixed, and preserved for laboratory identification, independent taxonomic verification, and long-term storage in reference or voucher collections. Quantitative and qualitative sampling of fishes follows standard methods previously established for the NAWQA Program. Common ichthyological techniques are used to process samples in the field and prepare fish specimens to be returned to the laboratory or sent to an institutional repository. Taxonomic identifications are reported by using a standardized list of scientific names that provides nomenclatural consistency and uniformity across study units.

  9. Recommendations for mass spectrometry data quality metrics for open access data (corollary to the Amsterdam principles).

    PubMed

    Kinsinger, Christopher R; Apffel, James; Baker, Mark; Bian, Xiaopeng; Borchers, Christoph H; Bradshaw, Ralph; Brusniak, Mi-Youn; Chan, Daniel W; Deutsch, Eric W; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L; Omenn, Gilbert S; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L; Simpson, Richard J; Slotta, Douglas; Smith, Richard D; Stein, Stephen E; Tabb, David L; Tagle, Danilo; Yates, John R; Rodriguez, Henry

    2012-01-01

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the U.S. National Cancer Institute (NCI) convened the "International Workshop on Proteomic Data Quality Metrics" in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the research community, journals, funding agencies, and data repositories. Attendees discussed and agreed upon two primary needs for the wide use of quality metrics: (i) an evolving list of comprehensive quality metrics and (ii) standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in Proteomics, Proteomics Clinical Applications, Journal of Proteome Research, and Molecular and Cellular Proteomics, as a public service to the research community. The peer review process was a coordinated effort conducted by a panel of referees selected by the journals.

  10. Recommendations for mass spectrometry data quality metrics for open access data (corollary to the Amsterdam principles).

    PubMed

    Kinsinger, Christopher R; Apffel, James; Baker, Mark; Bian, Xiaopeng; Borchers, Christoph H; Bradshaw, Ralph; Brusniak, Mi-Youn; Chan, Daniel W; Deutsch, Eric W; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L; Omenn, Gilbert S; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L; Simpson, Richard J; Slotta, Douglas; Smith, Richard D; Stein, Stephen E; Tabb, David L; Tagle, Danilo; Yates, John R; Rodriguez, Henry

    2011-12-01

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the U.S. National Cancer Institute (NCI) convened the "International Workshop on Proteomic Data Quality Metrics" in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the research community, journals, funding agencies, and data repositories. Attendees discussed and agreed up on two primary needs for the wide use of quality metrics: (i) an evolving list of comprehensive quality metrics and (ii) standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in Proteomics, Proteomics Clinical Applications, Journal of Proteome Research, and Molecular and Cellular Proteomics, as a public service to the research community. The peer review process was a coordinated effort conducted by a panel of referees selected by the journals.

  11. Recommendations for mass spectrometry data quality metrics for open access data (corollary to the Amsterdam Principles).

    PubMed

    Kinsinger, Christopher R; Apffel, James; Baker, Mark; Bian, Xiaopeng; Borchers, Christoph H; Bradshaw, Ralph; Brusniak, Mi-Youn; Chan, Daniel W; Deutsch, Eric W; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L; Omenn, Gilbert S; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L; Simpson, Richard J; Slotta, Douglas; Smith, Richard D; Stein, Stephen E; Tabb, David L; Tagle, Danilo; Yates, John R; Rodriguez, Henry

    2012-02-03

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the U.S. National Cancer Institute (NCI) convened the "International Workshop on Proteomic Data Quality Metrics" in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the research community, journals, funding agencies, and data repositories. Attendees discussed and agreed up on two primary needs for the wide use of quality metrics: (1) an evolving list of comprehensive quality metrics and (2) standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in the Journal of Proteome Research, Molecular and Cellular Proteomics, Proteomics, and Proteomics Clinical Applications as a public service to the research community. The peer review process was a coordinated effort conducted by a panel of referees selected by the journals.

  12. Recommendations for mass spectrometry data quality metrics for open access data (corollary to the Amsterdam Principles).

    PubMed

    Kinsinger, Christopher R; Apffel, James; Baker, Mark; Bian, Xiaopeng; Borchers, Christoph H; Bradshaw, Ralph; Brusniak, Mi-Youn; Chan, Daniel W; Deutsch, Eric W; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L; Omenn, Gilbert S; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L; Simpson, Richard J; Slotta, Douglas; Smith, Richard D; Stein, Stephen E; Tabb, David L; Tagle, Danilo; Yates, John R; Rodriguez, Henry

    2011-12-01

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the United States National Cancer Institute convened the "International Workshop on Proteomic Data Quality Metrics" in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the research community, journals, funding agencies, and data repositories. Attendees discussed and agreed up on two primary needs for the wide use of quality metrics: 1) an evolving list of comprehensive quality metrics and 2) standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in the Journal of Proteome Research, Molecular and Cellular Proteomics, Proteomics, and Proteomics Clinical Applications as a public service to the research community. The peer review process was a coordinated effort conducted by a panel of referees selected by the journals.

  13. Recommendations for Mass Spectrometry Data Quality Metrics for Open Access Data (Corollary to the Amsterdam Principles)*

    PubMed Central

    Kinsinger, Christopher R.; Apffel, James; Baker, Mark; Bian, Xiaopeng; Borchers, Christoph H.; Bradshaw, Ralph; Brusniak, Mi-Youn; Chan, Daniel W.; Deutsch, Eric W.; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L.; Omenn, Gilbert S.; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L.; Simpson, Richard J.; Slotta, Douglas; Smith, Richard D.; Stein, Stephen E.; Tabb, David L.; Tagle, Danilo; Yates, John R.; Rodriguez, Henry

    2011-01-01

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the United States National Cancer Institute convened the “International Workshop on Proteomic Data Quality Metrics” in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the research community, journals, funding agencies, and data repositories. Attendees discussed and agreed up on two primary needs for the wide use of quality metrics: 1) an evolving list of comprehensive quality metrics and 2) standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in the Journal of Proteome Research, Molecular and Cellular Proteomics, Proteomics, and Proteomics Clinical Applications as a public service to the research community. The peer review process was a coordinated effort conducted by a panel of referees selected by the journals. PMID:22052993

  14. Recommendations for Mass Spectrometry Data Quality Metrics for Open Access Data (Corollary to the Amsterdam Principles)

    PubMed Central

    Kinsinger, Christopher R.; Apffel, James; Baker, Mark; Bian, Xiaopeng; Borchers, Christoph H.; Bradshaw, Ralph; Brusniak, Mi-Youn; Chan, Daniel W.; Deutsch, Eric W.; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L.; Omenn, Gilbert S.; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L.; Simpson, Richard J.; Slotta, Douglas; Smith, Richard D.; Stein, Stephen E.; Tabb, David L.; Tagle, Danilo; Yates, John R.; Rodriguez, Henry

    2011-01-01

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the U.S. National Cancer Institute (NCI) convened the “International Workshop on Proteomic Data Quality Metrics” in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the research community, journals, funding agencies, and data repositories. Attendees discussed and agreed up on two primary needs for the wide use of quality metrics: (1) an evolving list of comprehensive quality metrics and (2) standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in the Journal of Proteome Research, Molecular and Cellular Proteomics, Proteomics, and Proteomics Clinical Applications as a public service to the research community. The peer review process was a coordinated effort conducted by a panel of referees selected by the journals. PMID:22053864

  15. Guidelines and standard procedures for studies of ground-water quality; selection and installation of wells, and supporting documentation

    USGS Publications Warehouse

    Lapham, W.W.; Wilde, F.D.; Koterba, M.T.

    1997-01-01

    This is the first of a two-part report to document guidelines and standard procedures of the U.S. Geological Survey for the acquisition of data in ground-water-quality studies. This report provides guidelines and procedures for the selection and installation of wells for water-quality studies/*, and the required or recommended supporting documentation of these activities. Topics include (1) documentation needed for well files, field folders, and electronic files; (2) criteria and information needed for the selection of water-supply and observation wells, including site inventory and data collection during field reconnaissance; and (3) criteria and preparation for installation of monitoring wells, including the effects of equipment and materials on the chemistry of ground-water samples, a summary of drilling and coring methods, and information concerning well completion, development, and disposition.

  16. [The German program for disease management guidelines--implementation with pathways and quality management].

    PubMed

    Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

    2007-07-15

    In Germany, physicians enrolled in disease management programs are legally obliged to follow evidence-based clinical practice guidelines. That is why a Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 aiming at implementation of best-practice evidence-based recommendations for nationwide as well as regional disease management programs. Against this background the article reviews programs, methods and tools for implementing DM-CPGs via clinical pathways as well as regional guidelines for outpatient care. Special reference is given to the institutionalized program of adapting DM-CPGs for regional use by primary-care physicians in the State of Hesse.

  17. Guideline for Technical Quality Assurance (TQA) of ultrasound devices (B-Mode)--version 1.0 (July 2012): EFSUMB Technical Quality Assurance Group--US-TQA/B.

    PubMed

    Kollmann, C; deKorte, C; Dudley, N J; Gritzmann, N; Martin, K; Evans, D H

    2012-12-01

    The Technical Quality Assurance group was initiated by the EFSUMB Board in 2007 and met firstly in 2008 to discuss and evaluate methods and procedures published for performing technical quality assurance for diagnostic ultrasound devices. It is the aim of this group of experts to advise the EFSUMB Board of effective and efficacious methods for routine use and to make recommendations regarding the technical aspects of EFSUMB by-law 9, parts 11.6. & 11.7. The group's work focused on new developments and related European projects to establish a common guideline. There is a great need of a well established protocol and dedicated processing software for the performance testing of medical ultrasound equipment. The measurements should be user independent as much as physically possible. Only if these goals are achieved in an international (firstly European) context, the optimal quality of ultrasound imaging can be offered and maintained to the medical community. This guideline aims to offer and summarize suitable procedures and evaluation processes to lend support for an optimal Technical Quality Assurance (TQA) scheme. The content of this guideline was presented to the EFSUMB Board of Directors (delegates) and approved by the EFSUMB Executive Board (ExB) at the regular meeting during EUROSON 2012 in Madrid April 2012.

  18. Accessibility

    EPA Pesticide Factsheets

    Federal laws, including Section 508 of the Rehabilitation Act, mandate that people with disabilities have access to the same information that someone without a disability would have. 508 standards cover electronic and information technology (EIT) products.

  19. Quality of Reporting and Adherence to ARRIVE Guidelines in Animal Studies for Chagas Disease Preclinical Drug Research: A Systematic Review.

    PubMed

    Gulin, Julián Ernesto Nicolás; Rocco, Daniela Marisa; García-Bournissen, Facundo

    2015-11-01

    Publication of accurate and detailed descriptions of methods in research articles involving animals is essential for health scientists to accurately interpret published data, evaluate results and replicate findings. Inadequate reporting of key aspects of experimental design may reduce the impact of studies and could act as a barrier to translation of research findings. Reporting of animal use must be as comprehensive as possible in order to take advantage of every study and every animal used. Animal models are essential to understanding and assessing new chemotherapy candidates for Chagas disease pathology, a widespread parasitic disease with few treatment options currently available. A systematic review was carried out to compare ARRIVE guidelines recommendations with information provided in publications of preclinical studies for new anti-Trypanosoma cruzi compounds. A total of 83 publications were reviewed. Before ARRIVE guidelines, 69% of publications failed to report any macroenvironment information, compared to 57% after ARRIVE publication. Similar proportions were observed when evaluating reporting of microenvironmental information (56% vs. 61%). Also, before ARRIVE guidelines publication, only 13% of papers described animal gender, only 18% specified microbiological status and 13% reported randomized treatment assignment, among other essential information missing or incomplete. Unfortunately, publication of ARRIVE guidelines did not seem to enhance reporting quality, compared to papers appeared before ARRIVE publication. Our results suggest that there is a strong need for the scientific community to improve animal use description, animal models employed, transparent reporting and experiment design to facilitate its transfer and application to the affected human population. Full compliance with ARRIVE guidelines, or similar animal research reporting guidelines, would be an excellent start in this direction.

  20. Quality of Reporting and Adherence to ARRIVE Guidelines in Animal Studies for Chagas Disease Preclinical Drug Research: A Systematic Review

    PubMed Central

    Gulin, Julián Ernesto Nicolás; Rocco, Daniela Marisa; García-Bournissen, Facundo

    2015-01-01

    Publication of accurate and detailed descriptions of methods in research articles involving animals is essential for health scientists to accurately interpret published data, evaluate results and replicate findings. Inadequate reporting of key aspects of experimental design may reduce the impact of studies and could act as a barrier to translation of research findings. Reporting of animal use must be as comprehensive as possible in order to take advantage of every study and every animal used. Animal models are essential to understanding and assessing new chemotherapy candidates for Chagas disease pathology, a widespread parasitic disease with few treatment options currently available. A systematic review was carried out to compare ARRIVE guidelines recommendations with information provided in publications of preclinical studies for new anti-Trypanosoma cruzi compounds. A total of 83 publications were reviewed. Before ARRIVE guidelines, 69% of publications failed to report any macroenvironment information, compared to 57% after ARRIVE publication. Similar proportions were observed when evaluating reporting of microenvironmental information (56% vs. 61%). Also, before ARRIVE guidelines publication, only 13% of papers described animal gender, only 18% specified microbiological status and 13% reported randomized treatment assignment, among other essential information missing or incomplete. Unfortunately, publication of ARRIVE guidelines did not seem to enhance reporting quality, compared to papers appeared before ARRIVE publication. Our results suggest that there is a strong need for the scientific community to improve animal use description, animal models employed, transparent reporting and experiment design to facilitate its transfer and application to the affected human population. Full compliance with ARRIVE guidelines, or similar animal research reporting guidelines, would be an excellent start in this direction. PMID:26587586

  1. The Relationship of IEP Quality to Curricular Access and Academic Achievement for Students with Disabilities

    ERIC Educational Resources Information Center

    La Salle, Tamika P.; Roach, Andrew T.; McGrath, Dawn

    2013-01-01

    The purpose of this study was to investigate the quality of Individualized Education Programs (IEPs) and its influence on academic achievement, inclusion in general education classrooms, and curricular access for students with disabilities. 130 teachers from the state of Indiana were asked to submit the most recent IEP of one of their students in…

  2. Improving Access to Needed Health Care Improves Low-Income Children's Quality of Life: Research Highlights

    ERIC Educational Resources Information Center

    Seid, Michael. Varni, James W.; Cummings, Leslie; Schonlau, Matthias

    2006-01-01

    This research brief describes an examination of the effect of the State Children's Health Insurance Program (SCHIP) on children's access to needed health services and on their quality of life. The analysis focused on a sample of California families who had recently enrolled in that state's SCHIP. The study found that, after enrollment, children…

  3. Access, Participation, and Supports: The Defining Features of High-Quality Inclusion

    ERIC Educational Resources Information Center

    Buysse, Virginia

    2011-01-01

    This article describes current knowledge about early childhood inclusion, summarizing research and the DEC/NAEYC joint position statement on inclusion. The article also describes effective or promising educational practices that promote access, participation, and supports--the defining features of high-quality inclusion. Future efforts to improve…

  4. Ensuring Access with Quality to California's Community Colleges. National Center Report #04-3

    ERIC Educational Resources Information Center

    Hayward, Gerald C.; Jones, Dennis P.; McGuinness, Aims C., Jr.; Timar, Allene

    2004-01-01

    This report finds that enrollment growth pressures, fee increases, and recent budget cuts in the California Community Colleges are having significant detrimental effects on student access and program quality. The report also provides recommendations for creating improvements that build from the state policy context and from existing promising…

  5. Information-Seeking in Family Day Care: Access, Quality and Personal Cost

    ERIC Educational Resources Information Center

    Corr, L.; Davis, E.; Cook, K.; Mackinnon, A.; Sims, M.; Herrman, H.

    2014-01-01

    Family day-care (FDC) educators work autonomously to provide care and education for children of mixed ages, backgrounds and abilities. To meet the demands and opportunities of their work and regulatory requirements, educators need access to context-relevant and high quality information. No previous research has examined how and where these workers…

  6. Balancing Quality and Access: Reducing State Policy Barriers to Electronically Delivered Higher Education Programs.

    ERIC Educational Resources Information Center

    Johnstone, Sally M.

    This project was designed to increase student access by addressing Western states' regulations on higher education programs delivered electronically across state lines, and to develop and get region-wide agreement on basic quality standards for distance education programs. The project achieved agreement on a set of "Principles of Good…

  7. A Correlational Analysis: Electronic Health Records (EHR) and Quality of Care in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Khan, Arshia A.

    2012-01-01

    Driven by the compulsion to improve the evident paucity in quality of care, especially in critical access hospitals in the United States, policy makers, healthcare providers, and administrators have taken the advise of researchers suggesting the integration of technology in healthcare. The Electronic Health Record (EHR) System composed of multiple…

  8. Educational Access Is Educational Quality: Indigenous Parents' Perceptions of Schooling in Rural Guatemala

    ERIC Educational Resources Information Center

    Ishihara-Brito, Reiko

    2013-01-01

    This paper presents the findings and implications of a qualitative study conducted in Guatemala, which focused on rural, indigenous parents' perceptions of their children's schooling and educational quality. For these parents, the simple fact that their children had improved access to school signifies a satisfactory educational accomplishment;…

  9. Is Increased Access Enough? Advanced Placement Courses, Quality, and Success in Low-Income Urban Schools

    ERIC Educational Resources Information Center

    Hallett, Ronald E.; Venegas, Kristan M.

    2011-01-01

    This article combines descriptive statistics and interviews with college-bound high school students to explore the connection between increased access and academic quality of Advanced Placement (AP) courses in low-income urban high schools. Results suggest that although moderately more opportunities to take AP courses exist than in previous years,…

  10. Student Assessment of Quality of Access at the National Open University of Nigeria (NOUN)

    ERIC Educational Resources Information Center

    Inegbedion, Juliet O.; Adu, Folorunso I.; Ofulue, Christine Y.

    2016-01-01

    This paper presents a study conducted by Inegbedion, Adu and Ofulue from the National Open University of Nigeria. The study focused on the quality of access (admission and registration) at NOUN from a student perspective. A survey design was used for the study while a multi-stage sampling technique was used to select the sample size. All the…

  11. Guidelines for the processing and quality assurance of benthic invertebrate samples collected as part of the National Water-Quality Assessment Program

    USGS Publications Warehouse

    Cuffney, T.F.; Gurtz, M.E.; Meador, M.R.

    1993-01-01

    Benthic invertebrate samples are collected as part of the U.S. Geological Survey's National Water-Quality Assessment Program. This is a perennial, multidisciplinary program that integrates biological, physical, and chemical indicators of water quality to evaluate status and trends and to develop an understanding of the factors controlling observed water quality. The Program examines water quality in 60 study units (coupled ground- and surface-water systems) that encompass most of the conterminous United States and parts of Alaska and Hawaii. Study-unit teams collect and process qualitative and semi-quantitative invertebrate samples according to standardized procedures. These samples are processed (elutriated and subsampled) in the field to produce as many as four sample components: large-rare, main-body, elutriate, and split. Each sample component is preserved in 10-percent formalin, and two components, large-rare and main-body, are sent to contract laboratories for further processing. The large-rare component is composed of large invertebrates that are removed from the sample matrix during field processing and placed in one or more containers. The main-body sample component consists of the remaining sample materials (sediment, detritus, and invertebrates) and is subsampled in the field to achieve a volume of 750 milliliters or less. The remaining two sample components, elutriate and split, are used for quality-assurance and quality-control purposes. Contract laboratories are used to identify and quantify invertebrates from the large-rare and main-body sample components according to the procedures and guidelines specified within this document. These guidelines allow the use of subsampling techniques to reduce the volume of sample material processed and to facilitate identifications. These processing procedures and techniques may be modified if the modifications provide equal or greater levels of accuracy and precision. The intent of sample processing is to

  12. Making GRADE accessible: a proposal for graphic display of evidence quality assessments.

    PubMed

    Khan, Khalid S; Borowiack, Ewa; Roos, Carolien; Kowalska, Monika; Zapalska, Anna; Mol, Ben W; Mignini, Luciano; Meads, Catherine; Walczak, Jacek

    2011-06-01

    When generating guidelines, quality of evidence is frequently reported in tabulated form capturing several domains, for example, study design, risk of bias and heterogeneity. Increasingly, this is done using the Grading of Recommendations Assessment, Development and Evaluation approach. As assimilating large amount of tabulated data across several comparisons and outcomes spread over many pages (sometimes hundreds) is not easy, there is a need to present evidence summaries in a more effective way. A graphic display plotting the several domains used in evidence grading on equiangular spokes starting from the same point, the data length of each spoke proportional to the magnitude of the quality, succinctly captures tabulated information. These plots allow easy identification of deficiencies, outliers and similarities in evidence quality for individual and multiple comparisons and outcomes, paving the way for their routine use alongside tabulated information.

  13. A comparison of sediment quality guidelines for toxicity assessment in the Sunderban wetlands (Bay of Bengal, India).

    PubMed

    Binelli, Andrea; Sarkar, Santosh Kumar; Chatterjee, Mousumi; Riva, Consuelo; Parolini, Marco; Bhattacharya, Bhaskar deb; Bhattacharya, Asok Kumar; Satpathy, Kamala Kanta

    2008-10-01

    The aim of this paper was to obtain the first screening ecotoxicological risk evaluation in the Sunderban wetlands, the largest prograding delta in the estuarine phase of the River Ganges. The characterization of exposure was conducted by means of an extensive survey of several persistent organic pollutants (PAHs, PCBs, DDTs, PBDEs, HCHs, HCB) measured in seven core sediments from the Sunderban wetlands, obtaining a dataset with more than 2200 analyses. The pollutant effects were assessed by the use of three different sediment quality guidelines (SQGs) previously developed in the literature to evaluate toxicity induced in sediment-dwelling organisms. The three different approaches chosen for risk assessment of the Sunderban were the consensus SQGs obtained by TEC (threshold effect concentration), PEC (probable effect concentration) and EEC (extreme effect concentration), the threshold/probable effect level (TEL/PEL) approach and, finally, the ERL-ERM guidelines, including the m-ERM-Q (mean ERM quotient). The evaluation of the toxicity induced by a mixture of the target pollutants indicated the importance of gamma-HCH contamination in the Sunderban sediments despite the very low concentrations measured in core sediments. A different sensitivity for toxicity assessment due to quality guidelines was obtained, as the consensus SQGs based on TEC were less conservative and protective than the TEL and ERL approaches, while the use of m-ERM-Q seems to be the most powerful tool to predict the toxicity related to a contaminant mixture.

  14. Levelling the Road Ahead: Guidelines for the Creation of WWW Pages Accessible to Blind and Visually Handicapped Users.

    ERIC Educational Resources Information Center

    Dixon, Judith M.

    1996-01-01

    Suggests guidelines for creating World Wide Web sites that accommodate those using speech or braille aids. Hypertext Markup Language coding should provide (1) one-column format rather than side-by-side columns; (2) stand-alone hyperlinks; (3) "ALT=" attributes for image displays; (4) text alternatives to images or image maps as links or…

  15. Guidelines and standard procedures for continuous water-quality monitors: Station operation, record computation, and data reporting

    USGS Publications Warehouse

    Wagner, Richard J.; Boulger, Robert W.; Oblinger, Carolyn J.; Smith, Brett A.

    2006-01-01

    The U.S. Geological Survey uses continuous water-quality monitors to assess the quality of the Nation's surface water. A common monitoring-system configuration for water-quality data collection is the four-parameter monitoring system, which collects temperature, specific conductance, dissolved oxygen, and pH data. Such systems also can be configured to measure other properties, such as turbidity or fluorescence. Data from sensors can be used in conjunction with chemical analyses of samples to estimate chemical loads. The sensors that are used to measure water-quality field parameters require careful field observation, cleaning, and calibration procedures, as well as thorough procedures for the computation and publication of final records. This report provides guidelines for site- and monitor-selection considerations; sensor inspection and calibration methods; field procedures; data evaluation, correction, and computation; and record-review and data-reporting processes, which supersede the guidelines presented previously in U.S. Geological Survey Water-Resources Investigations Report WRIR 00-4252. These procedures have evolved over the past three decades, and the process continues to evolve with newer technologies.

  16. Socioeconomic inequalities in the access to and quality of health care services

    PubMed Central

    Nunes, Bruno Pereira; Thumé, Elaine; Tomasi, Elaine; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2014-01-01

    OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services. PMID:26039400

  17. Restricted access to the environment and quality of life in adult survivors of childhood brain tumors.

    PubMed

    Brinkman, Tara M; Li, Zhenghong; Neglia, Joseph P; Gajjar, Amar; Klosky, James L; Allgood, Rachel; Stovall, Marilyn; Krull, Kevin R; Armstrong, Gregory T; Ness, Kirsten K

    2013-01-01

    Survivors of pediatric brain tumors (BTs) are at-risk for late effects which may affect mobility within and access to the physical environment. This study examined the prevalence of and risk factors for restricted environmental access in survivors of childhood BTs and investigated the associations between reduced environmental access, health-related quality of life (HRQOL), and survivors' social functioning. In-home evaluations were completed for 78 BT survivors and 78 population-based controls matched on age, sex, and zip-code. Chi-square tests and multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) for poor environmental access and reduced HRQOL. The median age of survivors was 22 years at the time of study. Compared to controls, survivors were more likely to report avoiding most dimensions of their physical environment, including a single flight of stairs (p < 0.001), uneven surfaces (p < 0.001), traveling alone (p = 0.01), and traveling to unfamiliar places (p = 0.001). Overall, survivors were 4.8 times more likely to report poor environmental access (95 % CI 2.0-11.5, p < 0.001). In survivors, poor environmental access was associated with reduced physical function (OR = 3.6, 95 % CI 1.0-12.8, p = 0.04), general health (OR = 6.0, 95 % CI 1.8-20.6, p = 0.002), and social functioning (OR = 4.3, 95 % CI 1.1-17.3, p = 0.03). Adult survivors of pediatric BTs were more likely to avoid their physical environment than matched controls. Restricted environmental access was associated with reduced HRQOL and diminished social functioning. Interventions directed at improving physical mobility may have significant impact on survivor quality of life.

  18. Telehealth: Increasing Access to High Quality Care by Expanding the Role of Technology in Correctional Medicine

    PubMed Central

    Young, Jeremy D.; Badowski, Melissa E.

    2017-01-01

    The United States (US) has a large correctional population. However, many incarcerated persons lack access to evidence-based, up-to-date medical care, particularly by subspecialty providers, due to limitations of geography, travel, cost and other resources. The use of telehealth technologies can remove these barriers, increasing access to high quality, multidisciplinary care. Studies have shown that, with telemedicine, timely triage and medical management can be provided across many disciplines, which may lead to improved clinical outcomes and significant cost savings. PMID:28208807

  19. From Access to Success: An Integrated Approach to Quality Higher Education Informed by Social Inclusion Theory and Practice

    ERIC Educational Resources Information Center

    Gidley, Jennifer M.; Hampson, Gary P.; Wheeler, Leone; Bereded-Samuel, Elleni

    2010-01-01

    Equitable access, success and quality in higher education are examined from a variety of ideological perspectives. "Quality" is positioned as a complex generic concept while "access" and "success" are identified as key concepts in the social inclusion domain, supplemented by the concept of "participation."…

  20. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Principles of evidence assessment and methods for reaching recommendations.

    PubMed

    Minozzi, S; Armaroli, P; Segnan, N

    2012-09-01

    Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The principles of evidence assessment and methods for reaching recommendations are presented here to promote international discussion and collaboration by making the principles and methods used in developing the guidelines known to a wider professional and scientific community. Following this methodology in the future updating of the guidelines has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multidisciplinary diagnosis and management of the disease.

  1. Using field data to assess the effects of pesticides on crustacea in freshwater aquatic ecosystems and verifying the level of protection provided by water quality guidelines.

    PubMed

    Guy, Martha; Singh, Lucina; Mineau, Pierre

    2011-07-01

    The purpose of this study was to investigate how well single-species laboratory data predict real-world pesticide toxicity effects on Crustacea. Data from field pesticide exposures from experimental mesocosm and small pond studies were converted into toxicity units (TUs) by dividing measured pesticide concentrations by the L(E)C50 for Daphnia or acute 5% hazard concentration for Crustacea (HC5-C). The proportion of crustacean taxa significantly affected by the pesticide treatment, called the count ratio of effect, was used in logistic regression models. Of 200 possible logistic model combinations of the TUs, fate, physicochemical variables, and structural variables versus the count ratio of effect for the mesocosm data, the best model was found to incorporate log(TU HC5-C). This model was used to convert pesticide water quality guidelines from around the world into estimates of the proportion of crustacean taxa predicted to be impacted by exposure to a pesticide at the water quality guideline concentration. This analysis suggests 64% of long-term water quality guidelines and 88% of short-term pesticide water quality guidelines are not protective of the aquatic life they are designed to protect. We conclude that empirically derived data from mesocosm studies should be incorporated into water quality guideline derivation for pesticides where available. Also, interspecific differences in susceptibility should be accounted for more accurately to ensure water quality guidelines are adequately protective against the adverse effects of pesticide exposure.

  2. Strategic purchasing reform in Estonia: Reducing inequalities in access while improving care concentration and quality.

    PubMed

    Habicht, Triin; Habicht, Jarno; van Ginneken, Ewout

    2015-08-01

    As of 2014, the Estonian Health Insurance Fund has adopted new purchasing procedures and criteria, which it now has started to implement in specialist care. Main changes include (1) redefined access criteria based on population need rather than historical supply, which aim to achieve more equal access of providers and specialties; (2) stricter definition and use of optimal workload criteria to increase the concentration of specialist care (3) better consideration of patient movement; and (4) an increased emphasis on quality to foster quality improvement. The new criteria were first used in the contract cycle that started in 2014 and resulted in fewer contracted providers for a similar volume of care compared to the previous contract cycle. This implies that provision of specialized care has become concentrated at fewer providers. It is too early to draw firm conclusions on the impact on care quality or on actors, but the process has sparked debate on the role of selective contracting and the role of public and private providers in Estonian health care. Lastly, the Estonian experience may hold important lessons for other countries looking to overcome inequalities in access while concentrating care and improving care quality.

  3. Metal contents in coastal waters of San Jorge Bay, Antofagasta, northern Chile: a base line for establishing seawater quality guidelines.

    PubMed

    Valdés, Jorge; Román, Domingo; Rivera, Lidia; Avila, Juan; Cortés, Pedro

    2011-12-01

    We measured the concentration of 12 metals in coastal waters of seven sites of San Jorge Bay in Antofagasta (northern Chile), in order to relate the presence of metals with the different uses of San Jorge Bay coastal border, and to evaluate the quality of the bay's bodies of water according to the proposed current Chilean Quality Guide for trace elements in seawater (CONAMA 2003). The results suggest that the coastal water of San Jorge Bay has very good quality according to the proposed regulation mentioned above. However, the distribution of metals such as Cu and Pb along the bay's coast line evidences a notorious effect of the industrial activity, which would involve different behavior patterns for some trace elements in some bodies of water, suggesting that the levels indicated in the environmental guideline of the Chilean legislation do not represent pollution-free environments.

  4. Guidelines and standard procedures for continuous water-quality monitors : site selection, field operation, calibration, record computation, and reporting

    USGS Publications Warehouse

    Wagner, Richard J.; Mattraw, H.C.; Ritz, G.F.; Smith, B.A.

    2000-01-01

    The U.S. Geological Survey uses continuous water-quality monitors to assess variations in the quality of the Nation's surface water. A common system configuration for data collection is the four-parameter water-quality monitoring system, which collects temperature, specific conductance, dissolved oxygen, and pH data, although systems can be configured to measure other properties such as turbidity or chlorophyll. The sensors that are used to measure these water properties require careful field observation, cleaning, and calibration procedures, as well as thorough procedures for the computation and publication of final records. Data from sensors can be used in conjunction with collected samples and chemical analyses to estimate chemical loads. This report provides guidelines for site-selection considerations, sensor test methods, field procedures, error correction, data computation, and review and publication processes. These procedures have evolved over the past three decades, and the process continues to evolve with newer technologies.

  5. From Principle to Practice: Using the Global Guidelines to Assess Quality Education and Care

    ERIC Educational Resources Information Center

    Barbour, Ann; Boyer, Wanda; Hardin, Belinda; Wortham, Sue

    2004-01-01

    Antarctica gathered in Ruschlikon, Switzerland, at the International Symposium on Early Childhood Education and Care for the 21st Century. The symposium's mission was to craft guidelines for programs that serve children under the age of formal schooling in countries throughout the world. After extensive discussions about what constitutes universal…

  6. Leading the Way to Environmental Literacy and Quality: National Guidelines for Environmental Education

    ERIC Educational Resources Information Center

    McCrea, Edward J.

    2006-01-01

    Ed McCrea, former executive director of North American Association for Environmental Education (NAEE), calls the development of the environmental education guidelines the single most important event that has occurred in the field of environmental education in the last decade. For the first time in its history, environmental education has a set of…

  7. 77 FR 22282 - Draft Guidelines on Biologics Quality Monitoring: Testing for the Detection of Mycoplasma...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-13

    ... Service under the Virus-Serum-Toxin Act, we are requesting comments on the scope of the guideline and its... veterinary vaccines regulated by the APHIS under the Virus-Serum-Toxin Act (VSTA), we are requesting comments... the regulations in 9 CFR chapter I, subchapter E (Viruses, Serums, Toxins, and Analogous...

