Science.gov

Sample records for accessibility quality guidelines

  1. 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 ...

  2. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Accessibility guidelines. 1191.1 Section 1191.1 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR BUILDINGS AND FACILITIES; ARCHITECTURAL BARRIERS ACT...

  3. 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.

  4. 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...

  5. Accessibility

    MedlinePlus

    ... www.nlm.nih.gov/medlineplus/accessibility.html MedlinePlus Accessibility To use the sharing features on this page, ... Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for EHRs ...

  6. Accessible Website Content Guidelines for Users with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Karreman, Joyce; van der Geest, Thea; Buursink, Esmee

    2007-01-01

    Background: The W3C Web Accessibility Initiative has issued guidelines for making websites better and easier to access for people with various disabilities (W3C Web Accessibility Initiative guidelines 1999). Method: The usability of two versions of a website (a non-adapted site and a site that was adapted on the basis of easy-to-read guidelines)…

  7. 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…

  8. 75 FR 51750 - Accessibility Guidelines for Shared Use Paths

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD Accessibility Guidelines for Shared Use Paths AGENCY: Architectural and... plans to develop new accessibility guidelines specific to shared use paths (SUPs) designed for use by... shared use paths, and those with expertise in this area to provide information to assist the Access...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... with the Fair Housing Act. The Guidelines may be found in the 24 CFR Chapter I, Subchapter A, Appendix... Guidelines. 200.929a Section 200.929a Housing and Urban Development Regulations Relating to Housing and Urban... Fair Housing Accessibility Guidelines. Builders and developers may use the Department's Fair...

  10. 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.

  11. 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…

  12. 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.

  13. 78 FR 38101 - Passenger Vessels Accessibility Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    .... See 69 FR 69244 and 69245, November 26, 2004. The ANPRM requested comment on whether and how to... guidelines for comment. See 71 FR 38563, July 7, 2006. We received more than 175 comments on the 2006...

  14. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... with the Fair Housing Act. The Guidelines may be found in the 24 CFR Chapter I, Subchapter A, Appendix... 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...

  15. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... with the Fair Housing Act. The Guidelines may be found in the 24 CFR Chapter I, Subchapter A, Appendix... 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...

  16. 24 CFR 200.929a - Fair Housing Accessibility Guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... with the Fair Housing Act. The Guidelines may be found in the 24 CFR Chapter I, Subchapter A, Appendix... 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...

  17. 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 ...

  18. [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 PMID:15083969

  19. 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.

  20. 78 FR 49248 - Passenger Vessels Accessibility Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... additional time to submit comments. DATES: For the proposed rule published June 25, 2013 (78 FR 38102... passengers with disabilities. See 78 FR 38102, June 25, 2013. In that notice, the Access Board requested... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1196 RIN 3014-AA11 Passenger Vessels...

  1. QUALITY ASSURANCE GUIDELINES FOR ENVIRONMENTAL HEALTH RESEARCH

    EPA Science Inventory

    This document provides conceptual guidelines for the development, implementation and evaluation of research task quality assurance plans for the staff of the Health Effects Research Laboratory (HERL/RTP) of the U.S. Environmental Protection Agency, Research Triangle Park, North C...

  2. 76 FR 77738 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... information technology covered by Section 508 of the Rehabilitation Act Amendments of 1998. 76 FR 76640... Accessibility Guidelines; Electronic and Information Technology Accessibility Standards AGENCY: Architectural... Guidelines and its Electronic and Information Technology Accessibility Standards. DATES: The hearings will...

  3. Guidelines on the use of ultrasound guidance for vascular access.

    PubMed

    Bouaziz, Hervé; Zetlaoui, Paul J; Pierre, Sébastien; Desruennes, Eric; Fritsch, Nicolas; Jochum, Denis; Lapostolle, Frédéric; Pirotte, Thierry; Villiers, Stéphane

    2015-02-01

    Insertion of vascular access is a common procedure with potential for iatrogenic events, some of which can be serious. The spread of ultrasound scanners in operating rooms, intensive care units and emergency departments has made ultrasound-guided catheterisation possible. The first guidelines were published a decade ago but are not always followed in France. The French Society of Anaesthesia and Intensive Care has decided to adopt a position on this issue through its Guidelines Committee in order to propose a limited number of simple guidelines. The method used was the GRADE(®) method using the most recently published meta-analyses as the source of references. The level of evidence found ranged from low to high and all the positive aspects associated with ultrasound guidance, i.e. fewer traumatic complications at puncture, probably or definitely outweigh the potential adverse consequences regardless of whether an adult or child is involved and regardless of the site of insertion. PMID:25829319

  4. 75 FR 16088 - Proposed Information Quality Guidelines Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... Disseminated by Federal Agencies, 67 FR 8452 (``OMB Guidelines''). The EAC developed the Proposed Information... 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....

  5. 76 FR 8753 - Final Information Quality Guidelines Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... Federal Agencies'' 67 FR 8452 (Feb. 22, 2002). The guidelines are not intended to be, and should not be... 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...

  6. 75 FR 37819 - Proposed Information Quality Guidelines Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ..., Objectivity, Utility, and Integrity of the Information Disseminated by Federal Agencies'' 67 FR 8452 (Feb. 22... 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...

  7. 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.

  8. [Guidelines in surgery: from the viewpoint of quality assurance].

    PubMed

    Ekkernkamp, A

    1997-01-01

    The German Society for Surgery takes the AWMF's instructions to create effective guidelines very seriously. International criteria for guidelines are fully accepted, for example, the guidelines for thrombosis prophylaxis. The guide plays a very important part in overall quality management, but it cannot replace further precautions like risk management, second opinions, or external quality control. Despite forensic problems, patients are definitely entitled to diagnostic and therapeutic guidelines. PMID:9574103

  9. Improving access to cancer guidelines: feedback from health care professionals

    PubMed Central

    Sahota, I.S.; Kostaras, X.; Hagen, N.A.

    2015-01-01

    Purpose We examined access to locally developed and other available clinical practice guidelines (cpgs) for the management of cancer and evaluated how to improve uptake. Methods A 12-question online survey was administered to 772 members of 12 multidisciplinary tumour teams in a Canadian provincial oncology program. The teams are composed of physicians, surgeons, nurses, allied health professionals, and researchers involved in the provision of cancer care across the province. Many of these individuals construct or provide input into the provincial cpgs. The questionnaires were administered online and were completed voluntarily. Results Responses were received from 232 individuals, a response rate of 30.1%. Most respondents (75.1%) indicated they actively referenced cpgs for cancer treatment. Of the 177 respondents who identified barriers to cpg access, 24.9% said that the cause was being too busy; 24.3% and 22.6% cited the user-unfriendliness of the Web site and a lack of awareness about the cpgs. When asked about innovative changes that could be made to improve access, the creation of cpg summary documents was identified as the most effective change (46.3%). The creation of summary documents was ranked highest by physicians, surgeons, and nurses. Conclusions Clinical practice guidelines are important tools for standardizing treatment protocols and improving outcomes in health care systems, but support for their use is variable among health care professionals. We have identified barriers to—and potential mitigating strategies for—more widespread access to cpgs by the various health professions involved in cancer care. Local creation of succinct and easily accessible cpgs was identified as the single most effective way to enhance access by health care professionals. PMID:26715871

  10. Accessing Quality Online Health Information: What Is the Solution?

    PubMed

    Boyer, Célia

    2016-01-01

    The majority of the adult population in both Europe and North America have access to the internet. Over 70% state that they have used the internet to look for health information and the majority started their search at a search engine. Given that search engines list sites according to popularity and not quality, it is imperative that users have a means of discerning trustworthy and honest information from non-reliable health information. The HONcode, a set of eight quality guidelines, ensures access to standardized trustworthy health information which can be used as a tool to guide consumers. PMID:27332317

  11. 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

  12. QUALITY ASSURANCE GUIDELINES FOR IERL-CI PROJECT OFFICERS

    EPA Science Inventory

    The document provides guidelines to Industrial Environmental Research Laboratory-Cincinnati (IERL-Ci) Project Officers for (1) incorporating quality assurance (QA) criteria in contract procurement and grant awards; (2) monitoring quality assurance of extramural projects; and (3) ...

  13. Quality Appraisal of Clinical Practice Guidelines on Pancreatic Cancer

    PubMed Central

    He, Zhiyun; Tian, Hongliang; Song, Ailin; Jin, Lan; Zhou, Xiaona; Liu, Xiaoye; Guo, Wei; Zhang, Zhongtao

    2015-01-01

    Abstract Clinical practice guidelines (CPGs) play an important role in health care. The guideline development process should be precise and rigorous to ensure that the results are reproducible and not vague. To determine the quality of guidelines, the Appraisal of Guidelines and Research and Evaluation (AGREE) instrument was developed and introduced. The objective of this study is to assess the methodological quality of CPGs on pancreatic cancer. Five databases (included MEDLINE and EMBASE) and guideline websites were searched till April, 2014. The methodological quality of the guidelines was assessed by 4 authors independently using the AGREE II instrument. From 2526 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (intraclass correlation coefficient = 0.86, 95% confidence interval 0.64–0.96). The mean scores were moderate for the domains “scope and purpose” and “clarity of presentation”; however, they were low for the domains “stakeholder involvement” (31.22), “rigor of development”, “applicability”, and “editorial independence”. These domain scores were lower when compared with international levels. There are 5 (23.81%) guidelines that described the systematic methods for searching. Moreover, only 5 (23.81%) guidelines reported that methodological expertise were included in the guideline developing teams. The quality and transparency of the development process and the consistency in the reporting of pancreatic cancer guidelines need to be improved. Many other methodological disadvantages were identified. In the future, pancreatic cancer CPGs should base on the best available evidence rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision making in this field. PMID:25816030

  14. 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…

  15. Quality assurance and risk reduction guidelines.

    PubMed

    Mody, D R; Davey, D D; Branca, M; Raab, S S; Schenck, U G; Stanley, M W; Wright, R G; Arbyn, M; Beccati, D; Bishop, J W; Collaço, L M; Cramer, S F; Fitzgerald, P; Heinrich, J; Jhala, N C; Montanari, G; Kapila, K; Naryshkin, S; Suprun, H Z

    2000-01-01

    Cervical cancer continues to be a major cause of death in women worldwide. The major problem facing most women is the unavailability of screening Pap tests in poor and underdeveloped countries. While rates of cancer deaths have decreased 60-80% in developed countries since the Pap test became available, the accuracy of Paps was challenged recently. In order to instill public confidence and promote optimal patient care, measures to improve the quality of the entire screening process should be undertaken. Continuous quality improvement processes are more appropriate than traditional quality assurance monitors. Although no standards can be defined that are applicable to all laboratory settings and nations, this document provides current views on universal quality procedures and risk reduction. Procedure/policy manuals, workload assessment, hierarchic/peer review, discrepancy analysis, rescreening studies and cytohistologic correlation are examples of universally applicable quality tools. The variability in practices in different parts of the world is also discussed. PMID:10934940

  16. 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. PMID:26378052

  17. ADAAG Manual: A Guide to the Americans with Disabilities Act Accessibility Guidelines.

    ERIC Educational Resources Information Center

    Architectural and Transportation Barriers Compliance Board, Washington, DC.

    The Access Board of the Architectural and Transportation Barriers Compliance Board has issued this guide to assist in the use of its American with Disabilities Act Accessibility Guidelines (ADAAG) for buildings and facilities. It explains some of the basic considerations for accessible design and clarifies specific ADAAG provisions. Advisory…

  18. 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…

  19. 76 FR 44663 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ...The Architectural and Transportation Barriers Compliance Board is proposing accessibility guidelines for the design, construction, and alteration of pedestrian facilities in the public right-of-way. The guidelines ensure that sidewalks, pedestrian street crossings, pedestrian signals, and other facilities for pedestrian circulation and use constructed or altered in the public right-of-way by......

  20. 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…

  1. Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey

    PubMed Central

    Yaşar, Ilknur; Kahveci, Rabia; Baydar Artantaş, Aylin; Ayhan Başer, Duygu; Gökşin Cihan, Fatma; Şencan, Irfan; Koç, Esra Meltem; Özkara, Adem

    2016-01-01

    Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. Aim This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. Methodology Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the “Statistical Yearbook of Turkey 2012” were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. Findings 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; Scope and purpose: 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. Conclusion This is the first

  2. Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines

    PubMed Central

    Jones, Roger; Hunt, Claire; Stevens, Richard; Dalrymple, Jamie; Driscoll, Richard; Sleet, Sarah; Smith, Jonathan Blanchard

    2009-01-01

    Background Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management. Aim To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome. Design of study Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition. Setting Community-based practice in England, UK. Methods Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines. Results A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease. Conclusion This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions. PMID:19520018

  3. Guideline on air-quality models (revised). Supplement A

    SciTech Connect

    Not Available

    1987-07-01

    This guideline recommends air quality modeling techniques that may be applied to air-pollution-control strategy evaluations and new source reviews, including prevention of significant deterioration. It is intended for use by EPA Regional Offices in judging the adequacy of modeling analyses performed by EPA, by State and local agencies, and by industry and its consultants. It also identifies modeling techniques and data bases that EPA considers acceptable. The guideline makes specific recommendations concerning air-quality models, data bases, and general requirements for concentration estimates. This is Supplement A to the guideline. It contains: (1) addition of a specific version of the Rough Terrain Diffusion Model (RTDM) as a screening model; (2) modification of the downwash algorithm in the Industrial Source Complex (ISC) model; (3) addition of the Offshore and Coastal Dispersion (OCD) model to Appendix A; and, (4) addition of the AVACTA II model to Appendix B.

  4. 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…

  5. USING SEDIMENT QUALITY GUIDELINES IN DREDGED MATERIAL ASSESSMENTS

    EPA Science Inventory

    Sediment quality guidelines (SQGs) are not formally included in the frameworks described in the Inland Testing manual and the Green Book because these frameworks are biologically based. The SQGs are often used informally, however, to help put the results of biological testing in ...

  6. Housing Adaptability Guidelines: A Concept to Make All Housing Accessible.

    ERIC Educational Resources Information Center

    Peoples Housing, Inc., Topanga, CA.

    Specifications for making adaptable dwelling units, minimally accessible designs which can later be inexpensively remodeled for the disabled, are presented. Advantages to providing many adaptable units rather than a few accessible ones are outlined, including eliminating the marketing problem, providing a disabled person with a wider choice of…

  7. 75 FR 43747 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... accessible transit vehicles,'' 32 Medical Engineering & Physics 230-236 (2010). T303.8.1 simplifies the...., buses characterized by an elevated passenger deck located over a baggage compartment). 56 FR 45530, September 6, 1991; 63 FR 51694, September 28, 1998. The Access Board's transportation vehicle guidelines...

  8. 76 FR 45481 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ... site at: http://www.access-board.gov/prowac/nprm.htm . Correction In the proposed rule FR Doc. 2011... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1190 RIN 3014-AA26 Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way AGENCY: Architectural and Transportation Barriers Compliance...

  9. 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.

  10. 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

    ... (76 FR 44664). In that notice, the Access Board proposed guidelines for accessible public rights-of... 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:...

  11. Survive On Call - A QI Project to Improve Access to Hospital Clinical Guidelines.

    PubMed

    Penders, Robert; Mallet, Mark

    2016-01-01

    Accessing clinical guidelines and telephone numbers can be time consuming for junior doctors, particularly during a busy on-call shift. Smartphones allow instant access to this information, without leaving a patient's bedside. This overcomes the relative paucity of fixed desktop computers available in most clinical areas. In this project, a trainee doctor developed a clinical smartphone app to improve the access of clinical and hospital-specific information. A representative sample of ten junior doctors were recruited to quantify the amount of time spent accessing guidelines using desktop computers, versus the App. The average time to access a common guideline (Hypokalaemia management) with the App was 12.4 seconds (95% CI 2.3), versus 76.8 seconds (95% CI 30.6) using a computer. A difference of 64.4 seconds (p < 0.001). The average time to access an Amiodarone prescribing guideline with the App was 25.9 seconds (95% CI 12.9), versus 142.0 seconds (95% CI 44.8) using a computer. A difference of 116.1 seconds (p < 0.001). User feedback was collected after each stage of release within the hospital. Following final release, users rated how much time they felt it saved them. 96.1% of respondents felt it either saved them time a 'few times a week' (53.85%) or 'significantly saved time every day' (42.31%). The project has significantly improved staff satisfaction with how easily they can access clinical guidelines and telephone numbers. They clearly feel it has improved their working efficiency. This has been supported by quantitative measures of actual time saved using the App. The ability to access such information in as little time as possible may be even more pertinent where decision-making is time-critical - for example in Anaesthesia and Emergency Medicine. Further study into these specialties is warranted to determine whether mobile information can impact upon patient safety and clinical outcomes. PMID:27239310

  12. Changing health care quality paradigms: the rise of clinical guidelines and quality measures in American medicine.

    PubMed

    Nigam, Amit

    2012-12-01

    Clinical guidelines and quality measures are important new paradigms for conceptualizing and managing quality in the United States. Researchers have proposed that professional elites-including members of academic medicine-were an important cause of the shift to guidelines and measures. This paper draws on content analysis of abstracts focused on quality in major American medical journals between 1975 and 2009 to empirically assess whether and how paradigms for managing quality changed in academic medicine. The content analysis shows that guidelines- and measures-based approaches to quality increased in prominence. Individual expertise-based approaches to quality, however, remain important. Concurrent with changing paradigms in academic medicine, there was a reorientation of policy toward increased use of guidelines and measures the late 1980s and early 1990s in the United States. This policy reorientation was informed by earlier work by medical researchers proposing new approaches to quality. The policy reorientation was followed by an increase in the prominence of guidelines and measures in medical research. PMID:22920278

  13. Derivation of water quality guidelines for priority pharmaceuticals.

    PubMed

    Kumar, Anupama; Batley, Graeme E; Nidumolu, Bhanu; Hutchinson, Thomas H

    2016-07-01

    Pharmaceuticals can enter freshwater and affect aquatic ecosystem health. Although toxicity tests have been carried out for the commonly used pharmaceuticals, evidence-based water quality guidelines have not been derived. High-reliability water quality guideline values have been derived for 4 pharmaceuticals-carbamazepine, diclofenac, fluoxetine, and propranolol-in freshwaters using a Burr type III distribution applied to species sensitivity distributions of chronic toxicity data. Data were quality-assured and had to meet acceptability criteria for "chronic" no-observed-effect concentrations or concentrations affecting 10% of species, endpoints of population relevance (namely, effect endpoints based on development, growth, reproduction, and survival). Biomarker response data (e.g., biochemical, histological, or molecular responses) were excluded from the derivation because they are typically not directly relevant to wildlife population-related impacts. The derived guideline values for 95% species protection were 9.2 μg/L, 770 μg/L, 1.6 μg/L, and 14 μg/L for carbamazepine, diclofenac, fluoxetine, and propranolol, respectively. These values are significantly higher than the unknown reliability values derived for the European Commission, Switzerland, or Germany that are based on the application of assessment factors to the most sensitive experimental endpoint (which may include biochemical, histological, or molecular biomarker responses) of a limited data set. The guideline values derived in the present study were not exceeded in recent data for Australian rivers and streams receiving pharmaceutical-containing effluents from wastewater-treatment plants. Environ Toxicol Chem 2016;35:1815-1824. © 2015 SETAC. PMID:26660719

  14. 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

  15. Educational Quality, Access, and Tuition Policy at State Universities.

    ERIC Educational Resources Information Center

    Seneca, Joseph J.; Taussig, Michael K.

    1987-01-01

    A quantitative study of the relationship between educational quality, access, and tuition rates at state universities suggests that these institutions face a trade-off between the goals of improving educational program quality and providing greater access, but that increases in student financial aid can improve access. (MSE)

  16. 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

  17. RAPADAPTE for rapid guideline development: high-quality clinical guidelines can be rapidly developed with limited resources.

    PubMed

    Alper, Brian S; Tristan, Mario; Ramirez-Morera, Anggie; Vreugdenhil, Maria M T; Van Zuuren, Esther J; Fedorowicz, Zbys

    2016-06-01

    Guideline development is challenging, expensive and labor-intensive. A high-quality guideline with 90 recommendations for breast cancer treatment was developed within 6 months with limited resources in Costa Rica. We describe the experience and propose a process others can use and adapt.The ADAPTE method (using existing guidelines to minimize repeating work that has been done) was used but existing guidelines were not current. The method was extended to use databases that systematically identify, appraise and synthesize evidence for clinical application (DynaMed, EBM Guidelines) to provide current evidence searches and critical appraisal of evidence. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the quality of evidence and the strength of recommendations. Draft recommendations with supporting evidence were provided to panel members for facilitated voting to target panel discussion to areas necessary for reaching consensus.Training panelists in guideline development methodology facilitated rapid consensus development. Extending 'guideline adaptation' to 'evidence database adaptation' was highly effective and efficient. Methods were created to simplify mapping DynaMed evidence ratings to GRADE ratings. Twelve steps are presented to facilitate rapid guideline development and enable further adaptation by others.This is a case report and the RAPADAPTE method was retrospectively derived. Prospective replication and validation will support advances for the guideline development community. If guideline development can be accelerated without compromising validity and relevance of the resulting recommendations this would greatly improve our ability to impact clinical care. PMID:27097885

  18. 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.

  19. A Quality of Context-Aware Approach to Access Control in Pervasive Environments

    NASA Astrophysics Data System (ADS)

    Toninelli, Alessandra; Corradi, Antonio; Montanari, Rebecca

    The widespread diffusion of wireless-enabled portable devices creates novel opportunities for users to share resources anywhere and anytime, but makes access control a crucial issue. User/device mobility and heterogeneity, together with network topology and conditions variability, complicate access control and call for novel solutions to dynamically adapt access decisions to the different operating conditions. Several research efforts have emerged in recent years that propose to exploit context-awareness to control access to resources based on context visibility and changes. Context-based access control requires, however, to take into account the quality of context information used to drive access decisions (QoC). Quality of context has in fact a profound impact on the correct behavior of any context-aware access control framework. Using context information with insufficient quality might increase the risk of incorrect access control decisions, thus leading to dangerous security breaches in resource sharing. In this paper we propose a QoC-aware approach to access control for anywhere, anytime resource sharing. The paper describes the design, implementation and evaluation of the Proteus policy framework, which combines two design guidelines to enable dynamic adaptation of policies depending on context changes: context-awareness with QoC guarantees and semantic technologies to allow high-level description of context/policy specification and reasoning about context/policies.

  20. 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

  1. Survive On Call - A QI Project to Improve Access to Hospital Clinical Guidelines

    PubMed Central

    Penders, Robert; Mallet, Mark

    2016-01-01

    Accessing clinical guidelines and telephone numbers can be time consuming for junior doctors, particularly during a busy on-call shift. Smartphones allow instant access to this information, without leaving a patient's bedside. This overcomes the relative paucity of fixed desktop computers available in most clinical areas. In this project, a trainee doctor developed a clinical smartphone app to improve the access of clinical and hospital-specific information. A representative sample of ten junior doctors were recruited to quantify the amount of time spent accessing guidelines using desktop computers, versus the App. The average time to access a common guideline (Hypokalaemia management) with the App was 12.4 seconds (95% CI 2.3), versus 76.8 seconds (95% CI 30.6) using a computer. A difference of 64.4 seconds (p < 0.001). The average time to access an Amiodarone prescribing guideline with the App was 25.9 seconds (95% CI 12.9), versus 142.0 seconds (95% CI 44.8) using a computer. A difference of 116.1 seconds (p < 0.001). User feedback was collected after each stage of release within the hospital. Following final release, users rated how much time they felt it saved them. 96.1% of respondents felt it either saved them time a ‘few times a week’ (53.85%) or ‘significantly saved time every day’ (42.31%). The project has significantly improved staff satisfaction with how easily they can access clinical guidelines and telephone numbers. They clearly feel it has improved their working efficiency. This has been supported by quantitative measures of actual time saved using the App. The ability to access such information in as little time as possible may be even more pertinent where decision-making is time-critical - for example in Anaesthesia and Emergency Medicine. Further study into these specialties is warranted to determine whether mobile information can impact upon patient safety and clinical outcomes. PMID:27239310

  2. 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…

  3. 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

  4. 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…

  5. Guidelines in cardiac clinical practice: evaluation of their methodological quality using the AGREE II instrument

    PubMed Central

    Sabharwal, Sanjeeve; Patel, Vanash; Nijjer, Sukhjinder S; Kirresh, Ali; Darzi, Ara; Chambers, John C; Malik, Iqbal; Kooner, Jaspal S; Athanasiou, Thanos

    2013-01-01

    Although clinical guidelines have an influential role in healthcare practice, their development process and the evidence they cite has been subject to criticism. This study evaluates the quality of guidelines in cardiac clinical practice by examining how they adhere to validated methodological standards in guideline development. A structured review of cardiac clinical practice guidelines published in seven cardiovascular journals between January 2001 and May 2011 was performed. The AGREE II assessment tool was used by two researchers to evaluate guideline quality. A total of 101 guidelines were identified. Assessment of guidelines using AGREE II found methodological quality to be highly variable (median score, 58.70%; range, 45.34–76.40%). ‘Scope and purpose’ (median score, 86.1%) and ‘clarity of development’ (median score, 83.3 %) were the two domains within AGREE II that received the highest scores. Applicability (median score, 20.80%; range, 4.20–54.20%) and editorial independence (median score, 33.30%; range, 0–62.50%) had the lowest scores. There is considerable variability in the quality of cardiac clinical practice guidelines and this has not improved over the last 10 years. Incorporating validated guideline assessment tools, such as AGREE II, may improve the quality of guidelines. PMID:23759888

  6. 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...

  7. 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…

  8. 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. PMID:12850112

  9. 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.

  10. 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.

  11. 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…

  12. European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

    PubMed Central

    von Karsa, L.; Patnick, J.; Segnan, N.; Atkin, W.; Halloran, S.; Lansdorp-Vogelaar, I.; Malila, N.; Minozzi, S.; Moss, S.; Quirke, P.; Steele, R. J.; Vieth, M.; Aabakken, L.; Altenhofen, L.; Ancelle-Park, R.; Antoljak, N.; Anttila, A.; Armaroli, P.; Arrossi, S.; Austoker, J.; Banzi, R.; Bellisario, C.; Blom, J.; Brenner, H.; Bretthauer, M.; Camargo Cancela, M.; Costamagna, G.; Cuzick, J.; Dai, M.; Daniel, J.; Dekker, E.; Delicata, N.; Ducarroz, S.; Erfkamp, H.; Espinàs, J. A.; Faivre, J.; Faulds Wood, L.; Flugelman, A.; Frkovic-Grazio, S.; Geller, B.; Giordano, L.; Grazzini, G.; Green, J.; Hamashima, C.; Herrmann, C.; Hewitson, P.; Hoff, G.; Holten, I.; Jover, R.; Kaminski, M. F.; Kuipers, E. J.; Kurtinaitis, J.; Lambert, R.; Launoy, G.; Lee, W.; Leicester, R.; Leja, M.; Lieberman, D.; Lignini, T.; Lucas, E.; Lynge, E.; Mádai, S.; Marinho, J.; Maučec Zakotnik, J.; Minoli, G.; Monk, C.; Morais, A.; Muwonge, R.; Nadel, M.; Neamtiu, L.; Peris Tuser, M.; Pignone, M.; Pox, C.; Primic-Zakelj, M.; Psaila, J.; Rabeneck, L.; Ransohoff, D.; Rasmussen, M.; Regula, J.; Ren, J.; Rennert, G.; Rey, J.; Riddell, R. H.; Risio, M.; Rodrigues, V.; Saito, H.; Sauvaget, C.; Scharpantgen, A.; Schmiegel, W.; Senore, C.; Siddiqi, M.; Sighoko, D.; Smith, R.; Smith, S.; Suchanek, S.; Suonio, E.; Tong, W.; Törnberg, S.; Van Cutsem, E.; Vignatelli, L.; Villain, P.; Voti, L.; Watanabe, H.; Watson, J.; Winawer, S.; Young, G.; Zaksas, V.; Zappa, M.; Valori, R.

