Sleep quantity, quality, and insomnia symptoms of medical students during clinical years. Relationship with stress and academic performance.

PubMed

Alsaggaf, Mohammed A; Wali, Siraj O; Merdad, Roah A; Merdad, Leena A

2016-02-01

To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep.

Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

PubMed Central

Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A.

2016-01-01

Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep. PMID:26837401

Image Quality Assessment of High-Resolution Satellite Images with Mtf-Based Fuzzy Comprehensive Evaluation Method

NASA Astrophysics Data System (ADS)

Wu, Z.; Luo, Z.; Zhang, Y.; Guo, F.; He, L.

2018-04-01

A Modulation Transfer Function (MTF)-based fuzzy comprehensive evaluation method was proposed in this paper for the purpose of evaluating high-resolution satellite image quality. To establish the factor set, two MTF features and seven radiant features were extracted from the knife-edge region of image patch, which included Nyquist, MTF0.5, entropy, peak signal to noise ratio (PSNR), average difference, edge intensity, average gradient, contrast and ground spatial distance (GSD). After analyzing the statistical distribution of above features, a fuzzy evaluation threshold table and fuzzy evaluation membership functions was established. The experiments for comprehensive quality assessment of different natural and artificial objects was done with GF2 image patches. The results showed that the calibration field image has the highest quality scores. The water image has closest image quality to the calibration field, quality of building image is a little poor than water image, but much higher than farmland image. In order to test the influence of different features on quality evaluation, the experiment with different weights were tested on GF2 and SPOT7 images. The results showed that different weights correspond different evaluating effectiveness. In the case of setting up the weights of edge features and GSD, the image quality of GF2 is better than SPOT7. However, when setting MTF and PSNR as main factor, the image quality of SPOT7 is better than GF2.

Analysis of environmental factors affecting the quality of teacher's life of public schools from Umuarama.

PubMed

Costa, Bruna Evellyn; Silva, Nicéia Luzia Selete

2012-01-01

In this study valued 100 public school teachers statewide Umuarama-Pr, through Maslach Burnout Inventory (MBI) and also a socio-demographic questionnaire with objective factors to analyze the work environment that affect the quality of life for teachers public schools in Umuarama. The results indicated that teachers age between 20 and 30 years show high index of emotional exhaustion. Between 30 and 40 years have a low average emotional exhaustion and depersonalization and an average professional achievement. Teachers between 40 and 50 years of aged had resulted in the average within the fields Burnout Inventory with a group that's worrying, because it is the limit in all items that characterize the burnout syndrome. Already in the professionals aged between 50 and 60 years have seen high levels of emotional exhaustion, low depersonalization and low professional achievement, this group, which probably already had some of these symptoms are only now been identified. This shows how is the quality of life of the group of teachers surveyed, and indicates the need for action to change this situation and find solutions. A suggestion of this work is to build a center for psychological support for teachers to learn to handle everyday situations.

Identifying Key Hospital Service Quality Factors in Online Health Communities

PubMed Central

Jung, Yuchul; Hur, Cinyoung; Jung, Dain

2015-01-01

Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and classification performance still has room for improvement, but the extraction results are applicable to more detailed analysis. Further analysis of the extracted information reveals that there are differences in the details of social media–based key quality factors for hospitals according to the regions in Korea, and the patterns of change seem to accurately reflect social events (eg, influenza epidemics). Conclusions These findings could be used to provide timely information to caregivers, hospital officials, and medical officials for health care policies. PMID:25855612

Amount and quality of sleep: exploring the role of stress and work experience in a sample of obstetrician-gynecologists.

PubMed

Taouk, Laura; Farrow, Victoria A; Schulkin, Jay

2017-05-02

Sufficient sleep is necessary for optimal performance and the delivery of safe and effective health care. To establish an empirical understanding of physician fatigue, the present study investigated the factors that contributed to the amount and the quality of sleep among obstetricians and gynecologists (ob-gyns). A survey of personal and work experiences was sent to 495 eligible physicians belonging to the American College of Obstetricians and Gynecologists (ACOG). Data were obtained from 287 ob-gyns for a response rate of 58.0%. Associations between sleep-related items and measures of stress and work-related factors were explored. Ob-gyns in our sample reported sleeping an average of 6.5 hours a night with 29.2% indicating that they received very or fairly bad quality of sleep. Average amount and quality of sleep were found to be independently related to the hours worked weekly, colleague support for a work-home balance, practice setting, perceived work-control, physician-specific stressors and perceived stress. In summary models, hours worked and perceived stress scores consistently emerged as predictors of amount of sleep. Overall, findings explained a small portion of the variance in sleep. Considering the multitude of factors that contribute to sleep, subtle associations warrant further investigation.

Heat transfer and pressure drop of condensation of hydrocarbons in tubes

NASA Astrophysics Data System (ADS)

Fries, Simon; Skusa, Severin; Luke, Andrea

2018-03-01

The heat transfer coefficient and pressure drop are investigated for propane. Two different mild steel plain tubes and saturation pressures are considered for varying mass flux and vapour quality. The pressure drop is compared to the Friedel-Correlation with two different approaches to determine the friction factor. The first is calculation as proposed by Friedel and the second is through single phase pressure drop investigations. For lower vapour qualities the experimental results are in better agreement with the approach of the calculated friction factor. For higher vapour qualities the experimental friction factor is more precise. The pressure drop increases for a decreasing tube diameter and saturation pressure. The circumferential temperature profile and heat transfer coefficients are shown for a constant vapour quality at varying mass fluxes. The subcooling is highest for the bottom of the tube and lowest for the top. The average subcooling as well as the circumferential deviation decreases for rising mass fluxes. The averaged heat transfer coefficients are compared to the model proposed by Thome and Cavallini. The experimental results are in good agreement with both correlations, however the trend is better described with the correlation from Thome. The experimental heat transfer coefficients are under predicted by Thome and over predicted by Cavallini.

Student-Designed River Study.

ERIC Educational Resources Information Center

Turkall, Sheila Florian

1996-01-01

Describes an integrated student-designed investigation in which students explore different aspects of the Chagrin River including the river ecosystem, velocity and average depth, river flooding, water quality, and economic and political factors. (JRH)

The Effect of Fuel Quality on Carbon Dioxide and Nitrogen Oxide Emissions, While Burning Biomass and RDF

NASA Astrophysics Data System (ADS)

Kalnacs, J.; Bendere, R.; Murasovs, A.; Arina, D.; Antipovs, A.; Kalnacs, A.; Sprince, L.

2018-02-01

The article analyses the variations in carbon dioxide emission factor depending on parameters characterising biomass and RDF (refuse-derived fuel). The influence of moisture, ash content, heat of combustion, carbon and nitrogen content on the amount of emission factors has been reviewed, by determining their average values. The options for the improvement of the fuel to result in reduced emissions of carbon dioxide and nitrogen oxide have been analysed. Systematic measurements of biomass parameters have been performed, by determining their average values, seasonal limits of variations in these parameters and their mutual relations. Typical average values of RDF parameters and limits of variations have been determined.

EVALUATION OF THE COMMUNITY MULTISCALE AIR QUALITY (CMAQ) MODEL VERSION 4.5: UNCERTAINTIES AND SENSITIVITIES IMPACTING MODEL PERFORMANCE: PART I - OZONE

EPA Science Inventory

This study examines ozone (O₃) predictions from the Community Multiscale Air Quality (CMAQ) model version 4.5 and discusses potential factors influencing the model results. Daily maximum 8-hr average O₃ levels are largely underpredicted when observed O_...

A Comparative Study of Scientific Publications in Health Care Sciences and Services from Mainland China, Taiwan, Japan, and India (2007–2014)

PubMed Central

Lv, Yipeng; Tang, Bihan; Liu, Xu; Xue, Chen; Liu, Yuan; Kang, Peng; Zhang, Lulu

2015-01-01

In this study, we aimed to compare the quantity and quality of publications in health care sciences and services journals from the Chinese mainland, Taiwan, Japan, and India. Journals in this category of the Science Citation Index Expanded were included in the study. Scientific papers were retrieved from the Web of Science online database. Quality was measured according to impact factor, citation of articles, number of articles published in top 10 journals, and the 10 most popular journals by country (area). In the field of health care sciences and services, the annual incremental rates of scientific articles published from 2007 to 2014 were higher than rates of published scientific articles in all fields. Researchers from the Chinese mainland published the most original articles and reviews and had the highest accumulated impact factors, highest total article citations, and highest average citation. Publications from India had the highest average impact factor. In the field of health care sciences and services, China has made remarkable progress during the past eight years in the annual number and percentage of scientific publications. Yet, there is room for improvement in the quantity and quality of such articles. PMID:26712774

A Comparative Study of Scientific Publications in Health Care Sciences and Services from Mainland China, Taiwan, Japan, and India (2007-2014).

PubMed

Lv, Yipeng; Tang, Bihan; Liu, Xu; Xue, Chen; Liu, Yuan; Kang, Peng; Zhang, Lulu

2015-12-24

In this study, we aimed to compare the quantity and quality of publications in health care sciences and services journals from the Chinese mainland, Taiwan, Japan, and India. Journals in this category of the Science Citation Index Expanded were included in the study. Scientific papers were retrieved from the Web of Science online database. Quality was measured according to impact factor, citation of articles, number of articles published in top 10 journals, and the 10 most popular journals by country (area). In the field of health care sciences and services, the annual incremental rates of scientific articles published from 2007 to 2014 were higher than rates of published scientific articles in all fields. Researchers from the Chinese mainland published the most original articles and reviews and had the highest accumulated impact factors, highest total article citations, and highest average citation. Publications from India had the highest average impact factor. In the field of health care sciences and services, China has made remarkable progress during the past eight years in the annual number and percentage of scientific publications. Yet, there is room for improvement in the quantity and quality of such articles.

Far-field coupling in nanobeam photonic crystal cavities

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

Rousseau, Ian, E-mail: ian.rousseau@epfl.ch; Sánchez-Arribas, Irene; Carlin, Jean-François

2016-05-16

We optimized the far-field emission pattern of one-dimensional photonic crystal nanobeams by modulating the nanobeam width, forming a sidewall Bragg cross-grating far-field coupler. By setting the period of the cross-grating to twice the photonic crystal period, we showed using three-dimensional finite-difference time-domain simulations that the intensity extracted to the far-field could be improved by more than three orders of magnitude compared to the unmodified ideal cavity geometry. We then experimentally studied the evolution of the quality factor and far-field intensity as a function of cross-grating coupler amplitude. High quality factor (>4000) blue (λ = 455 nm) nanobeam photonic crystals were fabricated out ofmore » GaN thin films on silicon incorporating a single InGaN quantum well gain medium. Micro-photoluminescence spectroscopy of sets of twelve identical nanobeams revealed a nine-fold average increase in integrated far-field emission intensity and no change in average quality factor for the optimized structure compared to the unmodulated reference. These results are useful for research environments and future nanophotonic light-emitting applications where vertical in- and out-coupling of light to nanocavities is required.« less

Measurements of the linear energy transfer spectra on the Mir orbital station and comparison with radiation transport models

NASA Technical Reports Server (NTRS)

Badhwar, G. D.; Konradi, A.; Atwell, W.; Golightly, M. J.; Cucinotta, F. A.; Wilson, J. W.; Petrov, V. M.; Tchernykh, I. V.; Shurshakov, V. A.; Lobakov, A. P.

1996-01-01

A tissue equivalent proportional counter designed to measure the linear energy transfer spectra (LET) in the range 0.2-1250 keV/micrometer was flown in the Kvant module on the Mir orbital station during September 1994. The spacecraft was in a 51.65 degrees inclination, elliptical (390 x 402 km) orbit. This is nearly the lower limit of its flight altitude. The total absorbed dose rate measured was 411.3 +/- 4.41 microGy/day with an average quality factor of 2.44. The galactic cosmic radiation (GCR) dose rate was 133.6 microGy/day with a quality factor of 3.35. The trapped radiation belt dose rate was 277.7 microGy/day with an average quality factor of 1.94. The peak rate through the South Atlantic Anomaly was approximately 12 microGy/min and nearly constant from one pass to another. A detailed comparison of the measured LET spectra has been made with radiation transport models. The GCR results are in good agreement with model calculations; however, this is not the case for radiation belt particles and again points to the need for improving the AP8 omni-directional trapped proton models.

[Job satisfaction and improvement factors in primary care professionals].

PubMed

Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

2013-09-06

The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

Publications by doctoral candidates at Charité University Hospital, Berlin, from 1998-2008.

PubMed

Ziemann, Esther; Oestmann, Jörg-Wilhelm

2012-05-01

One quality parameter of medical theses is the number of articles published by the doctoral candidates. Over the course of the past decade the Charité-Universitätsmedizin Berlin has taken steps to improve the quality of the theses completed by its doctoral students in medicine and increase their publication activity. This study was designed to verify the efficacy of these measures and to detect general trends. Medical theses completed in 1998, 2004 and 2008 (sample size >250 for each year) were retrospectively analyzed with regard to associated publications within a 7-year period (from 5 years before completion to 2 years thereafter). Quality and quantity were recorded. Publications found in the PubMed database were evaluated; the impact factor of the publishing journal was used as quality parameter. The sample sizes were 264 for 1998, 316 for 2004, and 316 for 2008. The number of publications per doctoral student increased from 0.78 to 1.39 over the course of the study period, and the average impact factor rose from 2.42 to 3.62. Analysis using the current impact factors of the publishing journals showed an increase from 3.13 to 3.85. The proportion of case reports fell from 12.7% to 8%. The proportion of first authorships remained about the same. The past decade has seen an increase in the number of publications by doctoral students at the Charité and a rise in the average impact factor of the journals concerned.

49 CFR 37.155 - Factors in decision to grant an undue financial burden waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Service § 37.155 Factors in decision to grant an undue financial burden waiver. (a) In making an undue... reduction in service, measured by service miles; (2) Average number of trips made by the entity's general... and quality of available resources for complementary paratransit service; and (10) Unique...

Exploring end of life priorities in Saudi males: usefulness of Q-methodology.

PubMed

Hammami, Muhammad M; Al Gaai, Eman; Hammami, Safa; Attala, Sahar

2015-11-26

Quality end-of-life care depends on understanding patients' end-of-life choices. Individuals and cultures may hold end-of-life priorities at different hierarchy. Forced ranking rather than independent rating, and by-person factor analysis rather than averaging may reveal otherwise masked typologies. We explored Saudi males' forced-ranked, end-of-life priorities and dis-priorities. Respondents (n = 120) rank-ordered 47 opinion statements on end-of-life care following a 9-category symmetrical distribution. Statements' scores were analyzed by averaging analysis and factor analysis (Q-methodology). Respondents' mean age was 32.1 years (range, 18-65); 52% reported average religiosity, 88 and 83% ≥ very good health and life-quality, respectively, and 100% ≥ high school education. Averaging analysis revealed that the extreme five end-of-life priorities were to, be at peace with God, be able to say the statement of faith, maintain dignity, resolve conflicts, and have religious death rituals respected, respectively. The extreme five dis-priorities were to, die in the hospital, not receive intensive care if in coma, die at peak of life, be informed about impending death by family/friends rather than doctor, and keep medical status confidential from family/friends, respectively. Q-methodology classified 67% of respondents into five highly transcendent opinion types. Type-I (rituals-averse, family-caring, monitoring-coping, life-quality-concerned) and Type-V (rituals-apt, family-centered, neutral-coping, life-quantity-concerned) reported the lowest and highest religiosity, respectively. Type-II (rituals-apt, family-dependent, monitoring-coping, life-quantity-concerned) and Type-III (rituals-silent, self/family-neutral, avoidance-coping, life-quality & quantity-concerned) reported the best and worst life-quality, respectively. Type-I respondents were the oldest with the lowest general health, in contrast to Type-IV (rituals-apt, self-centered, monitoring-coping, life-quality/quantity-neutral). Of the extreme 14 priorities/dis-priorities for the five types, 29, 14, 14, 50, and 36%, respectively, were not among the extreme 20 priorities/dis-priorities identified by averaging analysis for the entire cohort. 1) Transcendence was the extreme end-of-life priority, and dying in the hospital was the extreme dis-priority. 2) Quality of life was conceptualized differently with less emphasize on its physiological aspects. 3) Disclosure of terminal illness to family/close friends was preferred as long it is through the patient. 4) Q-methodology identified five types of constellations of end-of-life priorities and dis-priorities that may be related to respondents' demographics and are partially masked by averaging analysis.

A mathematical model of reservoir sediment quality prediction based on land-use and erosion processes in watershed

NASA Astrophysics Data System (ADS)

Junakova, N.; Balintova, M.; Junak, J.

2017-10-01

The aim of this paper is to propose a mathematical model for determining of total nitrogen (N) and phosphorus (P) content in eroded soil particles with emphasis on prediction of bottom sediment quality in reservoirs. The adsorbed nutrient concentrations are calculated using the Universal Soil Loss Equation (USLE) extended by the determination of the average soil nutrient concentration in top soils. The average annual vegetation and management factor is divided into five periods of the cropping cycle. For selected plants, the average plant nutrient uptake divided into five cropping periods is also proposed. The average nutrient concentrations in eroded soil particles in adsorbed form are modified by sediment enrichment ratio to obtain the total nutrient content in transported soil particles. The model was designed for the conditions of north-eastern Slovakia. The study was carried out in the agricultural basin of the small water reservoir Klusov.

Clustering and estimating fish fingerling abundance in a tidal river in close ploximity to a thermal power plant in Southern Thailand

NASA Astrophysics Data System (ADS)

Chesoh, S.; Lim, A.; Luangthuvapranit, C.

2018-04-01

This study aimed to cluster and to quantify the wild-caught fingerlings nearby thermal power plant. Samples were monthly collected by bongo nets from four upstream sites of the Na Thap tidal river in Thailand from 2008 to 2013. Each caught species was identified, counted and calculated density in term of individuals per 1,000 cubic meters. A total of 45 aquatic animal fingerlings was commonly trapped in the average density of 2,652 individuals per 1,000 cubic meters of water volume (1,235–4,570). The results of factor analysis revealed that factor 1 was represented by the largest group of freshwater fish species, factors 2 represented a medium-sized group of mesohaline species, factor 3 represented several brackish species and factor 4 was a few euryhaline species. All four factor reached maximum levels during May to October. Total average numbers of fish fingerling caught at the outflow showed greater than those of other sampling sites. The impact of heated pollution from power plant effluents did not clearly detected. Overall water quality according the Thailand Surface Water Quality Standards Coastal tidal periodic and seasonal runoff phenomena exhibit influentially factors. Continuous ecological monitoring is strongly recommended.

Scientific publications in public, environmental and occupational health journals by authors from China, Japan and Korea in East Asia: A 10-year literature survey from 2003 to 2012.

PubMed

Li, Meina; Liu, Xiaodong; Zhang, Lulu

2015-01-01

To compare the number and quality of public, environmental and occupational health articles published in international journals from the 3 major non-English speaking countries of East Asia: China, Japan and Korea. Public, environmental and occupational health articles from China, Japan and Korea that were published in 161 journals from 2003 to 2012 were retrieved from the Science Citation Index Expanded (SCIE) database. We recorded the numbers of total articles, impact factors (IF), citations, number of articles in top 10 journals, references as well as the article distribution from various regions in China. From 2003 to 2012, China, Japan and Korea published 5713, 3802 and 1967 papers respectively, with accumulated impact factor of 14 934.55, 8758.36 and 6189.25, the average impact factor of 2.61, 2.30 and 3.15 and the average citation numbers per document of 5.08, 6.49 and 5.25. In the top 10 high-impact public, environmental and occupational health journals, China, Japan and Korea accounted for 50.19%, 20.34% and 29.47% of all the papers published in those journals, respectively. Total impact factors of the most popular 10 papers for China, Japan and Korea were: 26.23, 27.08 and 26.91. Distribution of scientific papers among regions was unbalanced in China, for Hong Kong and Taiwan it accounted for 47.31% of the papers from China. From 2003 to 2012, both the quality and number of papers from China published in public, environmental and occupational health journals have greatly improved. China exceeded Japan and Korea in the number, accumulated impact factor, total citation times and the average number of references, while Korea had the highest average impact factor. Japan had the highest journal impact factor among the most popular journals, and the highest average citation number per document. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Analysis of the covariance function and aperture averaged fluctuations of irradiance to calculate Cn2

NASA Astrophysics Data System (ADS)

Cauble, Galen D.; Wayne, David T.

2017-09-01

The growth of optical communication has created a need to correctly characterize the atmospheric channel. Atmospheric turbulence along a given channel can drastically affect optical communication signal quality. One means of characterizing atmospheric turbulence is through measurement of the refractive index structure parameter, Cn2. When calculating Cn2 from the scintillation index, σΙ2,the point aperture scintillation index is required. Direct measurement of the point aperture scintillation index is difficult at long ranges due to the light collecting abilities of small apertures. When aperture size is increased past the atmospheric correlation width, aperture averaging decreases the scintillation index below that of the point aperture scintillation index. While the aperture averaging factor can be calculated from theory, it does not often agree with experimental results. Direct measurement of the aperture averaging factor via the pupil plane irradiance covariance function allows conversion from the aperture averaged scintillation index to the point aperture scintillation index. Using a finite aperture, camera, and detector, the aperture averaged scintillation index and aperture averaging factor are measured in parallel and the point aperture scintillation index is calculated. A new instrument built by SSC Pacific was used to collect scintillation data at the Townes Institute Science and Technology Experimentation Facility (TISTEF). This new instrument's data was then compared to BLS900 data. The results show that direct measurement of the aperture averaging factor is achievable using a camera and matches well with groundtruth instrumentation.

Paediatric x-ray radiation dose reduction and image quality analysis.

PubMed

Martin, L; Ruddlesden, R; Makepeace, C; Robinson, L; Mistry, T; Starritt, H

2013-09-01

Collaboration of multiple staff groups has resulted in significant reduction in the risk of radiation-induced cancer from radiographic x-ray exposure during childhood. In this study at an acute NHS hospital trust, a preliminary audit identified initial exposure factors. These were compared with European and UK guidance, leading to the introduction of new factors that were in compliance with European guidance on x-ray tube potentials. Image quality was assessed using standard anatomical criteria scoring, and visual grading characteristics analysis assessed the impact on image quality of changes in exposure factors. This analysis determined the acceptability of gradual radiation dose reduction below the European and UK guidance levels. Chest and pelvis exposures were optimised, achieving dose reduction for each age group, with 7%-55% decrease in critical organ dose. Clinicians confirmed diagnostic image quality throughout the iterative process. Analysis of images acquired with preliminary and final exposure factors indicated an average visual grading analysis result of 0.5, demonstrating equivalent image quality. The optimisation process and final radiation doses are reported for Carestream computed radiography to aid other hospitals in minimising radiation risks to children.

Ecological evaluation of rangeland quality in dry subtropics of Azerbaijan

NASA Astrophysics Data System (ADS)

Gasanova, A. F.

2014-12-01

The results of ecological evaluation of soil-landscape complexes of winter rangelands of Gobustan with the use of energy criteria are discussed. The diagnostic characteristics of soil fertility and correction coefficients for the thickness of texture of soil horizons, soil salinization, soil erosion, and microelemental composition of soils have been used to separate the soils of winter rangelands into several quality groups. A larger part of the soils belongs to the medium quality group with the mean weighted quality factor (bonitet) of 52. Special assessment scales have been suggested for the differential ecological assessment and monitoring of the rangelands. In the past 40 years, the area of steppe landscapes has decreased from 22.7 to 12%, whereas the area of semideserts has increased up to 64%. The area of best-quality soils within the studied rangelands had decreased by three times, and their average quality factor has decreased from 92 to 86.

Indoor air quality in primary schools in Kecioren, Ankara.

PubMed

Babayiğit, Mustafa Alparslan; Bakir, Bilal; Tekbaş, Omer Faruk; Oğur, Recai; Kiliç, Abdullah; Ulus, Serdar

2014-01-01

To increase the awareness of environmental risk factors by determining the indoor air quality status of primary schools. Indoor air quality parameters in 172 classrooms of 31 primary schools in Kecioren, Ankara, were examined for the purpose of assessing the levels of air pollutants (CO, CO2, SO2, NO2, and formaldehyde) within primary schools. Schools near heavy traffic had a statistically significant mean average of CO and SO2 (P < 0.05). The classrooms that had more than 35 students had higher and statistically significant averages of CO2, SO2, NO2, and formaldehyde compared to classrooms that had fewer than 35 students (P < 0.05). Of all classrooms, 29% had 100 CFU/100 mL and higher concentrations of microorganisms, which were not pathogens. Indoor air quality management should continually be maintained in primary schools for the prevention and control of acute and chronic diseases, particularly considering biological and chemical pollution.

Registration of interferometric SAR images

NASA Technical Reports Server (NTRS)

Lin, Qian; Vesecky, John F.; Zebker, Howard A.

1992-01-01

Interferometric synthetic aperture radar (INSAR) is a new way of performing topography mapping. Among the factors critical to mapping accuracy is the registration of the complex SAR images from repeated orbits. A new algorithm for registering interferometric SAR images is presented. A new figure of merit, the average fluctuation function of the phase difference image, is proposed to evaluate the fringe pattern quality. The process of adjusting the registration parameters according to the fringe pattern quality is optimized through a downhill simplex minimization algorithm. The results of applying the proposed algorithm to register two pairs of Seasat SAR images with a short baseline (75 m) and a long baseline (500 m) are shown. It is found that the average fluctuation function is a very stable measure of fringe pattern quality allowing very accurate registration.

COMPARISON STUDY OF VARIOUS PLASTICS AS THE WALL MATERIAL OF THGEM-BASED MICRODOSEMETERS FOR FAST NEUTRON MEASUREMENTS.

PubMed

Moslehi, A; Raisali, G; Lamehi, M

2017-04-15

To find appropriate substitutions for the expensive plastics of A-150 and rexolite used in the construction of thick gas electron multiplier (THGEM)-based tissue-equivalent proportional counters, in the present work, the responses of a THGEM-based microdosimetric detector made of A-150 and rexolite and three others composed of plexiglas (PMMA), polyethylene and polystyrene plastics as the wall materials have been compared. Lineal energy distribution, frequency-averaged lineal energy, dose-averaged lineal energy, mean quality factor and dose-equivalent for 0.1, 1 and 10 MeV neutrons and also for 241Am-Be neutrons are calculated using Geant4 simulation toolkit. Frequency-averaged lineal energy, dose-averaged lineal energy, mean quality factor and dose-equivalent values for all plastics are found similar. In addition, the response of an indigenously constructed microdosemeter with PMMA walls is also measured for 241Am-Be neutrons. The experimental results are in good agreement with the simulation predictions. Conclusively, it was found that the three considered plastics can be used as good candidates instead of A-150 and rexolite plastics in fast neutron microdosimetry. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Deconstructing racial differences: the effects of quality of education and cerebrovascular risk factors.

PubMed

Carvalho, Janessa O; Tommet, Doug; Crane, Paul K; Thomas, Michael L; Claxton, Amy; Habeck, Christian; Manly, Jennifer J; Romero, Heather R

2015-07-01

To evaluate the effects of vascular conditions and education quality on cognition over time in White and African American (AA) older adults. We investigated cross-sectional and longitudinal racial differences in executive functioning (EF) and memory composites among Whites (n = 461) and AAs (n = 118) enrolled in a cohort study. We examined whether cerebrovascular risk factors and Shipley Vocabulary scores (a proxy for education quality) accounted for racial differences. On average, AAs had lower quality of education and more cerebrovascular risk factors including hypertension, diabetes, and obesity. AAs had lower mean EF and memory at baseline, but there were no group differences in rates of decline. Cross-sectional racial differences in EF and memory persisted after controlling for vascular disease, but disappeared when controlling for Shipley Vocabulary. Quality of education appears to be more important than cerebrovascular risk factors in explaining cross-sectional differences in memory and EF performance between White and AA older adults. Further investigation is needed regarding the relative contribution of education quality and cerebrovascular risk factors to cognitive decline among ethnically/racially diverse older adults. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Concurrent elevation of CO2, O3 and temperature severely affects oil quality and quantity in rapeseed

PubMed Central

Namazkar, Shahla; Stockmarr, Anders; Frenck, Georg; Egsgaard, Helge; Terkelsen, Thilde; Mikkelsen, Teis; Ingvordsen, Cathrine Heinz; Jørgensen, Rikke Bagger

2016-01-01

Plant oil is an essential dietary and bio-energy resource. Despite this, the effects of climate change on plant oil quality remain to be elucidated. The present study is the first to show changes in oil quality and quantity of four rapeseed cultivars in climate scenarios with elevated [CO2], [O3] and temperature (T) combined and as single factors. The combination of environmental factors resembled IPCC’s ‘business as usual’ emission scenario predicted for late this century. Generally, the climate scenarios reduced the average amounts of the six fatty acids (FAs) analysed, though in some treatments single FAs remained unchanged or even increased. Most reduced was the FA essential for human nutrition, C18:3-ω3, which decreased by 39% and 45% in the combined scenarios with elevated [CO2]+T+[O3] and [CO2]+T, respectively. Average oil content decreased 3–17%. When [CO2] and T were elevated concurrently, the seed biomass was reduced by half, doubling the losses in FAs and oil content. This corresponded to a 58% reduction in the oil yield per hectare, and C18:3-ω3 decreased by 77%. Furthermore, the polyunsaturated FAs were significantly decreased. The results indicate undesirable consequences for production and health benefits of rapeseed oil with future climate change. The results also showed strong interactive effects of CO2, T and O3 on oil quality, demonstrating why prediction of climate effects requires experiments with combined factors and should not be based on extrapolation from single factor experiments. PMID:27222513

Climatic factors affecting quantity and quality grade of in vivo derived embryos of cattle.

PubMed

Chinchilla-Vargas, Josué; Jahnke, Marianna M; Dohlman, Tyler M; Rothschild, Max F; Gunn, Patrick J

2018-05-01

The present study investigated the effects of climatic variables on the quality grade and quantity of in vivo derived cattle embryos in the Midwestern United States. Climatic information included greatest and least daily temperature, average daily wind speed and average temperature-humidity index for each of the 765 records. The response variables included the number of ovarian structures, viable embryos, quality grade 1 embryos, quality grade 2 embryos, quality grade 3 embryos, freezable embryos (sum of quality grade 1 and quality grade 2 embryos), transferable embryos (sum of quality grade 1-3 embryos), degenerate embryos and unfertilized ova. Measures for variables among the breeds of donors and sires grouped by geographical origin were compared. A negative effect of greater temperatures during the early embryonic development stage tended (P < 0.10) to be associated with a decrease in the quality of embryos recovered. Interestingly, the greater the Temperature-Humidity Index (THI) during the early ovarian antral follicular development stage 40-45 days prior to ovulation was associated with a tendency for greater numbers of total number of freezable and transferable embryos recovered per uterine flushing (P < 0.10). Increased wind speed at the early antral follicular phase 40-45 days prior to ovulation was associated with an increase in the percentage of quality grade 1 embryos recovered (P < 0.05). Wind speed during the estrous synchronization period was also associated with a lesser number of embryos recovered (P < 0.05). This retrospective study confirms that climatic variables have significant effects on the in vivo production of cattle embryos and that wind speed should be considered in future analyses of factors affecting embryo quality. Copyright © 2018 Elsevier B.V. All rights reserved.

Backscatter factors and mass energy-absorption coefficient ratios for diagnostic radiology dosimetry

NASA Astrophysics Data System (ADS)

Benmakhlouf, Hamza; Bouchard, Hugo; Fransson, Annette; Andreo, Pedro

2011-11-01

Backscatter factors, B, and mass energy-absorption coefficient ratios, (μen/ρ)w, air, for the determination of the surface dose in diagnostic radiology were calculated using Monte Carlo simulations. The main purpose was to extend the range of available data to qualities used in modern x-ray techniques, particularly for interventional radiology. A comprehensive database for mono-energetic photons between 4 and 150 keV and different field sizes was created for a 15 cm thick water phantom. Backscattered spectra were calculated with the PENELOPE Monte Carlo system, scoring track-length fluence differential in energy with negligible statistical uncertainty; using the Monte Carlo computed spectra, B factors and (μen/ρ)w, air were then calculated numerically for each energy. Weighted averaging procedures were subsequently used to convolve incident clinical spectra with mono-energetic data. The method was benchmarked against full Monte Carlo calculations of incident clinical spectra obtaining differences within 0.3-0.6%. The technique used enables the calculation of B and (μen/ρ)w, air for any incident spectrum without further time-consuming Monte Carlo simulations. The adequacy of the extended dosimetry data to a broader range of clinical qualities than those currently available, while keeping consistency with existing data, was confirmed through detailed comparisons. Mono-energetic and spectra-averaged values were compared with published data, including those in ICRU Report 74 and IAEA TRS-457, finding average differences of 0.6%. Results are provided in comprehensive tables appropriated for clinical use. Additional qualities can easily be calculated using a designed GUI interface in conjunction with software to generate incident photon spectra.

A system to evaluate the scientific quality of biological and restoration objectives using National Wildlife Refuge Comprehensive Conservation Plans as a case study

USGS Publications Warehouse

Schroeder, R.L.

2006-01-01

It is widely accepted that plans for restoration projects should contain specific, measurable, and science-based objectives to guide restoration efforts. The United States Fish and Wildlife Service (USFWS) is in the process of developing Comprehensive Conservation Plans (CCPs) for more than 500 units in the National Wildlife Refuge System (NWRS). These plans contain objectives for biological and ecosystem restoration efforts on the refuges. Based on USFWS policy, a system was developed to evaluate the scientific quality of such objectives based on three critical factors: (1) Is the objective specific, measurable, achievable, results-oriented, and time-fixed? (2) What is the extent of the rationale that explains the assumptions, logic, and reasoning for the objective? (3) How well was available science used in the development of the objective? The evaluation system scores each factor on a scale of 1 (poor) to 4 (excellent) according to detailed criteria. The biological and restoration objectives from CCPs published as of September 2004 (60 total) were evaluated. The overall average score for all biological and restoration objectives was 1.73. Average scores for each factor were: Factor 1-1.97; Factor 2-1.86; Factor 3-1.38. The overall scores increased from 1997 to 2004. Future restoration efforts may benefit by using this evaluation system during the process of plan development, to ensure that biological and restoration objectives are of the highest scientific quality possible prior to the implementation of restoration plans, and to allow for improved monitoring and adaptive management.

The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses.

PubMed

Knardahl, Stein; Johannessen, Håkon A; Sterud, Tom; Härmä, Mikko; Rugulies, Reiner; Seitsamo, Jorma; Borg, Vilhelm

2017-02-08

Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses. Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies. Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality. We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study's sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries. There was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior. Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.

Biological interaction between sleep quality and depression in type 2 diabetes.

PubMed

Zhao, J; Li, X-L; Han, K; Tao, Z-Q; Wu, Z-M

2016-07-01

To explore the interaction of sleep quality and depression among patients with type 2 diabetes mellitus (T2DM). With multistage cluster sampling, the living quality of all participants was investigated. The indicator of interaction was calculated according to the delta method and non-conditional logistic regression model. There were 944 residents involved in the final analysis including 365 males and 579 females. The average age was (64 ± 10.2) years. The rate of poor sleep quality and poor sleep quality combined depression were 33.6% and 40.1%, respectively. Due to poor sleep quality and depression in patients with T2DM, the combined interaction index was 2.48 (95% CI 1.44-4.29), the relative excess risk was 3.42 (95% CI 2.16-4.67), and the attributable proportion was 0.51 (95% CI 0.32-0.70). An additive interaction rather than a multiplicative interaction of poor sleep quality and depression in affecting the quality of life was found in T2DM patients. When both factors existed at the same time, the interaction effect of these 2 factors was greater than the sum of the two factors.

Poster - 23: Dosimetric Characterization and Transferability of an Accessory Mounted Mini-Beam Collimator

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

Davis, William; Crewson, Cody; Alexander, Andrew

Objective: The dosimetric characterization of an accessory-mounted mini-beam collimator across three beam matched linear accelerators. Materials and Methods: Percent depth dose and profiles were measured for the open and mini-beam collimated fields. The average beam quality and peak-to-valley dose ratio (PVDR), the ratio of average peak dose to average valley dose, were obtained from these measurements. The open field relative output and the mini-beam collimator factor, the ratio of the mini-beam dose to open field dose at the beam center, were measured for square fields of side 2, 3, 4, and 5 cm. Mini-beam output as a function of collimatormore » inclination angle relative to the central axis was also investigated. Results and Discussion: Beam quality for both the open and mini-beam collimated fields agreed across all linacs to within ±1.0%. The PVDR was found to vary by up to ±6.6% from the mean. For the 2, 3, and 4 cm fields the average open field relative output with respect to the 5 cm field was 0.874±0.4%, 0.921±0.3%, and 0.962±0.1%. The average collimator factors were 0.450±3.9%, 0.443±3.9%, 0.438±3.9%, and 0.434±3.9%. A decrease in collimator factor greater than 7% was found for an inclination angle change of 0.09°. Conclusion: The mini-beam collimator has revealed a difference between the three linacs not apparent in the open field data, yet transferability can still be attained through thorough dosimetric characterization.« less

Quality of work life of rural emergency department nurses and physicians: a pilot study.

PubMed

Bragard, Isabelle; Fleet, Richard; Etienne, Anne-Marie; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Poitras, Julien; Dupuis, Gilles

2015-04-01

Information about recruitment and retention factors and quality of work life (QWL) in rural emergency departments (EDs) is limited. A pilot study was used to determine the feasibility of a large-scale study of these variables in Quebec EDs. Two EDs, approximately 10,000 and 30,000 patients per year respectively, were selected as convenience samples. An online survey containing the Quality of Work Life Systemic Inventory (QWLSI; 34 items) and the Recruitment and Retention Factors Questionnaire (39 items) was sent to ED nurses and physicians of these two EDs. Descriptive statistics of percentage, mean and standard deviation and correlations were used to analyse the data. Forty out of 64 eligible workers (62%) gave their consent to participate, but only 20 had completed both questionnaires. Participants' mean age was 42 years (SD = 11.6). The average participants satisfaction with their access to continuing education was low (Mean = 1.6, SD = 0.8). However, their satisfaction with technical resources (Mean = 2.4, SD = 0.7), pre-hospital and inter-hospital transfer services (Mean = 2.5, SD = 0.6), relationships with colleagues (Mean = 2.7, SD = 0.6) and managers (Mean = 2.2, SD = 0.7), work-life balance (Mean = 2.4, SD = 0.6) and emergency patient access to other departments (Mean = 3.7, SD = 0.6) was in the average. The impact of several aspects of the rural environment (e.g. tranquility) on quality of life was also in the average (Mean = 2.5, SD = 0.7). QWL was in the average, excepted subscale 'support offered to employee' for which the QWL was lower. Data collection was difficult and the larger study will require strategies to improve recruitment such as a paper alternative. The study showed globally good recruitment and retention factors and QWL for these ED nurses and physicians. These results will help hospital administrations better plan initiatives aimed at improving retention and QWL.

"Finite part" electric and magnetic stored energies for planar antennas

NASA Technical Reports Server (NTRS)

Cockrell, C. R.

1981-01-01

A pair of formulas representing the time-average "finite part" electric and magnetic stored energies for planar antennas are derived. It is also shown that the asymptotic reciprocal relationship between quality factor and relative bandwidth exists for planar antennas.

Long-term Changes in Extreme Air Pollution Meteorology and the Implications for Air Quality.

PubMed

Hou, Pei; Wu, Shiliang

2016-03-31

Extreme air pollution meteorological events, such as heat waves, temperature inversions and atmospheric stagnation episodes, can significantly affect air quality. Based on observational data, we have analyzed the long-term evolution of extreme air pollution meteorology on the global scale and their potential impacts on air quality, especially the high pollution episodes. We have identified significant increasing trends for the occurrences of extreme air pollution meteorological events in the past six decades, especially over the continental regions. Statistical analysis combining air quality data and meteorological data further indicates strong sensitivities of air quality (including both average air pollutant concentrations and high pollution episodes) to extreme meteorological events. For example, we find that in the United States the probability of severe ozone pollution when there are heat waves could be up to seven times of the average probability during summertime, while temperature inversions in wintertime could enhance the probability of severe particulate matter pollution by more than a factor of two. We have also identified significant seasonal and spatial variations in the sensitivity of air quality to extreme air pollution meteorology.

High Sensitivity and Specificity of Clinical Microscopy in Rural Health Facilities in Western Kenya Under an External Quality Assurance Program

PubMed Central

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-01-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. PMID:24935953

Perceived Stress and Coffee and Energy Drink Consumption Predict Poor Sleep Quality in Podiatric Medical Students A Cross-sectional Study.

PubMed

Sawah, Mohomad Al; Ruffin, Naeemah; Rimawi, Mohammad; Concerto, Carmen; Aguglia, Eugenio; Chusid, Eileen; Infortuna, Carmenrita; Battaglia, Fortunato

2015-09-01

A cross-sectional survey administered to first- and second-year podiatric medical students aimed to investigate the effect of coffee intake, energy drink consumption, and perceived stress on sleep quality in medical students during their preclinical studies. Ninety-eight of 183 students contacted (53.6%) completed a questionnaire comprising standard instruments measuring sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness scale), and perceived stress (ten-item Perceived Stress Scale). Furthermore, we investigated coffee and energy drink consumption. Logistic regression was conducted to identify factors associated with poor sleep quality and the relation between sleep quality and academic performance (grade point average). High prevalences of poor sleep quality, excessive daytime sleepiness, and perceived stress were reported. In addition, higher odds of developing poor sleep quality were associated with coffee and energy drink intake, perceived stress, and excessive daytime sleepiness. The total Pittsburgh Sleep Quality Index score was inversely correlated with grade point average. First- and second-year podiatric medical students have poor sleep quality. Further research is needed to identify effective strategies to reduce stress and decrease coffee and energy drink intake to minimize their negative effect on sleep quality and academic performance in podiatric medical students.

Gender, marital power, and marital quality in later life.

PubMed

Bulanda, Jennifer Roebuck

2011-01-01

This study uses data from the 1992 Health and Retirement Study to examine gender differences in marital power and marital quality among older adults and to assess whether there are gender differences in the correlates of marital quality and marital power in later life. Results show that women report lower marital happiness, marital interaction, and marital power than do men, on average. These differences persist even after controlling for a number of life-course events and transitions. Further, results show that gender differences are also evident in the relationship of employment, childrearing, caregiving, and health factors with marital quality and power.

[The impact of social and hygienic lifestyle factors on health status of students].

PubMed

Sakharova, O B; Kiku, P F; Gorborukova, T V

2012-01-01

The complex estimation of the impact of socio-hygienic lifestyle factors on the health of students has been performed. In the work the data of sociological analysis (questionnaire), the methods of multivariate statistics (correlation, regression analysis, method of correlation pleiades by P. V. Terentiev) were used. Among the analyzed components the average monthly income was found to make the greatest contribution of the health state and physical capacity of the studied contingent of students. The influence of this factor is most pronounced in a group of students with an average wealth. The quality of nutrition and the mode of life depend on the level of material well-being of students. Students with a deficiency or excess body weight are more susceptible to the effects of such lifestyle factors such as nutrition, physical activity, bad habits and prosperity.

An adaptive beamforming method for ultrasound imaging based on the mean-to-standard-deviation factor.

PubMed

Wang, Yuanguo; Zheng, Chichao; Peng, Hu; Chen, Qiang

2018-06-12

The beamforming performance has a large impact on image quality in ultrasound imaging. Previously, several adaptive weighting factors including coherence factor (CF) and generalized coherence factor (GCF) have been proposed to improved image resolution and contrast. In this paper, we propose a new adaptive weighting factor for ultrasound imaging, which is called signal mean-to-standard-deviation factor (SMSF). SMSF is defined as the mean-to-standard-deviation of the aperture data and is used to weight the output of delay-and-sum (DAS) beamformer before image formation. Moreover, we develop a robust SMSF (RSMSF) by extending the SMSF to the spatial frequency domain using an altered spectrum of the aperture data. In addition, a square neighborhood average is applied on the RSMSF to offer a more smoothed square neighborhood RSMSF (SN-RSMSF) value. We compared our methods with DAS, CF, and GCF using simulated and experimental synthetic aperture data sets. The quantitative results show that SMSF results in an 82% lower full width at half-maximum (FWHM) but a 12% lower contrast ratio (CR) compared with CF. Moreover, the SN-RSMSF leads to 15% and 10% improvement, on average, in FWHM and CR compared with GCF while maintaining the speckle quality. This demonstrates that the proposed methods can effectively improve the image resolution and contrast. Copyright © 2018 Elsevier B.V. All rights reserved.

Concurrent elevation of CO2, O3 and temperature severely affects oil quality and quantity in rapeseed.

PubMed

Namazkar, Shahla; Stockmarr, Anders; Frenck, Georg; Egsgaard, Helge; Terkelsen, Thilde; Mikkelsen, Teis; Ingvordsen, Cathrine Heinz; Jørgensen, Rikke Bagger

2016-07-01

Plant oil is an essential dietary and bio-energy resource. Despite this, the effects of climate change on plant oil quality remain to be elucidated. The present study is the first to show changes in oil quality and quantity of four rapeseed cultivars in climate scenarios with elevated [CO2], [O3] and temperature (T) combined and as single factors. The combination of environmental factors resembled IPCC's 'business as usual' emission scenario predicted for late this century. Generally, the climate scenarios reduced the average amounts of the six fatty acids (FAs) analysed, though in some treatments single FAs remained unchanged or even increased. Most reduced was the FA essential for human nutrition, C18:3-ω3, which decreased by 39% and 45% in the combined scenarios with elevated [CO2]+T+[O3] and [CO2]+T, respectively. Average oil content decreased 3-17%. When [CO2] and T were elevated concurrently, the seed biomass was reduced by half, doubling the losses in FAs and oil content. This corresponded to a 58% reduction in the oil yield per hectare, and C18:3-ω3 decreased by 77%. Furthermore, the polyunsaturated FAs were significantly decreased. The results indicate undesirable consequences for production and health benefits of rapeseed oil with future climate change. The results also showed strong interactive effects of CO2, T and O3 on oil quality, demonstrating why prediction of climate effects requires experiments with combined factors and should not be based on extrapolation from single factor experiments. © The Author 2016. Published by Oxford University Press on behalf of the Society for Experimental Biology.

Radiation dosimetry measurements with real time radiation monitoring device (RRMD)-II in Space Shuttle STS-79

NASA Technical Reports Server (NTRS)

Sakaguchi, T.; Doke, T.; Hayashi, T.; Kikuchi, J.; Hasebe, N.; Kashiwagi, T.; Takashima, T.; Takahashi, K.; Nakano, T.; Nagaoka, S.;

Forecasting models for flow and total dissolved solids in Karoun river-Iran

NASA Astrophysics Data System (ADS)

Salmani, Mohammad Hassan; Salmani Jajaei, Efat

2016-04-01

Water quality is one of the most important factors contributing to a healthy life. From the water quality management point of view, TDS (total dissolved solids) is the most important factor and many water developing plans have been implemented in recognition of this factor. However, these plans have not been perfect and very successful in overcoming the poor water quality problem, so there are a good volume of related studies in the literature. We study TDS and the water flow of the Karoun river in southwest Iran. We collected the necessary time series data from the Harmaleh station located in the river. We present two Univariate Seasonal Autoregressive Integrated Movement Average (ARIMA) models to forecast TDS and water flow in this river. Then, we build up a Transfer Function (TF) model to formulate the TDS as a function of water flow volume. A performance comparison between the Seasonal ARIMA and the TF models are presented.

Biological effectiveness of nuclear fragments produced by high-energy protons interacting in tissues near the bone- soft tissue interface

NASA Astrophysics Data System (ADS)

Shavers, Mark Randall

1999-12-01

High-energy protons in the galactic cosmic rays (GCR)-or generated by nuclear interactions of GCR heavy-ions with material-are capable of penetrating great thicknesses of shielding to irradiate humans in spacecraft or in lunar or Martian habitats. As protons interact with the nuclei of the elemental constituents of soft tissue and bone, low energy nuclei-target fragments-are emitted into the cells responsible for bone development and maintenance and for hematopoiesis. Leukemogenesis is the principal endpoint of concern because it is the most likely deleterious effect, and it has a short latency period and comparatively low survival rate, although other myelo- proliferative disorders and osteosarcoma also may be induced. A one-dimensional proton-target fragment transport model was used to calculate the energy spectra of fragments produced in bone and soft tissue, and present in marrow cavities at distances from a bone interface. In terms of dose equivalent, the target fragments are as significant as the incident protons. An average radiation quality factor was found to be between 1.8 and 2.6. Biological response to the highly non- uniform energy deposition of the target fragments is such that an alternative approach to conventional predictive risk assessment is needed. Alternative procedures are presented. In vitro cell response and relative biological effectiveness were calculated from the radial dose distribution of each fragment produced by 1-GeV protons using parameters of a modified Ion-Gamma- Kill (IGK) model of radiation action. The modelled endpoints were survival of C3H10t 1/2 and V79 cells, neoplastic transformation of C3H10t1/2 cells, and mutation of the X-linked hypoxanthine phosphoribosyltransferase (HPRT) locus in V79 cells. The dose equivalent and cell responses increased by 10% or less near the interface. Since RBE increases with decreasing dose in the IGK model, comparisons with quality factors were made at dose levels 0.01 <= D [Gy] <= 2. Applying average quality factors derived herein to GCR exposures results in a <= 5% increase of in average quality. Calculated RBEs indicate that accepted quality factors for high-energy protons may be too low due to the relatively high effectiveness of the low-charged target fragments. Derived RBEs for target fragments increase the calculated biological effectiveness of GCR by 20% to 180%.

Pre-adoptive Factors Predicting Lesbian, Gay, and Heterosexual Couples’ Relationship Quality Across the Transition to Adoptive Parenthood

PubMed Central

Goldberg, Abbie E.; Smith, JuliAnna Z.; Kashy, Deborah A.

2010-01-01

The current study examined pre-adoptive factors as predictors of relationship quality (love, ambivalence, and conflict) among 125 couples (44 lesbian couples, 30 gay couples, and 51 heterosexual couples) across the first year of adoptive parenthood. On average, all new parents experienced declines in their relationship quality across the first year of parenthood, regardless of sexual orientation, with women experiencing steeper declines in love. Parents who, pre-adoption, reported higher levels of depression, greater use of avoidant coping, lower levels of relationship maintenance behaviors, and less satisfaction with their adoption agencies reported lower relationship quality at the time of the adoption. The effect of avoidant coping on relationship quality varied by gender. Parents who, pre-adoption, reported higher levels of depression, greater use of confrontative coping, and higher levels of relationship maintenance behaviors reported greater declines in relationship quality. These findings have implications for professionals who work with adoptive parents both pre- and post-adoption. PMID:20545395

Exploring the performance of thin-film superconducting multilayers as kinetic inductance detectors for low-frequency detection

NASA Astrophysics Data System (ADS)

Zhao, Songyuan; Goldie, D. J.; Withington, S.; Thomas, C. N.

2018-01-01

We have solved numerically the diffusive Usadel equations that describe the spatially varying superconducting proximity effect in Ti-Al thin-film bi- and trilayers with thickness values that are suitable for kinetic inductance detectors (KIDs) to operate as photon detectors with detection thresholds in the frequency range of 50-90 GHz. Using Nam’s extension of the Mattis-Bardeen calculation of the superconductor complex conductivity, we show how to calculate the surface impedance for the spatially varying case, and hence the surface impedance quality factor. In addition, we calculate energy-and spatially-averaged quasiparticle lifetimes at temperatures well-below the transition temperature and compare to calculation in Al. Our results for the pair-breaking threshold demonstrate differences between bilayers and trilayers with the same total film thicknesses. We also predict high quality factors and long multilayer-averaged quasiparticle recombination times compared to thin-film Al. Our calculations give a route for designing KIDs to operate in this scientifically-important frequency regime.

[Long-term results after multiple trauma with ISS ≥ 25. Outcome and predictors of quality of life].

PubMed

Simmel, S; Drisch, S; Haag, S; Bühren, V

2013-09-01

The survival chances of multiple trauma patients have continually improved over the last decades; therefore, it is often not a question of whether a patient survives a severe accident but rather how the patient survives. In a retrospective study 127 patients were questioned regarding quality of life and health and possible influencing factors using the POLO chart an average of 70 months after suffering severe trauma (ISS Ø 35.6). The quality of life of severely injured patients is significantly reduced compared with the normal population even years after the trauma. In addition to four pretraumatic factors (older age, female gender, low education and previous illnesses) four posttraumatic variables (difficulties with authorities/institutions and unemployment as a consequence of the accident, long duration and subjectively inadequate treatment in hospital) were identified that have a negative impact on long-term quality of life. The self-reported quality of life after multiple trauma no longer permanently achieves the original level despite extensive rehabilitation measures. Post-traumatic factors have a greater impact on the long-term quality of life than the injury severity. A long-term care and specialized rehabilitation services are needed to improve outcome further.

English and Spanish oral cancer information on the internet: a pilot surface quality and content evaluation of oral cancer web sites.

PubMed

Irwin, Jeannie Y; Thyvalikakath, Thankam; Spallek, Heiko; Wali, Teena; Kerr, Alexander Ross; Schleyer, Titus

2011-01-01

Oral and pharyngeal cancers are responsible for over 7600 deaths each year in the United States. Given the significance of the disease and the fact that many individuals increasingly rely on health information on the Internet, it is important that patients and others can access clear and accurate oral cancer information on the Web. The objective of this study was threefold: (a) develop an initial method to evaluate surface and content quality of selected English- and Spanish-language oral cancer Web sites; (b) conduct a pilot evaluation; and (c) discuss implications of our findings for dental public health. We developed a search strategy to find oral cancer sites frequented by the public using Medline Plus, Google, and Yahoo in English and Spanish. We adapted the Information Quality Tool (IQT) to perform a surface evaluation and developed a novel tool to evaluate site content for 24 sites each in English and Spanish. English-language sites had an average IQT score of 76.6 (out of 100) and an average content score of 52.1 (out of 100). Spanish-language sites had an average IQT score of 50.3 and an average content score of 25.6. The study produced a quality assessment of oral cancer Web sites useful for clinicians and patients. Sites provided more information on clinical presentation, and etiology, and risk factors, than other aspects of oral cancer. The surface and quality of Spanish-language sites was low, possibly putting Hispanic populations at a disadvantage regarding oral cancer information on the Web.

Decision to abort after a prenatal diagnosis of sex chromosome abnormality: a systematic review of the literature.

PubMed

Jeon, Kwon Chan; Chen, Lei-Shih; Goodson, Patricia

2012-01-01

We performed a systematic review of factors affecting parental decisions to continue or terminate a pregnancy after prenatal diagnosis of a sex chromosome abnormality, as reported in published studies from 1987 to May 2011. Based on the Matrix Method for systematic reviews, 19 studies were found in five electronic databases, meeting specific inclusion/exclusion criteria. Abstracted data were organized in a matrix. Alongside the search for factors influencing parental decisions, each study was judged on its methodological quality and assigned a methodological quality score. Decisions either to terminate or to continue a sex chromosome abnormality-affected pregnancy shared five similar factors: specific type of sex chromosome abnormality, gestational week at diagnosis, parents' age, providers' genetic expertise, and number of children/desire for (more) children. Factors unique to termination decisions included parents' fear/anxiety and directive counseling. Factors uniquely associated with continuation decisions were parents' socioeconomic status and ethnicity. The studies' average methodological quality score was 10.6 (SD = 1.67; range, 8-14). Findings from this review can be useful in adapting and modifying guidelines for genetic counseling after prenatal diagnosis of a sex chromosome abnormality. Moreover, improving the quality of future studies on this topic may allow clearer understanding of the most influential factors affecting parental decisions.

High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.

PubMed

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-09-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. © The American Society of Tropical Medicine and Hygiene.

Diffusion of information technology supporting the Institute of Medicine's quality chasm care aims.

PubMed

Burke, Darrell; Menachemi, Nir; Brooks, Robert G

2005-01-01

This article examines the degree to which healthcare information technology (HIT) supporting the Institute of Medicine's (IOM) six care aims is utilized in the hospital setting and explores organizational factors associated with HIT use. Guided by the IOM's Crossing the quality chasm report and associated literature, 27 applications and/or capabilities are classified according to one or more of the six care aims. A structured survey of Florida hospitals identified the use of HIT. Results suggest that, on average, hospitals have not yet embraced HIT to support the IOM's care aims and that associated organizational factors vary according to care aim.

10 kHz ps 1342 nm laser generation by an electro-optically cavity-dumped mode-locked Nd:YVO4 laser

NASA Astrophysics Data System (ADS)

Chen, Ying; Liu, Ke; He, Li-jiao; Yang, Jing; Zong, Nan; Yang, Feng; Gao, Hong-wei; Liu, Zhao; Yuan, Lei; Lan, Ying-jie; Bo, Yong; Peng, Qin-jun; Cui, Da-fu; Xu, Zu-yan

2017-01-01

We have demonstrated an electro-optically cavity-dumped mode-locked (CDML) picosecond Nd:YVO4 laser at 1342 nm with 880 nm diode-laser direct pumping. At a repetition rate of 10 kHz, an average output power of 0.119 W was achieved, corresponding to a pulse energy of 11.9 μJ. Compared with the continuous wave mode-locking pulse energy of 17.5 nJ, the CDML pulse energy was 680 times higher. The pulse width was measured to be 33.4 ps, resulting in the peak power of 356 kW. Meanwhile, the beam quality was nearly diffraction limited with an average beam quality factor M2 of 1.29.

The Influence of God and Providence on Happiness and the Quality of Life of Patients Benefiting from Aesthetic Medicine Treatments in Poland.

PubMed

Galęba, Anna; Bajurna, Beata

2015-08-01

The research reveals the impact of a belief in god and god's Providence on the happiness and quality of life of patients benefiting from aesthetic medicine treatments in Poland (country where over 90 % of society declare to be deeply devout). The work also examines age and sex of the patients benefiting from beauty treatments (botulinum toxin, fillers, medical peels and needle mesotherapy), their quality of life and also the impact of various factors, including God and Divine Providence on their happiness. The research shows the analysis of factors influencing the successes or failures in the past year and presents the comparison of patients who have benefited from the aesthetic medicine treatments (cosmetic medicine) to the common average Polish citizens.

Quality of life in Essential Tremor Questionnaire (QUEST): development and initial validation.

PubMed

Tröster, Alexander I; Pahwa, Rajesh; Fields, Julie A; Tanner, Caroline M; Lyons, Kelly E

2005-09-01

Essential tremor (ET) can diminish functioning and quality of life (QOL) but generic QOL measures may be relatively insensitive to ET and its therapies. We sought to develop an ET-specific measure that might be more sensitive, acceptable to patients, relatively brief, and easily used. A sample of 200 patients (average age 70 years, range 30-91; average disease duration 15 years) rated the extent to which tremor impacts a function or state, tremor severity in various body parts, perceived health, and overall QOL. Responses to this initial questionnaire were subjected to principal components analysis (PCA). Inspection of factor coordinates, Eigenvalues, variance accounted for, and correlation matrices were used to select items for confirmatory PCA. Final scale reliability was assessed using Cronbach's alpha. Validity was evaluated by correlations between QOL scales and self-rated tremor severity. PCA of 65 initial items yielded 11 factors accounting for 71% of variance. Six factors were discarded. Two items were eliminated for not loading on a factor and 33 for perceived redundancy. Confirmatory PCA of the retained 30 items yielded an almost identical factor structure (six factors, 70% of variance accounted for, and similar item loadings). Because two factors had very few items loading on them, these two factors were combined into one scale. The final measure has five scales: Physical, Psychosocial, Communication, Hobbies/Leisure, and Work/Finance. Reliability was excellent for the whole instrument and four scales (> or =0.89), and good for the Work/Finance scale (0.79). Severity of voice and head tremor were the best correlates of Communication (0.70 and 0.35), while the Physical scale was related to right and left upper extremity tremor (0.59 and 0.56). Scales correlated more highly with patients' rating of their overall QOL than their health perception. A brief, 30-item, ET-specific QOL scale with excellent reliability was developed. Preliminary validity data are encouraging. The Quality of Life in Essential Tremor Questionnaire (QUEST) promises to facilitate QOL measurement in ET.

[The quality of professional life and the pride in working in public health. The results of a survey].

PubMed

Clúa Espuny, J L; Aguilar Martín, C

1998-09-30

To find what factors explain best the pride of belonging to a public health enterprise. A descriptive crossover study. One primary care CHS. Staff of 363 from Tortosa's Primary Care administrative staff. All the employees were sent a self-filling questionnaire on the quality of their professional life. 232 returned the questionnaire filled in (63.9%). They showed an average value for the overall quality of professional life (5.40 +/- 2.09). The general profile covered the following perceptions taken together: sufficient intrinsic motivation; in a work-place with sufficient responsibility, training and social support; associated with enough work-load; with some emotional support from the managers; having some inconveniences caused by work. The pride in belonging to the CHS was high (6.86 +/- 2.50), with those over 45 giving a significantly higher average reply. Among doctors, pride was significantly lower. The multiple regression model identified three significant variables which explained 67.5% of the variability in the pride of belonging to the CHS: recognition of effort, being properly trained for their current job and length of service. a) Professionals are quite proud of belonging to the CHS. b) Their perception of the quality of professional life is average.

[Quality of life and related factors among climacteric women from south Brazil].

PubMed

de Lorenzi, Dino R S; Saciloto, Bruno; Artico, Graziela R; Fontana, Sabrina K R

2009-01-01

This study aimed to evaluate the quality of life in climacteric and associated factor among women from Southeast Brazil. A cross-section study of 506 women aged between 45 and 60 years old attended at a university climacteric clinic from South Brazil from June to October 2002. Hysterectomized women, as well as hormonal therapy or hormonal contraceptive users were excluded. The quality of life was evaluated by the Women's Health Questionnaire (WHQ). Statistical analysis was performed with multiple linear regression analysis. The average of the age among the studied women was 51.3 (+/- 4.5) years old. About 15.4% were premenopausal, 34.4% perimenopausal and 50.2% postmenopausal women. The quality of life showed up deteriorated among the studied women. The factors related with quality of life were: the educational level (p < 0.01), the confirmation of smoking in the last year (p < 0.01), regular physical activity (p < 0.01), the confirmation of previous co-morbidities (p < 0.01) and the menopausal status (p < 0.01). A higher educational level, as well as the confirmation of regular physical activity led to a significant increase on their life quality. Smoking and previous clinical co-morbidities were responsible for the lower scores of quality of life. The pre-menopause was associated with a higher life quality level if compared to peri and post menopause. No differences in relation to the scores of life were identified among the perimenopausal and postmenopausal women. Nevertheless the menopausal status showed up associated to the quality of life, the results of the study pointed out that the climacteric is not just influenced by biological factors, but also by psychosocial and cultural factors.

Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep.

PubMed

Christensen, Matthew A; Bettencourt, Laura; Kaye, Leanne; Moturu, Sai T; Nguyen, Kaylin T; Olgin, Jeffrey E; Pletcher, Mark J; Marcus, Gregory M

2016-01-01

Smartphones are increasingly integrated into everyday life, but frequency of use has not yet been objectively measured and compared to demographics, health information, and in particular, sleep quality. The aim of this study was to characterize smartphone use by measuring screen-time directly, determine factors that are associated with increased screen-time, and to test the hypothesis that increased screen-time is associated with poor sleep. We performed a cross-sectional analysis in a subset of 653 participants enrolled in the Health eHeart Study, an internet-based longitudinal cohort study open to any interested adult (≥ 18 years). Smartphone screen-time (the number of minutes in each hour the screen was on) was measured continuously via smartphone application. For each participant, total and average screen-time were computed over 30-day windows. Average screen-time specifically during self-reported bedtime hours and sleeping period was also computed. Demographics, medical information, and sleep habits (Pittsburgh Sleep Quality Index-PSQI) were obtained by survey. Linear regression was used to obtain effect estimates. Total screen-time over 30 days was a median 38.4 hours (IQR 21.4 to 61.3) and average screen-time over 30 days was a median 3.7 minutes per hour (IQR 2.2 to 5.5). Younger age, self-reported race/ethnicity of Black and "Other" were associated with longer average screen-time after adjustment for potential confounders. Longer average screen-time was associated with shorter sleep duration and worse sleep-efficiency. Longer average screen-times during bedtime and the sleeping period were associated with poor sleep quality, decreased sleep efficiency, and longer sleep onset latency. These findings on actual smartphone screen-time build upon prior work based on self-report and confirm that adults spend a substantial amount of time using their smartphones. Screen-time differs across age and race, but is similar across socio-economic strata suggesting that cultural factors may drive smartphone use. Screen-time is associated with poor sleep. These findings cannot support conclusions on causation. Effect-cause remains a possibility: poor sleep may lead to increased screen-time. However, exposure to smartphone screens, particularly around bedtime, may negatively impact sleep.

Income, Relationship Quality, and Parenting: Associations with Child Development in Two-Parent Families

PubMed Central

Berger, Lawrence M.; McLanahan, Sara S.

2015-01-01

Prior research suggests considerable heterogeneity in the advantages of living in a two-parent family. Specifically, children living with married biological parents exhibit more favorable outcomes than children living with cohabiting biological parents and with married and cohabiting stepparents. To explain these differences, researchers have focused almost exclusively on differences in the levels of factors such as income, parental relationship quality, and parenting quality across family types. In this paper, we examined whether differences in the benefits associated with these factors might also account for some of the variation in children’s cognition and social-emotional development. Focusing on children at the time they enter kindergarten, we found only weak evidence of differences in benefits across family types. Rather, we found that children living in stepfather families experienced above average levels of parental relationship quality and parenting quality which, in turn, played a protective role vis-à-vis their cognitive and social-emotional development. PMID:26339104

Real time measurements of submicrometer aerosols in Seoul, Korea: Sources, characteristics, and processing of organic aerosols during winter time.

NASA Astrophysics Data System (ADS)

Kim, H.; Zhang, Q.

2016-12-01

Highly time-resolved chemical characterization of non-refractory submicrometer particulate matter (NR-PM1) was conducted in Seoul, the capital of Korea, using an Aerodyne high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS). The measurements were performed during winter when persistent air quality problems associated with elevated PM concentrations were observed. The average NR-PM1 concentration was 27.5 µg m-3 and the average mass was dominated by organics (44%), followed by nitrate (24%) and sulfate (10%). Five distinct sources of organic aerosol (OA) were identified from positive matrix factorization (PMF) analysis of the AMS data: vehicle emissions represented by a hydrocarbon-like OA factor (HOA), cooking represented by a cooking OA factor (COA), wood combustion represented by a biomass burning OA factor (BBOA), and secondary aerosol formation in the atmosphere that is represented by a semi-volatile oxygenated OA factor (SVOOA) and a low volatile oxygenated OA factor (LVOOA). These factors, on average, contributed 16, 20, 23, 15 and 26% to the total OA mass, respectively, with primary organic aerosol (POA = HOA + COA + BBOA) accounting for 59% of the OA mass. On average, both primary emissions and secondary aerosol formation are important factors affecting air quality in Seoul during winter, contributing approximately equal. However, differences in the fraction of PM source and properties were observed between high and low loading PM period. For example, during stagnant period with low wind speed (WS) (0.99 ± 0.7 m/s) and high RH (71%), high PM loadings (43.6 ± 12.4 µg m-3) with enhanced fractions of nitrate (27%) and SVOOA (8%) were observed, indicating a strong influence from locally generated secondary aerosol. On the other hand, when low PM loadings (12.6 ± 7.1 µg m-3), which were commonly associated with high WS (1.8 ± 1.1 m/s) and low RH (50 %), were observed, the fraction of regional sources, such as sulfate (12%) and LVOOA (21%) become higher whereas the fraction of locally emitted primary (COA, HOA) and locally formed secondary species (nitrate, SVOOA) become lower. Our results indicate that NR-PM1 concentrations, compositions and sources in Korea are very complex and meteorological conditions and air mass origins have a strong influence on properties of PM.

Construction variables considered in fabrication of a structural flakeboard

Treesearch

R.L. Geimer; E.W. Price

1978-01-01

Flake geometry, flake quality, flake alignment, average density, density gradients, layer thicknesses, and resin content were factors considered in determining the final construction details on structural flakeboards made from 1) western softwoods and 2) southern hardwood residues. After making compromises between board properties, a three-layer design was recommended...

Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus.

PubMed

Osonoi, Yusuke; Mita, Tomoya; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Kanazawa, Akio; Gosho, Masahiko; Fujitani, Yoshio; Watada, Hirotaka

2015-06-18

While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship. The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated. The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors. Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.

Medication-related risk factors associated with health-related quality of life among community-dwelling elderly in China.

PubMed

Zhang, Sha; Meng, Long; Qiu, Feng; Yang, Jia-Dan; Sun, Shusen

2018-01-01

Previous studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ. The study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression. A total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life. Patient's internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.

Integrating cognitive and peripheral factors in predicting hearing-aid processing effectiveness

PubMed Central

Kates, James M.; Arehart, Kathryn H.; Souza, Pamela E.

2013-01-01

Individual factors beyond the audiogram, such as age and cognitive abilities, can influence speech intelligibility and speech quality judgments. This paper develops a neural network framework for combining multiple subject factors into a single model that predicts speech intelligibility and quality for a nonlinear hearing-aid processing strategy. The nonlinear processing approach used in the paper is frequency compression, which is intended to improve the audibility of high-frequency speech sounds by shifting them to lower frequency regions where listeners with high-frequency loss have better hearing thresholds. An ensemble averaging approach is used for the neural network to avoid the problems associated with overfitting. Models are developed for two subject groups, one having nearly normal hearing and the other mild-to-moderate sloping losses. PMID:25669257

“Lucky Averaging”: Quality improvement on Adaptive Optics Scanning Laser Ophthalmoscope Images

PubMed Central

Huang, Gang; Zhong, Zhangyi; Zou, Weiyao; Burns, Stephen A.

2012-01-01

Adaptive optics(AO) has greatly improved retinal image resolution. However, even with AO, temporal and spatial variations in image quality still occur due to wavefront fluctuations, intra-frame focus shifts and other factors. As a result, aligning and averaging images can produce a mean image that has lower resolution or contrast than the best images within a sequence. To address this, we propose an image post-processing scheme called “lucky averaging”, analogous to lucky imaging (Fried, 1978) based on computing the best local contrast over time. Results from eye data demonstrate improvements in image quality. PMID:21964097

Dynamics of movie competition and popularity spreading in recommender systems.

PubMed

Yeung, C H; Cimini, G; Jin, C-H

2011-01-01

We introduce a simple model to study movie competition in recommender systems. Movies of heterogeneous quality compete against each other through viewers' reviews and generate interesting dynamics at the box office. By assuming mean-field interactions between the competing movies, we show that the runaway effect of popularity spreading is triggered by defeating the average review score, leading to box-office hits: Popularity rises and peaks before fade-out. The average review score thus characterizes the critical movie quality necessary for transition from box-office bombs to blockbusters. The major factors affecting the critical review score are examined. By iterating the mean-field dynamical equations, we obtain qualitative agreements with simulations and real systems in the dynamical box-office forms, revealing the significant role of competition in understanding box-office dynamics.

Dynamics of movie competition and popularity spreading in recommender systems

NASA Astrophysics Data System (ADS)

Yeung, C. H.; Cimini, G.; Jin, C.-H.

2011-01-01

We introduce a simple model to study movie competition in recommender systems. Movies of heterogeneous quality compete against each other through viewers’ reviews and generate interesting dynamics at the box office. By assuming mean-field interactions between the competing movies, we show that the runaway effect of popularity spreading is triggered by defeating the average review score, leading to box-office hits: Popularity rises and peaks before fade-out. The average review score thus characterizes the critical movie quality necessary for transition from box-office bombs to blockbusters. The major factors affecting the critical review score are examined. By iterating the mean-field dynamical equations, we obtain qualitative agreements with simulations and real systems in the dynamical box-office forms, revealing the significant role of competition in understanding box-office dynamics.

The quality of life of Brazilian adolescents with asthma: associated clinical and sociodemographic factors.

PubMed

Amaral, Lígia Menezes do; Moratelli, Lucas; Palma, Pamella Valente; Leite, Isabel Cristina Gonçalves

2014-08-01

Asthma is the most common chronic disease among adolescents. This study assessed the quality of life (QOL) related to health in adolescents with asthma and its determining factors (demographic, socioeconomic, and clinical). We also separately evaluated each of the parameters that comprised the asthma control classification. This was an observational, cross-sectional study of 114 adolescents who had doctor-diagnosed asthma. QOL was assessed using a version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) that was adapted and validated for Brazil, and higher scores indicated a better QOL. The level of asthma control was assessed using the rating system proposed by the Global Initiative for Asthma, and sociodemographic factors were evaluated. When the averages of the PAQLQ domains and overall scores were compared to the potentially explanatory variables, significantly lower average PAQLQ scores were obtained for individuals with an inadequate level of asthma control (p < 0.001). Of the control components, daytime symptoms, nighttime symptoms, and limited physical activity were related to QOL. However, the use of the β2 agonist and the peak flow functional parameter were not related to QOL. The level of asthma control was related to QOL, but this association manifested mainly in the subjective control domains, such as nighttime and daytime symptoms and physical activity limitations. The objective domain for control classification, represented by pulmonary function, was not an independent predictor or determinant of the QOL of adolescent asthma patients.

Community Characteristics and Mortality: The Relative Strength of Association of Different Community Characteristics

PubMed Central

Roberts, Eric; McCleary, Rachael; Buttorff, Christine; Gaskin, Darrell J.

2014-01-01

Objectives. We compared the strength of association between average 5-year county-level mortality rates and area-level measures, including air quality, sociodemographic characteristics, violence, and economic distress. Methods. We obtained mortality data from the National Vital Statistics System and linked it to socioeconomic and demographic data from the Census Bureau, air quality data, violent crime statistics, and loan delinquency data. We modeled 5-year average mortality rates (1998–2002) for all-cause, cancer, heart disease, stroke, and respiratory diseases as a function of county-level characteristics using ordinary least squares regression models. We limited analyses to counties with population of 100 000 or greater (n = 458). Results. Demographic and socioeconomic characteristics, particularly the percentage older than 65 years and near poor, were top predictors of all-cause and condition-specific mortality, as were a high concentration of construction and service workers. We found weaker associations for air quality, mortgage delinquencies, and violent crimes. Protective characteristics included the percentage of Hispanics, Asians, and married residents. Conclusions. Multiple factors influence county-level mortality. Although county demographic and socioeconomic characteristics are important, there are independent, although weaker, associations of other environmental characteristics. Future studies should investigate these factors to better understand community mortality risk. PMID:25033152

Effect of Feelings of Guilt and Shame on Life Quality of Women in Menopause

PubMed Central

Sohbet, Rabia

2017-01-01

Objectives Current study was conducted between September 2014 and January 2015 in Gaziantep proviency Şehitkamil town Şirinevler district. Purpose of the study is to measure changes experienced, point of view on menopause, and life style of women who are older than 40, living in said district, and within post-menopause and how these factors effected their feelings of guilt and shame. Methods Out of universe consisting of 800 women, 500 participants have joined the study. Data collected by personal information form, Guilt-Shame scales, and World Health Organization quality of life (WHOQOL-BREF) scales. SPSS 18 was used to conduct statistical analysis. Results Analysis indicated that 78.6% of the participants was not literate, 37.8% of the participants were was subjected to domestic violence. Fifty-five percent of the participants were found to see menopause as a predicament, 45.4% as a disease, and 56% as infertility. Results of scales are as follows; guilt factor 48.95 ± 0.37, shame factor 44.89 ± 0.27, body 10.64 ± 0.42, mental 10.96 ± 0.39, social 11.12 ± 0.49, environment 10.84 ± 0.37. Conclusions No significant correlation found between Guilt: body, mental, social, and environmental area (P < 0.05). It was found that there is a significant correlation between the thought that menopause is not a bad thing and the perceived guilt (P < 0.001). Results of analyses indicate that information about menopause significantly correlates between perceived guilt (P < 0.05). Current study found that as perceived shame and guild increases, the life quality of the sample decreases and the average life quality of the sample is below average. PMID:28523254

The influence of somatotype components and personality traits on the playing position and the quality of top Croatian female cadet handball players.

PubMed

Cavala, Marijana; Trninić, Viktorija; Jasić, Dajana; Tomljanović, Mario

2013-05-01

The research was conducted with the aim to establish the structure and the differences of morphological features and personality traits between different age groups of female cadet handball players grouped by their playing quality and playing positions. Further on, the research was done on 70 handball players aged 15, 31 on average, who were grouped according to their positions on goalkeepers, outside players, wings and pivots. Furthermore, according to the quality of playing, they were divided in two quality groups of players, those from the wider cadet national team, thus characterised as top female players in Croatia, and those who had never been invited into the cadet national team and thus can be referred to as low-quality, i.e. average female handball players. The structure of predictor variables has indicated the existence of general morphological factor assessing the players' constitution and two personality features factors - neuroticism and extraversion. The variance analysis showed no statistically significant differences of somatotype variables with relation to quality and playing position. By observing basic personality traits, a statistically significant difference was confirmed only in introversion-extraversion with a lower score in goalkeepers than in other positions, which indicates a higher level of introversion in this playing position. Such result was expected since this particular position abounds in specific tasks and demands in the game in relation to all other playing positions. Further on, it has been concluded that the selection of players must not be based only on the stated physical and psychological characteristics, but on relevant anthropological complexes determining performance and sport achievement.