  8. The role of yogurt in improving the quality of the American diet and meeting dietary guidelines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Dietary Guidelines for Americans (DGA) recommend 3 daily servings of lowfat or nonfat dairy products, however, two-thirds of Americans do not meet that goal. Including lowfat or nonfat yogurt as part of an overall healthful diet can be a positive step towards meeting the DGA. Yogurt contains cal...

  9. Budgeting for Quality and Survival in the 21st Century--Guidelines for Directors.

    ERIC Educational Resources Information Center

    Whitehead, R. Ann

    2003-01-01

    Offers practical guidelines for directors of child care centers on creating a budget and managing the center's finances. Suggests ways to establish priorities, establish a tuition rate, compute projected monthly enrollment and income, budget variable and fixed expenses, create the final budget, and monitor financial statements. (JPB)

  10. Attitudes toward Post-Trial Access to Medical Interventions: A Review of Academic Literature, Legislation, and International Guidelines.

    PubMed

    Cook, Kori; Snyder, Jeremy; Calvert, John

    2016-08-01

    There is currently no international consensus around post-trial obligations toward research participants, community members, and host countries. This literature review investigates arguments and attitudes toward post-trial access. The literature review found that academic discussions focused on the rights of research participants, but offered few practical recommendations for addressing or improving current practices. Similarly, there are few regulations or legislation pertaining to post-trial access. If regulatory changes are necessary, we need to understand the current arguments, legislation, and attitudes towards post-trial access and participants and community members. Given that clinical trials conducted in low-income countries will likely continue, there is an urgent need for consideration of post-trial benefits for participants, communities, and citizens of host countries. While this issue may not be as pressing in countries where participants have access to healthcare and medicines through public schemes, it is particularly important in regions where this may not be available.

  11. Drinking Water Quality Guidelines across Canadian provinces and territories: jurisdictional variation in the context of decentralized water governance.

    PubMed

    Dunn, Gemma; Bakker, Karen; Harris, Leila

    2014-04-25

    This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG) across Canada's 13 provinces and territories. This review is significant given that Canada's approach to drinking water governance is: (i) highly decentralized and (ii) discretionary. Canada is (along with Australia) only one of two Organization for Economic Cooperation and Development (OECD) member states that does not comply with the World Health Organization's (WHO) recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada's 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i) should standards be uniform or variable; (ii) should compliance be voluntary or legally binding; and (iii) should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada.

  12. Drinking Water Quality Guidelines across Canadian Provinces and Territories: Jurisdictional Variation in the Context of Decentralized Water Governance

    PubMed Central

    Dunn, Gemma; Bakker, Karen; Harris, Leila

    2014-01-01

    This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG) across Canada’s 13 provinces and territories. This review is significant given that Canada’s approach to drinking water governance is: (i) highly decentralized and (ii) discretionary. Canada is (along with Australia) only one of two Organization for Economic Cooperation and Development (OECD) member states that does not comply with the World Health Organization’s (WHO) recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada’s 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i) should standards be uniform or variable; (ii) should compliance be voluntary or legally binding; and (iii) should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada. PMID:24776725

  13. Traditional and emerging forms of dental practice. Cost, accessibility, and quality factors.

    PubMed Central

    Rovin, S; Nash, J

    1982-01-01

    The traditional and predominant manner of delivering dental care is through a fee-for-service, private practice system. A number of alternative dental care delivery systems have emerged and are being tested, and others are just emerging. These systems include department store practices, hospital dental services, health maintenance organizations, the independent practice of dental hygiene, and denturism. Although it is too soon to draw final conclusions about the efficacy and effectiveness of these systems, we examine them for their potential to compete with and change the way dental care is currently delivered. Using the parameters of cost, accessibility, and quality, we compare these systems to traditional dental practice. Some of these emerging forms clearly have the potential to complete favorably with traditional practice. Other seem less likely to alter the existing system substantially. The system which can best control costs, increase accessibility, and enhance quality will gain the competitive edge. PMID:7091453

  14. Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency

    PubMed Central

    Romano-Lieber, Nicolina Silvana; Ribeiro, Eliane; de Melo, Daniela Oliveira

    2016-01-01

    Background Annually, non-communicable diseases (NCDs) kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs) are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs. Methods We conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis. CPGs comprising pharmacological treatment recommendations were included. No language or year restrictions were applied. CPGs were excluded if they were merely for local use and referred to NCDs not listed above. CPG quality was independently assessed by two reviewers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II). Main Findings “Scope and purpose” and “clarity and presentation” domains received the highest scores. Sixteen of 26 CPGs were classified as low quality, and none were classified as high overall quality. No CPG was recommended without modification (77% were not recommended at all). After 2009, 2 domain scores (“rigor of development” and “clarity and presentation”) increased (61% and 73%, respectively). However, “rigor of development” was still rated < 30%. Conclusion Brazilian healthcare professionals should be concerned with CPG quality for the treatment of selected NCDs. Features that undermined AGREE II scores included the lack of a multidisciplinary team for the development group, no consideration of patients’ preferences, insufficient information regarding literature searches, lack of selection

  15. Effect-based trigger values for in vitro bioassays: Reading across from existing water quality guideline values.

    PubMed

    Escher, Beate I; Neale, Peta A; Leusch, Frederic D L

    2015-09-15

    Cell-based bioassays are becoming increasingly popular in water quality assessment. The new generations of reporter-gene assays are very sensitive and effects are often detected in very clean water types such as drinking water and recycled water. For monitoring applications it is therefore imperative to derive trigger values that differentiate between acceptable and unacceptable effect levels. In this proof-of-concept paper, we propose a statistical method to read directly across from chemical guideline values to trigger values without the need to perform in vitro to in vivo extrapolations. The derivation is based on matching effect concentrations with existing chemical guideline values and filtering out appropriate chemicals that are responsive in the given bioassays at concentrations in the range of the guideline values. To account for the mixture effects of many chemicals acting together in a complex water sample, we propose bioanalytical equivalents that integrate the effects of groups of chemicals with the same mode of action that act in a concentration-additive manner. Statistical distribution methods are proposed to derive a specific effect-based trigger bioanalytical equivalent concentration (EBT-BEQ) for each bioassay of environmental interest that targets receptor-mediated toxicity. Even bioassays that are indicative of the same mode of action have slightly different numeric trigger values due to differences in their inherent sensitivity. The algorithm was applied to 18 cell-based bioassays and 11 provisional effect-based trigger bioanalytical equivalents were derived as an illustrative example using the 349 chemical guideline values protective for human health of the Australian Guidelines for Water Recycling. We illustrate the applicability using the example of a diverse set of water samples including recycled water. Most recycled water samples were compliant with the proposed triggers while wastewater effluent would not have been compliant with a few

  16. Quality Improvement Guidelines for Imaging Detection and Treatment of Endoleaks following Endovascular Aneurysm Repair (EVAR)

    SciTech Connect

    Rand, T.; Uberoi, R.; Cil, B.; Munneke, G.; Tsetis, D.

    2013-02-15

    Major concerns after aortic aneurysm repair are caused by the presence of endoleaks, which are defined as persistent perigraft flow within the aortic aneurysm sac. Diagnosis of endoleaks can be performed with various imaging modalities, and indications for treatment are based on further subclassifications. Early detection and correct classification of endoleaks are crucial for planning patient management. The vast majority of endoleaks can be treated successfully by interventional means. Guidelines for Imaging Detection and Treatment of endoleaks are described in this article.

  17. United States Access Board

    MedlinePlus

    ... disabilities through leadership in accessible design and the development of accessibility guidelines and standards for the built environment, transportation, communication, medical diagnostic equipment, and information technology. ...

  18. Quality guidelines and standards for genetic laboratories/clinics in prenatal diagnosis on fetal samples obtained by invasive procedures. An attempt to establish a common European framework for quality assessment. EUCROMIC Quality Assessment Group.

    PubMed

    1997-01-01

    At a workshop in Leuven, November 8-10, 1996, 24 clinical and laboratory geneticists from 15 countries in Europe met and discussed minimum standards for prenatal diagnosis. These guidelines are intended for use as a reference manual by genetic centres all over Europe, especially in countries without national guidelines, in their efforts to achieve and maintain high standards. The workshop was restricted to discuss quality assessment on established invasive procedures for cytogenetic and molecular studies. The committee brought together from their own countries substantial experience of genetic counselling, cytogenetics, molecular biology and quality assessment. It is hoped that future discussions, embracing all aspects of clinical and laboratory genetic services will lead to the establishment of common guidelines for all European countries.

  19. 78 FR 10110 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way; Shared Use Paths

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    .... Regulatory Analyses In this preamble, ``we,'' ``us,'' and ``our'' refer to the Architectural and...-way or on an exclusive right-of-way with minimal cross flow by motor vehicles. The Washington State... surfaces of 5.2.9 Surface Structure pedestrian access routes and Hard, all-weather pavement...

  20. ASVCP quality assurance guidelines: control of preanalytical and analytical factors for hematology for mammalian and nonmammalian species, hemostasis, and crossmatching in veterinary laboratories.

    PubMed

    Vap, Linda M; Harr, Kendal E; Arnold, Jill E; Freeman, Kathleen P; Getzy, Karen; Lester, Sally; Friedrichs, Kristen R

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and provides recommendations for control of preanalytical and analytical factors related to hematology for mammalian and nonmammalian species, hemostasis testing, and crossmatching and is adapted from sections 1.1 and 2.3 (mammalian hematology), 1.2 and 2.4 (nonmammalian hematology), 1.5 and 2.7 (hemostasis testing), and 1.6 and 2.8 (crossmatching) of the complete guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.

  1. The Importance and Degree of Implementation of the European Standards and Guidelines for Internal Quality Assurance in Universities: The Views of Portuguese Academics

    ERIC Educational Resources Information Center

    Manatos, Maria J.; Rosa, Maria J.; Sarrico, Cláudia S.

    2015-01-01

    This research seeks to explore academics' perceptions of the importance and degree of implementation of the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) for internal quality assurance. It uses empirical evidence from Portugal, gathered via a questionnaire given to all university academics. Results show…

  2. Colonoscopy quality assurance in Ontario: Systematic review and clinical practice guideline

    PubMed Central

    Tinmouth, Jill; Kennedy, Erin B; Baron, David; Burke, Mae; Feinberg, Stanley; Gould, Michael; Baxter, Nancy; Lewis, Nancy

    2014-01-01

    Colonoscopy is fundamental to the diagnosis and management of digestive diseases and plays a key role in colorectal cancer (CRC) screening and diagnosis. Therefore, it is important to ensure that colonoscopy is of high quality. The present guidance document updates the evidence and recommendations in Cancer Care Ontario’s 2007 Colonoscopy Standards, and was conducted under the aegis of the Program in Evidence-Based Care. It is intended to support quality improvement for colonoscopies for all indications, including follow-up to a positive fecal occult blood test, screening for individuals who have a family history of CRC and those at average risk, investigation for symptomatic patients, and surveillance of those with a history of adenomatous polyps or CRC. A systematic review was performed to evaluate the existing evidence concerning the following three key aspects of colonoscopy: physician endoscopist training and maintenance of competency; institutional quality assurance parameters; and colonoscopy quality indicators and auditable outcomes. Where appropriate, indicators were designated quality indicators (where there was sufficient evidence to recommend a specific target) and auditable outcomes (insufficient evidence to recommend a specific target, but which should be monitored for quality assurance purposes). The guidance document may be used to support colonoscopy quality assurance programs to improve the quality of colonoscopy regardless of indication. Improvements in colonoscopy quality are anticipated to improve important outcomes in digestive diseases, such as reduction of the incidence of and mortality from CRC. PMID:24839621

  3. [Accession to the PIC/S and pharmaceutical quality system in Japan].

    PubMed

    Katori, Noriko

    2014-01-01

    In March, 2012, Japan made the application for membership of the Pharmaceutical Inspection convention and Pharmaceutical Inspection Co-operation scheme (PIC/S) which is an international body of a GMP inspection. The globalization of pharmaceutical manufacturing and sales has been a driving force behind the decision to become a PIC/S member. For the application for membership, Japan's GMP inspectorate needs to fulfill PIC/S requirements, for example, the inspection organization has to have a quality system as a global standard. One of the other requirements is that the GMP inspectorate can access Official Medicines Control Laboratories (OMCL) having high analytical skills and also have a quality system based on ISO 17025. I would like to describe the process to make up a quality system in the National Institute of Health Sciences and also the circumstances around the PIC/S application in Japan.

  4. Quality of Recovery Evaluation of the Protection Schemes for Fiber-Wireless Access Networks

    NASA Astrophysics Data System (ADS)

    Fu, Minglei; Chai, Zhicheng; Le, Zichun

    2016-03-01

    With the rapid development of fiber-wireless (FiWi) access network, the protection schemes have got more and more attention due to the risk of huge data loss when failures occur. However, there are few studies on the performance evaluation of the FiWi protection schemes by the unified evaluation criterion. In this paper, quality of recovery (QoR) method was adopted to evaluate the performance of three typical protection schemes (MPMC scheme, OBOF scheme and RPMF scheme) against the segment-level failure in FiWi access network. The QoR models of the three schemes were derived in terms of availability, quality of backup path, recovery time and redundancy. To compare the performance of the three protection schemes comprehensively, five different classes of network services such as emergency service, prioritized elastic service, conversational service, etc. were utilized by means of assigning different QoR weights. Simulation results showed that, for the most service cases, RPMF scheme was proved to be the best solution to enhance the survivability when planning the FiWi access network.

  5. The Role of Measurement Quality on Practical Guidelines for Assessing Measurement and Structural Invariance

    ERIC Educational Resources Information Center

    Kang, Yoonjeong; McNeish, Daniel M.; Hancock, Gregory R.

    2016-01-01

    Although differences in goodness-of-fit indices (?GOFs) have been advocated for assessing measurement invariance, studies that advanced recommended differential cutoffs for adjudicating invariance actually utilized a very limited range of values representing the quality of indicator variables (i.e., magnitude of loadings). Because quality of…

  6. Observed-to-expected ratio for adherence to treatment guidelines as a quality of care indicator for ovarian cancer☆

    PubMed Central

    Galvan-Turner, Valerie B.; Chang, Jenny; Ziogas, Argyrios; Bristow, Robert E.

    2016-01-01

    Objective To develop an observed-to-expected ratio (O/E) for adherence to National Comprehensive Cancer Network (NCCN) ovarian cancer treatment guidelines as a risk-adjusted hospital measure of quality care correlated with disease-specific survival. Methods Consecutive patients with stages I–IV epithelial ovarian cancer were identified from the California Cancer Registry (1/1/96–12/31/06). Using a fit logistic regression model, O/E for guideline adherence was calculated for each hospital and distributed into quartiles stratified by hospital annual case volume: lowest O/E quartile or annual hospital case volume <5, middle two O/E quartiles and volume ≥5, and highest O/E quartile and volume ≥5. A multivariable logistic regression model was used to characterize the independent effect of hospital O/E on ovarian cancer-specific survival. Results Overall, 18,491 patients were treated at 405 hospitals; 37.3% received guideline adherent care. Lowest O/E hospitals (n = 285) treated 4661 patients (25.2%), mean O/E = 0.77 ± 0.55 and median survival 38.9 months (95%CI = 36.2–42.0 months). Intermediate O/E hospitals (n = 85) treated 8715 patients (47.1%), mean O/E = 0.87 ± 0.17 and median survival of 50.5 months (95% CI = 48.4–52.8 months). Highest O/E hospitals (n = 35) treated 5115 patients (27.7%), mean O/E = 1.34 ± 0.14 and median survival of 53.8 months (95% CI = 50.2–58.2 months). After controlling for other variables, treatment at highest O/E hospitals was associated with independent and statistically significant improvement in ovarian cancer-specific survival compared to intermediate O/E (HR = 1.06, 95% CI = 1.01–1.11) and lowest O/E (1.16, 95% CI = 1.10–1.23) hospitals. Conclusions Calculation of hospital-specific O/E for NCCN treatment guideline adherence, combined with minimum case volume criterion, as a measure of ovarian cancer quality of care is feasible and is an independent predictor of survival. PMID:26387962

  7. Are migrants health policies aimed at improving access to quality healthcare? An analysis of Spanish policies.

    PubMed

    Vázquez, María Luisa; Terraza-Núñez, Rebeca; S-Hernández, Silvia; Vargas, Ingrid; Bosch, Lola; González, Andrea; Pequeño, Sandra; Cantos, Raquel; Martínez, Juan Ignacio; López, Luís Andrés

    2013-12-01

    Although until April 2012, all Spanish citizens regardless of their origin, residence status and work situation were entitled to health care, available evidence suggested inadequate access for immigrants. Following the Aday and Andersen model, we conducted an analysis of policy elements that affect immigrants' access to health care in Spain, based on documentary analysis of national policies and selected regional policies related to migrant health care. Selected documents were (a) laws and plans in force at the time containing migrant health policies and (b) evaluations. The analysis included policy principles, objectives, strategies and evaluations. Results show that the national and regional policies analyzed are based on the principle that health care is a right granted to immigrants by law. These policies include strategies to facilitate access to health care, reducing barriers for entry to the system, for example simplifying requirements and raising awareness, but mostly they address the necessary qualities for services to be able to attend to a more diverse population, such as the adaptation of resources and programs, or improved communication and training. However, limited planning was identified in terms of their implementation, necessary resources and evaluation. In conclusion, the policies address relevant barriers of access for migrants and signal improvements in the health system's responsiveness, but reinforcement is required in order for them to be effectively implemented.

  8. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    PubMed

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines.

  9. Air Quality uFIND: User-oriented Tool Set for Air Quality Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Hoijarvi, K.; Robinson, E. M.; Husar, R. B.; Falke, S. R.; Schultz, M. G.; Keating, T. J.

    2012-12-01

    Historically, there have been major impediments to seamless and effective data usage encountered by both data providers and users. Over the last five years, the international Air Quality (AQ) Community has worked through forums such as the Group on Earth Observations AQ Community of Practice, the ESIP AQ Working Group, and the Task Force on Hemispheric Transport of Air Pollution to converge on data format standards (e.g., netCDF), data access standards (e.g., Open Geospatial Consortium Web Coverage Services), metadata standards (e.g., ISO 19115), as well as other conventions (e.g., CF Naming Convention) in order to build an Air Quality Data Network. The centerpiece of the AQ Data Network is the web service-based tool set: user-oriented Filtering and Identification of Networked Data. The purpose of uFIND is to provide rich and powerful facilities for the user to: a) discover and choose a desired dataset by navigation through the multi-dimensional metadata space using faceted search, b) seamlessly access and browse datasets, and c) use uFINDs facilities as a web service for mashups with other AQ applications and portals. In a user-centric information system such as uFIND, the user experience is improved by metadata that includes the general fields for discovery as well as community-specific metadata to narrow the search beyond space, time and generic keyword searches. However, even with the community-specific additions, the ISO 19115 records were formed in compliance with the standard, so that other standards-based search interface could leverage this additional information. To identify the fields necessary for metadata discovery we started with the ISO 19115 Core Metadata fields and fields that were needed for a Catalog Service for the Web (CSW) Record. This fulfilled two goals - one to create valid ISO 19115 records and the other to be able to retrieve the records through a Catalog Service for the Web query. Beyond the required set of fields, the AQ Community added

  10. Appendix 7: EERE Quality Assurance Guidelines for General Program Evaluation Studies

    SciTech Connect

    2009-01-18

    This appendix provides two tables: options for implementing a third party quality assurance review panel; and key evaluation activities that should benefit from a QA review, identifying related QA factors and QA review participants.

  11. Guidelines for collection and field analysis of water-quality samples from streams in Texas

    USGS Publications Warehouse

    Wells, F.C.; Gibbons, W.J.; Dorsey, M.E.

    1990-01-01

    Analyses for unstable constituents or properties are by necessity performed in the field. This manual addresses analytical techniques and quality assurance for: (1) Water temperature; (2) specific conductance; (3) pH; (4) alkalinity; (5) dissolved oxygen; and (6) bacteria.

  12. Building America Top Innovations 2013 Profile – Quality Management System Guidelines

    SciTech Connect

    none,

    2013-09-01

    This Top Innovation profile describes quality management system tools that were customized for residential construction by BSC, IBACOS, and PHI, for use by builders, trades, and designers to help eliminate mistakes that would require high-cost rework.

  13. 76 FR 37376 - Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-27

    ..., the Commission develops and disseminates scientific and other information and reviews information..., cartographic, narrative, or audiovisual. 5. ``Integrity'' refers to security--the protection of information.... Information Quality Standards and Pre-dissemination Review The Marine Mammal Commission remains committed...

  14. How to Use the Indoor Air Quality Guidelines for Multifamily Building Upgrades

    EPA Pesticide Factsheets

    Remodeling or renovating an existing multifamily building not only has the potential to release pollutants into the home; it is also an opportunity to make changes that will improve the indoor air quality in your home.

  15. Energy Savings Plus Health Indoor Air Quality Guidelines for Multifamily Building Upgrades

    EPA Pesticide Factsheets

    Remodeling or renovating an existing multifamily building not only has the potential to release pollutants into the home; it is also an opportunity to make changes that will improve the indoor air quality in your home.

  16. Quality assurance grading guidelines for research and development at DOE facilities

    SciTech Connect

    Powell, T.B.; Morris, R.N.

    1993-01-01

    The quality assurance (QA) requirements for the US Department of Energy (DOE) are established in DOE Order 5700.6C. This order is applicable for all DOE departmental elements, management, and maintenance and operating contractors and requires that documented Quality Assurance Programs (QAPs) are prepared at all levels; it has one attachment. The DOE Office of Energy Research (DOE-ER) has issued a standard to ensure implementation of the full intent of this order in the ER community.

  17. A pilot study of staff nurses' perceptions of factors that influence quality of care in critical access hospitals.

    PubMed

    Baernholdt, Marianne; Jennings, Bonnie Mowinski; Lewis, Erica Jeané

    2013-01-01

    Knowledge is limited about quality of care (QOC) in rural hospitals, including the smallest hospitals, critical access hospitals. Staff nurses from 7 critical access hospitals identified items important for QOC across 4 levels of care: patients, microsystems, organizations, and environments. Several items were unique to critical access hospitals. Most QOC items were at the microsystem level, yet few of these items are routinely measured. These findings offer beginning evidence about how to advance QOC evaluations in rural hospitals.

  18. The Association between Dietary Quality and Dietary Guideline Adherence with Mental Health Outcomes in Adults: A Cross-Sectional Analysis.

    PubMed

    Meegan, Amy P; Perry, Ivan J; Phillips, Catherine M

    2017-03-05

    The prevalence of adverse mental health outcomes in adults is increasing. Although beneficial effects of selected micronutrients and foods on mental health have been reported, they do not reflect the impact of the habitual diet on mental health. Therefore, our objective is to examine potential associations between dietary quality, dietary composition and compliance with food pyramid recommendations with depressive symptoms, anxiety and well-being (assessed using CES-D, HADS-A and WHO-5 screening tools) in a cross-sectional sample of 2047 middle-aged adults. Diet was assessed using a self-completed FFQ. Chi-square tests, t-tests and logistic regression analyses were used to investigate the associations between dietary components and mental health outcomes. Dietary quality, but not dietary composition or guideline adherence, was associated with well-being. Those with high dietary quality were more likely to report well-being (OR =1.67, 95% CI 1.15-2.44, p = 0.007) relative to those with low dietary quality. This remained significant among females (OR = 1.92, (95% CI 1.14-3.23, p = 0.014) and non-obese individuals (OR = 2.03, 95% CI 1.28-3.20, p = 0.003). No associations between any dietary measures with anxiety or depressive symptoms were observed. These novel results highlight the importance of dietary quality in maintaining optimal psychological well-being. Better understanding of the relationship between dietary quality and mental health may provide insight into potential therapeutic or intervention strategies to improve mental health and well-being.

  19. The Association between Dietary Quality and Dietary Guideline Adherence with Mental Health Outcomes in Adults: A Cross-Sectional Analysis

    PubMed Central

    Meegan, Amy P.; Perry, Ivan J.; Phillips, Catherine M.

    2017-01-01

    The prevalence of adverse mental health outcomes in adults is increasing. Although beneficial effects of selected micronutrients and foods on mental health have been reported, they do not reflect the impact of the habitual diet on mental health. Therefore, our objective is to examine potential associations between dietary quality, dietary composition and compliance with food pyramid recommendations with depressive symptoms, anxiety and well-being (assessed using CES-D, HADS-A and WHO-5 screening tools) in a cross-sectional sample of 2047 middle-aged adults. Diet was assessed using a self-completed FFQ. Chi-square tests, t-tests and logistic regression analyses were used to investigate the associations between dietary components and mental health outcomes. Dietary quality, but not dietary composition or guideline adherence, was associated with well-being. Those with high dietary quality were more likely to report well-being (OR =1.67, 95% CI 1.15–2.44, p = 0.007) relative to those with low dietary quality. This remained significant among females (OR = 1.92, (95% CI 1.14–3.23, p = 0.014) and non-obese individuals (OR = 2.03, 95% CI 1.28–3.20, p = 0.003). No associations between any dietary measures with anxiety or depressive symptoms were observed. These novel results highlight the importance of dietary quality in maintaining optimal psychological well-being. Better understanding of the relationship between dietary quality and mental health may provide insight into potential therapeutic or intervention strategies to improve mental health and well-being. PMID:28273871

  20. Access to and quality use of non-communicable diseases medicines in Nepal.

    PubMed

    K C, Bhuvan; Heydon, Susan; Norris, Pauline

    2015-01-01

    Noncommunicable diseases are a major healthcare problem in Nepal and their burden is increasingevery year. Noncommunicable diseases (NCDs) bring additional challenges to the Nepalese healthcaresystem which is already experiencing infrastructure shortages, poor service delivery, inadequate essential medicines coverage and shortages of healthcare workers. The Nepal government provides a limited number of free essential medicines through the free essential healthcare services program. This consists of a basic healthcare package provided through primary healthcare (PHC) facilities and district hospitals. Though around 40 essential medicines are provided without charge, studies have reported problems with access especially in all rural areas. There is a need to improve access to, coverage and quality use of medicines. The government has decided to provide some free medicines for NCDs alongside free essential medicines to be distributed via current healthcare structures. Though well intended, this decision will put extra strain on the essential medicines program. It should be supplemented by a comprehensive NCDs policy that takes account of the issues of sustainability and quality use of medicines. Complex cases of NCDs will be managed by tertiary hospitals but most of the cases of NCDs especially for rural people and the poor will end up in secondary level public hospitals (district and zonal hospitals). Therefore, the government needs to strengthen these public hospitals. Meanwhile, given the severity of the NCDs problem in Nepal, the Ministry of Health and Population (MoHP) should liaise with nongovernmental and missionary hospitals especially in rural areas to run NCDs management services. The Ministry should encourage these hospitals to run hospital pharmacies to improve people's access to and quality use of NCDs medicines. At the primary healthcare level, the Ministry could run NCDs prevention and control programs but existing PHC workers need training to perform

  1. Use of clinical guidelines: perspectives from clinicians in paediatric and maternity hospitals in Kabul, Afghanistan.

    PubMed

    Graham, H; Tokhi, M; Edward, A; Salehi, A S; Turkmani, S; Duke, T; Bartlett, L

    2015-04-02

    This study explored the perceived value, role and reported use of clinical guidelines by clinicians in urban paediatric and maternity hospital settings, and the effect of current implementation strategies on clinician attitudes, knowledge and behaviour. A total of 63 clinicians from 7 paediatric and maternity hospitals in Kabul, Afghanistan participated in structured focus groups; content analysis methodology was used for identification and analysis of key themes. Seven sets of guidelines, protocols or standards were identified (including 5 WHO-endorsed guidelines). However, most are failing to achieve high levels of use. Factors associated with guideline use included: clinician involvement in guideline development; multidisciplinary training; demonstrable results; and positive clinician perceptions regarding guideline quality and contextual appropriateness. Implementation activities should fulfil 3 major objectives: promote guideline awareness and access; stimulate motivation among clinical guideline users; and actively facilitate adherence to guidelines.

  2. Establishing 'quality of life' parameters using behavioural guidelines for humane euthanasia of captive non-human primates.

    PubMed

    Lambeth, Sp; Schapiro, Sj; Bernacky, Bj; Wilkerson, Gk

    2013-09-01

    Chronic pain and distress are universally accepted conditions that may adversely affect an animal's quality of life (QOL) and lead to the humane euthanasia of an animal. At most research institutions and zoological parks in the USA, a veterinarian, who has physically examined the animal and reviewed the clinical records, ultimately decides when an animal has reached a humane endpoint. To aid in the difficult process of interpreting pain and distress, we have developed specific behavioural guidelines, in addition to standard clinical information, to help define unique characteristics and traits of primates to assess and promote discussion of an individual primate's QOL, and thereby, to assist in the decision-making process regarding euthanasia. These guidelines advocate the creation of a QOL team when the animal is diagnosed with a life-threatening or debilitating chronic condition, or at the time the animal is entered into a terminal study. The team compiles a list of characteristics unique to that individual animal by utilising a questionnaire and a behavioural ethogram. This list enables the team to quantitatively assess any deviations from the established normal behavioural repertoire of that individual. Concurrently, the QOL team determines the number of behavioural deviations that are needed to trigger an immediate discussion of the necessity for humane euthanasia of the animal. The team remains intact once created, and revisits the animal's condition as frequently as deemed necessary. This process improves animal welfare by continuing the quest to optimally define QOL for captive primates, and potentially for all captive animals.

  3. Factors Influencing Quality of Life in Caregivers of People with Parkinson's Disease and Implications for Clinical Guidelines

    PubMed Central

    Morley, D.; Dummett, S.; Peters, M.; Kelly, L.; Hewitson, P.; Dawson, J.; Fitzpatrick, R.; Jenkinson, C.

    2012-01-01

    The quality of life (QoL) of informal caregivers can be adversely affected by a number of factors. This issue, however, has not been well explored for carers of people with Parkinson's (PwP), with research largely restricted to the assessment of caregiver burden and caregiver strain. This study aims to determine the main influences on carer QoL in this population and consider results in the context of current clinical guidelines for the management of Parkinson's disease (PD). Carers completed the newly validated PDQ-Carer, and PwP completed the PDQ-39. The sample comprised 238 carers (mean age 68.20 years) and 238 PwP (mean age 71.64). Results suggest multiple influences on caregiver QoL. These include carer age, gender, health status, and duration of the caregiving role. PwP levels of mobility and cognitive impairment are also significant influences on carer QoL. Not only should practitioners and service providers be particularly aware of the heightened impact of PD on carers over time and as PwP symptoms deteriorate, but this should also be reflected in clinical guidelines for the management of PD. PMID:23316414

  4. Factors influencing quality of life in caregivers of people with Parkinson's disease and implications for clinical guidelines.

    PubMed

    Morley, D; Dummett, S; Peters, M; Kelly, L; Hewitson, P; Dawson, J; Fitzpatrick, R; Jenkinson, C

    2012-01-01

    The quality of life (QoL) of informal caregivers can be adversely affected by a number of factors. This issue, however, has not been well explored for carers of people with Parkinson's (PwP), with research largely restricted to the assessment of caregiver burden and caregiver strain. This study aims to determine the main influences on carer QoL in this population and consider results in the context of current clinical guidelines for the management of Parkinson's disease (PD). Carers completed the newly validated PDQ-Carer, and PwP completed the PDQ-39. The sample comprised 238 carers (mean age 68.20 years) and 238 PwP (mean age 71.64). Results suggest multiple influences on caregiver QoL. These include carer age, gender, health status, and duration of the caregiving role. PwP levels of mobility and cognitive impairment are also significant influences on carer QoL. Not only should practitioners and service providers be particularly aware of the heightened impact of PD on carers over time and as PwP symptoms deteriorate, but this should also be reflected in clinical guidelines for the management of PD.

  5. Public-private integrated partnerships demonstrate the potential to improve health care access, quality, and efficiency.

    PubMed

    Sekhri, Neelam; Feachem, Richard; Ni, Angela

    2011-08-01

    Around the world, publicly owned and run health services face challenges. In poor countries in particular, health services are characterized by such problems as inadequate infrastructure and equipment, frequent shortages of medicines and supplies, and low quality of care. Increasingly, both developed- and developing-country governments are embracing public-private partnerships to harness private financing and expertise to achieve public policy goals. An innovative form of these partnerships is the public-private integrated partnership, which goes a step further than more common hospital building and maintenance arrangements, by combining infrastructure renewal with delivery of clinical services. We describe the benefits and risks inherent in such integrated partnerships and present three case studies that demonstrate innovative design. We conclude that these partnerships have the potential to improve access, quality, and efficiency in health care. More such partnerships should be launched and rigorously evaluated, and their lessons should be widely shared to guide policy makers in the effective use of this model.