    2015-01-01

    Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. PMID:23212726

  13. Response to open access endoscopy findings by general practitioners guidelines need education for implementation.

    PubMed

    Todd, J A; Zubir, M A; Goudie, B M; Johnston, D A

    2000-04-01

    General practitioners may gain valuable information from the use of open access endoscopy. The benefit to the individual patient depends on the interpretation of the endoscopy findings and the subsequent action. The aim of the study was to determine GPs response to open access endoscopy findings of three conditions with possible malignant complications: Barrett's oesophagus, gastric ulcer and colonic adenomatous polyps. The study took place at Ninewells Hospital, Dundee. Using the endoscopy unit's records for the year, 1 January 1995 to 31 December 1995, all patients having had an open access upper gastro-intestinal endoscopy or sigmoidoscopy were identified. Case-notes were reviewed of patients who had Barrett's oesophagus, gastric ulcer or colonic polyps diagnosed. During the year, 1158 upper gastro-intestinal endoscopies and 293 sigmoidoscopies were performed by the open access service. The referral rates for the conditions were as follows: Barrett's oesophagus 56%; Gastric ulcers 56%; Adenomatous polyps 88%; Non adenomatous polyps 12.5%. The provision of guidelines does not ensure a high referral rate, education is a vital partner. PMID:10862438

  14. Developing Quality Indicators and Auditing Protocols from Formal Guideline Models: Knowledge Representation and Transformations

    PubMed Central

    Advani, Aneel; Goldstein, Mary; Shahar, Yuval; Musen, Mark A.

    2003-01-01

    Automated quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe a model representation and algorithm for deriving structured quality indicators and auditing protocols from formalized specifications of guidelines used in decision support systems. We apply the model and algorithm to the assessment of physician concordance with a guideline knowledge model for hypertension used in a decision-support system. The properties of our solution include the ability to derive automatically (1) context-specific and (2) case-mix-adjusted quality indicators that (3) can model global or local levels of detail about the guideline (4) parameterized by defining the reliability of each indicator or element of the guideline. PMID:14728124

  15. 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…

  16. 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

    ... Animal and Plant Health Inspection Service Draft Guidelines on Biologics Quality Monitoring: Testing for the Detection of Mycoplasma Contamination AGENCY: Animal and Plant Health Inspection Service, USDA... Service under the Virus-Serum-Toxin Act, we are requesting comments on the scope of the guideline and...

  17. Draft Guidelines for State and Areawide Water Quality Management Program Development.

    ERIC Educational Resources Information Center

    Environmental Protection Agency, Washington, DC.

    This document discusses the draft guidelines formulated by the Environmental Protection Agency (EPA) to assist the states in establishing a management program to integrate water quality and other resource management decisions. These guidelines are pfovided so that the long range goals of the Federal Water Pollution Control Act Amendments of 1972…

  18. 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.

  19. The Principal Quality Practice Guideline: Promoting Successful School Leadership in Alberta

    ERIC Educational Resources Information Center

    Alberta Education, 2009

    2009-01-01

    This Principal Quality Practice Guideline (PQPG) represents a first step in a process to develop a framework for quality school leadership in Alberta. It includes a statement on Principal Quality Practice and seven leadership dimensions, with supporting descriptors, reflecting the Alberta context. The PQPG is to be used as a basis for many…

  20. Methods for the guideline-based development of quality indicators--a systematic review

    PubMed Central

    2012-01-01

    Background Quality indicators (QIs) are used in many healthcare settings to measure, compare, and improve quality of care. For the efficient development of high-quality QIs, rigorous, approved, and evidence-based development methods are needed. Clinical practice guidelines are a suitable source to derive QIs from, but no gold standard for guideline-based QI development exists. This review aims to identify, describe, and compare methodological approaches to guideline-based QI development. Methods We systematically searched medical literature databases (Medline, EMBASE, and CINAHL) and grey literature. Two researchers selected publications reporting methodological approaches to guideline-based QI development. In order to describe and compare methodological approaches used in these publications, we extracted detailed information on common steps of guideline-based QI development (topic selection, guideline selection, extraction of recommendations, QI selection, practice test, and implementation) to predesigned extraction tables. Results From 8,697 hits in the database search and several grey literature documents, we selected 48 relevant references. The studies were of heterogeneous type and quality. We found no randomized controlled trial or other studies comparing the ability of different methodological approaches to guideline-based development to generate high-quality QIs. The relevant publications featured a wide variety of methodological approaches to guideline-based QI development, especially regarding guideline selection and extraction of recommendations. Only a few studies reported patient involvement. Conclusions Further research is needed to determine which elements of the methodological approaches identified, described, and compared in this review are best suited to constitute a gold standard for guideline-based QI development. For this research, we provide a comprehensive groundwork. PMID:22436067

  1. 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. PMID:25388929

  2. Guidelines for Selecting Quality K-12 Online Courses

    ERIC Educational Resources Information Center

    Rothschild, Mimi

    2005-01-01

    This article presents guidelines formulated by Learning By Grace, Inc., one of the nation's leading providers of online resources for homeschoolers, and is intended to help home educators navigate the multitude of available choices so that they will be better equipped to select the provider that offers the curriculum and services most suited to…

  3. Breaking Higher Education's Iron Triangle: Access, Cost, and Quality

    ERIC Educational Resources Information Center

    Daniel, John; Kanwar, Asha; Uvalic-Trumbic, Stamenka

    2009-01-01

    The requirements for a model that could allow higher education to expand rapidly in the developing world are that it be readily scalable (wide access), academically credible (high quality) and affordable (low cost). This could be achieved by building higher education networks around credible examination systems run by national or independent…

  4. Technology Access and Quality: The Importance of Public Policy.

    ERIC Educational Resources Information Center

    Camper, Elzar, Jr.; And Others

    1994-01-01

    Educators at all levels should participate in the process of making public policy concerning access to and quality of information technology, particularly in the following areas: strategic planning, telecommunications, regulation, resource allocation and training, technology development, and market determination and standards. (MSE)

  5. Combining relevance assignment with quality of the evidence to support guideline development.

    PubMed

    Fiszman, Marcelo; Bray, Bruce E; Shin, Dongwook; Kilicoglu, Halil; Bennett, Glen C; Bodenreider, Olivier; Rindflesch, Thomas C

    2010-01-01

    Clinical practice guidelines are used to disseminate best practice to clinicians. Successful guidelines depend on literature that is both relevant to the questions posed and based on high quality research in accordance with evidence-based medicine. Meeting these standards requires extensive manual review. We describe a system that combines symbolic semantic processing with a statistical method for selecting both relevant and high quality studies. We focused on a cardiovascular risk factor guideline, and the overall performance of the system was 56% recall, 91% precision (F0.5-score 0.81). If quality of the evidence is not taken into account, performance drops to 62% recall, 79% precision (F0.5-score 0.75). We suggest that this system can potentially improve the efficiency of the literature review process in guideline development. PMID:20841778

  6. 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.

  7. Clinical Practice Guidelines and Consensus Statements in Oncology – An Assessment of Their Methodological Quality

    PubMed Central

    Jacobs, Carmel; Graham, Ian D.; Makarski, Julie; Chassé, Michaël; Fergusson, Dean; Hutton, Brian; Clemons, Mark

    2014-01-01

    Background Consensus statements and clinical practice guidelines are widely available for enhancing the care of cancer patients. Despite subtle differences in their definition and purpose, these terms are often used interchangeably. We systematically assessed the methodological quality of consensus statements and clinical practice guidelines published in three commonly read, geographically diverse, cancer-specific journals. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine’s standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents. Findings Thirty-four consensus statements and 67 clinical practice guidelines were evaluated. The rigour of development score for consensus statements over the three journals was 32% lower than that of clinical practice guidelines. The editorial independence score was 15% lower for consensus statements than clinical practice guidelines. One journal

  8. 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. PMID:26988922

  9. 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

    ... on July 26, 2011. See 76 FR 44664 (July 26, 2011). A copy of the proposed accessibility guidelines... for trails and other outdoor developed areas in 2007. See 72 FR 34074 (June 20, 2007). A trail would... for sidewalks and other pedestrian facilities in the public right-of-way in 2002 and 2005. See 67...

  10. Guidelines for Professional Development of Online Teachers: Based on the SREB "Standards for Quality Online Teaching"

    ERIC Educational Resources Information Center

    Glowa, Elizabeth

    2009-01-01

    Working with member states, SREB developed the nation's first Standards for "Quality Online Teaching," which define the qualifications of a quality online teacher and the standards needed for academic preparation, content knowledge, online skills and delivery. Building on those standards, this report presents extensive guidelines that…

  11. 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…

  12. Guidelines for Professional Development of Online Teachers: Based on the SREB "Standards for Quality Online Teaching"

    ERIC Educational Resources Information Center

    Glowa, Elizabeth

    2009-01-01

    Working with member states, SREB developed the nation's first Standards for "Quality Online Teaching," which define the qualifications of a quality online teacher and the standards needed for academic preparation, content knowledge, online skills and delivery. Building on those standards, this report presents extensive guidelines that can assist…

  13. Developing Local Board of Health Guidelines to Promote Healthy Food Access — King County, Washington, 2010–2012

    PubMed Central

    Johnson, Donna B.; Krieger, James; MacDougall, Erin; Payne, Elizabeth; Chan, Nadine L.

    2015-01-01

    Policies that change environments are important tools for preventing chronic diseases, including obesity. Boards of health often have authority to adopt such policies, but few do so. This study assesses 1) how one local board of health developed a policy approach for healthy food access through vending machine guidelines (rather than regulations) and 2) the impact of the approach. Using a case study design guided by “three streams” policy theory and RE-AIM, we analyzed data from a focus group, interviews, and policy documents. The guidelines effectively supported institutional policy development in several settings. Recognition of the problem of chronic disease and the policy solution of vending machine guidelines created an opening for the board to influence nutrition environments. Institutions identified a need for support in adopting vending machine policies. Communities could benefit from the study board’s approach to using nonregulatory evidence-based guidelines as a policy tool. PMID:25927606

  14. Specific guidelines for assessing and improving the methodological quality of economic evaluations of newborn screening

    PubMed Central

    2012-01-01

    Background Economic evaluation of newborn screening poses specific methodological challenges. Amongst others, these challenges refer to the use of quality adjusted life years (QALYs) in newborns, and which costs and outcomes need to be considered in a full evaluation of newborn screening programmes. Because of the increasing scale and scope of such programmes, a better understanding of the methods of high-quality economic evaluations may be crucial for both producers/authors and consumers/reviewers of newborn screening-related economic evaluations. The aim of this study was therefore to develop specific guidelines designed to assess and improve the methodological quality of economic evaluations in newborn screening. Methods To develop the guidelines, existing guidelines for assessing the quality of economic evaluations were identified through a literature search, and were reviewed and consolidated using a deductive iterative approach. In a subsequent test phase, these guidelines were applied to various economic evaluations which acted as case studies. Results The guidelines for assessing and improving the methodological quality of economic evaluations in newborn screening are organized into 11 categories: “bibliographic details”, “study question and design”, “modelling”, “health outcomes”, “costs”, “discounting”, “presentation of results”, “sensitivity analyses”, “discussion”, “conclusions”, and “commentary”. Conclusions The application of the guidelines highlights important issues regarding newborn screening-related economic evaluations, and underscores the need for such issues to be afforded greater consideration in future economic evaluations. The variety in methodological quality detected by this study reveals the need for specific guidelines on the appropriate methods for conducting sound economic evaluations in newborn screening. PMID:22947299

  15. 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. PMID:24581397

  16. 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...

  17. 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. PMID:25690724

  18. 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

  19. 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…

  20. 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.

  1. Ensuring Access to HIV Prevention Services in South African HIV Vaccine Trials: Correspondence Between Guidelines and Practices

    PubMed Central

    Essack, Zaynab

    2014-01-01

    Researchers and sponsors are required to assist HIV prevention trial participants to remain HIV-uninfected by ensuring access to prevention services. Ethics guidelines require that these HIV risk-reduction services be state of the art. This and related ethics recommendations have been intensely debated. This descriptive study aimed to identify actual HIV prevention practices for two HIV vaccine trials at five South African sites, to explore whether actual practices meet guideline recommendations and to discuss implications for practices and ethics guidelines. Practices were examined through a review of site documents and interviews with site staff and network representatives, as well as community advisory board and research ethics committee representatives. A thematic analysis of HIV prevention practices, perspectives and perceived challenges was undertaken. Findings indicated that there was a high degree of correspondence between actual practices in South African HIV vaccine trials and guideline recommendations. Key challenges for implementing prevention services were identified as partnerships, provider-promotion of services and participant uptake of services. Practices deviated most from guidelines with regard to the description of prevention plans in informed consent forms. Recommendations are made for both practices and ethics guidelines. PMID:25031609

  2. Development of Quality Management Systems for Clinical Practice Guidelines in Korea

    PubMed Central

    Jo, Heui-Sug; Kim, Dong Ik; Chang, Sung-Goo; Shin, Ein-Soon

    2015-01-01

    This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers. PMID:26538997

  3. Development of Quality Management Systems for Clinical Practice Guidelines in Korea.

    PubMed

    Jo, Heui-Sug; Kim, Dong Ik; Chang, Sung-Goo; Shin, Ein-Soon; Oh, Moo-Kyung

    2015-11-01

    This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers. PMID:26538997

  4. QUALITY ASSURANCE GUIDELINES FOR ENVIRONMENTAL HEALTH EFFECTS RESEARCH

    EPA Science Inventory

    This document is a statement of the quality assurance (QA) policy of the Health Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina (HERL-RTP). It describes the HERL-RTP QA organization and the QA responsibilities of both mana...

  5. 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. PMID:25307764

  6. Medical guidelines, physician density, and quality of care: evidence from German SHARE data.

    PubMed

    Jürges, Hendrik; Pohl, Vincent

    2012-10-01

    We use German SHARE data to study the relationship between district general practitioner density and the quality of preventive care provided to older adults. We measure physician quality of care as the degree of adherence to medical guidelines (for the management of risk factors for cardiovascular disease and the prevention of falls) as reported by patients. Contrary to theoretical expectations, we find only weak and insignificant effects of physician density on quality of care. Our results shed doubt on the notion that increasing physician supply will increase the quality of care provided in Germany's present health care system. PMID:22203268

  7. 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...' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.508 Access to quality assurance records and documents within the agency. (a) Access...

  8. 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…

  9. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... clear from the needs expressed by the States and EPA Regional Offices, by many industries and trade... 51—Guideline on Air Quality Models Preface a. Industry and control agencies have long expressed a....0Bibliography 12.0References Appendix A to Appendix W of 40 CFR Part 51—Summaries of Preferred Air...

  10. 40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... clear from the needs expressed by the States and EPA Regional Offices, by many industries and trade... 51—Guideline on Air Quality Models Preface a. Industry and control agencies have long expressed a....0Bibliography 12.0References Appendix A to Appendix W of 40 CFR Part 51—Summaries of Preferred Air...

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... clear from the needs expressed by the States and EPA Regional Offices, by many industries and trade... 51—Guideline on Air Quality Models Preface a. Industry and control agencies have long expressed a....0Bibliography 12.0References Appendix A to Appendix W of 40 CFR Part 51—Summaries of Preferred Air...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... clear from the needs expressed by the States and EPA Regional Offices, by many industries and trade... 51—Guideline on Air Quality Models Preface a. Industry and control agencies have long expressed a....0Bibliography 12.0References Appendix A to Appendix W of 40 CFR Part 51—Summaries of Preferred Air...

  13. 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

    ... FR 8452-8460), pursuant to section 515 of the Treasury and General Government Appropriations Act for... FR 8452-8460) that direct each federal agency to (1) Issue its own guidelines ensuring and maximizing... June 2011 (76 FR 37376) intended to ensure and maximize the quality, objectivity, utility,...

  14. Quality Assurance Guidelines for Superior Vena Cava Stenting in Malignant Disease

    SciTech Connect

    Uberoi, Raman

    2006-06-15

    Superior vena cava stenting for the treatment of malignant superior vena cava obstruction is now well established. It offers simple, rapid, and safe palliation of a distressing and potentially fatal complication of mediastinal malignant disease and compares very favorably with standard therapies such as chemotherapy and radiotherapy. The following are quality assurance guidelines for superior vena cava stenting.

  15. Design guidelines for an umbilical cord blood stem cell therapy quality assessment model

    NASA Astrophysics Data System (ADS)

    Januszewski, Witold S.; Michałek, Krzysztof; Yagensky, Oleksandr; Wardzińska, Marta

    The paper enlists the pivotal guidelines for producing an empirical umbilical cord blood stem cell therapy quality assessment model. The methodology adapted was single equation linear model with domain knowledge derived from MEDAFAR classification. The resulting model is ready for therapeutical application.

  16. 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. ...

  17. 75 FR 13457 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... guidelines periodically. The Board published the guidelines on February 3, 1998. 63 FR 5608 (February 3, 1998... 21, 2000. 65 FR 80500 (December 21, 2000); 36 CFR part 1194. The standards were based on... kiosks. 73 FR 27614 (May 13, 2008). There have also been numerous settlement agreements and...

  18. Critical Appraisal of the Quality of Clinical Practice Guidelines for Stress Ulcer Prophylaxis

    PubMed Central

    Ye, Zhi-Kang; Liu, Ying; Cui, Xiang-Li; Liu, Li-Hong

    2016-01-01

    Background and Objective Inappropriate use of stress ulcer prophylaxis (SUP) is common in many hospitals. High-quality clinical practice guidelines (CPGs) produce better patient outcomes and promote cost-effective clinical care. Thus, the objective of this study was to evaluate the quality of CPGs for SUP. Methods A search was conducted for SUP CPGs using PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature database (CBM), guideline websites and Google (until March 1, 2015). The quality of CPGs was independently assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, and the specific recommendations in the CPGs were summarized and evaluated. Results A total of 7 CPGs for SUP were included. The highest median scores were in the clarity of presentation domain (89%), and the lowest median scores were in the editorial independence domain (0%). The rigor of development, stakeholder involvement, and applicability domains all scored below 40%. The specific recommendations for SUP varied, and the recommendations were inconsistent with the supporting evidence. Conclusions The overall quality of CPGs for SUP was relatively low, and no specific SUP CPG can be recommended. Not only should the AGREE II instrument be used to determine the quality of CPGs, but also the recommendations should be appraised based on supporting evidence, which would contribute to the development of high-quality CPGs. PMID:27152836

  19. 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. PMID:20872898

  20. [Measuring quality in the German Guideline Programme in Oncology (GGPO)—methodology and implementation].

    PubMed

    Nothacker, Monika; Muche-Borowski, Cathleen; Kopp, Ina B

    2014-01-01

    The German Guideline Programme in Oncology (GGPO) is a joint initiative between the German Cancer Society, the Association of the Scientific Medical Societies in Germany and German Cancer Aid. In accordance with the aims of the German National Cancer Plan, the GGPO supports the systematic development of high-quality guidelines. To enhance implementation and evaluation, the suggestion of performance measures (PMs) derived from guideline recommendations following a standardised methodology is obligatory within the GGPO. For this purpose, PM teams are convened representing the multidisciplinary guideline development groups including clinical experts, methodologists and patient representatives as well as those organisations that take an active part in and share responsibility for documentation and quality improvement, i.e., clinical cancer registries, certified cancer centres and, if appropriate, the institution responsible for external quality assurance according to the German Social Code (SGB). The primary selection criteria for PMs include strength of the underlying recommendation (strong, grade A), existing potential for improvement of care and measurability. The premises of data economy and standardised documentation are taken into account. Between May 2008 and July 2014, 12 guidelines with suggestions for 100 PMs have been published. The majority of the suggested performance measures is captured by the specific documentation requirements of the clinical cancer registries and certified cancer centres. This creates a solid basis for an active quality management and re-evaluation of the suggested PMs. In addition, the suspension of measures should be considered if improvement has been achieved on a broad scale and for a longer period in order to concentrate on a quality-oriented, economic documentation. PMID:25523845

  1. 41 CFR 102-79.115 - What guidelines must an agency follow if it elects to establish a public access defibrillation...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... agency follow if it elects to establish a public access defibrillation program in a Federal facility? 102... SPACE Assignment and Utilization of Space Public Access Defibrillation Programs § 102-79.115 What guidelines must an agency follow if it elects to establish a public access defibrillation program in...

  2. 41 CFR 102-79.115 - What guidelines must an agency follow if it elects to establish a public access defibrillation...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... agency follow if it elects to establish a public access defibrillation program in a Federal facility? 102... SPACE Assignment and Utilization of Space Public Access Defibrillation Programs § 102-79.115 What guidelines must an agency follow if it elects to establish a public access defibrillation program in...

  3. 41 CFR 102-79.115 - What guidelines must an agency follow if it elects to establish a public access defibrillation...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... agency follow if it elects to establish a public access defibrillation program in a Federal facility? 102... SPACE Assignment and Utilization of Space Public Access Defibrillation Programs § 102-79.115 What guidelines must an agency follow if it elects to establish a public access defibrillation program in...

  4. 41 CFR 102-79.115 - What guidelines must an agency follow if it elects to establish a public access defibrillation...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... agency follow if it elects to establish a public access defibrillation program in a Federal facility? 102... SPACE Assignment and Utilization of Space Public Access Defibrillation Programs § 102-79.115 What guidelines must an agency follow if it elects to establish a public access defibrillation program in...

  5. Guidelines for Quality Provision in Cross-Border Higher Education: Where Do We Strand? OECD Education Working Papers, No. 70

    ERIC Educational Resources Information Center

    Vincent-Lancrin, Stephan; Pfotenhauer, Sebastian

    2012-01-01

    The "Guidelines for Quality Provision in Cross-Border Higher Education" were developed and adopted to support and encourage international cooperation and enhance the understanding of the importance of quality provision in cross-border higher education. The purposes of the "Guidelines" are to protect students and other stakeholders from low-quality…

  6. Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy

    PubMed Central

    Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dubé, Catherine; Enns, Robert; Hollingworth, Roger; MacIntosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J; Valori, Roland

    2012-01-01

    BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. OBJECTIVE: To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. METHODS: A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. RESULTS: Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. DISCUSSION: The consensus process identified a clear need for high-quality clinical and outcomes research to support quality

  7. 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

  8. 77 FR 50068 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-20

    ... guidelines for buses, over-the-road buses, and vans. See 75 FR 43748, July 26, 2010. The NPRM revised both... meetings are requested to refrain from using perfume, cologne, and other fragrances for the comfort...

  9. Quality through Access, Access with Quality. The New Imperative for Higher Education. First Edition. The Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Bergquist, William H.

    This volume examines the often tense interplay between the objectives of quality and access in U.S. higher education. Part 1 frames the basic premises of the book regarding the environment in which contemporary colleges and universities operate, the need for integration of quality and access in such an environment, the central role played by…

  10. 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.

  11. Guidelines in the Register of the Association of Scientific Medical Societies in Germany – A Quality Improvement Campaign

    PubMed Central

    Nothacker, M. J.; Muche-Borowski, C.; Kopp, I. B.

    2014-01-01

    The Association of Scientific Medical Societies in Germany (AWMF) is the umbrella organization of medical scientific societies in Germany. The development of guidelines goes back to an initiative of the medical scientific societies and is coordinated by the AWMF. Rules for the inclusion of guidelines in the AWMF Guideline Register have been defined including how guidelines are classified. S1 guidelines are based only on recommendations by experts, whereas S2 guidelines require a structured consensus process or a systematic literature review. S3 guidelines include both elements. In addition to compulsory disclosure of any potential conflict of interest, transparent handling of potential conflicts of interest is an important confidence-building measure. For years, the trend has been to develop higher order (S2/S3) guidelines, and the German Society for Gynecology and Obstetrics (DGGG) has been no exception to the trend. In addition to its responsibility for specific S2 and S3 guidelines, the DGGG is also involved in numerous other interdisciplinary guidelines. When developing a guideline, it is essential to define the guidelineʼs scope, identify aspects which require improvement and agree on the goals. Target groups affected by the guidelines should be involved if they are interested. Different formats (long and short versions, practical instructions, conventional or electronic decision aids, patient versions) are useful to disseminate the guideline. The guideline can be adapted to local circumstances to encourage implementation of its recommendations. Implementation can be measured using quality indicators. Feedback from practitioners is important as this highlights areas which require improvement. The medical scientific societies in Germany can look back on almost two decades of work spent on developing guidelines, most of it done by unpaid voluntary contributors, making this a very successful quality initiative. PMID:25061235

  12. Toward ecosystem-based sediment quality guidelines for polychlorinated biphenyls (PCBs).

    PubMed

    Arblaster, Jennifer; Ikonomou, Michael G; Gobas, Frank A P C

    2015-10-01

    To investigate whether Sediment Quality Guidelines (SQGs) for polychlorinated biphenyls (PCBs) in Canada and British Columbia achieve their objective of protecting ecosystems, we measured and compiled concentrations of PCB congeners in sediments, bivalves, crustaceans, fish, and marine mammals from 3 areas off the Pacific coast of British Columbia, Canada. The concentration data showed that whereas PCB concentrations in sediments were predominantly below the SQG of 20 µg/kg dry weight, large fractions of the PCB concentrations in fish and shellfish species exceeded the tissue residue guideline for the consumption of fish and shellfish by wildlife (i.e., 50 µg/kg wet weight [ww]) but were below the tissue residue guideline for the consumption of fish and shellfish by human populations (i.e., 2000 µg/kg ww). Also, PCB concentrations in marine mammals exceeded toxicity reference concentrations. The concentration data were used to develop species- and location-specific Biota-Sediment Accumulation Factors (BSAF = Cbiota /Csediment ), that were used to estimate PCB concentrations in wildlife species that may exist if the PCB concentration in sediments are equal to the SQGs. The results show that if the PCB concentration is equal to the SQGs, then PCB concentrations in most wildlife species can be expected to exceed the tissue residue guideline for the consumption of fish and shellfish by wildlife species and by humans, as well as toxicity reference concentrations for marine mammals. A methodology for developing SQGs for PCBs that are protective of the health of different wildlife species and human consumers of fish and shellfish from general Canadian and coastal First Nations populations was developed and applied. The proposed guidelines may provide useful guidance to establish SQGs for PCBs that can account for the ecological diversity in coastal environments and that better achieve the intent of the guidelines to protect ecosystems. The proposed methodology for

  13. 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

  14. 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

  15. 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. PMID:12617198

  16. 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.