Characteristics and origin of the relatively high-quality tight reservoir in the Silurian Xiaoheba Formation in the southeastern Sichuan Basin

PubMed Central

Gong, Xiaoxing; Shi, Zejin; Wang, Yong; Tian, Yaming; Li, Wenjie; Liu, Lei

2017-01-01

A mature understanding of the sandstone gas reservoir in the Xiaoheba Formation in the southeastern Sichuan Basin remains lacking. To assess the reservoir characteristics and the origin of the high-quality reservoir in the Xiaoheba Formation, this paper uses systematic field investigations, physical property analysis, thin section identification, scanning electron microscopy and electron microprobe methods. The results indicate that the Xiaoheba sandstone is an ultra-tight and ultra-low permeability reservoir, with an average porosity of 2.97% and an average permeability of 0.56×10−3 μm2. This promising reservoir is mainly distributed in the Lengshuixi and Shuangliuba regions and the latter has a relatively high-quality reservoir with an average porosity of 5.28% and average permeability of 0.53×10−3 μm2. The reservoir space comprises secondary intergranular dissolved pores, moldic pores and fractures. Microfacies, feldspar dissolution and fracture connectivity control the quality of this reservoir. The relatively weak compaction and cementation in the interbedded delta front distal bar and interdistributary bay microfacies indirectly protected the primary intergranular pores and enhanced late-stage dissolution. Late-stage potassium feldspar dissolution was controlled by the early-stage organic acid dissolution intensity and the distance from the hydrocarbon generation center. Early-stage fractures acted as pathways for organic acid migration and were therefore important factors in the formation of the reservoir. Based on these observations, the area to the west of the Shuangliuba and Lengshuixi regions has potential for gas exploration. PMID:28686735

7 CFR 760.641 - Adjustments made to NAMP to reflect loss of quality.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the FSA State committee. The adjustment factor will be based on the average actual market price... market price of a crop due to a reduction in the intrinsic characteristics of the production resulting... crop for which the value is reduced due to excess moisture resulting from a disaster related condition...

Changes in Health Care Spending and Quality 4 Years into Global Payment

PubMed Central

Song, Zirui; Rose, Sherri; Safran, Dana G.; Landon, Bruce E.; Day, Matthew P.; Chernew, Michael E.

2014-01-01

BACKGROUND Spending and quality under global budgets remain unknown beyond 2 years. We evaluated spending and quality measures during the first 4 years of the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract (AQC). METHODS We compared spending and quality among enrollees whose physician organizations entered the AQC from 2009 through 2012 with those among persons in control states. We studied spending changes according to year, category of service, site of care, experience managing risk contracts, and price versus utilization. We evaluated process and outcome quality. RESULTS In the 2009 AQC cohort, medical spending on claims grew an average of $62.21 per enrollee per quarter less than it did in the control cohort over the 4-year period (P<0.001). This amount is equivalent to a 6.8% savings when calculated as a proportion of the average post-AQC spending level in the 2009 AQC cohort. Analogously, the 2010, 2011, and 2012 cohorts had average savings of 8.8% (P<0.001), 9.1% (P<0.001), and 5.8% (P = 0.04), respectively, by the end of 2012. Claims savings were concentrated in the outpatient-facility setting and in procedures, imaging, and tests, explained by both reduced prices and reduced utilization. Claims savings were exceeded by incentive payments to providers during the period from 2009 through 2011 but exceeded incentive payments in 2012, generating net savings. Improvements in quality among AQC cohorts generally exceeded those seen elsewhere in New England and nationally. CONCLUSIONS As compared with similar populations in other states, Massachusetts AQC enrollees had lower spending growth and generally greater quality improvements after 4 years. Although other factors in Massachusetts may have contributed, particularly in the later part of the study period, global budget contracts with quality incentives may encourage changes in practice patterns that help reduce spending and improve quality. (Funded by the Commonwealth Fund and others.) PMID:25354104

Quality of phenobarbital solid-dosage forms in the urban community of Nouakchott (Mauritania).

PubMed

Laroche, Marie-Laure; Traore, Hamidou; Merle, Louis; Gaulier, Jean-Michel; Viana, Marylene; Preux, Pierre-Marie

2005-08-01

Epilepsy is a major public-health problem in Africa. The quality of available drugs is a limiting factor for an adequate management. The aim of this study was to describe the proportion of poor-quality phenobarbital (PB) solid-dosage forms and evaluate the factors associated with its quality in Nouakchott (Mauritania). A cross-sectional study was carried out within pharmacies, hospitals, and on the parallel market in March 2003. PB samples were bought by a native person and then assayed by a liquid chromatography method. A package was considered to be of good quality if the active-substance average content was between 85 and 115% of the stated content printed on the packet. Forty-five pharmaceutical stores were visited, enabling us to collect 146 samples of PB. Three brand names were available in Nouakchott. They originated from France, Morocco, Senegal, and Egypt. Results: A prevalence of 13.7%[95% confidence interval (CI), 8.8-20.0] of poor-quality PB was found. All samples from Morocco were underdosed. The generic active content was satisfactory, but saccharose, an excipient with a potential side effects, was identified. Two factors associated with the good quality of PB have been put forward: tablets manufactured in France and loose packaging as generics conditioned in such a way were of good quality. This study shows that the quality of antiepileptic drugs in Africa is still worrying. The setting up of medicine quality control in Mauritania is legitimate. Considering the good quality of generic PB and its lower cost, this type of medicine should be promoted in this region.

Emissions of NOx, SO2, CO, and HCHO from commercial marine shipping during Texas Air Quality Study (TexAQS) 2006

NASA Astrophysics Data System (ADS)

Williams, E. J.; Lerner, B. M.; Murphy, P. C.; Herndon, S. C.; Zahniser, M. S.

2009-11-01

We report measurements of NOx, SO2, CO, and HCHO mass-based emission factors from more than 200 commercial vessel encounters in the Gulf of Mexico and the Houston-Galveston region of Texas during August and September, 2006. For underway ships, bulk freight carriers have the highest average NOx emissions at ˜87 g NOx (kg fuel)-1, followed by tanker ships at ˜79 g NOx (kg fuel)-1, while container carriers, passenger ships, and tugs all emit an average of about ˜60 g NOx (kg fuel)-1. Emission of NOx from stationary vessels was lower, except for container ships and tugs, and likely reflects use of medium-speed diesel engines. Overall, our mean NOx emission factors are 10-15% lower than published data. Average emission of SO2 was lower for passenger ships and tugs and tows (6-7 g SO2 (kg fuel)-1) than for larger cargo vessels (20-30 g SO2 (kg fuel)-1). Our data for large cargo ships in this region indicate an average residual fuel sulfur content of ˜1.4% which is a factor of two lower than the global average of 2.7%. Emission of CO was low for all categories (7-16 g CO (kg fuel)-1), although our mean overall CO emission factor is about 10% higher than published data. Emission of HCHO was less than 5% that of CO. Despite considerable variability, no functional relationships, such as emissions changes with engine speed or load, could be discerned. Comparison of emission factors from ships to those from other sources suggests ship emissions in this region cannot be ignored.

Intercomparison of methods for image quality characterization. II. Noise power spectrum

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

Dobbins, James T. III; Samei, Ehsan; Ranger, Nicole T.

Second in a two-part series comparing measurement techniques for the assessment of basic image quality metrics in digital radiography, in this paper we focus on the measurement of the image noise power spectrum (NPS). Three methods were considered: (1) a method published by Dobbins et al. [Med. Phys. 22, 1581-1593 (1995)] (2) a method published by Samei et al. [Med. Phys. 30, 608-622 (2003)], and (3) a new method sanctioned by the International Electrotechnical Commission (IEC 62220-1, 2003), developed as part of an international standard for the measurement of detective quantum efficiency. In addition to an overall comparison of themore » estimated NPS between the three techniques, the following factors were also evaluated for their effect on the measured NPS: horizontal versus vertical directional dependence, the use of beam-limiting apertures, beam spectrum, and computational methods of NPS analysis, including the region-of-interest (ROI) size and the method of ROI normalization. Of these factors, none was found to demonstrate a substantial impact on the amplitude of the NPS estimates ({<=}3.1% relative difference in NPS averaged over frequency, for each factor considered separately). Overall, the three methods agreed to within 1.6%{+-}0.8% when averaged over frequencies >0.15 mm{sup -1}.« less

Impact of B-Scan Averaging on Spectralis Optical Coherence Tomography Image Quality before and after Cataract Surgery

PubMed Central

Podkowinski, Dominika; Sharian Varnousfaderani, Ehsan; Simader, Christian; Bogunovic, Hrvoje; Philip, Ana-Maria; Gerendas, Bianca S.

2017-01-01

Background and Objective To determine optimal image averaging settings for Spectralis optical coherence tomography (OCT) in patients with and without cataract. Study Design/Material and Methods In a prospective study, the eyes were imaged before and after cataract surgery using seven different image averaging settings. Image quality was quantitatively evaluated using signal-to-noise ratio, distinction between retinal layer image intensity distributions, and retinal layer segmentation performance. Measures were compared pre- and postoperatively across different degrees of averaging. Results 13 eyes of 13 patients were included and 1092 layer boundaries analyzed. Preoperatively, increasing image averaging led to a logarithmic growth in all image quality measures up to 96 frames. Postoperatively, increasing averaging beyond 16 images resulted in a plateau without further benefits to image quality. Averaging 16 frames postoperatively provided comparable image quality to 96 frames preoperatively. Conclusion In patients with clear media, averaging 16 images provided optimal signal quality. A further increase in averaging was only beneficial in the eyes with senile cataract. However, prolonged acquisition time and possible loss of details have to be taken into account. PMID:28630764

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals

PubMed Central

2018-01-01

Objective To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. Methods A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. Results There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Conclusion Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture. PMID:29560330

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals.

PubMed

Choi, Sehoon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog; Han, Seung Hoon

2018-02-01

To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture.

Factors affecting breeding soundness classification of beef bulls examined at the Western College of Veterinary Medicine.

PubMed

Barth, Albert D; Waldner, Cheryl L

2002-04-01

Breeding soundness evaluation records from 2110 beef bulls, for the period of 1986 to 1999, were analyzed to determine the prevalence and importance of factors affecting breeding soundness classification. The percentage of all bulls classified as satisfactory ranged from 49.0% in January to 73.3% in May. The percentage of physically normal bulls with satisfactory semen quality ranged from 65.7% in January to 87.5% in June. Poor body condition or excessive body condition, below average or below the recommended minimum scrotal circumference, lameness, and severe scrotal frostbite significantly reduced the probability of a satisfactory breeding soundness classification. The percentage of sperm with midpiece defects declined significantly and the percentage of sperm with head defects increased significantly with the approach of summer. Photoperiod, cold stress, poor or excessive body condition, and reduced feed quality may interact to reduce semen quality in the winter months.

Mapping Air Quality Index of Carbon Monoxide (CO) in Medan City

NASA Astrophysics Data System (ADS)

Suryati, I.; Khair, H.

2017-03-01

This study aims to map and analyze air quality index of carbon monoxide (CO) in Medan City. This research used 12 (twelve) sampling points around in Medan with an hour duration each point. CO concentration was analyzed using the NDIR CO Analyzer sampling tool. The concentration CO was obtained between 1 ppm - 23 ppm, with an average concentration was 9.5 ppm. This condition is still below the national ambient air quality standard set by Government Regulation of Indonesian Republic Number 41-1999 amounted to 29 ppm. The result of CO concentration measurements was converted into air pollutant standard index, obtained the index value of 58 - 204. Surfer 10 was used to create map of air pollutant standard index for CO. The map illustrates very unhealthy area where located in the Medan Belawan district. The main factors affecting the concentration of CO are from transportation and meteorological factors.

High-power narrow-linewidth quasi-CW diode-pumped TEM00 1064 nm Nd:YAG ring laser.

PubMed

Liu, Yuan; Wang, Bao-shan; Xie, Shi-yong; Bo, Yong; Wang, Peng-yuan; Zuo, Jun-wei; Xu, Yi-ting; Xu, Jia-lin; Peng, Qin-jun; Cui, Da-fu; Xu, Zu-yan

2012-04-01

We demonstrated a high average power, narrow-linewidth, quasi-CW diode-pumped Nd:YAG 1064 nm laser with near-diffraction-limited beam quality. A symmetrical three-mirror ring cavity with unidirectional operation elements and an etalon was employed to realize the narrow-linewidth laser output. Two highly efficient laser modules and a 90° quartz rotator for birefringence compensation were used for the high output power. The maximum average output power of 62.5 W with the beam quality factor M(2) of 1.15 was achieved under a pump power of 216 W at a repetition rate of 500 Hz, corresponding to the optical-to-optical conversion efficiency of 28.9%. The linewidth of the laser at the maximum output power was measured to be less than 0.2 GHz.

Importance of background values in assessing the impact of heavy metals in river ecosystems: case study of Tisza River, Serbia.

PubMed

Štrbac, Snežana; Kašanin Grubin, Milica; Vasić, Nebojša

2017-11-30

The main objective of this paper is to evaluate how a choice of different background values may affect assessing the anthropogenic heavy metal pollution in sediments from Tisza River (Serbia). The second objective of this paper is to underline significance of using geochemical background values when establishing quality criteria for sediment. Enrichment factor (EF), geoaccumulation index (I geo ), pollution load index (PLI), and potential ecological risk index (PERI) were calculated using different background values. Three geochemical (average metal concentrations in continental crust, average metal concentrations in shale, and average metal concentrations in non-contaminated core sediment samples) and two statistical methods (delineation method and principal component analyses) were used for calculating background values. It can be concluded that obtained information of pollution status can be more dependent on the use of background values than the index/factor chosen. The best option to assess the potential river sediment contamination is to compare obtained concentrations of analyzed elements with concentrations of mineralogically and texturally comparable, uncontaminated core sediment samples. Geochemical background values should be taken into account when establishing quality criteria for soils, sediments, and waters. Due to complexity of the local lithology, it is recommended that environmental monitoring and assessment include selection of an appropriate background values to gain understanding of the geochemistry and potential source of pollution in a given environment.

Dosimetry for Small and Nonstandard Fields

NASA Astrophysics Data System (ADS)

Junell, Stephanie L.

The proposed small and non-standard field dosimetry protocol from the joint International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine working group introduces new reference field conditions for ionization chamber based reference dosimetry. Absorbed dose beam quality conversion factors (kQ factors) corresponding to this formalism were determined for three different models of ionization chambers: a Farmer-type ionization chamber, a thimble ionization chamber, and a small volume ionization chamber. Beam quality correction factor measurements were made in a specially developed cylindrical polymethyl methacrylate (PMMA) phantom and a water phantom using thermoluminescent dosimeters (TLDs) and alanine dosimeters to determine dose to water. The TLD system for absorbed dose to water determination in high energy photon and electron beams was fully characterized as part of this dissertation. The behavior of the beam quality correction factor was observed as it transfers the calibration coefficient from the University of Wisconsin Accredited Dosimetry Calibration Laboratory (UWADCL) 60Co reference beam to the small field calibration conditions of the small field formalism. TLD-determined beam quality correction factors for the calibration conditions investigated ranged from 0.97 to 1.30 and had associated standard deviations from 1% to 3%. The alanine-determined beam quality correction factors ranged from 0.996 to 1.293. Volume averaging effects were observed with the Farmer-type ionization chamber in the small static field conditions. The proposed small and non-standard field dosimetry protocols new composite-field reference condition demonstrated its potential to reduce or remove ionization chamber volume dependancies, but the measured beam quality correction factors were not equal to the standard CoP's kQ, indicating a change in beam quality in the small and non-standard field dosimetry protocols new composite-field reference condition relative to the standard broad beam reference conditions. The TLD- and alanine-determined beam quality correction factors in the composite-field reference conditions were approximately 3% greater and differed by more than one standard deviation from the published TG-51 kQ values for all three chambers.

School Quality and the Development of Cognitive Skills between Age Four and Six

PubMed Central

Borghans, Lex; Golsteyn, Bart H. H.; Zölitz, Ulf

2015-01-01

This paper studies the extent to which young children develop their cognitive ability in high and low quality schools. We use a representative panel data set containing cognitive test scores of 4-6 year olds in Dutch schools. School quality is measured by the school’s average achievement test score at age 12. Our results indicate that children in high-quality schools develop their skills substantially faster than those in low-quality schools. The results remain robust to the inclusion of initial ability, parental background, and neighborhood controls. Moreover, using proximity to higher-achieving schools as an instrument for school choice corroborates the results. The robustness of the results points toward a causal interpretation, although it is not possible to erase all doubt about unobserved confounding factors. PMID:26182123

Estimating Depolarization with the Jones Matrix Quality Factor

NASA Astrophysics Data System (ADS)

Hilfiker, James N.; Hale, Jeffrey S.; Herzinger, Craig M.; Tiwald, Tom; Hong, Nina; Schöche, Stefan; Arwin, Hans

2017-11-01

Mueller matrix (MM) measurements offer the ability to quantify the depolarization capability of a sample. Depolarization can be estimated using terms such as the depolarization index or the average degree of polarization. However, these calculations require measurement of the complete MM. We propose an alternate depolarization metric, termed the Jones matrix quality factor, QJM, which does not require the complete MM. This metric provides a measure of how close, in a least-squares sense, a Jones matrix can be found to the measured Mueller matrix. We demonstrate and compare the use of QJM to other traditional calculations of depolarization for both isotropic and anisotropic depolarizing samples; including non-uniform coatings, anisotropic crystal substrates, and beetle cuticles that exhibit both depolarization and circular diattenuation.

A quality evaluation methodology of health web-pages for non-professionals.

PubMed

Currò, Vincenzo; Buonuomo, Paola Sabrina; Onesimo, Roberta; de Rose, Paola; Vituzzi, Andrea; di Tanna, Gian Luca; D'Atri, Alessandro

2004-06-01

The proposal of an evaluation methodology for determining the quality of healthcare web sites for the dissemination of medical information to non-professionals. Three (macro) factors are considered for the quality evaluation: medical contents, accountability of the authors, and usability of the web site. Starting from two results in the literature the problem of whether or not to introduce a weighting function has been investigated. This methodology has been validated on a specialized information content, i.e., sore throats, due to the large interest such a topic enjoys with target users. The World Wide Web was accessed using a meta-search system merging several search engines. A statistical analysis was made to compare the proposed methodology with the obtained ranks of the sample web pages. The statistical analysis confirms that the variables examined (per item and sub factor) show substantially similar ranks and are capable of contributing to the evaluation of the main quality macro factors. A comparison between the aggregation functions in the proposed methodology (non-weighted averages) and the weighting functions, derived from the literature, allowed us to verify the suitability of the method. The proposed methodology suggests a simple approach which can quickly award an overall quality score for medical web sites oriented to non-professionals.

The use of modern technologies in carbon dioxide monitoring

NASA Astrophysics Data System (ADS)

Komínek, Petr; Weyr, Jan; Hirš, Jiří

2017-12-01

Indoor environment has huge influence on person's health and overall comfort. It is of great importance that we realize how essential indoor air quality is, considering we spend on average as much as 90% of our time indoors. There are many factors that affect indoor air quality: specifically, inside air temperature, relative humidity, and odors to name the most important factors. One of the key factors indicating indoor air quality is carbon dioxide (CO2) level. The CO2 levels, measured in prefab apartment buildings, indicates substantial indoor air quality issues. Therefore, a proper education of the occupants is of utmost importance. Also, great care should be directed towards technical and technological solutions that would ensure meeting the normative indoor environment criteria, especially indoor air CO2 levels. Thanks to the implementation of new emerging autonomous technologies, such as Internet of Things (IoT), monitoring in real-time is enhanced. An area where IoT plays a major role is in the monitoring of indoor environment. IoT technology (e.g. smart meters and sensors) provide awareness of information about the quality of indoor environment. There is a huge potential for influencing behaviour of the users. Through the web application, it is possible to educate people and ensure fresh air supply.

Organizational factors affecting length of stay in the emergency department: initial observational study.

PubMed

Bashkin, Osnat; Caspi, Sigalit; Haligoa, Rachel; Mizrahi, Sari; Stalnikowicz, Ruth

2015-01-01

Length of stay (LOS) is considered a key measure of emergency department throughput, and from the perspective of the patient, it is perceived as a measure of healthcare service quality. Prolonged LOS can be caused by various internal and external factors. This study examined LOS in the emergency department and explored the main factors that influence LOS and cause delay in patient care. Observations of 105 patients were performed over a 3-month period at the emergency room of a community urban hospital. Observers monitored patients from the moment of entrance to the department until discharge or admission to another hospital ward. Analysis revealed a general average total emergency department LOS of 438 min. Significant differences in average LOS were found between admitted patients (Mean = 544 min, SD = 323 min) and discharged patients (Mean = 291 min, SD = 286 min). In addition, nurse and physician change of shifts and admissions to hospital wards were found to be significant factors associated with LOS. Using an Ishikawa causal diagram, we explored various latent organizational factors that may prolong this time. The study identified several factors that are associated with high average emergency department LOS. High LOS may lead to increases in expenditures and may have implications for patient safety, whereas certain organizational changes, communication improvement, and time management may have a positive effect on it. Interdisciplinary methods can be used to explore factors causing prolonged emergency department LOS and contribute to a better understanding of them.

SFCHECK: a unified set of procedures for evaluating the quality of macromolecular structure-factor data and their agreement with the atomic model.

PubMed

Vaguine, A A; Richelle, J; Wodak, S J

1999-01-01

In this paper we present SFCHECK, a stand-alone software package that features a unified set of procedures for evaluating the structure-factor data obtained from X-ray diffraction experiments and for assessing the agreement of the atomic coordinates with these data. The evaluation is performed completely automatically, and produces a concise PostScript pictorial output similar to that of PROCHECK [Laskowski, MacArthur, Moss & Thornton (1993). J. Appl. Cryst. 26, 283-291], greatly facilitating visual inspection of the results. The required inputs are the structure-factor amplitudes and the atomic coordinates. Having those, the program summarizes relevant information on the deposited structure factors and evaluates their quality using criteria such as data completeness, structure-factor uncertainty and the optical resolution computed from the Patterson origin peak. The dependence of various parameters on the nominal resolution (d spacing) is also given. To evaluate the global agreement of the atomic model with the experimental data, the program recomputes the R factor, the correlation coefficient between observed and calculated structure-factor amplitudes and Rfree (when appropriate). In addition, it gives several estimates of the average error in the atomic coordinates. The local agreement between the model and the electron-density map is evaluated on a per-residue basis, considering separately the macromolecule backbone and side-chain atoms, as well as solvent atoms and heterogroups. Among the criteria are the normalized average atomic displacement, the local density correlation coefficient and the polymer chain connectivity. The possibility of computing these criteria using the omit-map procedure is also provided. The described software should be a valuable tool in monitoring the refinement procedure and in assessing structures deposited in databases.

Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep

PubMed Central

Christensen, Matthew A.; Bettencourt, Laura; Kaye, Leanne; Moturu, Sai T.; Nguyen, Kaylin T.; Olgin, Jeffrey E.; Pletcher, Mark J.; Marcus, Gregory M.

2016-01-01

Background Smartphones are increasingly integrated into everyday life, but frequency of use has not yet been objectively measured and compared to demographics, health information, and in particular, sleep quality. Aims The aim of this study was to characterize smartphone use by measuring screen-time directly, determine factors that are associated with increased screen-time, and to test the hypothesis that increased screen-time is associated with poor sleep. Methods We performed a cross-sectional analysis in a subset of 653 participants enrolled in the Health eHeart Study, an internet-based longitudinal cohort study open to any interested adult (≥ 18 years). Smartphone screen-time (the number of minutes in each hour the screen was on) was measured continuously via smartphone application. For each participant, total and average screen-time were computed over 30-day windows. Average screen-time specifically during self-reported bedtime hours and sleeping period was also computed. Demographics, medical information, and sleep habits (Pittsburgh Sleep Quality Index–PSQI) were obtained by survey. Linear regression was used to obtain effect estimates. Results Total screen-time over 30 days was a median 38.4 hours (IQR 21.4 to 61.3) and average screen-time over 30 days was a median 3.7 minutes per hour (IQR 2.2 to 5.5). Younger age, self-reported race/ethnicity of Black and "Other" were associated with longer average screen-time after adjustment for potential confounders. Longer average screen-time was associated with shorter sleep duration and worse sleep-efficiency. Longer average screen-times during bedtime and the sleeping period were associated with poor sleep quality, decreased sleep efficiency, and longer sleep onset latency. Conclusions These findings on actual smartphone screen-time build upon prior work based on self-report and confirm that adults spend a substantial amount of time using their smartphones. Screen-time differs across age and race, but is similar across socio-economic strata suggesting that cultural factors may drive smartphone use. Screen-time is associated with poor sleep. These findings cannot support conclusions on causation. Effect-cause remains a possibility: poor sleep may lead to increased screen-time. However, exposure to smartphone screens, particularly around bedtime, may negatively impact sleep. PMID:27829040

[Factors influencing the quality of life of elderly living in a pre-fabricated housing complex in the Sichuan earthquake area].

PubMed

Guo, Hong-Xia; Chen, Hong; Wong, Teresa Bik-Kwan Tsien; Chen, Qian; Au, May-Lan; Li, Yun

2012-02-01

The 2008 Sichuan Earthquake caused great damage to the environment and property. In the aftermath, many citizens were relocated to live in newly constructed prefabricated (prefab) communities. This paper explored the current quality of life (QOL) of elderly residents living in prefabricated communities in areas damaged by the Sichuan earthquake and identified factors of influence on QOL values. The ultimate objective was to provide evidence-based guidance for heath improvement measures. The authors used the short form WHOQOL-BREF to assess the quality of life of 191 elderly residents of prefabricated communities in the Sichuan Province 2008 earthquake zone. A Student's t-test, variance analysis, and stepwise multivariate regression methods were used to test the impact of various factors on QOL. Results indicate the self-assessed QOL of participants as good, although scores in the physical (average 56.2) and psychological (average 45.7) domains were significantly lower than the norm in China. Marital status, capital loss in the earthquake, number of children, level of perceived stress, income, interest, and family harmony each correlated with at least one of the short form WHOQOL-BREF domains in t-test and one-way analyses. After excluding for factor interaction effects using multivariate regression, we found interest, family harmony, monthly income and stress to be significant predictors of physical domain QOL, explaining 13.8% of total variance. Family harmony and interest explained 15.3% of total variance for psychological domain QOL; stress, marital status, family harmony, capital loss in the earthquake, number of children and interest explained 19.5% of total variance for social domain QOL; and stress, family harmony and interest explained 16.5% of total variance for environmental domain QOL. Family harmony and interest were significant factors across all domains, while others influenced a smaller proportion. Quality of life for elderly living in prefab communities should be improved. The authors hope study findings will increase awareness among healthcare providers regarding the quality of life of this vulnerable population. Study results suggest that key steps to promoting QOL in this population include improving family harmony, helping to cultivate well-rounded interests, alleviating economic stresses, providing necessary medical and psychological counseling services, and affording more social support.

Mothers' restrictive eating and food neophobia and fathers' dietary quality are associated with breast-feeding duration and introduction of solid foods: the STEPS study.

PubMed

Vaarno, Jenni; Niinikoski, Harri; Kaljonen, Anne; Aromaa, Minna; Lagström, Hanna

2015-08-01

The purpose of the present study was to examine the association between parental eating behaviours and dietary patterns and feeding practices of infants and young children. Data on infant-feeding practices were collected from each infant's birth via parentally self-administered follow-up diaries. Three questionnaires, the Three-Factor Eating Questionnaire, the Food Neophobia Scale and the Index of Diet Quality, were administered when the children were aged 4 and 13 months. South-western Finland. Families participating in the STEPS longitudinal cohort study (n 1797). Mean duration of exclusive breast-feeding was 2.4 months and total duration of breast-feeding averaged 8.1 months. The first solid food was introduced into children's diets at the age of 3.9 months, on average. Mothers with highly restrictive eating were more likely to introduce solid foods sooner than mothers who ranked lower in these behaviours (3.8 months v. 4.0 months, P = 0.012). Neophobic mothers breast-fed exclusively (2.0 v. 2.6 months, P = 0.038) and in total (7.2 v. 8.5 months, P = 0.039) for shorter times than average mothers, even after adjusting for various demographic characteristics. Fathers' diet quality was associated with total breast-feeding duration and with introduction of complementary foods in unadjusted analyses and with total breast-feeding duration also after adjusting for confounding factors. Mothers' and fathers' eating patterns and practices are associated with the feeding practices of infants and young children. Health promotion interventions seeking to improve parents' eating patterns might lead to more favourable feeding practices for infants and young children.

Sleep quality, sleep duration and physical activity in obese adolescents: effects of exercise training.

PubMed

Mendelson, M; Borowik, A; Michallet, A-S; Perrin, C; Monneret, D; Faure, P; Levy, P; Pépin, J-L; Wuyam, B; Flore, P

2016-02-01

Decreased sleep duration and altered sleep quality are risk factors for obesity in youth. Structured exercise training has been shown to increase sleep duration and improve sleep quality. This study aimed at evaluating the impact of exercise training for improving sleep duration, sleep quality and physical activity in obese adolescents (OB). Twenty OB (age: 14.5 ± 1.5 years; body mass index: 34.0 ± 4.7 kg m(-2) ) and 20 healthy-weight adolescents (HW) completed an overnight polysomnography and wore an accelerometer (SenseWear Bodymedia) for 7 days. OB participated in a 12-week supervised exercise-training programme consisting of 180 min of exercise weekly. Exercise training was a combination of aerobic exercise and resistance training. Sleep duration was greater in HW compared with OB (P < 0.05). OB presented higher apnoea-hypopnoea index than HW (P < 0.05). Physical activity (average daily metabolic equivalent of tasks [METs]) by accelerometer was lower in OB (P < 0.05). After exercise training, obese adolescents increased their sleep duration (+64.4 min; effect size: 0.88; P = 0.025) and sleep efficiency (+7.6%; effect size: 0.76; P = 0.028). Physical activity levels were increased in OB as evidenced by increased steps per day and average daily METs (P < 0.05). Improved sleep duration was associated with improved average daily METs (r = 0.48, P = 0.04). The present study confirms altered sleep duration and quality in OB. Exercise training improves sleep duration, sleep quality and physical activity. © 2015 World Obesity.

Determinants of Quality of Life and the Need for Support for the Elderly with Good Physical and Mental Functioning.

PubMed

Talarska, Dorota; Tobis, Sławomir; Kotkowiak, Marta; Strugała, Magdalena; Stanisławska, Joanna; Wieczorowska-Tobis, Katarzyna

2018-03-19

BACKGROUND The ageing of population is the reason that there are various strategies developed to help seniors acquire greater independence and a better quality of life. The aim of this study was to explore the relationship between the elderly peope's need for assistance and assessed quality of life. MATERIAL AND METHODS The study included 100 participants who were members of a Seniors Club in Poznań, Poland. The cross-sectional study utilized the following instruments: Abbreviated Mental Test Score (AMTS), Instrumental Activities of Daily Living (IADL), EASY-Care Standard 2010 questionnaire, (WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. RESULTS Members of the Seniors' Club showed good functional condition. In the AMTS test, they scored near maximum values (average 9.39±0.77 points), somewhat poorer results were found in the IADL scale (average 20.92±3.96 points). In the EASY-Care questionnaire, the study participants usually required partial support in the following areas: Mental health and well-being (59%), Staying healthy (29%), Getting around (22%), and Seeing, hearing and communicating (22%). The average score on Independence was 13.13±18.51, The risk of breakdown in care scale was 4.39±3.21. The risk of falls affected 21 participants (21%). Quality of life study using WHOQOL-BREF questionnaire found that the highest scores were achieved in Psychological and Environment domains, and the lowest score in the Physical health domain. CONCLUSIONS Quality of life as well as level of independence, risk of falls, and need for 24-hour care were significantly affected by the following factors: urinary incontinence, difficulties in mobility outside the home, despondency, and forgetfulness.

Knowledge, Attitudes, and Practices (KAP) of the Relationship between Air Pollution and Children’s Respiratory Health in Shanghai, China

PubMed Central

Wang, Rui; Yang, Yingying; Chen, Renjie; Kan, Haidong; Wu, Jinyi; Wang, Keran; Maddock, Jay E.; Lu, Yuanan

2015-01-01

To assess the status of, and factors associated with, residents’ knowledge, attitudes, and practices (KAP) related to air pollution and respiratory health of children in Shanghai, we conducted a cross-sectional survey. Demographic factors associated with residents’ knowledge were identified by multiple logistic regressions. The questionnaires were completed by 972 participants, half from the Shanghai Children Hospital and the other half from the Jiading communities. Half of the participants’ scores of knowledge and attitudes were equal or greater than 8.0 on a 9-point scale, over 75% of respondents’ practice scores were equal to or less than 4.0. Our studies demonstrated a significant difference of average knowledge scores between the two groups (t = 1.27, p < 0.05). The parents’ educational level (OR = 1.89, 2.48) and average annual household income (AAHI) (OR = 2.37, 2.40, 2.12) were the two strongest factors on knowledge awareness. In addition, statistical analysis revealed a significant difference between the two groups in their attitudes towards air quality and their perception of the government’s efforts to alleviate it. The hospital and community groups also showed significant differences in practices geared towards protecting their children’s health. Nearly 90% of the respondents agreed that improving air quality is the responsibility of every citizen, and the joint action of governments and all citizens should be utilized for enhanced control. In addition, more resources should be allocated towards providing citizens with appropriate practices to help lessen the effects of poor air quality. PMID:25664694

Premenstrual syndrome and life quality in Turkish health science students.

PubMed

İşik, Hatice; Ergöl, Şule; Aynioğlu, Öner; Şahbaz, Ahmet; Kuzu, Ayşe; Uzun, Müge

2016-04-19

The purpose of the present study was to investigate the incidence of PMS, risk factors affecting PMS symptoms, and life quality in health science students. A total of 608 volunteer female students studying at the health campus of a state university in Turkey were included in the study. The participants were asked to fill out questionnaires on sociodemographic data, PMS symptoms, and SF-36 life quality tests. The overall frequency of PMS among participants was 84.5%. The average PMS and general health SF scores were 118.34 ± 37.3 and 20.03 ± 3.72, respectively. Students who had irregular breakfast, drank ≥2 cups of coffee/day, and consumed alcohol or fast food had higher PMS scores. Irregular menstruation and family history increased PMS scores and decreased life quality (P < 0.05). The life quality of the students significantly decreased as the severity of PMS increased (P < 0.001). Low body mass index, family history, irregular menstruation, bad eating habits such as fast food consumption and irregular breakfasts, and coffee and alcohol consumption increased PMS risk significantly. In order to improve their life quality, students should be informed about the symptoms, risk factors, and management options of PMS.

High-Throughput RNA Interference Screening: Tricks of the Trade

PubMed Central

Nebane, N. Miranda; Coric, Tatjana; Whig, Kanupriya; McKellip, Sara; Woods, LaKeisha; Sosa, Melinda; Sheppard, Russell; Rasmussen, Lynn; Bjornsti, Mary-Ann; White, E. Lucile

2016-01-01

The process of validating an assay for high-throughput screening (HTS) involves identifying sources of variability and developing procedures that minimize the variability at each step in the protocol. The goal is to produce a robust and reproducible assay with good metrics. In all good cell-based assays, this means coefficient of variation (CV) values of less than 10% and a signal window of fivefold or greater. HTS assays are usually evaluated using Z′ factor, which incorporates both standard deviation and signal window. A Z′ factor value of 0.5 or higher is acceptable for HTS. We used a standard HTS validation procedure in developing small interfering RNA (siRNA) screening technology at the HTS center at Southern Research. Initially, our assay performance was similar to published screens, with CV values greater than 10% and Z′ factor values of 0.51 ± 0.16 (average ± standard deviation). After optimizing the siRNA assay, we got CV values averaging 7.2% and a robust Z′ factor value of 0.78 ± 0.06 (average ± standard deviation). We present an overview of the problems encountered in developing this whole-genome siRNA screening program at Southern Research and how equipment optimization led to improved data quality. PMID:23616418

Maternal Food-Related Practices, Quality of Diet, and Well-Being: Profiles of Chilean Mother-Adolescent Dyads.

PubMed

Schnettler, Berta; Grunert, Klaus G; Lobos, Germán; Miranda-Zapata, Edgardo; Denegri, Marianela; Hueche, Clementina

2018-04-03

To identify mother-adolescent dyad profiles according to food-related parenting practices and to determine differences in diet quality, family meal frequency, life satisfaction, and sociodemographic characteristics. Cross-sectional study. Mothers and children were surveyed in their homes or at schools in Temuco, Chile. A total of 300 mothers (average age, 41.6 years) and their adolescent children (average age, 13.2 years; 48.7% female). Maternal feeding practices using the abbreviated Family Food Behavior Survey (AFFBS), life satisfaction, food-related and family life satisfaction, diet quality, and eating habits. Principal component factor analysis and confirmatory factor analysis were used to verify Family Food Behavior Survey components in mother and adolescent subsamples. Hierarchical cluster analysis was used to identify profiles. Three AFFBS components were detected: maternal control of child snacking behavior, maternal presence during eating, and child involvement in food consumption. Cluster analysis identified 3 mother-adolescent dyad profiles with different food-related parenting practices (P ≤ .001), mother (P ≤ .05) and child (P ≤ .001) diet quality, frequency of shared family meals (P ≤ .001), and mother (P ≤ .001) and child (P ≤ .05) life satisfaction levels. Results indicated that maternal well-being increased with an increased frequency of shared mealtime. Significantly, in contrast to the findings of previous studies, greater control over child eating habits was shown to affect adolescent well-being positively. These findings, among others, may contribute to the development of strategies for improving diet quality, overall well-being, and well-being in the food and family domains for all family members. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Patient movement characteristics and the impact on CBCT image quality and interpretability.

PubMed

Spin-Neto, Rubens; Costa, Cláudio; Salgado, Daniela Mra; Zambrana, Nataly Rm; Gotfredsen, Erik; Wenzel, Ann

2018-01-01

To assess the impact of patient movement characteristics and metal/radiopaque materials in the field-of-view (FOV) on CBCT image quality and interpretability. 162 CBCT examinations were performed in 134 consecutive (i.e. prospective data collection) patients (age average: 27.2 years; range: 9-73). An accelerometer-gyroscope system registered patient's head position during examination. The threshold for movement definition was set at ≥0.5-mm movement distance based on accelerometer-gyroscope recording. Movement complexity was defined as uniplanar/multiplanar. Three observers scored independently: presence of stripe (i.e. streak) artefacts (absent/"enamel stripes"/"metal stripes"/"movement stripes"), overall unsharpness (absent/present) and image interpretability (interpretable/not interpretable). Kappa statistics assessed interobserver agreement. χ 2 tests analysed whether movement distance, movement complexity and metal/radiopaque material in the FOV affected image quality and image interpretability. Relevant risk factors (p ≤ 0.20) were entered into a multivariate logistic regression analysis with "not interpretable" as the outcome. Interobserver agreement for image interpretability was good (average = 0.65). Movement distance and presence of metal/radiopaque materials significantly affected image quality and interpretability. There were 22-28 cases, in which the observers stated the image was not interpretable. Small movements (i.e. <3 mm) did not significantly affect image interpretability. For movements ≥ 3 mm, the risk that a case was scored as "not interpretable" was significantly (p ≤ 0.05) increased [OR 3.2-11.3; 95% CI (0.70-65.47)]. Metal/radiopaque material was also a significant (p ≤ 0.05) risk factor (OR 3.61-5.05). Patient movement ≥3 mm and metal/radiopaque material in the FOV significantly affected CBCT image quality and interpretability.

Urban scale air quality modelling using detailed traffic emissions estimates

NASA Astrophysics Data System (ADS)

Borrego, C.; Amorim, J. H.; Tchepel, O.; Dias, D.; Rafael, S.; Sá, E.; Pimentel, C.; Fontes, T.; Fernandes, P.; Pereira, S. R.; Bandeira, J. M.; Coelho, M. C.

2016-04-01

The atmospheric dispersion of NOx and PM10 was simulated with a second generation Gaussian model over a medium-size south-European city. Microscopic traffic models calibrated with GPS data were used to derive typical driving cycles for each road link, while instantaneous emissions were estimated applying a combined Vehicle Specific Power/Co-operative Programme for Monitoring and Evaluation of the Long-range Transmission of Air Pollutants in Europe (VSP/EMEP) methodology. Site-specific background concentrations were estimated using time series analysis and a low-pass filter applied to local observations. Air quality modelling results are compared against measurements at two locations for a 1 week period. 78% of the results are within a factor of two of the observations for 1-h average concentrations, increasing to 94% for daily averages. Correlation significantly improves when background is added, with an average of 0.89 for the 24 h record. The results highlight the potential of detailed traffic and instantaneous exhaust emissions estimates, together with filtered urban background, to provide accurate input data to Gaussian models applied at the urban scale.

Insomnia in nursing students and related factors: A cross-sectional study.

PubMed

Güneş, Zeynep; Arslantaş, Hülya

2017-10-01

The aim of this study is to determine the factors affecting insomnia in nursing students. This study was conducted with 379 nursing students, studying at a university in western Anatolia/Turkey between 2014 and 2015 as a descriptive and cross-sectional analytic study. Data of the survey were collected using the Personal Inquiry Form, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Trait Anxiety Inventory and the Beck Depression Inventory, and a self-administered questionnaire. The Insomnia Severity Index score for the students is 11.51 ± 5.04 on average. It was found that as anxiety and depression increased, the Insomnia Severity Index score for the students also increased and there was a weak positive correlation. Also, a moderate positive correlation between sleep quality and insomnia severity was found. Significant correlations were found between some of the socio-demographic characteristics (lower socio-economic situation, irregular bedtime, and smoking) and insomnia, sleep quality, anxiety, and depression. Anxiety, depression, irregular bedtime, and lower socio-economic situation are factors that make falling asleep difficult. © 2017 John Wiley & Sons Australia, Ltd.

Overlapping genetic and environmental influences among men's alcohol consumption and problems, romantic quality and social support.

PubMed

Salvatore, J E; Prom-Wormley, E; Prescott, C A; Kendler, K S

2015-08-01

Alcohol consumption and problems are associated with interpersonal difficulties. We used a twin design to assess in men the degree to which genetic or environmental influences contributed to the covariance between alcohol consumption and problems, romantic quality and social support. The sample included adult male-male twin pairs (697 monozygotic and 487 dizygotic) for whom there were interview-based data on: alcohol consumption (average monthly alcohol consumption in the past year); alcohol problems (lifetime alcohol dependence symptoms); romantic conflict and warmth; friend problems and support; and relative problems and support. Key findings were that genetic and unique environmental factors contributed to the covariance between alcohol consumption and romantic conflict; genetic factors contributed to the covariance between alcohol problems and romantic conflict; and common and unique environmental factors contributed to the covariance between alcohol problems and friend problems. Recognizing and addressing the overlapping genetic and environmental influences that alcohol consumption and problems share with romantic quality and other indicators of social support may have implications for substance use prevention and intervention efforts.

Reading aloud: does previous trial history modulate the joint effects of stimulus quality and word frequency?

PubMed

O'Malley, Shannon; Besner, Derek

2013-07-01

No one would argue with the proposition that how we process events in the world is strongly affected by our experience. Nonetheless, recent experience (e.g., from the previous trial) is typically not considered in the analysis of timed cognitive performance in the laboratory. Masson and Kliegl (2013) reported that, in the context of the lexical decision task, the nature of the previous trial strongly modulates the joint effects of word frequency and stimulus quality-a joint effect that is widely reported to be additive when averaged over trial history. In particular, their analysis suggests there may be no genuine additivity of these factors. Here we extended this line of investigation by reanalyzing data reported by O'Malley and Besner (2008) in which subjects read words and nonwords aloud, with word frequency and stimulus quality as manipulated factors. These factors are additive on reaction time in the standard analysis of variance. Contrary to Masson and Kliegl's finding for lexical decision, when previous trial history is taken into consideration, these 2 factors still do not interact. This suggests that, at least in the context of reading aloud, previous trial does not modulate how the effects of these 2 factors combine. Some implications are briefly noted. PsycINFO Database Record (c) 2013 APA, all rights reserved.

A factor analysis of the SSQ (Speech, Spatial, and Qualities of Hearing Scale).

PubMed

Akeroyd, Michael A; Guy, Fiona H; Harrison, Dawn L; Suller, Sharon L

2014-02-01

The speech, spatial, and qualities of hearing questionnaire (SSQ) is a self-report test of auditory disability. The 49 items ask how well a listener would do in many complex listening situations illustrative of real life. The scores on the items are often combined into the three main sections or into 10 pragmatic subscales. We report here a factor analysis of the SSQ that we conducted to further investigate its statistical properties and to determine its structure. Statistical factor analysis of questionnaire data, using parallel analysis to determine the number of factors to retain, oblique rotation of factors, and a bootstrap method to estimate the confidence intervals. 1220 people who have attended MRC IHR over the last decade. We found three clear factors, essentially corresponding to the three main sections of the SSQ. They are termed "speech understanding", "spatial perception", and "clarity, separation, and identification". Thirty-five of the SSQ questions were included in the three factors. There was partial evidence for a fourth factor, "effort and concentration", representing two more questions. These results aid in the interpretation and application of the SSQ and indicate potential methods for generating average scores.

Gendered Time-Crunch and Work Factors in Denmark

ERIC Educational Resources Information Center

Deding, Mette; Lausten, Mette

2011-01-01

Being crunched for time is an important aspect of life quality. Although Denmark is a country known for gender-equality, on average mothers are more time-crunched than fathers. We show this using a representative sample of Danish dual-earner couples with at least one child aged 0-10 years. We analyze the determinants of time-crunch in relation to…

Photonic crystal ring resonator-based four-channel dense wavelength division multiplexing demultiplexer on silicon on insulator platform: design and analysis

NASA Astrophysics Data System (ADS)

Sreenivasulu, Tupakula; Bhowmick, Kaustav; Samad, Shafeek A.; Yadunath, Thamerassery Illam R.; Badrinarayana, Tarimala; Hegde, Gopalkrishna; Srinivas, Talabattula

2018-04-01

A micro/nanofabrication feasible compact photonic crystal (PC) ring-resonator-based channel drop filter has been designed and analyzed for operation in C and L bands of communication window. The four-channel demultiplexer consists of ring resonators of holes in two-dimensional PC slab. The proposed assembly design of dense wavelength division multiplexing setup is shown to achieve optimal quality factor, without altering the lattice parameters or resonator size or inclusion of scattering holes. Transmission characteristics are analyzed using the three-dimensional finite-difference time-domain simulation approach. The radiation loss of the ring resonator was minimized by forced cancelation of radiation fields by fine-tuning the air holes inside the ring resonator. An average cross talk of -34 dB has been achieved between the adjacent channels maintaining an average quality factor of 5000. Demultiplexing is achieved by engineering only the air holes inside the ring, which makes it a simple and tolerant design from the fabrication perspective. Also, the device footprint of 500 μm2 on silicon on insulator platform makes it easy to fabricate the device using e-beam lithography technique.

Scattering images from autocorrelation functions of P-wave seismic velocity images: the case of Tenerife Island (Canary Islands, Spain)

NASA Astrophysics Data System (ADS)

García-Yeguas, A.; Sánchez-Alzola, A.; De Siena, L.; Prudencio, J.; Díaz-Moreno, A.; Ibáñez, J. M.

2018-03-01

We present a P-wave scattering image of the volcanic structures under Tenerife Island using the autocorrelation functions of P-wave vertical velocity fluctuations. We have applied a cluster analysis to total quality factor attenuation ( {Q}_t^{-1} ) and scattering quality factor attenuation ( {Q}_{PSc}^{-1} ) images to interpret the structures in terms of intrinsic and scattering attenuation variations on a 2D plane, corresponding to a depth of 2000 m, and check the robustness of the scattering imaging. The results show that scattering patterns are similar to total attenuation patterns in the south of the island. There are two main areas where patterns differ: at Cañadas-Teide-Pico Viejo Complex, high total attenuation and average-to-low scattering values are observed. We interpret the difference as induced by intrinsic attenuation. In the Santiago Ridge Zone (SRZ) region, high scattering values correspond to average total attenuation. In our interpretation, the anomaly is induced by an extended scatterer, geometrically related to the surficial traces of Garachico and El Chinyero historical eruptions and the area of highest seismic activity during the 2004-2008 seismic crises.

Changing Diet Quality in China during 2004–2011

PubMed Central

Huang, Yingying; Wang, Hui; Tian, Xu

2016-01-01

Currently, under- and over-nutrition problems co-exist in China. However, systematic studies on the diet quality of Chinese residents have been scant. This study described the trend in diet quality of Chinese residents over a recent eight-year period and investigated the relevant influential factors. The data of Chinese adults aged 20–59 years was extracted from 2004, 2006, 2009, and 2011 China Health and Nutrition Survey. The China diet quality index (DQI) was employed to assess the diet quality of Chinese adults. The dietary consumption data of each individual was collected using a 24-h dietary recall and weighed food records implemented for three consecutive days. A mixed ordinary least squares regression model was applied to analyze the factors influencing the DQI scores of Chinese residents. Results showed that the diet quality of Chinese residents increased from 2004 to 2006, followed by a decrease in 2009 and 2011. The income, urbanicity index, and southern dummy were positively associated with DQI scores, whereas the size of household and labor intensity were negative predictors of DQI scores. The DQI scores also varied over BMI values. With an increase of the average income level in the future, the diet quality of Chinese residents is estimated to further improve. Moreover, urbanization could also contribute to reaching a more balanced diet. PMID:28029128

Methodological quality of systematic reviews on influenza vaccination.

PubMed

Remschmidt, Cornelius; Wichmann, Ole; Harder, Thomas

2014-03-26

There is a growing body of evidence on the risks and benefits of influenza vaccination in various target groups. Systematic reviews are of particular importance for policy decisions. However, their methodological quality can vary considerably. To investigate the methodological quality of systematic reviews on influenza vaccination (efficacy, effectiveness, safety) and to identify influencing factors. A systematic literature search on systematic reviews on influenza vaccination was performed, using MEDLINE, EMBASE and three additional databases (1990-2013). Review characteristics were extracted and the methodological quality of the reviews was evaluated using the assessment of multiple systematic reviews (AMSTAR) tool. U-test, Kruskal-Wallis test, chi-square test, and multivariable linear regression analysis were used to assess the influence of review characteristics on AMSTAR-score. Fourty-six systematic reviews fulfilled the inclusion criteria. Average methodological quality was high (median AMSTAR-score: 8), but variability was large (AMSTAR range: 0-11). Quality did not differ significantly according to vaccination target group. Cochrane reviews had higher methodological quality than non-Cochrane reviews (p=0.001). Detailed analysis showed that this was due to better study selection and data extraction, inclusion of unpublished studies, and better reporting of study characteristics (all p<0.05). In the adjusted analysis, no other factor, including industry sponsorship or journal impact factor had an influence on AMSTAR score. Systematic reviews on influenza vaccination showed large differences regarding their methodological quality. Reviews conducted by the Cochrane collaboration were of higher quality than others. When using systematic reviews to guide the development of vaccination recommendations, the methodological quality of a review in addition to its content should be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

16-channel DWDM based on 1D defect mode nonlinear photonic crystal

NASA Astrophysics Data System (ADS)

Kalhan, Abhishek; Sharma, Sanjeev; Kumar, Arun

2018-05-01

We propose a sixteen-channel Dense Wavelength Division Multiplexer (DWDM), using the 1-D defect mode nonlinear photonic crystal which is a function of intensity as well as wavelength. Here, we consider an alternate layer of two semiconductor materials in which we found the bandgap of materials when defect layer is introduced then 16-channel dense wavelength division multiplexer is obtained within bandgap. From the theoretical analysis, we can achieve average quality factor of 7800.4, the uniform spectral line-width of 0.2 nm, crosstalk of -31.4 dB, central wavelength changes 0.07 nm/(1GW/cm2) and 100% transmission efficiency. Thus, Sixteen-channel DWDM has very high quality factor, low crosstalk, near 100% power transmission efficiency and small channel spacing (1.44 nm).

Risk factors for low vision related functioning in the Mycotic Ulcer Treatment Trial: a randomised trial comparing natamycin with voriconazole

PubMed Central

Rose-Nussbaumer, Jennifer; Prajna, N Venkatesh; Krishnan, Tiruvengada; Mascarenhas, Jeena; Rajaraman, Revathi; Srinivasan, Muthiah; Raghavan, Anita; Oldenburg, Catherine E; O’Brien, Kieran S; Ray, Kathryn J; Porco, Travis C; McLeod, Stephen D; Acharya, Nisha R; Keenan, Jeremy D; Lietman, Thomas M

2016-01-01

Background/aims The Mycotic Ulcer Treatment Trial I (MUTT I) was a double-masked, multicentre, randomised controlled trial, which found that topical natamycin is superior to voriconazole for the treatment of filamentous fungal corneal ulcers. In this study, we determine risk factors for low vision-related quality of life in patients with fungal keratitis. Methods The Indian visual function questionnaire (IND-VFQ) was administered to MUTT I study participants at 3 months. Associations between patient and ulcer characteristics and IND-VFQ subscale score were assessed using generalised estimating equations. Results 323 patients were enrolled in the trial, and 292 (90.4%) completed the IND-VFQ at 3 months. Out of a total possible score of 100, the average VFQ score for all participants was 81.3 (range 0–100, SD 23.6). After correcting for treatment arm, each logMAR line of worse baseline visual acuity in the affected eye resulted in an average 1.2 points decrease on VFQ at 3 months (95% CI −1.8 to 0.6, p<0.001). Those who required therapeutic penetrating keratoplasty had an average of 25.2 points decrease on VFQ after correcting for treatment arm (95% CI −31.8 to −18.5, p<0.001). Study participants who were unemployed had on average 28.5 points decrease on VFQ (95% CI −46.9 to −10.2, p=0.002) after correcting for treatment arm. Conclusions Monocular vision loss from corneal opacity due to fungal keratitis reduced vision-related quality of life. Given the relatively high worldwide burden of corneal opacity, improving treatment outcomes of corneal infections should be a public health priority. Trial registration number Clinicaltrials.gov Identifier: NCT00996736. PMID:26531051

Quality assurance in mammography: College of Radiology Survey in Malaysia.

PubMed

Ho, E L M; Ng, K H; Wong, J H D; Wang, H B

2006-06-01

Malaysia's mammography QA practice was surveyed based on the Malaysian Ministry of Health and the American College of Radiology (ACR) requirements. Data on mammography unit, processor, image receptor, exposure factors, mean glandular dose (MGD), sensitometry, image quality and viewbox luminance were obtained. Mean developer temperature and cycle time were 34.1 +/- 1.8degreesC and 107.7 +/- 33.2 seconds. Mean base+fog level, speed index and contrast index were 0.20+/-0.01, 1.20+/-0.01 and 1.33+/-0.26 respectively. Eighty-six percent of the fifty centres passed the image quality test while 12.5% complied with ACR recommended viewbox luminance. Average MGD was 1.0+/-0.4 mGy. Malaysia is on the right track for QA but with room for total quality improvement.

Effects of a computerized cardiac teletriage decision support system on nurse performance: results of a controlled human factors experiment using a mid-fidelity prototype.

PubMed

Somoza, Kirsten Carroll; Momtahan, Kathryn; Lindgaard, Gitte

2007-01-01

A gap exists in cardiac care between known best practices and the actual level of care administered. To help bridge this gap, a proof of concept interface for a PDA-based decision support system (DSS) was designed for cardiac care nurses engaged in teletriage. This interface was developed through a user-centered design process. Quality of assessment, quality of recommendations, and number of questions asked were measured. Cardiac floor nurses' assessment quality performance, but not their recommendation quality performance, improved with the DSS. Nurses asked more questions with the DSS than without it, and these additional questions were predominantly classifiable as essential or beneficial to a good assessment. The average participant satisfaction score with the DSS was above neutral.

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

PubMed Central

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-01-01

Abstract The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client–provider consultation sessions. The cross-sectional study observed 366 client–provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63–0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07–14.21), adequate infrastructure (5.29; 95% CI: 2.89–7.69) and reagents (1.48; 95% CI: 1.02–1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92–4.36), job satisfaction (2.02; 95% CI: 1.21–2.83) and supervision (1.01; 95% CI: 0.35–1.68), while workload (−0.88; 95% CI: −1.75 to − 0.01) was negatively associated. Technical quality of the client–provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client–provider consultation sessions as measured by both health facility structural and provider factors. PMID:29194543

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

PubMed

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-11-01

The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility structural and provider factors. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Relationship Among Signal Fidelity, Hearing Loss, and Working Memory for Digital Noise Suppression.

PubMed

Arehart, Kathryn; Souza, Pamela; Kates, James; Lunner, Thomas; Pedersen, Michael Syskind

2015-01-01

This study considered speech modified by additive babble combined with noise-suppression processing. The purpose was to determine the relative importance of the signal modifications, individual peripheral hearing loss, and individual cognitive capacity on speech intelligibility and speech quality. The participant group consisted of 31 individuals with moderate high-frequency hearing loss ranging in age from 51 to 89 years (mean = 69.6 years). Speech intelligibility and speech quality were measured using low-context sentences presented in babble at several signal-to-noise ratios. Speech stimuli were processed with a binary mask noise-suppression strategy with systematic manipulations of two parameters (error rate and attenuation values). The cumulative effects of signal modification produced by babble and signal processing were quantified using an envelope-distortion metric. Working memory capacity was assessed with a reading span test. Analysis of variance was used to determine the effects of signal processing parameters on perceptual scores. Hierarchical linear modeling was used to determine the role of degree of hearing loss and working memory capacity in individual listener response to the processed noisy speech. The model also considered improvements in envelope fidelity caused by the binary mask and the degradations to envelope caused by error and noise. The participants showed significant benefits in terms of intelligibility scores and quality ratings for noisy speech processed by the ideal binary mask noise-suppression strategy. This benefit was observed across a range of signal-to-noise ratios and persisted when up to a 30% error rate was introduced into the processing. Average intelligibility scores and average quality ratings were well predicted by an objective metric of envelope fidelity. Degree of hearing loss and working memory capacity were significant factors in explaining individual listener's intelligibility scores for binary mask processing applied to speech in babble. Degree of hearing loss and working memory capacity did not predict listeners' quality ratings. The results indicate that envelope fidelity is a primary factor in determining the combined effects of noise and binary mask processing for intelligibility and quality of speech presented in babble noise. Degree of hearing loss and working memory capacity are significant factors in explaining variability in listeners' speech intelligibility scores but not in quality ratings.

The association between observed mobility and quality of life in the near elderly

PubMed Central

Sullivan, Jeff; Goldman, Dana P.; Gill, Thomas M.

2017-01-01

Introduction Chronic diseases associated with aging, such as arthritis, frequently cause reduced mobility, pain and diminished quality of life. To date, research on the association between mobility and quality of life has primarily focused in the elderly; hence, much less is known about this association in the near elderly. This cross-sectional study aimed to assess the association between mobility and quality of life measures in the near elderly. Methods A prospective observational study of persons aged 50–69 years was conducted. The primary endpoint was quality of life measured by EQ-5D-5L, and the primary explanatory variable was observed mobility assessed using the 6-minute walk distance (6MWD). We applied regression models controlling for demographic, health status and other factors to evaluate the association between 6MWD and EQ-5D-5L. Results Of the 183 participants analyzed in the study, 37% were male and the average age was 59.8 years. After adjusting for differences in demographic characteristics and health status, EQ-5D-5L-based utility values were 0.046 points (p<0.001), or 5.2% (95% CI: 2.7% to 7.8%), higher on average for individuals with 100 meters longer 6MWD. Holding constant the mobility-specific component of EQ-5D-5L, we still found that walking an additional 100 meters was associated with an EQ-5D-5L utility value that was 0.029 points (p<0.001), or 3.5% (95% CI: 1.7% to 5.5%), higher than the average participant. Among persons with arthritis, the association between 6MWD and EQ-5D-5L was slightly stronger. Conclusions Near elderly persons with better mobility had higher quality of life. Diseases that decrease mobility, such as arthritis, are likely to have a significant impact on quality of life. PMID:28827806

Taste phenotype associates with cardiovascular disease risk factors via diet quality in multivariate modeling.

PubMed

Sharafi, Mastaneh; Rawal, Shristi; Fernandez, Maria Luz; Huedo-Medina, Tania B; Duffy, Valerie B

2018-05-08

Sensations from foods and beverages drive dietary choices, which in turn, affect risk of diet-related diseases. Perception of these sensation varies with environmental and genetic influences. This observational study aimed to examine associations between chemosensory phenotype, diet and cardiovascular disease (CVD) risk. Reportedly healthy women (n = 110, average age 45 ± 9 years) participated in laboratory-based measures of chemosensory phenotype (taste and smell function, propylthiouracil (PROP) bitterness) and CVD risk factors (waist circumference, blood pressure, serum lipids). Diet variables included preference and intake of sweet/high-fat foods, dietary restraint, and diet quality based on reported preference (Healthy Eating Preference Index-HEPI) and intake (Healthy Eating Index-HEI). We found that females who reported high preference yet low consumption of sweet/high-fat foods had the highest dietary restraint and depressed quinine taste function. PROP nontasters were more likely to report lower diet quality; PROP supertasters more likely to consume but not like a healthy diet. Multivariate structural models were fitted to identify predictors of CVD risk factors. Reliable latent taste (quinine taste function, PROP tasting) and smell (odor intensity) variables were identified, with taste explaining more variance in the CVD risk factors. Lower bitter taste perception was associated with elevated risk. In multivariate models, the HEPI completely mediated the taste-adiposity and taste-HDL associations and partially mediated the taste-triglyceride or taste-systolic blood pressure associations. The taste-LDL pathway was significant and direct. The HEI could not replace HEPI in adequate models. However, using a latent diet quality variable with HEPI and HEI, increased the strength of association between diet quality and adiposity or CVD risk factors. In conclusion, bitter taste phenotype was associated with CVD risk factors via diet quality, particularly when assessed by level of food liking/disliking. Copyright © 2018 Elsevier Inc. All rights reserved.

[Effect of actoprotectors on the work capacity of operators during modeling of various factors of space flight].

PubMed

Bobkov, Iu G; Epishkin, A K

1988-01-01

This paper presents experimental findings indicating that bemithyl, an actoprotective agent, has a beneficial effect on the health status and work capacity of operators during simulated space flight and 56-hour continuous work. The drug enhanced psychophysiological tolerance of the operators and improved the quality of their work: the quality of their compensatory tracking was on the average 10% higher, the number of errors of their porsuit tracking was 1.8 times lower, and the time of visual signal detection was 2.4 times shorter as compared to the placebo controls.

Quasi-static finite element modeling of seismic attenuation and dispersion due to wave-induced fluid flow in poroelastic media

NASA Astrophysics Data System (ADS)

Quintal, Beatriz; Steeb, Holger; Frehner, Marcel; Schmalholz, Stefan M.

2011-01-01

The finite element method is used to solve Biot's equations of consolidation in the displacement-pressure (u - p) formulation. We compute one-dimensional (1-D) and two-dimensional (2-D) numerical quasi-static creep tests with poroelastic media exhibiting mesoscopic-scale heterogeneities to calculate the complex and frequency-dependent P wave moduli from the modeled stress-strain relations. The P wave modulus is used to calculate the frequency-dependent attenuation (i.e., inverse of quality factor) and phase velocity of the medium. Attenuation and velocity dispersion are due to fluid flow induced by pressure differences between regions of different compressibilities, e.g., regions (or patches) saturated with different fluids (i.e., so-called patchy saturation). Comparison of our numerical results with analytical solutions demonstrates the accuracy and stability of the algorithm for a wide range of frequencies (six orders of magnitude). The algorithm employs variable time stepping and an unstructured mesh which make it efficient and accurate for 2-D simulations in media with heterogeneities of arbitrary geometries (e.g., curved shapes). We further numerically calculate the quality factor and phase velocity for 1-D layered patchy saturated porous media exhibiting random distributions of patch sizes. We show that the numerical results for the random distributions can be approximated using a volume average of White's analytical solution and the proposed averaging method is, therefore, suitable for a fast and transparent prediction of both quality factor and phase velocity. Application of our results to frequency-dependent reflection coefficients of hydrocarbon reservoirs indicates that attenuation due to wave-induced flow can increase the reflection coefficient at low frequencies, as is observed at some reservoirs.

Analysis on the spatiotemporal characteristics of water quality and trophic states in Tiegang Reservoir: A public drinking water supply reservoir in South China

NASA Astrophysics Data System (ADS)

Song, Yun-long; Zhu, Jia; Li, Wang; Tao, Yi; Zhang, Jin-song

2017-08-01

Shenzhen is the most densely populated city in China and with a severe shortage of water. The per capita water resource is less than 200 m3, which is approximately 1/12 of the national average level. In 2016, nearly 90% of Shenzhen’s drinking water needed to be imported from the Pearl River. After arrived at Shenzhen, overseas water was firstly stockpiled in local reservoirs and then was supplied to nearby water works. Tiegang Reservoir is the largest drinking water supply reservoir and its water quality has played an important role to the city’s drinking water security. A fifteen-month’s field observation was conducted from April 2013 to June 2014 in Tiegang Reservoir, in order to analyze the temporal and spatial distribution of water quality factors and seasonal variation of trophic states. One-way ANOVA showed that significant difference was found in water quality factors on month (p<0.005). The spatial heterogeneity of water quality was obvious (p<0.05). The distribution pattern of WT, TOC, Silicate, NO3 --N, TN and Fe was pre-rainy period > latter rainy period > high temperature and rain free period > temperature jump period > winter drought period, while SD showed the contrary. Two-way ANOVA showed that months rather than locations were the key influencing factors of water quality factors succession. Tiegang reservoir was seriously polluted by TN, as a result WQI were at IV∼V level. If TN was not taken into account, WQI were atI∼III level. TLI (Σ) were about 35∼60, suggesting Tiegang reservoir was in mesotrophic and light-eutrophic trophic states. The WQI and TLI (Σ) in sampling sites 9 and 10 were poorer than that of other sites. The 14 water quality factors were divided into 5 groups by factor analysis (FA). The total interpretation rate was 73.54%. F1 represents the climatic change represented by water temperature. F2 and F4 represent the concentration of nutrients. F3 and F5 represent the sensory indexes of water body, such as turbidity, transparency. The FA results indicated that water quality potential risk factors was total nitrogen (TN), and potential risk factors also include chlorophyll-a and nitrate nitrogen (NO3 --N).

Watershed Regressions for Pesticides (WARP) for Predicting Annual Maximum and Annual Maximum Moving-Average Concentrations of Atrazine in Streams

USGS Publications Warehouse

Stone, Wesley W.; Gilliom, Robert J.; Crawford, Charles G.

2008-01-01

Regression models were developed for predicting annual maximum and selected annual maximum moving-average concentrations of atrazine in streams using the Watershed Regressions for Pesticides (WARP) methodology developed by the National Water-Quality Assessment Program (NAWQA) of the U.S. Geological Survey (USGS). The current effort builds on the original WARP models, which were based on the annual mean and selected percentiles of the annual frequency distribution of atrazine concentrations. Estimates of annual maximum and annual maximum moving-average concentrations for selected durations are needed to characterize the levels of atrazine and other pesticides for comparison to specific water-quality benchmarks for evaluation of potential concerns regarding human health or aquatic life. Separate regression models were derived for the annual maximum and annual maximum 21-day, 60-day, and 90-day moving-average concentrations. Development of the regression models used the same explanatory variables, transformations, model development data, model validation data, and regression methods as those used in the original development of WARP. The models accounted for 72 to 75 percent of the variability in the concentration statistics among the 112 sampling sites used for model development. Predicted concentration statistics from the four models were within a factor of 10 of the observed concentration statistics for most of the model development and validation sites. Overall, performance of the models for the development and validation sites supports the application of the WARP models for predicting annual maximum and selected annual maximum moving-average atrazine concentration in streams and provides a framework to interpret the predictions in terms of uncertainty. For streams with inadequate direct measurements of atrazine concentrations, the WARP model predictions for the annual maximum and the annual maximum moving-average atrazine concentrations can be used to characterize the probable levels of atrazine for comparison to specific water-quality benchmarks. Sites with a high probability of exceeding a benchmark for human health or aquatic life can be prioritized for monitoring.

Health-related quality of life in epilepsy patients receiving anti-epileptic drugs at National Referral Hospitals in Uganda: a cross-sectional study.

PubMed

Nabukenya, Anne M; Matovu, Joseph K B; Wabwire-Mangen, Fred; Wanyenze, Rhoda K; Makumbi, Fredrick

2014-04-12

Epilepsy is a devastating disorder that impacts on patients' quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs. A total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL. Just about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0-100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL. The HRQOL for epilepsy patients on AEDs is very low. The predictors of low HRQOL were socio factors (marital status, education) and drug side effects, frequency of seizure, and type of therapy.

[Effect factors analysis of knee function recovery after distal femoral fracture operation].

PubMed

Bei, Chaoyong; Wang, Ruiying; Tang, Jicun; Li, Qiang

2009-09-01

To investigate the effect factors of knee function recovery after operation in distal femoral fractures. From January 2001 to May 2007, 92 cases of distal femoral fracture were treated. There were 50 males and 42 females, aged 20-77 years old (average 46.7 years old). Fracture was caused by traffic accident in 48 cases, by falling from height in 26 cases, by bruise in 12 cases and by tumble in 6 cases. According to Müller's Fracture classification, there were 29 cases of type A, 12 cases of type B and 51 cases of type C. According to American Society of Anesthesiologists (ASA) classification, there were 21 cases of grade I, 39 cases of grade II, 24 cases of grade III, and 8 cases of grade IV. The time from injury to operation was 4 hours to 24 days with an average of 7 days. Anatomical plate was used in 43 cases, retrograde interlocking intramedullary nail in 37 cases, and bone screws, bolts and internal fixation with Kirschner pins in 12 cases. After operation, the HSS knee function score was used to evaluate efficacy. Ten related factors were applied for statistical analysis, to knee function recovery after operation in distal femoral fractures, such as age, sex, preoperative ASA classification, injury to surgery time, fracture type, treatment, reduction quality, functional exercise after operation, whether or not CPM functional training and postoperative complications. Wound healed by first intention in 88 cases, infection occurred in 4 cases. All patients followed up 16-32 months with an average of 23.1 months. Clinical union of fracture was achieved within 3-7 months after operation. Extensor device adhesions and the scope of activities of <80 degrees occurred in 29 cases, traumatic arthritis in 25 cases, postoperative fracture displacement in 6 cases, mild knee varus or valgus in 7 cases and implant loosening in 6 cases. According to HSS knee function score, the results were excellent in 52 cases, good in 15 cases, fair in 10 cases and poor in 15 cases with an excellent and good rate of 72.83%. Single factor analysis showed that age, preoperative ASA classification, fracture type, reduction quality, whether or not CPM functional exercise, and postoperative complications were significantly in knee function recovery (P < 0.05). logistic regression analysis showed that the fracture type, quality of reduction, whether or not CPM functional exercise, and age were major factors in the knee joint function recovery. Age, preoperative ASA classification, fracture type, reduction quality, and whether or not CPM functional training, postoperative complications factors may affect the knee joint function recovery. Adjustment to the patient's preoperative physical status, fractures anatomic reduction and firm fixation, early postoperative active and passive functional exercises, less postoperative complications can maximize the restoration of knee joint function.

Modifiable correlates of perceived cognitive function in breast cancer survivors up to 10 years after chemotherapy completion.

PubMed

Henneghan, Ashley; Stuifbergen, Alexa; Becker, Heather; Kesler, Shelli; King, Elisabeth

2018-04-01

Cognitive changes following breast cancer treatment are likely multifactorial and have been linked to emotional factors, biophysiological factors, and fatigue, among others. Little is known about the contributions of modifiable factors such as stress, loneliness, and sleep quality. The purpose of this study was to explore the direct and indirect effects of perceived stress, loneliness, and sleep quality on perceived cognitive function (PCF) in breast cancer survivors (BCS) after chemotherapy completion. In this observational study, BCS 6 months to 10 years post chemotherapy were recruited from the community. We measured perceived stress, loneliness, sleep quality, anxiety, depression, fatigue, and PCF. Data analyses included descriptive statistics, correlations, and mediation analyses utilizing ordinary least square regression. Ninety women who were on average 3 years post chemotherapy completion participated in the study. Moderate to largely negative correlations were found between PCF and the psychosocial and sleep variables (r values ranged from - 0.31 to - 0.70, p values < .0009). Mediation analyses revealed that stress and daytime sleepiness both directly and indirectly impact PCF and that loneliness and sleep quality only have indirect effects (through anxiety and fatigue). Our findings suggest that perceived cognitive changes following breast cancer treatment are multifactorial and that higher stress levels, loneliness, daytime sleepiness, and poorer sleep quality are linked to worse perceived cognitive functioning. Also, stress, loneliness, and sleep quality may affect cognitive functioning through a shared psychobiological pathway. Interventions targeting stress, loneliness, and sleep quality may improve perceived cognitive functioning in breast cancer survivors.

Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy.

PubMed

Jones, A Kyle; Pasciak, Alexander S; Wagner, Louis K

2016-07-01

To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (Eavg) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.

Variations in Daily Sleep Quality and Type 1 Diabetes Management in Late Adolescents

PubMed Central

Queen, Tara L.; Butner, Jonathan; Wiebe, Deborah; Berg, Cynthia A.

2016-01-01

Objective To determine how between- and within-person variability in perceived sleep quality were associated with adolescent diabetes management. Methods A total of 236 older adolescents with type 1 diabetes reported daily for 2 weeks on sleep quality, self-regulatory failures, frequency of blood glucose (BG) checks, and BG values. Average, inconsistent, and daily deviations in sleep quality were examined. Results Hierarchical linear models indicated that poorer average and worse daily perceived sleep quality (compared with one’s average) was each associated with more self-regulatory failures. Sleep quality was not associated with frequency of BG checking. Poorer average sleep quality was related to greater risk of high BG. Furthermore, inconsistent and daily deviations in sleep quality interacted to predict higher BG, with more consistent sleepers benefitting more from a night of high-quality sleep. Conclusions Good, consistent sleep quality during late adolescence may benefit diabetes management by reducing self-regulatory failures and risk of high BG. PMID:26994852

Changes of plasma vWF level in response to the improvement of air quality: an observation of 114 healthy young adults.

PubMed

Yuan, Zhonghai; Chen, Yan; Zhang, Ying; Liu, Hui; Liu, Qian; Zhao, Jun; Hu, Min; Huang, Wei; Wang, Guangfa; Zhu, Tong; Zhang, Jim; Zhu, Ping

2013-04-01

Plasma von Willebrand factor (vWF) is an important factor involving in hemostasis and various cardiovascular diseases. Air pollution is related to many respiratory and cardiovascular diseases. During the Olympic Games Beijing 2008 period (August 8 to September 17, 2008) when air quality in Beijing improved greatly, we studied the relationship between plasma vWF level and the factors of air pollution index (API), ABO blood group, and polymorphisms in vWF gene in healthy young adults. We recruited 114 healthy medical students. In a period of more than 4 months around the period of Olympic Games Beijing 2008, six blood samples at stages 1 and 2 (before Olympic Games), stages 3 and 4 (during Olympic Games), and stages 5 and 6 (after Olympic Games) were taken from every participant for the measurement of plasma vWF level and genotyping of three SNPs (rs7954855, rs7965413, and rs216311) in vWF gene. Daily air pollution index near their living places was obtained from the officially published data. The average API began to decrease from stage 2, reached to nadir in stages 3 and 4, and increased but was still lower in stages 5 and 6. Plasma vWF decreased during the experimental period in all participants. The average plasma vWF decreased from stage 2 and remained lower in stages 3-6. vWF level varied greatly among the participants (from 30 to 170 %) but decreased proportionately when we analyzed their levels individually. Participants with O blood type had lower plasma vWF level than those with A, B, and AB blood types. Those with the SNP in vWF gene causing homozygous threonine at codon 1381 had lower plasma vWF level than those with homozygous alanine or heterozygous alanine/threonine. In the 114 normal individuals, the average plasma vWF level decreased during the period of Olympic Games Beijing 2008 when air quality improved greatly. This suggests that control of air pollution may be useful to prevent some diseases such as cardiovascular diseases.

Facial averageness and genetic quality: Testing heritability, genetic correlation with attractiveness, and the paternal age effect.

PubMed

Lee, Anthony J; Mitchem, Dorian G; Wright, Margaret J; Martin, Nicholas G; Keller, Matthew C; Zietsch, Brendan P

2016-01-01

Popular theory suggests that facial averageness is preferred in a partner for genetic benefits to offspring. However, whether facial averageness is associated with genetic quality is yet to be established. Here, we computed an objective measure of facial averageness for a large sample ( N = 1,823) of identical and nonidentical twins and their siblings to test two predictions from the theory that facial averageness reflects genetic quality. First, we use biometrical modelling to estimate the heritability of facial averageness, which is necessary if it reflects genetic quality. We also test for a genetic association between facial averageness and facial attractiveness. Second, we assess whether paternal age at conception (a proxy of mutation load) is associated with facial averageness and facial attractiveness. Our findings are mixed with respect to our hypotheses. While we found that facial averageness does have a genetic component, and a significant phenotypic correlation exists between facial averageness and attractiveness, we did not find a genetic correlation between facial averageness and attractiveness (therefore, we cannot say that the genes that affect facial averageness also affect facial attractiveness) and paternal age at conception was not negatively associated with facial averageness. These findings support some of the previously untested assumptions of the 'genetic benefits' account of facial averageness, but cast doubt on others.

A Study of the Correlation between Religious Attitudes and Quality Of Life in Students at Jahrom University of Medical Sciences in 2014.