  6. Modeling access, cost, and perceived quality: computer simulation benefits orthodontic clinic staffing decisions.

    PubMed

    Montgomery, J B; LaFrancois, G G; Perry, M J

    2000-02-01

    Given limited financial resources, simulation permits a financial analysis of the optimum staffing levels for orthodontists and dental assistants in an orthodontic clinic. A computer simulation provides the information for managerial review. This study, by building a computer simulation of an orthodontic service, set out to determine the most efficient mix between providers and support staff to maximize access, maximize perceived quality, and minimize expenditures. Six combinations of providers and support staff were compared during an animated, computer-generated what-if analysis. Based on the clinic workload and size, on the cost per patient, and on the cost per quality point, the research team recommended a staffing mix of one orthodontist and three assistants. This study shows that computer simulation is an enormous asset as a decision support tool for management.

  7. Effects of unionised ammonia on tropical freshwater organisms: Implications on temperate-to-tropic extrapolation and water quality guidelines.

    PubMed

    Wang, Zhen; Leung, Kenneth M Y

    2015-10-01

    Unionised ammonia (NH3) is highly toxic to freshwater organisms. Yet, most of the available toxicity data on NH3 were predominantly generated from temperate regions, while toxicity data on NH3 derived from tropical species were limited. To address this issue, we first conducted standard acute toxicity tests on NH3 using ten tropical freshwater species. Subsequently, we constructed a tropical species sensitivity distribution (SSD) using these newly generated toxicity data and available tropical toxicity data of NH3, which was then compared with the corresponding temperate SSD constructed from documented temperate acute toxicity data. Our results showed that tropical species were generally more sensitive to NH3 than their temperate counterparts. Based on the ratio between temperate and tropical hazardous concentration 10% values, we recommend an extrapolation factor of four to be applied when surrogate temperate toxicity data or temperate water quality guidelines of NH3 are used for protecting tropical freshwater ecosystems.

  8. George M. Low trophy NASA's quality and excellence award, 1992. Application guidelines: Large business

    NASA Technical Reports Server (NTRS)

    1992-01-01

    The George M. Low Trophy is awarded to current NASA contractors, subcontractors, and suppliers in the aerospace industry who have demonstrated sustained excellence and outstanding achievements in quality and productivity for three or more years. The objectives of the award are to increase public awareness of the importance of quality and productivity to the Nation's aerospace program and industry in general; encourage domestic business to continue efforts to enhance quality, increase productivity, and thereby strengthen competitiveness; and provide the means for sharing the successful methods and techniques used by the applicants with other American enterprises. Information is given on candidate eligibility for large businesses, the selection process, the nomination letter, and the application report.

  9. Application of sediment quality guidelines in the assessment and management of contaminated surficial sediments in Port Jackson (Sydney Harbour), Australia.

    PubMed

    Birch, Gavin F; Taylor, Stuart E

    2002-06-01

    Sediments in the Port Jackson estuary are polluted by a wide range of toxicants and concentrations are among the highest reported for any major harbor in the world. Sediment quality guidelines (SQGs), developed by the National Oceanographic and Atmospheric Administration (NOAA) in the United States are used to estimate possible adverse biological effects of sedimentary contaminants in Port Jackson to benthic animals. The NOAA guidelines indicate that Pb, Zn, DDD, and DDE are the most likely contaminants to cause adverse biological effects in Port Jackson. On an individual chemical basis, the detrimental effects due to these toxicants may occur over extensive areas of the harbor, i.e., about 40%, 30%, 15% and 50%, respectively. The NOAA SQGs can also be used to estimate the probability of sediment toxicity for contaminant mixtures by determining the number of contaminants exceeding an upper guideline value (effects range medium, or ERM), which predicts probable adverse biological effects. The exceedence approach is used in the current study to estimate the probability of sediment toxicity and to prioritize the harbour in terms of possible adverse effects on sediment-dwelling animals. Approximately 1% of the harbor is mantled with sediment containing more than ten contaminants exceeding their respective ERM concentrations and, based on NOAA data, these sediments have an 80% probability of being toxic. Sediment with six to ten contaminants exceeding their respective ERM guidelines extend over approximately 4% of the harbor and have a 57% probability of toxicity. These areas are located in the landward reaches of embayments in the upper and central harbor in proximity to the most industrialised and urbanized part of the catchment. Sediment in a further 17% of the harbor has between one and five exceedences and has a 32% probability of being toxic. The application of SQGs developed by NOAA has not been tested outside North America, and the validity of using them in Port

  10. Strategy Guideline. Application of a Construction Quality Process to Existing Home Retrofits

    SciTech Connect

    Mallay, D.; Del Bianco, M.

    2013-08-01

    The Partnership for Home Innovation developed a construction quality process for new and existing high performance homes (HPH) in which high performance goals are established, specifications to meet those goals are defined, and construction monitoring points are added to the construction schedule so that critical energy efficiency details are systematically reviewed, documented, and tested in a timely manner. This report follows the evolution of the construction quality process from its development for new homes, to its application in the construction of a high performance home with enhanced specifications, and its application in a crawlspace renovation.

  11. Strategy Guideline: Application of a Construction Quality Process to Existing Home Retrofits

    SciTech Connect

    Mallay, D.; Del Bianco, M.

    2013-08-01

    The Home Innovation Research Labs developed a construction quality process for new and existing high performance homes (HPH) in which high performance goals are established, specifications to meet those goals are defined, and construction monitoring points are added to the construction schedule so that critical energy efficiency details are systematically reviewed, documented, and tested in a timely manner. This report follows the evolution of the construction quality process from its development for new homes, to its application in the construction of a high performance home with enhanced specifications, and its application in a crawlspace renovation.

  12. Quality in Individualized Family Service Plans: Guidelines for Practitioners, Programs, and Families

    ERIC Educational Resources Information Center

    Gatmaitan, Michelle; Brown, Teresa

    2016-01-01

    The IFSP is both a document and process for developing, implementing, and evaluating the supports and services delivered to infants and toddlers with disabilities and their families eligible under Part C of the Individuals With Disabilities Education Improvement Act (IDEA; 2004). Recently, researchers have defined IFSP quality based on five…

  13. Guidelines to implement quality management systems in microbiology laboratories for tissue banking.

    PubMed

    Vicentino, W; Rodríguez, G; Saldías, M; Alvarez, I

    2009-10-01

    Human tissues for implants are a biomedical product that is being used more frequently by many medical disciplines. There are infections in the patients related to the implanted tissues. The early detection of infections transmitted by blood and the microbiological study of tissues before their clinical use are strategies in tissue banks to prevent these situations. This work sought to contribute to establish the bases for the operation of a laboratory applied to the microbiological quality control of tissues. Based on classical microbiological principles, we defined the operation of microbiological control and tissues sterilization since 2003. We determine lists of acceptable microorganisms for every tissue, criteria for the interpretation of results, and a diagnostic algorithm of microbiological quality. We observed that the circumstances of donor death can be a determinant of the quality. The environment and the operator should be investigated as probable sources of contamination in outbreaks. The criteria of work based on a solid methodology must help to avoid the transmission of infections between donor and recipient. This is a critical point in the quality management of a tissue bank.

  14. Statistics, Measures, and Quality Standards for Assessing Digital Reference Library Services: Guidelines and Procedures.

    ERIC Educational Resources Information Center

    McClure, Charles R.; Lankes, R. David; Gross, Melissa; Choltco-Devlin, Beverly

    This manual is a first effort to begin to identify, describe, and develop procedures for assessing various aspects of digital reference service. Its overall purpose is to improve the quality of digital reference services and assist librarians to design and implement better digital reference services. More specifically, its aim is to: assist…

  15. Hybrid specification, storage, retrieval and runtime application of clinical guidelines.

    PubMed

    Shahar, Y

    2006-06-01

    Clinical guidelines are a major tool in improving the quality of medical care. However, most guidelines are in free text, are not machine-comprehensible and are not easily accessible to clinicians at the point of care. We have designed and implemented a web-based, modular, distributed architecture, the Digital Electronic Guideline Library (DeGeL), which facilitates gradual conversion of clinical guidelines from text to a formal representation in the chosen target guideline ontology. The architecture supports guideline classification, semantic markup, context-sensitive search, browsing, run-time application and retrospective quality assessment. The DeGeL hybrid meta-ontology includes elements common to all guideline ontologies, such as semantic classification and domain knowledge; it also includes four content-representation formats: free text, semi-structured text, semi-formal representation and a formal representation. These formats support increasingly sophisticated computational tasks. Guidelines can thus be in a hybrid representation in which guidelines, and even parts of the same guideline, might exist at different formalisation levels. We have also developed and rigorously evaluated a methodology and an associated web-based tool, Uruz, for gradually structuring and semi-formalising free-text clinical guidelines. Finally, we have designed, implemented and evaluated a new approach, the hybrid runtime application model, for supporting runtime application of clinical guidelines that are not necessarily in a machine-comprehensible format; in particular, when the guideline is in a semi-formal representation and the patient's data are either in an electronic medical record or in a paper format. The tool implementing this new approach, the Spock module, is customised at this point to the Asbru guideline specification language and exploits the hybrid structure of guidelines in DeGeL. The Spock module also exploits our temporal-abstraction mediator to the patient

  16. Access and Barriers to Immunization in West Bengal, India: Quality Matters

    PubMed Central

    Dutta, Arijita

    2013-01-01

    While many studies attempted to evaluate performance of immunization programmes in developing countries by full coverage, there is a growing awareness about the limitations of such evaluation, irrespective of the overall quality of performance. Availability of human resources, equipment, supporting drugs, and training of personnel are considered to be crucial indicators of the quality of immunization programme. Also, maintenance of time schedule has been considered crucial in the context of the quality of immunization. In addition to overall coverage of vaccination, the coverage of immunization given at right time (month-specific) is to be considered with utmost importance. In this paper, District Level Household and Facility Survey-3 (DLHS-3) 2007-2008 data have been used in exploring the quality of immunization in terms of month-specific vaccine coverage and barriers to access inWest Bengal, India. In West Bengal, the month-specific coverage stands badly below 20% but the simple non-month-specific coverage is as high as 75%. Among the demand-side factors, birthplace of the child and religion of the household heads came out as significant predictors while, from the supply-side, availability of male health workers and equipment at the subcentres, were the important determinants for month-specific vaccine coverage. Hence, there should be a vigorous attempt to make more focused planning, keeping in mind the nature of the barriers, for improvement of the month-specific coverage in West Bengal. PMID:24592593

  17. Access and barriers to immunization in West Bengal, India: quality matters.

    PubMed

    Barman, Debjani; Dutta, Arijita

    2013-12-01

    While many studies attempted to evaluate performance of immunization programmes in developing countries by full coverage, there is a growing awareness about the limitations of such evaluation, irrespective of the overall quality of performance. Availability of human resources, equipment, supporting drugs, and training of personnel are considered to be crucial indicators of the quality of immunization programme. Also, maintenance of time schedule has been considered crucial in the context of the quality of immunization. In addition to overall coverage of vaccination, the coverage of immunization given at right time (month-specific) is to be considered with utmost importance. In this paper, District Level Household and Facility Survey-3 (DLHS-3) 2007-2008 data have been used in exploring the quality of immunization in terms of month-specific vaccine coverage and barriers to access in West Bengal, India. In West Bengal, the month-specific coverage stands badly below 20% but the simple non-month-specific coverage is as high as 75%. Among the demand-side factors, birthplace of the child and religion of the household heads came out as significant predictors while, from the supply-side, availability of male health workers and equipment at the subcentres, were the important determinants for month-specific vaccine coverage. Hence, there should be a vigorous attempt to make more focused planning, keeping in mind the nature of the barriers, for improvement of the month-specific coverage in West Bengal.

  18. Technical requirements of spirometers in the strategy for guaranteeing the access to quality spirometry.

    PubMed

    Salas, Tomàs; Rubies, Carles; Gallego, Carlos; Muñoz, Pilar; Burgos, Felip; Escarrabill, Joan

    2011-09-01

    Access to quality spirometry is an essential objective in order to be able to minimize the underdiagnosis of respiratory diseases, especially in those that are most frequent, such as COPD and asthma. This objective can be reached in the short term, but it requires the simultaneous integration of different strategies: training of the health-care professionals who perform spirometry, definition of standards for the transmission of the information, technical requirements for acquiring apparatuses and the correct interpretation of the results. This present study shows the use of standards for the electronic exchange of clinical information. In order to normalize the treatment of the data related with spirometry and to enable the exchange of information, we have used the standard CDA R2 (Clinical Document Architecture, Release 2) of HL7 (Health Level Seven), version 3. HL7 is a product by HL7 International, a non-profit organization that deals in the production of standards in the health-care setting in order to facilitate interoperability. Furthermore, defining these standards is essential for ensuring that they are adopted by spirometer manufacturers. Be means of this process, the base is set for facilitating access to spirometry at the health-care level, while at the same time it is a fundamental technical element for designing quality control programs of the explorations.

  19. Summary of national standards and guidelines for pesticides in water, bed sediment, and aquatic organisms and their application to water-quality assessments

    USGS Publications Warehouse

    Nowell, Lisa H.; Resek, Elizabeth A.

    1994-01-01

    Current (1993) national standards and guidelines pertaining to pesticide contaminants in water, bed sediment, and fish and shellfish tissues are summarized to provide a condensed reference source for definitions and current values applicable to pesticides in aquatic environmental media. This report facilitates comparison of measured concen- trations of pesticides in environmental samples with applicable standards and guidelines. For each standard or guideline, the following is provided: (1) Definition, including the underlying assumptions and mathematical derivation; (2) originating agency; (3) statutory authority; (4) regulatory status and, for standards, the agency responsible for enforcing the standard; (5) applicable sampling medium; (6) beneficial use and resource protected, and (7) full citations of published documentation. The report emphasizes the appropriate application on national standards and guidelines to water-quality data on pesticides to aid in assessing potential adverse effects on human health, aquatic organisms, and wildlife. (USGS)

  20. Dairy cows welfare quality in tie-stall housing system with or without access to exercise

    PubMed Central

    2013-01-01

    Background Tie-stall housing of dairy cows is used extensively worldwide, despite of the welfare concerns regarding the restriction of voluntary movement and limitation of expression of the cows’ natural behaviour. The aim of this study was to compare the welfare quality of dairy cows kept in two types of tie-stall housing systems: with regular outdoor exercise and without access to exercise. In addition, the study investigated the relationship between different welfare measures of dairy cows kept in tie-stalls. Methods 3,192 lactating cows were assessed using the Welfare Quality® assessment protocol for cattle in 80 commercial dairy farms, half of the farms providing outdoor access for the animals to exercise. The descriptive statistical indicators were determined for the assessed measures and for the welfare criteria and principle scores. The data obtained in the two housing types were compared and the correlation coefficients were calculated between the different welfare measures. Results The significant differences found between the two housing systems for the majority of the animal based measures indicate the positive effect of exercise on the welfare of tethered cows. Many of the animal welfare parameters correlated with each other. For the farms allowing the cows’ turnout in a paddock, pasture or both, the mean scores for the welfare criteria and principles were higher than for the farms with permanent tethering of the cows, except the criteria absence of prolonged hunger and expression of social behaviours. The lowest scores were obtained for the criterion positive emotional state, in both housing systems. With regard to the overall classification, none of the farms were considered excellent. In the not classified category were only farms with all-year-round tethering of the animals and in the enhanced category only farms where the cows had outdoor access. Conclusions The welfare quality of the investigated dairy cows was significantly better in the

  1. Improving planning, design, reporting and scientific quality of animal experiments by using the Gold Standard Publication Checklist, in addition to the ARRIVE guidelines.

    PubMed

    Hooijmans, Carlijn R; de Vries, Rob; Leenaars, Marlies; Curfs, Jo; Ritskes-Hoitinga, Merel

    2011-03-01

    Several studies have demonstrated serious omissions in the way research that use animals is reported. In order to improve the quality of reporting of animal experiments, the Animals in research: reporting in vivo experiments (ARRIVE) Guidelines were published in the British Journal of Pharmacology in August 2010. However, not only the quality of reporting of completed animal studies needs to be improved, but also the design and execution of new experiments. With both these goals in mind, we published the Gold Standard Publication Checklist (GSPC) in May 2010, a few months before the ARRIVE guidelines appeared. In this letter, we compare the GSPC checklist with the ARRIVE Guidelines. The GSPC describes certain items in more detail, which makes it both easier to use when designing and conducting an experiment and particularly suitable for making systematic reviews of animal studies more feasible. In order to improve not only the reporting but also the planning, design, execution and thereby, the scientific quality of animal experiments, we strongly recommend to all scientists involved in animal experimentation and to editors of journals publishing animal studies to take a closer look at the contents of both the ARRIVE guidelines and GSPC, and select the set of guidelines which is most appropriate for their particular situation.

  2. Implementation of study results in guidelines and adherence to guidelines in clinical practice

    PubMed Central

    Waldfahrer, Frank

    2016-01-01

    Guidelines were introduced in hospital- and practice-based otorhinolaryngology in the 1990ies, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The society has cooperated in further 34 guidelines. The quality of the guidelines has been continuously improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF). Since increasing digitalization has made access to scientific publications quicker and simpler, relevant study results can be incorporated in guidelines more easily today than in the analog world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:28025601

  3. A framework for a distributed, hybrid, multiple-ontology clinical-guideline library, and automated guideline-support tools.

    PubMed

    Shahar, Yuval; Young, Ohad; Shalom, Erez; Galperin, Maya; Mayaffit, Alon; Moskovitch, Robert; Hessing, Alon

    2004-10-01

    Clinical guidelines are a major tool in improving the quality of medical care. However, most guidelines are in free text, not in a formal, executable format, and are not easily accessible to clinicians at the point of care. We introduce a Web-based, modular, distributed architecture, the Digital Electronic Guideline Library (DeGeL), which facilitates gradual conversion of clinical guidelines from text to a formal representation in chosen target guideline ontology. The architecture supports guideline classification, semantic markup, context-sensitive search, browsing, run-time application, and retrospective quality assessment. The DeGeL hybrid meta-ontology includes elements common to all guideline ontologies, such as semantic classification and domain knowledge; it also includes four content-representation formats: free text, semi-structured text, semi-formal representation, and a formal representation. These formats support increasingly sophisticated computational tasks. The DeGeL tools for support of guideline-based care operate, at some level, on all guideline ontologies. We have demonstrated the feasibility of the architecture and the tools for several guideline ontologies, including Asbru and GEM.

  4. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised Publication Guidelines from a Detailed Consensus Process.

    PubMed

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2015-01-01

    Since the publication of Standards for Quality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015, using 1) semistructured interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group; 2) two face-to-face consensus meetings to develop interim drafts; and 3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes the reporting of three key components of systematic efforts to improve the quality, value, and safety of health care: the use of formal and informal theory in planning, implementing, and evaluating improvement work; the context in which the work is done; and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve health care, recognizing that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature (www.squire-statement.org).

  5. [SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process].

    PubMed

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2015-11-20

    Since the publication of Standards for Quality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) semi-structured interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) two face-to-face consensus meetings to develop interim drafts, and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes the reporting of three key components of systematic efforts to improve the quality, value, and safety of healthcare: the use of formal and informal theory in planning, implementing, and evaluating improvement work; the context in which the work is done; and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve healthcare, recognizing that they can be complex and multi-dimensional. It provides common ground to share these discoveries in the scholarly literature (www.squire-statement.org).

  6. Development of the Anatomical Quality Assurance (AQUA) checklist: Guidelines for reporting original anatomical studies.

    PubMed

    Tomaszewski, Krzysztof A; Henry, Brandon Michael; Kumar Ramakrishnan, Piravin; Roy, Joyeeta; Vikse, Jens; Loukas, Marios; Tubbs, R Shane; Walocha, Jerzy A

    2017-01-01

    The rise of evidence-based anatomy has emphasized the need for original anatomical studies with high clarity, transparency, and comprehensiveness in reporting. Currently, inconsistencies in the quality and reporting of such studies have placed limits on accurate reliability and impact assessment. Our aim was to develop a checklist of reporting items that should be addressed by authors of original anatomical studies. The study steering committee formulated a preliminary conceptual design and began to generate items on the basis of a literature review and expert opinion. This led to the development of a preliminary checklist. The validity of this checklist was assessed by a Delphi procedure, and feedback from the Delphi panelists, who were experts in the area of anatomical research, was used to improve it. The Delphi procedure involved 12 experts in anatomical research. It comprised two rounds, after which unanimous consensus was reached regarding the items to be included in the checklist. The steering committee agreed to name the checklist AQUA. The preliminary AQUA Checklist consisted of 26 items divided into eight sections. Following round 1, some of the items underwent major revision and three new ones were introduced. The checklist was revised only for minor language inaccuracies after round 2. The final version of the AQUA Checklist consisted of the initial eight sections with a total of 29 items. The steering committee hopes the AQUA Checklist will improve the quality and reporting of anatomical studies. Clin. Anat. 30:14-20, 2017. © 2016 Wiley Periodicals, Inc.

  7. Improving product quality and productivity using better guidelines for concept design

    SciTech Connect

    Hinckley, C.M.; Barkan, P.

    1995-08-01

    The remarkable effectiveness of Japanese practices has led to a growing interest in the US in the development and application of rules and methodologies which attempt to capture design experience. US companies have found unexpected benefits and pitfalls in the application of these rules and methods. In this article, the authors critically examine one of the most widely accepted rules of Design for Manufacturability (DFM): minimize the number of parts. An examination of 240 assemblies and subassemblies has shown that rigid adherence to this rule can lead to unnecessarily complex parts and assembly. Quantitative insights derived from this study have led to a better design goal: minimize and simplify assembly operations. This new rule, which should not be rigidly interpreted, tends to reduce part count, while having the benefit of assuring improved assembly. Another significant advantage of the new design rule is that it results in lower product defect rates as demonstrated by correlations observed for a wide range of products from two different manufacturers. This research links quality to the product concept, enabling a new approach to improving quality at the earliest stages of design.

  8. Groundwater monitoring: Guidelines and methodology for developing and implementing a ground-water quality monitoring program

    SciTech Connect

    Everett, L.G.

    1984-01-01

    The handbook attempts to structure a cost-effective, generic groundwater pollution monitoring methodology that can be applied either on a regional basis or to site-specific, alternative approaches to monitoring the quality of groundwater at a considerable saving of time and money. Extensive detail is given to the relation of groundwater quality to the geohydrologic framework, constituents in the polluted groundwater, sources and causes of pollution, and use of water. Information is also given about groundwater monitoring techniques used in top soil, the vadose zone, ad the saturated zone. The costs of these techniques are described in figures and tables. Groundwater databases and their applicability to water resources information systems are also covered. Comprehensive site-specific examples are given of how to use the material in the handbook to monitoring major sources of groundwater pollution. Included are in-depth models of hazardous waste disposal, brine disposal, landfill leachate control, oxidation ponds and percolation ponds, septic fields, and agricultural return flow, as well as descriptions of cases of multiple-source municipal and agricultural pollution.

  9. Sperm quality and its relationship to natural and assisted conception: British Fertility Society guidelines for practice.

    PubMed

    Tomlinson, Mathew; Lewis, Sheena; Morroll, David

    2013-09-01

    Reports on the influence of semen parameters on natural or assisted pregnancy are contradictory, suggesting that the many confounding variables which contribute to outcome have not been taken into account. However, it is possible to derive some consensus for both natural and assisted conception by focussing on studies which use WHO-recommended semen analysis on relatively large populations, applying appropriate statistics and accounting for 'female factors'. The concentration of progressively motile sperm has consistently been shown to be the most predictive factor with regard to outcome. Around 64% of studies suggest that a reasonable chance of success with artificial insemination requires at least 5 × 10⁶ motile sperm and this is supported by the WHO's revised reference range for natural conception. Sperm morphology remains controversial, with a lack of standardisation across centres, the adoption of ever-stricter scoring criteria and changing reference values. Antisperm antibodies do not appear to influence outcome independently of sperm motility and agglutination. Sperm DNA damage appears to be related to sperm quality, embryo development and pregnancy loss, yet there remains no consensus on the best testing procedures, clinical reference values and how patients with an adverse result should be managed. In conclusion, laboratories should continue to focus on reducing the uncertainty and improving the quality of their basic semen analysis.

  10. Establishing ‘quality of life’ parameters using behavioural guidelines for humane euthanasia of captive non-human primates

    PubMed Central

    Lambeth, SP; Schapiro, SJ; Bernacky, BJ; Wilkerson, GK

    2014-01-01

    Chronic pain and distress are universally accepted conditions that may adversely affect an animal’s quality of life (QOL) and lead to the humane euthanasia of an animal. At most research institutions and zoological parks in the USA, a veterinarian, who has physically examined the animal and reviewed the clinical records, ultimately decides when an animal has reached a humane endpoint. To aid in the difficult process of interpreting pain and distress, we have developed specific behavioural guidelines, in addition to standard clinical information, to help define unique characteristics and traits of primates to assess and promote discussion of an individual primate’s QOL, and thereby, to assist in the decision-making process regarding euthanasia. These guidelines advocate the creation of a QOL team when the animal is diagnosed with a life-threatening or debilitating chronic condition, or at the time the animal is entered into a terminal study. The team compiles a list of characteristics unique to that individual animal by utilising a questionnaire and a behavioural ethogram. This list enables the team to quantitatively assess any deviations from the established normal behavioural repertoire of that individual. Concurrently, the QOL team determines the number of behavioural deviations that are needed to trigger an immediate discussion of the necessity for humane euthanasia of the animal. The team remains intact once created, and revisits the animal’s condition as frequently as deemed necessary. This process improves animal welfare by continuing the quest to optimally define QOL for captive primates, and potentially for all captive animals. PMID:25505822

  11. Translation of the UNESCO/OECD Guidelines for Quality Provision in Cross-Border Higher Education into Local Policy Contexts: A Comparative Study of Finland and Russia

    ERIC Educational Resources Information Center

    Kallo, Johanna; Semchenko, Anzhelika

    2016-01-01

    This article analyses the localisation of the United Nations Educational Scientific and Cultural Organisation (UNESCO)/Organisation for Economic Co-operation and Development (OECD) "Guidelines for Quality Provision in Cross-Border Higher Education" (2005) at the national and university levels in Finland and Russia. The article engages…

  12. Guidelines for OPAC Displays.

    ERIC Educational Resources Information Center

    Yee, Martha M.

    This paper describes the IFLA (International Federation of Library Associations and Institutions) guidelines for librarians charged with customizing OPAC (online public access catalog) software and vendors and producers of this software. The guidelines are intended to apply to all types of catalog, including World Wide Web-based catalogs, GUI…

  13. Using law to fight a silent epidemic: the role of health literacy in health care access, quality, & cost.

    PubMed

    Clark, Brietta

    2011-01-01

    The dominant rhetoric in the health care policy debate about cost has assumed an inherent tension between access and quality on the one hand, and cost effectiveness on the other; but an emerging discourse has challenged this narrative by presenting a more nuanced relationship between access, quality, and cost. This is reflected in the discourse surrounding health literacy, which is viewed as an important tool for achieving all three goals. Health literacy refers to one's ability to obtain, understand and use health information to make appropriate health decisions. Research shows that improving patients' health literacy can help overcome access barriers and empower patients to be better health care partners, which should lead to better health outcomes. Promoting health literacy can also reduce expenditures for unnecessary or inappropriate treatment. This explains why, as a policy matter, improving health literacy is an objective that has been embraced by almost every sector of the health care system. As a legal matter, however, the role of health literacy in ensuring quality and access is not as prominent. Although the health literacy movement is relatively young, it has roots in longstanding bioethical principles of patient autonomy, beneficence, and justice as well as the corresponding legal principles of informed consent, the right to quality care, and antidiscrimination. Assumptions and concerns about health literacy seem to do important, yet subtle work in these legal doctrines--influencing conclusions about patient understanding in informed consent cases, animating decisions about patient responsibility in malpractice cases, and underlying regulatory guidance concerning the quality of language assistance services that are necessary for meaningful access to care. Nonetheless, health literacy is not explicitly treated as a legally relevant factor in these doctrines. Moreover, there is no coherent legal framework for incorporating health literacy research that

  14. Guidelines for compliance with the National Environmental Policy Act and the California Environmental Quality Act

    SciTech Connect

    Kielusiak, C.

    1993-02-01

    The National Environmental Policy Act of 1969 (NEPA) sets forth national policy for the protection of the environment. The NEPA process is intended to help officials of the federal government make decisions that are based on an understanding of environmental consequences, and take actions that protect, restore, and enhance the environment. The California Environmental Quality Act of 1970 (CEQA) is similar to NEPA. The California legislature established CEQA to inform both state and local governmental decision-makers and the public about potential significant environmental effects of proposed activities, to identify ways to avoid or reduce environmental impacts, and to disclose to the public the reasons why a project is approved if significant environmental effects are involved. Lawrence Berkeley Laboratory (LBL), complies with the provisions of both NEPA and CEQA. This document defines the responsibilities and authorities for NEPA/CEQA compliance at LBL.

  15. Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation

    PubMed Central

    Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

    2016-01-01

    Introduction Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. Methods In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Results Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7–8) versus Group B: 8 (7–9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The

  16. Development of gemifloxacin in vitro susceptibility test methods for gonococci including quality control guidelines. The Quality Control Study Group.

    PubMed

    Jones, R N; Erwin, M E

    2000-07-01

    Gemifloxacin (formerly SB-265805 or LB20304a) is a new fluoronapthyridone with documented activity against Gram-positive and -negative organisms. The activity of gemifloxacin was tested against 150 Neisseria gonorrhoeae strains, using reference agar dilution, standardized disk diffusion, and Etest (AB BIODISK, Solna, Sweden) methods. Gemifloxacin was very potent against ciprofloxacin (CIPRO)-susceptible strains (MIC(90,) 0.008 microg/ml) but was significantly less active against the CIPRO-resistant gonococci (MIC(90,) 0.12 microg/ml). Etest and reference agar dilution MIC results showed excellent correlation (r = 0.96), and 98.7% MICs were within +/- one log(2) dilution. Agar dilution MICs were also compared to zone diameters obtained using gemifloxacin 5-microg disks; and complete intermethod categorical agreement (100%) was achieved applying breakpoints proposed as follows: < or =0.25 microg/ml (zone, > or =25 mm) for susceptible and > or =1 microg/ml (zone, < or =21 mm) for resistant. Gemifloxacin MIC and disk diffusion te quality control (QC) ranges were established for N. gonorrhoeae ATCC 49226. Data were collected from > or = seven laboratories, three GC agar medium lots for both agar MICs and disk methods, and two lots each of the 5- and 10-microg disks. The proposed MIC QC range was 0.002 to 0.016 microg/ml and the calculated mm zone ranges (median +/- 0.5x average mm range) for both disks were similar, but contained only 88.1 to 91.9% of participant results. To achieve the acceptable > or = 95% of all study results within range, a 43 to 54 mm limits (5-microg disks) were necessary. The excellent broad-spectrum activity and a low reported adverse effects profile of gemifloxacin shows a potential for treatment of fluoroquinolone-resistant gonorrhea.

  17. Association analysis of fiber quality traits and exploration of elite alleles in Upland cotton cultivars/accessions (Gossypium hirsutum L.).

    PubMed

    Cai, Caiping; Ye, Wenxue; Zhang, Tianzhen; Guo, Wangzhen

    2014-01-01

    Exploring the elite alleles and germplasm accessions related to fiber quality traits will accelerate the breeding of cotton for fiber quality improvement. In this study, 99 Gossypium hirsutum L. accessions with diverse origins were used to perform association analysis of fiber quality traits using 97 polymorphic microsatellite marker primer pairs. A total of 107 significant marker-trait associations were detected for three fiber quality traits under three different environments, with 70 detected in two or three environments and 37 detected in only one environment. Among the 70 significant marker-trait associations, 52.86% were reported previously, implying that these are stable loci for target traits. Furthermore, we detected a large number of elite alleles associated simultaneously with two or three traits. These elite alleles were mainly from accessions collected in China, introduced to China from the United States, or rare alleles with a frequency of less than 5%. No one cultivar contained more than half of the elite alleles, but 10 accessions were collected from China and the two introduced from the United States did contain more than half of these alleles. Therefore, there is great potential for mining elite alleles from germplasm accessions for use in fiber quality improvement in modern cotton breeding.

  18. Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

    PubMed

    Agha, Sohail; Gage, Anastasia; Balal, Asma

    2007-05-01

    With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to

  19. The DEDUCE Guided Query Tool: Providing Simplified Access to Clinical Data for Research and Quality Improvement

    PubMed Central

    Horvath, Monica M.; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

    2011-01-01

    In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction—the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a guided query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. PMID:21130181

  20. Development of a new quality fair access best value performance indicator (BVPI) for recycling services.

    PubMed

    Harder, M K; Stantzos, N; Woodard, R; Read, A

    2008-01-01

    Recycling schemes are being used worldwide to reduce the impact of municipal waste. Those using public funds are usually obliged to set performance indicators by which the standards of such schemes can be measured. In the UK, a set of statutory Best Value Performance Indicators (BVPI) must be reported annually, such as the Quality of Fair Access, which monitors the public's access to recycling facilities within 1000 m (known as BVPI 91). This work shows that BVPI 91, and performance indicators like it, quantify only very basic recycling services. A much more sensitive performance indicator is developed in this paper, labelled as the Maximum Practicable Recycling Rate Provision (MPRRP) achievable by a local authority. It indicates the percentage of local waste that could be reasonably recycled using the services provided, calculated on the basis of the average composition of the local waste, the local population coverage for collection of any materials, and nationally provided information stating how much of each material stream is generally suitable (practical) for recycling. Evidence for the usefulness of this new quantity is presented. Although this paper refers a particular performance indicator in the UK, its findings are applicable to all urban areas worldwide needing to monitor recycling service. Furthermore, the MPRRP could be used for planning purposes, and for determining the level of performance of an existing service, by comparing its predicted recycling rate to that actually obtained. Further work is now being carried out on this.

