A Structured-Grid Quality Measure for Simulated Hypersonic Flows

NASA Technical Reports Server (NTRS)

Alter, Stephen J.

2004-01-01

A structured-grid quality measure is proposed, combining three traditional measurements: intersection angles, stretching, and curvature. Quality assesses whether the grid generated provides the best possible tradeoffs in grid stretching and skewness that enable accurate flow predictions, whereas the grid density is assumed to be a constraint imposed by the available computational resources and the desired resolution of the flow field. The usefulness of this quality measure is assessed by comparing heat transfer predictions from grid convergence studies for grids of varying quality in the range of [0.6-0.8] on an 8'half-angle sphere-cone, at laminar, perfect gas, Mach 10 wind tunnel conditions.

Quality measures for the diagnosis and non-operative management of carpal tunnel syndrome in occupational settings.

PubMed

Nuckols, Teryl; Harber, Philip; Sandin, Karl; Benner, Douglas; Weng, Haoling; Shaw, Rebecca; Griffin, Anne; Asch, Steven

2011-03-01

Providing higher quality medical care to workers with occupationally associated carpal tunnel syndrome (CTS) may reduce disability, facilitate return to work, and lower the associated costs. Although many workers' compensation systems have adopted treatment guidelines to reduce the overuse of unnecessary care, limited attention has been paid to ensuring that the care workers do receive is high quality. Further, guidelines are not designed to enable objective assessments of quality of care. This study sought to develop quality measures for the diagnostic evaluation and non-operative management of CTS, including managing occupational activities and functional limitations. Using a variation of the well-established RAND/UCLA Appropriateness Method, we developed draft quality measures using guidelines and literature reviews. Next, in a two-round modified-Delphi process, a multidisciplinary panel of 11 U.S. experts in CTS rated the measures on validity and feasibility. Of 40 draft measures, experts rated 31 (78%) valid and feasible. Nine measures pertained to diagnostic evaluation, such as assessing symptoms, signs, and risk factors. Eleven pertain to non-operative treatments, such as the use of splints, steroid injections, and medications. Eleven others address assessing the association between symptoms and work, managing occupational activities, and accommodating functional limitations. These measures will complement existing treatment guidelines by enabling providers, payers, policymakers, and researchers to assess quality of care for CTS in an objective, structured manner. Given the characteristics of previous measures developed with these methods, greater adherence to these measures will probably lead to improved patient outcomes at a population level.

Approaches and Methodological As Well As Interpretative Issues in Quality of Life Research in Malaysia

PubMed Central

Hasanah, C. I.

2003-01-01

Quality of life measures are designed to enable patients’ perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision-making and research. This paper discusses some approaches, methodological as well as interpretative issues of health related quality of life research. PMID:23386798

[Integral quantitative evaluation of working conditions in the construction industry].

PubMed

Guseĭnov, A A

1993-01-01

Present method evaluating the quality of environment (using MAC and MAL) does not enable to assess completely and objectively the work conditions of building industry due to multiple confounding elements. A solution to this complicated problem including the analysis of various correlating elements of the system "human--work conditions--environment" may be encouraged by social norm of morbidity, which is independent on industrial and natural environment. The complete integral assessment enables to see the whole situation and reveal the points at risk.

Behind the Scenes

ERIC Educational Resources Information Center

Dahnert, Roger; Pack, Andrew

2007-01-01

High-quality sports facilities are an essential tool in recruiting top collegiate athletes and coaches. They enhance the school's competitiveness and enable expansion of the school's sports programs. In choosing schools, top athletes and coaches assess the quality of the stadium, playing fields, track and courts. But they also will be looking at…

[Integrated Quality Management System (IQMS): a model for improving the quality of reproductive health care in rural Kenya].

PubMed

Herrler, Claudia; Bramesfeld, Anke; Brodowski, Marc; Prytherch, Helen; Marx, Irmgard; Nafula, Maureen; Richter-Aairijoki, Heide; Musyoka, Lucy; Marx, Michael; Szecsenyi, Joachim

2015-01-01

To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance. The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts. 260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed. Copyright © 2015. Published by Elsevier GmbH.

Combining Archetypes, Ontologies and Formalization Enables Automated Computation of Quality Indicators.

PubMed

Legaz-García, María Del Carmen; Dentler, Kathrin; Fernández-Breis, Jesualdo Tomás; Cornet, Ronald

2017-01-01

ArchMS is a framework that represents clinical information and knowledge using ontologies in OWL, which facilitates semantic interoperability and thereby the exploitation and secondary use of clinical data. However, it does not yet support the automated assessment of quality of care. CLIF is a stepwise method to formalize quality indicators. The method has been implemented in the CLIF tool which supports its users in generating computable queries based on a patient data model which can be based on archetypes. To enable the automated computation of quality indicators using ontologies and archetypes, we tested whether ArchMS and the CLIF tool can be integrated. We successfully automated the process of generating SPARQL queries from quality indicators that have been formalized with CLIF and integrated them into ArchMS. Hence, ontologies and archetypes can be combined for the execution of formalized quality indicators.

Application of process mining to assess the data quality of routinely collected time-based performance data sourced from electronic health records by validating process conformance.

PubMed

Perimal-Lewis, Lua; Teubner, David; Hakendorf, Paul; Horwood, Chris

2016-12-01

Effective and accurate use of routinely collected health data to produce Key Performance Indicator reporting is dependent on the underlying data quality. In this research, Process Mining methodology and tools were leveraged to assess the data quality of time-based Emergency Department data sourced from electronic health records. This research was done working closely with the domain experts to validate the process models. The hospital patient journey model was used to assess flow abnormalities which resulted from incorrect timestamp data used in time-based performance metrics. The research demonstrated process mining as a feasible methodology to assess data quality of time-based hospital performance metrics. The insight gained from this research enabled appropriate corrective actions to be put in place to address the data quality issues. © The Author(s) 2015.

Total Quality Management of Information System for Quality Assessment of Pesantren Using Fuzzy-SERVQUAL

NASA Astrophysics Data System (ADS)

Faizah, Arbiati; Syafei, Wahyul Amien; Isnanto, R. Rizal

2018-02-01

This research proposed a model combining an approach of Total Quality Management (TQM) and Fuzzy method of Service Quality (SERVQUAL) to asses service quality. TQM implementation was as quality management orienting on customer's satisfaction by involving all stakeholders. SERVQUAL model was used to measure quality service based on five dimensions such as tangible, reliability, responsiveness, assurance, and empathy. Fuzzy set theory was to accommodate subjectivity and ambiguity of quality assessment. Input data consisted of indicator data and quality assessment aspect. Input data was, then, processed to be service quality assessment questionnaires of Pesantren by using Fuzzy method to get service quality score. This process consisted of some steps as follows : inputting dimension and questionnaire data to data base system, filling questionnaire through system, then, system calculated fuzzification, defuzzification, gap of quality expected and received by service receivers, and calculating each dimension rating showing quality refinement priority. Rating of each quality dimension was, then, displayed at dashboard system to enable users to see information. From system having been built, it could be known that tangible dimension had the highest gap, -0.399, thus it needs to be prioritized and gets evaluation and refinement action soon.

Human Connectome Project Informatics: quality control, database services, and data visualization

PubMed Central

Marcus, Daniel S.; Harms, Michael P.; Snyder, Abraham Z.; Jenkinson, Mark; Wilson, J Anthony; Glasser, Matthew F.; Barch, Deanna M.; Archie, Kevin A.; Burgess, Gregory C.; Ramaratnam, Mohana; Hodge, Michael; Horton, William; Herrick, Rick; Olsen, Timothy; McKay, Michael; House, Matthew; Hileman, Michael; Reid, Erin; Harwell, John; Coalson, Timothy; Schindler, Jon; Elam, Jennifer S.; Curtiss, Sandra W.; Van Essen, David C.

2013-01-01

The Human Connectome Project (HCP) has developed protocols, standard operating and quality control procedures, and a suite of informatics tools to enable high throughput data collection, data sharing, automated data processing and analysis, and data mining and visualization. Quality control procedures include methods to maintain data collection consistency over time, to measure head motion, and to establish quantitative modality-specific overall quality assessments. Database services developed as customizations of the XNAT imaging informatics platform support both internal daily operations and open access data sharing. The Connectome Workbench visualization environment enables user interaction with HCP data and is increasingly integrated with the HCP's database services. Here we describe the current state of these procedures and tools and their application in the ongoing HCP study. PMID:23707591

Environmental Assessment And Finding of No Significant Impact for the Low Impact Development Retrofit At Pillar Point Air Force Station, California

DTIC Science & Technology

2012-01-09

utilize LID techniques to enable greater on-site infiltration of storm water to improve storm water quality and restore natural water quality conditions...systems and conveyed through above- and below-ground piping to concrete roadside ditches. Stonn Water Quality Storm water quality monitoring has been...process of being awarded and implemented. The results of all referenced storm water quality and septic inspection reports is available upon request to

Characterization of Adipose Tissue Product Quality Using Measurements of Oxygen Consumption Rate.

PubMed

Suszynski, Thomas M; Sieber, David A; Mueller, Kathryn; Van Beek, Allen L; Cunningham, Bruce L; Kenkel, Jeffrey M

2018-03-14

Fat grafting is a common procedure in plastic surgery but associated with unpredictable graft retention. Adipose tissue (AT) "product" quality is affected by the methods used for harvest, processing and transfer, which vary widely amongst surgeons. Currently, there is no method available to accurately assess the quality of AT. In this study, we present a novel method for the assessment of AT product quality through direct measurements of oxygen consumption rate (OCR). OCR has exhibited potential in predicting outcomes following pancreatic islet transplant. Our study aim was to reapportion existing technology for its use with AT preparations and to confirm that these measurements are feasible. OCR was successfully measured for en bloc and postprocessed AT using a stirred microchamber system. OCR was then normalized to DNA content (OCR/DNA), which represents the AT product quality. Mean (±SE) OCR/DNA values for fresh en bloc and post-processed AT were 149.8 (± 9.1) and 61.1 (± 6.1) nmol/min/mg DNA, respectively. These preliminary data suggest that: (1) OCR and OCR/DNA measurements of AT harvested using conventional protocol are feasible; and (2) standard AT processing results in a decrease in overall AT product quality. OCR measurements of AT using existing technology can be done and enables accurate, real-time, quantitative assessment of the quality of AT product prior to transfer. The availability and further validation of this type of assay could enable optimization of fat grafting protocol by providing a tool for the more detailed study of procedural variables that affect AT product quality.

A quality assessment tool for markup-based clinical guidelines.

PubMed

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

2008-11-06

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

SU-F-J-178: A Computer Simulation Model Observer for Task-Based Image Quality Assessment in Radiation Therapy

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

Dolly, S; Mutic, S; Anastasio, M

Purpose: Traditionally, image quality in radiation therapy is assessed subjectively or by utilizing physically-based metrics. Some model observers exist for task-based medical image quality assessment, but almost exclusively for diagnostic imaging tasks. As opposed to disease diagnosis, the task for image observers in radiation therapy is to utilize the available images to design and deliver a radiation dose which maximizes patient disease control while minimizing normal tissue damage. The purpose of this study was to design and implement a new computer simulation model observer to enable task-based image quality assessment in radiation therapy. Methods: A modular computer simulation framework wasmore » developed to resemble the radiotherapy observer by simulating an end-to-end radiation therapy treatment. Given images and the ground-truth organ boundaries from a numerical phantom as inputs, the framework simulates an external beam radiation therapy treatment and quantifies patient treatment outcomes using the previously defined therapeutic operating characteristic (TOC) curve. As a preliminary demonstration, TOC curves were calculated for various CT acquisition and reconstruction parameters, with the goal of assessing and optimizing simulation CT image quality for radiation therapy. Sources of randomness and bias within the system were analyzed. Results: The relationship between CT imaging dose and patient treatment outcome was objectively quantified in terms of a singular value, the area under the TOC (AUTOC) curve. The AUTOC decreases more rapidly for low-dose imaging protocols. AUTOC variation introduced by the dose optimization algorithm was approximately 0.02%, at the 95% confidence interval. Conclusion: A model observer has been developed and implemented to assess image quality based on radiation therapy treatment efficacy. It enables objective determination of appropriate imaging parameter values (e.g. imaging dose). Framework flexibility allows for incorporation of additional modules to include any aspect of the treatment process, and therefore has great potential for both assessment and optimization within radiation therapy.« less

Image and Video Quality Assessment Using LCD: Comparisons with CRT Conditions

NASA Astrophysics Data System (ADS)

Tourancheau, Sylvain; Callet, Patrick Le; Barba, Dominique

In this paper, the impact of display on quality assessment is addressed. Subjective quality assessment experiments have been performed on both LCD and CRT displays. Two sets of still images and two sets of moving pictures have been assessed using either an ACR or a SAMVIQ protocol. Altogether, eight experiments have been led. Results are presented and discussed, some differences are pointed out. Concerning moving pictures, these differences seem to be mainly due to LCD moving artefacts such as motion blur. LCD motion blur has been measured objectively and with psycho-physics experiments. A motion-blur metric based on the temporal characteristics of LCD can be defined. A prediction model have been then designed which predict the differences of perceived quality between CRT and LCD. This motion-blur-based model enables the estimation of perceived quality on LCD with respect to the perceived quality on CRT. Technical solutions to LCD motion blur can thus be evaluated on natural contents by this mean.

Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research

PubMed Central

Weng, Chunhua

2013-01-01

Objective To review the methods and dimensions of data quality assessment in the context of electronic health record (EHR) data reuse for research. Materials and methods A review of the clinical research literature discussing data quality assessment methodology for EHR data was performed. Using an iterative process, the aspects of data quality being measured were abstracted and categorized, as well as the methods of assessment used. Results Five dimensions of data quality were identified, which are completeness, correctness, concordance, plausibility, and currency, and seven broad categories of data quality assessment methods: comparison with gold standards, data element agreement, data source agreement, distribution comparison, validity checks, log review, and element presence. Discussion Examination of the methods by which clinical researchers have investigated the quality and suitability of EHR data for research shows that there are fundamental features of data quality, which may be difficult to measure, as well as proxy dimensions. Researchers interested in the reuse of EHR data for clinical research are recommended to consider the adoption of a consistent taxonomy of EHR data quality, to remain aware of the task-dependence of data quality, to integrate work on data quality assessment from other fields, and to adopt systematic, empirically driven, statistically based methods of data quality assessment. Conclusion There is currently little consistency or potential generalizability in the methods used to assess EHR data quality. If the reuse of EHR data for clinical research is to become accepted, researchers should adopt validated, systematic methods of EHR data quality assessment. PMID:22733976

BASINS Framework and Features

EPA Pesticide Factsheets

BASINS enables users to efficiently access nationwide environmental databases and local user-specified datasets, apply assessment and planning tools, and run a variety of proven nonpoint loading and water quality models within a single GIS format.

Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.

Image quality assessment using deep convolutional networks

NASA Astrophysics Data System (ADS)

Li, Yezhou; Ye, Xiang; Li, Yong

2017-12-01

This paper proposes a method of accurately assessing image quality without a reference image by using a deep convolutional neural network. Existing training based methods usually utilize a compact set of linear filters for learning features of images captured by different sensors to assess their quality. These methods may not be able to learn the semantic features that are intimately related with the features used in human subject assessment. Observing this drawback, this work proposes training a deep convolutional neural network (CNN) with labelled images for image quality assessment. The ReLU in the CNN allows non-linear transformations for extracting high-level image features, providing a more reliable assessment of image quality than linear filters. To enable the neural network to take images of any arbitrary size as input, the spatial pyramid pooling (SPP) is introduced connecting the top convolutional layer and the fully-connected layer. In addition, the SPP makes the CNN robust to object deformations to a certain extent. The proposed method taking an image as input carries out an end-to-end learning process, and outputs the quality of the image. It is tested on public datasets. Experimental results show that it outperforms existing methods by a large margin and can accurately assess the image quality on images taken by different sensors of varying sizes.

Applications of low-cost sensing technologies for air quality monitoring and exposure assessment: How far have they gone?

EPA Science Inventory

Over the past decade, a range of sensor technologies became available on the market, enabling a revolutionary shift in air pollution monitoring and assessment. With their cost of up to three orders of magnitude lower than standard/reference instruments, many avenues for applicati...

Incentives and enablers to improve adherence in tuberculosis.

PubMed

Lutge, Elizabeth E; Wiysonge, Charles Shey; Knight, Stephen E; Sinclair, David; Volmink, Jimmy

2015-09-03

Patient adherence to medications, particularly for conditions requiring prolonged treatment such as tuberculosis (TB), is frequently less than ideal and can result in poor treatment outcomes. Material incentives to reward good behaviour and enablers to remove economic barriers to accessing care are sometimes given in the form of cash, vouchers, or food to improve adherence. To evaluate the effects of material incentives and enablers in patients undergoing diagnostic testing, or receiving prophylactic or curative therapy, for TB. We undertook a comprehensive search of the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; LILACS; Science Citation Index; and reference lists of relevant publications up to 5 June 2015. Randomized controlled trials of material incentives in patients being investigated for TB, or on treatment for latent or active TB. At least two review authors independently screened and selected studies, extracted data, and assessed the risk of bias in the included trials. We compared the effects of interventions using risk ratios (RR), and presented RRs with 95% confidence intervals (CI). The quality of the evidence was assessed using GRADE. We identified 12 eligible trials. Ten were conducted in the USA: in adolescents (one trial), in injection drug or cocaine users (four trials), in homeless adults (three trials), and in prisoners (two trials). The remaining two trials, in general adult populations, were conducted in Timor-Leste and South Africa. Sustained incentive programmesOnly two trials have assessed whether material incentives and enablers can improve long-term adherence and completion of treatment for active TB, and neither demonstrated a clear benefit (RR 1.04, 95% CI 0.97 to 1.14; two trials, 4356 participants; low quality evidence). In one trial, the incentive, given as a daily hot meal, was not well received by the population due to the inconvenience of attending the clinic at midday, whilst in the other trial, nurses distributing the vouchers chose to "ration" their distribution among eligible patients, giving only to those whom they felt were most deprived.Three trials assessed the effects of material incentives and enablers on completion of TB prophylaxis with mixed results (low quality evidence). A large effect was seen with regular cash incentives given to drug users at each clinic visit in a setting with extremely low treatment completion in the control group (treatment completion 52.8% intervention versus 3.6% control; RR 14.53, 95% CI 3.64 to 57.98; one trial, 108 participants), but no effects were seen in one trial assessing a cash incentive for recently released prisoners (373 participants), or another trial assessing material incentives offered by parents to teenagers (388 participants). Single once-only incentivesHowever in specific populations, such as recently released prisoners, drug users, and the homeless, trials show that material incentives probably do improve one-off clinic re-attendance for initiation or continuation of anti-TB prophylaxis (RR 1.58, 95% CI 1.27 to 1.96; three trials, 595 participants; moderate quality evidence), and may increase the return rate for reading of tuberculin skin test results (RR 2.16, 95% CI 1.41 to 3.29; two trials, 1371 participants; low quality evidence). Comparison of different types of incentivesSingle trials in specific sub-populations suggest that an immediate cash incentive may be more effective than delaying the incentive until completion of treatment (RR 1.11, 95% CI 0.98 to 1.24; one trial, 300 participants; low quality evidence), cash incentives may be more effective than non-cash incentives (completion of TB prophylaxis: RR 1.26, 95% CI 1.02 to 1.56; one trial, 141 participants; low quality evidence; return for skin test reading: RR 1.13, 95% CI 1.07 to 1.19; one trial, 652 participants; low quality evidence); and higher cash incentives may be more effective than lower cash incentives (RR 1.08, 95% CI 1.01 to 1.16; one trial, 404 participants; low quality evidence). Material incentives and enablers may have some positive short term effects on clinic attendance, particularly for marginal populations such as drug users, recently released prisoners, and the homeless, but there is currently insufficient evidence to know if they can improve long term adherence to TB treatment.

DESCQA: Synthetic Sky Catalog Validation Framework

NASA Astrophysics Data System (ADS)

Mao, Yao-Yuan; Uram, Thomas D.; Zhou, Rongpu; Kovacs, Eve; Ricker, Paul M.; Kalmbach, J. Bryce; Padilla, Nelson; Lanusse, François; Zu, Ying; Tenneti, Ananth; Vikraman, Vinu; DeRose, Joseph

2018-04-01

The DESCQA framework provides rigorous validation protocols for assessing the quality of high-quality simulated sky catalogs in a straightforward and comprehensive way. DESCQA enables the inspection, validation, and comparison of an inhomogeneous set of synthetic catalogs via the provision of a common interface within an automated framework. An interactive web interface is also available at portal.nersc.gov/project/lsst/descqa.

Methodology for stereoscopic motion-picture quality assessment

NASA Astrophysics Data System (ADS)

Voronov, Alexander; Vatolin, Dmitriy; Sumin, Denis; Napadovsky, Vyacheslav; Borisov, Alexey

2013-03-01

Creating and processing stereoscopic video imposes additional quality requirements related to view synchronization. In this work we propose a set of algorithms for detecting typical stereoscopic-video problems, which appear owing to imprecise setup of capture equipment or incorrect postprocessing. We developed a methodology for analyzing the quality of S3D motion pictures and for revealing their most problematic scenes. We then processed 10 modern stereo films, including Avatar, Resident Evil: Afterlife and Hugo, and analyzed changes in S3D-film quality over the years. This work presents real examples of common artifacts (color and sharpness mismatch, vertical disparity and excessive horizontal disparity) in the motion pictures we processed, as well as possible solutions for each problem. Our results enable improved quality assessment during the filming and postproduction stages.

The river absorption capacity determination as a tool to evaluate state of surface water

NASA Astrophysics Data System (ADS)

Wilk, Paweł; Orlińska-Woźniak, Paulina; Gębala, Joanna

2018-02-01

In order to complete a thorough and systematic assessment of water quality, it is useful to measure the absorption capacity of a river. Absorption capacity is understood as a pollution load introduced into river water that will not cause permanent and irreversible changes in the aquatic ecosystem and will not cause a change in the classification of water quality in the river profile. In order to implement the method, the Macromodel DNS/SWAT basin for the Middle Warta pilot (central Poland) was used to simulate nutrient loads. This enabled detailed analysis of water quality in each water body and the assessment of the size of the absorption capacity parameter, which allows the determination of how much pollution can be added to the river without compromising its quality class. Positive values of the calculated absorption capacity parameter mean that it is assumed that the ecosystem is adjusted in such a way that it can eliminate pollution loads through a number of self-purification processes. Negative values indicate that the load limit has been exceeded, and too much pollution has been introduced into the ecosystem for it to be able to deal with through the processes of self-purification. Absorption capacity thus enables the connection of environmental standards of water quality and water quality management plans in order to meet these standards.

Testing a simple field method for assessing nitrate removal in riparian zones

Treesearch

Philippe Vidon; Michael G. Dosskey

2008-01-01

Being able to identify riparian sites that function better for nitrate removal from groundwater is critical to using efficiently the riparian zones for water quality management. For this purpose, managers need a method that is quick, inexpensive, and accurate enough to enable effective management decisions. This study assesses the precision and accuracy of a simple...

An Overview of NPP VIIRS Pre-Launch and On-Orbit Calibration and Characterization

NASA Technical Reports Server (NTRS)

Butler, Jim; Gleason, Jim; Xiong, Jack; Chang, Vincent; Lee, Shih Yan

2011-01-01

NPP Visible Infrared Imaging Radiometer Suite (VIIRS) test program at the instrument and observatory level is complete and has provided an extensive amount of high quality data to enable the assessment of sensor performance.

An objective method for a video quality evaluation in a 3DTV service

NASA Astrophysics Data System (ADS)

Wilczewski, Grzegorz

2015-09-01

The following article describes proposed objective method for a 3DTV video quality evaluation, a Compressed Average Image Intensity (CAII) method. Identification of the 3DTV service's content chain nodes enables to design a versatile, objective video quality metric. It is based on an advanced approach to the stereoscopic videostream analysis. Insights towards designed metric mechanisms, as well as the evaluation of performance of the designed video quality metric, in the face of the simulated environmental conditions are herein discussed. As a result, created CAII metric might be effectively used in a variety of service quality assessment applications.

The Status of Secondary School Science Laboratory Activities for Quality Education in Case of Wolaita Zone, Southern Ethiopia

ERIC Educational Resources Information Center

Zengele, Ashebir Gogile; Alemayehu, Bereket

2016-01-01

A high quality science education in primary and secondary schools contributes to developing scientific literacy and would be expected to predispose students to study the enabling sciences at university. The major purpose of this study was to assess the practice and problems in science laboratory activities in the secondary school of Wolaita Zone,…

Quality assurance report - Loch Vale Watershed, 1999-2002

USGS Publications Warehouse

Botte, Jorin A.; Baron, Jill S.

2004-01-01

The National Park Service initiated the Loch Vale Watershed (LVWS) project in 1980 with funding from the Aquatic Effects Research Program of the National Acid Precipitation Assessment Program. Long-term ecological research and monitoring address watershed-scale ecosystem processes, particularly as they respond to atmospheric deposition and climate variability. Monitoring of meteorological, hydrologic, precipitation chemistry, and surface water quality parameters enable us to use long-term trends to distinguish natural from human-caused disturbances. Research into snow distribution, hydrologic flowpaths, vegetation responses to N deposition, isotopic transformations of N by forest and soil processes, trace metals, and aquatic ecological responses to disturbance enable us to understand processes that influence high elevation ecosystems.

Opportunities for improved diabetes care among patients of safety net practices: a safety net providers' strategic alliance study.

PubMed

Reichsman, Ann; Werner, James; Cella, Peggi; Bobiak, Sarah; Stange, Kurt C

2009-01-01

To identify barriers and opportunities for quality diabetes care in safety net practices. In 3 federally qualified health centers and 1 free clinic, 19 primary care clinicians profiled patient and visit characteristics and quality of care measures for 181 consecutive visits by adult type 2 diabetic patients. Open-ended questions assessed patient and clinician perception of barriers to diabetes care and patient report of enabling factors. A multidisciplinary team identified themes from open-ended responses. Logistic regression analyses assessed the association of the identified barriers/enablers with 2 measures of quality care: glycosylated hemoglobin and prophylactic aspirin use. Ranked barriers noted by patients included adherence (40%), financial/insurance (23%), and psychosocial (13%) factors. Clinicians ranked systemic factors, including financial/ insurance (32%) and cultural/psychosocial (29%) factors, as important to adherence (29%) in determining quality diabetes care. Patients reported dietary and medical adherence (37%) and family/health care worker support (17%) as helpful factors. Among 175 patients with available data, glycosylated hemoglobin levels were associated with patient report of financial/insurance factors both as a barrier when visits and medications were unaffordable and as an opportunity when free or low-cost medications and services were provided. Patients' adherence with aspirin prophylaxis was strongly associated with African American race, prior prescription of aspirin and distribution of aspirin at the practice site (p<.001). Patients were less likely than clinicians to identify systemic and contextual factors contributing to poor diabetes care. From the front line's perspective, enabling patient self-management and systemic support is a target for improving diabetes care in safety net practices.

The biopharmaceutics risk assessment roadmap for optimizing clinical drug product performance.

PubMed

Selen, Arzu; Dickinson, Paul A; Müllertz, Anette; Crison, John R; Mistry, Hitesh B; Cruañes, Maria T; Martinez, Marilyn N; Lennernäs, Hans; Wigal, Tim L; Swinney, David C; Polli, James E; Serajuddin, Abu T M; Cook, Jack A; Dressman, Jennifer B

2014-11-01

The biopharmaceutics risk assessment roadmap (BioRAM) optimizes drug product development and performance by using therapy-driven target drug delivery profiles as a framework to achieve the desired therapeutic outcome. Hence, clinical relevance is directly built into early formulation development. Biopharmaceutics tools are used to identify and address potential challenges to optimize the drug product for patient benefit. For illustration, BioRAM is applied to four relatively common therapy-driven drug delivery scenarios: rapid therapeutic onset, multiphasic delivery, delayed therapeutic onset, and maintenance of target exposure. BioRAM considers the therapeutic target with the drug substance characteristics and enables collection of critical knowledge for development of a dosage form that can perform consistently for meeting the patient's needs. Accordingly, the key factors are identified and in vitro, in vivo, and in silico modeling and simulation techniques are used to elucidate the optimal drug delivery rate and pattern. BioRAM enables (1) feasibility assessment for the dosage form, (2) development and conduct of appropriate "learning and confirming" studies, (3) transparency in decision-making, (4) assurance of drug product quality during lifecycle management, and (5) development of robust linkages between the desired clinical outcome and the necessary product quality attributes for inclusion in the quality target product profile. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Assessing Public Metabolomics Metadata, Towards Improving Quality.

PubMed

Ferreira, João D; Inácio, Bruno; Salek, Reza M; Couto, Francisco M

2017-12-13

Public resources need to be appropriately annotated with metadata in order to make them discoverable, reproducible and traceable, further enabling them to be interoperable or integrated with other datasets. While data-sharing policies exist to promote the annotation process by data owners, these guidelines are still largely ignored. In this manuscript, we analyse automatic measures of metadata quality, and suggest their application as a mean to encourage data owners to increase the metadata quality of their resources and submissions, thereby contributing to higher quality data, improved data sharing, and the overall accountability of scientific publications. We analyse these metadata quality measures in the context of a real-world repository of metabolomics data (i.e. MetaboLights), including a manual validation of the measures, and an analysis of their evolution over time. Our findings suggest that the proposed measures can be used to mimic a manual assessment of metadata quality.

Droplet Digital™ PCR Next-Generation Sequencing Library QC Assay.

PubMed

Heredia, Nicholas J

2018-01-01

Digital PCR is a valuable tool to quantify next-generation sequencing (NGS) libraries precisely and accurately. Accurately quantifying NGS libraries enable accurate loading of the libraries on to the sequencer and thus improve sequencing performance by reducing under and overloading error. Accurate quantification also benefits users by enabling uniform loading of indexed/barcoded libraries which in turn greatly improves sequencing uniformity of the indexed/barcoded samples. The advantages gained by employing the Droplet Digital PCR (ddPCR™) library QC assay includes the precise and accurate quantification in addition to size quality assessment, enabling users to QC their sequencing libraries with confidence.

SPEAR Trial: Smartphone Pediatric ElectrocARdiogram Trial

PubMed Central

Nguyen, Hoang H.; Van Hare, George F.; Rudokas, Michael; Bowman, Tammy; Silva, Jennifer N. A.

2015-01-01

Objectives Smartphone-enabled ECG devices have the potential to improve patient care by enabling remote ECG assessment of patients with potential and diagnosed arrhythmias. This prospective study aimed to assess the usefulness of pediatric ECG tracings generated by the AliveCor device (Oklahoma City, OK) and to assess user satisfaction. Study Design Enrolled pediatric patients with documented paroxysmal arrhythmia used the AliveCor device over a yearlong study period. Pediatric electrophysiologists reviewed all transmitted ECG tracings. Patient completed surveys were analyzed to assess user satisfaction. Results 35 patients were enrolled with the following diagnoses: supraventricular tachycardia (SVT, 57%), atrial fibrillation (AF, 11%), ectopic atrial tachycardia (EAT, 6%), atrial tachycardia (AT, 3%), and ventricular tachycardia (VT, 23%). A total of 238 tracings were received from 20 patients, 96% of which were of diagnostic quality for sinus rhythm, sinus tachycardia, SVT, and AF. 126 patient satisfaction surveys (64% from parents) were completed. 98% of the survey responses indicated that it was easy to obtain tracings, 93% found it easy to transmit the tracings, 98% showed added comfort in managing arrhythmia by having the device, and 93% showed interest in continued use of the device after the study period ended. Conclusions Smartphone-enabled ECG devices can generate tracings of diagnostic quality in children. User satisfaction was extremely positive. Use of the device to manage certain patients with AF and SVT showcases the future role of remote ECGs in the successful outpatient management of arrhythmias in children by potentially reducing Emergency Department visits and healthcare costs. PMID:26295569

Serving the Customer – Do Patient Feedback and Questionnaires Improve Quality?

PubMed

Keshtgar, Asma; D’Cruz, Len

2017-01-01

This review article aims to analyse whether patient feedback and questionnaires improve quality of care. It is recognized that patients cannot assess the medical competence of the clinician, yet patient experience provides an insight into the process of care through the patients’ eyes. Patient experience measures are more reliable for use to assess quality than patient satisfaction surveys. It is inappropriate to use patient satisfaction surveys as a basis for remuneration of dentists within the NHS. Patient Reported Outcome Measures (PROMs) have been a successful measure of patient experience in medicine and their introduction to dentistry needs to be considered. Clinical relevance: This article will enable clinicians to understand the importance of patient experience measures as a more reliable way of improving the quality of clinical care than patient satisfaction surveys.

The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review.

PubMed

Goedhart, Nicole S; van Oostveen, Catharina J; Vermeulen, Hester

2017-04-01

To assess and synthesise studies reporting direct associations between the structural empowerment of frontline nurses and quality outcomes, and to identify gaps in the current literature. The empowerment of nurses seems essential for delivering high-quality patient care. Understanding the relationship between empowerment and quality outcomes would enable nurse managers to make informed choices on improving the quality of care. A scoping review examining the relationship between the structural empowerment of nurses and the quality, effectiveness, safety, efficiency and patient-centredness of care in hospitals. Searching in MEDLINE, CINAHL, Business Source Premier and Embase identified 672 potentially relevant articles. Independent selection, quality assessment, data extraction and analysis were completed. Twelve cross-sectional studies originating from North America were included. These studies showed a variety of quality outcomes and statistics used. All studies reported positive associations between the structural empowerment of nurses, nurse assessed quality of care and patient safety climate, and work and unit effectiveness. Nurses having access to empowering structures positively affects the quality outcomes, i.e. quality, effectiveness, safety, efficiency and patient-centredness of patient care in hospitals. Nurse managers and leaders should ensure empowering work conditions for nurses in order to increase hospitals' quality of patient care. © 2017 John Wiley & Sons Ltd.

Using magnetic levitation for non-destructive quality control of plastic parts.

PubMed

Hennek, Jonathan W; Nemiroski, Alex; Subramaniam, Anand Bala; Bwambok, David K; Yang, Dian; Harburg, Daniel V; Tricard, Simon; Ellerbee, Audrey K; Whitesides, George M

2015-03-04

Magnetic levitation (MagLev) enables rapid and non-destructive quality control of plastic parts. The feasibility of MagLev as a method to: i) rapidly assess injection-molded plastic parts for defects during process optimization, ii) monitor the degradation of plastics after exposure to harsh environmental conditions, and iii) detect counterfeit polymers by density is demonstrated. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Web Implementation of Quality Assurance (QA) for X-ray Units in Balkanic Medical Institutions.

PubMed

Urošević, Vlade; Ristić, Olga; Milošević, Danijela; Košutić, Duško

2015-08-01

Diagnostic radiology is the major contributor to the total dose of the population from all artificial sources. In order to reduce radiation exposure and optimize diagnostic x-ray image quality, it is necessary to increase the quality and efficiency of quality assurance (QA) and audit programs. This work presents a web application providing completely new QA solutions for x-ray modalities and facilities. The software gives complete online information (using European standards) with which the corresponding institutions and individuals can evaluate and control a facility's Radiation Safety and QA program. The software enables storage of all data in one place and sharing the same information (data), regardless of whether the measured data is used by an individual user or by an authorized institution. The software overcomes the distance and time separation of institutions and individuals who take part in QA. Upgrading the software will enable assessment of the medical exposure level to ionizing radiation.

Quality assessment of decision-making in colorectal cancer multidisciplinary meetings.

PubMed

Seretis, Charalampos; Mankotia, Rajnish; Goonetilleke, Kolitha; Rawstorne, Edward

2014-01-01

The quality of decision-making in the colorectal multidisciplinary team (MDT) meetings can significantly affect the quality of care delivered to patients with colorectal cancer. We performed a prospective study to assess the quality of the MDT meetings in a specialized colorectal unit using an externally observational validated tool. An externally validated observational tool, the Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess the quality of clinical decision-making in 64 cases. Although case history information presented by the responsible surgeon was rated high (4.4/5), the quality of radiological and histopathological information regarding each patient's case which was available at the time was less adequate, scoring 3.9/5 and 3.8/5, respectively. Moreover, the precise knowledge of patients' personal views and circumstances was a field requiring further improvement. In a general overview however, the quality and extent of the available information enabled the MDT to provide a clear recommendation regarding the patients' treatment plans in 87.5% of the cases. The cMDT-MODe tool can be used to prospectively audit the quality of clinical decision-making in the colorectal MDT meetings and highlight the fields of potential improvement.

Patient satisfaction questionnaire--how to do them successfully.

PubMed

Holt, Vernon P

2006-01-01

In the current consumer-orientated environment, customer surveys are widely used to assess needs and levels of satisfaction. For the dental practice to succeed, it is important to assess the needs and levels of satisfaction of the patients. The planning and execution of a Patient Satisfaction Questionnaire survey is discussed, along with the quality assurance and marketing benefits that may accrue to the practice applying the lessons learnt from the survey. A well run survey will not only reveal levels of patient satisfaction with the practice care and service--a Quality Assurance exercise--but will also enable the practitioner to assess--and even influence--patients' awareness of the levels of care and service being delivered--a marketing benefit.

A new framework for interactive quality assessment with application to light field coding

NASA Astrophysics Data System (ADS)

Viola, Irene; Ebrahimi, Touradj

2017-09-01

In recent years, light field has experienced a surge of popularity, mainly due to the recent advances in acquisition and rendering technologies that have made it more accessible to the public. Thanks to image-based rendering techniques, light field contents can be rendered in real time on common 2D screens, allowing virtual navigation through the captured scenes in an interactive fashion. However, this richer representation of the scene poses the problem of reliable quality assessments for light field contents. In particular, while subjective methodologies that enable interaction have already been proposed, no work has been done on assessing how users interact with light field contents. In this paper, we propose a new framework to subjectively assess the quality of light field contents in an interactive manner and simultaneously track users behaviour. The framework is successfully used to perform subjective assessment of two coding solutions. Moreover, statistical analysis performed on the results shows interesting correlation between subjective scores and average interaction time.

An Automated Blur Detection Method for Histological Whole Slide Imaging

PubMed Central

Moles Lopez, Xavier; D'Andrea, Etienne; Barbot, Paul; Bridoux, Anne-Sophie; Rorive, Sandrine; Salmon, Isabelle; Debeir, Olivier; Decaestecker, Christine

2013-01-01

Whole slide scanners are novel devices that enable high-resolution imaging of an entire histological slide. Furthermore, the imaging is achieved in only a few minutes, which enables image rendering of large-scale studies involving multiple immunohistochemistry biomarkers. Although whole slide imaging has improved considerably, locally poor focusing causes blurred regions of the image. These artifacts may strongly affect the quality of subsequent analyses, making a slide review process mandatory. This tedious and time-consuming task requires the scanner operator to carefully assess the virtual slide and to manually select new focus points. We propose a statistical learning method that provides early image quality feedback and automatically identifies regions of the image that require additional focus points. PMID:24349343

Active Engagement with Assessment and Feedback Can Improve Group-Work Outcomes and Boost Student Confidence

ERIC Educational Resources Information Center

Scott, G. W.

2017-01-01

This study involves evaluation of a novel iterative group-based learning task developed to enable students to actively engage with assessment and feedback in order to improve the quality of their written work. The students were all in the final semester of their final year of study and enrolled on either BSc Zoology or BSc Marine and Freshwater…

Evaluating the feasibility of using online software to collect patient information in a chiropractic practice-based research network.

PubMed

Kania-Richmond, Ania; Weeks, Laura; Scholten, Jeffrey; Reney, Mikaël

2016-03-01

Practice based research networks (PBRNs) are increasingly used as a tool for evidence based practice. We developed and tested the feasibility of using software to enable online collection of patient data within a chiropractic PBRN to support clinical decision making and research in participating clinics. To assess the feasibility of using online software to collect quality patient information. The study consisted of two phases: 1) Assessment of the quality of information provided, using a standardized form; and 2) Exploration of patients' perspectives and experiences regarding online information provision through semi-structured interviews. Data analysis was descriptive. Forty-five new patients were recruited. Thirty-six completed online forms, which were submitted by an appropriate person 100% of the time, with an error rate of less than 1%, and submitted in a timely manner 83% of the time. Twenty-one participants were interviewed. Overall, online forms were preferred given perceived security, ease of use, and enabling provision of more accurate information. Use of online software is feasible, provides high quality information, and is preferred by most participants. A pen-and-paper format should be available for patients with this preference and in case of technical difficulties.

The geospatial data quality REST API for primary biodiversity data

PubMed Central

Otegui, Javier; Guralnick, Robert P.

2016-01-01

Summary: We present a REST web service to assess the geospatial quality of primary biodiversity data. It enables access to basic and advanced functions to detect completeness and consistency issues as well as general errors in the provided record or set of records. The API uses JSON for data interchange and efficient parallelization techniques for fast assessments of large datasets. Availability and implementation: The Geospatial Data Quality API is part of the VertNet set of APIs. It can be accessed at http://api-geospatial.vertnet-portal.appspot.com/geospatial and is already implemented in the VertNet data portal for quality reporting. Source code is freely available under GPL license from http://www.github.com/vertnet/api-geospatial. Contact: javier.otegui@gmail.com or rguralnick@flmnh.ufl.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26833340

The geospatial data quality REST API for primary biodiversity data.

PubMed

Otegui, Javier; Guralnick, Robert P

2016-06-01

We present a REST web service to assess the geospatial quality of primary biodiversity data. It enables access to basic and advanced functions to detect completeness and consistency issues as well as general errors in the provided record or set of records. The API uses JSON for data interchange and efficient parallelization techniques for fast assessments of large datasets. The Geospatial Data Quality API is part of the VertNet set of APIs. It can be accessed at http://api-geospatial.vertnet-portal.appspot.com/geospatial and is already implemented in the VertNet data portal for quality reporting. Source code is freely available under GPL license from http://www.github.com/vertnet/api-geospatial javier.otegui@gmail.com or rguralnick@flmnh.ufl.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

Software Analytical Instrument for Assessment of the Process of Casting Slabs

NASA Astrophysics Data System (ADS)

Franěk, Zdeněk; Kavička, František; Štětina, Josef; Masarik, Miloš

2010-06-01

The paper describes the original proposal of ways of solution and function of the program equipment for assessment of the process of casting slabs. The program system LITIOS was developed and implemented in EVRAZ Vitkovice Steel Ostrava on the equipment of continuous casting of steel (further only ECC). This program system works on the data warehouse of technological parameters of casting and quality parameters of slabs. It enables an ECC technologist to analyze the course of casting melt and with using statistics methods to set the influence of single technological parameters on the duality of final slabs. The system also enables long term monitoring and optimization of the production.

NUMERICAL MODELS AS ENABLING TOOLS FOR TIDAL-STREAM ENERGY EXTRACTION AND ENVIRONMENTAL IMPACT ASSESSMENT

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

Yang, Zhaoqing; Wang, Taiping

This paper presents a modeling study conducted to evaluate tidal-stream energy extraction and its associated potential environmental impacts using a three-dimensional unstructured-grid coastal ocean model, which was coupled with a water-quality model and a tidal-turbine module.

Alternative Land-Use Method for Spatially Informed Watershed Management Decision Making Using SWAT

EPA Science Inventory

In this study, a modification is proposed to the Soil and Water Assessment Tool (SWAT) to enable identification of areas where the implementation of best management practices would likely result in the most significant improvement in downstream water quality. To geospatially link...

Contract Management Process Maturity: Empirical Analysis of Organizational Assessments

DTIC Science & Technology

2009-08-27

maturity or learning capability ( Yueng , Ulrich, Nason, & Von Glinow, 1999), thus enabling them to produce high-quality goods and services faster, cheaper...from http://www.transcom.mil/organization2.cfm Yueng , A.K., Ulrich, D.O., Nason, S.W., & Von Glinow, M.A. (1999). Organizational learning

Automatic Assessment of Acquisition and Transmission Losses in Indian Remote Sensing Satellite Data

NASA Astrophysics Data System (ADS)

Roy, D.; Purna Kumari, B.; Manju Sarma, M.; Aparna, N.; Gopal Krishna, B.

2016-06-01

The quality of Remote Sensing data is an important parameter that defines the extent of its usability in various applications. The data from Remote Sensing satellites is received as raw data frames at the ground station. This data may be corrupted with data losses due to interferences during data transmission, data acquisition and sensor anomalies. Thus it is important to assess the quality of the raw data before product generation for early anomaly detection, faster corrective actions and product rejection minimization. Manual screening of raw images is a time consuming process and not very accurate. In this paper, an automated process for identification and quantification of losses in raw data like pixel drop out, line loss and data loss due to sensor anomalies is discussed. Quality assessment of raw scenes based on these losses is also explained. This process is introduced in the data pre-processing stage and gives crucial data quality information to users at the time of browsing data for product ordering. It has also improved the product generation workflow by enabling faster and more accurate quality estimation.

RFID in the blood supply chain--increasing productivity, quality and patient safety.

PubMed

Briggs, Lynne; Davis, Rodeina; Gutierrez, Alfonso; Kopetsky, Matthew; Young, Kassandra; Veeramani, Raj

2009-01-01

As part of an overall design of a new, standardized RFID-enabled blood transfusion medicine supply chain, an assessment was conducted for two hospitals: the University of Iowa Hospital and Clinics (UIHC) and Mississippi Baptist Health System (MBHS). The main objectives of the study were to assess RFID technological and economic feasibility, along with possible impacts to productivity, quality and patient safety. A step-by-step process analysis focused on the factors contributing to process "pain points" (errors, inefficiency, product losses). A process re-engineering exercise produced blueprints of RFID-enabled processes to alleviate or eliminate those pain-points. In addition, an innovative model quantifying the potential reduction in adverse patient effects as a result of RFID implementation was created, allowing improvement initiatives to focus on process areas with the greatest potential impact to patient safety. The study concluded that it is feasible to implement RFID-enabled processes, with tangible improvements to productivity and safety expected. Based on a comprehensive cost/benefit model, it is estimated for a large hospital (UIHC) to recover investment from implementation within two to three years, while smaller hospitals may need longer to realize ROI. More importantly, the study estimated that RFID technology could reduce morbidity and mortality effects substantially among patients receiving transfusions.

[The methodological assessment and qualitative evaluation of psychometric performance tests based on the example of modern tests that assess reading and spelling skills].

PubMed

Galuschka, Katharina; Rothe, Josefine; Schulte-Körne, Gerd

2015-09-01

This article looks at a means of objectively evaluating the quality of psychometric tests. This approach enables users to evaluate psychometric tests based on their methodological characteristics, in order to decide which instrument should be used. Reading and spelling assessment tools serve as examples. The paper also provides a review of German psychometric tests for the assessment of reading and spelling skills. This method facilitates the identification of psychometric tests.of high methodological quality which can be used for the assessment of reading and spelling skills. Reading performance should ideally be assessed with the following instruments: ELFE 1-6, LGVT 6-12, LESEN 6-7, LESEN 8-9, or WLLP-R. The tests to be used for the evaluation of spelling skills are DERET 1-2+, DERET 3-4+, WRT 1+, WRT 2+, WRT 3+, WRT 4+ or HSP 1-10.

Developing a dementia-specific preference-­based quality of life measure (AD-5D) in Australia: a valuation study protocol

PubMed Central

Comans, Tracy A; Nguyen, Kim-Huong; Mulhern, Brendan; Corlis, Megan; Li, Li; Welch, Alyssa; Kurrle, Susan E; Rowen, Donna; Moyle, Wendy; Kularatna, Sanjeewa; Ratcliffe, Julie

2018-01-01

Introduction Generic instruments for assessing health-related quality of life may lack the sensitivity to detect changes in health specific to certain conditions, such as dementia. The Quality of Life in Alzheimer’s Disease (QOL-AD) is a widely used and well-validated condition-specific instrument for assessing health-related quality of life for people living with dementia, but it does not enable the calculation of quality-adjusted life years, the basis of cost utility analysis. This study will generate a preference-based scoring algorithm for a health state classification system -the Alzheimer’s Disease Five Dimensions (AD-5D) derived from the QOL-AD. Methods and analysis Discrete choice experiments with duration (DCETTO) and best–worst scaling health state valuation tasks will be administered to a representative sample of 2000 members of the Australian general population via an online survey and to 250 dementia dyads (250 people with dementia and their carers) via face-to-face interview. A multinomial (conditional) logistic framework will be used to analyse responses and produce the utility algorithm for the AD-5D. Ethics and dissemination The algorithms developed will enable prospective and retrospective economic evaluation of any treatment or intervention targeting people with dementia where the QOL-AD has been administered and will be available online. Results will be disseminated through journals that publish health economics articles and through professional conferences. This study has ethical approval. PMID:29358437

Exercise to Counteract Loss of Bone and Muscle during Androgen Deprivation Therapy in Men with Prostate Cancer

DTIC Science & Technology

2008-08-01

increases 5- to 10-fold after the initiation of ADT19 and that the relative risk of osteoporotic fracture is increased by 30% to 300%.20-22 In 31 men...of bone turnover; serum sex hormones; physical functional performance; quality of life, and risk factors for cardiovascular disease (blood lipids...hormone binding globulin; physical functional performance; and quality of life. Local project support will enable additional assessments of risk

Exercise to Countereact Loss of Bone and Muscle During Androgen Deprivation Therapy in Men with Prostate Cancer

DTIC Science & Technology

2007-05-01

increases 5- to 10-fold after the initiation of ADT14 and that the relative risk of osteoporotic fracture is increased by 30% to 300%.15-17 In 31 men...of bone turnover; serum sex hormones; physical functional performance; quality of life, and risk factors for cardiovascular disease (blood lipids...hormone binding globulin; physical functional performance; and quality of life. Local project support will enable additional assessments of risk factors

32 CFR Appendix E to Part 247 - DoD Command Newspaper and Magazine Review System

Code of Federal Regulations, 2010 CFR

2010-07-01

... commanders in establishing and maintaining cost-effective internal communications essential to mission accomplishment. The system also enables internal information managers to assess the cost and effective use of...-day quality assurance procedures or established critique programs. C. Review criteria. Each newspaper...

Making Learning Happen: Strategies for an Interactive Classroom.

ERIC Educational Resources Information Center

Golub, Jeffrey N.

This is a book about "conscious learning," the kind of learning that enables students to assess the current level and quality of their language performance and then work to improve that performance deliberately, enthusiastically, and with commitment. The book takes complex, sophisticated understandings and reworks them into ready-to-use…

Adapting the nitrogen replacement approach to dryland spring wheat in the Pacific Northwest

USDA-ARS?s Scientific Manuscript database

Grain quality analyzers have become commercially available for combine harvesters to enable on-the-go mapping of grain protein levels across farm fields. A map of grain protein is potentially useful for post-harvest assessments of N management programs and development of future fertilizer N recomme...

Leadership qualities framework provides a useful tool for nurses.

PubMed

Guelbert, Catherine

2003-11-01

Good leadership can be difficult to define, but it is vital to inspiring staff to improve services. A framework has been developed to enable NHS leaders at all levels to assess their strengths and identify their development needs. It is applicable to leadership roles at any level, including nurses.

System-Level Action Required for Wide-Scale Improvement in Quality of Primary Health Care: Synthesis of Feedback from an Interactive Process to Promote Dissemination and Use of Aggregated Quality of Care Data.

PubMed

Bailie, Jodie; Laycock, Alison; Matthews, Veronica; Bailie, Ross

2016-01-01

There is an enduring gap between recommended practice and care that is actually delivered; and there is wide variation between primary health care (PHC) centers in delivery of care. Where aspects of care are not being done well across a range of PHC centers, this is likely due to inadequacies in the broader system. This paper aims to describe stakeholders' perceptions of the barriers and enablers to addressing gaps in Australian Aboriginal and Torres Strait Islander chronic illness care and child health, and to identify key drivers for improvement. This paper draws on data collected as part of a large-scale continuous quality improvement project in Australian Indigenous PHC settings. We undertook a qualitative assessment of stakeholder feedback on the main barriers and enablers to addressing gaps in care for Aboriginal and Torres Strait Islander children and in chronic illness care. Themes on barriers and enablers were further analyzed to develop a "driver diagram," an improvement tool used to locate barriers and enablers within causal pathways (as primary and secondary drivers), enabling them to be targeted by tailored interventions. We identified 5 primary drivers and 11 secondary drivers of high-quality care, and associated strategies that have potential for wide-scale implementation to address barriers and enablers for improving care. Perceived barriers to addressing gaps in care included both health system and staff attributes. Primary drivers were: staff capability to deliver high-quality care; availability and use of clinical information systems and decision support tools; embedding of quality improvement processes and data-driven decision-making; appropriate and effective recruitment and retention of staff; and community capacity, engagement and mobilization for health. Suggested strategies included mechanisms for increasing clinical supervision and support, staff retention, reorientation of service delivery, use of information systems and community health literacy. The findings identify areas of focus for development of barrier-driven, tailored interventions to improve health outcomes. They reinforce the importance of system-level action to improve health center performance and health outcomes, and of developing strategies to address system-wide challenges that can be adapted to local contexts.

Advancing Resident Assessment in Graduate Medical Education

PubMed Central

Swing, Susan R.; Clyman, Stephen G.; Holmboe, Eric S.; Williams, Reed G.

2009-01-01

Background The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. Intervention The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007–2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. Outcome The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008. PMID:21975993

Automated Data Quality Assurance using OGC Sensor Web Enablement Frameworks for Marine Observatories

NASA Astrophysics Data System (ADS)

Toma, Daniel; Bghiel, Ikram; del Rio, Joaquin; Hidalgo, Alberto; Carreras, Normandino; Manuel, Antoni

2014-05-01

Over the past years, environmental sensors have continuously improved by becoming smaller, cheaper, and more intelligent. Therefore, many sensor networks are increasingly deployed to monitor our environment. But due to the large number of sensor manufacturers, accompanying protocols and data encoding, automated integration and data quality assurance of diverse sensors in an observing systems is not straightforward, requiring development of data management code and manual tedious configuration. However, over the past few years it has been demonstrated that Open-Geospatial Consortium (OGC) frameworks can enable web services with fully-described sensor systems, including data processing, sensor characteristics and quality control tests and results. So far, the SWE framework does not describe how to integrate sensors on-the-fly with minimal human intervention. The data management software which enables access to sensors, data processing and quality control tests has to be implemented and the results have to be manually mapped to the SWE models. In this contribution, we describe a Sensor Plug & Play infrastructure for the Sensor Web by combining (1) OGC PUCK protocol - a simple standard embedded instrument protocol to store and retrieve directly from the devices the declarative description of sensor characteristics and quality control tests, (2) an automatic mechanism for data processing and quality control tests underlying the Sensor Web - the Sensor Interface Descriptor (SID) concept, as well as (3) a model for the declarative description of sensor which serves as a generic data management mechanism - designed as a profile and extension of OGC SWE's SensorML standard. We implement and evaluate our approach by applying it to the OBSEA Observatory, and can be used to demonstrate the ability to assess data quality for temperature, salinity, air pressure and wind speed and direction observations off the coast of Garraf, in the north-eastern Spain.

A neurite quality index and machine vision software for improved quantification of neurodegeneration.

PubMed

Romero, Peggy; Miller, Ted; Garakani, Arman

2009-12-01

Current methods to assess neurodegradation in dorsal root ganglion cultures as a model for neurodegenerative diseases are imprecise and time-consuming. Here we describe two new methods to quantify neuroprotection in these cultures. The neurite quality index (NQI) builds upon earlier manual methods, incorporating additional morphological events to increase detection sensitivity for the detection of early degeneration events. Neurosight is a machine vision-based method that recapitulates many of the strengths of NQI while enabling high-throughput screening applications with decreased costs.

The Significance of Quality Assurance within Model Intercomparison Projects at the World Data Centre for Climate (WDCC)

NASA Astrophysics Data System (ADS)

Toussaint, F.; Hoeck, H.; Stockhause, M.; Lautenschlager, M.

2014-12-01

The classical goals of a quality assessment system in the data life cycle are (1) to encourage data creators to improve their quality assessment procedures to reach the next quality level and (2) enable data consumers to decide, whether a dataset has a quality that is sufficient for usage in the target application, i.e. to appraise the data usability for their own purpose.As the data volumes of projects and the interdisciplinarity of data usage grow, the need for homogeneous structure and standardised notation of data and metadata increases. This third aspect is especially valid for the data repositories, as they manage data through machine agents. So checks for homogeneity and consistency in early parts of the workflow become essential to cope with today's data volumes.Selected parts of the workflow in the model intercomparison project CMIP5 and the archival of the data for the interdiscipliary user community of the IPCC-DDC AR5 and the associated quality checks are reviewed. We compare data and metadata checks and relate different types of checks to their positions in the data life cycle.The project's data citation approach is included in the discussion, with focus on temporal aspects of the time necessary to comply with the project's requirements for formal data citations and the demand for the availability of such data citations.In order to make different quality assessments of projects comparable, WDCC developed a generic Quality Assessment System. Based on the self-assessment approach of a maturity matrix, an objective and uniform quality level system for all data at WDCC is derived which consists of five maturity quality levels.

An empirical model of water quality for use in rapid management strategy evaluation in Southeast Queensland, Australia.

PubMed

de la Mare, William; Ellis, Nick; Pascual, Ricardo; Tickell, Sharon

2012-04-01

Simulation models have been widely adopted in fisheries for management strategy evaluation (MSE). However, in catchment management of water quality, MSE is hampered by the complexity of both decision space and the hydrological process models. Empirical models based on monitoring data provide a feasible alternative to process models; they run much faster and, by conditioning on data, they can simulate realistic responses to management actions. Using 10 years of water quality indicators from Queensland, Australia, we built an empirical model suitable for rapid MSE that reproduces the water quality variables' mean and covariance structure, adjusts the expected indicators through local management effects, and propagates effects downstream by capturing inter-site regression relationships. Empirical models enable managers to search the space of possible strategies using rapid assessment. They provide not only realistic responses in water quality indicators but also variability in those indicators, allowing managers to assess strategies in an uncertain world. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evaluating the feasibility of using online software to collect patient information in a chiropractic practice-based research network

PubMed Central

Kania-Richmond, Ania; Weeks, Laura; Scholten, Jeffrey; Reney, Mikaël

2016-01-01

Background: Practice based research networks (PBRNs) are increasingly used as a tool for evidence based practice. We developed and tested the feasibility of using software to enable online collection of patient data within a chiropractic PBRN to support clinical decision making and research in participating clinics. Purpose: To assess the feasibility of using online software to collect quality patient information. Methods: The study consisted of two phases: 1) Assessment of the quality of information provided, using a standardized form; and 2) Exploration of patients’ perspectives and experiences regarding online information provision through semi-structured interviews. Data analysis was descriptive. Results: Forty-five new patients were recruited. Thirty-six completed online forms, which were submitted by an appropriate person 100% of the time, with an error rate of less than 1%, and submitted in a timely manner 83% of the time. Twenty-one participants were interviewed. Overall, online forms were preferred given perceived security, ease of use, and enabling provision of more accurate information. Conclusions: Use of online software is feasible, provides high quality information, and is preferred by most participants. A pen-and-paper format should be available for patients with this preference and in case of technical difficulties. PMID:27069272

Quality improvement in physiotherapy services.

PubMed

Boak, George; Sephton, Ruth; Hough, Elaine; Ten Hove, Ruth

2017-06-12

Purpose The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach This is a multiple case study and information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications The findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of the authors' knowledge, no other longitudinal process change study in therapy services has been published.

Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review

PubMed Central

Kent, Angelle; Kobagi, Nadia; Huynh, Kha Tu; Clarke, Alix; Yoon, Minn N.

2017-01-01

Background Poor oral health has been a persistent problem in nursing home residents for decades, with severe consequences for residents and the health care system. Two major barriers to providing appropriate oral care are residents’ responsive behaviors to oral care and residents’ lack of ability or motivation to perform oral care on their own. Objectives To evaluate the effectiveness of strategies that nursing home care providers can apply to either prevent/overcome residents’ responsive behaviors to oral care, or enable/motivate residents to perform their own oral care. Materials and methods We searched the databases Medline, EMBASE, Evidence Based Reviews–Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science for intervention studies assessing the effectiveness of eligible strategies. Two reviewers independently (a) screened titles, abstracts and retrieved full-texts; (b) searched key journal contents, key author publications, and reference lists of all included studies; and (c) assessed methodological quality of included studies. Discrepancies at any stage were resolved by consensus. We conducted a narrative synthesis of study results. Results We included three one-group pre-test, post-test studies, and one cross-sectional study. Methodological quality was low (n = 3) and low moderate (n = 1). Two studies assessed strategies to enable/motivate nursing home residents to perform their own oral care, and to studies assessed strategies to prevent or overcome responsive behaviors to oral care. All studies reported improvements of at least some of the outcomes measured, but interpretation is limited due to methodological problems. Conclusions Potentially promising strategies are available that nursing home care providers can apply to prevent/overcome residents’ responsive behaviors to oral care or to enable/motivate residents to perform their own oral care. However, studies assessing these strategies have a high risk for bias. To overcome oral health problems in nursing homes, care providers will need practical strategies whose effectiveness was assessed in robust studies. PMID:28609476

Tracking blood products in blood centres using radio frequency identification: a comprehensive assessment.

PubMed

Davis, Rodeina; Geiger, Bradley; Gutierrez, Alfonso; Heaser, Julie; Veeramani, Dharmaraj

2009-07-01

Radio frequency identification (RFID) can be a key enabler for enhancing productivity and safety of the blood product supply chain. This article describes a systematic approach developed by the RFID Blood Consortium for a comprehensive feasibility and impact assessment of RFID application in blood centre operations. Our comprehensive assessment approach incorporates process-orientated and technological perspectives as well as impact analysis. Assessment of RFID-enabled process redesign is based on generic core processes derived from the three participating blood centres. The technological assessment includes RFID tag readability and performance evaluation, testing of temperature and biological effects of RF energy on blood products, and RFID system architecture design and standards. The scope of this article is limited to blood centre processes (from donation to manufacturing/distribution) for selected mainstream blood products (red blood cells and platelets). Radio frequency identification can help overcome a number of common challenges and process inefficiencies associated with identification and tracking of blood products. High frequency-based RFID technology performs adequately and safely for red blood cell and platelet products. Productivity and quality improvements in RFID-enabled blood centre processes can recoup investment cost in a 4-year payback period. Radio frequency identification application has significant process-orientated and technological implications. It is feasible and economically justifiable to incorporate RFID into blood centre processes.

Quality indicators for hip fracture care, a systematic review.

PubMed

Voeten, S C; Krijnen, P; Voeten, D M; Hegeman, J H; Wouters, M W J M; Schipper, I B

2018-05-17

Quality indicators are used to measure quality of care and enable benchmarking. An overview of all existing hip fracture quality indicators is lacking. The primary aim was to identify quality indicators for hip fracture care reported in literature, hip fracture audits, and guidelines. The secondary aim was to compose a set of methodologically sound quality indicators for the evaluation of hip fracture care in clinical practice. A literature search according to the PRISMA guidelines and an internet search were performed to identify hip fracture quality indicators. The indicators were subdivided into process, structure, and outcome indicators. The methodological quality of the indicators was judged using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. For structure and process indicators, the construct validity was assessed. Sixteen publications, nine audits and five guidelines were included. In total, 97 unique quality indicators were found: 9 structure, 63 process, and 25 outcome indicators. Since detailed methodological information about the indicators was lacking, the AIRE instrument could not be applied. Seven indicators correlated with an outcome measure. A set of nine quality indicators was extracted from the literature, audits, and guidelines. Many quality indicators are described and used. Not all of them correlate with outcomes of care and have been assessed methodologically. As methodological evidence is lacking, we recommend the extracted set of nine indicators to be used as the starting point for further clinical research. Future research should focus on assessing the clinimetric properties of the existing quality indicators.

The Components of Resilience--Perceptions of an Australian Rural Community

ERIC Educational Resources Information Center

Buikstra, Elizabeth; Ross, Helen; King, Christine A.; Baker, Peter G.; Hegney, Desley; McLachlan, Kathryn; Rogers-Clark, Cath

2010-01-01

Resilience, of individuals, is a well-established concept in the psychology/mental health literatures, but has been little explored in relation to communities. Related theory in the community development and social impact assessment literature provides insight into qualities and assets of communities that enable them to develop effectively or to…

TQM and Tough Love: At Inner-City Applegate Elementary, There Are High Expectations and No Excuses.

ERIC Educational Resources Information Center

Muir, Maya

2002-01-01

A Portland (Oregon) elementary school, formerly designated a local "crisis school," has improved academic achievement through a combination of Total Quality Management, high expectations, and tough love. Quarterly assessments enable staff to keep track of each student and guide instructional decisions. Small classes, on-site professional…

Comparison and validation of Fourier transform infrared spectroscopic methods for monitoring secondary cell wall cellulose from cotton fibers

USDA-ARS?s Scientific Manuscript database

The amount of secondary cell wall (SCW) cellulose in the fiber affects the quality and commercial value of cotton. Accurate assessments of SCW cellulose are essential for improving cotton fibers. Fourier Transform Infrared (FT-IR) spectroscopy enables distinguishing SCW from other cell wall componen...

JPL's Role in Advancing Earth System Science to Meet the Challenges of Climate and Environmental Change

NASA Technical Reports Server (NTRS)

Evans, Diane

2012-01-01

Objective 2.1.1: Improve understanding of and improve the predictive capability for changes in the ozone layer, climate forcing, and air quality associated with changes in atmospheric composition. Objective 2.1.2: Enable improved predictive capability for weather and extreme weather events. Objective 2.1.3: Quantify, understand, and predict changes in Earth s ecosystems and biogeochemical cycles, including the global carbon cycle, land cover, and biodiversity. Objective 2.1.4: Quantify the key reservoirs and fluxes in the global water cycle and assess water cycle change and water quality. Objective 2.1.5: Improve understanding of the roles of the ocean, atmosphere, land and ice in the climate system and improve predictive capability for its future evolution. Objective 2.1.6: Characterize the dynamics of Earth s surface and interior and form the scientific basis for the assessment and mitigation of natural hazards and response to rare and extreme events. Objective 2.1.7: Enable the broad use of Earth system science observations and results in decision-making activities for societal benefits.

High-resolution remote sensing of water quality in the San Francisco Bay-Delta Estuary

USGS Publications Warehouse

Fichot, Cédric G.; Downing, Bryan D.; Bergamaschi, Brian; Windham-Myers, Lisamarie; Marvin-DiPasquale, Mark C.; Thompson, David R.; Gierach, Michelle M.

2015-01-01

The San Francisco Bay–Delta Estuary watershed is a major source of freshwater for California and a profoundly human-impacted environment. The water quality monitoring that is critical to the management of this important water resource and ecosystem relies primarily on a system of fixed water-quality monitoring stations, but the limited spatial coverage often hinders understanding. Here, we show how the latest technology in visible/near-infrared imaging spectroscopy can facilitate water quality monitoring in this highly dynamic and heterogeneous system by enabling simultaneous depictions of several water quality indicators at very high spatial resolution. The airborne portable remote imaging spectrometer (PRISM) was used to derive high-spatial-resolution (2.6 × 2.6 m) distributions of turbidity, and dissolved organic carbon (DOC) and chlorophyll-a concentrations in a wetland-influenced region of this estuary. A filter-passing methylmercury vs DOC relationship was also developed using in situ samples and enabled the high-spatial-resolution depiction of surface methylmercury concentrations in this area. The results illustrate how high-resolution imaging spectroscopy can inform management and policy development in important inland and estuarine water bodies by facilitating the detection of point- and nonpoint-source pollution, and by providing data to help assess the complex impacts of wetland restoration and climate change on water quality and ecosystem productivity.

Assessing uncertain human exposure to ambient air pollution using environmental models in the Web

NASA Astrophysics Data System (ADS)

Gerharz, L. E.; Pebesma, E.; Denby, B.

2012-04-01

Ambient air quality can have significant impact on human health by causing respiratory and cardio-vascular diseases. Thereby, the pollutant concentration a person is exposed to can differ considerably between individuals depending on their daily routine and movement patterns. Using a straight forward approach this exposure can be estimated by integration of individual space-time paths and spatio-temporally resolved ambient air quality data. To allow a realistic exposure assessment, it is furthermore important to consider uncertainties due to input and model errors. In this work, we present a generic, web-based approach for estimating individual exposure by integration of uncertain position and air quality information implemented as a web service. Following the Model Web initiative envisioning an infrastructure for deploying, executing and chaining environmental models as services, existing models and data sources for e.g. air quality, can be used to assess exposure. Therefore, the service needs to deal with different formats, resolutions and uncertainty representations provided by model or data services. Potential mismatch can be accounted for by transformation of uncertainties and (dis-)aggregation of data under consideration of changes in the uncertainties using components developed in the UncertWeb project. In UncertWeb, the Model Web vision is extended to an Uncertainty-enabled Model Web, where services can process and communicate uncertainties in the data and models. The propagation of uncertainty to the exposure results is quantified using Monte Carlo simulation by combining different realisations of positions and ambient concentrations. Two case studies were used to evaluate the developed exposure assessment service. In a first study, GPS tracks with a positional uncertainty of a few meters, collected in the urban area of Münster, Germany were used to assess exposure to PM10 (particulate matter smaller 10 µm). Air quality data was provided by an uncertainty-enabled air quality model system which provided realisations of concentrations per hour on a 250 m x 250 m resolved grid over Münster. The second case study uses modelled human trajectories in Rotterdam, The Netherlands. The trajectories were provided as realisations in 15 min resolution per 4 digit postal code from an activity model. Air quality estimates were provided for different pollutants as ensembles by a coupled meteorology and air quality model system on a 1 km x 1 km grid with hourly resolution. Both case studies show the successful application of the service to different resolutions and uncertainty representations.

Developing a dementia-specific preference--based quality of life measure (AD-5D) in Australia: a valuation study protocol.

PubMed

Comans, Tracy A; Nguyen, Kim-Huong; Mulhern, Brendan; Corlis, Megan; Li, Li; Welch, Alyssa; Kurrle, Susan E; Rowen, Donna; Moyle, Wendy; Kularatna, Sanjeewa; Ratcliffe, Julie

2018-01-21

Generic instruments for assessing health-related quality of life may lack the sensitivity to detect changes in health specific to certain conditions, such as dementia. The Quality of Life in Alzheimer's Disease (QOL-AD) is a widely used and well-validated condition-specific instrument for assessing health-related quality of life for people living with dementia, but it does not enable the calculation of quality-adjusted life years, the basis of cost utility analysis. This study will generate a preference-based scoring algorithm for a health state classification system -the Alzheimer's Disease Five Dimensions (AD-5D) derived from the QOL-AD. Discrete choice experiments with duration (DCE TTO ) and best-worst scaling health state valuation tasks will be administered to a representative sample of 2000 members of the Australian general population via an online survey and to 250 dementia dyads (250 people with dementia and their carers) via face-to-face interview. A multinomial (conditional) logistic framework will be used to analyse responses and produce the utility algorithm for the AD-5D. The algorithms developed will enable prospective and retrospective economic evaluation of any treatment or intervention targeting people with dementia where the QOL-AD has been administered and will be available online. Results will be disseminated through journals that publish health economics articles and through professional conferences. This study has ethical approval. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Gaia: automated quality assessment of protein structure models.

PubMed

Kota, Pradeep; Ding, Feng; Ramachandran, Srinivas; Dokholyan, Nikolay V

2011-08-15

Increasing use of structural modeling for understanding structure-function relationships in proteins has led to the need to ensure that the protein models being used are of acceptable quality. Quality of a given protein structure can be assessed by comparing various intrinsic structural properties of the protein to those observed in high-resolution protein structures. In this study, we present tools to compare a given structure to high-resolution crystal structures. We assess packing by calculating the total void volume, the percentage of unsatisfied hydrogen bonds, the number of steric clashes and the scaling of the accessible surface area. We assess covalent geometry by determining bond lengths, angles, dihedrals and rotamers. The statistical parameters for the above measures, obtained from high-resolution crystal structures enable us to provide a quality-score that points to specific areas where a given protein structural model needs improvement. We provide these tools that appraise protein structures in the form of a web server Gaia (http://chiron.dokhlab.org). Gaia evaluates the packing and covalent geometry of a given protein structure and provides quantitative comparison of the given structure to high-resolution crystal structures. dokh@unc.edu Supplementary data are available at Bioinformatics online.

Method of radiometric quality assessment of NIR images acquired with a custom sensor mounted on an unmanned aerial vehicle

NASA Astrophysics Data System (ADS)

Wierzbicki, Damian; Fryskowska, Anna; Kedzierski, Michal; Wojtkowska, Michalina; Delis, Paulina

2018-01-01

Unmanned aerial vehicles are suited to various photogrammetry and remote sensing missions. Such platforms are equipped with various optoelectronic sensors imaging in the visible and infrared spectral ranges and also thermal sensors. Nowadays, near-infrared (NIR) images acquired from low altitudes are often used for producing orthophoto maps for precision agriculture among other things. One major problem results from the application of low-cost custom and compact NIR cameras with wide-angle lenses introducing vignetting. In numerous cases, such cameras acquire low radiometric quality images depending on the lighting conditions. The paper presents a method of radiometric quality assessment of low-altitude NIR imagery data from a custom sensor. The method utilizes statistical analysis of NIR images. The data used for the analyses were acquired from various altitudes in various weather and lighting conditions. An objective NIR imagery quality index was determined as a result of the research. The results obtained using this index enabled the classification of images into three categories: good, medium, and low radiometric quality. The classification makes it possible to determine the a priori error of the acquired images and assess whether a rerun of the photogrammetric flight is necessary.

QCloud: A cloud-based quality control system for mass spectrometry-based proteomics laboratories

PubMed Central

Chiva, Cristina; Olivella, Roger; Borràs, Eva; Espadas, Guadalupe; Pastor, Olga; Solé, Amanda

2018-01-01

The increasing number of biomedical and translational applications in mass spectrometry-based proteomics poses new analytical challenges and raises the need for automated quality control systems. Despite previous efforts to set standard file formats, data processing workflows and key evaluation parameters for quality control, automated quality control systems are not yet widespread among proteomics laboratories, which limits the acquisition of high-quality results, inter-laboratory comparisons and the assessment of variability of instrumental platforms. Here we present QCloud, a cloud-based system to support proteomics laboratories in daily quality assessment using a user-friendly interface, easy setup, automated data processing and archiving, and unbiased instrument evaluation. QCloud supports the most common targeted and untargeted proteomics workflows, it accepts data formats from different vendors and it enables the annotation of acquired data and reporting incidences. A complete version of the QCloud system has successfully been developed and it is now open to the proteomics community (http://qcloud.crg.eu). QCloud system is an open source project, publicly available under a Creative Commons License Attribution-ShareAlike 4.0. PMID:29324744

A randomized controlled trial of electrocoagulation-enabled biopsy versus conventional biopsy in the diagnosis of endobronchial lesions.

PubMed

Khan, Ajmal; Aggarwal, Ashutosh N; Agarwal, Ritesh; Bal, Amanjit; Gupta, Dheeraj

2011-01-01

Although electrocoagulation at time of endobronchial biopsy can potentially reduce procedure-related bleeding during fiberoptic bronchoscopy (FOB), it can also impair quality of tissue specimen; credible data for either are lacking. To evaluate the impact of hot biopsy on the quality of tissue samples and to quantify the amount of procedure-related bleeding during endobronchial biopsy. In this single-center, prospective, single-blind, randomized controlled study we included adult patients referred for FOB and having endobronchial lesions. Patients were randomized to bronchial biopsy using an electrocoagulation-enabled biopsy forceps, with (EC+ group) or without (EC- group) application of electrocoagulation current (40 W for 10 s in a monopolar mode). Procedure-related bleeding was semi-quantified by observer description, as well as through a visual analogue scale. Overall quality of biopsy specimen and tissue damage were assessed and graded by a pulmonary pathologist blinded to FOB details. 160 patients were randomized to endobronchial biopsy with (n = 81) or without (n = 79) the application of electrocoagulation. There were no severe bleeding episodes in either group, and severity of bleeding in the EC+ and EC- groups was similar (median visual analogue scale scores of 14 and 16, respectively). Histopathological diagnosis was similar in the EC+ and EC- groups (77.8% and 82.3%, respectively). There was no significant difference in tissue quality between the two groups. Use of electrocoagulation-enabled endobronchial biopsy does not alter specimen quality and does not result in any significant reduction in procedure-related bleeding. Copyright © 2010 S. Karger AG, Basel.

Achieving Goal-Concordant Care: A Conceptual Model and Approach to Measuring Serious Illness Communication and Its Impact

PubMed Central

Curtis, J. Randall; Tulsky, James A.

2018-01-01

Abstract Background: High-quality care for seriously ill patients aligns treatment with their goals and values. Failure to achieve “goal-concordant” care is a medical error that can harm patients and families. Because communication between clinicians and patients enables goal concordance and also affects the illness experience in its own right, healthcare systems should endeavor to measure communication and its outcomes as a quality assessment. Yet, little consensus exists on what should be measured and by which methods. Objectives: To propose measurement priorities for serious illness communication and its anticipated outcomes, including goal-concordant care. Methods: We completed a narrative review of the literature to identify links between serious illness communication, goal-concordant care, and other outcomes. We used this review to identify gaps and opportunities for quality measurement in serious illness communication. Results: Our conceptual model describes the relationship between communication, goal-concordant care, and other relevant outcomes. Implementation-ready measures to assess the quality of serious illness communication and care include (1) the timing and setting of serious illness communication, (2) patient experience of communication and care, and (3) caregiver bereavement surveys that include assessment of perceived goal concordance of care. Future measurement priorities include direct assessment of communication quality, prospective patient or family assessment of care concordance with goals, and assessment of the bereaved caregiver experience. Conclusion: Improving serious illness care necessitates ensuring that high-quality communication has occurred and measuring its impact. Measuring patient experience and receipt of goal-concordant care should be our highest priority. We have the tools to measure both. PMID:29091522

Achieving Goal-Concordant Care: A Conceptual Model and Approach to Measuring Serious Illness Communication and Its Impact.

PubMed

Sanders, Justin J; Curtis, J Randall; Tulsky, James A

2018-03-01

High-quality care for seriously ill patients aligns treatment with their goals and values. Failure to achieve "goal-concordant" care is a medical error that can harm patients and families. Because communication between clinicians and patients enables goal concordance and also affects the illness experience in its own right, healthcare systems should endeavor to measure communication and its outcomes as a quality assessment. Yet, little consensus exists on what should be measured and by which methods. To propose measurement priorities for serious illness communication and its anticipated outcomes, including goal-concordant care. We completed a narrative review of the literature to identify links between serious illness communication, goal-concordant care, and other outcomes. We used this review to identify gaps and opportunities for quality measurement in serious illness communication. Our conceptual model describes the relationship between communication, goal-concordant care, and other relevant outcomes. Implementation-ready measures to assess the quality of serious illness communication and care include (1) the timing and setting of serious illness communication, (2) patient experience of communication and care, and (3) caregiver bereavement surveys that include assessment of perceived goal concordance of care. Future measurement priorities include direct assessment of communication quality, prospective patient or family assessment of care concordance with goals, and assessment of the bereaved caregiver experience. Improving serious illness care necessitates ensuring that high-quality communication has occurred and measuring its impact. Measuring patient experience and receipt of goal-concordant care should be our highest priority. We have the tools to measure both.

Panning for the gold in health research: incorporating studies' methodological quality in meta-analysis.

PubMed

Johnson, Blair T; Low, Robert E; MacDonald, Hayley V

2015-01-01

Systematic reviews now routinely assess methodological quality to gauge the validity of the included studies and of the synthesis as a whole. Although trends from higher quality studies should be clearer, it is uncertain how often meta-analyses incorporate methodological quality in models of study results either as predictors, or, more interestingly, in interactions with theoretical moderators. We survey 200 meta-analyses in three health promotion domains to examine when and how meta-analyses incorporate methodological quality. Although methodological quality assessments commonly appear in contemporary meta-analyses (usually as scales), they are rarely incorporated in analyses, and still more rarely analysed in interaction with theoretical determinants of the success of health promotions. The few meta-analyses (2.5%) that did include such an interaction analysis showed that moderator results remained significant in higher quality studies or were present only among higher quality studies. We describe how to model quality interactively with theoretically derived moderators and discuss strengths and weaknesses of this approach and in relation to current meta-analytic practice. In large literatures exhibiting heterogeneous effects, meta-analyses can incorporate methodological quality and generate conclusions that enable greater confidence not only about the substantive phenomenon but also about the role that methodological quality itself plays.

Quality of life in long-term survivors of intensive care.

PubMed

Buckley, T A; Cheng, A Y; Gomersall, C D

2001-05-01

Traditionally, outcome from intensive care has focused on mortality. The cost of intensive care and the limited resources devoted to patients who have a poor prognosis also raises questions about the utilisation of such resources. There is increasing pressure for outcome evaluation of intensive care to incorporate assessment of long-term survival and the quality of life in survivors. The principal objectives of this article were to examine current methods of assessing quality of life measures in critically ill patients surviving intensive care and to determine the quality of life of these survivors. Direct and computerised search of published research articles. Measurement of quality of life after intensive care is not common practice. There is a lack of consensus concerning appropriate measuring instruments to be used and how best to interpret results. Despite the availability of general outcome tools and disease specific instruments, there is a paucity of studies in the literature which include assessments of quality of life following intensive care unit (ICU) care. Generic health indices suggest that the quality of life in ICU survivors is acceptable though in certain sub-groups, e.g. adult respiratory distress syndrome and sepsis, quality of life may be moderately impaired. ICU survivors appear to suffer less disability than chronic physical disease patients. Assessment of outcome after intensive care should include health related quality of life measurements. A unifying framework is required to enhance communication between clinicians, administrators and investigators of quality of life research and also to enable more rational and effective decision making at the bedside. Patients who survive intensive care appear to enjoy a reasonable standard of quality of life. While their health status may not be as good, subjectively patients find this acceptable.

Quality assessment of SPR sensor chips; case study on L1 chips.

PubMed

Olaru, Andreea; Gheorghiu, Mihaela; David, Sorin; Polonschii, Cristina; Gheorghiu, Eugen

2013-07-15

Surface quality of the Surface Plasmon Resonance (SPR) chips is a major limiting issue in most SPR analyses, even more for supported lipid membranes experiments, where both the organization of the lipid matrix and the subsequent incorporation of the target molecule depend on the surface quality. A novel quantitative method to characterize the quality of SPR sensors chips is described for L1 chips subject to formation of lipid films, injection of membrane disrupting compounds, followed by appropriate regeneration procedures. The method consists in analysis of the SPR reflectivity curves for several standard solutions (e.g. PBS, HEPES or deionized water). This analysis reveals the decline of sensor surface as a function of the number of experimental cycles (consisting in biosensing assay and regeneration step) and enables active control of surface regeneration for enhanced reproducibility. We demonstrate that quantitative evaluation of the changes in reflectivity curves (shape of the SPR dip) and of the slope of the calibration curve provides a rapid and effective procedure for surface quality assessment. Whereas the method was tested on L1 SPR sensors chips, we stress on its amenability to assess the quality of other types of SPR chips, as well. Copyright © 2013 Elsevier B.V. All rights reserved.

[Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

PubMed

Enge, M; Koch, A; Müller, T; Vorländer, T

2010-12-01

The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.

Tracking the quality of care for sick children using lot quality assurance sampling: targeting improvements of health services in Jigawa, Nigeria.

PubMed

Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J

2012-01-01

In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in HF service quality among Senatorial Districts (SD). LQAS was selected because it was affordable and could be used by local health workers (HW) in a population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid Health Facility Assessment (R-HFA) tool to identify high and low performing SD for specified indicators. LQAS identified variations in HF performance (n = 21) and enabled resources to be targeted to address priorities. All SD exhibited deficient essential services, supplies and equipment. Only 9.7% of HF had Artemisinin-based Combination Therapies and other first-line treatments for childhood illnesses. No SD and few HF exhibited adequate HW performance for the assessment, treatment or counselling of sick children. Using the IMCI algorithm, 17.5% of HW assessed the child's vaccination status, 46.8% assessed nutritional status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments were appropriate for the assessment. Exit interviews revealed that 5.1% of caregivers knew their children's illness, and only 19.9% could accurately describe how to administer the prescribed drug. This R-HFA, using LQAS principles, is a rapid, simple tool for assessing malaria services and can be used at scale. It identified technical deficiencies that could be corrected by improved continuing medical education, targeted supervision, and recurrent R-HFA assessments of the quality of services.

Tracking the Quality of Care for Sick Children Using Lot Quality Assurance Sampling: Targeting Improvements of Health Services in Jigawa, Nigeria

PubMed Central

Oladele, Edward Adekola; Ormond, Louise; Adeyemi, Olusegun; Patrick, David; Okoh, Festus; Oresanya, Olusola Bukola; Valadez, Joseph J.

2012-01-01

Background In Nigeria, 30% of child deaths are due to malaria. The National Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to improve the quality of paediatric malaria services delivered in health facilities (HF). This study reports a rapid approach used to assess the existing quality of services in Jigawa state at decentralised levels of the health system. Methods NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in HF service quality among Senatorial Districts (SD). LQAS was selected because it was affordable and could be used by local health workers (HW) in a population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid Health Facility Assessment (R-HFA) tool to identify high and low performing SD for specified indicators. Findings LQAS identified variations in HF performance (n = 21) and enabled resources to be targeted to address priorities. All SD exhibited deficient essential services, supplies and equipment. Only 9.7% of HF had Artemisinin-based Combination Therapies and other first-line treatments for childhood illnesses. No SD and few HF exhibited adequate HW performance for the assessment, treatment or counselling of sick children. Using the IMCI algorithm, 17.5% of HW assessed the child’s vaccination status, 46.8% assessed nutritional status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments were appropriate for the assessment. Exit interviews revealed that 5.1% of caregivers knew their children’s illness, and only 19.9% could accurately describe how to administer the prescribed drug. Conclusion This R-HFA, using LQAS principles, is a rapid, simple tool for assessing malaria services and can be used at scale. It identified technical deficiencies that could be corrected by improved continuing medical education, targeted supervision, and recurrent R-HFA assessments of the quality of services. PMID:23028519

Cutaneous Recording and Stimulation of Muscles Using Organic Electronic Textiles.

PubMed

Papaiordanidou, Maria; Takamatsu, Seiichi; Rezaei-Mazinani, Shahab; Lonjaret, Thomas; Martin, Alain; Ismailova, Esma

2016-08-01

Electronic textiles are an emerging field providing novel and non-intrusive solutions for healthcare. Conducting polymer-coated textiles enable a new generation of fully organic surface electrodes for electrophysiological evaluations. Textile electrodes are able to assess high quality muscular monitoring and to perform transcutaneous electrical stimulation. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

What predicts the quality of advanced cancer care in Latin America? A look at five countries: Argentina, Brazil, Cuba, Mexico, and Peru.

PubMed

Torres Vigil, Isabel; Aday, Lu Ann; De Lima, Liliana; Cleeland, Charles S

2007-09-01

Cancer is now a leading cause of death among adults in most Latin American nations. Yet, until recently, there has been limited research on the quality of, and access to, advanced cancer care in developing regions such as Latin America. This landmark, cross-national study assessed the quality of advanced cancer care in five Latin American countries by surveying a convenience sample of 777 physicians and nurses, and identifying the most salient influences on their quality-of-care assessments based on multiple linear regression analyses. Strategies for disseminating this survey included mass mailings, distribution at professional meetings/conferences, collaboration with Latin American institutions, professional organizations, and the Pan American Health Organization, and online posting. Results indicate that the respondents' assessments of the quality of, access to, and affordability of advanced cancer care varied significantly across nations (P<0.001). The strongest predictor of providers' national-level assessments of the quality of care was their ratings of access to advanced cancer care (Beta=0.647). Other predictors included affordability of care, country (Cuba vs. the other four countries), income-gap quintile, and institutional availability of opioid analgesics. Low prioritization of palliative care in both health care policy formulation and provider education also predicted the quality-of-care ratings. Findings from this study suggest that providers from five different nations hold similar equitable notions of quality care that are dependent on the provision of accessible and affordable care. Measures of social equity, such as the income-gap quintile of nations, and measures of policy barriers, such as the scale developed in this study, should be replicated in future studies to enable policy makers to assess and improve advanced cancer care in their countries.

First results of a national initiative to enable quality improvement of cardiovascular care by transparently reporting on patient-relevant outcomes.

PubMed

van Veghel, Dennis; Marteijn, Marloes; de Mol, Bas

2016-06-01

The aims of this study were to assess patient-relevant outcomes of delivered cardiovascular care by focusing on disease management as determined by a multidisciplinary Heart Team, to establish and share best practices by comparing outcomes and to embed value-based decision-making to improve quality and efficiency in Dutch heart centres. In 2014, 12 Dutch heart centres pooled patient-relevant outcome data, which resulted in transparent publication of the outcomes, including long-term follow-up up to 5 years, of approximately 86 000 heart patients. This study presents the results of both disease- and treatment patient-relevant outcome measures for coronary artery disease and aortic valve disease. The patients included were presented to a Heart Team and underwent invasive or operative treatment. In-hospital and out-of-hospital patient-relevant outcome measures were collected as well as initial conditions. Quality of life was assessed using the Short Form (SF)-36 or SF-12 health survey. In the Netherlands, patient-relevant and risk-adjusted outcomes of cardiovascular care in participating heart centres are published annually. Data were sufficiently reliable to enable comparisons and to subtract best practices. The statistically lower risk-adjusted mortality rate after coronary artery bypass grafting resulted in a voluntary roll-out of a perioperative safety check. The in-depth analysis of outcomes after percutaneous coronary intervention resulted in process improvements in several heart centres, such as pre-hydration for patients with renal insufficiency and the need of target vessel revascularizations within a year. Annual data collection on follow-up of patient-relevant outcomes of cardiovascular care, initiated and organized by physicians, appears feasible. Transparent publication of outcomes drives the improvement of quality within heart centres. The system of using a limited set of patient-relevant outcome measures enables reliable comparisons and exposes the quality of decision-making and the operational process. Transparent communication on outcomes is feasible, safe and cost-effective, and stimulates professional decision-making and disease management. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Composite measures of watershed health from a water quality perspective.

PubMed

Mallya, Ganeshchandra; Hantush, Mohamed; Govindaraju, Rao S

2018-05-15

Water quality data at gaging stations are typically compared with established federal, state, or local water quality standards to determine if violations (concentrations of specific constituents falling outside acceptable limits) have occurred. Based on the frequency and severity of water quality violations, risk metrics such as reliability, resilience, and vulnerability (R-R-V) are computed for assessing water quality-based watershed health. In this study, a modified methodology for computing R-R-V measures is presented, and a new composite watershed health index is proposed. Risk-based assessments for different water quality parameters are carried out using identified national sampling stations within the Upper Mississippi River Basin, the Maumee River Basin, and the Ohio River Basin. The distributional properties of risk measures with respect to water quality parameters are reported. Scaling behaviors of risk measures using stream order, specifically for the watershed health (WH) index, suggest that WH values increased with stream order for suspended sediment concentration, nitrogen, and orthophosphate in the Upper Mississippi River Basin. Spatial distribution of risk measures enable identification of locations exhibiting poor watershed health with respect to the chosen numerical standard, and the role of land use characteristics within the watershed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Providing Data Quality Information for Remote Sensing Applications

NASA Astrophysics Data System (ADS)

Albrecht, F.; Blaschke, T.; Lang, S.; Abdulmutalib, H. M.; Szabó, G.; Barsi, Á.; Batini, C.; Bartsch, A.; Kugler, Zs.; Tiede, D.; Huang, G.

2018-04-01

The availability and accessibility of remote sensing (RS) data, cloud processing platforms and provided information products and services has increased the size and diversity of the RS user community. This development also generates a need for validation approaches to assess data quality. Validation approaches employ quality criteria in their assessment. Data Quality (DQ) dimensions as the basis for quality criteria have been deeply investigated in the database area and in the remote sensing domain. Several standards exist within the RS domain but a general classification - established for databases - has been adapted only recently. For an easier identification of research opportunities, a better understanding is required how quality criteria are employed in the RS lifecycle. Therefore, this research investigates how quality criteria support decisions that guide the RS lifecycle and how they relate to the measured DQ dimensions. Subsequently follows an overview of the relevant standards in the RS domain that is matched to the RS lifecycle. Conclusively, the required research needs are identified that would enable a complete understanding of the interrelationships between the RS lifecycle, the data sources and the DQ dimensions, an understanding that would be very valuable for designing validation approaches in RS.

Emerging technology: A key enabler for modernizing pharmaceutical manufacturing and advancing product quality.

PubMed

O'Connor, Thomas F; Yu, Lawrence X; Lee, Sau L

2016-07-25

Issues in product quality have produced recalls and caused drug shortages in United States (U.S.) in the past few years. These quality issues were often due to outdated manufacturing technologies and equipment as well as lack of an effective quality management system. To ensure consistent supply of safe, effective and high-quality drug products available to the patients, the U.S. Food and Drug Administration (FDA) supports modernizing pharmaceutical manufacturing for improvements in product quality. Specifically, five new initiatives are proposed here to achieve this goal. They include: (i) advancing regulatory science for pharmaceutical manufacturing; (ii) establishing a public-private institute for pharmaceutical manufacturing innovation; (iii) creating incentives for investment in the technological upgrade of manufacturing processes and facilities; (iv) leveraging external expertise for regulatory quality assessment of emerging technologies; and (v) promoting the international harmonization of approaches for expediting the global adoption of emerging technologies. Published by Elsevier B.V.

Direct infusion mass spectrometry metabolomics dataset: a benchmark for data processing and quality control

PubMed Central

Kirwan, Jennifer A; Weber, Ralf J M; Broadhurst, David I; Viant, Mark R

2014-01-01

Direct-infusion mass spectrometry (DIMS) metabolomics is an important approach for characterising molecular responses of organisms to disease, drugs and the environment. Increasingly large-scale metabolomics studies are being conducted, necessitating improvements in both bioanalytical and computational workflows to maintain data quality. This dataset represents a systematic evaluation of the reproducibility of a multi-batch DIMS metabolomics study of cardiac tissue extracts. It comprises of twenty biological samples (cow vs. sheep) that were analysed repeatedly, in 8 batches across 7 days, together with a concurrent set of quality control (QC) samples. Data are presented from each step of the workflow and are available in MetaboLights. The strength of the dataset is that intra- and inter-batch variation can be corrected using QC spectra and the quality of this correction assessed independently using the repeatedly-measured biological samples. Originally designed to test the efficacy of a batch-correction algorithm, it will enable others to evaluate novel data processing algorithms. Furthermore, this dataset serves as a benchmark for DIMS metabolomics, derived using best-practice workflows and rigorous quality assessment. PMID:25977770

Review of indicators for cross-sectoral optimization of nosocomial infection prophylaxis – a perspective from structurally- and process-oriented hygiene

PubMed Central

Hübner, Nils-Olaf; Fleßa, Steffen; Jakisch, Ralf; Assadian, Ojan; Kramer, Axel

2012-01-01

In the care of patients, the prevention of nosocomial infections is crucial. For it to be successful, cross-sectoral, interface-oriented hygiene quality management is necessary. The goal is to apply the HACCP (Hazard Assessment and Critical Control Points) concept to hospital hygiene, in order to create a multi-dimensional hygiene control system based on hygiene indicators that will overcome the limitations of a procedurally non-integrated and non-cross-sectoral view of hygiene. Three critical risk dimensions can be identified for the implementation of three-dimensional quality control of hygiene in clinical routine: the constitution of the person concerned, the surrounding physical structures and technical equipment, and the medical procedures. In these dimensions, the establishment of indicators and threshold values enables a comprehensive assessment of hygiene quality. Thus, the cross-sectoral evaluation of the quality of structure, processes and results is decisive for the success of integrated infection prophylaxis. This study lays the foundation for hygiene indicator requirements and develops initial concepts for evaluating quality management in hygiene. PMID:22558049

Grading the quality of evidence and the strength of recommendations in clinical dentistry: a critical review of 2 prominent approaches.

PubMed

Faggion, Clovis Mariano

2010-06-01

The objective of this article was to critically review 2 prominent approaches used to grade the quality of evidence and the strength of recommendations. Every year much information becomes available as a result of publication of scientific papers, and clinicians should be able to assess current evidence so they, along with their patients, can make the most appropriate clinical decisions. This is particularly important when there is little or no high-quality evidence available about the subject of interest. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and the Strength of Recommendation Taxonomy (SORT) were evaluated. Strengths and weaknesses of these 2 systems are discussed, mainly on the basis of their relevance to clinical dentistry. The conclusion was that use of a system for grading the quality of evidence and the strength of recommendations is urgently required because of the great heterogeneity of the quality and type of evidence relating to many dental procedures. Use of such a system will enable clinicians and their patients to make more informed decisions.

State laws and the practice of lay midwifery.

PubMed Central

Butter, I H; Kay, B J

1988-01-01

A national survey was conducted to assess the current status and characteristics of state legislation regulating the practice of lay midwives. As of July 1987, 10 states have prohibitory laws, five states have grandmother clauses authorizing practicing midwives under repealed statutes, five states have enabling laws which are not used, and 10 states explicitly permit lay midwives to practice. In the 21 remaining states, the legal status of midwives is unclear. Much of the enabling legislation restricts midwifery practice often resulting in situations similar to those in states with prohibitory laws. Given the growth of an extensive grassroots movement of lay midwives committed to quality of care, this outcome suggests that 21 states with no legislation may provide better opportunities for midwifery practice than states with enabling laws. PMID:3407812

Holographic display system for restoration of sight to the blind

PubMed Central

Goetz, G A; Mandel, Y; Manivanh, R; Palanker, D V; Čižmár, T

2013-01-01

Objective We present a holographic near-the-eye display system enabling optical approaches for sight restoration to the blind, such as photovoltaic retinal prosthesis, optogenetic and other photoactivation techniques. We compare it with conventional LCD or DLP-based displays in terms of image quality, field of view, optical efficiency and safety. Approach We detail the optical configuration of the holographic display system and its characterization using a phase-only spatial light modulator. Main results We describe approaches to controlling the zero diffraction order and speckle related issues in holographic display systems and assess the image quality of such systems. We show that holographic techniques offer significant advantages in terms of peak irradiance and power efficiency, and enable designs that are inherently safer than LCD or DLP-based systems. We demonstrate the performance of our holographic display system in the assessment of cortical response to alternating gratings projected onto the retinas of rats. Significance We address the issues associated with the design of high brightness, near-the-eye display systems and propose solutions to the efficiency and safety challenges with an optical design which could be miniaturized and mounted onto goggles. PMID:24045579

Towards the Application of Fuzzy Logic for Developing a Novel Indoor Air Quality Index (FIAQI).

PubMed

Javid, Allahbakhsh; Hamedian, Amir Abbas; Gharibi, Hamed; Sowlat, Mohammad Hossein

2016-02-01

In the past few decades, Indoor Air Pollution (IAP) has become a primary concern to the point. It is increasingly believed to be of equal or greater importance to human health compared to ambient air. However, due to the lack of comprehensive indices for the integrated assessment of indoor air quality (IAQ), we aimed to develop a novel, Fuzzy-Based Indoor Air Quality Index (FIAQI) to bridge the existing gap in this area. We based our index on fuzzy logic, which enables us to overcome the limitations of traditional methods applied to develop environmental quality indices. Fifteen parameters, including the criteria air pollutants, volatile organic compounds, and bioaerosols were included in the FIAQI due mainly to their significant health effects. Weighting factors were assigned to the parameters based on the medical evidence available in the literature on their health effects. The final FIAQI consisted of 108 rules. In order to demonstrate the performance of the index, data were intentionally generated to cover a variety of quality levels. In addition, a sensitivity analysis was conducted to assess the validity of the index. The FIAQI tends to be a comprehensive tool to classify IAQ and produce accurate results. It seems useful and reliable to be considered by authorities to assess IAQ environments.

Great Salt Lake basins study unit

USGS Publications Warehouse

Waddell, Kidd M.; Baskin, Robert L.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began implementing a full-scale National Water-Quality Assessment (NAWQA) Program.The long-term goals of the NAWQA Program are to describe the status and trends in the quality of a large, representative part of the Nation’s surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors that affect the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at Federal, State, and local levels.A major design feature of the NAWQA Program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which ae the principal building blocks of the program upon which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include principal river basins and aquifer systems throughout the Nation. These study units cover areas from less than 1.000 to greater than 60,000 mi2 and incorporate from about 60 to 70 percent of the Nation’s water use and population served by public water supply. In 1993, assessment activities began in the Great Salt Lake Basins NAWQA study unit.

Towards the Application of Fuzzy Logic for Developing a Novel Indoor Air Quality Index (FIAQI)

PubMed Central

JAVID, Allahbakhsh; HAMEDIAN, Amir Abbas; GHARIBI, Hamed; SOWLAT, Mohammad Hossein

2016-01-01

Background: In the past few decades, Indoor Air Pollution (IAP) has become a primary concern to the point. It is increasingly believed to be of equal or greater importance to human health compared to ambient air. However, due to the lack of comprehensive indices for the integrated assessment of indoor air quality (IAQ), we aimed to develop a novel, Fuzzy-Based Indoor Air Quality Index (FIAQI) to bridge the existing gap in this area. Methods: We based our index on fuzzy logic, which enables us to overcome the limitations of traditional methods applied to develop environmental quality indices. Fifteen parameters, including the criteria air pollutants, volatile organic compounds, and bioaerosols were included in the FIAQI due mainly to their significant health effects. Weighting factors were assigned to the parameters based on the medical evidence available in the literature on their health effects. The final FIAQI consisted of 108 rules. In order to demonstrate the performance of the index, data were intentionally generated to cover a variety of quality levels. In addition, a sensitivity analysis was conducted to assess the validity of the index. Results: The FIAQI tends to be a comprehensive tool to classify IAQ and produce accurate results. Conclusion: It seems useful and reliable to be considered by authorities to assess IAQ environments. PMID:27114985

Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: A systematic review and meta-analysis.

PubMed

Antoszewska-Smith, Joanna; Sarul, Michał; Łyczek, Jan; Konopka, Tomasz; Kawala, Beata

2017-03-01

The aim of this systematic review was to compare the effectiveness of orthodontic miniscrew implants-temporary intraoral skeletal anchorage devices (TISADs)-in anchorage reinforcement during en-masse retraction in relation to conventional methods of anchorage. A search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science was performed. The keywords were orthodontic, mini-implants, miniscrews, miniplates, and temporary anchorage device. Relevant articles were assessed for quality according to Cochrane guidelines and the data extracted for statistical analysis. A meta-analysis of raw mean differences concerning anchorage loss, tipping of molars, retraction of incisors, tipping of incisors, and treatment duration was carried out. Initially, we retrieved 10,038 articles. The selection process finally resulted in 14 articles including 616 patients (451 female, 165 male) for detailed analysis. Quality of the included studies was assessed as moderate. Meta-analysis showed that use of TISADs facilitates better anchorage reinforcement compared with conventional methods. On average, TISADs enabled 1.86 mm more anchorage preservation than did conventional methods (P <0.001). The results of the meta-analysis showed that TISADs are more effective than conventional methods of anchorage reinforcement. The average difference of 2 mm seems not only statistically but also clinically significant. However, the results should be interpreted with caution because of the moderate quality of the included studies. More high-quality studies on this issue are necessary to enable drawing more reliable conclusions. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Nursing work environment in Saudi Arabia.

PubMed

Aboshaiqah, Ahmad E

2015-05-01

The purpose of this study was to assess the work environment as perceived by nurses in a large tertiary hospital in Saudi Arabia. The quality of patient care services has been associated with the quality of work environment of nurses. It is therefore important to assess the work environment in order to acquire baseline data and enable the institution to benchmark their status from established quality standards. This study used a descriptive survey with 1007 staff nurses across service units of a 1000-bed government-operated hospital. The American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Questionnaire was used for data collection. Scores were aggregated and interpreted. Effective decision making, authentic leadership, appropriate staffing, true collaboration, skilled communication and meaningful recognition were rated as good (mean range 3.53-3.76). Healthy work environments mutually benefit patients, nurses, nurse managers, health care providers, the health team, administration, the institution and the community at large. Valuable baseline data on the status of the work environment in this setting were generated. This should allow administrators and staff to work together in improving weaknesses and strengthening further whatever gains that are attained to ensure consistent provision of safe and quality patient care. © 2013 John Wiley & Sons Ltd.

The impact of a quality-improvement package on reproductive health services delivered by private providers in Uganda.

PubMed

Agha, Sohail

2010-09-01

This study assesses the effectiveness of a quality-improvement (QI) package designed to enable small-scale commercial reproductive health (RH) service providers to improve the services they offer. The study was conducted among midwives who are members of the Uganda Private Midwives Association. A pretest-post-test quasi-experimental panel study design was used wherein midwife clinics were allocated to two experimental groups and one control group. Baseline and follow-up measurements of structural and process attributes of quality were taken at the clinics by means of a facility inventory, interviews with midwives, and observations of client-provider interactions. Nearly 70 percent of the midwives who were trained to use the package reported that it was easy to use. Among clinics in which midwives received training in the use of the self-assessment tool and in developing action plans, structural and process attributes of quality improved only among those clinics in which the midwives' supervisors received training in finding solutions to the problems identified through self-assessments. The QI package may be implemented with small-scale private providers of RH services who are part of a professional association, network, or franchise that supervises their performance.

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

PubMed Central

Tripathi, Vandana; Stanton, Cynthia; Strobino, Donna; Bartlett, Linda

2015-01-01

Background High quality care is crucial in ensuring that women and newborns receive interventions that may prevent and treat birth-related complications. As facility deliveries increase in developing countries, there are concerns about service quality. Observation is the gold standard for clinical quality assessment, but existing observation-based measures of obstetric quality of care are lengthy and difficult to administer. There is a lack of consensus on quality indicators for routine intrapartum and immediate postpartum care, including essential newborn care. This study identified key dimensions of the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) in facility deliveries and developed a quality assessment measure representing these dimensions. Methods and Findings Global maternal and neonatal care experts identified key dimensions of QoPIIPC through a modified Delphi process. Experts also rated indicators of these dimensions from a comprehensive delivery observation checklist used in quality surveys in sub-Saharan African countries. Potential QoPIIPC indices were developed from combinations of highly-rated indicators. Face, content, and criterion validation of these indices was conducted using data from observations of 1,145 deliveries in Kenya, Madagascar, and Tanzania (including Zanzibar). A best-performing index was selected, composed of 20 indicators of intrapartum/immediate postpartum care, including essential newborn care. This index represented most dimensions of QoPIIPC and effectively discriminated between poorly and well-performed deliveries. Conclusions As facility deliveries increase and the global community pays greater attention to the role of care quality in achieving further maternal and newborn mortality reduction, the QoPIIPC index may be a valuable measure. This index complements and addresses gaps in currently used quality assessment tools. Further evaluation of index usability and reliability is needed. The availability of a streamlined, comprehensive, and validated index may enable ongoing and efficient observation-based assessment of care quality during labor and delivery in sub-Saharan Africa, facilitating targeted quality improvement. PMID:26107655

Describing methods and interventions: a protocol for the systematic analysis of the perioperative quality improvement literature.

PubMed

Jones, Emma; Lees, Nicholas; Martin, Graham; Dixon-Woods, Mary

2014-09-05

Quality improvement (QI) methods are widely used in surgery in an effort to improve care, often using techniques such as Plan-Do-Study-Act cycles to implement specific interventions. Explicit definition of both the QI method and quality intervention is necessary to enable the accurate replication of effective interventions in practice, facilitate cumulative learning, reduce research waste and optimise benefits to patients. This systematic review aims to assess quality of reporting of QI methods and quality interventions in perioperative care. Studies reporting on quality interventions implemented in perioperative care settings will be identified. Searches will be conducted in the Ovid SP version of Medline, Scopus, the Cochrane Central Register of Controlled Trials, the Cochrane Effective Practice and Organisation of Care database and the related articles function of PubMed. The journal BMJ Quality will be searched separately. Search strategy terms will relate to (i) surgery, (ii) QI and (iii) evaluation methods. Explicit exclusion and inclusion criteria will be applied. Data from studies will be extracted using a data extraction form. The Template for Intervention Description and Replication (TIDieR) checklist will be used to evaluate quality of reporting, together with additional items aimed at assessing QI methods specifically. PROSPERO http://CRD42014012845.

77 FR 42738 - Request for Information on Quality Measurement Enabled by Health IT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... Information on Quality Measurement Enabled by Health IT AGENCY: Agency for Healthcare Research and Quality (AHRQ), Health and Human Services (HHS). ACTION: Notice of Request for Information (RFI). SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) requests information from the Public, including...

Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania.

PubMed

Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A; Schulze, Alexander

2016-10-13

Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff. An electronic Tool to Improve Quality of Healthcare (e-TIQH) was developed to assess the quality of primary healthcare provision. The e-TIQH contains six sub-tools, each covering one quality dimension: infrastructure and equipment of the facility, its management and administration, job expectations, clinical skills of the staff, staff motivation and client satisfaction. As part of supportive supervision, council health staff conduct quality assessments in all primary healthcare facilities in a given council, including observation of clinical consultations and exit interviews with clients. Using a hand-held device, assessors enter data and view results in real time through automated data analysis, permitting immediate feedback to health workers. Based on the results, quality gaps and potential measures to address them are jointly discussed and actions plans developed. For illustrative purposes, preliminary findings from e-TIQH application are presented from eight councils of Tanzania for the period 2011-2013, with a quality score <75 % classed as 'unsatisfactory'. Staff motivation (<50 % in all councils) and job expectations (≤50 %) scored lowest of all quality dimensions at baseline. Clinical practice was unsatisfactory in six councils, with more mixed results for availability of infrastructure and equipment, and for administration and management. In contrast, client satisfaction scored surprisingly high. Over time, each council showed a significant overall increase of 3-7 % in mean score, with the most pronounced improvements in staff motivation and job expectations. Given its comprehensiveness, convenient handling and automated statistical reports, e-TIQH enables council health staff to conduct systematic quality assessments. Therefore e-TIQH may not only contribute to objectively identifying quality gaps, but also to more evidence-based supervision. E-TIQH also provides important information for resource planning. Institutional and financial challenges for implementing e-TIQH on a broader scale need to be addressed.

National Water-Quality Assessment program: The Trinity River Basin

USGS Publications Warehouse

Land, Larry F.

1991-01-01

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

[Quality assurance in therapy of chronic pain. Results obtained by a taskforce of the German Section of the Association for the Study of Pain on psychological assessment of chronic pain.].

PubMed

Denecke, H; Glier, B; Klinger, R; Nilges, P; Redegeld, M; Weiß, L; Kröner-Herwig, B

1995-01-01

This is the first in a series of publications presenting the results of a taskforce on quality assurance in psychological assessment of chronic pain. The initiative was motivated by the increasing and confusing variety of newly developed German instruments and/or translations of Anglo-American instruments. Our main work was therefore concentrated on the collection of existing German assessment instruments, on summarizing the essentials in a documentary sheet, and on examining their objectivity, reliability, validity, clinical relevance, economy and degree of empirical foundation. For each diagnostic domain we thus elaborated specific differential recommendations for those working in psychological pain research and clinical practice, in an attempt to devise criteria enabling them to choose the optimal instrument or test battery for their needs and conditions.

The Use of Sensory Analysis Techniques to Assess the Quality of Indoor Air.

PubMed

Lewkowska, Paulina; Dymerski, Tomasz; Gębicki, Jacek; Namieśnik, Jacek

2017-01-02

The quality of indoor air is one of the significant elements that influences people's well-being and health inside buildings. Emissions of pollutants, which may cause odor nuisance, are the main reason for people's complaints regarding the quality of indoor air. As a result, it is necessary to perform tests aimed at identifying the sources of odors inside buildings. The article contains basic information on the characteristics of the sources of indoor air pollution and the influence of the odor detection threshold on people's health and comfort. An attempt was also made to classify and use sensory analysis techniques to perform tests of the quality of indoor air, which would enable identification of sensory experience and would allow for indication of the degree of their intensity.

Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature.

PubMed

Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R; Salek, Sam

2017-01-01

Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general paucity of research in this area, particularly regarding the development and systematic application of techniques for evaluating quality decision making, with no consensus around a gold standard. This review has identified QoDoS as the most promising available technique for assessing decision making in the lifecycle of medicines and the next steps would be to further test its validity, sensitivity, and reliability.

Dispersive Raman spectroscopy for the nondestructive and rapid assessment of honey quality

NASA Astrophysics Data System (ADS)

Mignani, A. G.; Ciaccheri, L.; Mencaglia, A. A.; Di Sanzo, R.; Carabetta, S.; Russo, M. T.

2015-09-01

Raman spectroscopy performed using optical fibers, with excitation at 1064 nm and a dispersive detection scheme, was utilized to measure a selection of unifloral honeys produced in the Italian region of Calabria. The honey samples had three different botanical origins: chestnut, citrus, and acacia, respectively. A multivariate processing of the spectroscopic data enabled us to distinguish their botanical origin, and to build predictive models for quantifying important nutraceutic indicators such as the main sugars and potassium. Furthermore, the Raman spectra of chestnut honeys were compared with the taste profile measured by an electronic tongue, and a good correlation to bitter/savory taste was obtained. This experiment indicates the excellent potentials of Raman spectroscopy as an analytical tool for the nondestructive and rapid assessment of food-quality indicators.

Use of behavioral avoidance testing in natural resource damage assessment

USGS Publications Warehouse

Lipton, J.; Little, E.E.; Marr, J.C.A.; DeLonay, A.J.; Bengston, David A.; Henshel, Diane S.

1996-01-01

Natural Resource Damage Assessment (NRDA) provisions established under federal and state statutes enable natural resource trustees to recover compensation from responsible parties to restore injured natural resources. Behavioral avoidance testing with fish has been used in NRDAs to determine injuries to natural resources and to establish restoration thresholds. In this manuscript we evaluate the use of avoidance testing to NRDA. Specifically, we discuss potential “acceptance criteria” to evaluate the applicability and relevance of avoidance testing. These acceptance criteria include: (1) regulatory relevance, (2) reproducibility of testing, (3) ecological significance, (4) quality assurance/quality control, and (5) relevance to restoration. We discuss each of these criteria with respect to avoidance testing. Overall, we conclude that avoidance testing can be an appropriate, defensible, and desirable aspect of an NRDA.

Developing Confidence Limits For Reliability Of Software

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.

1991-01-01

Technique developed for estimating reliability of software by use of Moranda geometric de-eutrophication model. Pivotal method enables straightforward construction of exact bounds with associated degree of statistical confidence about reliability of software. Confidence limits thus derived provide precise means of assessing quality of software. Limits take into account number of bugs found while testing and effects of sampling variation associated with random order of discovering bugs.

Pharmaceutical quality by design: product and process development, understanding, and control.

PubMed

Yu, Lawrence X

2008-04-01

The purpose of this paper is to discuss the pharmaceutical Quality by Design (QbD) and describe how it can be used to ensure pharmaceutical quality. The QbD was described and some of its elements identified. Process parameters and quality attributes were identified for each unit operation during manufacture of solid oral dosage forms. The use of QbD was contrasted with the evaluation of product quality by testing alone. The QbD is a systemic approach to pharmaceutical development. It means designing and developing formulations and manufacturing processes to ensure predefined product quality. Some of the QbD elements include: Defining target product quality profile; Designing product and manufacturing processes; Identifying critical quality attributes, process parameters, and sources of variability; Controlling manufacturing processes to produce consistent quality over time. Using QbD, pharmaceutical quality is assured by understanding and controlling formulation and manufacturing variables. Product testing confirms the product quality. Implementation of QbD will enable transformation of the chemistry, manufacturing, and controls (CMC) review of abbreviated new drug applications (ANDAs) into a science-based pharmaceutical quality assessment.

Vadose Zone Monitoring as a Key to Groundwater Protection from Pollution Hazard

NASA Astrophysics Data System (ADS)

Dahan, Ofer

2016-04-01

Minimization subsurface pollution is much dependent on the capability to provide real-time information on the chemical and hydrological properties of the percolating water. Today, most monitoring programs are based on observation wells that enable data acquisitions from the saturated part of the subsurface. Unfortunately, identification of pollutants in well water is clear evidence that the contaminants already crossed the entire vadose-zone and accumulated in the aquifer water to detectable concentration. Therefore, effective monitoring programs that aim at protecting groundwater from pollution hazard should include vadose zone monitoring technologies that are capable to provide real-time information on the chemical composition of the percolating water. Obviously, identification of pollution process in the vadose zone may provide an early warning on potential risk to groundwater quality, long before contaminates reach the water-table and accumulate in the aquifers. Since productive agriculture must inherently include down leaching of excess lower quality water, understanding the mechanisms controlling transport and degradation of pollutants in the unsaturated is crucial for water resources management. A vadose-zone monitoring system (VMS), which was specially developed to enable continuous measurements of the hydrological and chemical properties of percolating water, was used to assess the impact of various agricultural setups on groundwater quality, including: (a) intensive organic and conventional greenhouses, (b) citrus orchard and open field crops , and (c) dairy farms. In these applications frequent sampling of vadose zone water for chemical and isotopic analysis along with continuous measurement of water content was used to assess the link between agricultural setups and groundwater pollution potential. Transient data on variation in water content along with solute breakthrough at multiple depths were used to calibrate flow and transport models. These models where then used to assess the long term impact of various agricultural setups on the quantity and quality of groundwater recharge. Relevant publications: Turkeltaub et al., WRR. 2016; Turkeltaub et al., J. Hydrol. 2015: Dahan et al., HESS 2014. Baram et al., J. Hydrol. 2012.

Assessing nutritional status in cancer: role of the Patient-Generated Subjective Global Assessment.

PubMed

Jager-Wittenaar, Harriët; Ottery, Faith D

2017-09-01

The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is used internationally as the reference method for proactive risk assessment (screening), assessment, monitoring and triaging for interventions in patients with cancer. This review aims to explain the rationale behind and data supporting the PG-SGA, and to provide an overview of recent developments in the utilization of the PG-SGA and the PG-SGA Short Form. The PG-SGA was designed in the context of a paradigm known as 'anabolic competence'. Uniquely, the PG-SGA evaluates the patient's status as a dynamic rather than static process. The PG-SGA has received new attention, particularly as a screening instrument for nutritional risk or deficit, identifying treatable impediments and guiding patients and professionals in triaging for interdisciplinary interventions. The international use of the PG-SGA indicates a critical need for high-quality and linguistically validated translations of the PG-SGA. As a 4-in-1 instrument, the PG-SGA can streamline clinic work flow and improve the quality of interaction between the clinician and the patient. The availability of multiple high-quality language versions of the PG-SGA enables the inclusion of the PG-SGA in international multicenter studies, facilitating meta-analysis and benchmarking across countries.

Assessing stability and performance of a digitally enabled supply chain: Retrospective of a pilot in Uttar Pradesh, India.

PubMed

Gilbert, Sarah Skye; Thakare, Neeraj; Ramanujapuram, Arun; Akkihal, Anup

2017-04-19

Immunization supply chains in low resource settings do not always reach children with necessary vaccines. Digital information systems can enable real time visibility of inventory and improve vaccine availability. In 2014, a digital, mobile/web-based information system was implemented in two districts of Uttar Pradesh, India. This retrospective investigates improvements and stabilization of supply chain performance following introduction of the digital information system. All data were collected via the digital information system between March 2014 and September 2015. Data included metadata and transaction logs providing information about users, facilities, and vaccines. Metrics evaluated include adoption (system access, timeliness and completeness), data quality (error rates), and performance (stock availability on immunization session days, replenishment response duration, rate of zero stock events). Stability was defined as the phase in which quality and performance metrics achieved equilibrium rates with minimal volatility. The analysis compared performance across different facilities and vaccines. Adoption appeared sufficiently high from the onset to commence stability measures of data quality and supply chain performance. Data quality stabilized from month 3 onwards, and supply chain performance stabilized from month 13 onwards. For data quality, error rates reduced by two thirds post stabilization. Although vaccine availability remained high throughout the pilot, the three lowest-performing facilities improved from 91.05% pre-stability to 98.70% post-stability (p<0.01; t-test). Average replenishment duration (as a corrective response to stock-out events) decreased 52.3% from 4.93days to 2.35days (p<0.01; t-test). Diphtheria-tetanus-pertussis vaccine was significantly less likely to be stocked out than any other material. The results suggest that given sufficient adoption, stability is sequentially achieved, beginning with data quality, and then performance. Identifying when a pilot stabilizes can enable more predictable, reliable cost estimates, and outcome forecasts in the scale-up phase. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Dementia care mapping: an approach to quality audit of services for people with dementia in two health districts.

PubMed

Younger, D; Martin, G W

2000-11-01

The audit reported in this paper and submitted to the Psychiatry of Old Age Management group, assessed six units within each of two health districts in the UK. Using a nonparticipatory observation method in the units selected, the aim was to measure quality and the environment of care. Dependency levels of the clients/residents were also estimated to give a clearer picture of the setting and the care requirements. This was intended to establish a baseline for the units mapped and to enable care developments to be focussed upon intended outcomes. Results led to a number of observations related to the levels of interaction between staff and clients/residents, the need for a wider range of activities to promote person-centred care, and a suggested route to the improvement in quality of life for this vulnerable group of people. Assessment of dependency levels linked to the results of the mapping showed that high dependency does not lead automatically to a lower quality of person centred care.

GeoViQua: quality-aware geospatial data discovery and evaluation

NASA Astrophysics Data System (ADS)

Bigagli, L.; Papeschi, F.; Mazzetti, P.; Nativi, S.

2012-04-01

GeoViQua (QUAlity aware VIsualization for the Global Earth Observation System of Systems) is a recently started FP7 project aiming at complementing the Global Earth Observation System of Systems (GEOSS) with rigorous data quality specifications and quality-aware capabilities, in order to improve reliability in scientific studies and policy decision-making. GeoViQua main scientific and technical objective is to enhance the GEOSS Common Infrastructure (GCI) providing the user community with innovative quality-aware search and evaluation tools, which will be integrated in the GEO-Portal, as well as made available to other end-user interfaces. To this end, GeoViQua will promote the extension of the current standard metadata for geographic information with accurate and expressive quality indicators, also contributing to the definition of a quality label (GEOLabel). GeoViQua proposed solutions will be assessed in several pilot case studies covering the whole Earth Observation chain, from remote sensing acquisition to data processing, to applications in the main GEOSS Societal Benefit Areas. This work presents the preliminary results of GeoViQua Work Package 4 "Enhanced geo-search tools" (WP4), started in January 2012. Its major anticipated technical innovations are search and evaluation tools that communicate and exploit data quality information from the GCI. In particular, GeoViQua will investigate a graphical search interface featuring a coherent and meaningful aggregation of statistics and metadata summaries (e.g. in the form of tables, charts), thus enabling end users to leverage quality constraints for data discovery and evaluation. Preparatory work on WP4 requirements indicated that users need the "best" data for their purpose, implying a high degree of subjectivity in judgment. This suggests that the GeoViQua system should exploit a combination of provider-generated metadata (objective indicators such as summary statistics), system-generated metadata (contextual/tracking information such as provenance of data and metadata), and user-generated metadata (informal user comments, usage information, rating, etc.). Moreover, metadata should include sufficiently complete access information, to allow rich data visualization and propagation. The following main enabling components are currently identified within WP4: - Quality-aware access services, e.g. a quality-aware extension of the OGC Sensor Observation Service (SOS-Q) specification, to support quality constraints for sensor data publishing and access; - Quality-aware discovery services, namely a quality-aware extension of the OGC Catalog Service for the Web (CSW-Q), to cope with quality constrained search; - Quality-augmentation broker (GeoViQua Broker), to support the linking and combination of the existing GCI metadata with GeoViQua- and user-generated metadata required to support the users in selecting the "best" data for their intended use. We are currently developing prototypes of the above quality-enabled geo-search components, that will be assessed in a sensor-based pilot case study in the next months. In particular, the GeoViQua Broker will be integrated with the EuroGEOSS Broker, to implement CSW-Q and federate (either via distribution or harvesting schemes) quality-aware data sources, GeoViQua will constitute a valuable test-bed for advancing the current best practices and standards in geospatial quality representation and exploitation. The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under Grant Agreement n° 265178.

Quality and Quantity of Rehabilitation Exercises Delivered By A 3-D Motion Controlled Camera: A Pilot Study.

PubMed

Komatireddy, Ravi; Chokshi, Anang; Basnett, Jeanna; Casale, Michael; Goble, Daniel; Shubert, Tiffany

2014-08-01

Tele-rehabiliation technologies that track human motion could enable physical therapy in the home. To be effective, these systems need to collect critical metrics without PT supervision both in real time and in a store and forward capacity. The first step of this process is to determine if PTs (PTs) are able to accurately assess the quality and quantity of an exercise repetition captured by a tele-rehabilitation platform. The purpose of this pilot project was to determine the level of agreement of quality and quantity of an exercise delivered and assessed by the Virtual Exercise Rehabilitation Assistant (VERA), and seven PTs. Ten healthy subjects were instructed by a PT in how to perform four lower extremity exercises. Subjects then performed each exercises delivered by VERA which counted repetitions and quality. Seven PTs independently reviewed video of each subject's session and assessed repetitions quality. The percent difference in total repetitions and analysis of the distribution of rating repetition quality was assessed between the VERA and PTs. The VERA counted 426 repetitions across 10 subjects performing the four different exercises while the mean repetition count from the PT panel was 426.7 (SD = 0.8). The VERA underestimated the total repetitions performed by 0.16% (SD = 0.03%, 95% CI 0.12 - 0. 22). Chi square analysis across raters was χ 2 = 63.17 (df = 6, p<.001), suggesting significant variance in at least one rater. The VERA count of repetitions was accurate in comparison to a seven member panel of PTs. For exercise quality the VERA was able to rate 426 exercise repetitions across 10 patients and four different exercises in a manner consistent with five out of seven experienced PTs.

EAPhy: A Flexible Tool for High-throughput Quality Filtering of Exon-alignments and Data Processing for Phylogenetic Methods.

PubMed

Blom, Mozes P K

2015-08-05

Recently developed molecular methods enable geneticists to target and sequence thousands of orthologous loci and infer evolutionary relationships across the tree of life. Large numbers of genetic markers benefit species tree inference but visual inspection of alignment quality, as traditionally conducted, is challenging with thousands of loci. Furthermore, due to the impracticality of repeated visual inspection with alternative filtering criteria, the potential consequences of using datasets with different degrees of missing data remain nominally explored in most empirical phylogenomic studies. In this short communication, I describe a flexible high-throughput pipeline designed to assess alignment quality and filter exonic sequence data for subsequent inference. The stringency criteria for alignment quality and missing data can be adapted based on the expected level of sequence divergence. Each alignment is automatically evaluated based on the stringency criteria specified, significantly reducing the number of alignments that require visual inspection. By developing a rapid method for alignment filtering and quality assessment, the consistency of phylogenetic estimation based on exonic sequence alignments can be further explored across distinct inference methods, while accounting for different degrees of missing data.

Real-time assessments of water quality: expanding nowcasting throughout the Great Lakes

USGS Publications Warehouse

,

2013-01-01

Nowcasts are systems that inform the public of current bacterial water-quality conditions at beaches on the basis of predictive models. During 2010–12, the U.S. Geological Survey (USGS) worked with 23 local and State agencies to improve existing operational beach nowcast systems at 4 beaches and expand the use of predictive models in nowcasts at an additional 45 beaches throughout the Great Lakes. The predictive models were specific to each beach, and the best model for each beach was based on a unique combination of environmental and water-quality explanatory variables. The variables used most often in models to predict Escherichia coli (E. coli) concentrations or the probability of exceeding a State recreational water-quality standard included turbidity, day of the year, wave height, wind direction and speed, antecedent rainfall for various time periods, and change in lake level over 24 hours. During validation of 42 beach models during 2012, the models performed better than the current method to assess recreational water quality (previous day's E. coli concentration). The USGS will continue to work with local agencies to improve nowcast predictions, enable technology transfer of predictive model development procedures, and implement more operational systems during 2013 and beyond.

Audits for advanced treatment dosimetry

NASA Astrophysics Data System (ADS)

Ibbott, G. S.; Thwaites, D. I.

2015-01-01

Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

An evaluation of the quality of obstetric morbidity coding using an objective assessment tool, the Performance Indicators For Coding Quality (PICQ).

PubMed

Lamb, Mary K; Innes, Kerry; Saad, Patricia; Rust, Julie; Dimitropoulos, Vera; Cumerlato, Megan

The Performance Indicators for Coding Quality (PICQ) is a data quality assessment tool developed by Australia's National Centre for Classification in Health (NCCH). PICQ consists of a number of indicators covering all ICD-10-AM disease chapters, some procedure chapters from the Australian Classification of Health Intervention (ACHI) and some Australian Coding Standards (ACS). The indicators can be used to assess the coding quality of hospital morbidity data by monitoring compliance of coding conventions and ACS; this enables the identification of particular records that may be incorrectly coded, thus providing a measure of data quality. There are 31 obstetric indicators available for the ICD-10-AM Fourth Edition. Twenty of these 31 indicators were classified as Fatal, nine as Warning and two Relative. These indicators were used to examine coding quality of obstetric records in the 2004-2005 financial year Australian national hospital morbidity dataset. Records with obstetric disease or procedure codes listed anywhere in the code string were extracted and exported from the SPSS source file. Data were then imported into a Microsoft Access database table as per PICQ instructions, and run against all Fatal and Warning and Relative (N=31) obstetric PICQ 2006 Fourth Edition Indicators v.5 for the ICD-10- AM Fourth Edition. There were 689,905 gynaecological and obstetric records in the 2004-2005 financial year, of which 1.14% were found to have triggered Fatal degree errors, 3.78% Warning degree errors and 8.35% Relative degree errors. The types of errors include completeness, redundancy, specificity and sequencing problems. It was found that PICQ is a useful initial screening tool for the assessment of ICD-10-AM/ACHI coding quality. The overall quality of codes assigned to obstetric records in the 2004- 2005 Australian national morbidity dataset is of fair quality.

Clinical trials in palliative care: a systematic review of their methodological characteristics and of the quality of their reporting.

PubMed

Bouça-Machado, Raquel; Rosário, Madalena; Alarcão, Joana; Correia-Guedes, Leonor; Abreu, Daisy; Ferreira, Joaquim J

2017-01-25

Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the results and of the strength of the available evidence. We sought to evaluate the methodological characteristics and assess the quality of reporting of clinical trials in palliative care. We performed a systematic review of published clinical trials assessing therapeutic interventions in palliative care. Trials were identified using MEDLINE (from its inception to February 2015). We assessed methodological characteristics and describe the quality of reporting using the Cochrane Risk of Bias tool. We retrieved 107 studies. The most common medical field studied was oncology, and 43.9% of trials evaluated pharmacological interventions. Symptom control and physical dimensions (e.g. intervention on pain, breathlessness, nausea) were the palliative care-specific issues most studied. We found under-reporting of key information in particular on random sequence generation, allocation concealment, and blinding. While the number of clinical trials in palliative care has increased over time, methodological quality remains suboptimal. This compromises the quality of studies. Therefore, a greater effort is needed to enable the appropriate performance of future studies and increase the robustness of evidence-based medicine in this important field.

Assessing primary care data quality.

PubMed

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Forests under climate change and air pollution: gaps in understanding and future directions for research.

PubMed

Matyssek, R; Wieser, G; Calfapietra, C; de Vries, W; Dizengremel, P; Ernst, D; Jolivet, Y; Mikkelsen, T N; Mohren, G M J; Le Thiec, D; Tuovinen, J-P; Weatherall, A; Paoletti, E

2012-01-01

Forests in Europe face significant changes in climate, which in interaction with air quality changes, may significantly affect forest productivity, stand composition and carbon sequestration in both vegetation and soils. Identified knowledge gaps and research needs include: (i) interaction between changes in air quality (trace gas concentrations), climate and other site factors on forest ecosystem response, (ii) significance of biotic processes in system response, (iii) tools for mechanistic and diagnostic understanding and upscaling, and (iv) the need for unifying modelling and empirical research for synthesis. This position paper highlights the above focuses, including the global dimension of air pollution as part of climate change and the need for knowledge transfer to enable reliable risk assessment. A new type of research site in forest ecosystems ("supersites") will be conducive to addressing these gaps by enabling integration of experimentation and modelling within the soil-plant-atmosphere interface, as well as further model development. Copyright © 2011 Elsevier Ltd. All rights reserved.

Anatomy of Data Integration

PubMed Central

Brazhnik, Olga; Jones, John F.

2007-01-01

Producing reliable information is the ultimate goal of data processing. The ocean of data created with the advances of science and technologies calls for integration of data coming from heterogeneous sources that are diverse in their purposes, business rules, underlying models and enabling technologies. Reference models, Semantic Web, standards, ontology, and other technologies enable fast and efficient merging of heterogeneous data, while the reliability of produced information is largely defined by how well the data represent the reality. In this paper we initiate a framework for assessing the informational value of data that includes data dimensions; aligning data quality with business practices; identifying authoritative sources and integration keys; merging models; uniting updates of varying frequency and overlapping or gapped data sets. PMID:17071142

Appreciative Inquiry for quality improvement in primary care practices.

PubMed

Ruhe, Mary C; Bobiak, Sarah N; Litaker, David; Carter, Caroline A; Wu, Laura; Schroeder, Casey; Zyzanski, Stephen J; Weyer, Sharon M; Werner, James J; Fry, Ronald E; Stange, Kurt C

2011-01-01

To test the effect of an Appreciative Inquiry (AI) quality improvement strategy on clinical quality management and practice development outcomes. Appreciative inquiry enables the discovery of shared motivations, envisioning a transformed future, and learning around the implementation of a change process. Thirty diverse primary care practices were randomly assigned to receive an AI-based intervention focused on a practice-chosen topic and on improving preventive service delivery (PSD) rates. Medical-record review assessed change in PSD rates. Ethnographic field notes and observational checklist analysis used editing and immersion/crystallization methods to identify factors affecting intervention implementation and practice development outcomes. The PSD rates did not change. Field note analysis suggested that the intervention elicited core motivations, facilitated development of a shared vision, defined change objectives, and fostered respectful interactions. Practices most likely to implement the intervention or develop new practice capacities exhibited 1 or more of the following: support from key leader(s), a sense of urgency for change, a mission focused on serving patients, health care system and practice flexibility, and a history of constructive practice change. An AI approach and enabling practice conditions can lead to intervention implementation and practice development by connecting individual and practice strengths and motivations to the change objective.

Appreciative Inquiry for Quality Improvement in Primary Care Practices

PubMed Central

Ruhe, Mary C.; Bobiak, Sarah N.; Litaker, David; Carter, Caroline A.; Wu, Laura; Schroeder, Casey; Zyzanski, Stephen; Weyer, Sharon M.; Werner, James J.; Fry, Ronald E.; Stange, Kurt C.

2014-01-01

Purpose To test the effect of an Appreciative Inquiry (AI) quality improvement strategy, on clinical quality management and practice development outcomes. AI enables discovery of shared motivations, envisioning a transformed future, and learning around implementation of a change process. Methods Thirty diverse primary care practices were randomly assigned to receive an AI-based intervention focused on a practice-chosen topic and on improving preventive service delivery (PSD) rates. Medical record review assessed change in PSD rates. Ethnographic fieldnotes and observational checklist analysis used editing and immersion/crystallization methods to identify factors affecting intervention implementation and practice development outcomes. Results PSD rates did not change. Field note analysis suggested that the intervention elicited core motivations, facilitated development of a shared vision, defined change objectives and fostered respectful interactions. Practices most likely to implement the intervention or develop new practice capacities exhibited one or more of the following: support from key leader(s), a sense of urgency for change, a mission focused on serving patients, health care system and practice flexibility, and a history of constructive practice change. Conclusions An AI approach and enabling practice conditions can lead to intervention implementation and practice development by connecting individual and practice strengths and motivations to the change objective. PMID:21192206

Sector-wise midpoint characterization factors for impact assessment of regional consumptive and degradative water use.

PubMed

Lin, Chia-Chun; Lin, Jia-Yu; Lee, Mengshan; Chiueh, Pei-Te

2017-12-31

Water availability, resulting from either a lack of water or poor water quality is a key factor contributing to regional water stress. This study proposes a set of sector-wise characterization factors (CFs), namely consumptive and degradative water stresses, to assess the impact of water withdrawals with a life cycle assessment approach. These CFs consider water availability, water quality, and competition for water between domestic, agricultural and industrial sectors and ecosystem at the watershed level. CFs were applied to a case study of regional water management of industrial water withdrawals in Taiwan to show that both regional or seasonal decrease in water availability contributes to a high consumptive water stress, whereas water scarcity due to degraded water quality not meeting sector standards has little influence on increased degradative water stress. Degradative water stress was observed more in the agricultural sector than in the industrial sector, which implies that the agriculture sector may have water quality concerns. Reducing water intensity and alleviating regional scale water stresses of watersheds are suggested as approaches to decrease the impact of both consumptive and degradative water use. The results from this study may enable a more detailed sector-wise analysis of water stress and influence water resource management policies. Copyright © 2017 Elsevier B.V. All rights reserved.

Sensor & Model Enabled Water Quality & Security Assessment System for Situational Awareness of Water Distribution Networks

DTIC Science & Technology

2010-06-01

Scenario – 12 gallons of readily available toxic substance – pump ($150 rental) – wrench to open a fire hydrant ($10)  One (1) terrorist, or...6 Gallons Water General Comments Aflatoxin 7.6 Potent Carcinogen Aldicarb 1.1 Cycloheximide 2.1 LSD 0.2 Highly Toxic , Psychoactive Mercuric Chloride...Chlorfenvinphos, Formetanate Hydrochloride, Acrolein, Chloropicrin, Sodium chloroacetate, Thyoglycolate medium, Crotoxyphos, Glyphosate , Jimsonweed, Methanol

Clinical benchmarking enabled by the digital health record.

PubMed

Ricciardi, T N; Masarie, F E; Middleton, B

2001-01-01

Office-based physicians are often ill equipped to report aggregate information about their patients and practice of medicine, since their practices have relied upon paper records for the management of clinical information. Physicians who do not have access to large-scale information technology support can now benefit from low-cost clinical documentation and reporting tools. We developed a hosted clinical data mart for users of a web-enabled charting tool, targeting the solo or small group practice. The system uses secure Java Server Pages with a dashboard-like menu to provide point-and-click access to simple reports such as case mix, medications, utilization, productivity, and patient demographics in its first release. The system automatically normalizes user-entered clinical terms to enhance the quality of structured data. Individual providers benefit from rapid patient identification for disease management, quality of care self-assessments, drug recalls, and compliance with clinical guidelines. The system provides knowledge integration by linking to trusted sources of online medical information in context. Information derived from the clinical record is clinically more accurate than billing data. Provider self-assessment and benchmarking empowers physicians, who may resent "being profiled" by external entities. In contrast to large-scale data warehouse projects, the current system delivers immediate value to individual physicians who choose an electronic clinical documentation tool.

Simultaneous Analysis and Quality Assurance for Diffusion Tensor Imaging

PubMed Central

Lauzon, Carolyn B.; Asman, Andrew J.; Esparza, Michael L.; Burns, Scott S.; Fan, Qiuyun; Gao, Yurui; Anderson, Adam W.; Davis, Nicole; Cutting, Laurie E.; Landman, Bennett A.

2013-01-01

Diffusion tensor imaging (DTI) enables non-invasive, cyto-architectural mapping of in vivo tissue microarchitecture through voxel-wise mathematical modeling of multiple magnetic resonance imaging (MRI) acquisitions, each differently sensitized to water diffusion. DTI computations are fundamentally estimation processes and are sensitive to noise and artifacts. Despite widespread adoption in the neuroimaging community, maintaining consistent DTI data quality remains challenging given the propensity for patient motion, artifacts associated with fast imaging techniques, and the possibility of hardware changes/failures. Furthermore, the quantity of data acquired per voxel, the non-linear estimation process, and numerous potential use cases complicate traditional visual data inspection approaches. Currently, quality inspection of DTI data has relied on visual inspection and individual processing in DTI analysis software programs (e.g. DTIPrep, DTI-studio). However, recent advances in applied statistical methods have yielded several different metrics to assess noise level, artifact propensity, quality of tensor fit, variance of estimated measures, and bias in estimated measures. To date, these metrics have been largely studied in isolation. Herein, we select complementary metrics for integration into an automatic DTI analysis and quality assurance pipeline. The pipeline completes in 24 hours, stores statistical outputs, and produces a graphical summary quality analysis (QA) report. We assess the utility of this streamlined approach for empirical quality assessment on 608 DTI datasets from pediatric neuroimaging studies. The efficiency and accuracy of quality analysis using the proposed pipeline is compared with quality analysis based on visual inspection. The unified pipeline is found to save a statistically significant amount of time (over 70%) while improving the consistency of QA between a DTI expert and a pool of research associates. Projection of QA metrics to a low dimensional manifold reveal qualitative, but clear, QA-study associations and suggest that automated outlier/anomaly detection would be feasible. PMID:23637895

Simultaneous analysis and quality assurance for diffusion tensor imaging.

PubMed

Lauzon, Carolyn B; Asman, Andrew J; Esparza, Michael L; Burns, Scott S; Fan, Qiuyun; Gao, Yurui; Anderson, Adam W; Davis, Nicole; Cutting, Laurie E; Landman, Bennett A

2013-01-01

Diffusion tensor imaging (DTI) enables non-invasive, cyto-architectural mapping of in vivo tissue microarchitecture through voxel-wise mathematical modeling of multiple magnetic resonance imaging (MRI) acquisitions, each differently sensitized to water diffusion. DTI computations are fundamentally estimation processes and are sensitive to noise and artifacts. Despite widespread adoption in the neuroimaging community, maintaining consistent DTI data quality remains challenging given the propensity for patient motion, artifacts associated with fast imaging techniques, and the possibility of hardware changes/failures. Furthermore, the quantity of data acquired per voxel, the non-linear estimation process, and numerous potential use cases complicate traditional visual data inspection approaches. Currently, quality inspection of DTI data has relied on visual inspection and individual processing in DTI analysis software programs (e.g. DTIPrep, DTI-studio). However, recent advances in applied statistical methods have yielded several different metrics to assess noise level, artifact propensity, quality of tensor fit, variance of estimated measures, and bias in estimated measures. To date, these metrics have been largely studied in isolation. Herein, we select complementary metrics for integration into an automatic DTI analysis and quality assurance pipeline. The pipeline completes in 24 hours, stores statistical outputs, and produces a graphical summary quality analysis (QA) report. We assess the utility of this streamlined approach for empirical quality assessment on 608 DTI datasets from pediatric neuroimaging studies. The efficiency and accuracy of quality analysis using the proposed pipeline is compared with quality analysis based on visual inspection. The unified pipeline is found to save a statistically significant amount of time (over 70%) while improving the consistency of QA between a DTI expert and a pool of research associates. Projection of QA metrics to a low dimensional manifold reveal qualitative, but clear, QA-study associations and suggest that automated outlier/anomaly detection would be feasible.

Performance tests and quality control of cathode ray tube displays.

PubMed

Roehrig, H; Blume, H; Ji, T L; Browne, M

1990-08-01

Spatial resolution, noise, characteristic curve, and absolute luminance are the essential parameters that describe physical image quality of a display. This paper presents simple procedures for assessing the performance of a cathode ray tube (CRT) in terms of these parameters as well as easy set up techniques. The procedures can be used in the environment where the CRT is used. The procedures are based on a digital representation of the Society of Motion Pictures and Television Engineers pattern plus a few simple other digital patterns. Additionally, measurement techniques are discussed for estimating brightness uniformity, veiling glare, and distortion. Apart from the absolute luminance, all performance features can be assessed with an uncalibrated photodetector and the eyes of a human observer. The measurement techniques especially enable the user to perform comparisons of different display systems.

Technology Assessment for Large Vertical-Lift Transport Tiltrotors

NASA Technical Reports Server (NTRS)

Germanowski, Peter J.; Stille, Brandon L.; Strauss, Michael P.

2010-01-01

The technical community has identified rotor efficiency as a critical enabling technology for large vertical-lift transport (LVLT) rotorcraft. The size and performance of LVLT aircraft will be far beyond current aircraft capabilities, enabling a transformational change in cargo transport effectiveness. Two candidate approaches for achieving high efficiency were considered for LVLT applications: a variable-diameter tiltrotor (VDTR) and a variable-speed tiltrotor (VSTR); the former utilizes variable-rotor geometry and the latter utilizes variable-rotor speed. Conceptual aircraft designs were synthesized for the VDTR and VSTR and compared to a conventional tiltrotor (CTR). The aircraft were optimized to a common objective function and bounded by a set of physical- and requirements-driven constraints. The resulting aircraft were compared for weight, size, performance, handling qualities, and other attributes. These comparisons established a measure of the relative merits of the variable-diameter and -speed rotor systems as enabling technologies for LVLT capability.

Impact of voice- and knowledge-enabled clinical reporting--US example.

PubMed

Bushko, Renata G; Havlicek, Penny L; Deppert, Edward; Epner, Stephen

2002-01-01

This study shows qualitative and quantitative estimates of the national and the clinic level impact of utilizing voice and knowledge enabled clinical reporting systems. Using common sense estimation methodology, we show that the delivery of health care can experience a dramatic improvement in four areas as a result of the broad use of voice and knowledge enabled clinical reporting: (1) Process Quality as measured by cost savings, (2) Organizational Quality as measured by compliance, (3) Clinical Quality as measured by clinical outcomes and (4) Service Quality as measured by patient satisfaction. If only 15 percent of US physicians replaced transcription with modem clinical reporting voice-based methodology, about one half billion dollars could be saved. $6.7 Billion could be saved annually if all medical reporting currently transcribed was handled with voice-and knowledge-enabled dictation and reporting systems.

Quality measures for nurse practitioner practice evaluation.

PubMed

Kleinpell, Ruth; Kapu, April N

2017-08-01

Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

HIV surveillance in MENA: recent developments and results.

PubMed

Bozicevic, Ivana; Riedner, Gabriele; Calleja, Jesus Maria Garcia

2013-11-01

To provide an overview of the current level of development and results from the national HIV surveillance systems of the 23 countries of the Middle East and North Africa (MENA), and to assess the quality of HIV surveillance systems in the period 2007-2011. A questionnaire was used to collect the information about the structure, activities and the results of HIV surveillance systems from the National AIDS Programmes. Assessment of the quality was based on four indicators: timeliness of data collection, appropriateness of populations under surveillance, consistency of the surveillance sites and groups measured over time, and coverage of the surveillance system. Only in four countries did surveillance systems enable assessment of epidemic trends in the same populations and locations over time, such as in pregnant women (Morocco, Iran), injecting drug users (Iran, Pakistan), female sex workers (Djibouti, Morocco) and male sex workers (Pakistan). There is increasing evidence of HIV infection being firmly established in at least one of the populations most at risk of HIV in nine MENA countries, while lower risk populations show elevated HIV prevalence in South Sudan, Djibouti and some parts of Somalia. The performance of HIV surveillance systems in several of the MENA countries has improved in recent years. The extent of HIV epidemics in the populations most at risk of HIV is still largely unknown in 10 countries. Multiple data sources that most of the countries still lack would enable indirectly estimation not only of the patterns of HIV epidemics but also the effectiveness of HIV responses.

Assessing reliability of protein-protein interactions by integrative analysis of data in model organisms.

PubMed

Lin, Xiaotong; Liu, Mei; Chen, Xue-wen

2009-04-29

Protein-protein interactions play vital roles in nearly all cellular processes and are involved in the construction of biological pathways such as metabolic and signal transduction pathways. Although large-scale experiments have enabled the discovery of thousands of previously unknown linkages among proteins in many organisms, the high-throughput interaction data is often associated with high error rates. Since protein interaction networks have been utilized in numerous biological inferences, the inclusive experimental errors inevitably affect the quality of such prediction. Thus, it is essential to assess the quality of the protein interaction data. In this paper, a novel Bayesian network-based integrative framework is proposed to assess the reliability of protein-protein interactions. We develop a cross-species in silico model that assigns likelihood scores to individual protein pairs based on the information entirely extracted from model organisms. Our proposed approach integrates multiple microarray datasets and novel features derived from gene ontology. Furthermore, the confidence scores for cross-species protein mappings are explicitly incorporated into our model. Applying our model to predict protein interactions in the human genome, we are able to achieve 80% in sensitivity and 70% in specificity. Finally, we assess the overall quality of the experimentally determined yeast protein-protein interaction dataset. We observe that the more high-throughput experiments confirming an interaction, the higher the likelihood score, which confirms the effectiveness of our approach. This study demonstrates that model organisms certainly provide important information for protein-protein interaction inference and assessment. The proposed method is able to assess not only the overall quality of an interaction dataset, but also the quality of individual protein-protein interactions. We expect the method to continually improve as more high quality interaction data from more model organisms becomes available and is readily scalable to a genome-wide application.

Life quality and living standards in big cities under conditions of high-rise construction development

NASA Astrophysics Data System (ADS)

Avdeeva, Elena; Averina, Tatiana; Kochetova, Larisa

2018-03-01

Modern urbanization processes occurring on a global scale inevitably lead to an increase in population density in large cities. People assess the state of life quality and living standards of megalopolises under conditions of high-rise construction development ambiguously. Using SWOT analysis, the authors distinguished positive and negative aspects of high-rise construction, highlighted threats to its development and its opportunities. The article considers the model of development of the city's industry and infrastructure, which enables determining the optimal volume of production by sectors and branches of city economy in order to increase its innovative, production and economic potential and business activity.

Effect of pooled comparative information on judgments of quality

PubMed Central

Baumgart, Leigh A.; Bass, Ellen J.; Voss, John D.; Lyman, Jason A.

2015-01-01

Quality assessment is the focus of many health care initiatives. Yet it is not well understood how the type of information used in decision support tools to enable judgments of quality based on data impacts the accuracy, consistency and reliability of judgments made by physicians. Comparative pooled information could allow physicians to judge the quality of their practice by making comparisons to other practices or other specific populations of patients. In this study, resident physicians were provided with varying types of information derived from pooled patient data sets: quality component measures at the individual and group level, a qualitative interpretation of the quality measures using percentile rank, and an aggregate composite quality score. 32 participants viewed thirty quality profiles consisting of information applicable to the practice of thirty de-identified resident physicians. Those provided with quality component measures and a qualitative interpretation of the quality measures (rankings) judged quality of care more similarly to experts and were more internally consistent compared to participants who were provided with quality component measures alone. Reliability between participants was significantly less for those who were provided with a composite quality score compared to those who were not. PMID:26949581

A simple, semi-prescriptive self-assessment model for TQM.

PubMed

Warwood, Stephen; Antony, Jiju

2003-01-01

This article presents a simple, semi-prescriptive self-assessment model for use in industry as part of a continuous improvement program such as Total Quality Management (TQM). The process by which the model was constructed started with a review of the available literature in order to research TQM success factors. Next, postal surveys were conducted by sending questionnaires to the winning organisations of the Baldrige and European Quality Awards and to a preselected group of enterprising UK organisations. From the analysis of this data, the self-assessment model was constructed to help organisations in their quest for excellence. This work confirmed the findings from the literature, that there are key factors that contribute to the successful implementation of TQM and these have different levels of importance. These key factors, in order of importance, are: effective leadership, the impact of other quality-related programs, measurement systems, organisational culture, education and training, the use of teams, efficient communications, active empowerment of the workforce, and a systems infrastructure to support the business and customer-focused processes. This analysis, in turn, enabled the design of a self-assessment model that can be applied within any business setting. Further work should include the testing and review of this model to ascertain its suitability and effectiveness within industry today.

Development and Validation of a Cross-Country Hospital Patient Quality of Care Assessment Tool in Europe.

PubMed

Villiers-Tuthill, Amanda; Doulougeri, Karolina; McGee, Hannah; Montgomery, Anthony; Panagopoulou, Efharis; Morgan, Karen

2017-12-01

Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework. We conducted a multi-country cross-sectional study. Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed. Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities. The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.

Toward standardized quantitative image quality (IQ) assessment in computed tomography (CT): A comprehensive framework for automated and comparative IQ analysis based on ICRU Report 87.

PubMed

Pahn, Gregor; Skornitzke, Stephan; Schlemmer, Hans-Peter; Kauczor, Hans-Ulrich; Stiller, Wolfram

2016-01-01

Based on the guidelines from "Report 87: Radiation Dose and Image-quality Assessment in Computed Tomography" of the International Commission on Radiation Units and Measurements (ICRU), a software framework for automated quantitative image quality analysis was developed and its usability for a variety of scientific questions demonstrated. The extendable framework currently implements the calculation of the recommended Fourier image quality (IQ) metrics modulation transfer function (MTF) and noise-power spectrum (NPS), and additional IQ quantities such as noise magnitude, CT number accuracy, uniformity across the field-of-view, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) of simulated lesions for a commercially available cone-beam phantom. Sample image data were acquired with different scan and reconstruction settings on CT systems from different manufacturers. Spatial resolution is analyzed in terms of edge-spread function, line-spread-function, and MTF. 3D NPS is calculated according to ICRU Report 87, and condensed to 2D and radially averaged 1D representations. Noise magnitude, CT numbers, and uniformity of these quantities are assessed on large samples of ROIs. Low-contrast resolution (CNR, SNR) is quantitatively evaluated as a function of lesion contrast and diameter. Simultaneous automated processing of several image datasets allows for straightforward comparative assessment. The presented framework enables systematic, reproducible, automated and time-efficient quantitative IQ analysis. Consistent application of the ICRU guidelines facilitates standardization of quantitative assessment not only for routine quality assurance, but for a number of research questions, e.g. the comparison of different scanner models or acquisition protocols, and the evaluation of new technology or reconstruction methods. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Improving the efficacy of healthcare services for Aboriginal Australians.

PubMed

Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle

2018-01-16

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.

Assessing cognitive functioning in females with Rett syndrome by eye-tracking methodology.

PubMed

Ahonniska-Assa, Jaana; Polack, Orli; Saraf, Einat; Wine, Judy; Silberg, Tamar; Nissenkorn, Andreea; Ben-Zeev, Bruria

2018-01-01

While many individuals with severe developmental impairments learn to communicate with augmentative and alternative communication (AAC) devices, a significant number of individuals show major difficulties in the effective use of AAC. Recent technological innovations, i.e., eye-tracking technology (ETT), aim to improve the transparency of communication and may also enable a more valid cognitive assessment. To investigate whether ETT in forced-choice tasks can enable children with very severe motor and speech impairments to respond consistently, allowing a more reliable evaluation of their language comprehension. Participants were 17 girls with Rett syndrome (M = 6:06 years). Their ability to respond by eye gaze was first practiced with computer games using ETT. Afterwards, their receptive vocabulary was assessed using the Peabody Picture Vocabulary Test-4 (PPVT-4). Target words were orally presented and participants responded by focusing their eyes on the preferred picture. Remarkable differences between the participants in receptive vocabulary were demonstrated using ETT. The verbal comprehension abilities of 32% of the participants ranged from low-average to mild cognitive impairment, and the other 68% of the participants showed moderate to severe impairment. Young age at the time of assessment was positively correlated with higher receptive vocabulary. The use of ETT seems to make the communicational signals of children with severe motor and communication impairments more easily understood. Early practice of ETT may improve the quality of communication and enable more reliable conclusions in learning and assessment sessions. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

PubMed

Sampurno, Fanny; Zheng, Jia; Di Stefano, Lydia; Millar, Jeremy L; Foster, Claire; Fuedea, Ferran; Higano, Celestia; Hulan, Hartwig; Mark, Stephen; Moore, Caroline; Richardson, Alison; Sullivan, Frank; Wenger, Neil S; Wittmann, Daniela; Evans, Sue

2018-03-01

We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicted by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater. The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes. We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Assessing early unplanned reoperations in neurosurgery: opportunities for quality improvement.

PubMed

McLaughlin, Nancy; Jin, Peng; Martin, Neil A

2015-07-01

Review of morbidities and mortality has been the primary method used to assess surgical quality by physicians, hospitals, and oversight agencies. The incidence of reoperation has been proposed as a candidate quality indicator for surgical care. The authors report a comprehensive assessment of reoperations within a neurosurgical department and discuss how such data can be integrated into quality improvement initiatives to optimize value of care delivery. All neurosurgical procedures performed in the main operating room or the outpatient surgery center at the Ronald Reagan UCLA Medical Center and UCLA Santa Monica Medical Center from July 2008 to December 2012 were considered for this study. Interventional radiology and stereotactic radiosurgery procedures were excluded. Early reoperations within 7 days of the index surgery were reviewed and their preventability status was evaluated. The incidence of early unplanned reoperation was 2.6% (occurring after 183 of 6912 procedures). More than half of the patients who underwent early unplanned reoperation initially had surgery for shunt-related conditions (34.4%) or intracranial tumor (23.5%). Shunt failure was the most common indication for early unplanned reoperation (34.4%), followed by postoperative bleeding (20.8%) and postoperative elevated intracranial pressure (9.8%). The average time interval (± SD) between the index surgery and reoperation was 3.0 ± 1.9 days. The average length of stay following reoperation was 12.1 ± 14.4 days. This study enabled an in-depth assessment of reoperations within an academic neurosurgical practice and identification of strategic opportunities for department-wide quality improvement initiatives. The authors provide a nuanced discussion regarding the use of absolute reoperations as a quality indicator for neurosurgical patient populations.

Quality of surgical randomized controlled trials for acute cholecystitis: assessment based on CONSORT and additional check items.

PubMed

Shikata, Satoru; Nakayama, Takeo; Yamagishi, Hisakazu

2008-01-01

In this study, we conducted a limited survey of reports of surgical randomized controlled trials, using the consolidated standards of reporting trials (CONSORT) statement and additional check items to clarify problems in the evaluation of surgical reports. A total of 13 randomized trials were selected from two latest review articles on biliary surgery. Each randomized trial was evaluated according to 28 quality measures that comprised items from the CONSORT statement plus additional items. Analysis focused on relationships between the quality of each study and the estimated effect gap ("pooled estimate in meta-analysis" -- "estimated effect of each study"). No definite relationships were found between individual study quality and the estimated effect gap. The following items could have been described but were not provided in almost all the surgical RCT reports: "clearly defined outcomes"; "details of randomization"; "participant flow charts"; "intention-to-treat analysis"; "ancillary analyses"; and "financial conflicts of interest". The item, "participation of a trial methodologist in the study" was not found in any of the reports. Although the quality of reporting trials is not always related to a biased estimation of treatment effect, the items used for quality measures must be described to enable readers to evaluate the quality and applicability of the reporting. Further development of an assessment tool is needed for items specific to surgical randomized controlled trials.

Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature

PubMed Central

Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R.; Salek, Sam

2017-01-01

Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general paucity of research in this area, particularly regarding the development and systematic application of techniques for evaluating quality decision making, with no consensus around a gold standard. This review has identified QoDoS as the most promising available technique for assessing decision making in the lifecycle of medicines and the next steps would be to further test its validity, sensitivity, and reliability. PMID:28443022

Analysis of transport eco-efficiency scenarios to support sustainability assessment: a study on Dhaka City, Bangladesh.

PubMed

Iqbal, Asif; Allan, Andrew; Afroze, Shirina

2017-08-01

The study focused to assess the level of efficiency (of both emissions and service quality) that can be achieved for the transport system in Dhaka City, Bangladesh. The assessment technique attempted to quantify the extent of eco-efficiency achievable for the system modifications due to planning or strategy. The eco-efficiency analysis was facilitated with a detailed survey data on Dhaka City transport system, which was conducted for 9 months in 2012-2013. Line source modelling (CALINE4) was incorporated to estimate the on-road emission concentration. The eco-efficiency of the transport systems was assessed with the 'multi-criteria analysis' (MCA) technique that enabled the valuation of systems' qualitative and quantitative parameters. As per the analysis, driving indiscipline on road can alone promise about 47% reductions in emissions, which along with the number of private vehicles were the important stressors that restrict achieving eco-efficiency in Dhaka City. Detailed analysis of the transport system together with the potential transport system scenarios can offer a checklist to the policy makers enabling to identify the possible actions needed that can offer greater services to the dwellers against lesser emissions, which in turn can bring sustainability of the system.

A framework for institutionalizing quality assurance.

PubMed

Silimperi, Diana R; Franco, Lynne Miller; Veldhuyzen van Zanten, Tisna; MacAulay, Catherine

2002-12-01

To develop a framework to support the institutionalization of quality assurance (QA). The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.

[Maturity Levels of Quality and Risk Management at the University Hospital Schleswig-Holstein].

PubMed

Jussli-Melchers, Jill; Hilbert, Carsten; Jahnke, Iris; Wehkamp, Kai; Rogge, Annette; Freitag-Wolf, Sandra; Kahla-Witzsch, Heike A; Scholz, Jens; Petzina, Rainer

2018-05-16

Quality and risk management in hospitals are not only required by law but also for an optimal patient-centered and process-optimized patient care. To evaluate the maturity levels of quality and risk management at the University Hospital Schleswig-Holstein (UKSH), a structured analytical tool was developed for easy and efficient application. Four criteria concerning quality management - quality assurance (QS), critical incident reporting system (CIRS), complaint management (BM) and process management (PM) - were evaluated with a structured questionnaire. Self-assessment and external assessment were performed to classify the maturity levels at the UKSH (location Kiel and Lübeck). Every quality item was graded into four categories from "A" (fully implemented) to "D" (not implemented at all). First of all, an external assessment was initiated by the head of the department of quality and risk management. Thereafter, a self-assessment was performed by 46 clinical units of the UKSH. Discrepancies were resolved in a collegial dialogue. Based on these data, overall maturity levels were obtained for every clinical unit. The overall maturity level "A" was reached by three out of 46 (6.5%) clinical units. No unit was graded with maturity level "D". 50% out of all units reached level "B" and 43.5% level "C". The distribution of the four different quality criteria revealed a good implementation of complaint management (maturity levels "A" and "B" in 78.3%), whereas the levels for CIRS were "C" and "D" in 73.9%. Quality assurance and process management showed quite similar distributions for the levels of maturity "B" and "C" (87% QS; 91% PM). The structured analytical tool revealed maturity levels of 46 clinical units of the UKSH and defined the maturity levels of four relevant quality criteria (QS, CIRS, BM, PM). As a consequence, extensive procedures were implemented to raise the standard of quality and risk management. In future, maturity levels will be reevaluated every two years. This qualitative maturity level model enables in a simple and efficient way precise statements concerning presence, manifestation and development of quality and risk management. © Georg Thieme Verlag KG Stuttgart · New York.

Assessment of surface water quality using a growing hierarchical self-organizing map: a case study of the Songhua River Basin, northeastern China, from 2011 to 2015.

PubMed

Jiang, Mingcen; Wang, Yeyao; Yang, Qi; Meng, Fansheng; Yao, Zhipeng; Cheng, Peixuan

2018-03-30

The analysis of a large number of multidimensional surface water monitoring data for extracting potential information plays an important role in water quality management. In this study, growing hierarchical self-organizing map (GHSOM) was applied to a water quality assessment of the Songhua River Basin in China using 22 water quality parameters monitored monthly from 13 monitoring sites from 2011 to 2015 (14,782 observations). The spatial and temporal features and correlation between the water quality parameters were explored, and the major contaminants were identified. The results showed that the downstream of the Second Songhua River had the worst water quality of the Songhua River Basin. The upstream and midstream of Nenjiang River and the Second Songhua River had the best. The major contaminants of the Songhua River were chemical oxygen demand (COD), ammonia nitrogen (NH 3 -N), total phosphorus (TP), and fecal coliform (FC). In the Songhua River, the water pollution at downstream has been gradually eased in years. However, FC and biochemical oxygen demand (BOD 5 ) showed growth over time. The component planes showed that three sets of parameters had positive correlations with each other. GHSOM was found to have advantages over self-organizing maps and hierarchical clustering analysis as follows: (1) automatically generating the necessary neurons, (2) intuitively exhibiting the hierarchical inheritance relationship between the original data, and (3) depicting the boundaries of the classification much more clearly. Therefore, the application of GHSOM in water quality assessments, especially with large amounts of monitoring data, enables the extraction of more information and provides strong support for water quality management.

[Safe drinking water supply to the Vologda Region's population using risk assessment methodology].

PubMed

Kuznetsova, I A; Figurina, T Ia; Shadrina, S Iu

2011-01-01

To supply the population with qualitative potable water is a priority problem in the provision of sanitary-and-epidemiologic well-being and in the prevention of disease in the Vologda Region. The monitoring of the results of laboratory control over the quality of drinking-water and the assessment of health risk enabled a package of measures to be proposed to optimize the conditions of drinking water supply in the Vologda Region. The risk assessment technology used by a state agency for sanitary-and-epidemiological surveillance makes it possible to substantiate a system of actions to organize household water use and to include scientifically grounded proposals into the developed regional and local programs.

Development of Instructional Modules for ICT Enabled Curriculum Transaction for Various Subjects at Secondary Level for Teacher Empowerment and Their Quality Assessment

ERIC Educational Resources Information Center

Gopal, G. V; Viswanathappa, G.; Kumar, P. Mohan; Biju, K.; Sharif, Nadeemulla

2010-01-01

Integrated instructional module in various subject areas at secondary level for Kerala was developed in a workshop mode and a CD was prepared using Linux-base. Training was given to the teachers in the instructional modules prepared by NIIT i.e. ICR and the same have been evaluated through a feedback mechanism. This paper is focusing on the…

Finding of No Significant Impact: Replacement of Chemical Cleaning Line Tinker Air Force Base Oklahoma City, Oklahoma

DTIC Science & Technology

2012-05-01

indoor air quality from installation of a new, improved cleaning line ventilation system. Cultural Resources No adverse effect on cultural...EA) has been prepared to assess the potential effects on the human and natural environment of replacing the chemical cleaning line at Tinker Air...providing improved system monitors and controls, reducing the overall energy consumption of the system, and enabling the system to accommodate larger

Quality improvement training for core medical and general practice trainees: a pilot study of project participation, completion and journal publication.

PubMed

McNab, Duncan; McKay, John; Bowie, Paul

2015-11-01

Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal. A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success. Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%). This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be realised. © The Author(s) 2015.

Multiplex picoliter-droplet digital PCR for quantitative assessment of DNA integrity in clinical samples.

PubMed

Didelot, Audrey; Kotsopoulos, Steve K; Lupo, Audrey; Pekin, Deniz; Li, Xinyu; Atochin, Ivan; Srinivasan, Preethi; Zhong, Qun; Olson, Jeff; Link, Darren R; Laurent-Puig, Pierre; Blons, Hélène; Hutchison, J Brian; Taly, Valerie

2013-05-01

Assessment of DNA integrity and quantity remains a bottleneck for high-throughput molecular genotyping technologies, including next-generation sequencing. In particular, DNA extracted from paraffin-embedded tissues, a major potential source of tumor DNA, varies widely in quality, leading to unpredictable sequencing data. We describe a picoliter droplet-based digital PCR method that enables simultaneous detection of DNA integrity and the quantity of amplifiable DNA. Using a multiplex assay, we detected 4 different target lengths (78, 159, 197, and 550 bp). Assays were validated with human genomic DNA fragmented to sizes of 170 bp to 3000 bp. The technique was validated with DNA quantities as low as 1 ng. We evaluated 12 DNA samples extracted from paraffin-embedded lung adenocarcinoma tissues. One sample contained no amplifiable DNA. The fractions of amplifiable DNA for the 11 other samples were between 0.05% and 10.1% for 78-bp fragments and ≤1% for longer fragments. Four samples were chosen for enrichment and next-generation sequencing. The quality of the sequencing data was in agreement with the results of the DNA-integrity test. Specifically, DNA with low integrity yielded sequencing results with lower levels of coverage and uniformity and had higher levels of false-positive variants. The development of DNA-quality assays will enable researchers to downselect samples or process more DNA to achieve reliable genome sequencing with the highest possible efficiency of cost and effort, as well as minimize the waste of precious samples. © 2013 American Association for Clinical Chemistry.

ScanRanker: Quality Assessment of Tandem Mass Spectra via Sequence Tagging

PubMed Central

Ma, Ze-Qiang; Chambers, Matthew C.; Ham, Amy-Joan L.; Cheek, Kristin L.; Whitwell, Corbin W.; Aerni, Hans-Rudolf; Schilling, Birgit; Miller, Aaron W.; Caprioli, Richard M.; Tabb, David L.

2011-01-01

In shotgun proteomics, protein identification by tandem mass spectrometry relies on bioinformatics tools. Despite recent improvements in identification algorithms, a significant number of high quality spectra remain unidentified for various reasons. Here we present ScanRanker, an open-source tool that evaluates the quality of tandem mass spectra via sequence tagging with reliable performance in data from different instruments. The superior performance of ScanRanker enables it not only to find unassigned high quality spectra that evade identification through database search, but also to select spectra for de novo sequencing and cross-linking analysis. In addition, we demonstrate that the distribution of ScanRanker scores predicts the richness of identifiable spectra among multiple LC-MS/MS runs in an experiment, and ScanRanker scores assist the process of peptide assignment validation to increase confident spectrum identifications. The source code and executable versions of ScanRanker are available from http://fenchurch.mc.vanderbilt.edu. PMID:21520941

Enhancement of automated blood flow estimates (ENABLE) from arterial spin-labeled MRI.

PubMed

Shirzadi, Zahra; Stefanovic, Bojana; Chappell, Michael A; Ramirez, Joel; Schwindt, Graeme; Masellis, Mario; Black, Sandra E; MacIntosh, Bradley J

2018-03-01

To validate a multiparametric automated algorithm-ENhancement of Automated Blood fLow Estimates (ENABLE)-that identifies useful and poor arterial spin-labeled (ASL) difference images in multiple postlabeling delay (PLD) acquisitions and thereby improve clinical ASL. ENABLE is a sort/check algorithm that uses a linear combination of ASL quality features. ENABLE uses simulations to determine quality weighting factors based on an unconstrained nonlinear optimization. We acquired a set of 6-PLD ASL images with 1.5T or 3.0T systems among 98 healthy elderly and adults with mild cognitive impairment or dementia. We contrasted signal-to-noise ratio (SNR) of cerebral blood flow (CBF) images obtained with ENABLE vs. conventional ASL analysis. In a subgroup, we validated our CBF estimates with single-photon emission computed tomography (SPECT) CBF images. ENABLE produced significantly increased SNR compared to a conventional ASL analysis (Wilcoxon signed-rank test, P < 0.0001). We also found the similarity between ASL and SPECT was greater when using ENABLE vs. conventional ASL analysis (n = 51, Wilcoxon signed-rank test, P < 0.0001) and this similarity was strongly related to ASL SNR (t = 24, P < 0.0001). These findings suggest that ENABLE improves CBF image quality from multiple PLD ASL in dementia cohorts at either 1.5T or 3.0T, achieved by multiparametric quality features that guided postprocessing of dementia ASL. 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:647-655. © 2017 International Society for Magnetic Resonance in Medicine.

Qualitative analysis of MMI raters' scorings of medical school candidates: A matter of taste?

PubMed

Christensen, Mette K; Lykkegaard, Eva; Lund, Ole; O'Neill, Lotte D

2018-05-01

Recent years have seen leading medical educationalists repeatedly call for a paradigm shift in the way we view, value and use subjectivity in assessment. The argument is that subjective expert raters generally bring desired quality, not just noise, to performance evaluations. While several reviews document the psychometric qualities of the Multiple Mini-Interview (MMI), we currently lack qualitative studies examining what we can learn from MMI raters' subjectivity. The present qualitative study therefore investigates rater subjectivity or taste in MMI selection interview. Taste (Bourdieu 1984) is a practical sense, which makes it possible at a pre-reflective level to apply 'invisible' or 'tacit' categories of perception for distinguishing between good and bad. The study draws on data from explorative in-depth interviews with 12 purposefully selected MMI raters. We find that MMI raters spontaneously applied subjective criteria-their taste-enabling them to assess the candidates' interpersonal attributes and to predict the candidates' potential. In addition, MMI raters seemed to share a taste for certain qualities in the candidates (e.g. reflectivity, resilience, empathy, contact, alikeness, 'the good colleague'); hence, taste may be the result of an ongoing enculturation in medical education and healthcare systems. This study suggests that taste is an inevitable condition in the assessment of students' performance. The MMI set-up should therefore make room for MMI raters' taste and their connoisseurship, i.e. their ability to taste, to improve the quality of their assessment of medical school candidates.

Histological evaluation and optimization of surgical vessel sealing systems

NASA Astrophysics Data System (ADS)

Lathrop, Robert; Ryan, Thomas; Gaspredes, Jonathan; Woloszko, Jean; Coad, James E.

2017-02-01

Surgical vessel sealing systems are widely used to achieve hemostasis and dissection in open surgery and minimally invasive, laparoscopic surgery. This enabling technology was developed about 17 years ago and continues to evolve with new devices and systems achieving improved outcomes. Histopathological assessment of thermally sealed tissues is a valuable tool for refining and comparing performance among surgical vessel sealing systems. Early work in this field typically assessed seal time, burst rate, and failure rate (in-situ). Later work compared histological staining methods with birefringence to assess the extent of thermal damage to tissues adjacent to the device. Understanding the microscopic architecture of a sealed vessel is crucial to optimizing the performance of power delivery algorithms and device design parameters. Manufacturers rely on these techniques to develop new products. A system for histopathological evaluation of vessels and sealing performance was established, to enable the direct assessment of a treatment's tissue effects. The parameters included the commonly used seal time, pressure burst rate and failure rate, as well as extensions of the assessment to include its likelihood to form steam vacuoles, adjacent thermal effect near the device, and extent of thermally affected tissue extruded back into the vessel lumen. This comprehensive assessment method provides an improved means of assessing the quality of a sealed vessel and understanding the exact mechanisms which create an optimally sealed vessel.

Standardised survey method for identifying catchment risks to water quality.

PubMed

Baker, D L; Ferguson, C M; Chier, P; Warnecke, M; Watkinson, A

2016-06-01

This paper describes the development and application of a systematic methodology to identify and quantify risks in drinking water and recreational catchments. The methodology assesses microbial and chemical contaminants from both diffuse and point sources within a catchment using Escherichia coli, protozoan pathogens and chemicals (including fuel and pesticides) as index contaminants. Hazard source information is gathered by a defined sanitary survey process involving use of a software tool which groups hazards into six types: sewage infrastructure, on-site sewage systems, industrial, stormwater, agriculture and recreational sites. The survey estimates the likelihood of the site affecting catchment water quality, and the potential consequences, enabling the calculation of risk for individual sites. These risks are integrated to calculate a cumulative risk for each sub-catchment and the whole catchment. The cumulative risks process accounts for the proportion of potential input sources surveyed and for transfer of contaminants from upstream to downstream sub-catchments. The output risk matrices show the relative risk sources for each of the index contaminants, highlighting those with the greatest impact on water quality at a sub-catchment and catchment level. Verification of the sanitary survey assessments and prioritisation is achieved by comparison with water quality data and microbial source tracking.

PRIDE Inspector Toolsuite: Moving Toward a Universal Visualization Tool for Proteomics Data Standard Formats and Quality Assessment of ProteomeXchange Datasets.

PubMed

Perez-Riverol, Yasset; Xu, Qing-Wei; Wang, Rui; Uszkoreit, Julian; Griss, Johannes; Sanchez, Aniel; Reisinger, Florian; Csordas, Attila; Ternent, Tobias; Del-Toro, Noemi; Dianes, Jose A; Eisenacher, Martin; Hermjakob, Henning; Vizcaíno, Juan Antonio

2016-01-01

The original PRIDE Inspector tool was developed as an open source standalone tool to enable the visualization and validation of mass-spectrometry (MS)-based proteomics data before data submission or already publicly available in the Proteomics Identifications (PRIDE) database. The initial implementation of the tool focused on visualizing PRIDE data by supporting the PRIDE XML format and a direct access to private (password protected) and public experiments in PRIDE.The ProteomeXchange (PX) Consortium has been set up to enable a better integration of existing public proteomics repositories, maximizing its benefit to the scientific community through the implementation of standard submission and dissemination pipelines. Within the Consortium, PRIDE is focused on supporting submissions of tandem MS data. The increasing use and popularity of the new Proteomics Standards Initiative (PSI) data standards such as mzIdentML and mzTab, and the diversity of workflows supported by the PX resources, prompted us to design and implement a new suite of algorithms and libraries that would build upon the success of the original PRIDE Inspector and would enable users to visualize and validate PX "complete" submissions. The PRIDE Inspector Toolsuite supports the handling and visualization of different experimental output files, ranging from spectra (mzML, mzXML, and the most popular peak lists formats) and peptide and protein identification results (mzIdentML, PRIDE XML, mzTab) to quantification data (mzTab, PRIDE XML), using a modular and extensible set of open-source, cross-platform libraries. We believe that the PRIDE Inspector Toolsuite represents a milestone in the visualization and quality assessment of proteomics data. It is freely available at http://github.com/PRIDE-Toolsuite/. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

ICESat Lidar and Global Digital Elevation Models: Application to DESDynI

NASA Technical Reports Server (NTRS)

Carabajal, Claudia C.; Harding, David J.; Suchdeo, Vijay P.

2010-01-01

Geodetic control is extremely important in the production and quality control of topographic data sets, enabling elevation results to be referenced to an absolute vertical datum. Global topographic data with improved geodetic accuracy achieved using global Ground Control Point (GCP) databases enable more accurate characterization of land topography and its change related to solid Earth processes, natural hazards and climate change. The multiple-beam lidar instrument that will be part of the NASA Deformation, Ecosystem Structure and Dynamics of Ice (DESDynI) mission will provide a comprehensive, global data set that can be used for geodetic control purposes. Here we illustrate that potential using data acquired by NASA's Ice, Cloud and land Elevation Satellite (ICEsat) that has acquired single-beam, globally distributed laser altimeter profiles (+/-86deg) since February of 2003 [1, 2]. The profiles provide a consistently referenced elevation data set with unprecedented accuracy and quantified measurement errors that can be used to generate GCPs with sub-decimeter vertical accuracy and better than 10 m horizontal accuracy. Like the planned capability for DESDynI, ICESat records a waveform that is the elevation distribution of energy reflected within the laser footprint from vegetation, where present, and the ground where illuminated through gaps in any vegetation cover [3]. The waveform enables assessment of Digital Elevation Models (DEMs) with respect to the highest, centroid, and lowest elevations observed by ICESat and in some cases with respect to the ground identified beneath vegetation cover. Using the ICESat altimetry data we are developing a comprehensive database of consistent, global, geodetic ground control that will enhance the quality of a variety of regional to global DEMs. Here we illustrate the accuracy assessment of the Shuttle Radar Topography Mission (SRTM) DEM produced for Australia, documenting spatially varying elevation biases of several meters in magnitude.

PRIDE Inspector Toolsuite: Moving Toward a Universal Visualization Tool for Proteomics Data Standard Formats and Quality Assessment of ProteomeXchange Datasets*

PubMed Central

Perez-Riverol, Yasset; Xu, Qing-Wei; Wang, Rui; Uszkoreit, Julian; Griss, Johannes; Sanchez, Aniel; Reisinger, Florian; Csordas, Attila; Ternent, Tobias; del-Toro, Noemi; Dianes, Jose A.; Eisenacher, Martin; Hermjakob, Henning; Vizcaíno, Juan Antonio

2016-01-01

The original PRIDE Inspector tool was developed as an open source standalone tool to enable the visualization and validation of mass-spectrometry (MS)-based proteomics data before data submission or already publicly available in the Proteomics Identifications (PRIDE) database. The initial implementation of the tool focused on visualizing PRIDE data by supporting the PRIDE XML format and a direct access to private (password protected) and public experiments in PRIDE. The ProteomeXchange (PX) Consortium has been set up to enable a better integration of existing public proteomics repositories, maximizing its benefit to the scientific community through the implementation of standard submission and dissemination pipelines. Within the Consortium, PRIDE is focused on supporting submissions of tandem MS data. The increasing use and popularity of the new Proteomics Standards Initiative (PSI) data standards such as mzIdentML and mzTab, and the diversity of workflows supported by the PX resources, prompted us to design and implement a new suite of algorithms and libraries that would build upon the success of the original PRIDE Inspector and would enable users to visualize and validate PX “complete” submissions. The PRIDE Inspector Toolsuite supports the handling and visualization of different experimental output files, ranging from spectra (mzML, mzXML, and the most popular peak lists formats) and peptide and protein identification results (mzIdentML, PRIDE XML, mzTab) to quantification data (mzTab, PRIDE XML), using a modular and extensible set of open-source, cross-platform libraries. We believe that the PRIDE Inspector Toolsuite represents a milestone in the visualization and quality assessment of proteomics data. It is freely available at http://github.com/PRIDE-Toolsuite/. PMID:26545397

An Internet of Things System for Underground Mine Air Quality Pollutant Prediction Based on Azure Machine Learning

PubMed Central

Jo, ByungWan

2018-01-01

The implementation of wireless sensor networks (WSNs) for monitoring the complex, dynamic, and harsh environment of underground coal mines (UCMs) is sought around the world to enhance safety. However, previously developed smart systems are limited to monitoring or, in a few cases, can report events. Therefore, this study introduces a reliable, efficient, and cost-effective internet of things (IoT) system for air quality monitoring with newly added features of assessment and pollutant prediction. This system is comprised of sensor modules, communication protocols, and a base station, running Azure Machine Learning (AML) Studio over it. Arduino-based sensor modules with eight different parameters were installed at separate locations of an operational UCM. Based on the sensed data, the proposed system assesses mine air quality in terms of the mine environment index (MEI). Principal component analysis (PCA) identified CH4, CO, SO2, and H2S as the most influencing gases significantly affecting mine air quality. The results of PCA were fed into the ANN model in AML studio, which enabled the prediction of MEI. An optimum number of neurons were determined for both actual input and PCA-based input parameters. The results showed a better performance of the PCA-based ANN for MEI prediction, with R2 and RMSE values of 0.6654 and 0.2104, respectively. Therefore, the proposed Arduino and AML-based system enhances mine environmental safety by quickly assessing and predicting mine air quality. PMID:29561777

An Internet of Things System for Underground Mine Air Quality Pollutant Prediction Based on Azure Machine Learning.

PubMed

Jo, ByungWan; Khan, Rana Muhammad Asad

2018-03-21

The implementation of wireless sensor networks (WSNs) for monitoring the complex, dynamic, and harsh environment of underground coal mines (UCMs) is sought around the world to enhance safety. However, previously developed smart systems are limited to monitoring or, in a few cases, can report events. Therefore, this study introduces a reliable, efficient, and cost-effective internet of things (IoT) system for air quality monitoring with newly added features of assessment and pollutant prediction. This system is comprised of sensor modules, communication protocols, and a base station, running Azure Machine Learning (AML) Studio over it. Arduino-based sensor modules with eight different parameters were installed at separate locations of an operational UCM. Based on the sensed data, the proposed system assesses mine air quality in terms of the mine environment index (MEI). Principal component analysis (PCA) identified CH₄, CO, SO₂, and H₂S as the most influencing gases significantly affecting mine air quality. The results of PCA were fed into the ANN model in AML studio, which enabled the prediction of MEI. An optimum number of neurons were determined for both actual input and PCA-based input parameters. The results showed a better performance of the PCA-based ANN for MEI prediction, with R ² and RMSE values of 0.6654 and 0.2104, respectively. Therefore, the proposed Arduino and AML-based system enhances mine environmental safety by quickly assessing and predicting mine air quality.

Dental hygiene self-assessment: a key to quality care.

PubMed

DeVore, L; Fried, J L; Dailey, J; Qori, C G

2000-01-01

To help achieve the goal of delivering quality care to the public, this study applied the Theory of Reasoned Action to dental hygienists' self-assessment (appraisal of one's performance). This theory suggests that individuals are likely to exhibit a given behavior, i.e., self-assessment, when they view it positively and when they believe that important others think they should perform it. To date, no research has been conducted on the self-assessment (SA) behaviors of practicing dental hygienists. The following research questions were addressed: what/who are the (1) behavioral beliefs; (2) normative beliefs; (3) salient referents; (4) attitudes toward self-assessment; (5) intentions to perform self-assessment; (6) outcomes associated with self-assessment; and (7) motivations to comply with self-assessment in a representative sample of dental hygienists? This study consisted of two phases: Phase I, telephone interviews (N = 30) and Phase II, a mailed survey of 600 randomly selected subjects. Interview responses from Phase I determined questionnaire items. Survey data analysis included descriptive statistics and correlations of component mean scores. A total of 273 usable surveys were returned, achieving a 46% response rate. Respondents valued the potential benefits of SA with a statistical mean of 2.70 on a six point scale ranging from minus three to plus three. Attitude correlated strongly with intention to self-assess (R = .7455). Survey respondents are motivated by their own beliefs and perceived benefits of SA rather than by the values of others. The insights that were derived from this study will permit the development of strategies to enable dental hygiene educators and practitioners to incorporate self-assessment as part of quality assurance plans. Application of well-developed self-assessment strategies promises potential benefits for dental hygienists and the public they serve.

Framework for the quality assurance of 'omics technologies considering GLP requirements.

PubMed

Kauffmann, Hans-Martin; Kamp, Hennicke; Fuchs, Regine; Chorley, Brian N; Deferme, Lize; Ebbels, Timothy; Hackermüller, Jörg; Perdichizzi, Stefania; Poole, Alan; Sauer, Ursula G; Tollefsen, Knut E; Tralau, Tewes; Yauk, Carole; van Ravenzwaay, Ben

2017-12-01

'Omics technologies are gaining importance to support regulatory toxicity studies. Prerequisites for performing 'omics studies considering GLP principles were discussed at the European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) Workshop Applying 'omics technologies in Chemical Risk Assessment. A GLP environment comprises a standard operating procedure system, proper pre-planning and documentation, and inspections of independent quality assurance staff. To prevent uncontrolled data changes, the raw data obtained in the respective 'omics data recording systems have to be specifically defined. Further requirements include transparent and reproducible data processing steps, and safe data storage and archiving procedures. The software for data recording and processing should be validated, and data changes should be traceable or disabled. GLP-compliant quality assurance of 'omics technologies appears feasible for many GLP requirements. However, challenges include (i) defining, storing, and archiving the raw data; (ii) transparent descriptions of data processing steps; (iii) software validation; and (iv) ensuring complete reproducibility of final results with respect to raw data. Nevertheless, 'omics studies can be supported by quality measures (e.g., GLP principles) to ensure quality control, reproducibility and traceability of experiments. This enables regulators to use 'omics data in a fit-for-purpose context, which enhances their applicability for risk assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

Crowe, Marie; Carlyle, Dave

2015-02-01

The present study aims to review the quality of open-access nursing journals listed in the Directory of Open Access Journals that published papers in 2013 with a nursing focus, written in English, and were freely accessible. Each journal was reviewed in relation to their publisher, year of commencement, number of papers published in 2013, fee for publication, indexing, impact factor, and evidence of requirements for ethics and disclosure statements. The quality of the journals was assessed by impact factors and the requirements for indexing in PubMed. A total of 552 were published in 2013 in the 19 open-access nursing journals that met the inclusion criteria. No journals had impact factors listed in Web of Knowledge, but three had low Scopus impact factors. Only five journals were indexed with PubMed. The quality of the 19 journals included in the review was evaluated as inferior to most subscription-fee journals. Mental health nursing has some responsibility to the general public, and in particular, consumers of mental health services and their families, for the quality of papers published in open-access journals. The way forward might involve dual-platform publication or a process that enables assessment of how research has improved clinical outcomes. © 2014 Australian College of Mental Health Nurses Inc.

Acceptability of quality reporting and pay for performance among primary health centers in Lebanon.

PubMed

Saleh, Shadi S; Alameddine, Mohamad S; Natafgi, Nabil M

2013-01-01

Primary health care (PHC) is emphasized as the cornerstone of any health care system. Enhancing PHC performance is considered a strategy to enhance effective and equitable access to care. This study assesses the acceptability of and factors associated with quality reporting among PHC centers (PHCCs) in Lebanon. The managers of 132 Lebanese Ministry of Health PHCCs were surveyed using a cross-sectional design. Managers' willingness to report quality, participate in comparative quality assessments, and endorse pay-for-performance schemes was evaluated. Collected data were matched to the infrastructural characteristics and services database. Seventy-six percent of managers responded to the questionnaire, 93 percent of whom were willing to report clinical performance. Most expressed strong support for peer-performance comparison and pay-for-performance schemes. Willingness to report was negatively associated with the religious affiliation of centers and presence of health care facilities in the catchment area and favorably associated with use of information systems and the size of population served. The great willingness of PHCC managers to employ quality-enhancing initiatives flags a policy priority for PHC stakeholders to strengthen PHCC infrastructure and to enable reporting in an easy, standardized, and systematic way. Enhancing equity necessitates education and empowerment of managers in remote areas and those managing religiously affiliated centers.

Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics.

PubMed

Kutner, Nancy G; Zhang, Rebecca

2017-08-07

Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated. The ESKD Quality Incentive Program (QIP) initiated in 2012 emphasizes clinical performance indicators, but a newly-added measure requires the monitoring of patient depression-an issue that is important for work ability and employment. We investigated depression scores and four dialysis-specific QIP measures in relation to work ability reported by a multi-clinic cohort of 528 working-age maintenance HD patients. The prevalence of elevated depression scores was substantially higher among patients who said they were not able to work, while only one of the four dialysis-specific clinical measures differed for patients able/not able to work. Ability to work may be among patients' top priorities. As the parameters of quality assessment continue to evolve, increased attention to patient priorities might facilitate work ability and employment outcomes.

Exploratory multivariate modeling and prediction of the physico-chemical properties of surface water and groundwater

NASA Astrophysics Data System (ADS)

Ayoko, Godwin A.; Singh, Kirpal; Balerea, Steven; Kokot, Serge

2007-03-01

SummaryPhysico-chemical properties of surface water and groundwater samples from some developing countries have been subjected to multivariate analyses by the non-parametric multi-criteria decision-making methods, PROMETHEE and GAIA. Complete ranking information necessary to select one source of water in preference to all others was obtained, and this enabled relationships between the physico-chemical properties and water quality to be assessed. Thus, the ranking of the quality of the water bodies was found to be strongly dependent on the total dissolved solid, phosphate, sulfate, ammonia-nitrogen, calcium, iron, chloride, magnesium, zinc, nitrate and fluoride contents of the waters. However, potassium, manganese and zinc composition showed the least influence in differentiating the water bodies. To model and predict the water quality influencing parameters, partial least squares analyses were carried out on a matrix made up of the results of water quality assessment studies carried out in Nigeria, Papua New Guinea, Egypt, Thailand and India/Pakistan. The results showed that the total dissolved solid, calcium, sulfate, sodium and chloride contents can be used to predict a wide range of physico-chemical characteristics of water. The potential implications of these observations on the financial and opportunity costs associated with elaborate water quality monitoring are discussed.

A data management approach to quality assurance using colorectal carcinoma reports from two institutions as a model.

PubMed

Sorge, John P; Harmon, C Reid; Sherman, Susan M; Baillie, E Eugene

2005-07-01

We used data management software to compare pathology report data concerning regional lymph node sampling for colorectal carcinoma from 2 institutions using different dissection methods. Data were retrieved from 2 disparate anatomic pathology information systems for all cases of colorectal carcinoma in 2003 involving the ascending and descending colon. Initial sorting of the data included overall lymph node recovery to assess differences between the dissection methods at the 2 institutions. Additional segregation of the data was used to challenge the application's capability of accurately addressing the complexity of the process. This software approach can be used to evaluate data from disparate computer systems, and we demonstrate how an automated function can enable institutions to compare internal pathologic assessment processes and the results of those comparisons. The use of this process has future implications for pathology quality assurance in other areas.

Evaluation of military field-water quality: Volume 9, Data for assessing health risks in potential theaters of operation for US military forces: (Final report)

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

Daniels, J.I.; Layton, D.W.

1988-02-01

Data are presented in this volume for assessing the health risks in populations of military personnel that could result as a consequence of exposure to field waters containing constituents or infectious organisms of military concern, which are from natural and anthropogenic sources, at levels above those recommended as field-water-quality standards (i.e., above safe levels). Turbidity and color are the physical properties that are of military concern in field water. The other constituents that are of military concern in field water are (1) total dissolved solids, (2) chloride, (3) magnesium, (4) sulfate, (5) arsenic, (6) cyanide, (7) the pesticide lindane, andmore » (8) metabolites of algae and associated bacteria. Bacteria, viruses, and parasites (e.g., protozoa and helminths) are categories of water-related infectious organisms that are of military concern. Figures were developed from dose-response data to enable military risk managers to quickly assess the potential performance-degrading effects in personnel exposed to a measured concentration of a particular constituent in field water. The general physical, chemical, and biological quality of field waters in geographic regions worldwide, representing potential theaters of operation for U.S. military forces, also are evaluated. This analysis is based on available water-quality monitoring data and indicators of likely water-quality conditions (e.g., geohydrology, climate, sanitation, industrialization, etc.). Accompanying our evaluation are maps and tables alerting military planners and risk managers to the physical, chemical, or biological quality of field water that can be expected generally in geographic regions of concern.« less

Quality of patient health information on the Internet: reviewing a complex and evolving landscape.

PubMed

Fahy, Eamonn; Hardikar, Rohan; Fox, Adrian; Mackay, Sean

2014-01-01

The popularity of the Internet has enabled unprecedented access to health information. As a largely unregulated source, there is potential for inconsistency in the quality of information that reaches the patient. To review the literature relating to the quality indicators of health information for patients on the Internet. A search of English language literature was conducted using PubMed, Google Scholar and EMBASE databases. Many articles have been published which assess the quality of information relating to specific medical conditions. Indicators of quality have been defined in an attempt to predict higher quality health information on the Internet. Quality evaluation tools are scoring systems based on indicators of quality. Established tools such as the HONcode may help patients navigate to more reliable information. Google and Wikipedia are important emerging sources of patient health information. The Internet is crucial for modern dissemination of health information, but it is clear that quality varies significantly between sources. Quality indicators for web-information have been developed but there is no agreed standard yet. We envisage that reliable rating tools, effective search engine ranking and progress in crowd-edited websites will enhance patient access to health information on the Internet.

Are patent medicine vendors effective agents in malaria control? Using lot quality assurance sampling to assess quality of practice in Jigawa, Nigeria.

PubMed

Berendes, Sima; Adeyemi, Olusegun; Oladele, Edward Adekola; Oresanya, Olusola Bukola; Okoh, Festus; Valadez, Joseph J

2012-01-01

Patent medicine vendors (PMV) provide antimalarial treatment and care throughout Sub-Saharan Africa, and can play an important role in the fight against malaria. Their close-to-client infrastructure could enable lifesaving artemisinin-based combination therapy (ACT) to reach patients in time. However, systematic assessments of drug sellers' performance quality are crucial if their role is to be managed within the health system. Lot quality assurance sampling (LQAS) could be an efficient method to monitor and evaluate PMV practice, but has so far never been used for this purpose. In support of the Nigeria Malaria Booster Program we assessed PMV practices in three Senatorial Districts (SDs) of Jigawa, Nigeria. A two-stage LQAS assessed whether at least 80% of PMV stores in SDs used national treatment guidelines. Acceptable sampling errors were set in consultation with government officials (alpha and beta <0.10). The hypergeometric formula determined sample sizes and cut-off values for SDs. A structured assessment tool identified high and low performing SDs for quality of care indicators. Drug vendors performed poorly in all SDs of Jigawa for all indicators. For example, all SDs failed for stocking and selling first-line antimalarials. PMV sold no longer recommended antimalarials, such as Chloroquine, Sulfadoxine-Pyrimethamine and oral Artesunate monotherapy. Most PMV were ignorant of and lacked training about new treatment guidelines that had endorsed ACTs as first-line treatment for uncomplicated malaria. There is urgent need to regularly monitor and improve the availability and quality of malaria treatment provided by medicine sellers in Nigeria; the irrational use of antimalarials in the ACT era revealed in this study bears a high risk of economic loss, death and development of drug resistance. LQAS has been shown to be a suitable method for monitoring malaria-related indicators among PMV, and should be applied in Nigeria and elsewhere to improve service delivery.

Are Patent Medicine Vendors Effective Agents in Malaria Control? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa, Nigeria

PubMed Central

Berendes, Sima; Adeyemi, Olusegun; Oladele, Edward Adekola; Oresanya, Olusola Bukola; Okoh, Festus; Valadez, Joseph J.

2012-01-01

Background Patent medicine vendors (PMV) provide antimalarial treatment and care throughout Sub-Saharan Africa, and can play an important role in the fight against malaria. Their close-to-client infrastructure could enable lifesaving artemisinin-based combination therapy (ACT) to reach patients in time. However, systematic assessments of drug sellers’ performance quality are crucial if their role is to be managed within the health system. Lot quality assurance sampling (LQAS) could be an efficient method to monitor and evaluate PMV practice, but has so far never been used for this purpose. Methods In support of the Nigeria Malaria Booster Program we assessed PMV practices in three Senatorial Districts (SDs) of Jigawa, Nigeria. A two-stage LQAS assessed whether at least 80% of PMV stores in SDs used national treatment guidelines. Acceptable sampling errors were set in consultation with government officials (alpha and beta <0.10). The hypergeometric formula determined sample sizes and cut-off values for SDs. A structured assessment tool identified high and low performing SDs for quality of care indicators. Findings Drug vendors performed poorly in all SDs of Jigawa for all indicators. For example, all SDs failed for stocking and selling first-line antimalarials. PMV sold no longer recommended antimalarials, such as Chloroquine, Sulfadoxine-Pyrimethamine and oral Artesunate monotherapy. Most PMV were ignorant of and lacked training about new treatment guidelines that had endorsed ACTs as first-line treatment for uncomplicated malaria. Conclusion There is urgent need to regularly monitor and improve the availability and quality of malaria treatment provided by medicine sellers in Nigeria; the irrational use of antimalarials in the ACT era revealed in this study bears a high risk of economic loss, death and development of drug resistance. LQAS has been shown to be a suitable method for monitoring malaria-related indicators among PMV, and should be applied in Nigeria and elsewhere to improve service delivery. PMID:22984555

Orthogonal Assessment of Biotherapeutic Glycosylation: A Case Study Correlating N-Glycan Core Afucosylation of Herceptin with Mechanism of Action.

PubMed

Upton, Rosie; Bell, Leonard; Guy, Colin; Caldwell, Paul; Estdale, Sian; Barran, Perdita E; Firth, David

2016-10-18

In the development of therapeutic antibodies and biosimilars, an appropriate biopharmaceutical CMC control strategy that connects critical quality attributes with mechanism of action should enable product assessment at an early stage of development in order to mitigate risk. Here we demonstrate a new analytical workflow using trastuzumab which comprises "middle-up" analysis using a combination of IdeS and the endoglycosidases EndoS and EndoS2 to comprehensively map the glycan content. Enzymatic cleavage between the two N-acetyl glucosamine residues of the chitobiose core of N-glycans significantly simplifies the oligosaccharide component enabling facile distinction of GlcNAc from GlcNAc with core fucose. This approach facilitates quantitative determination of total Fc-glycan core-afucosylation, which was in turn correlated with receptor binding affinity by surface plasmon resonance and in vitro ADCC potency with a cell based bioassay. The strategy also quantifies Fc-glycan occupancy and the relative contribution from high mannose glycans.

Use of multicriteria decision analysis for assessing the benefit and risk of over-the-counter analgesics.

PubMed

Moore, Andrew; Crossley, Anne; Ng, Bernard; Phillips, Lawrence; Sancak, Özgür; Rainsford, K D

2017-10-01

To test the ability of a multicriteria decision analysis (MCDA) model to incorporate disparate data sources of varying quality along with clinical judgement in a benefit-risk assessment of six well-known pain-relief drugs. Six over-the-counter (OTC) analgesics were evaluated against three favourable effects and eight unfavourable effects by seven experts who specialise in the relief of pain, two in a 2-day facilitated workshop whose input data and judgements were later peer-reviewed by five additional experts. Ibuprofen salts and solubilised emerged with the best benefit-risk profile, followed by naproxen, ibuprofen acid, diclofenac, paracetamol and aspirin. Multicriteria decision analysis enabled participants to evaluate the OTC analgesics against a range of favourable and unfavourable effects in a group setting that enabled all issues to be openly aired and debated. The model was easily communicated and understood by the peer reviewers, so the model should be comprehensible to physicians, pharmacists and other health professionals. © 2017 Royal Pharmaceutical Society.

Meat Quality Assessment by Electronic Nose (Machine Olfaction Technology)

PubMed Central

Ghasemi-Varnamkhasti, Mahdi; Mohtasebi, Seyed Saeid; Siadat, Maryam; Balasubramanian, Sundar

2009-01-01

Over the last twenty years, newly developed chemical sensor systems (so called “electronic noses”) have made odor analyses possible. These systems involve various types of electronic chemical gas sensors with partial specificity, as well as suitable statistical methods enabling the recognition of complex odors. As commercial instruments have become available, a substantial increase in research into the application of electronic noses in the evaluation of volatile compounds in food, cosmetic and other items of everyday life is observed. At present, the commercial gas sensor technologies comprise metal oxide semiconductors, metal oxide semiconductor field effect transistors, organic conducting polymers, and piezoelectric crystal sensors. Further sensors based on fibreoptic, electrochemical and bi-metal principles are still in the developmental stage. Statistical analysis techniques range from simple graphical evaluation to multivariate analysis such as artificial neural network and radial basis function. The introduction of electronic noses into the area of food is envisaged for quality control, process monitoring, freshness evaluation, shelf-life investigation and authenticity assessment. Considerable work has already been carried out on meat, grains, coffee, mushrooms, cheese, sugar, fish, beer and other beverages, as well as on the odor quality evaluation of food packaging material. This paper describes the applications of these systems for meat quality assessment, where fast detection methods are essential for appropriate product management. The results suggest the possibility of using this new technology in meat handling. PMID:22454572

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

PubMed

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

2016-09-01

In this study, we assessed the quality of publicly available cancer-related physical activity (PA) information appearing on reputable sites from Canada and other English-speaking countries. A cross-sectional Internet search was conducted on select countries (Canada, USA, Australia, New Zealand, UK) using Google to generate top 50 results per country for the keywords "'physical activity' AND 'cancer'". Top results were assessed for quality of PA information based on a coding frame. Additional searches were performed for Canadian-based sites to produce an exhaustive list. Results found that many sites offered cancer-related PA information (94.5%), but rarely defined PA (25.2%). Top 50 results from each country did not differ on any indicator examined. The exhaustive list of Canadian sites found that many sites gave information about PA for survivorship (78.3%) and prevention (70.0%), but rarely defined (6.7%) or referenced PA guidelines (28.3%). Cancer-related PA information is plentiful on the Internet but the quality needs improvement. Sites should do more than mention PA; they should provide definitions, examples and guidelines. With improvements, these websites would enable healthcare providers to effectively educate their patients about PA, and serve as a valuable resource to the general public who may be seeking cancer-related PA information. © 2016 John Wiley & Sons Ltd.

Systematic evaluation of RNA quality, microarray data reliability and pathway analysis in fresh, fresh frozen and formalin-fixed paraffin-embedded tissue samples.

PubMed

Wimmer, Isabella; Tröscher, Anna R; Brunner, Florian; Rubino, Stephen J; Bien, Christian G; Weiner, Howard L; Lassmann, Hans; Bauer, Jan

2018-04-20

Formalin-fixed paraffin-embedded (FFPE) tissues are valuable resources commonly used in pathology. However, formalin fixation modifies nucleic acids challenging the isolation of high-quality RNA for genetic profiling. Here, we assessed feasibility and reliability of microarray studies analysing transcriptome data from fresh, fresh-frozen (FF) and FFPE tissues. We show that reproducible microarray data can be generated from only 2 ng FFPE-derived RNA. For RNA quality assessment, fragment size distribution (DV200) and qPCR proved most suitable. During RNA isolation, extending tissue lysis time to 10 hours reduced high-molecular-weight species, while additional incubation at 70 °C markedly increased RNA yields. Since FF- and FFPE-derived microarrays constitute different data entities, we used indirect measures to investigate gene signal variation and relative gene expression. Whole-genome analyses revealed high concordance rates, while reviewing on single-genes basis showed higher data variation in FFPE than FF arrays. Using an experimental model, gene set enrichment analysis (GSEA) of FFPE-derived microarrays and fresh tissue-derived RNA-Seq datasets yielded similarly affected pathways confirming the applicability of FFPE tissue in global gene expression analysis. Our study provides a workflow comprising RNA isolation, quality assessment and microarray profiling using minimal RNA input, thus enabling hypothesis-generating pathway analyses from limited amounts of precious, pathologically significant FFPE tissues.

Quality of communication during telephone triage at Dutch out-of-hours centres.

PubMed

Derkx, Hay P; Rethans, Jan-Joost E; Maiburg, Bas H; Winkens, Ron A; Muijtjens, Arno M; van Rooij, Harrie G; Knottnerus, J André

2009-02-01

To assess the quality of communication skills of triagists, working at out-of-hours (OOH) centres, and to determine the correlation between the communication score and the duration of the telephone consultation. Telephone incognito standardised patients (TISPs) called 17 OOH centres presenting different clinical cases. The assessment of communication skills was carried out using the RICE-communication rating list. The duration of each telephone consultation was determined. The mean overall score for communication skills was 35% of the maximum feasible. Triagists usually asked questions about the clinical situation correctly and little about the patients' personal situation, perception of the problem or expectation. Advice about the outcome of triage and self-care advice was usually given without checking for patients' understanding and acceptance of the advice. Calls were often handled in an unstructured way, without summarizing or clarifying the different steps within the consultation. There was a positive correlation of 0.86 (p<0.01) between the overall communication score and the duration of the telephone consultation. Assessment of communication skills of triagists revealed specific shortcomings and learning points to improve the quality of communication skills during telephone triage. Training in telephone consultation should focus more on patient-centred communication with active listening, active advising and structuring the call. Apart from adequate communication skills, triagists need sufficient time for telephone consultation to enable high quality performance.

Evaluation of multi-resolution satellite sensors for assessing water quality and bottom depth of Lake Garda.

PubMed

Giardino, Claudia; Bresciani, Mariano; Cazzaniga, Ilaria; Schenk, Karin; Rieger, Patrizia; Braga, Federica; Matta, Erica; Brando, Vittorio E

2014-12-15

In this study we evaluate the capabilities of three satellite sensors for assessing water composition and bottom depth in Lake Garda, Italy. A consistent physics-based processing chain was applied to Moderate Resolution Imaging Spectroradiometer (MODIS), Landsat-8 Operational Land Imager (OLI) and RapidEye. Images gathered on 10 June 2014 were corrected for the atmospheric effects with the 6SV code. The computed remote sensing reflectance (Rrs) from MODIS and OLI were converted into water quality parameters by adopting a spectral inversion procedure based on a bio-optical model calibrated with optical properties of the lake. The same spectral inversion procedure was applied to RapidEye and to OLI data to map bottom depth. In situ measurements of Rrs and of concentrations of water quality parameters collected in five locations were used to evaluate the models. The bottom depth maps from OLI and RapidEye showed similar gradients up to 7 m (r = 0.72). The results indicate that: (1) the spatial and radiometric resolutions of OLI enabled mapping water constituents and bottom properties; (2) MODIS was appropriate for assessing water quality in the pelagic areas at a coarser spatial resolution; and (3) RapidEye had the capability to retrieve bottom depth at high spatial resolution. Future work should evaluate the performance of the three sensors in different bio-optical conditions.

Evaluation of the quality of the teaching-learning process in undergraduate courses in Nursing.

PubMed

González-Chordá, Víctor Manuel; Maciá-Soler, María Loreto

2015-01-01

to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing. prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis. nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p<0.05). There are statistically significant differences depending on the hospital and clinical practices unit (p<0.05). the analysis of the evaluation tools used in the article "Nursing Care in Welfare Processes" of the analyzed university undergraduate course enabled the detection of the areas for improvement in the teachinglearning process. The challenge of education in nursing is to reach the best clinical research and educational results, in order to provide improvements to the quality of education and health care.

Social Moderation and Dynamic Elements in Crowdsourced Geospatial Data: A Report on Quality Assessment, Dynamic Extensions and Mobile Device Engagement in the George Mason University Geocrowdsourcing Testbed

DTIC Science & Technology

2015-11-01

GMU) Associate Professor Dieter Pfoser describes an explosion of user generated content (UGC) available over the Internet (Pfoser 2011, Crooks et al...Crowdsourced and User - Generated Geospatial Data,” Annual (Fairfax, VA: George Mason University, November 29, 2012), http://www.dtic.mil/dtic/tr/fulltext/u2...area include GPS-enabled geosocial and 34 Dieter Pfoser, “On User - Generated

Spirometry training courses: Content, delivery and assessment - a position statement from the Australian and New Zealand Society of Respiratory Science.

PubMed

Swanney, Maureen P; O'Dea, Christopher A; Ingram, Emily R; Rodwell, Leanne T; Borg, Brigitte M

2017-10-01

Spirometry training courses are provided by health services and training organizations to enable widespread use of spirometry testing for patient care or for monitoring health. The primary outcome of spirometry training courses should be to enable participants to perform spirometry to international best practice, including testing of subjects, quality assurance and interpretation of results. Where valid results are not achieved or quality assurance programmes identify errors in devices, participants need to be able to adequately manage these issues in accordance with best practice. It is important that potential participants are confident in the integrity of the course they attend and that the course meets their expectations in terms of training. This position statement lists the content that the Australian and New Zealand Society of Respiratory Science (ANZSRS) has identified as required in a spirometry training course to adequately meet the primary outcomes mentioned above. The content requirements outlined in this position statement are based on the current international spirometry standards set out by the American Thoracic Society and European Respiratory Society. Furthermore, recommendations around course delivery for theoretical and practical elements of spirometry testing and post-course assessment are outlined in this statement. © 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

The application of the Accelerated Stability Assessment Program (ASAP) to quality by design (QbD) for drug product stability.

PubMed

Waterman, Kenneth Craig

2011-09-01

An isoconversion paradigm, where times in different temperature and humidity-controlled stability chambers are set to provide a fixed degradant level, is shown to compensate for the complex, non-single order kinetics of solid drug products. A humidity-corrected Arrhenius equation provides reliable estimates for temperature and relative humidity effects on degradation rates. A statistical protocol is employed to determine best fits for chemical stability data, which in turn allows for accurate estimations of shelf life (with appropriate confidence intervals) at any storage condition including inside packaging (based on the moisture vapor transmission rate of the packaging and moisture sorption isotherms of the internal components). These methodologies provide both faster results and far better predictions of chemical stability limited shelf life (expiry) than previously possible. Precise shelf-life estimations are generally determined using a 2-week, product-specific protocol. Once the model for a product is developed, it can play a critical role in providing the product understanding necessary for a quality by design (QbD) filing for product approval and enable rational control strategies to assure product stability. Moreover, this Accelerated Stability Assessment Program (ASAP) enables the coupling of product attributes (e.g., moisture content, packaging options) to allow for flexibility in how control strategies are implemented to provide a balance of cost, speed, and other factors while maintaining adequate stability.

Measuring Image Navigation and Registration Performance at the 3-Sigma Level Using Platinum Quality Landmarks

NASA Technical Reports Server (NTRS)

Carr, James L.; Madani, Houria

2007-01-01

Geostationary Operational Environmental Satellite (GOES) Image Navigation and Registration (INR) performance is specified at the 3- level, meaning that 99.7% of a collection of individual measurements must comply with specification thresholds. Landmarks are measured by the Replacement Product Monitor (RPM), part of the operational GOES ground system, to assess INR performance and to close the INR loop. The RPM automatically discriminates between valid and invalid measurements enabling it to run without human supervision. In general, this screening is reliable, but a small population of invalid measurements will be falsely identified as valid. Even a small population of invalid measurements can create problems when assessing performance at the 3-sigma level. This paper describes an additional layer of quality control whereby landmarks of the highest quality ("platinum") are identified by their self-consistency. The platinum screening criteria are not simple statistical outlier tests against sigma values in populations of INR errors. In-orbit INR performance metrics for GOES-12 and GOES-13 are presented using the platinum landmark methodology.

[Evaluation of social medicine expert assessment].

PubMed

Piechowiak, H

1989-10-01

There are only few scientific publications in literature on medical expertising in social medicine. Although this deficit may be explained by several facts, it cannot be justified. Evaluation is a systematic set of data collection and analysis activities undertaken to place social practice on a more rational basis, i.e. greater efficiency and justice. These aims also hold good for social medicine. Evaluation, however, is only the first step within a broader research programme for quality control and quality improvement efforts, which can be successfully performed only in cooperation with the social insurance institutions. Within their medical services these institutions should provide the organisational prerequisites to enable qualified scientific research in practical social medicine.

Food quality assessment by NIR hyperspectral imaging

NASA Astrophysics Data System (ADS)

Whitworth, Martin B.; Millar, Samuel J.; Chau, Astor

2010-04-01

Near infrared reflectance (NIR) spectroscopy is well established in the food industry for rapid compositional analysis of bulk samples. NIR hyperspectral imaging provides new opportunities to measure the spatial distribution of components such as moisture and fat, and to identify and measure specific regions of composite samples. An NIR hyperspectral imaging system has been constructed for food research applications, incorporating a SWIR camera with a cooled 14 bit HgCdTe detector and N25E spectrograph (Specim Ltd, Finland). Samples are scanned in a pushbroom mode using a motorised stage. The system has a spectral resolution of 256 pixels covering a range of 970-2500 nm and a spatial resolution of 320 pixels covering a swathe adjustable from 8 to 300 mm. Images are acquired at a rate of up to 100 lines s-1, enabling samples to be scanned within a few seconds. Data are captured using SpectralCube software (Specim) and analysed using ENVI and IDL (ITT Visual Information Solutions). Several food applications are presented. The strength of individual absorbance bands enables the distribution of particular components to be assessed. Examples are shown for detection of added gluten in wheat flour and to study the effect of processing conditions on fat distribution in chips/French fries. More detailed quantitative calibrations have been developed to study evolution of the moisture distribution in baguettes during storage at different humidities, to assess freshness of fish using measurements of whole cod and fillets, and for prediction of beef quality by identification and separate measurement of lean and fat regions.

HIV surveillance in MENA: recent developments and results

PubMed Central

Bozicevic, Ivana; Riedner, Gabriele; Calleja, Jesus Maria Garcia

2013-01-01

Objectives To provide an overview of the current level of development and results from the national HIV surveillance systems of the 23 countries of the Middle East and North Africa (MENA), and to assess the quality of HIV surveillance systems in the period 2007–2011. Methods A questionnaire was used to collect the information about the structure, activities and the results of HIV surveillance systems from the National AIDS Programmes. Assessment of the quality was based on four indicators: timeliness of data collection, appropriateness of populations under surveillance, consistency of the surveillance sites and groups measured over time, and coverage of the surveillance system. Results Only in four countries did surveillance systems enable assessment of epidemic trends in the same populations and locations over time, such as in pregnant women (Morocco, Iran), injecting drug users (Iran, Pakistan), female sex workers (Djibouti, Morocco) and male sex workers (Pakistan). There is increasing evidence of HIV infection being firmly established in at least one of the populations most at risk of HIV in nine MENA countries, while lower risk populations show elevated HIV prevalence in South Sudan, Djibouti and some parts of Somalia. Conclusions The performance of HIV surveillance systems in several of the MENA countries has improved in recent years. The extent of HIV epidemics in the populations most at risk of HIV is still largely unknown in 10 countries. Multiple data sources that most of the countries still lack would enable indirectly estimation not only of the patterns of HIV epidemics but also the effectiveness of HIV responses. PMID:23434789

Time trends in prostate cancer surgery: data from an Internet-based multicentre database.

PubMed

Schostak, Martin; Baumunk, Daniel; Jagota, Anita; Klopf, Christian; Winter, Alexander; Schäfers, Sebastian; Kössler, Robert; Brennecke, Volker; Fischer, Tom; Hagel, Susanne; Höchel, Steffen; Jäkel, Dierk; Lehsnau, Mike; Krege, Susanne; Rüffert, Bernd; Pretzer, Jana; Becht, Eduard; Zegenhagen, Thomas; Miller, Kurt; Weikert, Steffen

2012-02-01

To report our experience with an Internet-based multicentre database that enables tumour documentation, as well as the collection of quality-related parameters and follow-up data, in surgically treated patients with prostate cancer. The system was used to assess the quality of prostate cancer surgery and to analyze possible time-dependent trends in the quality of care. An Internet-based database system enabled a standardized collection of treatment data and clinical findings from the participating urological centres for the years 2005-2009. An analysis was performed aiming to evaluate relevant patient characteristics (age, pathological tumour stage, preoperative International Index of Erectile Function-5 score), intra-operative parameters (operating time, percentage of nerve-sparing operations, complication rate, transfusion rate, number of resected lymph nodes) and postoperative parameters (hospitalization time, re-operation rate, catheter indwelling time). Mean values were calculated and compared for each annual cohort from 2005 to 2008. The overall survival rate was also calculated for a subgroup of the Berlin patients. A total of 914, 1120, 1434 and 1750 patients submitted to radical prostatectomy in 2005, 2006, 2007 and 2008 were documented in the database. The mean age at the time of surgery remained constant (66 years) during the study period. More than half the patients already had erectile dysfunction before surgery (median International Index of Erectile Function-5 score of 19-20). During the observation period, there was a decrease in the percentage of pT2 tumours (1% in 2005; 64% in 2008) and a slight increase in the percentage of patients with lymph node metastases (8% in 2005; 10% in 2008). No time trend was found for the operating time (142-155 min) or the percentage of nerve-sparing operations (72-78% in patients without erectile dysfunction). A decreasing frequency was observed for the parameters: blood transfusions (1.9% in 2005; 0.5% in 2008), postoperative bleeding (2.6%; 1.2%) and re-operations (4.5%; 2.8%). The mean hospitalization time decreased accordingly (10 days in 2005; 8 days in 2008). The examined subcohort had an overall mortality of 1.5% (median follow-up of 3 years). An Internet-based database system for tumour documentation in patients with prostate cancer enables the collection and assessment of important parameters for the quality of care and outcomes. The participating centres show an improvement in the quality of surgical management, including a reduction of the complication rate. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cardiovascular and Metabolic Effects: A Summary

PubMed Central

van Kempen, Elise; Casas, Maribel; Pershagen, Göran; Foraster, Maria

2018-01-01

To update the current state of evidence and assess its quality, we conducted a systematic review on the effects of environmental noise exposure on the cardio-metabolic systems as input for the new WHO environmental noise guidelines for the European Region. We identified 600 references relating to studies on effects of noise from road, rail and air traffic, and wind turbines on the cardio-metabolic system, published between January 2000 and August 2015. Only 61 studies, investigating different end points, included information enabling estimation of exposure response relationships. These studies were used for meta-analyses, and assessments of the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A majority of the studies concerned traffic noise and hypertension, but most were cross-sectional and suffering from a high risk of bias. The most comprehensive evidence was available for road traffic noise and Ischeamic Heart Diseases (IHD). Combining the results of 7 longitudinal studies revealed a Relative Risk (RR) of 1.08 (95% CI: 1.01–1.15) per 10 dB (LDEN) for the association between road traffic noise and the incidence of IHD. We rated the quality of this evidence as high. Only a few studies reported on the association between transportation noise and stroke, diabetes, and/or obesity. The quality of evidence for these associations was rated from moderate to very low, depending on transportation noise source and outcome. For a comprehensive assessment of the impact of noise exposure on the cardiovascular and metabolic system, we need more and better quality evidence, primarily based on longitudinal studies. PMID:29470452

Multi-centric universal pseudonymisation for secondary use of the EHR.

PubMed

Lo Iacono, Luigi

2007-01-01

This paper discusses the importance of protecting the privacy of patient data kept in an Electronic Health Record (EHR) in the case, where it leaves the control- and protection-sphere of the health care realm for secondary uses such as clinical or epidemiological research projects, health care research, assessment of treatment quality or economic assessments. The paper focuses on multi-centric studies, where various data sources are linked together using Grid technologies. It introduces a pseudonymisation system which enables a multi-centric universal pseudonymisation, meaning that a patient's identity will result in the same pseudonym, regardless of which participating study center the patient data is collected.

Impacts of agricultural management practices on soil quality in Europe and China - an assessment within the framework of the EU iSQAPER project

NASA Astrophysics Data System (ADS)

Alaoui, Abdallah; Schwilch, Gudrun; Barão, Lúcia; Basch, Gottlieb; Sukkel, Wijnand; Lemesle, Julie; Ferreira, Carla; Garcia-Orenes, Fuensanta; Morugan, Alicia; Mataix, Jorge; Kosmas, Costas; Glavan, Matjaž; Tóth, Brigitta; Petrutza Gate, Olga; Lipiec, Jerzy; Reintam, Endla; Xu, Minggang; Di, Jiaying; Fan, Hongzhu; Geissen, Violette

2017-04-01

Agricultural soils are under a wide variety of pressures, including from increasing global demand for food associated with population growth, changing diets, land degradation, and associated productivity reductions potentially exacerbated by climate change. To manage the use of agricultural soils well, decision-makers need science-based, easily applicable, and cost-effective tools for assessing soil quality and soil functions. Since a practical assessment of soil quality requires the integrated consideration of key soil properties and their variations in space and time, providing such tools remains a challenging task. This study aims to assess the impact of innovative agricultural management practices on soil quality in 14 study sites across Europe (10) and China (4), covering the major pedo-climatic zones. The study is part of the European H2020 project iSQAPER, which involves 25 partners across Europe and China and is coordinated by Wageningen University, The Netherlands. iSQAPER is aimed at interactive soil quality assessment in Europe and China for agricultural productivity and environmental resilience. The study began with a thorough literature analysis to inform the selection of indicators for the assessment of soil structure and soil functions. A manual was then developed in order to standardize and facilitate the task of inventorying soil quality and management practices at the case study sites. The manual provides clear and precise instructions on how to assess the 11 selected soil quality indicators based on a visual soil assessment methodology. A newly developed infiltrometer was used to easily assess the soil infiltration capacity in the field and investigate hydrodynamic flow processes. Based on consistent calibration, the infiltrometer enables reliable prediction of key soil hydraulic properties. The main aim of this inventory is to link agricultural management practices to the soil quality status at the case study sites, and to identify innovative practices that have improved soil quality. The inventory and the scoring of soil quality are done together with land users at each study site. The idea is to compare the soil quality on a farm where management practices have changed 3 or more years ago with that on a control farm where practices have not changed, with both farms located in the same pedo-climatic zone and having comparable soil conditions. The case study partners were requested to identify at least 3 newly adopted management practices (or combinations thereof) and 3 related control farms. First results show that among 88 sets of paired plots, 60 pairs (68 %) show a positive impact of innovative agricultural management practices on soil quality. 18 pairs (21 %) do not show any difference in soil quality between soils under innovative practices and soils in the control plots, and the remaining 10 plots (11 %) show an inverse effect. The non-detectable effect of the innovative practices on soil quality are due to type of tillage management, soil type and fertility that mask the effect of management practices on soil and also due to time of the assessment. This assessment will be repeated in the coming years, with the aim of providing sound data on soil quality and its improvement through innovative management practices across Europe and China.

Chinese Cardiovascular Disease Mobile Apps’ Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review

PubMed Central

Xie, Bo; Su, Zhaohui; Zhang, Wenhui

2017-01-01

Background China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. Objective We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Methods Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Results Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps’ providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps’ information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Conclusions Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users’ preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. PMID:29242176

Chinese Cardiovascular Disease Mobile Apps' Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review.

PubMed

Xie, Bo; Su, Zhaohui; Zhang, Wenhui; Cai, Run

2017-12-14

China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps' providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps' information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users' preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management. ©Bo Xie, Zhaohui Su, Wenhui Zhang, Run Cai. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 14.12.2017.

Quality Assessment of Medical Apps that Target Medication-Related Problems.

PubMed

Loy, John Shiguang; Ali, Eskinder Eshetu; Yap, Kevin Yi-Lwern

2016-10-01

The advent of smartphones has enabled a plethora of medical apps for disease management. As of 2012, there are 40,000 health care-related mobile apps available in the market. Since most of these medical apps do not go through any stringent quality assessment, there is a risk of consumers being misinformed or misled by unreliable information. In this regard, apps that target medication-related problems (MRPs) are not an exception. There is little information on what constitutes quality in apps that target MRPs and how good the existing apps are. To develop a quality assessment tool for evaluating apps that target MRPs and assess the quality of such apps available in the major mobile app stores (iTunes and Google Play). The top 100 free and paid apps in the medical categories of iTunes and Google Play stores (total of 400 apps) were screened for inclusion in the final analysis. English language apps that targeted MRPs were downloaded on test devices to evaluate their quality. Apps intended for clinicians, patients, or both were eligible for evaluation. The quality assessment tool consisted of 4 sections (appropriateness, reliability, usability, privacy), which determined the overall quality of the apps. Apps that fulfilled the inclusion criteria were classified based on the presence of any 1 or more of the 5 features considered important for apps targeting MRPs (monitoring, interaction checker, dose calculator, medication information, medication record). Descriptive statistics and Mann-Whitney tests were used for analysis. Final analysis was based on 59 apps that fulfilled the study inclusion criteria. Apps with interaction checker (66.9%) and monitoring features (54.8%) had the highest and lowest overall qualities. Paid apps generally scored higher for usability than free apps (P = 0.006) but lower for privacy (P = 0.003). Half of the interaction checker apps were unable to detect interactions with herbal medications. Blood pressure and heart rate monitoring apps had the highest overall quality scores (67.7%), while apps that monitored visual, hearing, and temperature changes scored the lowest (35.5%). A quality assessment tool for evaluating medical apps targeting MRPs has been developed. Clinicians can use this tool to guide their assessments of medical apps that are appropriate for use in the health care setting. Although potentially useful apps were identified, many apps were found to have deficiencies in quality, among which was poor reliability scores for most of the apps. Continued assessments of the quality of apps targeting MRPs are recommended to ensure their usefulness for clinicians and patients. No outside funding supported this study. The authors have no conflicts of interests directly related to this study. Study concept and design were contributed by Loy and Yap. Loy collected the data and took the lead in data interpretation, along with Ali and Yap. The manuscript was primarily written by Loy, along with Yap, and revised primarily by Ali, along with Yap.

The European water framework directive: water quality classification and implications to engineering planning.

PubMed

Achleitner, Stefan; De Toffol, Sara; Engelhard, Carolina; Rauch, Wolfgang

2005-04-01

The European Water framework directive (WFD) is probably the most important environmental management directive that has been enacted over the last decade in the European Union. The directive aims at achieving an overall good ecological status in all European water bodies. In this article, we discuss the implementation steps of the WFD and their implications for environmental engineering practice while focusing on rivers as the main receiving waters. Arising challenges for engineers and scientists are seen in the quantitative assessment of water quality, where standardized systems are needed to estimate the biological status. This is equally of concern in engineering planning, where the prediction of ecological impacts is required. Studies dealing with both classification and prediction of the ecological water quality are reviewed. Further, the combined emission-water quality approach is discussed. Common understanding of this combined approach is to apply the most stringent of either water quality or emission standard to a certain case. In contrast, for example, the Austrian water act enables the application of only the water quality based approach--at least on a temporary basis.

Study protocol: using the Q-STEPS to assess and improve the quality of physical activity programmes for the elderly.

PubMed

Marques, Ana I; Rosa, Maria J; Amorim, Marlene; Soares, Pedro; Oliveira-Tavares, António; Santos, Rute; Mota, Jorge; Carvalho, Joana

2012-07-09

Aging is one of the most important and obvious phenomenon observed in our society. In the past years, there has been a growing concern in designing physical activity (PA) programmes for elderly people, because evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Accordingly, a growing body of literature points to the importance of a sound approach to planning and evaluation in order to improve the quality of PA programmes. However, while numerous PA programmes have been designed for the elderly in recent years, their evaluation has been scarce. Quality management processes and tools provide a practical way for organisations to assess, identify and shed light on the areas requiring improvement. The Quality Self-assessment Tool for Exercise Programmes for Seniors (Q-STEPS) seems to provide a framework tailored to evaluate PA programmes for the elderly. The primary purpose of this study is 1) to determine feasibility, acceptability and usability of the Q-STEPS. Secondary purposes of the study are: 2) to examine the quality of the PA programmes for elderly people developed by the Portuguese Local Administration over a three-year period of self-assessments in terms of: a) Enabler domains (Leadership, Policy and Strategy, People, Partnership and Resources, Processes); b) Result domains (Customer Results, People Results, Society Results and Key Performance Results); 3) to estimate the association between the use of Q-STEPS and some indicators relating to the elderly participants, during the three self-assessments, such as: attendance rates, physical fitness, health-related quality of life and the elderly's perceived quality of the programme. The study will be conducted in PA programmes for elderly adults from mainland Portuguese municipalities over a three-year period. The project will adopt a participative quality improvement approach that features annual learning cycles of: 1) self-assessment with the Q-STEPS; 2) feedback to and interpretation of results involving programme's staff; 3) action planning to achieve system changes; 4) implementation of strategies for change; and 5) review process through further self-assessment. The study will collect a range of process and outcome data that will be used to achieve the research aims. It is our understanding that the results of the Q-STEPS study will contribute directly to the evidence based on effectiveness of continuous quality improvement approaches, in order to improve customer satisfaction and adherence to PA programmes targeting the ageing population. This comprehensive evaluation will also add significant new knowledge regarding the characteristics associated with a sustainable public service.

Magnetic Resonance Imaging of Phosphocreatine and Determination of BOLD Kinetics in Lower Extremity Muscles using a Dual-Frequency Coil Array

NASA Astrophysics Data System (ADS)

Brown, Ryan; Khegai, Oleksandr; Parasoglou, Prodromos

2016-07-01

Magnetic resonance imaging (MRI) provides the unique ability to study metabolic and microvasculature functions in skeletal muscle using phosphorus and proton measurements. However, the low sensitivity of these techniques can make it difficult to capture dynamic muscle activity due to the temporal resolution required for kinetic measurements during and after exercise tasks. Here, we report the design of a dual-nuclei coil array that enables proton and phosphorus MRI of the human lower extremities with high spatial and temporal resolution. We developed an array with whole-volume coverage of the calf and a phosphorus signal-to-noise ratio of more than double that of a birdcage coil in the gastrocnemius muscles. This enabled the local assessment of phosphocreatine recovery kinetics following a plantar flexion exercise using an efficient sampling scheme with a 6 s temporal resolution. The integrated proton array demonstrated image quality approximately equal to that of a clinical state-of-the-art knee coil, which enabled fat quantification and dynamic blood oxygen level-dependent measurements that reflect microvasculature function. The developed array and time-efficient pulse sequences were combined to create a localized assessment of calf metabolism using phosphorus measurements and vasculature function using proton measurements, which could provide new insights into muscle function.

Case-mix adjustment and enabled reporting of the health care experiences of adults with disabilities.

PubMed

Palsbo, Susan E; Diao, Guoqing; Palsbo, Gregory A; Tang, Liansheng; Rosenberger, William F; Mastal, Margaret F

2010-09-01

To develop activity limitation clusters for case-mix adjustment of health care ratings and as a population profiler, and to develop a cognitively accessible report of statistically reliable quality and access measures comparing the health care experiences of adults with and without disabilities, within and across health delivery organizations. Observational study. Three California Medicaid health care organizations. Adults (N = 1086) of working age enrolled for at least 1 year in Medicaid because of disability. Not applicable. Principal components analysis created 4 clusters of activity limitations that we used to characterize case mix. We identified and calculated 28 quality measures using responses from a proposed enabled version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. We calculated scores for overall care as the weighted mean of the case-mix adjusted ratings. Disability caused a greater bias on health plan ratings and specialist ratings than did demographic factors. Proxy respondents rated care the same as self-respondents. Telephone and mail administration were equivalent for service reports, but telephone respondents tended to offer more positive global ratings. Plan-level reliability estimates for new composites on shared decision making and advice on healthy living are .79 and .87, respectively. Plan-level reliability estimates for a new composite measure on family planning did not discriminate between health plans because respondents rated all health plans poorly. Approximately 125 respondents per site are necessary to detect group differences. Self-reported activity limitations incorporating standard questions from the American Community Survey can be used to create a disability case-mix index and to construct profiles of a population's activity limitations. The enabled comparative report, which we call the Assessment of Health Plans and Providers by People with Activity Limitations, is more cognitively accessible than typical CAHPS report templates for state Medicaid plans. The CAHPS Medicaid reporting tools may provide misleading ratings of health plan and physician quality by people with disabilities because the mean ratings do not account for systematic biases associated with disability. More testing on larger populations would help to quantify the strength of various reporting biases.

Comparison of methodological quality of positive versus negative comparative studies published in Indian medical journals: a systematic review

PubMed Central

Charan, Jaykaran; Chaudhari, Mayur; Jackson, Ryan; Mhaskar, Rahul; Reljic, Tea; Kumar, Ambuj

2015-01-01

Objectives Published negative studies should have the same rigour of methodological quality as studies with positive findings. However, the methodological quality of negative versus positive studies is not known. The objective was to assess the reported methodological quality of positive versus negative studies published in Indian medical journals. Design A systematic review (SR) was performed of all comparative studies published in Indian medical journals with a clinical science focus and impact factor >1 between 2011 and 2013. The methodological quality of randomised controlled trials (RCTs) was assessed using the Cochrane risk of bias tool, and the Newcastle-Ottawa scale for observational studies. The results were considered positive if the primary outcome was statistically significant and negative otherwise. When the primary outcome was not specified, we used data on the first outcome reported in the history followed by the results section. Differences in various methodological quality domains between positive versus negative studies were assessed by Fisher's exact test. Results Seven journals with 259 comparative studies were included in this SR. 24% (63/259) were RCTs, 24% (63/259) cohort studies, and 49% (128/259) case–control studies. 53% (137/259) of studies explicitly reported the primary outcome. Five studies did not report sufficient data to enable us to determine if results were positive or negative. Statistical significance was determined by p value in 78.3% (199/254), CI in 2.8% (7/254), both p value and CI in 11.8% (30/254), and only descriptive in 6.3% (16/254) of studies. The overall methodological quality was poor and no statistically significant differences between reporting of methodological quality were detected between studies with positive versus negative findings. Conclusions There was no difference in the reported methodological quality of positive versus negative studies. However, the uneven reporting of positive versus negative studies (72% vs 28%) indicates a publication bias in Indian medical journals with an impact factor of >1. PMID:26109118

Measuring the Quality of Life of Visually Impaired Children: First Stage Psychometric Evaluation of the Novel VQoL_CYP Instrument.

PubMed

Tadić, Valerija; Cooper, Andrew; Cumberland, Phillippa; Lewando-Hundt, Gillian; Rahi, Jugnoo S

2016-01-01

To report piloting and initial validation of the VQoL_CYP, a novel age-appropriate vision-related quality of life (VQoL) instrument for self-reporting by children with visual impairment (VI). Participants were a random patient sample of children with VI aged 10-15 years. 69 patients, drawn from patient databases at Great Ormond Street Hospital and Moorfields Eye Hospital, United Kingdom, participated in piloting of the draft 47-item VQoL instrument, which enabled preliminary item reduction. Subsequent administration of the instrument, alongside functional vision (FV) and generic health-related quality of life (HRQoL) self-report measures, to 101 children with VI comprising a nationally representative sample enabled further item reduction and evaluation of psychometric properties using Rasch analysis. Construct validity was assessed through Pearson correlation coefficients. Item reduction through piloting (8 items removed for skewness and individual item response pattern) and validation (1 item removed for skewness and 3 for misfit in Rasch) produced a 35-item scale, with fit values within acceptable limits, no notable differential item functioning, good measurement precision, ordered response categories and acceptable targeting in Rasch. The VQoL_CYP showed good construct validity, correlating strongly with HRQoL scores, moderately with FV scores but not with acuity. Robust child-appropriate self-report VQoL measures for children with VI are necessary for understanding the broader impacts of living with a visual disability, distinguishing these from limited functioning per se. Future planned use in larger patient samples will allow further psychometric development of the VQoL_CYP as an adjunct to objective outcomes assessment.

Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders.

PubMed

Mashamba-Thompson, Tivani P; Jama, Ngcwalisa A; Sartorius, Benn; Drain, Paul K; Thompson, Rowan M

2017-01-08

Key stakeholders' involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients' needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.

Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

PubMed Central

Mashamba-Thompson, Tivani P.; Jama, Ngcwalisa A.; Sartorius, Benn; Drain, Paul K.; Thompson, Rowan M.

2017-01-01

Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics. PMID:28075337

[Validation and adhesion to GESIDA quality indicators in patients with HIV infection].

PubMed

Riera, Melchor; Esteban, Herminia; Suarez, Ignacio; Palacios, Rosario; Lozano, Fernando; Blanco, Jose R; Valencia, Eulalia; Ocampo, Antonio; Amador, Concha; Frontera, Guillem; vonWichmann-de Miguel, Miguel Angel

2016-01-01

The objective of the study is to validate the relevant GESIDA quality indicators for HIV infection, assessing the reliability, feasibility and adherence to them. The reliability was evaluated using the reproducibility of 6 indicators in peer review, with the second observer being an outsider. The feasibility and measurement of the level of adherence to the 22 indicators was conducted with annual fragmented retrospective collection of information from specific databases or the clinical charts of the nine participating hospitals. Reliability was very high, with interobserver agreement levels higher than 95% in 5 of the 6 indicators. The median time to achieve the indicators ranged between 5 and 600minutes, but could be achieved progressively from specific databases, enabling obtaining them automatically. As regards adherence to the indicators related with the initial evaluation of the patients, instructions and suitability of the guidelines for ART, adherence to ART, follow-up in clinics, and achieve an undetectable HIV by PCR at week 48 of the ART. Indicators of quality related to the prevention of opportunistic infections and control of comorbidities, the standards set were not achieved, and significant heterogeneity was observed between hospitals. The GESIDA quality indicators of HIV infection enabled the relevant indicators to be feasibly and reliably measured, and should be collected in all the units that care for patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Use of point-of-sale data to assess food and nutrient quality in remote stores.

PubMed

Brimblecombe, Julie; Liddle, Robyn; O'Dea, Kerin

2013-07-01

To examine the feasibility of using point-of-sale data to assess dietary quality of food sales in remote stores. A multi-site cross-sectional assessment of food and nutrient composition of food sales. Point-of-sale data were linked to Australian Food and Nutrient Data and compared across study sites and with nutrient requirements. Remote Aboriginal Australia. Six stores. Point-of-sale data were readily available and provided a low-cost, efficient and objective assessment of food and nutrient sales. Similar patterns in macronutrient distribution, food expenditure and key food sources of nutrients were observed across stores. In all stores, beverages, cereal and cereal products, and meat and meat products comprised approximately half of food sales (range 49–57 %). Fruit and vegetable sales comprised 10.4 (SD 1.9) % on average. Carbohydrate contributed 54.4 (SD 3.0) % to energy; protein 13.5 (SD 1.1) %; total sugars 28.9 (SD 4.3) %; and the contribution of total saturated fat to energy ranged from 11.0 to 14.4% across stores. Mg, Ca, K and fibre were limiting nutrients, and Na was four to five times higher than the midpoint of the average intake range. Relatively few foods were major sources of nutrients. Point-of-sale data enabled an assessment of dietary quality within stores and across stores with no burden on communities and at no cost, other than time required for analysis and reporting. Similar food spending patterns and nutrient profiles were observed across the six stores. This suggests potential in using point-of-sale data to monitor and evaluate dietary quality in remote Australian communities.

Use of a channelized Hotelling observer to assess CT image quality and optimize dose reduction for iteratively reconstructed images.

PubMed

Favazza, Christopher P; Ferrero, Andrea; Yu, Lifeng; Leng, Shuai; McMillan, Kyle L; McCollough, Cynthia H

2017-07-01

The use of iterative reconstruction (IR) algorithms in CT generally decreases image noise and enables dose reduction. However, the amount of dose reduction possible using IR without sacrificing diagnostic performance is difficult to assess with conventional image quality metrics. Through this investigation, achievable dose reduction using a commercially available IR algorithm without loss of low contrast spatial resolution was determined with a channelized Hotelling observer (CHO) model and used to optimize a clinical abdomen/pelvis exam protocol. A phantom containing 21 low contrast disks-three different contrast levels and seven different diameters-was imaged at different dose levels. Images were created with filtered backprojection (FBP) and IR. The CHO was tasked with detecting the low contrast disks. CHO performance indicated dose could be reduced by 22% to 25% without compromising low contrast detectability (as compared to full-dose FBP images) whereas 50% or more dose reduction significantly reduced detection performance. Importantly, default settings for the scanner and protocol investigated reduced dose by upward of 75%. Subsequently, CHO-based protocol changes to the default protocol yielded images of higher quality and doses more consistent with values from a larger, dose-optimized scanner fleet. CHO assessment provided objective data to successfully optimize a clinical CT acquisition protocol.

Clinical Data Warehouse: An Effective Tool to Create Intelligence in Disease Management.

PubMed

Karami, Mahtab; Rahimi, Azin; Shahmirzadi, Ali Hosseini

Clinical business intelligence tools such as clinical data warehouse enable health care organizations to objectively assess the disease management programs that affect the quality of patients' life and well-being in public. The purpose of these programs is to reduce disease occurrence, improve patient care, and decrease health care costs. Therefore, applying clinical data warehouse can be effective in generating useful information about aspects of patient care to facilitate budgeting, planning, research, process improvement, external reporting, benchmarking, and trend analysis, as well as to enable the decisions needed to prevent the progression or appearance of the illness aligning with maintaining the health of the population. The aim of this review article is to describe the benefits of clinical data warehouse applications in creating intelligence for disease management programs.

Review of functional markers for improving cooking, eating, and the nutritional qualities of rice

PubMed Central

Lau, Wendy C. P.; Rafii, Mohd Y.; Ismail, Mohd R.; Puteh, Adam; Latif, Mohammad A.; Ramli, Asfaliza

2015-01-01

After yield, quality is one of the most important aspects of rice breeding. Preference for rice quality varies among cultures and regions; therefore, rice breeders have to tailor the quality according to the preferences of local consumers. Rice quality assessment requires routine chemical analysis procedures. The advancement of molecular marker technology has revolutionized the strategy in breeding programs. The availability of rice genome sequences and the use of forward and reverse genetics approaches facilitate gene discovery and the deciphering of gene functions. A well-characterized gene is the basis for the development of functional markers, which play an important role in plant genotyping and, in particular, marker-assisted breeding. In addition, functional markers offer advantages that counteract the limitations of random DNA markers. Some functional markers have been applied in marker-assisted breeding programs and have successfully improved rice quality to meet local consumers’ preferences. Although functional markers offer a plethora of advantages over random genetic markers, the development and application of functional markers should be conducted with care. The decreasing cost of sequencing will enable more functional markers for rice quality improvement to be developed, and application of these markers in rice quality breeding programs is highly anticipated. PMID:26528304

Practical Approaches to Quality Improvement for Radiologists.

PubMed

Kelly, Aine Marie; Cronin, Paul

2015-10-01

Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

Living Labs: overview of ecological approaches for health promotion and rehabilitation.

PubMed

Korman, M; Weiss, P L; Kizony, R

2016-01-01

The term "Living Lab" was coined to reflect the use of sensors to monitor human behavior in real life environments. Until recently such measurements had been feasible only within experimental laboratory settings. The objective of this paper is to highlight research on health care sensing and monitoring devices that enable direct, objective and accurate capture of real-world functioning. Selected articles exemplifying the key technologies that allow monitoring of the motor-cognitive activity of persons with disabilities during naturally occurring daily experiences in real-life settings are discussed in terms of (1) the ways in which the Living Lab approach has been used to date, (2) limitations related to clinical assessment in rehabilitation settings and (3) three categories of the instruments most commonly used for this purpose: personal technologies, ambient technologies and external assistive systems. Technology's most important influences on clinical practice and rehabilitation are in a shift from laboratory-based to field-centered research and a transition between in-clinic performance to daily life activities. Numerous applications show its potential for real-time clinical assessment. Current technological solutions that may provide clinicians with objective, unobtrusive measurements of health and function, as well as tools that support rehabilitation on an individual basis in natural environments provide an important asset to standard clinical measures. Until recently objective clinical assessment could not be readily performed in a client's daily functional environment. Novel technologies enable health care sensing and monitoring devices that enable direct, objective and accurate capture of real-world functioning. Such technologies are referred to as a "Living Lab" approach since they enable the capture of objective and non-obtrusive data that clinicians can use to assess performance. Research and development in this field help clinicians support maintain independence and quality of life for people who have disabilities or who are aging, and to promote more effective methods of long-term rehabilitation and maintenance of a healthy life style.

Current Landscape and New Paradigms of Proficiency Testing and External Quality Assessment for Molecular Genetics

PubMed Central

Kalman, Lisa V.; Lubin, Ira M.; Barker, Shannon; du Sart, Desiree; Elles, Rob; Grody, Wayne W.; Pazzagli, Mario; Richards, Sue; Schrijver, Iris; Zehnbauer, Barbara

2015-01-01

Context Participation in proficiency testing (PT) or external quality assessment (EQA) programs allows the assessment and comparison of test performance among different clinical laboratories and technologies. In addition to the approximately 2300 tests for individual genetic disorders, recent advances in technology have enabled the development of clinical tests which quickly and economically analyze the entire human genome. New PT/EQA approaches are needed to ensure the continued quality of these complex tests. Objective To review the availability and scope of PT/EQA for molecular genetic testing for inherited conditions in Europe, Australasia and the United States; to evaluate the successes and demonstrated value of available PT/EQA programs; and to examine the challenges to the provision of comprehensive PT/EQA posed by new laboratory practices and methodologies. Data Sources The available literature on this topic was reviewed and supplemented with personal experiences of several PT/EQA providers. Conclusions PT/EQA schemes are available for common genetic disorders tested in many clinical laboratories, but are not available for most genetic tests offered by only one or a few laboratories. Provision of broad, method-based PT schemes, such as DNA sequencing, would allow assessment of a large number of tests for which formal PT is not currently available. Participation in PT/EQA improves the quality of testing by identifying inaccuracies that laboratories can trace to errors in the testing process. Areas of research and development to ensure that PT/EQA programs can meet the needs of new and evolving genetic tests and technologies are identified and discussed. PMID:23808472

A BMI-adjusted ultra-low-dose CT angiography protocol for the peripheral arteries-Image quality, diagnostic accuracy and radiation exposure.

PubMed

Schreiner, Markus M; Platzgummer, Hannes; Unterhumer, Sylvia; Weber, Michael; Mistelbauer, Gabriel; Loewe, Christian; Schernthaner, Ruediger E

2017-08-01

To investigate radiation exposure, objective image quality, and the diagnostic accuracy of a BMI-adjusted ultra-low-dose CT angiography (CTA) protocol for the assessment of peripheral arterial disease (PAD), with digital subtraction angiography (DSA) as the standard of reference. In this prospective, IRB-approved study, 40 PAD patients (30 male, mean age 72 years) underwent CTA on a dual-source CT scanner at 80kV tube voltage. The reference amplitude for tube current modulation was personalized based on the body mass index (BMI) with 120 mAs for [BMI≤25] or 150 mAs for [2570%) was assessed by two readers independently and compared to subsequent DSA. Radiation exposure was assessed with the computed tomography dose index (CTDIvol) and the dosis-length product (DLP). Objective image quality was assessed via contrast- and signal-to-noise ratio (CNR and SNR) measurements. Radiation exposure and image quality were compared between the BMI groups and between the BMI-adjusted ultra-low-dose protocol and the low-dose institutional standard protocol (ISP). The BMI-adjusted ultra-low-dose protocol reached high diagnostic accuracy values of 94% for Reader 1 and 93% for Reader 2. Moreover, in comparison to the ISP, it showed significantly (p<0.001) lower CTDIvol (1.97±0.55mGy vs. 4.18±0.62 mGy) and DLP (256±81mGy x cm vs. 544±83mGy x cm) but similar image quality (p=0.37 for CNR). Furthermore, image quality was similar between BMI groups (p=0.86 for CNR). A CT protocol that incorporates low kV settings with a personalized (BMI-adjusted) reference amplitude for tube current modulation and iterative reconstruction enables very low radiation exposure CTA, while maintaining good image quality and high diagnostic accuracy in the assessment of PAD. Copyright © 2017 Elsevier B.V. All rights reserved.

Technology-Enabled Capability Demonstration 4A Sustainability and Logistics-Basing: Initial Quality of Life and Soldier Readiness User Assessment

DTIC Science & Technology

2014-10-30

Eat (MRE), Meal Cold Weather/Long Range Patrol (MCW/LRP), Unitized Group Ration (UGR) Heat & Serve, UGR‐E...1000 PAX camp has the Soldiers receiving a hot meal (UGR‐A) for dinner in addition to breakfast. The 1000 PAX camp also has larger numbers of MWR...over AC in the TOC any day.” Figure 14: MWR Attribute Scores 3.1.3.5 Field Feeding The Soldiers prioritized breakfast rations slightly over dinner

BREAST: a novel method to improve the diagnostic efficacy of mammography

NASA Astrophysics Data System (ADS)

Brennan, P. C.; Tapia, K.; Ryan, J.; Lee, W.

2013-03-01

High quality breast imaging and accurate image assessment are critical to the early diagnoses, treatment and management of women with breast cancer. Breast Screen Reader Assessment Strategy (BREAST) provides a platform, accessible by researchers and clinicians world-wide, which will contain image data bases, algorithms to assess reader performance and on-line systems for image evaluation. The platform will contribute to the diagnostic efficacy of breast imaging in Australia and beyond on two fronts: reducing errors in mammography, and transforming our assessment of novel technologies and techniques. Mammography is the primary diagnostic tool for detecting breast cancer with over 800,000 women X-rayed each year in Australia, however, it fails to detect 30% of breast cancers with a number of missed cancers being visible on the image [1-6]. BREAST will monitor the mistakes, identify reasons for mammographic errors, and facilitate innovative solutions to reduce error rates. The BREAST platform has the potential to enable expert assessment of breast imaging innovations, anywhere in the world where experts or innovations are located. Currently, innovations are often being assessed by limited numbers of individuals who happen to be geographically located close to the innovation, resulting in equivocal studies with low statistical power. BREAST will transform this current paradigm by enabling large numbers of experts to assess any new method or technology using our embedded evaluation methods. We are confident that this world-first system will play an important part in the future efficacy of breast imaging.

Alcohol prices, beverage quality, and the demand for alcohol: quality substitutions and price elasticities.

PubMed

Gruenewald, Paul J; Ponicki, William R; Holder, Harold D; Romelsjö, Anders

2006-01-01

Although the published literature on alcohol beverage taxes, prices, sales, and related problems treats alcoholic beverages as a simple good, alcohol is a complex good composed of different beverage types (i.e., beer, wine, and spirits) and quality brands (e.g., high-, medium-, and low-quality beers). As a complex good, consumers may make substitutions between purchases of different beverage types and brands in response to price increases. For this reason, the availability of a broad range of beverage prices provides opportunities for consumers to mitigate the effects of average price increases through quality substitutions; a change in beverage choice in response to price increases to maintain consumption. Using Swedish price and sales data provided by Systembolaget for the years 1984 through 1994, this study assessed the relationships between alcohol beverage prices, beverage quality, and alcohol sales. The study examined price effects on alcohol consumption using seemingly unrelated regression equations to model the impacts of price increases within 9 empirically defined quality classes across beverage types. The models enabled statistical assessments of both own-price and cross-price effects between types and classes. The results of these analyses showed that consumers respond to price increases by altering their total consumption and by varying their brand choices. Significant reductions in sales were observed in response to price increases, but these effects were mitigated by significant substitutions between quality classes. The findings suggest that the net impacts of purposeful price policy to reduce consumption will depend on how such policies affect the range of prices across beverage brands.

[Quality indicators for the assessment of ST-segment elevation acute myocardial infarction (STEMI) networks. How hospital discharge records could be integrated with Emergency medical services data: the Emilia-Romagna STEMI network experience].

PubMed

Pavesi, Pier Camillo; Guastaroba, Paolo; Casella, Gianni; Berti, Elena; De Palma, Rossana; Di Bartolomeo, Stefano; Di Pasquale, Giuseppe

2015-09-01

The assessment of the regional network for ST-segment elevation acute myocardial infarction (STEMI) is fundamental for quality assurance. Since 2011 all Italian Health Authorities, in addition to hospital discharge records (HDR), must provide a standardized information flow (ERD) about emergency department (ED) and emergency medical system (EMS) activities. The aim of this study was to evaluate whether data integration of ERD with HDR may allow the development of appropriate quality indicators. Patients admitted to coronary care units (CCU) for STEMI between January 1 to December 31, 2013, were identified from the regional HDR database. All data were linked to those of the regional ERD database. Four quality indicators were defined: 1) rates of EMS activation, 2) rates of EMS direct transfer to the catheterization laboratory (Cath-lab), 3) transfer rates from a Spoke to a Hub hospital with angioplasty facilities, and 4) median time spent in ED. In 2013, 2793 patients with STEMI were admitted to the CCU. Of these, 1684 patients (60%) activated EMS and were transported to Spoke or Hub hospitals; 955 (57%) entered directly in CCU/Cath-lab; 677 were transferred directly to a Hub hospital ED without being admitted to a Spoke hospital. The median ED time in Hub hospital was 47 min (IQR 24-136) and in Spoke hospital 53 min (IQR 30-131). The integration among administrative data banks (i.e., HDR with ERD) allowed the assessment of the regional STEMI network and the identification of potentially useful quality indicators. Their easy availability should enable comparisons with local, national and international standards, and may favor quality improvement.

Social image quality

NASA Astrophysics Data System (ADS)

Qiu, Guoping; Kheiri, Ahmed

2011-01-01

Current subjective image quality assessments have been developed in the laboratory environments, under controlledconditions, and are dependent on the participation of limited numbers of observers. In this research, with the help of Web 2.0 and social media technology, a new method for building a subjective image quality metric has been developed where the observers are the Internet users. A website with a simple user interface that enables Internet users from anywhere at any time to vote for a better quality version of a pair of the same image has been constructed. Users' votes are recorded and used to rank the images according to their perceived visual qualities. We have developed three rank aggregation algorithms to process the recorded pair comparison data, the first uses a naive approach, the second employs a Condorcet method, and the third uses the Dykstra's extension of Bradley-Terry method. The website has been collecting data for about three months and has accumulated over 10,000 votes at the time of writing this paper. Results show that the Internet and its allied technologies such as crowdsourcing offer a promising new paradigm for image and video quality assessment where hundreds of thousands of Internet users can contribute to building more robust image quality metrics. We have made Internet user generated social image quality (SIQ) data of a public image database available online (http://www.hdri.cs.nott.ac.uk/siq/) to provide the image quality research community with a new source of ground truth data. The website continues to collect votes and will include more public image databases and will also be extended to include videos to collect social video quality (SVQ) data. All data will be public available on the website in due course.

The SAFER guides: empowering organizations to improve the safety and effectiveness of electronic health records.

PubMed

Sittig, Dean F; Ash, Joan S; Singh, Hardeep

2014-05-01

Electronic health records (EHRs) have potential to improve quality and safety of healthcare. However, EHR users have experienced safety concerns from EHR design and usability features that are not optimally adapted for the complex work flow of real-world practice. Few strategies exist to address unintended consequences from implementation of EHRs and other health information technologies. We propose that organizations equipped with EHRs should consider the strategy of "proactive risk assessment" of their EHR-enabled healthcare system to identify and address EHR-related safety concerns. In this paper, we describe the conceptual underpinning of an EHR-related self-assessment strategy to provide institutions a foundation upon which they could build their safety efforts. With support from the Office of the National Coordinator for Health Information Technology (ONC), we used a rigorous, iterative process to develop a set of 9 self-assessment tools to optimize the safety and safe use of EHRs. These tools, referred to as the Safety Assurance Factors for EHR Resilience (SAFER) guides, could be used to self-assess safety and effectiveness of EHR implementations, identify specific areas of vulnerability, and create solutions and culture change to mitigate risks. A variety of audiences could conduct these assessments, including frontline clinicians or care teams in different practices, or clinical, quality, or administrative leaders within larger institutions. The guides use a multifaceted systems-based approach to assess risk and empower organizations to work with internal or external stakeholders (eg, EHR developers) on optimizing EHR functionality and using EHRs to drive improvements in the quality and safety of healthcare.

Design of Cycle 3 of the National Water-Quality Assessment Program, 2013-2022: Part 1: Framework of Water-Quality Issues and Potential Approaches

USGS Publications Warehouse

Rowe, Gary L.; Belitz, Kenneth; Essaid, Hedeff I.; Gilliom, Robert J.; Hamilton, Pixie A.; Hoos, Anne B.; Lynch, Dennis D.; Munn, Mark D.; Wolock, David W.

2010-01-01

In 1991, the U.S. Congress established the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) Program to develop long-term, nationally consistent information on the quality of the Nation's streams and groundwater. Congress recognized the critical need for this information to support scientifically sound management, regulatory, and policy decisions concerning the increasingly stressed water resources of the Nation. The long-term goals of NAWQA are to: (1) assess the status of water-quality conditions in the United States, (2) evaluate long-term trends in water-quality conditions, and (3) link status and trends with an understanding of the natural and human factors that affect water quality. These goals are national in scale, include both surface water and groundwater, and include consideration of water quality in relation to both human uses and aquatic ecosystems. Since 1991, NAWQA assessments and findings have fostered and supported major improvements in the availability and use of unbiased scientific information for decisionmaking, resource management, and planning at all levels of government. These improvements have enabled agencies and stakeholders to cost-effectively address a wide range of water-quality issues related to natural and human influences on the quality of water and potential effects on aquatic ecosystems and human health (http://water.usgs.gov/nawqa/xrel.pdf). NAWQA, like all USGS programs, provides policy relevant information that serves as a scientific basis for decisionmaking related to resource management, protection, and restoration. The information is freely available to all levels of government, nongovernmental organizations, industry, academia, and the public, and is readily accessible on the NAWQA Web site and other diverse formats to serve the needs of the water-resource community at different technical levels. Water-quality conditions in streams and groundwater are described in more than 1,700 publications (available online at http://water.usgs.gov/nawqa/bib/), and are documented by more than 14 million data records representing about 7,600 stream sites, 8,100 wells, and 2,000 water-quality and ecological constituents that are available from the NAWQA data warehouse (http://infotrek.er.usgs.gov/traverse/f?p=NAWQA:HOME:0). The Program promotes collaboration and liaison with government officials, resource managers, industry representatives, and other stakeholders to increase the utility and relevance of NAWQA science to decisionmakers. As part of this effort, NAWQA supports integration of data from other organizations into NAWQA assessments, where appropriate and cost-effective, so that more comprehensive findings are available across geographic and temporal scales.

Rational Selection, Criticality Assessment, and Tiering of Quality Attributes and Test Methods for Analytical Similarity Evaluation of Biosimilars.

PubMed

Vandekerckhove, Kristof; Seidl, Andreas; Gutka, Hiten; Kumar, Manish; Gratzl, Gyöngyi; Keire, David; Coffey, Todd; Kuehne, Henriette

2018-05-10

Leading regulatory agencies recommend biosimilar assessment to proceed in a stepwise fashion, starting with a detailed analytical comparison of the structural and functional properties of the proposed biosimilar and reference product. The degree of analytical similarity determines the degree of residual uncertainty that must be addressed through downstream in vivo studies. Substantive evidence of similarity from comprehensive analytical testing may justify a targeted clinical development plan, and thus enable a shorter path to licensing. The importance of a careful design of the analytical similarity study program therefore should not be underestimated. Designing a state-of-the-art analytical similarity study meeting current regulatory requirements in regions such as the USA and EU requires a methodical approach, consisting of specific steps that far precede the work on the actual analytical study protocol. This white paper discusses scientific and methodological considerations on the process of attribute and test method selection, criticality assessment, and subsequent assignment of analytical measures to US FDA's three tiers of analytical similarity assessment. Case examples of selection of critical quality attributes and analytical methods for similarity exercises are provided to illustrate the practical implementation of the principles discussed.

[Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

2011-12-01

The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews). Copyright © 2011 Elsevier España S.L. All rights reserved.

CBCT-based bone quality assessment: are Hounsfield units applicable?

PubMed Central

Jacobs, R; Singer, S R; Mupparapu, M

2015-01-01

CBCT is a widely applied imaging modality in dentistry. It enables the visualization of high-contrast structures of the oral region (bone, teeth, air cavities) at a high resolution. CBCT is now commonly used for the assessment of bone quality, primarily for pre-operative implant planning. Traditionally, bone quality parameters and classifications were primarily based on bone density, which could be estimated through the use of Hounsfield units derived from multidetector CT (MDCT) data sets. However, there are crucial differences between MDCT and CBCT, which complicates the use of quantitative gray values (GVs) for the latter. From experimental as well as clinical research, it can be seen that great variability of GVs can exist on CBCT images owing to various reasons that are inherently associated with this technique (i.e. the limited field size, relatively high amount of scattered radiation and limitations of currently applied reconstruction algorithms). Although attempts have been made to correct for GV variability, it can be postulated that the quantitative use of GVs in CBCT should be generally avoided at this time. In addition, recent research and clinical findings have shifted the paradigm of bone quality from a density-based analysis to a structural evaluation of the bone. The ever-improving image quality of CBCT allows it to display trabecular bone patterns, indicating that it may be possible to apply structural analysis methods that are commonly used in micro-CT and histology. PMID:25315442

The use of health status questionnaires in the management of chronic obstructive pulmonary disease patients in clinical practice.

PubMed

van der Molen, Thys; Diamant, Zuzana; Kocks, Jan Willem H; Tsiligianni, Ioanna G

2014-08-01

Current guidelines recommend chronic obstructive pulmonary disease (COPD) management based on symptoms or health status assessment and lung function parameters. However, COPD is a complex and heterogeneous disease that needs an individualized approach for proper disease management. A structured consultation including health status assessment tools, such as the Clinical COPD Questionnaire and the COPD Assessment Test should improve the quality of the consultation, providing more information than symptoms alone. Both questionnaires are designed to provide the clinician information enabling a more personalized disease approach and subsequent management. Although both Clinical COPD Questionnaire and COPD Assessment Test have good discriminate properties, their use as prognostic markers of severity and their ability to modify disease management has not yet been fully established. New studies are needed to further determine their value on several disease outcomes.

Student-generated reading questions: diagnosing student thinking with diverse formative assessments.

PubMed

Offerdahl, Erika G; Montplaisir, Lisa

2014-01-01

Formative assessment has long been identified as a critical element to teaching for conceptual development in science. It is therefore important for university instructors to have an arsenal of formative assessment tools at their disposal which enable them to effectively uncover and diagnose all students' thinking, not just the most vocal or assertive. We illustrate the utility of one type of formative assessment prompt (reading question assignment) in producing high-quality evidence of student thinking (student-generated reading questions). Specifically, we characterized student assessment data using three distinct analytic frames to exemplify their effectiveness in diagnosing student learning in relationship to three sample learning outcomes. Our data will be useful for university faculty, particularly those engaged in teaching upper-level biochemistry courses and their prerequisites, as they provide an alternative mechanism for uncovering and diagnosing student understanding. © 2013 by The International Union of Biochemistry and Molecular Biology.

Habitat-based PCB environmental quality criteria for the protection of endangered killer whales (Orcinus orca).

PubMed

Alava, Juan José; Ross, Peter S; Lachmuth, Cara; Ford, John K B; Hickie, Brendan E; Gobas, Frank A P C

2012-11-20

The development of an area-based polychlorinated biphenyl (PCB) food-web bioaccumulation model enabled a critical evaluation of the efficacy of sediment quality criteria and prey tissue residue guidelines in protecting fish-eating resident killer whales of British Columbia and adjacent waters. Model-predicted and observed PCB concentrations in resident killer whales and Chinook salmon were in good agreement, supporting the model's application for risk assessment and criteria development. Model application shows that PCB concentrations in the sediments from the resident killer whale's Critical Habitats and entire foraging range leads to PCB concentrations in most killer whales that exceed PCB toxicity threshold concentrations reported for marine mammals. Results further indicate that current PCB sediment quality and prey tissue residue criteria for fish-eating wildlife are not protective of killer whales and are not appropriate for assessing risks of PCB-contaminated sediments to high trophic level biota. We present a novel methodology for deriving sediment quality criteria and tissue residue guidelines that protect biota of high trophic levels under various PCB management scenarios. PCB concentrations in sediments and in prey that are deemed protective of resident killer whale health are much lower than current criteria values, underscoring the extreme vulnerability of high trophic level marine mammals to persistent and bioaccumulative contaminants.

Spatial and temporal assessment of surface water quality in the Arka River, Akkar, Lebanon.

PubMed

Daou, Claude; Nabbout, Rony; Kassouf, Amine

2016-12-01

Surface water quality monitoring constitutes a crucial and important step in any water quality management system. Twenty-three physicochemical and microbiological parameters were assessed in surface water samples collected from the Arka River located in the Akkar District, north of Lebanon. Eight sampling locations were considered along the river and seven sampling campaigns were performed in order to evaluate spatial and temporal influences. The extraction of relevant information from this relatively large data set was done using principal component analysis (PCA), being a very well established chemometric tool in this field. In a first step, extracted PCA loadings revealed the implication of several physicochemical parameters in the discriminations and trends highlighted by PCA scores, mainly due to soil leaching and seawater intrusion. However, further investigations showed the implication of organic and bacterial parameters in the discrimination of stations in the Akkar flatland. These discriminations probably refer to anthropogenic pollution coming from the agricultural area and the surrounding villages. Specific ultraviolet absorption (SUVA) indices confirmed these findings since values decreased for samples collected across the villages and the flatland, indicating an increase in anthropogenic dissolved organic matter. This study will hopefully help the national and local authorities to ameliorate the surface water quality management, enabling its proper use for irrigation purposes.

Design and assessment of a novel SPECT system for desktop open-gantry imaging of small animals: A simulation study

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

Zeraatkar, Navid; Farahani, Mohammad Hossein; Rahmim, Arman

Purpose: Given increasing efforts in biomedical research utilizing molecular imaging methods, development of dedicated high-performance small-animal SPECT systems has been growing rapidly in the last decade. In the present work, we propose and assess an alternative concept for SPECT imaging enabling desktop open-gantry imaging of small animals. Methods: The system, PERSPECT, consists of an imaging desk, with a set of tilted detector and pinhole collimator placed beneath it. The object to be imaged is simply placed on the desk. Monte Carlo (MC) and analytical simulations were utilized to accurately model and evaluate the proposed concept and design. Furthermore, a dedicatedmore » image reconstruction algorithm, finite-aperture-based circular projections (FABCP), was developed and validated for the system, enabling more accurate modeling of the system and higher quality reconstructed images. Image quality was quantified as a function of different tilt angles in the acquisition and number of iterations in the reconstruction algorithm. Furthermore, more complex phantoms including Derenzo, Defrise, and mouse whole body were simulated and studied. Results: The sensitivity of the PERSPECT was 207 cps/MBq. It was quantitatively demonstrated that for a tilt angle of 30°, comparable image qualities were obtained in terms of normalized squared error, contrast, uniformity, noise, and spatial resolution measurements, the latter at ∼0.6 mm. Furthermore, quantitative analyses demonstrated that 3 iterations of FABCP image reconstruction (16 subsets/iteration) led to optimally reconstructed images. Conclusions: The PERSPECT, using a novel imaging protocol, can achieve comparable image quality performance in comparison with a conventional pinhole SPECT with the same configuration. The dedicated FABCP algorithm, which was developed for reconstruction of data from the PERSPECT system, can produce high quality images for small-animal imaging via accurate modeling of the system as incorporated in the forward- and back-projection steps. Meanwhile, the developed MC model and the analytical simulator of the system can be applied for further studies on development and evaluation of the system.« less

Assessing microscope image focus quality with deep learning.

PubMed

Yang, Samuel J; Berndl, Marc; Michael Ando, D; Barch, Mariya; Narayanaswamy, Arunachalam; Christiansen, Eric; Hoyer, Stephan; Roat, Chris; Hung, Jane; Rueden, Curtis T; Shankar, Asim; Finkbeiner, Steven; Nelson, Philip

2018-03-15

Large image datasets acquired on automated microscopes typically have some fraction of low quality, out-of-focus images, despite the use of hardware autofocus systems. Identification of these images using automated image analysis with high accuracy is important for obtaining a clean, unbiased image dataset. Complicating this task is the fact that image focus quality is only well-defined in foreground regions of images, and as a result, most previous approaches only enable a computation of the relative difference in quality between two or more images, rather than an absolute measure of quality. We present a deep neural network model capable of predicting an absolute measure of image focus on a single image in isolation, without any user-specified parameters. The model operates at the image-patch level, and also outputs a measure of prediction certainty, enabling interpretable predictions. The model was trained on only 384 in-focus Hoechst (nuclei) stain images of U2OS cells, which were synthetically defocused to one of 11 absolute defocus levels during training. The trained model can generalize on previously unseen real Hoechst stain images, identifying the absolute image focus to within one defocus level (approximately 3 pixel blur diameter difference) with 95% accuracy. On a simpler binary in/out-of-focus classification task, the trained model outperforms previous approaches on both Hoechst and Phalloidin (actin) stain images (F-scores of 0.89 and 0.86, respectively over 0.84 and 0.83), despite only having been presented Hoechst stain images during training. Lastly, we observe qualitatively that the model generalizes to two additional stains, Hoechst and Tubulin, of an unseen cell type (Human MCF-7) acquired on a different instrument. Our deep neural network enables classification of out-of-focus microscope images with both higher accuracy and greater precision than previous approaches via interpretable patch-level focus and certainty predictions. The use of synthetically defocused images precludes the need for a manually annotated training dataset. The model also generalizes to different image and cell types. The framework for model training and image prediction is available as a free software library and the pre-trained model is available for immediate use in Fiji (ImageJ) and CellProfiler.

A suite of phantom-based test methods for assessing image quality of photoacoustic tomography systems

NASA Astrophysics Data System (ADS)

Vogt, William C.; Jia, Congxian; Wear, Keith A.; Garra, Brian S.; Pfefer, T. Joshua

2017-03-01

As Photoacoustic Tomography (PAT) matures and undergoes clinical translation, objective performance test methods are needed to facilitate device development, regulatory clearance and clinical quality assurance. For mature medical imaging modalities such as CT, MRI, and ultrasound, tissue-mimicking phantoms are frequently incorporated into consensus standards for performance testing. A well-validated set of phantom-based test methods is needed for evaluating performance characteristics of PAT systems. To this end, we have constructed phantoms using a custom tissue-mimicking material based on PVC plastisol with tunable, biologically-relevant optical and acoustic properties. Each phantom is designed to enable quantitative assessment of one or more image quality characteristics including 3D spatial resolution, spatial measurement accuracy, ultrasound/PAT co-registration, uniformity, penetration depth, geometric distortion, sensitivity, and linearity. Phantoms contained targets including high-intensity point source targets and dye-filled tubes. This suite of phantoms was used to measure the dependence of performance of a custom PAT system (equipped with four interchangeable linear array transducers of varying design) on design parameters (e.g., center frequency, bandwidth, element geometry). Phantoms also allowed comparison of image artifacts, including surface-generated clutter and bandlimited sensing artifacts. Results showed that transducer design parameters create strong variations in performance including a trade-off between resolution and penetration depth, which could be quantified with our method. This study demonstrates the utility of phantom-based image quality testing in device performance assessment, which may guide development of consensus standards for PAT systems.

Using Data From Ontario's Episode-Based Funding Model to Assess Quality of Chemotherapy.

PubMed

Kaizer, Leonard; Simanovski, Vicky; Lalonde, Carlin; Tariq, Huma; Blais, Irene; Evans, William K

2016-10-01

A new episode-based funding model for ambulatory systemic therapy was implemented in Ontario, Canada on April 1, 2014, after a comprehensive knowledge transfer and exchange strategy with providers and administrators. An analysis of the data from the first year of the new funding model provided an opportunity to assess the quality of chemotherapy, which was not possible under the old funding model. Options for chemotherapy regimens given with adjuvant/curative intent or palliative intent were informed by input from disease site groups. Bundles were developed and priced to enable evidence-informed best practice. Analysis of systemic therapy utilization after model implementation was performed to assess the concordance rate of the treatments chosen with recommended practice. The actual number of cycles of treatment delivered was also compared with expert recommendations. Significant improvement compared with baseline was seen in the proportion of adjuvant/curative regimens that aligned with disease site group-recommended options (98% v 90%). Similar improvement was seen for palliative regimens (94% v 89%). However, overall, the number of cycles of adjuvant/curative therapy delivered was lower than recommended best practice in 57.5% of patients. There was significant variation by disease site and between facilities. Linking funding to quality, supported by knowledge transfer and exchange, resulted in a rapid improvement in the quality of systemic treatment in Ontario. This analysis has also identified further opportunities for improvement and the need for model refinement.

Effect of water quality and confounding factors on digestive enzyme activities in Gammarus fossarum.

PubMed

Charron, L; Geffard, O; Chaumot, A; Coulaud, R; Queau, H; Geffard, A; Dedourge-Geffard, O

2013-12-01

The feeding activity and subsequent assimilation of the products resulting from food digestion allow organisms to obtain energy for growth, maintenance and reproduction. Among these biological parameters, we studied digestive enzymes (amylase, cellulase and trypsin) in Gammarus fossarum to assess the impact of contaminants on their access to energy resources. However, to enable objective assessment of a toxic effect of decreased water quality on an organisms' digestive capacity, it is necessary to establish reference values based on its natural variability as a function of changing biotic and abiotic factors. To limit the confounding influence of biotic factors, a caging approach with calibrated male organisms from the same population was used. This study applied an in situ deployment at 23 sites of the Rhone basin rivers, complemented by a laboratory experiment assessing the influence of two abiotic factors (temperature and conductivity). The results showed a small effect of conductivity on cellulase activity and a significant effect of temperature on digestive enzyme activity but only at the lowest temperature (7 °C). The experimental conditions allowed us to define an environmental reference value for digestive enzyme activities to select sites where the quality of the water impacted the digestive capacity of the organisms. In addition to the feeding rate, this study showed the relevance of digestive enzymes as biomarkers to be used as an early warning tool to reflect organisms' health and the chemical quality of aquatic ecosystems.

Using an innovative combination of quality-by-design and green analytical chemistry approaches for the development of a stability indicating UHPLC method in pharmaceutical products.

PubMed

Boussès, Christine; Ferey, Ludivine; Vedrines, Elodie; Gaudin, Karen

2015-11-10

An innovative combination of green chemistry and quality by design (QbD) approach is presented through the development of an UHPLC method for the analysis of the main degradation products of dextromethorphan hydrobromide. QbD strategy was integrated to the field of green analytical chemistry to improve method understanding while assuring quality and minimizing environmental impacts, and analyst exposure. This analytical method was thoroughly evaluated by applying risk assessment and multivariate analysis tools. After a scouting phase aimed at selecting a suitable stationary phase and an organic solvent in accordance with green chemistry principles, quality risk assessment tools were applied to determine the critical process parameters (CPPs). The effects of the CPPs on critical quality attributes (CQAs), i.e., resolutions, efficiencies, and solvent consumption were further evaluated by means of a screening design. A response surface methodology was then carried out to model CQAs as function of the selected CPPs and the optimal separation conditions were determined through a desirability analysis. Resulting contour plots enabled to establish the design space (DS) (method operable design region) where all CQAs fulfilled the requirements. An experimental validation of the DS proved that quality within the DS was guaranteed; therefore no more robustness study was required before the validation. Finally, this UHPLC method was validated using the concept of total error and was used to analyze a pharmaceutical drug product. Copyright © 2015 Elsevier B.V. All rights reserved.

Variation in the health and biochemical condition of the coral Acropora tenuis along two water quality gradients on the Great Barrier Reef, Australia.

PubMed

Rocker, Melissa M; Francis, David S; Fabricius, Katharina E; Willis, Bette L; Bay, Line K

2017-06-30

This study explores how plasticity in biochemical attributes, used as indicators of health and condition, enables the coral Acropora tenuis to respond to differing water quality regimes in inshore regions of the Great Barrier Reef. Health attributes were monitored along a strong and weak water quality gradient, each with three reefs at increasing distances from a major river source. Attributes differed significantly only along the strong gradient; corals grew fastest, had the least dense skeletons, highest symbiont densities and highest lipid concentrations closest to the river mouth, where water quality was poorest. High nutrient and particulate loads were only detrimental to skeletal density, which decreased as linear extension increased, highlighting a trade-off. Our study underscores the importance of assessing multiple health attributes in coral reef monitoring. For example, autotrophic indices are poor indicators of coral health and condition, but improve when combined with attributes like lipid content and biomass. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enablers of and barriers to high quality clinical supervision among occupational therapists across Queensland in Australia: findings from a qualitative study.

PubMed

Martin, Priya; Kumar, Saravana; Lizarondo, Lucylynn; VanErp, Ans

2015-09-24

Health professionals practising in countries with dispersed populations such as Australia rely on clinical supervision for professional support. While there are directives and guidelines in place to govern clinical supervision, little is known about how it is actually conducted and what makes it effective. The purpose of this study was to explore the enablers of and barriers to high quality clinical supervision among occupational therapists across Queensland in Australia. This qualitative study took place as part of a broader project. Individual, in-depth, semi-structured interviews were conducted with occupational therapy supervisees in Queensland. The interviews explored the enablers of and barriers to high quality clinical supervision in this group. They further explored some findings from the initial quantitative study. Content analysis of the interview data resulted in eight themes. These themes were broadly around the importance of the supervisory relationship, the impact of clinical supervision and the enablers of and barriers to high quality clinical supervision. This study identified a number of factors that were perceived to be associated with high quality clinical supervision. Supervisor-supervisee matching and fit, supervisory relationship and availability of supervisor for support in between clinical supervision sessions appeared to be associated with perceptions of higher quality of clinical supervision received. Some face-to-face contact augmented with telesupervision was found to improve perceptions of the quality of clinical supervision received via telephone. Lastly, dual roles where clinical supervision and line management were provided by the same person were not considered desirable by supervisees. A number of enablers of and barriers to high quality clinical supervision were also identified. With clinical supervision gaining increasing prominence as part of organisational and professional governance, this study provides important lessons for successful and sustainable clinical supervision in practice contexts.

Quality of Life and Congenital Heart Disease in Childhood and Adolescence

PubMed Central

Bertoletti, Juliana; Marx, Giovana Caroline; Hattge, Sérgio Pedro; Pellanda, Lucia Campos

2014-01-01

Advances in cardiac surgery techniques and early diagnosis have enabled the increased survival of individuals with congenital heart disease. The investigation of the quality of life in children and adolescents with congenital heart disease provides complementary information to clinical data that can assist in decision making on the part of health professionals. Although many studies have been conducted to investigate the quality of life of children and adolescents with congenital heart disease, the results prove to be contradictory; while some studies show that congenital heart disease can impact the quality of life, others describe a better perception of quality of life among children and adolescents who suffer from the disease when compared with healthy control subjects. The purpose of this study is to review the literature on the assessment of health related quality of life in children and adolescents with congenital heart disease, in order to systematize the existing knowledge on this topic today. It is observed that research seeks to investigate aspects of personality in cardiac patients, their coping strategies used and perceived social support, aiming at better understanding the association of these variables with the level of quality of life in this population. PMID:24676375

Building quality mHealth for low resource settings.

PubMed

Ettinger, Kate Michi; Pharaoh, Hamilton; Buckman, Reymound Yaw; Conradie, Hoffie; Karlen, Walter

In low- and middle-income countries (LMIC), community health care workers (CHCW) are the primary point of care for millions of people. Mobile phone health applications (mHealth app) are the preferred technology platform to deliver clinical support to CHCW. In LMIC, limited regulatory oversight exists to guide quality and safety for medical devices, including mHealth. During the development of a mHealth app to assist CHCW with patient assessment and clinical diagnosis in rural South Africa, we applied human-centred design (HCD) and a bioethics consultation. The HCD approach enabled us to develop a mHealth app that responded to the needs and capacities of CHCW. The bioethics consultation prompted early consideration of safety concerns, social implications of our mHealth app and our technology's impact on the CHCW-patient relationship. In this study, we found that combining a HCD approach with bioethics consultation improved the design quality and reduced safety concerns for our mHealth app.

Opening the black box of ethics policy work: evaluating a covert practice.

PubMed

Frolic, Andrea; Drolet, Katherine; Bryanton, Kim; Caron, Carole; Cupido, Cynthia; Flaherty, Barb; Fung, Sylvia; McCall, Lori

2012-01-01

Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the "black box" of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews.

Design of an instrument to measure the quality of care in Physical Therapy.

PubMed

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; Prado, Cristiane do; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.

SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia.

PubMed

Nguyen, Thuong T; McKinney, Barbara; Pierson, Antoine; Luong, Khue N; Hoang, Quynh T; Meharwal, Sandeep; Carvalho, Humberto M; Nguyen, Cuong Q; Nguyen, Kim T; Bond, Kyle B

2014-01-01

The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. However, the paper-based format of the checklist makes administration cumbersome and limits timely analysis and communication of results. In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors' feedback about usability. The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries.

Towards an IMU Evaluation Framework for Human Body Tracking.

PubMed

Venek, Verena; Kremser, Wolfgang; Schneider, Cornelia

2018-01-01

Existing full-body tracking systems, which use Inertial Measurement Units (IMUs) as sensing unit, require expert knowledge for setup and data collection. Thus, the daily application for human body tracking is difficult. In particular, in the field of active and assisted living (AAL), tracking human movements would enable novel insights not only into the quantity but also into the quality of human movement, for example by monitoring functional training. While the current market offers a wide range of products with vastly different properties, literature lacks guidelines for choosing IMUs for body tracking applications. Therefore, this paper introduces developments towards an IMU evaluation framework for human body tracking which compares IMUs against five requirement areas that consider device features and data quality. The data quality is assessed by conducting a static and a dynamic error analysis. In a first application to four IMUs of different component consumption, the IMU evaluation framework convinced as promising tool for IMU selection.

Mini-implants for orthodontic anchorage.

PubMed

Reynders, Reint Meursinge; Ladu, Luisa

2017-10-27

Data sourcesPubmed, Embase, Cochrane Central Register of Controlled Trials and the Web of Science databases. Hand searches of the journals European Journal of Orthodontics, Journal of Orthodontics, Journal of Clinical Orthodontics, Seminars in Orthodontics, American Journal of Orthodontics & Dentofacial Orthopaedics and Angle Orthodontist.Study selectionTwo reviewers independently selected studies. Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of orthodontic patients requiring extraction of the maxillary first premolars and closure of the spaces without anchorage loss were considered.Data extraction and synthesisData extraction and risk of bias assessment were carried out independently by two reviewers. Meta-analysis and sensitivity analysis were conducted.ResultsFourteen studies; seven RCTS and seven CCTs were included. In total 303 patients received TISADs with 313 control patients. Overall the quality of the studies was considered to be moderate. Overall the TISAD group had significantly less anchorage loss than the control group. On average, TISADs enabled 1.86mm more anchorage preservation than did conventional methods.ConclusionsThe results of the meta-analysis showed that TISADs are more effective than conventional methods of anchorage reinforcement. The average difference of 2mm seems not only statistically but also clinically significant. However, the results should be interpreted with caution because of the moderate quality of the included studies. More high-quality studies on this issue are necessary to enable drawing more reliable conclusions.

DESCQA: An Automated Validation Framework for Synthetic Sky Catalogs

NASA Astrophysics Data System (ADS)

Mao, Yao-Yuan; Kovacs, Eve; Heitmann, Katrin; Uram, Thomas D.; Benson, Andrew J.; Campbell, Duncan; Cora, Sofía A.; DeRose, Joseph; Di Matteo, Tiziana; Habib, Salman; Hearin, Andrew P.; Bryce Kalmbach, J.; Krughoff, K. Simon; Lanusse, François; Lukić, Zarija; Mandelbaum, Rachel; Newman, Jeffrey A.; Padilla, Nelson; Paillas, Enrique; Pope, Adrian; Ricker, Paul M.; Ruiz, Andrés N.; Tenneti, Ananth; Vega-Martínez, Cristian A.; Wechsler, Risa H.; Zhou, Rongpu; Zu, Ying; The LSST Dark Energy Science Collaboration

2018-02-01

The use of high-quality simulated sky catalogs is essential for the success of cosmological surveys. The catalogs have diverse applications, such as investigating signatures of fundamental physics in cosmological observables, understanding the effect of systematic uncertainties on measured signals and testing mitigation strategies for reducing these uncertainties, aiding analysis pipeline development and testing, and survey strategy optimization. The list of applications is growing with improvements in the quality of the catalogs and the details that they can provide. Given the importance of simulated catalogs, it is critical to provide rigorous validation protocols that enable both catalog providers and users to assess the quality of the catalogs in a straightforward and comprehensive way. For this purpose, we have developed the DESCQA framework for the Large Synoptic Survey Telescope Dark Energy Science Collaboration as well as for the broader community. The goal of DESCQA is to enable the inspection, validation, and comparison of an inhomogeneous set of synthetic catalogs via the provision of a common interface within an automated framework. In this paper, we present the design concept and first implementation of DESCQA. In order to establish and demonstrate its full functionality we use a set of interim catalogs and validation tests. We highlight several important aspects, both technical and scientific, that require thoughtful consideration when designing a validation framework, including validation metrics and how these metrics impose requirements on the synthetic sky catalogs.

Clinical Quality Performance in U.S. Health Centers

PubMed Central

Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen

2012-01-01

Objective To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. Data Sources National data from the 2009 Uniform Data System. Data Collection/Extraction Methods Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Study Design Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Principal Findings Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Conclusions Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. PMID:22594465

Invited review: A position on the Global Livestock Environmental Assessment Model (GLEAM).

PubMed

MacLeod, M J; Vellinga, T; Opio, C; Falcucci, A; Tempio, G; Henderson, B; Makkar, H; Mottet, A; Robinson, T; Steinfeld, H; Gerber, P J

2018-02-01

The livestock sector is one of the fastest growing subsectors of the agricultural economy and, while it makes a major contribution to global food supply and economic development, it also consumes significant amounts of natural resources and alters the environment. In order to improve our understanding of the global environmental impact of livestock supply chains, the Food and Agriculture Organization of the United Nations has developed the Global Livestock Environmental Assessment Model (GLEAM). The purpose of this paper is to provide a review of GLEAM. Specifically, it explains the model architecture, methods and functionality, that is the types of analysis that the model can perform. The model focuses primarily on the quantification of greenhouse gases emissions arising from the production of the 11 main livestock commodities. The model inputs and outputs are managed and produced as raster data sets, with spatial resolution of 0.05 decimal degrees. The Global Livestock Environmental Assessment Model v1.0 consists of five distinct modules: (a) the Herd Module; (b) the Manure Module; (c) the Feed Module; (d) the System Module; (e) the Allocation Module. In terms of the modelling approach, GLEAM has several advantages. For example spatial information on livestock distributions and crops yields enables rations to be derived that reflect the local availability of feed resources in developing countries. The Global Livestock Environmental Assessment Model also contains a herd model that enables livestock statistics to be disaggregated and variation in livestock performance and management to be captured. Priorities for future development of GLEAM include: improving data quality and the methods used to perform emissions calculations; extending the scope of the model to include selected additional environmental impacts and to enable predictive modelling; and improving the utility of GLEAM output.

Oncology Nurses' Attitudes Toward the Edmonton Symptom Assessment System: Results From a Large Cancer Care Ontario Study.

PubMed

Green, Esther; Yuen, Dora; Chasen, Martin; Amernic, Heidi; Shabestari, Omid; Brundage, Michael; Krzyzanowska, Monika K; Klinger, Christopher; Ismail, Zahra; Pereira, José

2017-01-01

To examine oncology nurses' attitudes toward and reported use of the Edmonton Symptom Assessment System (ESAS) and to determine whether the length of work experience and presence of oncology certification are associated with their attitudes and reported usage.
. Exploratory, mixed-methods study employing a questionnaire approach.
. 14 regional cancer centers (RCCs) in Ontario, Canada.
. Oncology nurses who took part in a larger province-wide study that surveyed 960 interdisciplinary providers in oncology care settings at all of Ontario's 14 RCCs.
. Oncology nurses' attitudes and use of ESAS were measured using a 21-item investigator-developed questionnaire. Descriptive statistics and Kendall's tau-b or tau-c test were used for data analyses. Qualitative responses were analyzed using content analysis.
. Attitudes toward and self-reported use of standardized symptom screening and ESAS.
. More than half of the participants agreed that ESAS improves symptom screening, most said they would encourage their patients to complete ESAS, and most felt that managing symptoms is within their scope of practice and clinical responsibilities. Qualitative comments provided additional information elucidating the quantitative responses. Statistical analyses revealed that oncology nurses who have 10 years or less of work experience were more likely to agree that the use of standardized, valid instruments to screen for and assess symptoms should be considered best practice, ESAS improves symptom screening, and ESAS enables them to better manage patients' symptoms. No statistically significant difference was found between oncology-certified RNs and noncertified RNs on attitudes or reported use of ESAS.
. Implementing a population-based symptom screening approach is a major undertaking. The current study found that oncology nurses recognize the value of standardized screening, as demonstrated by their attitudes toward ESAS.
. Oncology nurses are integral to providing high-quality person-centered care. Using standardized approaches that enable patients to self-report symptoms and understanding barriers and enablers to optimal use of patient-reported outcome tools can improve the quality of patient care.

Unprecedently Large-Scale Kinase Inhibitor Set Enabling the Accurate Prediction of Compound–Kinase Activities: A Way toward Selective Promiscuity by Design?

PubMed Central

2016-01-01

Drug discovery programs frequently target members of the human kinome and try to identify small molecule protein kinase inhibitors, primarily for cancer treatment, additional indications being increasingly investigated. One of the challenges is controlling the inhibitors degree of selectivity, assessed by in vitro profiling against panels of protein kinases. We manually extracted, compiled, and standardized such profiles published in the literature: we collected 356 908 data points corresponding to 482 protein kinases, 2106 inhibitors, and 661 patents. We then analyzed this data set in terms of kinome coverage, results reproducibility, popularity, and degree of selectivity of both kinases and inhibitors. We used the data set to create robust proteochemometric models capable of predicting kinase activity (the ligand–target space was modeled with an externally validated RMSE of 0.41 ± 0.02 log units and R02 0.74 ± 0.03), in order to account for missing or unreliable measurements. The influence on the prediction quality of parameters such as number of measurements, Murcko scaffold frequency or inhibitor type was assessed. Interpretation of the models enabled to highlight inhibitors and kinases properties correlated with higher affinities, and an analysis in the context of kinases crystal structures was performed. Overall, the models quality allows the accurate prediction of kinase-inhibitor activities and their structural interpretation, thus paving the way for the rational design of compounds with a targeted selectivity profile. PMID:27482722

RNA-SeQC: RNA-seq metrics for quality control and process optimization.

PubMed

DeLuca, David S; Levin, Joshua Z; Sivachenko, Andrey; Fennell, Timothy; Nazaire, Marc-Danie; Williams, Chris; Reich, Michael; Winckler, Wendy; Getz, Gad

2012-06-01

RNA-seq, the application of next-generation sequencing to RNA, provides transcriptome-wide characterization of cellular activity. Assessment of sequencing performance and library quality is critical to the interpretation of RNA-seq data, yet few tools exist to address this issue. We introduce RNA-SeQC, a program which provides key measures of data quality. These metrics include yield, alignment and duplication rates; GC bias, rRNA content, regions of alignment (exon, intron and intragenic), continuity of coverage, 3'/5' bias and count of detectable transcripts, among others. The software provides multi-sample evaluation of library construction protocols, input materials and other experimental parameters. The modularity of the software enables pipeline integration and the routine monitoring of key measures of data quality such as the number of alignable reads, duplication rates and rRNA contamination. RNA-SeQC allows investigators to make informed decisions about sample inclusion in downstream analysis. In summary, RNA-SeQC provides quality control measures critical to experiment design, process optimization and downstream computational analysis. See www.genepattern.org to run online, or www.broadinstitute.org/rna-seqc/ for a command line tool.

Adaptive Statistical Iterative Reconstruction-V: Impact on Image Quality in Ultralow-Dose Coronary Computed Tomography Angiography.

PubMed

Benz, Dominik C; Gräni, Christoph; Mikulicic, Fran; Vontobel, Jan; Fuchs, Tobias A; Possner, Mathias; Clerc, Olivier F; Stehli, Julia; Gaemperli, Oliver; Pazhenkottil, Aju P; Buechel, Ronny R; Kaufmann, Philipp A

The clinical utility of a latest generation iterative reconstruction algorithm (adaptive statistical iterative reconstruction [ASiR-V]) has yet to be elucidated for coronary computed tomography angiography (CCTA). This study evaluates the impact of ASiR-V on signal, noise and image quality in CCTA. Sixty-five patients underwent clinically indicated CCTA on a 256-slice CT scanner using an ultralow-dose protocol. Data sets from each patient were reconstructed at 6 different levels of ASiR-V. Signal intensity was measured by placing a region of interest in the aortic root, LMA, and RCA. Similarly, noise was measured in the aortic root. Image quality was visually assessed by 2 readers. Median radiation dose was 0.49 mSv. Image noise decreased with increasing levels of ASiR-V resulting in a significant increase in signal-to-noise ratio in the RCA and LMA (P < 0.001). Correspondingly, image quality significantly increased with higher levels of ASiR-V (P < 0.001). ASiR-V yields substantial noise reduction and improved image quality enabling introduction of ultralow-dose CCTA.

Evaluation of the quality of the teaching-learning process in undergraduate courses in Nursing 1

PubMed Central

González-Chordá, Víctor Manuel; Maciá-Soler, María Loreto

2015-01-01

Abstract Objective: to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing. Method: prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis. Results: nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p<0.05). There are statistically significant differences depending on the hospital and clinical practices unit (p<0.05). Conclusion: the analysis of the evaluation tools used in the article "Nursing Care in Welfare Processes" of the analyzed university undergraduate course enabled the detection of the areas for improvement in the teachinglearning process. The challenge of education in nursing is to reach the best clinical research and educational results, in order to provide improvements to the quality of education and health care. PMID:26444173

Practice leadership and active support in residential services for people with intellectual disabilities: an exploratory study.

PubMed

Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B

2014-09-01

We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Need and greed in dermatology: disease and outcome measures in dermatological healthcare planning.

PubMed

Dalgard, Florence; Finlay, Andrew Y

2006-01-01

Assessing dermatological needs in the population and our ability to meet them is a challenge. The choice of outcome measures is central in dermatological healthcare planning. The concept of ill health and its relationship to dermatological outcome measures is described. Outcome measures used should provide information on these issues in order to gain insight into genuine needs and illness behavior in the population and to ensure quality of healthcare. Nevertheless, the dilemma of assigning priorities in healthcare planning remains; outcome measures in dermatology should be perceived as appropriate by patients as well as by caregivers and policy makers. It is important to stimulate research to develop and refine person-focused outcome measures. Their use is essential to assess dermatological health needs and to understand illness behavior. The information they can provide can enable provision and evaluation of healthcare quality and contribute to the challenge of making appropriate priority decisions in healthcare. Copyright (c) 2006 S. Karger AG, Basel.

[Development of an instrument for the surveillance of quality indicators in specialized training in Preventive Medicine and Public Health].

PubMed

Gil-Borrelli, Christian Carlo; Latasa, Pello; Reques, Laura; Alemán, Guadalupe

2015-01-01

This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

An analysis of computer-assisted pre-screening prior to elective surgery.

PubMed

Grant, C; Ludbrook, G L; O'Loughlin, E J; Corcoran, T B

2012-03-01

In order to assess the potential utility of guided patient self-assessment as an early preoperative triage tool, a computer-assisted questionnaire delivered by a non-clinician via telephone was 1) compared to face-to-face interview and examination by anaesthetists in outpatient clinics and 2) evaluated as a mechanism to stream patients to day of surgery assessment. In total, 514 patients scheduled for elective surgery in two tertiary public hospitals were assessed initially by telephone and then in an outpatient clinic. Both forms of assessment were marked by panels of specialist anaesthetists, who also provided an opinion on which patients would have been suitable to bypass preoperative anaesthetic outpatient assessment based upon information provided by the telephone interview. Overall, the quality of assessment provided by non-clinician telephone interview was comparable to face-to-face interview by anaesthetists, although more complex issues required face-to-face assessment. Panel review considered that 398 patients (60%) would not have required evaluation by an anaesthetist until the day of surgery, thus avoiding the need to separately attend a preoperative outpatient clinic. The sensitivity of telephone interview provided information to correctly classify patients as suitable for day of surgery evaluation was 98% (95% confidence interval 96 to 99%) with a specificity of 97% (95% confidence interval 92 to 98%). This study demonstrates that remote computer-assisted assessment can produce quality patient health information and enable early patient work-up and triage with the potential to reduce costs through more efficient use of resources.

Safety Assurance Factors for Electronic Health Record Resilience (SAFER): study protocol

PubMed Central

2013-01-01

Background Implementation and use of electronic health records (EHRs) could lead to potential improvements in quality of care. However, the use of EHRs also introduces unique and often unexpected patient safety risks. Proactive assessment of risks and vulnerabilities can help address potential EHR-related safety hazards before harm occurs; however, current risk assessment methods are underdeveloped. The overall objective of this project is to develop and validate proactive assessment tools to ensure that EHR-enabled clinical work systems are safe and effective. Methods/Design This work is conceptually grounded in an 8-dimension model of safe and effective health information technology use. Our first aim is to develop self-assessment guides that can be used by health care institutions to evaluate certain high-risk components of their EHR-enabled clinical work systems. We will solicit input from subject matter experts and relevant stakeholders to develop guides focused on 9 specific risk areas and will subsequently pilot test the guides with individuals representative of likely users. The second aim will be to examine the utility of the self-assessment guides by beta testing the guides at selected facilities and conducting on-site evaluations. Our multidisciplinary team will use a variety of methods to assess the content validity and perceived usefulness of the guides, including interviews, naturalistic observations, and document analysis. The anticipated output of this work will be a series of self-administered EHR safety assessment guides with clear, actionable, checklist-type items. Discussion Proactive assessment of patient safety risks increases the resiliency of health care organizations to unanticipated hazards of EHR use. The resulting products and lessons learned from the development of the assessment guides are expected to be helpful to organizations that are beginning the EHR selection and implementation process as well as those that have already implemented EHRs. Findings from our project, currently underway, will inform future efforts to validate and implement tools that can be used by health care organizations to improve the safety of EHR-enabled clinical work systems. PMID:23587208

Enabling Ethical Code Embeddedness in Construction Organizations: A Review of Process Assessment Approach.

PubMed

Oladinrin, Olugbenga Timo; Ho, Christabel Man-Fong

2016-08-01

Several researchers have identified codes of ethics (CoEs) as tools that stimulate positive ethical behavior by shaping the organisational decision-making process, but few have considered the information needed for code implementation. Beyond being a legal and moral responsibility, ethical behavior needs to become an organisational priority, which requires an alignment process that integrates employee behavior with the organisation's ethical standards. This paper discusses processes for the responsible implementation of CoEs based on an extensive review of the literature. The internationally recognized European Foundation for Quality Management Excellence Model (EFQM model) is proposed as a suitable framework for assessing an organisation's ethical performance, including CoE embeddedness. The findings presented herein have both practical and research implications. They will encourage construction practitioners to shift their attention from ethical policies to possible enablers of CoE implementation and serve as a foundation for further research on ethical performance evaluation using the EFQM model. This is the first paper to discuss the model's use in the context of ethics in construction practice.

GP Networks as enablers of quality of care: implementing a practice engagement framework in a General Practice Network.

PubMed

Pearce, Christopher; Shearer, Marianne; Gardner, Karina; Kelly, Jill; Xu, Tony Baixian

2012-01-01

This paper describes how the Melbourne East General Practice Network supports general practice to enable quality of care, it describes the challenges and enablers of change, and the evidence of practice capacity building and improved quality of care. Primary care is well known as a place where quality, relatively inexpensive medical care occurs. General practice is made up of multiple small sites with fragmented systems and a funding system that challenges a whole-of-practice approach to clinical care. General Practice Networks support GPs to synthesise complexity and crystallise solutions that enhance general practice beyond current capacity. Through a culture of change management, GP Networks create the link between the practice and the big picture of the whole health system and reduce the isolation of general practice. They distribute information (evidence-based learning and resources) and provide individualised support, responding to practice need and capacity.

IT investments can add business value.

PubMed

Williams, Terry G

2002-05-01

Investment in information technology (IT) is costly, but necessary to enable healthcare organizations to improve their infrastructure and achieve other improvement initiatives. Such an investment is even more costly, however, if the technology does not appropriately enable organizations to perform business processes that help them accomplish their mission of providing safe, high-quality care cost-effectively. Before committing to a costly IT investment, healthcare organizations should implement a decision-making process that can help them choose, implement, and use technology that will provide sustained business value. A seven-step decision-making process that can help healthcare organizations achieve this result involves performing a gap analysis, assessing and aligning organizational goals, establishing distributed accountability, identifying linked organizational-change initiatives, determining measurement methods, establishing appropriate teams to ensure systems are integrated with multidisciplinary improvement methods, and developing a plan to accelerate adoption of the IT product.

Development of the High-Order Decoupled Direct Method in Three Dimensions for Particulate Matter: Enabling Advanced Sensitivity Analysis in Air Quality Models

EPA Science Inventory

The high-order decoupled direct method in three dimensions for particular matter (HDDM-3D/PM) has been implemented in the Community Multiscale Air Quality (CMAQ) model to enable advanced sensitivity analysis. The major effort of this work is to develop high-order DDM sensitivity...

The use of cryopreserved sea urchin embryos (Paracentrotus lividus) in marine quality assessment.

PubMed

Paredes, E; Bellas, J

2015-06-01

We have established for first time an ecotoxicological bioassay using cryopreserved sea urchin embryos (Paracentotus lividus) and provided a comparison to the already standardized sea urchin embryo-larval bioassay, using selected (organic and inorganic) pollutants and sediment elutriates from 4 different locations from Ria de Vigo harbour (Galicia, NW Iberian Peninsula). A cryopreservation protocol was designed in order to enable the successful cryopreservation and cryobanking of gametes and embryos to be used for marine quality assessment and ensure the accessibility to high quality reproductive material all year round, as an option to conditioning adults for out of season reproduction. The calculated EC50 using the cryopreserved blastula was 53.7 μg L(-1) for copper, 81.0 μg L(-1) for lead, 300.6 μg L(-1) for BP-3 and 300.6 μg L(-1) for 4-MBC. The sensitivity of the classic sea urchin embryo-larval bioassay was compared with the bioassay conducted with cryopreserved blastula. The results showed that the use of cryopreserved blastula bioassay allows detecting lower concentrations of pollutants in comparison with the classic bioassay. Copyright © 2015 Elsevier Ltd. All rights reserved.

Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review

PubMed Central

Sawchuk, Dena; Currie, Kris; Vich, Manuel Lagravere; Palomo, Juan Martin

2016-01-01

Objective To evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies. Methods An electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2. Results Nine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies. Conclusions Current evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority. PMID:27668196

High-quality remote interactive imaging in the operating theatre

NASA Astrophysics Data System (ADS)

Grimstead, Ian J.; Avis, Nick J.; Evans, Peter L.; Bocca, Alan

2009-02-01

We present a high-quality display system that enables the remote access within an operating theatre of high-end medical imaging and surgical planning software. Currently, surgeons often use printouts from such software for reference during surgery; our system enables surgeons to access and review patient data in a sterile environment, viewing real-time renderings of MRI & CT data as required. Once calibrated, our system displays shades of grey in Operating Room lighting conditions (removing any gamma correction artefacts). Our system does not require any expensive display hardware, is unobtrusive to the remote workstation and works with any application without requiring additional software licenses. To extend the native 256 levels of grey supported by a standard LCD monitor, we have used the concept of "PseudoGrey" where slightly off-white shades of grey are used to extend the intensity range from 256 to 1,785 shades of grey. Remote access is facilitated by a customized version of UltraVNC, which corrects remote shades of grey for display in the Operating Room. The system is successfully deployed at Morriston Hospital, Swansea, UK, and is in daily use during Maxillofacial surgery. More formal user trials and quantitative assessments are being planned for the future.

Quantitative image analysis for evaluating the coating thickness and pore distribution in coated small particles.

PubMed

Laksmana, F L; Van Vliet, L J; Hartman Kok, P J A; Vromans, H; Frijlink, H W; Van der Voort Maarschalk, K

2009-04-01

This study aims to develop a characterization method for coating structure based on image analysis, which is particularly promising for the rational design of coated particles in the pharmaceutical industry. The method applies the MATLAB image processing toolbox to images of coated particles taken with Confocal Laser Scanning Microscopy (CSLM). The coating thicknesses have been determined along the particle perimeter, from which a statistical analysis could be performed to obtain relevant thickness properties, e.g. the minimum coating thickness and the span of the thickness distribution. The characterization of the pore structure involved a proper segmentation of pores from the coating and a granulometry operation. The presented method facilitates the quantification of porosity, thickness and pore size distribution of a coating. These parameters are considered the important coating properties, which are critical to coating functionality. Additionally, the effect of the coating process variations on coating quality can straight-forwardly be assessed. Enabling a good characterization of the coating qualities, the presented method can be used as a fast and effective tool to predict coating functionality. This approach also enables the influence of different process conditions on coating properties to be effectively monitored, which latterly leads to process tailoring.

Lidocaine/monoethylglycinexylidide test, galactose elimination test, and sorbitol elimination test for metabolic assessment of liver cell bioreactors.

PubMed

Gerlach, Jörg C; Brayfield, Candace; Puhl, Gero; Borneman, Reiner; Müller, Christian; Schmelzer, Eva; Zeilinger, Katrin

2010-06-01

Various metabolic tests were compared for the performance characterization of a liver cell bioreactor as a routine function assessment of cultures in a standby for patient application in clinical studies. Everyday quality assessment (QA) is essential to ensure a continuous level of cellular functional capacity in the development of hepatic progenitor cell expansion systems providing cells for regenerative medicine research; it is also of interest to meet safety requirements in bioartificial extracorporeal liver support systems under clinical evaluation. Quality criteria for the description of bioreactor cultures were developed using primary porcine liver cells as a model. Porcine liver cells isolated by collagenase perfusion with an average of 3 x 10(9) primary cells were used in 39 bioreactors for culture periods up to 33 days. Measurements of monoethylglycinexylidide synthesis and elimination of lidocaine, galactose elimination, and sorbitol elimination proved to be useful for routine QA of primary liver cell cultures. We demonstrate two methods for dispensing test substances, bolus administration and continuous, steady-state administration. Bolus test data were grouped in Standard, Therapy, Infection/Contamination, and Cell-free control groups. Statistical analyses show significant differences among all groups for every test substance. Post hoc comparisons indicated significant differences between Standard and Cell-free groups for all elimination parameters. For continuous tests, results were categorized according to number of culture days and time-dependent changes were analyzed. Continuous administration enables a better view of culture health and the time dependency of cellular function, whereas bolus administration is more flexible. Both procedures can be used to define cell function. Assessment of cellular function and bioreactor quality can contribute significantly to the quality of experimental or clinical studies in the field of hepatic bioreactor development.

A metadata reporting framework (FRAMES) for synthesis of ecohydrological observations

DOE PAGES

Christianson, Danielle S.; Varadharajan, Charuleka; Christoffersen, Bradley; ...

2017-06-20

Metadata describe the ancillary information needed for data interpretation, comparison across heterogeneous datasets, and quality control and quality assessment (QA/QC). Metadata enable the synthesis of diverse ecohydrological and biogeochemical observations, an essential step in advancing a predictive understanding of earth systems. Environmental observations can be taken across a wide range of spatiotemporal scales in a variety of measurement settings and approaches, and saved in multiple formats. Thus, well-organized, consistent metadata are required to produce usable data products from diverse observations collected in disparate field sites. However, existing metadata reporting protocols do not support the complex data synthesis needs of interdisciplinarymore » earth system research. We developed a metadata reporting framework (FRAMES) to enable predictive understanding of carbon cycling in tropical forests under global change. FRAMES adheres to best practices for data and metadata organization, enabling consistent data reporting and thus compatibility with a variety of standardized data protocols. We used an iterative scientist-centered design process to develop FRAMES. The resulting modular organization streamlines metadata reporting and can be expanded to incorporate additional data types. The flexible data reporting format incorporates existing field practices to maximize data-entry efficiency. With FRAMES’s multi-scale measurement position hierarchy, data can be reported at observed spatial resolutions and then easily aggregated and linked across measurement types to support model-data integration. FRAMES is in early use by both data providers and users. Here in this article, we describe FRAMES, identify lessons learned, and discuss areas of future development.« less

A metadata reporting framework (FRAMES) for synthesis of ecohydrological observations

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

Christianson, Danielle S.; Varadharajan, Charuleka; Christoffersen, Bradley

Metadata describe the ancillary information needed for data interpretation, comparison across heterogeneous datasets, and quality control and quality assessment (QA/QC). Metadata enable the synthesis of diverse ecohydrological and biogeochemical observations, an essential step in advancing a predictive understanding of earth systems. Environmental observations can be taken across a wide range of spatiotemporal scales in a variety of measurement settings and approaches, and saved in multiple formats. Thus, well-organized, consistent metadata are required to produce usable data products from diverse observations collected in disparate field sites. However, existing metadata reporting protocols do not support the complex data synthesis needs of interdisciplinarymore » earth system research. We developed a metadata reporting framework (FRAMES) to enable predictive understanding of carbon cycling in tropical forests under global change. FRAMES adheres to best practices for data and metadata organization, enabling consistent data reporting and thus compatibility with a variety of standardized data protocols. We used an iterative scientist-centered design process to develop FRAMES. The resulting modular organization streamlines metadata reporting and can be expanded to incorporate additional data types. The flexible data reporting format incorporates existing field practices to maximize data-entry efficiency. With FRAMES’s multi-scale measurement position hierarchy, data can be reported at observed spatial resolutions and then easily aggregated and linked across measurement types to support model-data integration. FRAMES is in early use by both data providers and users. Here in this article, we describe FRAMES, identify lessons learned, and discuss areas of future development.« less

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

PubMed

Wicherts, Jelte M

2016-01-01

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

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

PubMed Central

Wicherts, Jelte M.

2016-01-01

Background Recent controversies highlighting substandard peer review in Open Access (OA) and traditional (subscription) journals have increased the need for authors, funders, publishers, and institutions to assure quality of peer-review in academic journals. I propose that transparency of the peer-review process may be seen as an indicator of the quality of peer-review, and develop and validate a tool enabling different stakeholders to assess transparency of the peer-review process. Methods and Findings Based on editorial guidelines and best practices, I developed a 14-item tool to rate transparency of the peer-review process on the basis of journals’ websites. In Study 1, a random sample of 231 authors of papers in 92 subscription journals in different fields rated transparency of the journals that published their work. Authors’ ratings of the transparency were positively associated with quality of the peer-review process but unrelated to journal’s impact factors. In Study 2, 20 experts on OA publishing assessed the transparency of established (non-OA) journals, OA journals categorized as being published by potential predatory publishers, and journals from the Directory of Open Access Journals (DOAJ). Results show high reliability across items (α = .91) and sufficient reliability across raters. Ratings differentiated the three types of journals well. In Study 3, academic librarians rated a random sample of 140 DOAJ journals and another 54 journals that had received a hoax paper written by Bohannon to test peer-review quality. Journals with higher transparency ratings were less likely to accept the flawed paper and showed higher impact as measured by the h5 index from Google Scholar. Conclusions The tool to assess transparency of the peer-review process at academic journals shows promising reliability and validity. The transparency of the peer-review process can be seen as an indicator of peer-review quality allowing the tool to be used to predict academic quality in new journals. PMID:26824759

Development of the Japanese version of the Quality of Life in Late-stage Dementia Scale.

PubMed

Nagata, Yuma; Tanaka, Hiroyuki; Ishimaru, Daiki; Uematsu, Masayasu; Naito, Yasuo; Nishikawa, Takashi

2018-03-01

Until now, there has been no instrument to measure the quality of life (QoL) of patients with severe dementia in Japan. The purpose of this study was to translate the Quality of Life in Late-stage Dementia Scale and to evaluate the reliability and validity of the Japanese version (QUALID-J). We translated the Quality of Life in Late-stage Dementia into Japanese with permission from the original authors. We assessed a total of 70 dementia patients (14 men, 56 women; mean age: 87.4 ± 7.9 years) with the QUALID-J. The test-retest and inter-rater reliability of the QUALID-J was significant. With regard to the criterion-related validity, the correlation coefficient for the total score between the QUALID-J and Quality of Life for Alzheimer's Disease was -0.287 (P < 0.05). With regard to the construct validity, the QUALID-J total score was significantly correlated with the Mini-Mental State Examination (ρ = -0.346, P < 0.01), the Cognitive Test for Severe Dementia (ρ = -0.323, P < 0.01), the Neuropsychiatry Inventory-Nursing Home version (ρ = 0.386, P < 0.01), the Cornell Scale for Depression in Dementia (ρ = 0.262, P < 0.05), the Physical Self-Maintenance Scale (ρ = -0.283, P < 0.05), and the Pain Assessment in Advanced Dementia (ρ = 0.530, P < 0.01). The results of this study showed that the QUALID-J is a reliable and valid quality of life scale for severe dementia. This scale finally enables an adequate assessment of the quality of life of patients with severe dementia in Japan, which has not been possible until now. © 2018 Japanese Psychogeriatric Society.

Assessing the quality of digital elevation models obtained from mini unmanned aerial vehicles for overland flow modelling in urban areas

NASA Astrophysics Data System (ADS)

Leitão, João P.; Moy de Vitry, Matthew; Scheidegger, Andreas; Rieckermann, Jörg

2016-04-01

Precise and detailed digital elevation models (DEMs) are essential to accurately predict overland flow in urban areas. Unfortunately, traditional sources of DEM, such as airplane light detection and ranging (lidar) DEMs and point and contour maps, remain a bottleneck for detailed and reliable overland flow models, because the resulting DEMs are too coarse to provide DEMs of sufficient detail to inform urban overland flows. Interestingly, technological developments of unmanned aerial vehicles (UAVs) suggest that they have matured enough to be a competitive alternative to satellites or airplanes. However, this has not been tested so far. In this study we therefore evaluated whether DEMs generated from UAV imagery are suitable for urban drainage overland flow modelling. Specifically, 14 UAV flights were conducted to assess the influence of four different flight parameters on the quality of generated DEMs: (i) flight altitude, (ii) image overlapping, (iii) camera pitch, and (iv) weather conditions. In addition, we compared the best-quality UAV DEM to a conventional lidar-based DEM. To evaluate both the quality of the UAV DEMs and the comparison to lidar-based DEMs, we performed regression analysis on several qualitative and quantitative metrics, such as elevation accuracy, quality of object representation (e.g. buildings, walls and trees) in the DEM, which were specifically tailored to assess overland flow modelling performance, using the flight parameters as explanatory variables. Our results suggested that, first, as expected, flight altitude influenced the DEM quality most, where lower flights produce better DEMs; in a similar fashion, overcast weather conditions are preferable, but weather conditions and other factors influence DEM quality much less. Second, we found that for urban overland flow modelling, the UAV DEMs performed competitively in comparison to a traditional lidar-based DEM. An important advantage of using UAVs to generate DEMs in urban areas is their flexibility that enables more frequent, local, and affordable elevation data updates, allowing, for example, to capture different tree foliage conditions.

Subtask 1.18 - A Decision Tool for Watershed-Based Effluent Trading

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

Xixi Wang; Bethany A. Kurz; Marc D. Kurz

2006-11-30

Handling produced water in an economical and environmentally sound manner is vital to coalbed methane (CBM) development, which is expected to increase up to 60% in the next 10-15 years as the demand for natural gas increases. Current produced water-handling methods (e.g., shallow reinjection and infiltration impoundments) are too costly when implemented on a well-by-well basis. A watershed-based effluent credit trading approach may be a means of managing produced water at reduced cost while meeting or surpassing water quality regulations. This market-based approach allows for improved water quality management by enabling industrial, agricultural, and municipal discharge facilities to meet watermore » quality permit requirements by purchasing pollutant reduction credits from other entities within the same watershed. An evaluation of this concept was conducted for the Powder River Basin (PRB) of Montana and Wyoming by the Energy & Environmental Research Center (EERC). To conduct this assessment, the EERC collected and evaluated existing water quality information and developed the appropriate tools needed to assess the environmental and economic feasibility of specific trading scenarios. The accomplishments of this study include (1) an exploration of the available PRB water quantity and quality data using advanced statistical techniques, (2) development of an integrated water quality model that predicts the impacts of CBM produced water on stream salinity and sodicity, (3) development of an economic model that estimates costs and benefits from implementing potential trading options, (4) evaluation of hypothetical trading scenarios between select watersheds of the PRB, and (5) communication of the project concept and results to key state and federal agencies, industry representatives, and stakeholders of the PRB. The preliminary results of a basinwide assessment indicate that up to $684 million could be saved basinwide without compromising water quality as a result of implementing a watershed-based credit-trading approach.« less

Sperm quality assessment via separation and sedimentation in a microfluidic device.

PubMed

Chen, Chang-Yu; Chiang, Tsun-Chao; Lin, Cheng-Ming; Lin, Shu-Sheng; Jong, De-Shien; Tsai, Vincent F-S; Hsieh, Ju-Ton; Wo, Andrew M

2013-09-07

A major reason for infertility is due to male factors, including the quality of spermatozoa, which is a primary factor and often difficult to assess, particularly the total sperm concentration and its motile percentage. This work presents a simple microfluidic device to assess sperm quality by quantifying both total and motile sperm counts. The key design feature of the microfluidic device is two channels separated by a permeative phase-guide structure, where one channel is filled with raw semen and the other with pure buffer. The semen sample was allowed to reach equilibrium in both chambers, whereas non-motile sperms remained in the original channel, and roughly half of the motile sperms would swim across the phase-guide barrier into the buffer channel. Sperms in each channel agglomerated into pellets after centrifugation, with the corresponding area representing total and motile sperm concentrations. Total sperm concentration up to 10(8) sperms per ml and motile percentage in the range of 10-70% were tested, encompassing the cutoff value of 40% stated by World Health Organization standards. Results from patient samples show compact and robust pellets after centrifugation. Comparison of total sperm concentration between the microfluidic device and the Makler chamber reveal they agree within 5% and show strong correlation, with a coefficient of determination of R(2) = 0.97. Motile sperm count between the microfluidic device and the Makler chamber agrees within 5%, with a coefficient of determination of R(2) = 0.84. Comparison of results from the Makler Chamber, sperm quality analyzer, and the microfluidic device revealed that results from the microfluidic device agree well with the Makler chamber. The sperm microfluidic chip analyzes both total and motile sperm concentrations in one spin, is accurate and easy to use, and should enable sperm quality analysis with ease.

Life course socio-economic position and quality of life in adulthood: a systematic review of life course models

PubMed Central

2012-01-01

Background A relationship between current socio-economic position and subjective quality of life has been demonstrated, using wellbeing, life and needs satisfaction approaches. Less is known regarding the influence of different life course socio-economic trajectories on later quality of life. Several conceptual models have been proposed to help explain potential life course effects on health, including accumulation, latent, pathway and social mobility models. This systematic review aimed to assess whether evidence supported an overall relationship between life course socio-economic position and quality of life during adulthood and if so, whether there was support for one or more life course models. Methods A review protocol was developed detailing explicit inclusion and exclusion criteria, search terms, data extraction items and quality appraisal procedures. Literature searches were performed in 12 electronic databases during January 2012 and the references and citations of included articles were checked for additional relevant articles. Narrative synthesis was used to analyze extracted data and studies were categorized based on the life course model analyzed. Results Twelve studies met the eligibility criteria and used data from 10 datasets and five countries. Study quality varied and heterogeneity between studies was high. Seven studies assessed social mobility models, five assessed the latent model, two assessed the pathway model and three tested the accumulation model. Evidence indicated an overall relationship, but mixed results were found for each life course model. Some evidence was found to support the latent model among women, but not men. Social mobility models were supported in some studies, but overall evidence suggested little to no effect. Few studies addressed accumulation and pathway effects and study heterogeneity limited synthesis. Conclusions To improve potential for synthesis in this area, future research should aim to increase study comparability. Recommendations include testing all life course models within individual studies and the use of multiple measures of socio-economic position and quality of life. Comparable cross-national data would be beneficial to enable investigation of between-country differences. PMID:22873945

[Teamwork in the operating theatre: the German Observational Teamwork Assessment for Surgery (OTAS-D) and its first application in Germany].

PubMed

Passauer-Baierl, S; Chiapponi, C; Bruns, C J; Weigl, M

2014-12-01

The quality of surgical teamwork contributes to performance of the operating theatre team, service quality and patient safety in surgery. Observational tools are a feasible and reliable way to capture and evaluate teamwork in the operating theatre (OT). We introduce the German version of the Observational Teamwork Assessment for Surgery (OTAS-D) and present the first observational results from German OTs. Quality of surgical teamwork was assessed with observational teamwork assessment for surgery (OTAS-D). It evaluates five dimensions of OT teamwork: communication, coordination, cooperation/backup behaviour, leadership, and team monitoring/situation awareness. Each dimension is evaluated for each profession (surgical, nursing, and anaesthesia team) as well for each phase of the procedure (pre-, intra-, and post-operative). We observed n = 63 procedures, mainly in abdominal/general and orthopaedic surgery. Additionally, all OT team members scored their individual evaluation of the intra-operative teamwork (standardised 1-item questions). The OTAS-D evaluations showed meaningful results and differences for the OT professions as well as across the different phases of the procedures. Overall, a medium to good level of the OT teamwork was observed. There were no differences in regard to type of surgery (minimally invasive vs. open) or surgical specialties. With an increased coordination of the surgical team we observed a significantly increased cooperation of the nursing team (r = 0.36, p = 0.004). Concerning the OT staffs self-reports, the surgical and nursing teams reported higher scores for quality of surgical teamwork during the procedure than their anaesthesia team members. No significant relationships between observed quality of OT teamwork and self-reports were found. The German version of OTAS-D is a psychometrically robust method to capture the quality of teamwork in operating theatres. It enables the analyses of teamwork between the surgical, nursing and anaesthesia professions in acute surgical care. Limitations of the first application results are considered. Finally, potential applications for surgical teaching, research and quality management are discussed. Georg Thieme Verlag KG Stuttgart · New York.

Skills training after night shift work enables acquisition of endovascular technical skills on a virtual reality simulator.

PubMed

Naughton, Peter A; Aggarwal, Rajesh; Wang, Tim T; Van Herzeele, Isabelle; Keeling, Aoife N; Darzi, Ara W; Cheshire, Nicholas J W

2011-03-01

Adoption of residents' working time restrictions potentially undermines surgical training by reduction of operating room exposure. Simulation has been proposed as a way to acquire necessary skills in a laboratory environment but remains difficult to incorporate into training schedules. This study assessed whether residents working successive nights could acquire endovascular skills similar to colleagues working day shifts. This prospective observational cohort study recruited 20 junior residents, divided into day shift and night shift groups by their respective call schedule. After initial cognitive skills training, a validated renal artery stent module on an endovascular simulator was completed over a series of seven sequential shifts during 1 week. The primary outcome measure was serial technical skill assessments. Secondary measures comprised assessments of activity, cognitive performance, introspective fatigue, quality, and quantity of preceding sleep. Both groups demonstrated significant learning curves for total time at the first session median vs seventh session median (181 vs 564 seconds [P < .001]; night, 1399 vs 572 [P < .001]), fluoroscopy time (day, 702 vs 308 seconds, [P < .001]; night, 669 vs 313 [P < .001]), and contrast volume (day, 29 vs 13 mL [P < .001]; night, 40 vs 16 [P < .001]). Residents working day shifts reached plateau 1 day earlier in the above measures vs those on night duty. The night shift group walked more steps (P < .001), reviewed more patients (P < .001), performed worse on all cognitive assessments (P < .05), slept less (P < .05), had poorer quality of sleep (P = .001), and was more fatigued (P < .001) than the day shift group. Acquired skill was retained a week after completion of shifts. Technical skills training after night shift work enables acquisition of endovascular technical skills, although it takes longer than after day shift training. This study provides evidence for program directors to organize simulation-based training schedules for residents on night shift rotations. Copyright © 2011. Published by Mosby, Inc.

Building Data-Driven Pathways From Routinely Collected Hospital Data: A Case Study on Prostate Cancer

PubMed Central

Clark, Jeremy; Cooper, Colin S; Mills, Robert; Rayward-Smith, Victor J; de la Iglesia, Beatriz

2015-01-01

Background Routinely collected data in hospitals is complex, typically heterogeneous, and scattered across multiple Hospital Information Systems (HIS). This big data, created as a byproduct of health care activities, has the potential to provide a better understanding of diseases, unearth hidden patterns, and improve services and cost. The extent and uses of such data rely on its quality, which is not consistently checked, nor fully understood. Nevertheless, using routine data for the construction of data-driven clinical pathways, describing processes and trends, is a key topic receiving increasing attention in the literature. Traditional algorithms do not cope well with unstructured processes or data, and do not produce clinically meaningful visualizations. Supporting systems that provide additional information, context, and quality assurance inspection are needed. Objective The objective of the study is to explore how routine hospital data can be used to develop data-driven pathways that describe the journeys that patients take through care, and their potential uses in biomedical research; it proposes a framework for the construction, quality assessment, and visualization of patient pathways for clinical studies and decision support using a case study on prostate cancer. Methods Data pertaining to prostate cancer patients were extracted from a large UK hospital from eight different HIS, validated, and complemented with information from the local cancer registry. Data-driven pathways were built for each of the 1904 patients and an expert knowledge base, containing rules on the prostate cancer biomarker, was used to assess the completeness and utility of the pathways for a specific clinical study. Software components were built to provide meaningful visualizations for the constructed pathways. Results The proposed framework and pathway formalism enable the summarization, visualization, and querying of complex patient-centric clinical information, as well as the computation of quality indicators and dimensions. A novel graphical representation of the pathways allows the synthesis of such information. Conclusions Clinical pathways built from routinely collected hospital data can unearth information about patients and diseases that may otherwise be unavailable or overlooked in hospitals. Data-driven clinical pathways allow for heterogeneous data (ie, semistructured and unstructured data) to be collated over a unified data model and for data quality dimensions to be assessed. This work has enabled further research on prostate cancer and its biomarkers, and on the development and application of methods to mine, compare, analyze, and visualize pathways constructed from routine data. This is an important development for the reuse of big data in hospitals. PMID:26162314

The influence of physical factors on recognizing blood cells in the computer microscopy systems of acute leukemia diagnosis

NASA Astrophysics Data System (ADS)

Nikitaev, V. G.; Pronichev, A. N.; Polyakov, E. V.; Dmitrieva, V. V.; Tupitsyn, N. N.; Frenkel, M. A.; Mozhenkova, A. V.

2017-01-01

The work investigated the effect of the choice of color space component on blood cell detection based on the calculation of texture attributes of blood cells nuclei in bone marrow. The study identified the most informative color space and texture characteristics of blood cells, designed for components of these spaces. Significance ratio was introduced to assess the quality of features. We offered features that have enabled to divide lymphocytes from lymphoblasts. The selection of the features was based on the results of the data analysis.

The New Tropospheric Product of the International GNSS Service

NASA Technical Reports Server (NTRS)

Byun, Sung H.; Bar-Sever, Yoaz E.; Gendt, Gerd

2005-01-01

We compare this new approach for generating the IGS tropospheric products with the previous approach, which was based on explicit combination of total zenith delay contributions from the IGS ACs. The new approach enables the IGS to rapidly generate highly accurate and highly reliable total zenith delay time series for many hundreds of sites, thus increasing the utility of the products to weather modelers, climatologists, and GPS analysts. In this paper we describe this new method, and discuss issues of accuracy, quality control, utility of the new products and assess its benefits.

PLA coated paper containing active inorganic nanoparticles: Material characterization and fate of nanoparticles in the paper recycling process.

PubMed

Zhang, Hai; Bussini, Daniele; Hortal, Mercedes; Elegir, Graziano; Mendes, Joana; Jordá Beneyto, Maria

2016-06-01

For paper and paperboard packaging, recyclability plays an important role in conserving the resources and reducing the environmental impacts. Therefore, when it comes to the nano-enabled paper packaging material, the recyclability issue should be properly addressed. This study represents our first report on the fate of nanomaterials in paper recycling process. The packaging material of concern is a PLA (Polylactic Acid) coated paper incorporating zinc oxide nanoparticles in the coating layer. The material was characterised and assessed in a lab-scale paper recycling line. The recyclability test was based on a method adapted from ATICELCA MC501-13, which enabled to recover over 99% of the solids material. The mass balance result indicates that 86-91% zinc oxide nanoparticles ended up in the rejected material stream, mostly embedded within the polymer coating; whereas 7-16% nanoparticles ended up in the accepted material stream. Besides, the tensile strength of the recycled handsheets suggests that the nano-enabled coating had no negative impacts on the recovered fibre quality. Copyright © 2016 Elsevier Ltd. All rights reserved.

Systematic literature reviews and meta-analyses: part 6 of a series on evaluation of scientific publications.

PubMed

Ressing, Meike; Blettner, Maria; Klug, Stefanie J

2009-07-01

Because of the rising number of scientific publications, it is important to have a means of jointly summarizing and assessing different studies on a single topic. Systematic literature reviews, meta-analyses of published data, and meta-analyses of individual data (pooled reanalyses) are now being published with increasing frequency. We here describe the essential features of these methods and discuss their strengths and weaknesses. This article is based on a selective literature search. The different types of review and meta-analysis are described, the methods used in each are outlined so that they can be evaluated, and a checklist is given for the assessment of reviews and meta-analyses of scientific articles. Systematic literature reviews provide an overview of the state of research on a given topic and enable an assessment of the quality of individual studies. They also allow the results of different studies to be evaluated together when these are inconsistent. Meta-analyses additionally allow calculation of pooled estimates of an effect. The different types of review and meta-analysis are discussed with examples from the literature on one particular topic. Systematic literature reviews and meta-analyses enable the research findings and treatment effects obtained in different individual studies to be summed up and evaluated.

Providing activity for people with dementia in care homes: a cluster randomised controlled trial.

PubMed

Wenborn, Jennifer; Challis, David; Head, Jenny; Miranda-Castillo, Claudia; Popham, Carolyn; Thakur, Ruchi; Illes, Jacqueline; Orrell, Martin

2013-12-01

Activity levels remain low in care homes, but activity engagement can enhance residents' quality of life. This study aimed to assess an occupational therapy programme designed to enable care home staff to increase activity provision. A cluster randomised controlled trial with blinded assessment of outcome was conducted. A total of 210 residents with dementia in 16 care homes were recruited. Intervention homes received the programme, and control homes were provided usual care. Primary outcome is quality of life; secondary measures are dependency, challenging behaviour, depression, anxiety, severity of dementia and number and type of medication. Quality of life decreased overall with statistically significant change in staff ratings (p < 0.001). At follow-up, staff-rated quality of life was slightly lower in the intervention group (mean difference in staff ratings = -1.91, 95% CI -3.39 to -0.43, p = 0.01). There were no significant differences between the two groups for self-rated quality of life or secondary outcomes. The results may be related to the following: wide variability in how the intervention was implemented, such as low staff attendance at the education and coaching sessions, and patchy provision of additional activities to residents; or the residents' severity of dementia or the choice of outcome measures. Future studies need to pay more attention to process measures such as implementation and fidelity strategies, and outcome measures that better capture the focus of the intervention such as level of engagement and activity. Copyright © 2013 John Wiley & Sons, Ltd.

A predictive model for turfgrass color and quality evaluation using deep learning and UAV imageries

NASA Astrophysics Data System (ADS)

Phan, Claude; Raheja, Amar; Bhandari, Subodh; Green, Robert L.; Do, Dat

2017-05-01

Millions of Americans come into contact with turfgrass on a daily basis. Often undervalued and seen as visual support stimulus for a larger entity, millions of acres of turfgrass can be found on residential lawns (which also provides an area for recreation), commercial landscape, parks, athletic fields, and golf courses. Besides these uses, turfgrass provides many functional benefits to the environment, such as reducing soil erosion, cooling its surrounding area, and soil carbon sequestration. However, rapidly expanding uses of turfgrass have also raised alarm for natural resources conservation and environmental quality, the largest impact being water consumption. This paper presents a machine learning approach that can assist growers and researchers in determining the overall quality and color rating of turfgrass, thereby assisting in turfgrass management including optimized irrigation water scheduling. Tools from Google and NVIDIA enable models to be trained using deep learning techniques on personal computers or on small form factor processors that can be used aboard small unmanned aerial vehicles (UAVs). The typical evaluation process is a long, laborious process, which is subjective by nature, and thus often exposed to criticism and concern. A computational approach to quality and color assessment will provide faster, accurate, and more consistent ratings, which in turn will help increase irrigation water use efficiency. The overall goal of the ongoing research is to use deep learning techniques and UAV imageries for the turfgrass quality and color assessment and help all the stakeholders to optimize water conservation.

Glomalin accumulated in seagrass sediments reveals past alterations in soil quality due to land-use change

NASA Astrophysics Data System (ADS)

López-Merino, Lourdes; Serrano, Oscar; Adame, María Fernanda; Mateo, Miguel Ángel; Martínez Cortizas, Antonio

2015-10-01

Arbuscular mycorrhizal fungi (AMF), symbionts with most terrestrial plants, produce glomalin-related soil protein (GRSP), which plays a major role in soil structure and quality. Both fungi hyphae and protein production in soils are affected by perturbations related to land-use changes, implying that GRSP is a sensitive indicator of soil quality. Unfortunately, GRSP degrades within years to decades in oxic environments, preventing its use as palaeoecological proxy. However, GRSP is transported to marine, near-shore anoxic sediments, where it accumulates and remains non-degraded, enabling the assessment of its potential as a palaeoecological proxy for soil ecosystem's health. Exploiting this fact, we have obtained for the first time a long-term record (c. 1250 years) of GRSP content using a Posidonia oceanica seagrass mat sediment core from the Western Mediterranean (Portlligat Bay, Spain). The trends in GRSP content matched well with land-use changes related to agrarian activities reconstructed by pollen analysis. In periods of cultivation, GRSP accumulation in the mat decreased. Given the role played by GRSP, the results suggest that agrarian intensification may have resulted in perturbations to soil quality. Thus, GRSP in seagrass mat sediments can be used to assess long-term trends in continental soil quality induced by human activities. These findings open new possibilities in long-term ecology research, as other anoxic environments could be potentially valid too. Testing them would open the possibility to identify long-term patterns in soil quality and other environmental stressors that could also affect AMF and GRSP production in soils.

MRIQC: Advancing the automatic prediction of image quality in MRI from unseen sites

PubMed Central

2017-01-01

Quality control of MRI is essential for excluding problematic acquisitions and avoiding bias in subsequent image processing and analysis. Visual inspection is subjective and impractical for large scale datasets. Although automated quality assessments have been demonstrated on single-site datasets, it is unclear that solutions can generalize to unseen data acquired at new sites. Here, we introduce the MRI Quality Control tool (MRIQC), a tool for extracting quality measures and fitting a binary (accept/exclude) classifier. Our tool can be run both locally and as a free online service via the OpenNeuro.org portal. The classifier is trained on a publicly available, multi-site dataset (17 sites, N = 1102). We perform model selection evaluating different normalization and feature exclusion approaches aimed at maximizing across-site generalization and estimate an accuracy of 76%±13% on new sites, using leave-one-site-out cross-validation. We confirm that result on a held-out dataset (2 sites, N = 265) also obtaining a 76% accuracy. Even though the performance of the trained classifier is statistically above chance, we show that it is susceptible to site effects and unable to account for artifacts specific to new sites. MRIQC performs with high accuracy in intra-site prediction, but performance on unseen sites leaves space for improvement which might require more labeled data and new approaches to the between-site variability. Overcoming these limitations is crucial for a more objective quality assessment of neuroimaging data, and to enable the analysis of extremely large and multi-site samples. PMID:28945803

Synthetic Augmented Suture Anchor Reconstruction for a Complete Traumatic Distal Triceps Tendon Rupture in a Male Professional Bodybuilder with Postoperative Biomechanical Assessment

PubMed Central

Nikolaidou, Maria-Elissavet; Banke, Ingo J.; Laios, Thomas; Petsogiannis, Konstantinos; Mourikis, Anastasios

2014-01-01

Bodybuilding is a high-risk sport for distal triceps tendon ruptures. Management, especially in high-demanding athletes, is operative with suture anchor refixation technique being frequently used. However, the rate of rerupture is high due to underlying poor tendon quality. Thus, additional augmentation could be useful. This case report presents a reconstruction technique for a complete traumatic distal triceps tendon rupture in a bodybuilder with postoperative biomechanical assessment. A 28-year-old male professional bodybuilder was treated with a synthetic augmented suture anchor reconstruction for a complete triceps tendon rupture of his right dominant elbow. Postoperative biomechanical assessment included isokinetic elbow strength and endurance testing by using multiple angular velocities to simulate the “off-season” and “precompetition” phases of training. Eighteen months postoperatively and after full return to training, the biomechanical assessment indicated that the strength and endurance of the operated elbow joint was fully restored with even higher ratings compared to the contralateral healthy arm. The described reconstruction technique can be considered as an advisable option in high-performance athletes with underlying poor tendon quality due to high tensile strength and lack of donor site morbidity, thus enabling them to restore preinjury status and achieve safe return to sports. PMID:24711944

Is there enough research output of EU projects available to assess and improve health system performance? An attempt to understand and categorise the output of EU projects conducted between 2002 and 2012.

PubMed

Zander, Britta; Busse, Reinhard

2017-02-22

Adequate performance assessment benefits from the use of disaggregated data to allow a proper evaluation of health systems. Since routinely collected data are usually not disaggregated enough to allow stratified analyses of healthcare needs, utilisation, cost and quality across different sectors, international research projects could fill this gap by exploring means to data collection or even providing individual-level data. The aim of this paper is therefore to (1) study the availability and accessibility of relevant European-funded health projects, and (2) to analyse their contents and methodologies. The European Commission Public Health Projects Database and CORDIS were searched for eligible projects, which were then analysed by information openly available online. Overall, only a few of the 39 identified projects produced data useful for proper performance assessment, due to, for example, lacking available or accessible data, or poor linkage of health status to costs and patient experiences. Other problems were insufficient databases to identify projects and poor communication of project contents and results. A new approach is necessary to improve accessibility to and coverage of data on outcomes, quality and costs of health systems enabling decision-makers and health professionals to properly assess performance.

Concept of Operations Evaluation for Using Remote-Guidance Ultrasound for Exploration Spaceflight.

PubMed

Hurst, Victor W; Peterson, Sean; Garcia, Kathleen; Ebert, Douglas; Ham, David; Amponsah, David; Dulchavsky, Scott

2015-12-01

Remote-guidance (RG) techniques aboard the International Space Station (ISS) have enabled astronauts to collect diagnostic-level ultrasound (US) images. Exploration-class missions will likely require nonformally trained sonographers to operate with greater autonomy given longer communication delays (> 6 s for missions beyond the Moon) and blackouts. Training requirements for autonomous collection of US images by non-US experts are being determined. Novice US operators were randomly assigned to one of three groups to collect standardized US images while drawing expertise from A) RG only, B) a computer training tool only, or C) both RG and a computer training tool. Images were assessed for quality and examination duration. All operators were given a 10-min standardized generic training session in US scanning. The imaging task included: 1) bone fracture assessment in a phantom and 2) Focused Assessment with Sonography in Trauma (FAST) examination in a healthy volunteer. A human factors questionnaire was also completed. Mean time for group B during FAST was shorter (20.4 vs. 22.7 min) than time for the other groups. Image quality scoring was lower than in groups A or C, but all groups produced images of acceptable diagnostic quality. RG produces US images of higher quality than those produced with only computer-based instruction. Extended communication delays in exploration missions will eliminate the option of real-time guidance, thus requiring autonomous operation. The computer program used appears effective and could be a model for future digital US expertise banks. Terrestrially, it also provides adequate self-training and mentoring mechanisms.

Comparison of methodological quality of positive versus negative comparative studies published in Indian medical journals: a systematic review.

PubMed

Charan, Jaykaran; Chaudhari, Mayur; Jackson, Ryan; Mhaskar, Rahul; Reljic, Tea; Kumar, Ambuj

2015-06-24

Published negative studies should have the same rigour of methodological quality as studies with positive findings. However, the methodological quality of negative versus positive studies is not known. The objective was to assess the reported methodological quality of positive versus negative studies published in Indian medical journals. A systematic review (SR) was performed of all comparative studies published in Indian medical journals with a clinical science focus and impact factor >1 between 2011 and 2013. The methodological quality of randomised controlled trials (RCTs) was assessed using the Cochrane risk of bias tool, and the Newcastle-Ottawa scale for observational studies. The results were considered positive if the primary outcome was statistically significant and negative otherwise. When the primary outcome was not specified, we used data on the first outcome reported in the history followed by the results section. Differences in various methodological quality domains between positive versus negative studies were assessed by Fisher's exact test. Seven journals with 259 comparative studies were included in this SR. 24% (63/259) were RCTs, 24% (63/259) cohort studies, and 49% (128/259) case-control studies. 53% (137/259) of studies explicitly reported the primary outcome. Five studies did not report sufficient data to enable us to determine if results were positive or negative. Statistical significance was determined by p value in 78.3% (199/254), CI in 2.8% (7/254), both p value and CI in 11.8% (30/254), and only descriptive in 6.3% (16/254) of studies. The overall methodological quality was poor and no statistically significant differences between reporting of methodological quality were detected between studies with positive versus negative findings. There was no difference in the reported methodological quality of positive versus negative studies. However, the uneven reporting of positive versus negative studies (72% vs 28%) indicates a publication bias in Indian medical journals with an impact factor of >1. 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.

Patients' involvement in improvement initiatives: a qualitative systematic review.

PubMed

van, Claire; McInerney, Patricia; Cooke, Richard

2015-10-01

Over the last 20 years, quality improvement in health has become an important strategy in health services in many countries. With the emphasis on quality health care, there has been a shift in social paradigms towards including service users in their own health on different levels. There is growing evidence in literature on the positive impact on health outcomes where patients are active participants in their personal care. There is however less information available on the broader influence of users on improvement in systems. The objective of this review was to identify the barriers and enablers to patients being involved in quality improvement efforts directed towards their own health care. This review considered studies that included adults and children of any age experiencing any health problem.The review considered studies that explored patient or user participation in quality improvement and the factors enabling and hindering this processThe qualitative component of this review considered studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Other texts such as opinion papers and reports were also considered. The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in this review. The searches using all identified keywords and index terms included the databases PubMed, PsycINFO, Medline, Scopus, EBSCOhost and CINAHL.Qualitative, text and opinion papers were considered for inclusion in this review.Closely related concepts like community involvement, family involvement, patients' involvement in their own care (for example, in the case of shared decision making), and patient centeredness in the context of a consultation were excluded. Qualitative and textual papers selected for retrieval were assessed by two independent reviewers for authenticity prior to inclusion in the review using the standardized critical appraisal instruments from the Joanna Briggs Institute. Qualitative and textual data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The above findings were pooled and through the identification of categories, a final meta-synthesis was formulated. Two synthesized findings were created from the included papers. Firstly, there are barriers to patients' participation in quality improvement in health and in spite of policy support for user involvement in quality improvement, it is a difficult strategy to implement. The second synthesized finding was that there are enablers to patients' involvement in quality improvement: when patients are involved in quality improvement efforts in health care, there are innovative, often unexpected, outcomes at different levels of the process, and sustaining these efforts is possible with ongoing individual or group support.Five categories which supported the synthesized findings were created through the meta-aggregative process. There are enablers and barriers to involving patients in quality improvement in health care that need to be considered when planning such interventions.Relationships and roles will need to be very clear from the outset. A developmental approach needs to be considered where support and training is part of the project. Where patients are truly engaged in service improvement, unexpected innovation occurs.There are many more reports and opinion papers published regarding this topic than there are rigorous research studies. This leaves the field open to the development of good methodological studies related to quality improvement and in particular to the participation of patients.

Assessing dam development, land use conversion, and climate change pressures on tributary river flows and water quality of the Mekong's Tonle Sap basin.

NASA Astrophysics Data System (ADS)

Cochrane, T. A.; Arias, M. E.; Oeurng, C.; Arnaiz, M.; Piman, T.

2016-12-01

The Tonle Sap Lake is Southeast Asia's most productive freshwater fishery, but the productivity of this valuable ecosystem is under threat from extensive development in the lower Mekong. With dams potentially blocking all major tributaries along the lower Mekong River, the role of local Tonle Sap basin tributaries for maintaining environmental flows, sediment loads, and fish recruitment is becoming increasingly critical. Development within the Tonle Sap basin, however, is not stagnant. Developers are proposing extensive dam development in key Tonle Sap tributaries (see Figure). Some dams will provide hydroelectricity and others will provide opportunities for large-scale irrigation resulting in agro-industrial expansion. There is thus an immediate need to assess the current situation and understand future effects of dam development and land use conversion under climate change on local riverine ecosystems. A combination of remote sensing, field visits, and hydro-meteorological data analyses enabled an assessment of water infrastructure and agricultural development in the basin. The application of SWAT for modelling flows and water quality combined with HEC-RESSIM for reservoir operations enabled for a holistic modelling approach. Initial results show that dams and land use change dominate flow and water quality responses, when compared to climate change. Large ongoing dam and irrigation development in the Pursat and Battambang subbasins will critically alter the natural river flows to the Tonle Sap Lake. Some of the observed dams did not have provisions for sediment flushing, clearing of flooded areas, fish passages, or other environmental protection measures. Poor planning and operation of this infrastructure could have dire consequences on the fragile riverine ecosystem of Tonle Sap tributaries, resulting in fish migration barriers, losses in aquatic habitats, and ecological degradation. The seemingly chaotic development in the Tonle Sap basin induces a great level of complexity in the prediction of future change in flows, sediment, and nutrients to the Tonle Sap, which needs to be overcome with improved data gathering through tools such as remote sensing. Timely interventions to the current development is needed in order to alleviate future environmental pressures.

Measurement properties of questionnaires assessing participation in children and adolescents with a disability: a systematic review.

PubMed

Rainey, Linda; van Nispen, Ruth; van der Zee, Carlijn; van Rens, Ger

2014-12-01

To critically appraise the measurement properties of questionnaires measuring participation in children and adolescents (0-18 years) with a disability. Bibliographic databases were searched for studies evaluating the measurement properties of self-report or parent-report questionnaires measuring participation in children and adolescents (0-18 years) with a disability. The methodological quality of the included studies and the results of the measurement properties were evaluated using a checklist developed on consensus-based standards. The search strategy identified 3,977 unique publications, of which 22 were selected; these articles evaluated the development and measurement properties of eight different questionnaires. The Child and Adolescent Scale of Participation was evaluated most extensively, generally showing moderate positive results on content validity, internal consistency, reliability and construct validity. The remaining questionnaires also demonstrated positive results. However, at least 50 % of the measurement properties per questionnaire were not (or only poorly) assessed. Studies of high methodological quality, using modern statistical methods, are needed to accurately assess the measurement properties of currently available questionnaires. Moreover, consensus is required on the definition of the construct 'participation' to determine content validity and to enable meaningful interpretation of outcomes.

A review of consensus test methods for established medical imaging modalities and their implications for optical coherence tomography

NASA Astrophysics Data System (ADS)

Pfefer, Joshua; Agrawal, Anant

2012-03-01

In recent years there has been increasing interest in development of consensus, tissue-phantom-based approaches for assessment of biophotonic imaging systems, with the primary goal of facilitating clinical translation of novel optical technologies. Well-characterized test methods based on tissue phantoms can provide useful tools for performance assessment, thus enabling standardization and device inter-comparison during preclinical development as well as quality assurance and re-calibration in the clinical setting. In this review, we study the role of phantom-based test methods as described in consensus documents such as international standards for established imaging modalities including X-ray CT, MRI and ultrasound. Specifically, we focus on three image quality characteristics - spatial resolution, spatial measurement accuracy and image uniformity - and summarize the terminology, metrics, phantom design/construction approaches and measurement/analysis procedures used to assess these characteristics. Phantom approaches described are those in routine clinical use and tend to have simplified morphology and biologically-relevant physical parameters. Finally, we discuss the potential for applying knowledge gained from existing consensus documents in the development of standardized, phantom-based test methods for optical coherence tomography.

Can aging in place be cost effective? A systematic review.

PubMed

Graybill, Erin M; McMeekin, Peter; Wildman, John

2014-01-01

To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement. Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

Nursing home quality of life: study of an enabling garden.

PubMed

Raske, Martha

2010-05-01

The purpose of this study was to conduct an in-depth evaluation of the impact of the construction and use of an enabling garden on resident quality of life in a rural nursing home. This qualitative study used interviews with residents, family members, staff members, and community volunteers who built the garden. Findings suggest the garden had positive effects on resident quality of life, particularly in terms of meaningful daily activities, enjoyment of daily life, resident relationships, and functional competency. Implications for research and practice are discussed.

Trends in internet search activity, media coverage, and patient-centered health information after the FDA safety communications on surgical mesh for pelvic organ prolapse.

PubMed

Stone, Benjamin V; Forde, James C; Levit, Valerie B; Lee, Richard K; Te, Alexis E; Chughtai, Bilal

2016-11-01

In July 2011, the US Food and Drug Administration (FDA) issued a safety communication regarding serious complications associated with surgical mesh for pelvic organ prolapse, prompting increased media and public attention. This study sought to analyze internet search activity and news article volume after this FDA warning and to evaluate the quality of websites providing patient-centered information. Google Trends™ was utilized to evaluate search engine trends for the term "pelvic organ prolapse" and associated terms between 1 January 2004 and 31 December 2014. Google News™ was utilized to quantify the number of news articles annually under the term "pelvic organ prolapse." The search results for the term "pelvic organ prolapse" were assessed for quality using the Health On the Net Foundation (HON) certification. There was a significant increase in search activity from 37.42 in 2010 to 57.75 in 2011, at the time of the FDA communication (p = 0.021). No other annual interval had a statistically significant increase in search activity. The single highest monthly search activity, given the value of 100, was August 2011, immediately following the July 2011 notification, with the next highest value being 98 in July 2011. Linear regression analysis of news articles per year since the FDA communication revealed r 2  = 0.88, with a coefficient of 186. Quality assessment demonstrated that 42 % of websites were HON-certified, with .gov sites providing the highest quality information. Although the 2011 FDA safety communication on surgical mesh was associated with increased public and media attention, the quality of relevant health information on the internet remains of poor quality. Future quality assurance measures may be critical in enabling patients to play active roles in their own healthcare.

Can commercial low-cost sensor platforms contribute to air quality monitoring and exposure estimates?

PubMed

Castell, Nuria; Dauge, Franck R; Schneider, Philipp; Vogt, Matthias; Lerner, Uri; Fishbain, Barak; Broday, David; Bartonova, Alena

2017-02-01

The emergence of low-cost, user-friendly and very compact air pollution platforms enable observations at high spatial resolution in near-real-time and provide new opportunities to simultaneously enhance existing monitoring systems, as well as engage citizens in active environmental monitoring. This provides a whole new set of capabilities in the assessment of human exposure to air pollution. However, the data generated by these platforms are often of questionable quality. We have conducted an exhaustive evaluation of 24 identical units of a commercial low-cost sensor platform against CEN (European Standardization Organization) reference analyzers, evaluating their measurement capability over time and a range of environmental conditions. Our results show that their performance varies spatially and temporally, as it depends on the atmospheric composition and the meteorological conditions. Our results show that the performance varies from unit to unit, which makes it necessary to examine the data quality of each node before its use. In general, guidance is lacking on how to test such sensor nodes and ensure adequate performance prior to marketing these platforms. We have implemented and tested diverse metrics in order to assess if the sensor can be employed for applications that require high accuracy (i.e., to meet the Data Quality Objectives defined in air quality legislation, epidemiological studies) or lower accuracy (i.e., to represent the pollution level on a coarse scale, for purposes such as awareness raising). Data quality is a pertinent concern, especially in citizen science applications, where citizens are collecting and interpreting the data. In general, while low-cost platforms present low accuracy for regulatory or health purposes they can provide relative and aggregated information about the observed air quality. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Evaluation of the potential use of hybrid LC-MS/MS for active drug quantification applying the 'free analyte QC concept'.

PubMed

Jordan, Gregor; Onami, Ichio; Heinrich, Julia; Staack, Roland F

2017-11-01

Assessment of active drug exposure of biologics may be crucial for drug development. Typically, ligand-binding assay methods are used to provide free/active drug concentrations. To what extent hybrid LC-MS/MS procedures enable correct 'active' drug quantification is currently under consideration. Experimental & results: The relevance of appropriate extraction condition was evaluated by a hybrid target capture immuno-affinity LC-MS/MS method using total and free/active quality controls (QCs). The rapid extraction (10 min) provided correct results, whereas overnight incubation resulted in significant overestimation of the free/active drug (monclonal antibody) concentration. Conventional total QCs were inappropriate to determine optimal method conditions in contrast to free/active QCs. The 'free/active analyte QC concept' enables development of appropriate extraction conditions for correct active drug quantification by hybrid LC-MS/MS.

P-MartCancer-Interactive Online Software to Enable Analysis of Shotgun Cancer Proteomic Datasets.

PubMed

Webb-Robertson, Bobbie-Jo M; Bramer, Lisa M; Jensen, Jeffrey L; Kobold, Markus A; Stratton, Kelly G; White, Amanda M; Rodland, Karin D

2017-11-01

P-MartCancer is an interactive web-based software environment that enables statistical analyses of peptide or protein data, quantitated from mass spectrometry-based global proteomics experiments, without requiring in-depth knowledge of statistical programming. P-MartCancer offers a series of statistical modules associated with quality assessment, peptide and protein statistics, protein quantification, and exploratory data analyses driven by the user via customized workflows and interactive visualization. Currently, P-MartCancer offers access and the capability to analyze multiple cancer proteomic datasets generated through the Clinical Proteomics Tumor Analysis Consortium at the peptide, gene, and protein levels. P-MartCancer is deployed as a web service (https://pmart.labworks.org/cptac.html), alternatively available via Docker Hub (https://hub.docker.com/r/pnnl/pmart-web/). Cancer Res; 77(21); e47-50. ©2017 AACR . ©2017 American Association for Cancer Research.

Policy perspectives on the emerging pathways of personalized medicine

PubMed Central

Downing, Gregory J.

2009-01-01

Remarkable advances in the fundamental knowledge about the biological basis of disease and technical advances in methods to assess genomic information have led the health care system to the threshold of personalized medicine. It is now feasible to consider strategic application of genomic information to guide patient management by being predictive, preemptive, and preventive, and enabling patient participation in medical decisions. Early evidence of this transition has some hallmarks of disruptive innovation to existing health care practices. Presented here is an examination of the changes underway to enable this new concept in health care in the United States, to improve precision and quality of care through innovations aimed at individualized approaches to medical decision making. A broad range of public policy positions will need to be considered for the health care delivery enterprise to accommodate the promise of this new science and technology for the benefit of patients. PMID:20135895

Smart Ultrasound Remote Guidance Experiment (SURGE)- Concept of Operations Evaluation for Using Remote Guidance Ultrasound for Planetary Space Flight

NASA Technical Reports Server (NTRS)

Hurst, Victor, IV; Peterson, Sean; Garcia, Kathleen; Sargsyan, Ashot; Ebert, Douglas; Ham, David; Amponsah, David; Dulchavsky, Scott

2010-01-01

Introduction Use of remote guidance (RG) techniques aboard the International Space Station (ISS) has enabled astronauts to collect diagnostic-level ultrasound images. Exploration class missions will require this cohort of (typically) non-formally trained sonographers to operate with greater autonomy given the longer communication delays (2 seconds for ISS vs. >6 seconds for missions beyond the Moon) and communication blackouts. To determine the feasibility and training requirements for autonomous ultrasound image collection by non-expert ultrasound operators, ultrasound images were collected from a similar cohort using three different image collection protocols: RG only, RG with a computer-based learning tool (LT), and autonomous image collection with LT. The groups were assessed for both image quality and time to collect the images. Methods Subjects were randomized into three groups: RG only, RG with LT, and autonomous with LT. Each subject received 10 minutes of standardized training before the experiment. The subjects were tasked with making the following ultrasound assessments: 1) bone fracture and 2) focused assessment with sonography in trauma (FAST) to assess a patient s abdomen. Human factors-related questionnaire data were collected immediately after the assessments. Results The autonomous group did not out-perform the two groups that received RG. The mean time for the autonomous group to collect images was less than the RG groups, however the mean image quality for the autonomous group was less compared to both RG groups. Discussion Remote guidance continues to produce higher quality ultrasound images than autonomous ultrasound operation. This is likely due to near-instant feedback on image quality from the remote guider. Expansion in communication time delays, however, diminishes the capability to provide this feedback, thus requiring more autonomous ultrasound operation. The LT has the potential to be an excellent training and coaching component for autonomous ultrasound image collection during exploration missions.

Improving the Linkages between Air Pollution Epidemiology and Quantitative Risk Assessment

PubMed Central

Bell, Michelle L.; Walker, Katy; Hubbell, Bryan

2011-01-01

Background: Air pollution epidemiology plays an integral role in both identifying the hazards of air pollution as well as supplying the risk coefficients that are used in quantitative risk assessments. Evidence from both epidemiology and risk assessments has historically supported critical environmental policy decisions. The extent to which risk assessors can properly specify a quantitative risk assessment and characterize key sources of uncertainty depends in part on the availability, and clarity, of data and assumptions in the epidemiological studies. Objectives: We discuss the interests shared by air pollution epidemiology and risk assessment communities in ensuring that the findings of epidemiological studies are appropriately characterized and applied correctly in risk assessments. We highlight the key input parameters for risk assessments and consider how modest changes in the characterization of these data might enable more accurate risk assessments that better represent the findings of epidemiological studies. Discussion: We argue that more complete information regarding the methodological choices and input data used in epidemiological studies would support more accurate risk assessments—to the benefit of both disciplines. In particular, we suggest including additional details regarding air quality, demographic, and health data, as well as certain types of data-rich graphics. Conclusions: Relatively modest changes to the data reported in epidemiological studies will improve the quality of risk assessments and help prevent the misinterpretation and mischaracterization of the results of epidemiological studies. Such changes may also benefit epidemiologists undertaking meta-analyses. We suggest workshops as a way to improve the dialogue between the two communities. PMID:21816702

DESCQA: An Automated Validation Framework for Synthetic Sky Catalogs

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

Mao, Yao-Yuan; Kovacs, Eve; Heitmann, Katrin

The use of high-quality simulated sky catalogs is essential for the success of cosmological surveys. The catalogs have diverse applications, such as investigating signatures of fundamental physics in cosmological observables, understanding the effect of systematic uncertainties on measured signals and testing mitigation strategies for reducing these uncertainties, aiding analysis pipeline development and testing, and survey strategy optimization. The list of applications is growing with improvements in the quality of the catalogs and the details that they can provide. Given the importance of simulated catalogs, it is critical to provide rigorous validation protocols that enable both catalog providers and users tomore » assess the quality of the catalogs in a straightforward and comprehensive way. For this purpose, we have developed the DESCQA framework for the Large Synoptic Survey Telescope Dark Energy Science Collaboration as well as for the broader community. The goal of DESCQA is to enable the inspection, validation, and comparison of an inhomogeneous set of synthetic catalogs via the provision of a common interface within an automated framework. Here in this paper, we present the design concept and first implementation of DESCQA. In order to establish and demonstrate its full functionality we use a set of interim catalogs and validation tests. We highlight several important aspects, both technical and scientific, that require thoughtful consideration when designing a validation framework, including validation metrics and how these metrics impose requirements on the synthetic sky catalogs.« less

DESCQA: An Automated Validation Framework for Synthetic Sky Catalogs

DOE PAGES

Mao, Yao-Yuan; Kovacs, Eve; Heitmann, Katrin; ...

2018-02-08

The use of high-quality simulated sky catalogs is essential for the success of cosmological surveys. The catalogs have diverse applications, such as investigating signatures of fundamental physics in cosmological observables, understanding the effect of systematic uncertainties on measured signals and testing mitigation strategies for reducing these uncertainties, aiding analysis pipeline development and testing, and survey strategy optimization. The list of applications is growing with improvements in the quality of the catalogs and the details that they can provide. Given the importance of simulated catalogs, it is critical to provide rigorous validation protocols that enable both catalog providers and users tomore » assess the quality of the catalogs in a straightforward and comprehensive way. For this purpose, we have developed the DESCQA framework for the Large Synoptic Survey Telescope Dark Energy Science Collaboration as well as for the broader community. The goal of DESCQA is to enable the inspection, validation, and comparison of an inhomogeneous set of synthetic catalogs via the provision of a common interface within an automated framework. Here in this paper, we present the design concept and first implementation of DESCQA. In order to establish and demonstrate its full functionality we use a set of interim catalogs and validation tests. We highlight several important aspects, both technical and scientific, that require thoughtful consideration when designing a validation framework, including validation metrics and how these metrics impose requirements on the synthetic sky catalogs.« less

Merging and Visualization of Archived Oceanographic Acoustic, Optical, and Sensor Data to Support Improved Access and Interpretation

NASA Astrophysics Data System (ADS)

Malik, M. A.; Cantwell, K. L.; Reser, B.; Gray, L. M.

2016-02-01

Marine researchers and managers routinely rely on interdisciplinary data sets collected using hull-mounted sonars, towed sensors, or submersible vehicles. These data sets can be broadly categorized into acoustic remote sensing, imagery-based observations, water property measurements, and physical samples. The resulting raw data sets are overwhelmingly large and complex, and often require specialized software and training to process. To address these challenges, NOAA's Office of Ocean Exploration and Research (OER) is developing tools to improve the discoverability of raw data sets and integration of quality-controlled processed data in order to facilitate re-use of archived oceanographic data. Majority of recently collected OER raw oceanographic data can be retrieved from national data archives (e.g. NCEI and NOAA central library). Merging of disperse data sets by scientists with diverse expertise, however remains problematic. Initial efforts at OER have focused on merging geospatial acoustic remote sensing data with imagery and water property measurements that typically lack direct geo-referencing. OER has developed `smart' ship and submersible tracks that can provide a synopsis of geospatial coverage of various data sets. Tools under development enable scientists to quickly assess the relevance of archived OER data to their respective research or management interests, and enable quick access to the desired raw and processed data sets. Pre-processing of the data and visualization to combine various data sets also offers benefits to streamline data quality assurance and quality control efforts.

An integrated toolbox for processing and analysis of remote sensing data of inland and coastal waters - atmospheric correction

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

Haan, J.F. de; Kokke, J.M.M.; Hoogenboom, H.J.

1997-06-01

Deriving thematic maps of water quality parameters from a remote sensing image requires a number of processing steps, such as calibration, atmospheric correction, air-water interface correction, and application of water quality algorithms. A prototype version of an integrated software environment has recently been developed that enables the user to perform and control these processing steps. Major parts of this environment are: (i) access to the MODTRAN 3 radiative transfer code, (ii) a database of water quality algorithms, and (iii) a spectral library of Dutch coastal and inland waters, containing subsurface irradiance reflectance spectra and associated water quality parameters. The atmosphericmore » correction part of this environment is discussed here. It is shown that this part can be used to accurately retrieve spectral signatures of inland water for wavelengths between 450 and 750 nm, provided in situ measurements are used to determine atmospheric model parameters. Assessment of the usefulness of the completely integrated software system in an operational environment requires a revised version that is presently being developed.« less

Pepitome: evaluating improved spectral library search for identification complementarity and quality assessment

PubMed Central

Dasari, Surendra; Chambers, Matthew C.; Martinez, Misti A.; Carpenter, Kristin L.; Ham, Amy-Joan L.; Vega-Montoto, Lorenzo J.; Tabb, David L.

2012-01-01

Spectral libraries have emerged as a viable alternative to protein sequence databases for peptide identification. These libraries contain previously detected peptide sequences and their corresponding tandem mass spectra (MS/MS). Search engines can then identify peptides by comparing experimental MS/MS scans to those in the library. Many of these algorithms employ the dot product score for measuring the quality of a spectrum-spectrum match (SSM). This scoring system does not offer a clear statistical interpretation and ignores fragment ion m/z discrepancies in the scoring. We developed a new spectral library search engine, Pepitome, which employs statistical systems for scoring SSMs. Pepitome outperformed the leading library search tool, SpectraST, when analyzing data sets acquired on three different mass spectrometry platforms. We characterized the reliability of spectral library searches by confirming shotgun proteomics identifications through RNA-Seq data. Applying spectral library and database searches on the same sample revealed their complementary nature. Pepitome identifications enabled the automation of quality analysis and quality control (QA/QC) for shotgun proteomics data acquisition pipelines. PMID:22217208

An overview of the KORUS-AQ field study

NASA Astrophysics Data System (ADS)

Chang, L.; Ahn, J.; Park, J.; Hong, J.; Hong, Y.; Song, C. K.; Kim, S. K.; Park, R.; Kim, J.; Lefer, B. L.; Crawford, J. H.; Al-Saadi, J. A.

2016-12-01

Korea peninsular is under the influence of the largest emission source in East Asia in addition to local emissions, complicating effective pollution control by government. An international air quality field campaign in Korea, KORUS-AQ, was conducted during 6 weeks between May-June 2016, which was led by the National Institute of Environmental Research (NIER) of Korea and the National Aeronautics and Space Administration (NASA) of the United States. The KORUS-AQ focused on the air quality of SMA with the aim of characterizing chemical evolution, improving emission inventories, assessing trans-boundary contribution and validating satellite application. 133 research teams from 80 organizations in both Korea and U.S.A were involved in KORUS-AQ with 3 research aircrafts, 2 research vessels and 16 ground sites constituting multi-platform observations framework. KORUS-AQ campaign also served the preparation for the future launch of geostationary satellite instruments; GEMS (Geostationary Environmental Monitoring Spectrometer), TEMPO(Tropospheric Emissions: Monitoring of Pollution) and Sentinel-4 which will provide real-time air quality (e.g. O3, NO2, SO2, HCHO, AOD, etc.) data enabling us better understanding of air quality in globe.

Transitioning a bachelor of science in nursing program to blended learning: Successes, challenges & outcomes.

PubMed

Posey, Laurie; Pintz, Christine

2017-09-01

To help address the challenges of providing undergraduate nursing education in an accelerated time frame, the Teaching and Transforming through Technology (T3) project was funded to transition a second-degree ABSN program to a blended learning format. The project has explored the use of blended learning to: enable flexible solutions to support teaching goals and address course challenges; provide students with new types of independent learning activities outside of the traditional classroom; increase opportunities for active learning in the classroom; and improve students' digital literacy and lifelong learning skills. Program evaluation included quality reviews of the redesigned courses, surveys of student perceptions, pre- and post-program assessment of students' digital literacy and interviews with faculty about their experiences with the new teaching methods. Adopting an established quality framework to guide course design and evaluation for quality contributed to the efficient and effective development of a high-quality undergraduate blended nursing program. Program outcomes and lessons learned are presented to inform future teaching innovation and research related to blended learning in undergraduate nursing education. Copyright © 2016 Elsevier Ltd. All rights reserved.

Applying a Data Stewardship Maturity Matrix to the NOAA Observing System Portfolio Integrated Assessment Process

NASA Astrophysics Data System (ADS)

Peng, G.; Austin, M.

2017-12-01

Identification and prioritization of targeted user community needs are not always considered until after data has been created and archived. Gaps in data curation and documentation in the data production and delivery phases limit data's broad utility specifically for decision makers. Expert understanding and knowledge of a particular dataset is often required as a part of the data and metadata curation process to establish the credibility of the data and support informed decision-making. To enhance curation practices, content from NOAA's Observing System Integrated Assessment (NOSIA) Value Tree, NOAA's Data Catalog/Digital Object Identifier (DOI) projects (collection-level metadata) have been integrated with Data/Stewardship Maturity Matrices (data and stewardship quality information) focused on assessment of user community needs. This results in user focused evidence based decision making tools created by NOAA's National Environmental Satellite, Data, and Information Service (NESDIS) through identification and assessment of data content gaps related to scientific knowledge and application to key areas of societal benefit. Through enabling user need feedback from the beginning of data creation through archive allows users to determine the quality and value of data that is fit for purpose. Data gap assessment and prioritization are presented in a user-friendly way using the data stewardship maturity matrices as measurement of data management quality. These decision maker tools encourages data producers and data providers/stewards to consider users' needs prior to data creation and dissemination resulting in user driven data requirements increasing return on investment. A use case focused on need for NOAA observations linked societal benefit will be used to demonstrate the value of these tools.

What do evaluation instruments tell us about the quality of complementary medicine information on the internet?

PubMed

Breckons, Matthew; Jones, Ray; Morris, Jenny; Richardson, Janet

2008-01-22

Developers of health information websites aimed at consumers need methods to assess whether their website is of "high quality." Due to the nature of complementary medicine, website information is diverse and may be of poor quality. Various methods have been used to assess the quality of websites, the two main approaches being (1) to compare the content against some gold standard, and (2) to rate various aspects of the site using an assessment tool. We aimed to review available evaluation instruments to assess their performance when used by a researcher to evaluate websites containing information on complementary medicine and breast cancer. In particular, we wanted to see if instruments used the same criteria, agreed on the ranking of websites, were easy to use by a researcher, and if use of a single tool was sufficient to assess website quality. Bibliographic databases, search engines, and citation searches were used to identify evaluation instruments. Instruments were included that enabled users with no subject knowledge to make an objective assessment of a website containing health information. The elements of each instrument were compared to nine main criteria defined by a previous study. Google was used to search for complementary medicine and breast cancer sites. The first six results and a purposive six from different origins (charities, sponsored, commercial) were chosen. Each website was assessed using each tool, and the percentage of criteria successfully met was recorded. The ranking of the websites by each tool was compared. The use of the instruments by others was estimated by citation analysis and Google searching. A total of 39 instruments were identified, 12 of which met the inclusion criteria; the instruments contained between 4 and 43 questions. When applied to 12 websites, there was agreement of the rank order of the sites with 10 of the instruments. Instruments varied in the range of criteria they assessed and in their ease of use. Comparing the content of websites against a gold standard is time consuming and only feasible for very specific advice. Evaluation instruments offer gateway providers a method to assess websites. The checklist approach has face validity when results are compared to the actual content of "good" and "bad" websites. Although instruments differed in the range of items assessed, there was fair agreement between most available instruments. Some were easier to use than others, but these were not necessarily the instruments most widely used to date. Combining some of the better features of instruments to provide fewer, easy-to-use methods would be beneficial to gateway providers.

High Resolution Peripheral Quantitative Computed Tomography for Assessment of Bone Quality

NASA Astrophysics Data System (ADS)

Kazakia, Galateia

2014-03-01

The study of bone quality is motivated by the high morbidity, mortality, and societal cost of skeletal fractures. Over 10 million people are diagnosed with osteoporosis in the US alone, suffering 1.5 million osteoporotic fractures and costing the health care system over 17 billion annually. Accurate assessment of fracture risk is necessary to ensure that pharmacological and other interventions are appropriately administered. Currently, areal bone mineral density (aBMD) based on 2D dual-energy X-ray absorptiometry (DXA) is used to determine osteoporotic status and predict fracture risk. Though aBMD is a significant predictor of fracture risk, it does not completely explain bone strength or fracture incidence. The major limitation of aBMD is the lack of 3D information, which is necessary to distinguish between cortical and trabecular bone and to quantify bone geometry and microarchitecture. High resolution peripheral quantitative computed tomography (HR-pQCT) enables in vivo assessment of volumetric BMD within specific bone compartments as well as quantification of geometric and microarchitectural measures of bone quality. HR-pQCT studies have documented that trabecular bone microstructure alterations are associated with fracture risk independent of aBMD.... Cortical bone microstructure - specifically porosity - is a major determinant of strength, stiffness, and fracture toughness of cortical tissue and may further explain the aBMD-independent effect of age on bone fragility and fracture risk. The application of finite element analysis (FEA) to HR-pQCT data permits estimation of patient-specific bone strength, shown to be associated with fracture incidence independent of aBMD. This talk will describe the HR-pQCT scanner, established metrics of bone quality derived from HR-pQCT data, and novel analyses of bone quality currently in development. Cross-sectional and longitudinal HR-pQCT studies investigating the impact of aging, disease, injury, gender, race, and therapeutics on bone quality will be discussed.

Seasonal assessment and apportionment of surface water pollution using multivariate statistical methods: Sinos River, southern Brazil.

PubMed

Alves, Darlan Daniel; Riegel, Roberta Plangg; de Quevedo, Daniela Müller; Osório, Daniela Montanari Migliavacca; da Costa, Gustavo Marques; do Nascimento, Carlos Augusto; Telöken, Franko

2018-06-08

Assessment of surface water quality is an issue of currently high importance, especially in polluted rivers which provide water for treatment and distribution as drinking water, as is the case of the Sinos River, southern Brazil. Multivariate statistical techniques allow a better understanding of the seasonal variations in water quality, as well as the source identification and source apportionment of water pollution. In this study, the multivariate statistical techniques of cluster analysis (CA), principal component analysis (PCA), and positive matrix factorization (PMF) were used, along with the Kruskal-Wallis test and Spearman's correlation analysis in order to interpret a water quality data set resulting from a monitoring program conducted over a period of almost two years (May 2013 to April 2015). The water samples were collected from the raw water inlet of the municipal water treatment plant (WTP) operated by the Water and Sewage Services of Novo Hamburgo (COMUSA). CA allowed the data to be grouped into three periods (autumn and summer (AUT-SUM); winter (WIN); spring (SPR)). Through the PCA, it was possible to identify that the most important parameters in contribution to water quality variations are total coliforms (TCOLI) in SUM-AUT, water level (WL), water temperature (WT), and electrical conductivity (EC) in WIN and color (COLOR) and turbidity (TURB) in SPR. PMF was applied to the complete data set and enabled the source apportionment water pollution through three factors, which are related to anthropogenic sources, such as the discharge of domestic sewage (mostly represented by Escherichia coli (ECOLI)), industrial wastewaters, and agriculture runoff. The results provided by this study demonstrate the contribution provided by the use of integrated statistical techniques in the interpretation and understanding of large data sets of water quality, showing also that this approach can be used as an efficient methodology to optimize indicators for water quality assessment.

Instruments for measuring meaningful learning in healthcare students: a systematic psychometric review.

PubMed

Cadorin, Lucia; Bagnasco, Annamaria; Tolotti, Angela; Pagnucci, Nicola; Sasso, Loredana

2016-09-01

To identify, evaluate and describe the psychometric properties of instruments that measure learning outcomes in healthcare students. Meaningful learning is an active process that enables a wider and deeper understanding of concepts. It is the result of an interaction between new and prior knowledge and produces a long-standing change in knowledge and skills. In the field of education, validated and reliable instruments for assessing meaningful learning are needed. A psychometric systematic review. MEDLINE CINAHL, SCOPUS, ERIC, Cochrane Library, Psychology & Behavioural Sciences Collection Database from 1990-December 2013. Using pre-determined inclusion criteria, three reviewers independently identified studies for full-text review. Then they extracted data for quality appraisal and graded instrument validity using the Consensus-based Standards for the selection of the health status Measurement INstruments checklist and the Psychometric Grading Framework. Of the 57 studies identified for full-text review, 16 met the inclusion criteria and 13 different instruments were assessed. Following quality assessment, only one instrument was considered of good quality but it measured meaningful learning only in part; the others were either fair or poor. The Psychometric Grading Framework indicated that one instrument was weak, while the others were very weak. No instrument displayed adequate validity. The systematic review produced a synthesis of the psychometric properties of tools that measure learning outcomes in students of healthcare disciplines. Measuring learning outcomes is very important when educating health professionals. The identified tools may constitute a starting point for the development of other assessment tools. © 2016 John Wiley & Sons Ltd.

Usefulness of DWI in preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma: a systematic review and meta-analysis

PubMed Central

2014-01-01

Background The objective of this study was to perform a systematic review and a meta-analysis in order to estimate the diagnostic accuracy of diffusion weighted imaging (DWI) in the preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma. Methods Studies evaluating DWI for the detection of deep myometrial invasion in patients with endometrial carcinoma were systematically searched for in the MEDLINE, EMBASE, and Cochrane Library from January 1995 to January 2014. Methodologic quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies tool. Bivariate random-effects meta-analytic methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and receiver operating characteristic (ROC) curves. The study also evaluated the clinical utility of DWI in preoperative assessment of deep myometrial invasion. Results Seven studies enrolling a total of 320 individuals met the study inclusion criteria. The summary area under the ROC curve was 0.91. There was no evidence of publication bias (P = 0.90, bias coefficient analysis). Sensitivity and specificity of DWI for detection of deep myometrial invasion across all studies were 0.90 and 0.89, respectively. Positive and negative likelihood ratios with DWI were 8 and 0.11 respectively. In patients with high pre-test probabilities, DWI enabled confirmation of deep myometrial invasion; in patients with low pre-test probabilities, DWI enabled exclusion of deep myometrial invasion. The worst case scenario (pre-test probability, 50%) post-test probabilities were 89% and 10% for positive and negative DWI results, respectively. Conclusion DWI has high sensitivity and specificity for detecting deep myometrial invasion and more importantly can reliably rule out deep myometrial invasion. Therefore, it would be worthwhile to add a DWI sequence to the standard MRI protocols in preoperative evaluation of endometrial cancer in order to detect deep myometrial invasion, which along with other poor prognostic factors like age, tumor grade, and LVSI would be useful in stratifying high risk groups thereby helping in the tailoring of surgical approach in patient with low risk of endometrial carcinoma. PMID:25608571

Facilitating organisational development using a group-based formative assessment and benchmarking method: design and implementation of the International Family Practice Maturity Matrix.

PubMed

Elwyn, Glyn; Bekkers, Marie-Jet; Tapp, Laura; Edwards, Adrian; Newcombe, Robert; Eriksson, Tina; Braspenning, Jozé; Kuch, Christine; Adzic, Zlata Ozvacic; Ayankogbe, Olayinka; Cvetko, Tatjana; In 't Veld, Kees; Karotsis, Antonis; Kersnik, Janko; Lefebvre, Luc; Mecini, Ilir; Petricek, Goranka; Pisco, Luis; Thesen, Janecke; Turón, José María; van Rossen, Edward; Grol, Richard

2010-12-01

Well-organised practices deliver higher-quality care. Yet there has been very little effort so far to help primary care organisations achieve higher levels of team performance and to help them identify and prioritise areas where quality improvement efforts should be concentrated. No attempt at all has been made to achieve a method which would be capable of providing comparisons--and the stimulus for further improvement--at an international level. The development of the International Family Practice Maturity Matrix took place in three phases: (1) selection and refinement of organisational dimensions; (2) development of incremental scales based on a recognised theoretical framework; and (3) testing the feasibility of the approach on an international basis, including generation of an automated web-based benchmarking system. This work has demonstrated the feasibility of developing an organisational assessment tool for primary care organisations that is sufficiently generic to cross international borders and is applicable across a diverse range of health settings, from state-organised systems to insurer-based health economies. It proved possible to introduce this assessment method in 11 countries in Europe and one in Africa, and to generate comparison benchmarks based on the data collected. The evaluation of the assessment process was uniformly positive with the view that the approach efficiently enables the identification of priorities for organisational development and quality improvement at the same time as motivating change by virtue of the group dynamics. We are not aware of any other organisational assessment method for primary care which has been 'born international,' and that has involved attention to theory, dimension selection and item refinement. The principal aims were to achieve an organisational assessment which gains added value by using interaction, engagement comparative benchmarks: aims which have been achieved. The next step is to achieve wider implementation and to ensure that those who undertake the assessment method ensure linkages are made to planned investment in organisational development and quality improvement. Knowing the problems is only half the story.

KAT: a K-mer analysis toolkit to quality control NGS datasets and genome assemblies.

PubMed

Mapleson, Daniel; Garcia Accinelli, Gonzalo; Kettleborough, George; Wright, Jonathan; Clavijo, Bernardo J

2017-02-15

De novo assembly of whole genome shotgun (WGS) next-generation sequencing (NGS) data benefits from high-quality input with high coverage. However, in practice, determining the quality and quantity of useful reads quickly and in a reference-free manner is not trivial. Gaining a better understanding of the WGS data, and how that data is utilized by assemblers, provides useful insights that can inform the assembly process and result in better assemblies. We present the K-mer Analysis Toolkit (KAT): a multi-purpose software toolkit for reference-free quality control (QC) of WGS reads and de novo genome assemblies, primarily via their k-mer frequencies and GC composition. KAT enables users to assess levels of errors, bias and contamination at various stages of the assembly process. In this paper we highlight KAT's ability to provide valuable insights into assembly composition and quality of genome assemblies through pairwise comparison of k-mers present in both input reads and the assemblies. KAT is available under the GPLv3 license at: https://github.com/TGAC/KAT . bernardo.clavijo@earlham.ac.uk. Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

The National Network of State Perinatal Quality Collaboratives: A Growing Movement to Improve Maternal and Infant Health.

PubMed

Henderson, Zsakeba T; Ernst, Kelly; Simpson, Kathleen Rice; Berns, Scott; Suchdev, Danielle B; Main, Elliott; McCaffrey, Martin; Lee, Karyn; