Missionary Zeal: Some Problems with the Rhetoric, Vision and Approach of the AHELO Project

ERIC Educational Resources Information Center

Ashwin, Paul

2015-01-01

The OECD's Assessment of Higher Education Learning Outcomes (AHELO) project is an important contribution to discussions of how to define and measure the quality of global higher education. There is a genuine need for quality measures that can help to ensure students have equitable access to high-quality higher education wherever they study but do…

An Argument Approach to Observation Protocol Validity

ERIC Educational Resources Information Center

Bell, Courtney A.; Gitomer, Drew H.; McCaffrey, Daniel F.; Hamre, Bridget K.; Pianta, Robert C.; Qi, Yi

2012-01-01

This article develops a validity argument approach for use on observation protocols currently used to assess teacher quality for high-stakes personnel and professional development decisions. After defining the teaching quality domain, we articulate an interpretive argument for observation protocols. To illustrate the types of evidence that might…

Healthcare service quality: towards a broad definition.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

A Systems Analysis to Define the Types of Rations Needed to Support Amphibious Operations

DTIC Science & Technology

1985-09-01

Navy and the individual Marine) and in cost. • RATION QUALITY - High Acceptance - Maximize Quality - Minimize Menu Cycle As one of four...maintaining high customer acceptance. Carbohydrate-enhanced A- or B-Ration menus would be provided to embarked (shipboard) Marines for approximately 72...assistance; 2) the typical dietery myth that high protein meals are what will "help me perform at my peak" would be circumvented; the Marine would

How to Improve the Design and Delivery of High-Quality Technical Assistance. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2005

2005-01-01

Educators often use the term technical assistance to define services delivered or received in the pursuit of school- and district-improvement initiatives. More specifically, technical assistance can be defined as any assistance that identifies, selects, or designs research-based solutions and practices to support school improvement (Mattson &…

Choice in School: Its Importance and Scope

ERIC Educational Resources Information Center

Yagnamurthy, Sreekanth

2013-01-01

The author reviews various factors defining school choice, and school curricula. A key assumption behind the rhetoric logic of school choice is the notion that parents actually choose from schools of varying quality. If parents choose from high-quality schools, choice policy will enhance educational opportunities. If, however, the considered…

Approaching Common Ground: Defining Quality in Online Education

ERIC Educational Resources Information Center

Mitchell, Regina L. Garza

2010-01-01

The notion of quality in regard to teaching and learning has always been highly debatable. Is it best measured by qualitative or quantitative measures? Summative or formative assessments? Comparative or independent studies? As someone deeply involved with online education for many years, the author continues to seek definitive answers. During her…

Defining Steamside Management Zones or Riparian Buffers

Treesearch

Thomas M. Williams; Donald J. Lipscomb; Christopher J. Post

2004-01-01

Forestry Best Management Practices (BMPs) have been highly successful in protecting water quality throughout the Southeast. Numerous studies have found them to be effective in protecting water quality. Despite being mostly voluntary, compliance is generally about 90 percent across the region. Streamside Management Zones (SMZs) or riparian buffers are specified for...

Building Character through Literacy with Children's Literature

ERIC Educational Resources Information Center

Almerico, Gina M.

2014-01-01

Character education is described as curriculum specifically developed to teach children about the quality and traits of good character. One means in which children can learn about good character is through the pages of high quality children's literature. In this study, the author defines the characteristics of an effective character development…

The Relationship between Preschool Programming and School Readiness for Rural Children Entering Kindergarten

ERIC Educational Resources Information Center

Conway, Donna M.

2010-01-01

Children in the researcher's rural school district have limited opportunities for a high quality preschool programming that prepares them for school readiness. Quality preschool programming is defined as teachers with proper qualifications and training, small class size, stimulating curriculum, and parent involvement. The theoretical foundation…

[Phantom studies of ultrasound equipment for quality improvement in breast diagnosis].

PubMed

Madjar, H; Mundinger, A; Lattermann, U; Gufler, H; Prömpeler, H J

1996-04-01

According to the German guidelines for quality control of ultrasonic equipment, the following conditions are required for breast ultrasound: A transducer frequency between 5-7.5 MHz and a minimum field of view of 5 cm. Satisfactory images must be obtained in a depth between 0.5 and 4 cm with a wide tolerance of the focal zones. This allows the use of poor quality equipment which does not produce satisfactory image quality and it excludes a number of high frequency and high resolution transducers with a field of view below 5 cm. This study with a test phantom was performed to define image quality objectively. Sixteen ultrasound instruments in different price categories were used to perform standardized examinations on a breast phantom model 550 (ATS Laboratories, Bridgeport, USA). Contrast and spatial resolution in different penetration depths were investigated on cyst phantoms from 1-4 mm diameter and wire targets with defined distances between 0.5-3 mm 4 investigations reported the images. A positive correlation was seen between price category and image quality. This study demonstrates that transducer frequency and image geometry do not allow sufficient quality control. An improvement of ultrasound diagnosis is only possible if equipment guidelines are based on standard examinations with test phantoms.

Soft qualities in healthcare. Method and tools for soft qualities design in hospitals' built environments.

PubMed

Capolongo, S; Bellini, E; Nachiero, D; Rebecchi, A; Buffoli, M

2014-01-01

The design of hospital environments is determined by functional requirements and technical regulations, as well as numerous protocols, which define the structure and system characteristics that such environments need to achieve. In order to improve people's well-being and the quality of their experience within public hospitals, design elements (soft qualities) are added to those 'necessary' features. The aim of this research has been to experiment a new design process and also to create health care spaces with high environmental quality and capable to meet users' emotional and perceptual needs. Such needs were investigated with the help of qualitative research tools and the design criteria for one of these soft qualities - colour - were subsequently defined on the basis of the findings. The colour scheme design for the new San Paolo Hospital Emergency Department in Milan was used as case study. Focus groups were fundamental in defining the project's goals and criteria. The issues raised have led to believe that the proper procedure is not the mere consultation of the users in order to define the goals: users should rather be involved in the whole design process and become co-agents of the choices that determine the environment characteristics, so as to meet the quality requirements identified by the users themselves. The case study has shown the possibility of developing a designing methodology made by three steps (or operational tools) in which users' groups are involved in the choices, loading to plan the environments where compliance with expectations is already implied and verified by means of the process itself. Thus, the method leads to the creation of soft qualities in Healthcare.

High-quality Italian rice cultivars: chemical indices of ageing and aroma quality.

PubMed

Griglione, Alessandra; Liberto, Erica; Cordero, Chiara; Bressanello, Davide; Cagliero, Cecilia; Rubiolo, Patrizia; Bicchi, Carlo; Sgorbini, Barbara

2015-04-01

The volatile fractions of six Italian high-quality rice cultivars were investigated by HS-SPME-GC-MS to define fingerprinting and identify chemical markers and/or indices of ageing and aroma quality. In particular, four non-aromatic (Carnaroli, Carnise, Cerere and Antares) and two aromatic (Apollo and Venere) rices, harvested in 2010 and 2011, were monitored over 12months. Twenty-five aroma components were considered and, despite considerable inter-annual variability, some of them showed similar trends over time, including 2-(E)-octenal as a marker of ageing for all cultivars, and heptanal, octanal and 2-ethyl hexanol as cultivar-specific indicators. The area ratios 2-acetyl-1-pyrroline/1-octen-3-ol, for Venere, and 3-methyl-1-butanol/2-methyl-1-butanol, for Apollo, were also found to act as ageing indices. Additional information on release of key-aroma compounds was also obtained from quantitation and its dependence on grain shape and chemical composition. Heptanal/1-octen-3-ol and heptanal/octanal ratios were also defined as characterising the aroma quality indices of the six Italian rice cultivars investigated. Copyright © 2014 Elsevier Ltd. All rights reserved.

Realization of high quality production schedules: Structuring quality factors via iteration of user specification processes

NASA Technical Reports Server (NTRS)

Hamazaki, Takashi

1992-01-01

This paper describes an architecture for realizing high quality production schedules. Although quality is one of the most important aspects of production scheduling, it is difficult, even for a user, to specify precisely. However, it is also true that the decision as to whether a scheduler is good or bad can only be made by the user. This paper proposes the following: (1) the quality of a schedule can be represented in the form of quality factors, i.e. constraints and objectives of the domain, and their structure; (2) quality factors and their structure can be used for decision making at local decision points during the scheduling process; and (3) that they can be defined via iteration of user specification processes.

Can exercise improve self esteem in children and young people? A systematic review of randomised controlled trials

PubMed Central

Ekeland, E; Heian, F; Hagen, K; Coren, E

2005-01-01

Twenty three randomised controlled trials were analysed. A synthesis of several small, low quality trials indicates that exercise may have short term beneficial effects on self esteem in children and adolescents. However, high quality research on defined populations with adequate follow up is needed. PMID:16244186

New track shift safety limits for high-speed rail applications

DOT National Transportation Integrated Search

2001-11-01

Track shift is defined as the permanent lateral distortion of a track segment due to high vehicle induced lateral loads. Excessive track shift can lead to unsafe conditions leading to ride quality deterioration or vehicle derailment. Current track sh...

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

Park, C; Zhang, H; Chen, Y

Purpose: Recently, compressed sensing (CS) based iterative reconstruction (IR) method is receiving attentions to reconstruct high quality cone beam computed tomography (CBCT) images using sparsely sampled or noisy projections. The aim of this study is to develop a novel baseline algorithm called Mask Guided Image Reconstruction (MGIR), which can provide superior image quality for both low-dose 3DCBCT and 4DCBCT under single mathematical framework. Methods: In MGIR, the unknown CBCT volume was mathematically modeled as a combination of two regions where anatomical structures are 1) within the priori-defined mask and 2) outside the mask. Then we update each part of imagesmore » alternatively thorough solving minimization problems based on CS type IR. For low-dose 3DCBCT, the former region is defined as the anatomically complex region where it is focused to preserve edge information while latter region is defined as contrast uniform, and hence aggressively updated to remove noise/artifact. In 4DCBCT, the regions are separated as the common static part and moving part. Then, static volume and moving volumes were updated with global and phase sorted projection respectively, to optimize the image quality of both moving and static part simultaneously. Results: Examination of MGIR algorithm showed that high quality of both low-dose 3DCBCT and 4DCBCT images can be reconstructed without compromising the image resolution and imaging dose or scanning time respectively. For low-dose 3DCBCT, a clinical viable and high resolution head-and-neck image can be obtained while cutting the dose by 83%. In 4DCBCT, excellent quality 4DCBCT images could be reconstructed while requiring no more projection data and imaging dose than a typical clinical 3DCBCT scan. Conclusion: The results shown that the image quality of MGIR was superior compared to other published CS based IR algorithms for both 4DCBCT and low-dose 3DCBCT. This makes our MGIR algorithm potentially useful in various on-line clinical applications. Provisional Patent: UF#15476; WGS Ref. No. U1198.70067US00.« less

Technology development of fabrication techniques for advanced solar dynamic concentrators

NASA Technical Reports Server (NTRS)

Richter, Scott W.

1991-01-01

The objective of the advanced concentrator program is to develop the technology that will lead to lightweight, highly reflective, accurate, scaleable, and long lived space solar dynamic concentrators. The advanced concentrator program encompasses new and innovative concepts, fabrication techniques, materials selection, and simulated space environmental testing. Fabrication techniques include methods of fabricating the substrates and coating substrate surfaces to produce high quality optical surfaces, acceptable for further coating with vapor deposited optical films. The selected materials to obtain a high quality optical surface include microsheet glass and Eccocoat EP-3 epoxy, with DC-93-500 selected as a candidate silicone adhesive and levelizing layer. The following procedures are defined: cutting, cleaning, forming, and bonding microsheet glass. Procedures are also defined for surface cleaning, and EP-3 epoxy application. The results and analyses from atomic oxygen and thermal cycling tests are used to determine the effects of orbital conditions in a space environment.

A Procedure for High Resolution Satellite Imagery Quality Assessment

PubMed Central

Crespi, Mattia; De Vendictis, Laura

2009-01-01

Data products generated from High Resolution Satellite Imagery (HRSI) are routinely evaluated during the so-called in-orbit test period, in order to verify if their quality fits the desired features and, if necessary, to obtain the image correction parameters to be used at the ground processing center. Nevertheless, it is often useful to have tools to evaluate image quality also at the final user level. Image quality is defined by some parameters, such as the radiometric resolution and its accuracy, represented by the noise level, and the geometric resolution and sharpness, described by the Modulation Transfer Function (MTF). This paper proposes a procedure to evaluate these image quality parameters; the procedure was implemented in a suitable software and tested on high resolution imagery acquired by the QuickBird, WorldView-1 and Cartosat-1 satellites. PMID:22412312

Schools Funding in Georgia: Changes, Problems and Analysis

ERIC Educational Resources Information Center

Maglakelidze, Shorena; Giorgobiani, Zurab; Shukakidze, Berika

2013-01-01

There is no fixed rule about how financial resources must be directed to the education sector. It is quite clear that the size of investment in the sector well defines the quality of education students are offered. It is highly important to define the amount of money, which is needed for effective functioning of schools and it is also important to…

Defining Virtual Interactions: A Taxonomy for Researchers and Practitioners

DTIC Science & Technology

1999-11-01

Engineering and Management of the Air Force Institute of Technology Air University Air Education and Training Command In Partial Fulfillment of the...information technology and produce the maximum benefits for all virtual components involved. Vlll DEFINING VIRTUAL INTERACTIONS: A TAXONOMY FOR...allow the human factor to maximize information exchange and provide high quality products to intelligence consumers. Applicability of this research In

Toward a System of Total Quality Management: Applying the Deming Approach to the Education Setting.

ERIC Educational Resources Information Center

McLeod, Willis B.; And Others

1992-01-01

Recently, the Petersburg (Virginia) Public Schools have moved away from a highly centralized organizational structure to a Total Quality Management system featuring shared decision making and school-based management practices. The district was guided by Deming's philosophy that all stakeholders should be involved in defining the level of products…

Design Aids for Real-Time Systems (DARTS)

NASA Technical Reports Server (NTRS)

Szulewski, P. A.

1982-01-01

Design-Aids for Real-Time Systems (DARTS) is a tool that assists in defining embedded computer systems through tree structured graphics, military standard documentation support, and various analyses including automated Software Science parameter counting and metrics calculation. These analyses provide both static and dynamic design quality feedback which can potentially aid in producing efficient, high quality software systems.

ASSESSING COASTAL WATERS OF AMERICAN SAMOA: TERRITORY-WIDE WATER QUALITY DATA PROVIDE A CRITICAL 'BIG-PICTURE' VIEW FOR THIS TROPICAL ARCHIPELAGO

EPA Science Inventory

The coastal waters of American Samoa’s 5 high islands (Tutuila, Aunu’u, Ofu, Olosega,and Ta’u) were surveyed in 2004 using a probabilistic design. Water quality data were collected from the near-shore coastal habitat, defined as all near-shore coastal waters including embayments,...

POSNA Quality Safety Value Initiative: From Vision to Implementation to Early Results.

PubMed

Waters, Peter M; Flynn, John M

2015-01-01

The POSNA Quality, Safety and Value Initiative (QSVI) formally started with POSNA board approval in early 2011. The initial vision statement was: "To lead in defining our members' value based clinical care. To partner with hospital based and orthopedic organizational efforts to guarantee safe, high quality outcomes for our patients. To communicate our initiatives and results cooperatively with payer, credentialing, and compliance organizations to improve pediatric orthopedic care in North America."

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China.

PubMed

Xu, Xianglong; Liu, Dengyuan; Zhang, Zhangyi; Sharma, Manoj; Zhao, Yong

2017-07-20

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1-3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women.

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China

PubMed Central

Liu, Dengyuan; Zhang, Zhangyi; Zhao, Yong

2017-01-01

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1–3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women. PMID:28726747

Recursive search method for the image elements of functionally defined surfaces

NASA Astrophysics Data System (ADS)

Vyatkin, S. I.

2017-05-01

This paper touches upon the synthesis of high-quality images in real time and the technique for specifying three-dimensional objects on the basis of perturbation functions. The recursive search method for the image elements of functionally defined objects with the use of graphics processing units is proposed. The advantages of such an approach over the frame-buffer visualization method are shown.

[Quality management in implementing specialist pediatric palliative home care in Lower Saxony, Germany].

PubMed

Kremeike, Kerstin; Eulitz, Nina; Sens, Brigitte; Geraedts, Max; Reinhardt, Dirk

2012-01-01

To provide comprehensive high-quality health care is a great challenge in the context of high specialisation and intensive costs. This problem becomes further aggravated in service areas with low patient numbers and low numbers of specialists. Therefore, a multidimensional approach to quality development was chosen in order to optimise the care of children and adolescents with life-limiting conditions in Lower Saxony, a German federal state with a predominantly rural infrastructure. Different service structures were implemented and a classification of service provider's specialisation was defined on the basis of existing references of professional associations. Measures to optimise care were implemented in a process-oriented manner. High-quality health care can be facilitated by carefully worded requirements concerning the quality of structures combined with optimally designed processes. Parts of the newly implemented paediatric palliative care structures are funded by the statutory health insurance. Copyright © 2012. Published by Elsevier GmbH.

The quantitative control and matching of an optical false color composite imaging system

NASA Astrophysics Data System (ADS)

Zhou, Chengxian; Dai, Zixin; Pan, Xizhe; Li, Yinxi

1993-10-01

Design of an imaging system for optical false color composite (OFCC) capable of high-precision density-exposure time control and color balance is presented. The system provides high quality FCC image data that can be analyzed using a quantitative calculation method. The quality requirement to each part of the image generation system is defined, and the distribution of satellite remote sensing image information is analyzed. The proposed technology makes it possible to present the remote sensing image data more effectively and accurately.

On the potential impact of the newly proposed quality factors on space radiation protection

NASA Technical Reports Server (NTRS)

Wilson, John W.; Townsend, Lawrence W.; Cucinotta, Francis A.

1987-01-01

The recently proposed changes in the defined quality factor hold great potential for easing some of the protection requirements from electrons and protons in the near-Earth environment. At the same time, the high Linear Energy Transfer (LET) components play an even more important role which must be further evaluated. Several recommendations are made which need to be addressed before these new quality factors can be implemented into space radiation potection practice.

Lessons Learned on Quality (of) Standards

NASA Astrophysics Data System (ADS)

Gerlich, Rainer; Gerlich, Ralf

2011-08-01

Standards are used to describe and ensure the quality of products, services and processes throughout almost all branches of industry, including the field of software engineering. Contractors and suppliers are obligated by their customers and certification authorities to follow a certain set of standards during development. For example, a customer can easier actively participate in and control the contractor's process when enforcing a standard process..However, as with any requirement, a standard may also impede the contractor or supplier in assuring actual quality of the product in the sense of fitness for the purpose intended by the customer.This is the case when a standard defines specific quality assurance activities requiring a considerable amount of effort while other more efficient but equivalent or even superior approaches are blocked. Then improvement of the ratio between cost and quality exceeding miniscule advances is heavily impeded.While in some parts being too specific in defining the mechanisms of the enforced process, standards are sometimes too weak in defining the principles or goals on control of product quality.Therefore this paper addresses the following issues: (1) Which conclusions can be drawn on the quality and efficiency of a standard? (2) If and how is it possible to improve or evolve a standard? (3) How well does a standard guide a user towards high quality of the end product?One conclusion is that the analyzed standards do interfere with technological innovation, though the standards leave a lot of freedom for concretization and are understood as technology-independent.Another conclusion is that standards are not only a matter of quality but also a matter of competitiveness of the industry depending on resulting costs and time-to- market. When the costs induced by a standard are not adequate to the achievable quality, industry encounters a significant disadvantage.

How Reuse Influences Productivity in Object-Oriented Systems

NASA Technical Reports Server (NTRS)

Basili, Victor R.; Briand, Lionel C.; Melo, Walcelio L.

1997-01-01

Although reuse is assumed to be especially valuable in building high quality software as well as in Object Oriented (OO) development, limited empirical evidence connects reuse with productivity and quality gains. The author's eight system study begins to define such benefits in an OO framework, most notably in terms of reduce defect density and rework as well as in increased productivity.

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

PubMed

Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

[The significance of meat quality in marketing].

PubMed

Kallweit, E

1994-07-01

Food quality in general and meat quality in particular are not only evaluated by means of objective quality traits but the entire production process is gaining more attention by the modern consumer. Due to this development quality programs were developed to define the majority of the processes in all production and marketing steps which are again linked by contracts. Not all of these items are quality relevant, but are concessions to ethic principles (animal welfare etc.). This is demonstrated by the example of Scharrel-pork production. The price differentiation at the pork market is still influenced predominantly by quantitative carcass traits. On the European market quality programs still are of minor significance. Premiums which are paid for high quality standards are more or less compensated by higher production costs and lower lean meat percentages, which must be expected in stress susceptible strains. The high efforts to establish quality programs, however, help to improve the quality level in general, and secure the market shares for local producers.

The process of managerial control in quality improvement initiatives.

PubMed

Slovensky, D J; Fottler, M D

1994-11-01

The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs.

Is It Time for Entrustable Professional Activities for Residency Program Directors?

PubMed

Bing-You, Robert G; Holmboe, Eric; Varaklis, Kalli; Linder, Jo

2017-06-01

Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position. Based on personal observations as PDs and communications with others in the academic medicine community, the authors used work in competency-based medical education to define a list of potential EPAs for PDs. The benefits of developing these EPAs include being able to define competencies for PDs using a deconstructive process, highlighting the increasingly important role PDs play in leading high-quality graduate medical education programs, using EPAs as a framework to assess PD performance and provide feedback, allowing PDs to focus their professional development efforts on the most important areas for their work, and helping guide the PD recruitment and selection processes.

Facilitating the Authoring of Multimedia Social Problem Solving Skills Instructional Modules

ERIC Educational Resources Information Center

Boujarwah, Fatima A.

2012-01-01

Difficulties in social skills are generally considered defining characteristics of High-Functioning Autism (HFA). These difficulties interfere with the educational experiences and quality of life of individuals with HFA, and interventions must be highly individualized to be effective. I explore ways technologies may play a role in assisting…

Current Status of Multidisciplinary Care in Psoriatic Arthritis in Spain: NEXUS 2.0 Project.

PubMed

Queiro, Rubén; Coto, Pablo; Joven, Beatriz; Rivera, Raquel; Navío Marco, Teresa; de la Cueva, Pablo; Alvarez Vega, Jose Luis; Narváez Moreno, Basilio; Rodriguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Rodríguez, Jesús; Notario, Jaume; Pujol Busquets, Manel; García Font, Mercè; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea-Arana, Ana; Hergueta, Merce; López Montilla, M Dolores; Vélez García-Nieto, Antonio; Maceiras, Francisco; Rodríguez Pazos, Laura; Rubio Romero, Esteban; Rodríguez Fernandez Freire, Lourdes; Luelmo, Jesús; Gratacós, Jordi

2018-02-26

1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

NWTC Engineer Wins Prestigious International Electrotechnical Commission

Science.gov Websites

IEC TC88, the technical committee responsible for writing the international standards for wind energy levels of safety and by defining test methods that provide high-quality, reproducible test results."

Systematic Review and Quality Appraisal of Practice Guidelines for Self-Harm in Children and Adolescents.

PubMed

Courtney, Darren B; Duda, Stephanie; Szatmari, Peter; Henderson, Joanna; Bennett, Kathryn

2018-05-02

This study aimed to systematically identify and appraise clinical practice guidelines (CPGs) relating to the assessment and management of suicide risk and self-harm in children and adolescents. Our research question is as follows: For young people (under 18 years old) presenting to clinical care with suicide ideation or a history of self-harm, what is the quality of up-to-date CPGs? Using the PRISMA format, we systematically identified CPGs meeting our inclusion and exclusion criteria. Subsequently, two independent raters conducted appraisals of the eligible CPGs using the Appraisal of Guidelines for Research and Evaluation II instrument. CPGs were then classified as "poor quality," "minimum quality," and "high quality" using operationally defined criteria developed a priori. We identified 10 eligible CPGs published or renewed between 2005 and May 2017. Only the long-term management of self-harm CPGs produced by the National Institute for Health and Care Excellence met "high-quality" criteria. Despite multiple options of CPGs published to choose from, only one was identified as "high quality," where bias is adequately minimized. Clinicians are advised to direct resources to implementing the "high-quality" CPG. © 2018 The American Association of Suicidology.

Monitoring the sensory quality of canned white asparagus through cluster analysis.

PubMed

Arana, Inés; Ibañez, Francisco C; Torre, Paloma

2016-05-01

White asparagus is one of the 30 vegetables most consumed in the world. This paper unifies the stages of their sensory quality control. The aims of this work were to describe the sensory properties of canned white asparagus and their quality control and to evaluate the applicability of agglomerative hierarchical clustering (AHC) for classifying and monitoring the sensory quality of manufacturers. Sixteen sensory descriptors and their evaluation technique were defined. The sensory profile of canned white asparagus was high flavor characteristic, little acidity and bitterness, medium firmness and very light fibrosity, among other characteristics. The dendrogram established groups of manufacturers that had similar scores in the same set of descriptors, and each cluster grouped the manufacturers that had a similar quality profile. The sensory profile of canned white asparagus was clearly defined through the intensity evaluation of 16 descriptors, and the sensory quality report provided to the manufacturers is in detail and of easy interpretation. AHC grouped the manufacturers according to the highest quality scores in certain descriptors and is a useful tool because it is very visual. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

Application of response surface methodology to maximize the productivity of scalable automated human embryonic stem cell manufacture.

PubMed

Ratcliffe, Elizabeth; Hourd, Paul; Guijarro-Leach, Juan; Rayment, Erin; Williams, David J; Thomas, Robert J

2013-01-01

Commercial regenerative medicine will require large quantities of clinical-specification human cells. The cost and quality of manufacture is notoriously difficult to control due to highly complex processes with poorly defined tolerances. As a step to overcome this, we aimed to demonstrate the use of 'quality-by-design' tools to define the operating space for economic passage of a scalable human embryonic stem cell production method with minimal cell loss. Design of experiments response surface methodology was applied to generate empirical models to predict optimal operating conditions for a unit of manufacture of a previously developed automatable and scalable human embryonic stem cell production method. Two models were defined to predict cell yield and cell recovery rate postpassage, in terms of the predictor variables of media volume, cell seeding density, media exchange and length of passage. Predicted operating conditions for maximized productivity were successfully validated. Such 'quality-by-design' type approaches to process design and optimization will be essential to reduce the risk of product failure and patient harm, and to build regulatory confidence in cell therapy manufacturing processes.

The Strengths and Weaknesses of Total Quality Management in Higher Education.

ERIC Educational Resources Information Center

Hazzard, Terry

This paper defines Total Quality Management (TQM), discusses its origins, and identifies its strengths and weaknesses as they apply to higher education. The paper defines TQM as a philosophy of organizations that defines quality and improves organizational performance and administrative systems. The system originated from statistical quality…

Power quality improvement by using STATCOM control scheme in wind energy generation interface to grid

NASA Astrophysics Data System (ADS)

Kirmani, Sheeraz; Kumar, Brijesh

2018-01-01

“Electric Power Quality (EPQ) is a term that refers to maintaining the near sinusoidal waveform of power distribution bus voltages and currents at rated magnitude and frequency”. Today customers are more aware of the seriousness that the power quality possesses, this prompt the utilities to assure good quality of power to their customer. The power quality is basically customer centric. Increased focus of utilities toward maintaining reliable power supply by employing power quality improvement tools has reduced the power outages and black out considerably. Good power quality is the characteristic of reliable power supply. Low power factor, harmonic pollution, load imbalance, fast voltage variations are some common parameters which are used to define the power quality. If the power quality issues are not checked i.e. the parameters that define power quality doesn't fall within the predefined standards than it will lead into high electricity bill, high running cost in industries, malfunctioning of equipments, challenges in connecting renewable. Capacitor banks, FACTS devices, harmonic filters, SVC’s (static voltage compensators), STATCOM (Static-Compensator) are the solutions to achieve the power quality. The performance of Wind turbine generators is affected by poor quality power, at the same time these wind power generating plant affects the power quality negatively. This paper presents the STATCOM-BESS (battery energy storage system) system and studies its impact on the power quality in a system which consists of wind turbine generator, non linear load, hysteresis controller for controlling the operation of STATCOM and grid. The model is simulated in the MATLAB/Simulink. This scheme mitigates the power quality issues, improves voltage profile and also reduces harmonic distortion of the waveforms. BESS level out the imbalances caused in real power due to intermittent nature of wind power available due to varying wind speeds.

SQA of finite element method (FEM) codes used for analyses of pit storage/transport packages

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

Russel, E.

1997-11-01

This report contains viewgraphs on the software quality assurance of finite element method codes used for analyses of pit storage and transport projects. This methodology utilizes the ISO 9000-3: Guideline for application of 9001 to the development, supply, and maintenance of software, for establishing well-defined software engineering processes to consistently maintain high quality management approaches.

The impact of flying qualities on helicopter operational agility

NASA Technical Reports Server (NTRS)

Padfield, Gareth D.; Lappos, Nick; Hodgkinson, John

1993-01-01

Flying qualities standards are formally set to ensure safe flight and therefore reflect minimum, rather than optimum, requirements. Agility is a flying quality but relates to operations at high, if not maximum, performance. While the quality metrics and test procedures for flying, as covered for example in ADS33C, may provide an adequate structure to encompass agility, they do not currently address flight at high performance. This is also true in the fixed-wing world and a current concern in both communities is the absence of substantiated agility criteria and possible conflicts between flying qualities and high performance. AGARD is sponsoring a working group (WG19) title 'Operational Agility' that deals with these and a range of related issues. This paper is condensed from contributions by the three authors to WG19, relating to flying qualities. Novel perspectives on the subject are presented including the agility factor, that quantifies performance margins in flying qualities terms; a new parameter, based on maneuver acceleration is introduced as a potential candidate for defining upper limits to flying qualities. Finally, a probabilistic analysis of pilot handling qualities ratings is presented that suggests a powerful relationship between inherent airframe flying qualities and operational agility.

A novel approach to generating CER hypotheses based on mining clinical data.

PubMed

Zhang, Shuo; Li, Lin; Yu, Yiqin; Sun, Xingzhi; Xu, Linhao; Zhao, Wei; Teng, Xiaofei; Pan, Yue

2013-01-01

Comparative effectiveness research (CER) is a scientific method of investigating the effectiveness of alternative intervention methods. In a CER study, clinical researchers typically start with a CER hypothesis, and aim to evaluate it by applying a series of medical statistical methods. Traditionally, the CER hypotheses are defined manually by clinical researchers. This makes the task of hypothesis generation very time-consuming and the quality of hypothesis heavily dependent on the researchers' skills. Recently, with more electronic medical data being collected, it is highly promising to apply the computerized method for discovering CER hypotheses from clinical data sets. In this poster, we proposes a novel approach to automatically generating CER hypotheses based on mining clinical data, and presents a case study showing that the approach can facilitate clinical researchers to identify potentially valuable hypotheses and eventually define high quality CER studies.

Importance of water quality in container plant production

Treesearch

John M. Ruter

2013-01-01

High substrate pH is a major problem for producers of container-grown plants and seedlings. The primary cause of high substrate pH is irrigation water with high alkalinity. Alkalinity is defined as the capacity of water to neutralize acids. Some alkalinity in irrigation water is beneficial as it serves as a buffer to large swings in pH levels, but high alkalinity in...

Measuring Reciprocity in High Functioning Children and Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

van Ommeren, Tineke Backer; Begeer, Sander; Scheeren, Anke M.; Koot, Hans M.

2012-01-01

Few instruments have been developed that measure impairments in reciprocity, a defining feature of autism. We introduce a new test assessing the quality of reciprocal behaviour: the interactive drawing test (IDT). Children and adolescents (n = 49) with and without high functioning autism spectrum disorders (HFASD) were invited to collaborate with…

Instrument Quality Control.

PubMed

Jayakody, Chatura; Hull-Ryde, Emily A

2016-01-01

Well-defined quality control (QC) processes are used to determine whether a certain procedure or action conforms to a widely accepted standard and/or set of guidelines, and are important components of any laboratory quality assurance program (Popa-Burke et al., J Biomol Screen 14: 1017-1030, 2009). In this chapter, we describe QC procedures useful for monitoring the accuracy and precision of laboratory instrumentation, most notably automated liquid dispensers. Two techniques, gravimetric QC and photometric QC, are highlighted in this chapter. When used together, these simple techniques provide a robust process for evaluating liquid handler accuracy and precision, and critically underpin high-quality research programs.

The Quality of Rare Disease Registries: Evaluation and Characterization.

PubMed

Coi, Alessio; Santoro, Michele; Villaverde-Hueso, Ana; Lipucci Di Paola, Michele; Gainotti, Sabina; Taruscio, Domenica; Posada de la Paz, Manuel; Bianchi, Fabrizio

2016-01-01

The focus on the quality of the procedures for data collection, storing, and analysis in the definition and implementation of a rare disease registry (RDR) is the basis for developing a valid and long-term sustainable tool. The aim of this study was to provide useful information for characterizing a quality profile for RDRs using an analytical approach applied to RDRs participating in the European Platform for Rare Disease Registries 2011-2014 (EPIRARE) survey. An indicator of quality was defined by choosing a small set of quality-related variables derived from the survey. The random forest method was used to identify the variables best defining a quality profile for RDRs. Fisher's exact test was employed to assess the association with the indicator of quality, and the Cochran-Armitage test was used to check the presence of a linear trend along different levels of quality. The set of variables found to characterize high-quality RDRs focused on ethical and legal issues, governance, communication of activities and results, established procedures to regulate access to data and security, and established plans to ensure long-term sustainability. The quality of RDRs is usually associated with a good oversight and governance mechanism and with durable funding. The results suggest that RDRs would benefit from support in management, information technology, epidemiology, and statistics. © 2016 S. Karger AG, Basel.

Marketing Realities in Continuing Professional Education.

ERIC Educational Resources Information Center

Craven, Ruth F.; DuHamel, Martha B.

2000-01-01

Describes tenets of continuing professional education marketing: identify target audience, define mission, assess community needs, identify competition, establish credibility, develop marketing plans, provide options, evaluate, and develop high-quality programs. Offers advice for pricing, cancellations, new courses, promotion expenses, direct…

INTEGRATING PROBABILISTIC AND FIXED-SITE MONITORING FOR ROBUST WATER QUALITY ASSESSMENTS

EPA Science Inventory

Determining the extent of water-quality degradation, controlling nonpoint sources, and defining allowable amounts of contaminants are important water-quality issues defined in the Clean Water Act that require new monitoring data. Probabilistic, randomized stream water-quality mon...

Cryopreservation of Human Pluripotent Stem Cells in Defined Medium

PubMed Central

Liu, Weiwei; Chen, Guokai

2014-01-01

This protocol describes a cryopreservation procedure using an enzyme-free dissociation method to harvest cells and preserve cells in albumin-free chemically defined E8 medium for human pluripotent stem cells (hPSCs). The dissociation by EDTA/PBS produces small cell aggregates that allow high survival efficiency in passaging and cryopreservation. The preservation in E8 medium eliminates serum or other animal products, and is suitable for the increasing demand for high quality hPSCs in translational research. In combination with the special feature of EDTA/PBS dissociation, this protocol allows efficient cryopreservation in more time-saving manner. PMID:25366897

Defining and managing the quality of wilderness recreation experiences

Treesearch

Robert E. Manning; David W. Lime

2000-01-01

There is a substantial body of scientific literature on defining and managing the quality of wilderness experiences. Two conceptual frameworks derived from this literature—carrying capacity and the Recreation Opportunity Spectrum (ROS)—suggest that wilderness recreation experiences can be defined through indicators and standards of quality, and that wilderness...

Are nursing home survey deficiencies higher in facilities with greater staff turnover.

PubMed

Lerner, Nancy B; Johantgen, Meg; Trinkoff, Alison M; Storr, Carla L; Han, Kihye

2014-02-01

To examine CNA and licensed nurse (RN+LPN/LVN) turnover in relation to numbers of deficiencies in nursing homes. A secondary data analysis of information from the National Nursing Home Survey (NNHS) and contemporaneous data from the Online Survey, Certification and Reporting (OSCAR) database. Data were linked by facility as the unit of analysis to determine the relationship of CNA and licensed nurse turnover on nursing home deficiencies. The 2004 NNHS used a multistage sampling strategy to generate a final sample of 1174 nursing homes, which represent 16,100 NHs in the United States. This study focused on the 1151 NNHS facilities with complete deficiency data. Turnover was defined as the total CNAs/licensed nurse full-time equivalents (FTEs) who left during the preceding 3 months (full- and part-time) divided by the total FTE. NHs with high turnover were defined as those with rates above the 75th percentile (25.3% for CNA turnover and 17.9% for licensed nurse turnover) versus all other facilities. This study used selected OSCAR deficiencies from the Quality of Care, Quality of Life, and Resident Behavior categories, which are considered to be more closely related to nursing care. We defined NHs with high deficiencies as those with numbers of deficiencies above the 75th percentile versus all others. Using SUDAAN PROC RLOGIST, we included NNHS sampling design effects and examined associations of CNA/licensed nurse turnover with NH deficiencies, adjusting for staffing, skill mix, bed size, and ownership in binomial logistic regression models. High CNA turnover was associated with high numbers of Quality of Care (OR 1.53, 95% CI 1.10-2.13), Resident Behavior (OR 1.42, 95% CI 1.03-1.97) and total selected deficiencies (OR 1.54, 95% CI 1.12-2.12). Licensed nurse turnover was significantly related to Quality of Care deficiencies (OR 2.06, 95% CI 1.50-2.82) and total selected deficiencies (OR 1.71, 95% CI 1.25-2.33). When both CNA turnover and licensed nurse turnover were included in the same model, high licensed nurse turnover was significantly associated with Quality of Care and total deficiencies, whereas CNA turnover was not associated with that category of deficiencies. Turnover in nursing homes for both licensed nurses and CNAs is associated with quality problems as measured by deficiencies. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

A Systematic Process for Developing High Quality SaaS Cloud Services

NASA Astrophysics Data System (ADS)

La, Hyun Jung; Kim, Soo Dong

Software-as-a-Service (SaaS) is a type of cloud service which provides software functionality through Internet. Its benefits are well received in academia and industry. To fully utilize the benefits, there should be effective methodologies to support the development of SaaS services which provide high reusability and applicability. Conventional approaches such as object-oriented methods do not effectively support SaaS-specific engineering activities such as modeling common features, variability, and designing quality services. In this paper, we present a systematic process for developing high quality SaaS and highlight the essentiality of commonality and variability (C&V) modeling to maximize the reusability. We first define criteria for designing the process model and provide a theoretical foundation for SaaS; its meta-model and C&V model. We clarify the notion of commonality and variability in SaaS, and propose a SaaS development process which is accompanied with engineering instructions. Using the proposed process, SaaS services with high quality can be effectively developed.

Toward High-Performance Organizations.

ERIC Educational Resources Information Center

Lawler, Edward E., III

2002-01-01

Reviews management changes that companies have made over time in adopting or adapting four approaches to organizational performance: employee involvement, total quality management, re-engineering, and knowledge management. Considers future possibilities and defines a new view of what constitutes effective organizational design in management.…

"Highly Qualified" to Do What? The Relationship between NCLB Teacher Quality Mandates and the Use of Reform-Oriented Instruction in Middle School Mathematics

ERIC Educational Resources Information Center

Smith, Thomas M.; Desimone, Laura M.; Ueno, Koji

2005-01-01

The federal No Child Left Behind Act of 2001 (NCLB) calls for a highly qualified teacher in every classroom. According to the legislation, "highly qualified" is defined as full certification, a bachelor's degree, and demonstrated content knowledge in all core subjects taught. States, district, and schools are spending considerable…

Quality expectations and tolerance limits of trial master files (TMF) – Developing a risk-based approach for quality assessments of TMFs

PubMed Central

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B.

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs. PMID:26693218

Quality expectations and tolerance limits of trial master files (TMF) - Developing a risk-based approach for quality assessments of TMFs.

PubMed

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs.

Meeting the Early Learning Challenge: Supporting English Language Learners

ERIC Educational Resources Information Center

Matthews, Hannah

2011-01-01

The Race to The Top-Early Learning Challenge (RTT-ELC) is designed to improve the quality of early learning and development and close the achievement gap for children with high needs. The Departments of Education and Health and Human Services define high needs to include children who are English learners, often referred to as English Language…

Status and understanding of groundwater quality in the North San Francisco Bay groundwater basins, 2004

USGS Publications Warehouse

Kulongoski, Justin T.; Belitz, Kenneth; Landon, Matthew K.; Farrar, Christopher

2010-01-01

Groundwater quality in the approximately 1,000-square-mile (2,590-square-kilometer) North San Francisco Bay study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in northern California in Marin, Napa, and Sonoma Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA North San Francisco Bay study was designed to provide a spatially unbiased assessment of untreated groundwater quality in the primary aquifer systems. The assessment is based on water-quality and ancillary data collected by the USGS from 89 wells in 2004 and water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer systems (hereinafter referred to as primary aquifers) were defined by the depth interval of the wells listed in the CDPH database for the North San Francisco Bay study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifers; shallower groundwater may be more vulnerable to surficial contamination. The first component of this study, the status of the current quality of the groundwater resource, was assessed by using data from samples analyzed for volatile organic compounds (VOC), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the North San Francisco Bay study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California benchmarks. A relative-concentration greater than (>) 1.0 indicates a concentration above a benchmark, and less than or equal to (=) 1.0 indicates a concentration equal to or below a benchmark. Relative-concentrations of organic and special interest constituents were classified as ?high? (relative-concentration > 1.0), ?moderate? (0.1 1.0), ?moderate? (0.5 < relative-concentration = 1.0), or ?low? (relative-concentration = 0.5). Aquifer-scale proportion was used as a metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the primary aquifers that have a relative-concentration greater than 1.0; proportion is calculated on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers that have moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based and spatially-weighted-were used to evaluate aquifer-scale proportion for individual constituents and classes of constituents. Grid-based and spatially-weighted estimates were comparable in the North San Francisco Bay study unit (90-percent confidence intervals). For inorganic constituents with human-health benchmarks, relative-concentrations were high in 14.0 percent of the primary aquifers, moderate in 35.8 percent, and low in 50.2 percent. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of arsenic (10.0 percent), boron (4.1 percent), and lead (1.6 percent). In contrast, relative-concentrations of organic constituents (one or more) were high in 1.4 percent, moderate in 4.9 percent, and low in 93.7 percent (not detected in 64.8 percent) of the primary aquifers. The high aquifer-scale proport

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

PubMed Central

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

2012-01-01

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. OBJECTIVE: To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. METHODS: A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. RESULTS: Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. DISCUSSION: The consensus process identified a clear need for high-quality clinical and outcomes research to support quality improvement in the delivery of endoscopy services. CONCLUSIONS: The guidelines support quality improvement in endoscopy by providing explicit recommendations on systematic monitoring, assessment and modification of endoscopy service delivery to yield benefits for all patients affected by the practice of gastrointestinal endoscopy. PMID:22308578

High-quality electron beams from beam-driven plasma accelerators by wakefield-induced ionization injection.

PubMed

Martinez de la Ossa, A; Grebenyuk, J; Mehrling, T; Schaper, L; Osterhoff, J

2013-12-13

We propose a new and simple strategy for controlled ionization-induced trapping of electrons in a beam-driven plasma accelerator. The presented method directly exploits electric wakefields to ionize electrons from a dopant gas and capture them into a well-defined volume of the accelerating and focusing wake phase, leading to high-quality witness bunches. This injection principle is explained by example of three-dimensional particle-in-cell calculations using the code OSIRIS. In these simulations a high-current-density electron-beam driver excites plasma waves in the blowout regime inside a fully ionized hydrogen plasma of density 5×10(17)cm-3. Within an embedded 100  μm long plasma column contaminated with neutral helium gas, the wakefields trigger ionization, trapping of a defined fraction of the released electrons, and subsequent acceleration. The hereby generated electron beam features a 1.5 kA peak current, 1.5  μm transverse normalized emittance, an uncorrelated energy spread of 0.3% on a GeV-energy scale, and few femtosecond bunch length.

Facilitating the openEHR approach - organizational structures for defining high-quality archetypes.

PubMed

Kohl, Christian Dominik; Garde, Sebastian; Knaup, Petra

2008-01-01

Using openEHR archetypes to establish an electronic patient record promises rapid development and system interoperability by using or adopting existing archetypes. However, internationally accepted, high quality archetypes which enable a comprehensive semantic interoperability require adequate development and maintenance processes. Therefore, structures have to be created involving different health professions. In the following we present a model which facilitates and governs distributed but cooperative development and adoption of archetypes by different professionals including peer reviews. Our model consists of a hierarchical structure of professional committees and descriptions of the archetype development process considering these different committees.

A Quality Assurance Initiative for Commercial-Scale Production in High-Throughput Cryopreservation of Blue Catfish Sperm

PubMed Central

Hu, E; Liao, T. W.; Tiersch, T. R.

2013-01-01

Cryopreservation of fish sperm has been studied for decades at a laboratory (research) scale. However, high-throughput cryopreservation of fish sperm has recently been developed to enable industrial-scale production. This study treated blue catfish (Ictalurus furcatus) sperm high-throughput cryopreservation as a manufacturing production line and initiated quality assurance plan development. The main objectives were to identify: 1) the main production quality characteristics; 2) the process features for quality assurance; 3) the internal quality characteristics and their specification designs; 4) the quality control and process capability evaluation methods, and 5) the directions for further improvements and applications. The essential product quality characteristics were identified as fertility-related characteristics. Specification design which established the tolerance levels according to demand and process constraints was performed based on these quality characteristics. Meanwhile, to ensure integrity throughout the process, internal quality characteristics (characteristics at each quality control point within process) that could affect fertility-related quality characteristics were defined with specifications. Due to the process feature of 100% inspection (quality inspection of every fish), a specific calculation method, use of cumulative sum (CUSUM) control charts, was applied to monitor each quality characteristic. An index of overall process evaluation, process capacity, was analyzed based on in-control process and the designed specifications, which further integrates the quality assurance plan. With the established quality assurance plan, the process could operate stably and quality of products would be reliable. PMID:23872356

Defining Quality in Cardiovascular Imaging: A Scientific Statement From the American Heart Association.

PubMed

Shaw, Leslee J; Blankstein, Ron; Jacobs, Jill E; Leipsic, Jonathon A; Kwong, Raymond Y; Taqueti, Viviany R; Beanlands, Rob S B; Mieres, Jennifer H; Flamm, Scott D; Gerber, Thomas C; Spertus, John; Di Carli, Marcelo F

2017-12-01

The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care. Our proposed statement may serve as the foundation for integrating these quality indicators into establishing designations of quality laboratory practices and developing standards for value-based payment reform for imaging services. We also include recommendations for future clinical research to fulfill quality aims within cardiovascular imaging, including clinical hypotheses of improving patient outcomes, the importance of health status as an end point, and deferred testing options. Future research should evolve to define novel methods optimized for the role of cardiovascular imaging for detecting disease and guiding treatment and to demonstrate the role of cardiovascular imaging in facilitating healthcare quality. © 2017 American Heart Association, Inc.

Development of optimum process for electron beam cross-linking of high density polyethylene thermal energy storage pellets, process scale-up and production of application qualities of material

NASA Technical Reports Server (NTRS)

Salyer, I. O.

1980-01-01

The electron irradiation conditions required to prepare thermally from stable high density polyethylene (HDPE) were defined. The conditions were defined by evaluating the heat of fusion and the melting temperature of several HDPE specimens. The performance tests conducted on the specimens, including the thermal cycling tests in the thermal energy storage unit are described. The electron beam irradiation tests performed on the specimens, in which the total radiation dose received by the pellets, the electron beam current, the accelerating potential, and the atmospheres were varied, are discussed.

Defining Instructional Quality by Employing the Total Quality Management (TQM) Method: A Research Project.

ERIC Educational Resources Information Center

Croker, Robert E.; And Others

The feasibility of using W. E. Deming's total quality management (TQM) method to define instructional quality was examined by surveying three groups of students attending Idaho State University's College of Education and School of Applied Technology: 31 students seeking cosmetology certification; 75 undergraduates pursuing degrees in corporate…

Arthropod genomic resources for the 21st century

USDA-ARS?s Scientific Manuscript database

Genome references are foundational for high quality entomological research today. Species, sub populations and taxonomy are defined by gene flow and genome sequences. Gene content in arthropods is often directly reflective of life history, for example, diet and symbiont related gene loss is observed...

West Asian Special Libraries and Information Centers.

ERIC Educational Resources Information Center

Harvey, John F.

Special libraries are defined in this paper as those libraries serving such institutions as government offices, private corporations, associations, and university departments. Information centers are similar to special libraries but provide personalized, high quality reference service, usually in science and technology, and often using mechanical…

Can exercise improve self esteem in children and young people? A systematic review of randomised controlled trials.

PubMed

Ekeland, E; Heian, F; Hagen, K B

2005-11-01

A systematic review to determine if exercise alone or as part of a comprehensive intervention can improve self esteem in children and young people is described. Twenty three randomised controlled trials were analysed. A synthesis of several small, low quality trials indicates that exercise may have short term beneficial effects on self esteem in children and adolescents. However, high quality research on defined populations with adequate follow up is needed.

Narrative methods in quality improvement research

PubMed Central

Greenhalgh, T; Russell, J; Swinglehurst, D

2005-01-01



 This paper reviews and critiques the different approaches to the use of narrative in quality improvement research. The defining characteristics of narrative are chronology (unfolding over time); emplotment (the literary juxtaposing of actions and events in an implicitly causal sequence); trouble (that is, harm or the risk of harm); and embeddedness (the personal story nests within a particular social, historical and organisational context). Stories are about purposeful action unfolding in the face of trouble and, as such, have much to offer quality improvement researchers. But the quality improvement report (a story about efforts to implement change), which is common, must be distinguished carefully from narrative based quality improvement research (focused systematic enquiry that uses narrative methods to generate new knowledge), which is currently none. We distinguish four approaches to the use of narrative in quality improvement research—narrative interview; naturalistic story gathering; organisational case study; and collective sense-making—and offer a rationale, describe how data can be collected and analysed, and discuss the strengths and limitations of each using examples from the quality improvement literature. Narrative research raises epistemological questions about the nature of narrative truth (characterised by sense-making and emotional impact rather than scientific objectivity), which has implications for how rigour should be defined (and how it might be achieved) in this type of research. We offer some provisional guidance for distinguishing high quality narrative research in a quality improvement setting from other forms of narrative account such as report, anecdote, and journalism. PMID:16326792

Exploring global recognition of quality midwifery education: Vision or fiction?

PubMed

Luyben, Ans; Barger, Mary; Avery, Melissa; Bharj, Kuldip Kaur; O'Connell, Rhona; Fleming, Valerie; Thompson, Joyce; Sherratt, Della

2017-06-01

Midwifery education is the foundation for preparing competent midwives to provide a high standard of safe, evidence-based care for women and their newborns. Global competencies and standards for midwifery education have been defined as benchmarks for establishing quality midwifery education and practice worldwide. However, wide variations in type and nature of midwifery education programs exist. To explore and discuss the opportunities and challenges of a global quality assurance process as a strategy to promote quality midwifery education. Accreditation and recognition as two examples of quality assurance processes in education are discussed. A global recognition process, with its opportunities and challenges, is explored from the perspective of four illustrative case studies from Ireland, Kosovo, Latin America and Bangladesh. The discussion highlights that the establishment of a global recognition process may assist in promoting quality of midwifery education programs world-wide, but cannot take the place of formal national accreditation. In addition, a recognition process will not be feasible for many institutions without additional resources, such as financial support or competent evaluators. In order to achieve quality midwifery education through a global recognition process the authors present 5 Essential Challenges for Quality Midwifery Education. Quality midwifery education is vital for establishing a competent workforce, and improving maternal and newborn health. Defining a global recognition process could be instrumental in moving toward this goal, but dealing with the identified challenges will be essential. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Content Integrity, Conflict of Interest, and Commercial Support: Defining and Operationalizing the Terms.

PubMed

Dickerson, Pam; Chappell, Kathy

2015-01-01

One of the hallmarks of quality continuing education developed using accreditation criteria is content integrity. Components of content integrity include identifying, resolving, and disclosing conflict of interest; ensuring content is based on the best available evidence; managing commercial support (if applicable); and presenting the educational activity free of promotion or bias. This article explores content integrity, conflict of interest, and commercial support. Understanding and being able to operationalize these concepts will enable providers to offer high-quality educational activities that promote the professional development of nurses and/or improve the quality of patient care.

What methods are used to apply positive deviance within healthcare organisations? A systematic review

PubMed Central

Baxter, Ruth; Taylor, Natalie; Kellar, Ian; Lawton, Rebecca

2016-01-01

Background The positive deviance approach focuses on those who demonstrate exceptional performance, despite facing the same constraints as others. ‘Positive deviants’ are identified and hypotheses about how they succeed are generated. These hypotheses are tested and then disseminated within the wider community. The positive deviance approach is being increasingly applied within healthcare organisations, although limited guidance exists and different methods, of varying quality, are used. This paper systematically reviews healthcare applications of the positive deviance approach to explore how positive deviance is defined, the quality of existing applications and the methods used within them, including the extent to which staff and patients are involved. Methods Peer-reviewed articles, published prior to September 2014, reporting empirical research on the use of the positive deviance approach within healthcare, were identified from seven electronic databases. A previously defined four-stage process for positive deviance in healthcare was used as the basis for data extraction. Quality assessments were conducted using a validated tool, and a narrative synthesis approach was followed. Results 37 of 818 articles met the inclusion criteria. The positive deviance approach was most frequently applied within North America, in secondary care, and to address healthcare-associated infections. Research predominantly identified positive deviants and generated hypotheses about how they succeeded. The approach and processes followed were poorly defined. Research quality was low, articles lacked detail and comparison groups were rarely included. Applications of positive deviance typically lacked staff and/or patient involvement, and the methods used often required extensive resources. Conclusion Further research is required to develop high quality yet practical methods which involve staff and patients in all stages of the positive deviance approach. The efficacy and efficiency of positive deviance must be assessed and compared with other quality improvement approaches. PROSPERO registration number CRD42014009365. PMID:26590198

Faculty Members' Lived Experiences with Academic Quality in For-Profit On-Ground Gainful Employment Programs

ERIC Educational Resources Information Center

Booton, Carol M.

2013-01-01

Academic quality in for-profit vocational (Gainful Employment) programs is a concern for all stakeholders. However, academic quality is not easily defined. The Department of Education's Gainful Employment Rule defines academic quality With a few easily measured metrics such as student retention and job placement rate, despite the fact that…

A Vocabulary of Motives: Understanding How Parents Define Quality Time

ERIC Educational Resources Information Center

Snyder, Karrie Ann

2007-01-01

Although discussions of parenting refer to quality time, parents' views of quality time have not been explored. Using the Sloan 500 Family Study, this article examines how 220 parents from 110 dual-parent families define the spending quality time with their families and finds 3 distinct views: Structured-planning parents saw it as planned family…

Active for Life: Developmentally Appropriate Movement Programs for Young Children.

ERIC Educational Resources Information Center

Sanders, Stephen W.

This book provides guidance on what high-quality movement programs for young children should include, offering a curricular foundation, strategies for teaching, and assessment ideas. It defines and illustrates specific interrelated components of developmentally appropriate practice in providing movement education for young children. There are…

A model for predicting daily peak visitation and implications for recreation management and water quality: evidence from two rivers in Puerto Rico.

PubMed

Santiago, Luis E; Gonzalez-Caban, Armando; Loomis, John

2008-06-01

Visitor use surveys and water quality data indicates that high visitor use levels of two rivers in Puerto Rico does not appear to adversely affect several water quality parameters. Optimum visitor use to maximize visitor defined satisfaction is a more constraining limit on visitor use than water quality. Our multiple regression analysis suggests that visitor use of about 150 visitors per day yields the highest level of visitor reported satisfaction, a level that does not appear to affect turbidity of the river. This high level of visitor use may be related to the gregarious nature of Puerto Ricans and their tolerance for crowding on this densely populated island. The daily peak visitation model indicates that regulating the number of parking spaces may be the most effective way to keep visitor use within the social carrying capacity.