  1. The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

    PubMed

    Horvath, Monica M; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

    2011-04-01

    In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a Guided Query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion.

  2. Water quality laboratories in Colombia: a GIS-based study of urban and rural accessibility.

    PubMed

    Wright, Jim; Liu, Jing; Bain, Robert; Perez, Andrea; Crocker, Jonny; Bartram, Jamie; Gundry, Stephen

    2014-07-01

    The objective of this study was to quantify sample transportation times associated with mandated microbiological monitoring of drinking-water in Colombia. World Health Organization Guidelines for Drinking-Water Quality recommend that samples spend no more than 6h between collection and analysis in a laboratory. Census data were used to estimate the minimum number of operational and surveillance samples required from piped water supplies under national regulations. Drive-times were then computed from each supply system to the nearest accredited laboratory and translated into sample holding times based on likely daily monitoring patterns. Of 62,502 surveillance samples required annually, 5694 (9.1%) were found to be more than 6 h from the nearest of 278 accredited laboratories. 612 samples (1.0%) were more than 24 hours' drive from the nearest accredited laboratory, the maximum sample holding time recommended by the World Health Organization. An estimated 30% of required rural samples would have to be stored for more than 6 h before reaching a laboratory. The analysis demonstrates the difficulty of undertaking microbiological monitoring in rural areas and small towns from a fixed laboratory network. Our GIS-based approach could be adapted to optimise monitoring strategies and support planning of testing and transportation infra-structure development. It could also be used to estimate sample transport and holding times in other countries.

  3. [Systematic Review of the Methodology Quality in Lung Cancer Screening Guidelines].

    PubMed

    Li, Jiang; Su, Kai; Li, Fang; Tang, Wei; Huang, Yao; Wang, Le; Huang, Huiyao; Shi, Jufang; Dai, Min

    2016-10-20

    背景与目的 早期筛查可降低肺癌的死亡率,依据高质量的筛查指南进行实践工作是十分重要和必要的。本研究旨在了解国内外肺癌筛查指南研究的方法学质量,为我国的肺癌筛查权威指南的制定工作提供借鉴。方法 检索PubMed、Embase、Cochrane图书馆(Cochrane Library, CL)、Web of Science数据库、中国期刊全文数据库(China National Knowledge Infrastructure, CNKI)、中国生物医学文献数据库(China Bio-Medicine database, CBM)和万方等中英文共7个数据库(截至2016年2月)和相关网站有关肺癌筛查指南的所有中英文文献,按既定的纳入与排除标准,筛选文献、纳入国内外公开发布的国内外独立报告的具备方法学描述的肺癌筛查指南,采用欧洲指南研究与评估工具(Appraisal of Guidelines Research and Evaluation in Europe, AGREE II)对质量进行评价。结果 ①共纳入11篇报告研究方法的肺癌筛查指南。②纳入指南主要由美国(81%)发布,中国和加拿大各发布1篇具备方法学描述的指南。③政府发布指南1篇,肿瘤/胸科等专业机构发布指南数9篇,未指明发布机构的指南1篇。④方法学质量评估结果:“范围和目的”领域总体评价结果平均80分,“参与人员”领域总体评价结果平均52分,“严谨性”领域总体评价结果平均50分,“清晰性”领域总体评价结果平均76分,“应用性”领域总体评价结果平均43分和“独立性”领域总体评价结果平均59分。2013年和2015年发布的指南在各领域评分较高。加拿大的指南在6个领域得分均最高。7篇指南为A推荐等级,其余4篇指南为B推荐等级。结论 ①指南发布数量呈上升趋势,主要集中在肺癌疾病负担较重的国家。②指南的制定或更新有不断打破国家和地区界限的趋势。③循证实践指南制定方法已经逐渐成为各国

  4. The IEO Data Center Management System: Tools for quality control, analysis and access marine data

    NASA Astrophysics Data System (ADS)

    Casas, Antonia; Garcia, Maria Jesus; Nikouline, Andrei

    2010-05-01

    Since 1994 the Data Centre of the Spanish Oceanographic Institute develops system for archiving and quality control of oceanographic data. The work started in the frame of the European Marine Science & Technology Programme (MAST) when a consortium of several Mediterranean Data Centres began to work on the MEDATLAS project. Along the years, old software modules for MS DOS were rewritten, improved and migrated to Windows environment. Oceanographic data quality control includes now not only vertical profiles (mainly CTD and bottles observations) but also time series of currents and sea level observations. New powerful routines for analysis and for graphic visualization were added. Data presented originally in ASCII format were organized recently in an open source MySQL database. Nowadays, the IEO, as part of SeaDataNet Infrastructure, has designed and developed a new information system, consistent with the ISO 19115 and SeaDataNet standards, in order to manage the large and diverse marine data and information originated in Spain by different sources, and to interoperate with SeaDataNet. The system works with data stored in ASCII files (MEDATLAS, ODV) as well as data stored within the relational database. The components of the system are: 1.MEDATLAS Format and Quality Control - QCDAMAR: Quality Control of Marine Data. Main set of tools for working with data presented as text files. Includes extended quality control (searching for duplicated cruises and profiles, checking date, position, ship velocity, constant profiles, spikes, density inversion, sounding, acceptable data, impossible regional values,...) and input/output filters. - QCMareas: A set of procedures for the quality control of tide gauge data according to standard international Sea Level Observing System. These procedures include checking for unexpected anomalies in the time series, interpolation, filtering, computation of basic statistics and residuals. 2. DAMAR: A relational data base (MySql) designed to

  5. Urban Farmers' Markets: accessibility, offerings, and produce variety, quality, and price compared to nearby stores

    PubMed Central

    Maroko, Andrew; Sanon, Omar; Frias, Rafael; Schechter, Clyde B.

    2015-01-01

    Most food-environment research has focused narrowly on select stores and restaurants. There has been comparatively less attention to non-storefront food sources like farmers' markets (FMs), particularly in urban communities. The objective of the present study was to assess FMs' potential contribution to an urban food environment in terms of specific foods offered, and compare FM accessibility as well as produce variety, quality, and price to that of nearby stores. Investigators conducted a detailed cross-sectional assessment of all FMs in Bronx County, NY, and of the nearest store(s) selling produce within a half-mile walking distance (up to two stores per FM). The study included 26 FMs and 44 stores. Investigators assessed accessibility (locations of FMs and stores relative to each other, and hours of operation for each), variety (the number and type of all food items offered at FMs and all fresh produce items offered at stores), quality (where produce items were grown and if they were organic), and price (including any sales prices or promotional discounts). Analyses included frequencies, proportions, and variable distributions, as well as mixed-effect regressions, paired t-tests, and signed rank tests to compare FMs to stores. Geographic information systems (GIS) allowed for mapping of FM and store locations and determining street-network distances between them. The mean distance between FMs and the nearest store selling fresh produce was 0.15 miles (range 0.02-0.36 miles). FMs were open substantially fewer months, days, and hours than stores. FMs offered 26.4 fewer fresh produce items on average than stores (p values <0.02). FM produce items were more frequently local and organic, but often tended towards less-common/more-exotic and heirloom varieties. FMs were more expensive on average (p values <0.001 for pairwise comparisons to stores)—even for more-commonplace and “conventional” produce—especially when discounts or sales prices were considered

  6. Urban farmers' markets: accessibility, offerings, and produce variety, quality, and price compared to nearby stores.

    PubMed

    Lucan, Sean C; Maroko, Andrew R; Sanon, Omar; Frias, Rafael; Schechter, Clyde B

    2015-07-01

    Most food-environment research has focused narrowly on select stores and restaurants. There has been comparatively less attention to non-storefront food sources like farmers' markets (FMs), particularly in urban communities. The objective of the present study was to assess FMs' potential contribution to an urban food environment in terms of specific foods offered, and compare FM accessibility as well as produce variety, quality, and price to that of nearby stores. Investigators conducted a detailed cross-sectional assessment of all FMs in Bronx County, NY, and of the nearest store(s) selling produce within a half-mile walking distance (up to two stores per FM). The study included 26 FMs and 44 stores. Investigators assessed accessibility (locations of FMs and stores relative to each other, and hours of operation for each), variety (the number and type of all food items offered at FMs and all fresh produce items offered at stores), quality (where produce items were grown and if they were organic), and price (including any sales prices or promotional discounts). Analyses included frequencies, proportions, and variable distributions, as well as mixed-effect regressions, paired t-tests, and signed rank tests to compare FMs to stores. Geographic information systems (GIS) allowed for mapping of FM and store locations and determining street-network distances between them. The mean distance between FMs and the nearest store selling fresh produce was 0.15 miles (range 0.02-0.36 miles). FMs were open substantially fewer months, days, and hours than stores. FMs offered 26.4 fewer fresh produce items on average than stores (p values <0.02). FM produce items were more frequently local and organic, but often tended toward less-common/more-exotic and heirloom varieties. FMs were more expensive on average (p values <0.001 for pairwise comparisons to stores) - even for more-commonplace and "conventional" produce - especially when discounts or sales prices were considered. Fully, 32

  7. Cyberinfrastructure for Online Access to High-Quality Data: Advances and Opportunities (Invited)

    NASA Astrophysics Data System (ADS)

    Baru, C.

    2010-12-01

    Advanced cyberinfrastructure capabilities are enabling end-to-end management of data flows in observing system networks and online access to very large data archives. We provide an overview of several projects in earth and environmental sciences that have developed and deployed cyberinfrastructure for collecting and organizing field observations and remote sensing data, to make them available to a community of users. The data cyberinfrastructure framework should cover the range from data acquisition, quality control, data archiving, discovery, access, integration, and modeling. Using examples from different earth and environmental science cyberinfrastructure efforts, we will describe the state of the art in data cyberinfrastructure and future directions and challenges. The Tropical Ecology, Assessment and Monitoring (TEAM) Network (http://teamnetwork.org), which is a network of forested sites—currently consisting of 15 sites, and growing—distributed across Central America, South America, Africa, and Asia. Each site implements a standardized set of data collection protocols, all under the control of a common cyberinfrastructure. The data are available via a portal from a central site, but with appropriate access controls. The TEAM Network is run by Conservation International, in partnership with the Wildlife Conservation Society, Smithsonian Institute, and the Missouri Botanical Gardens, and is funded by the Moore Foundation. The EarthScope Data Portal (portal.earthscope.org) implements a virtual metadata catalog and a data cart to provides a means for simultaneously exploring EarthScope's various instrument networks, as well as seamlessly downloading data from multiple stations and instrument types. The prototype of the US Geoinformatics Information Network (US GIN) project is implementing a federated catalog, using the Catalog Services for Web (CSW) standard. The NSF-funded Opentopography.org—a spinoff of the GEON project, www.geongrid.org—provides online

  8. Quality assurance program guidelines for application to and use by manufacturers of rail/guideway vehicles, buses, automatic train control systems, and their major subsystems

    NASA Technical Reports Server (NTRS)

    Witkin, S. A.

    1976-01-01

    Guidelines are presented for a quality assurance system to be implemented by the manufacturer in support of designing, developing, fabricating, assembling, inspecting, testing, handling, and delivery of equipment being procured for use in public urban mass transit systems. The guidelines apply to this equipment when being procured for: (1) use in revenue service; (2) demonstration of systems that will be revenue producing or used by the public; (3) use as a prototype for follow-on operational/revenue producing equipment procurements; and (4) qualification tests.

  9. Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature

    PubMed Central

    Goodman, Daisy; Ogrinc, Greg; Davies, Louise; Baker, G Ross; Barnsteiner, Jane; Foster, Tina C; Gali, Kari; Hilden, Joanne; Horwitz, Leora; Kaplan, Heather C; Leis, Jerome; Matulis, John C; Michie, Susan; Miltner, Rebecca; Neily, Julia; Nelson, William A; Niedner, Matthew; Oliver, Brant; Rutman, Lori; Thomson, Richard

    2016-01-01

    Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org. PMID:27076505

  10. Public library computer training for older adults to access high-quality Internet health information

    PubMed Central

    Xie, Bo; Bugg, Julie M.

    2010-01-01

    An innovative experiment to develop and evaluate a public library computer training program to teach older adults to access and use high-quality Internet health information involved a productive collaboration among public libraries, the National Institute on Aging and the National Library of Medicine of the National Institutes of Health (NIH), and a Library and Information Science (LIS) academic program at a state university. One hundred and thirty-one older adults aged 54–89 participated in the study between September 2007 and July 2008. Key findings include: a) participants had overwhelmingly positive perceptions of the training program; b) after learning about two NIH websites (http://nihseniorhealth.gov and http://medlineplus.gov) from the training, many participants started using these online resources to find high quality health and medical information and, further, to guide their decision-making regarding a health- or medically-related matter; and c) computer anxiety significantly decreased (p < .001) while computer interest and efficacy significantly increased (p = .001 and p < .001, respectively) from pre- to post-training, suggesting statistically significant improvements in computer attitudes between pre- and post-training. The findings have implications for public libraries, LIS academic programs, and other organizations interested in providing similar programs in their communities. PMID:20161649

  11. Public library computer training for older adults to access high-quality Internet health information.

    PubMed

    Xie, Bo; Bugg, Julie M

    2009-09-01

    An innovative experiment to develop and evaluate a public library computer training program to teach older adults to access and use high-quality Internet health information involved a productive collaboration among public libraries, the National Institute on Aging and the National Library of Medicine of the National Institutes of Health (NIH), and a Library and Information Science (LIS) academic program at a state university. One hundred and thirty-one older adults aged 54-89 participated in the study between September 2007 and July 2008. Key findings include: a) participants had overwhelmingly positive perceptions of the training program; b) after learning about two NIH websites (http://nihseniorhealth.gov and http://medlineplus.gov) from the training, many participants started using these online resources to find high quality health and medical information and, further, to guide their decision-making regarding a health- or medically-related matter; and c) computer anxiety significantly decreased (p < .001) while computer interest and efficacy significantly increased (p = .001 and p < .001, respectively) from pre- to post-training, suggesting statistically significant improvements in computer attitudes between pre- and post-training. The findings have implications for public libraries, LIS academic programs, and other organizations interested in providing similar programs in their communities.

  12. Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

    PubMed

    Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

    2017-02-01

    We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record

  13. Drinking water insecurity: water quality and access in coastal south-western Bangladesh.

    PubMed

    Benneyworth, Laura; Gilligan, Jonathan; Ayers, John C; Goodbred, Steven; George, Gregory; Carrico, Amanda; Karim, Md Rezaul; Akter, Farjana; Fry, David; Donato, Katherine; Piya, Bhumika

    2016-01-01

    National drinking water assessments for Bangladesh do not reflect local variability, or temporal differences. This paper reports on the findings of an interdisciplinary investigation of drinking water insecurity in a rural coastal south-western Bangladesh. Drinking water quality is assessed by comparison of locally measured concentrations to national levels and water quality criteria; resident's access to potable water and their perceptions are based on local social surveys. Residents in the study area use groundwater far less than the national average; salinity and local rainwater scarcity necessitates the use of multiple water sources throughout the year. Groundwater concentrations of arsenic and specific conductivity (SpC) were greater than surface water (pond) concentrations; there was no statistically significant seasonal difference in mean concentrations in groundwater, but there was for ponds, with arsenic higher in the dry season. Average arsenic concentrations in local water drinking were 2-4 times times the national average. All of the local groundwater samples exceeded the Bangladesh guidance for SpC, although the majority of residents surveyed did not perceive their water as having a 'bad' or 'salty' taste.

  14. Predictions of sediment toxicity using consensus-based freshwater sediment quality guidelines

    USGS Publications Warehouse

    Ingersoll, C.G.; MacDonald, D.D.; Wang, N.; Crane, J.L.; Field, L.J.; Haverland, P.S.; Kemble, N.E.; Lindskoog, R.A.; Severn, C.; Smorong, D.E.

    2001-01-01

    The objectives of this study were to compare approaches for evaluating the combined effects of chemical mixtures on the toxicity in field-collected sediments and to evaluate the ability of consensus-based probable effect concentrations (PECs) to predict toxicity in a freshwater database on both a national and regional geographic basis. A database was developed from 92 published reports, which included a total of 1,657 samples with high-quality matching sediment toxicity and chemistry data from across North America. The database was comprised primarily of 10- to 14-day or 28- to 42-day toxicity tests with the amphipod Hyalella azteca (designated as the HA10 or HA28 tests) and 10- to 14-day toxicity tests with the midges Chironomus tentans or C. riparius (designated as the CS10 test). Mean PEC quotients were calculated to provide an overall measure of chemical contamination and to support an evaluation of the combined effects of multiple contaminants in sediments. There was an overall increase in the incidence of toxicity with an increase in the mean quotients in all three tests. A consistent increase in the toxicity in all three tests occurred at a mean quotient > 0.5, however, the overall incidence of toxicity was greater in the HA28 test compared to the short-term tests. The longer-term tests, in which survival and growth are measured, tend to be more sensitive than the shorter-term tests, with acute to chronic ratios on the order of six indicated for H. azteca. Different patterns were observed among the various procedures used to calculate mean quotients. For example, in the HA28 test, a relatively abrupt increase in toxicity was associated with elevated polychlorinated biphenyls (PCBs) alone or with elevated polycyclic aromatic hydrocarbons (PAHs) alone, compared to the pattern of a gradual increase in toxicity observed with quotients calculated using a combination of metals, PAHs, and PCBs. These analyses indicate that the different patterns in toxicity may be

  15. Applying a developmental approach to quality of life assessment in children and adolescents with psychological disorders: challenges and guidelines.

    PubMed

    Carona, Carlos; Silva, Neuza; Moreira, Helena

    2015-02-01

    Research on the quality of life (QL) of children/adolescents with psychological disorders has flourished over the last few decades. Given the developmental challenges of QL measurements in pediatric populations, the aim of this study was to ascertain the extent to which a developmental approach to QL assessment has been applied to pedopsychiatric QL research. A systematic literature search was conducted in three electronic databases (PubMed, PsycINFO, SocINDEX) from 1994 to May 2014. Quantitative studies were included if they assessed the self- or proxy-reported QL of children/adolescents with a psychological disorder. Data were extracted for study design, participants, QL instruments and informants, and statistical approach to age-related specificities. The systematic review revealed widespread utilization of developmentally appropriate QL instruments but less frequent use of both self and proxy reports and an inconsistent approach to age group specificities. Methodological guidelines are discussed to improve the developmental validity of QL research for children/adolescents with mental disorders.

  16. Recommendations for mass spectrometry data quality metrics for open access data(corollary to the Amsterdam principles)

    SciTech Connect

    Kingsinger, Christopher R.; Apffel, James; Baker, Mark S.; Bian, Xiaopeng; Borchers, Christoph H.; Bradshaw, Ralph A.; Brusniak, Mi-Youn; Chan, Daniel W.; Deutsch, Eric W.; Domon, Bruno; Gorman, Jeff; Grimm, Rudolf; Hancock, William S.; Hermjakob, Henning; Horn, David; Hunter, Christie; Kolar, Patrik; Kraus, Hans-Joachim; Langen, Hanno; Linding, Rune; Moritz, Robert L.; Omenn, Gilbert S.; Orlando, Ron; Pandey, Akhilesh; Ping, Peipei; Rahbar, Amir; Rivers, Robert; Seymour, Sean L.; Simpson, Richard J.; Slotta, Douglas; Smith, Richard D.; Stein, Stephen E.; Tabb, David L.; Tagle, Danilo; Yates, John R.; Rodriguez, Henry

    2011-12-01

    Policies supporting the rapid and open sharing of proteomic data are being implemented by the leading journals in the field. The proteomics community is taking steps to ensure that data are made publicly accessible and are of high quality, a challenging task that requires the development and deployment of methods for measuring and documenting data quality metrics. On September 18, 2010, the U.S. National Cancer Institute (NCI) convened the 'International Workshop on Proteomic Data Quality Metrics' in Sydney, Australia, to identify and address issues facing the development and use of such methods for open access proteomics data. The stakeholders at the workshop enumerated the key principles underlying a framework for data quality assessment in mass spectrometry data that will meet the needs of the search community, journals, funding agencies, and data repositories. Attendees discussed and agreed upon two primary needs for the wide use of quality metrics: (i)an evolving list of comprehensive quality metrics and (ii)standards accompanied by software analytics. Attendees stressed the importance of increased education and training programs to promote reliable protocols in proteomics. This workshop report explores the historic precedents, key discussions, and necessary next steps to enhance the quality of open access data. By agreement, this article is published simultaneously in Proteomics, Proteomics Clinical Applications, Journal of Proteome Research, and Molecular and Cellular Proteomics, as a public service to the research community.The peer review process was a coordinated effort conducted by a panel of referees selected by the journals.

  17. The importance of quality, access and price to health care consumers in Bulgaria: a self-explicated approach.

    PubMed

    Pavlova, Milena; Groot, Wim; van Merode, Godefridus

    2003-01-01

    One approach to the problem of low patient satisfaction in Bulgaria is to identify attributes of health care services that the consumers value most and to focus on their improvement. Based on data from a household survey, this paper examines the importance that health care consumers attach to quality, access and price. The survey was conducted in 2000 among the population of the region of Varna (the third largest city in Bulgaria). The elicitation of attribute importance was based on a self-explicated method. To analyse the data, an ordered logit regression was performed. The analysis shows that clinical quality is the most valued characteristic by Bulgarian health care consumers compared with social quality, access and price. Given the poor quality of health care provision in Bulgaria, the allocation of revenues to its improvement appears to be essential in order to raise patient satisfaction and to enhance social efficiency.

  18. Quality, bias and service user experience in healthcare: 10 years of mental health guidelines at the UK National Collaborating Centre for Mental Health.

    PubMed

    Kendall, Tim; Glover, Naomi; Taylor, Clare; Pilling, Stephen

    2011-08-01

    The guideline programme developed by the National Collaborating Centre for Mental Health (NCCMH) for the National Institute for Health and Clinical Excellence (NICE) is probably the most comprehensive and methodologically advanced mental health guideline programme in the world, covering most adults and children with mental health problems and addressing a broad range of pharmacological and psychological/psychosocial interventions. As the success of the NICE programme gains momentum, its influence in the National Health Service (NHS) grows. If guidelines contain systematic bias the effects will be widespread. Over the last 10 years the NCCMH has recognized imperfections and patterns of bias in the way that evidence is generated and included in guidelines, including psychological/psychosocial interventions and drug treatments. The pharmaceutical industry remains a major source of bias through selective reporting and publishing, and represents a threat to ensuring the evidence underpinning guidelines and clinical decision-making is as complete and reliable as possible. The inclusion of service users into guideline development at the NCCMH has developed in parallel to the identification and understanding of evidential bias, and is now becoming an important focus for high-quality guidelines which are becoming increasingly person-centred. For mental health this is as radical as the integration of psychological/psychosocial treatments into what has, for many years, been a largely medical domain. The future role of service users in monitoring their own experience of care and ensuring that trusts are accountable to them is now a real possibility and is likely to have an impact upon the traditional power relations in mental health and the stigma usually associated with psychiatric problems.

  19. Arteriovenous Access

    PubMed Central

    MacRae, Jennifer M.; Dipchand, Christine; Oliver, Matthew; Moist, Louise; Yilmaz, Serdar; Lok, Charmaine; Leung, Kelvin; Clark, Edward; Hiremath, Swapnil; Kappel, Joanne; Kiaii, Mercedeh; Luscombe, Rick; Miller, Lisa M.

    2016-01-01

    Complications of vascular access lead to morbidity and may reduce quality of life. In this module, we review both infectious and noninfectious arteriovenous access complications including neuropathy, aneurysm, and high-output access. For the challenging patients who have developed many complications and are now nearing their last vascular access, we highlight some potentially novel approaches. PMID:28270919

  20. Defining the Utility of Clinically Acceptable Variations in Evidence-Based Practice Guidelines for Evaluation of Quality Improvement Activities.

    ERIC Educational Resources Information Center

    Lescoe-Long, Mary; Long, Michael J.

    1999-01-01

    Examined the usefulness of systematically accounting for acceptable physician variations in guideline application. Review of 141 cases of treatment of acute myocardial infarction in a Canadian hospital show that even seemingly noncontentious guideline protocols do not offer a threshold of variation similar to conventional Continuous Quality…

  1. Guidelines for prevention in psychology.

    PubMed

    2014-04-01

    The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  2. [Using routine data for quality of care assessments: a critical review, taking quality indicators for the "National Disease Management Guideline for Chronic Heart Failure" as an example].

    PubMed

    Laux, Gunter; Nothacker, Monika; Weinbrenner, Susanne; Störk, Stefan; Blozik, Eva; Peters-Klimm, Frank; Szecsenyi, Jürgen; Scherer, Martin

    2011-01-01

    In December 2009, the first version of the German Disease Management Guideline (DM-CPG) for chronic heart failure was completed, including a set of proposed quality indicators for heart failure. This article explores whether proposed indicators can be derived from data collected routinely in general practices. For this purpose, previous experiences and data from the research project CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) conducted under guidance of the Department of General Medicine and Health Services Research at the University of Heidelberg, Germany, were applied. The availability of numerators and denominators needed for calculating the four quality indicators for diagnosis and pharmacotherapy proposed in the DM-CPG was checked within so-called "routine data" from the existing dataset of the CONTENT project. Within the given context, routine data are defined as data that are periodically transmitted from health care providers to cost units within the health care system. A thorough assessment has revealed that within the given context only one indicator could be deduced from routine data collection. This was the indicator measuring the proportion of patients receiving beta receptor antagonists, compared to all patients with heart failure NYHA class II to IV. Indeed, this single indicator will only be computable if the NYHA grade of heart failure severity and the presence or absence of contraindications to beta receptor antagonist therapy are routinely collected and the data merged into a central database. Against the background of these results it is obvious that a fully developed, transsectoral concept for data collection and data transfer needs to be implemented.

  3. Guidelines for Home Energy Professionals

    SciTech Connect

    2011-12-16

    The U.S. Department of Energy's (DOE's) Guidelines for Home Energy Professionals project (hereafter the Guidelines) fosters the growth of a high quality residential energy upgrade industry and a skilled and credentialed workforce.

  4. World Wide Access: Accessible Web Design.

    ERIC Educational Resources Information Center

    Washington Univ., Seattle.

    This brief paper considers the application of "universal design" principles to Web page design in order to increase accessibility for people with disabilities. Suggestions are based on the World Wide Web Consortium's accessibility initiative, which has proposed guidelines for all Web authors and federal government standards. Seven guidelines for…

  5. How Do Members of Different Stakeholder Groups Balance Concerns for Increasing Access with Improving Quality in the Tanzania Education System?

    ERIC Educational Resources Information Center

    Telli, Godfrey

    2012-01-01

    The purpose of this study was to explore how education stakeholders in Tanzania express and balance their priorities, perspectives, and concerns regarding the expansion of education access on the one hand, and improving quality of education on the other, as a means to enhance educational achievement. The study also explores how each group of…

  6. Designing to Promote Access, Quality, and Student Support in an Advanced Certificate Programme for Rural Teachers in South Africa

    ERIC Educational Resources Information Center

    Fresen, Jill W.; Hendrikz, Johan

    2009-01-01

    This paper reports on the re-design of the Advanced Certificate in Education (ACE) programme, which is offered by the University of Pretoria through distance education (DE) to teachers in rural South Africa. In 2007, a team re-designed the programme with the goal of promoting access, quality, and student support. The team included an independent…

  7. Rate Setting Policies: Ensuring Access and Improving Quality. Issues Meeting Proceedings (Washington, D.C., November 28-29, 2000).

    ERIC Educational Resources Information Center

    Schock, Lisa; Daugherty, Jane

    In November 2000, the Child Care Bureau, Administration for Children and Families, U.S. Department of Health and Human Services, convened an Issues Meeting focused on Rate-Setting Policies: Ensuring Access and Improving Quality. The meeting brought together state child care administrators and others for discussions on conducting effective market…

  8. FACILITATING ADVANCED URBAN METEOROLOGY AND AIR QUALITY MODELING CAPABILITIES WITH HIGH RESOLUTION URBAN DATABASE AND ACCESS PORTAL TOOLS

    EPA Science Inventory

    Information of urban morphological features at high resolution is needed to properly model and characterize the meteorological and air quality fields in urban areas. We describe a new project called National Urban Database with Access Portal Tool, (NUDAPT) that addresses this nee...

  9. Effect of using reporting guidelines during peer review on quality of final manuscripts submitted to a biomedical journal: masked randomised trial

    PubMed Central

    Cortés, J; Ribera, J M; Cardellach, F; Selva-O’Callaghan, A; Kostov, B; García, L; Cirugeda, L; Altman, D G; González, J A; Sànchez, J A; Miras, F; Urrutia, A; Fonollosa, V; Rey-Joly, C; Vilardell, M

    2011-01-01

    Objective To investigate the effect of an additional review based on reporting guidelines such as STROBE and CONSORT on quality of manuscripts. Design Masked randomised trial. Population Original research manuscripts submitted to the Medicina Clínica journal from May 2008 to April 2009 and considered suitable for publication. Intervention Control group: conventional peer reviews alone. Intervention group: conventional review plus an additional review looking for missing items from reporting guidelines. Outcomes Manuscript quality, assessed with a 5 point Likert scale (primary: overall quality; secondary: average quality of specific items in paper). Main analysis compared groups as allocated, after adjustment for baseline factors (analysis of covariance); sensitivity analysis compared groups as reviewed. Adherence to reviewer suggestions assessed with Likert scale. Results Of 126 consecutive papers receiving conventional review, 34 were not suitable for publication. The remaining 92 papers were allocated to receive conventional reviews alone (n=41) or additional reviews (n=51). Four papers assigned to the conventional review group deviated from protocol; they received an additional review based on reporting guidelines. We saw an improvement in manuscript quality in favour of the additional review group (comparison as allocated, 0.25, 95% confidence interval –0.05 to 0.54; as reviewed, 0.33, 0.03 to 0.63). More papers with additional reviews than with conventional reviews alone improved from baseline (22 (43%) v eight (20%), difference 23.6% (3.2% to 44.0%), number needed to treat 4.2 (from 2.3 to 31.2), relative risk 2.21 (1.10 to 4.44)). Authors in the additional review group adhered more to suggestions from conventional reviews than to those from additional reviews (average increase 0.43 Likert points (0.19 to 0.67)). Conclusions Additional reviews based on reporting guidelines improve manuscript quality, although the observed effect was smaller than

  10. The ribosome quality control pathway can access nascent polypeptides stalled at the Sec61 translocon.

    PubMed

    von der Malsburg, Karina; Shao, Sichen; Hegde, Ramanujan S

    2015-06-15

    Cytosolic ribosomes that stall during translation are split into subunits, and nascent polypeptides trapped in the 60S subunit are ubiquitinated by the ribosome quality control (RQC) pathway. Whether the RQC pathway can also target stalls during cotranslational translocation into the ER is not known. Here we report that listerin and NEMF, core RQC components, are bound to translocon-engaged 60S subunits on native ER membranes. RQC recruitment to the ER in cultured cells is stimulated by translation stalling. Biochemical analyses demonstrated that translocon-targeted nascent polypeptides that subsequently stall are polyubiquitinated in 60S complexes. Ubiquitination at the translocon requires cytosolic exposure of the polypeptide at the ribosome-Sec61 junction. This exposure can result from either failed insertion into the Sec61 channel or partial backsliding of translocating nascent chains. Only Sec61-engaged nascent chains early in their biogenesis were relatively refractory to ubiquitination. Modeling based on recent 60S-RQC and 80S-Sec61 structures suggests that the E3 ligase listerin accesses nascent polypeptides via a gap in the ribosome-translocon junction near the Sec61 lateral gate. Thus the RQC pathway can target stalled translocation intermediates for degradation from the Sec61 channel.

  11. The ribosome quality control pathway can access nascent polypeptides stalled at the Sec61 translocon

    PubMed Central

    von der Malsburg, Karina; Shao, Sichen; Hegde, Ramanujan S.

    2015-01-01

    Cytosolic ribosomes that stall during translation are split into subunits, and nascent polypeptides trapped in the 60S subunit are ubiquitinated by the ribosome quality control (RQC) pathway. Whether the RQC pathway can also target stalls during cotranslational translocation into the ER is not known. Here we report that listerin and NEMF, core RQC components, are bound to translocon-engaged 60S subunits on native ER membranes. RQC recruitment to the ER in cultured cells is stimulated by translation stalling. Biochemical analyses demonstrated that translocon-targeted nascent polypeptides that subsequently stall are polyubiquitinated in 60S complexes. Ubiquitination at the translocon requires cytosolic exposure of the polypeptide at the ribosome–Sec61 junction. This exposure can result from either failed insertion into the Sec61 channel or partial backsliding of translocating nascent chains. Only Sec61-engaged nascent chains early in their biogenesis were relatively refractory to ubiquitination. Modeling based on recent 60S–RQC and 80S–Sec61 structures suggests that the E3 ligase listerin accesses nascent polypeptides via a gap in the ribosome–translocon junction near the Sec61 lateral gate. Thus the RQC pathway can target stalled translocation intermediates for degradation from the Sec61 channel. PMID:25877867

  12. Implementation workshop of WHO guidelines on evaluation of malaria vaccines: Current regulatory concepts and issues related to vaccine quality, Pretoria, South Africa 07 Nov 2014.