  17. Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda

    PubMed Central

    Kiguli, Julie; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Mutebi, Aloysius; MacGregor, Hayley; Pariyo, George William

    2009-01-01

    This paper examines the community’s perspectives and perceptions on quality of health care delivery in two Uganda districts. The paper addresses community concerns on service quality. It focuses on the poor because they are a vulnerable group and often bear a huge burden of disease. Community views were solicited and obtained using eight focus group discussions, six in-depth and 12 key informant interviews. User perceptions and definitions of the quality of health services depended on a number of variables related to technical competence, accessibility to services, interpersonal relations and presence of adequate drugs, supplies, staff, and facility amenities. Results indicate that service delivery to the poor in the general population is perceived to be of low quality. The factors that were mentioned as affecting the quality of services delivered were inadequate trained health workers, shortage of essential drugs, poor attitude of the health workers, and long distances to health facilities. This paper argues that there should be an improvement in the quality of health services with particular attention being paid to the poor. Despite wide focus on improvement of the existing infrastructure and donor funding, there is still low satisfaction with health services and poor perceived accessibility. PMID:19936148

  18. 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.

  19. Guideline model for the bias-scheme-dependent power consumption of a resistive random access memory crossbar array

    NASA Astrophysics Data System (ADS)

    Sun, Wookyung; Choi, Sujin; Lim, Hyein; Shin, Hyungsoon

    2016-04-01

    The 1/2 and 1/3 bias schemes are commonly used to select a cell in a resistive random access memory (ReRAM) crossbar array. The 1/3 bias scheme is advantageous in terms of its write margin but typically requires a higher power consumption than the 1/2 bias scheme. The power consumption of ReRAM can vary according to the nonlinearity of the selector device. In this paper, we propose a power guideline model that suggests selector nonlinearity requirements to guarantee a lower power consumption for the 1/3 bias scheme than for the 1/2 bias scheme. Therefore, the selector nonlinearity requirements for the low power consumption of the 1/3 bias scheme can be immediately obtained using this guideline model without simulation.

  20. 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. PMID:24320778

  1. Linking water quality guidelines to the natural characteristics of catchments in order to support distinct aquatic ecosystems: Water quality guidelines for suspended particulate matter

    NASA Astrophysics Data System (ADS)

    Bilotta, G. S.; Grove, M. K.; Harrison, C.; Joyce, C. B.; Peacock, C.

    2012-12-01

    The natural characteristics of a catchment provide a template that controls the background rates of geomorphological processes operating within that catchment, which in-turn determines the background physico-chemical and hydro-morphological characteristics of the catchment's surface waters. Large differences in the natural characteristics of catchments (e.g. geology, topography, climate), lead to unique physico-chemical and hydro-morphological conditions that support unique freshwater communities. However, this uniqueness is not always recognised in international water quality guidelines, which often attempt to apply blanket water-quality guidelines to 'protect' a wide range of ecosystems. In this paper we investigate the natural characteristics that control background concentrations of suspended particulate matter (SPM - including nano-scale particles to sand-sized sediments), which is a well-known cause of ecological degradation. At present, the management of SPM is hampered by a lack of understanding of the SPM conditions that water quality managers should aim to achieve in contrasting environments in order to support good ecological status. To address this, in this paper we examine the SPM preferences of contrasting biological communities that are in reference condition (minimal anthropogenic disturbance and high ecological status). We analyse historical SPM data collected on a monthly basis from a wide range of reference-condition temperate environments (638 stream/river sites comprising 42 different biological community-types). This analysis reveals that there are statistically significant differences (One-way ANOVA p < 0.001) between the background SPM concentrations observed in contrasting communities that are in reference condition. Mean background SPM concentrations for contrasting communities ranged from 1.7 to 26.2 mg L-1 (i.e. more than a 15-fold difference). We propose a model for predicting environment-specific water quality guidelines for SPM. In

  2. 78 FR 59475 - Architectural Barriers Act Accessibility Guidelines; Outdoor Developed Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ..., which were published in the Federal Register on July 23, 2004 (69 FR 44151) and are codified in... 69 FR 44151 (July 23, 2004). The guidelines contain scoping and technical requirements. Scoping.... Changes Made to the Proposed Rule We issued a proposed rule in 2007. See 72 FR 34074 (June 20, 2007)....

  3. 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…

  4. 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.

  5. 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' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.508 Access to quality...

  6. 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. PMID:26433290

  7. ASVCP guidelines: quality assurance for portable blood glucose meter (glucometer) use in veterinary medicine.

    PubMed

    Gerber, Karen L; Freeman, Kathleen P

    2016-03-01

    Portable blood glucose meters (PBGM, glucometers) are a convenient, cost effective, and quick means to assess patient blood glucose concentration. The number of commercially available PBGM is constantly increasing, making it challenging to determine whether certain glucometers may have benefits over others for veterinary testing. The challenge in selection of an appropriate glucometer from a quality perspective is compounded by the variety of analytic methods used to quantify glucose concentrations and disparate statistical analysis in many published studies. These guidelines were developed as part of the ASVCP QALS committee response to establish recommendations to improve the quality of testing using point-of-care testing (POCT) handheld and benchtop devices in veterinary medicine. They are intended for clinical pathologists and laboratory professionals to provide them with background knowledge and specific recommendations for quality assurance (QA) and quality control (QC), and to serve as a resource to assist the provision of advice to veterinarians and technicians to improve the quality of results obtained when using PBGM. These guidelines are not intended to be all-inclusive; rather they provide a minimum standard for management of PBGM in the veterinary setting. PMID:26748942

  8. Assessment of the quality of clinical practice guidelines in Korea using the AGREE Instrument.

    PubMed

    Jo, Min-Woo; Lee, Jin Yong; Kim, Nam-Soon; Kim, Soo-Young; Sheen, Seungsoo; Kim, Seon Ha; Lee, Sang-Il

    2013-03-01

    The objective of this study was to conduct the systematic evaluation of methodological quality of clinical practice guidelines (CPGs) in Korea. The authors conducted a very comprehensive literature search to identify potential CPGs for evaluation. CPGs were selected which were consistent with a predetermined criteria. Four reviewers evaluated the quality of the CPGs using the Appraisal of Guidelines, Research and Evaluation (AGREE) Instrument. AGREE item scores and standardized domain scores were calculated. The inter-rater reliability of each domain was evaluated using the intra-class correlation coefficient (ICC). Consequently, 66 CPGs were selected and their quality evaluated. ICCs for CPG appraisal using the AGREE Instrument ranged from 0.626 to 0.877. Except for the "Scope and Purpose" and "Clarity and Presentation domains", 80% of CPGs scored less than 40 in all other domains. This review shows that many Korean research groups and academic societies have made considerable efforts to develop CPGs, and the number of CPGs has increased over time. However, the quality of CPGs in Korea were not good according to the AGREE Instrument evaluation. Therefore, we should make more of an effort to ensure the high quality of CPGs. PMID:23487579

  9. [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. PMID:25759341

  10. Calculation and uses of mean sediment quality guideline quotients: a critical review.

    PubMed

    Long, Edward R; Ingersoll, Christopher G; MacDonald, Donald D

    2006-03-15

    Fine-grained sediments contaminated with complex mixtures of organic and inorganic chemical contaminants can be toxic in laboratory tests and/or cause adverse impacts to resident benthic communities. Effects-based, sediment quality guidelines (SQGs) have been developed over the past 20 years to aid in the interpretation of the relationships between chemical contamination and measures of adverse biological effects. Mean sediment quality guideline quotients (mSQGQ) can be calculated by dividing the concentrations of chemicals in sediments by their respective SQGs and calculating the mean of the quotients for the individual chemicals. The resulting index provides a method of accounting for both the presence and the concentrations of multiple chemicals in sediments relative to their effects-based guidelines. Analyses of considerable amounts of data demonstrated that both the incidence and magnitude of toxicity in laboratory tests and the incidence of impairment to benthic communities increases incrementally with increasing mSQGQs. Such concentration/response relationships provide a basis for estimating toxicological risks to sediment-dwelling organisms associated with exposure to contaminated sediments with a known degree of accuracy. This sediment quality assessment tool has been used in numerous surveys and studies since 1994. Nevertheless, mean SQGQs have some important limitations and underlying assumptions that should be understood by sediment quality assessors. This paper provides an overview of the derivation methods and some of the principal advantages, assumptions, and limitations in the use of this sediment assessmenttool. Ideally, mean SQGQs should be included with other measures including results of toxicity tests and benthic community surveys to provide a weight of evidence when assessing the relative quality of contaminated sediments. PMID:16570590

  11. 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

  12. Quality improvement for neonatal nurses, part II: using a PDSA quality improvement cycle approach to implement an oral feeding progression guideline for premature infants.

    PubMed

    Marcellus, Lenora; Harrison, Adele; Mackinnon, Kathleen

    2012-01-01

    The development of clinical practice guidelines involving multiple health care providers presents a challenge in the neonatal intensive care unit (NICU). Implementation and evaluation of the guideline is as important as the development of the guideline itself. We explored the use of a quality improvement approach in the implementation of a feeding framework. A Plan-Do-Study-Act (PDSA) quality improvement cycle model was used to implement and evaluate a stepwise oral infant feeding guideline with emphasis on parent and care provider satisfaction. Three PDSA cycles were conducted, with each cycle resulting in modifications to use of the framework and development of knowledge translation and parent education techniques and tools. A PDSA cycle approach can be used effectively in guideline implementation and evaluation involving multidisciplinary health care professionals. This is Part II of a two-part series. Part I introduced the concept of quality improvement and tools for advancing practice changes. PMID:22763248

  13. 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. PMID:25471626

  14. BMUS guidelines for the regular quality assurance testing of ultrasound scanners by sonographers

    PubMed Central

    Russell, Stephen; Ward, Barry; Hoskins, Peter

    2013-01-01

    Quality Assurance of ultrasound systems is necessary to ensure the reliability of results and to check for deterioration in performance; a number of bodies have produced guidelines. Testing has traditionally been the responsibility of Medical Physics Departments but the important role of sonographers has been recognised and recent publications have included tests to be performed by ultrasound users. Since there are differences in approach between these publications the BMUS QA Working Party was established to provide a consistent set of guidelines specifically for sonographers. Three levels of testing are recommended, to include infection control and inspections for scanner and probe damage, basic display checks and further tests to assess drop-out, sensitivity and noise. These tests should form part of a programme that includes more comprehensive testing at longer intervals, perhaps by a Medical Physics Department.

  15. 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

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

    PubMed

    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

  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. PMID:24861193

  19. 78 FR 67303 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... document that appeared in the Federal Register of September 26, 2013 (78 FR 59476). The document issued a... (TTY). Email address: board.gov ">raggio@access- board.gov . SUPPLEMENTARY INFORMATION: In FR Doc. 2013-22876 appearing on page 59476 in the Federal Register of Thursday, September 26, 2013 (78 FR 59476),...

  20. 76 FR 76640 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... Information Technology Accessibility Standards (standards) were issued in December 2000, 65 FR 80500 (December... telecommunications equipment and customer premises equipment were issued in February 1998, 63 FR 5608 (February 3...) based on the TEITAC report. The ANPRM was published in the Federal Register in March 2010, 75 FR...

  1. Guidelines on Subject Access to Individual Works of Fiction, Drama, Etc. Second Edition.

    ERIC Educational Resources Information Center

    Aikawa, Hiroko; DeSirey, Jan; Gabel, Linda; Hayes, Susan; Nystrom, Kathy; Wilson, Mary Dabney; Thomas, Pat

    Though the payoffs are significant for reference librarians, readers' advisors, and library users, adding and maintaining subject access for works of imagination--fiction, poetry, and drama, for example--can mean a lot of work for the cataloging department. This new and updated edition is designed to help catalogers and others in the library to:…

  2. 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

  3. 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…

  4. Access to the Archives of United Nations Agencies: A RAMP Study with Guidelines.

    ERIC Educational Resources Information Center

    Ulate-Segura, Bodil

    Prepared under contract with the International Council on Archives (ICA), this study reviews expanded applications of archival research, the growing popular demand for information, and the resultant effect on the role of archives and archivists, especially in terms of access to records. Following an introductory discussion of the concept and role…

  5. 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…

  6. 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.

  7. 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. PMID:25318392

  8. Timely Access to Quality Health Care Among Georgia Children Ages 4 to 17 Years

    PubMed Central

    Ogbuanu, Chinelo; Goodman, David A.; Kahn, Katherine; Long, Cherie; Noggle, Brendan; Bagchi, Suparna; Barradas, Danielle; Castrucci, Brian

    2015-01-01

    We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically under-served area variable, and restricted to Georgia children ages 4–17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). Andersen's behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8 % reported access to higher quality care, 24.8 % reported access to moderate quality care, 22.8 % reported access to lower quality care, and 19.6 % reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15–9.26), and special health care needs (AOR:2.68; 95 % CI 1.42–5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18–0.53) and Hispanic (AOR:0.20; 95 % CI 0.08–0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia. PMID:23054451

  9. 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…

  10. 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…

  11. Quality Matters[TM] Accessibility Survey: Institutional Practices and Policies for Online Courses

    ERIC Educational Resources Information Center

    Frey, Barbara A.; King, Denise K.

    2011-01-01

    Quality Matters (QM) is a professional organization that offers a faculty-centered, peer review process to certify the quality of online and blended courses. The purpose of this white paper is to share the results of a Quality Matters accessibility benchmarking study administered to 84 subscriber institutions. The primary goal of the survey was to…

  12. 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…

  13. 41 CFR 102-79.115 - What guidelines must an agency follow if it elects to establish a public access defibrillation...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What guidelines must an agency follow if it elects to establish a public access defibrillation program in a Federal facility? 102-79.115 Section 102-79.115 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL...

  14. Girls' Education: Community Approaches to Access and Quality. Strong Beginnings.

    ERIC Educational Resources Information Center

    Dowd, Amy Jo; Greer, Heather

    Noting that girls' lack of access to education is related to a number of economic, social, religious, and cultural factors as well as a scarcity of places in schools and that promoting gender equity in school may help equity spread throughout the entire community, this report illustrates the gender equity approach used in the Save the Children's…

  15. 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.

  16. 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

  17. [The clinical guidelines as a potential tool to improving health care quality].

    PubMed

    Constantino-Casas, Patricia; Viniegra-Osorio, Arturo; Medécigo-Micete, Consuelo; del Pilar Torres-Arreola, Laura; Valenzuela-Flores, Adriana

    2009-01-01

    There is an increasing demand to ensure quality in the providing and receiving health care. Health care services face different challenges, such as: a growing aging population, increasing care costs, variations in clinical practice, and a fasting increase in the generation of information on diagnostic methods and therapies. In this context, a wave of development and use of clinical guidelines (CGL) based on scientific evidence has emerged worldwide, with the aim to creating tools to promote clinical excellence in practice. Our country and the Instituto Mexicano del Seguro Social (IMSS), with its experience in developing CGL has joined this trend as a main project. It is beneficial for IMSS health professionals and their patients. The aim of this paper is to present general information on definitions, structure, quality standards, development proceedings, updating, and potential advantages and disadvantages by using CGL. To achieve the expectations of a positive impact on quality and the health care budget distribution, health care personnel must be open to and receptive to the CGL recommendations and be flexible in changing their clinical practice. PMID:19624976

  18. Development and evaluation of consensus-based sediment quality guidelines for freshwater ecosystems

    USGS Publications Warehouse

    MacDonald, D.D.; Ingersoll, C.G.; Berger, T.A.

    2000-01-01

    Numerical sediment quality guidelines (SQGs) for freshwater ecosystems have previously been developed using a variety of approaches. Each approach has certain advantages and limitations which influence their application in the sediment quality assessment process. In an effort to focus on the agreement among these various published SQGs, consensus-based SQGs were developed for 28 chemicals of concern in freshwater sediments (i.e., metals, polycyclic aromatic hydrocarbons, polychlorinated biphenyls, and pesticides). For each contaminant of concern, two SQGs were developed from the published SQGs, including a threshold effect concentration (TEC) and a probable effect concentration (PEC). The resultant SQGs for each chemical were evaluated for reliability using matching sediment chemistry and toxicity data from field studies conducted throughout the United States. The results of this evaluation indicated that most of the TECs (i.e., 21 of 28) provide an accurate basis for predicting the absence of sediment toxicity. Similarly, most of the PECs (i.e., 16 of 28) provide an accurate basis for predicting sediment toxicity. Mean PEC quotients were calculated to evaluate the combined effects of multiple contaminants in sediment. Results of the evaluation indicate that the incidence of toxicity is highly correlated to the mean PEC quotient (R2 = 0.98 for 347 samples). It was concluded that the consensus-based SQGs provide a reliable basis for assessing sediment quality conditions in freshwater ecosystems.

  19. Derivation of South African water quality guidelines for Roundup(®) using species sensitivity distribution.

    PubMed

    Mensah, Paul K; Palmer, Caroline G; Muller, Wilhelmine J

    2013-10-01

    Glyphosate-based herbicides are among the leading products used in South Africa to control weeds and invading alien plant species. Although these herbicides ultimately find their way into aquatic ecosystems, South Africa has no water quality guideline based on indigenous species to protect the country's aquatic biota against these biocides. In this study, South African water quality guidelines (SAWQGs) for Roundup(®) based on species sensitivity distribution (SSD) using indigenous aquatic biota were developed. Short-term and long-term toxicity tests were conducted with eight different aquatic species belonging to five different taxonomic groups. Static non-renewal experimental methods were employed for short-term lethal tests (≤4 days), and static renewal for long-term sublethal tests (≥4 days ≤21 days). LC50 values for animal exposure and EC50 values for algae were calculated using probit analysis and linear regression of transformed herbicide concentration as natural logarithm data against percentage growth inhibition, respectively. No effect concentration (NEC) was determined based on the dynamic energy budget model, using survival data. The LC50, EC50 and NEC values were used to develop species sensitivity distribution (SSD) concentrations for Roundup(®). Based on the SSD concentrations, the short-term and long-term SAWQGs for Roundup(®) were derived as 0.250 (0.106-0.589) mg/L, and 0.002 (0.000-0.021) mg/L, respectively. These WQGs may be useful in protecting South African aquatic life against transient or long-term exposure to glyphosate-based chemicals as part of integrated water resources management. PMID:23856119

  20. [Trends in the quality evaluation of generic products and bioequivalence guidelines].

    PubMed

    Yomota, Chikako

    2012-01-01

    Recent activities on the generic products such as the revision of bioequivalence guidelines, the accomplish of the reevaluation of the oral dosage forms approved before 1995, and the action program for promoting comfortable use of generics issued by MHLW in 2007, were summarized in this review. The bioequivalence guidelines established in 1997 were revised in 2012 based on the discussion in a dissolution working group (WG). The WG were consists of the members from pharmaceutical companies, academia and regulators belonging to MHLW, PMDA and NIHS. In the revision, some flexibility in the dissolution test conditions was achieved considering the many experiences. And also the special Q&A for the combination products was published at the same time. The reevaluation of the oral products since 1997 was completed in 2010, and 1361 dissolution specifications for 4133 oral products were noticed. Through the reevaluation the sufficient similarity in the dissolution profiles between the standards product and the generic products was achieved in the Japanese pharmaceutical market. In the action program to promote the share of generics, the special committee was established in the NIHS to assess the scientific papers that reported the quality concern of the commercial generic products and to confirm the target quality of the products by testing. Many generic products were checked their dissolution profile similarities to the reference products in multimedia dissolution tests and the appropriate similarities were shown in most products. In some preparations, the purity tests were performed and the content of the impurity is confirmed to be in the acceptance range. PMID:23243982

  1. 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.

  2. Comparison of national and regional sediment quality guidelines for classifying sediment toxicity in California.

    PubMed

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

    2012-10-01

    A number of sediment quality guidelines (SQGs) have been developed for relating chemical concentrations in sediment to their potential for effects on benthic macroinvertebrates, but there have been few studies evaluating the relative effectiveness of different SQG approaches. Here we apply 6 empirical SQG approaches to assess how well they predict toxicity in California sediments. Four of the SQG approaches were nationally derived indices that were established in previous studies: effects range median (ERM), logistic regression model (LRM), sediment quality guideline quotient 1 (SQGQ1), and Consensus. Two approaches were variations of nationally derived approaches that were recalibrated to California-specific data (CA LRM and CA ERM). Each SQG approach was applied to a standardized set of matched chemistry and toxicity data for California and an index of the aggregate magnitude of contamination (e.g., mean SQG quotient or maximum probability of toxicity) was calculated. A set of 3 thresholds for classification of the results into 4 categories of predicted toxicity was established for each SQG approach using a statistical optimization procedure. The performance of each SQG approach was evaluated in terms of correlation and categorical classification accuracy. Each SQG index had a significant, but low, correlation with toxicity and was able to correctly classify the level of toxicity for up to 40% of samples. The CA LRM had the best overall performance, but the magnitude of differences in classification accuracy among the SQG approaches was relatively small. Recalibration of the indices using California data improved performance of the LRM, but not the ERM. The LRM approach is more amenable to revision than other national SQGs, which is a desirable attribute for use in programs where the ability to incorporate new information or chemicals of concern is important. The use of a consistent threshold development approach appeared to be a more important factor than type

  3. Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries

    PubMed Central

    Bain, Rob ES; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

    2012-01-01

    Abstract Objective To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Methods Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Findings Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. Conclusion The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement. PMID:22461718

  4. 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

  5. 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. PMID:27162502

  6. 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

  7. 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.

  8. Access to Quality: Common Directions for Uncommon Times.

    ERIC Educational Resources Information Center

    South Dakota Board of Regents, Pierre.

    This report discusses the formulation of a common mission statement by the South Dakota Board of Regents System of state-supported higher education. Twelve directions are identified in light of the system's needs and the state environment in South Dakota. These include: (1) ensuring the quality of undergraduate education; (2) selectively improving…

  9. 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…

  10. 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 of…

  11. 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.

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

    PubMed Central

    Xu, Yan

    2016-01-01

    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. PMID:26839943

  13. 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. PMID:26839943

  14. Evaluation of a practice guideline for the management of respiratory distress syndrome in preterm infants: A quality improvement initiative

    PubMed Central

    Read, Brooke; Lee, David SC; Fraser, Debbie

    2016-01-01

    BACKGROUND: The use of mechanical ventilation to treat respiratory distress syndrome in preterm infants has been associated with the development of bronchopulmonary dysplasia. As part of a quality improvement initiative to reduce the incidence of bronchopulmonary dysplasia in preterm infants, a new practice guideline for the management of respiratory distress syndrome was developed and adopted into practice in a neonatal intensive care unit in February 2012. OBJECTIVE: To evaluate the effects of implementing the new guideline in regard to the use of mechanical ventilation and surfactant, and the incidence of bronchopulmonary dypslasia. METHODS: An historical cohort of very preterm infants (gestational age 260 to 326 weeks) born one year before guideline implementation was compared with a similar cohort of infants born one year following guideline implementation. Data were collected retrospectively from the local neonatal intensive care unit database. RESULTS: A total of 272 preterm infants were included in the study: 129 in the preguideline cohort and 143 in the postguideline cohort. Following the implementation of the guideline, the proportion of infants treated with ongoing mechanical ventilation was reduced from 49% to 26% (P<0.001) and there was a trend toward a reduction in bronchopulmonary dysplasia (27% versus 18%; P=0.07). There was no difference in the proportion of infants treated with surfactant (54% versus 50%). CONCLUSION: The implementation of the practice guideline helped to minimize the use of ongoing mechanical ventilation in preterm infants. PMID:26941562

  15. 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

  16. An implementation framework for GEM encoded guidelines.

    PubMed Central

    Gershkovich, P.; Shiffman, R. N.

    2001-01-01

    Access to timely decision support information is critical for delivery of high-quality medical care. Transformation of clinical knowledge that is originally expressed in the form of a guideline to a computable format is one of the main obstacles to the integration of knowledge sharing functionality into computerized clinical systems. The Guideline Element Model (GEM) provides a methodology for such a transformation. Although the model has been used to store heterogeneous guideline knowledge, it is important to demonstrate that GEM markup facilitates guideline implementation. This report demonstrates the feasibility of implementation of GEM-encoded guideline recommendations using Apache Group s Cocoon Web Publishing Framework. We further demonstrate how XML-based programming allows for maintaining the separation of guideline content from processing logic and from presentation format. Finally, we analyze whether the guideline authors original intent has been sufficiently captured and conveyed to the end user. PMID:11825181

  17. 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

  18. 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.

  19. Guidelines for timely initiation of chemotherapy: a proposed framework for access to medical oncology and haematology cancer clinics and chemotherapy services.

    PubMed

    Alexander, M; Beattie-Manning, R; Blum, R; Byrne, J; Hornby, C; Kearny, C; Love, N; McGlashan, J; McKiernan, S; Milar, J L; Murray, D; Opat, S; Parente, P; Thomas, J; Tweddle, N; Underhill, C; Whitfield, K; Kirsa, S; Rischin, D

    2016-08-01

    These guidelines, informed by the best available evidence and consensus expert opinion, provide a framework to guide the timely initiation of chemotherapy for treating cancer. They sit at the intersection of patient experience, state-of-the-art disease management and rational efficient service provision for these patients at a system level. Internationally, cancer waiting times are routinely measured and publicly reported. In Australia, there are existing policies and guidelines relating to the timeliness of cancer care for surgery and radiation therapy; however, until now, equivalent guidance for chemotherapy was lacking. Timeliness of care should be informed, where available, by evidence for improved patient outcomes. Independent of this, it should be recognised that shorter waiting periods are likely to reduce patient anxiety. While these guidelines were developed as part of a proposed framework for consideration by the Victorian Department of Health, they are clinically relevant to national and international cancer services. They are intended to be used by clinical and administrative staff within cancer services. Adoption of these guidelines, which are for the timely triage, review and treatment of cancer patients receiving systemic chemotherapy, aims to ensure that patients receive care within a timeframe that will maximise health outcomes, and that access to care is consistent and equitable across cancer services. Local monitoring of performance against this guideline will enable cancer service providers to manage proactively future service demand. PMID:27553996

  20. Why do we observe a limited impact of primary care access measures on clinical quality indicators?

    PubMed

    Chung, Sukyung; Panattoni, Laura; Hung, Dorothy; Johns, Nicole; Trujillo, Laurel; Tai-Seale, Ming

    2014-01-01

    The study assessed the effects of enhanced primary care access and continuity on clinical quality in a large, multipayer, multispecialty ambulatory care organization with fee-for-service provider incentives. The difference-in-differences estimates indicate that access to own primary care physician is a statistically significant predictor of improved clinical quality, although the effect size is small such that clinical significance may be negligible. Reduced time for own primary care physician appointment and increased enrollment in electronic personal health record are positive predictors of chronic disease management processes and preventive screening but are inconsistently associated with clinical outcomes. Challenges in identifying relationships between access and quality outcomes in a real-world setting are also discussed. PMID:24594563

  1. 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

  2. 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.

  3. 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

  4. [BQS1 indicators as a monitoring tool for guideline implementation using selected quality indicators in the treatment of patients with breast cancer and femoral neck fractures].

    PubMed

    Schräder, Peter; Reiter, Anne; Boy, Oliver; Fischer, Burkhard; Döbler, Klaus

    2009-01-01

    Successfully implemented clinical guidelines can contribute to improvement in the quality of care. In the context of clinical guidelines, quality indicators play an important role. Quality indicators can contribute to the further development and updating of existing guidelines by analysing their results. In addition, these results support internal and external quality improvement activities and supply information on the implementation status of guideline recommendations giving an impression of the actual quality of care. In this paper the data of the mandatory German performance measurement (specimen radiograph of impalpable breast lesions, preoperative waiting time with femoral neck fracture) were analysed in respect to the extent that guideline recommendations have been implemented in clinical care. We analysed a database of 189,756 and 331,087 patients for the quality indicators 'specimen radiograph' and 'preoperative waiting time', respectively. Depending on the quality of the clinical guideline the results varied. After the publication of this recommendation as part of the German high-quality guideline for neoplasms of the breast in 2004 the proportion of radiographic controls of specimens after breast cancer surgery increased from initially 36% to 84% in 2006, and the variance as a measure of the variability of care decreased considerably. By contrast, the percentage of patients with femoral neck fracture undergoing surgery within 48h did not change noticeably (2003: 19%; 2006: 16%). A German high-quality guideline making a clear recommendation for early surgery does not yet exist. Quality indicators of the German mandatory performance measurement system are suitable for measuring the extent to which guideline recommendations have been implemented and for supporting their (further) development. PMID:19374283

  5. 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.

  6. 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. PMID:23160776

  7. Quality Multiple-Choice Test Questions: Item-Writing Guidelines and an Analysis of Auditing Testbanks.

    ERIC Educational Resources Information Center

    Hansen, James D.; Dexter, Lee

    1997-01-01

    Analysis of test item banks in 10 auditing textbooks found that 75% of questions violated one or more guidelines for multiple-choice items. In comparison, 70% of a certified public accounting exam bank had no violations. (SK)

  8. 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

  9. 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. PMID:26587586

  10. DELIVERING TIMELY WATER QUALITY INFORMATION TO YOUR COMMUNITY. THE LAKE ACCESS-MINNEAPOLIS PROJECT

    EPA Science Inventory

    This report is a summary of the near-real-time water quality-monitoring project conducted by a consortium of interested parties in the greater Minneapolis area. It was funded by an EPA program known as EMPACT (Environmental Monitoring, Public Access, and Community Tracking). In 1...

  11. 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…

  12. 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…

  13. 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…

  14. 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…

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. 417.106 Section 417.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  16. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. 417.106 Section 417.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  17. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. 417.106 Section 417.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  18. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. 417.106 Section 417.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  19. Higher Education Marketplaces: A Comparison of Variety, Access, Dependence, and Quality in 15 Metropolitan Areas.

    ERIC Educational Resources Information Center

    Dluhy, Milan J.; Maidique, Modesto A.

    1993-01-01

    Analysis of 15 U.S. metropolitan areas illustrates that characteristics of higher education in urban marketplaces are diverse. Metropolitan areas of the west and southwest rank highest when variety, access, dependence, and quality are used to assess the marketplaces. Size, region, and strategic economic location explain some of the variations.…

  20. 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…

  1. 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…

  2. The Role of Boards in College Access Programs: Creating and Maintaining Quality

    ERIC Educational Resources Information Center

    Center for Higher Education Policy Analysis, University of Southern California, 2006

    2006-01-01

    Access programs are facing increased scrutiny. Not all programs are equally effective. In an environment in which resources are short, funders increasingly require criteria that enable them to make informed decisions about program quality. As elaborated in this report , one role of a high performance board is to help develop benchmarks of…

  3. Student-generated behavioral guidelines to inform ethical practice: a quality improvement project.

    PubMed

    Wilk, Nancy; Bowllan, Nancy

    2011-01-01

    Nursing faculty members have become increasingly concerned with student incidences of cheating and the associated lack of commitment to ethical conduct. Our faculty believed that actively engaging students in the development of specific behavioral guidelines would result in improved ethical conduct and provide a bridge to future professional ethical practice. The authors discuss the use of focus groups to establish clear behavioral guidelines that align with the American Nurses Association Code of Ethics. PMID:22024685

  4. Primary health-care nurses and Internet health information-seeking: Access, barriers and quality checks.

    PubMed

    Gilmour, Jean; Strong, Alison; Chan, Helen; Hanna, Sue; Huntington, Annette

    2016-02-01

    Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice. PMID:25355072

  5. Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N)*

    PubMed Central

    Ollenschlager, G; Marshall, C; Qureshi, S; Rosenbrand, K; Burgers, J; Makela, M; Slutsky, J; t for

    2004-01-01

    

 Clinical practice guidelines are regarded as powerful tools to achieve effective health care. Although many countries have built up experience in the development, appraisal, and implementation of guidelines, until recently there has been no established forum for collaboration at an international level. As a result, in different countries seeking similar goals and using similar strategies, efforts have been unnecessarily duplicated and opportunities for harmonisation lost because of the lack of a supporting organisational framework. This triggered a proposal in 2001 for an international guidelines network built on existing partnerships. A baseline survey confirmed a strong demand for such an entity. A multinational group of guideline experts initiated the development of a non-profit organisation aimed at promotion of systematic guideline development and implementation. The Guidelines International Network (G-I-N) was founded in November 2002. One year later the Network released the International Guideline Library, a searchable database which now contains more than 2000 guideline resources including published guidelines, guidelines under development, "guidelines for guidelines", training materials, and patient information tools. By June 2004, 52 organisations from 27 countries had joined the network including institutions from Oceania, North America, and Europe, and WHO. This paper describes the process that led to the foundation of the G-I-N, its characteristics, prime activities, and ideas on future projects and collaboration. PMID:15576708

  6. 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

  7. 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

  8. 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., Jr.; 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.

  9. A soil radiological quality guideline value for wildlife-based protection in uranium mine rehabilitation.

    PubMed

    Doering, Che; Bollhöfer, Andreas

    2016-01-01

    A soil guideline value for radiological protection of the environment was determined for the impending rehabilitation of Ranger uranium mine in the wet-dry tropics of northern Australia. The guideline value was 1000 Bq kg(-1) of (226)Ra in the proposed waste rock substrate of the rehabilitated landform and corresponded to an above-baseline dose rate of 100 μGy h(-1) to the most highly exposed individuals of the limiting organism. The limiting organism was reptile based on an assessment using site-specific concentration ratio data. PMID:26350640

  10. 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

    ... 42 Public Health 4 2010-10-01 2010-10-01 false State assurance of access to care and procedures to assure quality and appropriateness of care. 457.495 Section 457.495 Public Health CENTERS FOR MEDICARE... State assurance of access to care and procedures to assure quality and appropriateness of care. A...

  11. The Quality and Accessibility of Primary School Music Education: Provision, Perceptions and Hopes in Six Non-Metropolitan Schools

    ERIC Educational Resources Information Center

    Hardcastle, Adam

    2009-01-01

    The National Review of School Music Education has systematically documented the variations in quality and accessibility of school music education in Australia. Rural and remote schools were found to be particularly vulnerable to relatively poorer quality and accessibility. These findings were not new; they echoed similar observations made by…

  12. 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. PMID:26149322

  13. 32 CFR Appendix H to Part 154 - Adjudicative Guidelines for Determining Eligibility for Access to Classified Information

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Behavior 12. The concern. Sexual behavior that involves a criminal offense indicates a personality or... personality disorder; (c) Sexual behavior that causes an individual to be vulnerable to coercion, exploitation.... Guideline I: Psychological Conditions 27. The concern. Certain emotional, mental, and personality...

  14. 32 CFR Appendix H to Part 154 - Adjudicative Guidelines for Determining Eligibility for Access to Classified Information

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Behavior 12. The concern. Sexual behavior that involves a criminal offense indicates a personality or... personality disorder; (c) Sexual behavior that causes an individual to be vulnerable to coercion, exploitation.... Guideline I: Psychological Conditions 27. The concern. Certain emotional, mental, and personality...

  15. 32 CFR Appendix H to Part 154 - Adjudicative Guidelines for Determining Eligibility for Access to Classified Information

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Behavior 12. The concern. Sexual behavior that involves a criminal offense indicates a personality or... personality disorder; (c) Sexual behavior that causes an individual to be vulnerable to coercion, exploitation.... Guideline I: Psychological Conditions 27. The concern. Certain emotional, mental, and personality...

  16. 32 CFR Appendix H to Part 154 - Adjudicative Guidelines for Determining Eligibility for Access to Classified Information

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Behavior 12. The concern. Sexual behavior that involves a criminal offense indicates a personality or... personality disorder; (c) Sexual behavior that causes an individual to be vulnerable to coercion, exploitation.... Guideline I: Psychological Conditions 27. The concern. Certain emotional, mental, and personality...

  17. 32 CFR Appendix H to Part 154 - Adjudicative Guidelines for Determining Eligibility for Access to Classified Information

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Behavior 12. The concern. Sexual behavior that involves a criminal offense indicates a personality or... personality disorder; (c) Sexual behavior that causes an individual to be vulnerable to coercion, exploitation.... Guideline I: Psychological Conditions 27. The concern. Certain emotional, mental, and personality...

  18. 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.

  19. 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…

  20. 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

    ... Management and Budget (67 FR 8452-8460), pursuant to section 515 of the Treasury and General Government... FR 8452-8460) that direct each federal agency to (1) Issue its own guidelines ensuring and maximizing... releases, archival records, public filings, subpoenas, or adjudicative processes. 3. ``Influential,''...

  1. 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...

  2. 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)

  3. Die another day: the obstacles facing fat people in accessing quality healthcare.

    PubMed

    Pausé, Cat

    2014-01-01

    In this issue of Narrative Inquiries in Bioethics, fat individuals share their healthcare experiences. Through reading the narratives, it becomes clear that access to proper healthcare is often blocked for fat patients by a variety of things, including shame and fat stigma. From physical spaces in which they do not fit, to doctors who diagnose all of their problems as 'fat', similar themes are echoed across the stories. And common are the refrains for better treatment, less shame, and access to evidenced based care from educated providers. In this manuscript, I highlight common themes from the stories and integrate them with themes from the literature. I allow the two dissenting narratives to suggest other ways of thinking about fatness and well-being. And I conclude by suggesting ways to provide better access to quality healthcare for fat individuals. PMID:25130353

  4. 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

  5. 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. PMID:27378034

  6. 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

  7. 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.

  8. Guidelines of the Council on Environmental Quality for the preparation of environmental impact statements.

    PubMed Central

    Willard, B E

    1975-01-01

    Definitions and the seven principles of ecology are listed. NEPA expresses or implies all seven. Section 101 is quoted in illustration. CEQ Guidelines implement Sec. 102(2)(C). The reasons for initial delays in implementation are reviewed; these are now largely resolved. The policy involves action through integrating engineering, economics and ecology. Alternative actions must be considered, and short-term effects weighed against the long-term goals. Twelve modes of approach are advocated. PMID:1157792

  9. [Guidelines and quality assurance in national and international practice in the area of plastic surgery].

    PubMed

    Eisenmann-Klein, M

    1997-01-01

    Multiple quality assurance activities in the German plastic surgery association are outlined, such as the collection of structural data, inspections of units by expert commissions, tracer diagnosis, continuous evaluation of health outcome by patient questionnaire, training programs for residents and a credit point system for congress activities. Interdisciplinary groups are formed for internal quality management within hospitals. EBOPRAS is responsible for accreditation of training centers and the European (Union) Board certification. EQUAM activities aim for quality improvement of biomaterials. Quality management activities within the International Confederation of Plastic, Reconstructive and Aesthetic Surgery concentrate on the definition of minimal requirements for training units and the establishment of a quality management philosophy. PMID:9574120

  10. Improving application of data quality information in accessing and using satellite data

    NASA Astrophysics Data System (ADS)

    Armstrong, E. M.; Huang, T.; Xing, Z.; Khalsa, S. J. S.; Chin, T. M.; Alarcon, C.

    2014-12-01

    A recurring demand in working with satellite-based earth science data records is the need to apply data quality information. Such quality information is often contained within the data files as an array of "flags", but can also be represented by more complex quality descriptions such as combinations of bit flags, or even other ancillary variables indicating thresholds to be applied to the geophysical variable of interest. For example, with Level 2 granules from the Group for High Resolution Sea Surface Temperature (GHRSST) project up to 6 independent variables can be used to screen the sea surface temperature measurements on a pixel-by-pixel basis. Quality screening of Level 3 data from the upcoming Soil Moisture Active Passive (SMAP) instrument can be become even more complex, involving 26 unique bit states or conditions a user can screen for. The application of quality information is often a laborious process until the user understands the implications of all the flags and bit conditions, and requires iterative approaches using custom software. In addition, most visualization packages do not understand how to apply quality information. The Virtual Quality Screening Service, a recently funded 2013 NASA ACCESS project, aims to address these issues and concerns. The project will develop an infrastructure to expose, apply, and extract quality screening information, building off known and proven NASA components for data extraction and subset-by-value, implementations of Map Reduce workflows, data discovery, ontologies and exposure to the user of granule-based quality information. Further sharing of results through well defined URLs and visualization capabilities will also be described. The presentation will focus on overall description of the technologies and informatics principals employed by the project, and recent results and infrastructure status. Examples of implementations of the end-to-end web service for quality screening with GHRSST and SMAP granules will be

  11. 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. ...

  12. Anaesthesia record system on handheld computers--pilot experience and uses for quality control and clinical guidelines.

    PubMed

    Fu, Qiang; Xue, Zhanggang; Zhu, Jie; Fors, Uno; Klein, Gunnar

    2005-02-01

    This paper describes a mobile information system to collect patient information for anesthesia quality control. In this system, a mobile database program was designed for use on handheld computers (Pocket PC). This program is used to collect patient data at the bedside on the handhelds, with a daily synchronization of the data between the anaesthesiologists' handhelds with the anaesthesia database. All collected data are later used for quality control analysis. Furthermore, clinical guidelines will be included on these same handhelds. During the pilot phase, data from a sample set of about 300 patients were incorporated. The processes and interfaces of the system are presented in the paper. The current mobile database system has been designed to replace the original paper-based data collection system. The individual anaesthesiologist's handheld synchronizes patient data daily with anaesthesia database center. This information database is analyzed and used not only to give feedback to the individual doctor or center, but also to review the use of the guidelines provided and the results of their utilization. PMID:15652637

  13. 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

  14. 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.

  15. 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…

  16. Home informatics in healthcare: assessment guidelines to keep up quality of care and avoid adverse effects.

    PubMed

    Roback, Kerstin; Herzog, Almut

    2003-01-01

    Due to an ageing population and improved treatment possibilities, a shortage in hospital beds is a fact in many countries. Home healthcare schemes using information technology (IT) are under development as a response to this and with the intention to produce a more cost-effective care. So far it has been shown that home healthcare is beneficial to certain patient groups. The trend is a widening of the criteria for admission to home healthcare, which means treatment in the home of more severe conditions that otherwise would require in-hospital care. Home informatics has the potential to become a means of providing good care at home. In this process, it is important to consider what new risks will be encountered when placing electronic equipment in the home care environment. Continuous assessment and guidance is important in order to achieve a safe and effective care. Based on a review of current knowledge this paper presents an inventory of risks and adverse events specific to this area. It was found that risks and adverse events could stem from technology in itself, from human-technology interaction conditions or from the environment in which the technology is placed. As a result from the risk inventory, this paper proposes guidelines for the planning and assessment of IT-based hospital-at-home schemes. These assessment guidelines are specifically aimed at performance improvement and thus to be considered a complement to the more general guidelines on telehomecare adopted by the American Telemedicine Association (ATA) in October 2002. PMID:12775936

  17. Examining IV Insulin Practice Guidelines in the Cardiac Surgery Patient: Nurses Evaluating Quality Outcomes.

    PubMed

    Westbrook, Amy; Sherry, Daisy; McDermott, Martha; Gobber, Michele; Pabst, Mary

    2016-01-01

    Recent changes in the Surgical Care Improvement Project guideline require blood glucose values be less than 180 mg/dL 18 to 24 hours after anesthesia end time after cardiac surgery. Our study compares the first group of patients transitioned off IV insulin on postoperative day 1, 24 hours after anesthesia end time, whereas the second group was transitioned off IV insulin on the second day, 48 hours after anesthesia end time. Results show no statistical difference in outcomes between groups. PMID:27164170

  18. 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. PMID:23850165

  19. 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…

  20. Sediment quality assessment and dredged material management in Spain: Part I, application of sediment quality guidelines in the Bay of Santander.

    PubMed

    Alvarez-Guerra, Manuel; Viguri, Javier R; Casado-Martínez, M Carmen; DelValls, T Angel

    2007-10-01

    Sediments are an essential component of aquatic ecosystems that must be assessed and managed properly. The use of quantitative environmental quality standards derived from consideration of sediment quality guidelines (SQGs) can be effective as part of a tiered risk assessment approach. In Part I of this 2-part paper addressing sediment quality assessment and dredged material management in Spain, different SQG methods are used to evaluate sediment quality in the Bay of Santander, located in the Cantabric Sea along the northern coast of Spain, and to guide development of empirically derived SQGs for marine sediments. The results of the study indicate a great heterogeneity of SQGs, both with regard to the numeric values for a particular chemical and the number of substances for which SQGs have been derived. The analysis highlights the scarce development of empirical SQGs for priority substances identified in current European Union water policy. Nonetheless, the application of SQGs makes it possible to classify different zones of sediment quality in the Bay of Santander. Part II of this 2-part paper considers the environmental impacts of dredged material disposal. Legislation and criteria used to regulate dredged material disposal at sea in different European countries are reviewed, and action levels derived by different countries were used to evaluate management of dredged sediments from Cádiz Bay, located on the South Atlantic coast of Spain. PMID:18046802

  1. 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

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

    PubMed Central

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

    2014-01-01

    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. PMID:24120573

  3. 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.

  4. 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.

  5. 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.

  6. Pediatric skin integrity practice guideline for institutional use: a quality improvement project.

    PubMed

    Kiss, Elizabeth A; Heiler, Mark

    2014-01-01

    Superior skin care is a nurse-sensitive outcome measure (Young, T., & Clark, M. (2009). Re-positioning for pressure ulcer prevention (protocol). The Cochrane Database of Systematic Review (2009) 3). This study sought to decrease incidence and risk of skin breakdown in the pediatric cardiac intensive care unit (PCICU). The study was conducted in a large hospital in upstate New York. A practice guideline was created and guided PCICU nurses on the interventions for potential skin-breakdown issues in their patients. The patients had a significant change in skin breakdown with a one-sided Fisher's Exact Test (p=.0422). A logistic regression model showed intervention as a significant factor in reducing incidence of pressure ulcers and length of stay (p=.0389). PMID:24582648

  7. ['Urinary tract infections'--revised CBO guideline. Dutch Institute for Quality Assurance].

    PubMed

    van den Broek, P J; van Everdingen, J J

    1999-12-01

    Recently the 'Kwaliteitsinstituut voor de gezondheidszorg CBO' (Dutch Institute++ for Health Care Improvement) published revised guidelines on urinary tract infections. In children less than one year old clinical signs of urinary tract infection are non-specific and the diagnosis should be ruled out by laboratory investigations: a nitrite test, followed by inspection of the urinary sediment for leucocytes and bacteria if the test is negative. If one of the investigations is positive an urinary culture is made and antimicrobial therapy is started as for pyelonephritis. The child should be referred to a paediatrician to examine the urinary tract for anatomical abnormalities with a view to possible preventive measures regarding renal function loss. Boys older than one year with urinary tract infections should be managed in the same way as younger children. In older girls examination of the urinary tract is indicated after recurrent infection. In adult women with complaints of urinary tract infection causes like vaginitis, pyelonephritis and genital herpes should be excluded. Urine is examined (nitrite test, if negative followed by urinary sediment) to confirm the diagnosis. A urine culture is not indicated. First-choice treatment for uncomplicated infection is trimethoprim or nitrofurantoin. Persistent infection may be treated blind with a second antimicrobial drug. Recurrent infection can be prevented by changing behaviour, antimicrobial prophylaxis or oestrogen cream in postmenopausal women. If a man with micturition complaints also suffers from pain in the perineum, the lower back or the lower abdomen or during ejaculation, a distinction should be made between bacterial prostatitis, non-bacterial prostatitis and prostatodynia. Uncomplicated urinary infections can be treated with trimethoprim or nitrofurantoin. Urinary catheters are a risk for infection and their use should be restricted in number and duration. Catheter care should follow the guidelines of the

  8. Image size invariant visual cryptography for general access structures subject to display quality constraints.

    PubMed

    Lee, Kai-Hui; Chiu, Pei-Ling

    2013-10-01

    Conventional visual cryptography (VC) suffers from a pixel-expansion problem, or an uncontrollable display quality problem for recovered images, and lacks a general approach to construct visual secret sharing schemes for general access structures. We propose a general and systematic approach to address these issues without sophisticated codebook design. This approach can be used for binary secret images in non-computer-aided decryption environments. To avoid pixel expansion, we design a set of column vectors to encrypt secret pixels rather than using the conventional VC-based approach. We begin by formulating a mathematic model for the VC construction problem to find the column vectors for the optimal VC construction, after which we develop a simulated-annealing-based algorithm to solve the problem. The experimental results show that the display quality of the recovered image is superior to that of previous papers. PMID:23674454

  9. European guidelines for quality assurance in cervical cancer screening: recommendations for collecting samples for conventional and liquid-based cytology.

    PubMed

    Arbyn, M; Herbert, A; Schenck, U; Nieminen, P; Jordan, J; Mcgoogan, E; Patnick, J; Bergeron, C; Baldauf, J-J; Klinkhamer, P; Bulten, J; Martin-Hirsch, P

    2007-06-01

    The current paper presents an annex in the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening. It provides guidance on how to make a satisfactory conventional Pap smear or a liquid-based cytology (LBC) sample. Practitioners taking samples for cytology should first explain to the woman the purpose, the procedure and how the result will be communicated. Three sampling methods are considered as acceptable for preparing conventional Pap smears: (i) the cervical broom; (ii) the combination of a spatula and an endocervical brush; and (iii) the extended tip spatula. Smear takers should take care to sample the entire circumference of the transformation zone, to quickly spread the cellular material over a glass slide, and to fix the preparation within a few seconds to avoid drying artefacts. According to local guidelines, one of these three methods may be preferred. Sampling with a cotton tip applicator is inappropriate. Similar procedures should be followed for sampling cells for LBC, but only plastic devices may be used. The collected cells should be quickly transferred into a vial with fixative liquid according to the instructions of the manufacturer of the LBC system. Subsequently, the slide or vial and the completed request form are sent to the laboratory for cytological interpretation. PMID:17573762

  10. 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.

  11. Quality control guidelines for disk diffusion and broth microdilution antimicrobial susceptibility tests with seven drugs for veterinary applications.

    PubMed

    Odland, B A; Erwin, M E; Jones, R N

    2000-01-01

    This multicenter study proposes antimicrobial susceptibility (MIC and disk diffusion methods) quality control (QC) parameters for seven compounds utilized in veterinary health. Alexomycin, apramycin, tiamulin, tilmicosin, and tylosin were tested by broth microdilution against various National Committee for Clinical Laboratory Standards (NCCLS)-recommended QC organisms (Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, Streptococcus pneumoniae ATCC 49619, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853). In addition, disk diffusion zone diameter QC limits were determined for apramycin, enrofloxacin, and premafloxacin by using E. coli ATCC 25922, P. aeruginosa ATCC 27853, and S. aureus ATCC 25923. The results from five or six participating laboratories produced >/=99.0% of MICs and >/=95.0% of the zone diameters within suggested guidelines. The NCCLS Subcommittee for Veterinary Antimicrobial Susceptibility Testing has recently approved these ranges for publication in the next M31 document. PMID:10618141

  12. 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.

  13. 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.

  14. 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. PMID:21821333

  15. Impact of a Standardized Treatment Guideline for Pediatric Iatrogenic Opioid Dependence: A Quality Improvement Initiative

    PubMed Central

    Reyburn-Orne, Teri; Youssef, Tarek H.; Haddad, Imad Y.; Gerkin, Richard D.

    2016-01-01

    OBJECTIVES: To determine whether utilization of a hospital-based clinical practice guideline for the care of pediatric iatrogenic opioid dependence (IOD) would promote a decrease in opioid exposure and improve management of opioid abstinence syndrome (AS). METHODS: This study is a retrospective chart review of critically ill patients from a tertiary care children's hospital. Inclusion criteria included mechanically ventilated patients up to 18 years of age who received continuous opioid infusions for at least 7 days and any length of methadone administration. Data on IOD patients from January 2005 to June 2010 was divided into 3 periods: baseline, phase 1, and phase 2. Primary outcome was decrease in opioid exposure, measured by methadone duration of use and any additional opioid bolus doses used in AS management. Documentation of additional opioid bolus doses was regarded as a surrogate measure of AS. Secondary outcomes included total cumulative fentanyl dose, continuous fentanyl infusion duration of use, and hospital and pediatric intensive care unit length of stay. RESULTS: There was a significant decrease in methadone duration of use in IOD patients from 15.3 ± 8.7 days at baseline to 9.5 ± 3.7 days during phase 1 (p = 0.002), to 8.1 ± 3.7 days on phase 2 (reduction not significant, p = 0.106) of this evaluation. Additional opioid bolus doses were significantly lower from baseline to phase 1 (5.5 ± 5.1 vs. 1.8 ± 2.3, p = 0.001) and from phase 1 to phase 2 (1.8 ± 2.3 vs. 0.2 ± 1.5, p = 0.003). For the remaining outcomes, differences were not observed among the evaluation periods, except for the total cumulative fentanyl dose, which was reduced from 2.8 ± 3.7 mg/kg at baseline to 1 ± 1 mg/kg only during phase 1 (p = 0.017). CONCLUSIONS: Introduction of a standardized, hospital-based clinical practice guideline for children with IOD reduced the length of exposure to opioids and improved opioid AS management. PMID:26997929

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....0Bibliography 12.0References Appendix A to Appendix W of 40 CFR Part 51—Summaries of Preferred Air Quality... assessing source impact and in evaluating control strategies. i. Appendix W to 40 CFR Part 51 itself... to Appendix A to Appendix W to 40 CFR Part 51. Appendix A contains summaries of refined air...

  17. 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…

  18. The INQAAHE Guidelines of Good Practice for External Quality Assurance Agencies: Assessment and Next Steps

    ERIC Educational Resources Information Center

    Morse, Jean Avnet

    2006-01-01

    INQAAHE is working to improve the portability of degrees and credits across national boundaries. By defining "good practices" for quality assurance agencies, INQAAHE will promote mutual recognition among agencies in different countries and the acceptance of their accreditation decisions outside their own country. This will allow students and…

  19. Programme Review Guidelines for Quality Assurance in Higher Education: A South African Perspective

    ERIC Educational Resources Information Center

    Bornman, Gertruida M.

    2004-01-01

    All educators should reflect on and assess the quality of their teaching and their learning programmes. Such reflection is the subject of this article. The focus is on higher education (HE) with particular emphasis on distance learning institutions. A particular educational programme is considered, namely a course-work Master's degree in…

  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. PREVENTION GUIDELINES SYSTEM/DATABASE

    EPA Science Inventory

    The Prevention Guidelines System gives public health practitioners quick access to the most current CDC recommendations and guidelines for the prevention, control, treatment and detection of infectious and chronic diseases, environmental hazards, natural or human-generated disast...

  2. 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)

  3. Affinity reagents for studying histone modifications & guidelines for their quality control.

    PubMed

    Kungulovski, Goran; Mauser, Rebekka; Jeltsch, Albert

    2015-10-01

    Histone post-translational modifications (PTMs) have pivotal functions in many chromatin processes, which makes their detection and characterization an imperative in chromatin biology. The established approaches for histone PTM characterization are generally based on affinity reagents specific for modified histone tails such as antibodies and, most recently, recombinant reading domains. Hence, the proper performance of these reagents is a critical precondition for the validity of the generated experimental data. In this review, we evaluate and update the quality criteria for assessment of the binding specificity of histone PTM affinity reagents. In addition, we discuss in detail the advantages and pitfalls of using antibodies and recombinant reading domains in chromatin biology research. Reading domains provide key advantages, such as consistent quality and recombinant production, but the future will tell if this emerging technology keeps its promises. PMID:26541466

  4. A statistical evaluation of the safety factor and species sensitivity distribution approaches to deriving environmental quality guidelines.

    PubMed

    Zajdlik, Barry Alan

    2016-04-01

    The species sensitivity distribution (SSD) distribution approach to estimating water quality guidelines (WQGs) is the preferred method in all jurisdictions reviewed (Australia, Canada, New Zealand, Organisation for Economic Co-operation and Development [OECD] members, South Africa, United States) and is one of the recommended methods for European Commission members for 33 priority and priority hazardous substances. In the event that jurisdiction-specific criteria for data quality, quantity, and taxonomic representation are not met, all of these jurisdictions endorse the use of additional safety factors (SFs) applied to either the SSD-based WQG or, the lowest suitable toxicity test endpoint. In Canada, the British Columbia Ministry of Environment endorses this latter approach as the preferred approach in the belief that so-derived WQGs are more protective than SSD-based WQGs. The level of protection afforded by the latter SF approach was evaluated by statistically sampling minima from random samples of the following distributions: normal, Gumbel, logistic, and Weibull, using a range of coefficients of variation (cVs) and applying the SFs of 2 or 10 used in British Columbia. The simulations indicate that the potentially affected fraction of species (PAF) can be as high as 20%, or, approach 0%. The PAF varies with sample size and CV. Because CVs can vary systematically with mode of toxic action, the PAF using SF-based WQGs can also vary systematically with analyte class. The varying levels of protection afforded by SF-based WQGs are generally inconsistent with the common water quality management goal that allows for a small degree of change under long-term exposure. The findings suggest that further efforts be made to develop high-quality WQGs that support informed decision making and are consistent with the environmental management goal instead of using SFs in the hope of achieving an acceptable but unknown, degree of environmental protection. PMID:26272692

  5. Reorganizing pediatric rehabilitation services to improve accessibility: do we sacrifice quality?

    PubMed Central

    2010-01-01

    Background The impact of a pediatric rehabilitation service delivery reorganization to improve access to services on parents' and service providers' perception of service quality was evaluated. Child-, family-, service- and service provider-related characteristics possibly associated with these perceptions were explored. Methods Perceptions were measured using the Measure of Processes of Care tools and open ended questions before (2007), during (2008) and following (2009) service reorganization. Child and family characteristics, services received and service provider data were documented. Mean MPOC scores were compared over time (ANOVAs and Generalized Estimating Equations) and t-tests, correlations and ANOVAs determined whether the characteristics influenced scores. Results Families' (n = 222) and service providers' (n = 129) perceptions of quality were high in 2007 (3.67 to 6.31/7) and remained high over the next 2 years (p ≥ 0.16). Two MPOC domain scores (Respectful care and Providing general information) were consistently scored the highest (mean ≥ 5.66/7) and the lowest (mean ≤ 4.75/7), respectively. Families with more education and those with children 12-21 years old tended to attribute lower MPOC scores. Participants were generally satisfied with the new service model and recommendations included improving information exchange. Conclusions Results suggest that it is possible to reorganize pediatric rehabilitation services while maintaining quality. PMID:20687932

  6. Standards for QUality Improvement Reporting Excellence 2.0: revised publication guidelines from a detailed consensus process.

    PubMed

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

    2016-02-01

    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 article, 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). PMID:26515734

  7. 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

    2015-11-01

    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 3 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). PMID:26523003

  8. Summary of air quality regulations and recommended guidelines for oil shale development in the Colorado Piceance Basin

    SciTech Connect

    Daniels, J.I.; Anspaugh, L.R.; Ondov, J.M.

    1982-02-01

    The Piceance Basin of northwestern Colorado contains the greatest domestic concentration of oil shale deposits favorably located for economical recovery. These deposits are defined geologically to be at least 30-ft thick with at least 30 gal of oil per ton of shale; by conservative estimate, they contain nearly 300-billion barrels (bbl) of recoverable shale oil. The technologies used to extract this oil will need to comply with federal and state environmental protection regulations, particularly those governing ambient air quality. The regulatory framework for preventing degradation of ambient air quality was amended on August 7, 1980, and these rules are especially applicable for controlling air pollution in oil shale recovery areas such as the Piceance Basin. In this report the amended regulations and those that existed before their promulgation are described and compared. In addition, recommended guidelines that can be used as criteria for protecting public health from nonregulated air pollutants are discussed. Finally, proposals for additional federal standards are introduced, and examples of regulatory options such as emission fees and emission-density zones currently being evaluated are presented.

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

    PubMed Central

    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). PMID:26517437

  10. Dietary quality-adherence to the dietary guidelines in Tehranian adolescents: Tehran Lipid and Glucose Study.

    PubMed

    Mirmiran, Parvin; Azadbakht, Leila; Azizi, Fereidoun

    2005-05-01

    The aim of this study was to determine the Healthy Eating Index (HEI) score and its relation take of nutrients and the number of servings from each food group consumed by adolescents residing in district 13 of Tehran. This study, conducted within the framework of Tehran Lipid and Glucose Study (TLGS), was a part of a dietary intake assessment carried out in 443 families, including 465 adolescents, aged 10-18 years, according to the Food Guide Pyramid and dietary guidelines on individuals residing in district 13 of Tehran. In this study, dietary intake was assessed with two-day 24-hour recalls. HEI was calculated based on nine components. The score range of each component was 0 to 10, the sum score of this index therefore being 90. The HEI score was categorized into three groups: less than 45 (poor diet), between 45-72 (needs improvement) and more than 72 (good diet). The mean score of HEI was 64.9 +/- 9.6 in boys and 64.8 +/- 9.4 in girls. The results showed that the number of servings of food groups in those with good diet was significantly higher than the two other groups (p < 0.05). In contrast the percent of saturated fat intake and cholesterol consumption in those with HEI > or = 72 was lower than the other groups (p < 0.05). The approximate number of food items consumed and the total nutrient intake by adolescents with HEI score > or = 72 was significantly higher than the others (p < 0.05). There was a significant positive correlation between the number of servings of grains group (r = 0.1), vegetables (r = 0.4), fruits (r = 0.4), dairy (r = 0.3), meat (r = 0.1), and HEI (p < 0.001). There was a significant negative correlation between fat intake (r = -0.2, p < 0.001), percent of saturated fatty acids (r = -0.2, p < 0.05), cholesterol consumption (r = -0.4, p < 0.05), and the ratio of polyunsaturated fatty acids/saturated fatty acids (P/S) in diet (r = 0.2, p < 0.05), and HEI score. Seventy-four, 23, and 3% of diets were categorized into "needs improvement

  11. [Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].

    PubMed

    Waldfahrer, F

    2016-04-01

    Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue 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:27128403

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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…

  18. Standardized quality assurance forms for organ transplantations with multilingual support, open access and UMLS coding.

    PubMed

    Varghese, Julian; Sünninghausen, Sarah Schulze; Dugas, Martin

    2015-01-01

    Quality assurance (QA) is a key factor to evaluate success of organ transplantations. In Germany QA documentation is progressively developed and enforced by law. Our objective is to share QA models from Germany in a standardized format within a form repository for world-wide reuse and exchange. Original QA forms were converted into standardized study forms according to the Operational Data Model (ODM) and shared for open access in an international forms repository. Form elements were translated into English and semantically enriched with Concept Unique Identifiers from the Unified Medical Language System (UMLS) based on medical expert decision. All forms are available on the web as multilingual ODM documents. UMLS concept coverage analysis indicates 92% coverage with few but critically important definition gaps. New content and infrastructure for harmonized documentation forms is provided in the domain of organ transplantations enabling world-wide reuse and exchange. PMID:26063252

  19. Financing American Indian health care: impacts and options for improving access and quality.

    PubMed

    Langwell, Kathryn; Anagnopoulos, Cheryl; Ryan, Frank; Melson, Jacob; Iron Rope, Sandor

    2009-10-01

    (1) Indian Health Service (HIS) per patient funding is less than half of national per capita health spending, and declined further between 2003 and 2006. (2) Under-funding of the IHS system has led to explicit rationing of services to American Indian and Alaska Native patients, with many specialized services provided only for "life or limb threatening" conditions. (3) IHS patients report experiencing access barriers and rate the quality of care process substantially lower than do Medicaid beneficiaries, but most indicate they prefer to use IHS for their health care. (4) Options to increase the funding for American Indian and Alaska Native health care exist, but would impose higher costs on federal and state budgets and are unlikely to be feasible in the current economic environment. However, IHS might be able to make certain organizational changes that would increase efficiency and its ability to extend existing funding to cover more services. PMID:19847975

  20. 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. PMID:24747256

  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. PMID:21130181

  2. 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.

  3. [GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence].

    PubMed

    Perleth, Matthias; Matthias, Katja; Langer, Gero; Meerpohl, Joerg J; Gartlehner, Gerald; Kaminski-Hartenthaler, Angela; Schünemann, Holger J

    2013-01-01

    In this article we describe how to include considerations about resource utilisation when making recommendations according to the GRADE approach. We focus on challenges with rating the confidence in effect estimates (quality of evidence) and incorporating resource use into evidence profiles and Summary of Findings (SoF) tables. GRADE recommends that important differences in resource use between alternative management strategies should be included along with other important outcomes in the evidence profile and SoF table. Key steps in considering resources in making recommendations with GRADE are the identification of items of resource use that may differ between alternative management strategies and that are potentially important to decision-makers, finding evidence for the differences in resource use, making judgements regarding confidence in effect estimates using the same criteria used for health outcomes, and valuing the resource use in terms of costs for the specific setting for which recommendations are being made. PMID:23790708

  4. Variation in guideline adherence in intrauterine insemination care.

    PubMed

    Haagen, Esther C; Nelen, Willianne L D M; Grol, Richard P T M; Braat, Didi D M; Hermens, Rosella P M G; Kremer, Jan A M

    2010-04-01

    Health-care delivery according to clinical practice guidelines is thought to be critical in achieving optimal outcomes. This study aimed to assess the extent to which practice performance in intrauterine insemination (IUI) care is consistent with guideline recommendations and to evaluate the association between guideline adherence and outcome of IUI care. In a retrospective cohort study, 1100 infertile couples who underwent IUI treatment at 10 Dutch hospitals were asked to grant access to their medical record for assessment of guideline adherence using 25 systematically developed guideline-based performance indicators. A total of 558 couples who started 2334 IUI cycles participated. Guideline adherence regarding 20 process and five structure aspects of IUI care was often substandard and varied considerably between hospitals. Out of 10 possible associations investigated, guideline adherence regarding sperm quality and guideline adherence regarding the total number of IUI cycles were associated with improved ongoing pregnancy rates after IUI. Thus, guideline adherence in IUI care is far from optimal and varies substantially between hospitals. As associations between guideline adherence and ongoing pregnancy after IUI were mainly non-significant, further research is needed to evaluate associations between guideline adherence and other outcomes of IUI care besides ongoing pregnancy, such as patient safety and cost effectiveness. PMID:20129823

  5. 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

  6. 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

  7. 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

  8. 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…

  9. 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

  10. A Spectrum Access Based on Quality of Service (QoS) in Cognitive Radio Networks

    PubMed Central

    Zhai, Linbo; Wang, Hua; Gao, Chuangen

    2016-01-01

    The quality of service (QoS) is important issue for cognitive radio networks. In the cognitive radio system, the licensed users, also called primary users (PUs), are authorized to utilize the wireless spectrum, while unlicensed users, also called secondary users (SUs), are not authorized to use the wireless spectrum. SUs access the wireless spectrum opportunistically when the spectrum is idle. While SUs use an idle channel, the instance that PUs come back makes SUs terminate their communications and leave the current channel. Therefore, quality of service (QoS) is difficult to be ensured for SUs. In this paper, we first propose an analysis model to obtain QoS for cognitive radio networks such as blocking probability, completed traffic and termination probability of SUs. When the primary users use the channels frequently, QoS of SUs is difficult to be ensured, especially the termination probability. Then, we propose a channel reservation scheme to improve QoS of SUs. The scheme makes the terminated SUs move to the reserved channels and keep on communications. Simulation results show that our scheme can improve QoS of SUs especially the termination probability with a little cost of blocking probability in dynamic environment. PMID:27171196

  11. A Spectrum Access Based on Quality of Service (QoS) in Cognitive Radio Networks.

    PubMed

    Zhai, Linbo; Wang, Hua; Gao, Chuangen

    2016-01-01

    The quality of service (QoS) is important issue for cognitive radio networks. In the cognitive radio system, the licensed users, also called primary users (PUs), are authorized to utilize the wireless spectrum, while unlicensed users, also called secondary users (SUs), are not authorized to use the wireless spectrum. SUs access the wireless spectrum opportunistically when the spectrum is idle. While SUs use an idle channel, the instance that PUs come back makes SUs terminate their communications and leave the current channel. Therefore, quality of service (QoS) is difficult to be ensured for SUs. In this paper, we first propose an analysis model to obtain QoS for cognitive radio networks such as blocking probability, completed traffic and termination probability of SUs. When the primary users use the channels frequently, QoS of SUs is difficult to be ensured, especially the termination probability. Then, we propose a channel reservation scheme to improve QoS of SUs. The scheme makes the terminated SUs move to the reserved channels and keep on communications. Simulation results show that our scheme can improve QoS of SUs especially the termination probability with a little cost of blocking probability in dynamic environment. PMID:27171196

  12. 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

  13. 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.

  14. 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.

  15. Evaluating the Good Ontology Design Guideline (GoodOD) with the Ontology Quality Requirements and Evaluation Method and Metrics (OQuaRE)

    PubMed Central

    Duque-Ramos, Astrid; Boeker, Martin; Jansen, Ludger; Schulz, Stefan; Iniesta, Miguela; Fernández-Breis, Jesualdo Tomás

    2014-01-01

    Objective To (1) evaluate the GoodOD guideline for ontology development by applying the OQuaRE evaluation method and metrics to the ontology artefacts that were produced by students in a randomized controlled trial, and (2) informally compare the OQuaRE evaluation method with gold standard and competency questions based evaluation methods, respectively. Background In the last decades many methods for ontology construction and ontology evaluation have been proposed. However, none of them has become a standard and there is no empirical evidence of comparative evaluation of such methods. This paper brings together GoodOD and OQuaRE. GoodOD is a guideline for developing robust ontologies. It was previously evaluated in a randomized controlled trial employing metrics based on gold standard ontologies and competency questions as outcome parameters. OQuaRE is a method for ontology quality evaluation which adapts the SQuaRE standard for software product quality to ontologies and has been successfully used for evaluating the quality of ontologies. Methods In this paper, we evaluate the effect of training in ontology construction based on the GoodOD guideline within the OQuaRE quality evaluation framework and compare the results with those obtained for the previous studies based on the same data. Results Our results show a significant effect of the GoodOD training over developed ontologies by topics: (a) a highly significant effect was detected in three topics from the analysis of the ontologies of untrained and trained students; (b) both positive and negative training effects with respect to the gold standard were found for five topics. Conclusion The GoodOD guideline had a significant effect over the quality of the ontologies developed. Our results show that GoodOD ontologies can be effectively evaluated using OQuaRE and that OQuaRE is able to provide additional useful information about the quality of the GoodOD ontologies. PMID:25148262

  16. Evidence-Based Practice Guidelines and School Nursing

    ERIC Educational Resources Information Center

    Adams, Susan; McCarthy, Ann Marie

    2007-01-01

    The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

  17. 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…

  18. School-Based Programs for Adolescent Parents and Their Young Children. Guidelines for Quality and Best Practice.

    ERIC Educational Resources Information Center

    Batten, Susan T.; Stowell, Bonita G.

    This document attempts to compile information on best practices for many of the core services of school-based programs for pregnant and parenting teens and their children. It includes an overview of standards and guidelines that have been substantiated by either research or professionals in the field. These guidelines are intended to help…

  19. 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…

  20. 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…

  1. 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...

  2. 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. PMID:25877867

  3. 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…

  4. 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.

  5. Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

    PubMed Central

    2012-01-01

    Introduction Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p < 0.05), reflecting a significantly greater proportion of lay-rescuers performing chest compressions at too fast a rate when trained and assessed with the 2010 rather than 2005 guidelines (6.04% vs. 2.67%; p < 0.05). Error rates for other skills did not differ between guideline groups. Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate. PMID:22876933

  6. A web server framework for rich interactive access to geologic and water quality data.

    NASA Astrophysics Data System (ADS)

    Scharling, Peter; Hinsby, Klaus; Brennan, Kelsy

    2014-05-01

    Geodata visualization and analysis is founded on proper access to all available data. Throughout several research projects Earthfx and GEUS managed to gather relevant data from both national and local databases into one platform. The web server platform which is easy accessible on the internet displays all types of spatially distributed geodata ranging from geochemistry, geological and geophysical well logs, surface- and airborne geophysics to any type of temporal measurements like water levels and trends in groundwater chemistry. Geological cross sections are an essential tool for the geoscientist. Moving beyond plan-view web mapping, GEUS and Earthfx have developed a webserver technology that provides the user with the ability to dynamically interact with geologic models developed for various projects in Denmark and in transboundary aquifers across the Danish-German border. The web map interface allows the user to interactively define the location of a multi-point profile, and the selected profile will be quickly drawn and illustrated as a slice through the 3D geologic model. Including all borehole logs within a user defined offset from the profile. A key aspect of the webserver technology is that the profiles are presented through a fully dynamic interface. Web users can select and interact with borehole logs contained in the underlying database, adjust vertical exaggeration, and add or remove off-section boreholes by dynamically adjusting the offset projection distance. In a similar manner to the profile tool, an interactive water level and water chemistry graphing tool has been integrated into the web service interface. Again, the focus is on providing a level of functionality beyond simple data display. Future extensions to the web interface and functionality are possible, as the web server utilizes the same code engine that is used for desktop geologic model construction and water quality data management. In summary, the GEUS/Earthfx web server tools

  7. Quality and accuracy of publicly accessible cancer-related physical activity information on the Internet: a cross-sectional assessment.

    PubMed

    Buote, R D; Malone, S D; Bélanger, L J; McGowan, E L

    2016-09-01

    In this study, we assessed the quality of publicly available cancer-related physical activity (PA) information appearing on reputable sites from Canada and other English-speaking countries. A cross-sectional Internet search was conducted on select countries (Canada, USA, Australia, New Zealand, UK) using Google to generate top 50 results per country for the keywords "'physical activity' AND 'cancer'". Top results were assessed for quality of PA information based on a coding frame. Additional searches were performed for Canadian-based sites to produce an exhaustive list. Results found that many sites offered cancer-related PA information (94.5%), but rarely defined PA (25.2%). Top 50 results from each country did not differ on any indicator examined. The exhaustive list of Canadian sites found that many sites gave information about PA for survivorship (78.3%) and prevention (70.0%), but rarely defined (6.7%) or referenced PA guidelines (28.3%). Cancer-related PA information is plentiful on the Internet but the quality needs improvement. Sites should do more than mention PA; they should provide definitions, examples and guidelines. With improvements, these websites would enable healthcare providers to effectively educate their patients about PA, and serve as a valuable resource to the general public who may be seeking cancer-related PA information. PMID:27283004

  8. Access and Quality of HIV-Related Point-of-Care Diagnostic Testing in Global Health Programs.

    PubMed

    Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N

    2016-02-01

    Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. PMID:26423384

  9. In vitro antimicrobial activity and MIC quality control guidelines of RPR 106972 (RPR 112808/RPR106950): a novel orally administered streptogramin combination. The Quality Control Study Group.

    PubMed

    Putnam, S D; Jones, R N; Johnson, D M

    1997-07-01

    RPR 106972 is a novel oral streptogramin combination with reported therapeutic potency against Gram-positive and certain respiratory tract pathogens. MICs for RPR 106972, quinupristin/dalfopristin, and seven comparison drugs were determined by the reference methods against 337 strains selected to define spectrum and potency. RPR 106972 demonstrated antimicrobial activity against oxacillin-susceptible and -resistant Staphylococcus aureus (MIC ranges of 0.12 to 2 micrograms/ml and 0.5 to 2 micrograms/ml, respectively), and coagulase-negative staphylococci were also inhibited by RPR 106972 (MIC90, < or = 0.5 microgram/ml) and quinupristin/dalfopristin (MIC90, < or = 0.25 microgram/ml). Against all streptococcal strains tested (including penicillin-resistant pneumococcus), RPR 106972 was highly active with MIC results at < or = 1 microgram/ml. RPR 106972 inhibited Corynebacterium jeikeium (MIC90, 0.5 microgram/ml). Moraxella catarrhalis (MIC90, 0.25 microgram/ml), and some Haemophilus influenzae (MIC50, 2 micrograms/ml). RPR 106972 and quinupristin/dalfopristin demonstrated little activity against Enterococcus faecalis (MIC90s, 4 to 32 micrograms/ml) as compared to Enterococcus faecium (MIC90s, 0.5 to 1 microgram/ml) and other Enterococcus ssp. (MIC90s, 1 microgram/ml). Studies to establish MIC quality-control guidelines indicated the following ranges: for E. faecalis ATCC 29212, 0.5 to 4 micrograms/ml; for S. aureus ATCC 29213, 0.25 to 1 microgram/ml; and for Streptococcus pneumoniae ATCC 49619, 0.06 to 0.5 microgram/ml. The results of this study indicate that the in vitro activity of RPR 106972 against Gram-positive bacteria and selected Gram-negative respiratory organisms is promising and warrants additional studies of pharmacokinetics, and in vivo infection model dynamics. PMID:9294704

  10. Plant sampling guidelines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This document provides GRACEnet guidelines for sampling plant shoots and roots with additional guidelines and references for determining plant quality. Plant biomass including rhizodeposition provides the majority of net primary production that fuels above- and below-ground ecosystems. Thus, high ca...

  11. 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

  12. 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,…

  13. Conflict of interest guidelines for clinical guidelines.

    PubMed

    Williams, Michael J; Kevat, Dev A S; Loff, Bebe

    2011-10-17

    • Clinical guidelines are being increasingly produced to improve quality of care, but are vulnerable to bias. • Only 15% of guidelines on the National Health and Medical Research Council portal from the most prolific developers have published conflict of interest statements, and fewer detail the processes used to manage conflicts. • Comprehensive disclosure of conflicts is needed to safeguard the integrity of clinical guidelines and the medical profession. • Peak bodies and clinicians should seek to promote an improvement to current poor practice. PMID:22004385

  14. Implementation of quality assurance in national foot and mouth disease laboratories, based on the guidelines of the Office International des Epizooties.

    PubMed

    De Clercq, K

    1998-12-01

    The final act of the Uruguay Round of the General Agreement on Tariffs and Trade, 1994, contains the Agreement on the Application of Sanitary and Phytosanitary Measures, which aims to reduce the negative effects of health barriers on international trade to a minimum. Therefore, the Office International des Epizooties (OIE) Regional Commission for Europe proposed that an accreditation system based on the EN 45000 standard should be applied to achieve international recognition of certificates and testing laboratories. To this end, the OIE Standards Commission published a series of guidelines for the evaluation of laboratory quality and proficiency testing. In 1995, the Food and Agriculture Organization European Commission for the Control of Foot and Mouth Disease recommended that the OIE proposal should be applied in all foot and mouth disease (FMD) diagnostic laboratories in Europe. This review summarises the EN 45001 standard and the OIE guidelines, and proposes that these guidelines should be taken as a basis for the implementation of a quality assurance programme in FMD laboratories. PMID:9850551

  15. 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. PMID:27243935

  16. 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

  17. Assessing metal toxicity in sediments using the equilibrium partitioning model and empirical sediment quality guidelines: a case study in the nearshore zone of the Bohai Sea, China.

    PubMed

    Li, Li; Wang, Xiaojing; Liu, Jihua; Shi, Xuefa; Ma, Deyi

    2014-08-15

    Surface sediments were collected from five nearshore (wastewater discharges, aquaculture facilities and a seaport) sites in Bohai Bay and Laizhou Bay, China. The equilibrium partitioning (EqP) model and empirical sediment quality guidelines (SQGs) were applied to assess the potential metal toxicity in the collected sediments. The results show that, based on the EqP model, 35% of stations exhibited potential metal toxicity. Several metals (Cu, Ni and Cr) exceeded the empirical SQGs (9-93% of the time), however these guidelines may not be suitable for use in the Bohai Sea owing to the background concentrations. The EqP model is a more useful method for assessing potential metal toxicity in Bohai Sea sediment than the empirical SQGs. Additionally, we have provided new understanding about methods for assessing sediment metal toxicity in the Bohai Sea that may be useful in other coastal areas in China. PMID:24993730

  18. 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. PMID:23792417

  19. Critical appraisal of clinical guidelines.

    PubMed

    Netsch, Debra S; Kluesner, Jean A

    2010-01-01

    Utilization of clinical guidelines is gaining in popularity due to their significant impact on clinical practice. While a plethora of guidelines exist, many are lacking in quality, based on current critical appraisal standards. It then becomes necessary for the end users of the guidelines to adopt or develop those that are deemed adequate for implementation. This often requires that users possess critical appraisal skills as they become proficient in discerning between guidelines of varying quality. This article provides direction and tools to support the critical appraisal process in the adoption of clinical guidelines. PMID:20838314

  20. 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. PMID

  1. Free open access medical education can help rural clinicians deliver 'quality care, out there'.

    PubMed

    Leeuwenburg, Tim J; Parker, Casey

    2015-01-01

    Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessible crowd-sourced adjunct, providing inline (contextual) and offline (asynchronous) content to augment traditional educational principles and the availability of relevant resources for life-long learning. This markedly reduces knowledge translation (the delay from inception of a new idea to bedside implementation) and allows rural clinicians to further expertise by engaging in discussion of cutting edge concepts with peers worldwide. PMID:26278340

  2. [Suicide prevention: guidelines for timely and well-organised help].

    PubMed

    Kerkhof, Ad J F M; van Hemert, Albert M

    2013-01-01

    In the Netherlands, guidelines for the diagnosis and treatment of suicidal behaviour and a quality paper on the continuity of care have recently been published. In the United Kingdom, adherence to a similar guideline was associated with a lower suicide rate. General practitioners and mental health workers need to be systematically educated and trained in the application of the guideline. Because the majority of victims who die by suicide are not under any type of medical supervision, close relatives and friends as well as 'gatekeepers' should become involved in its prevention. Relatives and friends need to have access to relevant information and receive support for their suspicions and questions. The general practitioner and the Internet play important roles in this regard. Budget cuts that affect access to acute mental health care have an adverse impact on suicide rates. PMID:23890165

  3. 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. PMID:26698197

  4. Implementation of NICE Clinical Guideline 95 for assessment of stable chest pain in a rapid access chest pain clinic reduces the mean number of investigations and cost per patient

    PubMed Central

    Lee, Alvin J X; Michail, Michael; Quaderi, Shumonta A; Richardson, James A; Aggarwal, Suneil K; Speechly-Dick, M Elsya

    2015-01-01

    Objective In 2010, the National Institute for Health and Care Excellence (NICE) in the UK published Clinical Guideline 95 (CG95) advocating risk stratification of patients using ‘CADScore’ to guide appropriate cardiac investigations for chest pain of recent onset. Implementation of the guideline in the University College London Hospitals NHS Foundation Trust was evaluated to see if it led to a reduction in the average cost of the diagnostic journey per patient and fewer investigations per patient in order to confirm a diagnosis. Methods This was a single centre study at a Tertiary Centre in Central London. The investigative journey for each patient presenting to the Rapid Access Chest Pain Clinic (RACPC) at University College London Hospitals NHS Foundation Trust was recorded. Retrospective analysis on this data was performed. Results Data for 4968 patients presenting to the RACPC from 2004 to 2012 was analysed and a size-matched cohort of 1503 patients preimplementation and postimplementation of the guidelines was compared. The mean cost of investigations postimplementation was £291.83 as compared to £319.54 preimplementation of the guidelines despite higher costs associated with some of the recommended initial investigations. The mean number of tests per patient postguidelines was 0.78 compared to 0.97 for preguidelines. An approximate twofold increase in patients not requiring tests was seen post-CG95 implementation (245 pre-CG95 vs 476 post-CG95). Conclusions The implementation of the NICE guidelines in our trust has reduced the average cost of the investigative journey and the number of investigations required per patient. PMID:25722859

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. The philosophy of clinical practice guidelines: purposes, problems, practicality and implementation.

    PubMed

    Hutchinson, A

    1998-03-01

    There are a number of technical and professional challenges to the use of clinical practice guidelines in the United Kingdom. Until recently, many guidelines have been consensus-based rather than being explicitly linked to evidence of effectiveness and have also been of variable quality. Moreover, clarity of purpose has been lacking with some guidelines being developed as a means of limiting access to secondary care rather than as a means of assisting clinical decision-making. Implementation of new research into practice and of clinical practice guideline recommendations shares many of the same barriers to changing clinician behaviour. Without local support systems to assist with implementation, including clinical audit programmes and methods of feeding back information on current practice, it is unlikely that guidelines will change practice in the majority of clinicians. Progress on the implementation of guidelines in the British National Health Service is discussed. PMID:9563563

  11. 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

    2012-04-01

    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. PMID:22473437

  12. 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

  13. 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.

  14. Methodological Quality Appraisal of 27 Korean Guidelines Using a Scoring Guide Based on the AGREE II Instrument and a Web-based Evaluation

    PubMed Central

    2016-01-01

    This study evaluated the methodological quality of CPGs using the Korean AGREE II scoring guide and a web-based appraisal system and was conducted by qualified appraisers. A total of 27 Korean CPGs were assessed under 6 domains and 23 items on the AGREE II instrument using the Korean scoring guide. The domain scores of the 27 guidelines were as following: the mean domain score was 82.7% (median 84.7%, ranging from 55.6% to 97.2%) for domain 1 (scope and purpose); 53.4% (median 56.9%, ranging from 11.1% to 95.8%) for domain 2 (stakeholder involvement); 63.0% (median 71.4%, ranging from 13.5% to 90.6%) for domain 3 (rigor of development); 88.9% (median 91.7%, ranging from 58.3% to 100.0%) for domain 4 (clarity of presentation); 30.1% (median 27.1%, ranging from 3.1% to 67.7%) for domain 5 (applicability); and 50.2% (median 58.3%, ranging from 0.0% to 93.8%) for domain 6 (editorial independence). Three domains including scope and purpose, rigor of development, and clarity of presentation were rated at more than 60% of the scaled domain score. Three domains including stakeholder involvement, applicability, and editorial independence were rated at less than 60% of the scaled domain score. Finally, of the 27 guidelines, 18 (66.7%) were rated at more than 60% of the scaled domain score for rigor of development and were categorized as high-quality guidelines. PMID:27134487

  15. Methodological Quality Appraisal of 27 Korean Guidelines Using a Scoring Guide Based on the AGREE II Instrument and a Web-based Evaluation.

    PubMed

    Chang, Sung-Goo; Kim, Dong-Ik; Shin, Ein-Soon; Jang, Ji-Eun; Yeon, Ji-Yun; Lee, Yoon-Seong

    2016-05-01

    This study evaluated the methodological quality of CPGs using the Korean AGREE II scoring guide and a web-based appraisal system and was conducted by qualified appraisers. A total of 27 Korean CPGs were assessed under 6 domains and 23 items on the AGREE II instrument using the Korean scoring guide. The domain scores of the 27 guidelines were as following: the mean domain score was 82.7% (median 84.7%, ranging from 55.6% to 97.2%) for domain 1 (scope and purpose); 53.4% (median 56.9%, ranging from 11.1% to 95.8%) for domain 2 (stakeholder involvement); 63.0% (median 71.4%, ranging from 13.5% to 90.6%) for domain 3 (rigor of development); 88.9% (median 91.7%, ranging from 58.3% to 100.0%) for domain 4 (clarity of presentation); 30.1% (median 27.1%, ranging from 3.1% to 67.7%) for domain 5 (applicability); and 50.2% (median 58.3%, ranging from 0.0% to 93.8%) for domain 6 (editorial independence). Three domains including scope and purpose, rigor of development, and clarity of presentation were rated at more than 60% of the scaled domain score. Three domains including stakeholder involvement, applicability, and editorial independence were rated at less than 60% of the scaled domain score. Finally, of the 27 guidelines, 18 (66.7%) were rated at more than 60% of the scaled domain score for rigor of development and were categorized as high-quality guidelines. PMID:27134487

  16. 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

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

    PubMed

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

    2008-03-01

    Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories. PMID:18174302

  18. 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. PMID:26392997

  19. 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

  20. Compliance with clinical practice guidelines for breast cancer treatment: a population-based study of quality-of-care indicators in Italy

    PubMed Central

    2013-01-01

    Background It has been documented that variations exist in breast cancer treatment despite wide dissemination of clinical practice guidelines. The aim of this population-based study was to evaluate the impact of regional guidelines (Piedmont guidelines, PGL) for breast cancer diagnosis and treatment on quality-of-care indicators in the Northwestern Italian region of Piedmont. Methods We included two samples of women aged 50–69 years with incident breast cancer treated in Piedmont before and after the introduction of PGL: 600 in 2002 (pre-PGL) and 621 in 2004 (post-PGL). Patients were randomly selected among all incident breast cancer cases identified through the hospital discharge records database. We extracted clinical data on breast cancer cases from medical charts and ascertained vital status through linkage with town offices. We assessed compliance with 14 quality-of-care indicators from PGL recommendations, before and after their introduction in clinical practice. Results Among patients with invasive lesions, 77.1% (N = 368) and 77.5% (N = 383) in the pre-PGL and post-PGL groups, respectively, received breast conservative surgery (BCS) as a first-line treatment. Following BCS, 87.7% received radiotherapy in 2002, compared to 87.9% in 2004. Of all patients at medium-to-high risk of distant metastasis, 65.5% (N = 268) and 63.6% (N = 252) received chemotherapy in 2002 and in 2004, respectively. Among the 117 patients with invasive lesions and negative estrogen receptor status in 2002, hormonal therapy was prescribed in 23 of them (19.6%). The incorrect prescription of hormonal therapy decreased to 10.8% (N = 10) among the 92 estrogen receptor-negative patients in 2004 (p < 0.01). Compliance with PGL recommendations was already high in the pre-PGL group, although some quality-of-care indicators did not reach the standard. In the pre/post analysis, 8 out of 14 quality-of-care indicators showed an improvement from 2002 to 2004, but only 4 out of 14 reached

  1. 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…

  2. A guideline management system.

    PubMed

    Ciccarese, Paolo; Caffi, Ezio; Boiocchi, Lorenzo; Quaglini, Silvana; Stefanelli, Mario

    2004-01-01

    This paper describes the architecture of NewGuide, a guide-line management system for handling the whole life cycle of a computerized clinical practice guideline. NewGuide components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store them, an inference engine to implement guidelines instances in a multi-user environment, and a reporting system storing the guidelines logs in order to be able to completely trace any individual physician guideline-based decision process. There is a system "central level" that maintains official versions of the guidelines, and local Healthcare Organizations may download and implement them according to their needs. The architecture has been implemented using the Java 2 Enterprise Edition (J2EE) platform. Simple Object Access Protocol (SOAP) and a set of con-tracts are the key factors for the integration of NewGuide with healthcare legacy systems. They allow maintaining unchanged legacy user interfaces and connecting the system with what-ever electronic patient record. The system functionality will be illustrated in three different contexts: homecare-based pressure ulcer prevention, acute ischemic stroke treatment and heart failure management by general practitioners. PMID:15360768

  3. 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

  4. [How to write, how to implement and how to evaluate a practice guideline in order to improve quality of care?].

    PubMed

    Moret, L; Lefort, C; Terrien, N

    2012-11-01

    Initiatives of clinical practices improvement have been gradually developing in France for 20 years. Nevertheless, effective implementation of change is still difficult for numerous reasons. The use of clinical practices guidelines is one of the different ways of improvement. It is however necessary to adapt these national guidelines to the specificities of the hospital and the team, to ensure implementation and appropriation by the professionals. These recommendations are thus translated into applicable and concrete standard operating procedures. These documents have to be built by and for the concerned professionals. They are also communication and training tools, precise, directive, uniform in terms of presentation and attractive visually. Once drafted, they have to be distributed widely to the professionals to facilitate implementation. The simple distribution of the recommendations is insufficient to modify the clinical practices and require association of several methods of promotion for an optimal appropriation. How then to make sure of their effective use? Practices evaluation is one of the steps of continuous professional development, including continuous training and analysis of clinical practices by using methods promoted by the "Haute Autorité de santé". One of them is the clinical audit; use of method assessing non-pertinent treatment is interesting too. Analysis of the non-conformities and gaps between theory and practice allows identifying various possible causes (professional, institutional, organizational or personal) in order to implement corrective action plans, in a logic of continuous improvement. PMID:23039956

  5. Tackling Student Literacy and Numeracy Underpreparedness in Ontario Colleges: Access, Quality and Funding

    ERIC Educational Resources Information Center

    Dziwak, Kasia

    2014-01-01

    As more students enter postsecondary education without the numeracy and literacy skills necessary for success, Ontario colleges are facing a challenge. While enrolment-based funding drives the colleges to seek growth to ensure financial stability, the quality assurance mechanism leads them to divert millions of dollars from their operating budgets…

  6. 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…

  7. 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,…

  8. 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…

  9. Access to a High Quality Education for English Language Learners. Information Brief

    ERIC Educational Resources Information Center

    Mid-Atlantic Equity Center, 2009

    2009-01-01

    Research on teaching and learning indicates that all students should be provided with programs, services, and teachers that engage them in rigorous academic work and promote deep disciplinary knowledge and higher order thinking skills (Walqui, 2006; Sanders & Rivers, 1996). Despite research findings on the importance of high quality teachers and…

  10. 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…

  11. 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. PMID:27451152

  12. Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review

    PubMed Central

    de Boer, Karin; Burggraaf, Henriëtte; Derks, Jan B.; van Dijk, Det; van Dillen, Jeroen; Dirksen, Carmen D.; Duvekot, Johannes J.; Franx, Arie; Hasaart, Tom H. M.; Huisjes, Anjoke J. M.; Kolkman, Diny; Kwee, Anneke; Mol, Ben W.; van Pampus, Mariëlle G.; de Roon-Immerzeel, Alieke; van Roosmalen, Jos J. M.; Roumen, Frans J. M. E.; Smid-Koopman, Ellen; Spaans, Wilbert A.; Visser, Harry; van Wijngaarden, Wim J.; Willekes, Christine; Wouters, Maurice G. A. J.

    2016-01-01

    Background There is an ongoing discussion on the rising CS rate worldwide. Suboptimal guideline adherence may be an important contributor to this rise. Before improvement of care can be established, optimal CS care in different settings has to be defined. This study aimed to develop and measure quality indicators to determine guideline adherence and identify target groups for improvement of care with direct effect on caesarean section (CS) rates. Method Eighteen obstetricians and midwives participated in an expert panel for systematic CS quality indicator development according to the RAND-modified Delphi method. A multi-center study was performed and medical charts of 1024 women with a CS and a stratified and weighted randomly selected group of 1036 women with a vaginal delivery were analysed. Quality indicator frequency and adherence were scored in 2060 women with a CS or vaginal delivery. Results The expert panel developed 16 indicators on planned CS and 11 indicators on unplanned CS. Indicator adherence was calculated, defined as the number of women in a specific obstetrical situation in which care was performed as recommended in both planned and unplanned CS settings. The most frequently occurring obstetrical situations with low indicator adherence were: 1) suspected fetal distress (frequency 17%, adherence 46%), 2) non-progressive labour (frequency 12%, CS performed too early in over 75%), 3) continuous support during labour (frequency 88%, adherence 37%) and 4) previous CS (frequency 12%), with adequate counselling in 15%. Conclusions We identified four concrete target groups for improvement of obstetrical care, which can be used as a starting point to reduce CS rates worldwide. PMID:26783742

  13. Measuring health care access and quality to improve health in populations.

    PubMed

    Kottke, Thomas E; Isham, George J

    2010-07-01

    Poor health status, rapidly escalating health care costs, and seemingly little association between investments in health care and health outcomes have prompted a call for a "pay-for-performance" system to improve population health. We suggest that both health plans and clinical service providers measure and report the rates of 5 behaviors: 1) smoking, 2) physical activity, 3) excessive drinking, 4) nutrition, and 5) condom use by sexually active youth. Because preventive services can improve population health, we suggest that health plans and clinical service providers report delivery rates of preventive services. We also suggest that an independent organization report 8 county-level indicators of health care performance: 1) health care expenditures, 2) insurance coverage, 3) rates of unmet medical, dental, and prescription drug needs, 4) preventive services delivery rates, 5) childhood vaccination rates, 6) rates of preventable hospitalizations, 7) an index of affordability, and 8) disparities in access to health care associated with race and income. To support healthy behaviors, access to work site wellness and health promotion programs should be measured. To promote coordinated care, an indicator should be developed for whether a clinical service provider is a member of an accountable care organization. To encourage clinical service providers and health plans to address the social determinants of health, organizational participation in community-benefit initiatives that address the leading social determinants of health should be assessed. PMID:20550831

  14. 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.

  15. 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. PMID:25711545

  16. Accessibility and Quality of Online Cancer-Related Clinical Trial Information for Naïve Searchers.

    PubMed

    Abel, Gregory A; Cronin, Angel M; Earles, Kristofer; Gray, Stacy W

    2015-10-01

    Although the Internet may help to increase cancer patients' awareness of clinical trials, little is known about the accessibility and quality of online clinical trial information. We simulated the experience of a naïve cancer patient without clinical trial knowledge by searching three popular search engines for treatment information for breast, lung, and prostate cancer, and myelodysplastic syndromes (MDS). Two coders independently evaluated website content for accessibility and quality. We screened 120 websites and identified 40 unique sites for analysis. Overall, 85% [95% confidence interval (CI), 70%-94%] of sites mentioned clinical trials on the landing page and 68% (51%-81%) included links to specific trials. Overall readability was poor. Approximately half of websites (36%-68%) included information on the potential benefits and risks of clinical trials and 40% provided information about when the site had been updated (25%-57%). Among sites with links to specific clinical trials, only 44% (25%-65%) provided an interactive interface that would allow patients to customize search results; breast (100%) and prostate (50%) sites were more interactive than lung (25%) and MDS (14%; P = 0.007). Although cancer clinical trial information is widely available on the Internet, its quality is highly variable. Given the fact that many emerging cancer therapeutics are personalized based on disease or genomic characteristics, interactive web-based interfaces could serve as powerful vehicles to help patients locate appropriate clinical trials. Without enhanced efforts to ensure greater interactivity of cancer treatment websites, patient awareness of relevant clinical trials may remain low. PMID:26265204

  17. 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.

  18. 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. PMID:26404635

  19. Mental health nurse practitioners in Australia: improving access to quality mental health care.

    PubMed

    Fisher, Jacklin E

    2005-12-01

    Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority 'area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners. PMID:16296989

  20. [Permanent vascular access for haemodialysis].

    PubMed

    Manafov, E N; Batrashov, V A; Sergeev, O G; Yudaev, S S

    2015-01-01

    The presence of a permanent vascular access (PVA) is the pledge of successful treatment of patients being on chronic haemodialysis (CD). Creation and maintenance of a functioning PVA is the priority task of vascular and endovascular surgeons, nephrologists and specialists of haemodialysis departments. According to the KDOQI guidelines, the most preferable type of PVA is a native arteriovenous fistula (AVF). As an alternative it is possible to use a synthetic prosthesis for creating an arteriovenous shunt (AVS) or implantation of a central venous catheter (CVC). Various complications of vascular accesses leading to their loss create the necessity of forming just another PVA, thus negatively influencing the life span and quality of life of this cohort of patients. Improving surgical technique and approaches to treatment, as well as carrying out dynamic monitoring of the condition of the created PVA make it possible to considerably decrease the incidence rate of such complications and to improve the quality of medical care rendered. PMID:26451410

  1. Ensuring global access to quality medicines: role of the US Pharmacopeia.

    PubMed

    Heyman, Matthew L; Williams, Roger L

    2011-04-01

    In the 5-year cycle that characterizes a continuous improvement of the US Pharmacopeial (USP) Convention, the Council of the Convention's Section on Global Public Health worked with USP's staff to assess USP's international contributions to date and to consider opportunities for expanding activities that help to ensure good healthcare around the globe.1 This article reviews USP's process and product standards that are used worldwide to ensure the quality of medicines and dietary supplements and to help mitigate the burden of counterfeit and substandard ingredients and products. The article also reviews USP's international programs during the past 5-year cycle, along with continuing and planned international activities. PMID:24081465

  2. 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. PMID:26141978

  3. Determination of Disk Diffusion and MIC Quality Control Guidelines for Solithromycin, a Novel Fluoroketolide Antibacterial, against Neisseria gonorrhoeae

    PubMed Central

    Ross, James E.; Farrell, David J.; Flamm, Robert K.; Jones, Ronald N.

    2015-01-01

    This solithromycin quality control study was performed to establish quality control (QC) ranges for the N. gonorrhoeae ATCC 49226 control strain for MIC agar dilution testing (AD) and zones by disk diffusion testing (DD). The following ranges were established: AD, 0.03 to 0.25 μg/ml, and DD, 33 to 43 mm. In January 2015, the CLSI Subcommittee on Antimicrobial Susceptibility Testing approved these ranges, which will be important when evaluating solithromycin against clinical isolates of N. gonorrhoeae. PMID:26378286

  4. 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.

  5. 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

  6. 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. PMID:22912352

  7. Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden.

    PubMed

    Avdic, Daniel

    2016-07-01

    Recent health care consolidation trends raise the important policy question whether improved emergency medical services and enhanced productivity can offset adverse quality effects from decreased access. This paper empirically analyzes how geographical distance from an emergency hospital affects the probability of surviving an acute myocardial infarction (AMI), accounting for health-based spatial sorting and data limitations on out-of-hospital mortality. Exploiting policy-induced variation in hospital distance derived from emergency hospital closures and detailed Swedish mortality data over two decades, results show a drastically decreasing probability of surviving an AMI as residential distance from a hospital increases one year after a closure occurred. The effect disappears in subsequent years, however, suggesting that involved agents quickly adapted to the new environment. PMID:27060525

  8. Locally weighted regression for accessing a database containing wheat grain NIR transmission spectra and grain quality parameters

    NASA Astrophysics Data System (ADS)

    Archibald, Douglas D.; Funk, David B.; Barton, Franklin E., II

    1999-01-01

    Networks of NIR transmission spectrometers operating in the range 850 to 1050 nm are used worldwide to determine wheat grain quality parameters such as protein content. These instrumental system often require maintenance of calibrations for each grain class, and updating of calibrations for each crop year. In order to facilitate annual updates nd eliminate the need for multiple wheat class calibration models, this laboratory is pursuing a modeling strategy that uses locally weighted regression (LWR) to access a spectral database. With LWR, the calibration model defines the procedure to access the database and calculate the prediction, and this model can potentially remain the same for all classes and crop years. Incorporation of new sample variation is accomplished by new additions to the spectral database. Details are presented on development of an NIR model for determination of protein in multiple wheat-classes using the LWR approach with Y- distance weighting. This model is compared with a linear partial least-squares regression model spanning the same diverse set of samples. Initial steps were taken to validate these models with spectra measured on seven instruments at two remote locations.

  9. 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.

  10. 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

  11. Obtaining the new HIV treatment guidelines.

    PubMed

    2001-02-28

    How to order the new HIV/AIDS official adult treatment guidelines by mail if you do not have computer access; how to get your questions about treatments answered at the same office; and other guidelines available including prevention of opportunistic infections, and what to do in case of occupational exposure to HIV. In addition, the official Web site for the guidelines has a marked copy which shows where the current adult guidelines are changed from the previous version. PMID:12765150

  12. 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. PMID:23957628

  13. 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

  14. Associations between factors affecting access to care and health-related quality of life: results of a statewide HIV/AIDS cross-sectional study.

    PubMed

    Krause, Denise D; Butler, Kenneth R; May, Warren L

    2013-01-01

    The objective of this cross-sectional study was to describe the relationship between access to care and health-related quality of life (HRQOL) for persons living with HIV/AIDS (PLWHA) in Mississippi by administering a statewide survey. A random probability sample of PLWHA was derived from the Mississippi State Department of Health's communicable disease tracking system. Interviews were conducted with 220 PLWHA to collect data on access to care, demographic and social characteristics, and HRQOL. Overall, most participants had access to care and reasonable HRQOL. Multivariate and univariate analyses were performed to measure associations between access to care and HRQOL. Univariate analyses showed that age, income, social networks, severity of disease, having been prescribed medications, and having experienced problems accessing care to be significantly associated with HRQOL scales. Multivariate analysis of variance models further demonstrated low-income level, having experienced problems accessing care, and having been prescribed antiretroviral medications to be significantly associated with HRQOL. Reducing barriers is a major factor in improving quality of life. This study provides needed insight into the relationship between access to care and HRQOL among PLWHA in Mississippi, which could be valuable to public health planners to help them better understand how to make the greatest impact on HRQOL. PMID:22612404

  15. Guidelines for systematic review in conservation and environmental management.

    PubMed

    Pullin, Andrew S; Stewart, Gavin B

    2006-12-01

    An increasing number of applied disciplines are utilizing evidence-based frameworks to review and disseminate the effectiveness of management and policy interventions. The rationale is that increased accessibility of the best available evidence will provide a more efficient and less biased platform for decision making. We argue that there are significant benefits for conservation in using such a framework, but the scientific community needs to undertake and disseminate more systematic reviews before the full benefit can be realized. We devised a set of guidelines for undertaking formalized systematic review, based on a health services model. The guideline stages include planning and conducting a review, including protocol formation, search strategy, data inclusion, data extraction, and analysis. Review dissemination is addressed in terms of current developments and future plans for a Web-based open-access library. By the use of case studies we highlight critical modifications to guidelines for protocol formulation, data-quality assessment, data extraction, and data synthesis for conservation and environmental management. Ecological data presented significant but soluble challenges for the systematic review process, particularly in terms of the quantity, accessibility, and diverse quality of available data. In the field of conservation and environmental management there needs to be further engagement of scientists and practitioners to develop and take ownership of an evidence-based framework. PMID:17181800

  16. Medicare program; standards for quality of water used in dialysis and revised guidelines on reuse of hemodialysis filters for end-stage renal disease (ESRD) patients--HCFA. Final rule.

    PubMed

    1995-09-18

    This final rule revises the Medicare conditions for coverage of suppliers of end-stage renal disease services. The revisions remove general language in the regulations regarding water quality; incorporate by reference standards for monitoring the quality of water used in dialysis as published by the Association for the Advancement of Medical Instrumentation (AAMI) in its document, "Hemodialysis Systems" (second edition); and update existing regulations to incorporate by reference the second edition of AAMI's voluntary guidelines on "Reuse of Hemodialyzers." PMID:10151653

  17. A review of safety, quality management, and practice guidelines for high-dose-rate brachytherapy: executive summary.

    PubMed

    Thomadsen, Bruce R; Erickson, Beth A; Eifel, Patricia J; Hsu, I-Chow; Patel, Rakesh R; Petereit, Daniel G; Fraass, Benedick A; Rivard, Mark J

    2014-01-01

    This white paper was commissioned by the American Society for Radiation Oncology (ASTRO) Board of Directors to evaluate the status of safety and practice guidance for high-dose-rate (HDR) brachytherapy. Given the maturity of HDR brachytherapy technology, this white paper considers, from a safety point of view, the adequacy of general physics and quality assurance guidance, as well as clinical guidance documents available for the most common treatment sites. The rate of medical events in HDR brachytherapy procedures in the United States in 2009 and 2010 was 0.02%, corresponding to 5-sigma performance. The events were not due to lack of guidance documents but failures to follow those recommendations or human failures in the performance of tasks. The white paper summarized by this Executive Summary reviews current guidance documents and offers recommendations regarding their application to delivery of HDR brachytherapy. It also suggests topics where additional research and guidance is needed. PMID:24890345

  18. 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. PMID:26880649

  19. 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

  20. 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…

  1. 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…

  2. 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…

  3. 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. PMID:26289814

  4. Study of quality assurance regulations for linear accelerators in Korea: A comparison study between the current status in Korea and the international guidelines

    NASA Astrophysics Data System (ADS)

    Lee, Hyunho; Jeong, Seonghoon; Jo, Yunhui; Yoon, Myonggeun

    2015-07-01

    Quality assurance (QA) for medical linear accelerators is indispensable for appropriate cancer treatment. Some international organizations and advanced Western countries have provided QA guidelines for linear accelerators. Currently, QA regulations for linear accelerators in Korean hospitals specify a system in which each hospital stipulates its independent hospital-based protocols for QA procedures (HP_QAPs) and conducts QA based on those HP_QAPs while regulatory authorities verify whether items under those HP_QAPs have been performed. However, because this regulatory method cannot guarantee the quality of universal treatment and QA items with tolerance criteria are different in many hospitals, the presentation of standardized QA items and tolerance criteria is essential. In this study, QA items in HP_QAPs from various hospitals and those presented by international organizations, such as the International Atomic Energy Agency, the European Union, and the American Association of Physicist in Medicine, and by advanced Western countries, such as the USA, the UK, and Canada, were compared. Concordance rates between QA items for linear accelerators that were presented by the aforementioned organizations and those currently being implemented in Korean hospitals were shown to exhibit a daily QA of 50%, a weekly QA of 22%, a monthly QA of 43%, and an annual QA of 65%, and the overall concordance rates of all QA items were approximately 48%. In the comparison between QA items being implemented in Korean hospitals and those being implemented in advanced Western countries, concordance rates were shown to exhibit a daily QA of 50%, a weekly QA of 33%, a monthly QA of 60%, and an annual QA of 67%, and the overall concordance rates of all QA items were approximately 57%. The results of this study indicate that the HP_QAPs currently implemented by Korean hospitals as QA standards for linear accelerators used in radiation therapy do not meet international standards. If this

  5. DRAFT PROPOSED GUIDELINES FOR ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    This document is part of a continuing, long-term effort to develop Agency-wide ecological risk assessment guidelines for EPA. The goal of the guidelines is to improve the quality and consistency of the Agency's ecological risk assessments. These guidelines move beyond the Agency'...

  6. 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

  7. Solvent and lipid accessibility prediction as a basis for model quality assessment in soluble and membrane proteins.

    PubMed

    Phatak, Mukta; Adamczak, Rafał; Cao, Baoqiang; Wagner, Michael; Meller, Jarosław

    2011-09-01

    On-going efforts to improve protein structure prediction stimulate the development of scoring functions and methods for model quality assessment (MQA) that can be used to rank and select the best protein models for further refinement. In this work, sequence-based prediction of relative solvent accessibility (RSA) is employed as a basis for a simple MQA method for soluble proteins, and subsequently extended to the much less explored case of (alpha-helical) membrane proteins. In analogy to soluble proteins, the level of exposure to the lipid of amino acid residues in transmembrane (TM) domains is captured in terms of the relative lipid accessibility (RLA), which is predicted from sequence using low-complexity Support Vector Regression models. On an independent set of 23 TM proteins, the new SVR-based predictor yields correlation coefficient (CC) of 0.56 between the predicted and observed RLA profiles, as opposed to CC of 0.13 for a baseline predictor that utilizes TMLIP2H empirical lipophilicity scale (with standard deviations of about 0.15). A simple MQA approach is then defined by ranking models of membrane proteins in terms of consistency between predicted and observed RLA profiles, as a measure of similarity to the native structure. The new method does not require a set of decoy models to optimize parameters, circumventing current limitations in this regard. Several different sets of models, including those generated by fragment based folding simulations, and decoys obtained by swapping TM helices to mimic errors in template based assignment, are used to assess the new approach. Predicted RLA profiles can be used to successfully discriminate near native models from non-native decoys in most cases, significantly improving the separation of correct and incorrectly folded models compared to a simple baseline approach that utilizes TMLIP2H. As suggested by the robust performance of a simple MQA method for soluble proteins that utilizes more accurate RSA predictions

  8. Supporting tools for guideline development and dissemination.

    PubMed

    Quaglini, S; Dazzi, L; Gatti, L; Stefanelli, M; Fassino, C; Tondini, C

    1998-01-01

    This paper describes a methodology for representing clinical practice guidelines and facilitating their introduction into the medical routine. Since this methodology can be exploited in a www environment, it can represent the basis for sharing clinical guidelines both between different institutions and between human and software agents cooperating within a clinical context. In addition, the proposed guideline formalization is intended to deal with patient and organization preferences. This goal is achieved by augmenting the guideline with decision analytic models and by linking the guideline with an organizational model of the clinical setting. The designed framework allows guideline development, tailoring and implementation, real-time access to the guideline prescriptions and guideline validation. PMID:9779886

  9. 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

  10. 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

  11. COASTAL GUIDELINES

    EPA Science Inventory

    Resource Purpose:Developed to support effluent guidelines for the coastal subcategory of the oil and gas extraction industry. Data were used to develop environmental impacts, potential regulatory limits, and the cost of regulation.
    Legislation/Enabling Authority:...

  12. 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…

  13. 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…

  14. Holistic Approaches to E-Learning Accessibility

    ERIC Educational Resources Information Center

    Phipps, Lawrie; Kelly, Brian

    2006-01-01

    The importance of accessibility to digital e-learning resources is widely acknowledged. The World Wide Web Consortium Web Accessibility Initiative has played a leading role in promoting the importance of accessibility and developing guidelines that can help when developing accessible web resources. The accessibility of e-learning resources…

  15. 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

  16. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Americans with Disabilities Act (ADA), effective March 15, 2012. 28 CFR 35.151(c)(3), as amended at 75 FR 56163, September 15, 2010; and 28 CFR 36.406(a)(3), as amended at 75 FR 56236, September 15, 2010. For state and local governments, the 2010 Standards consist of the regulations at 28 CFR 35.151 and...

  17. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., effective November 29, 2006. 49 CFR 37.9 and Appendix A to 49 CFR part 37, as amended at 71 FR 63263... facilities subject to its regulations under the Architectural Barriers Act. 41 CFR 102-76.65, as added at 70... its postal facilities subject to the Architectural Barriers Act, effective October 1, 2005. 39 CFR...

  18. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., effective November 29, 2006. 49 CFR 37.9 and Appendix A to 49 CFR part 37, as amended at 71 FR 63263... facilities subject to its regulations under the Architectural Barriers Act. 41 CFR 102-76.65, as added at 70... its postal facilities subject to the Architectural Barriers Act, effective October 1, 2005. 39 CFR...

  19. 36 CFR 1191.1 - Accessibility guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... facilities subject to its regulations under the Architectural Barriers Act. 41 CFR 102-76.65, as added at 70... its postal facilities subject to the Architectural Barriers Act, effective October 1, 2005. 39 CFR 254..., effective November 29, 2006. 49 CFR 37.9 and Appendix A to 49 CFR part 37, as amended at 71 FR...

  20. 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. PMID:25751545

  1. 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

  2. An Evaluation of Web-Based Clinical Practice Guidelines for Managing Problems Associated with Cannabis Use

    PubMed Central

    Turner, Michael W; Rooke, Sally E; Langton, Julia M; Gates, Peter J

    2012-01-01

    Background Cannabis is the most widely used illicit substance, and multiple treatment options and avenues exist for managing its use. There has been an increase in the development of clinical practice guidelines (CPGs) to improve standards of care in this area, many of which are disseminated online. However, little is known about the quality and accessibility of these online CPGs. Objective The purpose of study 1 was to determine the extent to which cannabis-related CPGs disseminated online adhere to established methodological standards. The purpose of study 2 was to determine if treatment providers are familiar with these guidelines and to assess their perceived quality of these guidelines. Methods Study 1 involved a systematic search using the Google Scholar search engine and the National Drugs Sector Information Service (NDSIS) website of the Alcohol and Other Drugs Council of Australia (ADCA) to identify CPGs disseminated online. To be included in the current study, CPGs needed to be free of charge and provide guidance on psychological interventions for reducing cannabis use. Four trained reviewers independently assessed the quality of the 7 identified guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Study 2 assessed 166 Australian cannabis-use treatment providers’ (mean age = 45.47 years, SD 12.14) familiarity with and opinions of these 7 guidelines using an online survey. Treatment providers were recruited using online advertisements that directed volunteers to a link to complete the survey, which was posted online for 6 months (January to June 2012). Primary study outcomes included quality scores and rates of guideline familiarity, guideline use, and discovery methods. Results Based on the AGREE II, the quality of CPGs varied considerably. Across different reporting domains, adherence to methodological standards ranged from 0% to 92%. Quality was lowest in the domains of rigor of development (50%), applicability (46

  3. 32 CFR 147.29 - Temporary eligibility for access.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Guidelines for Temporary Access § 147.29 Temporary eligibility for access. Based on a justified need meeting... 32 National Defense 1 2010-07-01 2010-07-01 false Temporary eligibility for access. 147.29...

  4. 32 CFR 147.29 - Temporary eligibility for access.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Guidelines for Temporary Access § 147.29 Temporary eligibility for access. Based on a justified need meeting... 32 National Defense 1 2011-07-01 2011-07-01 false Temporary eligibility for access. 147.29...

  5. Americans with Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities; Play Areas; Final Rule. Federal Register, Part IV: Architectural and Transportation Barriers Compliance Board, 36 CFR Part 1191.

    ERIC Educational Resources Information Center

    Federal Register, 2000

    2000-01-01

    The Architectural and Transportation Barriers Compliance Board has issued guidelines to serve as the basis for enforceable standards to be adopted by the Department of Justice for new construction and alterations of play areas covered by the Americans with Disabilities Act. The guidelines include scoping and technical provisions for ground level…

  6. 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

  7. 32 CFR 147.5 - Guideline C-Foreign preference.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Guideline C-Foreign preference. 147.5 Section... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.5 Guideline C—Foreign preference. (a) The concern. When an individual acts in such a way...

  8. 32 CFR 147.5 - Guideline C-Foreign preference.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Guideline C-Foreign preference. 147.5 Section... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.5 Guideline C—Foreign preference. (a) The concern. When an individual acts in such a way...

  9. 32 CFR 147.5 - Guideline C-Foreign preference.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Guideline C-Foreign preference. 147.5 Section... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.5 Guideline C—Foreign preference. (a) The concern. When an individual acts in such a way...

  10. 32 CFR 147.8 - Guideline F-Financial considerations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Guideline F-Financial considerations. 147.8..., MILITARY AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.8 Guideline F—Financial considerations. (a) The concern. An individual who...

  11. Proposed Guidelines for Operating Counselor Education and Supervision Training Clinics

    ERIC Educational Resources Information Center

    Lauka, Justin D.; McCarthy, Amanda K.

    2013-01-01

    The purpose of this article is to justify and present a set of guidelines for the effective and ethical administration of counselor education and supervision training clinics. Responding directly to a call for creating guidelines, the authors address core issues surrounding their development. Benefits for clear and accessible guidelines and risks…

  12. 32 CFR 147.4 - Guideline B-Foreign influence.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Guideline B-Foreign influence. 147.4 Section 147.4 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.4 Guideline B—Foreign...

  13. Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and Swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment.

    PubMed

    Rosenow, Felix; Bast, Thomas; Czech, Thomas; Feucht, Martha; Hans, Volkmar H; Helmstaedter, Christoph; Huppertz, Hans-Jürgen; Noachtar, Soheyl; Oltmanns, Frank; Polster, Tilman; Seeck, Margitta; Trinka, Eugen; Wagner, Kathrin; Strzelczyk, Adam

    2016-08-01

    The definition of minimal standards remains pivotal as a basis for a high standard of care and as a basis for staff allocation or reimbursement. Only limited publications are available regarding the required staffing or methodologic expertise in epilepsy centers. The executive board of the working group (WG) on presurgical epilepsy diagnosis and operative epilepsy treatment published the first guidelines in 2000 for Austria, Germany, and Switzerland. In 2014, revised guidelines were published and the WG decided to publish an unaltered English translation in this report. Because epilepsy surgery is an elective procedure, quality standards are particularly high. As detailed in the first edition of these guidelines, quality control relates to seven different domains: (1) establishing centers with a sufficient number of sufficiently and specifically trained personnel, (2) minimum technical standards and equipment, (3) continuous medical education of employees, (4) surveillance by trained personnel during 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) the cooperation of epilepsy centers. These standards required the certification of the different professions involved and minimum numbers of procedures. In the subsequent decade, quite a number of colleagues were certified by the trinational WG; therefore, the executive board of the WG decided in 2013 to make these standards obligatory. This revised version is particularly relevant given that the German procedure classification explicitly refers to the guidelines of the WG with regard to noninvasive/invasive preoperative video-EEG monitoring and invasive intraoperative diagnostics in epilepsy. PMID:27354263

  14. 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,…

  15. 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…

  16. Clinical practice guidelines: their use, misuse, and future directions.

    PubMed

    Sanders, James O; Bozic, Kevin J; Glassman, Steven D; Jevsevar, David S; Weber, Kristy L

    2014-03-01

    Evidence-based clinical practice guidelines (CPGs) have the potential to bring the best-quality evidence to orthopaedic surgeons and their patients. CPGs can improve quality by decreasing the variability in orthopaedic care, but they can also be misused through inappropriate development or application. The quality of a CPG is dependent on the strength of its evidence base, which is often deficient in orthopaedic publications. In addition, many surgeons express concern about legal liability associated with CPGs. Specific processes in CPG development and implementation can counter these potential problems. Other evidence tools, such as appropriate use criteria, also can help in the application of the proper treatment of patients by identifying those who are appropriate for specific procedures. Because payers, patients, and surgeons need access to the best evidence, CPGs will continue to be developed, and orthopaedic surgeons have the opportunity to ensure their proper development and implementation by understanding and participating in the process. PMID:24603823

  17. 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…

  18. 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. PMID:21929639

  19. 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. ...

  20. Quality.

    ERIC Educational Resources Information Center

    Evans, Judith L.; Schaeffer, Sheldon

    1996-01-01

    This issue of the Coordinator's Notebook focuses on the quality of Early Childhood Care and Development (ECCD) programs. The bulk of the issue is devoted to an article "Quality in ECCD: Everyone's Concern" (Judith Evans), which reviews the need for a definition of high quality in ECCD programs and discusses how diverse stakeholders define quality.…

  1. 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. PMID:27066258

  2. 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. PMID:24551412

  3. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... the Water Resources Council. Watershed projects are to be planned and carried out in a way that...

  4. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... the Water Resources Council. Watershed projects are to be planned and carried out in a way that...

  5. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... the Water Resources Council. Watershed projects are to be planned and carried out in a way that...

  6. PROPOSED GUIDELINES FOR ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    The Proposed Guidelines for Ecological Risk Assessment were published in the Federal Register on September 9, 1996 (61 FR 47552) for a 90 day public review and comment period. The Proposed Guidelines are being developed to improve the quality of and consistency among EPA's ecolog...

  7. 7 CFR 622.5 - Guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... NEPA (40 CFR parts 1500-1508) issued by the Council on Environmental Quality, and in Economic and... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... the Water Resources Council. Watershed projects are to be planned and carried out in a way that...

  8. Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions

    PubMed Central

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire

    2016-01-01

    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 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. PMID:24353274

  9. 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. PMID:26883021

  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. PMID:15966992

  11. 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

  12. 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…

  13. Access to High Quality Early Care and Education: Readiness and Opportunity Gaps in America. CEELO Policy Report

    ERIC Educational Resources Information Center

    Nores, Milagros; Barnett, W. Steven

    2014-01-01

    A substantial body of research establishes that high quality preschool education can enhance cognitive and social development with long-term benefits for later success in school, the economy, and society more broadly. Such programs have been found to have particularly large benefits for children who are economically disadvantaged. Such children…

  14. 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…

  15. Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London

    PubMed Central

    2012-01-01

    Background and aim There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants. Material and methods This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used. Results Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants. Conclusions The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care. PMID:22280521

  16. Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma

    PubMed Central

    Huang, Jian-kang; Ma, Ling; Song, Wen-hua; Lu, Bang-yu; Huang, Yu-bin; Dong, Hui-ming

    2016-01-01

    Background Endoscopic thyroidectomy for minimally invasive thyroid surgery has been widely applied in the past decade. The present study aimed to evaluate the effects of single-port access transaxillary totally endoscopic thyroidectomy on the postoperative outcomes and functional parameters, including quality of life and cosmetic result in patients with papillary thyroid carcinoma (PTC). Patients and methods Seventy-five patients with PTC who underwent endoscopic thyroidectomy via a single-port access transaxillary approach were included (experimental group). A total of 123 patients with PTC who were subjected to conventional open total thyroidectomy served as the control group. The health-related quality of life and cosmetic and satisfaction outcomes were assessed postoperatively. Results The mean operation time was significantly increased in the experimental group. The physiological functions and social functions in the two groups were remarkably augmented after 6 months of surgery. However, there was no significant difference in the scores of speech and taste between the two groups at the indicated time of 1 month and 6 months. In addition, the scores for appearance, satisfaction with appearance, role-physical, bodily pain, and general health in the experimental group were better than those in the control group at 1 month and 6 months after surgery. Conclusion The single-port access transaxillary totally endoscopic thyroidectomy is safe and feasible for the treatment of patients with PTC. The subjects who underwent this technique have a good perception of their general state of health and are likely to participate in social activities. It is worthy of being clinically used for patients with PTC. PMID:27445496

  17. New Asthma Guidelines What You Should Know

    MedlinePlus

    ... Home Current Issue Past Issues Special Section New Asthma Guidelines: What You Should Know Past Issues / Fall ... on. If you or a relative suffers from asthma, it is important to know that quality care ...

  18. 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

    2016-01-01

    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. PMID:26939036

  19. Accessing groundwater quality in lower part of Nagapattinam district, Southern India: using hydrogeochemistry and GIS interpolation techniques

    NASA Astrophysics Data System (ADS)

    Gnanachandrasamy, G.; Ramkumar, T.; Venkatramanan, S.; Vasudevan, S.; Chung, S. Y.; Bagyaraj, M.

    2015-03-01

    The aim of this present study was to evaluate groundwater quality in the lower part of Nagapattinam district, Tamil Nadu, Southern India. A detailed geochemical study of groundwater region is described, and the origin of the chemical composition of groundwater has been qualitatively evaluated, using observations over a period of two seasons premonsoon (June) and monsoon (November) in the year of 2010. To attempt this goal, samples were analysed for various physico-chemical parameters such as temperature, pH, salinity, Na+, Ca2+, K+, Mg2+, Cl-, HCO3 - and SO4 2-. The abundance of major cations concentration in groundwater is as Na > Ca > Mg > K, while that of anions is Cl > SO4 > HCO3. The Piper trilinear diagram indicates Ca-Cl2 facies, and according to USSL diagram, most of the sample exhibits high salinity hazard (C3S1) type in both seasons. It indicates that high salinity (C3) and low sodium (S1) are moderately suitable for irrigation purposes. Gibbs boomerang exhibits most of the samples mainly controlled by evaporation and weathering process sector in both seasons. Irrigation status of the groundwater samples indicates that it was moderately suitable for agricultural purpose. ArcGIS 9.3 software was used for the generation of various thematic maps and the final groundwater quality map. An interpolation technique inverse distance weighting was used to obtain the spatial distribution of groundwater quality parameters. The final map classified the ground quality in the study area. The results of this research show that the development of the management strategies for the aquifer system is vitally necessary.

  20. 1997 to Present: Quality and Versatile Access to the Deep Biosphere with Coupled Advanced CORKs and Fluid Pumping Systems

    NASA Astrophysics Data System (ADS)

    Cowen, J. P.; Lin, H.; Jungbluth, S.; Hsieh, C.; Rappe, M.; Glazer, B. T.; Matzinger, M.; Becker, K.; Fisher, A. T.; Amend, J. P.; Johnson, H. P.

    2011-12-01

    In 1997, a simple 'BioColumn' sampler was coupled to the CORK observatory at borehole 1026B to sample fluid chemistry, biomass and microbial community diversity (16S rRNA). The results demonstrated that the 65oC fluids from the 3.5 My old sediment-buried ocean basement support a diverse Bacteria and Archaea community (Cowen et al. 2003, Science 299, 120-123). The large bore of the overpressured CORK body provided high unassisted flow rates through the BioColumn, but possessed the disadvantage of the unknown extent to which the basement fluids were altered by the chemically and biologically (e.g., biofilm community) reactive surface of CORK's steel pipe. Subsequently, new generations of CORKs have incorporated less reactive materials in the CORK body, the use of stainless steel or inert PVDF (Teflon-like) 0.5" ID fluid delivery lines (FDL) running continuously from basement depths to accessible ports at the seafloor, and multiple FDLs from distinct depth horizons within basement. Simultaneously, we have developed increasingly capable fluid sensor and sampling systems for both real-time (Mobile Pumping and Sampling System-MPSS) and long-term autonomous applications (GeoMICROBE sleds). Both incorporate strong efficient pumps to overcome the drag inherent in the 0.5" or smaller bore FDL, multiple sensors (e.g., flow rate, temperature, O2, pH and redox-voltametry chemistry), versatile multi-port large volume fluid collection and/or in situ filtration systems, integrating computer controller/software and non-contaminating (inert) plumbing. These combined developments now provide unparalleled opportunities for access to large volumes of pristine basement samples for geochemical and microbial ecology studies. The MPSS and GeoMICROBE will be described. The multi-year results of organic geochemical and microbial community studies from recent studies at CORK observatories (boreholes 1301A, 1362A 1362B) on the Juan de Fuca Ridge flank will be summarized.

  1. Improving Data Quality for Title I Standards, Assessments, and Accountability Reporting: Guidelines for States, LEAs, and Schools (Non-Regulatory Guidance)

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    Spurred by the "No Child Left Behind Act" of 2001, virtually every educational reform program now includes an accountability component that requires sound data collection and reporting. Improving data quality has thus emerged as a high priority for educators and policymakers across the country. The list of programs for which data quality is…

  2. 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.

  3. A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination

    PubMed Central

    2013-01-01

    Introduction Refugees have many complex health care needs which should be addressed by the primary health care services, both on their arrival in resettlement countries and in their transition to long-term care. The aim of this narrative synthesis is to identify the components of primary health care service delivery models for such populations which have been effective in improving access, quality and coordination of care. Methods A systematic review of the literature, including published systematic reviews, was undertaken. Studies between 1990 and 2011 were identified by searching Medline, CINAHL, EMBASE, Cochrane Library, Scopus, Australian Public Affairs Information Service – Health, Health and Society Database, Multicultural Australian and Immigration Studies and Google Scholar. A limited snowballing search of the reference lists of all included studies was also undertaken. A stakeholder advisory committee and international advisers provided papers from grey literature. Only English language studies of evaluated primary health care models of care for refugees in developed countries of resettlement were included. Results Twenty-five studies met the inclusion criteria for this review of which 15 were Australian and 10 overseas models. These could be categorised into six themes: service context, clinical model, workforce capacity, cost to clients, health and non-health services. Access was improved by multidisciplinary staff, use of interpreters and bilingual staff, no-cost or low-cost services, outreach services, free transport to and from appointments, longer clinic opening hours, patient advocacy, and use of gender-concordant providers. These services were affordable, appropriate and acceptable to the target groups. Coordination between the different health care services and services responding to the social needs of clients was improved through case management by specialist workers. Quality of care was improved by training in cultural sensitivity and

  4. [Possibilities and limits of guidelines in medicine].

    PubMed

    Lauterbach, K W

    1998-03-01

    Clinical practice guidelines can be used to achieve optimal utilization of scarce resources for the medical management of defined patient groups. However, this does not mean that the total amount of resources allocated to these patient groups will be reduced automatically. Examples of different health economic consequences for guideline implementation will be discussed, especially with regards to the cost-effectiveness to therapy and to the total health care budget. The procedural steps for developing evidence-based practice guidelines are described and the cost for their development is estimated. For Germany, the amount of this cost is about 400,000 to 500,000 DM per practice guideline. The development of evidence-based guidelines without accounting for cost-effectiveness of therapy is not reasonable as cost-effectiveness is implied in the definition of guideline objectives. Practice guidelines that are not taking into consideration health economic data may diminish the cost-benefit relation of therapy. Quality criteria of sound evidence-based guidelines are introduced. Evidence-based guidelines that are developed in cooperation with recognized clinical experts attain wide acceptance among physicians. Sound evidence-based guidelines comprising cost-benefit relations of therapy can be the core of an internal health care reform. PMID:9577897

  5. Standards and Guidelines in Telemedicine and Telehealth

    PubMed Central

    Krupinski, Elizabeth A.; Bernard, Jordana

    2014-01-01

    The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations, such as the American Telemedicine Association (ATA), have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices, as well as being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms not just in the traditional clinical environments, and practice guidelines will be a key factor in fostering this growth. Creation of guidelines is important to payers and regulators as well as increasingly they are adopting and integrating them into regulations and policies. This paper will review some of the recent ATA efforts in developing telemedicine practice guidelines, review the role of research in guidelines development, review data regarding their use, and discuss some of areas where guidelines are still needed. PMID:27429261

  6. Process chemistry {ampersand} statistics quality assurance plan

    SciTech Connect

    Meznarich, H.K.

    1996-08-01

    This document provides quality assurance guidelines and quality control requirements for Process Chemistry and Statistics. This document is designed on the basis of Hanford Analytical Services Quality Assurance Plan (HASQAP) technical guidelines and is used for governing process chemistry activities.

  7. STRATEGY FOR REVISION TO THE AQUATIC LIFE CRITERIA GUIDELINES

    EPA Science Inventory

    The existing Guidelines for Deriving Water Quality Criteria for the Protection of Aquatic Life (the Guidelines) have not been updated since 1985. This effort will update the guidelines, as needed, to reflect scientific advancement in aquatic toxicology, aquatic biology, fate, tra...

  8. Confidentiality of College and University Faculty Personnel Files: Its Appropriate Role in Institutional Affairs [and] Statement on Access to and Disclosures from Employee Records. Self-Regulation Initiatives: Guidelines for Colleges and Universities, Nos. 7 and 8.

    ERIC Educational Resources Information Center

    American Council on Education, Washington, DC.

    Guidelines for colleges concerning the privacy of employee records are presented in two policy statements. Institutional policy should minimize intrusiveness, maximize fairness, and create legitimate expectations of confidentiality. In addition to strengthening professional equity of treatment, confidentiality permits consideration of both adverse…

  9. Thai health technology assessment guideline development.

    PubMed

    Teerawattananon, Yot; Chaikledkaew, Usa

    2008-06-01

    Health Technology Assessment (HTA) is a comprehensive form of policy research that provides information on the consequences of the application of health technology. It is used primarily to guide health care resource allocation decisions. In Thailand, there is increasing impetus to use HTA information to allow more explicit and transparent health care priority setting. A previous study indicated that serious attention needed to be given to the quality of reporting and the use of information in the analyses. These problems could be reduced by setting up standard guidelines for conducting HTA to stimulate the provision of standardized, reliable and good quality information for policy makers. Nevertheless, Thailand has not yet set up such guidelines. This may lead to low quality evaluations. Therefore, the objective of this article was to describe the rationale for guideline development, supporting principles, guideline development process, sources of information, and future challenges for HTA. PMID:19253483

  10. Guidelines to Contributors

    PubMed Central

    2011-01-01

    To address the task of the expansion of the Sudanese Journal of Paediatrics (SJP) to encompass the scientific work dealing with child health locally and abroad, it will be the purpose of the Editorial Board of SJP to encourage authors to submit high-quality papers for the refereed publication and to make a more varied source of material to our readers. “Guidelines to contributors “are published to help the authors to present their data in accordance with the currently accepted uniform style for submitted manuscripts. It is based on the recommendations of the International Committee of Medical Journal Editors [1] with minor modifications to suit the local facilities in developing countries.