Defining Hardwood Veneer Log Quality Attributes

Treesearch

Jan Wiedenbeck; Michael Wiemann; Delton Alderman; John Baumgras; William Luppold

2004-01-01

This publication provides a broad spectrum of information on the hardwood veneer industry in North America. Veneer manufacturers and their customers impose guidelines in specifying wood quality attributes that are very discriminating but poorly defined (e.g., exceptional color, texture, and/or figure characteristics). To better understand and begin to define the most...

Assessing sensory quality of rice to meet industry needs.

USDA-ARS?s Scientific Manuscript database

Food industries need consistent supplies of rice that are well-defined in terms of functional, nutritional, and sensory characteristics associated with intrinsic product quality to allow them to be directed to the most appropriate, highest value markets. Defining the sensory quality of rice is prob...

Five-Star Schools: Defining Quality in Early Childhood Programs

ERIC Educational Resources Information Center

Hertzog, Nancy B.

2012-01-01

Hakeem, Emily, Jose, and Latisha are all entering preschool in the fall. Their mothers are looking for the highest quality early childhood program they can find. Is there a guide for them to find a five-star program? Are all certified or accredited programs of equal quality? How do these parents and guardians know what defines quality in early…

Adult-acquired hidden penis in obese patients: a critical survey of the literature.

PubMed

Cavayero, Chase T; Cooper, Meghan A; Harlin, Stephen L

2015-03-01

Hidden penis is anatomically defined by a lack of firm attachments of the skin and dartos fascia to the underlying Buck fascia. To critically appraise the research evidence that could support the most effective surgical techniques for adult-acquired hidden penis in obese patients. Studies investigating patients with a diagnosis of hidden penis were identified. Of these studies, only those with adult patients classified as overweight or obese (body mass index >25) were included in the review. Three reviewers examined the abstracts of the studies identified in the initial Medline search, and abstracts considered potentially relevant underwent full-text review. Studies that included patients with congenital, iatrogenic (eg, circumcision issues or aesthetic genital surgery), or traumatic causes of hidden penis were excluded. Studies that did not define the diagnostic criteria for hidden penis were excluded to minimize the risk of definition bias. The quality of evidence for each study was determined after considering the following sources of bias: method of allocation to study groups, data analysis, presence of baseline differences between groups, objectivity of outcome, and completeness of follow-up. Using these criteria, studies were then graded as high, moderate, or low in quality. Seven studies with a total of 119 patients met the inclusion criteria. All but 1 of the studies were nonrandomized. One study provided a clear presentation of results and appropriate statistical analysis. Six studies accounted for individual-based differences, and 1 study failed to account for baseline differences altogether. Four studies addressed follow-up. One study was of high quality, 2 were of moderate quality, and 4 were of low quality. Building a clinical practice guideline for the surgical management of hidden penis has proven difficult because of a lack of high-quality, statistically significant data in the research synthesis. The authors elucidate the challenges and epitomize the collective wisdom of surgeons who have investigated this problem and emphasize the need for rigorous evaluative studies. © 2015 The American Osteopathic Association.

Prevalence of Poor Bone Quality in Women Undergoing Spinal Fusion Using Biomechanical-CT Analysis.

PubMed

Burch, Shane; Feldstein, Michael; Hoffmann, Paul F; Keaveny, Tony M

2016-02-01

Retrospective, cross-sectional analysis of vertebral bone quality in spine-fusion patients at a single medical center. To characterize the prevalence of osteoporosis and fragile bone strength in a spine-fusion population of women with an age range of 50 years to 70 years. Fragile bone strength is defined as the level of vertebral strength below which a patient is at as high a risk of future vertebral fracture as a patient having bone density-defined osteoporosis. Poor bone quality--defined here as the presence of either osteoporosis or fragile bone strength--is a risk factor for spine-fusion patients that often goes undetected but can now be assessed preoperatively by additional postprocessing of computed tomography (CT) scans originally ordered for perioperative clinical assessment. Utilizing such perioperative CT scans for a cohort of 98 women (age range: 51-70 yr) about to undergo spine fusion, we retrospectively used a phantomless calibration technique and biomechanical-CT postprocessing analysis to measure vertebral trabecular bone mineral density (BMD) (in mg/cm³) and by nonlinear finite element analysis, vertebral compressive strength (in Newtons, N) in the L1 or L2 vertebra. Preestablished validated threshold values were used to define the presence of osteoporosis (trabecular BMD of 80 mg/cm³ or lower) and fragile bone strength (vertebral strength of 4500 N or lower). Fourteen percent of the women tested positive for osteoporosis, 27% tested positive for fragile bone strength, and 29% were classified as having poor bone quality (either osteoporosis or fragile bone strength). Over this narrow age range, neither BMD nor vertebral strength were significantly correlated with age, weight, height, or body mass index (P values 0.14-0.97 for BMD; 0.13-0.51 for strength). Poor bone quality appears to be common in women between ages 50 years and 70 years undergoing spinal fusion surgery. 3.

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

7 CFR 657.5 - Identification of important farmlands.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the soil quality, growing season, and moisture supply needed to economically produce sustained high... frequently or are protected from flooding. Examples of soils that qualify as prime farmland are Palouse silt... section are defined in USDA publications: “Soil Taxonomy, Agriculture Handbook 436”; “Soil Survey Manual...

SetonWorldWide: A Case Study of Student Success

ERIC Educational Resources Information Center

DiSalvio, Philip

2009-01-01

This case study offers a strategic model of methods and services resulting in relatively high student success rates as defined by course completion of introductory first and second semester online courses. This strategic model is presented in the context of Sloan-C's "Five Pillars of Quality Online Education."

Tuning toward Completion

ERIC Educational Resources Information Center

Kolb, Marcus; Kalina, Michelle; Chapman, Adina

2013-01-01

The Obama administration and the Lumina Foundation have been the principal drivers focusing the nation on increasing the number of high-quality degrees and credentials. Tuning, a faculty-driven process for defining clear student learning outcomes--what a student should know, understand, and be able to do--is one of the ways to support this goal.

Response to Intervention Implementation Guide: The South Dakota Model

ERIC Educational Resources Information Center

South Dakota Department of Education, 2012

2012-01-01

The National Association of State Directors of Special Education (NASDSE, 2005) defines response to intervention (RTI) as the practice of providing high-quality instruction and intervention based on a student's needs, changing instruction and/or goals through frequent monitoring of progress, and applying the student response data to important…

Creative Thinking: Processes, Strategies, and Knowledge

ERIC Educational Resources Information Center

Mumford, Michael D.; Medeiros, Kelsey E.; Partlow, Paul J.

2012-01-01

Creative achievements are the basis for progress in our world. Although creative achievement is influenced by many variables, the basis for creativity is held to lie in the generation of high-quality, original, and elegant solutions to complex, novel, ill-defined problems. In the present effort, we examine the cognitive capacities that make…

Differences in aquatic habitat quality as an impact of one- and two-dimensional hydrodynamic model simulated flow variables

NASA Astrophysics Data System (ADS)

Benjankar, R. M.; Sohrabi, M.; Tonina, D.; McKean, J. A.

2013-12-01

Aquatic habitat models utilize flow variables which may be predicted with one-dimensional (1D) or two-dimensional (2D) hydrodynamic models to simulate aquatic habitat quality. Studies focusing on the effects of hydrodynamic model dimensionality on predicted aquatic habitat quality are limited. Here we present the analysis of the impact of flow variables predicted with 1D and 2D hydrodynamic models on simulated spatial distribution of habitat quality and Weighted Usable Area (WUA) for fall-spawning Chinook salmon. Our study focuses on three river systems located in central Idaho (USA), which are a straight and pool-riffle reach (South Fork Boise River), small pool-riffle sinuous streams in a large meadow (Bear Valley Creek) and a steep-confined plane-bed stream with occasional deep forced pools (Deadwood River). We consider low and high flows in simple and complex morphologic reaches. Results show that 1D and 2D modeling approaches have effects on both the spatial distribution of the habitat and WUA for both discharge scenarios, but we did not find noticeable differences between complex and simple reaches. In general, the differences in WUA were small, but depended on stream type. Nevertheless, spatially distributed habitat quality difference is considerable in all streams. The steep-confined plane bed stream had larger differences between aquatic habitat quality defined with 1D and 2D flow models compared to results for streams with well defined macro-topographies, such as pool-riffle bed forms. KEY WORDS: one- and two-dimensional hydrodynamic models, habitat modeling, weighted usable area (WUA), hydraulic habitat suitability, high and low discharges, simple and complex reaches

Defining quality in radiology.

PubMed

Blackmore, C Craig

2007-04-01

The introduction of pay for performance in medicine represents an opportunity for radiologists to define quality in radiology. Radiology quality can be defined on the basis of the production model that currently drives reimbursement, codifying the role of radiologists as being limited to the production of timely and accurate radiology reports produced in conditions of maximum patient safety and communicated in a timely manner. Alternately, quality in radiology can also encompass the professional role of radiologists as diagnostic imaging specialists responsible for the appropriate use, selection, interpretation, and application of imaging. Although potentially challenging to implement, the professional model for radiology quality is a comprehensive assessment of the ways in which radiologists add value to patient care. This essay is a discussion of the definition of radiology quality and the implications of that definition.

42 CFR 425.502 - Calculating the ACO quality performance score.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Patient/care giver experience. (ii) Care coordination/Patient safety. (iii) Preventative health. (iv) At... year. (1) For the first performance year of an ACO's agreement, CMS defines the quality performance... defined by CMS based on national Medicare fee-for-service rates, national MA quality measure rates, or a...

42 CFR 425.502 - Calculating the ACO quality performance score.

Code of Federal Regulations, 2014 CFR

2014-10-01

... four domains: (i) Patient/care giver experience. (ii) Care coordination/Patient safety. (iii... year. (1) For the first performance year of an ACO's agreement, CMS defines the quality performance... a point scale for the measures. (2)(i) CMS will define the quality benchmarks using fee-for-service...

42 CFR 425.502 - Calculating the ACO quality performance score.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Patient/care giver experience. (ii) Care coordination/Patient safety. (iii) Preventative health. (iv) At... year. (1) For the first performance year of an ACO's agreement, CMS defines the quality performance... defined by CMS based on national Medicare fee-for-service rates, national MA quality measure rates, or a...

Quality and performance measures of strain on intensive care capacity: a protocol for a systematic review.

PubMed

Soltani, S Abolfazi; Ingolfsson, Armann; Zygun, David A; Stelfox, Henry T; Hartling, Lisa; Featherstone, Robin; Opgenorth, Dawn; Bagshaw, Sean M

2015-11-12

The matching of critical care service supply with demand is fundamental for the efficient delivery of advanced life support to patients in urgent need. Mismatch in this supply/demand relationship contributes to "intensive care unit (ICU) capacity strain," defined as a time-varying disruption in the ability of an ICU to provide well-timed and high-quality intensive care support to any and all patients who are or may become critically ill. ICU capacity strain leads to suboptimal quality of care and may directly contribute to heightened risk of adverse events, premature discharges, unplanned readmissions, and avoidable death. Unrelenting strain on ICU capacity contributes to inefficient health resource utilization and may negatively impact the satisfaction of patients, their families, and frontline providers. It is unknown how to optimally quantify the instantaneous and temporal "stress" an ICU experiences due to capacity strain. We will perform a systematic review to identify, appraise, and evaluate quality and performance measures of strain on ICU capacity and their association with relevant patient-centered, ICU-level, and health system-level outcomes. Electronic databases (i.e., MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, and the Agency of Healthcare Research and Quality (AHRQ) - National Quality Measures Clearinghouse (NQMC)) will be searched for original studies of measures of ICU capacity strain. Selected gray literature sources will be searched. Search themes will focus on intensive care, quality, operations management, and capacity. Analysis will be primarily narrative. Each identified measure will be defined, characterized, and evaluated using the criteria proposed by the US Strategic Framework Board for a National Quality Measurement and Reporting System (i.e., importance, scientific acceptability, usability, feasibility). Our systematic review will comprehensively identify, define, and evaluate quality and performance measures of ICU capacity strain. This is a necessary step towards understanding the impact of capacity strain on quality and performance in intensive care and to develop innovative interventions aimed to improve efficiency, avoid waste, and better anticipate impending capacity shortfalls. PROSPERO, CRD42015017931.

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.

An integrative review of health-related quality of life in patients with critical limb ischaemia.

PubMed

Monaro, Susan; West, Sandra; Gullick, Janice

2017-10-01

To examine the domains and the domain-specific characteristics within a peripheral arterial disease health-related quality of life framework for their usefulness in defining critical limb ischaemia health-related quality of life. Critical Limb Ischaemia presents a highly individualised set of personal and health circumstances. Treatment options include conservative management, revascularisation or amputation. However, the links between treatment decisions and quality of life require further investigation. The framework for this integrative review was the peripheral arterial disease-specific health-related quality of life domains identified by Treat-Jacobson et al. The literature expanded and refined Treat-Jacobson's framework by modifying the characteristics to better describe health-related quality of life in critical limb ischaemia. Given that critical limb ischaemia is a highly individualised situation with powerful health-related quality of life implications, further research focusing on patient and family-centred decision-making relating to therapeutic options and advanced care planning is required. A critical limb ischaemia-specific, health-related quality of life tool is required to capture both the unique characteristics of this disorder, and the outcomes for active or conservative care among this complex group of patients. © 2016 John Wiley & Sons Ltd.

Quality controls in cellular immunotherapies: rapid assessment of clinical grade dendritic cells by gene expression profiling.

PubMed

Castiello, Luciano; Sabatino, Marianna; Zhao, Yingdong; Tumaini, Barbara; Ren, Jiaqiang; Ping, Jin; Wang, Ena; Wood, Lauren V; Marincola, Francesco M; Puri, Raj K; Stroncek, David F

2013-02-01

Cell-based immunotherapies are among the most promising approaches for developing effective and targeted immune response. However, their clinical usefulness and the evaluation of their efficacy rely heavily on complex quality control assessment. Therefore, rapid systematic methods are urgently needed for the in-depth characterization of relevant factors affecting newly developed cell product consistency and the identification of reliable markers for quality control. Using dendritic cells (DCs) as a model, we present a strategy to comprehensively characterize manufactured cellular products in order to define factors affecting their variability, quality and function. After generating clinical grade human monocyte-derived mature DCs (mDCs), we tested by gene expression profiling the degrees of product consistency related to the manufacturing process and variability due to intra- and interdonor factors, and how each factor affects single gene variation. Then, by calculating for each gene an index of variation we selected candidate markers for identity testing, and defined a set of genes that may be useful comparability and potency markers. Subsequently, we confirmed the observed gene index of variation in a larger clinical data set. In conclusion, using high-throughput technology we developed a method for the characterization of cellular therapies and the discovery of novel candidate quality assurance markers.

[Amendment of the structural quality for inpatient rheumatology. A forward-looking concept].

PubMed

Lakomek, H-J; Braun, J; Gromnica-Ihle, E; Fiehn, C; Claus, S; Specker, C; Jung, J; Krause, A; Lorenz, H-M; Robbers, J

2011-09-01

In 2010 a total of 9 guidelines on structural quality were endorsed by the Association of Rheumatology Clinics in Germany (VRA). These 9 structural criteria replace the regulations published in 2002 and were elaborated with the support of the German Rheumatology League. With guideline number 9 even the structural requirements for university hospitals are defined for the first time.Along with taking part in the quality project "Kobra" (continuous outcome benchmarking in rheumatology inpatient treatment) compliance with the new structural criteria constitutes a prerequisite for acquiring a quality certificate, which is awarded by an external institution.By this means the VRA sets the stage for its members to be prepared for future challenges and quality competition among hospitals. Furthermore, the provision of a high quality treatment for chronically diseased patients in rheumatology clinics will be effectively supported.

Agency-wide Quality System Documents

EPA Pesticide Factsheets

Quality specifications for EPA organizations as defined by EPA Directives are internal policy documents that apply only to EPA organizations. The Code of Federal Regulations defines specifications for extramural agreements with non-EPA organizations.

Educational Level, Anticoagulation Quality, and Clinical Outcomes in Elderly Patients with Acute Venous Thromboembolism: A Prospective Cohort Study.

PubMed

Hofmann, Eveline; Faller, Nicolas; Limacher, Andreas; Méan, Marie; Tritschler, Tobias; Rodondi, Nicolas; Aujesky, Drahomir

2016-01-01

Whether the level of education is associated with anticoagulation quality and clinical outcomes in patients with acute venous thromboembolism (VTE) is uncertain. We thus aimed to investigate the association between educational level and anticoagulation quality and clinical outcomes in elderly patients with acute VTE. We studied 817 patients aged ≥65 years with acute VTE from a Swiss prospective multicenter cohort study (09/2009-12/2013). We defined three educational levels: 1) less than high school, 2) high school, and 3) post-secondary degree. The primary outcome was the anticoagulation quality, expressed as the percentage of time spent in the therapeutic INR range (TTR). Secondary outcomes were the time to a first recurrent VTE and major bleeding. We adjusted for potential confounders and periods of anticoagulation. Overall, 56% of patients had less than high school, 25% a high school degree, and 18% a post-secondary degree. The mean percentage of TTR was similar across educational levels (less than high school, 61%; high school, 64%; and post-secondary, 63%; P = 0.36). Within three years of follow-up, patients with less than high school, high school, and a post-secondary degree had a cumulative incidence of recurrent VTE of 14.2%, 12.9%, and 16.4%, and a cumulative incidence of major bleeding of 13.3%, 15.1%, and 15.4%, respectively. After adjustment, educational level was neither associated with anticoagulation quality nor with recurrent VTE or major bleeding. In elderly patients with VTE, we did not find an association between educational level and anticoagulation quality or clinical outcomes.

Differences in Bone Quality between High versus Low Turnover Renal Osteodystrophy

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

Porter, Daniel S.; Pienkowski, David; Faugere, Marie-Claude

2012-01-01

Abnormal bone turnover is common in chronic kidney disease (CKD), but its effects on bone quality remain unclear. This study sought to quantify the relationship between abnormal bone turnover and bone quality. Iliac crest bone biopsies were obtained from CKD-5 patients on dialysis with low (n=18) or high (n=17) turnover, and from volunteers (n=12) with normal turnover and normal kidney function. Histomorphometric methods were used to quantify the microstructural parameters; Fourier transform infrared spectroscopy and nanoindentation were used to quantify the material and mechanical properties in bone. Reduced mineral-to-matrix ratio, mineral crystal size, stiffness and hardness were observed in bonemore » with high turnover compared to bone with normal or low turnover. Decreased cancellous bone volume and trabecular thickness were seen in bone with low turnover compared to bone with normal or high turnover. Bone quality, as defined by its microstructural, material, and mechanical properties, is related to bone turnover. These data suggest that turnover related alterations in bone quality may contribute to the known diminished mechanical competence of bone in CKD patients, albeit from different mechanisms for bone with high (material abnormality) vs. low (microstructural alteration) turnover. The present findings suggest that improved treatments for renal osteodystrophy should seek to avoid low or high bone turnover and aim for turnover rates as close to normal as possible.« less

An Alternative Definition of Quality of Undergraduate College Education: Toward Usable Knowledge for Improvement.

ERIC Educational Resources Information Center

Nordvall, Robert C.; Braxton, John M.

1996-01-01

Traditional approaches to defining academic quality (reputational, resources, and outcomes or value-added) are criticized as not providing useful information. An alternative perspective is offered, focusing on fundamental course-level academic processes and defining the quality of such processes as the level of understanding of course content…

Teaching High School Physical Education According to National Standards: The 6 Verbs of Success--Demonstrate, Understand, Participate, Achieve, Exhibit and Value

ERIC Educational Resources Information Center

Bert, Greg

2010-01-01

The six national content standards from NASPE define what a student should know and be able to do as a result of a high quality physical education program. The "NASPE SIX" serve as a North Star to guide teachers as they prepare and implement programs. Simply stated, the NASPE Standards for Physical Education are all about six simple…

Safety issues of high-concentrated hydrogen peroxide production used as rocket propellant

NASA Astrophysics Data System (ADS)

Romantsova, O. V.; Ulybin, V. B.

2015-04-01

The article dwells on the possibility of production of high-concentrated hydrogen peroxide with the Russian technology of isopropyl alcohol autoxidation. Analysis of fire/explosion hazards and reasons of insufficient quality is conducted for the technology. Modified technology is shown. Non-standard fire/explosion characteristics required for integrated fire/explosion hazards rating for modified hydrogen peroxide production based on the autoxidation of isopropyl alcohol are defined.

Using EPIC to Find Conflicts, Inconsistencies, and Gaps in Department of Defense Policies

DTIC Science & Technology

2013-01-01

documentation; or deliver preliminary findings. All RAND reports un- dergo rigorous peer review to ensure that they meet high standards for research quality...responsibilities and the products that result from their execution. Once the high -level frame- work was defined, successive lower layers were developed to further...Lead or Chief Engineer Component Acquisition Executive ( CAE ) Managers Configuration Steering Board Materiel developer Contractor Milestone Decision

[Output standard in the mental health services of Reggio Emilia, Italy. Methodological issues].

PubMed

Grassi, G

2000-01-01

The project Output Standards of the Mental Health Department (MHD) of Reggio Emilia is set out to define outputs and quality standards and to guarantee transparency and to facilitate organizational improvement. The MHD started an interprofessional working group that defined the MHD outputs as long as process, quality peculiarities, indicators and standards for each output. The MHD Director validated the group results. The MHD defined 9 outputs and its indicators and standards and consequently modified its data registration system, the way to supply free and partially charged services and budget indicators. As a result, a new instrument for management and quality control has been provided. The A. maintains that to define outputs, indicators and standards will allow to compare several services of the Department, get them omogeneous and guarantee and improve quality.

Use of Six Sigma strategies to pull the line on central line-associated bloodstream infections in a neurotrauma intensive care unit.

PubMed

Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen

2015-01-01

The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks.

Toward a Climate OSSE for NASA Earth Sciences

NASA Astrophysics Data System (ADS)

Leroy, S. S.; Collins, W. D.; Feldman, D.; Field, R. D.; Ming, Y.; Pawson, S.; Sanderson, B.; Schmidt, G. A.

2016-12-01

In the Continuity Study, the National Academy of Sciences advised that future space missions be rated according to five categories: the importance of a well-defined scientific objective, the utility of the observation in addressing the scientific objective, the quality with which the observation can be made, the probability of the mission's success, and the mission's affordability. The importance, probability, and affordability are evaluated subjectively by scientific consensus, by engineering review panels, and by cost models; however, the utility and quality can be evaluated objectively by a climate observation system simulation experiment (COSSE). A discussion of the philosophical underpinnings of a COSSE for NASA Earth Sciences will be presented. A COSSE is built upon a perturbed physics ensemble of a sophisticated climate model that can simulate a mission's prospective observations and its well-defined quantitative scientific objective and that can capture the uncertainty associated with each. A strong correlation between observation and scientific objective after consideration of physical uncertainty leads to a high quality. Persistence of a high correlation after inclusion of the proposed measurement error leads to a high utility. There are five criteria that govern that nature of a particular COSSE: (1) whether the mission's scientific objective is one of hypothesis testing or climate prediction, (2) whether the mission is empirical or inferential, (3) whether the core climate model captures essential physical uncertainties, (4) the level of detail of the simulated observations, and (5) whether complementarity or redundancy of information is to be valued. Computation of the quality and utility is done using Bayesian statistics, as has been done previously for multi-decadal climate prediction conditioned on existing data. We advocate for a new program within NASA Earth Sciences to establish a COSSE capability. Creation of a COSSE program within NASA Earth Sciences will require answers from the climate research community to basic questions, such as whether a COSSE capability should be centralized or de-centralized. Most importantly, the quantified scientific objective of a proposed mission must be defined with extreme specificity for a COSSE to be applied.

Clinical knowledge governance: the international perspective.

PubMed

Garde, Sebastian

2013-01-01

As a basis for semantic interoperability, ideally, a Clinical Knowledge Resource for a clinical concept should be defined formally and defined once in a way that all clinical professions and all countries can agree on. Clinical Knowledge Governance is required to create high-quality, reusable Clinical Knowledge Resources and achieve this aim. Traditionally, this is a time-consuming and cumbersome process, relying heavily on face-to-face meetings and being able to get sufficient input from clinicians. However, in a national or even international space, it is required to streamline the processes involved in creating Clinical Knowledge Resources. For this, a Web 2.0 tool that supports online collaboration of clinicians during their creation and publishing of Clinical Knowledge Resources has been developed. This tool is named the Clinical Knowledge Manager (CKM) and supports the development, review and publication of Clinical Knowledge Resources. Also, post-publication activities such as adding terminology bindings, translating the Clinical Knowledge Resource into another language and republishing it are supported. The acceptance of Clinical Knowledge Resources depends on their quality and being able to determine their quality, for example it is important to know that a broad umber of reviewers from various clinical disciplines have been involved in the development of the Clinical Knowledge Resource. We are still far from realizing the vision of a global repository of a great number of reusable, high-quality Clinical Knowledge Resources, which can provide the basis for broad semantic interoperability between systems. However progress towards this aim is being made around the world.

Comparison of family-planning service quality reported by adolescents and young adult women in Mexico.

PubMed

Darney, Blair G; Saavedra-Avendano, Biani; Sosa-Rubi, Sandra G; Lozano, Rafael; Rodriguez, Maria I

2016-07-01

Associations between age and patient-reported quality of family planning services were examined among young women in Mexico. A repeated cross-sectional analysis of survey data collected in 2006, 2009, and 2014 was performed. Data from women aged 15-29years who had not undergone sterilization and were currently using a modern contraceptive method were included. The primary outcome was high-quality care, defined as positive responses to all five quality items regarding contraceptive services included in the survey. Multivariable logistic regression and marginal probabilities were used to compare adolescents and women aged 20-29years. The responses of respondents using different contraceptive methods were compared. Data were included from 15 835 individuals. The multivariable analysis demonstrated lower odds of reporting high-quality care among women aged 15-19years (odds ratio 0.73; 95% confidence interval 0.60-0.88) and 20-24years (odds ratio 0.85; 95% confidence interval 0.75-0.96) compared with women aged 25-29years. Adolescents using hormonal and long-acting reversible contraception had significantly lower odds of reporting high-quality care compared with women aged 25-29. Adolescents in Mexico reported a lower quality of family planning services compared with young adult women. Continued research and policies are needed to improve the quality of contraceptive services. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Evaluation of an Integrated Telemonitoring Surveillance System in Patients with Coronary Heart Disease.

PubMed

Ammenwerth, E; Woess, S; Baumgartner, C; Fetz, B; van der Heidt, A; Kastner, P; Modre-Osprian, R; Welte, S; Poelzl, G

2015-01-01

Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life. A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases. Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor telemonitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (p< 0.01; MacNew questionnaire). Reductions in blood pressure and heart rate or an improvement in reaching defined goals could not be observed. The MyCor telemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes. Achieving long-term adherence and verifying clinical outcomes, however, remains an open issue. Our findings will promote further studies, addressing different strategies for an optimal mix of patient education, telemonitoring, feedback, and clinical follow-ups.

Defining and evaluating quality for ambulatory care educational programs.

PubMed

Bowen, J L; Stearns, J A; Dohner, C; Blackman, J; Simpson, D

1997-06-01

As the training of medical students and residents increasingly moves to ambulatory care settings, clerkship and program directors must find a way to use their limited resources to guide the development and evaluation of the quality of these ambulatory-based learning experiences. To evaluate quality, directors must first define, in operational and measurable terms, what is meant by the term "quality" as it is applied to ambulatory-based education. Using educational theories and the definition of quality used by health care systems, the authors propose an operational definition of quality for guiding the planning, implementation, and evaluation of ambulatory care educational programs. They assert that quality is achieved through the interaction of an optimal learning environment, defined educational goals and positive outcomes, participant satisfaction, and cost-effectiveness. By describing the components of quality along with examples of measurable indicators, the authors provide a foundation for the evaluation and improvement of instructional innovations in ambulatory care education for the benefit of teachers, learners, and patients.

Do Clinical Practice Guidelines Improve Quality?

PubMed

Baldassari, Cristina M

2017-07-01

Controversy exists surrounding how to best define and assess quality in the health care setting. Clinical practice guidelines (CPGs) have been developed to improve the quality of medical care by highlighting key clinical recommendations based on recent evidence. However, data linking CPGs to improvements in outcomes in otolaryngology are lacking. Numerous barriers contribute to difficulties in translating CPGs to improvements in quality. Future initiatives are needed to improve CPG adherence and define the impact of CPG recommendations on the quality of otolaryngologic care provided to our patients.

Defining health-related quality of life for young wheelchair users: A qualitative health economics study

PubMed Central

2017-01-01

Background Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use. Methods The sampling frame was children with impaired mobility (≤18 years) who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants’ homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life. Results Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1) participation and positive experiences; 2) self-worth and feeling fulfilled; 3) health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age. Conclusions Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this population. Development of a mobility-related quality of life outcome measure for children is recommended. PMID:28617820

Soil Quality Indicators to Define Land Use in the Area of Native Forest of Entre Ríos, Argentina

NASA Astrophysics Data System (ADS)

Wilson, M. G.; Tasi, H. A.; Paz González, A.; Díaz, E. L.; Sasal, M. C.

2012-04-01

The main economic activity in the area of native forest of the province of Entre Ríos (Argentina) has long been the agricultural and/or livestock production, especially cattle breeding. In recent years, the proportion of agricultural crops in the rotations, especially that of soybean, has increased, thus leading to an increase in the need for land clearing to incorporate new lands for agricultural use. Most of these lands are considered marginal for agricultural use. In addition rice farming with irrigation is a critical part of the Entre Ríos economy. Defining and assessing soil quality indicators (SQI) that show the evolution of the soil with different uses and management systems is a way to contribute to the knowledge of soil quality. The aims of this study were to characterize the current land use and land tenure in the area of native forest of Entre Ríos, as well as to identify and select variables sensitive to agricultural and/or livestock use of the most representative soils of this area (indicators of the dynamic quality of the soil) and define the most appropriate land use according to land suitability and behavior of these indicators. We identified the most representative soil subgroups (corresponding to the orders Vertisols, Mollisols and Alfisols) and defined the production systems livestock-agricultural, agricultural-livestock, agricultural without irrigation, and rice crop irrigated with water from groundwater and surface reservoirs. We also determined the physical, physico-chemical, chemical and microbiological variables of the soil, and characterized the quality of the water for irrigation. We selected the SQI using Principal Components Analysis, to form a minimum data set (MDS). The change in the use of the land responded to a favorable economic situation for agriculture that started in the 1990's. The leasing and sharecropping schemes and the incidental contracts have become increasingly important, predominating over the undivided property. We obtained the MDS for twelve combinations of soil subgroups and production systems. The MDS for each of them presented between six and nine SQI. The indicators showed greater variation in the MDS by production system than by unit of land. Total organic carbon content (TOC) and the structural stability index (Is) were included in all the MDS. The rice systems showed high dependence on the quality of the irrigation water. We also found high fragility of some soil subgroups. The results suggest that rotations including pastures in a high proportion should be considered, especially in Alfisols and Vertisols. The native forest is considered as the basis of sustainable production systems for the study area. Thus, the land that has already been cleared or is about to be cleared should consider an agricultural and/or livestock use according to its productive capacity and its limitations.

Soils and nutrition: A forest nursery perspective

Treesearch

Russell D. Briggs

2008-01-01

A brief review of the published proceedings from meetings of nursery managers over the past 30 years reveals a high level of consistency with respect to topics of interest from year to year. Seedling quality, defined as seedling capacity to effectively compete after outplanting, has been the unifying theme. Production issues, including collection, storage, and sowing...

World Wide Web Server Standards and Guidelines.

ERIC Educational Resources Information Center

Stubbs, Keith M.

This document defines the specific standards and general guidelines which the U.S. Department of Education (ED) will use to make information available on the World Wide Web (WWW). The purpose of providing such guidance is to ensure high quality and consistent content, organization, and presentation of information on ED WWW servers, in order to…

A Charter School's Journey toward Serving All Learners: A Case Study

ERIC Educational Resources Information Center

Drame, Elizabeth R.; Frattura, Elise

2011-01-01

Public charter schools across the country are struggling to better serve a range of students with disabilities. Using the approach of a participatory evaluation, a K-8 college preparatory school community of teachers, administrators, parents, and students were better able to define those practices that impeded or supported a high-quality proactive…

What should we expect from the hybrid room?

PubMed

Hertault, Adrien; Sobocinski, Jonathan; Spear, Rafaëlle; Azzaoui, Richard; Delloye, Matthieu; Fabre, Dominique; Haulon, Stephan

2017-04-01

The concept of hybrid room was defined as an optimized surgical theater, offering the best compromise between asepsis criteria from standard surgical rooms and high quality imaging equipment from fixed radiological suites. This review aimed at summarizing what vascular surgeons should expect from hybrid rooms in daily practice and in the near future.

A Study of North Carolina Technology Teacher Evaluation Practices and Job Satisfaction

ERIC Educational Resources Information Center

Olah, Dean Anthony

2013-01-01

Defining and measuring teacher effectiveness is one of the most hotly debated topics in public education today. The "No Child Left Behind" Act placed considerable emphasis on high quality teaching standards, making it a focal point of study among educators, administrators, and curriculum developers. Recruitment and retention of high…

Family Interaction Patterns, Career Planning Attitudes, and Vocational Identity of High School Adolescents

ERIC Educational Resources Information Center

Hargrove, Byron K.; Inman, Arpana G.; Crane, Randy L.

2005-01-01

The purpose of the current study was to examine how perceptions of family interaction patterns as defined along three dimensions of family environment (quality of family relationships, family goal-orientations, and degree of organization and control within the family system) predict vocational identity and career planning attitudes among male and…

Quality Issues in Propulsion

NASA Technical Reports Server (NTRS)

McCarty, John P.; Lyles, Garry M.

1997-01-01

Propulsion system quality is defined in this paper as having high reliability, that is, quality is a high probability of within-tolerance performance or operation. Since failures are out-of-tolerance performance, the probability of failures and their occurrence is the difference between high and low quality systems. Failures can be described at 3 levels: the system failure (which is the detectable end of a failure), the failure mode (which is the failure process), and the failure cause (which is the start). Failure causes can be evaluated & classified by type. The results of typing flight history failures shows that most failures are in unrecognized modes and result from human error or noise, i.e. failures are when engineers learn how things really work. Although the study based on US launch vehicles, a sampling of failures from other countries indicates the finding has broad application. The parameters of the design of a propulsion system are not single valued, but have dispersions associated with the manufacturing of parts. Many tests are needed to find failures, if the dispersions are large relative to tolerances, which could contribute to the large number of failures in unrecognized modes.

Quality assessment of economic evaluation studies in pediatric surgery: a systematic review.

PubMed

Fotso Kamdem, Arnaud; Nerich, Virginie; Auber, Frederic; Jantchou, Prévost; Ecarnot, Fiona; Woronoff-Lemsi, Marie-Christine

2015-04-01

To assess economic evaluation studies (EES) in pediatric surgery and to identify potential factors associated with high-quality studies. A systematic review of the literature using PubMed and Cochrane databases was conducted to identify EES in pediatric surgery published between 1 June 1993 and 30 June 2013. Assessment criteria are derived from the Drummond checklist. A high quality study was defined as a Drummond score ≥7. Logistic regression analysis was used to determine factors associated with high quality studies. 119 studies were included. 43.7% (n=52) of studies were full EES. Cost-effectiveness analysis was the most frequent (61.5%) type of full EES. Only 31.6% of studies had a Drummond score ≥7 and 73% of these were full EES. The factors associated with high quality were identification of costs (OR: 14.08; 95% CI: 3.38-100; p<0.001), estimation of utility value (OR: 8.13; 95% CI: 2.02-43.47; p=0.005) and study funding (OR: 3.50; 95% CI: 1.27-10.10; p=0.02). This review shows that the number and the quality of EES are low despite the increasing number of studies published in recent years. In the current context of budget constraints, our results should encourage pediatric surgeons to focus more on EES. Copyright © 2015 Elsevier Inc. All rights reserved.

Conceptualizing, Understanding, and Predicting Responsible Decisions and Quality Input

NASA Astrophysics Data System (ADS)

Wall, N.; PytlikZillig, L. M.

2012-12-01

In areas such as climate change, where uncertainty is high, it is arguably less difficult to tell when efforts have resulted in changes in knowledge, than when those efforts have resulted in responsible decisions. What is a responsible decision? More broadly, when it comes to citizen input, what is "high quality" input? And most importantly, how are responsible decisions and quality input enhanced? The aim of this paper is to contribute to the understanding of the different dimensions of "responsible" or "quality" public input and citizen decisions by comparing and contrasting the different predictors of those different dimensions. We first present different possibilities for defining, operationalizing and assessing responsible or high quality decisions. For example, responsible decisions or quality input might be defined as using specific content (e.g., using climate change information in decisions appropriately), as using specific processes (e.g., investing time and effort in learning about and discussing the issues prior to making decisions), or on the basis of some judgment of the decision or input itself (e.g., judgments of the rationale provided for the decisions, or number of issues considered when giving input). Second, we present results from our work engaging people with science policy topics, and the different ways that we have tried to define these two constructs. In the area of climate change specifically, we describe the development of a short survey that assesses exposure to climate information, knowledge of and attitudes toward climate change, and use of climate information in one's decisions. Specifically, the short survey was developed based on a review of common surveys of climate change related knowledge, attitudes, and behaviors, and extensive piloting and cognitive interviews. Next, we analyze more than 200 responses to that survey (data collection is currently ongoing and will be complete after the AGU deadline), and report the predictors of reported use of climate information in one's personal and work-related decisions, as well as significant predictors of one's willingness to commit to attend a four-hour public meeting and discussion with city leaders and energy experts for the purposes of thinking about and discussing local energy-related decisions. Finally, in order to consider future directions for assessing "responsible" or "quality" input in the area of climate change, we report data and results from experimental studies conducted in a different area of science: nanotechnology. Specifically, we discuss our methods for assessing quality of written input on the future development and regulation of nanotechnology under different experimental conditions (e.g., written alone or after discussion with a group), and the compare and contrast the best predictors of those operational definitions to those that we have explored in the area of climate change outreach contexts. Discussion will focus on the pros and cons of different ways of assessing the quality of public input.

High-quality lossy compression: current and future trends

NASA Astrophysics Data System (ADS)

McLaughlin, Steven W.

1995-01-01

This paper is concerned with current and future trends in the lossy compression of real sources such as imagery, video, speech and music. We put all lossy compression schemes into common framework where each can be characterized in terms of three well-defined advantages: cell shape, region shape and memory advantages. We concentrate on image compression and discuss how new entropy constrained trellis-based compressors achieve cell- shape, region-shape and memory gain resulting in high fidelity and high compression.

Research, development and pilot production of high output thin silicon solar cells

NASA Technical Reports Server (NTRS)

Iles, P. A.

1976-01-01

Work was performed to define and apply processes which could lead to high output from thin (2-8 mils) silicon solar cells. The overall problems are outlined, and two satisfactory process sequences were developed. These sequences led to good output cells in the thickness range to just below 4 mils; although the initial contract scope was reduced, one of these sequences proved capable of operating beyond a pilot line level, to yield good quality 4-6 mil cells of high output.

Approaches to ensuring and improving quality in the context of health system strengthening: a cross-site analysis of the five African Health Initiative Partnership programs

PubMed Central

2013-01-01

Background Integrated into the work in health systems strengthening (HSS) is a growing focus on the importance of ensuring quality of the services delivered and systems which support them. Understanding how to define and measure quality in the different key World Health Organization building blocks is critical to providing the information needed to address gaps and identify models for replication. Description of approaches We describe the approaches to defining and improving quality across the five country programs funded through the Doris Duke Charitable Foundation African Health Initiative. While each program has independently developed and implemented country-specific approaches to strengthening health systems, they all included quality of services and systems as a core principle. We describe the differences and similarities across the programs in defining and improving quality as an embedded process essential for HSS to achieve the goal of improved population health. The programs measured quality across most or all of the six WHO building blocks, with specific areas of overlap in improving quality falling into four main categories: 1) defining and measuring quality; 2) ensuring data quality, and building capacity for data use for decision making and response to quality measurements; 3) strengthened supportive supervision and/or mentoring; and 4) operational research to understand the factors associated with observed variation in quality. Conclusions Learning the value and challenges of these approaches to measuring and improving quality across the key components of HSS as the projects continue their work will help inform similar efforts both now and in the future to ensure quality across the critical components of a health system and the impact on population health. PMID:23819662

A high-level object-oriented model for representing relationships in an electronic medical record.

PubMed Central

Dolin, R. H.

1994-01-01

The importance of electronic medical records to improve the quality and cost-effectiveness of medical care continues to be realized. This growing importance has spawned efforts at defining the structure and content of medical data, which is heterogeneous, highly inter-related, and complex. Computer-assisted data modeling tools have greatly facilitated the process of representing medical data, however the complex inter-relationships of medical information can result in data models that are large and cumbersome to manipulate and view. This report presents a high-level object-oriented model for representing the relationships between objects or entities that might exist in an electronic medical record. By defining the relationship between objects at a high level and providing for inheritance, this model enables relating any medical entity to any other medical entity, even though the relationships were not directly specified or known during data model design. PMID:7949981

Evaluation of image quality of digital photo documentation of female genital injuries following sexual assault.

PubMed

Ernst, E J; Speck, Patricia M; Fitzpatrick, Joyce J

2011-12-01

With the patient's consent, physical injuries sustained in a sexual assault are evaluated and treated by the sexual assault nurse examiner (SANE) and documented on preprinted traumagrams and with photographs. Digital imaging is now available to the SANE for documentation of sexual assault injuries, but studies of the image quality of forensic digital imaging of female genital injuries after sexual assault were not found in the literature. The Photo Documentation Image Quality Scoring System (PDIQSS) was developed to rate the image quality of digital photo documentation of female genital injuries after sexual assault. Three expert observers performed evaluations on 30 separate images at two points in time. An image quality score, the sum of eight integral technical and anatomical attributes on the PDIQSS, was obtained for each image. Individual image quality ratings, defined by rating image quality for each of the data, were also determined. The results demonstrated a high level of image quality and agreement when measured in all dimensions. For the SANE in clinical practice, the results of this study indicate that a high degree of agreement exists between expert observers when using the PDIQSS to rate image quality of individual digital photographs of female genital injuries after sexual assault. © 2011 International Association of Forensic Nurses.

Filter methods to preserve local contrast and to avoid artifacts in gamut mapping

NASA Astrophysics Data System (ADS)

Meili, Marcel; Küpper, Dennis; Barańczuk, Zofia; Caluori, Ursina; Simon, Klaus

2010-01-01

Contrary to high dynamic range imaging, the preservation of details and the avoidance of artifacts is not explicitly considered in popular color management systems. An effective way to overcome these difficulties is image filtering. In this paper we investigate several image filter concepts for detail preservation as part of a practical gamut mapping strategy. In particular we define four concepts including various image filters and check their performance with a psycho-visual test. Additionally, we compare our performance evaluation to two image quality measures with emphasis on local contrast. Surprisingly, the most simple filter concept performs highly efficient and achieves an image quality which is comparable to the more established but slower methods.

Quality nursing care: a qualitative enquiry.

PubMed

Hogston, R

1995-01-01

In spite of the wealth of literature on quality nursing care, a disparity exists in defining quality. The purpose of this study was an attempt to seek out practising nurses' perceptions of quality nursing care and to present a definition of quality as described by nurses. Eighteen nurses from a large hospital in the south of England were interviewed. Qualitative analysis based on a modified grounded theory approach revealed three categories described as 'structure', 'process' and 'outcome'. This supports previous work on evaluating quality care but postulates that structure, process and outcome could also be used as a mechanism for defining quality. The categories are defined by using the words of the informants in order to explain the essential attributes of quality nursing care. The findings demonstrate how more informants cited quality in terms of process and outcome than structure. It is speculated that the significance of this rests with the fact that nurses have direct control over process and outcome whereas the political and economic climate in which nurses work is beyond their control and decisions over structure lie with their managers.

Defining and reconstructing clinical processes based on IHE and BPMN 2.0.

PubMed

Strasser, Melanie; Pfeifer, Franz; Helm, Emmanuel; Schuler, Andreas; Altmann, Josef

2011-01-01

This paper describes the current status and the results of our process management system for defining and reconstructing clinical care processes, which contributes to compare, analyze and evaluate clinical processes and further to identify high cost tasks or stays. The system is founded on IHE, which guarantees standardized interfaces and interoperability between clinical information systems. At the heart of the system there is BPMN, a modeling notation and specification language, which allows the definition and execution of clinical processes. The system provides functionality to define healthcare information system independent clinical core processes and to execute the processes in a workflow engine. Furthermore, the reconstruction of clinical processes is done by evaluating an IHE audit log database, which records patient movements within a health care facility. The main goal of the system is to assist hospital operators and clinical process managers to detect discrepancies between defined and actual clinical processes and as well to identify main causes of high medical costs. Beyond that, the system can potentially contribute to reconstruct and improve clinical processes and enhance cost control and patient care quality.

Health information technology and physicians' perceptions of healthcare quality.

PubMed

Fang, Hai; Peifer, Karen L; Chen, Jie; Rizzo, John A

2011-03-01

To investigate the relationship between the use of health information technology (HIT) and physician perceptions of providing high-quality care and to determine whether this relationship has changed over time. We used 2 waves of longitudinal data from the Community Tracking Study Physician Surveys, 2000-2001 and 2004-2005. Three measures of HIT were examined: a binary variable measuring the use of at least 1 type of HIT, a continuous variable measuring the total number of HIT types, and a binary variable measuring use of all 5 HIT types related to "meaningful use" of HIT as defined by Centers for Medicare and Medicaid Services. Three multivariate models were estimated to study the effect of each HIT measure on physicians' perception of providing high-quality care. Individual fixed-effects estimation also was used to control for individual time-invariant factors. Using at least 1 type of HIT significantly enhanced physicians' perception of providing high-quality care in 2000-2001, but not in 2004-2005. The marginal effect of adding 1 extra HIT type was positive and statistically significant in both periods. The association between using all 5 HIT types related to meaningful use and perceived quality was statistically significant in 2000-2001, but not in 2004-2005. Health information technology has become a multifunctional system and appears to have enhanced physicians' perception of providing high-quality care. Physicians' perceptions of medical care quality improved as the number of HIT types used increased. This study supports more extensive use of HIT in physician practices.

JIGSAW-GEO (1.0): Locally Orthogonal Staggered Unstructured Grid Generation for General Circulation Modelling on the Sphere

NASA Technical Reports Server (NTRS)

Engwirda, Darren

2017-01-01

An algorithm for the generation of non-uniform, locally orthogonal staggered unstructured spheroidal grids is described. This technique is designed to generate very high-quality staggered VoronoiDelaunay meshes appropriate for general circulation modelling on the sphere, including applications to atmospheric simulation, ocean-modelling and numerical weather prediction. Using a recently developed Frontal-Delaunay refinement technique, a method for the construction of high-quality unstructured spheroidal Delaunay triangulations is introduced. A locally orthogonal polygonal grid, derived from the associated Voronoi diagram, is computed as the staggered dual. It is shown that use of the Frontal-Delaunay refinement technique allows for the generation of very high-quality unstructured triangulations, satisfying a priori bounds on element size and shape. Grid quality is further improved through the application of hill-climbing-type optimisation techniques. Overall, the algorithm is shown to produce grids with very high element quality and smooth grading characteristics, while imposing relatively low computational expense. A selection of uniform and non-uniform spheroidal grids appropriate for high-resolution, multi-scale general circulation modelling are presented. These grids are shown to satisfy the geometric constraints associated with contemporary unstructured C-grid-type finite-volume models, including the Model for Prediction Across Scales (MPAS-O). The use of user-defined mesh-spacing functions to generate smoothly graded, non-uniform grids for multi-resolution-type studies is discussed in detail.

JIGSAW-GEO (1.0): locally orthogonal staggered unstructured grid generation for general circulation modelling on the sphere

NASA Astrophysics Data System (ADS)

Engwirda, Darren

2017-06-01

An algorithm for the generation of non-uniform, locally orthogonal staggered unstructured spheroidal grids is described. This technique is designed to generate very high-quality staggered Voronoi-Delaunay meshes appropriate for general circulation modelling on the sphere, including applications to atmospheric simulation, ocean-modelling and numerical weather prediction. Using a recently developed Frontal-Delaunay refinement technique, a method for the construction of high-quality unstructured spheroidal Delaunay triangulations is introduced. A locally orthogonal polygonal grid, derived from the associated Voronoi diagram, is computed as the staggered dual. It is shown that use of the Frontal-Delaunay refinement technique allows for the generation of very high-quality unstructured triangulations, satisfying a priori bounds on element size and shape. Grid quality is further improved through the application of hill-climbing-type optimisation techniques. Overall, the algorithm is shown to produce grids with very high element quality and smooth grading characteristics, while imposing relatively low computational expense. A selection of uniform and non-uniform spheroidal grids appropriate for high-resolution, multi-scale general circulation modelling are presented. These grids are shown to satisfy the geometric constraints associated with contemporary unstructured C-grid-type finite-volume models, including the Model for Prediction Across Scales (MPAS-O). The use of user-defined mesh-spacing functions to generate smoothly graded, non-uniform grids for multi-resolution-type studies is discussed in detail.

Standard classification of software documentation

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

General conceptual requirements for standard levels of documentation and for application of these requirements to intended usages. These standards encourage the policy to produce only those forms of documentation that are needed and adequate for the purpose. Documentation standards are defined with respect to detail and format quality. Classes A through D range, in order, from the most definitive down to the least definitive, and categories 1 through 4 range, in order, from high-quality typeset down to handwritten material. Criteria for each of the classes and categories, as well as suggested selection guidelines for each are given.

larvalign: Aligning Gene Expression Patterns from the Larval Brain of Drosophila melanogaster.

PubMed

Muenzing, Sascha E A; Strauch, Martin; Truman, James W; Bühler, Katja; Thum, Andreas S; Merhof, Dorit

2018-01-01

The larval brain of the fruit fly Drosophila melanogaster is a small, tractable model system for neuroscience. Genes for fluorescent marker proteins can be expressed in defined, spatially restricted neuron populations. Here, we introduce the methods for 1) generating a standard template of the larval central nervous system (CNS), 2) spatial mapping of expression patterns from different larvae into a reference space defined by the standard template. We provide a manually annotated gold standard that serves for evaluation of the registration framework involved in template generation and mapping. A method for registration quality assessment enables the automatic detection of registration errors, and a semi-automatic registration method allows one to correct registrations, which is a prerequisite for a high-quality, curated database of expression patterns. All computational methods are available within the larvalign software package: https://github.com/larvalign/larvalign/releases/tag/v1.0.

New educational tools to encourage high-school students' activity in stem

NASA Astrophysics Data System (ADS)

Mayorova, Vera; Grishko, Dmitriy; Leonov, Victor

2018-01-01

Many students have to choose their future profession during their last years in the high school and therefore to choose a university where they will get proper education. That choice may define their professional life for many years ahead or probably for the rest of their lives. Bauman Moscow State Technical University conducts various events to introduce future professions to high-school students. Such activity helps them to pick specialization in line with their interests and motivates them to study key scientific subjects. The paper focuses on newly developed educational tools to encourage high school students' interest in STEM disciplines. These tools include laboratory courses developed in the fields of physics, information technologies and mathematics. More than 2000 high school students already participated in these experimental courses. These activities are aimed at increasing the quality of STEM disciplines learning which will result in higher quality of training of future engineers.

The case against one-shot testing for initial dental licensure.

PubMed

Chambers, David W; Dugoni, Arthur A; Paisley, Ian

2004-03-01

High-stakes testing are expected to meet standards for cost-effectiveness, fairness, transparency, high reliability, and high validity. It is questionable whether initial licensure examinations in dentistry meet such standards. Decades of piecemeal adjustments in the system have resulted in limited improvement. The essential flaw in the system is reliance on a one-shot sample of a small segment of the skills, understanding, and supporting values needed for today's professional practice of dentistry. The "snapshot" approach to testing produces inherently substandard levels of reliability and validity. A three-step alternative is proposed: boards should (1) define the competencies required of beginning practitioners, (2) establish the psychometric standards needed to make defensible judgments about candidates, and (3) base licensure decisions only on portfolios of evidence that test for defined competencies at established levels of quality.

Working toward quality in obstetric anesthesia: a business approach.

PubMed

Lynde, Grant C

2017-06-01

Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's. Applying these lessons to the healthcare setting has been slow. Hospitals are only now introducing tools such as failure mode and effect analysis, Lean and Six Sigma into their quality divisions and are seeing significant cost reductions and outcomes improvements. The review will discuss the process for creating an effective quality program for an obstetric anesthesia division. Sustainable improvements in delivered care need to be based on an evaluation of service line needs, defining appropriate metrics, understanding current process flows, changing and measuring those processes, and developing mechanisms to ensure the new processes are maintained.

Evaluating YouTube as a Source of Patient Education on the Role of the Hospitalist: A Cross-Sectional Study

PubMed Central

Hudali, Tamer; Bhattarai, Mukul; Deckard, Alan; Hingle, Susan

2017-01-01

Background Hospital medicine is a relatively new specialty field, dedicated to the delivery of comprehensive medical care to hospitalized patients. YouTube is one of the most frequently used websites, offering access to a gamut of videos from self-produced to professionally made. Objective The aim of our study was to determine the adequacy of YouTube as an effective means to define and depict the role of hospitalists. Methods YouTube was searched on November 17, 2014, using the following search words: “hospitalist,” “hospitalist definition,” “what is the role of a hospitalist,” “define hospitalist,” and “who is a hospitalist.” Videos found only in the first 10 pages of each search were included. Non-English, noneducational, and nonrelevant videos were excluded. A novel 7-point scoring tool was created by the authors based on the definition of a hospitalist adopted by the Society of Hospital Medicine. Three independent reviewers evaluated, scored, and classified the videos into high, intermediate, and low quality based on the average score. Results A total of 102 videos out of 855 were identified as relevant and included in the analysis. Videos uploaded by academic institutions had the highest mean score. Only 6 videos were classified as high quality, 53 as intermediate quality, and 42 as low quality, with 82.4% (84/102) of the videos scoring an average of 4 or less. Conclusions Most videos found in the search of a hospitalist definition are inadequate. Leading medical organizations and academic institutions should consider producing and uploading quality videos to YouTube to help patients and their families better understand the roles and definition of the hospitalist. PMID:28073738

How Should "Quality" Technical Education and Training Be Defined? A Statement from the National Council for Occupational Education.

ERIC Educational Resources Information Center

Everett, James; Gershwin, Mary; Hayes, Homer; Jacobs, James; Mundhenk, Robert

Although objectively measurable achievement of outcomes is an important guide to the quality of education, the process of defining and assuring the quality of technical education and training must include consideration for the context in which technical education and training occurs. It is also critical to remember that education has two sets of…

Highly qualified does not equal high quality: A study of urban stakeholders' perceptions of quality in science teaching

NASA Astrophysics Data System (ADS)

Miranda, Rommel Joseph

By employing qualitative methods, this study sought to determine the perceptions that urban stakeholders hold about what characteristics should distinguish a high school science teacher whom they would consider to demonstrate high quality in science teaching. A maximum variation sample of six science teachers, three school administrators, six parents and six students from a large urban public school district were interviewed using semi-structured, in-depth interview techniques. From these data, a list of observable characteristics which urban stakeholders hold as evidence of high quality in science teaching was generated. Observational techniques were utilized to determine the extent to which six urban high school science teachers, who meet the NCLB Act criteria for being "highly qualified", actually possessed the characteristics which these stakeholders hold as evidence of high quality in science teaching. Constant comparative analysis was used to analyze the data set. The findings suggest that urban stakeholders perceive that a high school science teacher who demonstrates high quality in science teaching should be knowledgeable about their subject matter, their student population, and should be resourceful; should possess an academic background in science and professional experience in science teaching; should exhibit professionalism, a passion for science and teaching, and a dedication to teaching and student learning; should be skillful in planning and preparing science lessons and in organizing the classroom, in presenting the subject matter to students, in conducting a variety of hands-on activities, and in managing a classroom; and should assess whether students complete class goals and objectives, and provide feedback about grades for students promptly. The findings further reveal that some of the urban high school science teachers who were deemed to be "highly qualified", as defined by the NCLB Act, engaged in practices that threatened quality in science teaching and often failed to display the characteristics which urban stakeholders hold as evidence of high quality in science teaching. Thus, the criteria for "highly qualified" prescribed by policy makers and politicians do not necessarily translate into effective science teaching in urban settings. These findings emphasize the importance of stakeholder involvement in the design of educational reform initiatives.