    PubMed

    Ho, Mei Mei; Baca-Estrada, Maria; Conrad, Christoph; Karikari-Boateng, Eric; Kang, Hye-Na

    2015-08-26

    The current World Health Organization (WHO) guidelines on the quality, safety and efficacy of recombinant malaria vaccines targeting the pre-erythrocytic and blood stages of Plasmodium falciparum were adopted by the WHO Expert Committee on Biological Standardization in 2012 to provide guidance on the quality, nonclinical and clinical aspects of recombinant malaria vaccines. A WHO workshop was organised to facilitate implementation into African (national/regional) regulatory practices, of the regulatory evaluation principles outlined in the guidelines regarding quality aspects. The workshop was used also to share knowledge and experience on regulatory topics of chemistry, manufacturing and control with a focus on vaccines through presentations and an interactive discussion using a case study approach. The basic principles and concepts of vaccine quality including consistency of production, quality control and manufacturing process were presented and discussed in the meeting. By reviewing and practicing a case study, better understanding on the relationship between consistency of production and batch release tests of an adjuvanted pre-erythrocytic recombinant malaria vaccine was reached. The case study exercise was considered very useful to understand regulatory evaluation principles of vaccines and a suggestion was made to WHO to provide such practices also through its Global Learning Opportunities for Vaccine Quality programme.

  13. Linguistic acculturation and perceptions of quality, access, and discrimination in health care among Latinos in the United States.

    PubMed

    Becerra, David; Androff, David; Messing, Jill T; Castillo, Jason; Cimino, Andrea

    2015-01-01

    This study examined the relationship between acculturation and Latinos' perceptions of health care treatment quality, discrimination, and access to health information. The results of this study indicated that participants who had lower levels of acculturation perceived: 1) greater discrimination in health care treatment; 2) a lower quality of health care treatment; 3) less confidence filling out health related forms; and 4) greater challenges understanding written information about their medical conditions. Participants who identified as immigrants also perceived that their poor quality of medical care was due to their inability to pay and to their race/ethnicity.

  14. Macroscopic characterisations of Web accessibility

    NASA Astrophysics Data System (ADS)

    Lopes, Rui; Carriço, Luis

    2010-12-01

    The Web Science framework poses fundamental questions on the analysis of the Web, by focusing on how microscopic properties (e.g. at the level of a Web page or Web site) emerge into macroscopic properties and phenomena. One research topic on the analysis of the Web is Web accessibility evaluation, which centres on understanding how accessible a Web page is for people with disabilities. However, when framing Web accessibility evaluation on Web Science, we have found that existing research stays at the microscopic level. This article presents an experimental study on framing Web accessibility evaluation into Web Science's goals. This study resulted in novel accessibility properties of the Web not found at microscopic levels, as well as of Web accessibility evaluation processes themselves. We observed at large scale some of the empirical knowledge on how accessibility is perceived by designers and developers, such as the disparity of interpretations of accessibility evaluation tools warnings. We also found a direct relation between accessibility quality and Web page complexity. We provide a set of guidelines for designing Web pages, education on Web accessibility, as well as on the computational limits of large-scale Web accessibility evaluations.

  15. Payment mechanisms and the composition of physician practices: balancing cost-containment, access, and quality of care.

    PubMed

    Barham, Victoria; Milliken, Olga

    2015-07-01

    We take explicit account of the way in which the supply of physicians and patients in the economy affects the design of physician remuneration schemes, highlighting the three-way trade-off between quality of care, access, and cost. Both physicians and patients are heterogeneous. Physicians choose both the number of patients and the quality of care to provide to their patients. When determining physician payment rates, the principal must ensure access to care for all patients. When physicians can adjust the number of patients seen, there is no incentive to over-treat. In contrast, altruistic physicians always quality stint: they prefer to add an additional patient, rather than to increase the quality of service provided. A mixed payment mechanism does not increase the quality of service provided with respect to capitation. Offering a menu of compensation schemes may constitute a cost-effective strategy for inducing physicians to choose a given overall caseload but may also generate difficulties with access to care for frail patients.

  16. California hospital networks are narrower in Marketplace than in commercial plans, but access and quality are similar.

    PubMed

    Haeder, Simon F; Weimer, David L; Mukamel, Dana B

    2015-05-01

    Do insurance plans offered through the Marketplace implemented by the State of California under the Affordable Care Act restrict consumers' access to hospitals relative to plans offered on the commercial market? And are the hospitals included in Marketplace networks of lower quality compared to those included in the commercial plans? To answer these questions, we analyzed differences in hospital networks across similar plan types offered both in the Marketplace and commercially, by region and insurer. We found that the common belief that Marketplace plans have narrower networks than their commercial counterparts appears empirically valid. However, there does not appear to be a substantive difference in geographic access as measured by the percentage of people residing in at least one hospital market area. More surprisingly, depending on the measure of hospital quality employed, the Marketplace plans have networks with comparable or even higher average quality than the networks of their commercial counterparts.

  17. An update on efforts by the hospice community and the National Hospice Organization to improve access to quality hospice care.

    PubMed

    Mahoney, J

    1998-01-01

    More than a year has passed since the Center to Improve Care of the Dying and the Corcoran Gallery of Art sponsored the symposium entitled: A Good Dying: Shaping Health Care for the Last Months of Life. Using the National Hospice Foundation sponsored exhibition, Hospice: A Photographic Inquiry, as a backdrop, the symposium included presentations on the current state of hospice care as well as the obstacles that limit access to hospice care. This article represents an update on many of the activities of the National Hospice Organization and the greater hospice community as we continue to improve access to quality hospice care.

  18. Water Quality vs. Sanitation Accessibility: What is the most effective intervention point for preventing cholera in Dhaka, Bangladesh?

    NASA Astrophysics Data System (ADS)

    Majumder, M. S.; Gute, D.; Faruque, A. S.

    2011-12-01

    Every year, 3 to 5 million individuals contract cholera, an acute diarrheal infection that is caused by the ingestion of food or water containing the Vibrio cholerae bacterium. Because cholera is a waterborne disease, it can be transmitted quickly in environments with inadequate water and sanitation systems where infected waste can easily pollute drinking water. Today, Bangladesh continues to struggle with endemic cholera. Donor organizations address water and sanitation via localized initiatives, including the installation of community water collection sites (i.e. tubewells; water-boiling points; etc.). At this small-scale level, water quality and sanitation accessibility can be improved independently of one another, and when resources are limited, donors must invest in the most effective disease prevention options. This study used laboratory-confirmed cholera incidence data (2000-2009) collected by the International Centre of Diarrheal Disease Research, Bangladesh at their on-site hospital to compare the efficacy of interventions addressing water quality versus sanitation accessibility in Dhaka, Bangladesh. Data regarding use of sanitary latrines and boiling of drinking water were extracted from sequential patient interviews conducted at the Dhaka facility and used as surrogate variables for sanitation accessibility and water quality respectively. Our analysis indicates that boiling water is 10 times more effective at preventing cholera than the use of a sanitary latrine. This finding suggests that regulating water quality is perhaps more critical to cholera prevention than increasing sanitation accessibility in an urban environment like that of Dhaka. At present, WaterAid - one of Bangladesh's most significant water and sanitation donor organizations - invests the majority of its budget on improving sanitation accessibility. The World Health Organization and the United Nations Millennium Development Goals also prioritize sanitation accessibility. However, in

  19. Access, Cost and Quality: Tensions in the Development of Primary Education in Kenya

    ERIC Educational Resources Information Center

    Somerset, Anthony

    2011-01-01

    Throughout Kenya's history, tensions between two goals have characterised the educational policy debate: first, the expansion of access; second, the containment of costs. During the colonial period, cost-containment predominated, leading to severe restrictions on access and massive unmet social demand. Then, during post-Independence years,…

  20. Liposomal Nasal Spray versus Guideline-Recommended Steroid Nasal Spray in Patients with Chronic Rhinosinusitis: A Comparison of Tolerability and Quality of Life

    PubMed Central

    Eitenmüller, Anna; Böhm, Myriam; Glowania, Andreas; Pfaar, Oliver; Mösges, Ralph; Klimek, Ludger

    2014-01-01

    Objective. To investigate the tolerability and impact on quality of life of liposomal nasal spray compared to guideline-recommended steroid-based therapy in patients with chronic rhinosinusitis. Symptom reduction and use of antisymptomatic medication were also examined. Methods. In this monocenter, prospective, controlled, open, and noninterventional study, 60 patients with chronic rhinosinusitis were treated with liposomal nasal spray and 30 patients received steroid-based therapy. The study comprised five visits occurring at intervals of two to four weeks. Efficacy was determined according to the sinusitis symptom score documented daily. The polyp score was recorded at the initial and final visits. Tolerability was determined through the Nasal Spray Evaluation Questionnaire, and quality of life was ascertained with the SNOT-20 Score. Results. Both treatments achieved a significant reduction of sinusitis symptoms (P < 0.05) and also rhinoscopic improvement (P < 0.05). The majority of patients assessed the treatments as “good” or “very good,” and the quality of life improved significantly (P < 0.05). There was no significant difference in symptom reduction, QoL, and endoscopic exams between both treatments. Conclusion. The treatment of chronic rhinosinusitis with liposomal nasal spray results in a similar, significant reduction of symptoms and significant improvement in quality of life as guideline-recommended treatment and is therefore a comparable alternative. PMID:24963305

  1. Interactive effects of carbon footprint information and its accessibility on value and subjective qualities of food products.

    PubMed

    Kimura, Atsushi; Wada, Yuji; Kamada, Akiko; Masuda, Tomohiro; Okamoto, Masako; Goto, Sho-ichi; Tsuzuki, Daisuke; Cai, Dongsheng; Oka, Takashi; Dan, Ippeita

    2010-10-01

    We aimed to explore the interactive effects of the accessibility of information and the degree of carbon footprint score on consumers' value judgments of food products. Participants (n=151, undergraduate students in Japan) rated their maximum willingness to pay (WTP) for four food products varying in information accessibility (active-search or read-only conditions) and in carbon footprint values (low, middle, high, or non-display) provided. We also assessed further effects of information accessibly and carbon footprint value on other product attributes utilizing the subjective estimation of taste, quality, healthiness, and environmental friendliness. Results of the experiment demonstrated an interactive effect of information accessibility and the degree of carbon emission on consumer valuation of carbon footprint-labeled food. The carbon footprint value had a stronger impact on participants' WTP in the active-search condition than in the read-only condition. Similar to WTP, the results of the subjective ratings for product qualities also exhibited an interactive effect of the two factors on the rating of environmental friendliness for products. These results imply that the perceived environmental friendliness inferable from a carbon footprint label contributes to creating value for a food product.

  2. Flour Quality and Related Molecular Characterization of High Molecular Weight Glutenin Subunit Genes from Wild Emmer Wheat Accession TD-256.

    PubMed

    Zhang, Da-Le; He, Ting-Ting; Liang, Hui-Hui; Huang, Lu-Yu; Su, Ya-Zhong; Li, Yu-Ge; Li, Suo-Ping

    2016-06-22

    To clarify the effect of high molecular weight glutenin subunit (HMW-GS) from wild emmer wheat on flour quality, which has the same mobility as that from common wheat, the composition and molecular characterization of HMW-GS from wild emmer wheat accession TD-256, as well as its flour quality, were intensively analyzed. It is found that the mobilities of Glu-A1 and Glu-B1 subunits from TD-256 are consistent with those of bread wheat cv. 'XiaoYan 6'. Nevertheless, dough rheological properties of TD-256 reveal its poor flour quality. In the aspect of molecular structure from HMW-GS, only two conserved cysteine residues can be observed in the deduced protein sequence of 1Bx14* from TD-256, while most Glu-1Bx contain four conserved cysteine residues. In addition, as can be predicted from secondary structure, the quantity both of α-helixes and their amino acid residues of the subunits from TD-256 is fewer than those of common wheat. Though low molecular weight glutenin subunit (LMW-GS) and gliadin can also greatly influence flour quality, the protein structure of the HMW-GS revealed in this work can partly explain the poor flour quality of wild emmer accession TD-256.

  3. An Assessment of Female Prisoners’ Perception of the Accessibility of Quality Healthcare: A Survey in the Kumasi Central Prisons, Ghana

    PubMed Central

    Sarpong, AA; Otupiri, E; Yeboah-Awudzi, K; Osei-Yeboah, J; Berchie, GO; Ephraim, RKD

    2015-01-01

    Background: Accessibility of quality healthcare across the globe has generated a lot of attention among public health practitioners. Aim: This study explored the background characteristics of female prisoners and how it influences their assessment of the quality of accessible healthcare in the Kumasi Female Prison. Subjects and Methods: This descriptive cross-sectional survey was conducted at the Female section of the Kumasi Central Prisons from June to December 2011. We used pretested questionnaires to obtain quantitative data from all 39 inmates of the female Prisons. An in-depth interview was used to obtain qualitative data from the prison healthcare giver. Data were analyzed with Epi Info Version 3.5.1, (Centers for Disease Control and Prevention), Excel, and Graph Pad Prism version 5.00 for Windows (Graph Pad software, San Diego California USA, www.graphpad.com). Results: Using a 12-point scale inventory questionnaire, inmates with no formal education gave the highest mean health provision assessment score (6.0) whereas those with tertiary education gave the lowest (4.5). Females serving prison sentences gave the highest mean health assessment score whereas remand prisoners gave the lowest. Single females’ mean health assessment score was 5.7 whereas that of married inmates was 4.9. Unemployed inmates scored 5.8, informal 5.4 while civil servants scored 5.0. Conclusion: Access to quality healthcare was poor and demographic characteristics, marital status, educational background, and occupation influenced inmates’ perceptions of accessibility to quality healthcare. Inmates should be encouraged to be proactive in seeking healthcare irrespective of their background characteristics. PMID:26097759

  4. A widening rift in access and quality: growing evidence of economic disparities.

    PubMed

    Hurley, Robert E; Pham, Hoangmai H; Claxton, Gary

    2005-01-01

    Data from the Community Tracking Study provide a valuable perspective from which to observe how economic disparities--largely a function of different sources of coverage--influence access to medical care in the United States. Many recent investments and initiatives are focused on affluent communities and are accessible mainly to people with employer-based or Medicare coverage. For people with Medicaid or no coverage at all, access to basic care is worsening, as a result of stalled coverage expansions and service cutbacks. An improving economy could forestall further cuts and permit reversal of earlier Hones, but progress in closing this rift does not appear imminent.

  5. A method to derive the relationship between the annual and short-term air quality limits--analysis using the WHO Air Quality Guidelines for health protection.

    PubMed

    Lai, Hak-Kan; Hedley, Anthony J; Thach, Thuan-Quoc; Wong, Chit-Ming

    2013-09-01

    The World Health Organization (WHO) Air Quality Guidelines (AQG) were launched in 2006, but gaps remain in evidence on health impacts and relationships between short-term and annual AQG needed for health protection. We tested whether relationships between WHO short-term and annual AQG for particulates (PM10 and PM2.5) and nitrogen dioxide (NO2) are concordant worldwide and derived the annual limits for sulfur dioxide (SO2) and ozone (O3) based on the short-term AQG. We obtained air pollutant data over seven years (2004-2010) in seven cities from Asia-Pacific, North America and Europe. Based on probability distribution concept using maximum as the short-term limit and arithmetic mean as the annual limit, we developed a new method to derive limit value one from another in each paired limits for each pollutant with capability to account for allowable exceedances. We averaged the limit derived each year for each city, then used meta-analysis to pool the limit values in all cities. Pooled mean short-term limit for NO2 (140.5μg/m(3) [130.6-150.4]) was significantly lower than the WHO AQG of 200μg/m(3) while for PM10 (46.4μg/m(3) [95CI:42.1-50.7]) and PM2.5 (28.6μg/m(3) [24.5-32.6]) were not significantly different from the WHO AQG of 50 and 25μg/m(3) respectively. Pooled mean annual limits for SO2 and O3 were 4.6μg/m(3) [3.7-5.5] and 27.0μg/m(3) [21.7-32.2] respectively. Results were robust in various sensitivity analyses. The distribution relationships between the current WHO short-term and annual AQG are supported by empirical data from seven cities for PM10 and PM2.5, but not for NO2. The short-term AQG for NO2 should be lowered for concordance with the selected annual AQG for health protection.

  6. Quality Control Review of Air Force Audit Agency’s Special Access Program Audits

    DTIC Science & Technology

    2014-12-09

    external quality control review of the AFAA SAP audits in conjunction with the Army Audit Agency’s review of the AFAA non- SAP audits. We conducted this...provide reasonable assurance of meeting the objectives of quality control. We tested the AFAA SAP system of quality control for audits to the extent...control for the audit function of AFAA SAP in effect for the period ended September 30, 2013, was designed in accordance with quality standards

  7. Quality of qualitative research in the health sciences: Analysis of the common criteria present in 58 assessment guidelines by expert users.

    PubMed

    Santiago-Delefosse, M; Gavin, A; Bruchez, C; Roux, P; Stephen, S L

    2016-01-01

    The number of qualitative research methods has grown substantially over the last thirty years, both in social sciences and, more recently, in health sciences. This growth came with questions on the quality criteria needed to evaluate this work, and numerous guidelines were published. These guidelines, however, include many discrepancies, both in terms of vocabulary and structure. Many expert evaluators also decry the absence of consensual and reliable evaluation tools. To address this gap, we present the results of an evaluation of 58 existing guidelines in four major health science fields (medicine and epidemiology; nursing and health education; social sciences and public health; psychology/psychiatry, research methods and organization) by expert (n = 16) and peer (n = 40) users (e.g., article reviewers, experts allocating funds, editors). This research was conducted between 2011 and 2014 at the University of Lausanne in Switzerland. Experts met during three workshops spread over this period. A series of 12 consensual essential criteria, along with definitions, stemmed from a question in a semi-qualitative evaluation questionnaire that we developed. Although there is consensus on the name of the criteria, we highlight limitations on the ability to compare specific definitions of criteria across health science fields. We conclude that each criterion must be explained to come to broader consensus and identify definitions that are easily operational and consensual to all fields examined.

  8. Guidelines International Network: toward international standards for clinical practice guidelines.

    PubMed

    Qaseem, Amir; Forland, Frode; Macbeth, Fergus; Ollenschläger, Günter; Phillips, Sue; van der Wees, Philip

    2012-04-03

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development.

  9. Evidence-based practice guidelines--one way to enhance clinical practice.

    PubMed

    Bailes, Barbara K

    2002-06-01

    Abdominoplasty and liposuction guidelines are just two of the guidelines that can be accessed and used to enhance patient care. Guidelines also can be used to increase your knowledge about many other health care topics. The NGC has approved guidelines for managing chronic pain, as well as guidelines on chronic diseases (e.g., diabetes mellitus, hypertension, chronic obstructive pulmonary disease). Many patients have chronic diseases, and you or your family members also may be affected by chronic disorders. These guidelines provide you with a quick overview of evidence-based treatment protocols. These guidelines are not a panacea for evidence-based practice, but using them is one way that perioperative nurses can enhance their clinical skills. Though not everyone has personal Internet access, most health care facilities do or can make access a reality. Other options include medical or public libraries. Then one simply has to access the NGC web site and join other professionals in improving the quality and timeliness of patient care.

  10. The impact of cattle access on ecological water quality in streams: Examples from agricultural catchments within Ireland.

    PubMed

    Conroy, E; Turner, J N; Rymszewicz, A; O'Sullivan, J J; Bruen, M; Lawler, D; Lally, H; Kelly-Quinn, M

    2016-03-15

    Unrestricted cattle access to rivers and streams represent a potentially significant localised pressure on freshwater systems. However there is no consensus in the literature on the occurrence and extent of impact and limited research has examined the effects on aquatic biota in the humid temperate environment examined in the present study. Furthermore, this is one of the first times that research consider the potential for cattle access impacts in streams of varying water quality in Northern Europe. We investigated the effects of cattle access on macroinvertebrate communities and deposited fine sediment levels, in four rivers of high/good and four rivers of moderate water quality status which drain, low gradient, calcareous grassland catchments in Ireland. We assessed the temporal variability in macroinvertebrates communities across two seasons, spring and autumn. Site specific impacts were evident which appeared to be influenced by water quality status and season. All four high/good water status rivers revealed significant downstream changes in community structure and at least two univariate metrics (total richness and EPT richness together with taxon, E and EPT abundance). Two of the four moderate water status rivers showed significant changes in community structure, abundance and richness metrics and functional feeding groups driven in the main by downstream increases in collectors/gatherers, shredders and burrowing taxa. These two moderate water status rivers had high or prolonged livestock activity. In view of these findings, the potential for some of these sites to achieve at least high/good water quality status, as set out in the EU Water Framework Directive, may be compromised. The results presented highlight the need for additional research to further define the site specific factors and livestock management practices, under different discharge conditions, that increase the risk of impact on aquatic ecology due to these cattle-river interactions.

  11. Using the ACEI Global Guidelines Assessment to Evaluate the Quality of Early Child Care in Greek Settings

    ERIC Educational Resources Information Center

    Rentzou, Konstantina

    2010-01-01

    In recent years, there has been a significant growth of interest in ensuring that child care provision for children is of a high quality. This interest has been stimulated by research evidence according to which good quality child care has a positive influence on children's overall development. The global quality in Greek preschool and…

  12. Housing Quality and Access to Material and Learning Resources within the Home Environment in Developing Countries

    ERIC Educational Resources Information Center

    Bradley, Robert H.; Putnick, Diane L.

    2012-01-01

    This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were…

  13. Access, Quality, and Opportunity: A Case Study of Zambia Open Community Schools (ZOCS)

    ERIC Educational Resources Information Center

    Mwalimu, Michelle

    2011-01-01

    Community schools and other approaches to Alternative Primary Education or APE have increased access to primary education for underserved populations in Africa, Asia, and Latin America as a major goal of the Education for All (EFA) movement. In Zambia, a country where an estimated 20 percent of the basic education enrollment now attends community…

  14. Improving Access To, Quality, and the Effectiveness of Digital Tutoring in K-12 Education

    ERIC Educational Resources Information Center

    Burch, Patricia; Good, Annalee; Heinrich, Carolyn

    2016-01-01

    There is considerable variation in how providers of digital education describe what they do, their services, how students access services, and what is delivered, complicating efforts to accurately assess its impact. We examine program characteristics of digital tutoring providers using rich, longitudinal observational and interview data and then…

  15. Evaluating the Quality of Experience of a System for Accessing Educational Objects in Health

    ERIC Educational Resources Information Center

    Wanderley, Miguel; Menezes, Júlio, Jr.; Gusmão, Cristine; Lins, Rodrigo

    2016-01-01

    In the area of primary health care, there is a high demand in Brazil of permanent education and qualification of professionals who work in this field. Besides, nowadays it is a consensus that education can be benefited by the use of mobile devices, especially due to the possibilities of browsing, use and of easy access to different resources. In…

  16. Structuring Opportunity after Entry: Who Has Access to High Quality Instruction during College?

    ERIC Educational Resources Information Center

    Roksa, Josipa

    2016-01-01

    Background/Context: When inequality of opportunity is discussed in higher education, it typically pertains to access to college. Ample research has examined sociodemographic inequalities in transition to higher education and enrollment in particular types of institutions. Although providing valuable insights, social stratification research does…

  17. The Quality of Urban Environments: Mapping Variation in Access to Community Resources.

    ERIC Educational Resources Information Center

    Witten, Karen; Exeter, Daniel; Field, Adrian

    2003-01-01

    Discusses the relationship between community infrastructure and health through the development of the Community Resource Accessibility Index (CRAI) research tool.This area-based index of community services, facilities, and amenities enables comparisons between opportunity structures in the local environment and residents' health and wellbeing. It…

  18. Child Care for Low-Income Children with Disabilities: Access, Quality, and Parental Satisfaction

    ERIC Educational Resources Information Center

    Wall, Shavaun; Kisker, Ellen E.; Peterson, Carla A.; Carta, Judith J.; Jeon, Hyun-Joo

    2006-01-01

    Using data from the Early Head Start Research and Evaluation Project, this study analyzed the similarities and differences of variables associated with child care services for low-income families with young children with disabilities and low-income families with typically developing children. Four major variables were analyzed: access to child…

  19. Enhancing Access to and Quality of Basic Education through Head Teachers' Leadership Functions

    ERIC Educational Resources Information Center

    Oni, J. O.; Jegede, A. A.; Osisami, R. A.; Illo, C. O.; Lawal, R. O.; Fabinu, F. A.

    2016-01-01

    Basic education is the fundamental requirement for idiosyncratic and societal development. The individual child needs to have access to it and acquire it qualitatively. The sum total of all the knowledge attitude, skills and competences that the Nigerian child today acquires have been declared to be on the decline. Every stakeholder: teacher,…

  20. Baseline ecological risk assessment of the Calcasieu Estuary, Louisiana: 2. An evaluation of the predictive ability of effects-based sediment quality guidelines

    USGS Publications Warehouse

    MacDonald, Donald D.; Ingersoll, Christopher G.; Smorong, Dawn E.; Sinclair, Jesse A.; Lindskoog, Rebekka; Wang, Ning; Severn, Corrine; Gouguet, Ron; Meyer, John; Field, Jay

    2011-01-01

    Three sets of effects-based sediment-quality guidelines (SQGs) were evaluated to support the selection of sediment-quality benchmarks for assessing risks to benthic invertebrates in the Calcasieu Estuary, Louisiana. These SQGs included probable effect concentrations (PECs), effects range median values (ERMs), and logistic regression model (LRMs)-based T50 values. The results of this investigation indicate that all three sets of SQGs tend to underestimate sediment toxicity in the Calcasieu Estuary (i.e., relative to the national data sets), as evaluated using the results of 10-day toxicity tests with the amphipod, Hyalella azteca, or Ampelisca abdita, and 28-day whole-sediment toxicity tests with the H. azteca. These results emphasize the importance of deriving site-specific toxicity thresholds for assessing risks to benthic invertebrates.

  1. Guideline.gov: A Database of Clinical Specialty Guidelines.

    PubMed

    El-Khayat, Yamila M; Forbes, Carrie S; Coghill, Jeffrey G

    2017-01-01

    The National Guidelines Clearinghouse (NGC), also known as Guideline.gov, is a database of resources to assist health care providers with a central depository of guidelines for clinical specialty areas in medicine. The database is provided free of charge and is sponsored by the U.S. Department of Health and Human Services and the Agency for Healthcare Research and Quality. The guidelines for treatment are updated regularly, with new guidelines replacing older guidelines every five years. There are hundreds of current guidelines with more added each week. The purpose and goal of NGC is to provide physicians, nurses, and other health care providers, insurance companies, and others in the field of health care with a unified database of the most current, detailed, relevant, and objective clinical practice guidelines.

  2. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    PubMed Central

    2010-01-01

    Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international

  3. Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb.

    PubMed

    Jiang, Y Q; Zhu, Y X; Chen, X L; Xu, X; Li, F; Fu, H J; Shen, C Y; Lu, Y Y; Zhuang, Q J; Xu, G; Cai, Y Y; Zhang, Y; Liu, S S; Zhu, M Y; Li, S H

    2015-08-03

    We performed a 1-year cluster-randomized field trial to assess the effect of standardized management of chronic obstructive pulmonary disease (COPD) on lung function and quality of life (QOL) measures in patients in China. We used the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines and assessed indexes including pulmonary function, QOL, quality-adjusted life years (QALY), Medical Research Council (MRC) dyspnea scale, 6-min walk distance (6-MWD), number of emergency visits, and frequency of hospitalization. Of a total of 711 patients with chronic cough and asthma, 132 were diagnosed as having COPD and 102 participated in this study [intervention group (N = 47); control group (N = 55)]. We found that adherence to GOLD guidelines had a perceivable impact on 6-MWD, MRC dyspnea scale score, and QOL. The average QALY increased by 1.42/person/year in the intervention group, but declined by 0.95/person/year in the control group. We conclude that standardized management improves disease severity, QOL, and QALY in COPD patients when treatment protocols adhere to GOLD guidelines.

  4. The Healthy Eating Index-2010 Is a Valid and Reliable Measure of Diet Quality According to the 2010 Dietary Guidelines for Americans123

    PubMed Central

    Guenther, Patricia M.; Kirkpatrick, Sharon I.; Reedy, Jill; Krebs-Smith, Susan M.; Buckman, Dennis W.; Dodd, Kevin W.; Casavale, Kellie O.; Carroll, Raymond J.

    2014-01-01

    The Healthy Eating Index (HEI), a measure of diet quality, was updated to reflect the 2010 Dietary Guidelines for Americans and the accompanying USDA Food Patterns. To assess the validity and reliability of the HEI-2010, exemplary menus were scored and 2 24-h dietary recalls from individuals aged ≥2 y from the 2003–2004 NHANES were used to estimate multivariate usual intake distributions and assess whether the HEI-2010 1) has a distribution wide enough to detect meaningful differences in diet quality among individuals, 2) distinguishes between groups with known differences in diet quality by using t tests, 3) measures diet quality independently of energy intake by using Pearson correlation coefficients, 4) has >1 underlying dimension by using principal components analysis (PCA), and 5) is internally consistent by calculating Cronbach’s coefficient α. HEI-2010 scores were at or near the maximum levels for the exemplary menus. The distribution of scores among the population was wide (5th percentile = 31.7; 95th percentile = 70.4). As predicted, men’s diet quality (mean HEI-2010 total score = 49.8) was poorer than women’s (52.7), younger adults’ diet quality (45.4) was poorer than older adults’ (56.1), and smokers’ diet quality (45.7) was poorer than nonsmokers’ (53.3) (P < 0.01). Low correlations with energy were observed for HEI-2010 total and component scores (|r| ≤ 0.21). Cronbach’s coefficient α was 0.68, supporting the reliability of the HEI-2010 total score as an indicator of overall diet quality. Nonetheless, PCA indicated multiple underlying dimensions, highlighting the fact that the component scores are equally as important as the total. A comparable reevaluation of the HEI-2005 yielded similar results. This study supports the validity and the reliability of both versions of the HEI. PMID:24453128

  5. Efficient, quality-assured data capture in operational research through innovative use of open-access technology.

    PubMed

    Kumar, A M V; Naik, B; Guddemane, D K; Bhat, P; Wilson, N; Sreenivas, A N; Lauritsen, J M; Rieder, H L

    2013-03-21

    Ensuring quality of data during electronic data capture has been one of the most neglected components of operational research. Multicentre studies are also challenged with issues about logistics of travel, training, supervision, monitoring and troubleshooting support. Allocating resources to these issues can pose a significant bottleneck for operational research in resource-limited settings. In this article, we describe an innovative and efficient way of coordinating data capture in multicentre operational research using a combination of three open access technologies-EpiData for data capture, Dropbox for sharing files and TeamViewer for providing remote support.

  6. Protein and quality analyses of accessions from the USDA soybean germplasm collection for tofu production.

    PubMed

    Meng, Shi; Chang, Sam; Gillen, Anne M; Zhang, Yan

    2016-12-15

    Food-grade soybeans with large seed size, uniformity, clear hilum and a high 11S/7S ratio are favoured by the food industry for making tofu. In order to search for soybean lines with desirable characteristics for making foods, 22 soybean lines were selected from the USDA-Soybean Germplasm Collection, were grown in Stoneville, MS for biochemical analysis and tofu texture and sensory quality tests. Eight lines were identified, from 22 lines harvested in 2014, to be suitable for tofu making, as judged by chemical composition and sensory quality of pressed tofu. In the filled tofu making and texture analysis study, the correlation between A3 subunit content and filled tofu firmness was significant (N=22, r=0.77, P<0.001). The results indicated that the A3 subunit could be an indicator for predicting the firmness of tofu. The results provided important food quality information for the selection of soybean genotypes for improving food quality.

  7. Oversight Review: Quality Control Review of Naval Audit Service’s Special Access Program Audits

    DTIC Science & Technology

    2005-09-02

    undergo an external peer review at least once every 3 years by reviewers independent of the audit organization being reviewed. As the organization that...has audit policy and oversight responsibilities for audits in the Department of Defense, we conducted this external peer review of the NAVAUDSVC audits...requiring special access in conjunction with the Army Audit Agency’s external peer review of NAVAUDSVC non-SAP audits.