PubMed

Parniyan, Razieh; Kazemiane, Abdoreza; Jahromi, Marzieh Kargar; Poorgholami, Farzad

2016-10-01

General health is not simply determined by whether or not an individual is sick, but is dependent on physical, mental and social factors too. One such important factor is an individual's religious inclination. The present study aims to explore the correlation between religious beliefs and quality of life in the students at Jahrom University of Medical Sciences. This is a descriptive, cross-sectional study conducted in 2014. The sample consisted of 273 students who were randomly selected. Data were collected using Religious Attitude Questionnaire and a quality of life scale. The collected data were analyzed using Pearson's correlation coefficient and SPSS v. 23. The students' average age was 21.36±2.15. The means of their quality of life scores and religious attitude scores were 87.23 and 146.31 respectively. The results of Pearson's correlation test showed that there was a significant relationship between quality of life and its subscales on one hand and religious attitude and its indexes on the other; in other words, the students' mental well-being was found to correlate with their religious beliefs. Since religious beliefs affect college students' mental well-being and quality of life, it is suggested that through organized education, students' religious awareness be raised.

Association between costs and quality of acute myocardial infarction care hospitals under the Korea National Health Insurance program.

PubMed

Kang, Hee-Chung; Hong, Jae-Seok

2017-08-01

If cost reductions produce a cost-quality trade-off, healthcare policy makers need to be more circumspect about the use of cost-effective initiatives. Additional empirical evidence about the relationship between cost and quality is needed to design a value-based payment system. We examined the association between cost and quality performances for acute myocardial infarction (AMI) care at the hospital level.In 2008, this cross-sectional study examined 69 hospitals with 6599 patients hospitalized under the Korea National Health Insurance (KNHI) program. We separately estimated hospital-specific effects on cost and quality using the fixed effect models adjusting for average patient risk. The analysis examined the association between the estimated hospital effects against the treatment cost and quality. All hospitals were distributed over the 4 cost × quality quadrants rather than concentrated in only the trade-off quadrants (i.e., above-average cost and above-average quality, below-average cost and below-average quality). We found no significant trade-off between cost and quality among hospitals providing AMI care in Korea.Our results further contribute to formulating a rationale for value-based hospital-level incentive programs by supporting the necessity of different approaches depending on the quality location of a hospital in these 4 quadrants.

A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold?

PubMed

Nimdet, Khachapon; Chaiyakunapruk, Nathorn; Vichansavakul, Kittaya; Ngorsuraches, Surachat

2015-01-01

A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation. To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors. We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors. Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06). This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per capita depended on several factors may prompt discussions on the CE threshold policy. Our research work provides a foundation for defining future direction of decision criteria for an evidence-informed decision making system.

A one-dimensional, steady-state, dissolved-oxygen model and waste-load assimilation study for Wabash River, Huntington County, Indiana

USGS Publications Warehouse

Crawford, Charles G.; Wilber, William G.; Peters, James G.

1980-01-01

A digital model calibrated to conditions in the Wabash River in Huntington County, Ind., was used to predict alternatives for future waste loadings that would be compatible with Indiana stream water-quality standards defined for two critical hydrologic conditons, summer and winter low flows. The major point-source waste load affecting the Wabash River in Huntington County is the Huntington wastewater-treatment facility. The most significnt factor potentially affecting the dissolved-oxygen concentration during summer low flows is nitrification. However, nitrification should not be a limiting factor on the allowable nitrogenous and carbonaceous waste loads for the Huntington wastewater-treatment facility during summer low flows if the ammonia-nitrogen toxicity standard for Indiana streams is met. The disolved-oxygen standard for Indiana stream, an average of 5.0 milligrams per liter, should be met during summer and winter low flows if the National Pollution Discharge Elimination System 's 5-day, carbonaceous biochemical-oxygen demands of a monthly average concentration of 30 milligrams per liter and a maximum weekly average of 45 milligrams per liter are not exceeded. 

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality

NASA Astrophysics Data System (ADS)

Helge Østerås, Bjørn; Skaane, Per; Gullien, Randi; Catrine Trægde Martinsen, Anne

2018-02-01

The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra™). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra™. AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

Average glandular dose in paired digital mammography and digital breast tomosynthesis acquisitions in a population based screening program: effects of measuring breast density, air kerma and beam quality.

PubMed

Østerås, Bjørn Helge; Skaane, Per; Gullien, Randi; Martinsen, Anne Catrine Trægde

2018-01-25

The main purpose was to compare average glandular dose (AGD) for same-compression digital mammography (DM) and digital breast tomosynthesis (DBT) acquisitions in a population based screening program, with and without breast density stratification, as determined by automatically calculated breast density (Quantra ™ ). Secondary, to compare AGD estimates based on measured breast density, air kerma and half value layer (HVL) to DICOM metadata based estimates. AGD was estimated for 3819 women participating in the screening trial. All received craniocaudal and mediolateral oblique views of each breasts with paired DM and DBT acquisitions. Exposure parameters were extracted from DICOM metadata. Air kerma and HVL were measured for all beam qualities used to acquire the mammograms. Volumetric breast density was estimated using Quantra ™ . AGD was estimated using the Dance model. AGD reported directly from the DICOM metadata was also assessed. Mean AGD was 1.74 and 2.10 mGy for DM and DBT, respectively. Mean DBT/DM AGD ratio was 1.24. For fatty breasts: mean AGD was 1.74 and 2.27 mGy for DM and DBT, respectively. For dense breasts: mean AGD was 1.73 and 1.79 mGy, for DM and DBT, respectively. For breasts of similar thickness, dense breasts had higher AGD for DM and similar AGD for DBT. The DBT/DM dose ratio was substantially lower for dense compared to fatty breasts (1.08 versus 1.33). The average c-factor was 1.16. Using previously published polynomials to estimate glandularity from thickness underestimated the c-factor by 5.9% on average. Mean AGD error between estimates based on measurements (air kerma and HVL) versus DICOM header data was 3.8%, but for one mammography unit as high as 7.9%. Mean error of using the AGD value reported in the DICOM header was 10.7 and 13.3%, respectively. Thus, measurement of breast density, radiation dose and beam quality can substantially affect AGD estimates.

Real-time image-processing algorithm for markerless tumour tracking using X-ray fluoroscopic imaging.

PubMed

Mori, S

2014-05-01

To ensure accuracy in respiratory-gating treatment, X-ray fluoroscopic imaging is used to detect tumour position in real time. Detection accuracy is strongly dependent on image quality, particularly positional differences between the patient and treatment couch. We developed a new algorithm to improve the quality of images obtained in X-ray fluoroscopic imaging and report the preliminary results. Two oblique X-ray fluoroscopic images were acquired using a dynamic flat panel detector (DFPD) for two patients with lung cancer. The weighting factor was applied to the DFPD image in respective columns, because most anatomical structures, as well as the treatment couch and port cover edge, were aligned in the superior-inferior direction when the patient lay on the treatment couch. The weighting factors for the respective columns were varied until the standard deviation of the pixel values within the image region was minimized. Once the weighting factors were calculated, the quality of the DFPD image was improved by applying the factors to multiframe images. Applying the image-processing algorithm produced substantial improvement in the quality of images, and the image contrast was increased. The treatment couch and irradiation port edge, which were not related to a patient's position, were removed. The average image-processing time was 1.1 ms, showing that this fast image processing can be applied to real-time tumour-tracking systems. These findings indicate that this image-processing algorithm improves the image quality in patients with lung cancer and successfully removes objects not related to the patient. Our image-processing algorithm might be useful in improving gated-treatment accuracy.

Effects of various factors on sleep disorders and quality of life in Parkinson's disease.

PubMed

Telarovic, Srdjana; Mijatovic, Dragana; Telarovic, Irma

2015-12-01

In Parkinson's disease (PD), sleep disorders (SD) occur as a result of the neurochemical changes in sleep centres, neurodegenerative changes in dopaminergic neurons, and other factors. The most common SD include excessive daytime sleepiness, insomnia, restless legs syndrome and nocturia. The aim of the study was to compare quality of sleep, as a factor that greatly impacts quality of life (QoL), between PD patients and a control group and to further examine SD in the PD group with focus on incidence and SD types as well as on effects various factors (age, sex, PD characteristics, medication usage) have on these disorders. The study included 110 patients who met the criteria for the diagnosis of PD and 110 age-matched healthy controls. We used the Pittsburgh Sleep Quality Index, PD Sleep Scale, Epworth Sleepiness Scale, PD QoL Questionnaire-8 and PD Questionnaire-39 (items 30 and 33). In the group with PD, we considered the duration of the disease, the stage of disease according to the Hoehn and Yahr scale, medications and their impact on the SD. The average duration of the disease was 6 years and the mean stage was 2.44. The result showed significant differences in the sleep quality between groups. In the PD group, SD differences were also found according to gender, duration of the disease and medication usage. The most common SD were fragmented sleep, insomnia and nocturia. To improve the QoL of PD patients, it is necessary to pay more attention to detecting and solving SD.

Crew Factors in Flight Operations XII: A Survey of Sleep Quantity and Quality in On-Board Crew Rest Facilities

NASA Technical Reports Server (NTRS)

Rosekind, Mark R.; Gregory, Kevin B.; Co, Elizabeth L.; Miller, Donna L.; Dinges, David F.

2000-01-01

Many aircraft operated on long-haul commercial airline flights are equipped with on-board crew rest facilities, or bunks, to allow crewmembers to rest during the flight. The primary objectives of this study were to gather data on how the bunks were used, the quantity and quality of sleep obtained by flight crewmembers in the facilities, and the factors that affected their sleep. A retrospective survey comprising 54 questions of varied format addressed demographics, home sleep habits, and bunk sleep habits. Crewmembers from three airlines with long-haul fleets carrying augmented crews consisting of B747-100/200, B747-400, and MD-11 aircraft equipped with bunks returned a total of 1404 completed surveys (a 37% response rate). Crewmembers from the three carriers were comparable demographically, although one carrier had older, more experienced flight crewmembers. Each group, on average, rated themselves as "good" or "very good" sleepers at home, and all groups obtained about the same average amount of sleep each night. Most were able to sleep in the bunks, and about two thirds indicated that these rest opportunities benefited their subsequent flight deck alertness and performance. Comfort, environment, and physiology (e.g., being ready for sleep) were identified as factors that most promoted sleep. Factors cited as interfering with sleep included random noise, thoughts, heat, and the need to use the bathroom. These factors, in turn, suggest potential improvements to bunk facilities and their use. Ratings of the three aircraft types suggested differences among facilities. Bunks in the MD-11 were rated significantly better than either of the B747 types, and the B747-400 bunks received better ratings than did the older, B747-100/200 facilities.

Spatiotemporal Variations and Driving Factors of Air Pollution in China.

PubMed

Zhan, Dongsheng; Kwan, Mei-Po; Zhang, Wenzhong; Wang, Shaojian; Yu, Jianhui

2017-12-08

In recent years, severe and persistent air pollution episodes in China have drawn wide public concern. Based on ground monitoring air quality data collected in 2015 in Chinese cities above the prefectural level, this study identifies the spatiotemporal variations of air pollution and its associated driving factors in China using descriptive statistics and geographical detector methods. The results show that the average air pollution ratio and continuous air pollution ratio across Chinese cities in 2015 were 23.1 ± 16.9% and 16.2 ± 14.8%. The highest levels of air pollution ratio and continuous air pollution ratio were observed in northern China, especially in the Bohai Rim region and Xinjiang province, and the lowest levels were found in southern China. The average and maximum levels of continuous air pollution show distinct spatial variations when compared with those of the continuous air pollution ratio. Monthly changes in both air pollution ratio and continuous air pollution ratio have a U-shaped variation, indicating that the highest levels of air pollution occurred in winter and the lowest levels happened in summer. The results of the geographical detector model further reveal that the effect intensity of natural factors on the spatial disparity of the air pollution ratio is greater than that of human-related factors. Specifically, among natural factors, the annual average temperature, land relief, and relative humidity have the greatest and most significant negative effects on the air pollution ratio, whereas human factors such as population density, the number of vehicles, and Gross Domestic Product (GDP) witness the strongest and most significant positive effects on air pollution ratio.

Spatiotemporal Variations and Driving Factors of Air Pollution in China

PubMed Central

Zhan, Dongsheng; Zhang, Wenzhong; Wang, Shaojian; Yu, Jianhui

2017-01-01

In recent years, severe and persistent air pollution episodes in China have drawn wide public concern. Based on ground monitoring air quality data collected in 2015 in Chinese cities above the prefectural level, this study identifies the spatiotemporal variations of air pollution and its associated driving factors in China using descriptive statistics and geographical detector methods. The results show that the average air pollution ratio and continuous air pollution ratio across Chinese cities in 2015 were 23.1 ± 16.9% and 16.2 ± 14.8%. The highest levels of air pollution ratio and continuous air pollution ratio were observed in northern China, especially in the Bohai Rim region and Xinjiang province, and the lowest levels were found in southern China. The average and maximum levels of continuous air pollution show distinct spatial variations when compared with those of the continuous air pollution ratio. Monthly changes in both air pollution ratio and continuous air pollution ratio have a U-shaped variation, indicating that the highest levels of air pollution occurred in winter and the lowest levels happened in summer. The results of the geographical detector model further reveal that the effect intensity of natural factors on the spatial disparity of the air pollution ratio is greater than that of human-related factors. Specifically, among natural factors, the annual average temperature, land relief, and relative humidity have the greatest and most significant negative effects on the air pollution ratio, whereas human factors such as population density, the number of vehicles, and Gross Domestic Product (GDP) witness the strongest and most significant positive effects on air pollution ratio. PMID:29292783

Investigating the use of an antiscatter grid in chest radiography for average adults with a computed radiography imaging system

PubMed Central

Wood, T J; Avery, G; Balcam, S; Needler, L; Smith, A; Saunderson, J R; Beavis, A W

2015-01-01

Objective: The aim of this study was to investigate via simulation a proposed change to clinical practice for chest radiography. The validity of using a scatter rejection grid across the diagnostic energy range (60–125 kVp), in conjunction with appropriate tube current–time product (mAs) for imaging with a computed radiography (CR) system was investigated. Methods: A digitally reconstructed radiograph algorithm was used, which was capable of simulating CR chest radiographs with various tube voltages, receptor doses and scatter rejection methods. Four experienced image evaluators graded images with a grid (n = 80) at tube voltages across the diagnostic energy range and varying detector air kermas. These were scored against corresponding images reconstructed without a grid, as per current clinical protocol. Results: For all patients, diagnostic image quality improved with the use of a grid, without the need to increase tube mAs (and therefore patient dose), irrespective of the tube voltage used. Increasing tube mAs by an amount determined by the Bucky factor made little difference to image quality. Conclusion: A virtual clinical trial has been performed with simulated chest CR images. Results indicate that the use of a grid improves diagnostic image quality for average adults, without the need to increase tube mAs, even at low tube voltages. Advances in knowledge: Validated with images containing realistic anatomical noise, it is possible to improve image quality by utilizing grids for chest radiography with CR systems without increasing patient exposure. Increasing tube mAs by an amount determined by the Bucky factor is not justified. PMID:25571914

Fracture history in osteoporosis: risk factors and its effect on quality of life.

PubMed

Kuru, Pınar; Akyüz, Gülseren; Cerşit, Hülya Peynirci; Çelenlioğlu, Alp Eren; Cumhur, Ahmet; Biricik, Şefikcan; Kozan, Seda; Gökşen, Aylin; Özdemir, Mikail; Lüleci, Emel

2014-12-01

Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Cross-sectional study. We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo-41 questionnaire was also used for evaluating quality of life. The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial). When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.

Withdrawal times and associated factors in colonoscopy: a quality assurance multicenter assessment.

PubMed

Overholt, Bergein F; Brooks-Belli, Linda; Grace, Michael; Rankin, Kristin; Harrell, Royce; Turyk, Mary; Rosenberg, Fred B; Barish, Robert W; Gilinsky, Norman H

2010-04-01

To evaluate the use and impact of the recommended withdrawal time of at least 6 minutes from the cecum in colonoscopy in multiple gastroenterology endoscopy ambulatory surgery centers serving a wide geographical area. An observational prospective multicenter quality assurance review was conducted in 49 ambulatory surgery centers in 17 states with 315 gastroenterologists. There was no intervention with this quality assessment program as care of patients and the routine of gastroenterologists continued as standard practice. Multivariable analysis was applied to the database to examine factors affecting withdrawal time and polyp detection. There were 15,955 consecutive qualified patients receiving colonoscopies in a designated 4-week period. Gastroenterologists with average withdrawal times of 6 minutes or more in patients with no polyps were 1.8 times more likely to detect 1 or more polyps and had a significantly higher rate (P<0.0001) of polyp detection in patients with findings of polyps compared to gastroenterologists with average withdrawal times of less than 6 minutes in patients with no polyps. For patients with no pathology, the mean time of withdrawal was 6.98 (SD=4.34) minutes and for patients with pathology mean time of withdrawal was 11.27 (SD=6.71) minutes. Strongest predictors of withdrawal time of 6 minutes or more were presence of carcinoma (3.7 times more likely than those with no pathology), adenoma (2.0 times more likely than those with no pathology), and number of polyps visualized (1.7 times more likely for each polyp). This quality assurance assessment from standard colonoscopy practices of 315 gastroenterologists in 49 endoscopic ambulatory surgery centers serving a wide geographical area provides support for the merits of a colonoscopy withdrawal time from the cecum of 6 minutes or more to improve the detection of polyps.

Deceleration of Fusion–Fission Cycles Improves Mitochondrial Quality Control during Aging

PubMed Central

Meyer-Hermann, Michael; Osiewacz, Heinz D.

2012-01-01

Mitochondrial dynamics and mitophagy play a key role in ensuring mitochondrial quality control. Impairment thereof was proposed to be causative to neurodegenerative diseases, diabetes, and cancer. Accumulation of mitochondrial dysfunction was further linked to aging. Here we applied a probabilistic modeling approach integrating our current knowledge on mitochondrial biology allowing us to simulate mitochondrial function and quality control during aging in silico. We demonstrate that cycles of fusion and fission and mitophagy indeed are essential for ensuring a high average quality of mitochondria, even under conditions in which random molecular damage is present. Prompted by earlier observations that mitochondrial fission itself can cause a partial drop in mitochondrial membrane potential, we tested the consequences of mitochondrial dynamics being harmful on its own. Next to directly impairing mitochondrial function, pre-existing molecular damage may be propagated and enhanced across the mitochondrial population by content mixing. In this situation, such an infection-like phenomenon impairs mitochondrial quality control progressively. However, when imposing an age-dependent deceleration of cycles of fusion and fission, we observe a delay in the loss of average quality of mitochondria. This provides a rational why fusion and fission rates are reduced during aging and why loss of a mitochondrial fission factor can extend life span in fungi. We propose the ‘mitochondrial infectious damage adaptation’ (MIDA) model according to which a deceleration of fusion–fission cycles reflects a systemic adaptation increasing life span. PMID:22761564

Application of psychometric theory to the measurement of voice quality using rating scales.

PubMed

Shrivastav, Rahul; Sapienza, Christine M; Nandur, Vuday

2005-04-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the mid-range of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have been interpreted to show that listeners perceive voice quality in an idiosyncratic manner. Based on psychometric theory, the present research explored an alternative explanation for the poor interlistener agreement observed in previous research. This approach suggests that poor agreement between listeners may result, in part, from measurement errors related to a variety of factors rather than true differences in the perception of voice quality. In this study, 10 listeners rated breathiness for 27 vowel stimuli using a 5-point rating scale. Each stimulus was presented to the listeners 10 times in random order. Interlistener agreement and reliability were calculated from these ratings. Agreement and reliability were observed to improve when multiple ratings of each stimulus from each listener were averaged and when standardized scores were used instead of absolute ratings. The probability of exact agreement was found to be approximately .9 when using averaged ratings and standardized scores. In contrast, the probability of exact agreement was only .4 when a single rating from each listener was used to measure agreement. These findings support the hypothesis that poor agreement reported in past research partly arises from errors in measurement rather than individual differences in the perception of voice quality.

[Quality of the diet of a population of young people of Guadalajara].

PubMed

Fernández Morales, I; Aguilar Vilas, M V; Mateos Vega, C J; Martínez Para, M C

2009-01-01

The population of Guadalajara traditionally has consumed a Mediterranean diet with the typical variations of the central zone of the peninsula, but the acquisition of erroneous habits of life they can be translated, specially in the young people, in a not healthful nourishing conducts. To evaluate the quality of the diet, by means of an index of healthy nourishment (IAS) and percentage of adhesion to the Mediterranean diet (% ADM), of a teen population (n = 467) and their relation with different physiological parameters and sociodemográficos. A nutritional study has been realized on the quality of the diet in a teen population of Guadalajara of 467 young people (12-17 years) by means of questionnaires of frequency of consumption of seven days. Likewise, there has determined the ingestion of nutrients and the index of healthy nourishment (IAS) using the program of nutrition DIAL(c). The results show that the average of the population takes a diet with an acceptable IAS (62.78), though with trend towards low qualities, with high ingestions of saturated fats (38.90 +/- 6.58 g), cholesterol (384.69 +/- 74.24 mg) and sodium (3,395.43 +/-729.57 mg). Respect to % MDA there has been obtained an average value of 42.86 +/- 15.52%. These values differ depending on the age (improves with the age), the sex (better quality of the diet consumed by the girls). Likewise, all the factors sociodemográficos and the way of life considered, they influence the quality indicators used.

Quality of life at sea in Polish seafarer's evaluation.

PubMed

Jeżewska, Maria; Grubman-Nowak, Marta; Moryś, Joanna

2015-01-01

Work at sea is highly burdening, hazardous and stressful. Environmental, physical, and psychosociological factors have a great impact on the seafarer's quality of life and work. The research is a part of a broader psychological project performed on people working at sea in Poland during a period of 2011-2014. This report presents the self-evaluation of life quality conducted by a total of 1,700 Polish seafarers who took part in the study. The average age of the group was 45. Following methods were used: WHOQOL-BREF and the "Survey for people working at sea". Polish seafarers gave the highest rates to their social relationships (16.27), then the psychological functioning (15.62), and environment (15.51). The physical domain gave the lowest rates (14.63). The results have shown that quality of life of Polish seafarers is quite high.

A factor analysis of the SSQ (Speech, Spatial, and Qualities of Hearing Scale)

PubMed Central

2014-01-01

Objective The speech, spatial, and qualities of hearing questionnaire (SSQ) is a self-report test of auditory disability. The 49 items ask how well a listener would do in many complex listening situations illustrative of real life. The scores on the items are often combined into the three main sections or into 10 pragmatic subscales. We report here a factor analysis of the SSQ that we conducted to further investigate its statistical properties and to determine its structure. Design Statistical factor analysis of questionnaire data, using parallel analysis to determine the number of factors to retain, oblique rotation of factors, and a bootstrap method to estimate the confidence intervals. Study sample 1220 people who have attended MRC IHR over the last decade. Results We found three clear factors, essentially corresponding to the three main sections of the SSQ. They are termed “speech understanding”, “spatial perception”, and “clarity, separation, and identification”. Thirty-five of the SSQ questions were included in the three factors. There was partial evidence for a fourth factor, “effort and concentration”, representing two more questions. Conclusions These results aid in the interpretation and application of the SSQ and indicate potential methods for generating average scores. PMID:24417459

A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

NASA Astrophysics Data System (ADS)

Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

2018-01-01

The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

Correlates of a good death and the impact of hospice involvement: findings from the national survey of households affected by cancer.

PubMed

Cagle, John G; Pek, Jolynn; Clifford, Maggie; Guralnik, Jack; Zimmerman, Sheryl

2015-03-01

Knowing how to improve the dying experience for patients with end-stage cancer is essential for cancer professionals. However, there is little evidence on the relationship between clinically relevant factors and quality of death. Also, while hospice has been linked with improved outcomes, our understanding of factors that contribute to a "good death" when hospice is involved remains limited. This study (1) identified correlates of a good death and (2) provided evidence on the impact of hospice on quality of death. Using data from a survey of US households affected by cancer (N = 930, response rate 51 %), we fit regression models with a subsample of 158 respondents who had experienced the death of a family member with cancer. Measures included quality of death (good/bad) and clinically relevant factors including: hospice involvement, symptoms during treatment, whether wishes were followed, provider knowledge/expertise, and compassion. Respondents were 60 % female, 89 % White, and averaged 57 years old. Decedents were most often a respondent's spouse (46 %). While 73 % of respondents reported a good death, Hispanics were less likely to experience good death (p = 0.007). Clinically relevant factors, including hospice, were associated with good death (p < 0.05)--an exception being whether the physician said the cancer was curable/fatal. With adjustments, perceptions of provider knowledge/expertise was the only clinical factor that remained associated with good death. Enhanced provider training/communication, referrals to hospice and greater attention to symptom management may facilitate improved quality of dying. Additionally, the cultural relevance of the concept of a "good death" warrants further research.

Quality competition and hospital mergers-An experiment.

PubMed

Han, Johann; Kairies-Schwarz, Nadja; Vomhof, Markus

2017-12-01

On the basis of a Salop model with regulated prices, we investigate quality provision behaviour of competing hospitals before and after a merger. For this, we use a controlled laboratory experiment where subjects decided on the level of treatment quality as head of a hospital. We find that the post-merger average quality is significantly lower than the average pre-merger quality. However, for merger insiders and outsiders, average quality choices are significantly higher than predicted for pure profit-maximising hospitals. This upward deviation is potentially driven by altruistic behaviour towards patients. Furthermore, we find that in the case where sufficient cost synergies are realised by the merged hospitals, there is a significant increase in average quality choices compared to the scenario without synergies. Finally, we find that our results do not change when comparing individual decisions to team decisions. Copyright © 2017 John Wiley & Sons, Ltd.

Defect Analysis Of Quality Palm Kernel Meal Using Statistical Quality Control In Kernels Factory

NASA Astrophysics Data System (ADS)

Sembiring, M. T.; Marbun, N. J.

2018-04-01

The production quality has an important impact retain the totality of characteristics of a product or service to pay attention to its capabilities to meet the needs that have been established. Quality criteria Palm Kernel Meal (PKM) set Factory kernel is as follows: oil content: max 8.50%, water content: max 12,00% and impurity content: max 4.00% While the average quality of the oil content of 8.94%, the water content of 5.51%, and 8.45% impurity content. To identify the defective product quality PKM produced, then used a method of analysis using Statistical Quality Control (SQC). PKM Plant Quality Kernel shows the oil content was 0.44% excess of a predetermined maximum value, and 4.50% impurity content. With excessive PKM content of oil and dirt cause disability content of production for oil, amounted to 854.6078 kg PKM and 8643.193 kg impurity content of PKM. Analysis of the results of cause and effect diagram and SQC, the factors that lead to poor quality of PKM is Ampere second press oil expeller and hours second press oil expeller.

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

PubMed Central

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-01-01

Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers. PMID:27496241

Q-values for P and S waves in Southern Sinai and Southern Gulf of Suez Region, Egypt

NASA Astrophysics Data System (ADS)

Mohamed, Gad-Elkareem A.

2014-05-01

The quality factor Q has been estimated using spectral amplitudes of P and S waves from earthquakes recorded by the seismic network of the Egyptian National Seismological Network (ENSN) in southern Sinai and southern Gulf of Suez region. The earthquakes recorded at nine stations - DHA, NUB, TR1, TR2, KAT, SH2, GRB, HRG and SFG have been used in this study. The spectral amplitude ratios have been calculated between 2 - 20 Hz and single station spectral ratio method has been applied for this purpose. The results show that the quality factors for both P and S waves (Qp and Qs) increase as a function of frequency according to law the Q = Q0fn. By averaging the estimated Q- Value obtained at all stations we calculated the average attenuation laws: Qp = (13.15± 0.76) f0.95± 0.19 and Qs = (20.05± 0.79) f1.03±0.04 for P and S waves respectively. These relations are useful for the estimation of source parameters of earthquakes and simulation of earthquake strong ground motions. The QS /QP ratio for KAT station is less than 1 at lower frequencies, whereas at HRG and SH2 stations QS /QP ratio is are greater than 1.

Nutritional and hygienic quality of raw milk in the mid-northern region of Algeria: correlations and risk factors.

PubMed

Adjlane-Kaouche, Soumeya; Benhacine, Rafik; Ghozlane, Faiçal; Mati, Abderrahmane

2014-01-01

This paper aims to study the overall quality of raw milk in the mid-northern region of Algeria. The analysis results showed a decrease in the average temperature for the delivery of 1,54°C with P<0.001. However, no significant variation (P>0.05) was observed in almost all the physical and nutritional parameters studied (pH, fat content, and protein content) between M1 and M2. The average contamination by total mesophilic aerobic bacteria (TMAB), coliforms, yeasts, molds, and different pathogens in samples taken at M1 showed significant changes at M2. This was confirmed by the decrease of reduction time of methylene blue (RTMB), about 54%. The variation was described as follows: (P>0.05) for yeasts and (P<0.05) for molds in M1 and M2, (P<0.05) for TMAB in M1, and (P<0.001) for TC, FC, and TMAB in M2. The analysis for the detection of Salmonella spp. showed no contamination in all samples tested, while antibiotic residues were detected in 35% of milks delivered. In conclusion, several risk factors have been identified in this study, namely, the effect of the season and the distance between the farm and the dairy unit.

Nutritional and Hygienic Quality of Raw Milk in the Mid-Northern Region of Algeria: Correlations and Risk Factors

PubMed Central

Adjlane-Kaouche, Soumeya; Benhacine, Rafik; Ghozlane, Faiçal; Mati, Abderrahmane

2014-01-01

This paper aims to study the overall quality of raw milk in the mid-northern region of Algeria. The analysis results showed a decrease in the average temperature for the delivery of 1,54°C with P<0.001. However, no significant variation (P>0.05) was observed in almost all the physical and nutritional parameters studied (pH, fat content, and protein content) between M1 and M2. The average contamination by total mesophilic aerobic bacteria (TMAB), coliforms, yeasts, molds, and different pathogens in samples taken at M1 showed significant changes at M2. This was confirmed by the decrease of reduction time of methylene blue (RTMB), about 54%. The variation was described as follows: (P>0.05) for yeasts and (P<0.05) for molds in M1 and M2, (P<0.05) for TMAB in M1, and (P<0.001) for TC, FC, and TMAB in M2. The analysis for the detection of Salmonella spp. showed no contamination in all samples tested, while antibiotic residues were detected in 35% of milks delivered. In conclusion, several risk factors have been identified in this study, namely, the effect of the season and the distance between the farm and the dairy unit. PMID:25374932

Long-term trends of ambient particulate matter emission source contributions and the accountability of control strategies in Hong Kong over 1998-2008

NASA Astrophysics Data System (ADS)

Yuan, Zibing; Yadav, Varun; Turner, Jay R.; Louie, Peter K. K.; Lau, Alexis Kai Hon

2013-09-01

Despite extensive emission control measures targeting motor vehicles and to a lesser extent other sources, annual-average PM10 mass concentrations in Hong Kong have remained relatively constant for the past several years and for some air quality metrics, such as the frequency of poor visibility days, conditions have degraded. The underlying drivers for these long-term trends were examined by performing source apportionment on eleven years (1998-2008) of data for seven monitoring sites in the Hong Kong PM10 chemical speciation network. Nine factors were resolved using Positive Matrix Factorization. These factors were assigned to emission source categories that were classified as local (operationally defined as within the Hong Kong Special Administrative Region) or non-local based on temporal and spatial patterns in the source contribution estimates. This data-driven analysis provides strong evidence that local controls on motor vehicle emissions have been effective in reducing motor vehicle-related ambient PM10 burdens with annual-average contributions at neighborhood- and larger-scale monitoring stations decreasing by ˜6 μg m-3 over the eleven year period. However, this improvement has been offset by an increase in annual-average contributions from non-local contributions, especially secondary sulfate and nitrate, of ˜8 μg m-3 over the same time period. As a result, non-local source contributions to urban-scale PM10 have increased from 58% in 1998 to 70% in 2008. Most of the motor vehicle-related decrease and non-local source driven increase occurred over the period 1998-2004 with more modest changes thereafter. Non-local contributions increased most dramatically for secondary sulfate and secondary nitrate factors and thus combustion-related control strategies, including but not limited to power plants, are needed for sources located in the Pearl River Delta and more distant regions to improve air quality conditions in Hong Kong. PMF-resolved source contribution estimates were also used to examine differential contributions of emission source categories during high PM episodes compared to study-average behavior. While contributions from all source categories increased to some extent on high PM days, the increases were disproportionately high for the non-local sources. Thus, controls on emission sources located outside the Hong Kong Special Administrative Region will be needed to effectively decrease the frequency and severity of high PM episodes.

Trajectories of Quality of Life after Hematopoietic Cell Transplantation: Secondary Analysis of BMT CTN 0902 Data

PubMed Central

Jim, Heather S.L.; Sutton, Steven K.; Small, Brent J.; Jacobsen, Paul B.; Wood, William A.; Knight, Jennifer M.; Majhail, Navneet S.; Syrjala, Karen L.; Lee, Stephanie J.

2016-01-01

Summary Quality of life is increasingly recognized as an important secondary endpoint of hematopoietic cell transplantation (HCT). The current study examined the extent to which attrition results in biased estimates of patient quality of life. The study also examined whether patients differ in terms of trajectories of quality of life in the first six months post-transplant. A secondary data analysis was conducted of 701 participants who enrolled in the Blood and Marrow Transplantation Clinical Trials Network (BMT CTN) 0902 trial. Participants completed the SF-36, a measure of quality of life, prior to transplant and 100 and 180 days post-transplant. Results indicated that attrition resulted in slightly biased overestimates of quality of life but the amount of overestimation remained stable over time. Patients could be grouped into three distinct classes based on physical quality of life: 1) low and stable; 2) average and declining, then stable; and 3) average and stable. Four classes of patients emerged for mental quality of life: 1) low and stable; 2) average, improving, then stable; 3) higher than average (by almost 1 SD) and stable; and 4) average and stable. Taken together, these data provide a more comprehensive understanding of quality of life that can be used to educate HCT recipients and their caregivers. PMID:27538374

Bearing tester data compilation analysis, and reporting and bearing math modeling

NASA Technical Reports Server (NTRS)

Cody, J. C.

1986-01-01

Integration of heat transfer coefficients, modified to account for local vapor quality, into the 45 mm bearing model has been completed. The model has been evaluated with two flow rates and subcooled and saturated coolant. The evaluation showed that by increasing the flow from 3.6 to 7.0 lbs/sec the average ball temperature was decreased by 102 F, using a coolant temperature of -230 F. The average ball temperature was decreased by 63 F by decreasing the inlet coolant temperature from saturated to -230 F at a flow rate of 7.0 lbs/sec. Since other factors such as friction, cage heating, etc., affect bearing temperatures, the above bearing temperature effects should be considered as trends and not absolute values. The two phase heat transfer modification has been installed in the 57 mm bearing model and the effects on bearing temperatures have been evaluated. The average ball temperature was decreased by 60 F by increasing the flow rate from 4.6 to 9.0 lbs/sec for the subcooled case. By decreasing the inlet coolant temperature from saturation to -24 F, the average ball temperature was decreased 57 F for a flow rate of 9.0 lbs/sec. The technique of relating the two phase heat transfer coefficient to local vapor quality will be applied to the tester model and compared with test data.

Orthopedics research output from China, USA, UK, Japan, Germany and France: A 10-year survey of the literature.

PubMed

Xin, Z; Jin, C; Zhengrong, G; Liehu, C; Weizong, W; Quan, L; Xiao, C; Jiacan, S

2016-11-01

In the past decade, researchers have made great progress in the field of Orthopedics. However, the research status of different countries is unclear. To summarize the number of published articles, we assessed the cumulative impact factors in top orthopedic journals. The aims of the study were to measure: 1) the quality and quantity of publications in orthopedics-related journals from China and other five counties, 2) the trend of the number of publications in orthopedics-related journals. The related journals were selected based on the 2014 scientific citation index (SCI) and articles were searched based on the PubMed database. To assess the quantity and quality of research output, the number of publications including clinical trials, randomized controlled trials, meta-analyses, case reports, reviews, citations, impact factors, number of articles in the top 10 journals and most popular journals were recorded. A total of 143,138 orthopedics articles were published from 2005 to 2014. The USA accounts for 24.9% (35,763/143,138) of the publications, followed by UK (7878/143,138 (5.5%)), Japan (7133/143,138 (5.0%)), Germany (5942/143,138 (4.2%)), China (4143/143,138 (2.9%)) and France (2748/143,138 (1.9%)). The ranking for accumulated impact factors as follows: USA, UK, Japan, Germany, France and China. The mean impact factor's order is USA, China, Germany, Japan, France, UK, and interestingly the mean impact factors in Japan is similar to the Germany in 2005-2014. The USA had the highest percentage of articles in the top 10 journals, while China owns the least. The USA had the highest number of average citations, while Japan had lowest number of average citations. According to this study, we can conclude that the USA has had been leading the orthopedics research in the past 10 years. Although China still falls behind, it has made considerable progress in the orthopedics research, not only in quantity but also quality. IV. Copyright © 2016. Published by Elsevier Masson SAS.

Muscle Invasive Bladder Cancer: From Diagnosis to Survivorship

PubMed Central

Mohamed, N. E.; Diefenbach, M. A.; Goltz, H. H.; Lee, C. T.; Latini, D.; Kowalkowski, M.; Philips, C.; Hassan, W.; Hall, S. J.

2012-01-01

Bladder cancer is the fifth most commonly diagnosed cancer and the most expensive adult cancer in average healthcare costs incurred per patient in the USA. However, little is known about factors influencing patients' treatment decisions, quality of life, and responses to treatment impairments. The main focus of this paper is to better understand the impact of muscle invasive bladder cancer on patient quality of life and its added implications for primary caregivers and healthcare providers. In this paper, we discuss treatment options, side effects, and challenges that patients and family caregivers face in different phases along the disease trajectory and further identify crucial areas of needed research. PMID:22924038

Facilitators and Barriers to Dental Care Among Mexican Migrant Women and Their Families in North San Diego County.

PubMed

Velez, Diane; Palomo-Zerfas, Ana; Nunez-Alvarez, Arcela; Ayala, Guadalupe X; Finlayson, Tracy L

2017-10-01

To qualitatively examine facilitators and barriers to dental care access and quality services among Mexican migrant women and their families living in North San Diego County, California. Six focus groups were conducted, with 52 participants. Three focus groups were with community residents (average group size of 10), and three were with community health workers/leaders (called Lideres; average group size of 7). The behavioral model for vulnerable populations theoretical framework guided qualitative data analyses. Predisposing factors to dental care access varied and included immigration status, language, and dental care experiences. Barriers to accessing quality dental services included high cost, lack of insurance coverage, dissatisfaction with providers, long wait times and discrimination. Participants expressed a desire for health policy changes, including affordable coverage for immigrants and their families. This study provided insights into how dental care providers, community health centers, and policymakers can improve dental care access and services to migrant populations.

Average intensity and beam quality of optical coherence lattices in oceanic turbulence with anisotropy.

PubMed

Huang, Xianwei; Deng, Zhixiang; Shi, Xiaohui; Bai, Yanfeng; Fu, Xiquan

2018-02-19

Based on the extended Huygens-Fresnel principle, we have derived the analytical expression of the average intensity of optical coherence lattices (OCLs) in oceanic turbulence with anisotropy, and then the beam quality parameters including the Strehl ratio (SR) and the power-in-the-bucket (PIB) are obtained. One can find that the OCLs will eventually evolve into Gaussian shape with the periodicity reciprocity gradually breaking down when propagating through the anisotropic ocean water, and that the trend of evolving into Gaussian can be accelerated for increasing the ratio of temperature and salinity contributions to the refractive index spectrum ω, the lattice constant a and the rate of dissipation of mean square temperature χT or decreasing the anisotropic factor ξ and the rate of dissipation of turbulent kinetic energy per unit mass of fluid ε. Further, the SR and PIB in the target plane under the effects of oceanic parameters are discussed in detail, and the SR and PIB can be increased for the larger ξ and ε or the smaller χT and ω, namely, the beam quality becomes better. Our results can find potential application in the future optical communication system in an oceanic environment.

The German and Japanese health care systems: an international comparison using an input-output model.

PubMed

Rump, A; Schöffski, O

2016-12-01

The German and Japanese health care systems have common roots, but have evolved differently. Whereas the German system is often considered as expensive and poorly efficient, people in Japan are viewed as healthy and health care as comparatively cheap. In this study, we compared the quality, the effectiveness and efficiency of the German and Japanese health care systems. This study includes comparative health care data analysis. The quality and effectiveness of the German and Japanese health care systems were analyzed using an input-output model including 12 countries based on health indicators published by the OECD. Besides the invested resources, a risk-related input dimension was used for risk adjustment. The efficiency of the systems was assessed by relating the average output to the health expenses per capita. Health risks seem qualitatively different in Germany and Japan, but at the aggregate level, lifestyle does not seem to be an outstanding explanatory factor for health outcome differences between both countries. For investments in health resources, Germany is in a top position, whereas in the international comparison, the outcome is rather poor. The resources invested in Japan are also high, but slightly less than in Germany, whereas on average, the outcome is better. However, in the international comparison, resources as well as results in Japan show a very high variability. Relating the average output to the health expenses per capita indicates that on the average, the health care system in Japan is more efficient than in Germany. Germany and Japan have a quality problem with their health care systems. In Germany there is a transmission failure from structural to outcome quality that might be related to coordination problems between the outpatient and inpatient sector. Japan shows an unbalanced system that may be suspected to have a quality problem as a whole. As the development of the remuneration system including quality requirements is under the direct responsibility and guidance of the Ministry of Health in Japan, the issue might however be more easily solved in Japan than in Germany. Although on average, health care seems more efficient in Japan than in Germany, taking into account health as well as long-term care expenses and uncertainties related to exchange rate adjustments, the higher efficiency of the Japanese system becomes questionable. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Community structure, phytoplankton density and physical-chemical factor of batang palangki waters of sijunjung regency, west sumatera

NASA Astrophysics Data System (ADS)

Gusmaweti; Deswati, L.

2018-03-01

The long-term goal of this study is to provide an overview of the presence of phytoplankton in support of its functions in the waters of Batang Palangki as a conservation area of information on river water management, especially for Batang Palangki stakeholders. Specific targets to be achieved in achieving these objectives are (1) to know the density of phytoplankton, index of diversity of species, equitabilty index, domination index, and in Batang Palangki waters, and (2) to analyze the chemical and physical factors of the waters. The sampling method of phytoplankton is purposive sampling. The phytoplankton sampling is done By filtering 100 liters of water into the net plankton no 25 and filtered into the 25 cc, and then identified. The determination of water quality such as water temperature, water pH and watercolour. dissolved oxygen (DO) and BOD, and Hg content (mercury). The results showed that phytoplankton found from each of station was 370 individualis per liter with the highest density found in the station I of 155. The number of genus was 7, namely Neidium, Gyrogsima, Synedra, Frustulia, Fragillaria, Nitzschia and Peridinium. The diversity index averaged at 0.45, equabilty index averaged at 0.54, while the dominance index averaged at 0.28. Physical and chemical factor measurement results found that water temperature averaged at 26 °C, transparency ranged from 12 - 30 cm, velocity speed ranged from 8 - 15 m/s, while chemical factors such as DO, BOD, and COD ranged from 5.25 to 5.96 mg/L, 3.28 - 3.49 mg/L, and 47.05 - 76.25 mg/L respectively. Likewise, TOM measured in this research was 9.61 - 2.10 mg/L while Hg content ranged from 0.098 - 0.208 mg/L.

Predictors and Effective Factors on Quality of Life Among Iranian Patients with Rheumatoid Arthritis

PubMed Central

Karimi, Saied; Yarmohammadian, Mohammad Hossein; Shokri, Azad; Mottaghi, Payman; Qolipour, Kamal; Kordi, Ayan; Bahman Ziari, Najmeh

2013-01-01

Introduction: Rheumatoid arthritis is a chronic autoimmune disorder that leads to joint swelling, stiffness, pain and progressive joint destruction. It is a common disease with prevalence of 1% worldwide that affecting all aspects of patients’ lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life among the patients in Iran through a literature review. Methods: This study was conducted as a literature review over article published between 2000 to 2013, by using data bases comprise of Google scholar, Science Direct, Pubmed, IRANDOC, SID, Medlib, Magiran and by key words: “quality of life”, “rheumatoid arthritis”, “Iran” and their Persian equivalents. Finally 2065 articles assessed and according to the aim of the study are 11 studies synthesized. Extracted results first were summarized in Extraction Table, and then analyzed manually. Results: In reviewed articles rheumatoid arthritis patients’ quality of life was measured by using five different tools, the most important one of them was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean according included articles result was social functioning with average score of 63.4 and the lowest for physical limitation (physical role functioning) with score of 43. Overall, mean of eight dimensions was 52.47. The most important factors affecting quality of life were disease severity and pain, depression, income, educational, occupational status, married status, sign of disease, fatigue, anxiety and disease activity scores. Conclusion: The results of the study showed relatively low quality of life of rheumatoid arthritis patients in Iran. Empowering patients by participating them in service delivery process and decision making can improves quality of life and in this regard health care provider must be focused on patient self-care abilities and reinforcing this factor by training them. PMID:24167426

[Risk-adjusted assessment: late-onset infection in neonates].

PubMed

Gmyrek, Dieter; Koch, Rainer; Vogtmann, Christoph; Kaiser, Annette; Friedrich, Annette

2011-01-01

The weak point of the countrywide perinatal/neonatal quality surveillance is the ignorance of interhospital differences in the case mix of patients. As a result, this approach does not produce reliable benchmarking. The objective of this study was to adjust the result of the late-onset infection incidence of different hospitals according to their risk profile of patients by multivariate analysis. The perinatal/neonatal database of 41,055 newborns of the Saxonian quality surveillance from 1998 to 2004 was analysed. Based on 18 possible risk factors, a logistic regression model was used to develop a specific risk predictor for the quality indicator "late-onset infection". The developed risk predictor for the incidence of late-onset infection could be described by 4 of the 18 analysed risk factors, namely gestational age, admission from home, hypoxic ischemic encephalopathy and B-streptococcal infection. The AUC(ROC) value of this quality indicator was 83.3%, which demonstrates its reliability. The hospital ranking based on the adjusted risk assessment was very different from hospital rankings before this adjustment. The average correction of ranking position was 4.96 for 35 clinics. The application of the risk adjustment method proposed here allows for a more objective comparison of the incidence of the quality indicator "late onset infection" among different hospitals. Copyright © 2011. Published by Elsevier GmbH.

Analysis of ecological quality of the environment and influencing factors in China during 2005-2010.

PubMed

Wang, Shi-Xin; Yao, Yao; Zhou, Yi

2014-01-30

Since the twentieth century, China has been facing various kinds of environmental problems. It is necessary to evaluate and analyze the ecological status of the environment over China, which is of great importance for environmental protection measures. In this article, an Eco-environmental Quality Index (EQI) model is established using national remote sensing land-use data, NDVI data from MODIS and other statistical data. The model is used to evaluate the ecological status over China during 2005, 2008 and 2010, and spatial and temporal variations in EQI are analyzed during the period 2005-2010. We also discuss important factors affecting ecological quality, with special emphasis on meteorological conditions (including rainfall and sunshine duration) and anthropogenic factors (including normalized population and gross domestic product densities). The results show that, EQIs in northwestern China are generally lower than those in the southeast of the country, presenting a ladder-like distribution. There is significant correlation between EQI, rainfall and sunshine duration. Population density and GDP also have some relation to EQI. On the whole, the environmental quality results showed little variation during 2005-2010, with national average EQIs of 54.86, 55.07 and 54.43 in 2005, 2008 and 2010, respectively. During 2005-2010, differences in EQI were observed at the local level, but those at the provincial level were small.

Correlates associated with participation in physical activity among adults: a systematic review of reviews and update.

PubMed

Choi, Jaesung; Lee, Miyoung; Lee, Jong-Koo; Kang, Daehee; Choi, Ji-Yeob

2017-04-24

Understanding which factors influence participation in physical activity is important to improve the public health. The aim of the present review of reviews was to summarize and present updated evidence on personal and environmental factors associated with physical activity. MEDLINE and EMBASE were searched for reviews published up to 31 Jan. 2017 reporting on potential factors of physical activity in adults aged over 18 years. The quality of each review was appraised with the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist. The corrected covered area (CCA) was calculated as a measure of overlap for the primary publications in each review. Twenty-five articles met the inclusion criteria which reviewed 90 personal and 27 environmental factors. The average quality of the studies was moderate, and the CCA ranged from 0 to 4.3%. For personal factors, self-efficacy was shown as the strongest factor for participation in physical activity (7 out of 9). Intention to exercise, outcome expectation, perceived behavioral control and perceived fitness were positively associated with physical activity in more than 3 reviews, while age and bad status of health or fitness were negatively associated with participation in physical activity in more than 3 reviews. For environmental factors, accessibility to facilities, presence of sidewalks, and aesthetics were positively associated with participation in physical activity. The findings of this review of reviews suggest that some personal and environmental factors were related with participation in physical activity. However, an association of various factors with physical activity could not be established because of the lack of primary studies to build up the organized evidence. More studies with a prospective design should be conducted to understand the potential causes for physical activity.

The quality of health care and patient satisfaction: an exploratory investigation of the 5Qs model at some Egyptian and Jordanian medical clinics.

PubMed

Zineldin, Mosad

2006-01-01

To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently. A conceptual model including behavioural dimensions of patient-physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in-patients. Hospital C has above-average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under-average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health-care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy. The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health-care quality strategies. In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.

Evaluation of design ventilation requirements for enclosed parking facilities

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

Ayari, A.; Krarti, M.

2000-07-01

This paper proposes a new design approach to determine the ventilation requirements for enclosed parking garages. The design approach accounts for various factors that affect the indoor air quality within a parking facility, including the average CO emission rate, the average travel time, the number of cars, and the acceptable CO level within the parking garage. This paper first describes the results of a parametric analysis based on the design method that was developed. Then the design method is presented to explain how the ventilation flow rate can be determined for any enclosed parking facility. Finally, some suggestions are proposedmore » to save fan energy for ventilating parking garages using demand ventilation control strategies.« less

Comparison of Integrated Radiation Transport Models with TEPC Measurements for the Average Quality Factors in Spaceflights

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Nikjoo, Hooshang; Dicello, John F.; Pisacane, Vincent; Cucinotta, Francis A.

2007-01-01

The purpose of this work is to test our theoretical model for the interpretation of radiation data measured in space. During the space missions astronauts are exposed to the complex field of radiation type and kinetic energies from galactic cosmic rays (GCR), trapped protons, and sometimes solar particle events (SPEs). The tissue equivalent proportional counter (TEPC) is a simple time-dependent approach for radiation monitoring for astronauts on board the International Space Station. Another and a newer approach to Microdosimetry is the use of silicon-on-insulator (SOI) technology launched on the MidSTAR-1 mission in low Earth orbit (LEO). In the radiation protection practice, the average quality factor of a radiation field is defined as a function of linear energy transfer (LET), Q(sub ave)(LET). However, TEPC measures the average quality factor as a function of the lineal energy y, Q(sub ave)(y), defined as the average energy deposition in a volume divided by the average chord length of the volume. Lineal energy, y, deviates from LET due to energy straggling, delta-ray escape or entry, and nuclear fragments produced in the detector volume. Monte Carlo track structure simulation was employed to obtain the response of a TEPC irradiated with charged particle for an equivalent site diameter of 1 micron of wall-less counter. The calculated data of the energy absorption in the wall-less counter were compiled for various y values for several ion types at various discrete projectile energy levels. For the simulation of TEPC response from the mixed radiation environments inside a spacecraft, such as, Space Shuttle and International Space Station, the complete microdosimetric TEPC response, f( y, E, Z), were calculated with the Monte Carlo theoretical results by using the first order Lagrangian interpolation for a monovariate function at a given y value (y = 0.1 keV/micron 5000 keV/micron) at any projectile energy level (E = 0.01 MeV/u to 50,000 MeV/u) of each specific radiation type (Z = 1 to 28). Because the anomalous response has been observed at large event sizes in the experiment due to the escape of energy out of sensitive volume by delta-rays and the entry of delta-rays from the high-density wall into the low-density gas-volume cavity, Monte Carlo simulation was also made for the response of a walled-TEPC with wall thickness 2 mm and density 1 g/cm(exp 3). The radius of cavity was set to 6.35 mm and a gas density 7.874 x 10(exp -5) g/cm(exp 3). The response of the walled- and the wall-less counters were compared. The average quality factor Q(sub ave)(y) for trapped protons on STS-89 demonstrated the good agreement between the model calculations and flight TEPC data as shown. Using an integrated space radiation model (this includes the transport codes HZETRN and BRYNTRN, the quantum nuclear interaction model QMSFRG) and the resultant response distribution functions of walled-TEPC from Monte-Carlo track simulations, we compared model calculations with walled-TEPC measurements from NASA missions in LEO and made predictions for the lunar and the Mars missions. The Q(sub ave)(y) values for the trapped or the solar protons ranged from 1.9-2.5. This over-estimates the Qave(LET) values which ranged from 1.4-1.6. Both quantities increase with shield thickness due to nuclear fragmentation. The Q(sub ave)(LET) for the complete GCR spectra was found to be 3.5-4.5, while flight TEPCs measured 2.9-3.4 for Q(sub ave)(y). The GCR values are decreasing with the shield thickness. Our analysis for a proper interpretation of data supports the use of TEPCs for monitoring space radiation environment.

The UNO Aviation Monograph Series: The Airline Quality Rating 1998

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

1998-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline performance on combined multiple factors important to consumers. Development history and calculation details for the AQR rating system are detailed in The Airline Quality Rating 1991 issued in April, 1991, by the National Institute for Aviation Research at Wichita State University. This current report, Airline Quality Rating 1998, contains monthly Airline Quality Rating scores for 1997. Additional copies are available by contacting Wichita State University or University of Nebraska at Omaha. The Airline Quality Rating 1998 is a summary of month-by-month quality ratings for the ten major U.S. airlines operating during 1997. Using the Airline Quality Rating system and monthly performance data for each airline for the calendar year of 1997, individual and comparative ratings are reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for major airlines domestic operations for the 12 month period of 1997, and industry average results. Also, comparative Airline Quality Rating data for 1991 through 1996 are included to provide a longer term view of quality in the industry.

Effects of residential wastewater treatment systems on ground-water quality in west-central Jefferson County, Colorado

USGS Publications Warehouse

Hall, Dennis C.; Hillier, D.E.; Nickum, Edward; Dorrance, W.G.

1981-01-01

The use of residential wastewater-treatment systems in Evergreen Meadows, Marshdale, and Herzman Mesa, Colo., has degraded ground-water quality to some extent in each community. Age of community; average lot size; slope of land surface; composition, permeability, and thickness of surficial material; density, size , and orientation of fractures; maintenance of wastewater-treatment systems; and presence of animals are factors possibly contributing to the degradation of ground-water quality. When compared with effluent from aeration-treatment tanks, effluent fom septic-treatment tanks is characterized by greater biochemical oxygen demand and greater concentrations of detergents. When compared with effluent from septic-treatment tanks, effluent from aeration-treatment tanks is characterized by greater concentrations of dissolved oxygen, nitrite, nitrate, sulfate, and dissolved solids. (USGS)

Long-path measurements of pollutants and micrometeorology over Highway 401 in Toronto

NASA Astrophysics Data System (ADS)

You, Yuan; Staebler, Ralf M.; Moussa, Samar G.; Su, Yushan; Munoz, Tony; Stroud, Craig; Zhang, Junhua; Moran, Michael D.

2017-11-01

Traffic emissions contribute significantly to urban air pollution. Measurements were conducted over Highway 401 in Toronto, Canada, with a long-path Fourier transform infrared (FTIR) spectrometer combined with a suite of micrometeorological instruments to identify and quantify a range of air pollutants. Results were compared with simultaneous in situ observations at a roadside monitoring station, and with output from a special version of the operational Canadian air quality forecast model (GEM-MACH). Elevated mixing ratios of ammonia (0-23 ppb) were observed, of which 76 % were associated with traffic emissions. Hydrogen cyanide was identified at mixing ratios between 0 and 4 ppb. Using a simple dispersion model, an integrated emission factor of on average 2.6 g km-1 carbon monoxide was calculated for this defined section of Highway 401, which agreed well with estimates based on vehicular emission factors and observed traffic volumes. Based on the same dispersion calculations, vehicular average emission factors of 0.04, 0.36, and 0.15 g km-1 were calculated for ammonia, nitrogen oxide, and methanol, respectively.

A Comparison of Evaluation Metrics for Biomedical Journals, Articles, and Websites in Terms of Sensitivity to Topic

PubMed Central

Fu, Lawrence D.; Aphinyanaphongs, Yindalon; Wang, Lily; Aliferis, Constantin F.

2011-01-01

Evaluating the biomedical literature and health-related websites for quality are challenging information retrieval tasks. Current commonly used methods include impact factor for journals, PubMed’s clinical query filters and machine learning-based filter models for articles, and PageRank for websites. Previous work has focused on the average performance of these methods without considering the topic, and it is unknown how performance varies for specific topics or focused searches. Clinicians, researchers, and users should be aware when expected performance is not achieved for specific topics. The present work analyzes the behavior of these methods for a variety of topics. Impact factor, clinical query filters, and PageRank vary widely across different topics while a topic-specific impact factor and machine learning-based filter models are more stable. The results demonstrate that a method may perform excellently on average but struggle when used on a number of narrower topics. Topic adjusted metrics and other topic robust methods have an advantage in such situations. Users of traditional topic-sensitive metrics should be aware of their limitations. PMID:21419864

Outcomes associated with community-based research projects in teaching undergraduate public health.

PubMed

Bouhaimed, Manal; Thalib, Lukman; Doi, Suhail A R

2008-01-01

Community based research projects have been widely used in teaching public health in many institutions. Nevertheless, there is a paucity of information on the learning outcomes of such a teaching strategy. We therefore attempted to evaluate our experience with such a project based teaching process. The objective of this study was to evaluate the factors related to quality, impact and relevance of a 6-week student project for teaching public health in the faculty of medicine at Kuwait University. Interactive sessions familiarized students with research methods. Concurrently, they designed and completed a participatory project with a Community Medicine mentor. Questionnaires were used to assess quality, impact and relevance of the project, and these were correlated with multiple demographic, statistical and research design factors. We evaluated a total of 104 projects that were completed during the period of September 2001 to June 2006. Three dimensions of outcome were assessed: quality; impact and relevance. The average (mean + SE; maximum of 5) scores across all projects were 2.6 + 0.05 (range 1.7-3.7) for quality, 2.8 + 0.06 (range 1.7-4.3) for impact and 3.3 + 0.08 (range 1.3-5) for relevance. The analysis of the relationship between various factors and the scores on each dimension of assessment revealed that various factors were associated with improved quality, impact or relevance to public health practice. We conclude that use of more objective measurement instruments with better a priori conceptualization along with appropriate use of statistics and a more developed study design were likely to result in more meaningful research outcomes. We also found that a biostatistics or epidemiology mentor improved the research outcome.

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org

Purpose: To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Methods: Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according tomore » measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (E{sub avg}) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusions: The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.« less

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

Jones, A; Pasciak, A; Wagner, L

Purpose: To evaluate the sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams (SMPB) to be used in measuring the DRIP. Methods: A series of clinical and factorial Monte Carlo simulations were conducted to determine the shape of the scattered X-ray spectra incident on the operator in different clinical fluoroscopy scenarios. Two clinical evaluations studied the sensitivity of the scattered spectrum to gantry angle and patient size while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial evaluationsmore » studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size and beam quality for constant technical factors. Average energy was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affected the scattered spectrum indirectly through their effects on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in interventional cardiology, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusion: The scattered spectrum striking the operator in fluoroscopy, and therefore the DRIP, is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle. These results will help determine an appropriate set of SMPB to be used for measuring the DRIP.« less

Improve regional distribution and source apportionment of PM2.5 trace elements in China using inventory-observation constrained emission factors.

PubMed

Ying, Qi; Feng, Miao; Song, Danlin; Wu, Li; Hu, Jianlin; Zhang, Hongliang; Kleeman, Michael J; Li, Xinghua

2018-05-15

Contributions to 15 trace elements in airborne particulate matter with aerodynamic diameters <2.5μm (PM 2.5 ) in China from five major source sectors (industrial sources, residential sources, transportation, power generation and windblown dust) were determined using a source-oriented Community Multiscale Air Quality (CMAQ) model. Using emission factors in the composite speciation profiles from US EPA's SPECIATE database for the five sources leads to relatively poor model performance at an urban site in Beijing. Improved predictions of the trace elements are obtained by using adjusted emission factors derived from a robust multilinear regression of the CMAQ predicted primary source contributions and observation at the urban site. Good correlations between predictions and observations are obtained for most elements studied with R>0.5, except for crustal elements Al, Si and Ca, particularly in spring. Predicted annual and seasonal average concentrations of Mn, Fe, Zn and Pb in Nanjing and Chengdu are also consistently improved using the adjusted emission factors. Annual average concentration of Fe is as high as 2.0μgm -3 with large contributions from power generation and transportation. Annual average concentration of Pb reaches 300-500ngm -3 in vast areas, mainly from residential activities, transportation and power generation. The impact of high concentrations of Fe on secondary sulfate formation and Pb on human health should be evaluated carefully in future studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Validation of a computerized technique for automatically tracking and measuring the inferior vena cava in ultrasound imagery.

PubMed

Bellows, Spencer; Smith, Jordan; Mcguire, Peter; Smith, Andrew

2014-01-01

Accurate resuscitation of the critically-ill patient using intravenous fluids and blood products is a challenging, time sensitive task. Ultrasound of the inferior vena cava (IVC) is a non-invasive technique currently used to guide fluid administration, though multiple factors such as variable image quality, time, and operator skill challenge mainstream acceptance. This study represents a first attempt to develop and validate an algorithm capable of automatically tracking and measuring the IVC compared to human operators across a diverse range of image quality. Minimal tracking failures and high levels of agreement between manual and algorithm measurements were demonstrated on good quality videos. Addressing problems such as gaps in the vessel wall and intra-lumen speckle should result in improved performance in average and poor quality videos. Semi-automated measurement of the IVC for the purposes of non-invasive estimation of circulating blood volume poses challenges however is feasible.

[Quality of professional life and musculoskeletal disorders in nurses].

PubMed

Rodarte-Cuevas, Lilia; Araujo-Espino, Roxana; Trejo-Ortiz, Perla María; González-Tovar, José

To characterize the conditions of quality of working life, the presence of muscle- skeletal disorders and the association between these variables in nursing staff of a public hospital in Zacatecas, Mexico. A cross-sectional study with descriptive-correlational scope was designed. A stratified random sampling per shift was used in 107 cases. The Questionnaire Professional Quality of Life (CVP-35) was applied as well as the Nordic Questionnaire Standardized for musculoskeletal pain and work-related risk factors questionnaire. The quality of working life gained an average of 55.62 (SD=13.57), the intrinsic motivation was the best rated component with (M=75.06, SD=18.44), contrary to managerial support that got the lowest scores with (M=43.74, SD=21.71). The presence of risk factors in the development work of musculoskeletal problems obtained a mean of 50.10 (SD=26.69). The main musculoskeletal disorders occurred in the neck region, lumbar spine and knees with 42.1% for each one. The quality of working life decreased in the presence of muscle-skeletal problems in the lumbar region with (-0.188, p≤.050), dorsal (-0.206, p≤.050), neck (-0.175, p≤.050) and knees (-0.220, p≤.010). It is necessary to improve the working conditions of nurses to reduce the presence of musculoskeletal problems and improve their quality of working life. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

An adaptive large neighborhood search procedure applied to the dynamic patient admission scheduling problem.

PubMed

Lusby, Richard Martin; Schwierz, Martin; Range, Troels Martin; Larsen, Jesper

2016-11-01

The aim of this paper is to provide an improved method for solving the so-called dynamic patient admission scheduling (DPAS) problem. This is a complex scheduling problem that involves assigning a set of patients to hospital beds over a given time horizon in such a way that several quality measures reflecting patient comfort and treatment efficiency are maximized. Consideration must be given to uncertainty in the length of stays of patients as well as the possibility of emergency patients. We develop an adaptive large neighborhood search (ALNS) procedure to solve the problem. This procedure utilizes a Simulated Annealing framework. We thoroughly test the performance of the proposed ALNS approach on a set of 450 publicly available problem instances. A comparison with the current state-of-the-art indicates that the proposed methodology provides solutions that are of comparable quality for small and medium sized instances (up to 1000 patients); the two approaches provide solutions that differ in quality by approximately 1% on average. The ALNS procedure does, however, provide solutions in a much shorter time frame. On larger instances (between 1000-4000 patients) the improvement in solution quality by the ALNS procedure is substantial, approximately 3-14% on average, and as much as 22% on a single instance. The time taken to find such results is, however, in the worst case, a factor 12 longer on average than the time limit which is granted to the current state-of-the-art. The proposed ALNS procedure is an efficient and flexible method for solving the DPAS problem. Copyright © 2016 Elsevier B.V. All rights reserved.

Signal loss during fetal heart rate monitoring using maternal abdominal surface electrodes between 28 and 42 weeks of pregnancy.

PubMed

Fuchs, Tomasz; Pomorski, Michał; Grobelak, Krzysztof; Tomiałowicz, Marek; Zimmer, Mariusz

2014-01-01

Fetal electrocardiography is one of the methods for monitoring the well-being of the fetus. Signal loss limits the proper interpretation of electrocardiogram traces. The aim of this study was to assess the average signal loss in non-invasive abdominal fetal electrocardiogram (fECG) monitoring using the KOMPOREL fetal monitoring system (ITAM, Zabrze, Poland) in women between 28 and 42 week of pregnancy. The results were compared to FIGO (International Federation of Gynaecology and Obstetric) and DGGG (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe e.V.) recommendations concerning fetal heart monitoring. The correlation between fetal ECG signal quality, week of pregnancy and patient BMI was evaluated. 773 pregnant women, hospitalized and diagnosed in the Department of Gynecology and Obstetrics, Wroclaw Medical University, underwent 30 min of abdominal fECG recordings using the KOMPOREL fetal monitoring system. The average signal loss in abdominal fECG monitoring in the study group was 32%. FIGO recommendations describe an acceptable fetal signal loss of 20%. In our study, 46% (357/773) of the recordings were up to FIGO standards, with fetal heart rate success rates above 80%. According to DGGG guidelines, with acceptable fetal signal loss of 15%, only 39% (303/773) of the recordings could be assessed as accurate. No correlation between fECG signal quality, week of pregnancy and patient BMI was proved. The average signal loss in abdominal fECG monitoring in our study group was 32%. Low fECG signal quality may constitute a potentially limiting factor of the described fetal heart monitoring system. No relationship between fECG signal quality, week of pregnancy and patient BMI was proved.

Partitioning the grapevine growing season in the Douro Valley of Portugal: accumulated heat better than calendar dates

NASA Astrophysics Data System (ADS)

Real, António C.; Borges, José; Cabral, J. Sarsfield; Jones, Gregory V.

2015-08-01

Temperature and water status profiles during the growing season are the most important factors influencing the ripening of wine grapes. To model weather influences on the quality and productivity of the vintages, it is necessary to partition the growing season into smaller growth intervals in which weather variables are evaluated. A significant part of past and ongoing research on the relationships between weather and wine quality uses calendar-defined intervals to partition the growing season. The phenology of grapevines is not determined by calendar dates but by several factors such as accumulated heat. To examine the accuracy of different approaches, this work analyzed the difference in average temperature and accumulated precipitation using growth intervals with boundaries defined by means of estimated historical phenological dates and intervals defined by means of accumulated heat or average calendar dates of the Douro Valley of Portugal. The results show that in situations where there is an absence of historical phenological dates and/or no available data that makes the estimation of those dates possible, it is more accurate to use grapevine heat requirements than calendar dates to define growth interval boundaries. Additionally, we analyzed the ability of the length of growth intervals with boundaries based on grapevine heat requirements to differentiate the best from the worst vintage years with the results showing that vintage quality is strongly related to the phenological events. Finally, we analyzed the variability of growth interval lengths in the Douro Valley during 1980-2009 with the results showing a tendency for earlier grapevine physiology.

Source apportionment of heavy metals and ionic contaminants in rainwater tanks in a subtropical urban area in Australia.

PubMed

Huston, R; Chan, Y C; Chapman, H; Gardner, T; Shaw, G

2012-03-15

Due to prolonged droughts in recent years, the use of rainwater tanks in urban areas has increased in Australia. In order to apportion sources of contribution to heavy metal and ionic contaminants in rainwater tanks in Brisbane, a subtropical urban area in Australia, monthly tank water samples (24 sites, 31 tanks) and concurrent bulk deposition samples (18 sites) were collected during mainly April 2007-March 2008. The samples were analysed for acid-soluble metals, soluble anions, total inorganic carbon and total organic carbon, and characteristics such as total solid and pH. The Positive Matrix Factorisation model, EPA PMF 3.0, was used to apportion sources of contribution to the contaminants. Four source factors were identified for the bulk deposition samples, including 'crustal matter/sea salt', 'car exhausts/road side dust', 'industrial dust' and 'aged sea salt/secondary aerosols'. For the tank water samples, apart from these atmospheric deposition related factors which contributed in total to 65% of the total contaminant concentration on average, another six rainwater collection system related factors were identified, including 'plumbing', 'building material', 'galvanizing', 'roofing', 'steel' and 'lead flashing/paint' (contributing in total to 35% of the total concentration on average). The Australian Drinking Water Guideline for lead was exceeded in 15% of the tank water samples. The collection system related factors, in particular the 'lead flashing/paint' factor, contributed to 79% of the lead in the tank water samples on average. The concentration of lead in tank water was found to vary with various environmental and collection system factors, in particular the presence of lead flashing on the roof. The results also indicated the important role of sludge dynamics inside the tank on the quality of tank water. Copyright © 2011 Elsevier Ltd. All rights reserved.

The effective factors on library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences.

PubMed

Ashrafi-Rizi, Hasan; Sajad, Maryam Sadat; Rahmani, Sedigheh; Bahrami, Susan; Papi, Ahmad

2014-01-01

The efficient use of libraries can be an important factor in determining the educational quality of Universities. Therefore, investigation and identification of factors affecting library anxiety becomes increasingly necessary. The purpose of this research is to determine the factors effecting library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences. This was an applied survey research using Bostick's Library Anxiety questionnaire as data gathering tool. The statistical population consisted of all students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences (15011 students) with the sample size of 375 using stratified random sampling. The validity of data gathering tool was confirmed by experts in the library and information science and its reliability was determined by Cronbach's alpha (r = 0.92). Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (t-test and ANOVA) were used for data analysis using SPSS 18 software. Findings showed that the mean of library anxiety score was 2.68 and 2.66 for students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences respectively which is above average (2.5). Furthermore, age and gender had no meaningful effect on the library anxiety of students of Isfahan University of Medical Sciences, but gender had a meaningful effect on library anxiety of students of Shiraz University of Medical Sciences while age had no such effect. The results showed that the mean of factors effecting library anxiety in students of Isfahan University of Medical Sciences and students of Shiraz University of Medical Sciences is higher than average and therefore not satisfactory and only factors relating to feeling comfortable in the library is lower than average and somewhat satisfactory.

Global effects of income and income inequality on adult height and sexual dimorphism in height.

PubMed

Bogin, Barry; Scheffler, Christiane; Hermanussen, Michael

2017-03-01

Average adult height of a population is considered a biomarker of the quality of the health environment and economic conditions. The causal relationships between height and income inequality are not well understood. We analyze data from 169 countries for national average heights of men and women and national-level economic factors to test two hypotheses: (1) income inequality has a greater association with average adult height than does absolute income; and (2) neither income nor income inequality has an effect on sexual dimorphism in height. Average height data come from the NCD-RisC health risk factor collaboration. Economic indicators are derived from the World Bank data archive and include gross domestic product (GDP), Gross National Income per capita adjusted for personal purchasing power (GNI_PPP), and income equality assessed by the Gini coefficient calculated by the Wagstaff method. Hypothesis 1 is supported. Greater income equality is most predictive of average height for both sexes. GNI_PPP explains a significant, but smaller, amount of the variation. National GDP has no association with height. Hypothesis 2 is rejected. With greater average adult height there is greater sexual dimorphism. Findings support a growing literature on the pernicious effects of inequality on growth in height and, by extension, on health. Gradients in height reflect gradients in social disadvantage. Inequality should be considered a pollutant that disempowers people from the resources needed for their own healthy growth and development and for the health and good growth of their children. © 2017 Wiley Periodicals, Inc.

Perceptions and Efficacy of Flight Operational Quality Assurance (FOQA) Programs Among Small-scale Operators

DTIC Science & Technology

2012-01-01

regressive Integrated Moving Average ( ARIMA ) model for the data, eliminating the need to identify an appropriate model through trial and error alone...06 .11 13.67 16 .62 16 .14 .11 8.06 16 .95 * Based on the asymptotic chi-square approximation. 8 In general, ARIMA models address three...performance standards and measurement processes and a prevailing climate of organizational trust were important factors. Unfortunately, uneven

Strategies to Increase Adenoma Detection Rates.

PubMed

Brand, Eelco C; Wallace, Michael B

2017-03-01

The adenoma detection rate (ADR), i.e., the proportion of average risk patients with at least one adenoma detected during screening colonoscopy, is inversely associated with the development of interval colorectal cancer. Increasing the ADR is therefore an important proxy for increase in quality and efficacy of (screening) colonoscopy. Several potentially modifiable factors, such as, procedural and technological factors, and quality improvement programs, and their effect on the ADR will be reviewed. Procedural factors, such as, bowel preparation, withdrawal time, and position changes of the patient are associated with the ADR. While the relation of others, such as inspection during insertion, use of antispasmodic agents, and second inspection in the proximal colon, with the ADR is not completely clear. Many new colonoscopy technologies have been evaluated over recent years and are still under evaluation, but no unequivocal positive effect on the ADR has been observed in randomized trials that have mostly been performed by experienced endoscopists with high baseline ADRs. Several quality improvement programs have been evaluated and seem to have a positive effect on endoscopists' ADR. Increase in ADR is important for the protective benefit of colonoscopy. There are now extensive methods to measure, benchmark, and improve ADR but increased awareness of these is critical. We have provided an overview of potential factors that can be used to increase personal ADRs in every day practice.

Factors and values of willingness to pay for improved construction waste management--a perspective of Malaysian contractors.

PubMed

Begum, Rawshan Ara; Siwar, Chamhuri; Pereira, Joy Jacqueline; Jaafar, Abdul Hamid

2007-01-01

Malaysia is facing an increase in the generation of waste and of accompanying problems with the disposal of this waste. In the last two decades, extensive building and infrastructure development projects have led to an increase in the generation of construction waste material. The construction industry has a substantial impact on the environment, and its environmental effects are in direct relation to the quality and quantity of the waste it generates. This paper discusses general characteristics of the construction contractors, the contractors' willingness to pay (WTP) for improved construction waste management, determining factors which affect the amount of their willingness to pay, and suggestions and policy implications in the perspective of construction waste management in Malaysia. The data in this study is based on contractors registered with the construction industry development board (CIDB) of Malaysia. Employing the open ended contingent valuation method, the study assessed the contractors' average maximum WTP for improved construction waste management to be RM69.88 (1US$=3.6 RM) per tonne of waste. The result shows that the average maximum WTP is higher for large contractors than for medium and small contractors. The highest average maximum WTP value is RM88.00 for Group A (large contractors) RM78.25 for Group B (medium-size contractors) and RM55.80 for Group C (small contractors). One of the contributions of this study is to highlight the difference of CIDB registration grade in the WTP for improved construction waste management. It is found that contractors' WTP for improved waste collection and disposal services increases with the increase in contractors' current paid up capital. The identified factors and determinants of the WTP will assist the formulation of appropriate policies in addressing the construction waste problem in Malaysia and indirectly improve the quality of construction in the country.

The UNO Aviation Monograph Series: The Airline Quality Rating 1997

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

1997-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline performance on combined multiple factors important to consumers. Development history and calculation details for the AQR rating system are detailed in The Airline Quality Rating 1991 issued in April, 1991, by the National Institute for Aviation Research at Wichita State University. This current report, Airline Rating 1997, contains monthly Airline Quality Rating scores for 1996. Additional copies are available by contacting Wichita State University or the University of Nebraska at Omaha. The Airline Quality Rating (AQR) 1997 is a summary of a month-by-month quality ratings for the nine major domestic U.S. airlines operating during 1996. Using the Airline Quality Rating system and monthly performance data for each airline for the calendar year of 1996, individual and comparative ratings are reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for major domestic airlines across the 12 month period of 1996, and industry average results. Also comparative Airline Quality Rating data for 1991 through 1995 are included to provide a longer term view of quality in the industry.

Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents.

PubMed

Auvinen, Juha P; Tammelin, Tuija H; Taimela, Simo P; Zitting, Paavo J; Järvelin, Marjo-Riitta; Taanila, Anja M; Karppinen, Jaro I

2010-04-01

The quantity and quality of adolescents' sleep may have changed due to new technologies. At the same time, the prevalence of neck, shoulder and low back pain has increased. However, only a few studies have investigated insufficient quantity and quality of sleep as possible risk factors for musculoskeletal pain among adolescents. The aim of the study was to assess whether insufficient quantity and quality of sleep are risk factors for neck (NP), shoulder (SP) and low back pain (LBP). A 2-year follow-up survey among adolescents aged 15-19 years was (2001-2003) carried out in a subcohort of the Northern Finland Birth Cohort 1986 (n = 1,773). The outcome measures were 6-month period prevalences of NP, SP and LBP. The quantity and quality of sleep were categorized into sufficient, intermediate or insufficient, based on average hours spent sleeping, and whether or not the subject suffered from nightmares, tiredness and sleeping problems. The odds ratios (OR) and 95% confidence intervals (CI) for having musculoskeletal pain were obtained through logistic regression analysis, adjusted for previously suggested risk factors and finally adjusted for specific pain status at 16 years. The 6-month period prevalences of neck, shoulder and low back pain were higher at the age of 18 than at 16 years. Insufficient quantity or quality of sleep at 16 years predicted NP in both girls (OR 4.4; CI 2.2-9.0) and boys (2.2; 1.2-4.1). Similarly, insufficient sleep at 16 years predicted LBP in both girls (2.9; 1.7-5.2) and boys (2.4; 1.3-4.5), but SP only in girls (2.3; 1.2-4.4). After adjustment for pain status, insufficient sleep at 16 years predicted significantly only NP (3.2; 1.5-6.7) and LBP (2.4; 1.3-4.3) in girls. Insufficient sleep quantity or quality was an independent risk factor for NP and LBP among girls. Future studies should test whether interventions aimed at improving sleep characteristics are effective in the prevention and treatment of musculoskeletal pain.

Correlates of a Good Death and the Impact of Hospice Involvement: Findings from the National Survey of Households Affected by Cancer

PubMed Central

Cagle, John G.; Pek, Jolynn; Clifford, Maggie; Guralnik, Jack; Zimmerman, Sheryl

2017-01-01

Purpose Knowing how to improve the dying experience for patients with end-stage cancer is essential for cancer professionals. However, there is little evidence on the relationship between clinically relevant factors and quality of death. Also, while hospice has been linked with improved outcomes, our understanding of factors that contribute to a “good death” when hospice is involved remains limited. This study (1) identified correlates of a good death; and, (2) provided evidence on the impact of hospice on quality of death. Methods Using data from a survey of US households affected by cancer (N=930, response rate 51%), we fit regression models with a subsample of 158 respondents who had experienced the death of a family member with cancer. Measures included quality of death (good/bad) and clinically relevant factors including: hospice involvement, symptoms during treatment, whether wishes were followed, provider knowledge/expertise and compassion. Results Respondents were 60% female, 89% White, and averaged 57 years old. Decedents were most often a respondent's spouse (46%). While 73% of respondents reported a good death, Hispanics were less likely to experience good death (p=.007). Clinically relevant factors, including hospice, were associated with good death (p<.05) -- an exception being whether the physician said the cancer was curable/fatal. With adjustments, perceptions of provider knowledge/expertise was the only clinical factor that remained associated with good death. Conclusions Enhanced provider training/communication, referrals to hospice and greater attention to symptom management may facilitate improved quality of dying. Additionally, the cultural relevance of the concept of a “good death” warrants further research. PMID:25194877

Alignment error envelopes for single particle analysis.

PubMed

Jensen, G J

2001-01-01

To determine the structure of a biological particle to high resolution by electron microscopy, image averaging is required to combine information from different views and to increase the signal-to-noise ratio. Starting from the number of noiseless views necessary to resolve features of a given size, four general factors are considered that increase the number of images actually needed: (1) the physics of electron scattering introduces shot noise, (2) thermal motion and particle inhomogeneity cause the scattered electrons to describe a mixture of structures, (3) the microscope system fails to usefully record all the information carried by the scattered electrons, and (4) image misalignment leads to information loss through incoherent averaging. The compound effect of factors 2-4 is approximated by the product of envelope functions. The problem of incoherent image averaging is developed in detail through derivation of five envelope functions that account for small errors in 11 "alignment" parameters describing particle location, orientation, defocus, magnification, and beam tilt. The analysis provides target error tolerances for single particle analysis to near-atomic (3.5 A) resolution, and this prospect is shown to depend critically on image quality, defocus determination, and microscope alignment. Copyright 2001 Academic Press.

Impact of wildfires on the air quality of Mexico City, 1992-1999.

PubMed

Bravo, A H; Sosa, E R; Sánchez, A P; Jaimes, P M; Saavedra, R M I

2002-01-01

Wildfires in Mexico increased in 1998, compared to information for the last 6 years. The average number of wildfires in the Mexico City Metropolitan Area (MCMA) for this year (1998) were 58% (1916 events) more events than the 1992-1997 (average cases 1217 events). Mexico City affected area corresponds to 1.3% of the national affected area. The purpose of this paper is to evaluate the impact on the particles air quality due to the wildfire emissions at the MCMA and surrounding areas. Using the corresponding US EPA emission factors for wildfires, the tons of particulate matter, nitrogen oxides, carbon monoxide, and total hydrocarbons emitted by this source for the MCMA case were obtained. The calculated emissions during wildfires were correlated with the levels of particles present in the atmosphere. A comparison of the concentration levels of particles, both as PM10 as well as TSP, were made for the years 1992-1998, during wet and dry season, being March, April, and May the critical months due to the presence of wildfires. A good correlation is observed between particulate wildfire emissions and particulate air quality, being stronger for TSP. A clear impact on the particles air quality due to the increase of wildfires in 1998, is observed when this year is compared with 1997, presenting an increment of 200-300% for some monitoring stations.

Risk factors for low vision related functioning in the Mycotic Ulcer Treatment Trial: a randomised trial comparing natamycin with voriconazole.

PubMed

Rose-Nussbaumer, Jennifer; Prajna, N Venkatesh; Krishnan, Tiruvengada; Mascarenhas, Jeena; Rajaraman, Revathi; Srinivasan, Muthiah; Raghavan, Anita; Oldenburg, Catherine E; O'Brien, Kieran S; Ray, Kathryn J; Porco, Travis C; McLeod, Stephen D; Acharya, Nisha R; Keenan, Jeremy D; Lietman, Thomas M

2016-07-01

The Mycotic Ulcer Treatment Trial I (MUTT I) was a double-masked, multicentre, randomised controlled trial, which found that topical natamycin is superior to voriconazole for the treatment of filamentous fungal corneal ulcers. In this study, we determine risk factors for low vision-related quality of life in patients with fungal keratitis. The Indian visual function questionnaire (IND-VFQ) was administered to MUTT I study participants at 3 months. Associations between patient and ulcer characteristics and IND-VFQ subscale score were assessed using generalised estimating equations. 323 patients were enrolled in the trial, and 292 (90.4%) completed the IND-VFQ at 3 months. Out of a total possible score of 100, the average VFQ score for all participants was 81.3 (range 0-100, SD 23.6). After correcting for treatment arm, each logMAR line of worse baseline visual acuity in the affected eye resulted in an average 1.2 points decrease on VFQ at 3 months (95% CI -1.8 to 0.6, p<0.001). Those who required therapeutic penetrating keratoplasty had an average of 25.2 points decrease on VFQ after correcting for treatment arm (95% CI -31.8 to -18.5, p<0.001). Study participants who were unemployed had on average 28.5 points decrease on VFQ (95% CI -46.9 to -10.2, p=0.002) after correcting for treatment arm. Monocular vision loss from corneal opacity due to fungal keratitis reduced vision-related quality of life. Given the relatively high worldwide burden of corneal opacity, improving treatment outcomes of corneal infections should be a public health priority. Clinicaltrials.gov Identifier: NCT00996736. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Identification and prediction of health-related quality of life trajectories after a prostate cancer diagnosis.

PubMed

Farris, Megan S; Kopciuk, Karen A; Courneya, Kerry S; McGregor, S Elizabeth; Wang, Qinggang; Friedenreich, Christine M

2017-04-01

The aim of our study was to identify physical and mental health-related quality of life (HRQoL) trajectories after a prostate cancer diagnosis and systematically characterize trajectories by behaviours and prognostic factors. Prostate cancer survivors (n = 817) diagnosed between 1997 and 2000 were recruited between 2000 and 2002 into a prospective repeated measurements study. Behavioural/prognostic data were collected through in-person interviews and questionnaires. HRQoL was collected at three post-diagnosis time-points, approximately 2 years apart using the Short Form (SF)-36 validated questionnaire. To identify physical and mental HRQoL trajectories, group-based trajectory modelling was undertaken. Differences between groups were evaluated by assessing influential dropouts (mortality/poor health), behavioural/prognostic factors at diagnosis or during the follow-up. Three trajectories of physical HRQoL were identified including: average-maintaining HRQoL (32.2%), low-declining HRQoL (40.5%) and very low-maintaining HRQoL (27.3%). In addition, three trajectories for mental HRQoL were identified: average-increasing HRQoL (66.5%), above average-declining HRQoL (19.7%) and low-increasing HRQoL (13.8%). In both physical and mental HRQoL, dropout from mortality/poor health differed between trajectories, thus confirming HRQoL and mortality were related. Furthermore, increased Charlson comorbidity index score was consistently associated with physical and mental HRQoL group membership relative to average maintaining groups, while behaviours such as time-varying physical activity was associated with physical HRQoL trajectories but not mental HRQoL trajectories. It was possible to define three trajectories of physical and mental HRQoL after prostate cancer. These data provide insights regarding means for identifying subgroups of prostate cancer survivors with lower or declining HRQoL after diagnosis whom could be targeted for interventions aimed at improving HRQoL. © 2016 UICC.

Comparisons of Integrated Radiation Transport Models with Microdosimetry Data in Spaceflight

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Nikjoo, H.; Kim, M. Y.; Hu, X.; Dicello, J. F.; Pisacane, V. L.

2006-01-01

Astronauts are exposed to galactic cosmic rays (GCR), trapped protons, and possible solar particle events (SPE) during spaceflight. For such complicated mixtures of radiation types and kinetic energies, tissue equivalent proportional counters (TEPC's) represent a simple time-dependent approach for radiation monitoring. Of interest in radiation protection is the average quality factor of a radiation field defined as a function of linear energy transfer, LET, Q(sub ave)(LET). However TEPC's measure the average quality factors as a function of lineal energy (y), Q(sub ave)(y) defined as the average energy deposition in a volume divided by the average chord length of the volume. Lineal energy, y deviates from LET due to energy straggling, delta-ray escape or entry, and nuclear fragments produced in the detector. Using integrated space radiation models that includes the transport code HZETRN/BRYNTRN, the quantum nuclear interaction model, QMSFRG, and results from Monte-Carlo track simulations of TEPC's response to ions, we consider comparisons of model calculations to TEPC results from NASA missions in low Earth orbit and make predictions for lunar and Mars missions. Good agreement between the model and measured spectra from past NASA missions is found. A finding of this work is that TEPC's values for trapped or solar protons of Q(sub ave)(y) range from 1.9-2.5, overestimating Q(sub ave)(LET), which ranges from 1.4-1.6 with both quantities increasing with shielding depth due to nuclear secondaries Comparisons for the complete GCR spectra show that Q(sub ave)(LET) for GCR is approximately 3.5-4.5, while TEPC's measure 2.9-3.4 for Q(sub ave)(y) with the GCR values decreasing with depth as heavy ions are absorbed in shielding material. Our results support the use of TEPC's for space radiation environmental monitoring when computational analysis is used for proper data interpretation.

Methodological issues in genetic association studies of inherited thrombophilia: original report of recent practice.

PubMed

Simundic, Ana-Maria; Nikolac, Nora; Topic, Elizabeta

2009-01-01

The aims of this article are to evaluate the methodological quality of genetic association studies on the inherited thrombophilia published during 2003 to 2005, to identify the most common mistakes made by authors of those studies, and to examine if overall quality of the article correlates with the quality of the journal. Articles were evaluated by 2 independent reviewers using the checklist of 16 items. A total of 58 eligible studies were identified. Average total score was 7.59 +/- 1.96. Total article score did not correlate with the journal impact factor (r = 0.3971; 95% confidence interval [CI], 0.1547-0.5944, P = .002). Total score did not differ across years (P = .624). Finally, it is concluded that methodological quality of genetic association studies is not optimal, and it does not depend on the quality of the journal. Journals should adopt methodological criteria for reporting the genetic association studies, and editors should encourage authors to strictly adhere to those criteria.

The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study.

PubMed

Martínez Steele, Euridice; Popkin, Barry M; Swinburn, Boyd; Monteiro, Carlos A

2017-02-14

Recent population dietary studies indicate that diets rich in ultra-processed foods, increasingly frequent worldwide, are grossly nutritionally unbalanced, suggesting that the dietary contribution of these foods largely determines the overall nutritional quality of contemporaneous diets. Yet, these studies have focused on individual nutrients (one at a time) rather than the overall nutritional quality of the diets. Here we investigate the relationship between the energy contribution of ultra-processed foods in the US diet and its content of critical nutrients, individually and overall. We evaluated dietary intakes of 9,317 participants from 2009 to 2010 NHANES aged 1+ years. Food items were classified into unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. First, we examined the average dietary content of macronutrients, micronutrients, and fiber across quintiles of the energy contribution of ultra-processed foods. Then, we used Principal Component Analysis (PCA) to identify a nutrient-balanced dietary pattern to enable the assessment of the overall nutritional quality of the diet. Linear regression was used to explore the association between the dietary share of ultra-processed foods and the balanced-pattern PCA factor score. The scores were thereafter categorized into tertiles, and their distribution was examined across ultra-processed food quintiles. All models incorporated survey sample weights and were adjusted for age, sex, race/ethnicity, family income, and educational attainment. The average content of protein, fiber, vitamins A, C, D, and E, zinc, potassium, phosphorus, magnesium, and calcium in the US diet decreased significantly across quintiles of the energy contribution of ultra-processed foods, while carbohydrate, added sugar, and saturated fat contents increased. An inverse dose-response association was found between ultra-processed food quintiles and overall dietary quality measured through a nutrient-balanced-pattern PCA-derived factor score characterized by being richer in fiber, potassium, magnesium and vitamin C, and having less saturated fat and added sugars. This study suggests that decreasing the dietary share of ultra-processed foods is a rational and effective way to improve the nutritional quality of US diets.

Psychometric testing of the Spiritual Well-Being Scale-Mandarin version in Taiwanese cancer patients.

PubMed

Tang, Woung-Ru; Kao, Chen-Yi

2017-06-01

The spiritual well-being of terminally ill cancer patients is an important indicator of the quality of their lives and of the quality of hospice care, but no validated tools are available for assessing this indicator in Taiwan. The present cross-sectional study validated the Spiritual Well-Being Scale-Mandarin version (SWBS-M) by testing its psychometric properties in 243 cancer patients from five teaching hospitals throughout Taiwan. Construct validity was tested by factor analysis and hypothesis testing. Patients' spiritual well-being and quality of life were assessed using the SWBS-M and the McGill Quality of Life Questionnaire (MQoL), respectively. Overall, the SWBS-M had an internal consistency/reliability of 0.89. Exploratory factor analysis showed that the SWBS-M had an underlying two-factor structure, explaining 46.94% of the variance. SWBS-M scores correlated moderately with MQoL scores (r = 0.48, p < 0.01). Terminally ill cancer patients' spiritual well-being was inversely related to their average pain level during the previous 24 hours (r = -0.183, p = 0.006). Cancer patients' spiritual well-being also differed significantly with their experience of pain (t = -3.67, p < 0.001); terminally ill cancer patients with pain during the previous 24 hours had a lower sense of spiritual well-being than those without pain. Our findings support a two-factor model for the SWBS-M in terminally ill Taiwanese cancer patients. We recommend testing the psychometric properties of the SWBS-M in different patient populations to verify its factorial structure in other Asian countries.

Quality management and job related factors predicting satisfaction of dental clinic staff in Estonia.

PubMed

Merisalu, Eda; Männik, Georg; Põlluste, Kaja

2014-01-01

The aim of the study was to explore the role of managerial style, work environment factors and burnout in determining job satisfaction during the implementation of quality improvement activities in a dental clinic. Quantitative research was carried out using a prestructured anonymous questionnaire to survey 302 respondents in Kaarli Dental Clinic, Estonia. Dental clinic staff assessed job satisfaction, managerial style, work stress and burnout levels through the implementation period of ISO 9000 quality management system in 2003 and annually during 2006-2009. Binary logistic regression was used to explain the impact of satisfaction with management and work organisation, knowledge about managerial activities, work environment and psychosocial stress and burnout on job satisfaction. The response rate limits were between 60% and 89.6%. Job satisfaction increased significantly from 2003 to 2006 and the percentage of very satisfied staff increased from 17 to 38 (p<0.01) over this period. In 2007, the proportion of very satisfied people dropped to 21% before increasing again in 2008-2009 (from 24% to 35%). Binary logistic regression analysis resulted in a model that included five groups of factors: managerial support, information about results achieved and progress to goals, work organisation and working environment, as well as factors related to career, security and planning. The average scores of emotional exhaustion showed significant decrease, correlating negatively with job satisfaction (p<0.05). The implementation of quality improvement activities in the Kaarli Dental Clinic has improved the work environment by decreasing burnout symptoms and increased job satisfaction in staff.

Health-related quality of life in epilepsy patients receiving anti-epileptic drugs at National Referral Hospitals in Uganda: a cross-sectional study

PubMed Central

2014-01-01

Background Epilepsy is a devastating disorder that impacts on patients’ quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs. Methods A total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL. Results Just about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0–100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL. Conclusion The HRQOL for epilepsy patients on AEDs is very low. The predictors of low HRQOL were socio factors (marital status, education) and drug side effects, frequency of seizure, and type of therapy. PMID:24725904

Effects of soil conditions on survival and growth of black willow cuttings.

PubMed

Schaff, Steven D; Pezeshki, S Reza; Shields, F Douglas

2003-06-01

Current streambank restoration efforts focus on providing bank stability, enhancing water quality, and improving woody habitat using native vegetation rather than traditional engineering techniques. However, in most cases harsh site conditions limit restoration success. A two-year field study was conducted at Twentymile Creek, in northern Mississippi, investigating edaphic factors governing the survival of black willow (Salix nigra) cuttings used for streambank restoration. Low height growth, above-ground biomass production, and average leaf area were observed in willow cuttings grown in plots subjected to moisture deficits. However, sediment texture emerged as the dominant factor determining willow post growth, health, and survival. Shoot biomass, leaf biomass, and total above-ground biomass were 15-, 10-, and 14-fold greater for large willow cuttings (posts) grown in plots with sandy sediments relative to those grown in plots with similar moisture and soil redox potential but with silt and clay sediments. Average leaf size, average leaf mass and specific leaf area were all lower in fine textured plots. Under moisture conditions present at our sites, coarse-grained sediment (sand) was more conducive to willow growth, biomass production, and survival than were fine-grained sediments (silt/clay). Our results strongly suggest that soil texture and moisture conditions can determine restoration success. Therefore, it is critical that site conditions are factored into the selection of project locations prior to the initiation of willow planting restoration projects.

MOSFET detectors in quality assurance of tomotherapy treatments.

PubMed

Cherpak, Amanda; Studinski, Ryan C N; Cygler, Joanna E

2008-02-01

The purpose of this work was to characterize metal oxide semiconductor field-effect transistors (MOSFETs) in a 6 MV conventional linac and investigate their use for quality assurance of radiotherapy treatments with a tomotherapy Hi-Art unit. High sensitivity and standard sensitivity MOSFETs were first calibrated and then tested for reproducibility, field size dependence, and accuracy of measuring surface dose in a 6 MV beam as well as in a tomotherapy Hi-Art unit. In vivo measurements were performed on both a RANDO phantom and several head and neck cancer patients treated with tomotherapy and compared to TLD measurements and treatment plan doses to evaluate the performance of MOSFETs in a high gradient radiation field. The average calibration factor found was 0.345+/-2.5%cGy/mV for the high sensitivity MOSFETs tested and 0.901+/-2.4%cGy/mV for the standard sensitivity MOSFETs. MOSFET measured surface doses had an average agreement with ion chamber measurements of 1.55% for the high sensitivity MOSFET and 5.23% for the standard sensitivity MOSFET when averaged over all trials and field sizes tested. No significant dependence on field size was found for the standard sensitivity MOSFETs, however a maximum difference of 5.34% was found for the high sensitivity MOSFET calibration factors in the field sizes tested. Measurements made with MOSFETS on head and neck patients treated on a tomotherapy Hi-Art unit had an average agreement of (3.26+/-0.03)% with TLD measurements, however the average of the absolute difference between the MOSFET measurements and the treatment plan skin doses was (12.2+/-7.5)%. The MOSFET measured patient skin doses also had good reproducibility, with inter-fraction deviations ranging from 1.4% to 6.6%. Similar results were found from trials using a RANDO phantom. The MOSFETs performed well when used in the tomotherapy Hi-Art unit and did not increase the overall treatment set-up time when used for patient measurements. It was found that MOSFETs are suitable detectors for surface dose measurements in both conventional beam and tomotherapy treatments and they can provide valuable skin dose information in areas where the treatment planning system may not be accurate.

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

PubMed

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

2016-10-20

Lung cancer is the most common malignancy and screening can decrease the mortality. High quality screening guideline is necessary and important for effective work. Our study is to review and evaluate the basic characteristics and methodology quality of the current global lung cancer screening guidelines so as to provide useful information for domestic study in the future. Electronic searches were done in English and Chinese databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, CBM, Wanfang, and some cancer official websites. Articles were screened according to the predefined inclusion and exclusion criteria by two researchers. The quality of guidelines was assessed by AGREE II. At last, a total of 11 guidelines with methodology were included. The guidelines were issued mainly by USA (81%). Canada and China developed one, respectively. As for quality, the average score in the "Scale and objective" of all guidelines was 80, the average score in the "Participants" was 52, the average score in the "rigorism" was 50, the average score in the "clarity" was 76, the average score in the "application" was 43 and the average score in the "independence" was 59. The highest average score was found in 2013 and 2015. Canada guideline had higher quality in six domains. 7 guidelines were evaluated as A level. The number of clinical guidelines showed an increasing trend. Most guidelines were issued by developed countries with heavy burden. Multi-country contribution to one guideline was another trend. Evidence-based methodology was accepted globally in the guideline development.

A Survey of Mathematics Education Technology Dissertation Scope and Quality: 1968-2009

ERIC Educational Resources Information Center

Ronau, Robert N.; Rakes, Christopher R.; Bush, Sarah B.; Driskell, Shannon O.; Niess, Margaret L.; Pugalee, David K.

2014-01-01

We examined 480 dissertations on the use of technology in mathematics education and developed a Quality Framework (QF) that provided structure to consistently define and measure quality. Dissertation studies earned an average of 64.4% of the possible quality points across all methodology types, compared to studies in journals that averaged 47.2%.…

The relationship between social capital and quality management systems in European hospitals: a quantitative study.

PubMed

Hammer, Antje; Arah, Onyebuchi A; Dersarkissian, Maral; Thompson, Caroline A; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of hospital managers and the design and evaluation of hospital quality management systems.

The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study

PubMed Central

Hammer, Antje; Arah, Onyebuchi A.; DerSarkissian, Maral; Thompson, Caroline A.; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Background Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. Objectives We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. Methods We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. Results The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). Conclusion The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of hospital managers and the design and evaluation of hospital quality management systems. PMID:24392027

A Systematic Review of Studies Eliciting Willingness-to-Pay per Quality-Adjusted Life Year: Does It Justify CE Threshold?

PubMed Central

Nimdet, Khachapon; Chaiyakunapruk, Nathorn; Vichansavakul, Kittaya; Ngorsuraches, Surachat

2015-01-01

Background A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation. Objective To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors. Methods We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors. Results Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06). Conclusion This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per capita depended on several factors may prompt discussions on the CE threshold policy. Our research work provides a foundation for defining future direction of decision criteria for an evidence-informed decision making system. PMID:25855971

Gender, Emotion Work, and Relationship Quality: A Daily Diary Study

PubMed Central

Curran, Melissa A.; McDaniel, Brandon T.; Pollitt, Amanda M.; Totenhagen, Casey J.

2015-01-01

We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others’ emotional well-being. We examined emotion work two ways: trait (individuals’ average levels) and state (individuals’ daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals’ own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners. PMID:26508808

Gender, Emotion Work, and Relationship Quality: A Daily Diary Study.

PubMed

Curran, Melissa A; McDaniel, Brandon T; Pollitt, Amanda M; Totenhagen, Casey J

2015-08-01

We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others' emotional well-being. We examined emotion work two ways: trait (individuals' average levels) and state (individuals' daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals' own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners.

Cochlear implantation: An assessment of quality and readability of web-based information aimed at patients.

PubMed

Seymour, Nicky; Lakhani, Raj; Hartley, Benjamin; Cochrane, Lesley; Jephson, Christopher

2015-01-01

Patients should have access to high-quality health information websites on which to base their decision-making. There are concerns regarding the accuracy and quality of some health websites. We aimed to objectively measure website quality related to cochlear implantation. Selected patient-information websites were scored, depending on how highly they ranked on search engines and if they were ranked on more than one of the search engines used. The top 40 websites from three major search engines were analysed. The quality of each website was scored using the DISCERN tool and the readability was scored using the Flesch-Kincaid reading ease and the Gunning-Fog index. The average Flesch-Kincaid score was 49.7, giving an average reading age of a 15-17 years old, and the average Gunning-fog score was 13.1, which equals that of an 18 years old. Internet-based information regarding cochlear implantation is of varied quality and is written above the expected reading level of an average person.

Costs of postoperative sepsis: the business case for quality improvement to reduce postoperative sepsis in veterans affairs hospitals.

PubMed

Vaughan-Sarrazin, Mary S; Bayman, Levent; Cullen, Joseph J

2011-08-01

To estimate the incremental costs associated with sepsis as a complication of general surgery, controlling for patient risk factors that may affect costs (eg, surgical complexity and comorbidity) and hospital-level variation in costs. Database analysis. One hundred eighteen Veterans Health Affairs hospitals. A total of 13 878 patients undergoing general surgery during fiscal year 2006 (October 1, 2005, through September 30, 2006). Incremental costs associated with sepsis as a complication of general surgery (controlling for patient risk factors and hospital-level variation of costs), as well as the increase in costs associated with complications that co-occur with sepsis. Costs were estimated using the Veterans Health Affairs Decision Support System, and patient risk factors and postoperative complications were identified in the Veterans Affairs Surgical Quality Improvement Program database. Overall, 564 of 13 878 patients undergoing general surgery developed postoperative sepsis, for a rate of 4.1%. The average unadjusted cost for patients with no sepsis was $24 923, whereas the average cost for patients with sepsis was 3.6 times higher at $88 747. In risk-adjusted analyses, the relative costs were 2.28 times greater for patients with sepsis relative to patients without sepsis (95% confidence interval, 2.19-2.38), with the difference in risk-adjusted costs estimated at $26 972 (ie, $21 045 vs $48 017). Sepsis often co-occurred with other types of complications, most frequently with failure to wean the patient from mechanical ventilation after 48 hours (36%), postoperative pneumonia (31%), and reintubation for respiratory or cardiac failure (29%). Costs were highest when sepsis occurred with pneumonia or failure to wean the patient from mechanical ventilation after 48 hours. Given the high cost of treating sepsis, a business case can be made for quality improvement initiatives that reduce the likelihood of postoperative sepsis.

Air pollution and daily mortality: A new approach to an old problem

NASA Astrophysics Data System (ADS)

Lipfert, Frederick W.; Murray, Christian J.

2012-08-01

Many time-series studies find associations between acute health effects and ambient air quality under current conditions. However, few such studies link mortality with morbidity to provide rational bases for improving public health. This paper describes a research project that developed and validated a new modeling approach directly addressing changes in life expectancies and the prematurity of deaths associated with transient changes in air quality. We used state-space modeling and Kalman filtering of elderly Philadelphia mortality counts from 1974-88 to estimate the size of the population at highest risk of imminent death. This subpopulation appears stable over time but is sensitive to season and to environmental factors: ambient temperature, ozone, and total suspended particulate matter (TSP), as an index of airborne particles in this demonstration of methodology. This population at extreme risk averages fewer than 0.1% of the elderly. By considering successively longer lags or moving averages of TSP, we find that cumulative short-term effects on entry to the at-risk pool tend to level off and decrease as periods of exposure longer than a few days are considered. These estimated environmental effects on the elderly are consistent with previous analyses using conventional time-series methods. However, this new model suggests that such environmentally linked deaths comprise only about half of the subjects whose frailty is associated with environmental factors. The average life expectancy of persons in the at-risk pool is estimated to be 5-7 days, which may be reduced by less than one day by environmental effects. These results suggest that exposures leading up to severe acute frailty and subsequent risk of imminent death may be more important from a public health perspective than those directly associated with subsequent mortality.

Characteristics of typical non-road machinery emissions in China by using portable emission measurement system.

PubMed

Fu, Mingliang; Ge, Yunshan; Tan, Jianwei; Zeng, Tao; Liang, Bin

2012-10-15

Non-road machinery, especially construction equipment could be an important pollutant source of the deterioration in air quality in Chinese urban areas due to its large quantity and to the absence of stringent emission requirements. In this study, emission tests were performed on 12 excavators and 8 wheel loaders by using portable emission measurement system (PEMS) to determine their emission characteristics. The typical operating modes were categorized as idling mode, moving mode and working mode. Compared with those during idling and moving modes, the average time-based emission factors during working mode of HC were 2.61 and 1.27 times higher, NO(x) were 3.66 and 1.36 times higher, and PM were 4.05 and 1.95 times higher, respectively. Under all conditions, categories of the measured emissions increased with the rise in engine power. Compared with those of Stage I emission standard equipment, gaseous emissions and PM emitted from Stage II emission standard equipment were lower. The results indicated that, from Stage I to Stage II, the average reductions of HC, NO(x) and PM were 56%, 37% and 29% for the working mode, respectively. Those results also demonstrated the effectiveness of emission control regulation and the improvement of emission control technology. The data and tests show that the longer the accumulated working hours, the higher HC and NO(x) average fuel-based emission factors are. The emissions measured from the construction vehicles employed in this study were higher than the data collected in previous studies, which shows that it is critical for the government to put into effect more stringent emission regulations to further improve the air quality in Chinese urban areas. Copyright © 2012 Elsevier B.V. All rights reserved.

Ischemic heart disease and ambient air pollution of particulate matter 2.5 in 51 counties in the U.S.

PubMed

Balluz, Lina; Wen, Xiao-Jun; Town, Machell; Shire, Jeffrey D; Qualter, Judy; Mokdad, Ali

2007-01-01

Ischemic heart disease (IHD) is one of the most common health threats to the adult population of the U.S. and other countries. The objective of this study was to examine the association between exposure to elevated annual average levels of Particulate matter 2.5 (PM2.5) air quality index (AQI) and IHD in the general population. We combined data from the Behavioral Risk Factor Surveillance System and the U.S Environmental Protection Agency air quality database. We analyzed the data using SUDAAN software to adjust the effects of sampling bias, weights, and design effects. The prevalence of IHD was 9.6% among respondents who were exposed to an annual average level of PM2.5 AQI > 60 compared with 5.9% among respondents exposed to an annual average PM2.5 AQI < or = 60. The respondents with higher levels of PM2.5 AQI exposure were more likely to have IHD (adjusted odds ratio = 1.72, 95% confidence interval 1.11, 2.66) than respondents with lower levels of exposure after adjusting for age, gender, race/ethnicity, education, smoking, body mass index, diabetes, hypertension, and hypercholesterolemia. Our study suggested that exposure to relatively higher levels of average annual PM2.5 AQI may increase the likelihood of IHD. In addition to encouraging health-related behavioral changes to reduce IHD, efforts should also focus on implementing appropriate measures to reduce exposure to unhealthy AQI levels.

Letter from the Editor

NASA Astrophysics Data System (ADS)

Strassmeier, Klaus G.

2008-01-01

As of 2006, Astronomische Nachrichten -- Astronomical Notes has reached its all-time high regarding the ISI journal impact factor, with an impressive increase of 60% compared to 2005. We now rank at position 1,399, as shown in the statistics below. This is solely due to the increased number and quality of published articles: In 2006, Astronomische Nachrichten -- Astronomical Notes published 208 research papers and received 1,033 citations -- five citations per paper on average. In 2007, we have published 177 research papers, and one may be curious to see how their factor will develop. In co-operation with Wiley InterScience we have achieved an average o nline publication time of just 4.5 months. As in the past, publication in Astronomische Nachrichten -- Astronomical Notes} continues to be free of charge. Also, all articles of the first issue of each volume can be downloaded free of charge, as can all articles labelled ``Editor's Choice'', which are additionally featured with a color image on the front cover.

Passive dosimetry aboard the Mir Orbital Station: external measurements.

PubMed

Benton, E R; Benton, E V; Frank, A L

2002-10-01

This paper reports results from the first measurements made on the exterior of a LEO spacecraft of mean dose equivalent rate and average quality factor as functions of shielding depth for shielding less than 1 g/cm2 Al equivalent. Two sets of measurements were made on the outside of the Mir Orbital Station; one near solar maximum in June 1991 and one near solar minimum in 1997. Absorbed dose was measured using stacks of TLDs. LET spectrum from charged particles of LET infinity H2O > o r= 5keV/micrometers was measured using stacks of CR-39 PNTDs. Results from the TLD and PNTD measurements at a given shielding depth were combined to yield mean total dose rate, mean dose equivalent rate, and average quality factor. Measurements made near solar maximum tend to be greater than those made during solar minimum. Both mean dose rate and mean dose equivalent rate decrease by nearly four orders of magnitude within the first g/cm2 shielding illustrating the attenuation of both trapped electrons and low-energy trapped protons. In order to overcome problems with detector saturation after standard chemical processing, measurement of LET spectrum in the least shielded CR-39 PNTD layer (0.005 g/cm2 Al) was carried out using an atomic force microscope. c2002 Elsevier Science Ltd. All rights reserved.

Passive dosimetry aboard the Mir Orbital Station: external measurements

NASA Technical Reports Server (NTRS)

Benton, E. R.; Benton, E. V.; Frank, A. L.

2002-01-01

This paper reports results from the first measurements made on the exterior of a LEO spacecraft of mean dose equivalent rate and average quality factor as functions of shielding depth for shielding less than 1 g/cm2 Al equivalent. Two sets of measurements were made on the outside of the Mir Orbital Station; one near solar maximum in June 1991 and one near solar minimum in 1997. Absorbed dose was measured using stacks of TLDs. LET spectrum from charged particles of LET infinity H2O > o r= 5keV/micrometers was measured using stacks of CR-39 PNTDs. Results from the TLD and PNTD measurements at a given shielding depth were combined to yield mean total dose rate, mean dose equivalent rate, and average quality factor. Measurements made near solar maximum tend to be greater than those made during solar minimum. Both mean dose rate and mean dose equivalent rate decrease by nearly four orders of magnitude within the first g/cm2 shielding illustrating the attenuation of both trapped electrons and low-energy trapped protons. In order to overcome problems with detector saturation after standard chemical processing, measurement of LET spectrum in the least shielded CR-39 PNTD layer (0.005 g/cm2 Al) was carried out using an atomic force microscope. c2002 Elsevier Science Ltd. All rights reserved.

Measurement of transepidermal water loss in localized scleroderma.

PubMed

Ďurčanská, Veronika; Jedličková, Hana; Vašků, Vladimír

2016-05-01

Localized scleroderma (LS) is a disease characterized by fibrotic changes in the dermis. Connective tissue growth factor and transforming growth factor β2 are the main mediators of fibrogenesis; this, along with excessive connective tissue production, affects epidermal keratinocytes, and thereby contributes to the changed quality of skin barrier. The objective of this article was to study the objective measurement of the skin barrier quality in LS with transepidermal water loss (TEWL) meter. The measurements of TEWL were performed on LS plaques in all three stages of various body locations. Control measurements were made on the contralateral side of healthy skin. The difference between TEWL in LS area and the contralateral side of the healthy skin was evaluated. A higher average TEWL 7.86 g/m(2) /h (SD 5.29) was observed on LS plaques compared with the control measurements on healthy skin 6.39 g/m(2) /h (SD 2.77). TEWL average values decreased from the inflammatory stage, through the sclerotic and to the atrophic stage. The mean difference 1.301 g/m(2) /h (SD 5.16) was found between TEWL on LS plaques and on the contralateral healthy skin in 82 measurements, i.e., a higher TEWL was observed in LS. The difference was statistically significant with p = 0.0250. Although fibrogenesis in scleroderma is localized in dermis, the skin barrier changes can be detected. © 2016 Wiley Periodicals, Inc.

Atmospheric deposition effects on the chemistry of a stream in Northeastern Georgia

USGS Publications Warehouse

Buell, G.R.; Peters, N.E.

1988-01-01

The quantity and quality of precipitation and streamwater were measured from August 1985 through September 1986 in the Brier Creek watershed, a 440-ha drainage in the Southern Blue Ridge Province of northeastern Georgia, to determine stream sensitivity to acidic deposition. Precipitation samples collected at 2 sites had a volume-weighted average pH of 4.40 whereas stream samples collected near the mouth of Brier Creek had a discharge-weighted average pH of 6.70. Computed solute fluxes through the watershed and observed changes in streamwater chemistry during stormflow suggest that cation exchange, mineral weathering, SO42- adsorption by the soil, and groundwater discharge to the stream are probable factors affecting neutralization of precipitation acidity. Net solute fluxes for the watershed indicate that, of the precipitation input, > 99% of the H+, 93% of the NH4+ and NO3-, and 77% of the SO42- were retained. Sources within the watershed yielded base cations, Cl-, and HCO3- and accounted for 84, 47, and 100% of the net transport, respectively. Although streamwater SO42- and NO3- concentrations increased during stormflow, peak concentrations of these anions were much less than average concentrations in the precipitation. This suggests retention of these solutes occurs even when water residence time is short.The quantity and quality of precipitation and streamwater were measured from August 1985 through September 1986 in the Brier Creek watershed, a 440-ha drainage in the Southern Blue Ridge Province of northeastern Georgia, to determine stream sensitivity to acidic deposition. Precipitation samples collected at 2 sites had a volume-weighted average pH of 4.40 whereas stream samples collected near the mouth of Brier Creek had a discharge-weighted average pYH of 6.70. Computed solute fluxes through the watershed and observed changes in streamwater chemistry drying stormflow suggest that cation exchange, mineral weathering, SO42- adsorption by the soil, and groundwater discharge to the stream are probable factors affecting neutralization of precipitation acidity. Although streamwater SO42- and NO3- concentrations increased during stormflow, peak concentrations of these anions were much less than average concentrations in the precipitation. This suggests retention of these solutes occurs even when water residence time is short.

Hematology research output from Chinese authors and other countries: a 10-year survey of the literature.

PubMed

Zhang, Lei; Ye, Xin; Sun, Yi; Deng, An-mei; Qian, Bao-hua

2015-02-06

Hematologic disease affects people of all ages worldwide. In the past decade, researchers have made great progress in the field of hematology. In the present study we compared the hematology research output from China and other countries (USA, Germany, UK, Japan and South Korea) over the past 10 years and 5 years. The related articles were extracted based on the PubMed database. We recorded the number of publications, clinical trials, randomized controlled trials, meta-analyses, case reports, reviews, citations, impact factors, articles in the top 10 journals and most published journals to assess the quantity and quality of research output in each region. A total of 120,641 hematology-related articles were published from 2004 to 2013. The USA accounted for 27.13% (32,732/120,641) of the publications, followed by Germany (7,479/120,641; 6.20%), Japan (6,347/120,641; 5.26%), the UK (5,453/120,641; 4.52%), China (2,924/120,641; 2.42%) and South Korea (1,413/120,641; 1.17%). The ranking for cumulative impact factors was as follows: USA; Germany; UK; Japan; China and South Korea. The median impact factors in the UK, USA, and Germany were higher than Japan, South Korea, and China. Interestingly, the median impact factors in the three Asia countries were similar both in 2004-2013 and 2009-2013. The UK had the highest percentage of publications in the top 25% of journals, while China lagged behind and ranked last. When comparing the number of articles in the top 10 journals, the results were similar to the IF findings. Germany had the highest number of average citations, while China had the lowest number of average citation. The status of hematology research output from the 6 countries in 2009-2013 had little difference from 2004-2013. Thus, the USA has had a dominant role in hematologic research in the past 10 years. Overall, the quality of publications in European countries was better than Asia countries. Although China has made considerable progress in hematology research, the quality of research needs improvement.

7 CFR 1437.11 - Average market price and payment factors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Average market price and payment factors. 1437.11... ASSISTANCE PROGRAM General Provisions § 1437.11 Average market price and payment factors. (a) An average... average market price by the applicable payment factor (i.e., harvested, unharvested, or prevented planting...

The Combined Effect of Sleep Duration and Quality on Mental Health Among Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, Hee-Choon; Lee, Sang Gyu; Han, Kyu-Tae; Park, Eun-Cheol

2016-11-01

Sleep problems in the Republic of Korea Armed Forces have increased. This study analyzed the mental health impact of sleep duration and quality on personnel of the Republic of Korea Armed Forces. Data from the 2014 Military Health Survey were used. Degree of sleep duration and quality were measured by this self-reported questionnaire. Analysis of variance was carried out to compare Kessler Psychological Distress Scale 10 (K10) scores. Multiple logistic regression analysis identified associations between sleep duration, quality, and K10 scores. Among the personnel studied, 2.5% reported severe sleep difficulties. The average sleep duration was 6.83 ± 1.12 hours. Short sleep duration and sleep difficulty were associated with poorer K10 scores. Higher K10 scores among individuals with short sleep duration and low sleep quality were identified in the isolated military area group, the over 53 working hours/week group, and the enlisted soldier group. The factors listed were not by themselves associated with poorer mental health scores. Rather, specific workplaces and specific rank groups were more prone to poorer mental health. These results provide helpful information to minimize the negative psychological effects of sleep factors and to promote a sleep problem prevention and management policy. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

[Cultural regionalization for Notopterygium incisum based on 3S technology platform. I. Evaluation for growth suitability for N. incisum based on ecological factors analysis by Maxent and ArcGIS model].

PubMed

Sun, Hong-bing; Sun, Hui; Jiang, Shun-yuan; Zhou, Yi; Cao, Wen-long; Ji, Ming-chang; Zhy, Wen-tao; Yan, Han-jing

2015-03-01

Growth suitability as assessment indicators for medicinal plants cultivation was proposed based on chemical quality determination and ecological factors analysis by Maxent and ArcGIS model. Notopterygium incisum, an endangered Chinese medicinal plant, was analyzed as a case, its potential distribution areas at different suitability grade and regionalization map were formulated based on growth suitability theory. The results showed that the most suitable habitats is Sichuan province, and more than 60% of the most suitable areawas located in the western Sichuan such as Aba and Ganzi prefectures for N. incisum. The results indicated that habitat altitude, average air temperature in September, and vegetation types were the dominant factors contributing to the grade of plant growth, precipitation and slope were the major factors contributing to notopterol accumulation in its underground parts, while isoimperatorin in its underground parts was negatively corelated with precipitation and slope of its habitat. However, slope as a factor influencing chemical components seemed to be a pseudo corelationship. Therefore, there were distinguishing differences between growth suitability and quality suitability for medicinal plants, which was helpful to further research and practice of cultivation regionalization, wild resource monitoring and large-scale cultivation of traditional Chinese medicine plants.

Good quality sleep is associated with better academic performance among university students in Ethiopia.

PubMed

Lemma, Seblewengel; Berhane, Yemane; Worku, Alemayehu; Gelaye, Bizu; Williams, Michelle A

2014-05-01

This study assessed the association of sleep quality with academic performance among university students in Ethiopia. This cross-sectional study of 2,173 college students (471 female and 1,672 male) was conducted in two universities in Ethiopia. Students were selected into the study using a multistage sampling procedure, and data were collected through a self-administered questionnaire. Sleep quality was assessed using Pittsburgh Sleep Quality Index, and academic performance was based on self-reported cumulative grade point average. The Student's "t" test, analysis of variance, and multiple linear regression were used to evaluate associations. We found that students with better sleep quality score achieved better on their academic performance (P value = 0.001), while sleep duration was not associated with academic performance in the final model. Our study underscores the importance of sleep quality on better academic performance. Future studies need to identify the possible factors which influence sleep quality other than the academic environment repeatedly reported by other literature. It is imperative to design and implement appropriate interventions to improve sleep quality in light of the current body of evidence to enhance academic success in the study setting.

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts.

PubMed

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-08-05

The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Survey and comparison of sleep quality among fixed and changing shift staff in a steel factory in Tehran, Iran.

PubMed

Mohammadian, Farugh; Abbasinia, Marzieh; Rahmani, Abdolrasoul; Monazzam, Mohammad Reza; Asghari, Mehdi; Ahmadnezhad, Iman; Asadi, Ali

2013-01-01

Given the hazardous nature of the work in steel factories and that the staff has to deal with hazardous equipment and machines, improper sleep quality and drowsiness among the works tackles performance and boosts rate of job accidents. This study is aimed to survey the quality of sleep and sleepiness status and the pertinent factors among the workers in a rolling mill and a steel production company in Tehran, Iran. In a Cross-Sectional study 2011, 180 workers were selected randomly from a rolling mill and a steel production company in Tehran. A questionnaire was designed to collect demographic data and variables of work condition. Pitersborg's sleep quality questionnaire was used to survey quality and problems of Participants' sleep. Epworth Sleepiness questionnaire was used to deals with sleepiness during work, studying, watching TV, or during time spent in public. Average score of sleep quality for the fixed shift staff and changing shift staff were 7.5±2.82 and 8.49±2.95 respectively. Surveys of sleep quality for the two groups of the participants based on T-test showed a significant difference between the two groups so that the changing shift staff group suffered poorer sleep quality (p=0.03). Comparison of average drowsiness scores between the two groups of participants based on Mann-Whitney test showed no significant difference (p>0.005). Chi square test showed a significant difference between severity of drowsiness and type of working shift (p =0.028 and 0.009). Staff in revolving shifts suffers poor sleep quality comparing with staff with fixed working shift. Moreover, type of working shift greatly affects severity of drowsiness as staff at different work shift experienced different level of sleepiness. It is essential to survey sleep disorder of the staff in the industry and pay more emphasis on sleep disorder epidemic in other fields of industry.

Rural and Urban Differences in Air Quality, 2008–2012, and Community Drinking Water Quality, 2010–2015 — United States

PubMed Central

Kennedy, Caitlin; Monti, Michele; Yip, Fuyuen

2017-01-01

Problem/Condition The places in which persons live, work, and play can contribute to the development of adverse health outcomes. Understanding the differences in risk factors in various environments can help to explain differences in the occurrence of these outcomes and can be used to develop public health programs, interventions, and policies. Efforts to characterize urban and rural differences have largely focused on social and demographic characteristics. A paucity of national standardized environmental data has hindered efforts to characterize differences in the physical aspects of urban and rural areas, such as air and water quality. Reporting Period 2008–2012 for air quality and 2010–2015 for water quality. Description of System Since 2002, CDC’s National Environmental Public Health Tracking Program has collaborated with federal, state, and local partners to gather standardized environmental data by creating national data standards, collecting available data, and disseminating data to be used in developing public health actions. The National Environmental Public Health Tracking Network (i.e., the tracking network) collects data provided by national, state, and local partners and includes 21 health outcomes, exposures, and environmental hazards. To assess environmental factors that affect health, CDC analyzed three air-quality measures from the tracking network for all counties in the contiguous United States during 2008–2012 and one water-quality measure for 26 states during 2010–2015. The three air-quality measures include 1) total number of days with fine particulate matter (PM2.5) levels greater than the U.S. Environmental Protection Agency’s (EPA’s) National Ambient Air Quality Standards (NAAQS) for 24-hour average PM2.5 (PM2.5 days); 2) mean annual average ambient concentrations of PM2.5 in micrograms per cubic meter (mean PM2.5); and 3) total number of days with maximum 8-hour average ozone concentrations greater than the NAAQS (ozone days). The water-quality measure compared the annual mean concentration for a community water system (CWS) to the maximum contaminant level (MCL) defined by EPA for 10 contaminants: arsenic, atrazine, di(2-ethylhexyl) phthalate (DEHP), haloacetic acids (HAA5), nitrate, perchloroethene (PCE), radium, trichloroethene (TCE), total trihalomethanes (TTHM), and uranium. Findings are presented by urban-rural classification scheme: four metropolitan (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan) and two nonmetropolitan (micropolitan and noncore) categories. Regression modeling was used to determine whether differences in the measures by urban-rural categories were statistically significant. Results Patterns for all three air-quality measures suggest that air quality improves as areas become more rural (or less urban). The mean total number of ozone days decreased from 47.54 days in large central metropolitan counties to 3.81 days in noncore counties, whereas the mean total number of PM2.5 days decreased from 11.21 in large central metropolitan counties to 0.95 in noncore counties. The mean average annual PM2.5 concentration decreased from 11.15 μg/m3 in large central metropolitan counties to 8.87 μg/m3 in noncore counties. Patterns for the water-quality measure suggest that water quality improves as areas become more urban (or less rural). Overall, 7% of CWSs reported at least one annual mean concentration greater than the MCL for all 10 contaminants combined. The percentage increased from 5.4% in large central metropolitan counties to 10% in noncore counties, a difference that was significant, adjusting for U.S. region, CWS size, water source, and potential spatial correlation. Similar results were found for two disinfection by-products, HAA5 and TTHM. Arsenic was the only other contaminant with a significant result. Medium metropolitan counties had 3.1% of CWSs reporting at least one annual mean greater than the MCL, compared with 2.4% in large central counties. Interpretation Noncore (rural) counties experienced fewer unhealthy air-quality days than large central metropolitan counties, likely because of fewer air pollution sources in the noncore counties. All categories of counties had a mean annual average PM2.5 concentration lower than the EPA standard. Among all CWSs analyzed, the number reporting one or more annual mean contaminant concentrations greater the MCL was small. The water-quality measure suggests that water quality worsens as counties become more rural, in regards to all contaminants combined and for the two disinfection by-products individually. Although significant differences were found for the water-quality measure, the odds ratios were very small, making it difficult to determine whether these differences have a meaningful effect on public health. These differences might be a result of variations in water treatment practices in rural versus urban counties. Public Health Action Understanding the differences between rural and urban areas in air and water quality can help public health departments to identify, monitor, and prioritize potential environmental public health concerns and opportunities for action. These findings suggest a continued need to develop more geographically targeted, evidence-based interventions to prevent morbidity and mortality associated with poor air and water quality. PMID:28640797

Rural and Urban Differences in Air Quality, 2008-2012, and Community Drinking Water Quality, 2010-2015 - United States.

PubMed

Strosnider, Heather; Kennedy, Caitlin; Monti, Michele; Yip, Fuyuen

2017-06-23

The places in which persons live, work, and play can contribute to the development of adverse health outcomes. Understanding the differences in risk factors in various environments can help to explain differences in the occurrence of these outcomes and can be used to develop public health programs, interventions, and policies. Efforts to characterize urban and rural differences have largely focused on social and demographic characteristics. A paucity of national standardized environmental data has hindered efforts to characterize differences in the physical aspects of urban and rural areas, such as air and water quality. 2008-2012 for air quality and 2010-2015 for water quality. Since 2002, CDC's National Environmental Public Health Tracking Program has collaborated with federal, state, and local partners to gather standardized environmental data by creating national data standards, collecting available data, and disseminating data to be used in developing public health actions. The National Environmental Public Health Tracking Network (i.e., the tracking network) collects data provided by national, state, and local partners and includes 21 health outcomes, exposures, and environmental hazards. To assess environmental factors that affect health, CDC analyzed three air-quality measures from the tracking network for all counties in the contiguous United States during 2008-2012 and one water-quality measure for 26 states during 2010-2015. The three air-quality measures include 1) total number of days with fine particulate matter (PM 2.5 ) levels greater than the U.S. Environmental Protection Agency's (EPA's) National Ambient Air Quality Standards (NAAQS) for 24-hour average PM 2.5 (PM 2.5 days); 2) mean annual average ambient concentrations of PM 2.5 in micrograms per cubic meter (mean PM 2.5 ); and 3) total number of days with maximum 8-hour average ozone concentrations greater than the NAAQS (ozone days). The water-quality measure compared the annual mean concentration for a community water system (CWS) to the maximum contaminant level (MCL) defined by EPA for 10 contaminants: arsenic, atrazine, di(2-ethylhexyl) phthalate (DEHP), haloacetic acids (HAA5), nitrate, perchloroethene (PCE), radium, trichloroethene (TCE), total trihalomethanes (TTHM), and uranium. Findings are presented by urban-rural classification scheme: four metropolitan (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan) and two nonmetropolitan (micropolitan and noncore) categories. Regression modeling was used to determine whether differences in the measures by urban-rural categories were statistically significant. Patterns for all three air-quality measures suggest that air quality improves as areas become more rural (or less urban). The mean total number of ozone days decreased from 47.54 days in large central metropolitan counties to 3.81 days in noncore counties, whereas the mean total number of PM 2.5 days decreased from 11.21 in large central metropolitan counties to 0.95 in noncore counties. The mean average annual PM 2.5 concentration decreased from 11.15 μg/m 3 in large central metropolitan counties to 8.87 μg/m 3 in noncore counties. Patterns for the water-quality measure suggest that water quality improves as areas become more urban (or less rural). Overall, 7% of CWSs reported at least one annual mean concentration greater than the MCL for all 10 contaminants combined. The percentage increased from 5.4% in large central metropolitan counties to 10% in noncore counties, a difference that was significant, adjusting for U.S. region, CWS size, water source, and potential spatial correlation. Similar results were found for two disinfection by-products, HAA5 and TTHM. Arsenic was the only other contaminant with a significant result. Medium metropolitan counties had 3.1% of CWSs reporting at least one annual mean greater than the MCL, compared with 2.4% in large central counties. Noncore (rural) counties experienced fewer unhealthy air-quality days than large central metropolitan counties, likely because of fewer air pollution sources in the noncore counties. All categories of counties had a mean annual average PM 2.5 concentration lower than the EPA standard. Among all CWSs analyzed, the number reporting one or more annual mean contaminant concentrations greater the MCL was small. The water-quality measure suggests that water quality worsens as counties become more rural, in regards to all contaminants combined and for the two disinfection by-products individually. Although significant differences were found for the water-quality measure, the odds ratios were very small, making it difficult to determine whether these differences have a meaningful effect on public health. These differences might be a result of variations in water treatment practices in rural versus urban counties. Understanding the differences between rural and urban areas in air and water quality can help public health departments to identify, monitor, and prioritize potential environmental public health concerns and opportunities for action. These findings suggest a continued need to develop more geographically targeted, evidence-based interventions to prevent morbidity and mortality associated with poor air and water quality.

Using Cluster Analysis to Compartmentalize a Large Managed Wetland Based on Physical, Biological, and Climatic Geospatial Attributes.

PubMed

Hahus, Ian; Migliaccio, Kati; Douglas-Mankin, Kyle; Klarenberg, Geraldine; Muñoz-Carpena, Rafael

2018-04-27

Hierarchical and partitional cluster analyses were used to compartmentalize Water Conservation Area 1, a managed wetland within the Arthur R. Marshall Loxahatchee National Wildlife Refuge in southeast Florida, USA, based on physical, biological, and climatic geospatial attributes. Single, complete, average, and Ward's linkages were tested during the hierarchical cluster analyses, with average linkage providing the best results. In general, the partitional method, partitioning around medoids, found clusters that were more evenly sized and more spatially aggregated than those resulting from the hierarchical analyses. However, hierarchical analysis appeared to be better suited to identify outlier regions that were significantly different from other areas. The clusters identified by geospatial attributes were similar to clusters developed for the interior marsh in a separate study using water quality attributes, suggesting that similar factors have influenced variations in both the set of physical, biological, and climatic attributes selected in this study and water quality parameters. However, geospatial data allowed further subdivision of several interior marsh clusters identified from the water quality data, potentially indicating zones with important differences in function. Identification of these zones can be useful to managers and modelers by informing the distribution of monitoring equipment and personnel as well as delineating regions that may respond similarly to future changes in management or climate.

Motivators and hygiene factors among physicians responding to explicit incentives to improve the value of care.

PubMed

Waddimba, Anthony C; Burgess, James F; Young, Gary J; Beckman, Howard B; Meterko, Mark

2013-01-01

Physician's dissatisfaction is reported to be increasing, especially in primary care. The transition from fee-for-service to outcome-based reimbursements may make matters worse. To investigate influences of provider attitudes and practice settings on job satisfaction/dissatisfaction during transition to quality-based payment models, we assessed self-reported satisfaction/dissatisfaction with practice in a Rochester (New York)-area physician practice association in the process of implementing pay-for-performance. We linked cross-sectional data for 215 survey respondents on satisfaction ratings and behavioral attitudes with medical record data on their clinical behavior and practices, and census data on their catchment population. Factors associated with the odds of being satisfied or dissatisfied were determined via predictive multivariable logistic regression modeling. Dissatisfied physicians were more likely to have larger-than-average patient panels, lower autonomy and/or control, and beliefs that quality incentives were hindering patient care. Satisfied physicians were more likely to have a higher sense of autonomy and control, smaller patient volumes, and a less complex patient mix. Efforts to maintain or improve satisfaction among physicians should focus on encouraging professional autonomy during transitions from volume-based to quality/outcomes-based payment systems. An optimum balance between accountability and autonomy/control might maximize both health care quality and job satisfaction.

The N-Pact Factor: Evaluating the Quality of Empirical Journals with Respect to Sample Size and Statistical Power

PubMed Central

Fraley, R. Chris; Vazire, Simine

2014-01-01

The authors evaluate the quality of research reported in major journals in social-personality psychology by ranking those journals with respect to their N-pact Factors (NF)—the statistical power of the empirical studies they publish to detect typical effect sizes. Power is a particularly important attribute for evaluating research quality because, relative to studies that have low power, studies that have high power are more likely to (a) to provide accurate estimates of effects, (b) to produce literatures with low false positive rates, and (c) to lead to replicable findings. The authors show that the average sample size in social-personality research is 104 and that the power to detect the typical effect size in the field is approximately 50%. Moreover, they show that there is considerable variation among journals in sample sizes and power of the studies they publish, with some journals consistently publishing higher power studies than others. The authors hope that these rankings will be of use to authors who are choosing where to submit their best work, provide hiring and promotion committees with a superior way of quantifying journal quality, and encourage competition among journals to improve their NF rankings. PMID:25296159

Parental anxiety and quality of life of epileptic children.

PubMed

Li, Yong; Ji, Cheng-Ye; Qin, Jiong; Zhang, Zhi-Xiang

2008-06-01

To investigate the prevalence of parental anxiety associated with epileptic children, and to explore whether and how this specific condition affects children's quality of life (QOL), and what are the significant determinants for parental anxiety. Three hundred and forty parents whose children were affected with known epilepsy were enrolled in the study. Questionnaires for quality of life in childhood epilepsy (QOLCE), and hospital anxiety and depression (HAD) of parents were used to collect demographic data of both children and their parents, as well as clinical manifestations of epilepsy and family status. Parental anxiety (of any severity) was observed in 191 subjects at interview, giving a prevalence rate of 56.2%. Of the 191 subjects, 18.5% reported mild anxiety, 24.4% moderate anxiety, and 13.2% severe anxiety. Factors associated with parental anxiety included frequency of seizure in children, average monthly income per person and parents' knowledge about epilepsy (P < 0.05). Parental anxiety significantly (P = 0.000) correlated with quality of life of children with epilepsy. Parents of children with epilepsy are at high risk of having anxiety. Factors associated with parental anxiety originate both from children and from parents. Parental anxiety is significantly related with children's QOL. It is important for experts concerned to recognize such a relationship to improve the QOL of children and their parents.

Long-term improvements in oral communication skills and quality of peer relations in children with cochlear implants: parental testimony.

PubMed

Bat-Chava, Y; Martin, D; Imperatore, L

2014-11-01

Few research studies have examined longitudinal improvements in oral communication skills and quality of peer relationships of children with implants. Moreover, although the emerging literature suggests that improvement in social functioning follows improvement in oral communication, it is still unknown what factors enhance or impede the relations between these constructs. Based on parent interviews, the current study examined the long-term improvements in speech and oral language skills and relationships with hearing peers in 19 implanted children. Results demonstrate that on average, children continue to improve in oral communication skills and quality of peer relationships even years after implantation, especially those with initial poorer skills. While oral communication ability and quality of peer relationships are strongly associated at each time point, gains in these two variables are associated only for some of the children. Other factors, including self-confidence and peer acceptance, seem to moderate this relationship. Qualitative data are presented to illustrate these relations among variables and to assist in theory building. The results highlight the need for more specific examination of various developmental periods in combination with the progress of oral communication and peer relationships among children with implants. © 2013 John Wiley & Sons Ltd.

A multigene prognostic assay for selection of adjuvant chemotherapy in patients with T3, stage II colon cancer: impact on quality-adjusted life expectancy and costs.

PubMed

Hornberger, John; Lyman, Gary H; Chien, Rebecca; Meropol, Neal J

2012-12-01

Uncertainty exists regarding appropriate and affordable use of adjuvant chemotherapy in stage II colon cancer (T3, proficient DNA mismatch repair). This study aimed to estimate the effectiveness and costs from a US societal perspective of a multigene recurrence score (RS) assay for patients recently diagnosed with stage II colon cancer (T3, proficient DNA mismatch repair) eligible for adjuvant chemotherapy. RS was compared with guideline-recommended clinicopathological factors (tumor stage, lymph nodes examined, tumor grade, and lymphovascular invasion) by using a state-transition (Markov) lifetime model. Data were obtained from published literature, a randomized controlled trial (QUick And Simple And Reliable) of adjuvant chemotherapy, and rates of chemotherapy use from the National Cooperative Cancer Network Colon/Rectum Cancer Outcomes study. Life-years, quality-adjusted life expectancy, and lifetime costs were examined. The RS is projected to reduce adjuvant chemotherapy use by 17% compared with current treatment patterns and to increase quality-adjusted life expectancy by an average of 0.035 years. Direct medical costs are expected to decrease by an average of $2971 per patient. The assay was cost saving for all subgroups of patients stratified by clinicopathologic factors. The most influential variables affecting treatment decisions were projected years of life remaining, recurrence score, and patients' disutilities associated with adjuvant chemotherapy. Use of the multigene RS to assess recurrence risk after surgery in stage II colon cancer (T3, proficient DNA mismatch repair) may reduce the use of adjuvant chemotherapy without decreasing quality-adjusted life expectancy and be cost saving from a societal perspective. These findings need to be validated in additional cohorts, including studies of clinical practice as assay use diffuses into nonacademic settings. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Oral Health-Related Quality of Life in Children in Chile Treated for Cleft Lip and Palate: A Case-Control Approach.

PubMed

Aravena, Pedro C; Gonzalez, Tania; Oyarzún, Tamara; Coronado, César

2017-03-01

  To compare the oral health-related quality of life of patients treated for cleft lip and/or cleft palate (CL/P) versus unaffected children between 8 and 15 years of age using a Spanish-language version of the Child Oral Health Impact Profile (COHIP-Sp) administered to a Chilean population.   A cross-sectional study with a matched case-control design was used.   Participants were 48 children (mean age 11.3 years) with a history of CL/P from three cities in Chile and one group of 96 children (mean age 11.2 years) unaffected by CL/P. The COHIP-Sp was applied to both groups. Quality of life was compared according to the overall score and the average score of items and domains on the COHIP-Sp scale between the two groups (Mann-Whitney U test; P < .05).   The COHIP-Sp score was 94.1 ± 19.3 in children with CL/P and 97.1 ± 15.6 for the control group (P = .31). A significantly lower score was observed in the group with CL/P in the domains "functional well-being" (P = .001) and "school environment" (P = .001); the only average in favor of the quality of life in children with CL/P was in "self-image" (P = .0002).   The oral health-related quality of life of children with a history of CL/P was similar to that of the control group. Nevertheless, a lower quality of life was observed concerning items associated with speech and being understood by other people. Further study into the risk factors associated with surgery and rehabilitative treatment is recommended.

Cost Analysis of an Office-based Surgical Suite

PubMed Central

LaBove, Gabrielle

2016-01-01

Introduction: Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead. Methods: A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates. Results: The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy. Conclusions: Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult. PMID:27536482

[Menus offered in long-term care homes: quality of meal service and nutritional analysis].

PubMed

Rodríguez Rejón, Ana Isabel; Ruiz López, María Dolores; Malafarina, Vincenzo; Puerta, Antonio; Zuñiga, Antonia; Artacho, Reyes

2017-06-05

Institutionalization is a risk factor for malnutrition. Low energy intake and/or nutrient deficiencies are considered to be the main causes. To evaluate the quality of meals and meal service as well as the nutritional value of the main menus (regular menu, menu for diabetics, and pureed menu) offered in three long-term care (LTC) homes located in the metropolitan area of Granada (Spain). Cross-sectional study. A validated "quality of meals and meal service" set of indicators was applied. The menus were assessed by weighed food records on 14 consecutive days. The results were compared with the dietary reference intakes (DRIs) and the recommended number of servings. Important deficiencies in the quality of meals and meal service have been reported. Average energy varies from 1,788 to 2,124 kcal/day in the regular menus, from 1,687 to 1,924 kcal/day in the menus for diabetics, and from 1,518 to 1,639 kcal/day in the pureed menus. Average protein varied from 71.4 to 75.4 g/day, from 72.6 to 76.1 g/day, and from 50.5 to 54.7 g/day, respectively. None of the menus complied with the recommendations for fiber, potassium, magnesium, iodine, vitamin D, vitamin E, folate, nor for vegetables, fruit, milk products, olive oil, legumes, or nuts. It is necessary to ensure the implementation of regular routines for controlling the quality of meals and meal service as well as the nutritional value of the menus offered in LTC homes.

Evaluation of magnesium intake and its relation with bone quality in healthy young Korean women.

PubMed

Kim, Mi-Hyun; Yeon, Jee-Young; Choi, Mi-Kyeong; Bae, Yun Jung

2011-12-01

Many studies have reported magnesium's role in nutrition as a vital factor involved in bone health. However, not enough studies have evaluated magnesium (Mg) intakes in young women. In this study, we evaluated Mg intake in healthy adults and its relation with bone quality. A total of 484 healthy young women in their early 20s were enrolled into the study. Anthropometric measurements, dietary intake survey using 3-day dietary records, and the bone quality of the calcaneus using quantitative ultrasounds were obtained and analyzed. Average age, height, and weight of the subjects were respectively 20.20 years, 161.37 cm, and 54.09 kg, respectively. Also, the average broadband ultrasound attenuation, speed of sound (SOS), stiffness index (SI), and calcaneus T scores were 114.32 dB/MHz, 1,568.45 m/s, 95.23, and 0.36 g/cm(2), respectively. The subject's average intake of energy was 1,543.19 kcal, and the average Mg intake was 185.87 mg/day. Mg intake per 1,000 kcal of consumed energy in our subjects was 119.85 mg. Subjects consumed 63.11% of the recommended intake for Mg. Food groups consumed with high Mg content in our subjects included cereals (38.62 mg), vegetables (36.97 mg), milk (16.82 mg), legumes (16.72 mg), and fish (16.50 mg). The level of Mg intake per 1,000 kcal showed significant correlation to the SOS in the calcaneus (r = 0.110, p < 0.05) after adjustment for age, BMI, and percent body fat. In addition, the intakes of Mg from potatoes (p < 0.001), legumes (p < 0.05), and fungi and mushrooms (p < 0.05) positively correlated with the SOS of the calcaneus. In conclusion, the magnesium intake status of young Korean women aged 19-25 years is unsatisfactory. Improving dietary intake of Mg may positively impact bone quality in this population.

Quality of life in children with new-onset epilepsy

PubMed Central

Ferro, Mark A.; Camfield, Carol S.; Huang, Wenyi; Levin, Simon D.; Smith, Mary Lou; Wiebe, Samuel; Zou, Guangyong

2012-01-01

Objectives: To assess health-related quality of life (HRQL) over 2 years in children 4−12 years old with new-onset epilepsy and risk factors. Methods: Data are from a multicenter prospective cohort study, the Health-Related Quality of Life Study in Children with Epilepsy Study (HERQULES). Parents reported on children's HRQL and family factors and neurologists on clinical characteristics 4 times. Mean subscale and summary scores were computed for HRQL. Individual growth curve models identified trajectories of change in HRQL scores. Multiple regression identified baseline risk factors for HRQL 2 years later. Results: A total of 374 (82) questionnaires were returned postdiagnosis and 283 (62%) of eligible parents completed all 4. Growth rates for HRQL summary scores were most rapid during the first 6 months and then stabilized. About one-half experienced clinically meaningful improvements in HRQL, one-third maintained their same level, and one-fifth declined. Compared with the general population, at 2 years our sample scored significantly lower on one-third of CHQ subscales and the psychosocial summary. After controlling for baseline HRQL, cognitive problems, poor family functioning, and high family demands were risk factors for poor HRQL 2 years later. Conclusions: On average, HRQL was relatively good but with highly variable individual trajectories. At least one-half did not experience clinically meaningful improvements or declined over 2 years. Cognitive problems were the strongest risk factor for compromised HRQL 2 years after diagnosis and may be largely responsible for declines in the HRQL of children newly diagnosed with epilepsy. PMID:23019268

Islet product characteristics and factors related to successful human islet transplantation from the Collaborative Islet Transplant Registry (CITR) 1999-2010.

PubMed

Balamurugan, A N; Naziruddin, B; Lockridge, A; Tiwari, M; Loganathan, G; Takita, M; Matsumoto, S; Papas, K; Trieger, M; Rainis, H; Kin, T; Kay, T W; Wease, S; Messinger, S; Ricordi, C; Alejandro, R; Markmann, J; Kerr-Conti, J; Rickels, M R; Liu, C; Zhang, X; Witkowski, P; Posselt, A; Maffi, P; Secchi, A; Berney, T; O'Connell, P J; Hering, B J; Barton, F B

2014-11-01

The Collaborative Islet Transplant Registry (CITR) collects data on clinical islet isolations and transplants. This retrospective report analyzed 1017 islet isolation procedures performed for 537 recipients of allogeneic clinical islet transplantation in 1999-2010. This study describes changes in donor and islet isolation variables by era and factors associated with quantity and quality of final islet products. Donor body weight and BMI increased significantly over the period (p<0.001). Islet yield measures have improved with time including islet equivalent (IEQ)/particle ratio and IEQs infused. The average dose of islets infused significantly increased in the era of 2007-2010 when compared to 1999-2002 (445.4±156.8 vs. 421.3±155.4×0(3) IEQ; p<0.05). Islet purity and total number of β cells significantly improved over the study period (p<0.01 and <0.05, respectively). Otherwise, the quality of clinical islets has remained consistently very high through this period, and differs substantially from nonclinical islets. In multivariate analysis of all recipient, donor and islet factors, and medical management factors, the only islet product characteristic that correlated with clinical outcomes was total IEQs infused. This analysis shows improvements in both quantity and some quality criteria of clinical islets produced over 1999-2010, and these parallel improvements in clinical outcomes over the same period. © 2014 The Authors. American Journal of Transplantation Published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Islet Product Characteristics and Factors Related to Successful Human Islet Transplantation From the Collaborative Islet Transplant Registry (CITR) 1999–2010

PubMed Central

Balamurugan, A N; Naziruddin, B; Lockridge, A; Tiwari, M; Loganathan, G; Takita, M; Matsumoto, S; Papas, K; Trieger, M; Rainis, H; Kin, T; Kay, T W; Wease, S; Messinger, S; Ricordi, C; Alejandro, R; Markmann, J; Kerr-Conti, J; Rickels, M R; Liu, C; Zhang, X; Witkowski, P; Posselt, A; Maffi, P; Secchi, A; Berney, T; O’Connell, P J; Hering, B J; Barton, F B

2014-01-01

The Collaborative Islet Transplant Registry (CITR) collects data on clinical islet isolations and transplants. This retrospective report analyzed 1017 islet isolation procedures performed for 537 recipients of allogeneic clinical islet transplantation in 1999–2010. This study describes changes in donor and islet isolation variables by era and factors associated with quantity and quality of final islet products. Donor body weight and BMI increased significantly over the period (p < 0.001). Islet yield measures have improved with time including islet equivalent (IEQ)/particle ratio and IEQs infused. The average dose of islets infused significantly increased in the era of 2007–2010 when compared to 1999–2002 (445.4 ± 156.8 vs. 421.3 ± 155.4 ×103 IEQ; p < 0.05). Islet purity and total number of β cells significantly improved over the study period (p < 0.01 and <0.05, respectively). Otherwise, the quality of clinical islets has remained consistently very high through this period, and differs substantially from nonclinical islets. In multivariate analysis of all recipient, donor and islet factors, and medical management factors, the only islet product characteristic that correlated with clinical outcomes was total IEQs infused. This analysis shows improvements in both quantity and some quality criteria of clinical islets produced over 1999–2010, and these parallel improvements in clinical outcomes over the same period. PMID:25278159

General expressions for the coupling coefficient, quality and filling factors for a cavity with an insert using energy coupled mode theory.

PubMed

Elnaggar, Sameh Y; Tervo, Richard; Mattar, Saba M

2014-05-01

A cavity (CV) with a dielectric resonator (DR) insert forms an excellent probe for the use in electron paramagnetic resonance (EPR) spectrometers. The probe's coupling coefficient, κ, the quality factor, Q, and the filling factor, η are vital in assessing the EPR spectrometer's performance. Coupled mode theory (CMT) is used to derive general expressions for these parameters. For large permittivity the dominating factor in κ is the ratio of the DR and CV cross sectional areas rather than the dielectric constant. Thus in some cases, resonators with low dielectric constant can couple much stronger with the cavity than do resonators with a high dielectric constant. When the DR and CV frequencies are degenerate, the coupled η is the average of the two uncoupled ones. In practical EPR probes the coupled η is approximately half of that of the DR. The Q of the coupled system generally depends on the eigenvectors, uncoupled frequencies (ω1,ω2) and the individual quality factors (Q1,Q2). It is calculated for different probe configurations and found to agree with the corresponding HFSS® simulations. Provided there is a large difference between the Q1, Q2 pair and the frequencies of DR and CV are degenerate, Q is approximately equal to double the minimum of Q1 and Q2. In general, the signal enhancement ratio, Iwithinsert/Iempty, is obtained from Q and η. For low loss DRs it only depends on η1/η2. However, when the DR has a low Q, the uncoupled Qs are also needed. In EPR spectroscopy it is desirable to excite only a single mode. The separation between the modes, Φ, is calculated as a function of κ and Q. It is found to be significantly greater than five times the average bandwidth. Thus for practical probes, it is possible to excite one of the coupled modes without exciting the other. The CMT expressions derived in this article are quite general and are in excellent agreement with the lumped circuit approach and finite numerical simulations. Hence they can also be applied to a loop-gap resonator in a cavity. For the design effective EPR probes, one needs to consider the κ, Q and η parameters. Copyright © 2014 Elsevier Inc. All rights reserved.

General expressions for the coupling coefficient, quality and filling factors for a cavity with an insert using energy coupled mode theory

NASA Astrophysics Data System (ADS)

Elnaggar, Sameh Y.; Tervo, Richard; Mattar, Saba M.

2014-05-01

A cavity (CV) with a dielectric resonator (DR) insert forms an excellent probe for the use in electron paramagnetic resonance (EPR) spectrometers. The probe’s coupling coefficient, κ, the quality factor, Q, and the filling factor, η are vital in assessing the EPR spectrometer’s performance. Coupled mode theory (CMT) is used to derive general expressions for these parameters. For large permittivity the dominating factor in κ is the ratio of the DR and CV cross sectional areas rather than the dielectric constant. Thus in some cases, resonators with low dielectric constant can couple much stronger with the cavity than do resonators with a high dielectric constant. When the DR and CV frequencies are degenerate, the coupled η is the average of the two uncoupled ones. In practical EPR probes the coupled η is approximately half of that of the DR. The Q of the coupled system generally depends on the eigenvectors, uncoupled frequencies (ω1, ω2) and the individual quality factors (Q1, Q2). It is calculated for different probe configurations and found to agree with the corresponding HFSS® simulations. Provided there is a large difference between the Q1, Q2 pair and the frequencies of DR and CV are degenerate, Q is approximately equal to double the minimum of Q1 and Q2. In general, the signal enhancement ratio, I/Iempty, is obtained from Q and η. For low loss DRs it only depends on η1/η2. However, when the DR has a low Q, the uncoupled Qs are also needed. In EPR spectroscopy it is desirable to excite only a single mode. The separation between the modes, Φ, is calculated as a function of κ and Q. It is found to be significantly greater than five times the average bandwidth. Thus for practical probes, it is possible to excite one of the coupled modes without exciting the other. The CMT expressions derived in this article are quite general and are in excellent agreement with the lumped circuit approach and finite numerical simulations. Hence they can also be applied to a loop-gap resonator in a cavity. For the design effective EPR probes, one needs to consider the κ, Q and η parameters.

Factors Modifying Burnout in Osteopathic Medical Students.

PubMed

Lapinski, Jessica; Yost, Morgan; Sexton, Patricia; LaBaere, Richard J

2016-02-01

The purposes of the current study are to examine factors modifying burnout and identify which of these factors place osteopathic medical students at risk for developing burnout. The current study used a cross-sectional study design and an anonymous, web-based survey to assess burnout and depression in osteopathic medical students. The survey included Maslach Burnout Inventory, the Patient Health Questionnaire, the Stressors and their impact scale, students' sleeping and studying habits, and students' extracurricular involvement. In total, 1294 osteopathic medical students completed the survey. Burnout was present in 516 (39.9%) osteopathic medical students, and 1006 (77.0%) met criteria for depression. Females were 1.5 times more likely to be burned out in comparison to males. For the burnout subscales, males had lower emotional exhaustion, slightly higher depersonalization, and lower personal accomplishment. Lesbian/gay/bisexual/asexual students were 2.62 times more likely to be burned out compared with heterosexual students. Depression and academic, personal, and family stressors were all strongly linked to overall burnout. Finally, for modifiable factors, average hours of sleep, average hours spent studying, and club involvement appeared to be linked to burnout. The current study suggested that a variety of factors, including non-modifiable, situational, and modifiable, impact burnout in osteopathic medical students. Future research is necessary since burnout in physicians affects the quality of care provided to patients.

Average niche breadths of species in lake macrophyte communities respond to ecological gradients variably in four regions on two continents.

PubMed

Alahuhta, Janne; Virtala, Antti; Hjort, Jan; Ecke, Frauke; Johnson, Lucinda B; Sass, Laura; Heino, Jani

2017-05-01

Different species' niche breadths in relation to ecological gradients are infrequently examined within the same study and, moreover, species niche breadths have rarely been averaged to account for variation in entire ecological communities. We investigated how average environmental niche breadths (climate, water quality and climate-water quality niches) in aquatic macrophyte communities are related to ecological gradients (latitude, longitude, altitude, species richness and lake area) among four distinct regions (Finland, Sweden and US states of Minnesota and Wisconsin) on two continents. We found that correlations between the three different measures of average niche breadths and ecological gradients varied considerably among the study regions, with average climate and average water quality niche breadth models often showing opposite trends. However, consistent patterns were also found, such as widening of average climate niche breadths and narrowing of average water quality niche breadths of aquatic macrophytes along increasing latitudinal and altitudinal gradients. This result suggests that macrophyte species are generalists in relation to temperature variations at higher latitudes and altitudes, whereas species in southern, lowland lakes are more specialised. In contrast, aquatic macrophytes growing in more southern nutrient-rich lakes were generalists in relation to water quality, while specialist species are adapted to low-productivity conditions and are found in highland lakes. Our results emphasise that species niche breadths should not be studied using only coarse-scale data of species distributions and corresponding environmental conditions, but that investigations on different kinds of niche breadths (e.g., climate vs. local niches) also require finer resolution data at broad spatial extents.

A comparison of evaluation metrics for biomedical journals, articles, and websites in terms of sensitivity to topic.

PubMed

Fu, Lawrence D; Aphinyanaphongs, Yindalon; Wang, Lily; Aliferis, Constantin F

2011-08-01

Evaluating the biomedical literature and health-related websites for quality are challenging information retrieval tasks. Current commonly used methods include impact factor for journals, PubMed's clinical query filters and machine learning-based filter models for articles, and PageRank for websites. Previous work has focused on the average performance of these methods without considering the topic, and it is unknown how performance varies for specific topics or focused searches. Clinicians, researchers, and users should be aware when expected performance is not achieved for specific topics. The present work analyzes the behavior of these methods for a variety of topics. Impact factor, clinical query filters, and PageRank vary widely across different topics while a topic-specific impact factor and machine learning-based filter models are more stable. The results demonstrate that a method may perform excellently on average but struggle when used on a number of narrower topics. Topic-adjusted metrics and other topic robust methods have an advantage in such situations. Users of traditional topic-sensitive metrics should be aware of their limitations. Copyright © 2011 Elsevier Inc. All rights reserved.

The bioavailability of iron, zinc, protein and vitamin A is highly variable in French individual diets: Impact on nutrient inadequacy assessment and relation with the animal-to-plant ratio of diets.

PubMed

Perignon, Marlène; Barré, Tangui; Gazan, Rozenn; Amiot, Marie-Josèphe; Darmon, Nicole

2018-01-01

Nutritional adequacy depends on nutrient intakes and bioavailability which strongly varies with the plant- or animal-origin of foods. The aim was to estimate iron, zinc, protein and vitamin A bioavailability from individual diets, and investigate its relation with the animal-to-plant ratio (A/P) of diets. Bioavailability was estimated in 1899 French diets using diet-based algorithms or food-group specific conversion factors. Nutrient inadequacy was estimated based on i) bioavailability calculated in each individual diet and ii) average bioavailability assumed for Western-diets. Mean iron absorption, zinc absorption, protein quality and β-carotene conversion factor were 13%, 30%, 92%, and 17:1, respectively. Bioavailability displayed a high variability between individual diets, poorly explained by their A/P. Using individual bioavailability led to different inadequacy prevalence than with average factors assumed for Western-diets. In this population, the A/P does not seem sufficient to predict nutrient bioavailability and the corresponding recommended intakes. Nutritional adequacy should be assessed using bioavailability accounting for individual diets composition. Copyright © 2016 Elsevier Ltd. All rights reserved.

40 CFR 133.102 - Secondary treatment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... effluent quality attainable by secondary treatment in terms of the parameters—BOD5, SS and pH. All... permitting authority, in lieu of the parameter BOD5 and the levels of the effluent quality specified in... CBOD5 effluent quality provided: (i) The 30-day average shall not exceed 25 mg/l. (ii) The 7-day average...

Premenstrual Syndrome in Turkish college students and its effects on life quality.

PubMed

Pinar, Gul; Colak, Meric; Oksuz, Ergun

2011-01-01

The purpose of this research is to analyze the frequency of Premenstrual Syndrome (PMS) in college students, the factors affecting Premenstrual Syndrome and the effect of Premenstrual Syndrome on life quality. The research was performed on 316 students who study at Medical Sciences Faculty of Başkent University and accepted to take part in the research. The data of the research was compiled by using "Questionnaire Form", "PMS Rating Scale" and "Life Quality Scale" developed by the researchers. In the analysis of the data; Percentage distribution, Chi-square test, One Way Anova test, Logistic regression, Multi nominal regression analysis were used. PMS was detected in 72.1% of the students. The most frequent symptoms are mainly low back pain, stress-discomfort, nervous-anger, distention and breast tenderness. PMS was found significantly high in those students who have menstrual irregularity, who have dysmenorrhea, who consume 2 cups of coffee or above per day and who smoke and drink alcohol (p<0.05). When the relation of PMS with life quality was evaluated, it was determined that the life quality decreases as PMS score average increases (p<0.05). PMS rate is high in college students and this adversely affects the life quality. It was revealed that the preventive, instructive and consultancy roles of the medical staff became more of an issue in reducing the effect of the factors causing and/or aggravating these symptoms in order to decrease PMS incidence and to improve the life quality of the students. Copyright © 2010. Published by Elsevier B.V.

Thoughts of death and self-harm in patients with epilepsy or multiple sclerosis in a tertiary care center.

PubMed

Dickstein, Leah P; Viguera, Adele C; Nowacki, Amy S; Thompson, Nicolas R; Griffith, Sandra D; Baldessarini, Ross J; Katzan, Irene L

2015-01-01

Patients with epilepsy or multiple sclerosis (MS) have high risks of depression and increased risks of suicide, but little is known about their risks of suicidal ideation. We sought to (1) estimate the prevalence of thoughts of being better off dead or of self-harm among patients with epilepsy or MS, (2) identify risk factors for such thoughts, and (3) determine whether any risk factors interact with depression to predict such thoughts. A Cleveland Clinic database provided information on 20,734 visits of 6586 outpatients with epilepsy or MS. Outcome measures were thoughts of death or self-harm (Patient Health Questionnaire [PHQ] item-9), and total score ≥10 for the 8 remaining PHQ items (probable major depression). Generalized estimating equations accounted for repeat visits in tests of associations of PHQ item-9 responses with depression, age, sex, race, household income, disease severity, and quality of life. Prevalence of thoughts of death or self-harm averaged 14.4% overall (epilepsy, 14.0% and MS, 14.7%). Factors associated with positive PHQ item-9 responses in epilepsy were depression and male sex, modified by poor quality of life. Factors associated with positive PHQ item-9 in MS were depression, male sex, medical comorbidity, and poor quality of life; the effect of depression was worse with greater MS severity and being unmarried. Among patients with common neurologic disorders (epilepsy or MS), 14%-15% reported thoughts of death or self-harm associated with illness severity, depression, quality of life, male sex, and being unmarried. Such patients require further evaluation of clinical outcomes and effects of treatment. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Closed Incision Negative Pressure Wound Therapy vs Conventional Dry Dressings After Primary Knee Arthroplasty: A Randomized Controlled Study.

PubMed

Manoharan, Varaguna; Grant, Andrea L; Harris, Alicia C; Hazratwala, Kaushik; Wilkinson, Matthew P R; McEwen, Peter J C

2016-11-01

The purpose of this study was to assess the effect of negative pressure wound therapy (NPWT) on quality of life (QoL), wound complications, and cost after primary knee arthroplasty. A prospective analysis of 33 patients undergoing primary knee arthroplasty performed by 3 surgeons in one institution. The first 12 patients (3 bilateral and 9 unilateral) had conventional dry dressings (CDD) applied and cost of dressings was assessed. The other 21 patients all underwent bilateral knee arthroplasty and had either side randomized to receiving NPWT or CDD. Cost of dressings, wound complications, and QoL were compared. One patient had a reaction to the NPWT requiring readmission. Another had persistent wound drainage that required NPWT application. There were no wound issues in the remaining 31 patients. The average cost in the first 12 patients was Australian dollar $48.70 with an average of 1.5 changes on ward. In the 21 patients receiving both dressings, the average cost for CDD was less (Australian dollar $43.51 vs $396.02, P ≤ .011, effect size [ES] = 1.06). When comparing QoL factors, wound leakage (0.14 vs 0.39 P = .019, ES = 1.02), and wound protection (0.16 vs 0.33, P = .001, ES = 0.021) were better in the NPWT group. There was no other significant difference in QoL factors. The average number of changes on the ward was less for the NPWT group (1.19 vs 1.38, P = .317, ES = 1.02). We found no benefit in wound healing or cost with NPWT post knee arthroplasty. There was some benefit in NPWT QoL factors less wound leakage and better protection. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Heavy metal contamination in river water and sediments of the Swarnamukhi River Basin, India: risk assessment and environmental implications.

PubMed

Patel, Priyanka; Raju, N Janardhana; Reddy, B C Sundara Raja; Suresh, U; Sankar, D B; Reddy, T V K

2018-04-01

The concentration of heavy metals was analyzed each of 20 river water, suspended sediments and bed sediments along the stretch of Swarnamukhi River Basin. River water is not contaminated with heavy metals except Fe and Mn. Contamination factor in sediments shows considerable to very high degree contamination with Cr, Cu, Pb and Zn. The sources of these metals could be residential wastes, sewer outfall, fertilizers, pesticides (M-45 + carbondine) and traffic activities apart from natural weathering of granitic rocks present in the basin area. Principal component analyses indicate the interaction between metals in different media. The comparison of metals (Cu, Pb and Zn) in bed sediments of Swarnamukhi River with the Indian and world averages indicates that the values obtained in the basin are above the Indian averages and far below to the world averages. Average shale values and sediment quality guidelines point toward the enrichment and contamination of Cu, Cr, Pb and Zn to several fold leading to eco-toxicological risks in basin.

Cost analysis and facility reimbursement in the long-term health care industry.

PubMed Central

Ullmann, S G

1984-01-01

This article examines costs and develops a system of prospective reimbursement for the industry committed to long-term health care. Together with estimates of average cost functions--for purposes of determining those factors affecting the costs of long-term health care, the author examines in depth the cost effects of patient mix and facility quality. Policy implications are indicated. The article estimates cost savings and predicted improvements in facility performance resulting from adoption of a prospective reimbursement system. PMID:6427138

Remedial Investigation Report Area of Contamination (AOC) 43J. Volume 1 of 2

DTIC Science & Technology

1996-02-01

produced risks within the USEPA range (1x1W05 and 3x10’, respectively). If the modified cancer slope factor (CSF) for arsenic was used to estimate excess...lifetime cancer risks for both source area and downgradient groundwater quality, then the cancer risks associated with exposure to both average and...very poorly drained; nearly level, organic; occurs in depressions and on flat areas of uplands and glacial outwash plains. Windsor Series. Deep

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects.

PubMed

Gerhart, James I; Burns, John W; Post, Kristina M; Smith, David A; Porter, Laura S; Burgess, Helen J; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J

2017-06-01

Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function, and pain catastrophizing. Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function, and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep quality × time of day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night's sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects

PubMed Central

Gerhart, James I.; Burns, John W.; Post, Kristina M.; Smith, David A.; Porter, Laura S.; Burgess, Helen J.; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J.

2016-01-01

Background Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. Purpose This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. Methods Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function and pain catastrophizing. Results Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep Quality × Time of Day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. Conclusions Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night’s sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping. PMID:27844327

Parameter Search Algorithms for Microwave Radar-Based Breast Imaging: Focal Quality Metrics as Fitness Functions.

PubMed

O'Loughlin, Declan; Oliveira, Bárbara L; Elahi, Muhammad Adnan; Glavin, Martin; Jones, Edward; Popović, Milica; O'Halloran, Martin

2017-12-06

Inaccurate estimation of average dielectric properties can have a tangible impact on microwave radar-based breast images. Despite this, recent patient imaging studies have used a fixed estimate although this is known to vary from patient to patient. Parameter search algorithms are a promising technique for estimating the average dielectric properties from the reconstructed microwave images themselves without additional hardware. In this work, qualities of accurately reconstructed images are identified from point spread functions. As the qualities of accurately reconstructed microwave images are similar to the qualities of focused microscopic and photographic images, this work proposes the use of focal quality metrics for average dielectric property estimation. The robustness of the parameter search is evaluated using experimental dielectrically heterogeneous phantoms on the three-dimensional volumetric image. Based on a very broad initial estimate of the average dielectric properties, this paper shows how these metrics can be used as suitable fitness functions in parameter search algorithms to reconstruct clear and focused microwave radar images.

The patient with chronic epididymitis: characterization of an enigmatic syndrome.

PubMed

Nickel, J Curtis; Siemens, D Robert; Nickel, Kyle R; Downey, Joe

2002-04-01

We provide a baseline description of men diagnosed with chronic epididymitis, explore relevant associations that may be important etiological factors and suggest a classification system and specific symptom assessment tool. Men diagnosed with chronic epididymitis, described as symptoms of discomfort or pain at least 3 months in duration in the scrotum, testicle or epididymis localized to 1 or each epididymis on clinical examination, completed an extensive specific clinical inventory questionnaire. Evaluation included demographics, preceding and concurrent clinical history, duration since diagnosis, associated and previous clinical associations, frequency and severity of prostatitis, voiding and sexual symptoms, specific and general quality of life, and history of investigation and/or treatment for the condition. Volunteers with no past or concurrent history of chronic epididymitis completed similar clinical inventory questionnaires. A total of 50 consecutive men 21 to 83 years old (average age 46) diagnosed with chronic epididymitis who had an average symptom duration of 4.9 years (range 0.25 to 29) were enrolled in the study. The average pain score plus or minus standard deviation was 4.7 +/- 2.1 (range 0 to 10). Of the men 16% were reasonably satisfied with their quality of life. Although 66% of the patients thought about the symptoms some or a lot, in only 30% did symptoms keep them from doing the kinds of things that they would usually do. The most common previous therapies recollected by the patients were antibiotics (74%) and anti-inflammatory agents (36%). At the time of the survey 26% of the men were on some type of pain medication. There were no significant epidemiological, sexual, medical or associated factors that differentiated patients with chronic epididymitis from the 20 controls. A chronic epididymitis classification system (inflammatory, obstructive and epididymalgia) and a symptom assessment index based on assessing pain and quality of life-impact was developed. This comprehensive clinical survey of men diagnosed with chronic epididymitis is the first step for defining and characterizing this particular population. Development of a classification system and symptom assessment index may direct further studies in the etiology, epidemiology and management of chronic epididymitis.

Calculation of intercepted runoff depth based on stormwater quality and environmental capacity of receiving waters for initial stormwater pollution management.

PubMed

Peng, Hai-Qin; Liu, Yan; Gao, Xue-Long; Wang, Hong-Wu; Chen, Yi; Cai, Hui-Yi

2017-11-01

While point source pollutions have gradually been controlled in recent years, the non-point source pollution problem has become increasingly prominent. The receiving waters are frequently polluted by the initial stormwater from the separate stormwater system and the wastewater from sewage pipes through stormwater pipes. Consequently, calculating the intercepted runoff depth has become a problem that must be resolved immediately for initial stormwater pollution management. The accurate calculation of intercepted runoff depth provides a solid foundation for selecting the appropriate size of intercepting facilities in drainage and interception projects. This study establishes a separate stormwater system for the Yishan Building watershed of Fuzhou City using the InfoWorks Integrated Catchment Management (InfoWorks ICM), which can predict the stormwater flow velocity and the flow of discharge outlet after each rainfall. The intercepted runoff depth is calculated from the stormwater quality and environmental capacity of the receiving waters. The average intercepted runoff depth from six rainfall events is calculated as 4.1 mm based on stormwater quality. The average intercepted runoff depth from six rainfall events is calculated as 4.4 mm based on the environmental capacity of the receiving waters. The intercepted runoff depth differs when calculated from various aspects. The selection of the intercepted runoff depth depends on the goal of water quality control, the self-purification capacity of the water bodies, and other factors of the region.

Uncontrolled combustion of shredded tires in a landfill -Part 2: Population exposure, public health response, and an air quality index for urban fires

PubMed Central

Singh, Ashish; Spak, Scott N.; Stone, Elizabeth A.; Downard, Jared; Bullard, Robert; Pooley, Mark; Kostle, Pamela A.; Mainprize, Matthew W.; Wichman, Michael D.; Peters, Thomas; Beardsley, Douglas; Stanier, Charles O.

2015-01-01

The Iowa City Landfill in eastern Iowa, United States, experienced a fire lasting 18 days in 2012, in which a drainage layer of over 1 million shredded tires burned, generating smoke that impacted the surrounding metropolitan area of 130,000 people. This emergency required air monitoring, risk assessment, dispersion modeling, and public notification. This paper quantifies the impact of the fire on local air quality and proposes a monitoring approach and an Air Quality Index (AQI) for use in future tire fires and other urban fires. Individual fire pollutants are ranked for acute and cancer relative risks using hazard ratios, with the highest acute hazard ratios attributed to SO2, particulate matter, and aldehydes. Using a dispersion model in conjunction with the new AQI, we estimate that smoke concentrations reached unhealthy outdoor levels for sensitive groups out to distances of 3.1 km and 18 km at 24-h and 1-h average times, respectively. Modeled and measured concentrations of PM2.5 from smoke and other compounds such as VOCs and benzo[a]pyrene are presented at a range of distances and averaging times, and the corresponding cancer risks are discussed. Through reflection on the air quality response to the event, consideration of cancer and acute risks, and comparison to other tire fires, we recommend that all landfills with shredded tire liners plan for hazmat fire emergencies. A companion paper presents emission factors and detailed smoke characterization. PMID:25624787

Uncontrolled combustion of shredded tires in a landfill -Part 2: Population exposure, public health response, and an air quality index for urban fires.

PubMed

Singh, Ashish; Spak, Scott N; Stone, Elizabeth A; Downard, Jared; Bullard, Robert; Pooley, Mark; Kostle, Pamela A; Mainprize, Matthew W; Wichman, Michael D; Peters, Thomas; Beardsley, Douglas; Stanier, Charles O

2015-03-01

The Iowa City Landfill in eastern Iowa, United States, experienced a fire lasting 18 days in 2012, in which a drainage layer of over 1 million shredded tires burned, generating smoke that impacted the surrounding metropolitan area of 130,000 people. This emergency required air monitoring, risk assessment, dispersion modeling, and public notification. This paper quantifies the impact of the fire on local air quality and proposes a monitoring approach and an Air Quality Index (AQI) for use in future tire fires and other urban fires. Individual fire pollutants are ranked for acute and cancer relative risks using hazard ratios, with the highest acute hazard ratios attributed to SO 2 , particulate matter, and aldehydes. Using a dispersion model in conjunction with the new AQI, we estimate that smoke concentrations reached unhealthy outdoor levels for sensitive groups out to distances of 3.1 km and 18 km at 24-h and 1-h average times, respectively. Modeled and measured concentrations of PM 2.5 from smoke and other compounds such as VOCs and benzo[a]pyrene are presented at a range of distances and averaging times, and the corresponding cancer risks are discussed. Through reflection on the air quality response to the event, consideration of cancer and acute risks, and comparison to other tire fires, we recommend that all landfills with shredded tire liners plan for hazmat fire emergencies. A companion paper presents emission factors and detailed smoke characterization.

Does social support buffer the effects of occupational stress on sleep quality among paramedics? A daily diary study.

PubMed

Pow, Jessie; King, David B; Stephenson, Ellen; DeLongis, Anita

2017-01-01

Given evidence suggesting a detrimental effect of occupational stress on sleep, it is important to identify protective factors that may ameliorate this effect. We followed 87 paramedics upon waking and after work over 1 week using a daily diary methodology. Multilevel modeling was used to examine whether the detrimental effects of daily occupational stress on sleep quality were buffered by perceived social support availability. Paramedics who reported more support availability tended to report better quality sleep over the week. Additionally, perceived support availability buffered postworkday sleep from average occupational stress and days of especially high occupational stress. Perceived support availability also buffered off-workday sleep from the cumulative amount of occupational stress experienced over the previous workweek. Those with low levels of support displayed poor sleep quality in the face of high occupational stress; those high in support did not show significant effects of occupational stress on sleep. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Assessment of physical and mental health in male university students with varying sleep habits.

PubMed

Matsumoto, Yuuki; Toyomasu, Kouji; Uchimura, Naohisa

2011-01-01

Healthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.

[Analysis of the academic level and impact of ophthalmological periodicals in China].

PubMed

Xu, Xiao-quan; Mao, Wen-ming; Zheng, Jun-hai; Qu, Jia

2009-04-01

To analyse the whole level and impact of ophthalmological periodicals in China. It was studied by using bibliometrics analysis method. According to the data of CAJCCR in 2002 to 2007 and Chinese Citation Database in 2001 to 2007. The impact factor (IF), non-self-citing impact factor, total cited frequency, cited articles, immediacy index, rate of fund papers, web immediacy download rate, average value of h index were analysed and the non-self-citing rate, h(2)/n, high cited articles were calculated. In addition, the results of cited by cole databases at home and abroad. The average value of IF and cited frequency of 13 kinds of ophthalmological periodicals were 0.3940 and 657 respectively in 2001 to 2006, which were higher than that of D part of CAJCCR. The periodicals which the five indexes of IF, non-self-citing impact factor, total cited frequency, the non-self-citing rate, immediacy index, rate of fund papers, web immediacy download rate, average value of h index and h(2)/n, high cited articles were Top 5 and cited by five or more than five kinds of the cole databases at home and abroad were Chinese Journal of Ophthalmology, Chinese Journal of Ocular Fundus Diseases, Practical Chinese Journal of Ophthalmology and Chinese Journal of Optometry & Ophthalmology. Most of indexes of Chinese Journal of Ophthalmology were the first. There are big difference between the 13 kinds of ophthalmological periodicals. The qualities of some ophthalmological periodicals should be improved.

Relation between spiritual intelligence and clinical competency of nurses in Iran

PubMed Central

Karimi-Moonaghi, Hossein; Gazerani, Akram; Vaghee, Saeed; Gholami, Hassan; Salehmoghaddam, Amir Reza; Gharibnavaz, Raheleh

2015-01-01

Background: Clinical competency is one of the most important requirements in nursing profession, based on which nurses are assessed. To obtain an effective and improved form of clinical competency, several factors are observed and monitored by the health educational systems. Among these observed factors, spiritual intelligence is considered as one of the most significant factors in nurses’ success and efficacy. In this study, it is aimed to determine the spiritual intelligence status and its relationship with clinical competency. Materials and Methods: The descriptive–correlational research was carried out on 250 nurses in Mashhad educational hospitals, selected by multi-stage sampling. Demographic, clinical competency, and spiritual intelligence questionnaires were used for data collection and 212 questionnaires were analyzed. Results: About 53.3% of nurses obtained above average scores in spiritual intelligence. Clinical competency was evaluated by both self-evaluation and head nurse evaluation methods. Most nurses (53.8%) were having good level of clinical competency based on self-evaluation, 48.2% were at average level based on head nurse evaluation, and 53.3% were at average level based on overall score. A significant correlation was found between spiritual intelligence and clinical competency. Conclusions: In this study, the positive significant correlation between nurses’ spiritual intelligence and their clinical competency is investigated. Because of the positive effects of spiritual intelligence on nurses’ clinical competency and quality of care, it is recommended to develop nurses’ spiritual intelligence during their education and by way of continuous medical education. PMID:26793250

Effect of surface roughness on liquid property measurements using mechanically oscillating sensors

NASA Technical Reports Server (NTRS)

Jain, Mahaveer K.; Grimes, Craig A.

2002-01-01

The resonant frequency and quality factor Q of a liquid immersed magnetoelastic sensor are shown to shift linearly with the liquid viscosity and density product. Measurements using different grade oils, organic chemicals, and glycerol-water mixtures show that the surface roughness of the sensor in combination with the molecular size of the liquid play important roles in determining measurement sensitivity, which can be controlled through adjusting the surface roughness of the sensor surface. A theoretical model describing the sensor resonant frequency and quality factor Q as a function of liquid properties is developed using a novel equivalent circuit approach. Experimental results are in agreement with theory when the liquid molecule size is larger than the average surface roughness. However, when the molecular size of the liquid is small relative to the surface roughness features molecules are trapped, and the trapped molecules act both as a mass load and viscous load; the result is higher viscous damping of the sensor than expected. c2002 Elsevier Science B.V. All rights reserved.

The effects of socioeconomic status on stroke risk and outcomes.

PubMed

Marshall, Iain J; Wang, Yanzhong; Crichton, Siobhan; McKevitt, Christopher; Rudd, Anthony G; Wolfe, Charles D A

2015-12-01

The latest evidence on socioeconomic status and stroke shows that stroke not only disproportionately affects low-income and middle-income countries, but also socioeconomically deprived populations within high-income countries. These disparities are reflected not only in risk of stroke but also in short-term and long-term outcomes after stroke. Increased average levels of conventional risk factors (eg, hypertension, hyperlipidaemia, excessive alcohol intake, smoking, obesity, and sedentary lifestyle) in populations with low socioeconomic status account for about half of these effects. In many countries, evidence shows that people with lower socioeconomic status are less likely to receive good-quality acute hospital and rehabilitation care than people with higher socioeconomic status. For clinical practice, better implementation of well established treatments, effective management of risk factors, and equity of access to high-quality acute stroke care and rehabilitation will probably reduce inequality substantially. Overcoming barriers and adapting evidence-based interventions to different countries and health-care settings remains a research priority. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors impacting the success of post-mortem sperm rescue in the rhinoceros.

PubMed

Roth, T L; Stoops, M A; Robeck, T R; O'Brien, J K

2016-04-01

The goal of this study was to identify factors that influenced the ability to successfully rescue sperm post-mortem from rhinoceroses maintained in North American zoos. Factors considered included procedural technicalities, individual rhinoceros characteristics and timing. Gross testicular pathology was noted in 17.4% of males (4/23) but did not impact sperm recovery except in one case of azoospermia (4.3%). Of the males in which sperm recovery was attempted (n=21), 62% yielded quality samples considered adequate for cryopreservation (≥ 30% motility with ≥ 2.0 forward progressive status). A high percentage of males (70.6%; 12/17) from which reproductive tissue was removed an d cooled ≤ 4 h after death yielded quality sperm samples, whereas only 25% (1/4) of males from which tissue was removed>4h after death yielded quality samples. Quality samples were recovered 1-51 h post-mortem from rhinoceroses 8 to 36 years old. Neither type of illness (prolonged or acute), or method of death (euthanasia or natural) affected the ability to harvest quality samples (P > 0.05). The Indian rhinoceros yielded significantly more sperm on average (40 × 10(9)) than the African black rhinoceros (3.6 × 10(9); P < 0.01) and the African white rhinoceros (3.2 × 10(9); P < 0.05). Across all species and samples assessed (n = 11), mean post-thaw sperm motility (41%), was only 15% less than pre-freeze motility (56%) and only decreased to 22% during the 6h post-thaw assessment period. Rhinoceros sperm rescue post-mortem is relatively successful across a wide range of variables, especially when tissues are removed and cooled promptly after death, and should be considered standard practice among zoos. Copyright © 2016 Elsevier B.V. All rights reserved.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study.

PubMed

Lucassen, Eliane A; de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M; Rosendaal, Frits R; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R

2017-01-01

Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Cross-sectional analysis of 915 participants (45-65 years, 56% women, BMI 26 (range: 18-56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03-1.14), declined self-rated sleep quality (1.76, 1.03-3.01), sleep latency (1.18, 1.06-1.31), and a one hour later sleep timing (1.51, 1.08-2.11), but not sleep duration (1.05, 0.90-1.23), were associated with osteopenia. PSQI score (1.10, 1.02-1.19) was also associated with sarcopenia; OR's of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99-1.31) and 1.54 (0.91-2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals.

Effects of laser in situ keratomileusis on mental health-related quality of life.

PubMed

Tounaka-Fujii, Kaoru; Yuki, Kenya; Negishi, Kazuno; Toda, Ikuko; Abe, Takayuki; Kouyama, Keisuke; Tsubota, Kazuo

2016-01-01

The aims of our study were to investigate whether laser in situ keratomileusis (LASIK) improves health-related quality of life (HRQoL) and to identify factors that affect postoperative HRQoL. A total of 213 Japanese patients who underwent primary LASIK were analyzed in this study. The average age of patients was 35.0±9.4 years. The subjects were asked to answer questions regarding subjective quality of vision, satisfaction, and quality of life (using the Japanese version of 36-Item Short Form Health Survey Version 2) at three time points: before LASIK, 1 month after LASIK, and 6 months after LASIK. Longitudinal changes over 6 months in the outputs of mental component summary (MCS) score and the physical component summary (PCS) score from the 36-Item Short Form Health Survey Version 2 questionnaire were compared between time points using a linear mixed-effects model. Delta MCS and PCS were calculated by subtracting the postoperative score (1 month after LASIK) from the preoperative score. Preoperative and postoperative factors associated with a change in the MCS score or PCS score were evaluated via a linear regression model. The preoperative MCS score was 51.0±9.4 and increased to 52.0±9.8 and 51.5±9.6 at 1 month and 6 months after LASIK, respectively, and the trend for the change from baseline in MCS through 6 months was significant ( P =0.03). PCS score did not change following LASIK. Delta MCS was significantly negatively associated with preoperative spherical equivalent, axial length, and postoperative quality of vision, after adjusting for potential confounding factors. Mental HRQoL is not lost with LASIK, and LASIK may improve mental HRQoL. Preoperative axial length may predict postoperative mental HRQoL.

In-flight sleep of flight crew during a 7-hour rest break: implications for research and flight safety.

PubMed

Signal, T Leigh; Gander, Philippa H; van den Berg, Margo J; Graeber, R Curtis

2013-01-01

To assess the amount and quality of sleep that flight crew are able to obtain during flight, and identify factors that influence the sleep obtained. Flight crew operating flights between Everett, WA, USA and Asia had their sleep recorded polysomnographically for 1 night in a layover hotel and during a 7-h in-flight rest opportunity on flights averaging 15.7 h. Layover hotel and in-flight crew rest facilities onboard the Boeing 777-200ER aircraft. Twenty-one male flight crew (11 Captains, mean age 48 yr and 10 First Officers, mean age 35 yr). N/A. Sleep was recorded using actigraphy during the entire tour of duty, and polysomnographically in a layover hotel and during the flight. Mixed model analysis of covariance was used to determine the factors affecting in-flight sleep. In-flight sleep was less efficient (70% vs. 88%), with more nonrapid eye movement Stage 1/Stage 2 and more frequent awakenings per h (7.7/h vs. 4.6/h) than sleep in the layover hotel. In-flight sleep included very little slow wave sleep (median 0.5%). Less time was spent trying to sleep and less sleep was obtained when sleep opportunities occurred during the first half of the flight. Multivariate analyses suggest age is the most consistent factor affecting in-flight sleep duration and quality. This study confirms that even during long sleep opportunities, in-flight sleep is of poorer quality than sleep on the ground. With longer flight times, the quality and recuperative value of in-flight sleep is increasingly important for flight safety. Because the age limit for flight crew is being challenged, the consequences of age adversely affecting sleep quantity and quality need to be evaluated.

Response of freshwater algae to water quality in Qinshan Lake within Taihu Watershed, China

NASA Astrophysics Data System (ADS)

Zhang, Jianying; Ni, Wanmin; Luo, Yang; Jan Stevenson, R.; Qi, Jiaguo

Although frequent algal blooms in Taihu Lake in China have become major environmental problems and have drawn national and international attention, little is understood about the relationship between algal blooms and water quality. The goal of this study was to assess the growth and species responses of freshwater algae to variation in water quality in Qinshan Lake, located in headwaters of the Taihu watershed. Water samples were collected monthly from ten study sites in the Qinshan Lake and were analyzed for species distribution of freshwater algae and physiochemical parameters such as total nitrogen (TN), NH4+-N, NO3--N, total phosphorus (TP), chemical oxygen demand (COD Mn) and Chl-a. The results showed that average TN was 4.47 mg/L, with 92.2% of values greater than the TN standard set by the Chinese Environmental Protection Agency; average TP was 0.051 mg/L, with 37.9% of values above the TP national standard; and average trophic level index (TLI) was 53, the lower end of eutrophic condition. Average Chl-a concentration was 12.83 mg/m 3. Green algae and diatom far outweighed other freshwater algae and were dominant most time of the year, with the highest relative abundances of 96% and 99%, respectively. Blue-green algae, composed mainly toxic strains like Microcystis sp ., Nostoc sp. and Oscillatoria sp., became most dominant in the summer with the maximum relative abundance of 69%. The blue-green algae sank to the lake bottom to overwinter, and then dinoflagellates became the dominant species in the winter, with highest relative abundance of 89%. Analysis indicated that nutrients, especially control of ammonia and co-varying nutrients were the major restrictive factor of population growth of blue-green algae, suggesting that control in nutrient enrichments is the major preventive measure of algal blooms in Qinshan Lake.

Climacteric women at work: What lurks behind poor occupational quality of life?

PubMed

Gazibara, Tatjana; Rancic, Biljana; Radovanovic, Sanja; Kurtagic, Ilma; Nurkovic, Selmina; Kovacevic, Nikolina; Dotlic, Jelena

2018-04-18

Physical and psychological changes during menopausal transition may affect various aspects of everyday functioning including women's work ability and work productivity. Presence of menopausal symptoms has been well-acknowledged to negatively affect quality of life (QOL). However, data on factors associated with occupational QOL among women at this period of life are lacking. The authors' purpose in this study was to evaluate factors affecting occupational QOL in a sample of employed mid-life women who are experiencing menopause. The authors performed a cross-sectional study among 335 employed women aged 40 to 65 years from Serbia. Socio-demographic questionnaire, Utian's Quality of Life Scale, and Beck's Depression Inventory were used in data collection. Women's average monthly household income and educational level were positively correlated, while having uterine prolapse was negatively associated with occupational QOL. Significant regression models assessing impact of gynecological illnesses and menopause-specific symptoms on occupational QOL (direct value and categories-below vs. above mean) showed that having insomnia, uterine prolapse, and genital inflammations may differentiate "good" from "poor" occupational QOL. Uterine prolapse, genital inflammation, and insomnia were associated with worse occupational QOL among working women in menopausal transition.

The attenuation of Fourier amplitudes for rock sites in eastern North America

USGS Publications Warehouse

Atkinson, Gail M.; Boore, David M.

2014-01-01

We develop an empirical model of the decay of Fourier amplitudes for earthquakes of M 3–6 recorded on rock sites in eastern North America and discuss its implications for source parameters. Attenuation at distances from 10 to 500 km may be adequately described using a bilinear model with a geometric spreading of 1/R1.3 to a transition distance of 50 km, with a geometric spreading of 1/R0.5 at greater distances. For low frequencies and distances less than 50 km, the effective geometric spreading given by the model is perturbed using a frequency‐ and hypocentral depth‐dependent factor defined in such a way as to increase amplitudes at lower frequencies near the epicenter but leave the 1 km source amplitudes unchanged. The associated anelastic attenuation is determined for each event, with an average value being given by a regional quality factor of Q=525f 0.45. This model provides a match, on average, between the known seismic moment of events and the inferred low‐frequency spectral amplitudes at R=1  km (obtained by correcting for the attenuation model). The inferred Brune stress parameters from the high‐frequency source terms are about 600 bars (60 MPa), on average, for events of M>4.5.

Relationship between landscape characteristics and surface water quality.

PubMed

Chang, C L; Kuan, W H; Lui, P S; Hu, C Y

2008-12-01

The effects of landscape characteristics on surface water quality were evaluated in terms of land-use condition, soil type and slope. The case area, the Chichiawan stream in the Wulin catchment in Taiwan, is Formosan landlocked salmon's natural habitat. Due to the agriculture behavior and mankind's activities, the water and environmental quality has gradually worsened. This study applied WinVAST model to predict hydrological responses and non-point source pollution (NPSP) exports in the Wulin catchment. The land-use condition and the slope of land surface in a catchment are major effect factors for watershed responses, including flows and pollutant exports. This work discussed the possible variation of watershed responses induced by the change of land-use condition, soil type and slope, etc. The results show that hydrological responses are highly relative to the value of Curve Number (CN); Pollutant exports have large relation to the average slope of the land surface in the Wulin catchment.

High pumping-power fiber combiner for double-cladding fiber lasers and amplifiers

NASA Astrophysics Data System (ADS)

Zheng, Jinkun; Zhao, Wei; Zhao, Baoyin; Li, Zhe; Chang, Chang; Li, Gang; Gao, Qi; Ju, Pei; Gao, Wei; She, Shengfei; Wu, Peng; Hou, Chaoqi; Li, Weinan

2018-03-01

A high pumping-power fiber combiner for backward pumping configurations is fabricated and demonstrated by manufacturing process refinement. The pump power handling capability of every pump fiber can extend to 600 W, corresponding to the average pump coupling efficiency of 94.83%. Totally, 2.67-kW output power with the beam quality factor M2 of 1.41 was obtained, using this combiner in the fiber amplifier experimental setup. In addition, the temperature of the splicing region was less than 50.0°C in the designed combiner under the action of circulating cooling water. The experimental results prove that the designed combiner is a promising integrated all-fiber device for multikilowatt continuous-wave fiber laser with excellent beam quality.

Quality assurance of medicines supplied to low-income and middle-income countries: poor products in shiny boxes?

PubMed Central

Schiavetti, B; Meessen, B; Pouget, C; Caudron, J M; Marchal, B; Massat, P; Thys, S; Ravinetto, R

2017-01-01

Objective In today's context of globalisation of pharmaceutical production and distribution, international and national procurement agencies play a de facto key role in defining the quality of medicines available in sub-Saharan Africa. We evaluated the compliance of a sample of pharmaceutical distributors active in sub-Saharan Africa with the standards of the WHO guideline ‘Model Quality Assurance System (WHO MQAS) for procurement agencies’, and we investigated factors favouring or hindering the adequate implementation of the guideline. Methods We used mixed-methods methodology to analyse quantitative and qualitative data. The quantitative study consisted of a retrospective secondary analysis of data collected by QUAMED (Quality Medicines for all), a partnership that pleads for universal access to quality-assured medicines. The qualitative survey consisted of formal and informal interviews with key informants. We adopted an embedded multiple-case study design. Findings Our analysis suggests that international distributors based in Europe perform, on average, better than sub-Saharan African distributors. However, some weaknesses are ubiquitous and concern critical processes, such as the initial selection of the products and the ongoing reassessment of their quality. This is due to several different factors: weak regulatory oversight, insufficient human/financial resources, weak negotiating power, limited judicial autonomy and/or lack of institutional commitment to quality. Conclusions Our findings suggest that pharmaceutical distributors active in sub-Saharan Africa generally do not apply stringent criteria for selecting products and suppliers. Therefore, product quality is not consistently assured but depends on the requirements of purchasers. While long-term solutions are awaited, the WHO MQAS guideline should be used as an evaluation and training tool to upgrade current standards. PMID:28589013

Effects of land use and seasonality on stream water quality in a small tropical catchment: The headwater of Córrego Água Limpa, São Paulo (Brazil).

PubMed

Rodrigues, Valdemir; Estrany, Joan; Ranzini, Mauricio; de Cicco, Valdir; Martín-Benito, José Mª Tarjuelo; Hedo, Javier; Lucas-Borja, Manuel E

2018-05-01

Stream water quality is controlled by the interaction of natural and anthropogenic factors over a range of temporal and spatial scales. Among these anthropogenic factors, land cover changes at catchment scale can affect stream water quality. This work aims to evaluate the influence of land use and seasonality on stream water quality in a representative tropical headwater catchment named as Córrego Água Limpa (Sao Paulo, Brasil), which is highly influenced by intensive agricultural activities and urban areas. Two systematic sampling approach campaigns were implemented with six sampling points along the stream of the headwater catchment to evaluate water quality during the rainy and dry seasons. Three replicates were collected at each sampling point in 2011. Electrical conductivity, nitrates, nitrites, sodium superoxide, Chemical Oxygen Demand (DQO), colour, turbidity, suspended solids, soluble solids and total solids were measured. Water quality parameters differed among sampling points, being lower at the headwater sampling point (0m above sea level), and then progressively higher until the last downstream sampling point (2500m above sea level). For the dry season, the mean discharge was 39.5ls -1 (from April to September) whereas 113.0ls -1 were averaged during the rainy season (from October to March). In addition, significant temporal and spatial differences were observed (P<0.05) for the fourteen parameters during the rainy and dry period. The study enhance significant relationships among land use and water quality and its temporal effect, showing seasonal differences between the land use and water quality connection, highlighting the importance of multiple spatial and temporal scales for understanding the impacts of human activities on catchment ecosystem services. Copyright © 2017 Elsevier B.V. All rights reserved.

Relationship of therapeutic outcome with quality of life on type 2 diabetes mellitus patients in Abdul Azis Singkawang hospital

NASA Astrophysics Data System (ADS)

Perwitasari, D. A.; Urbayatun, S.; Faridah, I. N.; Masyithah, N.

2017-11-01

Diabetes is one of the diseases that required long treatment. Therapeutic outcome is one of the important factors that affect the quality of life. The purpose of this research is to know the effect of therapeutic result on quality of life in Abdul Azis Singkawang hospital. This study used Cross-sectional design. The inclusion criteria for this study was patients with type 2 diabetes mellitus (T2DM) outpatients over 18 years with ICD code X E.11. This study used the EQ-5D to measure patient's quality of life. We recruited 86 T2DM patients who met the inclusion criteria and were dominated by female respondents around 57%. The average value of quality of life EQ-5D was the index value 0.75±0.22 and visual analog scale 74.02±11.80. The result of the analysis showed that there was significant relationship between income and quality of life (p=0.001) and there was significant correlation between 2-hour PG and quality of life (p=0.037). The conclusion of this study was the therapeutic outcome affect the quality of life in 2-h PG, where the higher 2-h PG showed the low quality of life.

Angle-resolved reflection spectroscopy of high-quality PMMA opal crystal

NASA Astrophysics Data System (ADS)

Nemtsev, Ivan V.; Tambasov, Igor A.; Ivanenko, Alexander A.; Zyryanov, Victor Ya.

2018-02-01

PMMA opal crystal was prepared by a simple hybrid method, which includes sedimentation, meniscus formation and evaporation. We investigated three surfaces of this crystal by angle-resolved reflective light spectroscopy and SEM study. The angle-resolved reflective measurements were carried out in the 400-1100 nm range. We have determined the high-quality ordered surface of the crystal region. Narrow particle size distribution of the surface has been revealed. The average particle diameter obtained with SEM was nearly 361 nm. The most interesting result was that reflectivity of the surface turned out up to 98% at normal light incidence. Using a fit of dependences of the maximum reflectivity wavelength from an angle based on the Bragg-Snell law, the wavelength of maximum 0° reflectivity, the particle diameter and the fill factor have been determined. For the best surface maximum reflectivity wavelength of a 0° angle was estimated to be 869 nm. The particle diameter and fill factor were calculated as 372 nm and 0.8715, respectively. The diameter obtained by fitting is in excellent agreement with the particle diameter obtained with SEM. The reflectivity maximum is assumed to increase significantly when increasing the fill factor. We believe that using our simple approach to manufacture PMMA opal crystals will significantly increase the fabrication of high-quality photonic crystal templates and thin films.

Microseismic Monitoring Design Optimization Based on Multiple Criteria Decision Analysis

NASA Astrophysics Data System (ADS)

Kovaleva, Y.; Tamimi, N.; Ostadhassan, M.

2017-12-01

Borehole microseismic monitoring of hydraulic fracture treatments of unconventional reservoirs is a widely used method in the oil and gas industry. Sometimes, the quality of the acquired microseismic data is poor. One of the reasons for poor data quality is poor survey design. We attempt to provide a comprehensive and thorough workflow, using multiple criteria decision analysis (MCDA), to optimize planning micriseismic monitoring. So far, microseismic monitoring has been used extensively as a powerful tool for determining fracture parameters that affect the influx of formation fluids into the wellbore. The factors that affect the quality of microseismic data and their final results include average distance between microseismic events and receivers, complexity of the recorded wavefield, signal-to-noise ratio, data aperture, etc. These criteria often conflict with each other. In a typical microseismic monitoring, those factors should be considered to choose the best monitoring well(s), optimum number of required geophones, and their depth. We use MDCA to address these design challenges and develop a method that offers an optimized design out of all possible combinations to produce the best data acquisition results. We believe that this will be the first research to include the above-mentioned factors in a 3D model. Such a tool would assist companies and practicing engineers in choosing the best design parameters for future microseismic projects.

Influence of the South-to-North Water Transfer and the Yangtze River Mitigation Projects on the water quality of Han River, China

NASA Astrophysics Data System (ADS)

Liu, W.; Kuo, Y. M.

2016-12-01

The Middle Route of China's South-to-North Water Transfer (MSNW) and Yangtze-Han River Water Diversion (YHWD) Projects have been operated since 2014, which may deteriorate water quality in Han River. The 11 water sampling sites distributed from the middle and down streams of Han River watershed were monitored monthly between July 2014 and December 2015. Factor analysis and cluster analysis were applied to investigate the major pollution types and main variables influencing water quality in Han River. The factor analysis distinguishes three main pollution types (agricultural nonpoint source, organic, and phosphorus point source pollution) affecting water quality of Han River. Cluster analysis classified all sampling sites into four groups and determined their pollution source for both Dry and Wet seasons. The sites located at central city receive point source pollution in both seasons. The water quality in downstream Han River (excluding central city sites) was influenced by nonpoint source pollution from Jianghan Plain. Variations of water qualities are associated with hydrological conditions varied from operations of engineering projects and seasonal variability especially in Dry season. Good water quality as Class III mainly occurred when flow rate is greater than 800 cms in Dry season. The low average flow rate below 583 cms will degrade water quality as Class V at almost all sites. Elevating the flow rate discharged from MSNW and YHWD Projects to Han River can avoid degrading water quality especially in low flow conditions and may decrease the probability of algal bloom occurrence in Han River. Increasing the flow rate from 400 cms to 700 cms in main Han River can obviously improve the water quality of Han River. The investigation of relationships between water quality and flow rate in both projects can provide management strategies of water quality for various flow conditions.

Rating, ranking, and understanding acoustical quality in university classrooms

NASA Astrophysics Data System (ADS)

Hodgson, Murray

2002-08-01

Nonoptimal classroom acoustical conditions directly affect speech perception and, thus, learning by students. Moreover, they may lead to voice problems for the instructor, who is forced to raise his/her voice when lecturing to compensate for poor acoustical conditions. The project applied previously developed simplified methods to predict speech intelligibility in occupied classrooms from measurements in unoccupied and occupied university classrooms. The methods were used to predict the speech intelligibility at various positions in 279 University of British Columbia (UBC) classrooms, when 70% occupied, and for four instructor voice levels. Classrooms were classified and rank ordered by acoustical quality, as determined by the room-average speech intelligibility. This information was used by UBC to prioritize classrooms for renovation. Here, the statistical results are reported to illustrate the range of acoustical qualities found at a typical university. Moreover, the variations of quality with relevant classroom acoustical parameters were studied to better understand the results. In particular, the factors leading to the best and worst conditions were studied. It was found that 81% of the 279 classrooms have "good," "very good," or "excellent" acoustical quality with a "typical" (average-male) instructor. However, 50 (18%) of the classrooms had "fair" or "poor" quality, and two had "bad" quality, due to high ventilation-noise levels. Most rooms were "very good" or "excellent" at the front, and "good" or "very good" at the back. Speech quality varied strongly with the instructor voice level. In the worst case considered, with a quiet female instructor, most of the classrooms were "bad" or "poor." Quality also varies with occupancy, with decreased occupancy resulting in decreased quality. The research showed that a new classroom acoustical design and renovation should focus on limiting background noise. They should promote high instructor speech levels at the back of the classrooms. This involves, in part, limiting the amount of sound absorption that is introduced into classrooms to control reverberation. Speech quality is not very sensitive to changes in reverberation, so controlling it for its own sake should not be a design priority. copyright 2002 Acoustical Society of America.

Monitoring and assessment of water quality of Tasik Cempaka, Bangi

NASA Astrophysics Data System (ADS)

Sabri, Nurul Ain Syahirah Mohamad; Abdullah, Md Pauzi; Mat, Sohif

2014-09-01

A study was carried out to determine the status of water quality of Tasik Cempaka which is a part of Sg. Air Itam, located near the Bangi industrial area. The study was carried out for eight months from May and to December 2013. Eight sampling stations were selected from upstream to downstream of Sg. Air Itam which represent the entire body of the lake water. There are 8 parameters measured and Water Quality Indices (WQI) was calculated and classified according to the National Water Quality Standard (NWQS). The physical and chemical parameters were temperature, pH, conductivity, dissolve oxygen (DO), total suspended solid (TSS), ammoniacal nitrogen (AN), chemical oxygen demand (COD) and biochemical oxygen demand (BOD). Among parameters that are affected by pollution is AN, COD and BOD. Classification by WQI shows that the average for all sampling was 54 (dry) and 52 (wet). Both are of class III according to National Water Quality Standard (NWQS) indicating slightly polluted. This is mainly due to drainage from Bangi Golf Resort and Bangi-Putrajaya Hotel. Other factors are activities around Sg. Air Itam such as municipal activities, settlements and manufacturing industries.

Genetic and management factors affecting beef quality in grazing Hereford steers.

PubMed

Melucci, L M; Panarace, M; Feula, P; Villarreal, E L; Grigioni, G; Carduza, F; Soria, L A; Mezzadra, C A; Arceo, M E; Papaleo Mazzucco, J; Corva, P M; Irurueta, M; Rogberg-Muñoz, A; Miquel, M C

2012-12-01

Attributes contributing to differences in beef quality of 206 Hereford steers finished on pasture were assessed. Beef quality traits evaluated were: Warner-Bratzler meat tenderness and muscle and fat color at one and seven days after slaughter and trained sensory panel traits (tenderness, juiciness, flavor, and marbling) at seven days. Molecular markers were CAPN1 316 and an SNP in exon 2 on the leptin gene (E2FB). Average daily live weight gain, ultrasound monthly backfat thickness gain and rib-eye area gain were estimated. Molecular markers effects on meat quality traits were analyzed by mixed models. Association of meat quality with post weaning growth traits was analyzed by canonical correlations. Muscle color and marbling were affected by CAPN1 316 and E2FB and Warner-Bratzler meat tenderness by the former. The results confirm that marker assisted selection for tenderness is advisable only when beef aging is a common practice. The most important sources of variation in tenderness and color of meat remained unaccounted for. Copyright © 2012 Elsevier Ltd. All rights reserved.

Quantified-Self for Obesity: Physical Activity Behaviour Sensing to Improve Health Outcomes.

PubMed

Taylor, David; Murphy, Jennifer; Ahmad, Mian; Purkayastha, Sanjay; Scholtz, Samantha; Ramezani, Ramin; Vlaev, Ivaylo; Blakemore, Alexandra I F; Darzi, Ara

2016-01-01

Physical activity levels in bariatric patients have not been well documented, despite their importance in maintaining weight loss following surgery. This study investigated the feasibility of tracking physical activity using a smartphone app with minimal user interaction. Thus far, we have obtained good quality data from 255 patients at various points in their weight loss journey. Preliminary analyses indicate little change in physical activity levels following surgery with pre-surgery patients reaching an average of 16 minutes per day and post-surgery patients achieving a daily average of 21 minutes. Further analyses using machine-learning techniques will be conducted to determine whether physical activity is a critical factor in distinguishing between successful and unsuccessful weight loss outcomes and in the resolution of comorbid conditions in patients with similar clinical profiles.

Trends in workers compensation costs in a hotel-operating company over a six-year period.

PubMed

Kelley, C R; Mark, C R

1995-03-01

A large Honolulu-based hotel-operating company reviewed its workers compensation costs over the last 6 years. Data retrieved from the company's computerized data base is used to describe trends in injury incidence rate, average cost per claim, average medical cost per claim, and medical expenses as a percentage of total costs. Factors that might have influenced these parameters include company reorganization, employee training and safety programs, changes in the economy, company morale, aggressive case management, and the quality of the adjusting services hired. Cause-and-effect relationships, although suggested, cannot be proven. The data is presented, in this year of imminent workers compensation legislative reform, to increase the available factual data base on which rational and efficacious reform proposals can be developed.

Impacts of land use and population density on seasonal surface water quality using a modified geographically weighted regression.

PubMed

Chen, Qiang; Mei, Kun; Dahlgren, Randy A; Wang, Ting; Gong, Jian; Zhang, Minghua

2016-12-01

As an important regulator of pollutants in overland flow and interflow, land use has become an essential research component for determining the relationships between surface water quality and pollution sources. This study investigated the use of ordinary least squares (OLS) and geographically weighted regression (GWR) models to identify the impact of land use and population density on surface water quality in the Wen-Rui Tang River watershed of eastern China. A manual variable excluding-selecting method was explored to resolve multicollinearity issues. Standard regression coefficient analysis coupled with cluster analysis was introduced to determine which variable had the greatest influence on water quality. Results showed that: (1) Impact of land use on water quality varied with spatial and seasonal scales. Both positive and negative effects for certain land-use indicators were found in different subcatchments. (2) Urban land was the dominant factor influencing N, P and chemical oxygen demand (COD) in highly urbanized regions, but the relationship was weak as the pollutants were mainly from point sources. Agricultural land was the primary factor influencing N and P in suburban and rural areas; the relationship was strong as the pollutants were mainly from agricultural surface runoff. Subcatchments located in suburban areas were identified with urban land as the primary influencing factor during the wet season while agricultural land was identified as a more prevalent influencing factor during the dry season. (3) Adjusted R 2 values in OLS models using the manual variable excluding-selecting method averaged 14.3% higher than using stepwise multiple linear regressions. However, the corresponding GWR models had adjusted R 2 ~59.2% higher than the optimal OLS models, confirming that GWR models demonstrated better prediction accuracy. Based on our findings, water resource protection policies should consider site-specific land-use conditions within each watershed to optimize mitigation strategies for contrasting land-use characteristics and seasonal variations. Copyright © 2016 Elsevier B.V. All rights reserved.

On-Site Pilot Study - Removal of Uranium, Radium-226 and Arsenic from Impacted Leachate by Reverse Osmosis - 13155

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

McMurray, Allan; Everest, Chris; Rilling, Ken

Conestoga-Rovers and Associates (CRA-LTD) performed an on-site pilot study at the Welcome Waste Management Facility in Port Hope, Ontario, Canada, to evaluate the effectiveness of a unique leachate treatment process for the removal of radioactive contaminants from leachate impacted by low-level radioactive waste. Results from the study also provided the parameters needed for the design of the CRA-LTD full scale leachate treatment process design. The final effluent water quality discharged from the process to meet the local surface water discharge criteria. A statistical software package was utilized to obtain the analysis of variance (ANOVA) for the results from design ofmore » experiment applied to determine the effect of the evaluated factors on the measured responses. The factors considered in the study were: percent of reverse osmosis permeate water recovery, influent coagulant dosage, and influent total dissolved solids (TDS) dosage. The measured responses evaluated were: operating time, average specific flux, and rejection of radioactive contaminants along with other elements. The ANOVA for the design of experiment results revealed that the operating time is affected by the percent water recovery to be achieved and the flocculant dosage over the range studied. The average specific flux and rejection for the radioactive contaminants were not affected by the factors evaluated over the range studied. The 3 month long on-site pilot testing on the impacted leachate revealed that the CRA-LTD leachate treatment process was robust and produced an effluent water quality that met the surface water discharge criteria mandated by the Canadian Nuclear Safety Commission and the local municipality. (authors)« less

Quality of life after lacunar stroke: the Secondary Prevention of Small Subcortical Strokes study.

PubMed

Dhamoon, Mandip S; McClure, Leslie A; White, Carole L; Lau, Helena; Benavente, Oscar; Elkind, Mitchell S V

2014-01-01

We sought to describe the course and predictors of quality of life (QOL) after lacunar stroke. We hypothesized that there is a decline in QOL after recovery from lacunar stroke. The Secondary Prevention of Small Subcortical Strokes is a clinical trial in lacunar stroke patients with annual assessments of QOL with the stroke-specific QOL score. The overall score was used and analyzed as a continuous variable (range 0-5). We fit linear mixed models to assess the trend in QOL over time, assuming linearity of time, and adjusted for demographics, medical risk factors, cognitive factors, and functional status in univariable and multivariable models. Among 2870 participants, mean age was 63.4 years (SD 10.7), 63% were men, 51% White, 32% Hispanic, 36% had college education, 36% had diabetes, 89% had hypertension, and 10% had prior stroke. Mean poststroke Barthel Index (BI) score was 95.4 (assessed on average 6 months after stroke). In the final multivariable model, there was an average increase in QOL of .6% per year, and factors associated with decline in QOL over time included age (-.0003 per year, P < .0001), any college education (-.0013 per year, .01), prior stroke (-.004 per year, P < .0001), and BI (-.0002 per year, P < .0001). In this clinical trial of lacunar stroke patients, there was a slight annual increase in QOL overall, and age, level of education, and prior stroke were associated with changes in QOL over time. Multiple strokes may cause decline in QOL over time in the absence of recurrent events. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Vocal symptoms, voice activity, and participation profile and professional performance of call center operators.

PubMed

Piwowarczyk, Tatiana Carvalho; Oliveira, Gisele; Lourenço, Luciana; Behlau, Mara

2012-03-01

To analyze the phonatory and laryngopharyngeal symptoms reported by call center operators; and quantify the impact of these symptoms on quality of life, and the association between these issues and professional performance, number of monthly calls, and number of missed workdays. Call center operators (n=157) from a billing call center completed the Vocal Signs and Symptoms Questionnaire and the Brazilian version of the Voice Activity and Participation Profile (VAPP). The company provided data regarding professional performance, average number of monthly calls, and number of missed workdays for each employee. The mean number of current symptoms (6.8) was greater in the operators than data for the general population (1.7). On average, 4.2 symptoms were attributed to occupational factors. The average number of symptoms did not correlate with professional performance (P=0.571). However, fewer symptoms correlated with decreased missed workdays and higher mean monthly call figures. The VAPP scores were relatively low, suggesting little impact of voice difficulties on call center operator's quality of life. However, subjects with elevated VAPP scores also had poorer professional performance. The presence of vocal symptoms does not necessarily relate to decreased professional performance. However, an association between higher vocal activity limitation and participation scores and poorer professional performance was observed. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Impact beyond the impact factor.

PubMed

Zupanc, Günther K H

2014-02-01

The journal impact factor is an annually calculated number for each scientific journal, based on the average number of times its articles published in the two preceding years have been cited. It was originally devised as a tool for librarians and publishers to provide information about the citation performance of a journal as a whole, but over the last few decades it has increasingly been used to assess the quality of specific articles and the research performance of individual investigators, institutions, and countries. In addition to this clear abuse of the journal impact factor, several conceptual and technical issues limit its usability as a measure of journal reputation, especially when journals are compared across different fields. An author's decision regarding the suitability of a scholarly journal for publication should, therefore, be based on the impact that this journal makes in the field of research, rather than on the journal impact factor.

The effective factors on library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences

PubMed Central

Ashrafi-rizi, Hasan; Sajad, Maryam Sadat; Rahmani, Sedigheh; Bahrami, Susan; Papi, Ahmad

2014-01-01

Introduction: The efficient use of libraries can be an important factor in determining the educational quality of Universities. Therefore, investigation and identification of factors affecting library anxiety becomes increasingly necessary. The purpose of this research is to determine the factors effecting library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences. Materials and Methods: This was an applied survey research using Bostick's Library Anxiety questionnaire as data gathering tool. The statistical population consisted of all students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences (15011 students) with the sample size of 375 using stratified random sampling. The validity of data gathering tool was confirmed by experts in the library and information science and its reliability was determined by Cronbach's alpha (r = 0.92). Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (t-test and ANOVA) were used for data analysis using SPSS 18 software. Results: Findings showed that the mean of library anxiety score was 2.68 and 2.66 for students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences respectively which is above average (2.5). Furthermore, age and gender had no meaningful effect on the library anxiety of students of Isfahan University of Medical Sciences, but gender had a meaningful effect on library anxiety of students of Shiraz University of Medical Sciences while age had no such effect. Conclusion: The results showed that the mean of factors effecting library anxiety in students of Isfahan University of Medical Sciences and students of Shiraz University of Medical Sciences is higher than average and therefore not satisfactory and only factors relating to feeling comfortable in the library is lower than average and somewhat satisfactory. PMID:25250358

The Qatar genome: a population-specific tool for precision medicine in the Middle East

PubMed Central

Fakhro, Khalid A; Staudt, Michelle R; Ramstetter, Monica Denise; Robay, Amal; Malek, Joel A; Badii, Ramin; Al-Marri, Ajayeb Al-Nabet; Khalil, Charbel Abi; Al-Shakaki, Alya; Chidiac, Omar; Stadler, Dora; Zirie, Mahmoud; Jayyousi, Amin; Salit, Jacqueline; Mezey, Jason G; Crystal, Ronald G; Rodriguez-Flores, Juan L

2016-01-01

Reaching the full potential of precision medicine depends on the quality of personalized genome interpretation. In order to facilitate precision medicine in regions of the Middle East and North Africa (MENA), a population-specific genome for the indigenous Arab population of Qatar (QTRG) was constructed by incorporating allele frequency data from sequencing of 1,161 Qataris, representing 0.4% of the population. A total of 20.9 million single nucleotide polymorphisms (SNPs) and 3.1 million indels were observed in Qatar, including an average of 1.79% novel variants per individual genome. Replacement of the GRCh37 standard reference with QTRG in a best practices genome analysis workflow resulted in an average of 7* deeper coverage depth (an improvement of 23%) and 756,671 fewer variants on average, a reduction of 16% that is attributed to common Qatari alleles being present in QTRG. The benefit for using QTRG varies across ancestries, a factor that should be taken into consideration when selecting an appropriate reference for analysis. PMID:27408750

Perineal techniques during the second stage of labour for reducing perineal trauma.

PubMed

Aasheim, Vigdis; Nilsen, Anne Britt Vika; Reinar, Liv Merete; Lukasse, Mirjam

2017-06-13

Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011. To assess the effect of perineal techniques during the second stage of labour on the incidence and morbidity associated with perineal trauma. We searched Cochrane Pregnancy and Childbirth's Trials Register (26 September 2016) and reference lists of retrieved studies. Published and unpublished randomised and quasi-randomised controlled trials evaluating perineal techniques during the second stage of labour. Cross-over trials were not eligible for inclusion. Three review authors independently assessed trials for inclusion, extracted data and evaluated methodological quality. We checked data for accuracy. Twenty-two trials were eligible for inclusion (with 20 trials involving 15,181 women providing data). Overall, trials were at moderate to high risk of bias; none had adequate blinding, and most were unclear for both allocation concealment and incomplete outcome data. Interventions compared included the use of perineal massage, warm and cold compresses, and other perineal management techniques.Most studies did not report data on our secondary outcomes. We downgraded evidence for risk of bias, inconsistency, and imprecision for all comparisons. Hands off (or poised) compared to hands onHands on or hands off the perineum made no clear difference in incidence of intact perineum (average risk ratio (RR) 1.03, 95% confidence interval (CI) 0.95 to 1.12, two studies, Tau² 0.00, I² 37%, 6547 women; moderate-quality evidence), first-degree perineal tears (average RR 1.32, 95% CI 0.99 to 1.77, two studies, 700 women; low-quality evidence), second-degree tears (average RR 0.77, 95% CI 0.47 to 1.28, two studies, 700 women; low-quality evidence), or third- or fourth-degree tears (average RR 0.68, 95% CI 0.21 to 2.26, five studies, Tau² 0.92, I² 72%, 7317 women; very low-quality evidence). Substantial heterogeneity for third- or fourth-degree tears means these data should be interpreted with caution. Episiotomy was more frequent in the hands-on group (average RR 0.58, 95% CI 0.43 to 0.79, Tau² 0.07, I² 74%, four studies, 7247 women; low-quality evidence), but there was considerable heterogeneity between the four included studies.There were no data for perineal trauma requiring suturing. Warm compresses versus control (hands off or no warm compress)A warm compress did not have any clear effect on the incidence of intact perineum (average RR 1.02, 95% CI 0.85 to 1.21; 1799 women; four studies; moderate-quality evidence), perineal trauma requiring suturing (average RR 1.14, 95% CI 0.79 to 1.66; 76 women; one study; very low-quality evidence), second-degree tears (average RR 0.95, 95% CI 0.58 to 1.56; 274 women; two studies; very low-quality evidence), or episiotomy (average RR 0.86, 95% CI 0.60 to 1.23; 1799 women; four studies; low-quality evidence). It is uncertain whether warm compress increases or reduces the incidence of first-degree tears (average RR 1.19, 95% CI 0.38 to 3.79; 274 women; two studies; I² 88%; very low-quality evidence).Fewer third- or fourth-degree perineal tears were reported in the warm-compress group (average RR 0.46, 95% CI 0.27 to 0.79; 1799 women; four studies; moderate-quality evidence). Massage versus control (hands off or routine care)The incidence of intact perineum was increased in the perineal-massage group (average RR 1.74, 95% CI 1.11 to 2.73, six studies, 2618 women; I² 83% low-quality evidence) but there was substantial heterogeneity between studies). This group experienced fewer third- or fourth-degree tears (average RR 0.49, 95% CI 0.25 to 0.94, five studies, 2477 women; moderate-quality evidence).There were no clear differences between groups for perineal trauma requiring suturing (average RR 1.10, 95% CI 0.75 to 1.61, one study, 76 women; very low-quality evidence), first-degree tears (average RR 1.55, 95% CI 0.79 to 3.05, five studies, Tau² 0.47, I² 85%, 537 women; very low-quality evidence), or second-degree tears (average RR 1.08, 95% CI 0.55 to 2.12, five studies, Tau² 0.32, I² 62%, 537 women; very low-quality evidence). Perineal massage may reduce episiotomy although there was considerable uncertainty around the effect estimate (average RR 0.55, 95% CI 0.29 to 1.03, seven studies, Tau² 0.43, I² 92%, 2684 women; very low-quality evidence). Heterogeneity was high for first-degree tear, second-degree tear and for episiotomy - these data should be interpreted with caution. Ritgen's manoeuvre versus standard careOne study (66 women) found that women receiving Ritgen's manoeuvre were less likely to have a first-degree tear (RR 0.32, 95% CI 0.14 to 0.69; very low-quality evidence), more likely to have a second-degree tear (RR 3.25, 95% CI 1.73 to 6.09; very low-quality evidence), and neither more nor less likely to have an intact perineum (RR 0.17, 95% CI 0.02 to 1.31; very low-quality evidence). One larger study reported that Ritgen's manoeuvre did not have an effect on incidence of third- or fourth-degree tears (RR 1.24, 95% CI 0.78 to 1.96,1423 women; low-quality evidence). Episiotomy was not clearly different between groups (RR 0.81, 95% CI 0.63 to 1.03, two studies, 1489 women; low-quality evidence). Other comparisonsThe delivery of posterior versus anterior shoulder first, use of a perineal protection device, different oils/wax, and cold compresses did not show any effects on perineal outcomes. Only one study contributed to each of these comparisons, so data were insufficient to draw conclusions. Moderate-quality evidence suggests that warm compresses, and massage, may reduce third- and fourth-degree tears but the impact of these techniques on other outcomes was unclear or inconsistent. Poor-quality evidence suggests hands-off techniques may reduce episiotomy, but this technique had no clear impact on other outcomes. There were insufficient data to show whether other perineal techniques result in improved outcomes.Further research could be performed evaluating perineal techniques, warm compresses and massage, and how different types of oil used during massage affect women and their babies. It is important for any future research to collect information on women's views.

Analysis of quality of life and influencing factors in 197 Chinese patients with port-wine stains

PubMed Central

Wang, Juan; Zhu, Yu-you; Wang, Zhong-ying; Yao, Xiu-hua; Zhang, Lan-fang; Lv, Hong; Zhang, Si-ping; Hu, Bai

2017-01-01

Abstract Port-wine stains (PWS) are congenital capillary malformations, usually occurring on the face, neck, and other exposed parts of the skin, that have serious psychological and social impact on the patient. Most researchers focus on the treatment of PWS, but the quality of life (QoL) of PWS patients is seldom researched. The objective of this study is to evaluate the QoL of patients with PWS on exposed parts and explore the factors influencing the QoL of PWS patients. The QoL of 197 cases with PWS on exposed parts were prospectively studied using the Dermatology Life Quality Index questionnaire (DLQI), and the factors influencing the patients’ QoL were analyzed by single-factor analysis and multiple-factor logistic regression analysis. The reliability and validity of the QoL of PWS patients were then assessed by DLQI. A total of 197 valid questionnaires were collected. The DLQI scores in PWS cases ranged from 2 to 16, with 2 to 5 in 52.29% (103/197), 6 to 10 in 42.13% (83/197), and 11 to 20 in 5.58% (11/197). The main score elements of the DLQI focused on symptoms and feelings, daily activities, and social entertainment. Single-factor analysis and multiple-factor logistic regression analysis showed that the main influencing factors were female sex, skin hypertrophy, and lesion area >30 cm2. The inter-item correlation averaged 47.46% and the Cronbach α was 0.740, indicating high internal consistency. Correlation of the 6 dimensions of the DLQI questionnaires with the total scores showed that the Spearman correlation coefficient r ranged from 0.550 to 0.782 (P < .001), with symptoms and feelings having a correlation coefficient of 0.782 and a high correlation with total scores. This study shows that PWS has mild to moderate influence on the QoL of most patients, mainly on daily activities, social entertainment, and feelings. PMID:29390578

Predictors of non-vertebral fracture in older Chinese males and females: Mr. OS and Ms. OS (Hong Kong).

PubMed

Kwok, Timothy Chi Yui; Su, Yi; Khoo, Chyi Chyi; Leung, Jason; Kwok, Anthony; Orwoll, Eric; Woo, Jean; Leung, Ping Chung

2017-05-01

Clinical risk factors to predict fracture are useful in guiding management of patients with osteoporosis or falls. Clinical predictors may however be population specific because of differences in lifestyle, environment and ethnicity. Four thousand community-dwelling Chinese males and females with average ages of 72.4 and 72.6 years were followed up for incident fractures, with an average of 6.5 and 8.8 years, respectively. Clinical information was collected, and bone mineral density (BMD) measurements were carried out at baseline. Stepwise Cox regression models were used to identify risk factors of nonvertebral fractures, with BMD as covariate. Areas under the receiver-operating characteristic (ROC) curve (AUC) were compared among different risk models. The incidence rates of nonvertebral fractures were 10.3 and 20.5 per 1000 person years in males and females, respectively. In males, age ≥80, history of a fall in the past year, fracture history, chronic obstructive pulmonary disease, impaired visual depth perception and low physical health-related quality of life were significant fracture risk factors, independent of BMD. In females, the significant factors were fracture history, low visual acuity and slow narrow walking speed. The clinical risk factors had a significant influence on fracture risk irrespective of osteoporosis status, even having a better risk discrimination than BMD alone, especially in males. The best risk prediction model consisted both BMD and clinical risk factors. Clinical risk factors have additive value to hip BMD in predicting nonvertebral fractures in older Chinese people and may predict them better than BMD alone in older Chinese males.

Health-related quality of life of children with physical disabilities: a longitudinal study

PubMed Central

2014-01-01

Background Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent’s perceptions of child’s HRQoL across 18 months and 3) explore factors that predict these changes. Methods Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child’s factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors. Results CHQ scores of the study’s participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children’s behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time. Conclusions Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ. PMID:24476085

Health-related quality of life of children with physical disabilities: a longitudinal study.

PubMed

Law, Mary; Hanna, Steven; Anaby, Dana; Kertoy, Marilyn; King, Gillian; Xu, Liqin

2014-01-30

Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent's perceptions of child's HRQoL across 18 months and 3) explore factors that predict these changes. Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child's factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors. CHQ scores of the study's participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children's behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time. Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ.

Association of Amplitude and Stability of Circadian Rhythm, Sleep Quality, and Occupational Stress with Sickness Absence among a Gas Company Employees-A Cross Sectional Study from Iran.

PubMed

Zare, Rezvan; Choobineh, Alireza; Keshavarzi, Sareh

2017-09-01

The present study was carried out to assess the relationship between sickness absence and occupational stress, sleep quality, and amplitude and stability of circadian rhythm as well as to determine contributing factors of sickness absence. This cross sectional study was conducted on 400 randomly selected employees of an Iranian gas company. The data were collected using Pittsburgh sleep quality index, Karolinska sleepiness scale, circadian type inventory, and Osipow occupational stress questionnaires. The mean age and job tenure of the participants were 33.18 ± 5.64 years and 6.06 ± 4.99 years, respectively. Also, the participants had been absent from work on average 2.16 days a year. According to the results, 209 participants had no absences, 129 participants had short-term absences, and 62 participants had long-term absences. The results showed a significant relationship between short-term absenteeism and amplitude of circadian rhythm [odds ratio (OR) = 6.13], sleep quality (OR = 14.46), sleepiness (OR = 2.08), role boundary (OR = 6.45), and responsibility (OR = 5.23). Long-term absenteeism was also significantly associated with amplitude of circadian rhythm (OR = 2.42), sleep quality (OR = 21.56), sleepiness (OR = 6.44), role overload (OR = 4.84), role boundary (OR = 4.27), and responsibility (OR = 3.72). The results revealed that poor sleep quality, amplitude of circadian rhythm, and occupational stress were the contributing factors for sickness absence in the study population.

Quality of life in relation to physical, psychosocial and socioeconomic conditions among reindeer-herding Sami.

PubMed

Daergo, Laila; Edin-Liljegren, Anette; Sjölander, Per

2008-02-01

To analyse different aspects of health-related quality of life factors among members of reindeer-herding families. Cross-sectional study based on data from a comprehensive survey. The health-related quality of life (SF-36) factors were analysed on 99 (56 men, 43 women) adult members of reindeer-herding families. Comparisons were made between the reindeer-herding family members and a Swedish reference population. Associations between mental and physical component summary measures and a number of sociodemographic, biomedical, physical, psychosocial and socio-economic variables were analysed with multivariate regression statistics. Men scored higher than women on physical and social function and vitality. The average scores on the subscales for the reindeer-herding family members were similar to those of the Swedish reference population, except for reindeer-herding men who scored higher on physical function and lower on bodily pain. For women, the quality of life was related to age, sense of coherence, lifestyle and behavioural variables, as well as to issues such as diseases among close relatives, social networks and the economy of their business. For men, it was mainly related to musculoskeletal pain conditions, age, sense of coherence and physical and psychosocial working conditions. Men and women of the reindeer-herding families need partly different conditions to enjoy a high quality of life. From the results, it might be predicted that poor somatic and psychosocial health, increased intrusion from exploiters on the grazing land and declining profit in reindeer husbandry constitute important threats to a good quality of life among members of reindeer-herding families.

Measuring health-related quality of life in young adolescents: reliability and validity in the Norwegian version of the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales.

PubMed

Reinfjell, Trude; Diseth, Trond H; Veenstra, Marijke; Vikan, Arne

2006-09-14

Health-Related Quality of Life (HRQOL) studies concerning children and adolescents are a growing field of research. The Pediatric Quality of Life Inventory (PedsQL) is considered as a promising HRQOL instrument with the availability of age appropriate versions and parallel forms for both child and parents. The purpose of the current study was to evaluate the psychometric properties of the Norwegian translation of the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic core scale in a sample of healthy young adolescents. A cross-sectional study of 425 healthy young adolescents and 237 of their caregivers participating as a proxy. Reliability was assessed by Cronbach's alpha. Construct validity was assessed using exploratory factor analysis and by exploring the intercorrelations between and among the four PedsQL subscales for adolescents and their parents. All the self-report scales and proxy-report scales showed satisfactory reliability with Cronbach's alpha varying between 0.77 and 0.88. Factor analysis showed results comparable with the original version, except for the Physical Health scale. On average, monotrait-multimethod correlations were higher than multitrait-multimethod correlations. Sex differences were noted on the emotional functioning subscale, girls reported lower HRQOL than boys. The Norwegian PedsQL is a valid and reliable generic pediatric health-related Quality of Life measurement that can be recommended for self-reports and proxy-reports for children in the age groups ranging from 13-15 years.

Multiple enface image averaging for enhanced optical coherence tomography angiography imaging.

PubMed

Uji, Akihito; Balasubramanian, Siva; Lei, Jianqin; Baghdasaryan, Elmira; Al-Sheikh, Mayss; Borrelli, Enrico; Sadda, SriniVas R

2018-05-31

To investigate the effect of multiple enface image averaging on image quality of the optical coherence tomography angiography (OCTA). Twenty-one normal volunteers were enrolled in this study. For each subject, one eye was imaged with 3 × 3 mm scan protocol, and another eye was imaged with the 6 × 6 mm scan protocol centred on the fovea using the ZEISS Angioplex™ spectral-domain OCTA device. Eyes were repeatedly imaged to obtain nine OCTA cube scan sets, and nine superficial capillary plexus (SCP) and deep capillary plexus (DCP) were individually averaged after registration. Eighteen eyes with a 3 × 3 mm scan field and 14 eyes with a 6 × 6 mm scan field were studied. Averaged images showed more continuous vessels and less background noise in both the SCP and the DCP as the number of frames used for averaging increased, with both 3 × 3 and 6 × 6 mm scan protocols. The intensity histogram of the vessels dramatically changed after averaging. Contrast-to-noise ratio (CNR) and subjectively assessed image quality scores also increased as the number of frames used for averaging increased in all image types. However, the additional benefit in quality diminished when averaging more than five frames. Averaging only three frames achieved significant improvement in CNR and the score assigned by certified grades. Use of multiple image averaging in OCTA enface images was found to be both objectively and subjectively effective for enhancing image quality. These findings may of value for developing optimal OCTA imaging protocols for future studies. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

[Beauty judgment: review of the literature].

PubMed

Faure, Jacques; Bolender, Yves

2014-03-01

Esthetic judgments are surely subjective, but as surely, that does not preclude them being studied objectively through rigorous scientific methods. The factual basis of a science of esthetics is not to settle whether some person or image is "objectively beautiful" but rather to determine whether some representative set or sets of individuals judge or experience him/her/it as beautiful or unattractive. The aim of this paper is to review the definitional, theoretical and methodological aspects pertaining to the perception of facial/dental attractiveness by a group of representative individuals. The first part lays down the basic principles of the perception of facial/dental attractiveness: the perception involves a jury, a field of investigation and a test providing quantitative data; the following general determinants of beauty perception are reviewed: the average morphology, the judge's cultural background, the numerology, the judge's ethnical origin. Indirect determinants are the dentition, the osseous architecture and the muscular envelope. Some disruptive factors might alter the judges' facial perception. They might be qualified as either peripheral to the face or psycho-social factors. Peripheral factors include hair style and color, skin hue, wrinkles, lips color... Psycho-social factors cover the personality of the subject being evaluated, his/her intelligence or behavior. The second part deals specifically with the methodology used to determine facial attractiveness and to correlate this latter with a specific morphology. Typically such a study aims to determine average esthetic preferences for some set of visual displays among a particular jury, given a specific task to judge esthetic quality or qualities. The sample being studied, the displays, the jury or jurys, the rating procedure must all be specified prior to collecting data. A specific emphasis will be given to the rating process and the associated morphometrics, the ultimate goal being to discriminate morphologies judged as attractive among our patients. © EDP Sciences, SFODF, 2014.

Effects of improved spatial and temporal modeling of on-road vehicle emissions.

PubMed

Lindhjem, Christian E; Pollack, Alison K; DenBleyker, Allison; Shaw, Stephanie L

2012-04-01

Numerous emission and air quality modeling studies have suggested the need to accurately characterize the spatial and temporal variations in on-road vehicle emissions. The purpose of this study was to quantify the impact that using detailed traffic activity data has on emission estimates used to model air quality impacts. The on-road vehicle emissions are estimated by multiplying the vehicle miles traveled (VMT) by the fleet-average emission factors determined by road link and hour of day. Changes in the fraction of VMT from heavy-duty diesel vehicles (HDDVs) can have a significant impact on estimated fleet-average emissions because the emission factors for HDDV nitrogen oxides (NOx) and particulate matter (PM) are much higher than those for light-duty gas vehicles (LDGVs). Through detailed road link-level on-road vehicle emission modeling, this work investigated two scenarios for better characterizing mobile source emissions: (1) improved spatial and temporal variation of vehicle type fractions, and (2) use of Motor Vehicle Emission Simulator (MOVES2010) instead of MOBILE6 exhaust emission factors. Emissions were estimated for the Detroit and Atlanta metropolitan areas for summer and winter episodes. The VMT mix scenario demonstrated the importance of better characterizing HDDV activity by time of day, day of week, and road type. More HDDV activity occurs on restricted access road types on weekdays and at nonpeak times, compared to light-duty vehicles, resulting in 5-15% higher NOx and PM emission rates during the weekdays and 15-40% lower rates on weekend days. Use of MOVES2010 exhaust emission factors resulted in increases of more than 50% in NOx and PM for both HDDVs and LDGVs, relative to MOBILE6. Because LDGV PM emissions have been shown to increase with lower temperatures, the most dramatic increase from MOBILE6 to MOVES2010 emission rates occurred for PM2.5 from LDGVs that increased 500% during colder wintertime conditions found in Detroit, the northernmost city modeled.

Water quality of small seasonal wetlands in the Piedmont ecoregion, South Carolina, USA: Effects of land use and hydrological connectivity.

PubMed

Yu, Xubiao; Hawley-Howard, Joanna; Pitt, Amber L; Wang, Jun-Jian; Baldwin, Robert F; Chow, Alex T

2015-04-15

Small, shallow, seasonal wetlands with short hydroperiod (2-4 months) play an important role in the entrapment of organic matter and nutrients and, due to their wide distribution, in determining the water quality of watersheds. In order to explain the temporal, spatial and compositional variation of water quality of seasonal wetlands, we collected water quality data from forty seasonal wetlands in the lower Blue Ridge and upper Piedmont ecoregions of South Carolina, USA during the wet season of February to April 2011. Results indicated that the surficial hydrological connectivity and surrounding land-use were two key factors controlling variation in dissolved organic carbon (DOC) and total dissolved nitrogen (TDN) in these seasonal wetlands. In the sites without obvious land use changes (average developed area <0.1%), the DOC (p < 0.001, t-test) and TDN (p < 0.05, t-test) of isolated wetlands were significantly higher than that of connected wetlands. However, this phenomenon can be reversed as a result of land use changes. The connected wetlands in more urbanized areas (average developed area = 12.3%) showed higher concentrations of dissolved organic matter (DOM) (DOC: 11.76 ± 6.09 mg L(-1), TDN: 0.74 ± 0.22 mg L(-1), mean ± standard error) compared to those in isolated wetlands (DOC: 7.20 ± 0.62 mg L(-1), TDN: 0.20 ± 0.08 mg L(-1)). The optical parameters derived from UV and fluorescence also confirmed significant portions of protein-like fractions likely originating from land use changes such as wastewater treatment and livestock pastures. The average of C/N molar ratios of all the wetlands decreased from 77.82 ± 6.72 (mean ± standard error) in February to 15.14 ± 1.58 in April, indicating that the decomposition of organic matter increased with the temperature. Results of this study demonstrate that the water quality of small, seasonal wetlands has a direct and close association with the surrounding environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Contrast-enhanced MR Angiography of the Abdomen with Highly Accelerated Acquisition Techniques

PubMed Central

Mostardi, Petrice M.; Glockner, James F.; Young, Phillip M.

2011-01-01

Purpose: To demonstrate that highly accelerated (net acceleration factor [Rnet] ≥ 10) acquisition techniques can be used to generate three-dimensional (3D) subsecond timing images, as well as diagnostic-quality high-spatial-resolution contrast material–enhanced (CE) renal magnetic resonance (MR) angiograms with a single split dose of contrast material. Materials and Methods: All studies were approved by the institutional review board and were HIPAA compliant; written consent was obtained from all participants. Twenty-two studies were performed in 10 female volunteers (average age, 47 years; range, 27–62 years) and six patients with renovascular disease (three women; average age, 48 years; range, 37–68 years; three men; average age, 60 years; range, 50–67 years; composite average age, 54 years; range, 38–68 years). The two-part protocol consisted of a low-dose (2 mL contrast material) 3D timing image with approximate 1-second frame time, followed by a high-spatial-resolution (1.0–1.6-mm isotropic voxels) breath-hold 3D renal MR angiogram (18 mL) over the full abdominal field of view. Both acquisitions used two-dimensional (2D) sensitivity encoding acceleration factor (R) of eight and 2D homodyne (HD) acceleration (RHD) of 1.4–1.8 for Rnet = R · RHD of 10 or higher. Statistical analysis included determination of mean values and standard deviations of image quality scores performed by two experienced reviewers with use of eight evaluation criteria. Results: The 2-mL 3D time-resolved image successfully portrayed progressive arterial filling in all 22 studies and provided an anatomic overview of the vasculature. Successful timing was also demonstrated in that the renal MR angiogram showed adequate or excellent portrayal of the main renal arteries in 21 of 22 studies. Conclusion: Two-dimensional acceleration techniques with Rnet of 10 or higher can be used in CE MR angiography to acquire (a) a 3D image series with 1-second frame time, allowing accurate bolus timing, and (b) a high-spatial-resolution renal angiogram. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110242/-/DC1 PMID:21900616

Interpretation of TEPC Measurements in Space Flights for Radiation Monitoring

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Nikjoo, Hooshang; Dicello, John F.; Pisacane, Vincent; Cucinotta, Francis A.

2007-01-01

For the proper interpretation of radiation data measured in space, the results of integrated radiation transport models were compared with the tissue equivalent proportional counter (TEPC) measurements. TEPC is a simple, time-dependent approach to radiation monitoring for astronauts on board the International Space Station. Another and a newer approach to microdosimetry is the use of silicon-on-insulator (SOI) technology launched on the MidSTAR-1 mission in low Earth orbit (LEO). In the radiation protection practice, the average quality factor of a radiation field is defined as a function of linear energy transfer (LET), Qave(LET). However, TEPC measures the average quality factor as a function of the lineal energy y, Qave(y), defined as the average energy deposition in a volume divided by the average chord length of the volume. The deviation of y from LET is caused by energy straggling, delta-ray escape or entry, and nuclear fragments produced in the detector volume. The response distribution functions of the wall-less and walled TEPCs were calculated from Monte-Carlo track simulations. Using an integrated space radiation model (which includes the transport codes HZETRN and BRYNTRN, and the quantum nuclear interaction model QMSFRG) and the resultant response distribution functions from Monte-Carlo track simulations, we compared model calculations with the walled-TEPC measurements from NASA missions in LEO and made predictions for the lunar and the Mars missions. Good agreement was found for Qave(y) between the model and measured spectra from past NASA missions. The Qave(y) values for the trapped or the solar protons ranged from 1.9-2.5. This over-estimates the Qave(LET) values which ranged from 1.4-1.6. Both quantities increase with shield thickness due to nuclear fragmentation. The Qave(LET) for the complete GCR spectra was found to be 3.5-4.5, while flight TEPCs measured 2.9-3.4 for Qave(y). The GCR values are decreasing with the shield thickness. Our analysis of the measurements of TEPCs can be used for a proper interpretation of observed data of monitoring the space radiation environment.

Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan.

PubMed

Kang, Jiunn-Horng; Chen, Shih-Ching

2009-07-19

An irregular bedtime schedule is a prevalent problem in young adults, and could be a factor detrimentally affecting sleep quality. The goal of the present study was to explore the association between an irregular bedtime schedule and sleep quality, daytime sleepiness, and fatigue among undergraduate students in Taiwan. A total of 160 students underwent a semi-structured interview and completed a survey comprising 4 parts: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and a rating of irregular bedtime frequency. Participants were grouped into 3 groups in terms of irregular bedtime frequency: low, intermediate, or high according to their 2-week sleep log. To screen for psychological disorders or distress that may have affected responses on the sleep assessment measures, the Chinese health questionnaire-12 (CHQ-12) was also administered. We found an increase in bedtime schedule irregularity to be significantly associated with a decrease in average sleep time per day (Spearman r = -0.22, p = 0.05). Multivariate regression analysis revealed that irregular bedtime frequency and average sleep time per day were correlated with PSQI scores, but not with ESS or FSS scores. A significant positive correlation between irregular bedtime frequency and PSQI scores was evident in the intermediate (partial r = 0.18, p = 0.02) and high (partial r = 0.15, p = 0.05) frequency groups as compared to low frequency group. The results of our study suggest a high prevalence of both an irregular bedtime schedule and insufficient sleep among university students in Taiwan. Students with an irregular bedtime schedule may experience poor sleep quality. We suggest further research that explores the mechanisms involved in an irregular bedtime schedule and the effectiveness of interventions for improving this condition.

Data Quality Control Tools Applied to Seismo-Acoustic Arrays in Korea

NASA Astrophysics Data System (ADS)

Park, J.; Hayward, C.; Stump, B. W.

2017-12-01

We assess data quality (data gap, seismometer orientation, timing error, noise level and coherence between co-located sensors) for seismic and infrasound data in South Korea using six seismo-acoustic arrays, BRDAR, CHNAR, KSGAR, KMPAR, TJIAR, and YPDAR, cooperatively operated by Southern Methodist University and Korea Institute for Geosciences and Mineral Resources. Timing errors associated with seismometers can be found based on estimated changes in instrument orientation calculated from RMS errors between the reference array and each array seismometer using waveforms filtered from 0.1 to 0.35 Hz. Noise levels of seismic and infrasound data are analyzed to investigate local environmental effects and seasonal noise variation. In order to examine the spectral properties of the noise, the waveform are analyzed using Welch's method (Welch, 1967) that produces a single power spectral estimate from an average of spectra taken at regular intervals over a specific time period. This analysis quantifies the range of noise conditions found at each of the arrays over the given time period. We take an advantage of the fact that infrasound sensors are co-located or closely located to one another, which allows for a direct comparison of sensors, following the method by Ringler et al. (2010). The power level differences between two sensors at the same array in the frequency band of interest are used to monitor temporal changes in data quality and instrument conditions. A data quality factor is assigned to stations based on the average values of temporal changes estimated in the frequency and time domains. These monitoring tools enable us to automatically assess technical issue related to the instruments and data quality at each seismo-acoustic array as well as to investigate local environmental effects and seasonal variations in both seismic and infrasound data.

Air quality assessment of benzo(a)pyrene from asphalt plant operation.

PubMed

Gibson, Nigel; Stewart, Robert; Rankin, Erika

2012-01-01

A study has been carried out to assess the contribution of Polycyclic Aromatic Hydrocarbons (PAHs) from asphalt plant operation, utilising Benzo(a)pyrene (BaP) as a marker for PAHs, to the background air concentration around asphalt plants in the UK. The purpose behind this assessment was to determine whether the use of published BaP emission factors based on the US Environmental Protection Agency (EPA) methodology is appropriate in the context of the UK, especially as the EPA methodology does not give BaP emission factors for all activities. The study also aimed to improve the overall understanding of BaP emissions from asphalt plants in the UK, and determine whether site location and operation is likely to influence the contribution of PAHs to ambient air quality. In order to establish whether the use of US EPA emissions factors is appropriate, the study has compared the BaP emissions measured and calculated emissions rates from two UK sites with those estimated using US EPA emission factors. A dispersion modelling exercise was carried out to show the BaP contribution to ambient air around each site. This study showed that, as the US EPA methodology does not provide factors for all emission sources on asphalt plants, their use may give rise to over- or under-estimations, particularly where sources of BaP are temperature dependent. However, the contribution of both the estimated and measured BaP concentrations to environmental concentration were low, averaging about 0.05 ng m(-3) at the boundary of the sites, which is well below the UK BaP assessment threshold of 0.25 ng m(-3). Therefore, BaP concentrations, and hence PAH concentrations, from similar asphalt plant operations are unlikely to contribute negatively to ambient air quality.

Memorial Hermann: high reliability from board to bedside.

PubMed

Shabot, M Michael; Monroe, Douglas; Inurria, Juan; Garbade, Debbi; France, Anne-Claire

2013-06-01

In 2006 the Memorial Hermann Health System (MHHS), which includes 12 hospitals, began applying principles embraced by high reliability organizations (HROs). Three factors support its HRO journey: (1) aligned organizational structure with transparent management systems and compressed reporting processes; (2) Robust Process Improvement (RPI) with high-reliability interventions; and (3) cultural establishment, sustainment, and evolution. The Quality and Safety strategic plan contains three domains, each with a specific set of measures that provide goals for performance: (1) "Clinical Excellence;" (2) "Do No Harm;" and (3) "Saving Lives," as measured by the Serious Safety Event rate. MHHS uses a uniform approach to performance improvement--RPI, which includes Six Sigma, Lean, and change management, to solve difficult safety and quality problems. The 9 acute care hospitals provide multiple opportunities to integrate high-reliability interventions and best practices across MHHS. For example, MHHS partnered with the Joint Commission Center for Transforming Healthcare in its inaugural project to establish reliable hand hygiene behaviors, which improved MHHS's average hand hygiene compliance rate from 44% to 92% currently. Soon after compliance exceeded 85% at all 12 hospitals, the average rate of central line-associated bloodstream and ventilator-associated pneumonias decreased to essentially zero. MHHS's size and diversity require a disciplined approach to performance improvement and systemwide achievement of measurable success. The most significant cultural change at MHHS has been the expectation for 100% compliance with evidence-based quality measures and 0% incidence of patient harm.

Are quality improvement methods a fashion for hospitals in Taiwan?

PubMed

Chung, Kuo-Piao; Yu, Tsung-Hsien

2012-08-01

This study reviews the rise and fall of the quality improvement (QI) methods implemented by hospitals in Taiwan, and examines the factors related to these methods. Cross-sectional, questionnaire-based survey. One hundred and thirty-nine district teaching hospitals, regional hospitals and medical centers. Directors or the persons in charge of implementing QI methods. s) None. s) Breadth and depth of the 18 QI methods. Seventy-two hospitals responded to the survey, giving a response rate of 52%. In terms of breadth based on the hospitals' self-reporting, the average number of QI methods adopted per hospital was 11.78 (range: 7-17). More than 80% of the surveyed hospitals had implemented eight QI methods, and >50% had implemented five QI methods. The QI methods adopted by over 80% of the surveyed hospitals had been implemented for a period of ∼7 years. On the basis of the authors' classification, seven of the eight QI methods (except for QI team in total quality management) had an implementation depth of almost 70% or higher in the surveyed hospitals. This study provides a snapshot of the QI methods implemented by hospitals in Taiwan. The results show that the average breadth of the QI methods adopted was 11.78; however, only 8.83 were implemented deeply. The hospitals' accreditation level was associated with the breadth and depth of QI method implementation.

Nutritional quality of diet and academic performance in Chilean students.

PubMed

Correa-Burrows, Paulina; Burrows, Raquel; Blanco, Estela; Reyes, Marcela; Gahagan, Sheila

2016-03-01

To explore associations between the nutritional quality of diet at age 16 years and academic performance in students from Santiago, Chile. We assessed the nutritional quality of diet, using a validated food frequency questionnaire, in 395 students aged 16.8 ± 0.5 years. Depending on the amount of saturated fat, fibre, sugar and salt in the foods, diet was categorized as unhealthy, fair or healthy. Academic performance was assessed using high school grade-point average (GPA) and tests for college admission in language and mathematics. Academic results on or above the 75th percentile in our sample were considered good academic performance. We tested associations between nutritional quality of diet and good academic performance using logistic regression models. We considered sociodemographic, educational and body-mass index (BMI) factors as potential confounders. After controlling for potential confounding factors, an unhealthy diet at age 16 years was associated with reduced academic performance. Compared to participants with healthy diets, those with unhealthy diets were significantly less likely to perform well based on language tests (odds ratio, OR: 0.42; 95% confidence interval, CI: 0.18-0.98) mathematics tests (OR: 0.35; 95% CI: 0.15-0.82) or GPA (OR: 0.22; 95% CI: 0.09-0.56). In our sample, excessive consumption of energy-dense, low-fibre, high-fat foods at age 16 years was associated with reduced academic performance.

Factors associated with the impact of quality improvement collaboratives in mental healthcare: An exploratory study

PubMed Central

2012-01-01

Background Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods We studied three QICs involving 29 quality improvement (QI) teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions No general conclusions about the impact of the characteristics of QI teams on the quality of healthcare can be drawn, but support of the management and active, inspirational team leadership appear to be important. Not only patient outcomes but also the performance indicators of monitoring and screening/assessment showed improvement in many but not all of the QI teams with such characteristics. More studies are needed to identify factors associated with the impact of multidisciplinary practice guidelines in mental healthcare. PMID:22230594

Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults

PubMed Central

2012-01-01

Background Poor sleep tends to be patterned by sociodemographic and socioeconomic factors. The aim of this study was to examine the associations of sociodemographic and socioeconomic factors with sleep duration and insomnia-related symptoms across life course. Methods We used cross-sectional Health 2000 Survey (2000–2001) among a total of 5,578 adult Finns, aged 30–79 years, representative of adult Finnish population. Data about sociodemographic and socioeconomic circumstances, insomnia-related symptoms over the previous month as well as average sleep duration were collected by questionnaires. Multinomial logistic regression models were adjusted first for gender and age, second for sociodemographic factors, third additionally for socioeconomic factors, and fourth for all covariates and self-perceived health simultaneously. Results On average 70% of Finnish adults slept 7–8 hours a day. Frequent insomnia-related symptoms were more prevalent among women (14%) than men (10%). Not being married, not having children, having low education, low income, being unemployed, and being a disability retiree were associated with frequent insomnia-related symptoms. Similar factors were associated with short and long sleep duration. However, childhood socioeconomic position was mostly unrelated to sleep in adulthood except parental education had some associations with short sleep duration. Conclusions Disadvantaged socioeconomic position in adulthood, in particular income and employment status, is associated with poorer sleep. When promoting optimal sleep duration and better sleep quality, families with low incomes, unemployed people, and disability retirees should be targeted. PMID:22839359

The German Quality Network Sepsis: study protocol for the evaluation of a quality collaborative on decreasing sepsis-related mortality in a quasi-experimental difference-in-differences design.

PubMed

Schwarzkopf, Daniel; Rüddel, Hendrik; Gründling, Matthias; Putensen, Christian; Reinhart, Konrad

2018-01-18

While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany. The primary objective of the study is to decrease sepsis-related hospital mortality within a quality collaborative relying on claims data. The German Quality Network Sepsis (GQNS) is a quality collaborative involving 75 hospitals. This study protocol describes the conduction and evaluation of the start-up period of the GQNS running from March 2016 to August 2018. Democratic structures assure participatory action, a study coordination bureau provides central support and resources, and local interdisciplinary quality improvement teams implement changes within the participating hospitals. Quarterly quality reports focusing on risk-adjusted hospital mortality in cases with sepsis based on claims data are provided. Hospitals committed to publish their individual risk-adjusted mortality compared to the German average. A complex risk-model is used to control for differences in patient-related risk factors. Hospitals are encouraged to implement a bundle of interventions, e.g., interdisciplinary case analyses, external peer-reviews, hospital-wide staff education, and implementation of rapid response teams. The effectiveness of the GQNS is evaluated in a quasi-experimental difference-in-differences design by comparing the change of hospital mortality of cases with sepsis with organ dysfunction from a retrospective baseline period (January 2014 to December 2015) and the intervention period (April 2016 to March 2018) between the participating hospitals and all other German hospitals. Structural and process quality indicators of sepsis care as well as efforts for quality improvement are monitored regularly. The GQNS is a large-scale quality collaborative using a pragmatic approach based on claims data. A complex risk-adjustment model allows valid quality comparisons between hospitals and with the German average. If this study finds the approach to be useful for improving quality of sepsis care, it may also be applied to other diseases. ClinicalTrials.gov NCT02820675.

Process evaluation of the project P.A.T.H.S. (secondary 2 program): findings based on the co-walker scheme.

PubMed

Shek, Daniel T L; Tam, Suet-yan

2009-01-01

To understand the implementation quality of the Tier 1 Program (Secondary 2 Curriculum) of the P.A.T.H.S. Project, process evaluation was carried out by co-walkers through classroom observation of 195 units in 131 schools. Results showed that the overall level of program adherence was generally high with an average of 84.55%, and different factors of the implementation process were evaluated as positive. Quality of program implementation and achievement of program objectives were predicted by students' participation and involvement, strategies to enhance students' motivation, opportunity for reflection, time management, and class preparation. Success in program implementation was predicted by students' participation and involvement, classroom control, interactive delivery method, strategies to enhance students' motivation, opportunity for reflection, and lesson preparation.

[Surface water quality assessment in Miyun reservoir watershed, Beijing in the period 1980-2003].

PubMed

Zhang, Wei-wei; Sun, Dan-feng; Li, Hong; Zhou, Lian-di

2010-07-01

Single factor water quality identification index was adopted to assess the surface water quality of Miyun reservoir watershed in Beijing using nearly 20 years monitoring data of 4 sites, also the surface water quality pollution sources were analyzed. The results indicated TP had the largest temporal variation at every monitoring site, coefficients of variation were 93.86%, 86.08%, 50.56% and 139.47%, respectively. The following element was Hg, the coefficients of its variation were 86.08%, 25.75%, 56.52% and 47.01%, respectively. While TN, permanganate index, BOD5, Pb and Cr were relatively stable with small coefficient of temporal variation. The permanganate index, BOD5, Pb and Cr did not exceed to the Chinese surface drinking water standard limit in the study period, while Hg had high pollution risk in several years, such as monitoring sites S1 and S3 in 1992, monitoring sites S4 in 1996. The major pollutants of Miyun reservoir watershed in Beijing were TN and TP, and TN had larger pollution risk compared with TP in most years. Comparing to that before the 1990s, the decade average fertilizer, pesticide and agricultural plastic mulch inputs after the 1990s had increased by 46%, 173% and 359%, respectively. The husbandry proportion in agriculture rose from 24.4% to 39.8%, and the average gross industrial production by 424%. The upstream of Miyun reservoir had larger pollution risk than its downstream. In addition, Chaohe watershed contributed more TN and TP to the reservoir than Baihe watershed.

A practical method to standardise and optimise the Philips DoseRight 2.0 CT automatic exposure control system.

PubMed

Wood, T J; Moore, C S; Stephens, A; Saunderson, J R; Beavis, A W

2015-09-01

Given the increasing use of computed tomography (CT) in the UK over the last 30 years, it is essential to ensure that all imaging protocols are optimised to keep radiation doses as low as reasonably practicable, consistent with the intended clinical task. However, the complexity of modern CT equipment can make this task difficult to achieve in practice. Recent results of local patient dose audits have shown discrepancies between two Philips CT scanners that use the DoseRight 2.0 automatic exposure control (AEC) system in the 'automatic' mode of operation. The use of this system can result in drifting dose and image quality performance over time as it is designed to evolve based on operator technique. The purpose of this study was to develop a practical technique for configuring examination protocols on four CT scanners that use the DoseRight 2.0 AEC system in the 'manual' mode of operation. This method used a uniform phantom to generate reference images which form the basis for how the AEC system calculates exposure factors for any given patient. The results of this study have demonstrated excellent agreement in the configuration of the CT scanners in terms of average patient dose and image quality when using this technique. This work highlights the importance of CT protocol harmonisation in a modern Radiology department to ensure both consistent image quality and radiation dose. Following this study, the average radiation dose for a range of CT examinations has been reduced without any negative impact on clinical image quality.

650-nJ pulses from a cavity-dumped Yb:fiber-pumped ultrafast optical parametric oscillator

NASA Astrophysics Data System (ADS)

Lamour, Tobias P.; Reid, Derryck T.

2011-08-01

Sub-250-fs pulses with energies of up to 650 nJ and peak powers up to 2.07 MW were generated from a cavity-dumped optical parametric oscillator, synchronously-pumped at 15.3 MHz with sub-400-fs pulses from an Yb:fiber laser. The average beam quality factor of the dumped output was M2 ~1.2 and the total relative-intensity noise was 8 mdBc, making the system a promising candidate for ultrafast laser inscription of infrared materials.

A fast, robust pattern recognition asystem for low light level image registration and its application to retinal imaging

NASA Astrophysics Data System (ADS)

Wade, Alex Robert; Fitzke, Frederick W.

1998-08-01

We describe an image processing system which we have developed to align autofluorescence and high-magnification images taken with a laser scanning ophthalmoscope. The low signal to noise ratio of these images makes pattern recognition a non-trivial task. However, once n images are aligned and averaged, the noise levels drop by a factor of n and the image quality is improved. We include examples of autofluorescence images and images of the cone photoreceptor mosaic obtained using this system.

The big picture: does colonoscopy work?

PubMed

Hewett, David G; Rex, Douglas K

2015-04-01

Colonoscopy for average-risk colorectal cancer screening has transformed the practice of gastrointestinal medicine in the United States. However, although the dominant screening strategy, its use is not supported by randomized controlled trials. Observational data do support a protective effect of colonoscopy and polypectomy on colorectal cancer incidence and mortality, but the level of protection in the proximal colon is variable and operator-dependent. Colonoscopy by high-level detectors remains highly effective, and ongoing quality improvement initiatives should consider regulatory factors that motivate changes in physician behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

New Jersey's Medicaid waiver for acquired immunodeficiency syndrome

PubMed Central

Merzel, Cheryl; Crystal, Stephen; Sambamoorthi, Usha; Karus, Daniel; Kurland, Carol

1992-01-01

This article contains data from a study of New Jersey's home and community-based Medicaid waiver program for persons with symptomatic human immunodeficiency virus illness. Major findings include lower hospital costs and utilization for waiver participants compared with general Medicaid acquired immunodeficiency syndrome admissions in New Jersey. Average program expenditures were $2,400 per person per month. Based on study findings, it is evident that the waiver program is an important means of providing financial benefits and access to services and that comprehensive case management is a critical factor in assuring program quality. PMID:10120180

Evaluation of the quality of the college library websites in Iranian medical Universities based on the Stover model.

PubMed

Nasajpour, Mohammad Reza; Ashrafi-Rizi, Hasan; Soleymani, Mohammad Reza; Shahrzadi, Leila; Hassanzadeh, Akbar

2014-01-01

Today, the websites of college and university libraries play an important role in providing the necessary services for clients. These websites not only allow the users to access different collections of library resources, but also provide them with the necessary guidance in order to use the information. The goal of this study is the quality evaluation of the college library websites in Iranian Medical Universities based on the Stover model. This study uses an analytical survey method and is an applied study. The data gathering tool is the standard checklist provided by Stover, which was modified by the researchers for this study. The statistical population is the college library websites of the Iranian Medical Universities (146 websites) and census method was used for investigation. The data gathering method was a direct access to each website and filling of the checklist was based on the researchers' observations. Descriptive and analytical statistics (Analysis of Variance (ANOVA)) were used for data analysis with the help of the SPSS software. The findings showed that in the dimension of the quality of contents, the highest average belonged to type one universities (46.2%) and the lowest average belonged to type three universities (24.8%). In the search and research capabilities, the highest average belonged to type one universities (48.2%) and the lowest average belonged to type three universities. In the dimension of facilities provided for the users, type one universities again had the highest average (37.2%), while type three universities had the lowest average (15%). In general the library websites of type one universities had the highest quality (44.2%), while type three universities had the lowest quality (21.1%). Also the library websites of the College of Rehabilitation and the College of Paramedics, of the Shiraz University of Medical Science, had the highest quality scores. The results showed that there was a meaningful difference between the quality of the college library websites and the university types, resulting in college libraries of type one universities having the highest average score and the college libraries of type three universities having the lowest score.

Evaluation of the quality of the college library websites in Iranian medical Universities based on the Stover model

PubMed Central

Nasajpour, Mohammad Reza; Ashrafi-rizi, Hasan; Soleymani, Mohammad Reza; Shahrzadi, Leila; Hassanzadeh, Akbar

2014-01-01

Introduction: Today, the websites of college and university libraries play an important role in providing the necessary services for clients. These websites not only allow the users to access different collections of library resources, but also provide them with the necessary guidance in order to use the information. The goal of this study is the quality evaluation of the college library websites in Iranian Medical Universities based on the Stover model. Material and Methods: This study uses an analytical survey method and is an applied study. The data gathering tool is the standard checklist provided by Stover, which was modified by the researchers for this study. The statistical population is the college library websites of the Iranian Medical Universities (146 websites) and census method was used for investigation. The data gathering method was a direct access to each website and filling of the checklist was based on the researchers’ observations. Descriptive and analytical statistics (Analysis of Variance (ANOVA)) were used for data analysis with the help of the SPSS software. Findings: The findings showed that in the dimension of the quality of contents, the highest average belonged to type one universities (46.2%) and the lowest average belonged to type three universities (24.8%). In the search and research capabilities, the highest average belonged to type one universities (48.2%) and the lowest average belonged to type three universities. In the dimension of facilities provided for the users, type one universities again had the highest average (37.2%), while type three universities had the lowest average (15%). In general the library websites of type one universities had the highest quality (44.2%), while type three universities had the lowest quality (21.1%). Also the library websites of the College of Rehabilitation and the College of Paramedics, of the Shiraz University of Medical Science, had the highest quality scores. Discussion: The results showed that there was a meaningful difference between the quality of the college library websites and the university types, resulting in college libraries of type one universities having the highest average score and the college libraries of type three universities having the lowest score. PMID:25540794

Analysis of Variations in Hospital Use by Medicare Patients in Psro Areas, 1974-1977

PubMed Central

Deacon, Ronald; Lubitz, James; Gornick, Marian; Newton, Marilyn

1979-01-01

A study of the use of short-stay hospitals in PSRO areas by Medicare enrollees aged 65 and over for the period 1974 through 1977 revealed that discharge rates increased, average length of stay (ALOS) decreased, and days-of-care rates remained relatively constant in nearly all of the PSRO areas. The data show large variations in hospital use in PSRO areas within States and HEW regions, and suggest that factors within the area are critical determinants of hospital utilization. This study presents important implications for PSRO program policy for it suggests that factors other than physician and hospital behavior should also be considered when setting objectives for reducing misutilization and improving the quality of health care. PMID:10309054

Induction of a shorter compression phase is correlated with a deeper chest compression during metronome-guided cardiopulmonary resuscitation: a manikin study.

PubMed

Chung, Tae Nyoung; Bae, Jinkun; Kim, Eui Chung; Cho, Yun Kyung; You, Je Sung; Choi, Sung Wook; Kim, Ok Jun

2013-07-01

Recent studies have shown that there may be an interaction between duty cycle and other factors related to the quality of chest compression. Duty cycle represents the fraction of compression phase. We aimed to investigate the effect of shorter compression phase on average chest compression depth during metronome-guided cardiopulmonary resuscitation. Senior medical students performed 12 sets of chest compressions following the guiding sounds, with three down-stroke patterns (normal, fast and very fast) and four rates (80, 100, 120 and 140 compressions/min) in random sequence. Repeated-measures analysis of variance was used to compare the average chest compression depth and duty cycle among the trials. The average chest compression depth increased and the duty cycle decreased in a linear fashion as the down-stroke pattern shifted from normal to very fast (p<0.001 for both). Linear increase of average chest compression depth following the increase of the rate of chest compression was observed only with normal down-stroke pattern (p=0.004). Induction of a shorter compression phase is correlated with a deeper chest compression during metronome-guided cardiopulmonary resuscitation.

Effects on vocal range and voice quality of singing voice training: the classically trained female voice.

PubMed

Pabon, Peter; Stallinga, Rob; Södersten, Maria; Ternström, Sten

2014-01-01

A longitudinal study was performed on the acoustical effects of singing voice training under a given study program, using the voice range profile (VRP). Pretraining and posttraining recordings were made of students who participated in a 3-year bachelor singing study program. A questionnaire that included questions on optimal range, register use, classification, vocal health and hygiene, mixing technique, and training goals was used to rate and categorize self-assessed voice changes. Based on the responses, a subgroup of 10 classically trained female voices was selected, which was homogeneous enough for effects of training to be identified. The VRP perimeter contour was analyzed for effects of voice training. Also, a mapping within the VRP of voice quality, as expressed by the crest factor, was used to indicate the register boundaries and to monitor the acoustical consequences of the newly learned vocal technique of "mixed voice." VRPs were averaged across subjects. Findings were compared with the self-assessed vocal changes. Pre/post comparison of the average VRPs showed, in the midrange, (1) a decrease in the VRP area that was associated with the loud chest voice, (2) a reduction of the crest factor values, and (3) a reduction of maximum sound pressure level values. The students' self-evaluations of the voice changes appeared in some cases to contradict the VRP findings. VRPs of individual voices were seen to change over the course of a singing education. These changes were manifest also in the average group. High-resolution computerized recording, complemented with an acoustic register marker, allows a meaningful assessment of some effects of training, on an individual basis and for groups that comprise singers of a specific genre. It is argued that this kind of investigation is possible only within a focused training program, given by a faculty who has agreed on the goals. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain.

PubMed

Barth, Kelly S; Balliet, Wendy; Pelic, Christine M; Madan, Alok; Malcolm, Robert; Adams, David; Morgan, Katherine; Owczarski, Stefanie; Borckardt, Jeffrey J

2014-08-01

The objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis. This study utilized a descriptive, quasi-experimental, cross sectional design. Three hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center. Participants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures. Mean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P < 0.0001), increased pain rating at the time of the office visit (β = 0.16, P = 0.03), impairment of psychological quality of life (β = -0.27, P = 0.001) and endorsement of alcohol use (β = 0.16, P = 0.03). These factors accounted for 37% of the variance in current opioid misuse scores. Depression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis. Wiley Periodicals, Inc.

Have Nursing Home Compare quality measure scores changed over time in response to competition?

PubMed

Castle, Nicholas G; Engberg, John; Liu, Darren

2007-06-01

Currently, the Centers for Medicare and Medicaid Services report on 15 Quality Measures (QMs) on the Nursing Home Compare (NHC) website. It is assumed that nursing homes are able to make improvements on these QMs, and in doing so they will attract more residents. In this investigation, we examine changes in QM scores, and whether competition and/or excess demand have influenced these change scores over a period of 1 year. Data come from NHC and the On-line Survey Certification And Recording (OSCAR) system. QM change scores are calculated using values from January 2003 to January 2004. A series of regression analyses are used to examine the association of competition and excess demand on QM scores. Eight QMs show an average decrease in scores (ie, better quality) and six QMs show an average increase in scores (ie, worse quality). However, for 13 of the 14 QMs these average changes averaged less than 1%. The regression analyses show an association between higher competition and improving QM scores and an association between lower occupancy and improving QM scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, we show that it is in the most competitive markets and those with the lowest average occupancy rates that improvements in the QM scores are more likely.

Simulation of the effects of seasonally varying pumping on intraborehole flow and the vulnerability of public-supply wells to contamination

USGS Publications Warehouse

Yager, Richard M.; Heywood, Charles E.

2014-01-01

Public-supply wells with long screens in alluvial aquifers can produce waters of differing quality from different depths. Seasonal changes in quality are linked to seasonal changes in pumping rates that influence the distribution of flow into the well screens under pumping conditions and the magnitude and direction of intraborehole flow within the wells under ambient conditions. Groundwater flow and transport simulations with MODFLOW and MT3DMS were developed to quantify the effects of changes in average seasonal pumping rates on intraborehole flow and water quality at two long-screened, public-supply wells, in Albuquerque, New Mexico and Modesto, California, where widespread pumping has altered groundwater flow patterns. Simulation results indicate that both wells produce water requiring additional treatment to maintain potable quality in winter when groundwater withdrawals are reduced because less water is derived from parts of the aquifer that contain water requiring less treatment. Simulation results indicate that the water quality at both wells could be improved by increasing average winter-pumping rates to induce more lateral flow from parts of the aquifer that contain better quality water. Arsenic-bearing water produced by the Albuquerque well could be reduced from 55% to 45% by doubling average winter-pumping rate, while nitrate- and uranium-bearing water produced by the Modesto well could be reduced from 95% to 65% by nearly tripling the average winter-pumping rate. Higher average winter-pumping rates would also reduce the volume of intraborehole flow within both wells and prevent the exchange of poor quality water between shallow and deep parts of both aquifers.

Photochemical modeling of emissions trading of highly reactive volatile organic compounds in Houston, Texas. 2. Incorporation of chlorine emissions.

PubMed

Wang, Linlin; Thompson, Tammy; McDonald-Buller, Elena C; Allen, David T

2007-04-01

As part of the State Implementation Plan for attaining the National Ambient Air Quality Standard for ozone, the Texas Commission of Environmental Quality has created a Highly Reactive Volatile Organic Compounds (HRVOC) Emissions Cap and Trade Program for industrial point sources in the Houston/Galveston/Brazoria area. This series of papers examines the potential air quality impacts of this new emission trading program through photochemical modeling of potential trading scenarios; this paper examines the air quality impact of allowing facilities to trade chlorine emission reductions for HRVOC allocations on a reactivity weighted basis. The simulations indicate that trading of anthropogenic chlorine emission reductions for HRVOC allowances at a single facility or between facilities, in general, resulted in improvements in air quality. Decreases in peak 1-h averaged and 8-h averaged ozone concentrations associated with trading chlorine emissions for HRVOC allocations on a Maximum Incremental Reactivity (MIR) basis were up to 0.74 ppb (0.63%) and 0.56 ppb (0.61%), respectively. Air quality metrics based on population exposure decreased by up to 3.3% and 4.1% for 1-h and 8-h averaged concentrations. These changes are small compared to the maximum changes in ozone concentrations due to the VOC emissions from these sources (5-10 ppb for 8-h averages; up to 30 ppb for 1-h averages) and the chlorine emissions from the sources (5-10 ppb for maximum concentrations over wide areas and up to 70 ppb in localized areas). The simulations indicate that the inclusion of chlorine emissions in the trading program is likely to be beneficial to air quality and is unlikely to cause localized increases in ozone concentrations ("hot spots").

Trends and Burden of Bronchiectasis-Associated Hospitalizations in the United States, 1993-2006

PubMed Central

Seitz, Amy E.; Olivier, Kenneth N.; Steiner, Claudia A.; Montes de Oca, Ruben; Holland, Steven M.

2010-01-01

Background: Current data on bronchiectasis prevalence, trends, and risk factors are lacking; such data are needed to estimate the burden of disease and for improved medical care and public health resource allocation. The objective of the present study was to estimate the trends and burden of bronchiectasis-associated hospitalizations in the United States. Methods: We extracted hospital discharge records containing International Classification of Diseases, 9th Revision, Clinical Modification codes for bronchiectasis (494, 494.0, and 494.1) as any discharge diagnosis from the State Inpatient Databases from the Agency for Healthcare Research and Quality. Discharge records were extracted for 12 states with complete and continuous reporting from 1993 to 2006. Results: The average annual age-adjusted hospitalization rate from 1993 to 2006 was 16.5 hospitalizations per 100,000 population. From 1993 to 2006, the age-adjusted rate increased significantly, with an average annual percentage increase of 2.4% among men and 3.0% among women. Women and persons aged > 60 years had the highest rate of bronchiectasis-associated hospitalizations. The median cost for inpatient care was 7,827 US dollars (USD) (range, 13-543,914 USD). Conclusions: The average annual age-adjusted rate of bronchiectasis-associated hospitalizations increased from 1993 to 2006. This study furthers the understanding of the impact of bronchiectasis and demonstrates the need for further research to identify risk factors and reasons for the increasing burden. PMID:20435655

A minimally invasive methodology based on morphometric parameters for day 2 embryo quality assessment.

PubMed

Molina, Inmaculada; Lázaro-Ibáñez, Elisa; Pertusa, Jose; Debón, Ana; Martínez-Sanchís, Juan Vicente; Pellicer, Antonio

2014-10-01

The risk of multiple pregnancy to maternal-fetal health can be minimized by reducing the number of embryos transferred. New tools for selecting embryos with the highest implantation potential should be developed. The aim of this study was to evaluate the ability of morphological and morphometric variables to predict implantation by analysing images of embryos. This was a retrospective study of 135 embryo photographs from 112 IVF-ICSI cycles carried out between January and March 2011. The embryos were photographed immediately before transfer using Cronus 3 software. Their images were analysed using the public program ImageJ. Significant effects (P < 0.05), and higher discriminant power to predict implantation were observed for the morphometric embryo variables compared with morphological ones. The features for successfully implanted embryos were as follows: four cells on day 2 of development; all blastomeres with circular shape (roundness factor greater than 0.9), an average zona pellucida thickness of 13 µm and an average of 17695.1 µm² for the embryo area. Embryo size, which is described by its area and the average roundness factor for each cell, provides two objective variables to consider when predicting implantation. This approach should be further investigated for its potential ability to improve embryo scoring. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

In-Plume Emission Test Stand 2: emission factors for 10- to 100-kW U.S. military generators.

PubMed

Zhu, Dongzi; Nussbaum, Nicholas J; Kuhns, Hampden D; Chang, M-C Oliver; Sodeman, David; Uppapalli, Sebastian; Moosmüller, Hans; Chow, Judith C; Watson, John G

2009-12-01

Although emissions of air pollutants from some military tactical equipment are not subject to the emissions standards, local communities near military bases must conform to the National Ambient Air Quality Standards. Military diesel generators are widely used in training. A portable in-plume system was used to measure fuel-based emission factors (EFs) for particulate matter (PM), carbon monoxide (CO), nitrogen oxides (NOx), and hydrocarbons (HCs) for 30-, 60-, and 100-kW generators at five load levels and for cold starts. It was found that EFs depend on multiple parameters including engine size, engine load, unit age, and total running hours. The average CO EF of generators tested was 5% lower, and the average NOx EF was 63% lower than AP-42 estimates; average PM EF was 80% less than the AP-42 estimates. A 2002 model-year 60-kW engine produced 25% less PM than a 1995 engine of the same family with similar running hours. CO EFs decrease with increasing engine load, NOx EFs increase up to mid-loads and decrease slightly at high loads, PM EFs increase with loads for 30- and 60-kW engines. CO and PM have higher EFs and NOx has a lower EF during cold starts than during hot-stabilized operation. PM chemical source profiles were also examined.

[Variation pattern and its affecting factors of three-dimensional landscape in urban residential community of Shenyang].

PubMed

Zhang, Pei-Feng; Hu, Yuan-Man; Xiong, Zai-Ping; Liu, Miao

2011-02-01

Based on the 1:10000 aerial photo in 1997 and the three QuickBird images in 2002, 2005, and 2008, and by using Barista software and GIS and RS techniques, the three-dimensional information of the residential community in Tiexi District of Shenyang was extracted, and the variation pattern of the three-dimensional landscape in the district during its reconstruction in 1997-2008 and related affecting factors were analyzed with the indices, ie. road density, greening rate, average building height, building height standard deviation, building coverage rate, floor area rate, building shape coefficient, population density, and per capita GDP. The results showed that in 1997-2008, the building area for industry decreased, that for commerce and other public affairs increased, and the area for residents, education, and medical cares basically remained stable. The building number, building coverage rate, and building shape coefficient decreased, while the floor area rate, average building height, height standard deviation, road density, and greening rate increased. Within the limited space of residential community, the containing capacity of population and economic activity increased, and the environment quality also improved to some extent. The variation degree of average building height increased, but the building energy consumption decreased. Population growth and economic development had positive correlations with floor area rate, road density, and greening rate, but negative correlation with building coverage rate.

24 CFR Appendix B to Part 1000 - IHBG Block Grant Formula Mechanisms

Code of Federal Regulations, 2011 CFR

2011-04-01

... weighted average for AEL (NAEL). The FMR factor is also defined in § 1000.302 as the relative difference between a local area Fair Market Rent (FMR) and the national weighted average for FMR. OPSUB = [LR * LRSUB... FMR Factor weighted by national average of AEL Factor and FRM Factor. AEL FACTOR = AEL/NAEL. AEL...

Predictors of facial attractiveness and health in humans.

PubMed

Foo, Yong Zhi; Simmons, Leigh W; Rhodes, Gillian

2017-02-03

Facial attractiveness has been suggested to provide signals of biological quality, particularly health, in humans. The attractive traits that have been implicated as signals of biological quality include sexual dimorphism, symmetry, averageness, adiposity, and carotenoid-based skin colour. In this study, we first provide a comprehensive examination of the traits that predict attractiveness. In men, attractiveness was predicted positively by masculinity, symmetry, averageness, and negatively by adiposity. In women, attractiveness was predicted positively by femininity and negatively by adiposity. Skin colour did not predict attractiveness in either sex, suggesting that, despite recent interest in the literature, colour may play limited role in determining attractiveness. Male perceived health was predicted positively by averageness, symmetry, and skin yellowness, and negatively by adiposity. Female perceived health was predicted by femininity. We then examined whether appearance predicted actual health using measures that have been theoretically linked to sexual selection, including immune function, oxidative stress, and semen quality. In women, there was little evidence that female appearance predicted health. In men, we found support for the phenotype-linked fertility hypothesis that male masculinity signalled semen quality. However, we also found a negative relationship between averageness and semen quality. Overall, these results indicate weak links between attractive facial traits and health.

Predictors of facial attractiveness and health in humans

PubMed Central

Foo, Yong Zhi; Simmons, Leigh W.; Rhodes, Gillian

2017-01-01

Facial attractiveness has been suggested to provide signals of biological quality, particularly health, in humans. The attractive traits that have been implicated as signals of biological quality include sexual dimorphism, symmetry, averageness, adiposity, and carotenoid-based skin colour. In this study, we first provide a comprehensive examination of the traits that predict attractiveness. In men, attractiveness was predicted positively by masculinity, symmetry, averageness, and negatively by adiposity. In women, attractiveness was predicted positively by femininity and negatively by adiposity. Skin colour did not predict attractiveness in either sex, suggesting that, despite recent interest in the literature, colour may play limited role in determining attractiveness. Male perceived health was predicted positively by averageness, symmetry, and skin yellowness, and negatively by adiposity. Female perceived health was predicted by femininity. We then examined whether appearance predicted actual health using measures that have been theoretically linked to sexual selection, including immune function, oxidative stress, and semen quality. In women, there was little evidence that female appearance predicted health. In men, we found support for the phenotype-linked fertility hypothesis that male masculinity signalled semen quality. However, we also found a negative relationship between averageness and semen quality. Overall, these results indicate weak links between attractive facial traits and health. PMID:28155897

Life satisfaction across nations: the effects of women's political status and public priorities.

PubMed

York, Richard; Bell, Shannon Elizabeth

2014-11-01

Feminist scholars suggest that improving the quality of life of individuals living in nations around the world may be more readily achieved by increasing women's political power and by reorienting public-policy priorities, than by focusing primarily on economic growth. These considerations raise the question of which characteristics of societies are associated with the quality of life of the people in those societies. Here, we address this issue empirically by statistically analyzing cross-national data. We assess the effects of gender equality in the political sphere, as well as a variety of other factors, on the subjective well-being of nations, as indicated by average self-reported levels of life satisfaction. We find that people report the highest levels of life satisfaction in nations where women have greater political representation, where military spending is low, and where health care spending is high, controlling for a variety of other factors. GDP per capita, urbanization, and natural resource exploitation are not clearly associated with life satisfaction. These findings suggest that nations may be able to improve the subjective quality of life of people without increasing material wealth or natural resource consumption by increasing gender equality in politics and changing public spending priorities. Copyright © 2014 Elsevier Inc. All rights reserved.

Work-related stress as a cardiovascular risk factor in police officers: a systematic review of evidence.

PubMed

Magnavita, N; Capitanelli, I; Garbarino, S; Pira, E

2018-05-01

Several studies suggest that work-related stress in police officers may be associated with an increased risk of cardiovascular diseases. A systematic review of studies is, however, still lacking. According to PRISMA statement, a systematic search of PubMed, ISI Web of Science, Cinahl and PsychInfo electronic databases was undertaken. Studies published in English between 1/1/2000 and 31/12/2016 were included. A studies quality assessment was performed using the Newcastle Ottawa scale (NOS). The preliminary search retrieved 752 records. After selection, 16 studies (total population 17,698) were retrieved. The average quality of studies was low. Exposure to stress in cross-sectional studies was inconstantly associated with hypertension, obesity, dyslipidaemia, and impaired glucose metabolism. In addition, there was a prevalence of positive studies showing an association between stress and cardiovascular disease morbidity. Studies of higher quality, such as longitudinal studies on large sample size, were more supportive of a significant positive association between stress and cardiovascular risk factors. Results were, however, often conflicting and inconsistent with regard to definitions and measurement of stress, features of individual study design, study conduct, and conclusions drawn. A sound precautionary principle would be to adopt worksite health promotion programs designed to implement stress management strategies in this category of workers.

Baccalaureate Nursing Students' Abilities in Critically Identifying and Evaluating the Quality of Online Health Information.

PubMed

Theron, Maggie; Redmond, Anne; Borycki, Elizabeth M

2017-01-01

Both the Internet and social media have become important tools that patients and health professionals, including health professional students, use to obtain information and support their decision-making surrounding health care. Students in the health sciences require increased competence to select, appraise, and use online sources to adequately educate and support patients and advocate for patient needs and best practices. The purpose of this study was to ascertain if second year nursing students have the ability to critically identify and evaluate the quality of online health information through comparisons between student and expert assessments of selected online health information postings using an adapted Trust in Online Health Information scale. Interviews with experts provided understanding of how experts applied the selected criteria and what experts recommend for implementing nursing informatics literacy in curriculums. The difference between student and expert assessments of the quality of the online information is on average close to 40%. Themes from the interviews highlighted several possible factors that may influence informatics competency levels in students, specifically regarding the critical appraisal of the quality of online health information.

Low-cost, high-density sensor network for urban emission monitoring: BEACO2N

NASA Astrophysics Data System (ADS)

Kim, J.; Shusterman, A.; Lieschke, K.; Newman, C.; Cohen, R. C.

2017-12-01

In urban environments, air quality is spatially and temporally heterogeneous as diverse emission sources create a high degree of variability even at the neighborhood scale. Conventional air quality monitoring relies on continuous measurements with limited spatial resolution or passive sampling with high-density and low temporal resolution. Either approach averages the air quality information over space or time and hinders our attempts to understand emissions, chemistry, and human exposure in the near-field of emission sources. To better capture the true spatio-temporal heterogeneity of urban conditions, we have deployed a low-cost, high-density air quality monitoring network in San Francisco Bay Area distributed at 2km horizontal spacing. The BErkeley Atmospheric CO2 Observation Network (BEACO2N) consists of approximately 50 sensor nodes, measuring CO2, CO, NO, NO2, O­3, and aerosol. Here we describe field-based calibration approaches that are consistent with the low-cost strategy of the monitoring network. Observations that allow inference of emission factors and identification of specific local emission sources will also be presented.

Criteria to Extract High-Quality Protein Data Bank Subsets for Structure Users.

PubMed

Carugo, Oliviero; Djinović-Carugo, Kristina

2016-01-01

It is often necessary to build subsets of the Protein Data Bank to extract structural trends and average values. For this purpose it is mandatory that the subsets are non-redundant and of high quality. The first problem can be solved relatively easily at the sequence level or at the structural level. The second, on the contrary, needs special attention. It is not sufficient, in fact, to consider the crystallographic resolution and other feature must be taken into account: the absence of strings of residues from the electron density maps and from the files deposited in the Protein Data Bank; the B-factor values; the appropriate validation of the structural models; the quality of the electron density maps, which is not uniform; and the temperature of the diffraction experiments. More stringent criteria produce smaller subsets, which can be enlarged with more tolerant selection criteria. The incessant growth of the Protein Data Bank and especially of the number of high-resolution structures is allowing the use of more stringent selection criteria, with a consequent improvement of the quality of the subsets of the Protein Data Bank.

Space Radiation Cancer, Circulatory Disease and CNS Risks for Near Earth Asteroid and Mars Missions: Uncertainty Estimates for Never-Smokers

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Chappell, Lori J.; Wang, Minli; Kim, Myung-Hee

2011-01-01

The uncertainties in estimating the health risks from galactic cosmic rays (GCR) and solar particle events (SPE) are a major limitation to the length of space missions and the evaluation of potential risk mitigation approaches. NASA limits astronaut exposures to a 3% risk of exposure induced cancer death (REID), and protects against uncertainties in risks projections using an assessment of 95% confidence intervals after propagating the error from all model factors (environment and organ exposure, risk coefficients, dose-rate modifiers, and quality factors). Because there are potentially significant late mortality risks from diseases of the circulatory system and central nervous system (CNS) which are less well defined than cancer risks, the cancer REID limit is not necessarily conservative. In this report, we discuss estimates of lifetime risks from space radiation and new estimates of model uncertainties are described. The key updates to the NASA risk projection model are: 1) Revised values for low LET risk coefficients for tissue specific cancer incidence, with incidence rates transported to an average U.S. population to estimate the probability of Risk of Exposure Induced Cancer (REIC) and REID. 2) An analysis of smoking attributable cancer risks for never-smokers that shows significantly reduced lung cancer risk as well as overall cancer risks from radiation compared to risk estimated for the average U.S. population. 3) Derivation of track structure based quality functions depends on particle fluence, charge number, Z and kinetic energy, E. 4) The assignment of a smaller maximum in quality function for leukemia than for solid cancers. 5) The use of the ICRP tissue weights is shown to over-estimate cancer risks from SPEs by a factor of 2 or more. Summing cancer risks for each tissue is recommended as a more accurate approach to estimate SPE cancer risks. 6) Additional considerations on circulatory and CNS disease risks. Our analysis shows that an individual s history of smoking exposure has a larger impact on GCR risk estimates than amounts of radiation shielding or age at exposure (amongst adults). Risks for never-smokers compared to the average U.S. population are estimated to be reduced between 30% and 60% dependent on model assumptions. Lung cancer is the major contributor to the reduction for never-smokers, with additional contributions from circulatory diseases and cancers of the stomach, liver, bladder, oral cavity and esophagus, and leukemia. The relative contribution of CNS risks to the overall space radiation detriment is potentially increased for never-smokers such as most astronauts. Problems in estimating risks for former smokers and the influence of second-hand smoke are discussed. Compared to the LET approximation, the new track structure derived radiation quality functions lead to a reduced risk for relativistic energy particles and increased risks for intermediate energy particles. Revised estimates for the number of safe days in space at solar minimum for heavy shielding conditions are described for never-smokers and the average U.S. population. Results show that missions to near Earth asteroids (NEA) or Mars violate NASA's radiation safety standards with the current levels of uncertainties. Greater improvements in risk estimates for never-smokers are possible, and would be dependent on improved understanding of risk transfer models, and elucidating the role of space radiation on the various stages of disease formation (e.g. initiation, promotion, and progression).

Daily self-disclosure and sleep in couples.

PubMed

Kane, Heidi S; Slatcher, Richard B; Reynolds, Bridget M; Repetti, Rena L; Robles, Theodore F

2014-08-01

An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction, and health, is associated with sleep behavior. As part of a larger study of family processes, wives (n = 46) and husbands (n = 38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior night's sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the effect of high negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep.

Daily Self-Disclosure and Sleep in Couples

PubMed Central

Kane, Heidi S.; Slatcher, Richard B.; Reynolds, Bridget M.; Repetti, Rena L.; Robles, Theodore F.

2014-01-01

Objective An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction and health, is associated with sleep behavior. Method As part of a larger study of family processes, wives (n=46) and husbands (n=38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior night's sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. Results Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the negative effect of daily negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. Conclusion The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep. PMID:25068453

Regional water quality patterns in an alluvial aquifer: direct and indirect influences of rivers.

PubMed

Baillieux, A; Campisi, D; Jammet, N; Bucher, S; Hunkeler, D

2014-11-15

The influence of rivers on the groundwater quality in alluvial aquifers can be twofold: direct and indirect. Rivers can have a direct influence via recharge and an indirect one by controlling the distribution of fine-grained, organic-carbon rich flood deposits that induce reducing conditions. These direct and indirect influences were quantified for a large alluvial aquifer on the Swiss Plateau (50km(2)) in interaction with an Alpine river using nitrate as an example. The hydrochemistry and stable isotope composition of water were characterized using a network of 115 piezometers and pumping stations covering the entire aquifer. Aquifer properties, land use and recharge zones were evaluated as well. This information provided detailed insight into the factors that control the spatial variability of groundwater quality. Three main factors were identified: (1) diffuse agricultural pollution sources; (2) dilution processes resulting from river water infiltrations, revealed by the δ(18)OH2O and δ(2)HH2O contents of groundwater; and (3) denitrification processes, controlled by the spatial variability of flood deposits governed by fluvial depositional processes. It was possible to quantify the dependence of the nitrate concentration on these three factors at any sampling point of the aquifer using an end-member mixing model, where the average nitrate concentration in recharge from the agricultural area was evaluated at 52mg/L, and the nitrate concentration of infiltrating river at approximately 6mg/L. The study shows the importance of considering the indirect and direct impacts of rivers on alluvial aquifers and provides a methodological framework to evaluate aquifer scale water quality patterns. Copyright © 2014 Elsevier B.V. All rights reserved.

Implementation of a national external quality assessment program for medical laboratories in Burkina Faso: challenges, lessons learned, and perspectives.

PubMed

Sakandé, Jean; Nikièma, Abdoulaye; Kabré, Elie; Sawadogo, Charles; Nacoulma, Eric W; Sanou, Mamadou; Sangaré, Lassana; Traoré-Ouédraogo, Rasmata; Sawadogo, Mamadou; Gershy-Damet, Guy Michel

2014-02-01

The National External Quality Assessment (NEQA) program of Burkina Faso is a proficiency testing program mandatory for all laboratories in the country since 2006. The program runs two cycles per year and covers all areas of laboratories. All panels were validated by the expert committee before dispatch under optimal storage and transport conditions to participating laboratories along with report forms. Performance in the last 5 years varied by panel, with average annual performance of bacteriology panels for all laboratories rising from 75% in 2006 to 81% in 2010 and with a best average performance of 87% in 2007 and 2008. During the same period, malaria microscopy performance varied from 85% to 94%, with a best average performance of 94% in 2010; chemistry performance increased from 87% to 94%, with a best average annual performance of 97% in 2009. Hematology showed more variation in performance, ranging from 61% to 86%, with a best annual average performance of 90% in 2008. Average annual performance for immunology varied less between 2006 and 2010, recording 97%, 90%, and 95%. Except for malaria microscopy, annual performances for enrolled panels varied substantially from year to year, indicating some difficulty in maintaining consistency in quality. The main challenges of the NEQA program observed between 2006 to 2010 were funding, sourcing, and safe transportation of quality panels to all laboratories countrywide.

Estimating occupant satisfaction of HVAC system noise using quality assessment index.

PubMed

Forouharmajd, Farhad; Nassiri, Parvin; Monazzam, Mohammad R; Yazdchi, Mohammadreza

2012-01-01

Noise may be defined as any unwanted sound. Sound becomes noise when it is too loud, unexpected, uncontrolled, happens at the wrong time, contains unwanted pure tones or unpleasant. In addition to being annoying, loud noise can cause hearing loss, and, depending on other factors, can affect stress level, sleep patterns and heart rate. The primary object for determining subjective estimations of loudness is to present sounds to a sample of listeners under controlled conditions. In heating, ventilation and air conditioning (HVAC) systems only the ventilation fan industry (e.g., bathroom exhaust and sidewall propeller fans) uses loudness ratings. In order to find satisfaction, percent of exposure to noise is the valuable issue for the personnel who are working in these areas. The room criterion (RC) method has been defined by ANSI standard S12.2, which is based on measured levels of in HVAC systems noise in spaces and is used primarily as a diagnostic tool. The RC method consists of a family of criteria curves and a rating procedure. RC measures background noise in the building over the frequency range of 16-4000 Hz. This rating system requires determination of the mid-frequency average level and determining the perceived balance between high-frequency (HF) sound and low-frequency (LF) sound. The arithmetic average of the sound levels in the 500, 1000 and 2000 Hz octave bands is 44.6 dB; therefore, the RC 45 curve is selected as the reference for spectrum quality evaluation. The spectral deviation factors in the LF, medium-frequency sound and HF regions are 2.9, 7.5 and -2.3, respectively, giving a Quality Assessment Index (QAI) of 9.8. This concludes the QAI is useful in estimating an occupant's probable reaction when the system design does not produce optimum sound quality. Thus, a QAI between 5 and 10 dB represents a marginal situation in which acceptance by an occupant is questionable. However, when sound pressure levels in the 16 or 31.5 Hz octave bands exceed 65 dB, vibration in lightweight office construction is possible.

The Validity of Peer Review in a General Medicine Journal

PubMed Central

Jackson, Jeffrey L.; Srinivasan, Malathi; Rea, Joanna; Fletcher, Kathlyn E.; Kravitz, Richard L.

2011-01-01

All the opinions in this article are those of the authors and should not be construed to reflect, in any way, those of the Department of Veterans Affairs. Background Our study purpose was to assess the predictive validity of reviewer quality ratings and editorial decisions in a general medicine journal. Methods Submissions to the Journal of General Internal Medicine (JGIM) between July 2004 and June 2005 were included. We abstracted JGIM peer review quality ratings, verified the publication status of all articles and calculated an impact factor for published articles (Rw) by dividing the 3-year citation rate by the average for this group of papers; an Rw>1 indicates a greater than average impact. Results Of 507 submissions, 128 (25%) were published in JGIM, 331 rejected (128 with review) and 48 were either not resubmitted after revision was requested or were withdrawn by the author. Of 331 rejections, 243 were published elsewhere. Articles published in JGIM had a higher citation rate than those published elsewhere (Rw: 1.6 vs. 1.1, p = 0.002). Reviewer quality ratings of article quality had good internal consistency and reviewer recommendations markedly influenced publication decisions. There was no quality rating cutpoint that accurately distinguished high from low impact articles. There was a stepwise increase in Rw for articles rejected without review, rejected after review or accepted by JGIM (Rw 0.60 vs. 0.87 vs. 1.56, p<0.0005). However, there was low agreement between reviewers for quality ratings and publication recommendations. The editorial publication decision accurately discriminated high and low impact articles in 68% of submissions. We found evidence of better accuracy with a greater number of reviewers. Conclusions The peer review process largely succeeds in selecting high impact articles and dispatching lower impact ones, but the process is far from perfect. While the inter-rater reliability between individual reviewers is low, the accuracy of sorting is improved with a greater number of reviewers. PMID:21799867

Comparing Measures of Voice Quality From Sustained Phonation and Continuous Speech.

PubMed

Gerratt, Bruce R; Kreiman, Jody; Garellek, Marc

2016-10-01

The question of what type of utterance-a sustained vowel or continuous speech-is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation. Speakers with voice disorders sustained vowels and read sentences. Vowel samples were excerpted from the steadiest portion of each vowel in the sentences. In addition to sustained and excerpted vowels, a 3rd set of stimuli was created by shortening sustained vowel productions to match the duration of vowels excerpted from continuous speech. Acoustic measures were made on the stimuli, and listeners judged the severity of vocal quality deviation. Sustained vowels and those extracted from continuous speech contain essentially the same acoustic and perceptual information about vocal quality deviation. Perceived and/or measured differences between continuous speech and sustained vowels derive largely from voice source variability across segmental and prosodic contexts and not from variations in vocal fold vibration in the quasisteady portion of the vowels. Approaches to voice quality assessment by using continuous speech samples average across utterances and may not adequately quantify the variability they are intended to assess.

Stormwater runoff quality in correlation to land use and land cover development in Yongin, South Korea.

PubMed

Paule, M A; Memon, S A; Lee, B-Y; Umer, S R; Lee, C-H

2014-01-01

Stormwater runoff quality is sensitive to land use and land cover (LULC) change. It is difficult to understand their relationship in predicting the pollution potential and developing watershed management practices to eliminate or reduce the pollution risk. In this study, the relationship between LULC change and stormwater runoff quality in two separate monitoring sites comprising a construction area (Site 1) and mixed land use (Site 2) was analyzed using geographic information system (GIS), event mean concentration (EMC), and correlation analysis. It was detected that bare land area increased, while other land use areas such as agriculture, commercial, forest, grassland, parking lot, residential, and road reduced. Based on the analyses performed, high maximum range and average EMCs were found in Site 2 for most of the water pollutants. Also, urban areas and increased conversion of LULC into bare land corresponded to degradation of stormwater quality. Correlation analysis between LULC and stormwater quality showed the influence of different factors such as farming practices, geographical location, and amount of precipitation, vegetation loss, and anthropogenic activities in monitoring sites. This research found that GIS application was an efficient tool for monthly monitoring, validation and statistical analysis of LULC change in the study area.

The contextualized self: how team-member exchange leads to coworker identification and helping OCB.

PubMed

Farmer, Steven M; Van Dyne, Linn; Kamdar, Dishan

2015-03-01

This article develops the argument that team-member exchange (TMX) relationships operate at both between- and within-group levels of analysis to influence an employee's sense of identification with coworkers in the group and their helping organizational citizenship behavior (OCB) directed at coworkers. Specifically, we propose that relatively higher quality TMX relationships of an employee as compared with other members of the group influence an employee's sense of positive uniqueness, whereas higher average level of TMX quality in the group creates a greater sense of belonging. Multilevel modeling analysis of field data from 236 bank managers and their subordinates supports the hypotheses and demonstrates 3 key findings. First, team members identify more with their coworkers when they have high relative TMX quality compared with other group members and are also embedded in groups with higher average TMX. Second, identification with coworkers is positively related to helping OCB directed toward team members. Finally, identification with coworkers mediates the interactive effect of relative TMX quality and group average TMX quality on helping. When TMX group relations allow individuals to feel a valued part of the group, but still unique, they engage in higher levels of helping. Overall moderated mediation analysis demonstrates that the mediated relationship linking relative TMX quality with helping OCB via identification with coworkers is stronger when group average TMX is high, but not present when group average TMX is low. We discuss theoretical and practical implications and recommend future research on multilevel conceptualizations of TMX. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Factors Affecting Quality of Life of the Homebound Elderly Hemiparetic Stroke Patients

PubMed Central

Takemasa, Seiichi; Nakagoshi, Ryoma; Murakami, Masahito; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Koeda, Hideki; Naruse, Susumu

2014-01-01

[Purpose] This study examined the quality of life (QOL) of homebound elderly hemiparetic stroke patients and factors that affect it. [Subjects] The subjects of the study were 21 homebound elderly hemiparetic stroke patients who were 65 years old or over and required care for daily living (12 males and 9 females, average age: 79.3 ± 8.4 years old). Their physical and psychological conditions, QOL, and other characteristics were researched. [Methods] The Functional Independence Measure (FIM) was used for the activities of daily living (ADL) assessment, and the MOS 36-Item Short-Form Health Survey (SF-36, Japanese version 1.2) was used for the QOL assessment. [Results] No correlations were observed between the QOL of homebound elderly hemiparetic stroke patients and their age and gender. However, the results showed that their QOL was affected by their independence in ADL, bedridden degree, and care-need level. [Conclusion] These results suggest that in order to improve the QOL of homebound elderly hemiparetic stroke patients, ongoing rehabilitation to improve independence in ADL and lower the bedridden degree and care-need level is required. PMID:24648653

Prestigious Science Journals Struggle to Reach Even Average Reliability

PubMed Central

Brembs, Björn

2018-01-01

In which journal a scientist publishes is considered one of the most crucial factors determining their career. The underlying common assumption is that only the best scientists manage to publish in a highly selective tier of the most prestigious journals. However, data from several lines of evidence suggest that the methodological quality of scientific experiments does not increase with increasing rank of the journal. On the contrary, an accumulating body of evidence suggests the inverse: methodological quality and, consequently, reliability of published research works in several fields may be decreasing with increasing journal rank. The data supporting these conclusions circumvent confounding factors such as increased readership and scrutiny for these journals, focusing instead on quantifiable indicators of methodological soundness in the published literature, relying on, in part, semi-automated data extraction from often thousands of publications at a time. With the accumulating evidence over the last decade grew the realization that the very existence of scholarly journals, due to their inherent hierarchy, constitutes one of the major threats to publicly funded science: hiring, promoting and funding scientists who publish unreliable science eventually erodes public trust in science. PMID:29515380

Is the political system really related to health?

PubMed

Klomp, Jeroen; de Haan, Jakob

2009-07-01

We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new health measures, i.e., the health of individuals and the quality of the health care sector. Using a cross-country structural equation model with various economic and demographic control variables, we examine the relationship between the type of regime and political stability on the one hand and health on the other. The political variables and the control variables are measured as averages over the period 1980-1999. Our results suggest that democracy has a positive relationship with the health of individuals, while regime instability has a negative relationship with the health of individuals. Government instability is negatively related to individual health via its link with the quality of the health care sector, while democracy is positively related with individual health through its link with income. Our main findings are confirmed by the results of a panel model and various sensitivity tests.

Comparison of Colonoscopy Quality Measures Across Various Practice Settings and the Impact of Performance Scorecards.

PubMed

Inra, Jennifer A; Nayor, Jennifer; Rosenblatt, Margery; Mutinga, Muthoka; Reddy, Sarathchandra I; Syngal, Sapna; Kastrinos, Fay

2017-04-01

Quality performance measures for screening colonoscopy vary among endoscopists. The impact of practice setting is unknown. We aimed to (1) compare screening colonoscopy performance measures among three different US practice settings; (2) evaluate factors associated with adenoma detection; and (3) assess a scorecard intervention on performance metrics. This multi-center prospective study compared patient, endoscopist, and colonoscopy characteristics performed at a tertiary care hospital (TCH), community-based hospital (CBH), and private practice group (PPG). Withdrawal times (WT), cecal intubation, and adenoma detection rates (ADR) were compared by site at baseline and 12 weeks following scorecard distribution. Generalized linear mixed models identified factors associated with adenoma detection. Twenty-eight endoscopists performed colonoscopies on 1987 asymptomatic, average-risk individuals ≥50 years. Endoscopist and patient characteristics were similar across sites. The PPG screened more men (TCH: 42.8%, CBH: 45.0%, PPG: 54.2%; p < 0.0001). Preparation quality varied with good/excellent results in 70.6, 88.3, and 92% of TCH, CBH, and PPG cases, respectively (p < 0.0001). Male ADRs, cecal intubation, and WT exceeded recommended benchmarks despite variable results at each site; female ADRs were <15% at the PPG which screened the fewest females. Performance remained unchanged following scorecard distribution. Adenoma detection was associated with increasing patient age, male gender, WT, adequate preparation, but not practice setting. Each practice performed high-quality screening colonoscopy. Scorecards did not improve performance metrics. Preparation quality varies among practice settings and can be modified to improve adenoma detection.

Climatic factors directly impact the volatile organic compound fingerprint in green Arabica coffee bean as well as coffee beverage quality.

PubMed

Bertrand, B; Boulanger, R; Dussert, S; Ribeyre, F; Berthiot, L; Descroix, F; Joët, T

2012-12-15

Coffee grown at high elevations fetches a better price than that grown in lowland regions. This study was aimed at determining whether climatic conditions during bean development affected sensory perception of the coffee beverage and combinations of volatile compounds in green coffee. Green coffee samples from 16 plots representative of the broad range of climatic variations in Réunion Island were compared by sensory analysis. Volatiles were extracted by solid phase micro-extraction and the volatile compounds were analysed by GC-MS. The results revealed that, among the climatic factors, the mean air temperature during seed development greatly influenced the sensory profile. Positive quality attributes such as acidity, fruity character and flavour quality were correlated and typical of coffees produced at cool climates. Two volatile compounds (ethanal and acetone) were identified as indicators of these cool temperatures. Among detected volatiles, most of the alcohols, aldehydes, hydrocarbons and ketones appeared to be positively linked to elevated temperatures and high solar radiation, while the sensory profiles displayed major defects (i.e. green, earthy flavour). Two alcohols (butan-1,3-diol and butan-2,3-diol) were closely correlated with a reduction in aromatic quality, acidity and an increase in earthy and green flavours. We assumed that high temperatures induce accumulation of these compounds in green coffee, and would be detected as off-flavours, even after roasting. Climate change, which generally involves a substantial increase in average temperatures in mountainous tropical regions, could be expected to have a negative impact on coffee quality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Quality of Life of Post-Mastectomy Women Living in a Semi-Arid Region of Brazil.

PubMed

Araújo Neto, Emídio A; Alves, Beatriz C A; Gehrke, Flávia de S; Azzalis, Ligia A; Junqueira, Virginia C B; Sousa, Luiz Vinicius de A; Adami, Fernando; Fonseca, Fernando L A

2017-06-05

Health is the major reference regarding quality of life; when it comes to breast cancer in particular, the loss of a breast traumatically affects a woman's life, reflecting on her quality of life. Recognizing this problem, our aim was to investigate the quality of life of women who live in a semi-arid region of Brazil after breast cancer mastectomy. In this exploratory, transversal and observational study, a Brazilian variantof the shorter version of the original instrument from the World Health Organization Quality of Life (WHOQOL-BREF), applied in the study population, was analyzed and their socio-demographic profile was obtained. The sample was composed of 50 mastectomized women. The 50 included patients comprised women at a mean age of 54 years. Most of them had finished elementary school, and their average income was one Brazilian minimum monthly wage. Regarding the data related to quality of life, the highest score was found in the social relationships domain (4.29) followed by the psychological (4.09) and environmental (3.88) domains. The lowest score observed was for the physical domain (3.48). With these findings we can say that social and psychological parameters are driving factors of the quality of life in post-mastectomy women. Therefore, these results are useful to establish strategies to improve the quality of life of breast cancer mastectomy patients.

Health-Related Quality of Life and Associated Factors of Frontline Railway Workers: A Cross-Sectional Survey in the Ankang Area, Shaanxi Province, China

PubMed Central

Zhang, Xiaona; Chen, Gang; Xu, Feng; Zhou, Kaina; Zhuang, Guihua

2016-01-01

After validation of the widely used health-related quality of life (HRQOL) generic measure, the Short Form 36 version 2 (SF-36v2), we investigated the HRQOL and associated factors of frontline railway workers in China. Ground workers, conductors, and train drivers were selected from Ankang Precinct by using a stratified cluster sampling technique. A total of 784 frontline railway workers participated in the survey. The reliability and validity of SF-36v2 was satisfactory. The physical component summary (PCS) scores of three subgroups attained the average range for the USA general population, whereas the mental component summary (MCS) scores were well below the range. Most domains scored below the norm, except for the physical functioning (PF) domain. Among three subgroups, train drivers reported significantly lower scores on MCS and six health domains (excluding PF and bodily pain (BP)). After controlled confounders, conductors had significantly higher PCS and MCS scores than ground workers. There is heterogeneity on risk factors among three subgroups, but having long or irregular working schedules was negatively associated with HRQOL in all subgroups. SF-36v2 is a reliable and valid HRQOL measurement in railway workers in China. The frontline railway workers’ physical health was comparative to American norms, whilst mental health was relatively worse. Long or irregular working schedules were the most important factors. PMID:27916919

Influence of distance to urban markets on smallholder dairy farming systems in Kenya.

PubMed

Migose, S A; Bebe, B O; de Boer, I J M; Oosting, S J

2018-03-28

We studied influence of distance to urban markets on smallholder dairy farming system development. Farms were chosen from three locations that varied in distance to the urban market of Nakuru Town in the Kenyan highlands: urban location (UL, n = 10) at less than 15 km distance, mid-rural location (MRL, n = 11) in between 20 and 50 km west of Nakuru and extreme rural location (ERL, n = 9) beyond 50 km west and south-west of Nakuru. In-depth interviews with farmers and focus group discussions with eight groups of stakeholders were held to collect narratives and data about market quality, production factors, farm performance and functions of dairy cattle. We applied thematic content analysis to qualitative information by clustering narratives according to predefined themes and used ANOVA to analyse farm data. In UL, markets were functional, with predominantly informal market chains, with a high milk price (US $ 45.1/100 kg). Inputs were available in UL markets, but prices were high for inputs such as concentrates, fodder, replacement stock and hired labour. Moreover, availability of grazing land and the high opportunity costs for family labour were limiting dairy activities. In UL, milk production per cow (6.9 kg/cow/day) and per farm (20.1 kg/farm/day) were relatively low, and we concluded that farm development was constrained by scarcity of inputs and production factors. In rural locations (MRL and ERL), markets were functional with relatively low prices (average US $ 32.8/100 kg) for milk in both formal and informal market chains. Here, concentrates were relatively cheap but also of low quality. Fodder, replacement stock and labour were more available in rural locations than in UL. In rural locations, milk production per cow (average 7.2 kg/cow/day) and per farm (average 18.5 kg/farm/day) were low, and we concluded that farm development was constrained by low quality of concentrates and low price of milk. In all locations, production for subsistence was valued since income generated was used for non-dairy expenses. A tailor-made package of interventions that targets the above constraints is recommended for farm development.

Optimisation and establishment of diagnostic reference levels in paediatric plain radiography

NASA Astrophysics Data System (ADS)

Paulo, Graciano do Nascimento Nobre

Purpose: This study aimed to propose Diagnostic Reference Levels (DRLs) in paediatric plain radiography and to optimise the most frequent paediatric plain radiography examinations in Portugal following an analysis and evaluation of current practice. Methods and materials: Anthropometric data (weight, patient height and thickness of the irradiated anatomy) was collected from 9,935 patients referred for a radiography procedure to one of the three dedicated paediatric hospitals in Portugal. National DRLs were calculated for the three most frequent X-ray procedures at the three hospitals: chest AP/PA projection; abdomen AP projection; pelvis AP projection. Exposure factors and patient dose were collected prospectively at the clinical sites. In order to analyse the relationship between exposure factors, the use of technical features and dose, experimental tests were made using two anthropomorphic phantoms: a) CIRSTM ATOM model 705; height: 110cm, weight: 19kg and b) Kyoto kagakuTM model PBU-60; height: 165cm, weight: 50kg. After phantom data collection, an objective image analysis was performed by analysing the variation of the mean value of the standard deviation, measured with OsiriX software (Pixmeo, Switzerland). After proposing new exposure criteria, a Visual Grading Characteristic image quality evaluation was performed blindly by four paediatric radiologists, each with a minimum of 10 years of professional experience, using anatomical criteria scoring. Results: DRLs by patient weight groups have been established for the first time. ESAKP75 DRLs for both patient age and weight groups were also obtained and are described in the thesis. Significant dose reduction was achieved through the implementation of an optimisation programme: an average reduction of 41% and 18% on KAPP75 and ESAKP75, respectively for chest plain radiography; an average reduction of 58% and 53% on KAPP75 and ESAKP75, respectively for abdomen plain radiography; and an average reduction of 47% and 48% on KAPP75 and ESAKP75, respectively for pelvis plain radiography. Conclusion: Portuguese DRLs for plain radiography were obtained for paediatric plain radiography (chest AP/PA, abdomen and pelvis). Experimental phantom tests identified adequate plain radiography exposure criteria, validated by objective and subjective image quality analysis. The new exposure criteria were put into practice in one of the paediatric hospitals, by introducing an optimisation programme. The implementation of the optimisation programme allowed a significant dose reduction to paediatric patients, without compromising image quality. (Abstract shortened by ProQuest.).

Nonmaternal Care’s Association With Mother’s Parenting Sensitivity: A Case of Self-Selection Bias?

PubMed Central

Nomaguchi, Kei M.; DeMaris, Alfred

2013-01-01

Although attachment theory posits that the use of nonmaternal care undermines quality of mothers’ parenting, empirical evidence for this link is inconclusive. Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1,233), the authors examined the associations between nonmaternal care characteristics and maternal sensitivity during the first 3 years of children’s lives, with special attention to selection effects and moderation by resource levels. Findings from fixed-effects regression models suggested that, on average, there is little relationship between nonmaternal care characteristics and maternal sensitivity, once selection factors are held constant. Some evidence of moderation effects was found, however. Excellent-quality care is related to more sensitivity for mothers with lower family income. Poor-quality care is related to lower sensitivity for single mothers, but not partnered mothers. In sum, nonmaternal care characteristics do not seem to have as much influence on mothers’ parenting as attachment theory claims. PMID:23772093

Water-quality assessment of stormwater runoff from a heavily used urban highway bridge in Miami, Florida

USGS Publications Warehouse

McKenzie, Donald J.; Irwin, G.A.

1983-01-01

Runoff from a heavily-traveled, 1.43-acre bridge section of Interstate-95 in Miami, Florida, was comprehensively monitored for both quality and quantity during five selected storms between November 1979 and May 1981. For most water-quality parameters, 6 to 11 samples were collected during each of the 5 runoff events. Concentrations of most parameters in the runoff were quite variable both during individual storm events and among the five storm events; however, the ranges in parameter concentration were about the same magnitude report for numerous other highway and urban drainages. Data were normalized to estimate the average, discharge-weighted parameter loads per storm per acre of bridge surface and results suggested that the most significant factor influencing stormwater loads was parameter concentration. Rainfall intensity and runoff volume, however, influenced rates of loading. The total number of antecedent dry days and traffic volume did not appear to be conspicously related to either runoff concentrations or loads. (USGS)

Marginal Emissions Factors for Electricity Generation in the Midcontinent ISO.

PubMed

Thind, Maninder P S; Wilson, Elizabeth J; Azevedo, Inês L; Marshall, Julian D

2017-12-19

Environmental consequences of electricity generation are often determined using average emission factors. However, as different interventions are incrementally pursued in electricity systems, the resulting marginal change in emissions may differ from what one would predict based on system-average conditions. Here, we estimate average emission factors and marginal emission factors for CO 2 , SO 2 , and NO x from fossil and nonfossil generators in the Midcontinent Independent System Operator (MISO) region during years 2007-2016. We analyze multiple spatial scales (all MISO; each of the 11 MISO states; each utility; each generator) and use MISO data to characterize differences between the two emission factors (average; marginal). We also explore temporal trends in emissions factors by hour, day, month, and year, as well as the differences that arise from including only fossil generators versus total generation. We find, for example, that marginal emission factors are generally higher during late-night and early morning compared to afternoons. Overall, in MISO, average emission factors are generally higher than marginal estimates (typical difference: ∼20%). This means that the true environmental benefit of an energy efficiency program may be ∼20% smaller than anticipated if one were to use average emissions factors. Our analysis can usefully be extended to other regions to support effective near-term technical, policy and investment decisions based on marginal rather than only average emission factors.

Quantifying population exposure to airborne particulate matter during extreme events in California due to climate change

NASA Astrophysics Data System (ADS)

Mahmud, A.; Hixson, M.; Kleeman, M. J.

2012-02-01

The effect of climate change on population-weighted concentrations of particulate matter (PM) during extreme events was studied using the Parallel Climate Model (PCM), the Weather Research and Forecasting (WRF) model and the UCD/CIT 3-D photochemical air quality model. A "business as usual" (B06.44) global emissions scenario was dynamically downscaled for the entire state of California between the years 2000-2006 and 2047-2053. Air quality simulations were carried out for 1008 days in each of the present-day and future climate conditions using year-2000 emissions. Population-weighted concentrations of PM0.1, PM2.5, and PM10 total mass, components species, and primary source contributions were calculated for California and three air basins: the Sacramento Valley air basin (SV), the San Joaquin Valley air basin (SJV) and the South Coast Air Basin (SoCAB). Results over annual-average periods were contrasted with extreme events. Climate change between 2000 vs. 2050 did not cause a statistically significant change in annual-average population-weighted PM2.5 mass concentrations within any major sub-region of California in the current study. Climate change did alter the annual-average composition of the airborne particles in the SoCAB, with notable reductions of elemental carbon (EC; -3%) and organic carbon (OC; -3%) due to increased annual-average wind speeds that diluted primary concentrations from gasoline combustion (-3%) and food cooking (-4%). In contrast, climate change caused significant increases in population-weighted PM2.5 mass concentrations in central California during extreme events. The maximum 24-h average PM2.5 concentration experienced by an average person during a ten-year period in the SJV increased by 21% due to enhanced production of secondary particulate matter (manifested as NH4NO3). In general, climate change caused increased stagnation during future extreme pollution events, leading to higher exposure to diesel engines particles (+32%) and wood combustion particles (+14%) when averaging across the population of the entire state. Enhanced stagnation also isolated populations from distant sources such as shipping (-61%) during extreme events. The combination of these factors altered the statewide population-averaged composition of particles during extreme events, with EC increasing by 23%, nitrate increasing by 58%, and sulfate decreasing by 46%.

Quantifying population exposure to airborne particulate matter during extreme events in California due to climate change

NASA Astrophysics Data System (ADS)

Mahmud, A.; Hixson, M.; Kleeman, M. J.

2012-08-01

The effect of climate change on population-weighted concentrations of particulate matter (PM) during extreme pollution events was studied using the Parallel Climate Model (PCM), the Weather Research and Forecasting (WRF) model and the UCD/CIT 3-D photochemical air quality model. A "business as usual" (B06.44) global emissions scenario was dynamically downscaled for the entire state of California between the years 2000-2006 and 2047-2053. Air quality simulations were carried out for 1008 days in each of the present-day and future climate conditions using year-2000 emissions. Population-weighted concentrations of PM0.1, PM2.5, and PM10 total mass, components species, and primary source contributions were calculated for California and three air basins: the Sacramento Valley air basin (SV), the San Joaquin Valley air basin (SJV) and the South Coast Air Basin (SoCAB). Results over annual-average periods were contrasted with extreme events. The current study found that the change in annual-average population-weighted PM2.5 mass concentrations due to climate change between 2000 vs. 2050 within any major sub-region in California was not statistically significant. However, climate change did alter the annual-average composition of the airborne particles in the SoCAB, with notable reductions of elemental carbon (EC; -3%) and organic carbon (OC; -3%) due to increased annual-average wind speeds that diluted primary concentrations from gasoline combustion (-3%) and food cooking (-4%). In contrast, climate change caused significant increases in population-weighted PM2.5 mass concentrations in central California during extreme events. The maximum 24-h average PM2.5 concentration experienced by an average person during a ten-yr period in the SJV increased by 21% due to enhanced production of secondary particulate matter (manifested as NH4NO3). In general, climate change caused increased stagnation during future extreme pollution events, leading to higher exposure to diesel engines particles (+32%) and wood combustion particles (+14%) when averaging across the population of the entire state. Enhanced stagnation also isolated populations from distant sources such as shipping (-61%) during extreme events. The combination of these factors altered the statewide population-averaged composition of particles during extreme events, with EC increasing by 23 %, nitrate increasing by 58%, and sulfate decreasing by 46%.

Improved Satellite Retrievals of NO2 and SO2 over the Canadian Oil Sands and Comparisons with Surface Measurements

NASA Technical Reports Server (NTRS)

McLinden, C. A.; Fioletov, V.; Boersma, K. F.; Kharol, S. K.; Krotkov, N.; Lamsal, L.; Makar, P. A.; Martin, R. V.; Veefkind, J. P.; Yang, K.

2014-01-01

Satellite remote sensing is increasingly being used to monitor air quality over localized sources such as the Canadian oil sands. Following an initial study, significantly low biases have been identified in current NO2 and SO2 retrieval products from the Ozone Monitoring Instrument (OMI) satellite sensor over this location resulting from a combination of its rapid development and small spatial scale. Air mass factors (AMFs) used to convert line-of-sight "slant" columns to vertical columns were re-calculated for this region based on updated and higher resolution input information including absorber profiles from a regional-scale (15 km × 15 km resolution) air quality model, higher spatial and temporal resolution surface reflectivity, and an improved treatment of snow. The overall impact of these new Environment Canada (EC) AMFs led to substantial increases in the peak NO2 and SO2 average vertical column density (VCD), occurring over an area of intensive surface mining, by factors of 2 and 1.4, respectively, relative to estimates made with previous AMFs. Comparisons are made with long-term averages of NO2 and SO2 (2005-2011) from in situ surface monitors by using the air quality model to map the OMI VCDs to surface concentrations. This new OMI-EC product is able to capture the spatial distribution of the in situ instruments (slopes of 0.65 to 1.0, correlation coefficients of greater than 0.9). The concentration absolute values from surface network observations were in reasonable agreement, with OMI-EC NO2 and SO2 biased low by roughly 30%. Several complications were addressed including correction for the interference effect in the surface NO2 instruments and smoothing and clear-sky biases in the OMI measurements. Overall these results highlight the importance of using input information that accounts for the spatial and temporal variability of the location of interest when performing retrievals.

Characterization of the nanoDot OSLD dosimeter in CT.

PubMed

Scarboro, Sarah B; Cody, Dianna; Alvarez, Paola; Followill, David; Court, Laurence; Stingo, Francesco C; Zhang, Di; McNitt-Gray, Michael; Kry, Stephen F

2015-04-01

The extensive use of computed tomography (CT) in diagnostic procedures is accompanied by a growing need for more accurate and patient-specific dosimetry techniques. Optically stimulated luminescent dosimeters (OSLDs) offer a potential solution for patient-specific CT point-based surface dosimetry by measuring air kerma. The purpose of this work was to characterize the OSLD nanoDot for CT dosimetry, quantifying necessary correction factors, and evaluating the uncertainty of these factors. A characterization of the Landauer OSL nanoDot (Landauer, Inc., Greenwood, IL) was conducted using both measurements and theoretical approaches in a CT environment. The effects of signal depletion, signal fading, dose linearity, and angular dependence were characterized through direct measurement for CT energies (80-140 kV) and delivered doses ranging from ∼5 to >1000 mGy. Energy dependence as a function of scan parameters was evaluated using two independent approaches: direct measurement and a theoretical approach based on Burlin cavity theory and Monte Carlo simulated spectra. This beam-quality dependence was evaluated for a range of CT scanning parameters. Correction factors for the dosimeter response in terms of signal fading, dose linearity, and angular dependence were found to be small for most measurement conditions (<3%). The relative uncertainty was determined for each factor and reported at the two-sigma level. Differences in irradiation geometry (rotational versus static) resulted in a difference in dosimeter signal of 3% on average. Beam quality varied with scan parameters and necessitated the largest correction factor, ranging from 0.80 to 1.15 relative to a calibration performed in air using a 120 kV beam. Good agreement was found between the theoretical and measurement approaches. Correction factors for the measurement of air kerma were generally small for CT dosimetry, although angular effects, and particularly effects due to changes in beam quality, could be more substantial. In particular, it would likely be necessary to account for variations in CT scan parameters and measurement location when performing CT dosimetry using OSLD.

DOSIMETRIC response of a REM-500 in low energy neutron fields typical of nuclear power plants.

PubMed

Aslam; Matysiak, W; Atanackovic, J; Waker, A J

2012-06-01

This study investigates the response of a REM-500 to assess neutron quality factor and dose equivalent in low energy neutron fields, which are commonly encountered in the workplace environment of nuclear power stations. The McMaster University 3 MV Van de Graaff accelerator facility was used to measure the response of the instrument in monoenergetic neutron fields in the energy range 51 to 727 keV by bombarding a thin LiF target with 1.93-2.50 MeV protons. The energy distribution of the neutron fields produced in the facility was measured by a (3)He filled gas ionization chamber. The MCA mode of the REM-500 instrument was used to collect lineal energy distributions at varying neutron energies and to calculate the frequency and dose-mean lineal energies. The effective quality factor, Q-, was also calculated using the values of Q(y)listed in the REM-500 operation manual and compared with those of ICRP 60. The authors observed a continuously increasing trend in y - F, y-D, and Q-with an increase in neutron energy. It is interesting to note that standard tissue equivalent proportional counters (TEPCs) filled with tissue equivalent(TE) gas give rise to a similar trend for these microdosimetric quantities of interest in the same energy range; however, the averages calculated in this study are larger by about 15%compared to a TEPC filled with propane-based TE gas probably because of the larger stopping power of protons in propane compared to TE gas. These somewhat larger event sizes did not result in any significant increase in the Q-compared to those obtained from a TEPC filled with TE gas and were found to be in good agreement with other measurements reported earlier at corresponding neutron energies. The instrument quality factor response, R(Q), defined as the ratio of measured quality factor to the calculated quality factor in an ICRU tissue sphere,was found to vary with neutron energy. The instrument response,R(Q), was ~0.6 at 727 keV, which deteriorates further to ~0.3 at 51 keV neutron energy. The counter response based on ICRP 60 was comparable to an ideal response of 1.0 above 600 keV, which dropped to ~0.8 at 159 keV and ~0.4 at 51 keV neutron energy. The decline in counter quality factor response based on ICRP 60 was found to be much steeper than that when using the instrument’s built-in function for quality factor.The REM-500 measures a dose equivalent at 727 keV,which is 60% of the ambient dose equivalent, 40% at 159 keV,and 15% at 51 keV. Two algorithms have been developed, one for real time measurement and another to be used post measurement,and their efficacy is demonstrated in determining the quality factor and the ambient dose equivalent in low energy neutron fields, which are typical for the workplace environment in CANDU® nuclear power generating stations.

Influence of ecological factors on the production of active substances in the anti-cancer plant Sinopodophyllum hexandrum (Royle) T.S. Ying.

PubMed

Liu, Wei; Liu, Jianjun; Yin, Dongxue; Zhao, Xiaowen

2015-01-01

The quality of traditional Chinese herbal medicine, which plays a very important role in the health system of China, is determined by the active substances produced by the plants. The type, content, and proportion of these substances may vary depending on ecological factors in areas where the plants are grown. Sinopodophyllum hexandrum (Royle) T.S. Ying, an endangered plant species with great medical value, was investigated in eight production locations representative of its natural geographical distribution range in China. The correlation between the contents of the active ingredients extracted from the roots and rhizomes of S. hexandrum and the ecological factors were evaluated step-by-step using a series of computational biology methodologies. The results showed that ecological factors had significant effects on the contents but not on the types of the active ingredients in eight production locations. The primary ecological factors influencing the active substances included the annual average precipitation, July mean temperature, frost-free period, sunshine duration, soil pH, soil organic matter, and rapidly available potassium in the soil. The annual average precipitation was the most important determinant factor and was significantly and negatively correlated with the active ingredient contents (P < 0.001). In contrast, organic matter was the most important limiting factor and was significantly and positively correlated with the active substances. These ecological factors caused 98.13% of the total geographical variation of the active ingredient contents. The climate factors contributed more to the active ingredient contents than did the soil factors. It was concluded that from the view of the contents of the secondary metabolites and ecological factors of each growing location, in Jingyuan, Ningxia Province, and Yongdeng, Gansu Province, conditions were favorable to the production of podophyllotoxin and lignans, whereas in Shangri-La, Yunnan Province, and Nyingchi, Tibet, conditions were favorable to the production of quercetin and kaempferol.

Influence of Ecological Factors on the Production of Active Substances in the Anti-Cancer Plant Sinopodophyllum hexandrum (Royle) T.S. Ying

PubMed Central

Liu, Wei; Liu, Jianjun; Yin, Dongxue; Zhao, Xiaowen

2015-01-01

The quality of traditional Chinese herbal medicine, which plays a very important role in the health system of China, is determined by the active substances produced by the plants. The type, content, and proportion of these substances may vary depending on ecological factors in areas where the plants are grown. Sinopodophyllum hexandrum (Royle) T.S. Ying, an endangered plant species with great medical value, was investigated in eight production locations representative of its natural geographical distribution range in China. The correlation between the contents of the active ingredients extracted from the roots and rhizomes of S. hexandrum and the ecological factors were evaluated step-by-step using a series of computational biology methodologies. The results showed that ecological factors had significant effects on the contents but not on the types of the active ingredients in eight production locations. The primary ecological factors influencing the active substances included the annual average precipitation, July mean temperature, frost-free period, sunshine duration, soil pH, soil organic matter, and rapidly available potassium in the soil. The annual average precipitation was the most important determinant factor and was significantly and negatively correlated with the active ingredient contents (P < 0.001). In contrast, organic matter was the most important limiting factor and was significantly and positively correlated with the active substances. These ecological factors caused 98.13% of the total geographical variation of the active ingredient contents. The climate factors contributed more to the active ingredient contents than did the soil factors. It was concluded that from the view of the contents of the secondary metabolites and ecological factors of each growing location, in Jingyuan, Ningxia Province, and Yongdeng, Gansu Province, conditions were favorable to the production of podophyllotoxin and lignans, whereas in Shangri-La, Yunnan Province, and Nyingchi, Tibet, conditions were favorable to the production of quercetin and kaempferol. PMID:25874701

Mass extinction efficiency and extinction hygroscopicity of ambient PM2.5 in urban China.

PubMed

Cheng, Zhen; Ma, Xin; He, Yujie; Jiang, Jingkun; Wang, Xiaoliang; Wang, Yungang; Sheng, Li; Hu, Jiangkai; Yan, Naiqiang

2017-07-01

The ambient PM 2.5 pollution problem in China has drawn substantial international attentions. The mass extinction efficiency (MEE) and hygroscopicity factor (f(RH)) of PM 2.5 can be readily applied to study the impacts on atmospheric visibility and climate. The few previous investigations in China only reported results from pilot studies and are lack of spatial representativeness. In this study, hourly average ambient PM 2.5 mass concentration, relative humidity, and atmospheric visibility data from China national air quality and meteorological monitoring networks were retrieved and analyzed. It includes 24 major Chinese cities from nine city-clusters with the period of October 2013 to September 2014. Annual average extinction coefficient in urban China was 759.3±258.3Mm -1 , mainly caused by dry PM 2.5 (305.8.2±131.0Mm -1 ) and its hygroscopicity (414.6±188.1Mm -1 ). High extinction coefficient values were resulted from both high ambient PM 2.5 concentration (68.5±21.7µg/m 3 ) and high relative humidity (69.7±8.6%). The PM 2.5 mass extinction efficiency varied from 2.87 to 6.64m 2 /g with an average of 4.40±0.84m 2 /g. The average extinction hygroscopic factor f(RH=80%) was 2.63±0.45. The levels of PM 2.5 mass extinction efficiency and hygroscopic factor in China were in comparable range with those found in developed countries in spite of the significant diversities among all 24 cities. Our findings help to establish quantitative relationship between ambient extinction coefficient (visual range) and PM 2.5 & relative humidity. It will reduce the uncertainty of extinction coefficient estimation of ambient PM 2.5 in urban China which is essential for the research of haze pollution and climate radiative forcing. Copyright © 2017 Elsevier Inc. All rights reserved.

Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

PubMed

Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

2017-08-01

The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Long-term average spectrum in screening of voice quality in speech: untrained male university students.

PubMed

Leino, Timo

2009-11-01

Voice quality has mainly been studied in trained speakers, singers, and dysphonic patients. Few studies have concerned ordinary untrained university students' voices. In light of earlier studies of professional voice users, it was hypothesized that good, poor, and intermediate voices would be distinguishable on the basis of long-term average spectrum characteristics. In the present study, voice quality of 50 Finnish vocally untrained male university students was studied perceptually and using long-term average spectrum analysis of text reading samples of one minute duration. Equivalent sound level (Leq) of text reading was also measured. According to the results, the good and ordinary voices differed from the poor ones in their relatively higher sound level in the frequency range of 1-3 kHz and a prominent peak at 3-4 kHz. Good voices, however, did not differ from the ordinary voices in terms of the characteristics of the long-term average spectrum (LTAS). The strength of the peak at 3-4 kHz and the voice-quality scores correlated weakly but significantly. Voice quality and alpha ratio (level difference above and below 1 kHz) correlated likewise. Leq was significantly higher in the students with good and ordinary voices than in those with poor voices. The connections between Leq, voice quality, and the formation of the peak at 3-4 kHz warrant further studies.

Patterns of domestic exposure to carbon monoxide and particulate matter in households using biomass fuel in Janakpur, Nepal.

PubMed

Bartington, S E; Bakolis, I; Devakumar, D; Kurmi, O P; Gulliver, J; Chaube, G; Manandhar, D S; Saville, N M; Costello, A; Osrin, D; Hansell, A L; Ayres, J G

2017-01-01

Household Air Pollution (HAP) from biomass cooking fuels is a major cause of morbidity and mortality in low-income settings worldwide. In Nepal the use of open stoves with solid biomass fuels is the primary method of domestic cooking. To assess patterns of domestic air pollution we performed continuous measurement of carbon monoxide (CO) and particulate Matter (PM 2.5 ) in 12 biomass fuel households in Janakpur, Nepal. We measured kitchen PM 2.5 and CO concentrations at one-minute intervals for an approximately 48-h period using the TSI DustTrak II 8530/SidePak AM510 (TSI Inc, St. Paul MN, USA) or EL-USB-CO data logger (Lascar Electronics, Erie PA, USA) respectively. We also obtained information regarding fuel, stove and kitchen characteristics and cooking activity patterns. Household cooking was performed in two daily sessions (median total duration 4 h) with diurnal variability in pollutant concentrations reflecting morning and evening cooking sessions and peak concentrations associated with fire-lighting. We observed a strong linear relationship between PM 2.5 measurements obtained by co-located photometric and gravimetric monitoring devices, providing local calibration factors of 4.9 (DustTrak) and 2.7 (SidePak). Overall 48-h average CO and PM 2.5 concentrations were 5.4 (SD 4.3) ppm (12 households) and 417.6 (SD 686.4) μg/m 3 (8 households), respectively, with higher average concentrations associated with cooking and heating activities. Overall average PM 2.5 concentrations and peak 1-h CO concentrations exceeded WHO Indoor Air Quality Guidelines. Average hourly PM 2.5 and CO concentrations were moderately correlated (r = 0.52), suggesting that CO has limited utility as a proxy measure for PM 2.5 exposure assessment in this setting. Domestic indoor air quality levels associated with biomass fuel combustion in this region exceed WHO Indoor Air Quality standards and are in the hazardous range for human health. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Women's social eating environment and its associations with dietary behavior and weight management.

PubMed

Mötteli, Sonja; Siegrist, Michael; Keller, Carmen

2017-03-01

As an unhealthy social eating environment is considered a risk factor for obesity, this study aimed to examine women's regular eating networks and the extent to which diet-related variables were associated with those of their regular eating companions. In Study Part I (N = 579), an egocentric network approach was used to investigate women's perceptions of their eating networks. In Study Part II (N = 262), the participants' most important eating companions responded to a similar survey, and the corresponding answers were matched. The results showed that women shared their meals most frequently with spouses and other family members. Women who dined more often with healthy eaters reported on average a higher diet quality and a lower body mass index (BMI), which were also significant after controlling for individual factors. Study Part II expanded these results by showing that different diet-related factors such as diet quality, eating styles and BMI were correlated between women and their most important eating companions (r = 0.16-0.30, p < 0.05). Moreover, an actor-partner interdependence model revealed that a higher diet quality of the eating companions was associated with a lower BMI in women, controlled for their own eating behavior (b = -0.45, p < 0.05). This study showed similarities and interdependence between women's dietary behavior and body weight and those of their regular eating companions. This might indicate that regular eating networks have a shared understanding of what constitutes a normal diet, which might be an important factor to consider in the promotion of healthy eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality of life of caregivers: a cross-sectional study.

PubMed

Ovayolu, Ozlem; Ovayolu, Nimet; Tuna, Döndü; Serçe, Sibel; Sevinç, Alper; Pirbudak Çöçelli, Lütfiye

2014-08-01

This descriptive study was conducted to evaluate the quality of life of cancer caregivers. One hundred and seventy-eight caregivers of patients who were diagnosed with cancer in Gaziantep oncology hospital participated in the study. Data were collected by using a questionnaire and quality of life scale. The scale was scored between 0 and 10, where '10' indicated the best and '0' indicated the worst level. It was determined that the majority of caregivers were young and female, the overall total score average of quality of life was 4.5 ± 1.1, and the subdomain with the lowest value was the psychological subdomain. All quality of life subdomain score averages and the overall total score averages were observed to be low in women, as well as in those who provided care for their own children, who lived in the same house with the patient and who gave care for 19-24 h daily. © 2013 Wiley Publishing Asia Pty Ltd.

Observations of the Infrared Solar Spectrum from Space by the ATMOS Experiment

NASA Technical Reports Server (NTRS)

Abrams, M. C.; Goldman, A.; Gunson, M. R.; Rinsland, C. P.; Zander, R.

1999-01-01

The final flight of the Atmospheric Trace Molecule Spectroscopy experiment as part of the Atmospheric na Laboratory for Applications and Science (ATLAS-3) Space Shuttle mission in 1994 provided a new opportunity to measure broadband 625-4800/ cm, 2.1 - 16 micron infrared solar spectra at an unapodized resolution of 0.0l/ cm from space. The majority of the observations were obtained as exoatmospheric, of near Sun center, absorption spectra, which were later ratioed to grazing atmospheric measurements to compute the atmospheric transmission of the Earth's atmosphere and analyzed for vertical profiles of minor and trace gases. Relative to the SPACELAB-3 mission that produced 4800 high Sun spectra (which were averaged into four grand average spectra), the ATLAS-3 mission produced some 40,000 high Sun spectra (which have been similarly averaged) with an improvement in signal-to-noise ratio of a factor of 3-4 in the spectral region between 1000 and 4800/ cm. A brief description of the spectral calibration and spectral quality is given as well as the location of electronic archives of these spectra.

Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey.

PubMed

Eltaybani, Sameh; Noguchi-Watanabe, Maiko; Igarashi, Ayumi; Saito, Yumiko; Yamamoto-Mitani, Noriko

2018-04-01

Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models. To identify the factors associated with long-term care nurses' intention to stay in their current workplace. A cross-sectional questionnaire survey. Two hundred and fifty-seven hospitals with long-term care wards across Japan. A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals. The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace. Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in gerontological nursing, and a high salary). By contrast, intention to stay was negatively associated with emotional exhaustion (0.93 [0.91-0.95]) and depersonalization (0.91 [0.89-0.93]). Intention to stay was associated with neither nurses' qualifications nor patient medical acuity. Reason for choosing the workplace, work engagement, getting support from the nurse manager, and perceived quality of care process are significant predictors of long-term care nurses' intention to stay in the workplace. Promoting such nurses' work engagement, provision of high-quality care, and access to educational opportunities might augment long-term care nurses' intention to stay. Copyright © 2018 Elsevier Ltd. All rights reserved.

Reduction of effective dose and organ dose to the eye lens in head MDCT using iterative image reconstruction and automatic tube current modulation.

PubMed

Ryska, Pavel; Kvasnicka, Tomas; Jandura, Jiri; Klzo, Ludovit; Grepl, Jakub; Zizka, Jan

2014-06-01

To compare the effective and eye lens radiation dose in helical MDCT brain examinations using automatic tube current modulation in conjunction with either standard filtered back projection (FBP) technique or iterative reconstruction in image space (IRIS). Of 400 adult brain MDCT examinations, 200 were performed using FBP and 200 using IRIS with the following parameters: tube voltage 120 kV, rotation period 1 second, pitch factor 0.55, automatic tube current modulation in both transverse and longitudinal planes with reference mAs 300 (FBP) and 200 (IRIS). Doses were calculated from CT dose index and dose length product values utilising ImPACT software; the organ dose to the lens was derived from the actual tube current-time product value applied to the lens. Image quality was assessed by two independent readers blinded to the type of image reconstruction technique. The average effective scan dose was 1.47±0.26 mSv (FBP) and 0.98±0.15 mSv (IRIS), respectively (33.3% decrease). The average organ dose to the eye lens decreased from 40.0±3.3 mGy (FBP) to 26.6±2.0 mGy (IRIS, 33.5% decrease). No significant change in diagnostic image quality was noted between IRIS and FBP scans (P=0.17). Iterative reconstruction of cerebral MDCT examinations enables reduction of both effective and organ eye lens dose by one third without signficant loss of image quality.

Trends in Classroom Observation Scores

PubMed Central

Lockwood, J. R.; McCaffrey, Daniel F.

2014-01-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System–Secondary (CLASS-S) protocol from 458 middle school teachers over a 2-year period to study changes over time in (a) the average quality of teaching for the population of teachers, (b) the average severity of the population of raters, and (c) the severity of individual raters. To obtain these estimates and assess them in the context of other factors that contribute to the variability in scores, we develop an augmented G study model that is broadly applicable for modeling sources of variability in classroom observation ratings data collected over time. In our data, we found that trends in teaching quality were small. Rater drift was very large during raters’ initial days of observation and persisted throughout nearly 2 years of scoring. Raters did not converge to a common level of severity; using our model we estimate that variability among raters actually increases over the course of the study. Variance decompositions based on the model find that trends are a modest source of variance relative to overall rater effects, rater errors on specific lessons, and residual error. The discussion provides possible explanations for trends and rater divergence as well as implications for designs collecting ratings over time. PMID:29795823

Trends in Classroom Observation Scores.

PubMed

Casabianca, Jodi M; Lockwood, J R; McCaffrey, Daniel F

2015-04-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from 458 middle school teachers over a 2-year period to study changes over time in (a) the average quality of teaching for the population of teachers, (b) the average severity of the population of raters, and (c) the severity of individual raters. To obtain these estimates and assess them in the context of other factors that contribute to the variability in scores, we develop an augmented G study model that is broadly applicable for modeling sources of variability in classroom observation ratings data collected over time. In our data, we found that trends in teaching quality were small. Rater drift was very large during raters' initial days of observation and persisted throughout nearly 2 years of scoring. Raters did not converge to a common level of severity; using our model we estimate that variability among raters actually increases over the course of the study. Variance decompositions based on the model find that trends are a modest source of variance relative to overall rater effects, rater errors on specific lessons, and residual error. The discussion provides possible explanations for trends and rater divergence as well as implications for designs collecting ratings over time.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study

PubMed Central

de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M.; Rosendaal, Frits R.; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R.

2017-01-01

Context Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. Objective To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Design, setting and participants Cross-sectional analysis of 915 participants (45–65 years, 56% women, BMI 26 (range: 18–56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). Results After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03–1.14), declined self-rated sleep quality (1.76, 1.03–3.01), sleep latency (1.18, 1.06–1.31), and a one hour later sleep timing (1.51, 1.08–2.11), but not sleep duration (1.05, 0.90–1.23), were associated with osteopenia. PSQI score (1.10, 1.02–1.19) was also associated with sarcopenia; OR’s of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99–1.31) and 1.54 (0.91–2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. Conclusions These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals. PMID:28459884

Effects of laser in situ keratomileusis on mental health-related quality of life

PubMed Central

Tounaka-Fujii, Kaoru; Yuki, Kenya; Negishi, Kazuno; Toda, Ikuko; Abe, Takayuki; Kouyama, Keisuke; Tsubota, Kazuo

2016-01-01

Purpose The aims of our study were to investigate whether laser in situ keratomileusis (LASIK) improves health-related quality of life (HRQoL) and to identify factors that affect postoperative HRQoL. Materials and methods A total of 213 Japanese patients who underwent primary LASIK were analyzed in this study. The average age of patients was 35.0±9.4 years. The subjects were asked to answer questions regarding subjective quality of vision, satisfaction, and quality of life (using the Japanese version of 36-Item Short Form Health Survey Version 2) at three time points: before LASIK, 1 month after LASIK, and 6 months after LASIK. Longitudinal changes over 6 months in the outputs of mental component summary (MCS) score and the physical component summary (PCS) score from the 36-Item Short Form Health Survey Version 2 questionnaire were compared between time points using a linear mixed-effects model. Delta MCS and PCS were calculated by subtracting the postoperative score (1 month after LASIK) from the preoperative score. Preoperative and postoperative factors associated with a change in the MCS score or PCS score were evaluated via a linear regression model. Results The preoperative MCS score was 51.0±9.4 and increased to 52.0±9.8 and 51.5±9.6 at 1 month and 6 months after LASIK, respectively, and the trend for the change from baseline in MCS through 6 months was significant (P=0.03). PCS score did not change following LASIK. Delta MCS was significantly negatively associated with preoperative spherical equivalent, axial length, and postoperative quality of vision, after adjusting for potential confounding factors. Conclusion Mental HRQoL is not lost with LASIK, and LASIK may improve mental HRQoL. Preoperative axial length may predict postoperative mental HRQoL. PMID:27713617

It's not just average faces that are attractive: computer-manipulated averageness makes birds, fish, and automobiles attractive.

PubMed

Halberstadt, Jamin; Rhodes, Gillian

2003-03-01

Average faces are attractive. We sought to distinguish whether this preference is an adaptation for finding high-quality mates (the direct selection account) or whether it reflects more general information-processing mechanisms. In three experiments, we examined the attractiveness of birds, fish, and automobiles whose averageness had been manipulated using digital image manipulation techniques common in research on facial attractiveness. Both manipulated averageness and rated averageness were strongly associated with attractiveness in all three stimulus categories. In addition, for birds and fish, but not for automobiles, the correlation between subjective averageness and attractiveness remained significant when the effect of subjective familiarity was partialled out. The results suggest that at least two mechanisms contribute to the attractiveness of average exemplars. One is a general preference for familiar stimuli, which contributes to the appeal of averageness in all three categories. The other is a preference for averageness per se, which was found for birds and fish, but not for automobiles, and may reflect a preference for features signaling genetic quality in living organisms, including conspecifics.

Surface Fatigue Lives of Case-Carburized Gears With an Improved Surface Finish

NASA Technical Reports Server (NTRS)

Krantz, T. L.; Alanou, M. P.; Evans, H. P.; Snidle, R. W.; Krantz, T. L. (Technical Monitor)

2000-01-01

Previous research provides qualitative evidence that an improved surface finish can increase the surface fatigue lives of gears. To quantify the influence of surface roughness on life, a set of AISI 93 10 steel gears was provided with a nearmirror finish by superfinishing. The effects of the superfinishing on the quality of the gear tooth surfaces were determined using data from metrology, profilometry, and interferometric microscope inspections. The superfinishing reduced the roughness average by about a factor of 5. The superfinished gears were subjected to surface fatigue testing at 1.71 -GPa (248-ksi) Hertz contact stress, and the data were compared with the NASA Glenn gear fatigue data base. The lives of gears with superfinished teeth were about four times greater compared with the lives of gears with ground teeth but with otherwise similar quality.

High beam quality of a Q-switched 2-µm Tm,Ho:LuVO4 laser

NASA Astrophysics Data System (ADS)

Wang, Wei; Yang, Xining; Shen, Yingjie; Li, Linjun; Zhou, Long; Yang, Yuqiang; Bai, Yunfeng; Xie, Wenqiang; Ye, Guangchao; Yu, Xiaoyang

2018-05-01

A diode-end-pumped 2.05-µm Q-switched Tm,Ho:LuVO4 laser is reported in this paper. The cryogenic Tm3+ (5.0 at.%),Ho3+ (0.5 at.%):LuVO4 crystal was pumped by an 800-nm laser diode. At a pulse repetition frequency of 10 kHz, the maximum average output power of 3.77 W was achieved at 77 K when an incident pump power of 14.7 W was used. The slope efficiency and optical-optical conversion efficiency were 28.3 and 25.6%, respectively. The maximum per pulse energy was 2.54 mJ for a pulse duration of 69.9 ns. The beam quality factor Mx 2 was approximately 1.17 and My 2 was approximately 1.01 for the Tm,Ho:LuVO4 laser.

[Wellness holidays--wholesome wish or one-sided reality].

PubMed

Müller, H; Kaufmann, E L

2001-04-01

The term wellness is widely used in European tourism. The principal observations regarding the wellness industry concern an expanding supply of and an insufficiently researched demand for wellness programs. The quality dimension of wellness services is increasingly becoming the decisive competitive factor. For this reason quality management plays an important role. Market research shows that average 3- to 5-star hotels provide fairly comprehensive wellness facilities. Wellness hotels should therefore specialize in health information, individual care and a wide range of cultural and relaxation programs. Although the same hotel can host cure and wellness guests at the same time, these two segments have to be considered separately when deciding on the marketing strategy. We therefore assume that wellness is pursued solely by 'healthy' people, the prime aim being prevention. 'Normal cure guests' aim to heal their illness.

A longitudinal examination of positive changes in quality-of-life after traumatic brain injury.

PubMed

Gould, Kate R; Ponsford, Jennie L

2015-01-01

Most studies of quality-of-life (QoL) after traumatic brain injury (TBI) reveal a largely negative picture, yet some survivors show positive changes (PC). Understanding PC in QoL may assist clinicians in facilitating post-injury adjustment. This study aimed to prospectively explore changes in QoL from pre- to post-injury, identify those with PC and examine predictive and associated factors. Ninety-five participants, recruited from consecutive admissions to a rehabilitation hospital, were prospectively assessed at least once over the first 4 years post-injury. Measures of QoL, psychiatric disorders, coping style and psychosocial outcome were administered at each assessment. Participants' mean QoL was in the average range pre-injury and at follow-up. A third demonstrated PC post-injury, which tended to remain stable. PC participants tended to rate their relatives as of greater importance than other participants, but did not rate their health as high. Group membership was not predicted by pre-injury demographic or injury factors, but it was significantly associated with psychosocial and functional outcome. Even after a significant brain injury, some individuals show sustained improved QoL. Factors such as lack of 'good old days' bias and increased value placed on family may have important clinical utility.

Factors influencing healthcare utilization among children with pneumonia in Muntinlupa City, the Philippines.

PubMed

Kim, Soon Ae; Capeding, Maria Rosario Z; Kilgore, Paul E

2014-05-01

We evaluated the factors influencing healthcare utilization among children aged < 5 years with pneumonia symptoms in Muntinlupa City, the Philippines. We interviewed 1,330 caregivers from 190 households per district in seven districts from March to April, 2009 using a standardized questionnaire to obtain information about demographic characteristics, access to healthcare facilities, and potential barriers to healthcare utilization. The mean age of the children was 32 months; 54.7% were boys. Seventy-four point three percents (n = 972) of caregivers stated when their child had pneumonia symptoms they brought them to a government health center, 14.1% (n = 184) went to a private clinic, 8.0% (n = 104) went to a hospital, 3% (n = 40) were treated at home and 0.5% (n = 7) received traditional medicine from a local healer. Caregivers required an average of 12 minutes to reach a healthcare facility. Reasons given by caregivers for their choice of healthcare facility were low cost (47.5%), availability and accessibility to transportation (29.6%) and perceived good quality of care (16.5%). In conclusion, nearly three quarters of caregivers interviewed brought their child with pneumonia symptoms to a government health center for treatment. Cost was the main factor influencing choice, followed by transportation availability and quality of care.

An analysis of interplanetary space radiation exposure for various solar cycles

NASA Technical Reports Server (NTRS)

Badhwar, G. D.; Cucinotta, F. A.; O'Neill, P. M.; Wilson, J. W. (Principal Investigator)

1994-01-01

The radiation dose received by crew members in interplanetary space is influenced by the stage of the solar cycle. Using the recently developed models of the galactic cosmic radiation (GCR) environment and the energy-dependent radiation transport code, we have calculated the dose at 0 and 5 cm water depth; using a computerized anatomical man (CAM) model, we have calculated the skin, eye and blood-forming organ (BFO) doses as a function of aluminum shielding for various solar minima and maxima between 1954 and 1989. These results show that the equivalent dose is within about 15% of the mean for the various solar minima (maxima). The maximum variation between solar minimum and maximum equivalent dose is about a factor of three. We have extended these calculations for the 1976-1977 solar minimum to five practical shielding geometries: Apollo Command Module, the least and most heavily shielded locations in the U.S. space shuttle mid-deck, center of the proposed Space Station Freedom cluster and sleeping compartment of the Skylab. These calculations, using the quality factor of ICRP 60, show that the average CAM BFO equivalent dose is 0.46 Sv/year. Based on an approach that takes fragmentation into account, we estimate a calculation uncertainty of 15% if the uncertainty in the quality factor is neglected.

Effects of diesel particle filter retrofits and accelerated fleet turnover on drayage truck emissions at the Port of Oakland.

PubMed

Dallmann, Timothy R; Harley, Robert A; Kirchstetter, Thomas W

2011-12-15

Heavy-duty diesel drayage trucks have a disproportionate impact on the air quality of communities surrounding major freight-handling facilities. In an attempt to mitigate this impact, the state of California has mandated new emission control requirements for drayage trucks accessing ports and rail yards in the state beginning in 2010. This control rule prompted an accelerated diesel particle filter (DPF) retrofit and truck replacement program at the Port of Oakland. The impact of this program was evaluated by measuring emission factor distributions for diesel trucks operating at the Port of Oakland prior to and following the implementation of the emission control rule. Emission factors for black carbon (BC) and oxides of nitrogen (NO(x)) were quantified in terms of grams of pollutant emitted per kilogram of fuel burned using a carbon balance method. Concentrations of these species along with carbon dioxide were measured in the exhaust plumes of individual diesel trucks as they drove by en route to the Port. A comparison of emissions measured before and after the implementation of the truck retrofit/replacement rule shows a 54 ± 11% reduction in the fleet-average BC emission factor, accompanied by a shift to a more highly skewed emission factor distribution. Although only particulate matter mass reductions were required in the first year of the program, a significant reduction in the fleet-average NO(x) emission factor (41 ± 5%) was observed, most likely due to the replacement of older trucks with new ones.

Food supplement 20070721-GX may increase CD34+ stem cells and telomerase activity.

PubMed

Lin, Po-Cheng; Chiou, Tzyy-Wen; Liu, Po-Yen; Chen, Shee-Ping; Wang, Hsin-I; Huang, Pi-Chun; Lin, Shinn-Zong; Harn, Horng-Jyh

2012-01-01

Few rejuvenation and antiaging markers are used to evaluate food supplements. We measured three markers in peripheral blood to evaluate the antiaging effects of a food supplement containing placental extract. Samples were evaluated for CD34(+) cells, insulin-like growth factor 1 (IGF1), and telomerase activity, which are all markers related to aging. To control the quality of this food supplement, five active components were monitored. In total, we examined 44 individuals who took the food supplement from 1.2 months to 23 months; the average number of CD34(+) cells was almost 6-fold higher in the experimental group compared with the control group. Food supplement intake did not change serum IGF1 levels significantly. Finally, the average telomerase activity was 30% higher in the subjects taking this food supplement. In summary, our results suggest that the placental extract in the food supplement might contribute to rejuvenation and antiaging.

Compact high-efficiency 100-W-level diode-side-pumped Nd:YAG laser with linearly polarized TEM00 mode output.

PubMed

Xu, Yi-Ting; Xu, Jia-Lin; Guo, Ya-Ding; Yang, Feng-Tu; Chen, Yan-Zhong; Xu, Jian; Xie, Shi-Yong; Bo, Yong; Peng, Qin-Jun; Cui, Dafu; Xu, Zu-Yan

2010-08-20

We present a compact high-efficiency and high-average-power diode-side-pumped Nd:YAG rod laser oscillator operated with a linearly polarized fundamental mode. The oscillator resonator is based on an L-shaped convex-convex cavity with an improved module and a dual-rod configuration for birefringence compensation. Under a pump power of 344 W, a linearly polarized average output power of 101.4 W at 1064 nm is obtained, which corresponds to an optical-to-optical conversion efficiency of 29.4%. The laser is operated at a repetition rate of 400 Hz with a beam quality factor of M(2)=1.14. To the best of our knowledge, this is the highest optical-to-optical efficiency for a side-pumped TEM(00) Nd:YAG rod laser oscillator with a 100-W-level output ever reported.

Vibration energy harvester with sustainable power based on a single-crystal piezoelectric cantilever array.

PubMed

Kim, Moonkeun; Lee, Sang-Kyun; Ham, Yong-Hyun; Yang, Yil Suk; Kwon, Jong-Kee; Kwon, Kwang-Ho

2012-08-01

We designed and fabricated a bimorph cantilever array for sustainable power with an integrated Cu proof mass to obtain additional power and current. We fabricated a cantilever system using single-crystal piezoelectric material and compared the calculations for single and arrayed cantilevers to those obtained experimentally. The vibration energy harvester had resonant frequencies of 60.4 and 63.2 Hz for short and open circuits, respectively. The damping ratio and quality factor of the cantilever device were 0.012 and 41.66, respectively. The resonant frequency at maximum average power was 60.8 Hz. The current and highest average power of the harvester array were found to be 0.728 mA and 1.61 mW, respectively. The sustainable maximum power was obtained after slightly shifting the short-circuit frequency. In order to improve the current and power using an array of cantilevers, we also performed energy conversion experiments.

Validation/Calibration of SMOS L2 Soil Moisture in Crop Area, Eastern China

NASA Astrophysics Data System (ADS)

Cui, Huizhen; Jiang, Lingmei; Yang, Na; Lu, Zheng

2016-08-01

The Soil Moisture and Ocean Salinity (SMOS) is the worldwide satellite dedicated to retrieve soil moisture information at the global scale, with a high temporal resolution, and from space borne L-band 2-D interferometry radiometer. Product validation for the accuracy of data and utilization is a crucial step. At present, the validation work carried out in China was mainly concentrated in the Tibetan Plateau. The study of this paper mainly focused on the validation of SMOS L2 soil moisture data products in the north of Henan province plain region. This region is in front of Taihang Mountains. Results from the average-average and node- site comparison show that the correlation coefficients (R) between 0.20 and 0.40, also the existence of dry bias mainly concentrated in the 0.07 0.11m3m-3. Finally, this paper analysed the influence factors on the quality of SMOS soil moisture products.

Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India.

PubMed

Kaphle, Sangya; Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal

2015-05-28

mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where an additional point in CommCare proficiency score increased the quality score by around half a point (0.541, P=.07), and experience score by around a third of a point (0.308, P=.03). Age affected CommCare user type negatively, with an increase in age increasing the likelihood of belonging to a lower category of CommCare adoption (-0.105, P=.08). Other individual characteristics did not affect adoption or the predicted values estimating the relationship between adoption and quality and experience of care, although illiteracy was able to affect the relationship negatively. mHealth technology adoption by frontline workers can positively impact the quality and experience of care they provide. Individual characteristics, especially literacy and age, can be important elements affecting technology adoption and the way users leverage the technology for their work. Our formative study provides informed hypotheses and methods for further research.

Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India

PubMed Central

Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal

2015-01-01

Background mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. Objective To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Methods Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Results Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where an additional point in CommCare proficiency score increased the quality score by around half a point (0.541, P=.07), and experience score by around a third of a point (0.308, P=.03). Age affected CommCare user type negatively, with an increase in age increasing the likelihood of belonging to a lower category of CommCare adoption (-0.105, P=.08). Other individual characteristics did not affect adoption or the predicted values estimating the relationship between adoption and quality and experience of care, although illiteracy was able to affect the relationship negatively. Conclusions mHealth technology adoption by frontline workers can positively impact the quality and experience of care they provide. Individual characteristics, especially literacy and age, can be important elements affecting technology adoption and the way users leverage the technology for their work. Our formative study provides informed hypotheses and methods for further research. PMID:26023001

Impact of complications and bladder cancer stage on quality of life in patients with different types of urinary diversions.

PubMed

Prcic, Alden; Aganovic, Damir; Hadziosmanovic, Osman

2013-12-01

Determine correlation between complications and stage of the disease and their impact on quality of life in patients with different types of ileal urinary derivation after radical cystectomy, and upon estimation of acquired results, to suggest the most acceptable type of urinary diversion. In five year period a prospective clinical study was performed on 106 patients, to whom a radical cystectomy was performed due to bladder cancer. Patients were divided into two groups, 66 patients with ileal conduit derivation and 40 patients with orthotopic derivation, whereby in each group a comparison between reflux and anti-reflux technique of orthotopic bladder was made. All patients from both groups filled the Sickness Impact Profile score six months after the operation. All patients had CT urography or Intravenous urography performed, as well as standard laboratory, vitamin B12 blood values, in order to evaluate early (ileus or subileus, wound dehiscence, bladder fistula, rupture of orthotopic bladder, urine extravazation) and late complications (VUR, urethral stricture, ureter stenosis, metabolic acidosis, mineral dis-balance, hypovitaminosis of vitamin B12, increased resorption of bone calcium, urinary infection, kidney damage, relapse of primary disease), so as disease stage and it's impact on quality of life. From gained results we observe that each category of SIP score correlates with different rate of correlation with the type of operation, group, T, N, and R grade, except work category. Average value of SIP score rises depending on the type of operation and T stage. It is notable that there is no difference in T1 stage, no matter the type of operation. So the average value of SIP score in T1 stage for conduit was 20.3, for Abol-Enein and Ghoneim 17.25 and Hautmann 18.75 respectively. Average value of SIP score in T2 stage for conduit was 31, for Abol-Enein and Ghoneim 19.1 and Hautmann 17.8. Average value of SIP score in T3 stage for conduit was 38.03, for Abol-Enein and Ghoneim 18.75 and Hautmann 19.5. SIP score for T4 was present only in patients with conduit performed and average value od SIP score was 40.42. There is a high level of correlation of late complications and psychosocial and physical dimension with their parameters, while for an independent dimension of correlation is not significant. Early complications have insignificant correlation in all categories of SIP score. Upon analyzing quality of life and morbidity, significant advantage is given to orthotopic derivations, especially Hautmann derivation with Chimney modification, unless there are no absolute contraindications for performing this type of operation. Factors which mostly influence quality of life are cancer stage, type of derivation, late complications and patient age. SIP score, as a well validated questionnaire, are applicable in this kind of research.

Emission factors of SO2, NOx and particles from ships in Neva Bay from ground-based and helicopter-borne measurements and AIS-based modeling

NASA Astrophysics Data System (ADS)

Beecken, J.; Mellqvist, J.; Salo, K.; Ekholm, J.; Jalkanen, J.-P.; Johansson, L.; Litvinenko, V.; Volodin, K.; Frank-Kamenetsky, D. A.

2014-10-01

Emission factors of SO2, NOx and size distributed particle numbers were measured for approximately 300 different ships in the Gulf of Finland and Neva Bay area during two campaigns in August/September 2011 and June/July 2012. The measurements were carried out from a harbor vessel and from an MI-8 helicopter downwind of passing ships. Other measurements were carried out from shore sites near the island of Kronstadt and along the river Neva in the city area of Saint Petersburg. Most ships were running at reduced speed (10 knots), i.e. not at their optimal load. Vessels for domestic and international shipping were monitored. It was seen that the distribution of the SO2 emission factors is bi-modal with averages of 4.6 gSO2 kgfuel-1 and 18.2 gSO2 kgfuel-1 for the lower and the higher mode, respectively. The emission factors show compliance with the 1% fuel sulfur content SECA limit for 90% of the vessels in 2011 and 97% in 2012. The distribution of the NOx emission factor is mono-modal with an average of 58 gNOx kgfuel-1. The corresponding emission related to the generated power yields an average of 12.1 gNOx kWh-1. The distribution of the emission factors for particulate number shows that nearly 90% of all particles in the 5.6 nm to 10 μm size range were below 70 nm in diameter. The distribution of the corresponding emission factors for the mass indicates two separated main modes, one for particles between 30 and 300 nm the other above 2 μm. The average particle emission factors were found to be in the range from 0.7 to 2.7 × 1016 particles kgfuel-1 and 0.2 to 3.4 gPM kgfuel-1, respectively. The NOx and particulate emissions are comparable with other studies. The measured emission factors were compared, for individual ships, to modeled ones using the Ship Traffic Emission Assessment Model (STEAM) of the Finnish Meteorological Institute. A reasonably good agreement for gaseous sulfur and nitrogen emissions can be seen for ships in international traffic, but significant deviations are found for inland vessels. Considering particulate mass, the modeled data is about two to three times above the measured results, which probably reflects the assumptions made in the modeled fuel sulfur content. The sulfur contents in the fuel retrieved from the measurements were lower than the previously used assumptions by the city of Saint Petersburg when carrying out atmospheric modeling and using these measurements it was possible to better assess the impact of shipping on air quality.

Emission factors of SO2, NOx and particles from ships in Neva Bay from ground-based and helicopter-borne measurements and AIS-based modeling

NASA Astrophysics Data System (ADS)

Beecken, J.; Mellqvist, J.; Salo, K.; Ekholm, J.; Jalkanen, J.-P.; Johansson, L.; Litvinenko, V.; Volodin, K.; Frank-Kamenetsky, D. A.

2015-05-01

Emission factors of SO2, NOx and size-distributed particle numbers were measured for approximately 300 different ships in the Gulf of Finland and Neva Bay area during two campaigns in August/September 2011 and June/July 2012. The measurements were carried out from a harbor vessel and from an Mi-8 helicopter downwind of passing ships. Other measurements were carried out from shore sites near the island of Kronstadt and along the Neva River in the urban area of Saint Petersburg. Most ships were running at reduced speed (10 kn), i.e., not at their optimal load. Vessels for domestic and international shipping were monitored. It was seen that the distribution of the SO2 emission factors is bi-modal, with averages of 4.6 and 18.2 gSO2 kgfuel-1 for the lower and the higher mode, respectively. The emission factors show compliance with the 1% fuel sulfur content Sulfur Emission Control Areas (SECA) limit for 90% of the vessels in 2011 and 97% in 2012. The distribution of the NOx emission factor is mono-modal, with an average of 58 gNOx kgfuel-1. The corresponding emission related to the generated power yields an average of 12.1 gNOx kWh-1. The distribution of the emission factors for particulate number shows that nearly 90% of all particles in the 5.6 nm to 10 μm size range were below 70 nm in diameter. The distribution of the corresponding emission factors for the mass indicates two separated main modes, one for particles between 30 and 300 nm and the other for above 2 μm. The average particle emission factors were found to be in the range from 0.7 to 2.7 × 1016 particles kgfuel-1 and 0.2 to 3.4 gPM kgfuel-1, respectively. The NOx and particulate emissions are comparable with other studies. The measured emission factors were compared, for individual ships, to modeled ones using the Ship Traffic Emission Assessment Model (STEAM) of the Finnish Meteorological Institute. A reasonably good agreement for gaseous sulfur and nitrogen emissions can be seen for ships in international traffic, but significant deviations are found for inland vessels. Regarding particulate mass, the values of the modeled data are about 2-3 times higher than the measured results, which probably reflects the assumptions made in the modeled fuel sulfur content. The sulfur contents in the fuel retrieved from the measurements were lower than the previously used assumptions by the City of Saint Petersburg when carrying out atmospheric modeling, and using these measurements it was possible to better assess the impact of shipping on air quality.

Customer care. Patient satisfaction in the prehospital setting.

PubMed

Doering, G T

1998-09-01

The focus of the study was to prioritize six emergency medical service treatment factors in terms of their impact upon patient satisfaction in the prehospital setting. The six treatment areas analyzed were: EMS response time; medical care provided on scene; explanation of care by the provider; the provider's ability to reduce patient anxiety; the provider's ability to meet the patient's non-medical needs; and the level of courtesy/politeness shown by the EMS provider toward the patient. Telephone interviews were conducted with both patients and bystanders to obtain their perception of how well the system met their needs. The study analyzed how the six issues were rated and then evaluated the impact an individual's low score in a category had on that person's overall rating of the service provided. The overall satisfaction rating is not a calculated score, but an overall score specified by the respondent. The effect each issue had on the respondent's overall rating was determined by averaging the overall ratings for a category's low scorers, averaging the overall ratings for high scorers and then measuring the difference. Results of the study indicate that the factor with the greatest negative impact on patient satisfaction came from a perceived lack of crew courtesy and politeness. Respondents who indicated a fair to poor score in this category decreased their overall score by 60.2%. Ratings in other categories yielded the following results: When respondents rated the response time as fair to poor, their average overall rating showed an 18.4% decrease. When respondents rated the quality of medical care as fair to poor, their average overall rating showed a decrease of 22.6%. When the crew's ability to explain what was happening to the patient was rated as fair to poor, the average overall score dropped 33.6%. When the EMT's and medic's ability to reduce the patient's anxiety was rated fair to poor, average overall score declined by 32.6%. Finally, when the crew's ability to satisfy a patient's non-medical needs was rated as fair to poor, the average overall score diminished by 37.4%.

Correlation of gravestone decay and air quality 1960-2010

NASA Astrophysics Data System (ADS)

Mooers, H. D.; Carlson, M. J.; Harrison, R. M.; Inkpen, R. J.; Loeffler, S.

2017-03-01

Evaluation of spatial and temporal variability in surface recession of lead-lettered Carrara marble gravestones provides a quantitative measure of acid flux to the stone surfaces and is closely related to local land use and air quality. Correlation of stone decay, land use, and air quality for the period after 1960 when reliable estimates of atmospheric pollution are available is evaluated. Gravestone decay and SO2 measurements are interpolated spatially using deterministic and geostatistical techniques. A general lack of spatial correlation was identified and therefore a land-use-based technique for correlation of stone decay and air quality is employed. Decadally averaged stone decay is highly correlated with land use averaged spatially over an optimum radius of ≈7 km even though air quality, determined by records from the UK monitoring network, is not highly correlated with gravestone decay. The relationships among stone decay, air-quality, and land use is complicated by the relatively low spatial density of both gravestone decay and air quality data and the fact that air quality data is available only as annual averages and therefore seasonal dependence cannot be evaluated. However, acid deposition calculated from gravestone decay suggests that the deposition efficiency of SO2 has increased appreciably since 1980 indicating an increase in the SO2 oxidation process possibly related to reactions with ammonia.

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients.

PubMed

Sakakibara, Brodie M; Kim, Amy J; Eng, Janice J

2017-02-01

The aims of this review were to describe the self-management interventions used to improve risk factor control in stroke patients and quantitatively assess their effects on the following: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose) and (2) individual risk factors. We systematically searched the PubMed, PsycINFO, CINAHL and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The self-management interventions were qualitatively described, and the data included in meta-analyses. Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low-quality studies were removed (SMD = 0.10 [95 % CI = 0.02 to 0.17], I 2  = 0 %, p = 0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95 % CI = 0.04 to 0.25], I 2  = 0 %, p = 0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95 % CI = 0.07 to 0.56], I 2  = 0 %, p = 0.01). Self-management interventions appear to be effective at improving overall risk factor control; however, more high-quality research is needed to corroborate this observation. Self-management has a greater effect on lifestyle behaviour risk factors than medical risk factors, with the largest effect at improving medication adherence.

Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus.

PubMed

Tang, Yunzhao; Meng, Lingling; Li, Daiqing; Yang, Min; Zhu, Yanjuan; Li, Chenguang; Jiang, Zhenhuan; Yu, Ping; Li, Zhu; Song, Hongna; Ni, Changlin

2014-01-01

Copious evidence from epidemiological and laboratory studies has revealed that sleep status is associated with glucose intolerance, insulin resistance, thus increasing the risk of developing type 2 diabetes. The aim of this study was to reveal the interaction of sleep quality and sleep quantity on glycemic control in patients with type 2 diabetes mellitus. From May 2013 to May 2014, a total of 551 type 2 diabetes patients in Tianjin Metabolic Diseases Hospital were enrolled. Blood samples were taken to measure glycosylated hemoglobin (HbA1c), and all the patients completed the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep status. "Good sleep quality" was defined as PQSI <5, "average sleep quality" was defined as PQSI 6-8, and "poor sleep quality" was defined as PQSI >8. Poor glycemic control was defined as HbA1c ≥7%. Sleep quantity was categorized as <6, 6-8, and >8 hours/night. Short sleep time was defined as sleep duration <6 hours/night. In the poor glycemic control group, the rate of patients who had insufficient sleep was much higher than that in the other group (χ(2) = 11.16, P = 0.037). The rate of poor sleep quality in poor glycemic control group was much greater than that in the average control group (χ(2) = 9.79, P = 0.007). After adjusted by gender, age, body mass index, and disease duration, the adjusted PSQI score's OR was 1.048 (95% CI 1.007-1.092, P = 0.023) for HbA1c level. The sleep duration's OR was 0.464 (95% CI 0.236-0.912, P = 0.026) for HbA1c level. One-way analysis of variance showed that the poor sleep quality group had the highest homeostasis model assessment-insulin resistance (P < 0.01). Inadequate sleep, in both quality and quantity, should be regarded as a plausible risk factor for glycemic control in type 2 diabetes. Poor sleep might bring much more serious insulin resistance and could be the reason for bad glycemic control. A good night's sleep should be seen as a critical health component tool in the prevention and treatment of type 2 diabetes. It is important for clinicians to target the root causes of short sleep duration and/or poor sleep quality.

Health related quality of life in patients with community-acquired pneumococcal pneumonia in France.

PubMed

Andrade, Luiz Flavio; Saba, Grèce; Ricard, Jean-Damien; Messika, Jonathan; Gaillat, Jacques; Bonnin, Pierre; Chidiac, Christian; Illes, Hajnal-Gabriela; Laurichesse, Henri; Detournay, Bruno; Petitpretz, Patrick; de Pouvourville, Gérard

2018-02-02

Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values. Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. "Usual activities" was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge. This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.

Gender Roles and Mental Health in Women With and at Risk for HIV

PubMed Central

Brody, Leslie R.; Stokes, Lynissa R.; Dale, Sannisha K.; Kelso, Gwendolyn A.; Cruise, Ruth C.; Weber, Kathleen M.; Burke-Miller, Jane K.; Cohen, Mardge H.

2014-01-01

Predominantly low-income and African American women from the same community, HIV-infected (n = 100; HIV+) and uninfected (n = 42; HIV−), were assessed on reported gender roles in sexual and other close relationships—including levels of self-silencing, unmitigated communion, and sexual relationship power—at a single recent study visit during 2008–2012. Recent gender roles were investigated in relation to depressive symptoms and health-related quality of life assessed both at a single visit during 2008–2012 and averaged over semiannual visits (for depressive symptoms) and annual visits (for quality of life) occurring between 1994 and 2012. Compared to HIV− women, HIV+ women reported significantly higher levels of several aspects of self-silencing, unmitigated communion, and multi-year averaged depressive symptoms as well as lower levels of sexual relationship power and recent and multi-year averaged quality of life. For both HIV+ and HIV− women, higher self-silencing and unmitigated communion significantly related to recent or multi-year averaged higher depressive symptoms and lower quality of life. Intervention strategies designed to increase self-care and self-advocacy in the context of relationships could potentially minimize depressive symptoms and enhance quality of life in women with and at risk for HIV. PMID:25492991

Episodic air quality impacts of plug-in electric vehicles

NASA Astrophysics Data System (ADS)

Razeghi, Ghazal; Carreras-Sospedra, Marc; Brown, Tim; Brouwer, Jack; Dabdub, Donald; Samuelsen, Scott

2016-07-01

In this paper, the Spatially and Temporally Resolved Energy and Environment Tool (STREET) is used in conjunction with University of California Irvine - California Institute of Technology (UCI-CIT) atmospheric chemistry and transport model to assess the impact of deploying plug-in electric vehicles and integrating wind energy into the electricity grid on urban air quality. STREET is used to generate emissions profiles associated with transportation and power generation sectors for different future cases. These profiles are then used as inputs to UCI-CIT to assess the impact of each case on urban air quality. The results show an overall improvement in 8-h averaged ozone and 24-h averaged particulate matter concentrations in the South Coast Air Basin (SoCAB) with localized increases in some cases. The most significant reductions occur northeast of the region where baseline concentrations are highest (up to 6 ppb decrease in 8-h-averaged ozone and 6 μg/m3 decrease in 24-h-averaged PM2.5). The results also indicate that, without integration of wind energy into the electricity grid, the temporal vehicle charging profile has very little to no effect on urban air quality. With the addition of wind energy to the grid mix, improvement in air quality is observed while charging at off-peak hours compared to the business as usual scenario.

Influence of oral health on quality of life in pregnant women.

PubMed

Moimaz, Suzely As; Rocha, Najara B; Garbin, Artênio Ji; Garbin, Cléa As; Saliba, Orlando

2016-09-01

This study evaluated the relationships between oral conditions and oral health-related quality of life (OHRQoL), as well as related factors. A crosssectional study was performed on 119 postnatal women who had sought prenatal care during pregnancy in the public health system of São Paulo State, Brazil. The women received oral clinical exams and were interviewed using the questions on the OHIP14. A second survey with information about their socioeconomic status, pregnancy and health habits was administered. The highest OHIP14 scores were found in the area of physical pain, with an average score of 10.6. Average DMFT rate for the population was 12.2 (±6.1), with the majority having DMFT ≥4.5 (89.9%). Most of the women needed some type of dental prosthesis (59.7%), had some type of periodontal disease (90.8%), tooth decay (73.9%), missing teeth (64.7%) and were in need of oral treatment (68.1%). The OHIP14 scores were significantly associated with age (p=0.02), first pregnancy (p<0.001), need for dental prosthesis (p<0.001), presence of dental caries (p<0.001) and missing teeth (p=0.01). In the multivariate analysis, the worst OHRQoL was significantly associated with the presence of caries (p=0.03). The results suggest an association between the worst oral condition and poorer quality of life during pregnancy. This risk group should be prioritized in the health services in order to treat and recover the oral health of pregnant women, promoting better oral health conditions and better quality of life for their children. Sociedad Argentina de Investigación Odontológica.

The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study.

PubMed

Cheng, Adam; Lin, Yiqun; Nadkarni, Vinay; Wan, Brandi; Duff, Jonathan; Brown, Linda; Bhanji, Farhan; Kessler, David; Tofil, Nancy; Hecker, Kent; Hunt, Elizabeth A

2018-01-01

We aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality. We analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training. Step stool use was voluntary. We explored the association between 1) step stool use and CPR quality, and 2) provider adjusted height and CPR quality. Adjusted height was defined as provider height + 23 cm (if step stool was used). Below-average height participants were ≤ gender-specific average height; the remainder were above average height. We assessed for interaction between study arm and both adjusted height and step stool use. One hundred twenty-four subjects participated; 1,230 30-second epochs of CPR were analysed. Step stool use was associated with improved compression depth in below-average (female, p=0.007; male, p<0.001) and above-average (female, p=0.001; male, p<0.001) height providers. There is an association between adjusted height and compression depth (p<0.001). Visual feedback attenuated the effect of height (p=0.025) on compression depth; JIT training did not (p=0.918). Visual feedback and JIT training attenuated the effect of step stool use (p<0.001) on compression depth. Step stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

Teratogens: a public health issue – a Brazilian overview

PubMed Central

Mazzu-Nascimento, Thiago; Melo, Débora Gusmão; Morbioli, Giorgio Gianini; Carrilho, Emanuel; Vianna, Fernanda Sales Luiz; da Silva, André Anjos; Schuler-Faccini, Lavinia

2017-01-01

Abstract Congenital anomalies are already the second cause of infant mortality in Brazil, as in many other middle-income countries in Latin America. Birth defects are a result of both genetic and environmental factors, but a multifactorial etiology has been more frequently observed. Here, we address the environmental causes of birth defects – or teratogens – as a public health issue and present their mechanisms of action, categories and their respective maternal-fetal deleterious effects. We also present a survey from 2008 to 2013 of Brazilian cases involving congenital anomalies (annual average of 20,205), fetal deaths (annual average of 1,530), infant hospitalizations (annual average of 82,452), number of deaths of hospitalized infants (annual average of 2,175), and the average cost of hospitalizations (annual cost of $7,758). Moreover, we report on Brazilian cases of teratogenesis due to the recent Zika virus infection, and to the use of misoprostol, thalidomide, alcohol and illicit drugs. Special attention has been given to the Zika virus infection, now proven to be responsible for the microcephaly outbreak in Brazil, with 8,039 cases under investigation (from October 2015 to June 2016). From those cases, 1,616 were confirmed and 324 deaths occurred due to microcephaly complications or alterations on the central nervous system. Congenital anomalies impact life quality and raise costs in specialized care, justifying the classification of teratogens as a public health issue. PMID:28534929

Daily sleep quality affects drug craving, partially through indirect associations with positive affect, in patients in treatment for nonmedical use of prescription drugs

PubMed Central

Lydon-Staley, David M.; Cleveland, H. Harrington; Huhn, Andrew S.; Cleveland, Michael J.; Harris, Jonathan; Stankoski, Dean; Deneke, Erin; Meyer, Roger E.; Bunce, Scott C.

2016-01-01

Objective Sleep disturbance has been identified as a risk factor for relapse in addiction to a range of substances. The relationship between sleep quality and treatment outcome has received relatively little attention in research on nonmedical use of prescription drugs (NMUPD). This study examined the within-person association between sleep quality and craving in medically detoxified patients in residence for the treatment of NMUPD. Method Participants (n= 68) provided daily reports of their sleep quality, negative affect (NA), positive affect (PA), and craving for an average of 9.36 (SD= 2.99) days. Within-person associations of sleep quality and craving were examined using multilevel modeling. Within-person mediation analyses were used to evaluate the mediating roles of NA and PA in the relationship between sleep quality and craving. Results Greater cravings were observed on days of lower than usual sleep quality (γ10 = −0.10, p = .003). Thirty-one percent of the overall association between sleep quality and craving was explained by PA, such that poorer sleep quality was associated with lower PA and, in turn, lower PA was associated with greater craving. No evidence emerged for an indirect association between sleep quality and craving through NA. Conclusions Daily fluctuations in sleep quality were associated with fluctuations in craving, an association partially explained by the association between sleep quality and daily PA. These data encourage further research on the relationship between sleep, affect, and craving in NMUPD patients, as well as in patients with other substance use disorders. PMID:27544697

Daily sleep quality affects drug craving, partially through indirect associations with positive affect, in patients in treatment for nonmedical use of prescription drugs.

PubMed

Lydon-Staley, David M; Cleveland, H Harrington; Huhn, Andrew S; Cleveland, Michael J; Harris, Jonathan; Stankoski, Dean; Deneke, Erin; Meyer, Roger E; Bunce, Scott C

2017-02-01

Sleep disturbance has been identified as a risk factor for relapse in addiction to a range of substances. The relationship between sleep quality and treatment outcome has received relatively little attention in research on nonmedical use of prescription drugs (NMUPD). This study examined the within-person association between sleep quality and craving in medically detoxified patients in residence for the treatment of NMUPD. Participants (n=68) provided daily reports of their sleep quality, negative affect (NA), positive affect (PA), and craving for an average of 9.36 (SD=2.99) days. Within-person associations of sleep quality and craving were examined using multilevel modeling. Within-person mediation analyses were used to evaluate the mediating roles of NA and PA in the relationship between sleep quality and craving. Greater cravings were observed on days of lower than usual sleep quality (γ 10 =-0.10, p=0.003). Thirty-one percent of the overall association between sleep quality and craving was explained by PA, such that poorer sleep quality was associated with lower PA and, in turn, lower PA was associated with greater craving. No evidence emerged for an indirect association between sleep quality and craving through NA. Daily fluctuations in sleep quality were associated with fluctuations in craving, an association partially explained by the association between sleep quality and daily PA. These data encourage further research on the relationship between sleep, affect, and craving in NMUPD patients, as well as in patients with other substance use disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using dental care resources optimally: quality-efficiency trade-offs in a competitive private market.

PubMed

Prasad, Banuru Muralidhara; Varatharajan, D

2011-01-01

Modern lifestyle changes led to increased dental care needs in India. Consequently, there has been a sharp rise in dentist numbers. Karnataka state alone produces 2,500 dentists annually, who are engaged in the non-government sector owing to inadequate public sector opportunities. This article aims to assess Karnataka private dental clinic quality and efficiency. Dentists were interviewed using a close-ended, structured interview schedule and their clinics were assessed using a checklist adopted from guidelines for providing machinery and equipment under the National Oral Health Care Programme (NOHCP). Dental "hotel" and clinical quality were scored based on this checklist. Clinical quality was "excellent" in 12 per cent of clinics and poor in 49 per cent. Clinics with better infrastructure charged higher price (p < 0.05). Multi-chair clinics charging fixed rates were high (81 per cent). According to 59.5 per cent of dentists, competition did not improve quality while 27 per cent felt that competition increased price, not quality. About 30.9 per cent of the poor quality clinics, 41 per cent average quality clinics and 26 per cent good quality clinics were technically efficient. The multi chair clinics offered better quality at higher prices and single chair clinics provided poorer quality at lower prices. In other words, they had a sub-optimal price-quality mix. Therefore, there is a need to regulate price and quality in all clinics to arrive at an optimal price-quality mix so that clients are not overburdened financially even while receiving good quality dental care. The article advocates that resources are used optimally as a way to achieve value for money and to achieve break-even points thereby providing quality care in a competitive market. Factors that influence dental practitioner behaviour are evaluated.

Genetic and Non-Genetic Factors Affecting the Quality of Anticoagulation Control and Vascular Events in Atrial Fibrillation.

PubMed

Park, Yun Kyung; Lee, Mi Ji; Kim, Jae Ha; Lee, Jin Soo; Park, Rae Woong; Kim, Gyeong-Moon; Chung, Chin-Sang; Lee, Kwang Ho; Kim, June Soo; Lee, Soo-Youn; Bang, Oh Young

2017-06-01

Warfarin has a narrow therapeutic window. We hypothesized that genetic factors related to warfarin metabolism (CYP2C9) and activity (VKORC1) would show stronger associations than modifiable factors with the quality of anticoagulation control and risks for thromboembolism and hemorrhage. In this retrospective cohort analysis, clinical and genetic data were collected from 380 patients with atrial fibrillation (AF) who were followed for an average observation period of 4 years. We evaluated the factors associated with time in therapeutic range (TTR, international normalized ratio [INR]: 2-3) and vascular events (either thromboembolic or hemorrhagic), including both genetic (CYP2C9 and VKORC1 genotype) and modifiable factors (anticoagulation service and warfarin dose assessment interval). The genotypic frequency of CYP2C9*3 (rs1057910) was 9.5% and that of VKORC1 1173C>T (rs9934438) was 16.3%. TTR showed dependence on VKORC1 polymorphism: TTR was higher in carriers of the VKORC1 1173C>T than of the VKORC1 TT genotype (61.7 ± 16.0% versus 56.7 ± 17.4%, P = .031). Multivariate testing showed that the VKORC1 genotype and anticoagulation service were independently related to labile INRs (TTR <65%). Vascular events were observed in 66 patients (18.4%) during the study period. A Cox proportional hazard model showed that the use of anticoagulation service and patients' characteristics, such as AF-thromboembolic risk (CHA 2 DS 2 -VASc score: Congestive heart failure, Hypertension, Age 75 years or older, Diabetes mellitus, previous Stroke or transient ischemic attack, Vascular disease, Age 65 to 74 years, female) and consequence (neurologic disability), but not genetic factors, were independently associated with vascular events. Both genetic factor (VKORC1 genotype) and clinical efforts (anticoagulation service) influenced the quality of anticoagulation control. However, clinical events were more strongly associated with patient characteristics and clinical efforts than with genetic factors. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Low birth weight of contemporary African Americans: an intergenerational effect of slavery?

PubMed

Jasienska, Grazyna

2009-01-01

The average birth weight in the contemporary African-American population is about 250 g lower than the average birth weight of European Americans. Differences in genetic and socioeconomic factors present between these two groups can explain only part of birth weight variation. I propose a hypothesis that the low birth weight of contemporary African Americans not only results from the difference in present exposure to lifestyle factors known to affect fetal development but also from conditions experienced during the period of slavery. Slaves had poor nutritional status during all stages of life because of the inadequate dietary intake accompanied by high energetic costs of physical work and infectious diseases. The concept of "fetal programming" suggests that physiology and metabolism including growth and fat accumulation of the developing fetus, and, thus its birth weight, depend on intergenerational signal of environmental quality passed through generations of matrilinear ancestors. I suggest that several generations that have passed since the abolition of slavery in the United States (1865) has not been enough to obliterate the impact of slavery on the current biological and health condition of the African-American population. (c) 2008 Wiley-Liss, Inc.

Aerosol transport model evaluation of an extreme smoke episode in Southeast Asia

NASA Astrophysics Data System (ADS)

Hyer, Edward J.; Chew, Boon Ning

2010-04-01

Biomass burning is one of many sources of particulate pollution in Southeast Asia, but its irregular spatial and temporal patterns mean that large episodes can cause acute air quality problems in urban areas. Fires in Sumatra and Borneo during September and October 2006 contributed to 24-h mean PM 10 concentrations above 150 μg m -3 at multiple locations in Singapore and Malaysia over several days. We use the FLAMBE model of biomass burning emissions and the NAAPS model of aerosol transport and evolution to simulate these events, and compare our simulation results to 24-h average PM 10 measurements from 54 stations in Singapore and Malaysia. The model simulation, including the FLAMBE smoke source as well as dust, sulfate, and sea salt aerosol species, was able to explain 50% or more of the variance in 24-h PM 10 observations at 29 of 54 sites. Simulation results indicated that biomass burning smoke contributed to nearly all of the extreme PM 10 observations during September-November 2006, but the exact contribution of smoke was unclear because the model severely underestimated total smoke emissions. Using regression analysis at each site, the bias in the smoke aerosol flux was determined to be a factor of between 2.5 and 10, and an overall factor of 3.5 was estimated. After application of this factor, the simulated smoke aerosol concentration averaged 20% of observed PM 10, and 40% of PM 10 for days with 24-h average concentrations above 150 μg m -3. These results suggest that aerosol transport models can aid analysis of severe pollution events in Southeast Asia, but that improvements are needed in models of biomass burning smoke emissions.

Intercomparison of radiation measurements on STS-63.

PubMed

Badhwar, G D; Atwell, W; Cash, B; Weyland, M; Petrov, V M; Tchernykh, I V; Akatov YuA; Shurshakov, V A; Arkhangelsky, V V; Kushin, V V; Klyachin, N A; Benton, E V; Frank, A L; Benton, E R; Frigo, L A; Dudkin, V E; Potapov YuV; Vana, N; Schoner, W; Fugger, M

1996-11-01

A joint NASA Russia study of the radiation environment inside the Space Shuttle was performed on STS-63. This was the second flight under the Shuttle-Mir Science Program (Phase 1). The Shuttle was launched on 2 February 1995, in a 51.65 degrees inclination orbit and landed at Kennedy Space Center on 11 February 1995, for a total flight duration of 8.27 days. The Shuttle carried a complement of both passive and active detectors distributed throughout the Shuttle volume. The crew exposure varied from 1962 to 2790 microGy with an average of 2265.8 microGy or 273.98 microGy/day. Crew exposures varied by a factor of 1.4, which is higher than usual for STS mission. The flight altitude varied from 314 to 395 km and provided a unique opportunity to obtain dose variation with altitude. Measurements of the average east-west dose variation were made using two active solid state detectors. The dose rate in the Spacehab locker, measured using a tissue equivalent proportional counter (TEPC), was 413.3 microGy/day, consistent with measurements made using thermoluminescent detectors (TLDs) in the same locker. The average quality factor was 2.33, and although it was higher than model calculations, it was consistent with values derived from high temperature peaks in TLDs. The dose rate due to galactic cosmic radiation was 110.6 microGy/day and agreed with model calculations. The dose rate from trapped particles was 302.7 microGy/day, nearly a factor of 2 lower than the prediction of the AP8 model. The neutrons in the intermediate energy range of 1-20 MeV contributed 13 microGy/day and 156 microSv/day, respectively. Analysis of data from the charged particle spectrometer has not yet been completed.

Effect of nutritional status on the ovarian follicular population, yield and quality of oocytes in the Ngaoundere Gudali zebu (Bos indicus)

PubMed Central

Kouamo, Justin; Tidjou, Sorelle Gwladys Djatche; Zoli, Andre Pagnah; Mfopit, Youssouf Mouliom

2015-01-01

Aim: The aim of this study was to investigate the effect of nutritional status of the Gudali cows slaughtered at the Ngaoundere abattoir on follicular population, quality, and oocytes yield. Materials and Methods: Blood and ovaries were collected from 81 cows aged 6.35±0.24 years (3-12 years old), with a body condition score (BCS) of 2.93±0.09 (1-5). In each ovary, the follicle were counted and classified as small (<3 mm), medium (3-8 mm) and large (>8 mm) using an electronic caliper. Oocytes were collected by slicing technique and classified according to the homogeneity of the cytoplasm and layers of granulosa into four groups: I, II, III, and IV. The nutritional status of the animals was determined by quantification of serum glucose, total cholesterol, total protein, albumin, globulins, urea, and phosphorus level. Results: Of the total 162 ovaries harvested, 2916 follicles were counted on the ovarian surface with an average population of 36.00±2.17 follicles/cow. According to a size distribution, 16.67±1.54 (46.3%), 18.83±1.27 (52.3%), and 0.51±0.07 (1.4%), respectively for small (<3 mm), medium (3-8 mm), and large (>8 mm) were recorded. About 1,929 oocytes were obtained, with an average recovered of 23.81±1.53 oocytes/cow. Depending on the quality, 7.79±0.55 (32.7%), 6.04±0.41 (25.3%), 4.89±0.44 (20.6%), and 5.10±0.54 (21.4%) oocytes qualities I, II, III, and IV were obtained respectively; with an average cultivable oocyte recovered of 13.83±0.89 (58%). Cows with BCS > 3 and a high albumin and phosphorus level showed a highest number of follicles and oocytes able for in vitro maturation. Conclusion: These results indicated that nutrition remains an important factor for the in vitro production of the good embryo and the BCS is a useful tool for the selection of females’ oocytes donors. PMID:27047123

Assessing product image quality for online shopping

NASA Astrophysics Data System (ADS)

Goswami, Anjan; Chung, Sung H.; Chittar, Naren; Islam, Atiq

2012-01-01

Assessing product-image quality is important in the context of online shopping. A high quality image that conveys more information about a product can boost the buyer's confidence and can get more attention. However, the notion of image quality for product-images is not the same as that in other domains. The perception of quality of product-images depends not only on various photographic quality features but also on various high level features such as clarity of the foreground or goodness of the background etc. In this paper, we define a notion of product-image quality based on various such features. We conduct a crowd-sourced experiment to collect user judgments on thousands of eBay's images. We formulate a multi-class classification problem for modeling image quality by classifying images into good, fair and poor quality based on the guided perceptual notions from the judges. We also conduct experiments with regression using average crowd-sourced human judgments as target. We compute a pseudo-regression score with expected average of predicted classes and also compute a score from the regression technique. We design many experiments with various sampling and voting schemes with crowd-sourced data and construct various experimental image quality models. Most of our models have reasonable accuracies (greater or equal to 70%) on test data set. We observe that our computed image quality score has a high (0.66) rank correlation with average votes from the crowd sourced human judgments.

40 CFR 63.1035 - Quality improvement program for pumps.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that have poorer than average emission performance and those that have better than average emission... with poorer than average emission performance. A superior performing pump or pump seal technology is... the areas identified as having poorer than average performance, except as provided in paragraph (d)(6...

The Quality vs. the Quantity of Schooling: What Drives Economic Growth?

ERIC Educational Resources Information Center

Breton, Theodore R.

2011-01-01

This paper challenges Hanushek and Woessmann's (2008) contention that the quality and not the quantity of schooling determines a nation's rate of economic growth. I first show that their statistical analysis is flawed. I then show that when a nation's average test scores and average schooling attainment are included in a national income model,…

Preliminary Final Environmental Impact Statement

DTIC Science & Technology

2000-12-01

Suitabilities - Brooks AFB .................................................................... 3-49 3.5-2 National and Texas Ambient Air Quality...night average sound level NAAQS = National Ambient Air Quality Standards NPDES = National Pollutant Discharge Elimination System ROI = region of...Dos Rios, and Medio Creek plants. These plants treat an average of 130 MG of wastewater per day, with a total capacity (including an excess margin

VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

PubMed

Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

2017-04-04

In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA's existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3-100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes.

Spatial-Temporal Analysis of Air Pollution, Climate Change, and Total Mortality in 120 Cities of China, 2012-2013.

PubMed

Liu, Longjian; Yang, Xuan; Liu, Hui; Wang, Mingquan; Welles, Seth; Márquez, Shannon; Frank, Arthur; Haas, Charles N

2016-01-01

China has had a rapid increase in its economy over the past three decades. However, the economic boom came at a certain cost of depleting air quality. In the study, we aimed to examine the burden of air pollution and its association with climatic factors and health outcomes using data from Chinese national and city-level air quality and public health surveillance systems. City-level daily air pollution index (API, a sum weighted index of SO2, NO2, PM10, CO, and Ozone) in 120 cities in 2012 and 2013, and its association with climate factors were analyzed using multiple linear regression analysis, spatial autocorrelation analysis, and panel fixed models. City-level ecological association between annual average API and total mortality were examined using univariate and partial correlation analysis. Sensitivity analysis was conducted by taking the consideration of time-lag effect between exposures and outcomes. The results show that among the 120 cities, annual average API significantly increased from 2012 to 2013 (65.05 vs. 75.99, p < 0.0001). The highest average API was in winter, and the lowest in summer. A significantly spatial clustering of elevated API was observed, with the highest API in northwest China in 2012 and with the highest in east China in 2013. In 2012, 5 (4%) of the 120 cities had ≥60 days with API >100 (defined as "slightly polluted"), however, it increased to 21 cities (18%) that experienced API >100 for ≥60 days in 2013. Furthermore, 16 cities (13%) in 2012 and 35 (29%) in 2013 experienced a maximum API >300 (defined as "severely polluted"). API was negatively and significantly correlated with heat index, precipitation, and sunshine hours, but positively with air pressure. Cities with higher API concentrations had significantly higher total mortality rates than those with lower API. About a 4-7% of the variation in total mortality could be explained by the difference in API across the nation. In conclusion, the study highlights an increased trend of air pollution from 2012 to 2013 in China. The magnitude of air pollution varied by seasons and regions and correlated with climatic factors and total mortality across the country.

Spatial–Temporal Analysis of Air Pollution, Climate Change, and Total Mortality in 120 Cities of China, 2012–2013

PubMed Central

Liu, Longjian; Yang, Xuan; Liu, Hui; Wang, Mingquan; Welles, Seth; Márquez, Shannon; Frank, Arthur; Haas, Charles N.

2016-01-01

China has had a rapid increase in its economy over the past three decades. However, the economic boom came at a certain cost of depleting air quality. In the study, we aimed to examine the burden of air pollution and its association with climatic factors and health outcomes using data from Chinese national and city-level air quality and public health surveillance systems. City-level daily air pollution index (API, a sum weighted index of SO2, NO2, PM10, CO, and Ozone) in 120 cities in 2012 and 2013, and its association with climate factors were analyzed using multiple linear regression analysis, spatial autocorrelation analysis, and panel fixed models. City-level ecological association between annual average API and total mortality were examined using univariate and partial correlation analysis. Sensitivity analysis was conducted by taking the consideration of time-lag effect between exposures and outcomes. The results show that among the 120 cities, annual average API significantly increased from 2012 to 2013 (65.05 vs. 75.99, p < 0.0001). The highest average API was in winter, and the lowest in summer. A significantly spatial clustering of elevated API was observed, with the highest API in northwest China in 2012 and with the highest in east China in 2013. In 2012, 5 (4%) of the 120 cities had ≥60 days with API >100 (defined as “slightly polluted”), however, it increased to 21 cities (18%) that experienced API >100 for ≥60 days in 2013. Furthermore, 16 cities (13%) in 2012 and 35 (29%) in 2013 experienced a maximum API >300 (defined as “severely polluted”). API was negatively and significantly correlated with heat index, precipitation, and sunshine hours, but positively with air pressure. Cities with higher API concentrations had significantly higher total mortality rates than those with lower API. About a 4–7% of the variation in total mortality could be explained by the difference in API across the nation. In conclusion, the study highlights an increased trend of air pollution from 2012 to 2013 in China. The magnitude of air pollution varied by seasons and regions and correlated with climatic factors and total mortality across the country. PMID:27486572

An overview of the PM10 pollution problem, in the Metropolitan Area of Athens, Greece. Assessment of controlling factors and potential impact of long range transport.

PubMed

Grivas, G; Chaloulakou, A; Kassomenos, P

2008-01-15

The present study analyzes PM(10) concentration data collected by the Greek air quality monitoring network at 8 sites over the Greater Athens Area, for the period of 2001-2004. The primary objectives were to assess the degree of compliance with the EU-legislated air quality standard for PM(10) and also provide an overall statistical examination of the factors controlling the seasonal and spatial variation of concentrations, over the wider urban agglomeration. Daily concentrations, averaged over the whole study period, ranged between 32.3 and 60.9 microg m(-3). The four-year average concentration of PM(10) at five sites exceeded the annual limit value of 40 microg m(-3), while most of the sites surpassed the allowed percentage of exceedances of the daily limit value (50 microg m(-3)), for each of the four years. The seasonal variation of PM(10) levels was not found to be uniform across the eight sites, with average cold-period concentrations being higher at four of them and warm period concentrations being significantly higher at three sites, which also displayed recurring annual variation of monthly concentrations. Concentration levels displayed moderate spatial heterogeneity. Nevertheless significant inter-site correlations were observed (ranging between 0.55 and 085). The determination of the spatial correlation levels relied mainly on site types rather than on inter-site distances. Monitoring sites were classified accordingly using cluster analysis in two groups presenting distinct spatiotemporal variation and affected by different particle formation processes. The group including urban sites was mainly affected by primary, combustion-related processes and especially vehicular traffic, as it was also deduced through the examination of the diurnal distribution of particulate levels and through factor analysis. On the contrary, suburban background sites seemed more affected by particle transport from more polluted neighboring areas and secondary particle formation through gaseous precursors, both processes aided from favoring meteorological conditions. The association of the PM(10) levels with backwards trajectories was also examined, in an attempt to account for the possible long range transport of particles in Athens. It was found that a notable part of area-wide episodic events could be attributed to trans-boundary transport of particles, with the origins of some severe dust outbreaks traced back to the Sahara desert and the Western Mediterranean.

Development of a stacked ensemble model for forecasting and analyzing daily average PM2.5 concentrations in Beijing, China.

PubMed

Zhai, Binxu; Chen, Jianguo

2018-04-18

A stacked ensemble model is developed for forecasting and analyzing the daily average concentrations of fine particulate matter (PM 2.5 ) in Beijing, China. Special feature extraction procedures, including those of simplification, polynomial, transformation and combination, are conducted before modeling to identify potentially significant features based on an exploratory data analysis. Stability feature selection and tree-based feature selection methods are applied to select important variables and evaluate the degrees of feature importance. Single models including LASSO, Adaboost, XGBoost and multi-layer perceptron optimized by the genetic algorithm (GA-MLP) are established in the level 0 space and are then integrated by support vector regression (SVR) in the level 1 space via stacked generalization. A feature importance analysis reveals that nitrogen dioxide (NO 2 ) and carbon monoxide (CO) concentrations measured from the city of Zhangjiakou are taken as the most important elements of pollution factors for forecasting PM 2.5 concentrations. Local extreme wind speeds and maximal wind speeds are considered to extend the most effects of meteorological factors to the cross-regional transportation of contaminants. Pollutants found in the cities of Zhangjiakou and Chengde have a stronger impact on air quality in Beijing than other surrounding factors. Our model evaluation shows that the ensemble model generally performs better than a single nonlinear forecasting model when applied to new data with a coefficient of determination (R 2 ) of 0.90 and a root mean squared error (RMSE) of 23.69μg/m 3 . For single pollutant grade recognition, the proposed model performs better when applied to days characterized by good air quality than when applied to days registering high levels of pollution. The overall classification accuracy level is 73.93%, with most misclassifications made among adjacent categories. The results demonstrate the interpretability and generalizability of the stacked ensemble model. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Characteristics of nitrogen loading and its influencing factors in several typical agricultural watersheds of subtropical China.

PubMed

Li, Yuyuan; Jiao, Junxia; Wang, Yi; Yang, Wen; Meng, Cen; Li, Baozhen; Li, Yong; Wu, Jinshui

2015-02-01

Increasingly, the characteristics of nitrogen (N) loading have been recognized to be critical for the maintenance and restoration of water quality in agricultural watersheds, in response to the spread of water eutrophication. This paper estimates N loading and investigates its influencing factors in ten small watersheds variously dominated by forest and agricultural land use types in the subtropics of China, over an observation period of 23-29 months. The results indicate that the average concentrations of total nitrogen (TN), NH4 (+)-N, and NO3 (-)-N were 0.83, 0.07, and 0.46 mg N L(-1) in the forest watersheds and 1.49-5.16, 0.21-3.23, and 0.99-1.30 mg N L(-1) in the agricultural watersheds, respectively. Such concentrations exceed the national criteria for nutrient pollution in surface waters considerably, suggesting severe stream pollution in the studied agricultural watersheds. The average annual TN loadings (ANL) were estimated to be 1,640.8 kg N km(-2) year(-1) in the agricultural watersheds, 63.3-86.1 % of which was composed of dissolved inorganic N (DIN; comprising NO3 (-)-N and NH4 (+)-N). The watershed with intensive livestock production (i.e., the maximum livestock density of 2.66 animal units (AU) ha(-1)) exhibited the highest ANL (2,928.7 kg N km(-2) year(-1)) related to N loss with effluent discharge. The results of correlation and principle component analysis suggest that livestock production was the dominant influencing factor for the TN and NH4 (+)-N loadings and that the percentages of cropland in watersheds can significantly increase the NO3 (-)-N loading in agricultural watersheds. Therefore, to restore and maintain water quality, animal production regulations and more careful planning of land use are necessary in the agricultural watersheds of subtropical China.

Hot mill process parameters impacting on hot mill tertiary scale formation

NASA Astrophysics Data System (ADS)

Kennedy, Jonathan Ian

For high end steel applications surface quality is paramount to deliver a suitable product. A major cause of surface quality issues is from the formation of tertiary scale. The scale formation depends on numerous factors such as thermo-mechanical processing routes, chemical composition, thickness and rolls used. This thesis utilises a collection of data mining techniques to better understand the influence of Hot Mill process parameters on scale formation at Port Talbot Hot Strip Mill in South Wales. The dataset to which these data mining techniques were applied was carefully chosen to reduce process variation. There are several main factors that were considered to minimise this variability including time period, grade and gauge investigated. The following data mining techniques were chosen to investigate this dataset: Partial Least Squares (PLS); Logit Analysis; Principle Component Analysis (PCA); Multinomial Logistical Regression (MLR); Adaptive Neuro Inference Fuzzy Systems (ANFIS). The analysis indicated that the most significant variable for scale formation is the temperature entering the finishing mill. If the temperature is controlled on entering the finishing mill scale will not be formed. Values greater than 1070 °C for the average Roughing Mill and above 1050 °C for the average Crop Shear temperature are considered high, with values greater than this increasing the chance of scale formation. As the temperature increases more scale suppression measures are required to limit scale formation, with high temperatures more likely to generate a greater amount of scale even with fully functional scale suppression systems in place. Chemistry is also a significant factor in scale formation, with Phosphorus being the most significant of the chemistry variables. It is recommended that the chemistry specification for Phosphorus be limited to a maximum value of 0.015 % rather than 0.020 % to limit scale formation. Slabs with higher values should be treated with particular care when being processed through the Hot Mill to limit scale formation.

Energy Potential of Biomass from Conservation Grasslands in Minnesota, USA

PubMed Central

Jungers, Jacob M.; Fargione, Joseph E.; Sheaffer, Craig C.; Wyse, Donald L.; Lehman, Clarence

2013-01-01

Perennial biomass from grasslands managed for conservation of soil and biodiversity can be harvested for bioenergy. Until now, the quantity and quality of harvestable biomass from conservation grasslands in Minnesota, USA, was not known, and the factors that affect bioenergy potential from these systems have not been identified. We measured biomass yield, theoretical ethanol conversion efficiency, and plant tissue nitrogen (N) as metrics of bioenergy potential from mixed-species conservation grasslands harvested with commercial-scale equipment. With three years of data, we used mixed-effects models to determine factors that influence bioenergy potential. Sixty conservation grassland plots, each about 8 ha in size, were distributed among three locations in Minnesota. Harvest treatments were applied annually in autumn as a completely randomized block design. Biomass yield ranged from 0.5 to 5.7 Mg ha−1. May precipitation increased biomass yield while precipitation in all other growing season months showed no affect. Averaged across all locations and years, theoretical ethanol conversion efficiency was 450 l Mg−1 and the concentration of plant N was 7.1 g kg−1, both similar to dedicated herbaceous bioenergy crops such as switchgrass. Biomass yield did not decline in the second or third year of harvest. Across years, biomass yields fluctuated 23% around the average. Surprisingly, forb cover was a better predictor of biomass yield than warm-season grass with a positive correlation with biomass yield in the south and a negative correlation at other locations. Variation in land ethanol yield was almost exclusively due to variation in biomass yield rather than biomass quality; therefore, efforts to increase biomass yield might be more economical than altering biomass composition when managing conservation grasslands for ethanol production. Our measurements of bioenergy potential, and the factors that control it, can serve as parameters for assessing the economic viability of harvesting conservation grasslands for bioenergy. PMID:23577208

APOLLO: a quality assessment service for single and multiple protein models.

PubMed

Wang, Zheng; Eickholt, Jesse; Cheng, Jianlin

2011-06-15

We built a web server named APOLLO, which can evaluate the absolute global and local qualities of a single protein model using machine learning methods or the global and local qualities of a pool of models using a pair-wise comparison approach. Based on our evaluations on 107 CASP9 (Critical Assessment of Techniques for Protein Structure Prediction) targets, the predicted quality scores generated from our machine learning and pair-wise methods have an average per-target correlation of 0.671 and 0.917, respectively, with the true model quality scores. Based on our test on 92 CASP9 targets, our predicted absolute local qualities have an average difference of 2.60 Å with the actual distances to native structure. http://sysbio.rnet.missouri.edu/apollo/. Single and pair-wise global quality assessment software is also available at the site.

Religious Burning as a Major Source of Atmospheric Fine Aerosols in Lhasa city in the Tibetan Plateau

NASA Astrophysics Data System (ADS)

Liu, S.; Cui, Y.; Zhixuan, B.; Bian, J.; McKeen, S. A.; Watts, L. A.; Ciciora, S. J.; Gao, R. S.

2017-12-01

Measurements of aerosols in the Tibetan Plateau are scant due to the high altitude and harsh climate. To bridge this gap, we carried out the first field measurements of aerosol size distributions in Lhasa, a major city in the Tibetan Plateau that has been experiencing fast urbanization and reduced air quality. Aerosol number size distribution was continuously measured using an optical particle size spectrometer near the center of Lhasa city during the Asian summer monsoon season in 2016. The mass concentration of fine particles was modulated by boundary layer dynamics, with an average of 11 µg m-3 and the high values exceeding 50 µg m-3 during religious holidays. Daytime high concentration coincided with the religious burning of biomass and incense in the temples during morning hours, which produced heavy smoke. Factor analysis revealed a factor that is likely induced by religious burning. The factor contributed 34% of the campaign-average fine particle mass and the contribution reached up to 80% during religious holidays. The mass size distribution of aerosols produced from religious burnings peaked at 500 nm, indicating that these particles could efficiently decrease visibility and promote health risk. Because of its significance, our results suggest that more attention should be paid to religious burning, a currently under-studied source, in the Tibetan Plateau and in other regions of the world where religious burnings are frequently practiced.

Attenuation of Lg waves in the New Madrid seismic zone of the central United States using the coda normalization method

NASA Astrophysics Data System (ADS)

Nazemi, Nima; Pezeshk, Shahram; Sedaghati, Farhad

2017-08-01

Unique properties of coda waves are employed to evaluate the frequency dependent quality factor of Lg waves using the coda normalization method in the New Madrid seismic zone of the central United States. Instrument and site responses are eliminated and source functions are isolated to construct the inversion problem. For this purpose, we used 121 seismograms from 37 events with moment magnitudes, M, ranging from 2.5 to 5.2 and hypocentral distances from 120 to 440 km recorded by 11 broadband stations. A singular value decomposition (SVD) algorithm is used to extract Q values from the data, while the geometric spreading exponent is assumed to be a constant. Inversion results are then fitted with a power law equation from 3 to 12 Hz to derive the frequency dependent quality factor function. The final results of the analysis are QVLg (f) = (410 ± 38) f0.49 ± 0.05 for the vertical component and QHLg (f) = (390 ± 26) f0.56 ± 0.04 for the horizontal component, where the term after ± sign represents one standard error. For stations within the Mississippi embayment with an average sediment depth of 1 km around the Memphis metropolitan area, estimation of quality factor using the coda normalization method is not well-constrained at low frequencies (f < 3 Hz). There may be several reasons contributing to this issue, such as low frequency surface wave contamination, site effects, or even a change in coda wave scattering regime which can exacerbate the scatter of the data.

Analysis of subsequent publication and impact of abstracts presented at the Sir Peter Freyer Surgical Symposium: Focus on the Plenary Session.

PubMed

O' Connor, D J; Lowery, A J; Kearney, D; McAnena, O J; Sweeney, K J; Kerin, M J

2015-09-01

The quality of abstracts presented at a conference reflects the academic activity and research productivity of the surgical/scientific association concerned. The abstract to publication rate (44.5 % internationally), is an important indicator of the quality of presented research. To evaluate the publication rate and impact of abstracts presented at the plenary session of the Sir Peter Freyer Surgical Symposium over a 25-year period (1989-2014), and identify factors influencing publication. Plenary abstracts were identified from abstract books of the Symposium from 1989-2014. The authors, institution, subspecialty and research subject were recorded. A Medline search with name of the first and last author, key words and content of all abstracts was conducted to identify related publications. The impact factor (IF) of the journal and the time to publication was recorded. 298 presented abstracts resulted in 168 publications (publication rate: 56 %). Basic Science research accounted for 80 % (n = 237) of the total number of presentations with the remaining 20 % (n = 61) being categorised as clinical research. Overall, cancer research accounted for 48 % of presented work. The average time to publication was 2 ± 7 years, while 11 % of all published studies achieved publication in the year of the symposium. The median impact factor for published research was 3.558 (IF range 0-39). These results indicate that the quality of papers presented at the Sir Peter Freyer Surgical Symposium compares favourably with international equivalents, making this meeting an important forum for Irish Academic Surgery.

Valuing avoided morbidity using meta-regression analysis: what can health status measures and QALYs tell us about WTP?

PubMed

Van Houtven, George; Powers, John; Jessup, Amber; Yang, Jui-Chen

2006-08-01

Many economists argue that willingness-to-pay (WTP) measures are most appropriate for assessing the welfare effects of health changes. Nevertheless, the health evaluation literature is still dominated by studies estimating nonmonetary health status measures (HSMs), which are often used to assess changes in quality-adjusted life years (QALYs). Using meta-regression analysis, this paper combines results from both WTP and HSM studies applied to acute morbidity, and it tests whether a systematic relationship exists between HSM and WTP estimates. We analyze over 230 WTP estimates from 17 different studies and find evidence that QALY-based estimates of illness severity--as measured by the Quality of Well-Being (QWB) Scale--are significant factors in explaining variation in WTP, as are changes in the duration of illness and the average income and age of the study populations. In addition, we test and reject the assumption of a constant WTP per QALY gain. We also demonstrate how the estimated meta-regression equations can serve as benefit transfer functions for policy analysis. By specifying the change in duration and severity of the acute illness and the characteristics of the affected population, we apply the regression functions to predict average WTP per case avoided. Copyright 2006 John Wiley & Sons, Ltd.

Automatic extraction of three-dimensional thoracic aorta geometric model from phase contrast MRI for morphometric and hemodynamic characterization.

PubMed

Volonghi, Paola; Tresoldi, Daniele; Cadioli, Marcello; Usuelli, Antonio M; Ponzini, Raffaele; Morbiducci, Umberto; Esposito, Antonio; Rizzo, Giovanna

2016-02-01

To propose and assess a new method that automatically extracts a three-dimensional (3D) geometric model of the thoracic aorta (TA) from 3D cine phase contrast MRI (PCMRI) acquisitions. The proposed method is composed of two steps: segmentation of the TA and creation of the 3D geometric model. The segmentation algorithm, based on Level Set, was set and applied to healthy subjects acquired in three different modalities (with and without SENSE reduction factors). Accuracy was evaluated using standard quality indices. The 3D model is characterized by the vessel surface mesh and its centerline; the comparison of models obtained from the three different datasets was also carried out in terms of radius of curvature (RC) and average tortuosity (AT). In all datasets, the segmentation quality indices confirmed very good agreement between manual and automatic contours (average symmetric distance < 1.44 mm, DICE Similarity Coefficient > 0.88). The 3D models extracted from the three datasets were found to be comparable, with differences of less than 10% for RC and 11% for AT. Our method was found effective on PCMRI data to provide a 3D geometric model of the TA, to support morphometric and hemodynamic characterization of the aorta. © 2015 Wiley Periodicals, Inc.

Environmental Factors Correlated with Culturable Enterococci Concentrations in Tropical Recreational Waters: A Case Study in Escambron Beach, San Juan, Puerto Rico.

PubMed

Laureano-Rosario, Abdiel E; Symonds, Erin M; Rueda-Roa, Digna; Otis, Daniel; Muller-Karger, Frank E

2017-12-19

Enterococci concentration variability at Escambron Beach, San Juan, Puerto Rico, was examined in the context of environmental conditions observed during 2005-2015. Satellite-derived sea surface temperature (SST), turbidity, direct normal irradiance, and dew point were combined with local precipitation, winds, and mean sea level (MSL) observations in a stepwise multiple regression analyses (Akaike Information Criteria model selection). Precipitation, MSL, irradiance, SST, and turbidity explained 20% of the variation in observed enterococci concentrations based upon these analyses. Changes in these parameters preceded increases in enterococci concentrations by 24 h up to 11 days, particularly during positive anomalies of turbidity, SST, and 480-960 mm of accumulated (4 days) precipitation, which relates to bacterial ecology. Weaker, yet still significant, increases in enterococci concentrations were also observed during positive dew point anomalies. Enterococci concentrations decreased with elevated irradiance and MSL anomalies. Unsafe enterococci concentrations per US EPA recreational water quality guidelines occurred when 4-day cumulative precipitation ranged 481-960 mm; irradiance < 667 W·m -2 ; daily average turbidity anomaly >0.005 sr -1 ; SST anomaly >0.8 °C; and 3-day average MSL anomaly <-18.8 cm. This case study shows that satellite-derived environmental data can be used to inform future water quality studies and protect human health.

Emission factors of volatile organic compounds (VOCs) based on the detailed vehicle classification in a tunnel study.

PubMed

Zhang, Qijun; Wu, Lin; Fang, Xiaozhen; Liu, Mingyue; Zhang, Jing; Shao, Min; Lu, Sihua; Mao, Hongjun

2018-05-15

In order to obtain VOCs emission characteristics and emission factors from vehicle, a tunnel experiment was conducted in the Fu Gui Mountain Tunnel in Nanjing, China. The tunnel is located in the middle of city, with total length of 480m and speed limit of 50km/h. The studied vehicle fleet was composed of 87% light duty vehicles and 13% heavy duty vehicles (liquefied natural gas bus, LNGB). The emerging radio frequency identification (RFID) technology was used to divide fine vehicles type including China I, China II, China III, China IV, China V and LNGB. Ambient air samples (4-h averages) were collected inside the tunnel using 3.2L stainless-steel canisters. Samples collected in the canisters were analyzed for 97 individual VOCs using high-resolution GC-MS in the laboratory. The average tunnel emission factor for the collective light-duty vehicles was 160.79±65.94mg/(km∗veh), and for the China I, China II, China III, China IV and China V vehicles, it was 632.07±259.44, 450.35±184.85, 205.42±84.32, 118.51±48.65, and 110.61±45.4mg/(km∗veh), respectively. The average emission factor for heavy-duty vehicles was 358.02±124.86mg/(km∗veh). Ethane, isopentane, propane, ethylene, toluene, propylene and 2,3-dimethylbutane were the most common VOC species in vehicle emissions. The total O 3 formation potential was 373.88mg∗O 3 /(km∗veh) in the tunnel. Ethylene, propylene, m/p-xylene, toluene, and isopentane were the largest contributors to O 3 production. Compared with previous studies, fuel quality increased from China II-FQ to China IV-FQ levels, while the BTEX emission levels exhibited a decreasing trend. Copyright © 2017 Elsevier B.V. All rights reserved.

An evaluation of image quality and accuracy of eye bank measurement of donor cornea endothelial cell density in the Specular Microscopy Ancillary Study.

PubMed

Lass, Jonathan H; Gal, Robin L; Ruedy, Katrina J; Benetz, Beth Ann; Beck, Roy W; Baratz, Keith H; Holland, Edward J; Kalajian, Andrea; Kollman, Craig; Manning, Francis J; Mannis, Mark J; McCoy, Kristen; Montoya, Monty; Stulting, Doyle; Xing, Dongyuan

2005-03-01

The Specular Microscopy Ancillary Study was designed to examine donor corneal endothelial specular image quality, compare the central endothelial cell density determined by eye banks with the endothelial cell density determined by a central specular microscopy reading center, and evaluate donor factors that may have an impact on specular image quality and endothelial cell density accuracy. Nonrandomized comparative trial. Endothelial specular images of donor corneas assigned in the Cornea Donor Study. Certified readers assessed donor image quality (analyzable from fair to excellent vs. unanalyzable) and determined the central endothelial cell density. Independent adjudication was performed if there was a difference in the quality of grading or if the endothelial cell density varied by > or =5.0% between readers. Average reading center-determined endothelial cell density was compared with the endothelial cell density determined by each eye bank. Evaluation of image quality and accuracy of endothelial cell density. Of 688 donor endothelial images submitted by 23 eye banks, 663 (96%) were analyzable (excellent, 40 [6%]; good, 302 [44%]; fair, 321 [47%]), and 25 (4%) were unanalyzable by reading center standards. In situ retrieval and greater epithelial exposure correlated with a higher image quality grading. The eye bank-determined endothelial cell density of 434 of the 663 (65%) analyzable images were within 10% of the endothelial cell density determined by the reading center, whereas 185 (28%) were more than 10% higher and 44 (7%) were more than 10% lower. Greater variation in endothelial cell density between the eye banks and the reading center was observed with shorter time of death to preservation, presence of an epithelial defect, folds in Descemet's membrane, lower image quality, and the use of fixed-frame or center method endothelial cell density analysis. Overall, donor endothelial specular image quality and accuracy of endothelial cell density determination were good. However, the data suggest that factors that may affect image quality and contribute to variation in interpretation of the endothelial cell density should be addressed, because the donor endothelial cell density is an important parameter for assessing long-term corneal graft survival.

Determinants of quality of shared sanitation facilities in informal settlements: case study of Kisumu, Kenya.

PubMed

Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy; Rheingans, Richard

2017-01-11

Shared facilities are not recognised as improved sanitation due to challenges of maintenance as they easily can be avenues for the spread of diseases. Thus there is need to evaluate the quality of shared facilities, especially in informal settlements, where they are commonly used. A shared facility can be equated to a common good whose management depends on the users. If users do not work collectively towards keeping the facility clean, it is likely that the quality may depreciate due to lack of maintenance. This study examined the quality of shared sanitation facilities and used the common pool resource (CPR) management principles to examine the determinants of shared sanitation quality in the informal settlements of Kisumu, Kenya. Using a multiple case study design, the study employed both quantitative and qualitative methods. In both phases, users of shared sanitation facilities were interviewed, while shared sanitation facilities were inspected. Shared sanitation quality was a score which was the dependent variable in a regression analysis. Interviews during the qualitative stage were aimed at understanding management practices of shared sanitation users. Qualitative data was analysed thematically by following the CPR principles. Shared facilities, most of which were dirty, were shared by an average of eight households, and their quality decreased with an increase in the number of households sharing. The effect of numbers on quality is explained by behaviour reflected in the CPR principles, as it was easier to define boundaries of shared facilities when there were fewer users who cooperated towards improving their shared sanitation facility. Other factors, such as defined management systems, cooperation, collective decision making, and social norms, also played a role in influencing the behaviour of users towards keeping shared facilities clean and functional. Apart from hardware factors, quality of shared sanitation is largely due to group behaviour of users. The CPR principles form a crucial lens through which the dynamics of shared sanitation facilities in informal settlements can be understood. Development and policy efforts should incorporate group behaviour as they determine the quality of shared sanitation facilities.

Study of Water Quality Changes due to Offshore Dike Development Plan at Semarang Bay

NASA Astrophysics Data System (ADS)

Wibowo, M.; Hakim, B. A.

2018-03-01

Now, coast of Semarang Gulf is experiencing rapid growth because Semarang as a center economic growth in Central Java. On the other hand, coast of Gulf Semarang also experience a variety of very complex problems, such as tidal flood, land subsidence, as well as coastal damage due to erosion and sedimentation process. To overcome these problems BPPT and other institutions proposed construction of offshore dike. Construction of the offshore dike is a technology intervention to the marine environment that will certainly affect the hydrodynamic balance in coastal water including water quality in the Gulf of Semarang. Therefore, to determine changes in water quality that will happen is necessary to study the water quality modeling. The study was conducted by using a computational modeling software MIKE-21 Eco Lab Module from DHI. Based on this study result knowed that development offshore dike will change water quality in the west and east dam that formed. In west dam the average value of the DO decline 81.56% - 93.32 % and the average value of BOD rise from 22.01 to 31.19% and in the east dam, there is an increase average value DO of 83.19% - 75.80%, while the average value of BOD decrease by 95,04% - 96.01%. To prevent the downward trend in water quality due to the construction of the offshore dike, its necessary precautions at the upstream area before entering the Gulf of Semarang.

An Air Quality Data Analysis System for Interrelating Effects, Standards and Needed Source Reductions

ERIC Educational Resources Information Center

Larsen, Ralph I.

1973-01-01

Makes recommendations for a single air quality data system (using average time) for interrelating air pollution effects, air quality standards, air quality monitoring, diffusion calculations, source-reduction calculations, and emission standards. (JR)

Sleep habits in adolescents of Saudi Arabia; distinct patterns and extreme sleep schedules.

PubMed

Merdad, Roah A; Merdad, Leena A; Nassif, Rawan A; El-Derwi, Douaa; Wali, Siraj O

2014-11-01

There is a need for comprehensive studies on adolescents' sleep habits in the Middle Eastern region. The aim of this study was to investigate the sleep-wake patterns, prevalence of excessive daytime sleepiness (EDS), and disturbed sleep among adolescents in Saudi Arabia and to identify the associated factors. The study was a cross-sectional survey done on a random sample of 1035 high school students, ages 14-23 years, in Jeddah, Saudi Arabia. The response rate was 91%. Students filled a self-reported questionnaire that included sleep-wake questions, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Perceived Stress Scale, academic performance, and personal data. Students slept an average of 7.0 hours on school nights, with an average delay of 2.8 and 6.0 hours in weekend sleep and rise times, respectively. Around 1 in 10 students stayed up all night and slept after returning from school (exhibiting a reversed sleep cycle) on weeknights. This pattern was more prevalent among boys and students with lower grade point averages. The prevalence of sleep disturbance was 65%, and EDS was found in 37% of the students. Predictors of EDS were school type, stress, napping and caffeine use, while gender was a predictor of disturbed sleep. Adolescents in Saudi Arabia showed a high percentage of poor sleep quality. Compared with adolescents from other countries, they had a larger delay in weekend sleep and rise times. An alarming reversed sleep cycle on weekdays is present and highlights the need for further assessment. Copyright © 2014 Elsevier B.V. All rights reserved.

Black Carbon Emissions from In-use Ships: Results from CalNex 2010

NASA Astrophysics Data System (ADS)

Buffaloe, Gina Marise

Black carbon (BC) mass emission factors (EFBC; g-BC (kg-fuel)--1) from a variety of ocean going vessels have been determined from measurements of BC and CO2 concentrations in ship plumes intercepted by the R/V Atlantis during the 2010 California Nexus (CalNex) campaign. The ships encountered were all operating within 24 nautical miles of the California coast and were utilizing relatively low sulphur fuels. Black carbon concentrations within the plumes, from which EFBC values are determined, were measured using four independent instruments: a photoacoustic spectrometer and a particle soot absorption photometer, which measure light absorption, and a single particle soot photometer and soot particle aerosol mass spectrometer, which measure the mass concentration of refractory BC directly. The measured EFBC have been divided into vessel type categories and engine type categories, from which averages have been determined. The geometric average EFBC, determined from over 71 vessels and 135 plumes encountered, was 0.31 g-BC (kg-fuel)--1. The most frequent engine type encountered was the slow speed diesel (SSD), and the most frequent SSD vessel type was the cargo ship sub-category. Average and median EF BC values from these two categories are compared to previous observations from the Texas Air Quality Study (TexAQS) in 2006, in which the ships encountered were predominately operating high sulphur fuels. There is some indication that the EFBC values for SSD vessels during CalNex were lower than during TexAQS, although ship-to-ship variability in these data sets makes it difficult to draw firm conclusions about the influence of fuel quality on EFBC.

Improving Procedure Start Times and Decreasing Delays in Interventional Radiology: A Department's Quality Improvement Initiative.

PubMed

Villarreal, Monica C; Rostad, Bradley S; Wright, Richard; Applegate, Kimberly E

2015-12-01

To identify and reduce reasons for delays in procedure start times, particularly the first cases of the day, within the interventional radiology (IR) divisions of the Department of Radiology using principles of continuous quality improvement. An interdisciplinary team representative of the IR and preprocedure/postprocedure care area (PPCA) health care personnel, managers, and data analysts was formed. A standardized form was used to document both inpatient and outpatient progress through the PPCA and IR workflow in six rooms and to document reasons for delays. Data generated were used to identify key problems areas, implement improvement interventions, and monitor their effects. Project duration was 6 months. The average number of on-time starts for the first case of the day increased from 23% to 56% (P value < .01). The average number of on-time, scheduled outpatients increased from 30% to 45% (P value < .01). Patient wait time to arrive at treatment room once they were ready for their procedure was reduced on average by 10 minutes (P value < .01). Patient care delay duration per 100 patients was reduced from 30.3 to 21.6 hours (29% reduction). Number of patient care delays per 100 patients was reduced from 46.6 to 40.1 (17% reduction). Top reasons for delay included waiting for consent (26% of delays duration) and laboratory tests (12%). Many complex factors contribute to procedure start time delays within an IR practice. A data-driven and patient-centered, interdisciplinary team approach was effective in reducing delays in IR. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Risk cross sections and their application to risk estimation in the galactic cosmic-ray environment

NASA Technical Reports Server (NTRS)

Curtis, S. B.; Nealy, J. E.; Wilson, J. W.; Chatterjee, A. (Principal Investigator)

1995-01-01

Radiation risk cross sections (i.e. risks per particle fluence) are discussed in the context of estimating the risk of radiation-induced cancer on long-term space flights from the galactic cosmic radiation outside the confines of the earth's magnetic field. Such quantities are useful for handling effects not seen after low-LET radiation. Since appropriate cross-section functions for cancer induction for each particle species are not yet available, the conventional quality factor is used as an approximation to obtain numerical results for risks of excess cancer mortality. Risks are obtained for seven of the most radiosensitive organs as determined by the ICRP [stomach, colon, lung, bone marrow (BFO), bladder, esophagus and breast], beneath 10 g/cm2 aluminum shielding at solar minimum. Spectra are obtained for excess relative risk for each cancer per LET interval by calculating the average fluence-LET spectrum for the organ and converting to risk by multiplying by a factor proportional to R gamma L Q(L) before integrating over L, the unrestricted LET. Here R gamma is the risk coefficient for low-LET radiation (excess relative mortality per Sv) for the particular organ in question. The total risks of excess cancer mortality obtained are 1.3 and 1.1% to female and male crew, respectively, for a 1-year exposure at solar minimum. Uncertainties in these values are estimated to range between factors of 4 and 15 and are dominated by the biological uncertainties in the risk coefficients for low-LET radiation and in the LET (or energy) dependence of the risk cross sections (as approximated by the quality factor). The direct substitution of appropriate risk cross sections will eventually circumvent entirely the need to calculate, measure or use absorbed dose, equivalent dose and quality factor for such a high-energy charged-particle environment.

Predictors of improvement in subjective sleep quality reported by older adults following group-based cognitive behavior therapy for sleep maintenance and early morning awakening insomnia.

PubMed

Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

2013-09-01

Cognitive behavior therapy is an effective nonpharmacologic treatment for insomnia. However, individualized administration is costly and often results in substantial variability in treatment response across individual patients, particularly so for older adults. Group-based administration has demonstrated impressive potential for a brief and inexpensive answer to the effective treatment of insomnia in the older population. It is important to identify potential predictors of response to such a treatment format to guide clinicians when selecting the most suitable treatment for their patients. The aim of our study was to identify factors that predict subjective sleep quality of older adults following group-based administration of cognitive behavior therapy for insomnia (CBT-I). Eighty-six adults (41 men; mean age, 64.10 y; standard deviation [SD], 6.80) with sleep maintenance or early morning awakening insomnia were selected from a community-based sample to participate in a 4-week group-based treatment program of CBT-I. Participants were required to complete 7-day sleep diaries and a comprehensive battery of questionnaires related to sleep quality and daytime functioning. Hierarchical multiple regression analyses were used to identify factors predicting subjective sleep quality immediately following treatment and at 3-month follow-up. Sleep diaries reported average nightly sleep efficiency (SE), which was used as the outcome measure of sleep quality. Participants with the greatest SE following treatment while controlling for pretreatment SE were relatively younger and had more confidence in their ability to sleep at pretreatment. These characteristics may be useful to guide clinicians when considering the use of a group-based CBT-I for sleep maintenance or early morning awakening insomnia in older adults. Copyright © 2013 Elsevier B.V. All rights reserved.

Practice leadership and active support in residential services for people with intellectual disabilities: an exploratory study.

PubMed

Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B

2014-09-01

We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Systematic review of the primary research on minority ethnic groups and end-of-life care from the United Kingdom.

PubMed

Evans, Natalie; Meñaca, Arantza; Andrew, Erin V W; Koffman, Jonathan; Harding, Richard; Higginson, Irene J; Pool, Robert; Gysels, Marjolein

2012-02-01

Patients from minority ethnic groups experience lower rates of referrals to end-of-life (EoL) care services, higher levels of dissatisfaction with services, and perceive some services as culturally inappropriate. To systematically review original studies of minority ethnic groups and EoL care in the U.K. and appraise their quality. Searches were carried out in 13 electronic databases, eight journals, reference lists, and the gray literature. Studies of minority ethnic groups and EoL care in the U.K. were included. Studies were graded for quality and key themes were identified. Forty-five studies met inclusion criteria. Study quality was good on average. Identified key themes included age structure; inequality by disease group; referrals; caregivers; place of care and death; awareness of services and communication; and cultural competency. Strategies described for the reduction of inequities were partial and reactive. The format of 10 studies prevented quality grading; these were, however, reviewed as they provided unique insights. Variations in terminology and sampling frames complicated comparison across studies. The results highlight the multiple and related factors that contribute to low service use and substandard quality of services experienced by minority ethnic groups, and the need for authors to clarify what they mean by "culturally competent" EoL care. The synthesis of diverse and disparate studies underpins a number of key recommendations for health care professionals and policymakers. Tackling these epidemiological, demographic, institutional, social, and cultural factors will require a systematic and organization-wide approach rather than the current piecemeal and reactive interventions. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Assessment of Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and Dysthymic Disorder (DD): A Comparative Study.

PubMed

Vasudev, Roopesh Gopal Nariyandada; Yallappa, Sudarshan Chikkanayakanahalli; Saya, Ganesh Kumar

2015-05-01

There is paucity of data on Quality of Life (QOL) in non-psychotic mental disorders. To assess the Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and compare it with Dysthymic Disorder (DD). This hospital based cross-sectional study was conducted in 30 patients each diagnosed to have OCD and DD during October 2009 to September 2011 in a medical institution in Davanagere, Karnataka, India. DSM-IV-TR (Diagnostic statistical manual-IV-Text Revised) criteria was used for diagnosis of OCD and DD. Yale Brown Obsessive Compulsive Scale (Y-BOCS) and WHO QOL BREF (brief form) scales were used. Data was analysed by independent sample t-test. Overall QOL score was 51.07(SD=11.47) and 50.91(SD=7.41) in OCD and DD groups respectively. QOL score was comparatively low in psychological domain with score of 44.12(SD=14.14) and 45.10(12.35) in OCD and DD respectively. There was no significant difference in the QOL score of the two groups with respect to socio demographic variables in OCD group, but it was different with respect to place of residence in DD group (p<0.05). In Q1(perception on quality of life) and Q2 (perception on quality of health) domain, QOL score was marginally higher than average in both the groups. In Y-BOCS scale, no statistical significant association was found between severity of OCD and QOL score in each of the domains (p>0.05). Overall QOL score was average and there was no significant difference of QOL score between the OCD and DD groups implying that both these non-psychotic mental disorders may have same influence or effect on QOL of the subjects. Further analytical studies will explore the associated factors of QOL in OCD and DD.

Assessment of Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and Dysthymic Disorder (DD): A Comparative Study

PubMed Central

Vasudev, Roopesh Gopal Nariyandada; Yallappa, Sudarshan Chikkanayakanahalli

2015-01-01

Introduction There is paucity of data on Quality of Life (QOL) in non-psychotic mental disorders. Aim To assess the Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and compare it with Dysthymic Disorder (DD). Materials and Methods This hospital based cross-sectional study was conducted in 30 patients each diagnosed to have OCD and DD during October 2009 to September 2011 in a medical institution in Davanagere, Karnataka, India. DSM-IV-TR (Diagnostic statistical manual-IV-Text Revised) criteria was used for diagnosis of OCD and DD. Yale Brown Obsessive Compulsive Scale (Y-BOCS) and WHO QOL BREF (brief form) scales were used. Data was analysed by independent sample t-test. Results Overall QOL score was 51.07(SD=11.47) and 50.91(SD=7.41) in OCD and DD groups respectively. QOL score was comparatively low in psychological domain with score of 44.12(SD=14.14) and 45.10(12.35) in OCD and DD respectively. There was no significant difference in the QOL score of the two groups with respect to socio demographic variables in OCD group, but it was different with respect to place of residence in DD group (p<0.05). In Q1(perception on quality of life) and Q2 (perception on quality of health) domain, QOL score was marginally higher than average in both the groups. In Y-BOCS scale, no statistical significant association was found between severity of OCD and QOL score in each of the domains (p>0.05). Conclusion Overall QOL score was average and there was no significant difference of QOL score between the OCD and DD groups implying that both these non-psychotic mental disorders may have same influence or effect on QOL of the subjects. Further analytical studies will explore the associated factors of QOL in OCD and DD. PMID:26155540

NOAA's National Weather Service/Environmental Protection Agency - United

Science.gov Websites

Integration Image | Loop View | Daily View | Point Guidance | | Experimental Air Quality Guidance | Product Map To View Additional Guidance Graphic of Air Quality Forecast Guidance for the CONUS Mouse over or Image Alaska 1-Hr Average Ozone Concentration Image Hawaii 1-Hr Average Ozone Concentration Image 8-Hr

A study on the relationship between urban roads and car fuel consumption based on the ST-matching algorithm

NASA Astrophysics Data System (ADS)

Liu, Mingshan; Zhang, Wenbo; Zhou, Yuan; Xun, Yanqin; Wang, Rui

2017-07-01

Since the study of fuel consumptions is of great importance and the related data is accessible, many researches about factors affecting fuel consumptions have appeared.To sum up, the driving style of drivers, automobile emissions and the type of the routes are the mainly three factors.Classification is relatively single.In order to improve the classification accuracy' this text studies that there exist some special roads,when drivers drive through them,their fuel consumptions will be similar because of road qualities.To achieve this goal, the first step is to calculate fuel consumptions per 100km of all city roads.Recognizing and examining special roads based on the ST-Matching algorithm.Third is to analyze road qualities of special roads like the length of roads, the speed of driving, and compare them with other common roads.Then we choose 4 cases to analyze. We find that when driving through special roads, fuel consumptions would be similar because of road qualities.Besides, the average length of special roads is longer than common roads' and the mean velocity, the speed of getting and off special roads are faster than common roads'.The findings in this paper can filter out special road segments as noisy data in the study of relationship between driving styles and fuel consumptions,and it also has very high practical significance on recommending fuel-efficient paths.

Interprofessional care in intensive care settings and the factors that impact it: results from a scoping review of ethnographic studies.

PubMed

Paradis, Elise; Leslie, Myles; Gropper, Michael A; Aboumatar, Hanan J; Kitto, Simon; Reeves, Scott

2013-12-01

At the heart of safe cultures are effective interactions within and between interprofessional teams. Critical care clinicians see severely ill patients who require coordinated interprofessional care. In this scoping review, we asked: "What do we know about processes, relationships, organizational and contextual factors that shape the ability of clinicians to deliver interprofessional care in adult ICUs?" Using the 5-stage process established by Levac et al. (2010), we reviewed 981 abstracts to identify ethnographic articles that shed light on interprofessional care in the intensive care unit. The quality of selected articles is assessed using best practices in ethnographic research; their main insights evaluated in light of an interprofessional framework developed by Reeves et al (Interprofessional Teamwork for Health and Social Care. San Francisco, CA: Wiley-Blackwell; 2010). Overall, studies were of mixed quality, with an average (SD) score of 5.8 out of 10 (1.77). Insights into intensive care unit cultures include the importance of paying attention to workflow, the nefarious impact of hierarchical relationships, the mixed responses to protocols imposed from the top down, and a general undertheorization of sex and race. This review highlights several lessons for safe cultures and argues that more needs to be known about the context of critical care if quality and safety interventions are to succeed. Copyright © 2013 Elsevier Inc. All rights reserved.

Feasibility model study for Blumbangreksa product model based on lean startup method

NASA Astrophysics Data System (ADS)

Pakpahan, A. K.; Dewobroto, W. S.; Pratama, R. Y.

2017-12-01

Based on the data from Ministry of Maritime Affairs and Fisheries in 2015, the productivity of shrimp farmers in Indonesia is still below China, India and Thailand, because of the low survival rate of shrimp seeds were planted in Indonesia. Water quality factors become a significant factor that increasesthe survival rate of shrimp seeds plantation, therefore team of PT. Atnic EkoteknoWicaksana create a tool called Blumbangreksa that able to monitor water quality of shrimp farms, measure temperature, salinity, pH, DO (dissolved oxygen), TDS (total dissolve solid) in water and moist air over the surface of the water and GSM -based and Internet of things. Based on the research results, unique value proposition of Blumbangreksa products is the measurement result of water quality are accurate, real-time measurements, based on Internet of things and have the ability measurements at once. Based on the feasibility study using the opportunity assessment of Marty Cagan, it can be seen that the product has fulfilled ten elements of assessment opportunity, so Blumbangreksa products are considered feasible. Initial investment fund of Blumbangreksa products is Rp 1,369,856,574, with profitability index of 1:51 and average breakeven products each year as many as 18 products are sold, and the payback period for 4 years and 2 months, therefore the business of Blumbangreksa product is feasible.

The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies.

PubMed

Menzies, Nicolas A; Suharlim, Christian; Geng, Fangli; Ward, Zachary J; Brenzel, Logan; Resch, Stephen C

2017-10-06

Evidence on immunization costs is a critical input for cost-effectiveness analysis and budgeting, and can describe variation in site-level efficiency. The Expanded Program on Immunization Costing and Financing (EPIC) Project represents the largest investigation of immunization delivery costs, collecting empirical data on routine infant immunization in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. We developed a pooled dataset from individual EPIC country studies (316 sites). We regressed log total costs against explanatory variables describing service volume, quality, access, other site characteristics, and income level. We used Bayesian hierarchical regression models to combine data from different countries and account for the multi-stage sample design. We calculated output elasticity as the percentage increase in outputs (service volume) for a 1% increase in inputs (total costs), averaged across the sample in each country, and reported first differences to describe the impact of other predictors. We estimated average and total cost curves for each country as a function of service volume. Across countries, average costs per dose ranged from $2.75 to $13.63. Average costs per child receiving diphtheria, tetanus, and pertussis ranged from $27 to $139. Within countries costs per dose varied widely-on average, sites in the highest quintile were 440% more expensive than those in the lowest quintile. In each country, higher service volume was strongly associated with lower average costs. A doubling of service volume was associated with a 19% (95% interval, 4.0-32) reduction in costs per dose delivered, (range 13% to 32% across countries), and the largest 20% of sites in each country realized costs per dose that were on average 61% lower than those for the smallest 20% of sites, controlling for other factors. Other factors associated with higher costs included hospital status, provision of outreach services, share of effort to management, level of staff training/seniority, distance to vaccine collection, additional days open per week, greater vaccination schedule completion, and per capita gross domestic product. We identified multiple features of sites and their operating environment that were associated with differences in average unit costs, with service volume being the most influential. These findings can inform efforts to improve the efficiency of service delivery and better understand resource needs.

Study on characteristics of the aperture-averaging factor of atmospheric scintillation in terrestrial optical wireless communication

NASA Astrophysics Data System (ADS)

Shen, Hong; Liu, Wen-xing; Zhou, Xue-yun; Zhou, Li-ling; Yu, Long-Kun

2018-02-01

In order to thoroughly understand the characteristics of the aperture-averaging effect of atmospheric scintillation in terrestrial optical wireless communication and provide references for engineering design and performance evaluation of the optics system employed in the atmosphere, we have theoretically deduced the generally analytic expression of the aperture-averaging factor of atmospheric scintillation, and numerically investigated characteristics of the apertureaveraging factor under different propagation conditions. The limitations of the current commonly used approximate calculation formula of aperture-averaging factor have been discussed, and the results showed that the current calculation formula is not applicable for the small receiving aperture under non-uniform turbulence link. Numerical calculation has showed that aperture-averaging factor of atmospheric scintillation presented an exponential decline model for the small receiving aperture under non-uniform turbulent link, and the general expression of the model was given. This model has certain guiding significance for evaluating the aperture-averaging effect in the terrestrial optical wireless communication.

Grain and tortilla quality in landraces and improved maize grown in the highlands of Mexico.

PubMed

Vázquez-Carrillo, Gricelda; García-Lara, Silverio; Salinas-Moreno, Yolanda; Bergvinson, David J; Palacios-Rojas, Natalia

2011-06-01

The maize produced in the highlands of Mexico (>2,400 masl) is generally not accepted by the flour and masa and tortilla industry. The objective of this work was to evaluate the grain quality and tortilla properties of maize landraces commonly grown in the highlands of Mexico and compare them with improved germplasm (hybrids). Germplasm analysis included 11 landraces, 32 white hybrids, and six yellow hybrids. Grain quality was analyzed for a range of physical and chemical factors, as well as for alkaline cooking quality. Landrace grains tended to be heterogeneous in terms of size, hardness and color. All landraces had soft-intermediate grains with an average flotation index (FI) of 61%. In contrast, hybrid grains were homogenous in size and color, and harder than landrace grains, with a FI of 38%. Protein, free sugars, oil and phenolic content in landraces were higher than in the hybrids. Significant correlations were found between phenolic content and tortilla color (r= -0.60; p<0.001). Three landraces were identified as appropriate for the masa and tortilla industry, while all the hybrids evaluated fulfilled the requirements of this industry.

Psychosocial aspect of quality of life among working and unemployed nurses and midwives.

PubMed

Czekirda, Marta; Chruściel, Paweł; Czekirda, Neomi; Jarosz, Mirosław J

2017-09-21

The objective of the study was to explain differences in the subjective evaluation of the psychological and social aspects of quality of life in a group of working and unemployed nurses and midwives. The survey was conducted in a group of 620 professionally-active and inactive people (315 nurses and 305 midwives), selected by random stratified-systematic sampling. The tool used to gather empirical material was the standardized questionnaire WHOQoL-100. Professionally-active nurses evaluated the mental domain less favourably (M=12.33), compared with unemployed nurses (M=12.73), and the difference between average values was statistically significant (p=.043). It is also worth noting that in the group of midwives there were significant differences in each discussed domain. The unemployed respondents evaluated more positively the overall quality of life (M=14.29; p=.005) and the mental domain (M=12.85; p=.009), while the social domain was evaluated less favourably by the professionally-active midwives (M=12.73; p=.022). Paradoxically, those who were unemployed made slightly more positive evaluations in comparison with the professionally active. Professional work is not a factor preferably affecting the quality of life and its psychosocial dimension. The higher quality of life of the unemployed respondents may result from the buffering impact of social support.

Willingness to pay for safe drinking water: A contingent valuation study in Jacksonville, FL.

PubMed

Chatterjee, Chiradip; Triplett, Russell; Johnson, Christopher K; Ahmed, Parvez

2017-12-01

A surprising number of U.S. cities have drinking water with unhealthy levels of chemicals and contaminants. The city of Jacksonville (Florida), the location for this study, owns the dubious distinction of being ranked among the worst major American cities in water quality according to water quality tests conducted between 2005 and 2009 by the Environmental Working Group (EWG). This report of toxic chemicals in the Jacksonville water supply generated considerable negative publicity and coincides with a frequent and common complaint among residents of foul-smelling water. System revenues from water supply and program subsidies from government are often inadequate in mitigating the problems, perceived or real, with water quality. Therefore, this paper investigates how much residents will be willing to pay for improvements in the quality of tap water. The commonly known economic metric willingness-to-pay (WTP) is applied to estimate any possible rate hikes public utility can assess in any effort to improve real or perceived water quality. The study shows that the estimated weighted average of WTP is $6.22, which can be added to the regular water bill without eliciting much negative reaction from residents. Evidence shows that factors such as trust in authorities, health concerns, family structure, and education significantly impact the WTP. Published by Elsevier Ltd.

Evaluation of Aesthetic and Quality-of-Life Results after Immediate Breast Reconstruction with Definitive Form-Stable Anatomical Implants.

PubMed

Kuroda, Flavia; Urban, Cicero; Zucca-Matthes, Gustavo; de Oliveira, Vilmar Marques; Arana, Gabriel Hubner; Iera, Marco; Rietjens, Mario; Santos, Gabriela; Spagnol, Caroline; de Lima, Rubens Silveira

2016-02-01

Although there are many reports on different techniques in breast reconstruction, there are few data regarding immediate breast reconstruction with definitive form-stable anatomical implants in terms of aesthetics and quality-of-life outcomes. Ninety-four patients underwent mastectomy with immediate breast reconstruction using anatomical implants and contralateral symmetrization. Aesthetic results were evaluated by three different methods: the patient's self-report, the assessment of four independent specialists (two breast surgeons and two plastic surgeons from different institutions), and the BCCT.core software. Quality of life was evaluated by means of the BREAST-Q instrument. Average age ± SD was 52.1 ± 11.6 years. Most of patients had medium size breasts and T1 tumors. Patients had evaluated their aesthetic results better than did software and specialists. There was no significant difference in the comparison between software and specialist's evaluation. Multifactorial analysis showed that age older than 70 years and radiotherapy were significant risk factors for poor aesthetic outcomes after immediate breast reconstruction with implants. Considering quality of life, most of the patients were satisfied with their outcome and psychosocial and sexual well-being. Immediate breast reconstruction with implants and contralateral symmetrization had a positive impact on the quality of life and showed satisfactory outcomes when evaluated by subjective and objective methods.

Designing and evaluating the MULTICOM protein local and global model quality prediction methods in the CASP10 experiment

PubMed Central

2014-01-01

Background Protein model quality assessment is an essential component of generating and using protein structural models. During the Tenth Critical Assessment of Techniques for Protein Structure Prediction (CASP10), we developed and tested four automated methods (MULTICOM-REFINE, MULTICOM-CLUSTER, MULTICOM-NOVEL, and MULTICOM-CONSTRUCT) that predicted both local and global quality of protein structural models. Results MULTICOM-REFINE was a clustering approach that used the average pairwise structural similarity between models to measure the global quality and the average Euclidean distance between a model and several top ranked models to measure the local quality. MULTICOM-CLUSTER and MULTICOM-NOVEL were two new support vector machine-based methods of predicting both the local and global quality of a single protein model. MULTICOM-CONSTRUCT was a new weighted pairwise model comparison (clustering) method that used the weighted average similarity between models in a pool to measure the global model quality. Our experiments showed that the pairwise model assessment methods worked better when a large portion of models in the pool were of good quality, whereas single-model quality assessment methods performed better on some hard targets when only a small portion of models in the pool were of reasonable quality. Conclusions Since digging out a few good models from a large pool of low-quality models is a major challenge in protein structure prediction, single model quality assessment methods appear to be poised to make important contributions to protein structure modeling. The other interesting finding was that single-model quality assessment scores could be used to weight the models by the consensus pairwise model comparison method to improve its accuracy. PMID:24731387

Designing and evaluating the MULTICOM protein local and global model quality prediction methods in the CASP10 experiment.

PubMed

Cao, Renzhi; Wang, Zheng; Cheng, Jianlin

2014-04-15

Protein model quality assessment is an essential component of generating and using protein structural models. During the Tenth Critical Assessment of Techniques for Protein Structure Prediction (CASP10), we developed and tested four automated methods (MULTICOM-REFINE, MULTICOM-CLUSTER, MULTICOM-NOVEL, and MULTICOM-CONSTRUCT) that predicted both local and global quality of protein structural models. MULTICOM-REFINE was a clustering approach that used the average pairwise structural similarity between models to measure the global quality and the average Euclidean distance between a model and several top ranked models to measure the local quality. MULTICOM-CLUSTER and MULTICOM-NOVEL were two new support vector machine-based methods of predicting both the local and global quality of a single protein model. MULTICOM-CONSTRUCT was a new weighted pairwise model comparison (clustering) method that used the weighted average similarity between models in a pool to measure the global model quality. Our experiments showed that the pairwise model assessment methods worked better when a large portion of models in the pool were of good quality, whereas single-model quality assessment methods performed better on some hard targets when only a small portion of models in the pool were of reasonable quality. Since digging out a few good models from a large pool of low-quality models is a major challenge in protein structure prediction, single model quality assessment methods appear to be poised to make important contributions to protein structure modeling. The other interesting finding was that single-model quality assessment scores could be used to weight the models by the consensus pairwise model comparison method to improve its accuracy.

Growth and development and their environmental and biological determinants.

PubMed

da Rocha Neves, Kelly; de Souza Morais, Rosane Luzia; Teixeira, Romero Alves; Pinto, Priscilla Avelino Ferreira

2016-01-01

To investigate child growth, cognitive/language development, and their environmental and biological determinants. This was a cross-sectional, predictive correlation study with all 92 children aged 24-36 months who attended the municipal early childhood education network in a town in the Vale do Jequitinhonha region, in 2011. The socioeconomic profile was determined using the questionnaire of the Associação Brasileira de Empresas de Pesquisa. The socio-demographicand maternal and child health profiles were created through a self-prepared questionnaire. The height-for-age indicator was selected to represent growth. Cognitive/language development was assessed through the Bayley Scale of Infant and Toddler Development. The quality of educational environments was assessed by Infant/Toddler Environment Scale; the home environment was assessed by the Home Observation for Measurement of the Environment. The neighborhood quality was determined by a self-prepared questionnaire. A multivariate linear regression analysis was performed. Families were predominantly from socioeconomic class D, with low parental education. The prevalence of stunted growth was 14.1%; cognitive and language development were below average at 28.6% and 28.3%, respectively. Educational institutions were classified as inadequate, and 69.6% of homes were classified as presenting a risk for development. Factors such as access to parks and pharmacies and perceived security received the worst score regarding neighborhood environment. Biological variables showed a greater association with growth and environmental variables with development. The results showed a high prevalence of stunting and below-average results for cognitive/language development among the participating children. Both environmental and biological factors were related to growth and development. However, biological variables showed a greater association with growth, whereas environmental variables were associated with development. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Out-of-Field Dose Equivalents Delivered by Passively Scattered Therapeutic Proton Beams for Clinically Relevant Field Configurations

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

Wroe, Andrew; Centre for Medical Radiation Physics, University of Wollongong, Wollongong; Clasie, Ben

2009-01-01

Purpose: Microdosimetric measurements were performed at Massachusetts General Hospital, Boston, MA, to assess the dose equivalent external to passively delivered proton fields for various clinical treatment scenarios. Methods and Materials: Treatment fields evaluated included a prostate cancer field, cranial and spinal medulloblastoma fields, ocular melanoma field, and a field for an intracranial stereotactic treatment. Measurements were completed with patient-specific configurations of clinically relevant treatment settings using a silicon-on-insulator microdosimeter placed on the surface of and at various depths within a homogeneous Lucite phantom. The dose equivalent and average quality factor were assessed as a function of both lateral displacement frommore » the treatment field edge and distance downstream of the beam's distal edge. Results: Dose-equivalent value range was 8.3-0.3 mSv/Gy (2.5-60-cm lateral displacement) for a typical prostate cancer field, 10.8-0.58 mSv/Gy (2.5-40-cm lateral displacement) for the cranial medulloblastoma field, 2.5-0.58 mSv/Gy (5-20-cm lateral displacement) for the spinal medulloblastoma field, and 0.5-0.08 mSv/Gy (2.5-10-cm lateral displacement) for the ocular melanoma field. Measurements of external field dose equivalent for the stereotactic field case showed differences as high as 50% depending on the modality of beam collimation. Average quality factors derived from this work ranged from 2-7, with the value dependent on the position within the phantom in relation to the primary beam. Conclusions: This work provides a valuable and clinically relevant comparison of the external field dose equivalents for various passively scattered proton treatment fields.« less

Quantifying Training Loads in Contemporary Dance.

PubMed

Jeffries, Annie C; Wallace, Lee; Coutts, Aaron J

2017-07-01

To describe the training demands of contemporary dance and determine the validity of using the session rating of perceived exertion (sRPE) to monitor exercise intensity and training load in this activity. In addition, the authors examined the contribution of training (ie, accelerometry and heart rate) and non-training-related factors (ie, sleep and wellness) to perceived exertion during dance training. Training load and ActiGraphy for 16 elite amateur contemporary dancers were collected during a 49-d period, using heart-rate monitors, accelerometry, and sRPE. Within-individual correlation analysis was used to determine relationships between sRPE and several other measures of training intensity and load. Stepwise multiple regressions were used to determine a predictive equation to estimate sRPE during dance training. Average weekly training load was 4283 ± 2442 arbitrary units (AU), monotony 2.13 ± 0.92 AU, strain 10677 ± 9438 AU, and average weekly vector magnitude load 1809,707 ± 1015,402 AU. There were large to very large within-individual correlations between training-load sRPE and various other internal and external measures of intensity and load. The stepwise multiple-regression analysis also revealed that 49.7% of the adjusted variance in training-load sRPE was explained by peak heart rate, metabolic equivalents, soreness, motivation, and sleep quality (y = -4.637 + 13.817%HR peak + 0.316 METS + 0.100 soreness + 0.116 motivation - 0.204 sleep quality). The current findings demonstrate the validity of the sRPE method for quantifying training load in dance, that dancers undertake very high training loads, and a combination of training and nontraining factors contribute to perceived exertion in dance training.

Quality of life of middle-aged adults in single households in South Korea.

PubMed

Song, Hyun Jin; Park, Susan; Kwon, Jin-Won

2018-04-18

The number of single households has increased worldwide with middle-aged people in such households indicating the highest increase. However, there is a lack of studies on the topic. This study estimated the quality of life (QOL) by household type for middle-aged Korean adults. We used the Korea National Health and Nutrition Examination Survey data from 2007 to 2015. QOL was analyzed using EQ-5D 3-level, and demographic and health-related variables were included as confounders. The households were divided into single household, married couple without child, other one-generation, married couple with child, single parent with child, other two-generation, and three-generation. Logistic regression using level, strata, and sample weight of data was performed based on average QOL. This study included 18,147 responders aged 45-64 years, with single households constituting 5.7%. Single households having average or less QOL were 48.4%, with men and women constituting 40.1 and 53.3%, respectively. After adjusting socioeconomic factors and health-related factors, the odds ratio (OR) of single households was 1.375 (95% CI 1.122-1.684) compared to the three-generation group. According to the sex, the OR of single households with men was higher (OR 1.552, 95% CI 1.121-2.149). However, no significance was found in women. The study results revealed that middle-aged people in single households had low QOL than those in multi-person households. The trend was significantly observable in men than in women. Because middle-aged adults might transform into elderly with low QOL, program development and social support for middle-aged adults in single households should be provided.

[Quality of Outcome after Primary Total Hip Replacement at a Maximum Care Hospital in Relation to Preoperative Influencing Factors].

PubMed

Osmanski-Zenk, K; Steinig, N S; Glass, Ä; Mittelmeier, W; Bader, R

2015-12-01

As the need for joint replacements will continue to rise, the outcome of primary total hip replacement (THR) must be improved and stabilised at a high level. In this study, we investigated whether pre-operative risk factors, such as gender, age and body weight at the time of the surgery or a restricted physical status (ASA-Status > 2 or Kellgren and Lawrence grade > 2) have a negative influence on the post-operative results or on patient satisfaction. Retrospective data collection and a prospective interview were performed with 486 patients who underwent primary total hip replacement between January 2007 and December 2010 in our hospital. The patients' satisfaction and quality of life were surveyed with the WOMAC-Score, SF-36 and EuroQol-5. Differences between more than two independent spot tests were tested with the non-parametric Kruskal-Wallis test. Differences between two independent spot tests were tested with the non-parametric Mann-Whitney U test. The frequencies were reported and odds ratios calculated. The confidence interval was set at 95 %. The level of significance was p < 0.05. The average WOMAC-Score was 77.1 and the total score of the SF-36 was 66.9 points. The patients declared an average EuroQol Index of 0.81. Our data show that the patients' gender did not influence the duration of surgery or the scores. However, female patients tended to exhibit more postoperative complications. However, increased patient age at the time of surgery was associated with an increased OR for duration of surgery, length of stay and risk of complications. Patients who had a normal body weight at time of the surgery showed better peri- and post-operative results. We showed that the preoperative estimated Kellgren and Lawrence grade had a significant influence on the duration of surgery. The ASA classification influenced the duration of surgery as well the length of stay and the rate of complications. The quality of results after primary THR depends on preoperative factors. Existing comorbidities have a significant influence on the duration of surgery and therefore on the perioperative rate of complications and the postoperative outcome. Despite improvements in the functional and subjective outcome after primary THR, an adverse preoperative symptomatic status is associated with less favourable postoperative results. Georg Thieme Verlag KG Stuttgart · New York.