[National health resources for highly specialised medicine].

PubMed

Bratlid, Dag; Rasmussen, Knut

2005-11-03

In order to monitor quality and efficiency in the use of health resources for highly specialised medicine, a National Professional Council has since 1990 advised the Norwegian health authorities on the establishing and localisation of such services. A comprehensive review of both the quality, economy and the geographical distribution of patients in each specialised service has been carried out. 33 defined national programmes were centralised to one hospital only and distributed among seven university hospitals. Eight multiregional programmes were centralised to two hospitals only and included four university hospitals. In 2001, a total of 2711 new patients were treated in these programmes. The system seems to have secured a sufficient patient flow to each programme so as to maintain quality. However, a geographically skewed distribution of patients was noted, particularly in some of the national programmes. In a small country like Norway, with 4.5 million inhabitants, a centralised monitoring of highly specialised medicine seems both rational and successful. By the same logic, however, international cooperation should probably be sought for the smallest patient groups.

Experimental based experiences with the introduction of a water safety plan for a multi-located university clinic and its efficacy according to WHO recommendations

PubMed Central

Dyck, Alexander; Exner, Martin; Kramer, Axel

2007-01-01

Background Due to the high number of immunosuppressed and other predisposed patients hospitals have to control and ensure the microbiological water quality. The origin for the occurrence of pathogenic microorganisms in water pipes is the formation of biofilm. Methods For the permanent control of water safety a water safety plan (WSP) was realized as recommended by the WHO following the principle "search and destroy". The WSP is based on an established HACCP concept due to the special focus. The most important measures include the concept for sample taking depending on patient risk. 3 different categories) are distinguished: risk area1 (high infection risk), risk 2 (moderate infection risk), and risk area 3 (not increased infection risk). Additionally to the threshold value of the German law for the quality of drinking water (TrinkwV) three more limiting values were defined (warning, alert, and worst case) for immediate risk adapted reaction. Additional attention has to be focussed on lavatory sinks, which are an open bacterial reservoir. Therefore continuous disinfecting siphons were installed as part of the WSP in high risk areas. If extended technical equipment is not available, especially for immunocompromised patients the following measures are easy to realize: boiled (or sun exposed) water for nursing procedures as well alimentary use, no showering. Results Comparing data over 3 years the microbial water quality was significantly improved resulting in no new case of nosocomial Legionella pneumoniae and decrease in neonatal sepsis. Conclusion According to average situations with highly contaminated water system the management must be defined with implementation of water task force, immediate providing of special equipment, information of patients and staff and control of the water quality, an example for successful decontamination of the hospital within 24 hours is given. PMID:17355621

Systematic review of scope and quality of electronic patient record data in primary care

PubMed Central

Thiru, Krish; Hassey, Alan; Sullivan, Frank

2003-01-01

Objective To systematically review measures of data quality in electronic patient records (EPRs) in primary care. Design Systematic review of English language publications, 1980-2001. Data sources Bibliographic searches of medical databases, specialist medical informatics databases, conference proceedings, and institutional contacts. Study selection Studies selected according to a predefined framework for categorising review papers. Data extraction Reference standards and measurements used to judge quality. Results Bibliographic searches identified 4589 publications. After primary exclusions 174 articles were classified, 52 of which met the inclusion criteria for review. Selected studies were primarily descriptive surveys. Variability in methods prevented meta-analysis of results. Forty eight publications were concerned with diagnostic data, 37 studies measured data quality, and 15 scoped EPR quality. Reliability of data was assessed with rate comparison. Measures of sensitivity were highly dependent on the element of EPR data being investigated, while the positive predictive value was consistently high, indicating good validity. Prescribing data were generally of better quality than diagnostic or lifestyle data. Conclusion The lack of standardised methods for assessment of quality of data in electronic patient records makes it difficult to compare results between studies. Studies should present data quality measures with clear numerators, denominators, and confidence intervals. Ambiguous terms such as “accuracy” should be avoided unless precisely defined. PMID:12750210

[Quality evaluation of the orthodontic practice for certification by ISO 9001. A procedure beneficial for medical, medico-dental or hospital service].

PubMed

Becker, G

2001-01-01

The accreditation of the ISO 9001 certification (ISO = International Standard Organization) is an external evaluation procedure carried out by independent experts, whose object is the analysis of the operational methods and practices of a medical care facility (e.g. hospital, private clinic, general practitioner's or dentist's practice) which decided to assume the concept, implementation and control of its own quality policy. The whole accreditation procedure represents the basic structure of a continuous dynamic progressiveness within a cabinet eager to offer outstanding quality. Moreover, it guarantees active and voluntary participation of every single member of the medical administration or technical team involved in the realization of this primary objective. In other words, we are talking about a very strong dynamic innovation leading to a change of views and the improvement of communication means, while simultaneously enhancing the security and quality aspects of medical care. The continuous guarantee of high quality medical care calls for precise planning and systematization of actions. First of all, these actions are defined, analyzed and listed in precise work procedures. As they are defined with the agreement of the whole team, they implicate respect and self control. This requires of course transparency of the treatment methods, whose different steps and procedures are described in detail in a logogramm set up in common.

Using Ensemble-Based Methods for Directly Estimating Causal Effects: An Investigation of Tree-Based G-Computation

ERIC Educational Resources Information Center

Austin, Peter C.

2012-01-01

Researchers are increasingly using observational or nonrandomized data to estimate causal treatment effects. Essential to the production of high-quality evidence is the ability to reduce or minimize the confounding that frequently occurs in observational studies. When using the potential outcome framework to define causal treatment effects, one…

Indiana Social Studies Proficiency Guide: An Aid to Curriculum Development. 1996 Edition.

ERIC Educational Resources Information Center

Indiana State Dept. of Education, Indianapolis. Center for School Improvement and Performance.

This guide outlines the kinds of learning opportunities that should be available to Indiana students in high-quality social studies programs, but it is not intended as a prescribed curriculum. The guide defines social studies as the integrated study of the social sciences and the humanities to promote civic competence. Social studies education…

77 FR 12257 - Proposed Priorities, Requirements, Definitions, And Selection Criteria; Teacher Incentive Fund...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... stipends for teachers who agree to observe their peers for evaluative purposes. By proposing to design its... criteria that are designed to ensure that TIF grantees use high-quality LEA-wide evaluation and support...- designed and implemented LEA-wide. In this notice, we define an HCMS as the system an LEA uses to make...

Supporting Authors in the Development of Task-Based Learning in Serious Virtual Worlds

ERIC Educational Resources Information Center

Bellotti, Francesco; Berta, Riccardo; De Gloria, Alessandro; Primavera, Ludovica

2010-01-01

Serious virtual worlds (SVWs) represent a great opportunity for learning and should embed a lot of high-quality contextualised information so that the player can take the most from his or her exploration of the environment. This requires defining new methodologies and tools for effective production. We have investigated this issue in implementing…

Considering the Role of Tutoring in Student Engagement: Reflections from a South African University

ERIC Educational Resources Information Center

Faroa, Brendon Duran

2017-01-01

Student engagement has been defined as the extent to which students are engaged in activities that higher education research has shown to be linked with high-quality learning outcomes. The ubiquitous influence of the term "student engagement" has been felt throughout the higher education landscape. This is especially true for South…

Negotiating Identities for Mathematics Teaching in the Context of Professional Development

ERIC Educational Resources Information Center

Gresalfi, Melissa Sommerfeld; Cobb, Paul

2011-01-01

This article presents an analytical approach for documenting the identities for teaching that mathematics teachers negotiate as they participate in 2 or more communities that define high-quality teaching differently. Drawing on data from the first 2 years of a collaboration with a group of middle school mathematics teachers, the article focuses on…

Test-Wiseness Cues in the Options of Mathematics Items.

ERIC Educational Resources Information Center

Kuntz, Patricia

The quality of mathematics multiple choice items and their susceptibility to test wiseness were examined. Test wiseness was defined as "a subject's capacity to utilize the characteristics and formats of the test and/or test taking situation to receive a high score." The study used results of the Graduate Record Examinations Aptitude Test (GRE) and…

"AfterZone:" Outcomes for Youth Participating in Providence's Citywide After-School System. Executive Summary

ERIC Educational Resources Information Center

Kauh, Tina J.

2011-01-01

This executive summary highlights the main findings from our participation and outcomes analysis of the "AfterZone" initiative--a citywide system-building effort in Providence, Rhode Island, that aims to provide high-quality, accessible out-of-school-time services to middle school youth. The summary briefly defines the AfterZone's unique…

A NASA family of minicomputer systems, Appendix A

NASA Technical Reports Server (NTRS)

Deregt, M. P.; Dulfer, J. E.

1972-01-01

This investigation was undertaken to establish sufficient specifications, or standards, for minicomputer hardware and software to provide NASA with realizable economics in quantity purchases, interchangeability of minicomputers, software, storage and peripherals, and a uniformly high quality. The standards will define minicomputer system component types, each specialized to its intended NASA application, in as many levels of capacity as required.

Building Community: 4th-Grade Team Reaches through Classroom Walls to Collaborate

ERIC Educational Resources Information Center

Chapman, Sue

2014-01-01

Imagine, for a second, a school where teachers see themselves as leaders and work together to ensure that all children have access to engaging, high quality instruction every day. How might these teachers define teacher leadership and articulate its purpose? What suggestions would they offer about how teacher leadership can be grown and supported?…

75 FR 5634 - Grand Challenges of the 21st Century; Request for Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... sustainable growth and the creation of high-quality jobs. One of the goals of the President's strategy is to..., etc.) that are interested in collaborating with each other and the Administration to achieve one or.... Some define important problems in a particular field of science and engineering. For example, in 1900...

Including English Learners in a Multitiered Approach to Early Reading Instruction and Intervention

ERIC Educational Resources Information Center

Fien, Hank; Smith, Jean Louise M.; Baker, Scott K.; Chaparro, Erin; Baker, Doris Luft; Preciado, Jorge A.

2011-01-01

Delivering high-quality reading instruction to English language learners (ELLs) in the early grades is one of the most challenging issues facing schools. The report of the National Literacy Panel on Language-Minority Children and Youth (NLP; August & Shanahan, 2006) defined "English language learners" as students who come from language backgrounds…

Determining quality in doctoral programming: A grounded theory study of biological sciences, English studies, and special education

NASA Astrophysics Data System (ADS)

Fansler, A. Gigi

This study uses the grounded theory approach to identify how 12 faculty members at Illinois State University define the key determinants of a quality doctoral program. Two sets of interviews were conducted, lasting from 45 to 90 minutes. The first round of interviews was guided by the following open-ended questions: (1) How do you define a quality doctoral program? (2) What has led you to define quality in that way? and (3) What events or actions have you experienced that have been evidence of "quality?" While these three served as the primary questions, many follow-up questions and prompts were used throughout the entire interview process. A subsequent interview was conducted with the participants in order to explore the 12 emergent categories. The theory was generated using the transcriptions from both rounds of interviews and a conceptual map that was revised throughout the process. The researcher used open-coding, axial coding, and selective coding throughout the study until saturation of the data was achieved, and relationships among the categories were formed. The following nine factors of the model emerged from the data: (a) professional mentorship; (b) faculty productivity; (c) program accountability and/or evaluation; (d) students who publish; (e) solid educational experience; (f) quality of students; (g) student placement; (h) experience as a faculty member; (i) experiences as a doctoral student. The first seven describe how the 12 faculty members defined a quality doctoral program. The last two address the factors that led the participants to define quality in the way they did. This study provides leaders of higher education institutions a glimpse of one stakeholder group's perceptions of what constitutes a quality doctoral program. Such information can be used as a starting point for assessing quality of doctoral programs in an era of accountability.

Road-corridor planning in the EIA procedure in Spain. A review of case studies

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

Loro, Manuel, E-mail: manuel.loro@upm.es; Transport Research Centre; Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid

The assessment of different alternatives in road-corridor planning must be based on a number of well-defined territorial variables that serve as decision making criteria, and this requires a high-quality preliminary environmental assessment study. In Spain the formal specifications for the technical requirements stipulate the constraints that must be considered in the early stages of defining road corridors, but not how they should be analyzed and ranked. As part of the feasibility study of a new road definition, the most common methodology is to establish different levels of Territorial Carrying Capacity (TCC) in the study area in order to summarize themore » territorial variables on thematic maps and to ease the tracing process of road-corridor layout alternatives. This paper explores the variables used in 22 road-construction projects conducted by the Ministry of Public Works that were subject to the Spanish EIA regulation and published between 2006 and 2008. The aim was to evaluate the quality of the methods applied and the homogeneity and suitability of the variables used for defining the TCC. The variables were clustered into physical, environmental, land-use and cultural constraints for the purpose of comparing the TCC values assigned in the studies reviewed. We found the average quality of the studies to be generally acceptable in terms of the justification of the methodology, the weighting and classification of the variables, and the creation of a synthesis map. Nevertheless, the methods for assessing the TCC are not sufficiently standardized; there is a lack of uniformity in the cartographic information sources and methodologies for the TCC valuation. -- Highlights: • We explore 22 road-corridor planning studies subjected to the Spanish EIA regulation. • We analyze the variables selected for defining territorial carrying capacity. • The quality of the studies is acceptable (methodology, variable weighting, mapping). • There is heterogeneity in the methods for territorial carrying capacity valuation.« less

Sustainable waste management through end-of-waste criteria development.

PubMed

Zorpas, Antonis A

2016-04-01

The Waste Framework Directive 2000/98 (WFD) contains specific requirements to define end-of-waste criteria (EWC). The main goal of EWC is to remove and eliminate the administrative loads of waste legislation for safe and high-quality waste materials, thereby facilitating and assisting recycling. The target is to produce effective with high quality of recyclables materials, promoting product standardization and quality and safety assurance, and improving harmonization and legal certainty in the recyclable material markets. At the same time, those objectives aim to develop a plan in order to improve the development and wider use of environmental technologies, which reduce pressure on environment and at the same time address the three dimensions of the Lisbon strategy: growth, jobs and environment. This paper presents the importance of EWC, and the approach of setting EWC as EWC affect several management systems as well as sustainable and clean technologies.

Multi-Resolution Unstructured Grid-Generation for Geophysical Applications on the Sphere

NASA Technical Reports Server (NTRS)

Engwirda, Darren

2015-01-01

An algorithm for the generation of non-uniform unstructured grids on ellipsoidal geometries is described. This technique is designed to generate high quality triangular and polygonal meshes appropriate for general circulation modelling on the sphere, including applications to atmospheric and ocean simulation, and numerical weather predication. Using a recently developed Frontal-Delaunay-refinement technique, a method for the construction of high-quality unstructured ellipsoidal Delaunay triangulations is introduced. A dual polygonal grid, derived from the associated Voronoi diagram, is also optionally generated as a by-product. Compared to existing techniques, it is shown that the Frontal-Delaunay approach typically produces grids with near-optimal element quality and smooth grading characteristics, while imposing relatively low computational expense. Initial results are presented for a selection of uniform and non-uniform ellipsoidal grids appropriate for large-scale geophysical applications. The use of user-defined mesh-sizing functions to generate smoothly graded, non-uniform grids is discussed.

Status of groundwater quality in the Coastal Los Angeles Basin, 2006-California GAMA Priority Basin Project

USGS Publications Warehouse

Goldrath, Dara; Fram, Miranda S.; Land, Michael; Belitz, Kenneth

2012-01-01

Groundwater quality in the approximately 860-square-mile (2,227-square-kilometer) Coastal Los Angeles Basin study unit (CLAB) was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study area is located in southern California in Los Angeles and Orange Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA CLAB study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality and ancillary data collected in 2006 by the USGS from 69 wells and on water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer system was defined by the depth interval of the wells listed in the CDPH database for the CLAB study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study assesses the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifer system of the CLAB study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic and special-interest constituents [perchlorate, N-nitrosodimethylamine (NDMA), 1,2,3-trichloropropane (1,2,3-TCP), and 1,4-dioxane] were classified as "high" (relative-concentration>1.0), "moderate" (0.5status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifer system with moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based and spatially weighted-were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the CLAB study unit (within 90-percent confidence intervals). Inorganic constituents with human-health benchmarks were detected at high relative-concentrations in 5.6 percent of the primary aquifer system and moderate in 26 percent. High aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of arsenic (1.9 percent), nitrate (1.9 percent), and uranium (1.2 percent). Inorganic constituents with secondary maximum contaminant levels (SMCL) were detected at high relative-concentrations in 18 percent of the primary aquifer system and moderate in 47 percent. The constituents present at high relative-concentrations included total dissolved solids (1.9 percent), manganese (15 percent), and iron (9.4 percent). Relative-concentrations of organic constituents (one or more) were high in 3.7 percent, and moderate in 13 percent, of the primary aquifer system. The high aquifer-scale proportion of organic constituents primarily reflected high aquifer-scale proportions of solvents, including trichloroethene (TCE; 1.7 percent), perchloroethene (PCE; 1.1 percent), and carbon tetrachloride (1.0 percent). Of the 204 organic constituents analyzed, 44 constituents were detected. Eleven organic constituents had detection frequencies of greater than 10 percent: the trihalomethanes chloroform and bromodichloromethane, the solvents TCE, PCE, cis-1,2-dichloroethene, and 1,1-dichloroethene, the herbicides atrazine, simazine, prometon, and tebuthiuron, and the gasoline additive methyl tert-butyl ether (MTBE). Most detections were at low relative-concentrations. The special-interest constituent perchlorate was detected at high relative-concentrations in 0.5 percent of the primary aquifer system, and at moderate relative-concentrations in 35 percent. The special-interest constituent 1,4-dioxane was detected at high relative-concentrations, but an insufficient number of samples was analyzed to provide a representative estimate of aquifer-scale proportion.

Beyond Accreditation: What Defines a Quality Funeral Service Education Program? An Investigation of the Relationship between Educational Correlates and Program Quality in Funeral Service Education

ERIC Educational Resources Information Center

Fritch, John Bradley

2011-01-01

This study sought to determine what defines a quality funeral service education program beyond accreditation. The study examined the opinions of funeral service education chairs (N = 45, representing 80% of the population) who are leaders of funeral service education programs accredited by the American Board of Funeral Service Education.…

Poor sleep quality predicts decreased cognitive function independently of chronic mountain sickness score in young soldiers with polycythemia stationed in Tibet.

PubMed

Kong, Fan-Yi; Li, Qiang; Liu, Shi-Xiang

2011-01-01

Little is known about the association between poor sleep and cognitive function in people with polycythemia at high altitude. The aim of this study was to survey the sleep quality of individuals with polycythemia at high altitude and determine its association with cognitive abilities. We surveyed 230 soldiers stationed in Tibet (all men; mean age 21-52±4.30 yr) at altitudes ranging from 3658 to 3996 m. All participants were given a blood tests for hemoglobin level and a questionnaire survey of cognitive function. Polycythemia was defined as excessive erythrocytosis (Hb≥21 g/dL in men or ≥19 g/dL in women). Poor sleepers were defined as having a global Pittsburgh Sleep Quality Index score (PSQI)>5. Cognitive abilities were determined by the Chinese revision of the Wechsler Adult Intelligence Scale and the Benton Visual Retention Test. Multiple linear regression analysis was used to determine the association between the PSQI and cognitive function. Logistic regression analysis was performed to determine the independent effect of sleep quality on cognitive function. The global PSQI score of enrolled participants was 8.14±3.79. Seventy-five (32.6%) soldiers were diagnosed with polycythemia. The proportion of poor sleepers was 1.45 times greater in those with polycythemia compared with those without polycythemia [95% (confidence interval) CI 1.82-2.56], and they had a statistically significant lower score for cognitive function. Multiple linear regression analysis showed that the global PSQI score was negatively associated with IQ (β=0.11, 95% CI -0.16 to -0.05) and digit symbol scores (β=0.66, 95% CI -0.86 to -0.44). Poor sleep quality was determined to be an independent predictor of impaired IQ [odds ratio (OR) 1.59, 95% CI 1.30-1.95] and digit symbol score (OR 1.18, 95% CI 1.07-1.31) in logistic regression analysis. The present study showed that for young soldiers with polycythemia at high altitude impaired subjective sleep quality was an independent predictor of decreased cognitive function, especially IQ and verbal short-term memory.

[Quality assurance in intensive care: the situation in Switzerland].

PubMed

Frutiger, A

1999-10-30

The movement for quality in medicine is starting to take on the dimensions of a crusade. Quite logically it has also reached the intensive care community. Due to their complex multidisciplinary functioning and because of the high costs involved, ICUs are model services reflecting the overall situation in our hospitals. The situation of Swiss intensive care is particularly interesting, because for over 25 years standards for design and staffing of Swiss ICUs have been in effect and were enforced via onsite visits by the Swiss Society of Intensive Care without government involvement. Swiss intensive care thus defined its structures long before the word "accreditation" had even been used in this context. While intensive care in Switzerland is practised in clearly defined, well equipped and adequately staffed units, much less is known about process quality and outcomes of these services. Statistics on admissions, length of stay and length of mechanical ventilation, as well as severity data based on a simple classification system, are collected nationwide and allow some limited insight into the overall process of care. Results of intensive care are not systematically assessed. In response to the constant threat of cost containment, Swiss ICUs should increasingly focus on process quality and results, while maintaining their existing good structures.

Textbook Outcome: A Composite Measure for Quality of Elective Aneurysm Surgery.

PubMed

Karthaus, Eleonora G; Lijftogt, Niki; Busweiler, Linde A D; Elsman, Bernard H P; Wouters, Michel W J M; Vahl, Anco C; Hamming, Jaap F

2017-11-01

To investigate a new composite quality measurement, which comprises a desirable outcome for elective aneurysm surgery, called "Textbook Outcome" (TO). Single-quality indicators in vascular surgery are often not distinctive and insufficiently reflect the quality of care. All patients undergoing elective abdominal aortic aneurysm repair, registered in the Dutch Surgical Aneurysm Audit between 2014 and 2015 were included. TO was defined as the percentage of patients who had abdominal aortic aneurysm-repair without intraoperative complications, postoperative surgical complications, reinterventions, prolonged hospital stay [endovascular aneurysm repair (EVAR) ≤4 d, open surgical repair (OSR) ≤10 d], readmissions, and postoperative mortality (≤30 d after surgery/at discharge). Case-mix adjusted TO rates were used to compare hospitals and to compare individual hospital results for different procedures. Five thousand one hundred seventy patients were included, of whom 4039 were treated with EVAR and 1131 with OSR. TO was achieved in 71% of EVAR and 53% of OSR. Important obstacles for achieving TO were a prolonged hospital stay, postoperative complications, and readmissions. Adjusted TO rates varied from 38% to 89% (EVAR) and from 0% to 97% (OSR) between individual hospitals. Hospitals with a high TO for OSR also had a high TO for EVAR; however, a high TO for EVAR did not implicate a high TO for OSR. TO generates additional information to evaluate the overall quality of the care of elective aneurysm surgery, which subsequently can be used by hospitals to improve the quality of their care.

Fertility preservation in children, adolescents, and young adults with cancer: Quality of clinical practice guidelines and variations in recommendations.

PubMed

Font-Gonzalez, Anna; Mulder, Renée L; Loeffen, Erik A H; Byrne, Julianne; van Dulmen-den Broeder, Eline; van den Heuvel-Eibrink, Marry M; Hudson, Melissa M; Kenney, Lisa B; Levine, Jennifer M; Tissing, Wim J E; van de Wetering, Marianne D; Kremer, Leontien C M

2016-07-15

Fertility preservation care for children, adolescents, and young adults (CAYAs) with cancer is not uniform among practitioners. To ensure high-quality care, evidence-based clinical practice guidelines (CPGs) are essential. The authors identified existing CPGs for fertility preservation in CAYAs with cancer, evaluated their quality, and explored differences in recommendations. A systematic search in PubMed (January 2000-October 2014); guideline databases; and Web sites of oncology, pediatric, and fertility organizations was performed. Two reviewers evaluated the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). From high-quality CPGs, the authors evaluated concordant and discordant areas among the recommendations. A total of 25 CPGs regarding fertility preservation were identified. The average AGREE II domain scores (scale of 0%-100%) varied from 15% on applicability to 100% on clarity of presentation. The authors considered 8 CPGs (32%) to be of high quality, which was defined as scores ≥60% in any 4 domains. Large variations in the recommendations of the high-quality CPGs were observed, with 87.2% and 88.6%, respectively, of discordant guideline areas among the fertility preservation recommendations for female and male patients with cancer. Only approximately one-third of the identified CPGs were found to be of sufficient quality. Of these CPGs, the fertility preservation recommendations varied substantially, which can be a reflection of inadequate evidence for specific recommendations, thereby hindering the ability of providers to deliver high-quality care. CPGs including a transparent decision process for fertility preservation can help health care providers to deliver optimal and uniform care, thus improving the quality of life of CAYAs with cancer and cancer survivors. Cancer 2016;122:2216-23. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Honey Bee (Apis mellifera) Queen Reproductive Potential Affects Queen Mandibular Gland Pheromone Composition and Worker Retinue Response.

PubMed

Rangel, Juliana; Böröczky, Katalin; Schal, Coby; Tarpy, David R

2016-01-01

Reproductive division of labor is one of the defining traits of honey bees (Apis mellifera), with non-reproductive tasks being performed by workers while a single queen normally monopolizes reproduction. The decentralized organization of a honey bee colony is maintained in large part by a bouquet of queen-produced pheromones, the distribution of which is facilitated by contact among workers throughout the hive. Previous studies have shown that the developmental fate of honey bee queens is highly plastic, with queens raised from younger worker larvae exhibiting higher measures of reproductive potential compared to queens raised from older worker larvae. We investigated differences in the chemical composition of the mandibular glands and attractiveness to workers of "high-quality" queens (i.e., raised from first instar worker larvae; more queen-like) and "low-quality" queens (i.e., raised from third instar worker larvae; more worker-like). We characterized the chemical profiles of the mandibular glands of high-quality queens and low-quality queens using GC-MS and used the worker retinue response as a measure of the attractiveness to workers of high-quality queens vs. low-quality queens. We found that queen quality affected the chemical profiles of mandibular gland contents differently across years, showing significant differences in the production of the queen mandibular pheromone ("QMP") components HVA and 9-HDA in 2010, but no significant differences of any glandular compound in 2012. We also found that workers were significantly more attracted to high-quality queens than to low-quality queens in 2012, possibly because of increased attractiveness of their mandibular gland chemical profiles. Our results indicate that the age at which honey bee larvae enter the "queen-specific" developmental pathway influences the chemical composition of queen mandibular glands and worker behavior. However, these changes are not consistent across years, suggesting that other external factors may play important roles in modulating queen quality.

Designing a Broadband Pump for High-Quality Micro-Lasers via Modified Net Radiation Method.

PubMed

Nechayev, Sergey; Reusswig, Philip D; Baldo, Marc A; Rotschild, Carmel

2016-12-07

High-quality micro-lasers are key ingredients in non-linear optics, communication, sensing and low-threshold solar-pumped lasers. However, such micro-lasers exhibit negligible absorption of free-space broadband pump light. Recently, this limitation was lifted by cascade energy transfer, in which the absorption and quality factor are modulated with wavelength, enabling non-resonant pumping of high-quality micro-lasers and solar-pumped laser to operate at record low solar concentration. Here, we present a generic theoretical framework for modeling the absorption, emission and energy transfer of incoherent radiation between cascade sensitizer and laser gain media. Our model is based on linear equations of the modified net radiation method and is therefore robust, fast converging and has low complexity. We apply this formalism to compute the optimal parameters of low-threshold solar-pumped lasers. It is revealed that the interplay between the absorption and self-absorption of such lasers defines the optimal pump absorption below the maximal value, which is in contrast to conventional lasers for which full pump absorption is desired. Numerical results are compared to experimental data on a sensitized Nd 3+ :YAG cavity, and quantitative agreement with theoretical models is found. Our work modularizes the gain and sensitizing components and paves the way for the optimal design of broadband-pumped high-quality micro-lasers and efficient solar-pumped lasers.

Designing a Broadband Pump for High-Quality Micro-Lasers via Modified Net Radiation Method

PubMed Central

Nechayev, Sergey; Reusswig, Philip D.; Baldo, Marc A.; Rotschild, Carmel

2016-01-01

High-quality micro-lasers are key ingredients in non-linear optics, communication, sensing and low-threshold solar-pumped lasers. However, such micro-lasers exhibit negligible absorption of free-space broadband pump light. Recently, this limitation was lifted by cascade energy transfer, in which the absorption and quality factor are modulated with wavelength, enabling non-resonant pumping of high-quality micro-lasers and solar-pumped laser to operate at record low solar concentration. Here, we present a generic theoretical framework for modeling the absorption, emission and energy transfer of incoherent radiation between cascade sensitizer and laser gain media. Our model is based on linear equations of the modified net radiation method and is therefore robust, fast converging and has low complexity. We apply this formalism to compute the optimal parameters of low-threshold solar-pumped lasers. It is revealed that the interplay between the absorption and self-absorption of such lasers defines the optimal pump absorption below the maximal value, which is in contrast to conventional lasers for which full pump absorption is desired. Numerical results are compared to experimental data on a sensitized Nd3+:YAG cavity, and quantitative agreement with theoretical models is found. Our work modularizes the gain and sensitizing components and paves the way for the optimal design of broadband-pumped high-quality micro-lasers and efficient solar-pumped lasers. PMID:27924844

The potential impacts of electric vehicles on air quality in the urban areas of Barcelona and Madrid (Spain)

NASA Astrophysics Data System (ADS)

Soret, A.; Guevara, M.; Baldasano, J. M.

2014-12-01

This work analyses the potential air quality improvements resulting from three fleet electrification scenarios (∼13, 26 and 40%) by replacing conventional vehicles with Electric Battery Vehicles (EBVs), Plug-in Hybrid Electric Vehicles (PHEVs) and Hybrid Electric Vehicles (HEVs). This study has been performed for the cities of Barcelona and Madrid (Spain), where road transport is the primary emission source. In these urban areas, several air quality problems are present, mainly related to NO2 and particulate matter. The WRF-ARW/HERMESv2/CMAQ model system has been applied at high spatial (1 × 1 km2) and temporal (1 h) resolution. The results show that fleet electrification offers a potential for emission abatement, especially related to NOx and CO. Regarding the more ambitious scenario (∼40% fleet electrification), reductions of 11% and 17% of the total NOx emissions are observed in Barcelona and Madrid respectively. These emissions reductions involve air quality improvements in NO2 maximum hourly values up to 16%: reductions up to 30 and 35 μg m-3 in Barcelona and Madrid, respectively. Furthermore, an additional scenario has been defined considering electric generation emissions associated with EBVs and PHEVs charging from a combined-cycle power plant. These charging emissions would produce slight NO2 increases in the downwind areas of <3 μg m-3. Thus, fleet electrification would improve urban air quality even when considering emissions associated with charging electric vehicles. However, two further points should be considered. First, fleet electrification cannot be considered a unique solution, and other management strategies may be defined. This is especially important with respect to particulate matter emissions, which are not significantly reduced by fleet electrification (<5%) due to the high weight of non-exhaust emissions. Second, a significant introduction of electric vehicles (26-40%) involving all vehicle categories is required to improve urban air quality.

Classification of soft-shell materials for leisure outdoor jackets by clo defined from thermal properties testing

NASA Astrophysics Data System (ADS)

Tesinova, P.; Steklova, P.; Duchacova, T.

2017-10-01

Materials for outdoor activities are produced in various combinations and lamination helps to combine two or more components for gaining high comfort properties and lighten the structure. Producers can choose exact suitable material for construction of part or set of so called layered clothing for expected activity. Decreasing the weight of materials when preserving of high quality of water-vapour permeability, wind resistivity and hydrostatic resistivity and other comfort and usage properties is a big task nowadays. This paper is focused on thermal properties as an important parameter for being comfort during outdoor activities. Softshell materials were chosen for testing and computation of clo. Results compared with standardised clo table helps us to classify thermal insulation of the set of fabrics when defining proper clothing category.

Advanced fabrication of Si nanowire FET structures by means of a parallel approach.

PubMed

Li, J; Pud, S; Mayer, D; Vitusevich, S

2014-07-11

In this paper we present fabricated Si nanowires (NWs) of different dimensions with enhanced electrical characteristics. The parallel fabrication process is based on nanoimprint lithography using high-quality molds, which facilitates the realization of 50 nm-wide NW field-effect transistors (FETs). The imprint molds were fabricated by using a wet chemical anisotropic etching process. The wet chemical etch results in well-defined vertical sidewalls with edge roughness (3σ) as small as 2 nm, which is about four times better compared with the roughness usually obtained for reactive-ion etching molds. The quality of the mold was studied using atomic force microscopy and scanning electron microscopy image data. The use of the high-quality mold leads to almost 100% yield during fabrication of Si NW FETs as well as to an exceptional quality of the surfaces of the devices produced. To characterize the Si NW FETs, we used noise spectroscopy as a powerful method for evaluating device performance and the reliability of structures with nanoscale dimensions. The Hooge parameter of fabricated FET structures exhibits an average value of 1.6 × 10(-3). This value reflects the high quality of Si NW FETs fabricated by means of a parallel approach that uses a nanoimprint mold and cost-efficient technology.

Development of Range Design Elements and Quality Control/Quality Assurance Guidance to Reduce Maintenance Requirements on Training Ranges

DTIC Science & Technology

2006-11-01

exercises. Potential Resolution: 1. Installations must ensure that they understand the composition of civilian populations outside of their...Installation trainers, SRP Support Agency trainers or contract training specialists should layout each range based on the composition defined in the...defined time limit to respond to submittals with a pre-defined team member composition so that changes could be reviewed consistently. Only mission

Fluorine-Based DRIE of Fused Silica

NASA Technical Reports Server (NTRS)

Yee, Karl; Shcheglov, Kirill; Li, Jian; Choi, Daniel

2007-01-01

A process of deep reactive-ion etching (DRIE) using a fluorine-based gas mixture enhanced by induction-coupled plasma (ICP) has been demonstrated to be effective in forming high-aspect-ratio three-dimensional patterns in fused silica. The patterns are defined in part by an etch mask in the form of a thick, high-quality aluminum film. The process was developed to satisfy a need to fabricate high-aspect-ratio fused-silica resonators for vibratory microgyroscopes, and could be used to satisfy similar requirements for fabricating other fused-silica components.

Eating frequency is inversely associated with BMI, waist circumference and the proportion of body fat in Korean adults when diet quality is high, but not when it is low: analysis of the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV).

PubMed

Kim, Sunmi; Yang, Jeong Hee; Park, Gyeong-Hun

2018-04-01

The role of eating frequency (EF) in obesity development has been debated, and few studies have investigated Asian populations. Diet quality might affect the association between EF and obesity. Therefore, we investigated the association between EF and obesity indicators in a representative sample of Korean adults with consideration to diet quality. This cross-sectional study used data of 6951 participants aged 19-93 years (male 49·8 %, female 50·2 %) from the Fourth Korean National Health and Nutrition Examination Survey. EF was assessed using a questionnaire, and diet quality was defined as mean adequacy ratio (MAR). To explore the association between EF and obesity indicators, we used multiple linear regression analyses with and without interaction terms between diet quality and EF. EF was inversely associated with each obesity indicator, including body fat percentage (BF%), BMI and waist circumference (WC), showing a significant linear trend (P<0·001 for BF%, WC and BMI). In addition, the association between EF and each obesity indicator was significantly altered according to diet quality (P value of the interaction term EF×diet quality=0·008 in the regression model for BF%, <0·001 for BMI and 0·043 for WC). In the stratified analyses according to diet quality, EF had a significant inverse association with BF%, WC and BMI in the high diet quality groups, but not in the low diet quality groups. This study suggests that EF is inversely associated with the obesity indicators when diet quality is high, but not when it is low in Korean adults.

How Do Deaf Adults Define Quality of Life?

ERIC Educational Resources Information Center

McAbee, Emilee R.; Drasgow, Erik; Lowrey, K. Alisa

2017-01-01

Six deaf adults defined quality of life (QOL) in personal interviews. Questions were based on an eight-domain QOL framework: physical well-being, emotional well-being, interpersonal relations, social inclusion, personal development, material well-being, self-determination, and rights (Schalock & Alonso, 2002). The interview process had three…

Status of groundwater quality in the Upper Santa Ana Watershed, November 2006--March 2007--California GAMA Priority Basin Project

USGS Publications Warehouse

Kent, Robert; Belitz, Kenneth

2012-01-01

Groundwater quality in the approximately 1,000-square-mile (2,590-square-kilometer) Upper Santa Ana Watershed (USAW) study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in southern California in Riverside and San Bernardino Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The GAMA USAW study was designed to provide a spatially unbiased assessment of untreated groundwater quality within the primary aquifer systems in the study unit. The primary aquifer systems (hereinafter, primary aquifers) are defined as the perforation interval of wells listed in the California Department of Public Health (CDPH) database for the USAW study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifers; shallower groundwater may be more vulnerable to surficial contamination. The assessment is based on water-quality and ancillary data collected by the U.S. Geological Survey (USGS) from 90 wells during November 2006 through March 2007, and water-quality data from the CDPH database. The status of the current quality of the groundwater resource was assessed based on data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. The status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the USAW study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration above a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration equal to or less than a benchmark. Organic and special-interest constituent relative-concentrations were classified as "high" (> 1.0), "moderate" (0.1 1.0), "moderate" (0.5 < relative-concentration ≤ 1.0), or "low" ( ≤ 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. Aquifer-scale proportions are defined as the percentage of the area of the primary aquifer system with concentrations above or below specified thresholds relative to regulatory or aesthetic benchmarks. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifers with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal, rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers with moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the USAW study unit (within 90-percent confidence intervals). Inorganic constituents with human-health benchmarks had relative-concentrations that were high in 32.9 percent of the primary aquifers, moderate in 29.3 percent, and low in 37.8 percent. The high aquifer-scale proportion of these inorganic constituents primarily reflected high aquifer-scale proportions of nitrate (high relative-concentration in 25.3 percent of the aquifer), although seven other inorganic constituents with human-health benchmarks also were detected at high relative-concentrations in some percentage of the aquifer: arsenic, boron, fluoride, gross alpha activity, molybdenum, uranium, and vanadium. Perchlorate, as a constituent of special interest, was evaluated separately from other inorganic constituents, and had high relative-concentrations in 11.1 percent, moderate in 53.3 percent, and low or not detected in 35.6 percent of the primary aquifers. In contrast to the inorganic constituents, relative-concentrations of organic constituents (one or more) were high in 6.7 percent, moderate in 11.1 percent, and low or not detected in 82.2 percent of the primary aquifers. Of the 237 organic and special-interest constituents analyzed for, 39 constituents were detected (21 VOCs, 13 pesticides, 3 pharmaceuticals, and 2 constituents of special interest). All of the detected VOCs had health-based benchmarks, and five of these—1,1-dichloroethene, 1,2-dibromo-3-chloropropane (DBCP), tetrachloroethene (PCE), carbon tetrachloride, and trichloroethene (TCE)—were detected in at least one sample at a concentration above a benchmark (high relative-concentration). Seven of the 13 pesticides had health-based benchmarks, and none were detected above these benchmarks (no high relative-concentrations). Pharmaceuticals do not have health-based benchmarks. Thirteen organic constituents were frequently detected (detected in at least 10 percent of samples without regard to relative-concentrations): bromodichloromethane, chloroform, cis-1,2-dichloroethene, 1,1-dichloroethene, dichlorodifluoromethane (CFC-12), methyl tert-butyl ether (MTBE), PCE, TCE, trichlorofluoromethane (CFC-11), atrazine, bromacil, diuron, and simazine.

Population-Based Pediatric Reference Intervals in General Clinical Chemistry: A Swedish Survey.

PubMed

Ridefelt, Peter

2015-01-01

Very few high quality studies on pediatric reference intervals for general clinical chemistry and hematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The Swedish survey included 701 healthy children. Reference intervals for general clinical chemistry and hematology were defined.

Teacher- or Learner-Centred? Science Teacher Beliefs Related to Topic Specific Pedagogical Content Knowledge: A South African Case Study

ERIC Educational Resources Information Center

Mavhunga, Elizabeth; Rollnick, Marissa

2016-01-01

In science education, learner-centred classroom practices are widely accepted as desirable and are associated with responsive and reformed kinds of teacher beliefs. They are further associated with high-quality Pedagogical Content Knowledge (PCK). Topic-Specific Pedagogical Content Knowledge (TSPCK), a version of PCK defined at topic level, is…

Modelling for Ship Design and Production

DTIC Science & Technology

1991-09-01

the physical production process. The product has to be delivered within the chain of order processing . The process “ship production” is defined by the...environment is of increasing importance. Changing product types, complexity and parallelism of order processing , short throughput times and fixed due...specialized and high quality products under manu- facturing conditions which ensure economic and effective order processing . Mapping these main

Community Colleges and Regional Recovery: Strategies for State Action. Project on State and Metropolitan Innovation

ERIC Educational Resources Information Center

Kazis, Richard

2011-01-01

Employers need a pipeline of quality workers with different levels of skill and desired earnings. Almost half of U.S. jobs today can be defined as "middle skill" jobs, requiring less than a four-year degree but more than a high school diploma. The Bureau of Labor Statistics (BLS) occupational projections indicate that job categories for…

Fabrication Of SNS Weak Links On SOS Substrates

NASA Technical Reports Server (NTRS)

Hunt, Brian D.

1995-01-01

High-quality superconductor/normal-conductor/superconductor (SNS) devices ("weak links") containing epitaxial films of YBa(2)Cu(3)O(7-x) and SrTiO(3) fabricated on silicon-on-sapphire (SOS) substrates with help of improved multilayer buffer system. Process for fabrication of edge-defined SNS weak links described in "Edge-Geometry SNS Devices Made of Y/Ba/Cu" (NPO-18552).

Building an ethical organizational culture.

PubMed

Nelson, William A; Taylor, Emily; Walsh, Thom

2014-01-01

The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

High throughput electrospinning of high-quality nanofibers via an aluminum disk spinneret

NASA Astrophysics Data System (ADS)

Zheng, Guokuo

In this work, a simple and efficient needleless high throughput electrospinning process using an aluminum disk spinneret with 24 holes is described. Electrospun mats produced by this setup consisted of fine fibers (nano-sized) of the highest quality while the productivity (yield) was many times that obtained from conventional single-needle electrospinning. The goal was to produce scaled-up amounts of the same or better quality nanofibers under variable concentration, voltage, and the working distance than those produced with the single needle lab setting. The fiber mats produced were either polymer or ceramic (such as molybdenum trioxide nanofibers). Through experimentation the optimum process conditions were defined to be: 24 kilovolt, a distance to collector of 15cm. More diluted solutions resulted in smaller diameter fibers. Comparing the morphologies of the nanofibers of MoO3 produced by both the traditional and the high throughput set up it was found that they were very similar. Moreover, the nanofibers production rate is nearly 10 times than that of traditional needle electrospinning. Thus, the high throughput process has the potential to become an industrial nanomanufacturing process and the materials processed by it may be used as filtration devices, in tissue engineering, and as sensors.

Individual differences, density dependence and offspring birth traits in a population of red deer

PubMed Central

Stopher, Katie V; Pemberton, Josephine M; Clutton-Brock, Tim H; Coulson, Tim

2008-01-01

Variation between individuals is an essential component of natural selection and evolutionary change, but it is only recently that the consequences of persistent differences between individuals on population dynamics have been considered. In particular, few authors have addressed whether interactions exist between individual quality and environmental variation. In part, this is due to the difficulties of collecting sufficient data, but also the challenge of defining individual quality. Using a long-established study population of red deer, Cervus elaphus, inhabiting the North Block of the Isle of Rum, and three quality measures, this paper investigates how differences in maternal quality affect variation in birth body mass and date, as population density varies, and how this differs depending on the sex of the offspring and the maternal quality measure used. Significant interactions between maternal quality, measured as a hind's total contribution to population growth, and population density are reported for birth mass, but only for male calves. Analyses using dominance or age at primiparity to define maternal quality showed no significant interactions with population density, highlighting the difficulties of defining a consistent measure of individual quality. PMID:18522909

Status and understanding of groundwater quality in the northern San Joaquin Basin, 2005

USGS Publications Warehouse

Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth; Jurgens, Bryant C.

2010-01-01

Groundwater quality in the 2,079 square mile Northern San Joaquin Basin (Northern San Joaquin) study unit was investigated from December 2004 through February 2005 as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Project was developed in response to the Groundwater Quality Monitoring Act of 2001 that was passed by the State of California and is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The Northern San Joaquin study unit was the third study unit to be designed and sampled as part of the Priority Basin Project. Results of the study provide a spatially unbiased assessment of the quality of raw (untreated) groundwater, as well as a statistically consistent basis for comparing water quality throughout California. Samples were collected from 61 wells in parts of Alameda, Amador, Calaveras, Contra Costa, San Joaquin, and Stanislaus Counties; 51 of the wells were selected using a spatially distributed, randomized grid-based approach to provide statistical representation of the study area (grid wells), and 10 of the wells were sampled to increase spatial density and provide additional information for the evaluation of water chemistry in the study unit (understanding/flowpath wells). The primary aquifer systems (hereinafter, primary aquifers) assessed in this study are defined by the depth intervals of the wells in the California Department of Public Health database for each study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from quality of groundwater in the primary aquifers; shallow groundwater may be more vulnerable to contamination from the surface. Two types of assessments were made: (1) status, assessment of the current quality of the groundwater resource; and (2) understanding, identification of the natural and human factors affecting groundwater quality. Relative-concentrations (sample concentrations divided by benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. Benchmarks used in this study were either health-based (regulatory and non-regulatory) or aesthetic based (non-regulatory). For inorganic constituents, relative-concentrations were classified as high (equal to or greater than 1.0), indicating relative-concentrations greater than benchmarks; moderate (equal to or greater than 0.5, and less than 1.0); or, low (less than 0.5). For organic and special- interest constituents [1,2,3-trichloropropane (1,2,3-TCP), N-nitrosodimethylamine (NDMA), and perchlorate], relative- concentrations were classified as high (equal to or greater than 1.0); moderate (equal to or greater than 0.1 and less than 1.0); or, low (less than 0.1). Aquifer-scale proportion was used as the primary metric in the status assessment for groundwater quality. High aquifer- scale proportion is defined as the percentage of the primary aquifer with relative-concentrations greater than 1.0; moderate and low aquifer-scale proportions are defined as the percentage of the primary aquifer with moderate and low relative- concentrations, respectively. The methods used to calculate aquifer-scale proportions are based on an equal-area grid; thus, the proportions are areal rather than volumetric. Two statistical approaches - grid-based, which used one value per grid cell, and spatially weighted, which used the full dataset - were used to calculate aquifer-scale proportions for individual constituents and classes of constituents. The spatially weighted estimates of high aquifer-scale proportions were within the 90-percent confidence intervals of the grid-based estimates in all cases. The understanding assessment used statistical correlations between constituent relative-concentrations and

[A new joint approach to drug management: clinical pharmacy services and risk management unit].

PubMed

Schwartz, Vardit; Kravitz, Martine Szyper

2015-04-01

According to the "To Err is Human" report, medication-related errors are common in medicine and may have several and different effects. Clinical Pharmacy is a leading worldwide established pharmacy service which has been improving the quality of care for the last 30 years. The accumulated experience shows improved quality of care, improved patient safety and economic benefit. These understandings led to the definition and expansion of the Clinical Pharmacist Intervention Program and a joint project with the Risk Management Unit was created. A characterization process was conducted, parameters were defined for monitoring and surveillance and interventions were devised. The relevant data requiring pharmacist intervention was defined (e.g., dose adjustments, contraindications, side-effects); a report was devised, based on the patient's electronic medical record; daily follow-up included analysis, stratification, quantification and understanding of the different types of pharmacist interventions. The pharmacist interventions were summed up and assessed for performance and quality control. Between March 2013 and February 2014 the medical records of 14,499 patients were examined in our hospital Only in 16% of the records an active pharmacist intervention was performed, according to the parameters defined. Interventions for potentially high risk events such as therapeutic duplication, drug administration in spite of contraindication and in spite of documented allergy were very rare, less than 2% of all the pharmacist interventions. This joint venture, which is based on an existing platform, reflects an up-to-date view of an important facet of the clinical work performed at the hospital, helps identify trends, potential failures and vulnerabilities with regard to medication treatment and allows the formulation of intervention programs to improve the quality and safety of drug therapy.

High-volume image quality assessment systems: tuning performance with an interactive data visualization tool

NASA Astrophysics Data System (ADS)

Bresnahan, Patricia A.; Pukinskis, Madeleine; Wiggins, Michael

1999-03-01

Image quality assessment systems differ greatly with respect to the number and types of mags they need to evaluate, and their overall architectures. Managers of these systems, however, all need to be able to tune and evaluate system performance, requirements often overlooked or under-designed during project planning. Performance tuning tools allow users to define acceptable quality standards for image features and attributes by adjusting parameter settings. Performance analysis tools allow users to evaluate and/or predict how well a system performs in a given parameter state. While image assessment algorithms are becoming quite sophisticated, duplicating or surpassing the human decision making process in their speed and reliability, they often require a greater investment in 'training' or fine tuning of parameters in order to achieve optimum performance. This process may involve the analysis of hundreds or thousands of images, generating a large database of files and statistics that can be difficult to sort through and interpret. Compounding the difficulty is the fact that personnel charged with tuning and maintaining the production system may not have the statistical or analytical background required for the task. Meanwhile, hardware innovations have greatly increased the volume of images that can be handled in a given time frame, magnifying the consequences of running a production site with an inadequately tuned system. In this paper, some general requirements for a performance evaluation and tuning data visualization system are discussed. A custom engineered solution to the tuning and evaluation problem is then presented, developed within the context of a high volume image quality assessment, data entry, OCR, and image archival system. A key factor influencing the design of the system was the context-dependent definition of image quality, as perceived by a human interpreter. This led to the development of a five-level, hierarchical approach to image quality evaluation. Lower-level pass-fail conditions and decision rules were coded into the system. Higher-level image quality states were defined by allowing the users to interactively adjust the system's sensitivity to various image attributes by manipulating graphical controls. Results were presented in easily interpreted bar graphs. These graphs were mouse- sensitive, allowing the user to more fully explore the subsets of data indicated by various color blocks. In order to simplify the performance evaluation and tuning process, users could choose to view the results of (1) the existing system parameter state, (2) the results of any arbitrary parameter values they chose, or (3) the results of a quasi-optimum parameter state, derived by applying a decision rule to a large set of possible parameter states. Giving managers easy- to-use tools for defining the more subjective aspects of quality resulted in a system that responded to contextual cues that are difficult to hard-code. It had the additional advantage of allowing the definition of quality to evolve over time, as users became more knowledgeable as to the strengths and limitations of an automated quality inspection system.

A machine learning model to determine the accuracy of variant calls in capture-based next generation sequencing.

PubMed

van den Akker, Jeroen; Mishne, Gilad; Zimmer, Anjali D; Zhou, Alicia Y

2018-04-17

Next generation sequencing (NGS) has become a common technology for clinical genetic tests. The quality of NGS calls varies widely and is influenced by features like reference sequence characteristics, read depth, and mapping accuracy. With recent advances in NGS technology and software tools, the majority of variants called using NGS alone are in fact accurate and reliable. However, a small subset of difficult-to-call variants that still do require orthogonal confirmation exist. For this reason, many clinical laboratories confirm NGS results using orthogonal technologies such as Sanger sequencing. Here, we report the development of a deterministic machine-learning-based model to differentiate between these two types of variant calls: those that do not require confirmation using an orthogonal technology (high confidence), and those that require additional quality testing (low confidence). This approach allows reliable NGS-based calling in a clinical setting by identifying the few important variant calls that require orthogonal confirmation. We developed and tested the model using a set of 7179 variants identified by a targeted NGS panel and re-tested by Sanger sequencing. The model incorporated several signals of sequence characteristics and call quality to determine if a variant was identified at high or low confidence. The model was tuned to eliminate false positives, defined as variants that were called by NGS but not confirmed by Sanger sequencing. The model achieved very high accuracy: 99.4% (95% confidence interval: +/- 0.03%). It categorized 92.2% (6622/7179) of the variants as high confidence, and 100% of these were confirmed to be present by Sanger sequencing. Among the variants that were categorized as low confidence, defined as NGS calls of low quality that are likely to be artifacts, 92.1% (513/557) were found to be not present by Sanger sequencing. This work shows that NGS data contains sufficient characteristics for a machine-learning-based model to differentiate low from high confidence variants. Additionally, it reveals the importance of incorporating site-specific features as well as variant call features in such a model.

Neural networks with fuzzy Petri nets for modeling a machining process

NASA Astrophysics Data System (ADS)

Hanna, Moheb M.

1998-03-01

The paper presents an intelligent architecture based a feedforward neural network with fuzzy Petri nets for modeling product quality in a CNC machining center. It discusses how the proposed architecture can be used for modeling, monitoring and control a product quality specification such as surface roughness. The surface roughness represents the output quality specification manufactured by a CNC machining center as a result of a milling process. The neural network approach employed the selected input parameters which defined by the machine operator via the CNC code. The fuzzy Petri nets approach utilized the exact input milling parameters, such as spindle speed, feed rate, tool diameter and coolant (off/on), which can be obtained via the machine or sensors system. An aim of the proposed architecture is to model the demanded quality of surface roughness as high, medium or low.

Patients Should Define Value in Health Care: A Conceptual Framework.

PubMed

Kamal, Robin N; Lindsay, Sarah E; Eppler, Sara L

2018-05-10

The main tenet of value-based health care is delivering high-quality care that is centered on the patient, improving health, and minimizing cost. Collaborative decision-making frameworks have been developed to help facilitate delivering care based on patient preferences (patient-centered care). The current value-based health care model, however, focuses on improving population health and overlooks the individuality of patients and their preferences for care. We highlight the importance of eliciting patient preferences in collaborative decision making and describe a conceptual framework that incorporates individual patients' preferences when defining value. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Child center closures: Does nonprofit status provide a comparative advantage?

PubMed

Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E

2013-03-01

Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy.

Child center closures: Does nonprofit status provide a comparative advantage?

PubMed Central

Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E.

2013-01-01

Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy. PMID:23543882

Metal Chemical and Isotope Characterisation in the Upper Loire River Basin, France

NASA Astrophysics Data System (ADS)

Widory, D.; Nigris, R.; Morard, A.; Gassama, N.; Poirier, A.; Bourrain, X.

2016-12-01

The Water Framework Directive (WFD) elaborated by the European Commission regulates water resources in the EC based on five years management plans. A new management plan that started in 2016 imposes strict water quality criteria to its member states, including good status thresholds for metallic contaminants. The Loire River, the most important river in France, flows through areas with lithologies naturally containing high metal concentrations in the upper part of its basin. Understanding these metal fluxes into the river is thus a prerequisite to understand their potential impact on the quality of its water in regards to the criteria defined by the WFD. The Massif Central, a residue of the Hercynian chain, is composed of granitic and volcanic rocks. Both its upstream position in the Loire basin and its numerous metal mineralizations made this region a good candidate for characterizing the natural metal geochemical background of its surface waters. To fulfill this objective we focused on the Pb, Cd and Zn chemical and isotope characteristics of selected non-anthropized small watersheds. The investigated small watersheds were selected for supposedly draining a single lithology and undergoing (as far as possible) negligible to no anthropogenic pressure. Results showed that although the high metal potential of the upper part of the Loire River basin has been highly exploited by humans for centuries, metal concentrations during the hydrological cycle are still under the guidelines defined by the WFD. Isotope compositions/ratios are strongly related to the corresponding lithologies along the rivers and help precisely define the local geochemical background that can then be used to identify and quantify any anthropogenic inputs downstream.

Defining quality of care.

PubMed

Campbell, S M; Roland, M O; Buetow, S A

2000-12-01

This paper defines quality of health care. We suggest that there are two principal dimensions of quality of care for individual patients; access and effectiveness. In essence, do users get the care they need, and is the care effective when they get it? Within effectiveness, we define two key components--effectiveness of clinical care and effectiveness of inter-personal care. These elements are discussed in terms of the structure of the health care system, processes of care, and outcomes resulting from care. The framework relates quality of care to individual patients and we suggest that quality of care is a concept that is at its most meaningful when applied to the individual user of health care. However, care for individuals must placed in the context of providing health care for populations which introduces additional notions of equity and efficiency. We show how this framework can be of practical value by applying the concepts to a set of quality indicators contained within the UK National Performance Assessment Framework and to a set of widely used indicators in the US (HEDIS). In so doing we emphasise the differences between US and UK measures of quality. Using a conceptual framework to describe the totality of quality of care shows which aspects of care any set of quality indicators actually includes and measures and, and which are not included.

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico

PubMed Central

De Castro, Filipa; Barrientos-Gutiérrez, Tonatiuh; Leyva-López, Ahideé

2017-01-01

Objective Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world’s adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents. Methods This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015. Results At the national level 13.9% (95%CI: 6.9–26.0) of healthcare units provide low quality, 68.6% (95%CI: 58.4–77.3) medium quality and 17.5% (95%CI: 11.9–25.0) high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best. Conclusions The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care. PMID:28273129

Defining geo-habitats for groundwater ecosystem assessments: an example from England and Wales (UK)

NASA Astrophysics Data System (ADS)

Weitowitz, Damiano C.; Maurice, Louise; Lewis, Melinda; Bloomfield, John P.; Reiss, Julia; Robertson, Anne L.

2017-12-01

Groundwater ecosystems comprising micro-organisms and metazoans provide an important contribution to global biodiversity. Their complexity depends on geology, which determines the physical habitat available, and the chemical conditions within it. Despite this, methods of classifying groundwater habitats using geological data are not well established and researchers have called for higher resolution habitat frameworks. A novel habitat typology for England and Wales (UK) is proposed, which distinguishes 11 geological habitats (geo-habitats) on hydrogeological principles and maps their distribution. Hydrogeological and hydrochemical data are used to determine the characteristics of each geo-habitat, and demonstrate their differences. Using these abiotic parameters, a new method to determine abiotic habitat quality is then developed. The geo-habitats had significantly different characteristics, validating the classification system. All geo-habitats were highly heterogeneous, containing both high quality habitat patches that are likely to be suitable for fauna, and areas of low quality that may limit faunal distributions. Karstic and porous habitats generally were higher quality than fractured habitats. Overall, 70% of England and Wales are covered by lower quality fractured habitats, with only 13% covered by higher quality habitats. The main areas of high quality habitats occur in central England as north-south trending belts, possibly facilitating dispersal along this axis. They are separated by low quality geo-habitats that may prevent east-west dispersal of fauna. In south-west England and Wales suitable geo-habitats occur as small isolated patches. Overall, this paper provides a new national-scale typology that is adaptable for studies in other geographic areas.

Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes.

PubMed

Swinbourne, Richard; Gill, Nicholas; Vaile, Joanna; Smart, Daniel

2016-10-01

Despite the perceived importance of sleep for athletes, little is known regarding athlete sleep quality, their prevalence of daytime sleepiness or risk factors for obstructive sleep apnoea (OSA) such as snoring and witnessed apnoeic episodes. The purpose of the present study was to characterise normative sleep quality among highly trained team sport athletes. 175 elite or highly trained rugby sevens, rugby union and cricket athletes completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS) and Quality of Life questionnaires and an OSA risk factor screen. On average, athletes reported 7.9 ± 1.3 h of sleep per night. The average PSQI score was 5.9 ± 2.6, and 50% of athletes were found to be poor sleepers (PSQI > 5). Daytime sleepiness was prevalent throughout the population (average global score of 8.5) and clinically significant (ESS score of ≥10) in 28% of athletes. OSA may be an important clinical consideration within athletic populations, as a considerable number of athletes (38%) defined themselves as snorers and 8% reported having a witnessed apnoeic episode. The relationship between self-rated sleep quality and actual PSQI score was strong (Pearson correlation of 0.4 ± 0.1, 90% confidence limits). These findings suggest that this cohort of team sport athletes suffer a preponderance of poor sleep quality, with associated high levels of daytime sleepiness. Athletes should receive education about how to improve sleep wake schedules, extend total sleep time and improve sleep quality.

Meaning and barriers to quality care service provision in Child and Adolescent Mental Health Services: Qualitative study of stakeholder perspectives.

PubMed

Svirydzenka, Nadzeya; Ronzoni, Pablo; Dogra, Nisha

2017-02-20

Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant's views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS. An initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS. No respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.

Detection of coliform bacteria and Escherichia coli by multiplex polymerase chain reaction: comparison with defined substrate and plating methods for water quality monitoring.

PubMed Central

Bej, A K; McCarty, S C; Atlas, R M

1991-01-01

Multiplex polymerase chain reaction (PCR) and gene probe detection of target lacZ and uidA genes were used to detect total coliform bacteria and Escherichia coli, respectively, for determining water quality. In tests of environmental water samples, the lacZ PCR method gave results statistically equivalent to those of the plate count and defined substrate methods accepted by the U.S. Environmental Protection Agency for water quality monitoring and the uidA PCR method was more sensitive than 4-methylumbelliferyl-beta-D-glucuronide-based defined substrate tests for specific detection of E. coli. Images PMID:1768116

[Quality of the Early Cervical Cancer Detection Program in the State of Nuevo León].

PubMed

Salinas-Martínez, A M; Villarreal-Ríos, E; Garza-Elizondo, M E; Fraire-Gloria, J M; López-Franco, J J; Barboza-Quintana, O

1997-01-01

To determine the quality of the Early Cervical Cancer Detection Program in the state of Nuevo León. A random selection of 4791 cytologic reports were analyzed, emitted by the State Ministry of Health, the University Hospital and the Mexican Institute for Social Security early cervical cancer detection modules. Pap tests of women with hysterectomy, current pregnancy, menopause or positive result were excluded. Quality was measured with previously defined standards. Analysis included, besides univariate statistics, tests of significance for proportions and means. The quality of the program was fairly satisfactory at the level of the State. The quality of the sampling procedure was low; 39.9% of the tests contained endocervical cells. Quality of coverage was low; 15.6% were women 25+years with first time Pap test. Quality of opportunity was high; 8.5 +/- 7 weekdays between the date of the pap smear and the interpretation date. Strategies are needed to increase the impact of the state program, such as improving the sampling procedure and the coverage quality levels.

Defining quality metrics and improving safety and outcome in allergy care.

PubMed

Lee, Stella; Stachler, Robert J; Ferguson, Berrylin J

2014-04-01

The delivery of allergy immunotherapy in the otolaryngology office is variable and lacks standardization. Quality metrics encompasses the measurement of factors associated with good patient-centered care. These factors have yet to be defined in the delivery of allergy immunotherapy. We developed and applied quality metrics to 6 allergy practices affiliated with an academic otolaryngic allergy center. This work was conducted at a tertiary academic center providing care to over 1500 patients. We evaluated methods and variability between 6 sites. Tracking of errors and anaphylaxis was initiated across all sites. A nationwide survey of academic and private allergists was used to collect data on current practice and use of quality metrics. The most common types of errors recorded were patient identification errors (n = 4), followed by vial mixing errors (n = 3), and dosing errors (n = 2). There were 7 episodes of anaphylaxis of which 2 were secondary to dosing errors for a rate of 0.01% or 1 in every 10,000 injection visits/year. Site visits showed that 86% of key safety measures were followed. Analysis of nationwide survey responses revealed that quality metrics are still not well defined by either medical or otolaryngic allergy practices. Academic practices were statistically more likely to use quality metrics (p = 0.021) and perform systems reviews and audits in comparison to private practices (p = 0.005). Quality metrics in allergy delivery can help improve safety and quality care. These metrics need to be further defined by otolaryngic allergists in the changing health care environment. © 2014 ARS-AAOA, LLC.

Teacher’s sleep quality: linked to social job characteristics?

PubMed Central

KOTTWITZ, Maria U.; GERHARDT, Christin; PEREIRA, Diana; ISELI, Lionel; ELFERING, Achim

2017-01-01

Besides dealing with high workload, being a teacher is challenging with respect to the social context. There is increasing evidence that adverse social job characteristics challenge sleep quality. The current study tests whether restraint sleep quality (defined as worse sleep quality before than during vacation) is related to time-related job stressors, job resources, and social job characteristics. Forty-eight elementary school teachers (42% women) participated both during the last week before and the first week after vacation. Before vacation, teachers were asked for demographics and working conditions with reference to the last 30 d, and sleep quality with reference to the last 7 d. After vacation sleep quality during vacation was assessed and used as reference for working time sleep quality. Results showed mean levels of sleep quality increased during vacation. In teachers with restrained working time sleep quality (38%), experiences of failure at work, social exclusion, and emotional dissonance were more frequent than in teachers with unrestrained working time sleep quality (Ps<0.05). Groups did not differ in time-related stressors, time control and social support from supervisors. Emotion work, social exclusion and individual experience of failure seem to challenge sleep quality in teachers. PMID:28804097

Water-quality assessment of the Smith River drainage basin, California and Oregon

USGS Publications Warehouse

Iwatsubo, Rick T.; Washabaugh, Donna S.

1982-01-01

A water-quality assessment of the Smith River drainage basin was made to provide a summary of the water-quality conditions including known or potential water-quality problems. Results of the study showed that the water quality of the Smith River is excellent and generally meets the water-quality objectives for the beneficial uses identified by the California Regional Water Quality Control Board, North Coast Region. Known and potential problems related to water quality include: Sedimentation resulting from both natural erosional processes and land-use activities such as timber harvest, road construction, and mining that accelerate the erosional processes; bacterial contamination of surface and ground waters from inundated septic tanks and drainfields, and grazing activities; industrial spills which have resulted in fish kills and oil residues; high concetrations of iron in ground water; log and debris jams creating fish migration barriers; and pesticide and trace-element contamination from timber-harvest and mining activities, respectively. Future studies are needed to establish: (1) a sustained long-term monitoring program to provide a broad coverage of water-quality conditions in order to define long-term water-quality trends; and (2) interpretive studies to determine the source of known and potential water-quality problems. (USGS)

Teacher's sleep quality: linked to social job characteristics?

PubMed

Kottwitz, Maria U; Gerhardt, Christin; Pereira, Diana; Iseli, Lionel; Elfering, Achim

2018-02-07

Besides dealing with high workload, being a teacher is challenging with respect to the social context. There is increasing evidence that adverse social job characteristics challenge sleep quality. The current study tests whether restraint sleep quality (defined as worse sleep quality before than during vacation) is related to time-related job stressors, job resources, and social job characteristics. Forty-eight elementary school teachers (42% women) participated both during the last week before and the first week after vacation. Before vacation, teachers were asked for demographics and working conditions with reference to the last 30 d, and sleep quality with reference to the last 7 d. After vacation sleep quality during vacation was assessed and used as reference for working time sleep quality. Results showed mean levels of sleep quality increased during vacation. In teachers with restrained working time sleep quality (38%), experiences of failure at work, social exclusion, and emotional dissonance were more frequent than in teachers with unrestrained working time sleep quality (Ps<0.05). Groups did not differ in time-related stressors, time control and social support from supervisors. Emotion work, social exclusion and individual experience of failure seem to challenge sleep quality in teachers.

Spatially explicit measures of production of young alewives in Lake Michigan: Linkage between essential fish habitat and recruitment

USGS Publications Warehouse

Hook, Tomas O.; Rutherford, Edward S.; Brines, Shannon J.; Mason, Doran M.; Schwab, David J.; McCormick, Michael; Desorcie, Timothy J.

2003-01-01

The identification and protection of essential habitats for early life stages of fishes are necessary to sustain fish stocks. Essential fish habitat for early life stages may be defined as areas where fish densities, growth, survival, or production rates are relatively high. To identify critical habitats for young-of-year (YOY) alewives (Alosa pseud oharengus) in Lake Michigan, we integrated bioenergetics models with GIS (Geographic Information Systems) to generate spatially explicit estimates of potential population production (an index of habitat quality). These estimates were based upon YOY alewife bioenergetic growth rate potential and their salmonine predators’ consumptive demand. We compared estimates of potential population production to YOY alewife yield (an index of habitat importance). Our analysis suggested that during 1994–1995, YOY alewife habitat quality and yield varied widely throughout Lake Michigan. Spatial patterns of alewife yield were not significantly correlated to habitat quality. Various mechanisms (e.g., predator migrations, lake circulation patterns, alternative strategies) may preclude YOY alewives from concentrating in areas of high habitat quality in Lake Michigan.

Measures of symptoms and life quality to predict emergent use of institutional health care resources in chronic obstructive airways disease.

PubMed

Traver, G A

1988-11-01

Thirty subjects with severe chronic obstructive airways disease participated in a study to identify differences in symptoms and life quality between those with high and low emergent use of institutional health care resources. Emergent use was defined as care obtained through unscheduled, nonroutine methods of access to health care providers. There were 15 subjects in each group; the groups had similar sex distribution and were not significantly different for percent predicted forced expiratory volume in 1 second (mean 29.8%), use of home oxygen (15 of 30 subjects), or prevalence of CO2 retention (nine of 30). Symptoms and life quality were measured by using three paper and pencil tests, the Bronchitis-Emphysema Symptom Checklist, the Sickness-Impact Profile, and the Katz Adjustment Scale for relatives. Findings demonstrated consistently more symptoms and impairment of life quality in the "high emergent" group. The differences reached statistical significance for irritability, anxiety, helplessness, nervousness, peripheral sensory complaints, alienation, social interaction, and emotional behavior. Discriminant analysis provided a prediction formula that yielded 80% correct prediction for the two groups.

Quality of life and coping in patients awaiting heart transplantation.

PubMed

Muirhead, J; Meyerowitz, B E; Leedham, B; Eastburn, T E; Merrill, W H; Frist, W H

1992-01-01

The psychosocial adaptation of patients awaiting heart transplantation has not been defined. Forty-one patients (36 men, 5 women; mean age, 48 years) completed standardized questionnaires before transplantation to assess quality of life, physical symptoms, marital/social adjustment, psychiatric morbidity, coping, and compliance to medical regimens. Also, data were obtained from spouses/partners and the transplantation nurse coordinator. Unlike previously reported findings with patients after transplantation, those awaiting transplantation report moderate dissatisfaction with quality of life. Patients report physical symptoms, functional disabilities, sexual dysfunction, and psychological distress. Nonetheless, reported levels of compliance with the medical regimens and of social support were high, and both patients and spouses/partners provided marital adjustment ratings on the Dyadic Adjustment Scale that were comparable to those of well-adjusted, happily married couples. High levels of coping also were recorded. Having a positive attitude and seeking social support were the most common coping strategies, whereas confrontation, acceptance, and escapism were relatively uncommon. In conclusion, patients awaiting heart transplantation, although dissatisfied with quality of life, maintain positive psychological and social adjustment.

Validation of an Argentine version of Lupus Quality of Life questionnaire.

PubMed

Machado Escobar, M A; Yacuzzi, M S; Martinez, R N; González Lucero, L; Bellomio, V I; Santana, M; Galindo, L; Mayer, M M; Barreira, J C; Sarano, J; Gomez, G; Collado, M V; Martinez, A; Orozco, M C; Betancur, G; Dal Pra, F; Sanchez, A; Juarez, V; Lucero, E V

2016-12-01

To determine reproducibility and validity of an Argentine version of the Lupus Quality of Life questionnaire (LupusQoL) and to determine cut-off values in the questionnaire. One hundred and forty-seven systemic lupus erythematosus patients (American College of Rheumatology 1982/1997) were assessed from April 2014 to July 2014. Demographic and socioeconomic variables were collected, as well as SELENA/SLEDAI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index Score, comorbidities and treatment data. Patients completed LupusQoL-Argentine version and European Quality of Life Questionnaire (EuroQoL-5D). Internal consistency and reliability were examined. Convergent validity with EuroQoL-5D was assessed through analysis of latent classes, which established homogeneous categories from the responses of each domain of LupusQoL and for the total. Out of 147 patients, 93.2% were female, mean age 36.4 ± 11.1 years, mean disease duration 2.7 ± 9 years, mean SELENA/SLEDAI 2.7 ± 3 points. The cut-off point that defined good or bad quality of life was 0.739 for EuroQoL 5D and 63 for LupusQoL. Cut-off values for each LupusQoL domain were also defined, creating two classes in each of them. There was moderate to high concordance to classify quality of life (Kappa = 0.74, 95% confidence interval = 0.54, 0.95). The Argentine version of LupusQoL is a valid, reliable and reproducible instrument to assess quality of life. In this study, cut-off points that allow the classification of patients regarding whether they have good or bad quality of life are established for the first time. © The Author(s) 2016.

Soil structural quality assessment for soil protection regulation

NASA Astrophysics Data System (ADS)

Johannes, Alice; Boivin, Pascal

2017-04-01

Soil quality assessment is rapidly developing worldwide, though mostly focused on the monitoring of arable land and soil fertility. Soil protection regulations assess soil quality differently, focusing on priority pollutants and threshold values. The soil physical properties are weakly considered, due to lack of consensus and experimental difficulties faced with characterization. Non-disputable, easy to perform and inexpensive methods should be available for environmental regulation to be applied, which is unfortunately not the case. As a consequence, quantitative soil physical protection regulation is not applied, and inexpensive soil physical quality indicators for arable soil management are not available. Overcoming these limitations was the objective of a research project funded by the Swiss federal office for environment (FOEN). The main results and the perspectives of application are given in this presentation. A first step of the research was to characterize soils in a good structural state (reference soils) under different land use. The structural quality was assessed with field expertise and Visual Evaluation of the Soil Structure (VESS), and the physical properties were assessed with Shrinkage analysis. The relationships between the physical properties and the soil constituents were linear and highly determined. They represent the reference properties of the corresponding soils. In a second step, the properties of physically degraded soils were analysed and compared to the reference properties. This allowed defining the most discriminant parameters departing the different structure qualities and their threshold limits. Equivalent properties corresponding to these parameters but inexpensive and easy to determine were defined and tested. More than 90% of the samples were correctly classed with this method, which meets, therefore, the requirements for practical application in regulation. Moreover, result-oriented agri-environmental schemes for soil quality are now proposed to farmers based on these indicators.

Study of improving the quality of bread and wheat-aegilops hybrids with the biotechnological ways

NASA Astrophysics Data System (ADS)

Ganbarzada, Aygun; Hasanova, Sudaba

2016-08-01

The great need of the people to bread demands to increase high qualitative grain plants. At present time for solving these problem different methods of biochemistry, genetics and molecular biology are widely used in the process of selection. To investigate biochemical peculiarities of wheat-aegilops hybrids and to define the correlative relation between these characteristics. To investigate the technological peculiarities of wheat- aegilops hybrids and to define the relation between their main biochemical and technological characteristics. The conclusion of this investigation showed the followings- the wheat-aegilops hybrids according to their morphological and biochemical characteristics have approached to wheats. The electrophoretic spectres of the wheat- aegilops hybrids which have stable for their morphological characteristics are homogeny and heterogenic. Hereditarily some group protein components have passed to their tribes from their parents. But spontaneous hybridisation results in taking part the components of other unknown wheats in these electrophoretic spectres. There is a relation between the electrophoretic spectres and the indications of the grain quality.

Recommendations and Ongoing Efforts within the NASA Data Quality Working Group

NASA Astrophysics Data System (ADS)

Moroni, D. F.; Ramapriyan, H.; Bagwell, R.; Downs, R. R.

2015-12-01

Since its inception in March 2014, the NASA Data Quality Working Group (DQWG) has procured a set of 12 high level recommendations which had been sifted from and aggregated from a prioritized subset of nearly 100 unique recommendations spanning four unique data quality management phases and distributed between two actionable categories. The four data quality management phases as identified by the DQWG are: 1. Capturing (i.e., deriving, collecting and organizing the information), 2. Describing (i.e., documenting and procuring the information for public consumption), 3. Facilitating Discovery (i.e., publishing and providing access to the information), and 4. Enabling Use (i.e., enhancing the utility of the information). Mapping each of our recommendations to one or more of the above management phases is intended to enable improved assessment of cost, feasibility, and relevancy to the entities responsible for implementing such recommendations. The DQWG further defined two distinct actionable categories: 1) Data Systems and 2) Science. The purpose of these actionable categories is to define specifically who is responsible for the implementation and adherence toward these recommendations; we refer to the responsible entities as the "actionees". Here we will summarize each of the high level recommendations along with their corresponding management phases and actionees. We will present what has recently been identified as our set of "low-hanging fruit" recommendations, which are intended for near-term implementation. Finally, we will present the status and motivation for continuing and future planned activities, which include but are not limited to: engaging inter-agency and international communities, more direct feedback from Earth observation missions, and mapping of "low-hanging fruit" recommendations to existing solutions.

Can we trust cancer information on the Internet?--A comparison of interactive cancer risk sites.

PubMed

Ekman, Alexandra; Hall, Per; Litton, Jan-Eric

2005-08-01

To investigate the prevalence and quality of interactive cancer risk sites on the Internet. A cancer risk site was defined as a website that gave an estimate of the individual risk of developing cancer. Six search engines and one Meta crawler were used to search the Internet for cancer risk sites (including breast, prostate, colon, and lung cancer). A set of defined quality criteria for health related websites was used to evaluate the websites during 2001 and 2002. The number of cancer risk sites, as defined above, increased by 50% between 2001 and 2002. Only two out of 22 cancer risk sites fulfilled the quality criteria adequately. No signs of a change in trend (with regard to the quality criteria met) were noted in January 2005. The overall quality of the documentation on the cancer risk sites was poor and no improvement was seen during the study period. The majority of the cancer risk sites do not give reliable risk estimates.

Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period.

PubMed

Tomfohr, Lianne M; Buliga, Elena; Letourneau, Nicole L; Campbell, Tavis S; Giesbrecht, Gerald F

2015-08-01

The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. © 2015 Associated Professional Sleep Societies, LLC.

Understanding and development of manufacturable screen-printed contacts on high sheet-resistance emitters for low-cost silicon solar cells

NASA Astrophysics Data System (ADS)

Hilali, Mohamed M.

2005-11-01

A simple cost-effective approach was proposed and successfully employed to fabricate high-quality screen-printed (SP) contacts to high sheet-resistance emitters (100 O/sq) to improve the Si solar cell efficiency. Device modeling was used to quantify the performance enhancement possible from the high sheet-resistance emitter for various cell designs. It was found that for performance enhancement from the high sheet-resistance emitter, certain cell design criteria must be satisfied. Model calculations showed that in order to achieve any performance enhancement over the conventional ˜40 O/sq emitter, the high sheet resistance emitter solar cell must have a reasonably good (<120,000 cm/s) or low front-surface recombination velocity (FSRV). Model calculations were also performed to establish requirements for high fill factors (FFs). The results showed that the series resistance should be less than 0.8 O-cm2, the shunt resistance should be greater than 1000 O-cm2, and the junction leakage current should be less than 25 nA/cm2. Analytical microscopy and surface analysis techniques were used to study the Ag-Si contact interface of different SP Ag pastes. Physical and electrical properties of SP Ag thick-film contacts were studied and correlated to understand and achieve good-quality ohmic contacts to high sheet-resistance emitters for solar cells. This information was then used to define the criteria for high-quality screen-printed contacts. The role of paste constituents and firing scheme on contact quality were investigated to tailor the high-quality screen-printed contact interface structure that results in high performance solar cells. Results indicated that small particle size, high glass transition temperature, rapid firing and less aggressive glass frit help in producing high-quality contacts. Based on these results high-quality SP contacts with high FFs > 0.78 on high sheet-resistance emitters were achieved for the first time using a simple single-step firing process. This technology was applied to different substrates (monocrystalline and multicrystalline) and surfaces (textured and planar). Cell efficiencies of ˜16.2% on low-cost EFG ribbon substrates were achieved on high sheet-resistance emitters with SP contacts. A record high-efficiency SP solar cell of 19% with textured high sheet-resistance emitter was also fabricated and modeled.

Quality assurance of multiport image-guided minimally invasive surgery at the lateral skull base.

PubMed

Nau-Hermes, Maria; Schmitt, Robert; Becker, Meike; El-Hakimi, Wissam; Hansen, Stefan; Klenzner, Thomas; Schipper, Jörg

2014-01-01

For multiport image-guided minimally invasive surgery at the lateral skull base a quality management is necessary to avoid the damage of closely spaced critical neurovascular structures. So far there is no standardized method applicable independently from the surgery. Therefore, we adapt a quality management method, the quality gates (QG), which is well established in, for example, the automotive industry and apply it to multiport image-guided minimally invasive surgery. QG divide a process into different sections. Passing between sections can only be achieved if previously defined requirements are fulfilled which secures the process chain. An interdisciplinary team of otosurgeons, computer scientists, and engineers has worked together to define the quality gates and the corresponding criteria that need to be fulfilled before passing each quality gate. In order to evaluate the defined QG and their criteria, the new surgery method was applied with a first prototype at a human skull cadaver model. We show that the QG method can ensure a safe multiport minimally invasive surgical process at the lateral skull base. Therewith, we present an approach towards the standardization of quality assurance of surgical processes.

Quality Assurance of Multiport Image-Guided Minimally Invasive Surgery at the Lateral Skull Base

PubMed Central

Nau-Hermes, Maria; Schmitt, Robert; Becker, Meike; El-Hakimi, Wissam; Hansen, Stefan; Klenzner, Thomas; Schipper, Jörg

2014-01-01

For multiport image-guided minimally invasive surgery at the lateral skull base a quality management is necessary to avoid the damage of closely spaced critical neurovascular structures. So far there is no standardized method applicable independently from the surgery. Therefore, we adapt a quality management method, the quality gates (QG), which is well established in, for example, the automotive industry and apply it to multiport image-guided minimally invasive surgery. QG divide a process into different sections. Passing between sections can only be achieved if previously defined requirements are fulfilled which secures the process chain. An interdisciplinary team of otosurgeons, computer scientists, and engineers has worked together to define the quality gates and the corresponding criteria that need to be fulfilled before passing each quality gate. In order to evaluate the defined QG and their criteria, the new surgery method was applied with a first prototype at a human skull cadaver model. We show that the QG method can ensure a safe multiport minimally invasive surgical process at the lateral skull base. Therewith, we present an approach towards the standardization of quality assurance of surgical processes. PMID:25105146

Status of groundwater quality in the Southern, Middle, and Northern Sacramento Valley study units, 2005-08: California GAMA Priority Basin Project

USGS Publications Warehouse

Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth

2011-01-01

Groundwater quality in the Southern, Middle, and Northern Sacramento Valley study units was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study units are located in California's Central Valley and include parts of Butte, Colusa, Glenn, Placer, Sacramento, Shasta, Solano, Sutter, Tehama, Yolo, and Yuba Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The three study units were designated to provide spatially-unbiased assessments of the quality of untreated groundwater in three parts of the Central Valley hydrogeologic province, as well as to provide a statistically consistent basis for comparing water quality regionally and statewide. Samples were collected in 2005 (Southern Sacramento Valley), 2006 (Middle Sacramento Valley), and 2007-08 (Northern Sacramento Valley). The GAMA studies in the Southern, Middle, and Northern Sacramento Valley were designed to provide statistically robust assessments of the quality of untreated groundwater in the primary aquifer systems that are used for drinking-water supply. The assessments are based on water-quality data collected by the USGS from 235 wells in the three study units in 2005-08, and water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer systems (hereinafter, referred to as primary aquifers) assessed in this study are defined by the depth intervals of the wells in the CDPH database for each study unit. The quality of groundwater in shallow or deep water-bearing zones may differ from quality of groundwater in the primary aquifers; shallow groundwater may be more vulnerable to contamination from the surface. The status of the current quality of the groundwater resource was assessed by using data from samples analyzed for volatile organic compounds (VOC), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifers of the three Sacramento Valley study units, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentrations divided by benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than 1.0 indicates a concentration greater than a benchmark. For organic (volatile organic compounds and pesticides) and special-interest (perchlorate) constituents, relative-concentrations were classified as high (greater than 1.0); moderate (equal to or less than 1.0 and greater than 0.1); or low (equal to or less than 0.1). For inorganic (major ion, trace element, nutrient, and radioactive) constituents, the boundary between low and moderate relative-concentrations was set at 0.5. Aquifer-scale proportions were used in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifers that have a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentage of the primary aquifers that have moderate and low relative-concentrations, respectively. Two statistical approaches-grid-based, which used one value per grid cell, and spatially-weighted, which used the full dataset-were used to calculate aquifer-scale proportions for individual constituents and classes of constituents. High and moderate aquifer-scale proportions were significantly greater for inorgani

PMG: online generation of high-quality molecular pictures and storyboarded animations

PubMed Central

Autin, Ludovic; Tufféry, Pierre

2007-01-01

The Protein Movie Generator (PMG) is an online service able to generate high-quality pictures and animations for which one can then define simple storyboards. The PMG can therefore efficiently illustrate concepts such as molecular motion or formation/dissociation of complexes. Emphasis is put on the simplicity of animation generation. Rendering is achieved using Dino coupled to POV-Ray. In order to produce highly informative images, the PMG includes capabilities of using different molecular representations at the same time to highlight particular molecular features. Moreover, sophisticated rendering concepts including scene definition, as well as modeling light and materials are available. The PMG accepts Protein Data Bank (PDB) files as input, which may include series of models or molecular dynamics trajectories and produces images or movies under various formats. PMG can be accessed at http://bioserv.rpbs.jussieu.fr/PMG.html. PMID:17478496

Transition Metal Dichalcogenide Growth via Close Proximity Precursor Supply

NASA Astrophysics Data System (ADS)

O'Brien, Maria; McEvoy, Niall; Hallam, Toby; Kim, Hye-Young; Berner, Nina C.; Hanlon, Damien; Lee, Kangho; Coleman, Jonathan N.; Duesberg, Georg S.

2014-12-01

Reliable chemical vapour deposition (CVD) of transition metal dichalcogenides (TMDs) is currently a highly pressing research field, as numerous potential applications rely on the production of high quality films on a macroscopic scale. Here, we show the use of liquid phase exfoliated nanosheets and patterned sputter deposited layers as solid precursors for chemical vapour deposition. TMD monolayers were realized using a close proximity precursor supply in a CVD microreactor setup. A model describing the growth mechanism, which is capable of producing TMD monolayers on arbitrary substrates, is presented. Raman spectroscopy, photoluminescence, X-ray photoelectron spectroscopy, atomic force microscopy, transmission electron microscopy, scanning electron microscopy and electrical transport measurements reveal the high quality of the TMD samples produced. Furthermore, through patterning of the precursor supply, we achieve patterned growth of monolayer TMDs in defined locations, which could be adapted for the facile production of electronic device components.

Using high-resolution phosphorus data to investigate mitigation measures in headwater river catchments

NASA Astrophysics Data System (ADS)

Campbell, J. M.; Jordan, P.; Arnscheidt, J.

2015-01-01

This study reports the use of high-resolution water quality monitoring to assess the influence of changes in land use management on total phosphorus (TP) transfers in two 5 km2 agricultural sub-catchments. Specifically, the work investigates the issue of agricultural soil P management and subsequent diffuse transfers at high river flows over a 5-year timescale. The work also investigates the phenomenon of low flow P pollution from septic tank systems (STSs) and mitigation efforts - a key concern for catchment management. Results showed an inconsistent response to soil P management over 5 years with one catchment showing a convergence to optimum P concentrations and the other an overall increase. Both catchments indicated an overall increase in P concentration in defined high flow ranges. Low flow P concentration showed little change or higher P concentrations in defined low flow ranges despite replacement of defective systems and this is possibly due to a number of confounding reasons including increased housing densities due to new-builds. The work indicates fractured responses to catchment management advice and mitigation and that the short to medium term may be an insufficient time to expect the full implementation of policies (here defined as convergence to optimum soil P concentration and mitigation of STSs) and also to gauge their effectiveness.

Using high-resolution phosphorus data to investigate mitigation measures in headwater river catchments

NASA Astrophysics Data System (ADS)

Campbell, J. M.; Jordan, P.; Arnscheidt, J.

2014-09-01

This study reports the use of high resolution water quality monitoring to assess the influence of changes in landuse management on total phosphorus (TP) transfers in two 5 km2 agricultural sub-catchments. Specifically, the work investigates the "wicked problem" of agricultural soil P management and subsequent diffuse transfers at high river flows over a five year timescale. The work also investigates the phenomenon of low flow P pollution from septic tank systems (STS) and mitigation efforts - here termed the "filthy issue" of rural catchment management. Results showed an inconsistent response to soil P management over five years with one catchment showing a convergence to optimum P concentrations and the other an overall increase. Both catchments indicated an overall increase in P concentration in defined high flow ranges. Low flow P concentration showed little change or higher P concentrations in defined low flow ranges despite replacement of defective systems and this is possibly due to a number of confounding reasons including increased housing densities due to new-builds. The work indicates fractured responses to catchment management advice and mitigation and that the short to medium term may be an insufficient time to expect the full implementation of policies (here defined as convergence to optimum soil P concentration and mitigation of STS) and also to gauge their effectiveness.

El juego de aparentar y el desarrollo de los ninos pequenos (Pretend Play and Young Children's Development). ERIC Digest.

ERIC Educational Resources Information Center

Bergen, Doris

Although pretend play has long been part of the early childhood curriculum, recent emphasis on accountability in education seems to have led to a decline in the general understanding of the contribution that high-quality play can make to children's cognitive development in the early years. This Spanish-language Digest defines the cluster of…

Genetic polymorphisms in lung disease: bandwagon or breakthrough?

PubMed Central

Iannuzzi, Michael C; Maliarik, Mary; Rybicki, Benjamin

2002-01-01

The study of genetic polymorphisms has touched every aspect of pulmonary and critical care medicine. We review recent progress made using genetic polymorphisms to define pathophysiology, to identify persons at risk for pulmonary disease and to predict treatment response. Several pitfalls are commonly encountered in studying genetic polymorphisms, and this article points out criteria that should be applied to design high-quality genetic polymorphism studies. PMID:11980584

Providing Child Care to Military Families: The Role of the Demand Formula in Defining Need and Informing Policy

ERIC Educational Resources Information Center

Moini, Joy S.; Zellman, Gail L.; Gates, Susan M.

2006-01-01

The Department of Defense (DoD) is committed to meeting the need for child care among military families. DoD supports the largest employer-sponsored system of high-quality child care in the country. Through accredited child development centers (CDCs), family child care (FCC) homes, youth centers, and other after-school programs, DoD currently…

Local-Scale Air Quality Modeling in Support of Human Health and Exposure Research (Invited)

NASA Astrophysics Data System (ADS)

Isakov, V.

2010-12-01

Spatially- and temporally-sparse information on air quality is a key concern for air-pollution-related environmental health studies. Monitor networks are sparse in both space and time, are costly to maintain, and are often designed purposely to avoid detecting highly localized sources. Recent studies have shown that more narrowly defining the geographic domain of the study populations and improvements in the measured/estimated ambient concentrations can lead to stronger associations between air pollution and hospital admissions and mortality records. Traditionally, ambient air quality measurements have been used as a primary input to support human health and exposure research. However, there is increasing evidence that the current ambient monitoring network is not capturing sharp gradients in exposure due to the presence of high concentration levels near, for example, major roadways. Many air pollutants exhibit large concentration gradients near large emitters such as major roadways, factories, ports, etc. To overcome these limitations, researchers are now beginning to use air quality models to support air pollution exposure and health studies. There are many advantages to using air quality models over traditional approaches based on existing ambient measurements alone. First, models can provide spatially- and temporally-resolved concentrations as direct input to exposure and health studies and thus better defining the concentration levels for the population in the geographic domain. Air quality models have a long history of use in air pollution regulations, and supported by regulatory agencies and a large user community. Also, models can provide bidirectional linkages between sources of emissions and ambient concentrations, thus allowing exploration of various mitigation strategies to reduce risk to exposure. In order to provide best estimates of air concentrations to support human health and exposure studies, model estimates should consider local-scale features, regional-scale transport, and photochemical transformations. Since these needs are currently not met by a single model, hybrid air quality modeling has recently been developed to combine these capabilities. In this paper, we present the results of two studies where we applied the hybrid modeling approach to provide spatial and temporal details in air quality concentrations to support exposure and health studies: a) an urban-scale air quality accountability study involving near-source exposures to multiple ambient air pollutants, and b) an urban-scale epidemiological study involving human health data based on emergency department visits.

Capacity building and predictors of success for HIV-1 drug resistance testing in the Asia-Pacific region and Africa

PubMed Central

Land, Sally; Zhou, Julian; Cunningham, Philip; Sohn, Annette H; Singtoroj, Thida; Katzenstein, David; Mann, Marita; Sayer, David; Kantor, Rami

2013-01-01

Background The TREAT Asia Quality Assessment Scheme (TAQAS) was developed as a quality assessment programme through expert education and training, for laboratories in the Asia-Pacific and Africa that perform HIV drug-resistance (HIVDR) genotyping. We evaluated the programme performance and factors associated with high-quality HIVDR genotyping. Methods Laboratories used their standard protocols to test panels of human immunodeficiency virus (HIV)-positive plasma samples or electropherograms. Protocols were documented and performance was evaluated according to a newly developed scoring system, agreement with panel-specific consensus sequence, and detection of drug-resistance mutations (DRMs) and mixtures of wild-type and resistant virus (mixtures). High-quality performance was defined as detection of ≥95% DRMs. Results Over 4.5 years, 23 participating laboratories in 13 countries tested 45 samples (30 HIV-1 subtype B; 15 non-B subtypes) in nine panels. Median detection of DRMs was 88–98% in plasma panels and 90–97% in electropherogram panels. Laboratories were supported to amend and improve their test outcomes as appropriate. Three laboratories that detected <80% DRMs in early panels demonstrated subsequent improvement. Sample complexity factors – number of DRMs (p<0.001) and number of DRMs as mixtures (p<0.001); and laboratory performance factors – detection of mixtures (p<0.001) and agreement with consensus sequence (p<0.001), were associated with high performance; sample format (plasma or electropherogram), subtype and genotyping protocol were not. Conclusion High-quality HIVDR genotyping was achieved in the TAQAS collaborative laboratory network. Sample complexity and detection of mixtures were associated with performance quality. Laboratories conducting HIVDR genotyping are encouraged to participate in quality assessment programmes. PMID:23845227

Introduction of a hybrid treatment delivery system used for quality assurance in multi-catheter interstitial brachytherapy

NASA Astrophysics Data System (ADS)

Kallis, Karoline; Kreppner, Stephan; Lotter, Michael; Fietkau, Rainer; Strnad, Vratislav; Bert, Christoph

2018-05-01

Multi-catheter interstitial brachytherapy (iBT) is a treatment option for breast cancer patients after breast conserving surgery. Typically, only a few additional quality interventions after the first irradiation have been introduced to ensure the planned treatment delivery. Therefore, the purpose of this study is to show the possibilities of an electromagnetic tracking (EMT) system integrated into the afterloader for quality assurance (QA) in high-dose rate (HDR) iBT of patients with breast cancer. The hybrid afterloader system equipped with an electromagnetic sensor was used for all phantom and patient measurements. Phantom measurements were conducted to estimate the quality of different evaluation schemes. After a coherent point drift registration of the EMT traces to the reconstructed catheters based on computed tomograms the dwell positions (DP) were defined. Different fitting and interpolation methods were analyzed for the reconstruction of DPs. All estimated DPs were compared to the DPs defined in treatment planning. Until now, the implant geometry of 20 patients treated with HDR brachytherapy was acquired and explored. Regarding the reconstruction techniques, both fitting and interpolation were able to detect manually introduced shifts and swaps. Nonetheless, interpolation showed superior results (RMSE  =  1.27 mm), whereas fitting seemed to be more stable to distortion and motion. The EMT system proved to be beneficial for QA in brachytherapy and furthermore, clinical feasibility was proven.

Comprehensive quality evaluation of medical Cannabis sativa L. inflorescence and macerated oils based on HS-SPME coupled to GC-MS and LC-HRMS (q-exactive orbitrap®) approach.

PubMed

Calvi, Lorenzo; Pentimalli, Daniela; Panseri, Sara; Giupponi, Luca; Gelmini, Fabrizio; Beretta, Giangiacomo; Vitali, Davide; Bruno, Massimo; Zilio, Emanuela; Pavlovic, Radmila; Giorgi, Annamaria

2018-02-20

There are at least 554 identified compounds in C. sativa L., among them 113 phytocannabinoids and 120 terpenes. Phytocomplex composition differences between the pharmaceutical properties of different medical cannabis chemotype have been attributed to strict interactions, defined as 'entourage effect', between cannabinoids and terpenes as a result of synergic action. The chemical complexity of its bioactive constituents highlight the need for standardised and well-defined analytical approaches able to characterise the plant chemotype, the herbal drug quality as well as to monitor the quality of pharmaceutical cannabis extracts and preparations. Hence, in the first part of this study an analytical procedures involving the combination of headspace-solid-phase microextraction (HS-SPME) coupled to GC-MS and High Resolution Mass-Spectrometry LC-HRMS (Orbitrap ® ) were set up, validated and applied for the in-depth profiling and fingerprinting of cannabinoids and terpenes in two authorised medical grade varieties of Cannabis sativa L. inflorescences (Bedrocan ® and Bediol ® ) and in obtained macerated oils. To better understand the trend of all volatile compounds and cannabinoids during oil storage a new procedure for cannabis macerated oil preparation without any thermal step was tested and compared with the existing conventional methods to assess the potentially detrimental effect of heating on overall product quality. Copyright © 2017 Elsevier B.V. All rights reserved.

The methodological quality of systematic reviews published in high-impact nursing journals: a review of the literature.

PubMed

Pölkki, Tarja; Kanste, Outi; Kääriäinen, Maria; Elo, Satu; Kyngäs, Helvi

2014-02-01

To analyse systematic review articles published in the top 10 nursing journals to determine the quality of the methods employed within them. Systematic review is defined as a scientific research method that synthesises high-quality scientific knowledge on a given topic. The number of such reviews in nursing science has increased dramatically during recent years, but their methodological quality has not previously been assessed. A review of the literature using a narrative approach. Ranked impact factor scores for nursing journals were obtained from the Journal Citation Report database of the Institute of Scientific Information (ISI Web of Knowledge). All issues from the years 2009 and 2010 of the top 10 ranked journals were included. CINAHL and MEDLINE databases were searched to locate studies using the search terms 'systematic review' and 'systematic literature review'. A total of 39 eligible studies were identified. Their methodological quality was evaluated through the specific criteria of quality assessment, description of synthesis and strengths and weaknesses reported in the included studies. Most of the eligible systematic reviews included several different designs or types of quantitative study. The majority included a quality assessment, and a total of 17 different criteria were identified. The method of synthesis was mentioned in about half of the reviews, the most common being narrative synthesis. The weaknesses of reviews were discussed, while strengths were rarely highlighted. The methodological quality of the systematic reviews examined varied considerably, although they were all published in nursing journals with a high-impact factor. Despite the fact that systematic reviews are considered the most robust source of research evidence, they vary in methodological quality. This point is important to consider in clinical practice when applying the results to patient care. © 2013 Blackwell Publishing Ltd.

In their own words: Patients and families define high-quality palliative care in the intensive care unit*

PubMed Central

Nelson, Judith E.; Puntillo, Kathleen A.; Pronovost, Peter J.; Walker, Amy S.; McAdam, Jennifer L.; Ilaoa, Debra; Penrod, Joan

2011-01-01

Objective Although the majority of hospital deaths occur in the intensive care unit and virtually all critically ill patients and their families have palliative needs, we know little about how patients and families, the most important “stakeholders,” define high-quality intensive care unit palliative care. We conducted this study to obtain their views on important domains of this care. Design Qualitative study using focus groups facilitated by a single physician. Setting A 20-bed general intensive care unit in a 382-bed community hospital in Oklahoma; 24-bed medical–surgical intensive care unit in a 377-bed tertiary, university hospital in urban California; and eight-bed medical intensive care unit in a 311-bed Veterans’ Affairs hospital in a northeastern city. Patients Randomly-selected patients with intensive care unit length of stay ≥5 days in 2007 to 2008 who survived the intensive care unit, families of survivors, and families of patients who died in the intensive care unit. Interventions None. Measurements and Main Results Focus group facilitator used open-ended questions and scripted probes from a written guide. Three investigators independently coded meeting transcripts, achieving consensus on themes. From 48 subjects (15 patients, 33 family members) in nine focus groups across three sites, a shared definition of high-quality intensive care unit palliative care emerged: timely, clear, and compassionate communication by clinicians; clinical decision-making focused on patients’ preferences, goals, and values; patient care maintaining comfort, dignity, and personhood; and family care with open access and proximity to patients, interdisciplinary support in the intensive care unit, and bereavement care for families of patients who died. Participants also endorsed specific processes to operationalize the care they considered important. Conclusions Efforts to improve intensive care unit palliative care quality should focus on domains and processes that are most valued by critically ill patients and their families, among whom we found broad agreement in a diverse sample. Measures of quality and effective interventions exist to improve care in domains that are important to intensive care unit patients and families. PMID:20198726

Honey Bee (Apis mellifera) Queen Reproductive Potential Affects Queen Mandibular Gland Pheromone Composition and Worker Retinue Response

PubMed Central

Böröczky, Katalin; Schal, Coby; Tarpy, David R.

2016-01-01

Reproductive division of labor is one of the defining traits of honey bees (Apis mellifera), with non-reproductive tasks being performed by workers while a single queen normally monopolizes reproduction. The decentralized organization of a honey bee colony is maintained in large part by a bouquet of queen-produced pheromones, the distribution of which is facilitated by contact among workers throughout the hive. Previous studies have shown that the developmental fate of honey bee queens is highly plastic, with queens raised from younger worker larvae exhibiting higher measures of reproductive potential compared to queens raised from older worker larvae. We investigated differences in the chemical composition of the mandibular glands and attractiveness to workers of “high-quality” queens (i.e., raised from first instar worker larvae; more queen-like) and “low-quality” queens (i.e., raised from third instar worker larvae; more worker-like). We characterized the chemical profiles of the mandibular glands of high-quality queens and low-quality queens using GC-MS and used the worker retinue response as a measure of the attractiveness to workers of high-quality queens vs. low-quality queens. We found that queen quality affected the chemical profiles of mandibular gland contents differently across years, showing significant differences in the production of the queen mandibular pheromone (“QMP”) components HVA and 9-HDA in 2010, but no significant differences of any glandular compound in 2012. We also found that workers were significantly more attracted to high-quality queens than to low-quality queens in 2012, possibly because of increased attractiveness of their mandibular gland chemical profiles. Our results indicate that the age at which honey bee larvae enter the “queen-specific” developmental pathway influences the chemical composition of queen mandibular glands and worker behavior. However, these changes are not consistent across years, suggesting that other external factors may play important roles in modulating queen quality. PMID:27281328

Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

PubMed

Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

2012-11-01

Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

Fabrication of high quality cDNA microarray using a small amount of cDNA.

PubMed

Park, Chan Hee; Jeong, Ha Jin; Jung, Jae Jun; Lee, Gui Yeon; Kim, Sang-Chul; Kim, Tae Soo; Yang, Sang Hwa; Chung, Hyun Cheol; Rha, Sun Young

2004-05-01

DNA microarray technology has become an essential part of biological research. It enables the genome-scale analysis of gene expression in various types of model systems. Manufacturing high quality cDNA microarrays of microdeposition type depends on some key factors including a printing device, spotting pins, glass slides, spotting solution, and humidity during spotting. UsingEthe Microgrid II TAS model printing device, this study defined the optimal conditions for producing high density, high quality cDNA microarrays with the least amount of cDNA product. It was observed that aminosilane-modified slides were superior to other types of surface modified-slides. A humidity of 30+/-3% in a closed environment and the overnight drying of the spotted slides gave the best conditions for arraying. In addition, the cDNA dissolved in 30% DMSO gave the optimal conditions for spotting compared to the 1X ArrayIt, 3X SSC and 50% DMSO. Lastly, cDNA in the concentration range of 100-300 ng/ micro l was determined to be best for arraying and post-processing. Currently, the printing system in this study yields reproducible 9000 spots with a spot size 150 mm diameter, and a 200 nm spot spacing.

Novel quality indicators for metastatic colorectal cancer management identify significant variations in these measures across treatment centers in Australia.

PubMed

Turner, Natalie Heather; Wong, Hui-Li; Field, Kathryn; Wong, Rachel; Shapiro, Jeremy; Yip, Desmond; Nott, Louise; Tie, Jeanne; Kosmider, Suzanne; Tran, Ben; Desai, Jayesh; McKendrick, Joseph; Zimet, Allan; Richardson, Gary; Iddawela, Mahesh; Gibbs, Peter

2015-09-01

Defining multidisciplinary quality of care indicators (QCIs) for metastatic colorectal cancer (mCRC) could improve understanding of variations in routine practice care. This may identify areas of below-average performance, which could then be addressed by clinicians to improve the quality of care delivered. This study aimed to define a panel of QCIs in mCRC and, based on these QCIs, to evaluate quality of care across multiple Australian sites. A panel of clinicians with expertise in colorectal cancer defined evidence-based or best practice-based QCIs relevant to the routine multidisciplinary management of mCRC patients through structured consensus discussion. Related data were extracted from the Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) registry, a prospectively maintained database recording comprehensive details on consecutive mCRC patients across multiple Australian hospitals. Variations in QCIs across sites were explored. Of 13 QCIs defined, data related to 10 were reliably extracted from TRACC. Analysis of data on 1276 patients across 10 sites demonstrated low rates of screening for hereditary nonpolyposis colorectal cancer in young patients and significant variation in surveillance-detected recurrences, lung resection rates and palliative chemotherapy use. Exploratory analyses suggested correlation between liver resection rates and survival. We have defined a novel set of mCRC QCIs and have demonstrated wide variation in the quality of care of mCRC across multiple Australian sites. With further validation to confirm a direct correlation between QCI and patient outcomes, these QCIs could be applied to improve the quality of care received by all mCRC patients. © 2015 Wiley Publishing Asia Pty Ltd.

A software quality model and metrics for risk assessment

NASA Technical Reports Server (NTRS)

Hyatt, L.; Rosenberg, L.

1996-01-01

A software quality model and its associated attributes are defined and used as the model for the basis for a discussion on risk. Specific quality goals and attributes are selected based on their importance to a software development project and their ability to be quantified. Risks that can be determined by the model's metrics are identified. A core set of metrics relating to the software development process and its products is defined. Measurements for each metric and their usability and applicability are discussed.

Ontology Based Quality Evaluation for Spatial Data

NASA Astrophysics Data System (ADS)

Yılmaz, C.; Cömert, Ç.

2015-08-01

Many institutions will be providing data to the National Spatial Data Infrastructure (NSDI). Current technical background of the NSDI is based on syntactic web services. It is expected that this will be replaced by semantic web services. The quality of the data provided is important in terms of the decision-making process and the accuracy of transactions. Therefore, the data quality needs to be tested. This topic has been neglected in Turkey. Data quality control for NSDI may be done by private or public "data accreditation" institutions. A methodology is required for data quality evaluation. There are studies for data quality including ISO standards, academic studies and software to evaluate spatial data quality. ISO 19157 standard defines the data quality elements. Proprietary software such as, 1Spatial's 1Validate and ESRI's Data Reviewer offers quality evaluation based on their own classification of rules. Commonly, rule based approaches are used for geospatial data quality check. In this study, we look for the technical components to devise and implement a rule based approach with ontologies using free and open source software in semantic web context. Semantic web uses ontologies to deliver well-defined web resources and make them accessible to end-users and processes. We have created an ontology conforming to the geospatial data and defined some sample rules to show how to test data with respect to data quality elements including; attribute, topo-semantic and geometrical consistency using free and open source software. To test data against rules, sample GeoSPARQL queries are created, associated with specifications.

Does Elite Sport Degrade Sleep Quality? A Systematic Review.

PubMed

Gupta, Luke; Morgan, Kevin; Gilchrist, Sarah

2017-07-01

Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown. The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology. Studies relating to sleep involving participants described on a pre-defined continuum of 'eliteness' were located through a systematic search of four research databases: SPORTDiscus, PubMed, Science Direct and Google Scholar, up to April 2016. Once extracted, studies were categorised as (1) those mainly describing sleep structure/patterns, (2) those mainly describing sleep quality and insomnia symptomatology and (3) those exploring associations between aspects of elite sport and sleep outcomes. The search returned 1676 records. Following screening against set criteria, a total of 37 studies were identified. The quality of evidence reviewed was generally low. Pooled sleep quality data revealed high levels of sleep complaints in elite athletes. Three risk factors for sleep disturbance were broadly identified: (1) training, (2) travel and (3) competition. While acknowledging the limited number of high-quality evidence reviewed, athletes show a high overall prevalence of insomnia symptoms characterised by longer sleep latencies, greater sleep fragmentation, non-restorative sleep, and excessive daytime fatigue. These symptoms show marked inter-sport differences. Two underlying mechanisms are implicated in the mediation of sport-related insomnia symptoms: pre-sleep cognitive arousal and sleep restriction.

Ground-water quality in east-central Idaho valleys

USGS Publications Warehouse

Parliman, D.J.

1982-01-01

From May through November 1978, water quality, geologic, and hydrologic data were collected for 108 wells in the Lemhi, Pahsimeroi, Salman River (Stanley to Salmon), Big Lost River, and Little Lost River valleys in east-central Idaho. Data were assembled to define, on a reconnaissance level, water-quality conditions in major aquifers and to develop an understanding of factors that affected conditions in 1978 and could affect future ground-water quality. Water-quality characteristics determined include specific conductance, pH, water temperature, major dissolved cations, major dissolved anions, and coliform bacteria. Concentrations of hardness, nitrite plus nitrate, coliform bacteria, dissolved solids, sulfate, chloride, fluoride , iron, calcium, magnesium, sodium, potassium or bicarbonate exceed public drinking water regulation limits or were anomalously high in some water samples. Highly mineralized ground water probably is due to the natural composition of the aquifers and not to surface contamination. Concentrations of coliform bacteria that exceed public drinking water limits and anomalously high dissolved nitrite-plus-nitrite concentrations are from 15- to 20-year old irrigation wells in heavily irrigated or more densely populated areas of the valleys. Ground-water quality and quantity in most of the study area are sufficient to meet current (1978) population and economic demands. Ground water in all valleys is characterized by significant concentrations of calcium, magnesium, and bicarbonate plus carbonate ions. Variations in the general trend of ground-water composition (especially in the Lemhi Valley) probably are most directly related to variability in aquifer lithology and proximity of sampling site to source of recharge. (USGS)

Nutrition and physical activity for the prevention and treatment of age-related sarcopenia.

PubMed

Bosaeus, Ingvar; Rothenberg, Elisabet

2016-05-01

Sarcopenia, defined as loss of skeletal muscle mass and function, is associated with adverse outcomes such as physical disability, impaired quality of life and increased mortality. Several mechanisms are involved in the development of sarcopenia. Potentially modifiable factors include nutrition and physical activity. Protein metabolism is central to the nutritional issues, along with other potentially modifying nutritional factors as energy balance and vitamin D status. An increasing but still incomplete knowledge base has generated recent recommendations on an increased protein intake in the elderly. Several factors beyond the total amount of protein consumed emerge as potentially important in this context. A recent summit examined three hypotheses: (1) A meal threshold; habitually consuming 25-30 g protein at breakfast, lunch and dinner provides sufficient protein to effectively stimulate muscle protein anabolism; (2) Protein quality; including high-quality protein at each meal improves postprandial muscle protein synthesis; and (3) performing physical activity in close temporal proximity to a high-quality protein meal enhances muscle anabolism. Optimising the potential for muscle protein anabolism by consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, appears as a promising strategy to prevent or delay the onset of sarcopenia. However, results of interventions are inconsistent, and well-designed, standardised studies evaluating exercise or nutrition interventions are needed before guidelines can be developed for the prevention and treatment of age-related sarcopenia.

Building high-quality assay libraries for targeted analysis of SWATH MS data.

PubMed

Schubert, Olga T; Gillet, Ludovic C; Collins, Ben C; Navarro, Pedro; Rosenberger, George; Wolski, Witold E; Lam, Henry; Amodei, Dario; Mallick, Parag; MacLean, Brendan; Aebersold, Ruedi

2015-03-01

Targeted proteomics by selected/multiple reaction monitoring (S/MRM) or, on a larger scale, by SWATH (sequential window acquisition of all theoretical spectra) MS (mass spectrometry) typically relies on spectral reference libraries for peptide identification. Quality and coverage of these libraries are therefore of crucial importance for the performance of the methods. Here we present a detailed protocol that has been successfully used to build high-quality, extensive reference libraries supporting targeted proteomics by SWATH MS. We describe each step of the process, including data acquisition by discovery proteomics, assertion of peptide-spectrum matches (PSMs), generation of consensus spectra and compilation of MS coordinates that uniquely define each targeted peptide. Crucial steps such as false discovery rate (FDR) control, retention time normalization and handling of post-translationally modified peptides are detailed. Finally, we show how to use the library to extract SWATH data with the open-source software Skyline. The protocol takes 2-3 d to complete, depending on the extent of the library and the computational resources available.

The Relationship of Previous Training and Experience of Journal Peer Reviewers to Subsequent Review Quality

PubMed Central

Callaham, Michael L; Tercier, John

2007-01-01

Background Peer review is considered crucial to the selection and publication of quality science, but very little is known about the previous experiences and training that might identify high-quality peer reviewers. The reviewer selection processes of most journals, and thus the qualifications of their reviewers, are ill defined. More objective selection of peer reviewers might improve the journal peer review process and thus the quality of published science. Methods and Findings 306 experienced reviewers (71% of all those associated with a specialty journal) completed a survey of past training and experiences postulated to improve peer review skills. Reviewers performed 2,856 reviews of 1,484 separate manuscripts during a four-year study period, all prospectively rated on a standardized quality scale by editors. Multivariable analysis revealed that most variables, including academic rank, formal training in critical appraisal or statistics, or status as principal investigator of a grant, failed to predict performance of higher-quality reviews. The only significant predictors of quality were working in a university-operated hospital versus other teaching environment and relative youth (under ten years of experience after finishing training). Being on an editorial board and doing formal grant (study section) review were each predictors for only one of our two comparisons. However, the predictive power of all variables was weak. Conclusions Our study confirms that there are no easily identifiable types of formal training or experience that predict reviewer performance. Skill in scientific peer review may be as ill defined and hard to impart as is “common sense.” Without a better understanding of those skills, it seems unlikely journals and editors will be successful in systematically improving their selection of reviewers. This inability to predict performance makes it imperative that all but the smallest journals implement routine review ratings systems to routinely monitor the quality of their reviews (and thus the quality of the science they publish). PMID:17411314

Evaluating YouTube as a Source of Patient Education on the Role of the Hospitalist: A Cross-Sectional Study.

PubMed

Hudali, Tamer; Papireddy, Muralidhar; Bhattarai, Mukul; Deckard, Alan; Hingle, Susan

2017-01-10

Hospital medicine is a relatively new specialty field, dedicated to the delivery of comprehensive medical care to hospitalized patients. YouTube is one of the most frequently used websites, offering access to a gamut of videos from self-produced to professionally made. The aim of our study was to determine the adequacy of YouTube as an effective means to define and depict the role of hospitalists. YouTube was searched on November 17, 2014, using the following search words: "hospitalist," "hospitalist definition," "what is the role of a hospitalist," "define hospitalist," and "who is a hospitalist." Videos found only in the first 10 pages of each search were included. Non-English, noneducational, and nonrelevant videos were excluded. A novel 7-point scoring tool was created by the authors based on the definition of a hospitalist adopted by the Society of Hospital Medicine. Three independent reviewers evaluated, scored, and classified the videos into high, intermediate, and low quality based on the average score. A total of 102 videos out of 855 were identified as relevant and included in the analysis. Videos uploaded by academic institutions had the highest mean score. Only 6 videos were classified as high quality, 53 as intermediate quality, and 42 as low quality, with 82.4% (84/102) of the videos scoring an average of 4 or less. Most videos found in the search of a hospitalist definition are inadequate. Leading medical organizations and academic institutions should consider producing and uploading quality videos to YouTube to help patients and their families better understand the roles and definition of the hospitalist. ©Tamer Hudali, Muralidhar Papireddy, Mukul Bhattarai, Alan Deckard, Susan Hingle. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 10.01.2017.

Friendship quality in adolescents with and without an intellectual disability.

PubMed

Tipton, Leigh A; Christensen, Lisa; Blacher, Jan

2013-11-01

High friendship quality is often defined by high levels of intimacy, companionship, closeness and low levels of conflict. Quality friendships develop over time and may be influenced by both behaviour problems and social skills. Participants were 103, 13-year-old adolescents with or without intellectual disabilities in the United States. Adolescents and their mothers participated in an open-ended interview of friendship quality and completed measures of social skills and behaviour problems. This study addressed differences in friendship quality between children with and without intellectual disabilities and explored early indicators of friendship development. Adolescents with intellectual disabilities (ID) had friendships characterized by significantly lower levels of warmth/closeness and positive reciprocity than their typically developing peers. Likewise, adolescents with ID spent less time with friends outside of school and were less likely to have a cohesive group of friends. Social skills and behaviour problems at age 9 predicted friendship quality at age 13 above and beyond disability status, with higher levels of social skills and lower levels of behaviour problems related to higher ratings on measures of friendship quality. It appears that adolescents with intellectual disabilities have friendships that are characterized by less warmth/closeness and less positive reciprocity than the friendships of their typically developing peers. This discrepancy appears to be impacted by early social skills and behaviour problems in addition to the presence of the intellectual disability. © 2013 John Wiley & Sons Ltd.

Variation of organic matter quantity and quality in streams at Critical Zone Observatory watersheds

USGS Publications Warehouse

Miller, Matthew P.; Boyer, Elizabeth W.; McKnight, Diane M.; Brown, Michael G.; Gabor, Rachel S.; Hunsaker, Carolyn T.; Iavorivska , Lidiia; Inamdar, Shreeram; Kaplan, Louis A.; Johnson, Dale W.; Lin, Henry; McDowell, William H.; Perdrial, Julia N.

2016-01-01

The quantity and chemical composition of dissolved organic matter (DOM) in surface waters influence ecosystem processes and anthropogenic use of freshwater. However, despite the importance of understanding spatial and temporal patterns in DOM, measures of DOM quality are not routinely included as part of large-scale ecosystem monitoring programs and variations in analytical procedures can introduce artifacts. In this study, we used consistent sampling and analytical methods to meet the objective of defining variability in DOM quantity and quality and other measures of water quality in streamflow issuing from small forested watersheds located within five Critical Zone Observatory sites representing contrasting environmental conditions. Results show distinct separations among sites as a function of water quality constituents. Relationships among rates of atmospheric deposition, water quality conditions, and stream DOM quantity and quality are consistent with the notion that areas with relatively high rates of atmospheric nitrogen and sulfur deposition and high concentrations of divalent cations result in selective transport of DOM derived from microbial sources, including in-stream microbial phototrophs. We suggest that the critical zone as a whole strongly influences the origin, composition, and fate of DOM in streams. This study highlights the value of consistent DOM characterization methods included as part of long-term monitoring programs for improving our understanding of interactions among ecosystem processes as controls on DOM biogeochemistry.

Quality of care and economic considerations of active surveillance of men with prostate cancer

PubMed Central

2018-01-01

The current health care climate mandates the delivery of high-value care for patients considering active surveillance for newly-diagnosed prostate cancer. Value is defined by increasing benefits (e.g., quality) for acceptable costs. This review discusses quality of care considerations for men contemplating active surveillance, and highlights cost implications at the patient, health-system, and societal level related to pursuit of non-interventional management of men diagnosed with localized prostate cancer. In general, most quality measures are focused on prostate cancer care in general, rather that active surveillance patients specifically. However, most prostate cancer quality measures are pertinent to men seeking close observation of their prostate tumors with active surveillance. These include accurate documentation of clinical stage, informed discussion of all treatment options, and appropriate use of imaging for less-aggressive prostate cancer. Furthermore, interventions that may help improve the quality of care for active surveillance patients are reviewed (e.g., quality collaboratives, judicious antibiotic use, etc.). Finally, the potential economic impact and benefits of broad acceptance of active surveillance strategies are highlighted. PMID:29732278

Quality of care and economic considerations of active surveillance of men with prostate cancer.

PubMed

Filson, Christopher P

2018-04-01

The current health care climate mandates the delivery of high-value care for patients considering active surveillance for newly-diagnosed prostate cancer. Value is defined by increasing benefits (e.g., quality) for acceptable costs. This review discusses quality of care considerations for men contemplating active surveillance, and highlights cost implications at the patient, health-system, and societal level related to pursuit of non-interventional management of men diagnosed with localized prostate cancer. In general, most quality measures are focused on prostate cancer care in general, rather that active surveillance patients specifically. However, most prostate cancer quality measures are pertinent to men seeking close observation of their prostate tumors with active surveillance. These include accurate documentation of clinical stage, informed discussion of all treatment options, and appropriate use of imaging for less-aggressive prostate cancer. Furthermore, interventions that may help improve the quality of care for active surveillance patients are reviewed (e.g., quality collaboratives, judicious antibiotic use, etc.). Finally, the potential economic impact and benefits of broad acceptance of active surveillance strategies are highlighted.

Breast imaging. A practical look at its capabilities and its limitations.

PubMed

Clark, R; Nemec, L; Love, N

1992-10-01

The film-screen technique is evolving as the standard for mammography. Sonography is the only other method that currently has a defined role in breast imaging. Mammography should be performed at facilities that have received American College of Radiology accreditation or its equivalent, because technical quality assurance is an important part of mammographic practice. Interpretive quality may be assured by outcome audits performed by mammography facilities. Primary care physicians are best suited to encouraging eligible women to undergo screening studies and should consider these recommendations: Refer patients for screening mammography to accredited facilities according to established guidelines. Educate patients about the need for regular screening. Provide annual breast physical examination. Refresh your knowledge on breast health and the techniques of physical examination if necessary. Teach patients breast self-examination techniques. Demand low-cost, high-quality screening mammography; be aware of local variability of charges and quality.

A Regression-Based Family of Measures for Full-Reference Image Quality Assessment

NASA Astrophysics Data System (ADS)

Oszust, Mariusz

2016-12-01

The advances in the development of imaging devices resulted in the need of an automatic quality evaluation of displayed visual content in a way that is consistent with human visual perception. In this paper, an approach to full-reference image quality assessment (IQA) is proposed, in which several IQA measures, representing different approaches to modelling human visual perception, are efficiently combined in order to produce objective quality evaluation of examined images, which is highly correlated with evaluation provided by human subjects. In the paper, an optimisation problem of selection of several IQA measures for creating a regression-based IQA hybrid measure, or a multimeasure, is defined and solved using a genetic algorithm. Experimental evaluation on four largest IQA benchmarks reveals that the multimeasures obtained using the proposed approach outperform state-of-the-art full-reference IQA techniques, including other recently developed fusion approaches.

Material recycling of post-consumer polyolefin bulk plastics: Influences on waste sorting and treatment processes in consideration of product qualities achievable.

PubMed

Pfeisinger, Christian

2017-02-01

Material recycling of post-consumer bulk plastics made up of polyolefins is well developed. In this article, it is examined which effects on waste sorting and treatment processes influence the qualities of polyolefin-recyclats. It is shown that the properties and their changes during the product life-cycle of a polyolefin are defined by its way of polymerisation, its nature as a thermoplast, additives, other compound and composite materials, but also by the mechanical treatments during the production, its use where contact to foreign materials is possible and the waste sorting and treatment processes. Because of the sum of the effects influencing the quality of polyolefin-recyclats, conclusions are drawn for the material recycling of polyolefins to reach high qualities of their recyclats. Also, legal requirements like the EU regulation 1907/2006 concerning the registration, evaluation, authorisation and restrictions on chemicals are considered.

Quality in Teaching Laboratories.

ERIC Educational Resources Information Center

Stubington, John F.

1995-01-01

Describes a Japanese process-oriented approach called KAIZEN for improving the quality of existing teaching laboratories. It provides relevant quality measurements and indicates how quality can be improved. Use of process criteria sidesteps the difficulty of defining quality for laboratory experiments and allows separation of student assessment…

Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program

PubMed Central

Epstein, Arnold M.; Orav, E. John; Filice, Clara E.; Samson, Lok Wong; Joynt Maddox, Karen E.

2017-01-01

Importance Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. Objective To compare performance in the PVBM Program by practice characteristics. Design, Setting, and Participants Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. Exposures High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Main Outcomes and Measures Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Results Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, −0.55 [95% CI, −0.77 to −0.32]; high social risk only: z score, −0.86 [95% CI, −1.17 to −0.54]; and high medical and social risk: −0.78 [95% CI, −1.04 to −0.51]) (P < .001 across groups). Practices categorized as high social risk only performed the best on the composite cost score (z score, −0.52 [95% CI, −0.71 to −0.33]), low risk had the next best cost score (z score, −0.18 [95% CI, −0.25 to −0.10]), then high medical and social risk (z score, 0.40 [95% CI, 0.23 to 0.57]), and then high medical risk only (z score, 0.82 [95% CI, 0.65 to 0.99]) (P < .001 across groups). Total per capita costs were $9506 for practices categorized as low risk, $13 683 for high medical risk only, $8214 for high social risk only, and $11 692 for high medical and social risk. These patterns were associated with fewer bonuses and more penalties for high-risk practices. Conclusions and Relevance During the first year of the Medicare Physician Value-Based Payment Modifier Program, physician practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. PMID:28763549

Product quality considerations for mammalian cell culture process development and manufacturing.

PubMed

Gramer, Michael J

2014-01-01

The manufacturing of a biologic drug from mammalian cells results in not a single substance, but an array of product isoforms, also known as variants. These isoforms arise due to intracellular or extracellular events as a result of biological or chemical modification. The most common examples related to biomanufacturing include amino acid modifications (glycosylation, isomerization, oxidation, adduct formation, pyroglutamate formation, phosphorylation, sulfation, amidation), amino acid sequence variants (genetic mutations, amino acid misincorporation, N- and C-terminal heterogeneity, clipping), and higher-order structure modifications (misfolding, aggregation, disulfide pairing). Process-related impurities (HCP, DNA, media components, viral particles) are also important quality attributes related to product safety. The observed ranges associated with each quality attribute define the product quality profile. A biologic drug must have a correct and consistent quality profile throughout clinical development and scale-up to commercial production to ensure product safety and efficacy. In general, the upstream process (cell culture) defines the quality of product-related substances, whereas the downstream process (purification) defines the residual level of process- and product-related impurities. The purpose of this chapter is to review the impact of the cell culture process on product quality. Emphasis is placed on studies with industrial significance and where the direct mechanism of product quality impact was determined. Where possible, recommendations for maintaining consistent or improved quality are provided.

Structural and optical characteristics of GaAs films grown on Si/Ge substrates

NASA Astrophysics Data System (ADS)

Rykov, A. V.; Dorokhin, M. V.; Vergeles, P. S.; Baidus, N. V.; Kovalskiy, V. A.; Yakimov, E. B.; Soltanovich, O. A.

2018-03-01

A GaAs/AlAs heterostructure and a GaAs film grown on Si/Ge substrates have been fabricated and studied. A Ge buffer on a silicon substrate was fabricated using the MBE process. A3B5 films were grown by MOCVD at low pressures. Photoluminescence spectroscopy was used to define the optical quality of A3B5 films. Structural properties were investigated using the electron beam induced current method. It was established that despite a rather high density of dislocations on the epitaxial layers, the detected photoluminescence radiation of layers indicates the acceptable crystalline quality of the top GaAs layer.

Cultural and contextual analysis of quality of life among older Nepali women.

PubMed

Shrestha, Srijana; Zarit, Steven H

2012-06-01

The quality-of-life construct can be used to assess how well an individual's needs are met or being met by the society. However, in the dominant narratives of quality of life in old age, exploration of the impact of cultural differences on how older adults define and assess their quality of life has been limited. Moreover, the examination of heterogeneity within one culture and its influence on quality of life has been largely ignored. The present study compares the quality of life as defined by two samples of Nepali elderly women, those who live with their families and those who live in an old-age home, and presents data on factors associated with quality of life in the two samples. The results show that social and cultural norms, informed by religious principles that prescribe familial elder care, impact how quality of life is described by both groups of women.

Screening for inter-hospital differences in cesarean section rates in low-risk deliveries using administrative data: an initiative to improve the quality of care.

PubMed

Aelvoet, Willem; Windey, Francis; Molenberghs, Geert; Verstraelen, Hans; Van Reempts, Patrick; Foidart, Jean-Michel

2008-01-04

Rising national cesarean section rates (CSRs) and unexplained inter-hospital differences in CSRs, led national and international bodies to select CSR as a quality indicator. Using hospital discharge abstracts, we aimed to document in Belgium (1) inter-hospital differences in CSRs among low risk deliveries, (2) a national upward CSR trend, (3) lack of better neonatal outcomes in hospitals with high CSRs, and (4) possible under-use of CS. We defined a population of low risk deliveries (singleton, vertex, full-term, live born, <4500 g, >2499 g). Using multivariable logistic regression techniques, we provided degrees of evidence regarding the observed departure ([relative risk-1]*100) of each hospital (N = 107) from the national CSR and its trend. To determine a benchmark, we defined three CSR groups (high, average and low) and compared them regarding 1 minute Apgar scores and other neonatal endpoints. An anonymous feedback is provided to the hospitals, the College of Physicians (with voluntary disclosure of the outlying hospitals for quality improvement purposes) and to the policy makers. Compared with available information, the completeness and accuracy of the data, regarding the variables selected to determine our study population, showed adequate. Important inter-hospital differences were found. Departures ranged from -65% up to +75%, and 9 "high CSR" and 13 "low CSR" outlying hospitals were identified. We observed a national increasing trend of 1.019 (95%CI [1.015; 1.022]) per semester, adjusted for age groups. In the "high CSR" group 1 minute Apgar scores <4 were over-represented in the subgroup of vaginal deliveries, suggesting CSs not carried out for medical reasons. Under-use of CS was also observed. Given their questionable completeness, except Apgar scores, our neonatal results, showing a significant association of CS with adverse neonatal endpoints, are to be cautiously interpreted. Taking the available evidence into account, the "Average CSR" group seemed to be the best benchmark candidate. Rather than firm statements about quality of care, our results are to be considered a useful screening. The inter-hospital differences in CSR, the national CS upward trend, the indications of over-use and under-use, the geographically different obstetric patterns and the admission day-related concentration of deliveries, whether or not by CS, may trigger initiatives aiming at improving quality of care.

International consensus on a complications list after gastrectomy for cancer.

PubMed

Baiocchi, Gian Luca; Giacopuzzi, Simone; Marrelli, Daniele; Reim, Daniel; Piessen, Guillaume; Matos da Costa, Paulo; Reynolds, John V; Meyer, Hans-Joachim; Morgagni, Paolo; Gockel, Ines; Lara Santos, Lucio; Jensen, Lone Susanne; Murphy, Thomas; Preston, Shaun R; Ter-Ovanesov, Mikhail; Fumagalli Romario, Uberto; Degiuli, Maurizio; Kielan, Wojciech; Mönig, Stefan; Kołodziejczyk, Piotr; Polkowski, Wojciech; Hardwick, Richard; Pera, Manuel; Johansson, Jan; Schneider, Paul M; de Steur, Wobbe O; Gisbertz, Suzanne S; Hartgrink, Henk; van Sandick, Joanna W; Portolani, Nazario; Hölscher, Arnulf H; Botticini, Maristella; Roviello, Franco; Mariette, Christophe; Allum, William; De Manzoni, Giovanni

2018-05-30

Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus. The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications. A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet. The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.

Goals of Quality in Doctoral Studies and Forecasted Outcomes

ERIC Educational Resources Information Center

Zelvys, Rimantas

2007-01-01

This article discusses the quality assurance policy of doctoral studies implemented in Lithuania and its probable outcomes are forecasted. In scientific literature the quality of education is commonly defined as a holistic phenomenon composed of the quality of initial conditions, quality of process and quality of outputs. The accomplished document…

The transition to parenthood among young African American and Latino couples: relational predictors of risk for parental dysfunction.

PubMed

Florsheim, Paul; Sumida, Emi; McCann, Claire; Winstanley, Matthew; Fukui, Ritsuko; Seefeldt, Trina; Moore, David

2003-03-01

This study examined relationship factors associated with parental dysfunction among young African American and Latino couples. Parent dysfunction was defined in terms of parenting stress, child abuse potential, physically punitive behavior, and paternal disengagement. Fathers who reported positive relations with their own parents and partners before childbirth reported more positive adjustments to parenthood at follow-up. The quality of the prebirth partner relationship buffered the impact of a relationship breakup on a young father's adjustment to parenthood. The quality of a mother's relationship with her parents was the best predictor of her adjustment to parenthood. However, mothers who reported large declines in the quality of the partner relationship also reported high levels of parenting stress. Clinical and policy implications of findings are discussed.

Design and implementation of a control structure for quality products in a crude oil atmospheric distillation column.

PubMed

Sotelo, David; Favela-Contreras, Antonio; Sotelo, Carlos; Jiménez, Guillermo; Gallegos-Canales, Luis

2017-11-01

In recent years, interest for petrochemical processes has been increasing, especially in refinement area. However, the high variability in the dynamic characteristics present in the atmospheric distillation column poses a challenge to obtain quality products. To improve distillates quality in spite of the changes in the input crude oil composition, this paper details a new design of a control strategy in a conventional crude oil distillation plant defined using formal interaction analysis tools. The process dynamic and its control are simulated on Aspen HYSYS ® dynamic environment under real operating conditions. The simulation results are compared against a typical control strategy commonly used in crude oil atmospheric distillation columns. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Hexagonal Nanopyramidal Prisms of Nearly Intrinsic InN on Patterned GaN Nanowire Arrays

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

Golam Sarwar, A. T. M.; Leung, Benjamin; Wang, George T.

By using multiple growth steps that separate the nucleation and growth processes, we show that nearly intrinsic InN single nanocrystals of high optical quality can be formed on patterned GaN nanowire arrays by molecular beam epitaxy. The InN nanostructures form into well-defined hexagonal prisms with pyramidal tops. Micro-photoluminescence (μ-PL) is carried out at low temperature (LT: 28.2 K) and room temperature (RT: 285 K) to gauge the relative material quality of the InN nanostructures. Nanopyramidal prisms grown using a three-step growth method are found to show superior quantum efficiency. In conclusion, excitation and temperature dependent μ-PL demonstrates the very highmore » quality and nearly intrinsic nature of the ordered InN nanostructure arrays.« less

Hexagonal Nanopyramidal Prisms of Nearly Intrinsic InN on Patterned GaN Nanowire Arrays

DOE PAGES

Golam Sarwar, A. T. M.; Leung, Benjamin; Wang, George T.; ...

2018-01-04

By using multiple growth steps that separate the nucleation and growth processes, we show that nearly intrinsic InN single nanocrystals of high optical quality can be formed on patterned GaN nanowire arrays by molecular beam epitaxy. The InN nanostructures form into well-defined hexagonal prisms with pyramidal tops. Micro-photoluminescence (μ-PL) is carried out at low temperature (LT: 28.2 K) and room temperature (RT: 285 K) to gauge the relative material quality of the InN nanostructures. Nanopyramidal prisms grown using a three-step growth method are found to show superior quantum efficiency. In conclusion, excitation and temperature dependent μ-PL demonstrates the very highmore » quality and nearly intrinsic nature of the ordered InN nanostructure arrays.« less

Quality research in radiation oncology: a self-improvement initiative 30 years ahead of its time?

PubMed

Wilson, J Frank; Owen, Jean

2005-12-01

The quality of cancer care in the United States should be better than it is. Society has demanded improvement, but much work remains to be done to define and measure both the current quality of care and the steps needed to optimize such care. Various public and private organizations are directing early efforts toward attempts to determine the quality of selected oncology services as a first step in a broad-based quality improvement process. In contrast, the ACR Patterns of Care Study (PCS) for over 30 years has relied on exemplary voluntary engagement by American radiation oncologists in critical self-assessment and self-improvement as a highly effective pathway to improved practice quality. This article provides an overview of the documented historical and recent impact of PCS research findings on practice and describes the deliberate adaptation of the PCS identity and methodology to the quality-sensitive national environment with the new project name Quality Research in Radiation Oncology. The article concludes with a discussion of the rationale for continuing this unique quality improvement initiative and some of the challenges to this imperative that are being faced.

[Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

PubMed

Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

2014-01-01

Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements. Copyright © 2014. Published by Elsevier GmbH.

Different paths to high-quality care: three archetypes of top-performing practice sites.

PubMed

Feifer, Chris; Nemeth, Lynne; Nietert, Paul J; Wessell, Andrea M; Jenkins, Ruth G; Roylance, Loraine; Ornstein, Steven M

2007-01-01

Primary care practices use different approaches in their quest for high-quality care. Previous work in the Practice Partner Research Network (PPRNet) found that improved outcomes are associated with strategies to prioritize performance, involve staff, redesign elements of the delivery system, make patients active partners in guideline adherence, and use tools embedded in the electronic medical record. The aim of this study was to examine variations in the adoption of improvements among sites achieving the best outcomes. This study used an observational case study design. A practice-level measure of adherence to clinical guidelines was used to identify the highest performing practices in a network of internal and family medicine practices participating in a national demonstration project. We analyzed qualitative and quantitative information derived from project documents, field notes, and evaluation questionnaires to develop and compare case studies. Nine cases are described. All use many of the same improvement strategies. Differences in the way improvements are organized define 3 distinct archetypes: the Technophiles, the Motivated Team, and the Care Enterprise. There is no single approach that explains the superior performance of high-performing practices, though each has adopted variations of PPRNet's improvement model. Practices will vary in their path to high-quality care. The archetypes could prove to be a useful guide to other practices selecting an overall quality improvement approach.

Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature.

PubMed

Kalamar, Amanda M; Lee-Rife, Susan; Hindin, Michelle J

2016-09-01

Child marriage, defined as marriage before the age of 18 years, is a human rights violation that can have lasting adverse educational and economic impacts. The objective of this review was to identify high-quality interventions and evaluations to decease child marriage in low- and middle-income countries. PubMed, Embase, PsycInfo, CINAHL Plus, Popline, and the Cochrane Databases were searched without language limitations for articles published through November 2015. Gray literature was searched by hand. Reference tracing was used, as well as the unpacking of systematic reviews. Retained articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Eleven high-quality interventions and evaluations were abstracted. Six found positive results in decreasing the proportion married or increasing age at marriage, one had both positive and negative findings, and four had no statistical impact on the proportion married or age at marriage. There is wide range of high-quality, impactful interventions included in this review which can inform researchers, donors, and policy makers about where to make strategic investments to eradicate marriage, a current target of the Sustainable Development Goals. Despite the cultural factors that promote child marriage, the diversity of interventions can allow decision makers to tailor interventions to the cultural context of the target population. Copyright © 2016. Published by Elsevier Inc.

High aspect ratio nano-fabrication of photonic crystal structures on glass wafers using chrome as hard mask.

PubMed

Hossain, Md Nazmul; Justice, John; Lovera, Pierre; McCarthy, Brendan; O'Riordan, Alan; Corbett, Brian

2014-09-05

Wafer-scale nano-fabrication of silicon nitride (Si x N y ) photonic crystal (PhC) structures on glass (quartz) substrates is demonstrated using a thin (30 nm) chromium (Cr) layer as the hard mask for transferring the electron beam lithography (EBL) defined resist patterns. The use of the thin Cr layer not only solves the charging effect during the EBL on the insulating substrate, but also facilitates high aspect ratio PhCs by acting as a hard mask while deep etching into the Si x N y . A very high aspect ratio of 10:1 on a 60 nm wide grating structure has been achieved while preserving the quality of the flat top of the narrow lines. The presented nano-fabrication method provides PhC structures necessary for a high quality optical response. Finally, we fabricated a refractive index based PhC sensor which shows a sensitivity of 185 nm per RIU.

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

Quality control and improvement of cancer care: what is needed? 4th European Roundtable Meeting (ERTM) May 5th, 2017, Berlin, Germany.

PubMed

Ortmann, Olaf; Helbig, Ulrike; Torode, Julie; Schreck, Stefan; Karjalainen, Sakari; Bettio, Manola; Ringborg, Ulrik; Klinkhammer-Schalke, Monika; Bray, Freddy

2018-06-01

National Cancer Control Plans (NCCPs) often describe structural requirements for high quality cancer care. During the fourth European Roundtable Meeting (ERTM) participants shared learnings from their own national setting to formulate best practice in optimizing communication strategies between parties involved in clinical cancer registries, cancer centers and guideline groups. A decentralized model of data collection close to the patient and caregiver enhances timely completion and the quality of the data captured. Nevertheless, central coordination is necessary to define datasets, indicators, standard settings, education, training and quality control to maintain standards across the network. In particular, interaction of parties in cancer care network has to be established and maintained on a regular basis. After establishing the structural requirements of cancer care networks, communication between the different components and parties is required to analyze outcome data, provide regular reporting to all and develop strategies for continuous improvement of quality across the network.

Cluster analysis application in research on pork quality determinants

NASA Astrophysics Data System (ADS)

Przybylski, W.; Wasiewicz, P.; Zieliński, P.; Gromadzka-Ostrowska, J.; Olczak, E.; Jaworska, D.; Niemyjski, S.; Santé-Lhoutellier, V.

2010-09-01

In this paper data mining methods were applied to investigate features determining high quality pork meat. The aim of the study was analysis of conditionality of the pork meat quality defined in coherence with HDL and LDL cholesterol concentration, plasma leptin, triglycerides, plasma glucose and serum. The research was carried out on 54 pigs. originated from crossbreeding of Naima sows with P76-PenArLan boars hybrids line. Meat quality parameters were evaluated in samples derived from the Longissimus (LD) muscle taken behind the last rib on the basis: the pH value, meat colour, drip loss, the RTN, intramuscular fat and glycolytic potential. The results of this study were elaborated by using R environment and show that cluster and regression analysis can be a useful tool for in-depth analysis of the determinants of the quality of pig meat in homogeneous populations of pigs. However, the question of determinants of the level of glycogen and fat in meat requires further research.

A Novel Approach to High Definition, High-Contrast Video Capture in Abdominal Surgery

PubMed Central

Cosman, Peter H.; Shearer, Christopher J.; Hugh, Thomas J.; Biankin, Andrew V.; Merrett, Neil D.

2007-01-01

Objective: The aim of this study was to define the best available option for video capture of surgical procedures for educational and archival purposes, with a view to identifying methods of capturing high-quality footage and identifying common pitfalls. Summary Background Data: Several options exist for those who wish to record operative surgical techniques on video. While high-end equipment is an unnecessary expense for most surgical units, several techniques are readily available that do not require industrial-grade audiovisual recording facilities, but not all are suited to every surgical application. Methods: We surveyed and evaluated the available technology for video capture in surgery. Our evaluation included analyses of video resolution, depth of field, contrast, exposure, image stability, and frame composition, as well as considerations of cost, accessibility, utility, feasibility, and economies of scale. Results: Several video capture options were identified, and the strengths and shortcomings of each were catalogued. None of the commercially available options was deemed suitable for high-quality video capture of abdominal surgical procedures. A novel application of off-the-shelf technology was devised to address these issues. Conclusions: Excellent quality video capture of surgical procedures within deep body cavities is feasible using commonly available equipment and technology, with minimal technical difficulty. PMID:17414600

Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction.

PubMed

Warner, Courtney J; Horvath, Alexander J; Powell, Richard J; Columbo, Jesse A; Walsh, Teri R; Goodney, Philip P; Walsh, Daniel B; Stone, David H

2015-08-01

Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

[Drug-promoting advertisements in the Dutch Journal of Medicine and Pharmaceutical Weekly: not always evidence based].

PubMed

van Eeden, Annelies E; Roach, Rachel E J; Halbesma, Nynke; Dekker, Friedo W

2012-01-01

To determine and compare the foundation of claims in drug-promoting advertisements in a Dutch journal for physicians and a Dutch journal for pharmacists. A cross-sectional study. We included all the drug-promoting advertisements referring to a randomized controlled trial (RCT) we could find on Medline from 2 volumes of the Dutch Journal of Medicine (Nederlands Tijdschrift voor Geneeskunde; NTvG) and the (also Dutch) Pharmaceutical Weekly (Pharmaceutisch Weekblad; PW). The validity of the advertisements (n = 54) and the methodological quality of the referenced RCTs (n = 150) were independently scored by 250 medical students using 2 standardised questionnaires. The advertisements' sources were concealed from the students. Per journal, the percentage of drug-promoting advertisements having a valid claim and the percentage of high-quality RCT references were determined. Average scores on quality and validity were compared between the 2 journals. On a scale of 0-18 points, the mean quality scores of the RCTs differed 0.3 (95% CI: -0.1-0.7) between the NTvG (score: 14.8; SD: 2.2) and the PW (score: 14.5; SD: 2.6). The difference between the validity scores of drug-promoting advertisements in the NTvG (score: 5.8; SD: 3.3) and the PW (score: 5.6; SD: 3.6) was 0.3 (95% CI: -0.3-0.9) on a scale of 0-10 points. For both journals, an average of 15% of drug-promoting advertisements was valid (defined as a validity score of > 8 points); 35% of the RCTs referred to was of good methodological quality (defined as a quality score of > 16 points). The substantiation of many claims in drug-promoting advertisements in the NTvG and the PW was mediocre. There was no difference between the 2 journals.

Lake trout spawning habitat in the Great Lakes - a review of current knowledge

USGS Publications Warehouse

Marsden, J. Ellen; Casselman, John M.; Edsall, Thomas A.; Elliott, Robert F.; Fitzsimons, John D.; Horns, William H.; Manny, Bruce A.; McAughey, Scott C.; Sly, Peter G.; Swanson, Bruce L.

1995-01-01

We review existing information on lake trout spawning habitat, which might indicate whether habitat is now a limiting factor in lake trout reproductive success. Lake trout spawning habitat quality is defined by the presence or absence of olfactory cues for homing, reef location with respect to the shoreline, water depth, proximity to nursery areas, reef size, contour, substrate size and shape, depth of interstitial spaces, water temperature at spawning time, water quality in interstitial spaces, and the presence of egg and fry predators. Data on factors which attracted native spawners to spawning reefs are lacking, due to the absence of historic data on egg deposition. No direct evidence of egg deposition has been collected from sites deeper than 18 m. Interstitial space and, therefore, substrate size and shape, appear to be critical for both site selection by adults and protection of eggs and fry. Water quality is clearly important for egg incubation, but the critical parameters which define water quality have not yet been well determined in the field. Exposure to wave energy, dictated in part by reef location, may maintain high water quality but may also damage or dislodge eggs. The importance of olfactory cues, water temperature, and proximity to nursery habitat to spawning trout is unclear. Limited data suggest that egg and fry predators, particularly exotic species, may critically affect fry production and survival. Although availability of physical spawning habitat is probably not limiting lake trout reproduction, changes in water quality and species composition may negatively affect early life stages. This review of habitat factors that affect early life stages of lake trout suggests several priorities for research and management.

Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction

PubMed Central

Warner, Courtney J.; Horvath, Alexander J.; Powell, Richard J.; Columbo, Jesse A.; Walsh, Teri R.; Goodney, Philip P.; Walsh, Daniel B.; Stone, David H.

2017-01-01

Objective Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. Methods All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Results Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Conclusions Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. PMID:25935271

East Europe Report

DTIC Science & Technology

1987-01-07

technically advanced, high quality product, but also to the perceived economic impact of a given innova- tion. This is defined for exported products...chronic woe of all socialist systems is economic inefficiency. This is apparently the one thing about which there was no disagreement at the ...International Round Table on "Socialism and Economics ," which was held from 20 through 24 October in Cavtata. In fact, if not the very existence of , then at

Fabrication and characterisation of embedded metal nanostructures by ion implantation with nanoporous anodic alumina masks

NASA Astrophysics Data System (ADS)

Guan, Wei; Peng, Nianhua; Jeynes, Christopher; Ghatak, Jay; Peng, Yong; Ross, Ian M.; Bhatta, Umananda M.; Inkson, Beverley J.; Möbus, Günter

2013-07-01

Lateral ordered Co, Pt and Co/Pt nanostructures were fabricated in SiO2 and Si3N4 substrates by high fluence metal ion implantation through periodic nanochannel membrane masks based on anodic aluminium oxides (AAO). The quality of nanopatterning transfer defined by various AAO masks in different substrates was examined by transmission electron microscopy (TEM) in both imaging and spectroscopy modes.

Building capacity for providing canopy cover and canopy height at FIA plot locations using high-resolution imagery and leaf-off LiDAR

Treesearch

Rachel Riemann; Jarlath O' Neil-Dunne; Greg C. Liknes

2012-01-01

Tree canopy cover and canopy height information are essential for estimating volume, biomass, and carbon; defining forest cover; and characterizing wildlife habitat. The amount of tree canopy cover also influences water quality and quantity in both rural and urban settings. Tree canopy cover and canopy height are currently collected at FIA plots either in the field or...

Automating Software Design Metrics.

DTIC Science & Technology

1984-02-01

INTRODUCTION 1 ", ... 0..1 1.2 HISTORICAL PERSPECTIVE High quality software is of interest to both the software engineering com- munity and its users. As...contributions of many other software engineering efforts, most notably [MCC 77] and [Boe 83b], which have defined and refined a framework for quantifying...AUTOMATION OF DESIGN METRICS Software metrics can be useful within the context of an integrated soft- ware engineering environment. The purpose of this

How Are We Doing? Why Not Ask the Kids: Measuring Climate in Kindergarten and Primary Classrooms.

ERIC Educational Resources Information Center

Fuqua, J. Diane

Ways in which elementary and junior high school teachers can use the My Class Inventory (MCI) to assess their students' views of classroom climate are discussed. The climate of a group is defined as the quality of the internal environment that persists over time and is experienced by members of the group. The short form of the MCI, which is…

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.

Accelerating Adverse Outcome Pathway Development Using ...

EPA Pesticide Factsheets

The adverse outcome pathway (AOP) concept links molecular perturbations with organism and population-level outcomes to support high-throughput toxicity testing. International efforts are underway to define AOPs and store the information supporting these AOPs in a central knowledgebase, however, this process is currently labor-intensive and time-consuming. Publicly available data sources provide a wealth of information that could be used to define computationally-predicted AOPs (cpAOPs), which could serve as a basis for creating expert-derived AOPs in a much more efficient way. Computational tools for mining large datasets provide the means for extracting and organizing the information captured in these public data sources. Using cpAOPs as a starting point for expert-derived AOPs should accelerate AOP development. Coupling this with tools to coordinate and facilitate the expert development efforts will increase the number and quality of AOPs produced, which should play a key role in advancing the adoption of twenty-first century toxicity testing strategies. This review article describes how effective knowledge management and automated approaches to AOP development can enhance and accelerate the development and use of AOPs. As the principles documented in this review are put into practice, we anticipate that the quality and quantity of AOPs available will increase substantially. This, in turn, will aid in the interpretation of ToxCast and other high-throughput tox

It's All Relative: A Validation of Radiation Quality Comparison Metrics

NASA Technical Reports Server (NTRS)

Chappell, Lori J.; Milder, Caitlin M.; Elgart, S. Robin; Semones, Edward J.

2017-01-01

The difference between high-LET and low-LET radiation is quantified by a measure called relative biological effectiveness (RBE). RBE is defined as the ratio of the dose of a reference radiation to that of a test radiation to achieve the same effect level, and thus, is described either as an iso-effector dose-to-dose ratio. A single dose point is not sufficient to calculate an RBE value; therefore, studies with only one dose point usually calculate an effect-to-effect ratio. While not formally used in radiation protection, these iso-dose values may still be informative. Shuryak, et al 2017 investigated the use of an iso-dose metric termed "radiation effects ratio" (RER) and used both RBE and RER to estimate high-LET risks. To apply RBE or RER to risk prediction, the selected metric must be uniquely defined. That is, the calculated value must be consistent within a model given a constant set of constraints and assumptions, regardless of how effects are defined using statistical transformations from raw endpoint data. We first test the RBE and the RER to determine whether they are uniquely defined using transformations applied to raw data. Then, we test whether both metrics can predict heavy ion response data after simulated effect size scaling between human populations or when converting animal to human endpoints.

Review of the Research Literature on Defining and Demonstrating Quality Teaching and Impact in Higher Education

ERIC Educational Resources Information Center

Strang, Lucy; Bélanger, Julie; Manville, Catriona; Meads, Catherine

2016-01-01

In March 2016, the Higher Education Academy (HEA) commissioned RAND Europe to conduct a literature review of research published since 2012, with the aim of identifying and summarising the key trends and issues in the literature on how "quality teaching" and its impact are currently being defined and demonstrated at higher education…

SU-E-J-47: Development of a High-Precision, Image-Guided Radiotherapy, Multi- Purpose Radiation Isocenter Quality-Assurance Calibration and Checking System

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

Liu, C; Yan, G; Helmig, R

2014-06-01

Purpose: To develop a system that can define the radiation isocenter and correlate this information with couch coordinates, laser alignment, optical distance indicator (ODI) settings, optical tracking system (OTS) calibrations, and mechanical isocenter walkout. Methods: Our team developed a multi-adapter, multi-purpose quality assurance (QA) and calibration device that uses an electronic portal imaging device (EPID) and in-house image-processing software to define the radiation isocenter, thereby allowing linear accelerator (Linac) components to be verified and calibrated. Motivated by the concept that each Linac component related to patient setup for image-guided radiotherapy based on cone-beam CT should be calibrated with respect tomore » the radiation isocenter, we designed multiple concentric adapters of various materials and shapes to meet the needs of MV and KV radiation isocenter definition, laser alignment, and OTS calibration. The phantom's ability to accurately define the radiation isocenter was validated on 4 Elekta Linacs using a commercial ball bearing (BB) phantom as a reference. Radiation isocenter walkout and the accuracy of couch coordinates, ODI, and OTS were then quantified with the device. Results: The device was able to define the radiation isocenter within 0.3 mm. Radiation isocenter walkout was within ±1 mm at 4 cardinal angles. By switching adapters, we identified that the accuracy of the couch position digital readout, ODI, OTS, and mechanical isocenter walkout was within sub-mm. Conclusion: This multi-adapter, multi-purpose isocenter phantom can be used to accurately define the radiation isocenter and represents a potential paradigm shift in Linac QA. Moreover, multiple concentric adapters allowed for sub-mm accuracy for the other relevant components. This intuitive and user-friendly design is currently patent pending.« less

High-Reliability Health Care: Getting There from Here

PubMed Central

Chassin, Mark R; Loeb, Jerod M

2013-01-01

Context Despite serious and widespread efforts to improve the quality of health care, many patients still suffer preventable harm every day. Hospitals find improvement difficult to sustain, and they suffer “project fatigue” because so many problems need attention. No hospitals or health systems have achieved consistent excellence throughout their institutions. High-reliability science is the study of organizations in industries like commercial aviation and nuclear power that operate under hazardous conditions while maintaining safety levels that are far better than those of health care. Adapting and applying the lessons of this science to health care offer the promise of enabling hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations. Methods We combined the Joint Commission's knowledge of health care organizations with knowledge from the published literature and from experts in high-reliability industries and leading safety scholars outside health care. We developed a conceptual and practical framework for assessing hospitals’ readiness for and progress toward high reliability. By iterative testing with hospital leaders, we refined the framework and, for each of its fourteen components, defined stages of maturity through which we believe hospitals must pass to reach high reliability. Findings We discovered that the ways that high-reliability organizations generate and maintain high levels of safety cannot be directly applied to today's hospitals. We defined a series of incremental changes that hospitals should undertake to progress toward high reliability. These changes involve the leadership's commitment to achieving zero patient harm, a fully functional culture of safety throughout the organization, and the widespread deployment of highly effective process improvement tools. Conclusions Hospitals can make substantial progress toward high reliability by undertaking several specific organizational change initiatives. Further research and practical experience will be necessary to determine the validity and effectiveness of this framework for high-reliability health care. PMID:24028696

High-reliability health care: getting there from here.

PubMed

Chassin, Mark R; Loeb, Jerod M

2013-09-01

Despite serious and widespread efforts to improve the quality of health care, many patients still suffer preventable harm every day. Hospitals find improvement difficult to sustain, and they suffer "project fatigue" because so many problems need attention. No hospitals or health systems have achieved consistent excellence throughout their institutions. High-reliability science is the study of organizations in industries like commercial aviation and nuclear power that operate under hazardous conditions while maintaining safety levels that are far better than those of health care. Adapting and applying the lessons of this science to health care offer the promise of enabling hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations. We combined the Joint Commission's knowledge of health care organizations with knowledge from the published literature and from experts in high-reliability industries and leading safety scholars outside health care. We developed a conceptual and practical framework for assessing hospitals' readiness for and progress toward high reliability. By iterative testing with hospital leaders, we refined the framework and, for each of its fourteen components, defined stages of maturity through which we believe hospitals must pass to reach high reliability. We discovered that the ways that high-reliability organizations generate and maintain high levels of safety cannot be directly applied to today's hospitals. We defined a series of incremental changes that hospitals should undertake to progress toward high reliability. These changes involve the leadership's commitment to achieving zero patient harm, a fully functional culture of safety throughout the organization, and the widespread deployment of highly effective process improvement tools. Hospitals can make substantial progress toward high reliability by undertaking several specific organizational change initiatives. Further research and practical experience will be necessary to determine the validity and effectiveness of this framework for high-reliability health care. © 2013 The Authors. The Milbank Quarterly published by Wiley Periodicals Inc. on behalf of Milbank Memorial Fund.

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

PubMed

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

2016-01-01

A Best Practice Guideline about Dialysis fluid purity was developed under the leadership of the Spanish Society of Nephrology in 2004. The second edition revised Guideline considered new evidences and International Standard. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. This Guideline is based on the ISO13959, European Pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis, literature reviews, according to their level of evidence, and the opinion of the expert Spanish group. Two levels of quality of water were defined: purified water and high purified water (ultra pure) and for dialysate: ultra pure dialysate. Regular use of ultra pure dialysate is recommended for all type of hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anaemia and amiloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (4.1.2), conductivity, microbial and endotoxins (4.1.1): Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (anexos). For microbiological monitoring, R2A medium is recommended, incubated during 7-14 days at a temperature of 17-23°C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Total Quality Management in Education. Second Edition.

ERIC Educational Resources Information Center

Sallis, Edward

Quality is at the top of most agendas, and improving quality is probably the most important task facing any institution. In addition, quality is difficult to define or measure. This book, the second edition of "Total Quality Management in Education," introduces the key concepts of Total Quality Management (TQM) and demonstrates how they…

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines the water quality goals of a water body, or portion thereof, by designating the use or uses to be made... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Water quality standards. 130.3 Section...

The Formation and Characterization of GaN Hexagonal Pyramids

NASA Astrophysics Data System (ADS)

Zhang, Shi-Ying; Xiu, Xiang-Qian; Lin, Zeng-Qin; Hua, Xue-Mei; Xie, Zi-Li; Zhang, Rong; Zheng, You-Dou

2013-05-01

GaN with hexagonal pyramids is fabricated using the photo-assisted electroless chemical etching method. Defective areas of the GaN substrate are selectively etched in a mixed solution of KOH and K2S2O8 under ultraviolet illumination, producing submicron-sized pyramids. Hexagonal pyramids on the etched GaN with well-defined {101¯1¯} facets and very sharp tips are formed. High-resolution x-ray diffraction shows that etched GaN with pyramids has a higher crystal quality, and micro-Raman spectra reveal a tensile stress relaxation in GaN with pyramids compared with normal GaN. The cathodoluminescence intensity of GaN after etching is significantly increased by three times, which is attributed to the reduction in the internal reflection, high-quality GaN with pyramids and the Bragg effect.

Quality versus quantity: The complexities of quality of life determinations for neonatal nurses.

PubMed

Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

2017-11-01

The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered to be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years? The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation. Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Ethical processes and procedures have been adhered to by the researchers. A qualitative approach was used to analyse the data. The theme 'difficult choices' was generated which comprised three sub-themes: 'damaged through survival', 'the importance of the brain' and 'families are important'. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby's life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family's life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field. Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice.

Systematic review of communication partner training in aphasia: methodological quality.

PubMed

Cherney, Leora R; Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey

2013-10-01

Twenty-three studies identified from a previous systematic review examining the effects of communication partner training on persons with aphasia and their communication partners were evaluated for methodological quality. Two reviewers rated the studies on defined methodological quality criteria relevant to each study design. There were 11 group studies, seven single-subject participant design studies, and five qualitative studies. Quality scores were derived for each study. The mean inter-rater reliability of scores for each study design ranged from 85-93%, with Cohen's Kappa indicating substantial agreement between raters. Methodological quality of research on communication partner training in aphasia was highly varied. Overall, group studies employed the least rigorous methodology as compared to single subject and qualitative research. Only two of 11 group studies complied with more than half of the quality criteria. No group studies reported therapist blinding and only one group study reported participant blinding. Across all types of studies, the criterion of treatment fidelity was most commonly omitted. Failure to explicitly report certain methodological quality criteria may account for low ratings. Using methodological rating scales specific to the type of study design may help improve the methodological quality of aphasia treatment studies, including those on communication partner training.

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector—Results from a Nationally Representative Outlet Survey

PubMed Central

2015-01-01

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85–115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. PMID:25897065

Study Quality in Higher Education Institution: Philosophy and Praxeology of Management

ERIC Educational Resources Information Center

Juodaityte, Audrone

2004-01-01

This article defines total quality philosophy, its transformations and significance for study quality in higher education institution. It reveals the concepts, principles and problems of study quality management and provides overview of implementation of study quality management at today's European universities. The experience of two European…

41 CFR 101-26.803-2 - Reporting quality deficiencies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reporting quality... § 101-26.803-2 Reporting quality deficiencies. (a) Quality deficiencies are defined as defects or nonconforming conditions which limit or prohibit the item received from fulfilling its intended purpose. Quality...

Cost-Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infection in Long-Term Care Facilities: Economic Evaluation with a Randomized Controlled Trial

PubMed Central

van den Hout, Wilbert B; Caljouw, Monique A A; Putter, Hein; Cools, Herman J M; Gussekloo, Jacobijn

2014-01-01

Objectives To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk. Design Economic evaluation with a randomized controlled trial. Setting Long-term care facilities. Participants LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk. Measurements UTI incidence (clinically or strictly defined), survival, quality of life, quality-adjusted life years (QALYs), and costs. Results In the weeks after a clinical UTI, participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high-UTI-risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3,800 per prevented clinically defined UTI (95% confidence interval = €1,300–infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTIs. Taking cranberry capsules had a 22% probability of being cost-effective compared with placebo (at a willingness to pay of €40,000 per QALY). In low-UTI-risk participants, use of cranberry capsules was only 3% likely to be cost-effective. Conclusion In high-UTI-risk residents, taking cranberry capsules may be effective in preventing UTIs but is not likely to be cost-effective in the investigated dosage, frequency, and setting. In low-UTI-risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost-effective. PMID:25180379

Maelstrom Research guidelines for rigorous retrospective data harmonization

PubMed Central

Fortier, Isabel; Raina, Parminder; Van den Heuvel, Edwin R; Griffith, Lauren E; Craig, Camille; Saliba, Matilda; Doiron, Dany; Stolk, Ronald P; Knoppers, Bartha M; Ferretti, Vincent; Granda, Peter; Burton, Paul

2017-01-01

Abstract Background: It is widely accepted and acknowledged that data harmonization is crucial: in its absence, the co-analysis of major tranches of high quality extant data is liable to inefficiency or error. However, despite its widespread practice, no formalized/systematic guidelines exist to ensure high quality retrospective data harmonization. Methods: To better understand real-world harmonization practices and facilitate development of formal guidelines, three interrelated initiatives were undertaken between 2006 and 2015. They included a phone survey with 34 major international research initiatives, a series of workshops with experts, and case studies applying the proposed guidelines. Results: A wide range of projects use retrospective harmonization to support their research activities but even when appropriate approaches are used, the terminologies, procedures, technologies and methods adopted vary markedly. The generic guidelines outlined in this article delineate the essentials required and describe an interdependent step-by-step approach to harmonization: 0) define the research question, objectives and protocol; 1) assemble pre-existing knowledge and select studies; 2) define targeted variables and evaluate harmonization potential; 3) process data; 4) estimate quality of the harmonized dataset(s) generated; and 5) disseminate and preserve final harmonization products. Conclusions: This manuscript provides guidelines aiming to encourage rigorous and effective approaches to harmonization which are comprehensively and transparently documented and straightforward to interpret and implement. This can be seen as a key step towards implementing guiding principles analogous to those that are well recognised as being essential in securing the foundational underpinning of systematic reviews and the meta-analysis of clinical trials. PMID:27272186

A structured approach to recording AIDS-defining illnesses in Kenya: A SNOMED CT based solution

PubMed Central

Oluoch, Tom; de Keizer, Nicolette; Langat, Patrick; Alaska, Irene; Ochieng, Kenneth; Okeyo, Nicky; Kwaro, Daniel; Cornet, Ronald

2016-01-01

Introduction Several studies conducted in sub-Saharan Africa (SSA) have shown that routine clinical data in HIV clinics often have errors. Lack of structured and coded documentation of diagnosis of AIDS defining illnesses (ADIs) can compromise data quality and decisions made on clinical care. Methods We used a structured framework to derive a reference set of concepts and terms used to describe ADIs. The four sources used were: (i) CDC/Accenture list of opportunistic infections, (ii) SNOMED Clinical Terms (SNOMED CT), (iii) Focus Group Discussion (FGD) among clinicians and nurses attending to patients at a referral provincial hospital in western Kenya, and (iv) chart abstraction from the Maternal Child Health (MCH) and HIV clinics at the same hospital. Using the January 2014 release of SNOMED CT, concepts were retrieved that matched terms abstracted from approach iii & iv, and the content coverage assessed. Post-coordination matching was applied when needed. Results The final reference set had 1054 unique ADI concepts which were described by 1860 unique terms. Content coverage of SNOMED CT was high (99.9% with pre-coordinated concepts; 100% with post-coordination). The resulting reference set for ADIs was implemented as the interface terminology on OpenMRS data entry forms. Conclusion Different sources demonstrate complementarity in the collection of concepts and terms for an interface terminology. SNOMED CT provides a high coverage in the domain of ADIs. Further work is needed to evaluate the effect of the interface terminology on data quality and quality of care. PMID:26184057

A multiresolution method for climate system modeling: application of spherical centroidal Voronoi tessellations

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

Ringler, Todd; Ju, Lili; Gunzburger, Max

2008-11-14

During the next decade and beyond, climate system models will be challenged to resolve scales and processes that are far beyond their current scope. Each climate system component has its prototypical example of an unresolved process that may strongly influence the global climate system, ranging from eddy activity within ocean models, to ice streams within ice sheet models, to surface hydrological processes within land system models, to cloud processes within atmosphere models. These new demands will almost certainly result in the develop of multiresolution schemes that are able, at least regionally, to faithfully simulate these fine-scale processes. Spherical centroidal Voronoimore » tessellations (SCVTs) offer one potential path toward the development of a robust, multiresolution climate system model components. SCVTs allow for the generation of high quality Voronoi diagrams and Delaunay triangulations through the use of an intuitive, user-defined density function. In each of the examples provided, this method results in high-quality meshes where the quality measures are guaranteed to improve as the number of nodes is increased. Real-world examples are developed for the Greenland ice sheet and the North Atlantic ocean. Idealized examples are developed for ocean–ice shelf interaction and for regional atmospheric modeling. In addition to defining, developing, and exhibiting SCVTs, we pair this mesh generation technique with a previously developed finite-volume method. Our numerical example is based on the nonlinear, shallow water equations spanning the entire surface of the sphere. This example is used to elucidate both the potential benefits of this multiresolution method and the challenges ahead.« less

An effective XML based name mapping mechanism within StoRM

NASA Astrophysics Data System (ADS)

Corso, E.; Forti, A.; Ghiselli, A.; Magnoni, L.; Zappi, R.

2008-07-01

In a Grid environment the naming capability allows users to refer to specific data resources in a physical storage system using a high level logical identifier. This logical identifier is typically organized in a file system like structure, a hierarchical tree of names. Storage Resource Manager (SRM) services map the logical identifier to the physical location of data evaluating a set of parameters as the desired quality of services and the VOMS attributes specified in the requests. StoRM is a SRM service developed by INFN and ICTP-EGRID to manage file and space on standard POSIX and high performing parallel and cluster file systems. An upcoming requirement in the Grid data scenario is the orthogonality of the logical name and the physical location of data, in order to refer, with the same identifier, to different copies of data archived in various storage areas with different quality of service. The mapping mechanism proposed in StoRM is based on a XML document that represents the different storage components managed by the service, the storage areas defined by the site administrator, the quality of service they provide and the Virtual Organization that want to use the storage area. An appropriate directory tree is realized in each storage component reflecting the XML schema. In this scenario StoRM is able to identify the physical location of a requested data evaluating the logical identifier and the specified attributes following the XML schema, without querying any database service. This paper presents the namespace schema defined, the different entities represented and the technical details of the StoRM implementation.

Improvement of quality of 3D printed objects by elimination of microscopic structural defects in fused deposition modeling.

PubMed

Gordeev, Evgeniy G; Galushko, Alexey S; Ananikov, Valentine P

2018-01-01

Additive manufacturing with fused deposition modeling (FDM) is currently optimized for a wide range of research and commercial applications. The major disadvantage of FDM-created products is their low quality and structural defects (porosity), which impose an obstacle to utilizing them in functional prototyping and direct digital manufacturing of objects intended to contact with gases and liquids. This article describes a simple and efficient approach for assessing the quality of 3D printed objects. Using this approach it was shown that the wall permeability of a printed object depends on its geometric shape and is gradually reduced in a following series: cylinder > cube > pyramid > sphere > cone. Filament feed rate, wall geometry and G-code-defined wall structure were found as primary parameters that influence the quality of 3D-printed products. Optimization of these parameters led to an overall increase in quality and improvement of sealing properties. It was demonstrated that high quality of 3D printed objects can be achieved using routinely available printers and standard filaments.

Key Performance Indicators in Radiology: You Can't Manage What You Can't Measure.

PubMed

Harvey, H Benjamin; Hassanzadeh, Elmira; Aran, Shima; Rosenthal, Daniel I; Thrall, James H; Abujudeh, Hani H

2016-01-01

Quality assurance (QA) is a fundamental component of every successful radiology operation. A radiology QA program must be able to efficiently and effectively monitor and respond to quality problems. However, as radiology QA has expanded into the depths of radiology operations, the task of defining and measuring quality has become more difficult. Key performance indicators (KPIs) are highly valuable data points and measurement tools that can be used to monitor and evaluate the quality of services provided by a radiology operation. As such, KPIs empower a radiology QA program to bridge normative understandings of health care quality with on-the-ground quality management. This review introduces the importance of KPIs in health care QA, a framework for structuring KPIs, a method to identify and tailor KPIs, and strategies to analyze and communicate KPI data that would drive process improvement. Adopting a KPI-driven QA program is both good for patient care and allows a radiology operation to demonstrate measurable value to other health care stakeholders. Copyright © 2015 Mosby, Inc. All rights reserved.

Information quality-control model

NASA Technical Reports Server (NTRS)

Vincent, D. A.

1971-01-01

Model serves as graphic tool for estimating complete product objectives from limited input information, and is applied to cost estimations, product-quality evaluations, and effectiveness measurements for manpower resources allocation. Six product quality levels are defined.

Federal Environmental Monitoring: Will the Bubble Burst?

ERIC Educational Resources Information Center

Miller, Stan

1978-01-01

A quality assurance program for environmental monitoring is identified as necesary for the collection of reliable, interchangeable, and legally defensible data. The article defines quality assurance and describes the EPA quality assurance program. (MA)

Aligning quality and payment for heart failure care: defining the challenges.

PubMed

Havranek, Edward P; Krumholz, Harlan M; Dudley, R Adams; Adams, Kirkwood; Gregory, Douglas; Lampert, Steven; Lindenfeld, Joann; Massie, Barry M; Pina, Ileana; Restaino, Susan; Rich, Michael W; Konstam, Marvin A

2003-08-01

Hospitals may not support programs that improve the quality of care delivered to heart failure patients because these programs lower readmission rates and empty beds, and therefore further diminish already-declining revenues. A conflict between the highest quality of care and financial solvency does not serve the interests of patients, physicians, hospitals, or payers. In principle, resolution of this conflict is simple: reimbursement systems should reward higher quality care. In practice, resolving the conflict is not simple. A recent roundtable discussion sponsored by the Heart Failure Society of America identified 4 major challenges to the design and implementation of reimbursement schemes that promote higher quality care for heart failure: defining quality, accounting for differences in disease severity, crafting novel payment mechanisms, and overcoming professional parochialism. This article describes each of these challenges in turn.

Framework for Multidisciplinary Analysis, Design, and Optimization with High-Fidelity Analysis Tools

NASA Technical Reports Server (NTRS)

Orr, Stanley A.; Narducci, Robert P.

2009-01-01

A plan is presented for the development of a high fidelity multidisciplinary optimization process for rotorcraft. The plan formulates individual disciplinary design problems, identifies practical high-fidelity tools and processes that can be incorporated in an automated optimization environment, and establishes statements of the multidisciplinary design problem including objectives, constraints, design variables, and cross-disciplinary dependencies. Five key disciplinary areas are selected in the development plan. These are rotor aerodynamics, rotor structures and dynamics, fuselage aerodynamics, fuselage structures, and propulsion / drive system. Flying qualities and noise are included as ancillary areas. Consistency across engineering disciplines is maintained with a central geometry engine that supports all multidisciplinary analysis. The multidisciplinary optimization process targets the preliminary design cycle where gross elements of the helicopter have been defined. These might include number of rotors and rotor configuration (tandem, coaxial, etc.). It is at this stage that sufficient configuration information is defined to perform high-fidelity analysis. At the same time there is enough design freedom to influence a design. The rotorcraft multidisciplinary optimization tool is built and substantiated throughout its development cycle in a staged approach by incorporating disciplines sequentially.

40 CFR 131.2 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS General Provisions § 131.2 Purpose. A water quality standard defines the water quality goals of a water... criteria necessary to protect the uses. States adopt water quality standards to protect public health or...

40 CFR 131.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS General Provisions § 131.2 Purpose. A water quality standard defines the water quality goals of a water... criteria necessary to protect the uses. States adopt water quality standards to protect public health or...

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

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

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

2009-01-01

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

Perceptual video quality assessment in H.264 video coding standard using objective modeling.

PubMed

Karthikeyan, Ramasamy; Sainarayanan, Gopalakrishnan; Deepa, Subramaniam Nachimuthu

2014-01-01

Since usage of digital video is wide spread nowadays, quality considerations have become essential, and industry demand for video quality measurement is rising. This proposal provides a method of perceptual quality assessment in H.264 standard encoder using objective modeling. For this purpose, quality impairments are calculated and a model is developed to compute the perceptual video quality metric based on no reference method. Because of the shuttle difference between the original video and the encoded video the quality of the encoded picture gets degraded, this quality difference is introduced by the encoding process like Intra and Inter prediction. The proposed model takes into account of the artifacts introduced by these spatial and temporal activities in the hybrid block based coding methods and an objective modeling of these artifacts into subjective quality estimation is proposed. The proposed model calculates the objective quality metric using subjective impairments; blockiness, blur and jerkiness compared to the existing bitrate only calculation defined in the ITU G 1070 model. The accuracy of the proposed perceptual video quality metrics is compared against popular full reference objective methods as defined by VQEG.

Evaluation of Adherence to Quality Measures for Prostate Cancer Radiotherapy in the United States: Results from the Quality Research in Radiation Oncology (QRRO) Survey

PubMed Central

Zelefsky, Michael J.; Lee, W. Robert; Zietman, Anthony; Khalid, Najma; Crozier, Cheryl; Owen, Jean; Wilson, J. Frank

2012-01-01

Purpose To test the feasibility of using proposed quality indicators to assess radiotherapy quality in prostate cancer management based on a 2007 stratified random survey of treating academic and non-academic US institutions. Methods and Materials 414 patients with clinically localized prostate cancer treated with external beam radiotherapy (EBRT) or brachytherapy were selected from 45 institutions. Indicators used as specific measurable clinical performance measures to represent surrogates for quality of radiotherapy delivery included established measures, such as the use of prescription doses ≥75 Gy for intermediate- and high-risk EBRT patients and androgen-deprivation therapy (ADT) in conjunction with EBRT for patients with high-risk disease, and emerging measures, including daily target localization (image-guidance) to correct for organ motion for EBRT patients. Results 167 patients (47%) were treated with 6 MV photons, 31 (9%) were treated with 10 MV, 65 (18%) received 15 MV, and the remaining 90 (26%) 16–23 MV. For intermediate- plus high-risk patients (n=181), 78% were treated to ≥75 Gy. Among favorable-risk patients, 72% were treated to ≥75 Gy. Among high-risk EBRT patients, 60 (87%) were treated with ADT in conjunction with EBRT and 13% (n=9) with radiotherapy alone. Among low- and intermediate-risk patients, 10% and 42%, respectively, were treated with ADT plus EBRT. For 24% of EBRT patients (85/354), weekly electronic portal imaging was obtained as verification films without daily target localization and the remaining 76% were treated with daily localization of the target using various methods. Conclusions Adherence to defined quality indicators was observed in a majority of patients. ≈90% of high-risk patients are treated with ADT plus EBRT and ≈80% of intermediate- and high-risk patients receive prescription doses >=75 Gy, consistent with the published results of randomized trials. PMID:23471563

Evaluation of Adherence to Quality Measures for Prostate Cancer Radiotherapy in the United States: Results from the Quality Research in Radiation Oncology (QRRO) Survey.

PubMed

Zelefsky, Michael J; Lee, W Robert; Zietman, Anthony; Khalid, Najma; Crozier, Cheryl; Owen, Jean; Wilson, J Frank

2013-01-01

To test the feasibility of using proposed quality indicators to assess radiotherapy quality in prostate cancer management based on a 2007 stratified random survey of treating academic and non-academic US institutions. 414 patients with clinically localized prostate cancer treated with external beam radiotherapy (EBRT) or brachytherapy were selected from 45 institutions. Indicators used as specific measurable clinical performance measures to represent surrogates for quality of radiotherapy delivery included established measures, such as the use of prescription doses ≥75 Gy for intermediate- and high-risk EBRT patients and androgen-deprivation therapy (ADT) in conjunction with EBRT for patients with high-risk disease, and emerging measures, including daily target localization (image-guidance) to correct for organ motion for EBRT patients. 167 patients (47%) were treated with 6 MV photons, 31 (9%) were treated with 10 MV, 65 (18%) received 15 MV, and the remaining 90 (26%) 16-23 MV. For intermediate- plus high-risk patients (n=181), 78% were treated to ≥75 Gy. Among favorable-risk patients, 72% were treated to ≥75 Gy. Among high-risk EBRT patients, 60 (87%) were treated with ADT in conjunction with EBRT and 13% (n=9) with radiotherapy alone. Among low- and intermediate-risk patients, 10% and 42%, respectively, were treated with ADT plus EBRT. For 24% of EBRT patients (85/354), weekly electronic portal imaging was obtained as verification films without daily target localization and the remaining 76% were treated with daily localization of the target using various methods. Adherence to defined quality indicators was observed in a majority of patients. ≈90% of high-risk patients are treated with ADT plus EBRT and ≈80% of intermediate- and high-risk patients receive prescription doses >=75 Gy, consistent with the published results of randomized trials.

Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period

PubMed Central

Tomfohr, Lianne M.; Buliga, Elena; Letourneau, Nicole L.; Campbell, Tavis S.; Giesbrecht, Gerald F.

2015-01-01

Objective: The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Design, Setting, and Participants: Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Results: Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Conclusions: Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. Citation: Tomfohr LM, Buliga E, Letourneau NL, Campbell TS, Giesbrecht GF. Trajectories of sleep quality and associations with mood during the perinatal period. SLEEP 2015;38(8):1237–1245. PMID:25845691

A reconnaissance study of the effect of irrigated agriculture on water quality in the Ogallala Formation, Central High Plains Aquifer

USGS Publications Warehouse

McMahon, Peter B.

2000-01-01

In 1998, the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program began a regional study of water quality in the High Plains aquifer. The High Plains aquifer underlies an area of about 174,000 square miles in parts of eight States. Because of its large size, the High Plains aquifer has been divided into three regions: the Southern High Plains, Central High Plains, and Northern High Plains. Although an assessment of water quality in each of the three regions is planned, the initial focus will be the Central High Plains aquifer. Anyone who has flown over the Central High Plains in the summer and has seen the large green circles associated with center pivot sprinklers knows that irrigated agriculture is a widespread land use. Pesticides and fertilizers applied on those irrigated fields will not degrade ground-water quality if they remain in or above the root zone. However, if those chemicals move downward through the unsaturated zone to the water table, they may degrade the quality of the ground water. Water is the principal agent for transporting chemicals from land surface to the water table, and in the semiarid Central High Plains, irrigation often represents the most abundant source of water during the growing season. One objective of NAWQA's High Plains Regional Ground-Water study is to evaluate the effect of irrigated agriculture on the quality of recently recharged water in the Ogallala Formation of the Central High Plains aquifer. The Ogallala Formation is the principal geologic unit in the Central High Plains aquifer, and it consists of poorly sorted clay, silt, sand, and gravel that generally is unconsolidated (Gutentag and others, 1984). Approximately 23 percent of the cropland overlying the Ogallala Formation is irrigated (U.S. Department of Agriculture, 1999). The NAWQA Program generally defines recently recharged ground water to be water recharged in the last 50 years. The water table in the Ogallala Formation is separated from overlying land-use practices by as much as 400 feet of unsaturated sediments. Consequently, one may hypothesize that recently recharged water is not present in the formation. The U.S. Geological Survey conducted a reconnaissance study in 1999 to establish (a) if recently recharged water was present in the Ogallala Formation underlying irrigated cropland and (b) if agricultural land-use practices affect water quality. Results from the reconnaissance study will be used to determine whether a full-scale land-use study is warranted.

Defining a Quality Education. Proceedings of the Annual Conference of the North East Association for Institutional Research (19th, Washington, D.C., November 14-17, 1992).

ERIC Educational Resources Information Center

Price, Jane, Ed.

This publication contains 25 papers from a conference on defining quality higher education. Opening sections cover the conference program and members of the conference's steering committee. A representative sampling of papers includes the following: "The College Student Experiences Questionnaire: A Follow-Up Study of Academic and Social…

Family Impacts among Children with Autism Spectrum Disorder: The Role of Health Care Quality

PubMed Central

Zuckerman, Katharine E.; Lindly, Olivia J.; Bethell, Christina D.; Kuhlthau, Karen

2014-01-01

Objectives To compare health care quality and family employment and financial impacts among children with special health care needs (CSHCN) with autism spectrum disorder (CSHCN+ASD), CSHCN with functional limitations (CSHCN+FL), and CSHCN lacking these conditions (other CSHCN). To test whether high health care quality was associated with reduced family impacts among CSHCN+ASD. Methods Data from the 2009-2010 National Survey of CSHCN were used to compare 3025 CSHCN+ASD, 6505 CSHCN+FL, and 28 296 other CSHCN. Weighted multivariate logistic regression analyses examined six age-relevant, federally-defined health care quality indicators and five family financial and employment impact indicators. Two composite measures were additionally used: (1) receipt of care that met all age-relevant quality indicators; and (2) had ≥ two of the five adverse family impacts. Results Across all health care quality indicators CSHCN+ASD fared poorly, with only 7.4% meeting all age-relevant indicators. CSHCN+ASD had worse health care quality than other CSHCN, including CSHCN+FL. CSHCN+ASD also had high rates of adverse family impact, with over half experiencing two or more adverse impacts. Rates of adverse family impact were higher in CSHCN+ASD than other CSHCN, including CSHCN+FL. Among CSHCN+ASD, those whose health care that met federal quality standards were less likely to have multiple adverse family impacts than CSHCN+ASD whose health care did not meet federal quality standards. Conclusions CSHCN+ASD are more prone to experience poor health care quality and family impacts than other CSHCN, even CSHCN+FL. Receipt of care meeting federal quality standards may potentially lessen adverse family impacts for CSHCN+ASD. PMID:24976352

Making Quality Sense: A Guide to Quality, Tools and Techniques, Awards and the Thinking Behind Them.

ERIC Educational Resources Information Center

Owen, Jane

This document is intended to guide further education colleges and work-based learning providers through some of the commonly used tools, techniques, and theories of quality management. The following are among the topics discussed: (1) various ways of defining quality; methods used by organizations to achieve quality (quality control, quality…

Surface inspection system for carriage parts

NASA Astrophysics Data System (ADS)

Denkena, Berend; Acker, Wolfram

2006-04-01

Quality standards are very high in carriage manufacturing, due to the fact, that the visual quality impression is highly relevant for the purchase decision for the customer. In carriage parts even very small dents can be visible on the varnished and polished surface by observing reflections. The industrial demands are to detect these form errors on the unvarnished part. In order to meet the requirements, a stripe projection system for automatic recognition of waviness and form errors is introduced1. It bases on a modified stripe projection method using a high resolution line scan camera. Particular emphasis is put on achieving a short measuring time and a high resolution in depth, aiming at a reliable automatic recognition of dents and waviness of 10 μm on large curved surfaces of approximately 1 m width. The resulting point cloud needs to be filtered in order to detect dents. Therefore a spatial filtering technique is used. This works well on smoothly curved surfaces, if frequency parameters are well defined. On more complex parts like mudguards the method is restricted by the fact that frequencies near the define dent frequencies occur within the surface as well. To allow analysis of complex parts, the system is currently extended by including 3D CAD models into the process of inspection. For smoothly curved surfaces, the measuring speed of the prototype is mainly limited by the amount of light produced by the stripe projector. For complex surfaces the measuring speed is limited by the time consuming matching process. Currently, the development focuses on the improvement of the measuring speed.

Rationale behind the near-ideal catalysis of Candida antarctica lipase A (CAL-A) for highly concentrating ω-3 polyunsaturated fatty acids into monoacylglycerols.

PubMed

He, Yongjin; Li, Jingbo; Kodali, Sitharam; Chen, Bilian; Guo, Zheng

2017-03-15

Dramatic decline in the quality and quantity of ω-3 PUFAs from marine resource demands new environmental-friendly technology to produce high quality ω-3 PUFAs concentrates in a better bioavailable form. Accordingly this work demonstrated an exceptionally highly efficient non-aqueous approach that non-regiospecific and non ω-3 PUFAs preferential Candida antarctica lipase A (CAL-A), functioning as a near-ideal biocatalyst, is capable to directly concentrate ω-3 PUFAs from 20% to 30% in oils to up to >90% in monoacylglycerols form through one step reaction. The rationale behind the experimental observation is justified and the catalytic property and specificity of an ideal enzyme tackling this task are defined. High selectivity and efficiency, excellent reusability of biocatalyst, general applicability for concentrating ω-3 PUFAs from both fish and microalgae oils, simple process for product recovery (e.g. by short path distillation), make this novel approach a highly industrially relevant and with potential application in food and drug industries. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Impact of Teacher Quality Grants on Long-Term Professional Development of Physical Science Teachers

NASA Astrophysics Data System (ADS)

Urquhart, Mary L.; Bober, Kendra M.

2006-02-01

The Texas Higher Education Coordinating Board Teacher Quality Grants, supported through No Child Left Behind, are intended to ensure that secondary teachers of specific subjects are "highly qualified". Now in their third year, these grants have done much to shape long-term professional development for teachers in the physical sciences at the University of Texas at Dallas (UTD). The grants have also created a suite of challenges and benefits for the UTD Science Education M.A.T. program. Teacher Quality Grants are based on the No Child Left Behind framework that requires teachers to be "highly qualified" as defined by the state. Recruitment is required to be targeted at teachers who are uncertified or teach one or more classes out of their content area and who work in high needs local school districts. Many of the students brought into our program through these grants have incoming content knowledge in physics similar to that typical of undergraduate non-majors, and a large percentage are uncomfortable with basic mathematics as well. How and what we teach has been dramatically impacted by the Teacher Quality Grants, as have our assessments and evaluations. An ongoing challenge has been to implement a Physics Education Research (PER)-based course design while meeting the specific requirements of the Teacher Quality Grant program. The Teacher Quality Grants have also provided a great deal of opportunity to new and existing teachers in our program. A barrier to our teachers, rising tuition costs, has been removed and as a result a mandate has become a doorway of opportunity for physical science teachers.

Emergency Medicine and Critical Care Blogs and Podcasts: Establishing an International Consensus on Quality.

PubMed

Thoma, Brent; Chan, Teresa M; Paterson, Quinten S; Milne, W Kenneth; Sanders, Jason L; Lin, Michelle

2015-10-01

This study identified the most important quality indicators for online educational resources such as blogs and podcasts. A modified Delphi process that included 2 iterative surveys was used to build expert consensus on a previously defined list of 151 quality indicators divided into 3 themes: credibility, content, and design. Aggregate social media indicators were used to identify an expert population of editors from a defined list of emergency medicine and critical care blogs and podcasts. Survey 1 consisted of the quality indicators and a 7-point Likert scale. The mean score for each quality indicator was included in survey 2, which asked participants whether to "include" or "not include" each quality indicator. The cut point for consensus was defined at greater than 70% "include." Eighty-three percent (20/24) of bloggers and 90.9% (20/22) of podcasters completed survey 1 and 90% (18/20) of bloggers and podcasters completed survey 2. The 70% inclusion criteria were met by 44 and 80 quality indicators for bloggers and podcasters, respectively. Post hoc, a 90% cutoff was used to identify a list of 14 and 26 quality indicators for bloggers and podcasters, respectively. The relative importance of quality indicators for emergency medicine blogs and podcasts was determined. This will be helpful for resource producers trying to improve their blogs or podcasts and for learners, educators, and academic leaders assessing their quality. These results will inform broader validation studies and attempts to develop user-friendly assessment instruments for these resources. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

An exploratory survey of methods used to develop measures of performance

NASA Astrophysics Data System (ADS)

Hamner, Kenneth L.; Lafleur, Charles A.

1993-09-01

Nonmanufacturing organizations are being challenged to provide high-quality products and services to their customers, with an emphasis on continuous process improvement. Measures of performance, referred to as metrics, can be used to foster process improvement. The application of performance measurement to nonmanufacturing processes can be very difficult. This research explored methods used to develop metrics in nonmanufacturing organizations. Several methods were formally defined in the literature, and the researchers used a two-step screening process to determine the OMB Generic Method was most likely to produce high-quality metrics. The OMB Generic Method was then used to develop metrics. A few other metric development methods were found in use at nonmanufacturing organizations. The researchers interviewed participants in metric development efforts to determine their satisfaction and to have them identify the strengths and weaknesses of, and recommended improvements to, the metric development methods used. Analysis of participants' responses allowed the researchers to identify the key components of a sound metrics development method. Those components were incorporated into a proposed metric development method that was based on the OMB Generic Method, and should be more likely to produce high-quality metrics that will result in continuous process improvement.

An experimental search strategy retrieves more precise results than PubMed and Google for questions about medical interventions

PubMed Central

Dylla, Daniel P.; Megison, Susan D.

2015-01-01

Objective. We compared the precision of a search strategy designed specifically to retrieve randomized controlled trials (RCTs) and systematic reviews of RCTs with search strategies designed for broader purposes. Methods. We designed an experimental search strategy that automatically revised searches up to five times by using increasingly restrictive queries as long at least 50 citations were retrieved. We compared the ability of the experimental and alternative strategies to retrieve studies relevant to 312 test questions. The primary outcome, search precision, was defined for each strategy as the proportion of relevant, high quality citations among the first 50 citations retrieved. Results. The experimental strategy had the highest median precision (5.5%; interquartile range [IQR]: 0%–12%) followed by the narrow strategy of the PubMed Clinical Queries (4.0%; IQR: 0%–10%). The experimental strategy found the most high quality citations (median 2; IQR: 0–6) and was the strategy most likely to find at least one high quality citation (73% of searches; 95% confidence interval 68%–78%). All comparisons were statistically significant. Conclusions. The experimental strategy performed the best in all outcomes although all strategies had low precision. PMID:25922798

Quality by design for herbal drugs: a feedforward control strategy and an approach to define the acceptable ranges of critical quality attributes.

PubMed

Yan, Binjun; Li, Yao; Guo, Zhengtai; Qu, Haibin

2014-01-01

The concept of quality by design (QbD) has been widely accepted and applied in the pharmaceutical manufacturing industry. There are still two key issues to be addressed in the implementation of QbD for herbal drugs. The first issue is the quality variation of herbal raw materials and the second issue is the difficulty in defining the acceptable ranges of critical quality attributes (CQAs). To propose a feedforward control strategy and a method for defining the acceptable ranges of CQAs for the two issues. In the case study of the ethanol precipitation process of Danshen (Radix Salvia miltiorrhiza) injection, regression models linking input material attributes and process parameters to CQAs were built first and an optimisation model for calculating the best process parameters according to the input materials was established. Then, the feasible material space was defined and the acceptable ranges of CQAs for the previous process were determined. In the case study, satisfactory regression models were built with cross-validated regression coefficients (Q(2) ) all above 91 %. The feedforward control strategy was applied successfully to compensate the quality variation of the input materials, which was able to control the CQAs in the 90-110 % ranges of the desired values. In addition, the feasible material space for the ethanol precipitation process was built successfully, which showed the acceptable ranges of the CQAs for the concentration process. The proposed methodology can help to promote the implementation of QbD for herbal drugs. Copyright © 2013 John Wiley & Sons, Ltd.

Defining and measuring traffic data quality traffic data quality workshop : white paper.

DOT National Transportation Integrated Search

2002-12-31

Recent research and analyses have identified several issues regarding the quality of traffic data available from intelligent transportation systems for transportation operations, planning, or other functions. The Federal Highway Administration (FHWA)...

Prevalence of sleep duration on an average school night among 4 nationally representative successive samples of American high school students, 2007-2013.

PubMed

Basch, Charles E; Basch, Corey H; Ruggles, Kelly V; Rajan, Sonali

2014-12-11

Consistency, quality, and duration of sleep are important determinants of health. We describe sleep patterns among demographically defined subgroups from the Youth Risk Behavior Surveillance System reported in 4 successive biennial representative samples of American high school students (2007 to 2013). Across the 4 waves of data collection, 6.2% to 7.7% of females and 8.0% to 9.4% of males reported obtaining 9 or more hours of sleep. Insufficient duration of sleep is pervasive among American high school students. Despite substantive public health implications, intervention research on this topic has received little attention.

Toward a Global Water Quality Observing and Forecasting System

EPA Science Inventory

The Group on Earth Observations (GEO) Coastal and Inland Water Quality Working Group held a Water Quality Summit at the World Meteorological Organization (WMO) in Geneva, Switzerland April 20 to 22, 2015. The goal was to define specific water quality component requirements and de...

Quality of Patient-Provider Communication Among Cancer Survivors: Findings From a Nationally Representative Sample.

PubMed

Chawla, Neetu; Blanch-Hartigan, Danielle; Virgo, Katherine S; Ekwueme, Donatus U; Han, Xuesong; Forsythe, Laura; Rodriguez, Juan; McNeel, Timothy S; Yabroff, K Robin

2016-12-01

Although patient-provider communication is an essential component of health care delivery, little is known about the quality of these discussions among patients with cancer. Data are from the 2011 Medical Expenditure Panel Survey Experiences with Cancer survey among 1,202 adult cancer survivors. We evaluated discussions with any provider after a cancer diagnosis about: (1) follow-up care; (2) late or long-term treatment effects; (3) lifestyle recommendations, such as diet, exercise, and quitting smoking; and (4) emotional or social needs. Using a response scale ranging from "did not discuss" to "discussed in detail," a summary score was constructed to define communication quality as high, medium, or low. Patient factors associated with the quality of provider discussions were examined using multivariable polytomous logistic regression analyses. At the time of the survey, approximately one half of the patients (46%) were either within 1 year (24.1%) or between 1 and 5 years (22.0%) of treatment. More than one third of cancer survivors reported that they did not receive detailed communication about follow-up care, and more than one half reported that they did not receive detailed communication regarding late or long-term effects, lifestyle recommendations, or emotional and social needs. Only 24% reported high-quality communication for all four elements, indicating that the vast majority experienced suboptimal communication. In multivariable analysis, survivors reporting a high communication quality with providers included those who were within 1 year of treatment, between the ages of 18 and 64 years, non-Hispanic black or other ethnicity, and married. Study findings demonstrate gaps in the communication quality experienced by cancer survivors in the United States and help identify survivors for targeted interventions.

Sensory and rapid instrumental methods as a combined tool for quality control of cooked ham.

PubMed

Barbieri, Sara; Soglia, Francesca; Palagano, Rosa; Tesini, Federica; Bendini, Alessandra; Petracci, Massimiliano; Cavani, Claudio; Gallina Toschi, Tullia

2016-11-01

In this preliminary investigation, different commercial categories of Italian cooked pork hams have been characterized using an integrated approach based on both sensory and fast instrumental measurements. For these purposes, Italian products belonging to different categories (cooked ham, "selected" cooked ham and "high quality" cooked ham) were evaluated by sensory descriptive analysis and by the application of rapid tools such as image analysis by an "electronic eye" and texture analyzer. The panel of trained assessors identified and evaluated 10 sensory descriptors able to define the quality of the products. Statistical analysis highlighted that sensory characteristics related to appearance and texture were the most significant in discriminating samples belonged to the highest (high quality cooked hams) and the lowest (cooked hams) quality of the product whereas the selected cooked hams, showed intermediate characteristics. In particular, high quality samples were characterized, above all, by the highest intensity of pink intensity, typical appearance and cohesiveness, and, at the same time, by the lowest intensity of juiciness; standard cooked ham samples showed the lowest intensity of all visual attributes and the highest value of juiciness, whereas the intermediate category (selected cooked ham) was not discriminated from the other. Also physical-rheological parameters measured by electronic eye and texture analyzer were effective in classifying samples. In particular, the PLS model built with data obtained from the electronic eye showed a satisfactory performance in terms of prediction of the pink intensity and presence of fat attributes evaluated during the sensory visual phase. This study can be considered a first application of this combined approach that could represent a suitable and fast method to verify if the meat product purchased by consumer match its description in terms of compliance with the claimed quality.

Identifying priorities for quality improvement at an emergency Department in Ghana.

PubMed

DeWulf, Annelies; Otchi, Elom H; Soghoian, Sari

2017-08-30

Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program. Semi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities. Twenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality. ED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.

Grazing Incidence Optics for X-rays Interferometry

NASA Technical Reports Server (NTRS)

Shipley, Ann; Zissa, David; Cash, Webster; Joy, Marshall

1999-01-01

Grazing incidence mirror parameters and constraints for x-ray interferometry are described. We present interferometer system tolerances and ray trace results used to define mirror surface accuracy requirements. Mirror material, surface figure, roughness, and geometry are evaluated based on analysis results. We also discuss mirror mount design constraints, finite element analysis, environmental issues, and solutions. Challenges associated with quantifying high accuracy mirror surface quality are addressed and test results are compared with theoretical predictions.

Achieving Interoperability Through Base Registries for Governmental Services and Document Management

NASA Astrophysics Data System (ADS)

Charalabidis, Yannis; Lampathaki, Fenareti; Askounis, Dimitris

As digital infrastructures increase their presence worldwide, following the efforts of governments to provide citizens and businesses with high-quality one-stop services, there is a growing need for the systematic management of those newly defined and constantly transforming processes and electronic documents. E-government Interoperability Frameworks usually cater to the technical standards of e-government systems interconnection, but do not address service composition and use by citizens, businesses, or other administrations.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

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

Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert

2005-01-01

The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management andmore » software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.« less

Is the economic value of hydrological forecasts related to their quality? Case study of the hydropower sector.

NASA Astrophysics Data System (ADS)

Cassagnole, Manon; Ramos, Maria-Helena; Thirel, Guillaume; Gailhard, Joël; Garçon, Rémy

2017-04-01

The improvement of a forecasting system and the evaluation of the quality of its forecasts are recurrent steps in operational practice. However, the evaluation of forecast value or forecast usefulness for better decision-making is, to our knowledge, less frequent, even if it might be essential in many sectors such as hydropower and flood warning. In the hydropower sector, forecast value can be quantified by the economic gain obtained with the optimization of operations or reservoir management rules. Several hydropower operational systems use medium-range forecasts (up to 7-10 days ahead) and energy price predictions to optimize hydropower production. Hence, the operation of hydropower systems, including the management of water in reservoirs, is impacted by weather, climate and hydrologic variability as well as extreme events. In order to assess how the quality of hydrometeorological forecasts impact operations, it is essential to first understand if and how operations and management rules are sensitive to input predictions of different quality. This study investigates how 7-day ahead deterministic and ensemble streamflow forecasts of different quality might impact the economic gains of energy production. It is based on a research model developed by Irstea and EDF to investigate issues relevant to the links between quality and value of forecasts in the optimisation of energy production at the short range. Based on streamflow forecasts and pre-defined management constraints, the model defines the best hours (i.e., the hours with high energy prices) to produce electricity. To highlight the link between forecasts quality and their economic value, we built several synthetic ensemble forecasts based on observed streamflow time series. These inputs are generated in a controlled environment in order to obtain forecasts of different quality in terms of accuracy and reliability. These forecasts are used to assess the sensitivity of the decision model to forecast quality. Relationships between forecast quality and economic value are discussed. This work is part of the IMPREX project, a research project supported by the European Commission under the Horizon 2020 Framework programme, with grant No. 641811 (http://www.imprex.eu)

Acute Uterine Bleeding Unrelated to Pregnancy: A Southern California Permanente Medical Group Practice Guideline

PubMed Central

Munro, Malcolm G

2013-01-01

Acute uterine bleeding unrelated to pregnancy has been defined as bleeding “sufficient in volume as to, in the opinion of the treating clinician, require urgent or emergent intervention.” The Southern California Permanente Medical Group updated its guidelines for the management of this condition on the basis of the best available evidence, as identified in a systematic review of the available literature. Given the paucity of studies evaluating this condition, the guidelines, by necessity, include recommendations largely based on opinion or other sources such as case series that are, in general, categorized as low-quality evidence. Medical interventions with single or combined gonadal steroidal agents administered parenterally or orally show promise, but more high-quality studies are needed to better define the appropriate drugs, dose, and administrative scheduling. There is also some evidence that intrauterine tamponade may be useful in at least selected cases. Special attention must be paid to both diagnosing and treating inherited disorders of hemostasis, such as von Willebrand disease, that may otherwise be underdiagnosed in both adolescent and adult women. PMID:24355890

Quality Rating Systems--The Experiences of Center Directors

ERIC Educational Resources Information Center

Friedman, Dana E.

2007-01-01

Quality Rating System (QRS) initiatives define levels of quality based on research and then support providers with funding and technical assistance to increase their quality. Each program is assessed and given a number of "stars" to indicate to parents what level of quality the program has reached. In this article, the author describes…

Cancer Care Ontario's Systematic Symptom Screening Strategy: A Human-Centred Design Approach to Exploring System Gaps and Defining Strategies for the Future.

PubMed

Molloy, Sean; McHugh, Tom; Amernic, Heidi; Mahase, Wenonah; Kurkjian, Serena; Grossi, Robert; Pottie, Patricia; Hurwitz, Gillian; Green, Esther

2018-01-01

Cancer patients experience a high symptom burden throughout their illness. Quality cancer symptom management has been shown to improve patient quality of life and prevent emergency department use. Cancer Care Ontario introduced standardized symptom screening in Ontario, using the Edmonton Symptom Assessment System (ESAS) to facilitate patient reporting and management of symptoms. However, patient symptom information is not always sufficiently addressed. To address these gaps, patient and family advisors collaborated with clinicians, administrators and health system leaders from across the Province in a Symptom Management Summit to share perspectives and co-design context-specific solutions to improve care in their region. © 2018 Longwoods Publishing.

Community Defined Health: Thinking from the Inside Out.

ERIC Educational Resources Information Center

Blecke, Janalou; Hadden, Lisa

2000-01-01

Describes the "Community Defined Health" (trademark) process developed by the Center for Health Professions, Saginaw, Michigan, to capture caring, citizen engagement, and the quality of relationships and assure that these intangible assets become as valuable as institutionally defined health indicators in curricula for the health…

The first sight of love: Relationship-defining memories and marital satisfaction across adulthood.

PubMed

Alea, Nicole; Vick, Stephanie C

2010-10-01

The current study begins the exploration of relationship-defining memories (i.e., the first time someone met their spouse) across adulthood. Men and women ranging from 20 to 85 years old (N=267; M age=47.19) completed a measure of marital satisfaction, wrote a relationship-defining memory, and answered questions about the quality of their memory (i.e., vividness, valence, emotional intensity, and rehearsal). Data were collected online. Results indicate that individuals over 70 and those younger than 30 rehearsed relationship-defining memories most often. Women in midlife also reported more vivid memories. The quality of relationship-defining memories also predicted marital satisfaction. Relationship-defining memories that were more vivid, positive, emotionally intense, and rehearsed related to higher marital satisfaction. Age and gender differences were minimal. Results are discussed in the context of the adaptive social function of autobiographical memories, such that these memories might have a role in influencing marital satisfaction across adulthood.

Cost-utility analyses of drug therapies in breast cancer: a systematic review.

PubMed

Nerich, Virginie; Saing, Sopany; Gamper, Eva Maria; Kemmler, Georg; Daval, Franck; Pivot, Xavier; Holzner, Bernhard

2016-10-01

The economic evaluation (EE) of health care products has become a necessity. Their quality must be high in order to trust the results and make informed decisions. While cost-utility analyses (CUAs) should be preferred to cost-effectiveness analyses in the oncology area, the quality of breast cancer (BC)-related CUA has been given little attention so far. Thus, firstly, a systematic review of published CUA related to drug therapies for BC, gene expression profiling, and HER2 status testing was performed. Secondly, the quality of selected CUA was assessed and the factors associated with a high-quality CUA identified. The systematic literature search was conducted in PubMed, MEDLINE/EMBASE, and Cochrane to identify published CUA between 2000 and 2014. After screening and data extraction, the quality of each selected CUA was assessed by two independent reviewers, using the checklist proposed by Drummond et al. The analysis of factors associated with a high-quality CUA (defined as a Drummond score ≥7) was performed using a two-step approach. Our systematic review was based on 140 CUAs and showed a wide variety of methodological approaches, including differences in the perspective adopted, the time horizon, measurement of cost and effectiveness, and more specially health-state utility values (HSUVs). The median Drummond score was 7 [range 3-10]. Only one in two of the CUA (n = 74) had a Drummond score ≥7, synonymous of "high quality." The statistically significant predictors of a high-quality CUA were article with "gene expression profiling" topic (p = 0.001), consulting or pharmaceutical company as main location of first author (p = 0.004), and articles with both incremental cost-utility ratio and incremental cost-effectiveness ratio as outcomes of EE (p = 0.02). Our systematic review identified only 140 CUAs published over the past 15 years with one in two of high quality. It showed a wide variety of methodological approaches, especially focused on HSUVs. A critical appraisal of utility values is necessary to better understand one of the main difficulties encountered by authors and propose areas for improvement to increase the quality of CUA. Since the last 5 years, there is a tendency toward an improvement in the quality of these studies, probably coupled with economic context, a better and widely spreading of recommendations and thus appropriation by medical practitioners. That being said, there is an urgent need for mandatory use of European and international recommendations to ensure quality of such approaches and to allow easy comparison.

David Adler Lectureship Award Talk: III-V Semiconductor Nanowires on Silicon for Future Devices

NASA Astrophysics Data System (ADS)

Riel, Heike

Bottom-up grown nanowires are very attractive materials for direct integration of III-V semiconductors on silicon thus opening up new possibilities for the design and fabrication of nanoscale devices for electronic, optoelectronic as well as quantum information applications. Template-Assisted Selective Epitaxy (TASE) allows the well-defined and monolithic integration of complex III-V nanostructures and devices on silicon. Achieving atomically abrupt heterointerfaces, high crystal quality and control of dimension down to 1D nanowires enabled the demonstration of FETs and tunnel devices based on In(Ga)As and GaSb. Furthermore, the strong influence of strain on nanowires as well as results on quantum transport studies of InAs nanowires with well-defined geometry will be presented.

Quality challenges associated with microbial-based cleaning products from the Industry Perspective.

PubMed

Teasdale, Steve M; Kademi, Ali

2018-06-01

Microbial-based cleaning products (MBCPs) continue to gain popularity in the market as environmentally friendly cleaners. The majority of these products contain spores of various Bacillus species. Although the microorganisms used in MBCPs are subject to regulation in Canada under the Canadian Environmental Protection Act, the products themselves are not. Unlike other types of microbial products such as probiotics and biopesticides, the use, manufacture and quality parameters of MBCPs in Canada and other countries are poorly defined and not specifically subject to any required standards. Due to their complexity and nature, these products feature unique quality challenges. We noted the existing MBCPs we analyzed vary vastly in quality; external microbial contaminants, viability of the spores and the biocompatibility of the ingredients are issues that greatly affect product quality. A proper taxonomic identification of the bacterial species used also seems to be a major challenge for a number of manufacturers. A good understanding of the mechanisms governing these quality challenges and the adoption of good practices for the cultivation, harvesting, formulation, and manufacture of these types of products are essential for achieving high-quality performance standards. Copyright © 2017 Elsevier Ltd. All rights reserved.

Blind prediction of natural video quality.

PubMed

Saad, Michele A; Bovik, Alan C; Charrier, Christophe

2014-03-01

We propose a blind (no reference or NR) video quality evaluation model that is nondistortion specific. The approach relies on a spatio-temporal model of video scenes in the discrete cosine transform domain, and on a model that characterizes the type of motion occurring in the scenes, to predict video quality. We use the models to define video statistics and perceptual features that are the basis of a video quality assessment (VQA) algorithm that does not require the presence of a pristine video to compare against in order to predict a perceptual quality score. The contributions of this paper are threefold. 1) We propose a spatio-temporal natural scene statistics (NSS) model for videos. 2) We propose a motion model that quantifies motion coherency in video scenes. 3) We show that the proposed NSS and motion coherency models are appropriate for quality assessment of videos, and we utilize them to design a blind VQA algorithm that correlates highly with human judgments of quality. The proposed algorithm, called video BLIINDS, is tested on the LIVE VQA database and on the EPFL-PoliMi video database and shown to perform close to the level of top performing reduced and full reference VQA algorithms.

Status and understanding of groundwater quality in the San Francisco Bay groundwater basins, 2007—California GAMA Priority Basin Project

USGS Publications Warehouse

Parsons, Mary C.; Kulongoski, Justin T.; Belitz, Kenneth

2013-01-01

Groundwater quality in the approximately 620-square-mile (1,600-square-kilometer) San Francisco Bay study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in the Southern Coast Ranges of California, in San Francisco, San Mateo, Santa Clara, Alameda, and Contra Costa Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA San Francisco Bay study was designed to provide a spatially unbiased assessment of the quality of untreated groundwater within the primary aquifer system, as well as a statistically consistent basis for comparing water quality throughout the State. The assessment is based on water-quality and ancillary data collected by the USGS from 79 wells in 2007 and is supplemented with water-quality data from the California Department of Public Health (CDPH) database. The primary aquifer system is defined by the depth interval of the wells listed in the CDPH database for the San Francisco Bay study unit. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifer system; shallower groundwater may be more vulnerable to surficial contamination. The first component of this study, the status of the current quality of the groundwater resource, was assessed by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. Water- quality data from the CDPH database also were incorporated for this assessment. This status assessment is intended to characterize the quality of groundwater resources within the primary aquifer system of the San Francisco Bay study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal and (or) California benchmarks. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic and special-interest constituents were classified as low (relative- concentration ≤ 0.1), moderate (0.1 1.0). Inorganic constituent relative- concentrations were classified as low (relative-concentration ≤ 0.5), moderate (0.5 1.0). A lower threshold value of relative-concentration was used to distinguish between low and moderate values of organic constituents because organic constituents are generally less prevalent and have smaller relative-concentrations than naturally occurring inorganic constituents. Aquifer-scale proportion was used as the metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the primary aquifer system that has relative-concentration greater than 1.0 for a particular constituent or class of constituents; proportion is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system that have moderate and low relative-concentrations, respectively. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportion for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable in the San Francisco Bay study unit (90-percent confidence intervals). Inorganic constituents with health-based benchmarks were present at high relative-concentrations in 5.1 percent of the primary aquifer system, and at moderate relative-concentrations in 25 percent. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of barium (3.0 percent) and nitrate (2.1 percent). Inorganic constituents with secondary maximum contaminant levels were present at high relative-concentrations in 14 percent of the primary aquifer system and at moderate relative-concentrations in 33 percent. The constituents present at high relative-concentrations included total dissolved solids (7.0 percent), chloride (6.1 percent), manganese (12 percent), and iron (3.0 percent). Organic constituents with health-based benchmarks were present at high relative-concentrations in 0.6 percent and at moderate relative-concentrations in 12 percent of the primary aquifer system. Of the 202 organic constituents analyzed for, 32 were detected. Three organic constituents were frequently detected (in 10 percent or more of samples): the trihalomethane chloroform, the solvent 1,1,1-trichloroethane and the refrigerant 1,1,2-trichlorotrifluoroethane. One special-interest constituent, perchlorate, was detected at moderate relative-concentrations in 42 percent of the primary aquifer system. The second component of this work, the understanding assessment, identified some of the primary natural and human factors that may affect groundwater quality by evaluating land use, physical characteristics of the wells, and geochemical conditions of the aquifer. Results from these evaluations were used to explain the occurrence and distribution of constituents in the study unit.

The Functional Quality of Soluble Recombinant Polypeptides Produced in Escherichia coli Is Defined by a Wide Conformational Spectrum▿

PubMed Central

Martínez-Alonso, Mónica; González-Montalbán, Nuria; García-Fruitós, Elena; Villaverde, Antonio

2008-01-01

We have observed that a soluble recombinant green fluorescent protein produced in Escherichia coli occurs in a wide conformational spectrum. This results in differently fluorescent protein fractions in which morphologically diverse soluble aggregates abound. Therefore, the functional quality of soluble versions of aggregation-prone recombinant proteins is defined statistically rather than by the prevalence of a canonical native structure. PMID:18836021

Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

PubMed

Terwee, Caroline B; Mokkink, Lidwine B; Knol, Dirk L; Ostelo, Raymond W J G; Bouter, Lex M; de Vet, Henrica C W

2012-05-01

The COSMIN checklist is a standardized tool for assessing the methodological quality of studies on measurement properties. It contains 9 boxes, each dealing with one measurement property, with 5-18 items per box about design aspects and statistical methods. Our aim was to develop a scoring system for the COSMIN checklist to calculate quality scores per measurement property when using the checklist in systematic reviews of measurement properties. The scoring system was developed based on discussions among experts and testing of the scoring system on 46 articles from a systematic review. Four response options were defined for each COSMIN item (excellent, good, fair, and poor). A quality score per measurement property is obtained by taking the lowest rating of any item in a box ("worst score counts"). Specific criteria for excellent, good, fair, and poor quality for each COSMIN item are described. In defining the criteria, the "worst score counts" algorithm was taken into consideration. This means that only fatal flaws were defined as poor quality. The scores of the 46 articles show how the scoring system can be used to provide an overview of the methodological quality of studies included in a systematic review of measurement properties. Based on experience in testing this scoring system on 46 articles, the COSMIN checklist with the proposed scoring system seems to be a useful tool for assessing the methodological quality of studies included in systematic reviews of measurement properties.

Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care.

PubMed

Davison, Sara N; Levin, Adeera; Moss, Alvin H; Jha, Vivekanand; Brown, Edwina A; Brennan, Frank; Murtagh, Fliss E M; Naicker, Saraladevi; Germain, Michael J; O'Donoghue, Donal J; Morton, Rachael L; Obrador, Gregorio T

2015-09-01

Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Current paradigms of care for this highly vulnerable population are variable, prognostic and assessment tools are limited, and quality of care, particularly regarding conservative and palliative care, is suboptimal. The KDIGO Controversies Conference on Supportive Care in CKD reviewed the current state of knowledge in order to define a roadmap to guide clinical and research activities focused on improving the outcomes of people living with advanced CKD, including those on dialysis. An international group of multidisciplinary experts in CKD, palliative care, methodology, economics, and education identified the key issues related to palliative care in this population. The conference led to a working plan to address outstanding issues in this arena, and this executive summary serves as an output to guide future work, including the development of globally applicable guidelines.

Risk Communication of Groundwater Quality in Northern Malawi, Africa

NASA Astrophysics Data System (ADS)

Holm, R.

2011-12-01

Malawi lies in Africa's Great Rift Valley. Its western border is defined by Lake Malawi, the third largest lake in Africa. Over 80% of Malawians live in rural areas and 90% of the labor force is associated with agriculture. More than half of the population lives below the poverty line. Area characteristics indicate a high likelihood of nitrate and total coliform in community drinking water. Infants exposed to high nitrate are at risk of developing methemoglobinemia. In addition, diarrheal diseases from unsafe drinking water are one of the top causes of mortality in children under five. Without sufficient and sustainable supplies of clean water, these challenges will continue to threaten Malawi's ability to overcome the devastating impact of diarrheal diseases on its population. Therefore, Malawi remains highly dependent on outside assistance and influence to reduce or eliminate the threat posed by unsafe drinking water. This research presents a literature review of nitrate and total coliform groundwater quality and a proposed risk communication plan for drinking water in northern Malawi.

[Ophthalmologic reading charts : Part 2: Current logarithmically scaled reading charts].

PubMed

Radner, W

2016-12-01

To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization. For the present study, the following logarithmically scaled reading charts were investigated using a measuring microscope (iNexis VMA 2520; Nikon, Tokyo): Eschenbach, Zeiss, OCULUS, MNREAD (Minnesota Near Reading Test), Colenbrander, and RADNER. Calculations were made according to EN-ISO 8596 and the International Research Council recommendations. Modern reading charts and cards exhibit a logarithmic progression of print sizes. The RADNER reading charts comprise four different cards with standardized test items (sentence optotypes), a well-defined stop criterion, accurate letter sizes, and a high print quality. Numbers and Landolt rings are also given in the booklet. The OCULUS cards have currently been reissued according to recent standards and also exhibit a high print quality. In addition to letters, numbers, Landolt rings, and examples taken from a timetable and the telephone book, sheet music is also offered. The Colenbrander cards use short sentences of 44 characters, including spaces, and exhibit inaccuracy at smaller letter sizes, as do the MNREAD cards. The MNREAD cards use sentences of 60 characters, including spaces, and have a high print quality. Modern reading charts show that international standards can be achieved with test items similar to optotypes, by using recent technology and developing new concepts of test-item standardization. Accurate print sizes, high print quality, and a logarithmic progression should become the minimum requirements for reading charts and reading cards in ophthalmology.

On the definition of adapted audio/video profiles for high-quality video calling services over LTE/4G

NASA Astrophysics Data System (ADS)

Ndiaye, Maty; Quinquis, Catherine; Larabi, Mohamed Chaker; Le Lay, Gwenael; Saadane, Hakim; Perrine, Clency

2014-01-01

During the last decade, the important advances and widespread availability of mobile technology (operating systems, GPUs, terminal resolution and so on) have encouraged a fast development of voice and video services like video-calling. While multimedia services have largely grown on mobile devices, the generated increase of data consumption is leading to the saturation of mobile networks. In order to provide data with high bit-rates and maintain performance as close as possible to traditional networks, the 3GPP (The 3rd Generation Partnership Project) worked on a high performance standard for mobile called Long Term Evolution (LTE). In this paper, we aim at expressing recommendations related to audio and video media profiles (selection of audio and video codecs, bit-rates, frame-rates, audio and video formats) for a typical video-calling services held over LTE/4G mobile networks. These profiles are defined according to targeted devices (smartphones, tablets), so as to ensure the best possible quality of experience (QoE). Obtained results indicate that for a CIF format (352 x 288 pixels) which is usually used for smartphones, the VP8 codec provides a better image quality than the H.264 codec for low bitrates (from 128 to 384 kbps). However sequences with high motion, H.264 in slow mode is preferred. Regarding audio, better results are globally achieved using wideband codecs offering good quality except for opus codec (at 12.2 kbps).

Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective.

PubMed

Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh

2014-07-27

Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.

A New Model for Solving Time-Cost-Quality Trade-Off Problems in Construction

PubMed Central

Fu, Fang; Zhang, Tao

2016-01-01

A poor quality affects project makespan and its total costs negatively, but it can be recovered by repair works during construction. We construct a new non-linear programming model based on the classic multi-mode resource constrained project scheduling problem considering repair works. In order to obtain satisfactory quality without a high increase of project cost, the objective is to minimize total quality cost which consists of the prevention cost and failure cost according to Quality-Cost Analysis. A binary dependent normal distribution function is adopted to describe the activity quality; Cumulative quality is defined to determine whether to initiate repair works, according to the different relationships among activity qualities, namely, the coordinative and precedence relationship. Furthermore, a shuffled frog-leaping algorithm is developed to solve this discrete trade-off problem based on an adaptive serial schedule generation scheme and adjusted activity list. In the program of the algorithm, the frog-leaping progress combines the crossover operator of genetic algorithm and a permutation-based local search. Finally, an example of a construction project for a framed railway overpass is provided to examine the algorithm performance, and it assist in decision making to search for the appropriate makespan and quality threshold with minimal cost. PMID:27911939

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

ERIC Educational Resources Information Center

New Zealand Qualifications Authority, Wellington.

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

Title IV Quality Control Project, Stage II. Management Option II: Delivery System Quality Improvements.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

Stage Two of the Title IV Quality Control Project is an integrated study of quality in five related Federal financial aid programs for postsecondary students. Section 1 of the paper establishes a framework for defining quality improvements, in order to identify the types of changes that would tend to improve quality across all facets of the…

Probability concepts in quality risk management.

PubMed

Claycamp, H Gregg

2012-01-01

Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management.

[Social medicine and healthcare economics. The framework for future forms of healthcare].

PubMed

Rebscher, Herbert

2008-05-01

In the political debate, even in academia, the concepts of "profitability" or "efficiency" are thrown around very robustly and freely with no regard for the players themselves. Economically speaking there can be no efficiency without a definition of targets in terms of outcomes and their level of quality. If even the government's Council of Economic Experts itself finds in its assessment of hospital funding that the "reform's target parameters - improving the profitability of service provision - have developed positively", but adds that "whether this also applies to the quality of services provided or to the realisation of healthcare outcomes remains to be seen due to the lack of evidence" [21], this indicates a one-sided and problematic curtailment of the concept even by highly competent bodies. Economic control of new forms of healthcare by means of prices and fees for clearly defined services is a complex problem that has not been dealt with adequately. All pricing is based on classification models aimed at ensuring cost and benefit clusters that are as homogeneous as possible. Classification models in healthcare as a basis for price control targets need constant adjusting to ensure accuracy of mapping and appropriateness to performance. A prerequisite for the methodology behind price control models of this kind is presupposing a responsible, rule-bound and criteria-based handling of "variance" and "coincidence" by means of risk-adjusted quality and price systems. They will define the character of a wide range of steering tools and have an effect that goes beyond the narrow formal confines of the sector. That is why the regulatory framework will need first and foremost to define a qualitative framework for the political "security infrastructure" by means of deregulated economic processes in which price control becomes accountable and is justified in terms of content.

The gut microbiota and the liver: implications for clinical practice.

PubMed

Quigley, Eamonn M; Monsour, Howard P

2013-11-01

While a central role for the microbiota in the precipitation of infectious and non-infectious complications of liver disease has been long established, evidence for a more fundamental role in the etiology of several liver diseases continues to accumulate. However, though progress is rapidly occurring in this area, the definitive delineation of the precise relevance of changes in the microbiota to various forms and stages of liver disease is still far from complete. While high quality clinical evidence supports the use of antibiotic therapy, in the management of hepatic encephalopathy, spontaneous bacterial peritonitis and other infectious complications, how these interventions impact on the microbiota and microbiota-host interactions has not been clearly defined. Although probiotics and even, perhaps, fecal transplantation hold promise in the management of liver disease, and the potential impact of probiotics is supported by a considerable amount of laboratory data, high-quality clinical evidence is scanty.

Water quality of a coastal lagoon (ES, Brazil): abiotic aspects, cytogenetic damage, and phytoplankton dynamics.

PubMed

Duarte, Ian Drumond; Silva, Nayara Heloisa Vieira Fraga; da Costa Souza, Iara; de Oliveira, Larissa Bassani; Rocha, Lívia Dorsch; Morozesk, Mariana; Bonomo, Marina Marques; de Almeida Pereira, Thaís; Dias, Mauro Cesar; de Oliveira Fernandes, Valéria; Matsumoto, Silvia Tamie

2017-04-01

Assessment of water resources requires interdisciplinary studies that include multiple ecosystem aspects. This study evaluated the water quality of Juara Lagoon (ES, Brazil) based on physical and chemical variables, cytogenetic responses in Allium cepa and phytoplankton dynamics. Three sampling sites were defined and water samples were collected during two sampling periods. Analyses such as determination of photic zone, conductivity, and concentrations of nutrients and metals were conducted as well as cytotoxic, mutagenic, and genotoxic potentials using A. cepa test. The main attributes of phytoplankton community, such as total richness, total density, density by class, dominance, and diversity, were also evaluated. Results have revealed that Juara Lagoon has signs of artificial eutrophication at two sampling sites due to high levels of total phosphorus and ammonia nitrogen. Cytotoxic, genotoxic, and mutagenic potentials were detected as well as high concentrations of Fe and Mn. Furthermore, 165 phytoplankton taxa were recorded, with highest richness in Chlorophyceae and Cyanophyceae classes. In addition, Cyanophyceae presented as the highest density class. A. cepa test and phytoplankton community evaluation indicated that the ecological quality of Juara Lagoon is compromised.

Effects of spatial resolution ratio in image fusion

USGS Publications Warehouse

Ling, Y.; Ehlers, M.; Usery, E.L.; Madden, M.

2008-01-01

In image fusion, the spatial resolution ratio can be defined as the ratio between the spatial resolution of the high-resolution panchromatic image and that of the low-resolution multispectral image. This paper attempts to assess the effects of the spatial resolution ratio of the input images on the quality of the fused image. Experimental results indicate that a spatial resolution ratio of 1:10 or higher is desired for optimal multisensor image fusion provided the input panchromatic image is not downsampled to a coarser resolution. Due to the synthetic pixels generated from resampling, the quality of the fused image decreases as the spatial resolution ratio decreases (e.g. from 1:10 to 1:30). However, even with a spatial resolution ratio as small as 1:30, the quality of the fused image is still better than the original multispectral image alone for feature interpretation. In cases where the spatial resolution ratio is too small (e.g. 1:30), to obtain better spectral integrity of the fused image, one may downsample the input high-resolution panchromatic image to a slightly lower resolution before fusing it with the multispectral image.

Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study.

PubMed

Tzeng, Dong-Sheng; Chung, Wei-Ching; Lin, Chi-Hung; Yang, Chun-Yuh

2012-09-08

Taiwan's National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

A Review of Paradigms for Evaluating the Quality of Online Education Programs

ERIC Educational Resources Information Center

Shelton, Kaye

2011-01-01

As the demands for public accountability increase for higher education, institutions must demonstrate quality within programs and processes, including those provided through online education. While quality may be elusive to specifically quantify, there have been several recommendations for identifying and defining quality online education that…

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

Quality in Accounting Education: What Say the Academics?

ERIC Educational Resources Information Center

Watty, Kim

2005-01-01

Purpose: To provide a view of quality in accounting education from the perspective of a critical stakeholder group--academic accountants. The identification of this view adds to the growing discussions around quality, and how it is assured in higher education. Design/methodology/approach: Applying a framework for defining quality in higher…

Quality Assurance--Best Practices for Assessing Online Programs

ERIC Educational Resources Information Center

Wang, Qi

2006-01-01

Educators have long sought to define quality in education. With the proliferation of distance education and online learning powered by the Internet, the tasks required to assess the quality of online programs become even more challenging. To assist educators and institutions in search of quality assurance methods to continuously improve their…

Achieving Quality Learning in Higher Education.

ERIC Educational Resources Information Center

Nightingale, Peggy; O'Neil, Mike

This volume on quality learning in higher education discusses issues of good practice particularly action learning and Total Quality Management (TQM)-type strategies and illustrates them with seven case studies in Australia and the United Kingdom. Chapter 1 discusses issues and problems in defining quality in higher education. Chapter 2 looks at…

Assessing Quality in Home Visiting Programs

ERIC Educational Resources Information Center

Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

2013-01-01

Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

More Value to Defining Quality

ERIC Educational Resources Information Center

Van Kemenade, Everard; Pupius, Mike; Hardjono, Teun W.

2008-01-01

There are lots of definitions of quality, and also of quality in education. Garvin (1984) discerns five approaches: the transcendental approach, the product-oriented approach, the customer-oriented approach, the manufacturing-oriented approach and the value-for-money approach. Harvey and Green (1993) give five interrelated concepts of quality as:…

Optimization and development of stable w/o/w cosmetic multiple emulsions by means of the Quality by Design approach.

PubMed

Kovács, A; Erős, I; Csóka, I

2016-04-01

The aim of our present work was to develop stable water-in-oil-in-water (w/o/w) cosmetic multiple emulsions that are proper for cosmetic use and can also be applied on the skin as pharmaceutical vehicles by means of Quality by Design (QbD) concept. This product design concept consists of a risk assessment step and also the 'predetermination' of the critical material attributes and process parameters of a stable multiple emulsion system. We have set up the hypothesis that the stability of multiple emulsions can be improved by the development based on such systematic planning - making a map of critical product parameters - so their industrial usage can be increased. The risk assessment and the determination of critical physical-chemical stability parameters of w/o/w multiple emulsions to define critical control points were performed by means of quality tools and the leanqbd(™) (QbD Works LLC, Fremont, CA, U.S.A.) software. Critical materials and process parameters: Based on the results of preformulation experiments, three factors, namely entrapped active agent, preparation methodology and shear rate, were found to be highly critical factors for critical quality attributes (CQAs) and for stability, whereas the nature of oil was found a medium level risk factor. The results of the risk assessment are the following: (i) droplet structure and size distribution should be evaluated together to be able to predict the stability issues, (ii) the presence of entrapped active agents had a great impact on droplet structure, (iii) the viscosity curves represent the structural changes during storage, if the decrease in relative viscosity is >15% the emulsion disintegrates, and (iv) it is enough to use the shear rate between 34g and 116g relative centrifugal force (RCF). CQAs: By risk assessment, we discovered that four factors should be considered to be high-risk variables as compared to others: droplet size, droplet structure, viscosity and multiple character were found to be highly critical attributes. The preformulation experiment is the part of a development plan. On the basis of these results, the control strategy can be defined and a stable multiple emulsion can be ensured that meets the relevant stakeholders' quality expectations. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Quality Assurance Framework for Mini-Grids

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

Baring-Gould, Ian; Burman, Kari; Singh, Mohit

Providing clean and affordable energy services to the more than 1 billion people globally who lack access to electricity is a critical driver for poverty reduction, economic development, improved health, and social outcomes. More than 84% of populations without electricity are located in rural areas where traditional grid extension may not be cost-effective; therefore, distributed energy solutions such as mini-grids are critical. To address some of the root challenges of providing safe, quality, and financially viable mini-grid power systems to remote customers, the U.S. Department of Energy (DOE) teamed with the National Renewable Energy Laboratory (NREL) to develop a Qualitymore » Assurance Framework (QAF) for isolated mini-grids. The QAF for mini-grids aims to address some root challenges of providing safe, quality, and affordable power to remote customers via financially viable mini-grids through two key components: (1) Levels of service: Defines a standard set of tiers of end-user service and links them to technical parameters of power quality, power availability, and power reliability. These levels of service span the entire energy ladder, from basic energy service to high-quality, high-reliability, and high-availability service (often considered 'grid parity'); (2) Accountability and performance reporting framework: Provides a clear process of validating power delivery by providing trusted information to customers, funders, and/or regulators. The performance reporting protocol can also serve as a robust monitoring and evaluation tool for mini-grid operators and funding organizations. The QAF will provide a flexible alternative to rigid top-down standards for mini-grids in energy access contexts, outlining tiers of end-user service and linking them to relevant technical parameters. In addition, data generated through implementation of the QAF will provide the foundation for comparisons across projects, assessment of impacts, and greater confidence that will drive investment and scale-up in this sector. The QAF implementation process also defines a set of implementation guidelines that help the deployment of mini-grids on a regional or national scale, helping to insure successful rapid deployment of these relatively new remote energy options. Note that the QAF is technology agnostic, addressing both alternating current (AC) and direct current (DC) mini-grids, and is also applicable to renewable, fossil-fuel, and hybrid systems.« less

Geodetic glacier mass balances at the push of a button: application of Structure from Motion technology on aerial images in mountain regions

NASA Astrophysics Data System (ADS)

Bolch, T.; Mölg, N.

2017-12-01

The application of Structure-from-Motion (SfM) to generate digital terrain models (DTMs) derived out of images from various kinds of sources has strongly increased in recent years. The major reason for this is its easy-to-use handling in comparison to conventional photogrammetry. In glaciology, DTMs are intensely used, among others, to calculate the geodetic mass balances. Few studies investigated the application of SfM to aerial images in mountainous terrain and results look promising. We tested this technique in a demanding environment in the Swiss Alps including very steep slopes, snow and ice covered terrain. SfM (using the commercial software packages of Agisoft Photoscan and Pix4DMapper) and conventional photogrammetry (ERDAS Photogrammetry) were applied on archival aerial images for nine dates between 1946 and 2005 the results were compared regarding bundle adjustment and final DTM quality. The overall precision of the DTMs could be defined with the use of a modern, high-quality reference DTM by Swisstopo. Results suggest a high performance of SfM to produce DTMs of similar quality as conventional photogrammetry. A ground resolution of high quality (little noise and artefacts) can be up to 50% higher, with 3-6 times less user effort. However, the controls on the commercial SfM software packages are limited in comparison to ERDAS Photogrammetry. SfM performs less reliably when few images with little overlap are processed. Overall, the uncertainty of DTMs from the different software are comparable and mostly within the uncertainty range of the reference DTM, making them highly valuable for glaciological purposes. Even though SfM facilitates the largely automated production of high quality DTMs, the user is not exempt from a thorough quality check, at best with reference data where available.

Drawing on Other Disciplines to Define Quality in Bioethics Education

ERIC Educational Resources Information Center

Avci, Ercan

2017-01-01

In light of the lack of scholarly studies on the determination of quality in bioethics education, this paper aims to elaborate the concept of quality, focus on its understanding in education and explore a definition of quality in bioethics education. The findings of the literature-based research indicate that quality is a multidimensional concept…

The Attributive Theory of Quality: A Model for Quality Measurement in Higher Education.

ERIC Educational Resources Information Center

Afshar, Arash

A theoretical basis for defining and measuring the quality of institutions of higher education, namely for accreditation purposes, is developed. The theory, the Attributive Theory of Quality, is illustrated using a calculation model that is based on general systems theory. The theory postulates that quality only exists in relation to the…

Defining Quality in Assisted Living: Comparing Apples, Oranges, and Broccoli

ERIC Educational Resources Information Center

Hawes, Catherine; Phillips, Charles D.

2007-01-01

Purpose: The purpose of this article is to discuss and describe various measures of quality, quality indicators, and uses of information on quality with specific reference to the role or purpose of assisted living. Design and Methods: We reviewed a variety of major studies of assisted living quality. We elaborated models of assisted living based…

Evaluating quality management systems for HIV rapid testing services in primary healthcare clinics in rural KwaZulu-Natal, South Africa

PubMed Central

Jaya, Ziningi; Drain, Paul K.

2017-01-01

Introduction Rapid HIV tests have improved access to HIV diagnosis and treatment by providing quick and convenient testing in rural clinics and resource-limited settings. In this study, we evaluated the quality management system for voluntary and provider-initiated point-of-care HIV testing in primary healthcare (PHC) clinics in rural KwaZulu-Natal (KZN), South Africa. Material and methods We conducted a quality assessment audit in eleven PHC clinics that offer voluntary HIV testing and counselling in rural KZN, South Africa from August 2015 to October 2016. All the participating clinics were purposively selected from the province-wide survey of diagnostic services. We completed an on-site monitoring checklist, adopted from the WHO guidelines for assuring accuracy and reliability of HIV rapid tests, to assess the quality management system for HIV rapid testing at each clinic. To determine clinic’s compliance to WHO quality standards for HIV rapid testing the following quality measure was used, a 3-point scale (high, moderate and poor). A high score was defined as a percentage rating of 90 to 100%, moderate was defined as a percentage rating of 70 to 90%, and poor was defined as a percentage rating of less than 70%. Clinic audit scores were summarized and compared. We employed Pearson pair wise correlation coefficient to determine correlations between clinics audit scores and clinic and clinics characteristics. Linear regression model was computed to estimate statistical significance of the correlates. Correlations were reported as significant at p ≤0.05. Results Nine out of 11 audited rural PHC clinics are located outside 20Km of the nearest town and hospital. Majority (18.2%) of the audited rural PHC clinics reported that HIV rapid test was performed by HIV lay counsellors. Overall, ten clinics were rated moderate, in terms of their compliance to the stipulated WHO guidelines. Audit results showed that rural PHC clinics’ average rating score for compliance to the WHO guidelines ranged between 64.4% (CI: 44%– 84%) and 89.2% (CI: 74%– 100%).Ten out of eleven of the clinics were rated as moderate (70–89%). All clinic have scored highest for the following audit component: equipment; process control and specimen management; and facility ad safety, with 100%. Clinics obtained the lowest scores for the assessment audit component followed by process improvement and organisation, with 40.9% (CI: 15.7–66.1%), 45.5% (CI: 10.4–80.5%) and 56.8% (CI: 31.8 81.8%), respectively. A statistically significant correlation was observed between the following: category of staff performing the HIV rapid tests in the audited clinics and service and satisfactory audit component; weekly average number of patients using the audited PHC clinics and service and satisfactory audit component; number of HIV lay counsellors in the audited clinics and quality control audit component with p<0.05. Discussion In the small audit of primary healthcare clinics located within the rural part of KwaZulu-Natal, results revealed an overall moderate rating of the quality management system for rapid HIV testing. Improvements in the organisation, quality control, process improvement and assessment components could enable a higher quality assurance rating for rural HIV testing in KwaZulu-Natal. PMID:28829801

Evaluating quality management systems for HIV rapid testing services in primary healthcare clinics in rural KwaZulu-Natal, South Africa.

PubMed

Jaya, Ziningi; Drain, Paul K; Mashamba-Thompson, Tivani P

2017-01-01

Rapid HIV tests have improved access to HIV diagnosis and treatment by providing quick and convenient testing in rural clinics and resource-limited settings. In this study, we evaluated the quality management system for voluntary and provider-initiated point-of-care HIV testing in primary healthcare (PHC) clinics in rural KwaZulu-Natal (KZN), South Africa. We conducted a quality assessment audit in eleven PHC clinics that offer voluntary HIV testing and counselling in rural KZN, South Africa from August 2015 to October 2016. All the participating clinics were purposively selected from the province-wide survey of diagnostic services. We completed an on-site monitoring checklist, adopted from the WHO guidelines for assuring accuracy and reliability of HIV rapid tests, to assess the quality management system for HIV rapid testing at each clinic. To determine clinic's compliance to WHO quality standards for HIV rapid testing the following quality measure was used, a 3-point scale (high, moderate and poor). A high score was defined as a percentage rating of 90 to 100%, moderate was defined as a percentage rating of 70 to 90%, and poor was defined as a percentage rating of less than 70%. Clinic audit scores were summarized and compared. We employed Pearson pair wise correlation coefficient to determine correlations between clinics audit scores and clinic and clinics characteristics. Linear regression model was computed to estimate statistical significance of the correlates. Correlations were reported as significant at p ≤0.05. Nine out of 11 audited rural PHC clinics are located outside 20Km of the nearest town and hospital. Majority (18.2%) of the audited rural PHC clinics reported that HIV rapid test was performed by HIV lay counsellors. Overall, ten clinics were rated moderate, in terms of their compliance to the stipulated WHO guidelines. Audit results showed that rural PHC clinics' average rating score for compliance to the WHO guidelines ranged between 64.4% (CI: 44%- 84%) and 89.2% (CI: 74%- 100%).Ten out of eleven of the clinics were rated as moderate (70-89%). All clinic have scored highest for the following audit component: equipment; process control and specimen management; and facility ad safety, with 100%. Clinics obtained the lowest scores for the assessment audit component followed by process improvement and organisation, with 40.9% (CI: 15.7-66.1%), 45.5% (CI: 10.4-80.5%) and 56.8% (CI: 31.8 81.8%), respectively. A statistically significant correlation was observed between the following: category of staff performing the HIV rapid tests in the audited clinics and service and satisfactory audit component; weekly average number of patients using the audited PHC clinics and service and satisfactory audit component; number of HIV lay counsellors in the audited clinics and quality control audit component with p<0.05. In the small audit of primary healthcare clinics located within the rural part of KwaZulu-Natal, results revealed an overall moderate rating of the quality management system for rapid HIV testing. Improvements in the organisation, quality control, process improvement and assessment components could enable a higher quality assurance rating for rural HIV testing in KwaZulu-Natal.

Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review

PubMed Central

Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E.; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C.; Roy, Jean-Sébastien

2016-01-01

Objective: To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. Methods: A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. Results: The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. Conclusion: There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers. PMID:27488037

Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review.

PubMed

Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C; Roy, Jean-Sébastien

2016-09-30

To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers.

Academic goals and learning quality in higher education students.

PubMed

Valle, Antonio; Núñez, José C; Cabanach, Ramón G; González-Pienda, Julio A; Rodríguez, Susana; Rosário, Pedro; Muñoz-Cadavid, María A; Cerezo, Rebeca

2009-05-01

In this paper, the relations between academic goals and various indicators that define the quality of the learning process are analyzed. The purpose was to determine to what extent high, moderate, or low levels of academic goals were positively or negatively related to effort regulation, the value assigned to academic tasks, meta-cognitive self-regulation, self-efficacy, beliefs about learning control, and management of time and study environment. The investigation was carried out with a sample of 632 university students (70% female and 30% male) and mean age of 21.22 (SD=2.2).The results show that learning goals, or task orientation, are positively related to all the indictors of learning quality considered herein. Although for other kinds of goals-work-avoidance goals, performance-approach goals, and performance-avoidance goals-significant relations were not found with all the indicators, there was a similar tendency of significant results in all cases; the higher the levels of these goals, the lower the levels of the indicators of learning quality.

Extracting Information about the Electronic Quality of Organic Solar-Cell Absorbers from Fill Factor and Thickness

NASA Astrophysics Data System (ADS)

Kaienburg, Pascal; Rau, Uwe; Kirchartz, Thomas

2016-08-01

Understanding the fill factor in organic solar cells remains challenging due to its complex dependence on a multitude of parameters. By means of drift-diffusion simulations, we thoroughly analyze the fill factor of such low-mobility systems and demonstrate its dependence on a collection coefficient defined in this work. We systematically discuss the effect of different recombination mechanisms, space-charge regions, and contact properties. Based on these findings, we are able to interpret the thickness dependence of the fill factor for different experimental studies from the literature. The presented model provides a facile method to extract the photoactive layer's electronic quality which is of particular importance for the fill factor. We illustrate that over the past 15 years, the electronic quality has not been continuously improved, although organic solar-cell efficiencies increased steadily over the same period of time. Only recent reports show the synthesis of polymers for semiconducting films of high electronic quality that are able to produce new efficiency records.

Defining process design space for a hydrophobic interaction chromatography (HIC) purification step: application of quality by design (QbD) principles.

PubMed

Jiang, Canping; Flansburg, Lisa; Ghose, Sanchayita; Jorjorian, Paul; Shukla, Abhinav A

2010-12-15

The concept of design space has been taking root under the quality by design paradigm as a foundation of in-process control strategies for biopharmaceutical manufacturing processes. This paper outlines the development of a design space for a hydrophobic interaction chromatography (HIC) process step. The design space included the impact of raw material lot-to-lot variability and variations in the feed stream from cell culture. A failure modes and effects analysis was employed as the basis for the process characterization exercise. During mapping of the process design space, the multi-dimensional combination of operational variables were studied to quantify the impact on process performance in terms of yield and product quality. Variability in resin hydrophobicity was found to have a significant influence on step yield and high-molecular weight aggregate clearance through the HIC step. A robust operating window was identified for this process step that enabled a higher step yield while ensuring acceptable product quality. © 2010 Wiley Periodicals, Inc.

Introduction of Transplant Registry Unified Management Program 2 (TRUMP2): scripts for TRUMP data analyses, part I (variables other than HLA-related data).

PubMed

Atsuta, Yoshiko

2016-01-01

Collection and analysis of information on diseases and post-transplant courses of allogeneic hematopoietic stem cell transplant recipients have played important roles in improving therapeutic outcomes in hematopoietic stem cell transplantation. Efficient, high-quality data collection systems are essential. The introduction of the Second-Generation Transplant Registry Unified Management Program (TRUMP2) is intended to improve data quality and more efficient data management. The TRUMP2 system will also expand possible uses of data, as it is capable of building a more complex relational database. The construction of an accessible data utilization system for adequate data utilization by researchers would promote greater research activity. Study approval and management processes and authorship guidelines also need to be organized within this context. Quality control of processes for data manipulation and analysis will also affect study outcomes. Shared scripts have been introduced to define variables according to standard definitions for quality control and improving efficiency of registry studies using TRUMP data.

Optimistic and pessimistic self-assessment of own diets is associated with age, self-rated health and weight status in Danish adults.

PubMed

Sørensen, Mette Rosenlund; Matthiessen, Jeppe; Holm, Lotte; Knudsen, Vibeke Kildegaard; Andersen, Elisabeth Wreford; Tetens, Inge

2017-07-01

The aim of this study was to analyse concordance between Danish adults' recorded diet quality and their own assessment of the healthiness and to examine socio-demographic, health and behavioural characteristics associated with an optimistic or pessimistic self-assessment. Data were derived from The Danish National Survey of Diet and Physical Activity 2011-2013 and included a random sample of 3014 adults (18-75 y). Diet quality was evaluated on the basis of seven-day pre-coded food diaries and categorised 'unhealthy', 'somewhat healthy' and 'healthy'. Self-assessment of the healthiness of own diets was registered via personal interviews and categorised healthy enough 'to a high degree', 'to some degree' or 'not at all/only partly'. Highly and somewhat optimistic self-assessment, respectively, were defined as assessing own diets as healthy enough to a high degree or to some degree while having unhealthy diets. Highly and somewhat pessimistic self-assessment, respectively, were defined as assessing own diets as not healthy enough or healthy enough to some degree while having healthy diets. Multiple logistic regression models were used to examine characteristics associated with optimistic and pessimistic self-assessments, respectively. Among individuals with unhealthy diets, 13% were highly optimistic and 42% somewhat optimistic about the healthiness of their diets. Among individuals with healthy diets, 14% were highly pessimistic and 51% somewhat pessimistic about the healthiness of their diets. Highly optimistic self-assessment was associated with increasing age, excellent self-rated health, normal weight and a moderate activity level. Highly pessimistic self-assessment was associated with decreasing age, good self-rated health and being obese. The findings indicate that people seem to use personal health characteristics as important references when assessing the healthiness of their diets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Changes in the relationship between nursing home financial performance and quality of care under public reporting.

PubMed

Park, Jeongyoung; Werner, Rachel M

2011-07-01

The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes with increased incentives to engage in quality-based competition. If quality improvement activities require substantial production costs, nursing home profitability may become a more important predictor of quality under public reporting. This study explores the relationship between financial performance and quality of care and test whether this relationship changes under public reporting. Using a 10-year (fiscal years 1997-2006) panel data set of 9444 skilled nursing facilities in the US, this study employs a facility fixed-effects with and without instrumental variables approach to test the effect of finances on quality improvement and correct for potential endogeneity. The results show that better financial performance, as reflected by the 1-year lagged total profit margin, is modestly associated with higher quality but only after public reporting is initiated. These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality. Copyright © 2010 John Wiley & Sons, Ltd.

Dairy intensification in developing countries: effects of market quality on farm-level feeding and breeding practices.

PubMed

Duncan, A J; Teufel, N; Mekonnen, K; Singh, V K; Bitew, A; Gebremedhin, B

2013-12-01

Smallholder dairy production represents a promising income generating activity for poor farmers in the developing world. Because of the perishable nature of milk, marketing arrangements for collection, distribution and sale are important for enhanced livelihoods in the smallholder dairy sector. In this study we examined the relationship between market quality and basic feeding and breeding practices at farm level. We define market quality as the attractiveness and reliability of procurement channels and associated input supply arrangements. We took as our study countries, India with its well-developed smallholder dairy sector, and Ethiopia where the smallholder dairy industry has remained relatively undeveloped despite decades of development effort. We conducted village surveys among producer groups in 90 villages across three States in India and two Regions in Ethiopia. Producer groups were stratified according to three levels of market quality - high, medium and low. Data showed that diet composition was relatively similar in India and Ethiopia with crop residues forming the major share of the diet. Concentrate feeding tended to be more prominent in high market quality sites. Herd composition changed with market quality with more dairy (exotic) cross-bred animals in high market quality sites in both India and Ethiopia. Cross-bred animals were generally more prominent in India than Ethiopia. Herd performance within breed did not change a great deal along the market quality gradient. Parameters such as calving interval and milk yield were relatively insensitive to market quality. Insemination of cross-bred cows was predominantly by artificial insemination (AI) in India and accounted for around half of cross-bred cow inseminations in Ethiopia. Data on perceptions of change over the last decade indicated that per herd and per cow productivity are both increasing in high market quality sites with a more mixed picture in medium and low-quality sites. Similarly dairy-derived income is on the increase in high market quality sites. This is accompanied by a strong increase in stall feeding at the expense of grazing. The study indicates that the first constraint to intensification of dairy production in Ethiopia is the genetic quality of the herd. There is less scope for improved AI provision in India since the cross-bred herd is mainly serviced by AI already. However, as for Ethiopia, there is considerable scope for closing yield gaps in India through improved feed use and supply. Results strongly show that well-developed markets with good procurement arrangements are key for sustainable dairy intensification.

Space Shuttle flying qualities and flight control system assessment study, phase 2

NASA Technical Reports Server (NTRS)

Myers, T. T.; Johnston, D. E.; Mcruer, D. T.

1983-01-01

A program of flying qualities experiments as part of the Orbiter Experiments Program (OEX) is defined. Phase 1, published as CR-170391, reviewed flying qualities criteria and shuttle data. The review of applicable experimental and shuttle data to further define the OEX plan is continued. An unconventional feature of this approach is the use of pilot strategy model identification to relate flight and simulator results. Instrumentation, software, and data analysis techniques for pilot model measurements are examined. The relationship between shuttle characteristics and superaugmented aircraft is established. STS flights 1 through 4 are reviewed from the point of view of flying qualities. A preliminary plan for a coordinated program of inflight and simulator research is presented.

The accurate assessment of small-angle X-ray scattering data

DOE PAGES

Grant, Thomas D.; Luft, Joseph R.; Carter, Lester G.; ...

2015-01-23

Small-angle X-ray scattering (SAXS) has grown in popularity in recent times with the advent of bright synchrotron X-ray sources, powerful computational resources and algorithms enabling the calculation of increasingly complex models. However, the lack of standardized data-quality metrics presents difficulties for the growing user community in accurately assessing the quality of experimental SAXS data. Here, a series of metrics to quantitatively describe SAXS data in an objective manner using statistical evaluations are defined. These metrics are applied to identify the effects of radiation damage, concentration dependence and interparticle interactions on SAXS data from a set of 27 previously described targetsmore » for which high-resolution structures have been determined via X-ray crystallography or nuclear magnetic resonance (NMR) spectroscopy. Studies show that these metrics are sufficient to characterize SAXS data quality on a small sample set with statistical rigor and sensitivity similar to or better than manual analysis. The development of data-quality analysis strategies such as these initial efforts is needed to enable the accurate and unbiased assessment of SAXS data quality.« less

Postimpoundment survey of water-quality characteristics of Raystown Lake, Huntingdon and Bedford Counties, Pennsylvania

USGS Publications Warehouse

Williams, Donald R.

1978-01-01

Water-quality data, collected from May 1974 to September 1976 at thirteen sites within Raystown Lake and in the inflow and outflow channels, define the water-quality characteristics of the lake water and the effects of impoundment on the quality of the lake outflow. Depth-profile measurements show Raystown Lake to be dimictic. Thermal stratification is well developed during the summer. Generally high concentrations of dissolved oxygen throughout the hypolimnion during thermal stratification, low phytoplankton concentrations, and small diel fluctuations of dissolved oxygen, pH, and specific conductance indicate that the lake is low in nutrients, or oligotrophic. Algal assays of surface samples indicate that orthophosphate was a growth-limiting nutrient. The diatoms (Chrysophyta) were the dominant phytoplankton group found through-out the study period. The lake waters contained very low populations of zooplankton. Fecal coliform and fecal streptococcus densities measured throughout the lake indicated no potentially dangerous areas of water-contact recreation. The most apparent effect that the impoundment had on water quality was the removal of nutrients, particularly orthophosphate, through phytoplankton uptake and sediment deposition.

The patient's perspective in the Dutch National Technical Agreement on Telemedicine.

PubMed

Meijer, Wouter J

2008-01-01

In 2007, the Dutch National Technical Agreement (NTA) for Telemedicine was established. Telemedicine deals with care processes. The goals of Telemedicine were defined broadly, including quality of life in non-medical terms as seen from the patient's perspective: 1) independence, 2) self-reliance; 3) participation in society and social life and 4) self-determination (autonomy through freedom of choice) for the care consumer and his environment. Quality aspects were defined at three levels:1) patient level Telemedicine must be in line with his needs. 2) level of information provision, such as: patient's rights in information control were also defined in the NTA: the care consumer has ultimate control over his own data. The care consumer decides who, in which functional capacity within the care process, is entitled to access which data at which level (reading) and is entitled to process it in some way: making additions, changes or possibly deleting (writing). On request, the healthcare provider must allow the care consumer access to his own data as quickly as possible and/or provide a copy of (part of) the record.3) level of business processes, e.g.it is important that the care process is designed on the basis of statutory requirements for the allocation and registration of the roles, rights and obligations of all actors concerned. For quality assurance, the processes must be defined on the basis of the function that they perform in the achievement of the goals (intended outcome), from the starting situation (input). The intended outcome means that the needs or requirements of the involved parties are fulfilled. The quality of the Telemedicine service must be assured in a cyclical and ongoing process. This can best be done by developing a quality management system based on indicators and criteria for quality.

Draft Genome Sequence of thermoalkaliphilic Caldalkalibacillus thermarum strain TA2.A1 Reveals Molecular Adaptations to Extreme pH and Temperature

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

Kalamorz, Falk; Keis, Stefanie; Stanton, Jo-Ann

The genes and molecular machines that allow for a thermoalkaliphilic lifestyle have not been defined. To address this goal, we report on the improved high-quality draft genome sequence of Caldalkalibacillus thermarum strain TA2.A1, an obligately aerobic bacterium that grows optimally at pH 9.5 and 65 to 70 C on a wide variety of carbon and energy sources.

[Allocation decisions of health insurance rehabilitation managers--An explorative case study concerning stroke rehabilitation].

PubMed

Hasenbein, U; Wallesch, C-W

2003-12-01

We investigated processes of and subjective reasons for resource allocation in three out of four rehabilitation specialists of a regional office of a major health insurance. Decisions of health insurance personnel include approval of and duration of rehabilitation treatment and choice of clinical provider. Insurance specialists are mainly involved in documentation and coordination, whereas decisions mainly follow expert recommendations, mainly of the medical service. Allocation is based primarily on somatic impairment and disability, psychosocial function, motivation and rehabilitation potential are regarded as secondary. Goals and expected results of rehabilitation are neither individually defined nor their achievement evaluated. Decision processes are dominated by routines and agreements. Only exceptionally, defined rules and procedures are applied. Active case management is hampered by a highly specialized internal structure of the investigated insurance fund. The optimal fulfillment of individual requirements for a limited-time rehabilitation treatment is the central criterion for decision making. However, the specialists lack detailed information concerning appropriateness, quality and efficacy of rehabilitation providers, especially when taking patient-related variables into account. Instead, they trust that only high-quality institutions are contracted. Systematic control and feedback of rehabilitation results is not available. The surveyed rehabilitation managers do not include cost aspects in their decision-making. They would regard this as alien to a member- and patient-oriented policy. Improvement potentials with respect to rehabilitation case management are being reviewed.

Flight test of the X-29A at high angle of attack: Flight dynamics and controls

NASA Technical Reports Server (NTRS)

Bauer, Jeffrey E.; Clarke, Robert; Burken, John J.

1995-01-01

The NASA Dryden Flight Research Center has flight tested two X-29A aircraft at low and high angles of attack. The high-angle-of-attack tests evaluate the feasibility of integrated X-29A technologies. More specific objectives focus on evaluating the high-angle-of-attack flying qualities, defining multiaxis controllability limits, and determining the maximum pitch-pointing capability. A pilot-selectable gain system allows examination of tradeoffs in airplane stability and maneuverability. Basic fighter maneuvers provide qualitative evaluation. Bank angle captures permit qualitative data analysis. This paper discusses the design goals and approach for high-angle-of-attack control laws and provides results from the envelope expansion and handling qualities testing at intermediate angles of attack. Comparisons of the flight test results to the predictions are made where appropriate. The pitch rate command structure of the longitudinal control system is shown to be a valid design for high-angle-of-attack control laws. Flight test results show that wing rock amplitude was overpredicted and aileron and rudder effectiveness were underpredicted. Flight tests show the X-29A airplane to be a good aircraft up to 40 deg angle of attack.

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.

Biomedical word sense disambiguation with ontologies and metadata: automation meets accuracy

PubMed Central

Alexopoulou, Dimitra; Andreopoulos, Bill; Dietze, Heiko; Doms, Andreas; Gandon, Fabien; Hakenberg, Jörg; Khelif, Khaled; Schroeder, Michael; Wächter, Thomas

2009-01-01

Background Ontology term labels can be ambiguous and have multiple senses. While this is no problem for human annotators, it is a challenge to automated methods, which identify ontology terms in text. Classical approaches to word sense disambiguation use co-occurring words or terms. However, most treat ontologies as simple terminologies, without making use of the ontology structure or the semantic similarity between terms. Another useful source of information for disambiguation are metadata. Here, we systematically compare three approaches to word sense disambiguation, which use ontologies and metadata, respectively. Results The 'Closest Sense' method assumes that the ontology defines multiple senses of the term. It computes the shortest path of co-occurring terms in the document to one of these senses. The 'Term Cooc' method defines a log-odds ratio for co-occurring terms including co-occurrences inferred from the ontology structure. The 'MetaData' approach trains a classifier on metadata. It does not require any ontology, but requires training data, which the other methods do not. To evaluate these approaches we defined a manually curated training corpus of 2600 documents for seven ambiguous terms from the Gene Ontology and MeSH. All approaches over all conditions achieve 80% success rate on average. The 'MetaData' approach performed best with 96%, when trained on high-quality data. Its performance deteriorates as quality of the training data decreases. The 'Term Cooc' approach performs better on Gene Ontology (92% success) than on MeSH (73% success) as MeSH is not a strict is-a/part-of, but rather a loose is-related-to hierarchy. The 'Closest Sense' approach achieves on average 80% success rate. Conclusion Metadata is valuable for disambiguation, but requires high quality training data. Closest Sense requires no training, but a large, consistently modelled ontology, which are two opposing conditions. Term Cooc achieves greater 90% success given a consistently modelled ontology. Overall, the results show that well structured ontologies can play a very important role to improve disambiguation. Availability The three benchmark datasets created for the purpose of disambiguation are available in Additional file 1. PMID:19159460

Predictors of vision impairment in Multiple Sclerosis.

PubMed

Sanchez-Dalmau, Bernardo; Martinez-Lapiscina, Elena H; Pulido-Valdeolivas, Irene; Zubizarreta, Irati; Llufriu, Sara; Blanco, Yolanda; Sola-Valls, Nuria; Sepulveda, Maria; Guerrero, Ana; Alba, Salut; Andorra, Magi; Camos, Anna; Sanchez-Vela, Laura; Alfonso, Veronica; Saiz, Albert; Villoslada, Pablo

2018-01-01

Visual impairment significantly alters the quality of life of people with Multiple Sclerosis (MS). The objective of this study was to identify predictors (independent variables) of visual outcomes, and to define their relationship with neurological disability and retinal atrophy when assessed by optical coherence tomography (OCT). We performed a cross-sectional analysis of 119 consecutive patients with MS, assessing vision using high contrast visual acuity (LogMar), 2.5% and 1.25% low contrast visual acuity (Sloan charts), and color vision (Hardy-Rand-Rittler plates). Quality of vision is a patient reported outcome based on an individual's unique perception of his or her vision and was assessed with the Visual Functioning Questionnaire-25 (VFQ-25) with the 10 neuro-ophthalmologic items. MS disability was assessed using the expanded disability status scale (EDSS), the MS functional composite (MSFC) and the brief repetitive battery-neuropsychology (BRB-N). Retinal atrophy was assessed using spectral domain OCT, measuring the thickness of the peripapillar retinal nerve fiber layer (pRNFL) and the volume of the ganglion cell plus inner plexiform layer (GCIPL). The vision of patients with MS was impaired, particularly in eyes with prior optic neuritis. Retinal atrophy (pRNFL and GCIPL) was closely associated with impaired low contrast vision and color vision, whereas the volume of the GCIPL showed a trend (p = 0.092) to be associated with quality of vision. Multiple regression analysis revealed that EDSS was an explanatory variable for high contrast vision after stepwise analysis, GCIPL volume for low contrast vision, and GCIPL volume and EDSS for color vision. The explanatory variables for quality of vision were high contrast vision and color vision. In summary, quality of vision in MS depends on the impairment of high contrast visual acuity and color vision due to the disease.

Definition of chronic kidney disease and measurement of kidney function in original research papers: a review of the literature.

PubMed

Anderson, Jocelyn; Glynn, Liam G

2011-09-01

Over the past decade, chronic kidney disease (CKD) has become an area of intensive clinical and epidemiological research. Despite the clarity provided by the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines, there appears to be within the CKD research literature significant disagreement on how to define CKD and measure kidney function. The objectives of this study were to investigate the variety of methods used to define CKD and to measure kidney function in original research papers as well as to investigate whether the quality of the journal had any effect on the quality of the methodology used. This was a descriptive review and not a meta-analysis. Information was extracted from each article including publication details (including the journal's impact factor), definition of CKD, method used to estimate kidney function and quantity of serum creatinine readings used to define CKD. An electronic search of MEDLINE through OVID was completed using the search term CKD. The search was limited to articles in English published in 2009. Studies were included in the review only if they were original research articles including patients with CKD. Articles were excluded if they reported data from a paediatric population, a population solely on dialysis or if there was no full-text access through OVID. Each article was assessed for quality with respect to using KDOQI CKD definition criteria. A description of the pooled data was completed and chi-square tests were used to investigate the relation between article quality and journal quality. Analysis was carried out using SPSS (15.0) and a P-value of <0.05 was considered to indicate statistical significance. The final review included 301 articles. There were a variety of methods used to define CKD in original research articles. Less than 20% (n = 59) of the articles adhered to the established international criteria for defining CKD. The majority of articles (52.1%) did not indicate the quantity of serum creatinine measurements used to define CKD. The impact factor or specialist nature of the scientific journal appears to have no bearing on whether or not published articles use the gold standard KDOQI guidelines for labelling a patient with a diagnosis of CKD. This review of literature found that a variety of definitions are being used in original research articles to define CKD and measure kidney function which calls into question the validity and reliability of such research findings and associated clinical guidelines. International consensus is urgently required to improve validity and generalizability of CKD research findings.

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector--Results from a Nationally Representative Outlet Survey.

PubMed

Act Consortium Drug Quality Project Team And The Impact Study Team

2015-06-01

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85-115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. © The American Society of Tropical Medicine and Hygiene.

Severity of Lipodystrophy Is Associated with Decreased Health-Related Quality of Life

PubMed Central

Murri, Rita; Orlando, Gabriella; Giovanardi, Chiara; Squillace, Nicola; Vandelli, Marcella; Beghetto, Barbara; Nardini, Giulia; De Paola, Maria; Esposito, Roberto; Wu, Albert W.

2008-01-01

Abstract The impact of lipodystrophy (LD) on quality of life is high, but it has not been demonstrated in literature. The objective of the study was to assess the impact of LD on the health–related quality of life (HRQOL) in HIV-infected people on highly active antiretroviral therapy (HAART). Patients with LD phenotype defined by the Multicenter AIDS Cohort Study (MACS) were included. Three different methods were used to define LD severity: both patient and physician evaluation using the HIV Outpatient Study (HOPS) severity scales and the Lipodystrophy Case Definition (LDCD). The HRQOL was evaluated by MOS-HIV Health Survey. Four hundred one patients on HAART for a mean of 108 ± 52 months were evaluated for LD at the Metabolic Clinic of Modena and Reggio Emilia University were enrolled from January 2003 to July 2006. According to self-perceived or physician-based HOPS, 106 (26.5%) and 122 (30.4%) patients had severe LD. Females had significantly more severe LD. Few HRQOL scores correlated to LD severity using the physician-based score (both HOPSph and LDCD), while all the HRQOL scores correlated with LD severity when a patient-based score was used (HOPSpt). In multiple linear regression analysis, Mental Health HRQOL score, gender, body mass index, age, body image satisfaction were independent predictors of patient-based (HOPSpt) LD, while none of the HRQOL scores, but female gender, age, waist-to-hip ratio, limb fat, and body image satisfaction were correlated with physician-estimated HOPSph LD severity. HRQOL was strongly correlated with LD severity when a patient-based score was used. For an overall assessment of the impact of LD on HIV-infected people, both patient-based and physician-based measures are required. PMID:18647097

Functional Status, Quality of Life, and Costs Associated With Fibromyalgia Subgroups: A Latent Profile Analysis.

PubMed

Luciano, Juan V; Forero, Carlos G; Cerdà-Lafont, Marta; Peñarrubia-María, María Teresa; Fernández-Vergel, Rita; Cuesta-Vargas, Antonio I; Ruíz, José M; Rozadilla-Sacanell, Antoni; Sirvent-Alierta, Elena; Santo-Panero, Pilar; García-Campayo, Javier; Serrano-Blanco, Antoni; Pérez-Aranda, Adrián; Rubio-Valera, María

2016-10-01

Although fibromyalgia syndrome (FM) is considered a heterogeneous condition, there is no generally accepted subgroup typology. We used hierarchical cluster analysis and latent profile analysis to replicate Giesecke's classification in Spanish FM patients. The second aim was to examine whether the subgroups differed in sociodemographic characteristics, functional status, quality of life, and in direct and indirect costs. A total of 160 FM patients completed the following measures for cluster derivation: the Center for Epidemiological Studies-Depression Scale, the Trait Anxiety Inventory, the Pain Catastrophizing Scale, and the Control over Pain subscale. Pain threshold was measured with a sphygmomanometer. In addition, the Fibromyalgia Impact Questionnaire-Revised, the EuroQoL-5D-3L, and the Client Service Receipt Inventory were administered for cluster validation. Two distinct clusters were identified using hierarchical cluster analysis ("hypersensitive" group, 69.8% and "functional" group, 30.2%). In contrast, the latent profile analysis goodness-of-fit indices supported the existence of 3 FM patient profiles: (1) a "functional" profile (28.1%) defined as moderate tenderness, distress, and pain catastrophizing; (2) a "dysfunctional" profile (45.6%) defined by elevated tenderness, distress, and pain catastrophizing; and (3) a "highly dysfunctional and distressed" profile (26.3%) characterized by elevated tenderness and extremely high distress and catastrophizing. We did not find significant differences in sociodemographic characteristics between the 2 clusters or among the 3 profiles. The functional profile was associated with less impairment, greater quality of life, and lower health care costs. We identified 3 distinct profiles which accounted for the heterogeneity of FM patients. Our findings might help to design tailored interventions for FM patients.

[Comparison of 4 methods of evaluating protein quality in vegetable sources].

PubMed

Muñoz de Maquiña, A; Gross, R; Schoeneberger, H; Villacorta, L

1983-12-01

This study compares the practical value of the following methods: protein efficiency ratio (PER), blood urea concentration in rats (BUC), relative nutritive value (RNV), and predicted protein value (PPV) to evaluate the protein quality of 41 diets of plant origin. Results demonstrated low correlations between PER and RNV (r = 0.66), PER and PPV (r = 0.53), RNV and PPV (r = 0.54), whereas there was a high negative correlation between PER and BUC (r = -0.89). These different procedures can be useful and valid for distinct and well-defined objectives, but the evaluation of results must be made in accordance with the purpose of the experiment. In assessing the protein quality of foodstuffs, it is therefore recommended that mathematical computer models be developed which take into account the cybernetic system of the amino acid metabolism. This would definitely reduce the actual need of expensive long-term biological assays.

Benchmarking study of corporate research management and planning practices

NASA Astrophysics Data System (ADS)

McIrvine, Edward C.

1992-05-01

During 1983-84, Xerox Corporation was undergoing a change in corporate style through a process of training and altered behavior known as Leadership Through Quality. One tenet of Leadership Through Quality was benchmarking, a procedure whereby all units of the corporation were asked to compare their operation with the outside world. As a part of the first wave of benchmark studies, Xerox Corporate Research Group studied the processes of research management, technology transfer, and research planning in twelve American and Japanese companies. The approach taken was to separate `research yield' and `research productivity' (as defined by Richard Foster) and to seek information about how these companies sought to achieve high- quality results in these two parameters. The most significant findings include the influence of company culture, two different possible research missions (an innovation resource and an information resource), and the importance of systematic personal interaction between sources and targets of technology transfer.

Perceived assessment metrics for visible and infrared color fused image quality without reference image

NASA Astrophysics Data System (ADS)

Yu, Xuelian; Chen, Qian; Gu, Guohua; Ren, Jianle; Sui, Xiubao

2015-02-01

Designing objective quality assessment of color-fused image is a very demanding and challenging task. We propose four no-reference metrics based on human visual system characteristics for objectively evaluating the quality of false color fusion image. The perceived edge metric (PEM) is defined based on visual perception model and color image gradient similarity between the fused image and the source images. The perceptual contrast metric (PCM) is established associating multi-scale contrast and varying contrast sensitivity filter (CSF) with color components. The linear combination of the standard deviation and mean value over the fused image construct the image colorfulness metric (ICM). The color comfort metric (CCM) is designed by the average saturation and the ratio of pixels with high and low saturation. The qualitative and quantitative experimental results demonstrate that the proposed metrics have a good agreement with subjective perception.

Investigation of the effects of bandwidth and time delay on helicopter roll-axis handling qualities

NASA Technical Reports Server (NTRS)

Pausder, Heinz-Juergen; Blanken, Chris L.

1992-01-01

Several years of cooperative research conducted under the U.S./German Memorandum of Understanding (MOU) in helicopter flight control has recently resulted in a successful handling qualities study. The focus of this cooperative research has been the effects on handling qualities due to time delays in combination with a high bandwidth vehicle. The jointly performed study included the use of U.S. ground-based simulation and German in-flight simulation facilities. The NASA-Ames Vertical Motion Simulator (VMS) was used to develop a high bandwidth slalom tracking task which took into consideration the constraints of the facilities. The VMS was also used to define a range of the test parameters and to perform initial handling qualities evaluations. The flight tests were conducted using DLR's variable-stability BO 105 S3 Advanced Technology Testing Helicopter System (ATTHeS). Configurations included a rate command and an attitude command response system with added time delays up to 160 milliseconds over the baseline and bandwidth values between 1.5 and 4.5 rad/sec. Sixty-six evaluations were performed in about 25 hr of flight time during 10 days of testing. The results indicate a need to more tightly constrain the allowable roll axis phase delay for the Level 1 and Level 2 requirements in the U.S. Army's specification for helicopter handling qualities, ADS-33C.

Investigation of the effects of bandwidth and time delay on helicopter roll-axis handling qualities

NASA Technical Reports Server (NTRS)

Blanken, Chris L.; Pausder, Heinz-Jurgen

1994-01-01

Several years of cooperative research conducted under the U.S./German Memorandum of Understanding (MOU) in helicopter aeromechanics have recently resulted in a successful handling qualities study. The focus of this cooperative research has been the effect of time delays in a high bandwidth vehicle on handling qualities. The jointly performed study included the use of U.S. ground-based simulation and German in-flight simulation facilities. The NASA-Ames Vertical Motion Simulator (VMS) was used to develop a high bandwidth slalom tracking task which took into consideration the constraints of the facilities. The VMS was used to define a range of the test parameters and to perform initial handling qualities evaluations. The flight tests were conducted using DLR's variable-stability BO 105 S3 Advanced Technology Testing Helicopter System (ATTHeS). Configurations included a rate command and an attitude command response system with added time delays of up to 160 milliseconds over the baseline and band width values between 1.5 and 4.5 rad/sec. Sixty-six evaluations were performed in about 25 hours of flight time during ten days of testing. The results indicate a need to more tightly constrain the allowable roll axis phase delay for the Level 1 and Level 2 requirements in the U.S. Army's specification for helicopter handling qualities Aeronautical Design Standard (ADS)-33C.

Investigation of the effects of bandwidth and time delay on helicopter roll-axis handling qualities

NASA Technical Reports Server (NTRS)

Pausder, Heinz-Juergen; Blanken, Chris L.

1993-01-01

Several years of cooperative research conducted under the U.S./German Memorandum of Understanding (MOU) in helicopter flight control has recently resulted in a successful handling qualities study. The focus of this cooperative research has been the effects on handling qualities due to time delays in combination with a high bandwidth vehicle. The jointly performed study included the use of U.S. ground-based simulation and German in-flight simulation facilities. The NASA-Ames Vertical Motion Simulator (VMS) was used to develop a high bandwidth slalom tracking task which took into consideration the constraints of the facilities. The VMS was also used to define a range of the test parameters and to perform initial handling qualities evaluations. The flight tests were conducted using DLR's variable-stability BO 105 S3 Advanced Technology Testing Helicopter System (ATTHeS). Configurations included a rate command and an attitude command response system with added time delays up to 160 milliseconds over the baseline and bandwidth values between 1.5 and 4.5 rad/sec. Sixty-six evaluations were performed in about 25 hours of flight time during ten days of testing. The results indicate a need to more tightly constrain the allowable roll axis phase delay for the Level 1 and Level 2 requirements in the U.S. Army's specification for helicopter handling qualities, ADS-33C.

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

A network-based method to evaluate quality of reproducibility of differential expression in cancer genomics studies

PubMed Central

Geng, Haijiang; Li, Zhihui; Li, Jiabing; Lu, Tao; Yan, Fangrong

2015-01-01

BACKGROUND Personalized cancer treatments depend on the determination of a patient's genetic status according to known genetic profiles for which targeted treatments exist. Such genetic profiles must be scientifically validated before they is applied to general patient population. Reproducibility of findings that support such genetic profiles is a fundamental challenge in validation studies. The percentage of overlapping genes (POG) criterion and derivative methods produce unstable and misleading results. Furthermore, in a complex disease, comparisons between different tumor subtypes can produce high POG scores that do not capture the consistencies in the functions. RESULTS We focused on the quality rather than the quantity of the overlapping genes. We defined the rank value of each gene according to importance or quality by PageRank on basis of a particular topological structure. Then, we used the p-value of the rank-sum of the overlapping genes (PRSOG) to evaluate the quality of reproducibility. Though the POG scores were low in different studies of the same disease, the PRSOG was statistically significant, which suggests that sets of differentially expressed genes might be highly reproducible. CONCLUSIONS Evaluations of eight datasets from breast cancer, lung cancer and four other disorders indicate that quality-based PRSOG method performs better than a quantity-based method. Our analysis of the components of the sets of overlapping genes supports the utility of the PRSOG method. PMID:26556852

Potential and Limitations of Cochrane Reviews in Pediatric Cardiology: A Systematic Analysis.

PubMed

Poryo, Martin; Khosrawikatoli, Sara; Abdul-Khaliq, Hashim; Meyer, Sascha

2017-04-01

Evidence-based medicine has contributed substantially to the quality of medical care in pediatric and adult cardiology. However, our impression from the bedside is that a substantial number of Cochrane reviews generate inconclusive data that are of limited clinical benefit. We performed a systematic synopsis of Cochrane reviews published between 2001 and 2015 in the field of pediatric cardiology. Main outcome parameters were the number and percentage of conclusive, partly conclusive, and inconclusive reviews as well as their recommendations and their development over three a priori defined intervals. In total, 69 reviews were analyzed. Most of them examined preterm and term neonates (36.2%), whereas 33.3% included also non-pediatric patients. Leading topics were pharmacological issues (71.0%) followed by interventional (10.1%) and operative procedures (2.9%). The majority of reviews were inconclusive (42.9%), while 36.2% were conclusive and 21.7% partly conclusive. Although the number of published reviews increased during the three a priori defined time intervals, reviews with "no specific recommendations" remained stable while "recommendations in favor of an intervention" clearly increased. Main reasons for missing recommendations were insufficient data (n = 41) as well as an insufficient number of trials (n = 22) or poor study quality (n = 19). There is still need for high-quality research, which will likely yield a greater number of Cochrane reviews with conclusive results.

Assuring fish safety and quality in international fish trade.

PubMed

Ababouch, Lahsen

2006-01-01

International trade in fishery commodities reached US 58.2 billion dollars in 2002, a 5% improvement relative to 2000 and a 45% increase over 1992 levels. Within this global trade, developing countries registered a net trade surplus of US 17.4 billion dollars in 2002 and accounted for almost 50% by value and 55% of fish exports by volume. This globalization of fish trade, coupled with technological developments in food production, handling, processing and distribution, and the increasing awareness and demand of consumers for safe and high quality food have put food safety and quality assurance high in public awareness and a priority for many governments. Consequently, many countries have tightened food safety controls, imposing additional costs and requirements on imports. As early as 1980, there was an international drive towards adopting preventative HACCP-based safety and quality systems. More recently, there has been a growing awareness of the importance of an integrated, multidisciplinary approach to food safety and quality throughout the entire food chain. Implementation of this approach requires an enabling policy and regulatory environment at national and international levels with clearly defined rules and standards, establishment of appropriate food control systems and programmes at national and local levels, and provision of appropriate training and capacity building. This paper discusses the international framework for fish safety and quality, with particular emphasis on the United Nation's Food and Agricultural Organization's (FAO) strategy to promote international harmonization and capacity building.

Delivering High Value Inflammatory Bowel Disease Care Through Telemedicine Visits.

PubMed

Li, Shawn X; Thompson, Kimberly D; Peterson, Tracey; Huneven, Shelley; Carmichael, Jamie; Glazer, Fredric J; Darling, Katelyn; Siegel, Corey A

2017-10-01

Patients with inflammatory bowel disease (IBD) require regular follow-up to manage their care, which requires significant amount of time and out-of-pocket costs. Telemedicine in the form of video virtual visits could serve as an alternative to in-office visits. The aim of this project was to understand if telemedicine can provide high value care (defined as quality/cost) to outpatients with IBD. Patients who participated in the IBD telemedicine clinic in the second half of 2015 were included. Patient-reported survey data before and after the virtual visit were collected. A retrospective review was performed on the study cohort for quality outcome measures a year before and after starting the telemedicine clinic. Outcomes were analyzed using simple descriptive statistics. Differences in quality outcomes were compared using odds ratios. Forty-eight patients were included in the analysis. Most patients travel more than 25 miles each way, take half a day off, and on average incur an additional out-of-pocket cost of $62 for an in-office visit. Most patients (98%) agreed that there was enough time spent with their physician, 91% agreed that they felt like the physician understood their disease state, and 78% reported that they clearly understood the follow-up plan after the visit. Analysis of quality outcome measures did not show any drop in the overall quality of care, after initiating the telemedicine program. Telemedicine offers a low cost and convenient alternative for patients with IBD without compromising quality of care.

Development and Validation of the Scan of Postgraduate Educational Environment Domains (SPEED): A Brief Instrument to Assess the Educational Environment in Postgraduate Medical Education

PubMed Central

Schönrock-Adema, Johanna; Visscher, Maartje; Raat, A. N. Janet; Brand, Paul L. P.

2015-01-01

Introduction Current instruments to evaluate the postgraduate medical educational environment lack theoretical frameworks and are relatively long, which may reduce response rates. We aimed to develop and validate a brief instrument that, based on a solid theoretical framework for educational environments, solicits resident feedback to screen the postgraduate medical educational environment quality. Methods Stepwise, we developed a screening instrument, using existing instruments to assess educational environment quality and adopting a theoretical framework that defines three educational environment domains: content, atmosphere and organization. First, items from relevant existing instruments were collected and, after deleting duplicates and items not specifically addressing educational environment, grouped into the three domains. In a Delphi procedure, the item list was reduced to a set of items considered most important and comprehensively covering the three domains. These items were triangulated against the results of semi-structured interviews with 26 residents from three teaching hospitals to achieve face validity. This draft version of the Scan of Postgraduate Educational Environment Domains (SPEED) was administered to residents in a general and university hospital and further reduced and validated based on the data collected. Results Two hundred twenty-three residents completed the 43-item draft SPEED. We used half of the dataset for item reduction, and the other half for validating the resulting SPEED (15 items, 5 per domain). Internal consistencies were high. Correlations between domain scores in the draft and brief versions of SPEED were high (>0.85) and highly significant (p<0.001). Domain score variance of the draft instrument was explained for ≥80% by the items representing the domains in the final SPEED. Conclusions The SPEED comprehensively covers the three educational environment domains defined in the theoretical framework. Because of its validity and brevity, the SPEED is promising as useful and easily applicable tool to regularly screen educational environment quality in postgraduate medical education. PMID:26413836

Status of groundwater quality in the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit, 2008-2010: California GAMA Priority Basin Project

USGS Publications Warehouse

Parsons, Mary C.; Hancock, Tracy Connell; Kulongoski, Justin T.; Belitz, Kenneth

2014-01-01

Groundwater quality in the approximately 963-square-mile Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit was investigated as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in southern California in San Bernardino, Riverside, San Diego, and Imperial Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey and the Lawrence Livermore National Laboratory. The GAMA Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study was designed to provide a spatially unbiased assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality and ancillary data collected by the U.S. Geological Survey from 52 wells (49 grid wells and 3 understanding wells) and on water-quality data from the California Department of Public Health database. The primary aquifer system was defined by the depth intervals of the wells listed in the California Department of Public Health database for the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study assesses the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds (VOCs), pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifer system of the Borrego Valley, Central Desert, and Low-Use Basins of the Mojave and Sonoran Deserts study unit, not the treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to 1.0 indicates a concentration equal to or less than a benchmark. Relative-concentrations of organic constituents and special-interest constituents [perchlorate and N-nitrosodimethylamine (NDMA)] were classified as high (relative-concentration greater than 1.0), moderate (relative-concentration greater than 0.1 and less than or equal to 1.0), or low (relative-concentration less than or equal to 0.1). Relative-concentrations of inorganic constituents were classified as high (relative-concentration greater than 1.0), moderate (relative-concentration greater than 0.5 and less than or equal to 1.0), or low (relative-concentration less than or equal to 0.5). Aquifer-scale proportion was used as the primary metric in the status assessment for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a high relative-concentration for a particular constituent or class of constituents; this percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system with moderate and low relative-concentrations, respectively, of a constituent or class of constituents. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. Grid-based and spatially weighted estimates were comparable to each other (within 90-percent confidence intervals) in the study unit. Inorganic constituents (one or more) with health-based benchmarks were detected at high relative-concentrations in 48 percent of the primary aquifer system and at moderate relative-concentrations in 26 percent of the primary aquifer system. The high aquifer-scale proportion of inorganic constituents primarily reflected high aquifer-scale proportions of fluoride (27 percent), arsenic (18 percent), molybdenum (16 percent), boron (10 percent), uranium (5.6 percent), gross alpha radioactivity (9.7 percent), and nitrate (2.7 percent). The inorganic constituents with secondary maximum contaminant levels (SMCLs) were detected at high relative-concentrations in 13 percent of the primary aquifer system and at moderate relative-concentrations in 39 percent. The high aquifer-scale proportion for SMCL constituents reflected high aquifer-scale proportions of total dissolved solids (TDS, 11 percent), manganese (2.8 percent), and chloride (2.8 percent). Organic constituents were not detected at high relative-concentrations in the primary aquifer system, and were present at moderate relative-concentrations in 5.0 percent, and at low relative-concentrations or were not detected in 95 percent of the primary aquifer system. Of the 148 organic constituents analyzed, 12 constituents were detected. Two organic constituents, chloroform and tetrachloroethene (PCE), were detected in more than 10 percent of samples, but were detected mostly at low relative-concentrations.

Quality in Early Education Classrooms: Definitions, Gaps, and Systems

ERIC Educational Resources Information Center

Pianta, Robert; Downer, Jason; Hamre, Bridget

2016-01-01

Parents, professionals, and policymakers agree that quality is crucial for early education. But precise, consistent, and valid definitions of quality have been elusive. In this article, Robert Pianta, Jason Downer, and Bridget Hamre tackle the questions of how to define quality, how to measure it, and how to ensure that more children experience…

Defining Quality in Undergraduate Education: Directions for Future Research Informed by a Literature Review

ERIC Educational Resources Information Center

Bowers, Alison W.; Ranganathan, Shyam; Simmons, Denise R.

2018-01-01

Objectives: This research brief explores the literature addressing quality in undergraduate education to identify what previous research has said about quality and to offer future directions for research on quality in undergraduate education. Method: We conducted a scoping review to provide a broad overview of existing research. Using targeted…

The pattern space factor and quality factor of cylindrical source antennas

NASA Astrophysics Data System (ADS)

Jarem, John M.

1982-09-01

For the first time the quality factor of cylindrical source antennas is derived by a plane wave expansion. The evanescent energy (and therefore the quality factor) as defined by a plane wave expansion is shown to be different from Collin and Rothschild's [IEEE Trans. Antennas Propagation AP-12, 23 (1964)] quality factor.

Evaluating benefits and costs of changes in water quality.

Treesearch

Jessica Koteen; Susan J. Alexander; John B. Loomis

2002-01-01

Water quality affects a variety of uses, such as municipal water consumption and recreation. Changes in water quality can influence the benefits water users receive. The problem is how to define water quality for specific uses. It is not possible to come up with one formal definition of water quality that fits all water uses. There are many parameters that influence...

Quality Rating and Improvement Systems: A Strategic Movement for Defining Quality

ERIC Educational Resources Information Center

Neugebauer, Roger

2009-01-01

One of the most important trends in the early childhood field is the emergence of quality rating systems (QRS), or quality rating and improvement systems (QRIS), which are designed to assess, improve, and communicate the level of quality of early and school-age care programs. QRS came onto the scene in 1998 when Oklahoma enacted its "Reaching…

Model for selecting quality standards for a salad bar through identifying elements of customer satisfaction.

PubMed

Ouellet, D; Norback, J P

1993-11-01

Continuous quality improvement is the new requirement of the Joint Commission on Accreditation of Healthcare Organizations. This means that meeting quality standards will not be enough. Dietitians will need to improve those standards and the way they are selected. Because quality is defined in terms of the customers, all quality improvement projects must start by defining what customers want. Using a salad bar as an example, this article presents and illustrates a technique developed in Japan to identify which elements in a product or service will satisfy or dissatisfy consumers. Using a model and a questionnaire format developed by Kano and coworkers, 273 students were surveyed to classify six quality elements of a salad bar. Four elements showed a dominant "must-be" characteristic: food freshness, labeling of the dressings, no spills in the food, and no spills on the salad bar. The two other elements (food easy to reach and food variety) showed a dominant one-dimensional characteristic. By better understanding consumer perceptions of quality elements, foodservice managers can select quality standards that focus on what really matters to their consumers.

Quality Requirements for Electronic Health Record Systems*. A Japanese-German Information Management Perspective.

PubMed

Winter, Alfred; Takabayashi, Katsuhiko; Jahn, Franziska; Kimura, Eizen; Engelbrecht, Rolf; Haux, Reinhold; Honda, Masayuki; Hübner, Ursula H; Inoue, Sozo; Kohl, Christian D; Matsumoto, Takehiro; Matsumura, Yasushi; Miyo, Kengo; Nakashima, Naoki; Prokosch, Hans-Ulrich; Staemmler, Martin

2017-08-07

For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities. To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS. Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions. The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management). Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.

Data Quality in Rare Diseases Registries.

PubMed

Kodra, Yllka; Posada de la Paz, Manuel; Coi, Alessio; Santoro, Michele; Bianchi, Fabrizio; Ahmed, Faisal; Rubinstein, Yaffa R; Weinbach, Jérôme; Taruscio, Domenica

2017-01-01

In the field of rare diseases, registries are considered power tool to develop clinical research, to facilitate the planning of appropriate clinical trials, to improve patient care and healthcare planning. Therefore high quality data of rare diseases registries is considered to be one of the most important element in the establishment and maintenance of a registry. Data quality can be defined as the totality of features and characteristics of data set that bear on its ability to satisfy the needs that result from the intended use of the data. In the context of registries, the 'product' is data, and quality refers to data quality, meaning that the data coming into the registry have been validated, and ready for use for analysis and research. Determining the quality of data is possible through data assessment against a number of dimensions: completeness, validity; coherence and comparability; accessibility; usefulness; timeliness; prevention of duplicate records. Many others factors may influence the quality of a registry: development of standardized Case Report Form and security/safety controls of informatics infrastructure. With the growing number of rare diseases registries being established, there is a need to develop a quality validation process to evaluate the quality of each registry. A clear description of the registry is the first step when assessing data quality or the registry evaluation system. Here we report a template as a guide for helping registry owners to describe their registry.

Objective assessment of obesogenic environments in youth: geographic information system methods and spatial findings from the Neighborhood Impact on Kids study.

PubMed

Frank, Lawrence D; Saelens, Brian E; Chapman, James; Sallis, James F; Kerr, Jacqueline; Glanz, Karen; Couch, Sarah C; Learnihan, Vincent; Zhou, Chuan; Colburn, Trina; Cain, Kelli L

2012-05-01

GIS-based walkability measures designed to explain active travel fail to capture "playability" and proximity to healthy food. These constructs should be considered when measuring potential child obesogenic environments. The aim of this study was to describe the development of GIS-based multicomponent physical activity and nutrition environment indicators of child obesogenic environments in the San Diego and Seattle regions. Block group-level walkability (street connectivity, residential density, land-use mix, and retail floor area ratio) measures were constructed in each region. Multiple sources were used to enumerate parks (∼900-1600 per region) and food establishments (∼10,000 per region). Physical activity environments were evaluated on the basis of walkability and presence and quality of parks. Nutrition environments were evaluated based on presence and density of fast-food restaurants and distance to supermarkets. Four neighborhood types were defined using high/low cut points for physical activity and nutrition environments defined through an iterative process dependent on regional counts of fast-food outlets and overall distance to parks and grocery stores from census block groups where youth live. To identify sufficient numbers of children aged 6-11 years, high physical activity environment block groups had at least one high-quality park within 0.25 miles and were above median walkability, whereas low physical activity environment groups had no parks and were below median walkability. High nutrition environment block groups had a supermarket within 0.5 miles, and fewer than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Low nutrition environments had either no supermarket, or a supermarket and more than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Income, educational attainment, and ethnicity varied across physical activity and nutrition environments. These approaches to defining neighborhood environments can be used to study physical activity, nutrition, and obesity outcomes. Findings presented in a companion paper validate these GIS methods for measuring obesogenic environments. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.

Assessment of maternal health care quality: conceptual and methodologic issues.

PubMed

Lane, D S; Kelman, H R

1975-10-01

Past efforts in assessment of the quality of maternity care have been analyzed in order to develop an evaluation framework that will have utility and applicability beyond a specific program, population, or health discipline. Presently available evaluation approaches have focused attention on either "high risk" populations or upon women experiencing a complicated pregnancy or delivery. Quality has been defined as the extent to which normative or empirically derived standards of obstetrical care have been applied. An alternative approach is suggested which conceives of the pregnancy as a normal physiological event but with the potentiality of either causing or exacerbating social or health problems. Maternity care quality is viewed as the application of those necessary health and health-related services that are required to safeguard the health of the mother and offspring, minimize the noxious consequences of pre-existing or concurrent health hazards or conditions, and upgrade the health and social functioning of those women who require it. Additionally, the system of services should be functionally organized to optimize care. Indicators of quality are suggested which incorporate structural, process, and outcome variables, and which link medical and consumer criteria in a comprehensive community level approach to quality assessment.

Certification of production-quality gLite Job Management components

NASA Astrophysics Data System (ADS)

Andreetto, P.; Bertocco, S.; Capannini, F.; Cecchi, M.; Dorigo, A.; Frizziero, E.; Giacomini, F.; Gianelle, A.; Mezzadri, M.; Molinari, E.; Monforte, S.; Prelz, F.; Rebatto, D.; Sgaravatto, M.; Zangrando, L.

2011-12-01

With the advent of the recent European Union (EU) funded projects aimed at achieving an open, coordinated and proactive collaboration among the European communities that provide distributed computing services, more strict requirements and quality standards will be asked to middleware providers. Such a highly competitive and dynamic environment, organized to comply a business-oriented model, has already started pursuing quality criteria, thus requiring to formally define rigorous procedures, interfaces and roles for each step of the software life-cycle. This will ensure quality-certified releases and updates of the Grid middleware. In the European Middleware Initiative (EMI), the release management for one or more components will be organized into Product Team (PT) units, fully responsible for delivering production ready, quality-certified software and for coordinating each other to contribute to the EMI release as a whole. This paper presents the certification process, with respect to integration, installation, configuration and testing, adopted at INFN by the Product Team responsible for the gLite Web-Service based Computing Element (CREAM CE) and for the Workload Management System (WMS). The used resources, the testbeds layout, the integration and deployment methods, the certification steps to provide feedback to developers and to grant quality results are described.

The influence of organic production on food quality - research findings, gaps and future challenges.

PubMed

Załęcka, Aneta; Bügel, Susanne; Paoletti, Flavio; Kahl, Johannes; Bonanno, Adriana; Dostalova, Anne; Rahmann, Gerold

2014-10-01

Although several meta-analysis studies have been published comparing the quality of food derived from organic and non-organic origin, it is still not clear if food from organic production per se can guarantee product-related added value to consumers. This paper aims to summarize the status quo in order to identify research gaps and suggest future research challenges. Organic food is described according to a quality model already published. The influence of organic production on food quality is structured in primary production and processing. Furthermore, organic food authentication is discussed. Organic food seems to contain fewer pesticide residues and statistically more selected health-related compounds such as polyphenols in plant products and polyunsaturated fatty acids in milk and meat products, but the health relevance for consumers is not clear yet. Comparing food from organic origin with so called 'conventional' food seems not to be appropriate, because 'conventional' is not defined. In organic food quality research a system approach is needed from which systemic markers can be selected. Research on the impact of processing technologies on the quality according to organic principles seems of high relevance, since most of the food is processed. © 2014 Society of Chemical Industry.

Biometric parameters of the bream (Abramis brama) as indicators for long-term changes in fish health and environmental quality--data from the German ESB.

PubMed

Teubner, Diana; Paulus, Martin; Veith, Michael; Klein, Roland

2015-02-01

Piscifaunal health depends upon the state and quality of the aquatic environment. Variations in physical condition of fish may therefore be attributed to changes in environmental quality. Based on time series of up to 20 years of biometric data of bream from multiple sampling sites of the German environmental specimen bank (ESB), this study assessed whether changes in biometric parameters are able to indicate long-term alterations in fish health and environmental quality. Evaluated biometric parameters of fish health comprised length and weight of individuals of a defined age class, the condition factor, lipid content and hepatosomatic index (HSI). Although there are negative trends of the HSI, the overall development of health parameters can be interpreted as positive. This seems to suggest that health parameters conclusively mirror the long-term improvement of water quality in the selected rivers. However, the applicability of the condition factor as well as lipid content as indicators for fish health remained subject to restrictions. Altogether, the results from the ESB confirmed the high value of biometric parameters for monitoring of long-term changes in state and quality of aquatic ecosystems.

Quality Assurance in a School of Dentistry: Getting Started.

ERIC Educational Resources Information Center

Guba, Christianne J.

1990-01-01

Steps in establishment of Indiana University School of Dentistry's quality assurance program included gathering existing information on quality assurance; ascertaining administrative support; appointing a committee; defining terms and setting goals; raising awareness and commitment; designing a patient satisfaction survey; undertaking a chart…

40 CFR 58.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... QUALITY SURVEILLANCE General Provisions § 58.1 Definitions. As used in this part, all terms not defined... his or her authorized representative. Air Quality System (AQS) means EPA's computerized system for storing and reporting of information relating to ambient air quality data. Approved regional method (ARM...

Meteorological Processes Affecting Air Quality – Research and Model Development Needs

EPA Science Inventory

Meteorology modeling is an important component of air quality modeling systems that defines the physical and dynamical environment for atmospheric chemistry. The meteorology models used for air quality applications are based on numerical weather prediction models that were devel...

Quality Educational Programming.

ERIC Educational Resources Information Center

Corson, Harvey Jay; And Others

1987-01-01

The section meeting of the 1987 Forum on Deafness included the following presentations: "Early Identification and the Hearing Impaired Child's Right to Become" (Judith Marlowe); "Quality Education for All Deaf Children: An Achievable Goal" (Jack Brownley); "Defining Quality at the Postsecondary Level" (Edgar Lowell); "Charting the Transition from…

Requirements for satisfactory flying qualities of airplanes

NASA Technical Reports Server (NTRS)

Gilruth, R R

1943-01-01

Report discusses the results of an analysis of available data to determine what measured characteristics are significant in defining satisfactory flying qualities, what characteristics are reasonable to require of an airplane, and what influence the various design features have on the observed flying qualities.

[Assessment of financial performance improves the quality of healthcare provided by medical organizations].

PubMed

Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev

2009-01-01

Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality.

Viticulture microzoning: a functional approach aiming to grape and wine qualities

NASA Astrophysics Data System (ADS)

Bonfante, A.; Agrillo, A.; Albrizio, R.; Basile, A.; Buonomo, R.; De Mascellis, R.; Gambuti, A.; Giorio, P.; Guida, G.; Langella, G.; Manna, P.; Minieri, L.; Moio, L.; Siani, T.; Terribile, F.

2014-12-01

This paper aims to test a new physically oriented approach to viticulture zoning at the farm scale, strongly rooted on hydropedology and aiming to achieve a better use of environmental features with respect to plant requirement and wine production. The physics of our approach is defined by the use of soil-plant-atmosphere simulation models which applies physically-based equations to describe the soil hydrological processes and solves soil-plant water status. This study (ZOVISA project) was conducted in a farm devoted to high quality wines production (Aglianico DOC), located in South Italy (Campania region, Mirabella Eclano-AV). The soil spatial distribution was obtained after standard soil survey informed by geophysical survey. Two Homogenous Zones (HZs) were identified; in each one of those a physically based model was applied to solve the soil water balance and estimate the soil functional behaviour (crop water stress index, CWSI) defining the functional Homogeneous Zones (fHzs). In these last, experimental plots were established and monitored for investigating soil-plant water status, crop development (biometric and physiological parameters) and daily climate variables (temperature, solar radiation, rainfall, wind). The effects of crop water status on crop response over must and wine quality were then evaluated in the fHZs. This was performed by comparing crop water stress with (i) crop physiological measurement (leaf gas exchange, chlorophyll a fluorescence, leaf water potential, chlorophyll content, LAI measurement), (ii) grape bunches measurements (berry weight, sugar content, titratable acidity, etc.) and (iii) wine quality (aromatic response). Eventually this experiment has proved the usefulness of the physical based approach also in the case of mapping viticulture microzoning.

[Quality prescription indicators in defined daily doses. Are we getting it right?].

PubMed

Caamaño-Isorna, Francisco; Alvarez-Gil, Rosa

2008-01-01

Quality prescription indicators of use potential level (UPLI) are defined as the proportion that represents consumption of specific active principles as opposed to the total consumption of the anatomical therapeutic category. The UPLIs that have gradually been defined in Spain employ the defined daily dose (DDD) as the unit of measurement. Although the DDD is not necessarily the same as the therapeutic equivalent dose (TED), some authors have argued that the DDD is a standard unit of measurement and is therefore valid. However, this view may not be correct, given that the relationships between the TED and the DDD differ, depending on the drug, even within the same anatomical therapeutic category. Therefore, the use of DDDs in UPLI s may lead to prescription of a medicine being encouraged or discouraged depending on its TED/DDD ratio.

The medical director and quality requirements in the dialysis facility.

PubMed

Schiller, Brigitte

2015-03-06

Four decades after the successful implementation of the ESRD program currently providing life-saving dialysis therapy to >430,000 patients, the definitions of and demands for a high-quality program have evolved and increased at the same time. Through substantial technological advances ESRD care improved, with a predominant focus on the technical aspects of care and the introduction of medications such as erythropoiesis-stimulating agents and active vitamin D for anemia and bone disease management. Despite many advances, the size of the program and the increasingly older and multimorbid patient population have contributed to continuing challenges for providing consistently high-quality care. Medicare's Final Rule of the Conditions for Coverage (April 2008) define the medical director of the dialysis center as the leader of the interdisciplinary team and the person ultimately accountable for quality, safety, and care provided in the center. Knowledge and active leadership with a hands-on approach in the quality assessment and performance improvement process (QAPI) is essential for the achievement of high-quality outcomes in dialysis centers. A collaborative approach between the dialysis provider and medical director is required to optimize outcomes and deliver evidence-based quality care. In 2011 the Centers for Medicare & Medicaid Services introduced a pay-for-performance program-the ESRD quality incentive program (QIP)- with yearly varying quality metrics that result in payment reductions in subsequent years when targets are not achieved during the performance period. Success with the QIP requires a clear understanding of the structure, metrics, and scoring methods. Information on achievement and nonachievement is publicly available, both in facilities (through the facility performance score card) and on public websites (including Medicare's Dialysis Facility Compare). By assuming the leadership role in the quality program of dialysis facilities, the medical director is given an important opportunity to improve patients' lives and effect true change in a patient population dealing with a very challenging chronic disease. This article in the series on the role of the medical director summarizes the medical director's specific role in the quality improvement process in the dialysis facility and the associated requirements and programs, including QAPI and QIP. Copyright © 2015 by the American Society of Nephrology.

Impact of nutrition interventions on pediatric mortality and nutrition outcomes in humanitarian emergencies: A systematic review.

PubMed

Balhara, Kamna S; Silvestri, David M; Tyler Winders, W; Selvam, Anand; Kivlehan, Sean M; Becker, Torben K; Levine, Adam C

2017-12-01

Malnutrition contributes to paediatric morbidity and mortality in disasters and complex emergencies, but summary data describing specific nutritional interventions in these settings are lacking. This systematic review aimed to characterise such interventions and their effects on paediatric mortality, anthropometric measures and serum markers of nutrition. A systematic search of OVID MEDLINE, Cochrane Library and relevant grey literature was conducted. We included all randomised controlled trials and observational controlled studies evaluating effectiveness of nutritional intervention(s) on defined health outcomes in children and adolescents (0-18 years) within a disaster or complex emergency. We extracted study characteristics, interventions and outcomes data. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. A total of 31 studies met inclusion criteria. Most were conducted in Africa (17), during periods of conflict or hunger gaps (14), and evaluated micronutrient supplementation (14) or selective feeding (10). Overall study quality was low, with only two high and four moderate quality studies. High- and medium-quality studies demonstrated positive impact of fortified spreads, ready-to-use therapeutic foods, micronutrient supplementation, and food and cash transfers. In disasters and complex emergencies, high variability and low quality of controlled studies on paediatric malnutrition limit meaningful data aggregation. If existing research gaps are to be addressed, the inherent unpredictability of humanitarian emergencies and ethical considerations regarding controls may warrant a paradigm shift in what constitutes adequate methods. Periodic hunger gaps may offer a generalisable opportunity for robust trials, but consensus on meaningful nutritional endpoints is needed. © 2017 John Wiley & Sons Ltd.

Optimal molecular profiling of tissue and tissue components: defining the best processing and microdissection methods for biomedical applications.

PubMed

Bova, G Steven; Eltoum, Isam A; Kiernan, John A; Siegal, Gene P; Frost, Andra R; Best, Carolyn J M; Gillespie, John W; Emmert-Buck, Michael R

2005-01-01

Isolation of well-preserved pure cell populations is a prerequisite for sound studies of the molecular basis of pancreatic malignancy and other biological phenomena. This chapter reviews current methods for obtaining anatomically specific signals from molecules isolated from tissues, a basic requirement for productive linking of phenotype and genotype. The quality of samples isolated from tissue and used for molecular analysis is often glossed-over or omitted from publications, making interpretation and replication of data difficult or impossible. Fortunately, recently developed techniques allow life scientists to better document and control the quality of samples used for a given assay, creating a foundation for improvement in this area. Tissue processing for molecular studies usually involves some or all of the following steps: tissue collection, gross dissection/identification, fixation, processing/embedding, storage/archiving, sectioning, staining, microdissection/annotation, and pure analyte labeling/identification. High-quality tissue microdissection does not necessarily mean high-quality samples to analyze. The quality of biomaterials obtained for analysis is highly dependent on steps upstream and downstream from tissue microdissection. We provide protocols for each of these steps, and encourage you to improve upon these. It is worth the effort of every laboratory to optimize and document its technique at each stage of the process, and we provide a starting point for those willing to spend the time to optimize. In our view, poor documentation of tissue and cell type of origin and the use of nonoptimized protocols is a source of inefficiency in current life science research. Even incremental improvement in this area will increase productivity significantly.

Unified Perspective for Categorization of Educational Quality Indicators from an Accreditation Process View--Relationships between Educational Quality Indicators Defined by Accrediting Agencies in México at the Institutional and Program Level, and Those Defined by Institutions of Higher Education

ERIC Educational Resources Information Center

Sosa Lopez, Jorge; Salinas Yañez, Miguel Alberto; Morales Salgado, Maria Del Rocío; Reyes Vergara, Maria De Lourdes

2016-01-01

This research provides an introduction and background on accreditation of higher education in México focusing on FIMPES (Federation of Mexican Private Institutions of Higher Education), CACEI (Council for Accreditation and Certification of Education in Engineering), and CETYS University as a case study to establish relationships between…

Quality improvement in pediatric sepsis.

PubMed

Melendez, Elliot; Bachur, Richard

2015-06-01

Although there is abundant literature detailing the impact of quality improvement in adult sepsis, the pediatric literature is lacking. Despite consensus definitions for sepsis, which patients along the sepsis spectrum should receive aggressive management and the exact onset of sepsis ('time zero') are not clearly established. In the adult emergency department (ED), sepsis onset is defined as the time of entry into the ED; however, this definition cannot be applied to hospitalized patients or patients who evolve during their ED course. Since the time of sepsis onset will dictate the timeliness of subsequent process measures, the variable definitions in the literature make it difficult to generalize findings among prior studies. Despite the variation in defining time zero, aggressive fluid administration, timely antibiotics, and compliance with sepsis bundles have been shown to improve mortality and to reduce hospital and intensive care length of stay. In addition, early identification tools show promise in beginning to define sepsis onset and retrospective search tools may allow improved case finding of those children of concern for sepsis. Quality improvement in pediatric sepsis is evolving. As we continue to define quality measures, we must standardize the definition of sepsis onset. This definition should be applicable to any treatment venue to ensure measures can be evaluated across all settings. In addition, we must delineate which patients along the sepsis spectrum should be candidates for timely interventions and standardize other outcome measures beyond mortality.

Metrology: Calibration and measurement processes guidelines

NASA Technical Reports Server (NTRS)

Castrup, Howard T.; Eicke, Woodward G.; Hayes, Jerry L.; Mark, Alexander; Martin, Robert E.; Taylor, James L.

1994-01-01

The guide is intended as a resource to aid engineers and systems contracts in the design, implementation, and operation of metrology, calibration, and measurement systems, and to assist NASA personnel in the uniform evaluation of such systems supplied or operated by contractors. Methodologies and techniques acceptable in fulfilling metrology quality requirements for NASA programs are outlined. The measurement process is covered from a high level through more detailed discussions of key elements within the process, Emphasis is given to the flowdown of project requirements to measurement system requirements, then through the activities that will provide measurements with defined quality. In addition, innovations and techniques for error analysis, development of statistical measurement process control, optimization of calibration recall systems, and evaluation of measurement uncertainty are presented.

Involving vendors in continuous quality improvement efforts.

PubMed

McDevitt, M C

1995-03-01

In the hospital environment, vendors supply a wide range of items, from surgical sutures to the latest in high-cost technological equipment. Also, many clinical and support services, such as respiratory therapy, transcription, and computer databanks are now outsourced to commercial vendors. Interaction with such vendors is often less than satisfactory, with prolonged timelines and disruption of an important process that is being computerized. Although hospitals deal with very few vendors in long-term relationships, such as those seen in manufacturing, this should not preclude the formation of a supplier-customer relationship that goes beyond management's interaction with the sales representative in response to a request for proposal. This is especially true when a process improvement team has studied an internal process and defined a key quality characteristic.

Theory research of seam recognition and welding torch pose control based on machine vision

NASA Astrophysics Data System (ADS)

Long, Qiang; Zhai, Peng; Liu, Miao; He, Kai; Wang, Chunyang

2017-03-01

At present, the automation requirement of the welding become higher, so a method of the welding information extraction by vision sensor is proposed in this paper, and the simulation with the MATLAB has been conducted. Besides, in order to improve the quality of robot automatic welding, an information retrieval method for welding torch pose control by visual sensor is attempted. Considering the demands of welding technology and engineering habits, the relative coordinate systems and variables are strictly defined, and established the mathematical model of the welding pose, and verified its feasibility by using the MATLAB simulation in the paper, these works lay a foundation for the development of welding off-line programming system with high precision and quality.

Social support moderates the effects of stress on sleep in adolescents.

PubMed

van Schalkwijk, Frank J; Blessinga, Agaath N; Willemen, Agnes M; Van Der Werf, Ysbrand D; Schuengel, Carlo

2015-08-01

Academic expectations and demands become primary sources of stress during adolescence, negatively affecting sleep. To cope with stress, adolescents may turn to social support figures. The present study tested the extent of main and moderating effects of various sources of social support on the association between stress and sleep. Adolescents (n = 202, meanage 14.6 years, standard deviation = 0.71) reported on academic stress, sleep, and support using questionnaires during a low- and high-stress period, defined by the absence or presence of examinations, respectively. Inquiries were made regarding social support from parents, friends, and class supervisor. During both stress periods, academic stress was associated negatively with sleep quality and positively with sleep reduction. Social support increased sleep quality and lowered sleep reduction. In addition, social support moderated the effects of academic stress on sleep, thus improving sleep quality and lowering sleep reduction. Moderating effects were stronger during a period of high stress. The present study showed that adolescents can benefit from stress moderation through social support by improvements of sleep quality and sleep reduction. Such moderating effects should be taken into account when studying stress and sleep. Implications and recommendations based on these findings are discussed. © 2015 European Sleep Research Society.

High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance.

PubMed

Johnsen, Bjørn Helge; Westli, Heidi Kristina; Espevik, Roar; Wisborg, Torben; Brattebø, Guttorm

2017-11-10

High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of "push" of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers. The results of this study emphasize the team leader's role in initiating and updating a team's shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.

Status and understanding of groundwater quality in the Klamath Mountains study unit, 2010: California GAMA Priority Basin Project

USGS Publications Warehouse

Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth

2014-01-01

Groundwater quality in the Klamath Mountains (KLAM) study unit was investigated as part of the Priority Basin Project of the California Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in Del Norte, Humboldt, Shasta, Siskiyou, Tehama, and Trinity Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA Priority Basin Project was designed to provide a spatially unbiased, statistically robust assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality data and explanatory factors for groundwater samples collected in 2010 by the USGS from 39 sites and on water-quality data from the California Department of Public Health (CDPH) water-quality database. The primary aquifer system was defined by the depth intervals of the wells listed in the CDPH water-quality database for the KLAM study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study included two types of assessments: (1) a status assessment, which characterized the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds, pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements, and (2) an understanding assessment, which evaluated the natural and human factors potentially affecting the groundwater quality. The assessments were intended to characterize the quality of groundwater resources in the primary aquifer system of the KLAM study unit, not the quality of treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentrations divided by the health- or aesthetic-based benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration less than or equal to a benchmark. Relative-concentrations of organic constituents were classified as “high” (relative-concentration > 1.0), “moderate” (0.1 Aquifer-scale proportion was used in the status assessment as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system with moderate and low relative-concentrations, respectively. The KLAM study unit includes more than 8,800 square miles (mi2), but only those areas near the sampling sites, about 920 mi2, are included in the areal assessment of the study unit. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. To confirm this methodology, 90 percent confidence intervals were calculated for the grid-based high aquifer-scale proportions and were compared to the spatially weighted results, which were found to be within these confidence intervals in all cases. Grid-based results were selected for use in the status assessment unless, as was observed in a few cases, a grid-based result was zero and the spatially weighted result was not zero, in which case, the spatially weighted result was used. The status assessment showed that inorganic constituents with human-health benchmarks were detected at high relative-concentrations in 2.6 percent of the primary aquifer system and at moderate relative-concentrations in 10 percent of the system. The high aquifer-scale proportion for inorganic constituents mainly reflected the high aquifer-scale proportions of boron. Inorganic constituents with secondary maximum contaminant levels were detected at high relative-concentrations in 13 percent of the primary aquifer system and at moderate relative-concentrations in 10 percent of the system. The constituents present at high relative-concentrations included iron and manganese. Organic constituents with human-health benchmarks were not detected at high relative-concentrations, but were detected at moderate relative-concentrations in 1.9 percent of the primary aquifer system. The 1.9 percent reflected a spatially weighted moderate aquifer-scale proportion for the gasoline additive methyl tert-butyl ether. Of the 148 organic constituents analyzed, 14 constituents were detected. Only one organic constituent had a detection frequency of greater than 10 percent—the trihalomethane, chloroform. The second component of this study, the understanding assessment, identified the natural and human factors that may have affected the groundwater quality in the KLAM study unit by evaluating statistical correlations between water-quality constituents and potential explanatory factors. The potential explanatory factors evaluated were aquifer lithology, land use, hydrologic conditions, depth, groundwater age, and geochemical conditions. Results of the statistical evaluations were used to explain the occurrence and distribution of constituents in the KLAM study unit. Groundwater age distribution (modern, mixed, or pre-modern), redox class (oxic, mixed, or anoxic), and dissolved oxygen concentration were the explanatory factors that best explained occurrence patterns of the inorganic constituents. High concentrations of boron were found to be associated with groundwater classified as mixed or pre-modern with respect to groundwater age. Boron was also negatively correlated to dissolved oxygen and positively correlated to specific conductance. Iron and manganese concentrations were strongly associated with low dissolved oxygen concentrations, anoxic and mixed redox classifications, and pre-modern groundwater. Specific conductance concentrations were found to be related to pre-modern groundwater, low dissolved oxygen concentrations, and high pH. Chloroform was selected for additional evaluation in the understanding assessment because it was detected in more than 10 percent of wells sampled in the KLAM study unit. Septic tank density was the only explanatory factor that was found to relate to chloroform concentrations.

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

Garg, A

The SuperMACHO Project is a five-year survey toward the Large Magellanic Cloud (LMC) aimed at understanding the nature of the populations of lenses responsible for the excess microlensing rates observed by the MACHO project. Survey observations were completed in 2006. A rich side-product of this survey is a catalog of variable sources down to a depth of VR 23, including many classes of pulsating variables such as {delta}-Scuti and RR Lyrae. Through their position in the Period-Luminosity diagram and their light curve characteristics we have identified 2323 high amplitude {delta}-Scuti (HADS) having high quality light curves. sing Fourier decomposition ofmore » the HADS light curves, we find that the period-luminosity (PL) relation defined by the firt-overtone (FO) pulsators does not show a clear separation from the PL-relation defined by the fundamental (F) pulsators. This differs from other instability strip pulsators such as type c RR Lyrae. We also present evidence for a larger amplitude, subluminous population of HADS similar to that observed in Fornax.« less

The Role of Independent V&V in Upstream Software Development Processes

NASA Technical Reports Server (NTRS)

Easterbrook, Steve

1996-01-01

This paper describes the role of Verification and Validation (V&V) during the requirements and high level design processes, and in particular the role of Independent V&V (IV&V). The job of IV&V during these phases is to ensure that the requirements are complete, consistent and valid, and to ensure that the high level design meets the requirements. This contrasts with the role of Quality Assurance (QA), which ensures that appropriate standards and process models are defined and applied. This paper describes the current state of practice for IV&V, concentrating on the process model used in NASA projects. We describe a case study, showing the processes by which problem reporting and tracking takes place, and how IV&V feeds into decision making by the development team. We then describe the problems faced in implementing IV&V. We conclude that despite a well defined process model, and tools to support it, IV&V is still beset by communication and coordination problems.

Possibilities of CT Scanning as Analysis Method in Laser Additive Manufacturing

NASA Astrophysics Data System (ADS)

Karme, Aleksis; Kallonen, Aki; Matilainen, Ville-Pekka; Piili, Heidi; Salminen, Antti

Laser additive manufacturing is an established and constantly developing technique. Structural assessment should be a key component to ensure directed evolution towards higher level of manufacturing. The macroscopic properties of metallic structures are determined by their internal microscopic features, which are difficult to assess using conventional surface measuring methodologies. X-ray microtomography (CT) is a promising technique for three-dimensional non-destructive probing of internal composition and build of various materials. Aim of this study is to define the possibilities of using CT scanning as quality control method in LAM fabricated parts. Since the parts fabricated with LAM are very often used in high quality and accuracy demanding applications in various industries such as medical and aerospace, it is important to be able to define the accuracy of the build parts. The tubular stainless steel test specimens were 3D modelled, manufactured with a modified research AM equipment and imaged after manufacturing with a high-power, high-resolution CT scanner. 3D properties, such as surface texture and the amount and distribution of internal pores, were also evaluated in this study. Surface roughness was higher on the interior wall of the tube, and deviation from the model was systematically directed towards the central axis. Pore distribution showed clear organization and divided into two populations; one following the polygon model seams along both rims, and the other being associated with the concentric and equidistant movement path of the laser. Assessment of samples can enhance the fabrication by guiding the improvement of both modelling and manufacturing process.

Community oncology in an era of payment reform.

PubMed

Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

2014-01-01

Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

Development of Novel Monoclonal Antibodies that Define Differentiation Stages of Human Stromal (Mesenchymal) Stem Cells

PubMed Central

Andersen, Ditte C.; Kortesidis, Angela; Zannettino, Andrew C.W.; Kratchmarova, Irina; Chen, Li; Jensen, Ole N.; Teisner, Børge; Gronthos, Stan; Jensen, Charlotte H.; Kassem, Moustapha

2011-01-01

Human mesenchymal stem cells (hMSC) are currently being introduced for cell therapy, yet, antibodies specific for native and differentiated MSCs are required for their identification prior to clinical use. Herein, high quality antibodies against MSC surface proteins were developed by immunizing mice with hMSC, and by using a panel of subsequent screening methods. Flow cytometry analysis revealed that 83.5, 1.1, and 8.5% of primary cultures of hMSC were double positive for STRO-1 and either of DJ 3, 9, and 18, respectively. However, none of the three DJ antibodies allowed enrichment of clonogenic hMSC from BMMNCs as single reagents. Using mass-spectrometric analysis, we identified the antigen recognised by DJ3 as CD44, whereas DJ9 and DJ18 recognized HLA-DRB1 and Collagen VI, respectively. The identified proteins were highly expressed throughout in vitro osteogenic- and adipogenic differentiation. Interestingly, undifferentiated cells revealed a sole cytoplasmic distribution pattern of Collagen VI, which however changed to an extracellular matrix appearance upon osteogenic- and adipogenic differentiation. In relation to this, we found that STRO-1+/-/Collagen VI- sorted hMSC contained fewer differentiated alkaline phosphatase + cells compared to STRO-1+/-/Collagen VI+ hMSC, suggesting that Collagen VI on the cell membrane exclusively defines differentiated MSCs. In conclusion, we have generated a panel of high quality antibodies to be used for characterization of MSCs, and in addition our results may suggest that the DJ18 generated antibody against Collagen VI can be used for negative selection of cultured undifferentiated MSCs. PMID:21614487

40 CFR 131.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS..., reviewing, revising, and approving water quality standards by the States as authorized by section 303(c) of... water quality standards for Great Lakes States or Great Lakes Tribes (as defined in 40 CFR 132.2) to...

DISC (Defense Industrial Supply Center) TQM (Total Quality Management) Operations Plan

DTIC Science & Technology

1989-07-01

This document represents the continuance of the Defense Industrial Supply Center implementation of Total Quality Management which began in 1986. It...outlines how DISC intends to emphasize process improvement through the integration of all TQM initiates. Quality management at DISC prescribes defining

The Assessment of Marital Quality: A Reevaluation.

ERIC Educational Resources Information Center

Fincham, Frank D.; Bradbury, Thomas N.

1987-01-01

Examines problem of marital quality not being defined or readily distinguishable from other relevant constructs such as communication. Explores implications of treating marital quality as the global evaluation of one's marriage, for the association between empirical and conceptual dependence, the interpretation of responses to self-report…

Irregular analytical errors in diagnostic testing - a novel concept.

PubMed

Vogeser, Michael; Seger, Christoph

2018-02-23

In laboratory medicine, routine periodic analyses for internal and external quality control measurements interpreted by statistical methods are mandatory for batch clearance. Data analysis of these process-oriented measurements allows for insight into random analytical variation and systematic calibration bias over time. However, in such a setting, any individual sample is not under individual quality control. The quality control measurements act only at the batch level. Quantitative or qualitative data derived for many effects and interferences associated with an individual diagnostic sample can compromise any analyte. It is obvious that a process for a quality-control-sample-based approach of quality assurance is not sensitive to such errors. To address the potential causes and nature of such analytical interference in individual samples more systematically, we suggest the introduction of a new term called the irregular (individual) analytical error. Practically, this term can be applied in any analytical assay that is traceable to a reference measurement system. For an individual sample an irregular analytical error is defined as an inaccuracy (which is the deviation from a reference measurement procedure result) of a test result that is so high it cannot be explained by measurement uncertainty of the utilized routine assay operating within the accepted limitations of the associated process quality control measurements. The deviation can be defined as the linear combination of the process measurement uncertainty and the method bias for the reference measurement system. Such errors should be coined irregular analytical errors of the individual sample. The measurement result is compromised either by an irregular effect associated with the individual composition (matrix) of the sample or an individual single sample associated processing error in the analytical process. Currently, the availability of reference measurement procedures is still highly limited, but LC-isotope-dilution mass spectrometry methods are increasingly used for pre-market validation of routine diagnostic assays (these tests also involve substantial sets of clinical validation samples). Based on this definition/terminology, we list recognized causes of irregular analytical error as a risk catalog for clinical chemistry in this article. These issues include reproducible individual analytical errors (e.g. caused by anti-reagent antibodies) and non-reproducible, sporadic errors (e.g. errors due to incorrect pipetting volume due to air bubbles in a sample), which can both lead to inaccurate results and risks for patients.

Nephrologists’ Perspectives on Defining and Applying Patient-Centered Outcomes in Hemodialysis

PubMed Central

Winkelmayer, Wolfgang C.; Wheeler, David C.; van Biesen, Wim; Tugwell, Peter; Manns, Braden; Hemmelgarn, Brenda; Harris, Tess; Crowe, Sally; Ju, Angela; O’Lone, Emma; Evangelidis, Nicole; Craig, Jonathan C.

2017-01-01

Background and objectives Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists’ perspectives on defining and implementing patient-centered outcomes in hemodialysis. Design, setting, participants, & measurements Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand. Transcripts were thematically analyzed. Results We identified five themes on defining and implementing patient-centered outcomes in hemodialysis: explicitly prioritized by patients (articulated preferences and goals, ascertaining treatment burden, defining hemodialysis success, distinguishing a physician-patient dichotomy, and supporting shared decision making), optimizing wellbeing (respecting patient choice, focusing on symptomology, perceptible and tangible, and judging relevance and consequence), comprehending extensive heterogeneity of clinical and quality of life outcomes (distilling diverse priorities, highly individualized, attempting to specify outcomes, and broadening context), clinically hamstrung (professional deficiency, uncertainty and complexity in measurement, beyond medical purview, specificity of care, mechanistic mindset [focused on biochemical targets and comorbidities], avoiding alarm, and paradoxical dilemma), and undermined by system pressures (adhering to overarching policies, misalignment with mandates, and resource constraints). Conclusions Improving patient-centered outcomes is regarded by nephrologists to encompass strategies that address patient goals and improve wellbeing and treatment burden in patients on hemodialysis. However, efforts are hampered by ambiguities about how to prioritize, measure, and manage the plethora of critical comorbidities and broader quality of life outcomes in a care setting that is technically demanding and driven by biochemical targets. Identifying critical patient–important outcomes and mechanisms for integrating them into practice may help to deliver patient-centered care in hemodialysis and other chronic disease settings. PMID:28223290

Competencies Framework for Climate Services.

NASA Astrophysics Data System (ADS)

Aguilar, Enric

2016-04-01

The World Climate Conference-3 (Geneva, 2009) established the Global Framework for Climate Services (GFCS) to enable better management of the risks of climate variability and change and adaptation to climate change at all levels, through development and incorporation of science-based climate information and prediction into planning, policy and practice. The GFCS defines Climate Services as the result of transforming climate data into climate information in a way that responds to user needs and assists decision-making by individuals and organizations. Capacity Development is a cross-cutting pillar of the GFCS to ensure that services are provided by institutions with professionals whom achieved the adequate set of competencies recommended by WMO, which are yet to be fully defined. The WMO-Commission for Climatology Expert Team on Education and Training, ET-ETR, has been working to define a Competencies Framework for Climate Services to help the institutions to deliver high quality climate services in compliance with WMO standards and regulations, specifically those defined by WMO's Commission for Climatology and the GFCS. This framework is based in 5 areas or competence, closely associated to the areas of work of climate services providers: create and manage climate data sets; derive products from climate data; create and/or interpret climate forecasts and model output; ensure the quality of climate information and services; communicate climatological information with users. With this contribution, we intend to introduce to a wider audience the rationale behind these 5 top-level competency statements and the performance criteria associated with them, as well as the plans of the ET-ETR for further developing them into an instrument to support education and training within the WMO members, specially the National Meteorological and Hydrological Services.

A Study of Quality of Service Communication for High-Speed Packet-Switching Computer Sub-Networks

NASA Technical Reports Server (NTRS)

Cui, Zhenqian

1999-01-01

With the development of high-speed networking technology, computer networks, including local-area networks (LANs), wide-area networks (WANs) and the Internet, are extending their traditional roles of carrying computer data. They are being used for Internet telephony, multimedia applications such as conferencing and video on demand, distributed simulations, and other real-time applications. LANs are even used for distributed real-time process control and computing as a cost-effective approach. Differing from traditional data transfer, these new classes of high-speed network applications (video, audio, real-time process control, and others) are delay sensitive. The usefulness of data depends not only on the correctness of received data, but also the time that data are received. In other words, these new classes of applications require networks to provide guaranteed services or quality of service (QoS). Quality of service can be defined by a set of parameters and reflects a user's expectation about the underlying network's behavior. Traditionally, distinct services are provided by different kinds of networks. Voice services are provided by telephone networks, video services are provided by cable networks, and data transfer services are provided by computer networks. A single network providing different services is called an integrated-services network.

What do you think of my picture? Investigating factors of influence in profile images context perception

NASA Astrophysics Data System (ADS)

Mazza, F.; Da Silva, M. P.; Le Callet, P.; Heynderickx, I. E. J.

2015-03-01

Multimedia quality assessment has been an important research topic during the last decades. The original focus on artifact visibility has been extended during the years to aspects as image aesthetics, interestingness and memorability. More recently, Fedorovskaya proposed the concept of 'image psychology': this concept focuses on additional quality dimensions related to human content processing. While these additional dimensions are very valuable in understanding preferences, it is very hard to define, isolate and measure their effect on quality. In this paper we continue our research on face pictures investigating which image factors influence context perception. We collected perceived fit of a set of images to various content categories. These categories were selected based on current typologies in social networks. Logistic regression was adopted to model category fit based on images features. In this model we used both low level and high level features, the latter focusing on complex features related to image content. In order to extract these high level features, we relied on crowdsourcing, since computer vision algorithms are not yet sufficiently accurate for the features we needed. Our results underline the importance of some high level content features, e.g. the dress of the portrayed person and scene setting, in categorizing image.

Language learning, socioeconomic status, and child-directed speech.

PubMed

Schwab, Jessica F; Lew-Williams, Casey

2016-07-01

Young children's language experiences and language outcomes are highly variable. Research in recent decades has focused on understanding the extent to which family socioeconomic status (SES) relates to parents' language input to their children and, subsequently, children's language learning. Here, we first review research demonstrating differences in the quantity and quality of language that children hear across low-, mid-, and high-SES groups, but also-and perhaps more importantly-research showing that differences in input and learning also exist within SES groups. Second, in order to better understand the defining features of 'high-quality' input, we highlight findings from laboratory studies examining specific characteristics of the sounds, words, sentences, and social contexts of child-directed speech (CDS) that influence children's learning. Finally, after narrowing in on these particular features of CDS, we broaden our discussion by considering family and community factors that may constrain parents' ability to participate in high-quality interactions with their young children. A unification of research on SES and CDS will facilitate a more complete understanding of the specific means by which input shapes learning, as well as generate ideas for crafting policies and programs designed to promote children's language outcomes. WIREs Cogn Sci 2016, 7:264-275. doi: 10.1002/wcs.1393 For further resources related to this article, please visit the WIREs website. © 2016 Wiley Periodicals, Inc.

Implementing clinical protocols in oncology: quality gaps and the learning curve phenomenon.

PubMed

Kedikoglou, Simos; Syrigos, Konstantinos; Skalkidis, Yannis; Ploiarchopoulou, Fani; Dessypris, Nick; Petridou, Eleni

2005-08-01

The quality improvement effort in clinical practice has focused mostly on 'performance quality', i.e. on the development of comprehensive, evidence-based guidelines. This study aimed to assess the 'conformance quality', i.e. the extent to which guidelines once developed are correctly and consistently applied. It also aimed to assess the existence of quality gaps in the treatment of certain patient segments as defined by age or gender and to investigate methods to improve overall conformance quality. A retrospective audit of clinical practice in a well-defined oncology setting was undertaken and the results compared to those obtained from prospectively applying an internally developed clinical protocol in the same setting and using specific tools to increase conformance quality. All indicators showed improvement after the implementation of the protocol that in many cases reached statistical significance, while in the entire cohort advanced age was associated (although not significantly) with sub-optimal delivery of care. A 'learning curve' phenomenon in the implementation of quality initiatives was detected, with all indicators improving substantially in the second part of the prospective study. Clinicians should pay separate attention to the implementation of chosen protocols and employ specific tools to increase conformance quality in patient care.

How Should Quality of Education Be Re-Defined for Education Achievements in Tanzania? What Are Stakeholders' Opinions?

ERIC Educational Resources Information Center

Telli, Godfrey

2013-01-01

Quality of education is a complex concept. Numerous studies attribute quality of education as an inclusive term that contains access and input on the one hand and process, output or outcome on the other. Others regard access and input of education as separate but equally important concepts of quality of education. For the latter, quality of…

Comparison of cavity preparation quality using an electric motor handpiece and an air turbine dental handpiece.

PubMed

Kenyon, Brian J; Van Zyl, Ian; Louie, Kenneth G

2005-08-01

The high-speed high-torque (electric motor) handpiece is becoming more popular in dental offices and laboratories in the United States. It is reported to cut more precisely and to assist in the creation of finer margins that enhance cavity preparations. The authors conducted an in vitro study to compare the quality of cavity preparations fabricated with a high-speed high-torque (electric motor) handpiece and a high-speed low-torque (air turbine) handpiece. Eighty-six dental students each cut two Class I preparations, one with an air turbine handpiece and the other with an electric motor high-speed handpiece. The authors asked the students to cut each preparation accurately to a circular outline and to establish a flat pulpal floor with 1.5 millimeters' depth, 90-degree exit angles, parallel vertical walls and sharp internal line angles, as well as to refine the preparation to achieve flat, smooth walls with a well-defined cavosurface margin. A single faculty member scored the preparations for criteria and refinement using a nine-point scale (range, 1-9). The authors analyzed the data statistically using paired t tests. In preparation criteria, the electric motor high-speed handpiece had a higher average grade than did the air turbine handpiece (5.07 and 4.90, respectively). For refinement, the average grade for the air turbine high-speed handpiece was greater than that for the electric motor high-speed handpiece (5.72 and 5.52, respectively). The differences were not statistically significant. The electric motor high-speed handpiece performed as well as, but not better than, the air turbine handpiece in the fabrication of high-quality cavity preparations.

First clinicial results on the feasibility, quality and reproducibility of aberrometry-based intraoperative refraction during cataract surgery.

PubMed

Huelle, Jan O; Katz, Toam; Druchkiv, Vasyl; Pahlitzsch, Milena; Steinberg, Johannes; Richard, Gisbert; Linke, Stephan J

2014-11-01

To provide the first clinical data in determining the feasibility, quality and precision of intraoperative wavefront aberrometry (IWA)-based refraction in patients with cataract. IWA refraction was recorded at 7 defined measurement points during standardised cataract surgery in 74 eyes of 74 consecutive patients (mean age 69±11.3 years). Precision and measurement quality was evaluated by the 'limits of agreement' approach, regression analysis, correlation analysis, Analysis of variance (ANOVA) and ORs for predicting measurement failure. Wavefront map (WFM) quality was objectivised and compared with the Pentacam Nuclear Staging analysis. Out of 814 IWA measurement attempts, 462 WFMs could be obtained. The most successful readings (n=63) were achieved in aphakia with viscoelastic. The highest (50.63%, SD 20.23) and lowest (29.19%, SD 13.94) quality of WFMs across all measurement points were found after clear corneal incision and in pseudophakia with viscoelastic, respectively. High consistency across repeated measures were found for mean spherical equivalent (SE) differences in aphakia with -0.01D and pseudophakia with -0.01D, but ranges were high (limits of agreement +0.69 D and -0.72 D; +1.53 D and -1.54 D, respectively). With increasing WFM quality, higher precision in measurements was observed. This is the first report addressing quality and reproducibility of WA in a large sample. IWA refraction in aphakia, for instance, appears to be reliable once stable and pressurised anterior chamber conditions are achieved. More efforts are required to improve the precision and quality of measurements before IWA can be used to guide the surgical refractive plan in cataract surgery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Life sciences flight experiments program, life sciences project division, procurement quality provisions

NASA Technical Reports Server (NTRS)

House, G.

1980-01-01

Methods are defined for implementing quality assurance policy and requirements for life sciences laboratory equipment, experimental hardware, integration and test support equipment, and integrated payloads.

Comprehensive Identification and Bread-Making Quality Evaluation of Common Wheat Somatic Variation Line AS208 on Glutenin Composition

PubMed Central

Du, Lipu; Cao, Xinyou; Zhang, Xiaoxiang; Zhou, Yang; Yan, Yueming; Ye, Xingguo

2016-01-01

High molecular weight glutenin subunits (HMW-GSs) are important seed storage proteins in wheat (Triticum aestivum) that determine wheat dough elasticity and processing quality. Clarification of the defined effectiveness of HMW-GSs is very important to breeding efforts aimed at improving wheat quality. To date, there have no report on the expression silencing and quality effects of 1Bx20 and 1By20 at the Glu-B1 locus in wheat. A wheat somatic variation line, AS208, in which both 1Bx20 and 1By20 at Glu-B1 locus were silenced, was developed recently in our laboratory. Evaluation of agronomic traits and seed storage proteins by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and reversed-phase high performance liquid chromatography (RP-HPLC) indicated that AS208 was highly similar to its parental cultivar Lunxuan987 (LX987), with the exception that the composition and expression of HMW-GSs was altered. The 1Bx20 and 1By20 in AS208 were further identified to be missing by polymerase chain reaction (PCR) and quantitative real-time RT-PCR (qRT-PCR) assays. Based on the PCR results for HMW-GS genes and their promoters in AS208 compared with LX987, 1Bx20 and 1By20 were speculated to be deleted in AS208 during in vitro culture. Quality analysis of this line with Mixograph, Farinograph, and Extensograph instruments, as well as analysis of bread-making quality traits, demonstrated that the lack of the genes encoding 1Bx20 and 1By20 caused various negative effects on dough processing and bread-making quality traits, including falling number, dough stability time, mixing tolerance index, crude protein values, wet gluten content, bread size, and internal cell structure. AS208 can potentially be used in the functional dissection of other HMW-GSs as a plant material with desirable genetic background, and in biscuit making industry as a high-quality weak gluten wheat source. PMID:26765256