  8. Using Early Learning Standards to Provide High-Quality Education for All Children: The Early Learning Guidelines Toolkit

    ERIC Educational Resources Information Center

    Flores, Roseanne L.; Curby, Timothy W.; Coleman, Hardin; Melo, Kristan

    2016-01-01

    Today with the rise in the number of 3- to 6-year-old children enrolled in center-based early childhood programs, and a focus on program quality, it becomes imperative for educators to have a better understanding of the role research plays in establishing high-quality programs as these programs provide much of the foundation that supports early…

  9. Assessing the Quality of Mobile Exercise Apps Based on the American College of Sports Medicine Guidelines: A Reliable and Valid Scoring Instrument

    PubMed Central

    Bian, Jiang; Leavitt, Trevor; Vincent, Heather K; Vander Zalm, Lindsey; Teurlings, Tyler L; Smith, Megan D

    2017-01-01

    Background Regular physical activity can not only help with weight management, but also lower cardiovascular risks, cancer rates, and chronic disease burden. Yet, only approximately 20% of Americans currently meet the physical activity guidelines recommended by the US Department of Health and Human Services. With the rapid development of mobile technologies, mobile apps have the potential to improve participation rates in exercise programs, particularly if they are evidence-based and are of sufficient content quality. Objective The goal of this study was to develop and test an instrument, which was designed to score the content quality of exercise program apps with respect to the exercise guidelines set forth by the American College of Sports Medicine (ACSM). Methods We conducted two focus groups (N=14) to elicit input for developing a preliminary 27-item scoring instruments based on the ACSM exercise prescription guidelines. Three reviewers who were no sports medicine experts independently scored 28 exercise program apps using the instrument. Inter- and intra-rater reliability was assessed among the 3 reviewers. An expert reviewer, a Fellow of the ACSM, also scored the 28 apps to create criterion scores. Criterion validity was assessed by comparing nonexpert reviewers’ scores to the criterion scores. Results Overall, inter- and intra-rater reliability was high with most coefficients being greater than .7. Inter-rater reliability coefficients ranged from .59 to .99, and intra-rater reliability coefficients ranged from .47 to 1.00. All reliability coefficients were statistically significant. Criterion validity was found to be excellent, with the weighted kappa statistics ranging from .67 to .99, indicating a substantial agreement between the scores of expert and nonexpert reviewers. Finally, all apps scored poorly against the ACSM exercise prescription guidelines. None of the apps received a score greater than 35, out of a possible maximal score of 70. Conclusions

  10. Contribution of Neighborhood Income and Access to Quality Physical Activity Resources to Physical Activity in Ethnic Minority Women Over Time

    PubMed Central

    Lee, Rebecca E.; Mama, Scherezade K.; Adamus-Leach, Heather J.; Soltero, Erica G.

    2015-01-01

    Purpose To create and test an index to indicate both availability and quality of physical activity (PA) resources (PARs), to examine associations between access to quality PARs and changes in PA, and to determine whether this association differed in lower- and higher-income neighborhoods. Design Longitudinal, 6-month intervention. Setting. Houston and Austin, Texas. Subjects African-American and Hispanic or Latina women. Measures Women (N = 410) completed a questionnaire and accelerometry to measure PA. Neighborhoods (N = 163) were classified as lower- or higher-income by median household income at the census-tract level. PARs were audited using the PARA (physical activity resource assessment). Access to quality PARs was determined by a composite index (QPAR) of features, amenities, and incivilities. Analysis Repeated measures analyses of variance were used to examine changes in PA by (1) neighborhood income (lower/higher) and QPAR (lower/higher) groups, and (2) neighborhood income (lower/higher) and number of PARs (lower/higher) groups, adjusting for ethnicity, household income, and body mass index. Results Women in neighborhoods with lower QPAR scores had small increases in self-reported vigorous PA (M Δ = 327.8 metabolic equivalent of task [MET]-min/wk) and decreases in accelerometer PA (M = −3.4 min/d), compared to those with higher QPAR scores who had larger increases in self-reported vigorous PA (M Δ = 709.8 MET-min/wk) and increased accelerometer PA (M = 3.9 min/d). There was a significant interaction between changes in leisure-time PA, QPAR score, and number of PARs (p =.049). Women with both more PARs and higher QPAR scores reported greater increases in leisure-time PA than women with fewer PARs and lower QPAR scores. Conclusion Access to higher-quality PARs can help increase or maintain PA over time regardless of neighborhood income. PAR quality is a separate and distinct, important determinant of PA in ethnic minority women. PMID:24524382

  11. Housing Quality and Access to Material and Learning Resources within the Home Environment in Developing Countries

    PubMed Central

    Bradley, Robert H.; Putnick, Diane L.

    2011-01-01

    This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were consistently tied to HDI; the availability of formal and informal learning materials little less so. Gross domestic product (GDP) tended to show a stronger independent relation with housing quality and material resources than life expectancy and education. Formal learning resources were independently related to the GDP and education indices, and informal learning resources were not independently related to any constituent indices of the overall HDI. PMID:22277008

  12. [Improved access and quality of palliative care: the Vaud cantonal programme and the Lausanne model].

    PubMed

    Hongler, Thomas; Decollogny, Anne; Clivaz Luchez, Patrizia; Clément, Christine

    2008-02-20

    The Canton of Vaud introduced a development programme of palliative care in 2002. The goal of the programme was to ensure equal access to palliative care for anyone suffering from chronic progressive disease. One cornerstone of this programme is the desire to focus the intervention in the person's home, when desired by the patient and his family. Care networks are responsible for the implementation of this programme. The model presented here illustrates the means implemented and makes a preliminary assessment, which confirms the relevance of the main axes of the programme--training front-line teams, mobile second line teams specialized in palliative care and bed units.

  13. Making the Business Case for Energy Savings Plus Health: Indoor Air Quality Guidelines for School Building Upgrades

    EPA Pesticide Factsheets

    The Energy Savings Plus Health Guide equips school districts to integrate indoor air quality protections into school energy efficiency retrofits and other building upgrade projects. This page describes the business case for energy savings in schools.

  14. Defining an exposure-response relationship for suspended kaolin clay particulates and aquatic organisms: work toward defining a water quality guideline for suspended solids.

    PubMed

    Gordon, Andrew K; Palmer, Carolyn G

    2015-04-01

    Water quality guidelines for suspended solids generally rely on the percentage departure from reference condition, an approach that has been criticized. Attempts to develop a biological effects-base guideline have, however, been confounded by low data availability. Furthermore, the high biological response variability to suspended solids exposure suggests that organisms are responding not only to exposure concentration and duration but also to other mechanisms of effect associated with suspended particles (e.g., size, shape, and geochemical composition). An alternative option is to develop more situation and site specific guidelines by generating biological effects data to suspended particles of a particular geochemistry and restricted size range. With this in mind, aquatic organism responses to kaolin clay particle exposure were collated from the literature and incorporated into 2 exposure-response relationship approaches. The species sensitivity distribution approach produced a hazardous concentration affecting 5% of species estimate of 58 mg/L for mortality responses, and 36 mg/L for sublethal data. The severity-of-ill-effect approach produced similar estimates for lethal and sublethal data. These results suggest that aquatic organisms are slightly more tolerant of kaolin clay particles than particles from barite or bentonite clays, based on results from previous studies on these clay types. This type of information can enable better estimates of the risk faced by aquatic organisms exposed to suspended solids. For example, when the sediments of a particular water body are dominated by a particular type of clay particle, then the most appropriate exposure-response relationship can be applied.

  15. The Effect of Personalized Guideline-Concordant Treatment on Quality of Life and Functional Impairment in Bipolar Disorder

    PubMed Central

    Sylvia, Louisa G.; Rabideau, Dustin J.; Nierenberg, Andrew A.; Bowden, Charles L.; Friedman, Edward S.; Iosifescu, Dan V.; Thase, Michael E.; Ketter, Terence; Greiter, Elizabeth A.; Calabrese, Joseph R.; Leon, Andrew C.; Ostacher, Michael J.; Reilly-Harrington, Noreen

    2014-01-01

    Objectives The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium. Methods In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus ”optimal personalized treatment (OPT), or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning. Results Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over six months, patients in both treatment groups improved in quality of life and life functioning (p-values < 0.0001); without a statistically significant difference between the two treatment groups (p-values > 0.05). Within the lithium group, improvement in quality of life and functioning were not associated with concurrent lithium levels at week 12 or week 24 (p-values > 0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over six months. Conclusions Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder. PMID:25194782

  16. Quality Assurance Grading Guidelines for Research and Development at DOE Facilities (DOE Order 5700.6C)

    SciTech Connect

    Powell, T.B.

    1992-01-01

    The quality assurance (QA) requirements for the U.S. Department of Energy (DOE) are established in DOE Order 5700.6C. This order is applicable for all DOE departmental elements, management, and maintenance and operating contractors and requires that documented Quality Assurance Programs (QAPs) are prepared at all levels; it has one attachment. The DOE Office of Energy Research (DOE-ER) has issued a standard to ensure implementation of the full intent of this order in the ER community.

  17. Toxicity of magnesium pulses to tropical freshwater species and the development of a duration-based water quality guideline.

    PubMed

    Hogan, Alicia C; Trenfield, Melanie A; Harford, Andrew J; van Dam, Rick A

    2013-09-01

    Six freshwater species (Chlorella sp., Lemna aequinoctialis, Amerianna cumingi, Hydra viridissima, Moinodaphnia macleayi, and Mogurnda mogurnda) were exposed to 4-h, 8-h, and 24-h Mg pulses in natural creek water. Magnesium toxicity to all species increased with exposure duration; however, the extent of increase and the nature of the relationship differed greatly between species. Based on median inhibitory concentrations (IC50s), and compared with continuous exposure data from a previous study, the increase in toxicity with increasing exposure duration from 4 h to continuous (72-144 h) ranged from approximately 2-fold for Chlorella sp. and H. viridissima to greater than 40-fold for A. cumingi. Moreover, the form of the relationship between Mg toxicity and duration ranged from linear or near-linear to exponential for different species. The life-stage at which M. macleayi was exposed was important, with cladocerans pulsed at the onset of reproductive maturity being approximately 4 times more sensitive (based on IC50s) than younger than 6-h-old neonates. Species sensitivity distributions were constructed for the 4-h, 8-h, and 24-h pulse durations, from which 99% species protection guideline values (95% confidence limits [CLs]) of 94 (6.4-1360) mg/L, 14 (0.5-384) mg/L, and 8.0 (0.5-144) mg/L Mg, respectively, were derived. These values were plotted against exposure duration (h) and polynomial interpolation used to derive a guideline value for any pulse duration within the range assessed.

  18. Investing in Young Children: A Fact Sheet on Early Care and Education Participation, Access, and Quality

    ERIC Educational Resources Information Center

    Schmit, Stephanie; Matthews, Hannah; Smith, Sheila; Robbins, Taylor

    2013-01-01

    Across the U.S., large numbers of young children are affected by one or more risk factors that have been linked to academic failure and poor health. High quality early care and education can play a critical role in promoting young children's early learning and success in life, while also supporting families' economic security. Young…

  19. Does Access to High Quality Early Education Vary by State Policy Context?

    ERIC Educational Resources Information Center

    Connors, Maia C.; Morris, Pamela A.; Friedman-Krauss, Allison H.

    2015-01-01

    Research suggests that attending high quality, formal early childhood education (ECE) is associated with stronger cognitive and social-emotional skills, especially for low-income children. Yet at current funding levels, federally-funded programs like Head Start cannot serve all eligible children. Thus, state-level policies governing the…

  20. Expanding Access and Quality in Uganda: The Challenges of Building a Plane while Flying It

    ERIC Educational Resources Information Center

    Cutright, Marc

    2010-01-01

    Uganda is among many nations in sub-Saharan Africa that are trying simultaneously to expand higher education opportunities and to enhance the quality of higher-education offerings. These are particularly challenging goals in resource-rich environments and are even more difficulty in environments of more limited resources to include funding,…

  1. Strategic Priorities for Improving Access to Quality Education in the Kurdistan Region--Iraq. Monograph

    ERIC Educational Resources Information Center

    Vernez, Georges; Culbertson, Shelly; Constant, Louay

    2014-01-01

    The Kurdistan Regional Government (KRG) began an ambitious reform of the Kurdistan Region of Iraq's (KRI's) kindergarten through grade 12 (K-12) education system beginning in 2007 in an effort to modernize the curriculum, upgrade school facilities, and raise the quality of instruction. In 2010, RAND was asked to conduct a one-year study to assess…

  2. [Impact of the use of luer access devices on the quality of chronic hemodialysis].

    PubMed

    Raingeard, Erwin; Delcroix, Catherine; Lavainne, Frédéric; Séchet, Emmanuelle; Thibaud, Charlotte; Clouet, Johann; Dimet, Jérôme; Grimandi, Gaël

    2012-11-01

    Luer access valves are medical devices used to reduce infectious risks by securing repetitive handling in chronic hemodialysis using central catheter. Their impact on the effectiveness of a hemodialysis session still remains poorly studied. This in vivo study aims to evaluate its effectiveness. Tego(®) and Q-Syte(®) valves were used in alternation for each patient for four weeks (428 hemodialysis sessions). The two-luer access valves have led to a significant increase in the dysfunction of the hemodialysis sessions (51.8% compared to the usual care (39.3%) (P=0.012). The analysis by sub-category suggests a heterogeneous behavior of the two devices. The Q-Syte(®) valve showed significantly more dysfunction than the Tego(®) valve or the absence of valve. However, both valve systems tested can maintain the performance of the hemodialysis session as they don't change the dose of dialysis. This study highlights that an evaluation of each device must be performed prior to their use to assess the risk-benefit balance.

  3. Impact of genetic drift on developing access and benefit sharing guidelines under the Nagoya Protocol: The case of Meishan pigs imported into the US

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Convention on Biological Diversity developed the Nagoya Protocol (NP) on access and benefit sharing (ABS) for international exchange of genetic resources across life forms. Concerns are NP will be cumbersome, stifle research, and not accommodate diverse life forms, such as livestock. NP was deve...

  4. Assurance of Academic Quality at the Age of Virtually Free Access to Colleges

    NASA Astrophysics Data System (ADS)

    Kamimura, Tomohiko

    In the age of open admission to colleges, changes need to be made to the social mission of each college. In order to maintain a high standard of education, the following issues need to be discussed and coped with in each college : the establishment of the social mission of each college ; clarification of educational goals; a system for enforcing educational programs ; evaluation method of the outcome. An activity for academic quality assurance has been introduced in the college of engineering at Shibaura Institute of Technology. The systems for improving core academic competence, including a system of advice on withdrawal, educational content and so on, were introduced into foundation courses. For education in specialized field, an educational program based on JABEE has been utilized. This program fulfills the requirements of academic quality assurance.

  5. Oversight Review: Quality Control Review of Army Audit Agency’s Special Access Program Audits

    DTIC Science & Technology

    2005-08-25

    external peer review at least once every three years by reviewers independent of the audit organization being reviewed. As the organization that has audit...policy and oversight responsibilities for audits in the DoD, we conducted this external peer review of the AAA SAP audits in conjunction with the Air...Force Audit Agency (AFAA) external peer review of AAA non-SAP audits. An audit organization’s quality control policies and procedures should be

  6. Oversight Review: Quality Control Review of Air Force Audit Agency’s Special Access Program Audits

    DTIC Science & Technology

    2005-08-26

    external peer review at least once every 3 years by reviewers independent of the audit organization being reviewed. As the organization that has audit...policy and oversight responsibilities for audits in the Department of Defense, we conducted this external peer review of the AFAA SAP audits in...conjunction with the Naval Audit Service’s external peer review of AFAA non-SAP audits. An audit organization’s quality control policies and procedures

  7. Retrieval practice enhances the accessibility but not the quality of memory.

    PubMed

    Sutterer, David W; Awh, Edward

    2016-06-01

    Numerous studies have demonstrated that retrieval from long-term memory (LTM) can enhance subsequent memory performance, a phenomenon labeled the retrieval practice effect. However, the almost exclusive reliance on categorical stimuli in this literature leaves open a basic question about the nature of this improvement in memory performance. It has not yet been determined whether retrieval practice improves the probability of successful memory retrieval or the quality of the retrieved representation. To answer this question, we conducted three experiments using a mixture modeling approach (Zhang & Luck, 2008) that provides a measure of both the probability of recall and the quality of the recalled memories. Subjects attempted to memorize the color of 400 unique shapes. After every 10 images were presented, subjects either recalled the last 10 colors (the retrieval practice condition) by clicking on a color wheel with each shape as a retrieval cue or they participated in a control condition that involved no further presentations (Experiment 1) or restudy of the 10 shape/color associations (Experiments 2 and 3). Performance in a subsequent delayed recall test revealed a robust retrieval practice effect. Subjects recalled a significantly higher proportion of items that they had previously retrieved relative to items that were untested or that they had restudied. Interestingly, retrieval practice did not elicit any improvement in the precision of the retrieved memories. The same empirical pattern also was observed following delays of greater than 24 hours. Thus, retrieval practice increases the probability of successful memory retrieval but does not improve memory quality.

  8. Global access to safe water: accounting for water quality and the resulting impact on MDG progress.

    PubMed

    Onda, Kyle; LoBuglio, Joe; Bartram, Jamie

    2012-03-01

    Monitoring of progress towards the Millennium Development Goal (MDG) drinking water target relies on classification of water sources as "improved" or "unimproved" as an indicator for water safety. We adjust the current Joint Monitoring Programme (JMP) estimate by accounting for microbial water quality and sanitary risk using the only-nationally representative water quality data currently available, that from the WHO and UNICEF "Rapid Assessment of Drinking Water Quality". A principal components analysis (PCA) of national environmental and development indicators was used to create models that predicted, for most countries, the proportions of piped and of other-improved water supplies that are faecally contaminated; and of these sources, the proportions that lack basic sanitary protection against contamination. We estimate that 1.8 billion people (28% of the global population) used unsafe water in 2010. The 2010 JMP estimate is that 783 million people (11%) use unimproved sources. Our estimates revise the 1990 baseline from 23% to 37%, and the target from 12% to 18%, resulting in a shortfall of 10% of the global population towards the MDG target in 2010. In contrast, using the indicator "use of an improved source" suggests that the MDG target for drinking-water has already been achieved. We estimate that an additional 1.2 billion (18%) use water from sources or systems with significant sanitary risks. While our estimate is imprecise, the magnitude of the estimate and the health and development implications suggest that greater attention is needed to better understand and manage drinking water safety.

  9. Assessment of metal toxicity and development of sediment quality guidelines using the equilibrium partitioning model for the Three Gorges Reservoir, China.

    PubMed

    Gao, Li; Gao, Bo; Wei, Xin; Zhou, Huaidong; Xu, Dongyu; Wang, Yuchun

    2015-11-01

    The impoundment of the Three Gorges Reservoir (TGR) in China influences the quality of the water supply. Surface sediment samples from the TGR mainstream and three tributaries were collected. Acid volatile sulfide (AVS), simultaneously extractable metals (SEMs), and the fraction of organic carbon (f(oc)) were used to assess the toxicity of heavy metals. Sediment quality guidelines (SQGs) were established using the equilibrium partitioning approach. The results showed that the surface sediments were found to be oxic or suboxic. AVS concentrations in sediments were relatively low, below SEM concentrations. The [SEM] - [AVS] model indicated that all sediments possibly have adverse effects on aquatic life. However, ([SEM] - [AVS])/f(oc) predicted no adverse biological effects in some areas of the Meixi and Caotang Rivers, while adverse effects to aquatic life were uncertain for the other sediments. The partitioning coefficients, water quality criteria, and residual metals in the sediments were the main factors influencing the SQGs for the TGR, while the metals bound to AVS had a negligible effect. The normalized TGR SQGs were all much higher than the existing standards except for cadmium and copper. The differences might be attributed to the approaches used for derivation of SQGs and the physical and chemical characteristics of the sediments.

  10. Quality assurance grading guidelines for research and development at DOE facilities. DOE Order 5700.6C

    SciTech Connect

    Powell, T.B.; Morris, R.N.

    1992-10-01

    The quality assurance (QA) requirements for the US Department of Energy (DOE) are established in DOE Order 5700.6C. This order is applicable for all DOE departmental elements, management, and maintenance and operating contractors and requires that documented Quality Assurance Programs (QAPS) are prepared at all levels; it has one attachment. The DOE Office of Energy Research (DOE-ER) has issued a standard to ensure implementation of the full intent of this order in the ER community. This report discusses order 5700.6C in relation to research with DOE.

  11. [Guidelines for clinical practice].

    PubMed

    Vleugels, A M

    1997-01-01

    Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete

  12. The Evidence-based Practice for Improving Quality method has greater impact on improvement of outcomes than dissemination of practice change guidelines and quality improvement training in neonatal intensive care units

    PubMed Central

    Lee, Shoo K; Aziz, Khalid; Singhal, Nalini; Cronin, Catherine M

    2015-01-01

    OBJECTIVES: To determine whether outcome improvements achieved by neonatal intensive care units (NICUs) in the Evidence-based Practice for Improving Quality (EPIQ) trial could be reproduced in other NICUs by providing quality improvement (QI) training and practice change guidelines developed during the EPIQ trial; and to examine whether the results of the EPIQ trial were sustained. METHODS: The present prospective before-after study included 5812 infants born at ≤32 weeks’ gestation and admitted to 19 level 3 NICUs in the Canadian Neonatal Network between October 1, 2005 and December 31, 2007. During a three-month baseline period, multi-disciplinary teams received general training in QI techniques at a two-day workshop, and practice change guidelines targeting nosocomial infection (NI) and bronchopulmonary dysplasia (BPD) developed during the EPIQ trial were provided to all participants. Outcome data collected during the intervention period were compared with data from the baseline period and reported quarterly. RESULTS: In NICUs that had not previously participated in the EPIQ trial (non-EPIQ NICUs), there were no significant changes in the incidence trends of NI or BPD. However, within NICUs that had previously participated in the EPIQ trial (EPIQ NICUs) there was a continued reduction in the incidence trend of NI and BPD among EPIQ NICUs randomized during the trial to reduce NI and BPD, respectively. CONCLUSIONS: Providing NICUs with QI training and practice change guidelines developed during a successful QI initiative in other units is not effective. The authors speculate that successful practice change involves organizational culture and behaviour change, and should be driven by context-specific evidence. PMID:25722645

  13. Equal Access to All.

    ERIC Educational Resources Information Center

    Schettler, Joel

    2002-01-01

    Discusses the Section 508 amendment to the Rehabilitation Act of 1973 that directs the use of technology. Describes guidelines for online training accessibility with which vendors hoping for government business must fully comply. (JOW)

  14. Linear Accelerator and Gamma Knife-Based Stereotactic Cranial Radiosurgery: Challenges and Successes of Existing Quality Assurance Guidelines and Paradigms

    SciTech Connect

    Goetsch, Steven J.

    2008-05-01

    Intracranial stereotactic radiosurgery has been practiced since 1951. The technique has expanded from a single dedicated unit in Stockholm in 1968 to hundreds of centers performing an estimated 100,000 Gamma Knife and linear accelerator cases in 2005. The radiation dosimetry of small photon fields used in this technique has been well explored in the past 15 years. Quality assurance recommendations have been promulgated in refereed reports and by several national and international professional societies since 1991. The field has survived several reported treatment errors and incidents, generally reacting by strengthening standards and precautions. An increasing number of computer-controlled and robotic-dedicated treatment units are expanding the field and putting patients at risk of unforeseen errors. Revisions and updates to previously published quality assurance documents, and especially to radiation dosimetry protocols, are now needed to ensure continued successful procedures that minimize the risk of serious errors.

  15. The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

    PubMed

    Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

    2012-09-01

    Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

  16. Preliminary MRI quality assessment and device acceptance guidelines for a multicenter bioclinical study: the GO Glioblastoma Project.

    PubMed

    Ollivro, Sylvain; Eliat, Pierre-Antoine; Hitti, Eric; Tran, Loan; de Certaines, Jacques D; Saint-Jalmes, Hervé

    2012-10-01

    It is a major challenge to guarantee homogeneous acquisition during a prospective multicenter magnetic resonance imaging (MRI) study that makes use of different devices. The goal of the multicenter Grand Ouest Glioblastoma Project (GOGP) was to correlate MRI quantitative parameters with biological markers extracted from image-guided biopsies. Therefore, it was essential to ensure spatial coherence of the parameters as well as the signal intensity and homogeneity. The project included the same MRI protocol implemented on six devices from different manufacturers. The key point was the initial acceptance of the imaging devices and protocol sequences. For this purpose, and to allow comparison of quantitative patient data, we propose a specific method for quality assessment. A common quality control based on 10 parameters was established. Three pulse sequences of the clinical project protocol were applied using three test-objects. A fourth test-object was used to assess T1 accuracy. Although geometry-related parameters, signal-to-noise ratio, uniformity, and T1 measurements varied slightly depending on the different devices, they nevertheless remained within the recommendations and expectations of the multicenter project. This kind of quality control procedure should be undertaken as a prerequisite to any multicenter clinical project involving quantitative MRI and comparison of data acquisitions with quantitative biological image-guided biopsies.

  17. Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International

    PubMed Central

    Munroe, Erik; Hayes, Brendan; Taft, Julia

    2015-01-01

    Background: To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. Methods: We analyzed MSI’s social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008–2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011–2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI “Impact 2” model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Results: Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44

  18. Uniform guidelines improve client care.

    PubMed

    Barnett, B

    1994-12-01

    Uniform national guidelines on the delivery of family planning methods and services improve client care, assuming these guidelines are based on current scientific information. Compliance with these guidelines yields safe and efficient delivery of family planning services. Service providers need information, training, supplies, and guidelines to deliver quality services. Guidelines contribute to consistency among family planning programs in different settings. Even though clinics may not provide the same services, the guidelines allow them to provide the same standards of care. Specifically, eligibility criteria, contraindications, and follow-up schedules are the same regardless of the service delivery point. Various international health organizations (such as World Health Organization, USAID, Program for International Training in Health, International Planned Parenthood Federation, and Association for Voluntary Surgical Contraception) have developed guidelines for family planning service delivery. Governments can use these documents to develop national family planning guidelines and policies. They should adapt the guidelines to local needs and consider program resources. After development of the national guidelines, training, workshops, and dissemination of written materials should be provided for policymakers, physicians, nurses, and other health providers. Countries that have either developed or are working to draft their own national guidelines are Cameroon, Ghana, Mexico, and Nepal.

  19. Use of sediment quality guidelines and related tools for the asssessment of contaminated sediments: Executive summary sooklet of a SETAC Pellston Workshop

    USGS Publications Warehouse

    Wenning, R. J.; Ingersoll, Christopher G.

    2002-01-01

    This publication summarizes the results of a Pellston Workshop sponsored by the Society of Environmental Toxicology and Chemistry (SETAC), held 17-22 August 2002 in Fairmont, Montana, USA. The full technical proceedings of the workshop will be published separately by SET AC in 2003. Previous SETAC workshops have focused on sediment ecological risk assessment (ERA) (Dickson et al. 1987; Ingersoll et al. 1997) and porewater toxicity testing (Carr and Nipper 2003). Another recent workshop addressed the application of weight-of-evidence (WOE) methods in ERA (Burton et al. 2002). These previous workshops focused on how, when, and why ERAs are needed in sediment assessments. However, more focused discussion among scientists, environmental regulators, and environmental managers is now needed to build on this previous work. Specifically, additional guidance is needed on procedures that can be used to integrate the information derived from multiple chemical and biological lines of evidence (LOE). These LOE, which are developed through the application of different assessment tools, often include the use of chemically based sediment quality guidelines (SQGs) to evaluate sediment contamination and to help practitioners in sediment assessment and management formulate risk management decisions. This workshop focused on evaluation of the scientific foundations supporting different chemically based numeric SQGs and methods to improve the integration of SQGs into different sediment quality assessment frameworks that include information derived from multiple chemical and biological LOE.

  20. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    PubMed

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  1. Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing

    PubMed Central

    Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions. PMID:24385662

  2. Effluent Guidelines

    EPA Pesticide Factsheets

    Effluent guidelines are national standards for wastewater discharges to surface waters and municipal sewage treatment plants. We issue the regulations for industrial categories based on the performance of treatment and control technologies.

  3. Interconnection Guidelines

    EPA Pesticide Factsheets

    The Interconnection Guidelines provide general guidance on the steps involved with connecting biogas recovery systems to the utility electrical power grid. Interconnection best practices including time and cost estimates are discussed.

  4. Qualifying codes under software quality assurance: Two examples as guidelines for codes that are existing or under development

    SciTech Connect

    Mangold, D.

    1993-05-01

    Software quality assurance is an area of concem for DOE, EPA, and other agencies due to the poor quality of software and its documentation they have received in the past. This report briefly summarizes the software development concepts and terminology increasingly employed by these agencies and provides a workable approach to scientific programming under the new requirements. Following this is a practical description of how to qualify a simulation code, based on a software QA plan that has been reviewed and officially accepted by DOE/OCRWM. Two codes have recently been baselined and qualified, so that they can be officially used for QA Level 1 work under the DOE/OCRWM QA requirements. One of them was baselined and qualified within one week. The first of the codes was the multi-phase multi-component flow code TOUGH version 1, an already existing code, and the other was a geochemistry transport code STATEQ that was under development The way to accomplish qualification for both types of codes is summarized in an easy-to-follow step-by step fashion to illustrate how to baseline and qualify such codes through a relatively painless procedure.

  5. Medicare Access and CHIP Reauthorization Act: What do Geriatrics Healthcare Professionals Need to Know About the Quality Payment Program?

    PubMed

    Unroe, Kathleen T; Hollmann, Peter A; Goldstein, Alanna C; Malone, Michael L

    2017-03-17

    Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA. CMS received extensive input from stakeholders including the American Geriatrics Society. Under the Quality Payment Program, CMS streamlined multiple Medicare value-based payment programs into a new Merit-based Incentive Payment System (MIPS). CMS also outlined how it will provide incentives for participation in Advanced Alternative Payment Models (called APMs). Although Medicare payments to geriatrics health professionals will not be based on the new MIPS formula until 2019, those payments will be based upon performance during a 90-day period in 2017. This article defines geriatrics health professionals as clinicians who care for a predominantly older adult population and who are eligible to bill under the Medicare Physician Fee Schedule. Given the current paucity of eligible APMs, this article will focus on MIPS while providing a brief overview of APMs.

  6. Tools for assessing the quality and accessibility of online health information: initial testing among breast cancer websites.

    PubMed

    Whitten, Pamela; Nazione, Samantha; Lauckner, Carolyn

    2013-12-01

    Health websites are used frequently, but there are many concerns about their value as information sources. Additionally, there are numerous personal barriers that prevent individuals from wholly benefitting from them. In order to assess the quality of health websites and their accessibility to users, we created tools based on previous research that examine design aspects, information validity, motivational health content and literacy content. To test these tools, we examined 155 breast cancer websites and created scores for each assessment tool to describe the percent of constructs on the average website. Results demonstrated that websites performed best on the design tool followed by the information validity, motivational health content and literacy assessment tools. The average website contained the majority of the design and information validity constructs, but only about a third of the motivational health or literacy constructs. Multiple items from the motivational health content and literacy assessment tools were not found on any of the websites, and many were only represented on a handful of sites. Overall, the assessment tools were useful in evaluating the quality of websites, and could serve as valuable resources for health website developers in the future.

  7. Access, quality, and costs of care at physician owned hospitals in the United States: observational study

    PubMed Central

    Orav, E John; Jena, Anupam B; Dudzinski, David M; Le, Sidney T; Jha, Ashish K

    2015-01-01

    Objective To compare physician owned hospitals (POHs) with non-POHs on metrics around patient populations, quality of care, costs, and payments. Design Observational study. Setting Acute care hospitals in 95 hospital referral regions in the United States, 2010. Participants 2186 US acute care hospitals (219 POHs and 1967 non-POHs). Main outcome measures Proportions of patients using Medicaid and those from ethnic and racial minority groups; hospital performance on patient experience metrics, care processes, risk adjusted 30 day mortality, and readmission rates; costs of care; care payments; and Medicare market share. Results The 219 POHs were more often small (<100 beds), for profit, and in urban areas. 120 of these POHs were general (non-specialty) hospitals. Compared with patients from non-POHs, those from POHs were younger (77.4 v 78.4 years, P<0.001), less likely to be admitted through an emergency department (23.2% v. 29.0%, P<0.001), equally likely to be black (5.1% v 5.5%, P=0.85) or to use Medicaid (14.9% v 15.4%, P=0.75), and had similar numbers of chronic diseases and predicted mortality scores. POHs and non-POHs performed similarly on patient experience scores, processes of care, risk adjusted 30 day mortality, 30 day readmission rates, costs, and payments for acute myocardial infarction, congestive heart failure, and pneumonia. Conclusion Although POHs may treat slightly healthier patients, they do not seem to systematically select more profitable or less disadvantaged patients or to provide lower value care. PMID:26333819

  8. Guideline-Directed Medication Use in Patients With Heart Failure With Reduced Ejection Fraction in India: American College of Cardiology's PINNACLE India Quality Improvement Program.