  11. [Combining microcredit, microinsurance, and the provision of health care can improve access to quality care in urban areas of Africa: Results of an experiment in the Bandalungwa health zone in Kinshasa, the Congo].

    PubMed

    Manzambi Kuwekita, J; Gosset, C; Guillaume, M; Balula Semutsari, M-P; Tshiama Kabongo, E; Bruyere, O; Reginster, J-Y

    2015-01-01

    This study, based on a survey conducted in 2008, examines how combining microcredit, microinsurance, and health care provision can improve access to quality care in the health zone of Bandalungwa, in Kinshasa. The bivariate analysis showed a significant association between increased purchasing power and earnings (p = 0.001), between earnings and savings (p = 0.000), and between health insurance and improved access to health care. These results show that 68.8% of borrowers reported an increase in their purchasing power, of whom 82% reported profits. Those with savings were 24.7 times more likely to purchase health insurance than those without; and 72% of those who regularly made health insurance payments improved their access to care. Combining microcredit, health microinsurance, and health care can improve access to quality health care at lower cost. This suggests that health insurance could usefully be integrated into the primary health-care system. PMID:26643890

  12. Global Initiatives for Early Childhood Care and Education: Global Guidelines and Global Guidelines Assessment

    ERIC Educational Resources Information Center

    Trube, Mary Barbara

    2015-01-01

    This report focuses on the Association for Childhood Education International's (ACEI) Global Guidelines (GG) and Global Guidelines Assessment (GGA), which were developed in response to and in keeping with the prominence that the issue of quality early childhood care, development, and education has reached globally. Further, the paper positions the…

  13. Five Steps to an Accessible Classroom Website

    ERIC Educational Resources Information Center

    Amundson, Linda

    2009-01-01

    When teachers or technology coordinators publish a website, they are providing a product for a diverse group of people. That's why website design should follow accessibility guidelines. Websites should be accessible to those with visual, hearing, movement, cognitive, and speech disabilities. Good design means greater accessibility for all. This…

  14. Improving Web Accessibility in a University Setting

    ERIC Educational Resources Information Center

    Olive, Geoffrey C.

    2010-01-01

    Improving Web accessibility for disabled users visiting a university's Web site is explored following the World Wide Web Consortium (W3C) guidelines and Section 508 of the Rehabilitation Act rules for Web page designers to ensure accessibility. The literature supports the view that accessibility is sorely lacking, not only in the USA, but also…

  15. Access to Education for Orphans and Vulnerable Children in Uganda: A Multi-District, Cross-Sectional Study Using Lot Quality Assurance Sampling from 2011 to 2013

    PubMed Central

    Crossland, Nadine; Valadez, Joseph J.

    2015-01-01

    Objectives This study estimates the proportion of Orphans and Vulnerable Children (OVC) attending school in 89 districts of Uganda from 2011 – 2013 and investigates the factors influencing OVC access to education among this population. Methods This study used secondary survey data from OVCs aged 5 – 17 years, collected using Lot Quality Assurance Sampling in 87 Ugandan districts over a 3-year period (2011 – 2013). Estimates of OVC school attendance were determined for the yearly time periods. Logistic regression was used to investigate the factors influencing OVC access to education. Results 19,354 children aged 5-17 were included in the analysis. We estimated that 79.1% (95% CI: 78.5% – 79.7%) of OVCs attended school during the 3-year period. Logistic regression revealed the odds of attending school were lower among OVCs from Western (OR 0.88; 95% CI: 0.79 – 0.99) and Northern (OR 0.64; 95% CI: 0.56 – 0.73) regions compared to the Central region. Female OVCs had a significantly higher odds of attending school (OR 1.09; 95% CI: 1.02 – 1.17) compared to their male counterparts. When adjusting for all variables simultaneously, we found the odds of school attendance reduced by 12% between 2011 and 2012 among all OVCs (OR 0.88; 95% CI: 0.81 – 0.97). Conclusion Our findings reinforce the need to provide continuing support to OVC in Uganda, ensuring they have the opportunity to attain an education. The data indicate important regional and gender variation that needs to be considered for support strategies and in social policy. The results suggest the need for greater local empowerment to address the needs of OVCs. We recommend further research to understand why OVC access to education and attendance varies between regions and improvement of district level mapping of OVC access to education, and further study to understand the particular factors impacting the lower school attendance of male OVCs. PMID:26181056

  16. Optical techniques for the determination of nitrate in environmental waters: Guidelines for instrument selection, operation, deployment, maintenance, quality assurance, and data reporting

    USGS Publications Warehouse

    Pellerin, Brian A.; Bergamaschi, Brian A.; Downing, Bryan D.; Saraceno, John Franco; Garrett, Jessica D.; Olsen, Lisa D.

    2013-01-01

    The recent commercial availability of in situ optical sensors, together with new techniques for data collection and analysis, provides the opportunity to monitor a wide range of water-quality constituents on time scales in which environmental conditions actually change. Of particular interest is the application of ultraviolet (UV) photometers for in situ determination of nitrate concentrations in rivers and streams. The variety of UV nitrate sensors currently available differ in several important ways related to instrument design that affect the accuracy of their nitrate concentration measurements in different types of natural waters. This report provides information about selection and use of UV nitrate sensors by the U.S. Geological Survey to facilitate the collection of high-quality data across studies, sites, and instrument types. For those in need of technical background and information about sensor selection, this report addresses the operating principles, key features and sensor design, sensor characterization techniques and typical interferences, and approaches for sensor deployment. For those needing information about maintaining sensor performance in the field, key sections in this report address maintenance and calibration protocols, quality-assurance techniques, and data formats and reporting. Although the focus of this report is UV nitrate sensors, many of the principles can be applied to other in situ optical sensors for water-quality studies.

  17. Quality of Diagnosis and Treatment Plans after Using the "Diagnostic Guideline for Anxiety and Challenging Behaviours" in People with Intellectual Disabilities: A Comparative Multiple Case Study Design

    ERIC Educational Resources Information Center

    Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; van Achterberg, Theo

    2016-01-01

    Background: People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and…

  18. The digital divide at an urban community health center: implications for quality improvement and health care access.

    PubMed

    Denizard-Thompson, Nancy M; Feiereisel, Kirsten B; Stevens, Sheila F; Miller, David P; Wofford, James L

    2011-06-01

    Health care policy encourages better electronic connectivity between patient and the office practice. However, whether patients are able to partner with the practice in using communication technologies is not known. We sought to determine (1) the proportion of clinic patients who use internet and cell phone text messaging technologies, (2) the level of patient interest in using these technologies for the purpose of managing clinical appointments and patient education. Consecutive adult patients, clinicians and staff at an urban community health center were surveyed during a one-week period in order to estimate the frequency of technology use by patients. A total of 308 survey cards were collected during the designated week (response rate of 85% (308/362). One-third (34.0%, 105) of surveyed patients used the internet and text messaging daily or weekly, while nearly two-thirds (59.7%, 182) never used these technologies. There were no racial or gender differences in the proportion of patients who used the internet daily or weekly. In contrast, African-Americans used text messaging more often than whites (28.2 vs. 21.4%, P < .05), and females more than males (30.8 vs. 18.5%, P < .05). Younger patients (>50) used the internet and text messaging more often than older patients (50.6 vs. 16.6%, 44.3 vs. 7.3%, respectively). Despite the low use of both technologies, patient's interest in managing clinic appointments was high (40.3% for the Internet and 56.8% for text messaging). Clinicians and staff estimated patient's daily/weekly use of internet and cellphone messaging at 40.3% (± 22.0), and 56.8% (± 25.7), respectively. Most patients at this urban community health center reported never using the internet or cell phone text messaging. Clinicians overestimated technology use by patients. Planning for clinic infrastructure, quality improvement, and patient education should include assessment of technology use patterns by patients. PMID:21086028

  19. The Process Guidelines for High-Performance Buildings

    SciTech Connect

    Grondzik, W.

    1999-07-01

    The Process Guidelines for High-Performance Buildings are a set of recommendations for the design and operation of efficient and effective commercial/institutional buildings. The Process Guidelines have been developed in a searchable database format and are intended to replace print documents that provide guidance for new building designs for the State of Florida and for the operation of existing State buildings. The Process Guidelines for High-Performance buildings reside on the World Wide Web and are publicly accessible. Contents may be accessed in a variety of ways to best suit the needs of the user. The Process Guidelines address the interests of a range of facilities professionals; are organized around the primary phases of building design, construction, and operation; and include content dealing with all major building systems. The Process Guidelines for High-Performance Buildings may be accessed through the ``Resources'' area of the edesign Web site: http://fcn.state.fl.us/fdi/edesign/resource/index.html.

  20. Waste-assimilation capacity of the Arkansas River in Pueblo County, Colorado, as it relates to water-quality guidelines and stream classification

    USGS Publications Warehouse

    Cain, Doug; Baldridge, Duaina; Edelmann, Patrick

    1980-01-01

    The waste-assimulation capacity of a 42-mile reach of the Arkansas River in Pueblo County, Colo., was evaluated using a one-dimensional steady-state water-quality model. The model is capable of accurately predicting concentrations of carbonaceous biochemical oxygen demand, total ammonia, total nitrate and dissolved oxygen; predicted concentrations of total organic nitrogen and total nitrite are less accurate. Simulation capability for nonionized ammonia was provided by defining its relationship to total ammonia. The model was used to simulate the water-quality effects of 63 combinations of wastewater treatment at the Pueblo Wastewater Treatment Plant and CF and I Steel Corporation. The mixing zone of the effluent from the Pueblo Wastewater Treatment Plant with the Arkansas River was determined to be 2.7 miles in length during the study. (USGS)

  1. Dutch Venous Ulcer guideline update.

    PubMed

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-19

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates. PMID:24843102

  2. National Bookmobile Guidelines, 1992.

    ERIC Educational Resources Information Center

    Ohio State Library, Columbus.

    This publication is based on the work of The State Library of Ohio, the National Bookmobile Guidelines Committee, and staff of local Ohio bookmobile programs. Draft guidelines were approved by the 7th National Bookmobile Conference (May 31-June 2, 1992). The Guidelines provide brief statements of standards followed by specifics which indicate…

  3. National Bookmobile Guidelines, 1988.

    ERIC Educational Resources Information Center

    Ohio State Library, Columbus.

    These guidelines were developed by the bookmobile community that has met in Columbus, Ohio, since 1985 for their annual conference. The guidelines comprise the collaborative effort of hundreds of conference participants and representatives from 79 libraries throughout the United States and Canada, who discussed the guidelines in regional and state…

  4. 28 CFR 513.32 - Guidelines for disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Guidelines for disclosure. 513.32 Section 513.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Release of Information General Provisions and Procedures § 513.32 Guidelines...

  5. 28 CFR 513.32 - Guidelines for disclosure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Guidelines for disclosure. 513.32 Section 513.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Release of Information General Provisions and Procedures § 513.32 Guidelines...

  6. 28 CFR 513.32 - Guidelines for disclosure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Guidelines for disclosure. 513.32 Section 513.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Release of Information General Provisions and Procedures § 513.32 Guidelines...

  7. 28 CFR 513.32 - Guidelines for disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Guidelines for disclosure. 513.32 Section 513.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Release of Information General Provisions and Procedures § 513.32 Guidelines...

  8. Section 504/ADA: Guidelines for Educators in Kansas. Revised.

    ERIC Educational Resources Information Center

    Miller, Joan; Bieker, Rod; Copenhaver, John

    This document presents the Kansas State Department of Education's guidelines to Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA). The guidelines specifically address Subparts A, B, C, and D of the regulations for Section 504 which deal with general provisions, employment practices, accessibility and education. An…

  9. Socioeconomic inequalities in mortality from conditions amenable to medical interventions: do they reflect inequalities in access or quality of health care?

    PubMed Central

    2012-01-01

    Background Previous studies have reported large socioeconomic inequalities in mortality from conditions amenable to medical intervention, but it is unclear whether these can be attributed to inequalities in access or quality of health care, or to confounding influences such as inequalities in background risk of diseases. We therefore studied whether inequalities in mortality from conditions amenable to medical intervention vary between countries in patterns which differ from those observed for other (non-amenable) causes of death. More specifically, we hypothesized that, as compared to non-amenable causes, inequalities in mortality from amenable causes are more strongly associated with inequalities in health care use and less strongly with inequalities in common risk factors for disease such as smoking. Methods Cause-specific mortality data for people aged 30–74 years were obtained for 14 countries, and were analysed by calculating age-standardized mortality rates and relative risks comparing a lower with a higher educational group. Survey data on health care use and behavioural risk factors for people aged 30–74 years were obtained for 12 countries, and were analysed by calculating age-and sex-adjusted odds ratios comparing a low with a higher educational group. Patterns of association were explored by calculating correlation coefficients. Results In most countries and for most amenable causes of death substantial inequalities in mortality were observed, but inequalities in mortality from amenable causes did not vary between countries in patterns that are different from those seen for inequalities in non-amenable mortality. As compared to non-amenable causes, inequalities in mortality from amenable causes are not more strongly associated with inequalities in health care use. Inequalities in mortality from amenable causes are also not less strongly associated with common risk factors such as smoking. Conclusions We did not find evidence that inequalities in

  10. A Work in Progress: Accessible Trails, Campsites, and Other Outdoor Recreation Areas.

    ERIC Educational Resources Information Center

    McGovern, John N.

    2001-01-01

    Appointed by the U.S. Access Board, the Recreation Access Advisory Committee developed guidelines for making outdoor recreation facilities and areas accessible to persons with disabilities. Following negative public comment, a regulatory negotiation committee conducted public meetings and devised accessibility guidelines for trails that allowed…

  11. [Technical recommendations and best practice guidelines for May-Grünwald-Giemsa staining: literature review and insights from the quality assurance].

    PubMed

    Piaton, Eric; Fabre, Monique; Goubin-Versini, Isabelle; Bretz-Grenier, Marie-Françoise; Courtade-Saïdi, Monique; Vincent, Serge; Belleannée, Geneviève; Thivolet, Françoise; Boutonnat, Jean; Debaque, Hervé; Fleury-Feith, Jocelyne; Vielh, Philippe; Cochand-Priollet, Béatrix; Egelé, Caroline; Bellocq, Jean-Pierre; Michiels, Jean-François

    2015-08-01

    May-Grünwald-Giemsa (MGG) stain is a Romanowsky-type, polychromatic stain as those of Giemsa, Leishman and Wright. Apart being the reference method of haematology, it has become a routine stain of diagnostic cytopathology for the study of air-dried preparations (lymph node imprints, centrifuged body fluids and fine needle aspirations). In the context of their actions of promoting the principles of quality assurance in cytopathology, the French Association for Quality Assurance in Anatomic and Cytologic Pathology (AFAQAP) and the French Society of Clinical Cytology (SFCC) conducted a proficiency test on MGG stain in 2013. Results from the test, together with the review of literature data allow pre-analytical and analytical steps of MGG stain to be updated. Recommendations include rapid air-drying of cell preparations/imprints, fixation using either methanol or May-Grünwald alone for 3-10minutes, two-step staining: 50% May-Grünwald in buffer pH 6.8 v/v for 3-5minutes, followed by 10% buffered Giemsa solution for 10-30minutes, and running water for 1-3minutes. Quality evaluation must be performed on red blood cells (RBCs) and leukocytes, not on tumour cells. Under correct pH conditions, RBCs must appear pink-orange (acidophilic) or buff-coloured, neither green nor blue. Leukocyte cytoplasm must be almost transparent, with clearly delineated granules. However, staining may vary somewhat and testing is recommended for automated methods (slide stainers) which remain the standard for reproducibility. Though MGG stain remains the reference stain, Diff-Quik(®) stain can be used for the rapid evaluation of cell samples. PMID:26188673

  12. Clinical guidelines and their civil law effects.

    PubMed

    Hulst, E

    2002-01-01

    The number of clinical guidelines or protocols for medical treatment is growing. Considered as an important instrument for increasing the quality of medicine, these originally intended technical guidelines turn out to influence doctor's civil liability. Ignoring those guidelines in itself may cause a breach of a doctor's duty of care according to civil law and he may be charged to produce evidence that his medical treatment was correct. This development is taking place in several countries as France, Germany, United Kingdom and the Netherlands. PMID:15795994

  13. EPA's neurotoxicity risk assessment guidelines.

    PubMed

    Boyes, W K; Dourson, M L; Patterson, J; Tilson, H A; Sette, W F; MacPhail, R C; Li, A A; O'Donoghue, J L

    1997-12-01

    The proposed Neurotoxicity Risk Assessment Guidelines (U.S. EPA, 1995c Fed. Reg. 60(192), 52032-52056) of the U.S. Environmental Protection Agency (EPA) were the subject of a workshop at the 1997 Meeting of the Society of Toxicology. The workshop considered the role of guidelines in the risk assessment process, the primary features, scientific basis, and implications of the guidelines for EPA program offices, as well as for industrial neurotoxicologists from the perspectives of both pesticides and toxic substances regulation. The U.S. National Academy of Sciences (NAS, 1983, Risk Assessment in the Federal Government: Managing the Process) established a framework for distinguishing risk management from risk assessment, the latter being the result of integrating hazard identification, hazard characterization, and exposure assessment data. The guidelines are intended to establish operating principles that will be used when examining data in a risk assessment context. The proposed neurotoxicity risk assessment guidelines provide a conceptual framework for deciding whether or not a chemically induced effect can be considered to be evidence of neurotoxicity. Topics in the proposed guidelines include structural and functional effects, dose-response and -duration considerations, and relationships between effects. Among the issues that must be considered are the multiplicity of chemical effects, the levels of biological organization in the nervous system, and the tests, measurements, and protocols used. Judgment of the adversity of an effect depends heavily on the amount and types of data available. The attribution of a chemically induced effect to an action on the nervous system depends on several factors such as the quality of the study, the nature of the outcome, dose-response and time-response relationships, and the possible involvement of nonneural factors. The guidelines will also serve as a reference for those conducting neurotoxicity testing, as well as establish a

  14. Guidelines for collecting and processing samples of stream bed sediment for analysis of trace elements and organic contaminants for the National Water-Quality Assessment Program

    USGS Publications Warehouse

    Shelton, Larry R.; Capel, Paul D.

    1994-01-01

    A major component of the U.S. Geological Survey's National Water-Quality Assessment program is to assess the occurrence and distribution of trace elements and organic contaminants in streams. The first phase of the strategy for the assessment is to analyze samples of bed sediments from depositional zones. Fine-grained particles deposited in these zones are natural accumulators of trace elements and hydrophobic organic compounds. For the information to be comparable among studies in many different parts of the Nation, strategies for selecting stream sites and depositional zones are critical. Fine-grained surficial sediments are obtained from several depositional zones within a stream reach and composited to yield a sample representing average conditions. Sample collection and processing must be done consistently and by procedures specifically designed to separate the fine material into fractions that yield uncontaminated samples for trace-level analytes in the laboratory. Special coring samplers and other instruments made of Teflon are used for collection. Samples are processed through a 2.0-millimeter stainless-steel mesh sieve for organic contaminate analysis and a 63-micrometer nylon-cloth sieve for trace-element analysis. Quality assurance is maintained by strict collection and processing procedures, duplicate samplings, and a rigid cleaning procedure.

  15. Improving clinical practice guidelines for practicing cardiologists.

    PubMed

    Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Dwyer, Edward M; Eberly, Shirley; Francis, Charles; Gillespie, John A; Goldstein, Robert E; Greenberg, Henry; Haigney, Mark; Krone, Ronald J; Klein, Helmut; Lichstein, Edgar; Locati, Emanuela; Marcus, Frank I; Moss, Arthur J; Oakes, David; Ryan, Daniel H; Bloch Thomsen, Poul E; Zareba, Wojciech

    2015-06-15

    Cardiac-related clinical practice guidelines have become an integral part of the practice of cardiology. Unfortunately, these guidelines are often long, complex, and difficult for practicing cardiologists to use. Guidelines should be condensed and their format upgraded, so that the key messages are easier to comprehend and can be applied more readily by those involved in patient care. After presenting the historical background and describing the guideline structure, we make several recommendations to make clinical practice guidelines more user-friendly for clinical cardiologists. Our most important recommendations are that the clinical cardiology guidelines should focus exclusively on (1) class I recommendations with established benefits that are supported by randomized clinical trials and (2) class III recommendations for diagnostic or therapeutic approaches in which quality studies show no benefit or possible harm. Class II recommendations are not evidence based but reflect expert opinions related to published clinical studies, with potential for personal bias by members of the guideline committee. Class II recommendations should be published separately as "Expert Consensus Statements" or "Task Force Committee Opinions," so that both majority and minority expert opinions can be presented in a less dogmatic form than the way these recommendations currently appear in clinical practice guidelines. PMID:25918027

  16. Providing Quality Postsecondary Education: Access and Accountability. Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Ninth Congress, First Session (April 28, 2005) S. Hrg. 109-126

    ERIC Educational Resources Information Center

    US Senate, 2005

    2005-01-01

    The Committee convened a hearing to examine access and accountability relating to providing quality postsecondary education, focusing on the federal government's role in making postsecondary education financially available for Americans. Statements were presented by: Michael B. Enzi, Chairman, Committee on Health, Education, Labor, and Pensions;…

  17. Use of EORTC Target Definition Guidelines for Dose-Intensified Salvage Radiation Therapy for Recurrent Prostate Cancer: Results of the Quality Assurance Program of the Randomized Trial SAKK 09/10

    SciTech Connect

    Sassowsky, Manfred; Gut, Philipp; Hölscher, Tobias; Hildebrandt, Guido; Müller, Arndt-Christian; Najafi, Yousef; Kohler, Götz; Kranzbühler, Helmut; Guckenberger, Matthias; Zwahlen, Daniel R.; Azinwi, Ngwa C.; Plasswilm, Ludwig; Takacs, Istvan; Reuter, Christiane; Sumila, Marcin; Manser, Peter; Ost, Piet; Böhmer, Dirk; Pilop, Christiane; Aebersold, Daniel M.; and others

    2013-11-01

    Purpose: Different international target volume delineation guidelines exist and different treatment techniques are available for salvage radiation therapy (RT) for recurrent prostate cancer, but less is known regarding their respective applicability in clinical practice. Methods and Materials: A randomized phase III trial testing 64 Gy vs 70 Gy salvage RT was accompanied by an intense quality assurance program including a site-specific and study-specific questionnaire and a dummy run (DR). Target volume delineation was performed according to the European Organisation for the Research and Treatment of Cancer guidelines, and a DR-based treatment plan was established for 70 Gy. Major and minor protocol deviations were noted, interobserver agreement of delineated target contours was assessed, and dose-volume histogram (DVH) parameters of different treatment techniques were compared. Results: Thirty European centers participated, 43% of which were using 3-dimensional conformal RT (3D-CRT), with the remaining centers using intensity modulated RT (IMRT) or volumetric modulated arc technique (VMAT). The first submitted version of the DR contained major deviations in 21 of 30 (70%) centers, mostly caused by inappropriately defined or lack of prostate bed (PB). All but 5 centers completed the DR successfully with their second submitted version. The interobserver agreement of the PB was moderate and was improved by the DR review, as indicated by an increased κ value (0.59 vs 0.55), mean sensitivity (0.64 vs 0.58), volume of total agreement (3.9 vs 3.3 cm{sup 3}), and decrease in the union volume (79.3 vs 84.2 cm{sup 3}). Rectal and bladder wall DVH parameters of IMRT and VMAT vs 3D-CRT plans were not significantly different. Conclusions: The interobserver agreement of PB delineation was moderate but was improved by the DR. Major deviations could be identified for the majority of centers. The DR has improved the acquaintance of the participating centers with the trial

  18. Guideline of guidelines: thromboprophylaxis for urological surgery.

    PubMed

    Violette, Philippe D; Cartwright, Rufus; Briel, Matthias; Tikkinen, Kari A O; Guyatt, Gordon H

    2016-09-01

    Decisions regarding thromboprophylaxis in urologic surgery involve a trade-off between decreased risk of venous thromboembolism (VTE) and increased risk of bleeding. Both patient- and procedure-specific factors are critical in making an informed decision on the use of thromboprophylaxis. Our systematic review of the literature revealed that existing guidelines in urology are limited. Recommendations from national and international guidelines often conflict and are largely based on indirect as opposed to procedure-specific evidence. These issues have likely contributed to large variation in the use of VTE prophylaxis within and between countries. The majority of existing guidelines typically suggest prolonged thromboprophylaxis for high-risk abdominal or pelvic surgery, without clear clarification of what these procedures are, for up to 4 weeks post-discharge. Existing guidance may result in the under-treatment of procedures with low risk of bleeding and the over-treatment of oncological procedures with low risk of VTE. Guidance for patients who are already anticoagulated are not specific to urological procedures but generally involve evaluating patient and surgical risks when deciding on bridging therapy. The European Association of Urology Guidelines Office has commissioned an ad hoc guideline panel that will present a formal thromboprophylaxis guideline for specific urological procedures and patient risk factors. PMID:27037846

  19. Development of American Sign Language Guidelines for K-12 Academic Assessments.

    PubMed

    Higgins, Jennifer A; Famularo, Lisa; Cawthon, Stephanie W; Kurz, Christopher A; Reis, Jeanne E; Moers, Lori M

    2016-10-01

    The U.S. federal Every Student Succeeds Act (ESSA) was enacted with goals of closing achievement gaps and providing all students with access to equitable and high-quality instruction. One requirement of ESSA is annual statewide testing of students in grades 3-8 and once in high school. Some students, including many deaf or hard-of-hearing (D/HH) students, are eligible to use test supports, in the form of accommodations and accessibility tools, during state testing. Although technology allows accommodations and accessibility tools to be embedded within a digital assessment system, the success of this approach depends on the ability of test developers to appropriately represent content in accommodated forms. The Guidelines for Accessible Assessment Project (GAAP) sought to develop evidence- and consensus-based guidelines for representing test content in American Sign Language. In this article, we present an overview of GAAP, review of the literature, rationale, qualitative and quantitative research findings, and lessons learned. PMID:27542953

  20. I.S.Mu.L.T - Rotator Cuff Tears Guidelines.

    PubMed

    Oliva, Francesco; Piccirilli, Eleonora; Bossa, Michela; Via, Alessio Giai; Colombo, Alessandra; Chillemi, Claudio; Gasparre, Giuseppe; Pellicciari, Leonardo; Franceschetti, Edoardo; Rugiero, Clelia; Scialdoni, Alessandro; Vittadini, Filippo; Brancaccio, Paola; Creta, Domenico; Buono, Angelo Del; Garofalo, Raffaele; Franceschi, Francesco; Frizziero, Antonio; Mahmoud, Asmaa; Merolla, Giovanni; Nicoletti, Simone; Spoliti, Marco; Osti, Leonardo; Padulo, Johnny; Portinaro, Nicola; Tajana, Gianfranco; Castagna, Alex; Foti, Calogero; Masiero, Stefano; Porcellini, Giuseppe; Tarantino, Umberto; Maffulli, Nicola

    2015-01-01

    Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources. PMID:26958532