    PubMed

    Pokharel, Yashashwi; Wei, Jessica; Hira, Ravi S; Kalra, Ankur; Shore, Supriya; Kerkar, Prafulla G; Kumar, Ganesh; Risch, Samantha; Vicera, Veronique; Oetgen, William J; Deswal, Anita; Turakhia, Mintu P; Glusenkamp, Nathan; Virani, Salim S

    2016-03-01

    Little is known about the use of guideline-directed medical therapy (GDMT) in outpatients with heart failure with reduced left ventricular ejection fraction (HFrEF; ≤40%) in India. Our objective was to understand the use of GDMT in outpatients with HFrEF in India. The Practice Innovation And Clinical Excellence (PINNACLE) India Quality Improvement Program (PIQIP) is a registry for cardiovascular quality improvement in India supported by the American College of Cardiology Foundation. Between January 2008 and September 2014, we evaluated documentation of use of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and β-blockers, or both, among outpatients with HFrEF seeking care in 10 centers enrolled in the PIQIP registry. Among 75 639 patients in the PIQIP registry, 34 995 had EF reported, and 15 870 had an EF ≤40%. The mean age was 56 years; 23% were female. Hypertension, diabetes, coronary artery disease, and myocardial infarction were present in 37%, 23%, 27%, and 17%, respectively. Use of ACEIs/ARBs, β-blockers, and both were documented in 33.5%, 34.9%, and 29.6% of patients, respectively. The documentation of GDMT was higher in men, in patients age ≥65 years, and in those with presence of hypertension, diabetes, or coronary artery disease. Documentation of GDMT gradually increased over the study period. Among patients enrolled in the PIQIP registry, about two-thirds of patients with EF ≤40% did not have documented receipt of GDMT. This study is an initial step toward improving adherence to GDMT in India and highlights the feasibility of examining quality of care in HFrEF in a resource-limited setting.

  9. EPRI condensate polisher guidelines

    SciTech Connect

    Larkin, B.A.; Webb, L.C.; Sawochka, S.G.; Crits, G.J.; Pocock, F.J.; Wirth, L.

    1995-01-01

    Cycle chemistry is one of the most important contributors to the loss of availability of generating units. Condensate polishing can significantly improve cycle chemistry by improving cycle water quality and minimizing the transport of contaminants in the power cycle. The EPRI-funded project described in this paper developed comprehensive guidelines for condensate polishing based upon information gathered from utility surveys, equipment vendors, and resin suppliers. Existing literature was also surveyed for pertinent input. Comprehensive guidelines which outline guidance for design, operation, maintenance, surveillance, management, and retrofitting of condensate polishing systems were developed. Economics of condensate polishing were evaluated and a roadmap for economic evaluation for utilities to follow was produced.

  10. Vascular access for hemodialysis: thrills and thrombosis.

    PubMed

    Gilpin, Victoria; Nichols, W Kirt

    2010-06-01

    Hemodialysis is a life saving treatment for Americans with end stage renal disease. In the last decade, liberal selection of patients treated by hemodialysis has resulted in patients who are substantially older, diabetics, who have higher co-morbidities including extensive atherosclerotic vascular disease. Many of these patients start hemodialysis treatments with a synthetic graft access rather than with their own native vessels. Grafts are appropriate for patients with inadequate vessels for construction of an arterio-venous (A-V) fistulas. The National Kidney Foundation published the Dialysis Outcome Quality Initiative (DOQI) guidelines in 1997, a set of evidenced based guidelines regarding the optimal management of vascular access. One important guideline had been to increase the number of patient dialyzing with Arterio-Venous (A-V) fistulas rather than A-V grafts which are prone to frequent stenosis, thrombosis, and thus are more costly and labor intensive. The prevalence of patient dialyzing with fistulas depends on several factors; timing of the referral, anatomy and adequacy of the patients vessels, type of fistula placed, fistula maturation, minimal accepted dialysis blood flow and patency of the fistula. The management of a vascular access for hemodialysis is a challenging area of practice for those who care for the hemodialysis patient population. The multidisciplinary approach to management of patients with hemodialysis access includes support, education, collaboration and ongoing communication with the multidisciplinary team, patients, and their family members.

  11. Low Quality of Free Coaching Apps With Respect to the American College of Sports Medicine Guidelines: A Review of Current Mobile Apps

    PubMed Central

    Bian, Jiang; Leavitt, Trevor; Bromwell, Jennifer; Harris III, Charles; Vincent, Heather

    2015-01-01

    Background Low physical activity level is a significant contributor to chronic disease, weight dysregulation, and mortality. Nearly 70% of the American population is overweight, and 35% is obese. Obesity costs an estimated US$ 147 billion annually in health care, and as many as 95 million years of life. Although poor nutritional habits remain the major culprit, lack of physical activity significantly contributes to the obesity epidemic and related lifestyle diseases. Objective Over the past 10 years, mobile devices have become ubiquitous, and there is an ever-increasing number of mobile apps that are being developed to facilitate physical activity, particularly for active people. However, no systematic assessment has been performed about their quality with respect to following the parameters of sound fitness principles and scientific evidence, or suitability for a variety of fitness levels. The aim of this paper is to fill this gap and assess the quality of mobile coaching apps on iOS mobile devices. Methods A set of 30 popular mobile apps pertaining to physical activity programming was identified and reviewed on an iPhone device. These apps met the inclusion criteria and provided specific prescriptive fitness and exercise programming content. The content of these apps was compared against the current guidelines and fitness principles established by the American College of Sports Medicine (ACSM). A weighted scoring method based on the recommendations of the ACSM was developed to generate subscores for quality of programming content for aerobic (0-6 scale), resistance (0-6 scale), and flexibility (0-2 scale) components using the frequency, intensity, time, and type (FITT) principle. An overall score (0-14 scale) was generated from the subscores to represent the overall quality of a fitness coaching app. Results Only 3 apps scored above 50% on the aerobic component (mean 0.7514, SD 1.2150, maximum 4.1636), 4 scored above 50% on the resistance/strength component (mean

  12. Guideline Implementation: Hand Hygiene.

    PubMed

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  13. Design for Accessibility.

    ERIC Educational Resources Information Center

    Conn, David R.; McCallum, Barry

    1982-01-01

    Discusses the facets of building design which affect the accessibility of libraries for the physically disabled and presents some basic guidelines for designing accessible libraries. Types of disabilities, questions relating to site design, and specific architectural and physical features of libraries (entranceways, lighting, stairways, and…

  14. Improving access to clinical guidance: redevelopment of a junior doctor intranet page

    PubMed Central

    Walkden, Graham; Millwood, Sinead; Cavanagh, Andrew

    2015-01-01

    Junior doctors frequently rely on electronic access to clinical guidelines to inform assessment and management, particularly whilst on-call and occasionally during emergencies. Difficulties in locating and accessing up to date guidance from different hospital intranet sites can lead to delays or errors in patient management. We used a focus group and email feedback to redesign an intranet site for junior doctors which logically organised the documents which doctors said they needed access to in one readily accessible location. A quality improvement project was carried out over six months, testing two iterations of the new junior doctors' intranet site before a third version was launched and evaluated. Their performance was measured by the number of mouse clicks and the time required for doctors to find a representative subset of five guidelines, and revisions were made at each cycle based on feedback from doctors and stakeholders. Cumulatively, we demonstrated a decrease in the total number of clicks required to access the sample of guidelines from 18 to 12 clicks, a corresponding decrease in the time required to access the sample of guidelines from 130 seconds to 22 seconds, and an increase in user satisfaction. We maintained one-click access to emergency guidance. In conclusion, we have developed and implemented an electronic resource for junior doctors which provides more immediate access to both emergency and non-emergency clinical guidance. To ensure the resource remains up to date, it will be maintained by Foundation Programme representatives at our hospital on a rolling basis. PMID:26734395

  15. [Planning guidelines for prosthodontic treatment].

    PubMed

    Shiga, Hiroshi; Terada, Yoshihiro; Shinya, Akiyoshi; Ikebe, Kazunori; Tamazawa, Yoshinori; Nagadome, Hatsumi; Akagawa, Yasumasa

    2008-01-01

    In recent years "practice guidelines" based on EBM techniques have even been attracting attention at a societal level, and guidelines modeled after the procedure for preparing practice guideline (described at http://www.niph.go.jp/glgl-4.3rev.htm) have begun to be drafted and made public. With the aim of ensuring the quality and presenting the basic concepts of prosthodontic therapy, the Japan Prosthodontic Society, which bears a great obligation and responsibility toward society and the Japanese public, has decided to undertake the formulation of guidelines related to prosthodontic therapy, and decided to first undertake the formulation of "Practice guideline for denture relining and rebasing", and to prepare a guideline model. We tried to prepare the guidelines according to the "Procedure for preparing practice guidelines", but because of the scientific uniqueness of prosthodontic treatment and dentistry, research to elucidate the basis of treatment has been insufficient, and we ultimately reconfirmed the current state of affairs in which it is difficult to perform. We therefore prepared the guidelines based on the limited evidence obtained in a search of the scientific literature and on the consensus of experts. The Japan Prosthodontic Society has investigated and prepared a Society guideline "model" to the extent possible at the present time, and it has prepared "Guidelines for adhesion bridge" and "Practice guidelines for denture prosthodontics" based on it. Nevertheless, the fact of the matter is that we are faced with numerous problems, and we think that in the future new bases and clinical knowledge will be accumulated by promoting scientific clinical research, and that the guidelines should be revised regularly based on them.

  16. Does the Public Sector Outperform the Nonprofit and For-Profit Sectors? Evidence from a National Panel Study on Nursing Home Quality and Access

    ERIC Educational Resources Information Center

    Amirkhanyan, Anna A.; Kim, Hyun Joon; Lambright, Kristina T.

    2008-01-01

    Are public and private organizations fundamentally different? This question has been among the most enduring inquiries in public administration. Our study explores the impact of organizational ownership on two complementary aspects of performance: service quality and access to services for impoverished clients. Derived from public management…

  17. South Africa: Distance Higher Education Policies for Access, Social Equity, Quality, and Social and Economic Responsiveness in a Context of the Diversity of Provision

    ERIC Educational Resources Information Center

    Badat, Saleem

    2005-01-01

    The principal concern of this paper is the implication of the increasing diversity of higher education provision in South Africa for equity of access and opportunity for historically disadvantaged social groups, high-quality provision, and social and economic responsiveness in distance higher education. This diversity is signalled by a variety of…

  18. Access to Services, Quality of Care, and Family Impact for Children with Autism, Other Developmental Disabilities, and Other Mental Health Conditions

    ERIC Educational Resources Information Center

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire

    2014-01-01

    This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with…

  19. Access and Quality in Education in Resettlement Schools: The Case Study of Zvivingwi Secondary School in Gutu District, Masvingo Province in Zimbabwe

    ERIC Educational Resources Information Center

    Jenjekwa, Vincent

    2013-01-01

    In Zimbabwe, the discourse on access and quality in education has been a raging one since the colonial days of bottlenecks and outright discrimination against black Zimbabweans in education. The doors to education were declared open to all at independence in 1980 with the new Zimbabwe government's enunciated policy of education for all. It is an…

  20. Use of Sediment Quality Guidelines and pollution indicators for the assessment of heavy metal and PAH contamination in Greek surficial sea and lake sediments.

    PubMed

    Hahladakis, John; Smaragdaki, Eleftheria; Vasilaki, Georgia; Gidarakos, Evangelos

    2013-03-01

    Eight different surface sediment samples (K1-K8) were collected from two separate areas of Lake Koumoundourou and two samples (E1 and E2) from one area of Elefsis Bay, Athens, Greece. The level of pollution attributed to heavy metals was evaluated using several pollution indicators. Degree of Contamination, Modified Contamination Degree and Geoaccumulation Indexes were applied in order to determine and assess the anthropogenic contribution of the selected six elements (Cr, Ni, Cu, Zn, As and Pb). Moreover, the adverse effects of the sediments to aquatic organisms, from both heavy metals and polycyclic aromatic hydrocarbons (PAHs), were determined by using Sediment Quality Guidelines. The results indicated that Lake Koumoundourou is contaminated with heavy metals in a moderate degree and almost 50 % of the sediments are associated with frequent observation of adverse effects, when it comes to Ni and occasional observation of adverse effects, when it comes to Cu, Zn and Pb. As far as PAHs are concerned, around 60 % of the samples can be occasionally associated to toxic biological effects according to the effect-range classification for phenanthrene, benzo(a)anthracene, chrysene and pyrene. Finally, samples taken from the north side of the lake are more contaminated with PAHs than the ones taken from the east side probably due to the existence of the water barrier which acts as a reservoir of PAHs.

  1. Combining contamination indexes, sediment quality guidelines and multivariate data analysis for metal pollution assessment in marine sediments of Cienfuegos Bay, Cuba.

    PubMed

    Peña-Icart, Mirella; Pereira-Filho, Edenir Rodrigues; Lopes Fialho, Lucimar; Nóbrega, Joaquim A; Alonso-Hernández, Carlos; Bolaños-Alvarez, Yoelvis; Pomares-Alfonso, Mario S

    2017-02-01

    The purpose of the present work was to combine several tools for assessing metal pollution in marine sediments from Cienfuegos Bay. Fourteen surface sediments collected in 2013 were evaluated. Concentrations of As, Cu, Ni, Zn and V decreased respect to those previous reported. The metal contamination was spatially distributed in the north and south parts of the bay. According to the contamination factor (CF) enrichment factor (EF) and index of geoaccumulation (Igeo), Cd and Cu were classified in that order as the most contaminated elements in most sediment. Comparison of the total metal concentrations with the threshold (TELs) and probable (PELs) effect levels in sediment quality guidelines suggested a more worrisome situation for Cu, of which concentrations were occasional associated with adverse biological effects in thirteen sediments, followed by Ni in nine sediments; while adverse effects were rarely associated with Cd. Probably, Cu could be considered as the most dangerous in the whole bay because it was classified in the high contamination levels by all indexes and, simultaneously, associated to occasional adverse effects in most samples. Despite the bioavailability was partially evaluated with the HCl method, the low extraction of Ni (<3% in all samples) and Cu (<55%, except sample 3) and the relative high extraction of Cd (50% or more, except sample 14) could be considered as an attenuating (Ni and Cu) or increasing (Cd) factor in the risk assessment of those element.

  2. Food Web Bioaccumulation Model for Resident Killer Whales from the Northeastern Pacific Ocean as a Tool for the Derivation of PBDE-Sediment Quality Guidelines.

    PubMed

    Alava, Juan José; Ross, Peter S; Gobas, Frank A P C

    2016-01-01

    Resident killer whale populations in the NE Pacific Ocean are at risk due to the accumulation of pollutants, including polybrominated diphenyl ethers (PBDEs). To assess the impact of PBDEs in water and sediments in killer whale critical habitat, we developed a food web bioaccumulation model. The model was designed to estimate PBDE concentrations in killer whales based on PBDE concentrations in sediments and the water column throughout a lifetime of exposure. Calculated and observed PBDE concentrations exceeded the only toxicity reference value available for PBDEs in marine mammals (1500 μg/kg lipid) in southern resident killer whales but not in northern resident killer whales. Temporal trends (1993-2006) for PBDEs observed in southern resident killer whales showed a doubling time of ≈5 years. If current sediment quality guidelines available in Canada for polychlorinated biphenyls are applied to PBDEs, it can be expected that PBDE concentrations in killer whales will exceed available toxicity reference values by a large margin. Model calculations suggest that a PBDE concentration in sediments of approximately 1.0 μg/kg dw produces PBDE concentrations in resident killer whales that are below the current toxicity reference value for 95 % of the population, with this value serving as a precautionary benchmark for a management-based approach to reducing PBDE health risks to killer whales. The food web bioaccumulation model may be a useful risk management tool in support of regulatory protection for killer whales.

  3. Future Directions in the Use of Telemental Health to Improve the Accessibility and Quality of Children's Mental Health Services

    PubMed Central

    Myers, Kathleen

    2016-01-01

    Abstract Objectives: This concluding commentary offers a brief overview of progress to date in providing telemental health services to children, and then offers a critical vision for future research needed to provide the rigorous empirical foundation for telemental health to be considered a well-established format for the delivery of children's mental health services. Methods: We review how recent years have witnessed advances in the science and practice of children's telemental health, and the articles in this special series collectively offered a critical step forward in the establishment of a guiding literature to provide informed direction for child providers incorporating remote technologies to extend their practices. Results: Researchers must be cautious not to develop a “horse race” mentality and a misguided search for a decisive “winner” regarding the ultimate effectiveness of child telemental health versus traditional clinic-based treatments. Instead, research efforts are needed to examine key mediators and moderators of telemental health treatment response. The question should not be simply whether telemental health strategies are supported, but rather when, under what circumstances, and for whom telemental health formats may be most indicated. Barriers to the continued evolution of children's telemental health are discussed, and we consider issues of telemental health reimbursement and matters of cross-state professional jurisdiction. Conclusions: Continued efforts are needed in order to fully actualize the potential of children's telemental health to optimize the quality and transform the accessibility of mental health services for all children, regardless of income or geography. PMID:26859722

  4. Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation.

    PubMed

    Camm, A John; Pinto, Fausto J; Hankey, Graeme J; Andreotti, Felicita; Hobbs, F D Richard

    2015-07-01

    Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Cardiology (ESC) guidelines for the management of AF, the Action for Stroke Prevention alliance writing group have identified key reasons for the suboptimal implementation of the guidelines at a global, regional, and local level, with an emphasis on access restrictions to guideline-recommended therapies. Following identification of these barriers, the group has developed an expert consensus on strategies to augment the implementation of current guidelines, including practical, educational, and access-related measures. The potential impact of healthcare quality measures for stroke prevention on guideline implementation is also explored. By providing practical guidance on how to improve implementation of the ESC guidelines, or region-specific modifications of these guidelines, the aim is to reduce the potentially devastating impact that stroke can have on patients, their families and their carers.

  5. Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation

    PubMed Central

    Camm, A. John; Pinto, Fausto J.; Hankey, Graeme J.; Andreotti, Felicita; Hobbs, F.D. Richard

    2015-01-01

    Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Cardiology (ESC) guidelines for the management of AF, the Action for Stroke Prevention alliance writing group have identified key reasons for the suboptimal implementation of the guidelines at a global, regional, and local level, with an emphasis on access restrictions to guideline-recommended therapies. Following identification of these barriers, the group has developed an expert consensus on strategies to augment the implementation of current guidelines, including practical, educational, and access-related measures. The potential impact of healthcare quality measures for stroke prevention on guideline implementation is also explored. By providing practical guidance on how to improve implementation of the ESC guidelines, or region-specific modifications of these guidelines, the aim is to reduce the potentially devastating impact that stroke can have on patients, their families and their carers. PMID:26116685

  6. Scoring Guidelines.

    ERIC Educational Resources Information Center

    Tamir, Pinchas; Doran, Rodney L.

    1992-01-01

    Scoring guidelines are given for four forms of the practical skills tests of the Second International Association for the Evaluation of Educational Improvement Science Study conducted in the following countries in the 1980s: (1) Hungary; (2) Japan; (3) Korea; (4) Singapore; (5) Israel; and (6) the United States. (SLD)

  7. Copyright Guidelines.

    ERIC Educational Resources Information Center

    National Center for Educational Communication (DHEW/OE), Washington, DC.

    The U.S. Office of Education has prepared Guidelines on authorizing copyright protection for materials developed under project grants or contracts as effective June 8, 1970. A supplement is available as LI 002 915. This booklet supersedes OE-11018 entitled "Limited Copyright Protection for Materials Developed Under Project Grants and…

  8. Assessment of the quality of reporting in randomised controlled trials of acupuncture in the Korean literature using the CONSORT statement and STRICTA guidelines

    PubMed Central

    Kim, Kun Hyung; Kang, Jung Won; Lee, Myeong Soo; Lee, Jae-Dong

    2014-01-01

    Objectives This study aims to assess the completeness of reporting of randomised controlled trials (RCTs) of acupuncture in the Korean literature. Design Systematic review. Methods We searched 12 Korean databases and 7 Korean journals to identify eligible RCTs of acupuncture published from 1996 to July 2011. We used the Consolidated Standards of Reporting Trials (CONSORT) checklist for parallel RCTs and the revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) to assess the quality of reporting in Korean RCTs. We compared the completeness of reporting of CONSORT and STRICTA items in RCTs published in two time periods (1996–2004 referred to as the early period and 2005–2011 referred to as the late period). Results We analysed 146 eligible RCTs using the CONSORT statement concerning RCTs of both needling and non-needling acupuncture and the STRICTA guidelines for 90 trials of needling acupuncture. Among the 103 RCTs in the late period, the proportion of RCTs that completely reported the CONSORT items of outcome definition (15.5%), sample size calculation (2.9%), randomisation (56%), allocation concealment (5.8%), implementation of allocation (11.7%), outcome assessor blinding (20.3%), flow of participants (25.2%), number of participants analysed (19.4%), ancillary analyses (0.0%), adverse events (24.3%), generalisability of findings (1.9%) and overall evidence (32.0%) remained small. Among the 61 RCTs of needling acupuncture in the late period, the STRICTA items of setting/context (24.6%) and practitioner background (27.9%) showed incomplete reporting. The completeness of reporting improved over time in several CONSORT and STRICTA items. Conclusions The completeness of reporting of Korean RCTs of acupuncture was suboptimal according to the CONSORT and revised STRICTA statements. Trial authors and journal editors should use the CONSORT statement and STRICTA guidelines for transparent reporting in Korean RCTs of acupuncture. The

  9. WHO indoor air quality guidelines on household fuel combustion: Strategy implications of new evidence on interventions and exposure-risk functions

    NASA Astrophysics Data System (ADS)

    Bruce, Nigel; Pope, Dan; Rehfuess, Eva; Balakrishnan, Kalpana; Adair-Rohani, Heather; Dora, Carlos

    2015-04-01

    Background: 2.8 billion people use solid fuels as their primary cooking fuel; the resulting high levels of household air pollution (HAP) were estimated to cause more than 4 million premature deaths in 2012. The people most affected are among the world's poorest, and past experience has shown that securing adoption and sustained use of effective, low-emission stove technologies and fuels in such populations is not easy. Among the questions raised by these challenges are (i) to what levels does HAP exposure need to be reduced in order to ensure that substantial health benefits are achieved, and (ii) what intervention technologies and fuels can achieve the required levels of HAP in practice? New WHO air quality guidelines are being developed to address these issues. Aims: To address the above questions drawing on evidence from new evidence reviews conducted for the WHO guidelines. Methods: Discussion of key findings from reviews covering (i) systematic reviews of health risks from HAP exposure, (ii) newly developed exposure-response functions which combine combustion pollution risk evidence from ambient air pollution, second-hand smoke, HAP and active smoking, and (iii) a systematic review of the impacts of solid fuel and clean fuel interventions on kitchen levels of, and personal exposure to, PM2.5 and carbon monoxide (CO). Findings: Evidence on health risks from HAP suggest that controlling this exposure could reduce the risk of multiple child and adult health outcomes by 20-50%. The new integrated exposure-response functions (IERs) indicate that in order to secure these benefits, HAP levels require to be reduced to the WHO IT-1 annual average level (35 μg/m3 PM2.5), or below. The second review found that, in practice, solid fuel 'improved stoves' led to large percentage and absolute reductions, but post-intervention kitchen levels were still very high, at several hundreds of μg/m3 of PM2.5, although most solid fuel stove types met the WHO 24-hr average guideline

  10. World Health Organization increases its drinking-water guideline for uranium.

    PubMed

    Frisbie, Seth H; Mitchell, Erika J; Sarkar, Bibudhendra

    2013-10-01

    The World Health Organization (WHO) released the fourth edition of Guidelines for Drinking-water Quality in July, 2011. In this edition, the drinking-water guideline for uranium (U) was increased to 30 μg L(-1) despite the conclusion that "deriving a guideline value for uranium in drinking-water is complex, because the data [from exposures to humans] do not provide a clear no-effect concentration" and "Although some minor biochemical changes associated with kidney function have been reported to be correlated with uranium exposure at concentrations below 30 μg L(-1), these findings are not consistent between studies" (WHO, Uranium in Drinking-water, Background document for development of WHO Guidelines for Drinking-water Quality, available: , accessed 13 October 2011). This paper reviews the WHO drinking-water guideline for U, from its introduction as a 2 μg L(-1) health-based guideline in 1998 through its increase to a 30 μg L(-1) health-based guideline in 2011. The current 30 μg L(-1) WHO health-based drinking-water guideline was calculated using a "no-effect group" with "no evidence of renal damage [in humans] from 10 renal toxicity indicators". However, this nominal "no-effect group" was associated with increased diastolic blood pressure, systolic blood pressure, and glucose excretion in urine. In addition, the current 30 μg L(-1) guideline may not protect children, people with predispositions to hypertension or osteoporosis, pre-existing chronic kidney disease, and anyone with a long exposure. The toxic effects of U in drinking water on laboratory animals and humans justify a re-evaluation by the WHO of its decision to increase its U drinking-water guideline.

  11. Access to Coronary Artery Bypass Graft Surgery under Pay for Performance: Evidence from the Premier Hospital Quality Incentive Demonstration

    PubMed Central

    Epstein, Arnold M.; Joynt, Karen E.; Jha, Ashish K.; Orav, E. John

    2014-01-01

    Background Although Pay for Performance (P4P) has become common, many worry that P4P will lead providers to avoid offering surgical procedures to the sickest patients out of concern that poor outcomes will lead to financial penalties. Methods and Results We used Medicare data to compare change in rates of coronary artery bypass graft surgery (CABG) between 2002–03 and 2008–09 among patients with acute myocardial infarction (AMI) admitted to 126 hospitals participating in Medicare’s Premier Hospital Quality Incentive Demonstration P4P program (HQID) with patients in 848 control hospitals participating in public reporting alone. We examined rates for all AMI patients and those in the top decile of predicted mortality based on demographics, medical comorbidities and AMI characteristics. We identified 91,393 patients admitted for AMI in Premier hospitals and 502,536 Medicare patients admitted for AMI in control hospitals. CABG rates for AMI patients in Premier decreased from 13.6% in 2002–03 to 10.4% in 2008–09; there was a comparable decrease in non-Premier hospitals (13.6% to 10.6%, p-value for comparison of changes between Premier and non-Premier of 0.67). CABG rates for high-risk patients in Premier decreased from 8.4% in FY 2002–3 to 8.2% in 2008–9. Patterns were similar in non-Premier hospitals (8.4% to 8.3%, p-value for comparison of changes between Premier and non-Premier, 0.82). Conclusions Our results show no evidence of a deleterious impact of P4P on access to CABG for high-risk patients with AMI. These results should be reassuring to those concerned about the potential negative impact of P4P on high-risk patients. PMID:25160840

  12. Osteoporosis guidelines.

    PubMed

    Barlow, D H

    2007-10-01

    The Position Statement from the International Menopause Society (IMS) in 2004 recommends the use of hormone therapy for the 'avoidance of bone-wasting and fractures'. It also states that 'prevention, not treatment, is the most feasible goal'. In updating the Statement, this paper considers the relevance of Osteoporosis Guidelines. Relevant documents will be of two broad types. These may be consensus statements/position statements that summarize the 'state of the art' for practitioners, based on the work of expert groups, or they may be formal Guidelines generated through formal 'evidence-based' methodology. The former approach is generally used by Societies and can be generated through relatively efficient consensus processes. The latter approach will normally involve extensive work and cost, necessarily becomes very detailed, involving systematic review and technology appraisal and can lead to highly specific recommendations on intervention thresholds. For the revision of the general IMS Position Statement, the specific IMS Paper on Postmenopausal Osteoporosis (2005) must be a key reference document. This provides a description of the international consensus on the management of osteoporosis up to late 2004 and which remains relevant today. Additionally, other consensus statements and systematic guidelines need to be considered. Across these documents providing guidance, the substantial influence of the International Osteoporosis Foundation/National Osteoporosis Foundation Position Paper, defining a 'New approach to the development of assessment guidelines for osteoporosis', can be seen. This flagged the importance of a shift from guidance, tying the diagnostic threshold to the intervention threshold, and instead advised linking the intervention threshold to estimated fracture risk probability. This moves the intervention decision away from a simple bone density threshold to a more complex, but more realistic, threshold estimate, taking into account a range of

  13. Melatonin as a pro-osteogenic agent in oral implantology: a systematic review of histomorphometric outcomes in animals and quality evaluation using ARRIVE guidelines.

    PubMed

    Arora, H; Ivanovski, S

    2017-04-01

    The aim of this review was to evaluate the outcomes of preclinical trials that assessed the use of melatonin as a pro-osteogenic agent in the field of oral implantology. Melatonin is a hormone that has been shown to have beneficial antioxidant and bone-metabolic effects. A number of experimental studies have analysed its effect in promoting osseointegration around dental implants in animals. A bibliographic search in PubMed, Scopus and EBSCOhost was performed. Animal studies that quantitatively analysed the pro-osteogenic effect of melatonin were included. Quality assessment of the included studies was performed using the ARRIVE guidelines. Eight studies met the inclusion criteria. The experimental animals used were dogs, rabbits and rats. Melatonin was used in a lyophilized powdered form, an injectable form or as a dipping solution. Six of the eight studies included showed a statistically significant positive effect of melatonin on bone-implant contact and various other histomorphometric parameters. The ARRIVE criteria were generally well reported by the included studies (17.5 ± 1.60/24), although several criteria (including randomization and blinding) were poorly documented, with most of the studies showing a high/unclear risk of bias. The majority of the studies included showed a statistically significant positive effect of melatonin on bone formation around implants. However, the clinical significance of this effect was unclear given the high/unclear risk of bias in the majority of included studies. Given the limited amount of data available, further research should be conducted to evaluate the clinical potential of this pineal hormone in clinically relevant situations, such as compromised sites or patients.

  14. Does the public sector outperform the nonprofit and for-profit sectors? Evidence from a national panel study on nursing home quality and access.

    PubMed

    Amirkhanyan, Anna A; Kim, Hyun Joon; Lambright, Kristina T

    2008-01-01

    Are public and private organizations fundamentally different? This question has been among the most enduring inquiries in public administration. Our study explores the impact of organizational ownership on two complementary aspects of performance: service quality and access to services for impoverished clients. Derived from public management research on performance determinants and nursing home care literature, our hypotheses stipulate that public, nonprofit, and for-profit nursing homes use different approaches to balance the strategic tradeoff between two aspects of performance. Panel data on 14,423 facilities were analyzed to compare measures of quality and access across three sectors using different estimation methods. Findings indicate that ownership status is associated with critical differences in both quality and access. Public and nonprofit organizations are similar in terms of quality, and both perform significantly better than their for-profit counterparts. When compared to nonprofit and, in some cases, for-profit facilities, public nursing homes have a significantly higher share of Medicaid recipients. The paper proposes strategies to address the identified long-term care divide.

  15. Clinical Practice Guidelines for Rare Diseases: The Orphanet Database

    PubMed Central

    Pavan, Sonia; Rommel, Kathrin; Mateo Marquina, María Elena; Höhn, Sophie; Lanneau, Valérie; Rath, Ana

    2017-01-01

    Clinical practice guidelines (CPGs) for rare diseases (RDs) are scarce, may be difficult to identify through Internet searches and may vary in quality depending on the source and methodology used. In order to contribute to the improvement of the diagnosis, treatment and care of patients, Orphanet (www.orpha.net) has set up a procedure for the selection, quality evaluation and dissemination of CPGs, with the aim to provide easy access to relevant, accurate and specific recommendations for the management of RDs. This article provides an analysis of selected CPGs by medical domain coverage, prevalence of diseases, languages and type of producer, and addresses the variability in CPG quality and availability. CPGs are identified via bibliographic databases, websites of research networks, expert centres or medical societies. They are assessed according to quality criteria derived from the Appraisal of Guidelines, REsearch and Evaluation (AGREE II) Instrument. Only open access CPGs and documents for which permission from the copyright holders has been obtained are disseminated on the Orphanet website. From January 2012 to July 2015, 277 CPGs were disseminated, representing coverage of 1,122 groups of diseases, diseases or subtypes in the Orphanet database. No language restriction is applied, and so far 10 languages are represented, with a predominance of CPGs in English, French and German (92% of all CPGs). A large proportion of diseases with identified CPGs belong to rare oncologic, neurologic, hematologic diseases or developmental anomalies. The Orphanet project on CPG collection, evaluation and dissemination is a continuous process, with regular addition of new guidelines, and updates. CPGs meeting the quality criteria are integrated to the Orphanet database of rare diseases, together with other types of textual information and the appropriate services for patients, researchers and healthcare professionals in 40 countries. PMID:28099516

  16. Testing the Digital Divide: Does Access to High-Quality Use of Technology in Schools Affect Student Achievement?

    ERIC Educational Resources Information Center

    Talley, Gregory Keith

    2012-01-01

    This study investigates the relationship between access, use of technology and student achievement in public middle schools in Maryland. The objective of this study was to determine whether a digital divide (differences in access and utilization of technology based on student characteristics of race, socioeconomic status, and gender) exists among…

  17. Roadmap for Teacher Access to Student-Level Longitudinal Data: Key Focus Areas to Ensure Quality Implementation. Data for Action

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2014

    2014-01-01

    Teachers have access to information about the students in their classrooms each year, but schools and districts often cannot provide teachers with longitudinal data (or data linked over time). Given resource constraints in schools and districts, states are best positioned to ensure that teachers have secure access to their students' longitudinal…

  18. Clinical practice guidelines in hypertension: a review.

    PubMed

    Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, José Kelvin; Galvez-Olortegui, Tomas Vladimir; Sosa-Rosado, José Manuel; Camacho-Saavedra, Luis Arturo

    2015-10-23

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in hypertension. This is the first in a series of review articles, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Of all clinical practice guidelines, three were selected and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used to assess each guide. The guidelines obtained the lowest score in the domain of applicability (mean 43.8%); while the highest score was for clarity of presentation (mean 81.5%). The lowest percentage was found in the applicability domain (European guideline) and the highest of all scores was found in two domains: scope and purpose, and clarity of presentation (Canadian guideline). Assessing the quality of the clinical practice guidelines analyzed, the Canadian is one with the best scores obtained by applying the AGREE II instrument, and it is advised to be used without modifications.

  19. Vascular access creation and care should be provided by nephrologists.

    PubMed

    Malovrh, Marko

    2015-01-01

    The long-term survival and quality of life of patients on hemodialysis is dependent on the adequacy of dialysis via an appropriately placed vascular access. Recent clinical practice guidelines recommend the creation of native arteriovenous fistula or synthetic graft before start of chronic hemodialysis therapy to prevent the need for complication-prone dialysis catheters. The direct involvement of nephrologists in the management of referral patterns, predialysis follow-up, policy of venous preservation, preoperative evaluation, vascular access surgery and vascular access care seems to be important and productive targets for the quality of care delivered to the patients with end-stage renal disease. Early referral to nephrologists is important for delay progression of both kidney disease and its complications by specific and adequate treatment, for education program which should include modification of lifestyle, medication management, selection of treatment modality and instruction for vein preservation and vascular access. Nephrologists are responsible for on-time placement and adequate maturation of vascular access. The number of nephrologists around the world who create their own fistulas and grafts is growing, driven by a need for better patient outcomes on hemodialysis. Nephrologists have also a key role for care of vascular access during hemodialysis treatment by following vascular access function using clinical data, physical examination and additional ultrasound evaluation. Timely detection of malfunctioning vascular access means timely surgical or radiological intervention and increases the survival of vascular access.

  20. Implementation of the epilepsy center of excellence to improve access to and quality of care – protocol for a mixed methods study

    PubMed Central

    2014-01-01

    Background To address the growing problem of epilepsy among aging Veterans and younger Veterans who have experienced a traumatic brain injury (TBI), the Veterans Health Administration (VA) has implemented 16 Epilepsy Centers of Excellence (ECOE) to assure increased access to high quality of care for Veterans with epilepsy. Each ECOE consists of a network of regional hubs to which spoke facilities refer Veterans for subspecialty treatment. The ECOEs are expected to improve access to and quality of epilepsy care through patient care, consultation and education. This study aims to: evaluate the effectiveness of the ECOE structure by describing changes in the quality of and access to care for epilepsy before and after the ECOE initiative using QUality Indicators in Epilepsy Treatment (QUIET Indicators); describe associations between changes in the structure and processes of care and Relational Coordination (RC), a model of task-oriented communication that has been shown to play a role in implementation science; and determine if variations in care are related to levels of RC. Methods This four-year comparative case study uses a mixed-methods approach. We will use VA inpatient, outpatient, pharmacy, and chart abstraction data to identify changes in the quality of and access to epilepsy care in the VA between Fiscal Year 2008 and Fiscal Year 2014. Qualitative and survey methods will be used to identify changes in the structure and processes of epilepsy care and RC over the course of the study. We will then link data from the first two objectives to determine the extent to which quality of and access to epilepsy care is associated with RC using multivariable models. Discussion This innovative study has the potential to improve understanding of hub-and-spoke model effectiveness, VA epilepsy care, and models of epilepsy specialty care more globally. Moreover, it contributes to implementation science by advancing understanding of the role of RC in the context of a major

  1. Pay More Attention: a national mixed methods study to identify the barriers and facilitators to ensuring equal access to high-quality hospital care and services for children and young people with and without learning disabilities and their families

    PubMed Central

    Oulton, Kate; Wray, Jo; Carr, Lucinda; Hassiotis, Angela; Jewitt, Carey; Kerry, Sam; Gibson, Faith

    2016-01-01

    Introduction Despite evidence of health inequalities for adults with intellectual disability (ID) there has yet to be a comprehensive review of how well hospital services are meeting the needs of children and young people (CYP) with ID and their families. We do not know how relevant existing recommendations and guidelines are to CYP, whether these are being applied in the paediatric setting or what difference they are making. Evidence of parental dissatisfaction with the quality, safety and accessibility of hospital care for CYP with ID exists. However, the extent to which their experience differs from parents of CYP without ID is not known and the views and experiences of CYP with ID have not been investigated. We will compare how services are delivered to, and experienced by CYP aged 5–15 years with and without ID and their families to see what inequalities exist, for whom, why and under what circumstances. Methods and analysis We will use a transformative, mixed methods case study design to collect data over four consecutive phases. We will involve CYP, parents and hospital staff using a range of methods; interviews, parental electronic diary, hospital and community staff questionnaire, patient and parent satisfaction questionnaire, content analysis of hospital documents and a retrospective mapping of patient hospital activity. Qualitative data will be managed and analysed using NVivo and quantitative data will be analysed using parametric and non-parametric descriptive statistics. Ethics and dissemination The study will run from December 2015 to November 2018. We have Health Authority Approval (IRAS project ID: 193932) for phase 1 involving staff only and ethical and Health Authority Approval for phases 2–4 (IRAS project ID: 178525). We will disseminate widely to relevant stakeholders, using a range of accessible formats, including social media. We will publish in international peer-reviewed journals and present to professional, academic and lay audiences

  2. An open-access database of grape harvest dates for climate research: data description and quality assessment

    NASA Astrophysics Data System (ADS)

    Daux, V.; Garcia de Cortazar-Atauri, I.; Yiou, P.; Chuine, I.; Garnier, E.; Ladurie, E. Le Roy; Mestre, O.; Tardaguila, J.

    2012-09-01

    We present an open-access dataset of grape harvest dates (GHD) series that has been compiled from international, French and Spanish literature and from unpublished documentary sources from public organizations and from wine-growers. As of June 2011, this GHD dataset comprises 380 series mainly from France (93% of the data) as well as series from Switzerland, Italy, Spain and Luxemburg. The series have variable length (from 1 to 479 data, mean length of 45 data) and contain gaps of variable sizes (mean ratio of observations/series length of 0.74). The longest and most complete ones are from Burgundy, Switzerland, Southern Rhône valley, Jura and Ile-de-France. The most ancient harvest date of the dataset is in 1354 in Burgundy. The GHD series were grouped into 27 regions according to their location, to geomorphological and geological criteria, and to past and present grape varieties. The GHD regional composite series (GHD-RCS) were calculated and compared pairwise to assess their reliability assuming that series close to one another are highly correlated. Most of the pairwise correlations are significant (p-value < 0.001) and strong (mean pairwise correlation coefficient of 0.58). As expected, the correlations tend to be higher when the vineyards are closer. The highest correlation (R = 0.91) is obtained between the High Loire Valley and the Ile-de-France GHD-RCS. The strong dependence of the vine cycle on temperature and, therefore, the strong link between the harvest dates and the temperature of the growing season was also used to test the quality of the GHD series. The strongest correlations are obtained between the GHD-RCS and the temperature series of the nearest weather stations. Moreover, the GHD-RCS/temperature correlation maps show spatial patterns similar to temperature correlation maps. The stability of the correlations over time is explored. The most striking feature is their generalised deterioration at the late 19th-early 20th century. The possible

  3. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., well-child care, well-adolescent care and childhood and adolescent immunizations. (b) Access to covered... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH...

  4. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... adequate number of visits to specialists experienced in treating the specific medical condition and access to out-of-network providers when the network is not adequate for the enrollee's medical condition....

  5. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... adequate number of visits to specialists experienced in treating the specific medical condition and access to out-of-network providers when the network is not adequate for the enrollee's medical condition....

  6. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... adequate number of visits to specialists experienced in treating the specific medical condition and access to out-of-network providers when the network is not adequate for the enrollee's medical condition....

  7. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... monitor and treat enrollees with chronic, complex, or serious medical conditions, including access to an adequate number of visits to specialists experienced in treating the specific medical condition and...

  8. The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs.

    PubMed

    Howlett, Jonathan G; McKelvie, Robert S; Costigan, Jeannine; Ducharme, Anique; Estrella-Holder, Estrellita; Ezekowitz, Justin A; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Herd, Anthony M; Isaac, Debra; Kouz, Simon; Leblanc, Kori; Liu, Peter; Mann, Elizabeth; Moe, Gordon W; O'Meara, Eileen; Rajda, Miroslav; Siu, Samuel; Stolee, Paul; Swiggum, Elizabeth; Zeiroth, Shelley

    2010-04-01

    Since 2006, the Canadian Cardiovascular Society heart failure (HF) guidelines have published annual focused updates for cardiovascular care providers. The 2010 Canadian Cardiovascular Society HF guidelines update focuses on an increasing issue in the western world - HF in ethnic minorities - and in an uncommon but important setting - the pregnant patient. Additionally, due to increasing attention recently given to the assessment of how care is delivered and measured, two critically important topics - disease management programs in HF and quality assurance - have been included. Both of these topics were written from a clinical perspective. It is hoped that the present update will become a useful tool for health care providers and planners in the ongoing evolution of care for HF patients in Canada.

  9. The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

    PubMed Central

    Howlett, Jonathan G; McKelvie, Robert S; Costigan, Jeannine; Ducharme, Anique; Estrella-Holder, Estrellita; Ezekowitz, Justin A; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Herd, Anthony M; Isaac, Debra; Kouz, Simon; Leblanc, Kori; Liu, Peter; Mann, Elizabeth; Moe, Gordon W; O’Meara, Eileen; Rajda, Miroslav; Siu, Samuel; Stolee, Paul; Swiggum, Elizabeth; Zeiroth, Shelley

    2010-01-01

    Since 2006, the Canadian Cardiovascular Society heart failure (HF) guidelines have published annual focused updates for cardiovascular care providers. The 2010 Canadian Cardiovascular Society HF guidelines update focuses on an increasing issue in the western world – HF in ethnic minorities – and in an uncommon but important setting – the pregnant patient. Additionally, due to increasing attention recently given to the assessment of how care is delivered and measured, two critically important topics – disease management programs in HF and quality assurance – have been included. Both of these topics were written from a clinical perspective. It is hoped that the present update will become a useful tool for health care providers and planners in the ongoing evolution of care for HF patients in Canada. PMID:20386768

  10. The Role of Access to Head Start and Quality Ratings for Spanish-Speaking Dual Language Learners' (DLLs) Participation in Early Childhood Education.

    PubMed

    Greenfader, Christa Mulker; Miller, Elizabeth B

    2014-01-01

    Data from the Head Start Impact Study (N = 4,442) were used to test for differences between Spanish-speaking Dual Language Learners (DLLs) and monolingual English-speaking children in: (1) Head Start attendance rates when randomly assigned admission; and (2) quality ratings of other early childhood education (ECE) programs attended when not randomly assigned admission to Head Start. Logistic regressions showed that Spanish-speaking DLL children randomly assigned a spot in Head Start were more likely than monolingual-English learners to attend. Further, Spanish-speaking DLLs not randomly assigned a spot in Head Start were more likely to attend higher-quality ECE centers than non-DLL children. Policy implications are discussed, suggesting that, if given access, Spanish-speaking DLL families will take advantage of quality ECE programs.

  11. The Role of Access to Head Start and Quality Ratings for Spanish-Speaking Dual Language Learners’ (DLLs) Participation in Early Childhood Education

    PubMed Central

    2014-01-01

    Data from the Head Start Impact Study (N = 4,442) were used to test for differences between Spanish-speaking Dual Language Learners (DLLs) and monolingual English-speaking children in: (1) Head Start attendance rates when randomly assigned admission; and (2) quality ratings of other early childhood education (ECE) programs attended when not randomly assigned admission to Head Start. Logistic regressions showed that Spanish-speaking DLL children randomly assigned a spot in Head Start were more likely than monolingual-English learners to attend. Further, Spanish-speaking DLLs not randomly assigned a spot in Head Start were more likely to attend higher-quality ECE centers than non-DLL children. Policy implications are discussed, suggesting that, if given access, Spanish-speaking DLL families will take advantage of quality ECE programs. PMID:25018585

  12. Terminology Guideline for Classifying Offshore Wind Energy Resources

    SciTech Connect

    Beiter, Philipp; Musial, Walt

    2016-09-01

    The purpose of this guideline is to establish a clear and consistent vocabulary for conveying offshore wind resource potential and to interpret this vocabulary in terms that are familiar to the oil and gas (O&G) industry. This involves clarifying and refining existing definitions of offshore wind energy resource classes. The terminology developed in this guideline represents one of several possible sets of vocabulary that may differ with respect to their purpose, data availability, and comprehensiveness. It was customized to correspond with established offshore wind practices and existing renewable energy industry terminology (e.g. DOE 2013, Brown et al. 2015) while conforming to established fossil resource classification as best as possible. The developers of the guideline recognize the fundamental differences that exist between fossil and renewable energy resources with respect to availability, accessibility, lifetime, and quality. Any quantitative comparison between fossil and renewable energy resources, including offshore wind, is therefore limited. For instance, O&G resources are finite and there may be significant uncertainty associated with the amount of the resource. In contrast, aboveground renewable resources, such as offshore wind, do not generally deplete over time but can vary significantly subhourly, daily, seasonally, and annually. The intent of this guideline is to make these differences transparent and develop an offshore wind resource classification that conforms to established fossil resource classifications where possible. This guideline also provides methods to quantitatively compare certain offshore wind energy resources to O&G resource classes for specific applications. Finally, this guideline identifies areas where analogies to established O&G terminology may be inappropriate or subject to misinterpretation.

  13. Taking care of your vascular access for hemodialysis

    MedlinePlus

    ... blood through the access. This is called stenosis. Day-to-day Care of Your Vascular Access Following these guidelines ... pulse (also called thrill) in your access every day. Your health care provider will show you how. ...

  14. American Cancer Society Lung Cancer Screening Guidelines

    PubMed Central

    Wender, Richard; Fontham, Elizabeth T. H.; Barrera, Ermilo; Colditz, Graham A.; Church, Timothy R.; Ettinger, David S.; Etzioni, Ruth; Flowers, Christopher R.; Gazelle, G. Scott; Kelsey, Douglas K.; LaMonte, Samuel J.; Michaelson, James S.; Oeffinger, Kevin C.; Shih, Ya-Chen Tina; Sullivan, Daniel C.; Travis, William; Walter, Louise; Wolf, Andrew M. D.; Brawley, Otis W.; Smith, Robert A.

    2013-01-01

    Findings from the National Cancer Institute’s National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. PMID:23315954

  15. American Cancer Society lung cancer screening guidelines.

    PubMed

    Wender, Richard; Fontham, Elizabeth T H; Barrera, Ermilo; Colditz, Graham A; Church, Timothy R; Ettinger, David S; Etzioni, Ruth; Flowers, Christopher R; Gazelle, G Scott; Kelsey, Douglas K; LaMonte, Samuel J; Michaelson, James S; Oeffinger, Kevin C; Shih, Ya-Chen Tina; Sullivan, Daniel C; Travis, William; Walter, Louise; Wolf, Andrew M D; Brawley, Otis W; Smith, Robert A

    2013-01-01

    Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation.

  16. The "Diagnostic Guideline for Anxiety and Challenging Behaviour" for Persons with Intellectual Disabilities: Preliminary Outcomes on Internalizing Problems, Challenging Behaviours, Quality of Life and Clients' Satisfaction

    ERIC Educational Resources Information Center

    Pruijssers, Addy; Meijel, Berno; Maaskant, Marian; Teerenstra, Steven; van Achterberg, Theo

    2017-01-01

    Background: People with intellectual disabilities are vulnerable to develop psychopathology (in particular anxiety) and related challenging behaviour. Method: A comparative multiple case study with an experimental and a control condition. Results: The application of the guideline showed a trend of decreases of internalizing problems (P = 0.07) and…

  17. Access to What? Creating a Composite Measure of Educational Quantity and Educational Quality for 11 African Countries

    ERIC Educational Resources Information Center

    Spaull, Nicholas; Taylor, Stephen

    2015-01-01

    The aim of the current study is to create a composite statistic of educational quantity and educational quality by combining household data (Demographic and Health Survey) on grade completion and survey data (Southern and Eastern African Consortium for Monitoring Educational Quality) on cognitive outcomes for 11 African countries: Kenya, Lesotho,…

  18. World Ocean Database online: Access and use of quality controlled oceanographic profile data for oceanographic and climate change studies

    NASA Astrophysics Data System (ADS)

    Boyer, T.; Levitus, S.; Baranova, O.; Locarnini, R.; Garcia, H.; Johnson, D.; Antonov, J.; Gelfeld, B.; Tatusko, R.

    2004-12-01

    The World Ocean Database 2001 (WOD01) was released in 2001 on CD and online as part of the IOC "Global Ocean Data Archeology and Rescue" (GODAR) and "World Ocean Database projects". The goal of these projects is to make available the largest possible database of quality controlled historical and modern oceanographic profile data to be used in scientific studies. The database contains nearly 7 million temperature profiles, more than 2 million salinity profiles, as well as observations of oxygen content, nutrient levels, and plankton counts. To help users of the data who want to work with only a subset of the data, the online WODselect system was developed to select, view, and download user specified subsets of the WOD01. All data undergo rigorous quality control procedures. The results of the quality control do not result in elimination of data from the database. Rather, flags are attached to each measurement leaving the decision to the user on whether to follow the underlying quality control decisions. The most important quality control is the use of the data in-house for scientific research. This research reveals quality control problems which have eluded all previous steps in the quality control procedure. The online version of the WOD01 is updated monthly based on ongoing quality control through scientific research.

  19. Equitable Access to Educational Resources: An Investigation of the Distribution of Teacher Quality across Secondary Schools in South Florida

    ERIC Educational Resources Information Center

    Richards, Sabrina

    2014-01-01

    This quantitative study examined secondary schools across a south Florida school district to determine the relationship between school characteristics and measures of teacher quality with the aim of ascertaining the equitable distribution of the educational resource, teacher quality. Data regarding student population, staff climate survey…

  20. Low-Skill Workers' Access to Quality Green Jobs. Perspectives on Low-Income Working Families. Brief 13

    ERIC Educational Resources Information Center

    Martinson, Karin; Stanczyk, Alexandra; Eyster; Lauren

    2010-01-01

    This brief discusses strategies for improving access to green jobs among those with low skill levels, particularly jobs that can help improve workers' economic standing and better support their families. In order to understand where green jobs for low-skill individuals can be found, the first section provides an overview of green industries and…

  1. 78 FR 18562 - Economic and Environmental Principles and Guidelines for Water and Related Land Resources...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... Act. The revised Principles and Guidelines consist of three key components: (1) The Principles and... QUALITY Economic and Environmental Principles and Guidelines for Water and Related Land Resources... Environmental Principles and Guidelines for Water and Related Land Resources Implementation...

  2. IPUMS-International High Precision Population Census Microdata Samples: Balancing the Privacy-Quality Tradeoff by Means of Restricted Access Extracts

    PubMed Central

    McCaa, Robert; Ruggles, Steven; Davern, Michael; Swenson, Tami; Palipudi, Krishna Mohan

    2016-01-01

    A breakthrough in the tradeoff between privacy and data quality has been achieved for restricted access to population census microdata samples. The IPUMS-International website, as of June 2006, offers integrated microdata for 47 censuses, totaling more than 140 million person records, with 13 countries represented. Over the next four years, the global collaboratory led by the Minnesota Population Center, with major funding by the United States National Science Foundation and the National Institutes of Health, will disseminate samples for more than 100 additional censuses. The statistical authorities of more than 50 countries have already entrusted microdata to the project under a uniform memorandum of understanding which permits researchers to obtain custom extracts without charge and to analyze the microdata using their own hardware and software. This paper describes the disclosure control methods used by the IPUMS initiative to protect privacy and to provide access to high precision census microdata samples.

  3. Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

    PubMed

    Soekarjo, Damayanti; Zehner, Elizabeth

    2011-10-01

    It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding.

  4. Utilization of clinical practice guidelines: barriers and facilitators.

    PubMed

    Keiffer, Melanie R

    2015-06-01

    Clinical practice guidelines augment clinician decision making. Researchers cite a lack of knowledge of guideline existence, complexity of guidelines, staff attitude, lack of training, time and resource constraints as reasons for nonadherence. This project sought to understand factors that promote or prevent guideline implementation at the point of care. Respondents' viewed clinical practice guidelines as valid tools necessary to standardize patient care and exhibited proficiency in synthesis and integration of guidelines into clinical decisions and treatment plans. Efficient and effective guidelines impact patient safety and quality by increasing the consistency of behavior and replacing idiosyncratic behaviors with best practices.

  5. Developing nursing computer interpretable guidelines: a feasibility study of heart failure guidelines in homecare.

    PubMed

    Topaz, Maxim; Shalom, Erez; Masterson-Creber, Ruth; Rhadakrishnan, Kavita; Monsen, Karen A; Bowles, Kathryn H

    2013-01-01

    Homecare is the fastest growing healthcare sector and evidence based information systems are critically needed. Nurses provide most of the care in homecare setting, yet there is a lack of knowledge on the feasibility of applying existing methodologies to generate computer interpretable nursing guidelines for home care. This study examined the feasibility of encoding homecare nursing heart failure guideline into a computer interpretable format. First, we achieved experts' consensus on the relevant guideline. Then, after training on the graphical tool for gradual knowledge specification (Gesher), we generated a comprehensive, hierarchical and time-oriented computer interpretable guideline using one of the guideline modeling languages (Asbru). The final guideline included 167 recommendations and experts' evaluation confirmed the adequacy of guideline knowledge representation. Future work should expand the applicability of our methodology and tools to nursing specialties other than heart failure and develop methods for comprehensive quality evaluation of the resulting guidelines.

  6. The Human Proteome Organization-Proteomics Standards Initiative Quality Control Working Group: Making Quality Control More Accessible for Biological Mass Spectrometry.

    PubMed

    Bittremieux, Wout; Walzer, Mathias; Tenzer, Stefan; Zhu, Weimin; Salek, Reza M; Eisenacher, Martin; Tabb, David L

    2017-03-30

    To have confidence in results acquired during biological mass spectrometry experiments, a systematic approach to quality control is of vital importance. Nonetheless, until now, only scattered initiatives have been undertaken to this end, and these individual efforts have often not been complementary. To address this issue, the Human Proteome Organization-Proteomics Standards Initiative has established a new working group on quality control at its meeting in the spring of 2016. The goal of this working group is to provide a unifying framework for quality control data. The initial focus will be on providing a community-driven standardized file format for quality control. For this purpose, the previously proposed qcML format will be adapted to support a variety of use cases for both proteomics and metabolomics applications, and it will be established as an official PSI format. An important consideration is to avoid enforcing restrictive requirements on quality control but instead provide the basic technical necessities required to support extensive quality control for any type of mass spectrometry-based workflow. We want to emphasize that this is an open community effort, and we seek participation from all scientists with an interest in this field.

  7. Public Service Guidelines in an Electronic Environment.

    ERIC Educational Resources Information Center

    Barkley, Daniel C.

    1998-01-01

    In today's electronic environment, government information librarians face new challenges, especially in the arena of quality public-service provision. Given the lack of clear guidelines that Federal Depository Library Program participants follow, and based upon suggested guidelines of reference-oriented literature, a new set of public services…

  8. Selecting an appropriate strategy to make quality 7.1 % chlorhexidine digluconate accessible for umbilical cord care.

    PubMed

    Metzler, Mutsumi; Coffey, Patricia S

    2016-01-01

    Achieving increased access to medicines in low- and middle-income countries is a complex issue that requires a holistic approach. Choosing an appropriate manufacturing strategy that can ensure a sustainable supply of these medicines is an essential component of that approach. The Chlorhexidine Working Group, a consortium of more than 25 international organizations, donors, and manufacturers led by PATH, has been working to increase access to 7.1 % chlorhexidine digluconate for umbilical cord care in low- and middle-income countries to reduce neonatal mortality due to infection. The working group initially considered two strategies for manufacture of this commodity: (1) production and global distribution by a multinational company; and (2) production and regional distribution by locally owned companies or subsidiaries of multinational companies based in low- and middle-income countries. Local production may be beneficial to public health and economic development in these countries, yet capability and capacity of pharmaceutical manufacturers, regulatory and legal provisions, and market factors must be carefully assessed and addressed to ensure that local production is the correct strategy and that it contributes to improved access to the medicine. To date, this effort to implement a local production strategy has resulted in successful registration of 7.1 % chlorhexidine digluconate for umbilical cord care by manufacturers in Bangladesh, Kenya, Nepal, and Nigeria. Additionally, the product is now available in domestic and export markets.

  9. Guideline for primary care management of headache in adults

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. Quality of evidence A comprehensive search was conducted for relevant guidelines and systematic reviews published between January 2000 and May 2011. The guidelines were critically appraised using the AGREE (Appraisal of Guidelines for Research and Evaluation) tool, and the 6 highest-quality guidelines were used as seed guidelines for the guideline adaptation process. Main message A multidisciplinary guideline development group of primary care providers and other specialists crafted 91 specific recommendations using a consensus process. The recommendations cover diagnosis, investigation, and management of migraine, tension-type, medication-overuse, and cluster headache. Conclusion A clinical practice guideline for the Canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidence-informed care for patients with headache. PMID:26273080

  10. Vascular access for hemodialysis: arteriovenous fistula.

    PubMed

    Malovrh, Marko

    2005-06-01

    The long-term survival and quality of life of patients on hemodialysis (HD) is dependant on the adequacy of dialysis via an appropriately placed vascular access. The optimal vascular access is unquestionably the autologous arteriovenous fistula (AVF), with the most common method being the conventional radio-cephalic fistula at the wrist. Recent clinical practice guidelines recommend the creation of native fistula or synthetic graft before the start of chronic HD therapy to prevent the need for complication-prone dialysis catheters. This could also have a beneficial effect on the rapidity of worsening kidney failure. A multidisciplinary approach (nephrologists, surgeons, radiologists and nurses) should improve the HD outcome by promoting the use of AVF. An important additional component of this program is the Doppler ultrasound for preoperative vascular mapping. Such an approach may be realized without unsuccessful surgical explorations, with a minimal early failure rate and a high maturation, even in patients with diabetes mellitus.

  11. Current clinical practice guidelines in atrial fibrillation: a review.

    PubMed

    Galvez-Olortegui, José Kelvin; Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, Tomas Vladimir; Godoy-Palomino, Armando; Camacho-Saavedra, Luis

    2016-01-14

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in atrial fibrillation. This is the second in a series of articles of review, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Among all clinical practice guidelines, we selected the American, Canadian and NICE (National Institute for Health and Care Excellence) guidelines. We used the AGREE (Appraisal of Guidelines for Research and Evaluation) II instrument for the assessment. In general, the guidelines obtained the lowest score in the applicability domain (mean 36.1%); while the highest score was for clarity of presentation (mean 93.5%). The lowest percentage was found in the editorial independence domain (Canadian guideline) and the highest of all scores in the applicability domain (NICE guideline). Regarding global quality, the NICE guideline obtained the AGREE II instrument best scores, followed by the American guideline, both recommended for use without modifications.

  12. Access and utilisation of healthcare services in rural Tanzania: A comparison of public and non-public facilities using quality, equity, and trust dimensions.

    PubMed

    Shayo, Elizabeth H; Senkoro, Kesheni P; Momburi, Romanus; Olsen, Øystein E; Byskov, Jens; Makundi, Emmanuel A; Kamuzora, Peter; Mboera, Leonard E G

    2016-01-01

    This study compared the access and utilisation of health services in public and non-public health facilities in terms of quality, equity and trust in the Mbarali district, Tanzania. Interviews, focus group discussions, and informal discussions were used to generate data. Of the 1836 respondents, 1157 and 679 respondents sought healthcare services on their last visit at public or non-public health facilities, respectively. While 45.5% rated the quality of services to be good in both types of facilities, reported medicine shortages were more pronounced among those who visited public rather than non-public health facilities (OR = 1.7, 95% CI 1.4, 2.1). Respondents who visited public facilities were 4.9 times less likely than those who visited non-public facilities to emphasise the influence of cost in accessing and utilising health care (OR = 4.9, CI 3.9-6.1). A significant difference was also found in the provider-client relationship satisfaction level between non-public (89.1%) and public facilities (74.7%) (OR = 2.8, CI: 1.5-5.0), indicating a level of lower trust in the later. Revised strategies are needed to ensure availability of medicines in public facilities, which are used by the majority of the population, while strengthening private-public partnerships to harmonise healthcare costs.

  13. Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions.

    PubMed

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire

    2014-10-01

    This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with Special Health Care Needs was utilized to examine the association between child's special needs condition and three outcomes (N = 18,136): access to services (difficulty using services, difficulty getting referrals, lack of source of care, and inadequate insurance coverage), quality of care (lack of care coordination, lack of shared decision making, and no routine screening), and family impact (financial, employment, and time-related burden). Multivariate logistic regressions were performed to compare caregivers of children with autism spectrum disorders to caregivers of children with developmental disabilities (cerebral palsy, Down syndrome, developmental delay, or intellectual disability), mental health conditions (attention deficit hyperactivity disorder, anxiety, behavioral/conduct problems, or depression), or both developmental disabilities and mental health conditions. Caregivers of children with autism spectrum disorders were significantly more likely to report difficulty using services, lack of source of care, inadequate insurance coverage, lack of shared decision making and care coordination, and adverse family impact as compared to caregivers of children with developmental disabilities, mental health conditions, or both.

  14. Promoting Access to Quality Child Care: Critical Steps in Conducting Market Rate Surveys and Establishing Rate Policies.

    ERIC Educational Resources Information Center

    Stoney, Louise

    This report is designed to help policymakers, child care providers, and advocates establish child care rate support policies that support high quality in the context of government-subsidized, privately-provided child care. It also provides advice on the development and interpretation of market rate surveys of local child care fees. Part 1…

  15. Toward a Model of Influence in Persuasive Discussions: Negotiating Quality, Authority, Privilege, and Access within a Student-Led Argument

    ERIC Educational Resources Information Center

    Engle, Randi A.; Langer-Osuna, Jennifer M.; McKinney de Royston, Maxine

    2014-01-01

    It is commonly observed that during classroom or group discussions some students have greater influence than may be justified by the normative quality of those students' contributions. We propose a 5-component theoretical framework in order to explain how undue influence unfolds. We build on literatures on persuasion, argumentation, discourse, and…

  16. Analyzing Accessibility Dimension of Urban Quality of Life: Where Urban Designers Face Duality between Subjective and Objective Reading of Place

    ERIC Educational Resources Information Center

    Lotfi, Sedigheh; Koohsari, M. J.

    2009-01-01

    The subject of urban quality of life and the promotion of its concept in particular, has always been the central focus of urban designers. This term is a multi-conceptual and dimensions. However most of the scholars have agreed that the concept consisted from two main dimensions; objective and subjective which these two approaches are used for its…

  17. Results for Learning Report 2012: Fostering Evidence-Based Dialogue to Monitor Access and Quality in Education

    ERIC Educational Resources Information Center

    Cortese, Lauren; Crouch, Luis; Pinto, Nancy; Salgado, Vania; Schmidt, Caroline; Soman, Kouassi; Thiam, Mamadou; Chaluda, Ania; Omoeva, Carina

    2012-01-01

    The Global Partnership for Education (GPE) works with low-income countries around the world to help them provide basic education of good quality to all of their children. Countries develop education sector plans that set clear targets and commitments; their partners including donors, multilateral agencies, civil society and the private sector…

  18. Expanding access to high-quality plain-language patient education information through context-specific hyperlinks

    PubMed Central

    Ancker, Jessica S.; Mauer, Elizabeth; Hauser, Diane; Calman, Neil

    2016-01-01

    Medical records, which are increasingly directly accessible to patients, contain highly technical terms unfamiliar to many patients. A federally qualified health center (FQHC) sought to help patients interpret their records by embedding context-specific hyperlinks to plain-language patient education materials in its portal. We assessed the impact of this innovation through a 3-year retrospective cohort study. A total of 12,877 (10% of all patients) in this safety net population had used the MPC links. Black patients, Latino patients comfortable using English, and patients covered by Medicaid were more likely to use the informational hyperlinks than other patients. The positive association with black race and Latino ethnicity remained statistically significant in multivariable models that controlled for insurance type. We conclude that many of the sociodemographic factors associated with the digital divide do not present barriers to accessing context-specific patient education information once in the portal. In fact, this type of highly convenient plain-language patient education may provide particular value to patients in traditionally disadvantaged groups. PMID:28269821

  19. Expanding access to high-quality plain-language patient education information through context-specific hyperlinks.

    PubMed

    Ancker, Jessica S; Mauer, Elizabeth; Hauser, Diane; Calman, Neil

    2016-01-01

    Medical records, which are increasingly directly accessible to patients, contain highly technical terms unfamiliar to many patients. A federally qualified health center (FQHC) sought to help patients interpret their records by embedding context-specific hyperlinks to plain-language patient education materials in its portal. We assessed the impact of this innovation through a 3-year retrospective cohort study. A total of 12,877 (10% of all patients) in this safety net population had used the MPC links. Black patients, Latino patients comfortable using English, and patients covered by Medicaid were more likely to use the informational hyperlinks than other patients. The positive association with black race and Latino ethnicity remained statistically significant in multivariable models that controlled for insurance type. We conclude that many of the sociodemographic factors associated with the digital divide do not present barriers to accessing context-specific patient education information once in the portal. In fact, this type of highly convenient plain-language patient education may provide particular value to patients in traditionally disadvantaged groups.

  20. Guidelines for identifying suspect/counterfeit material

    SciTech Connect

    1995-09-01

    These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.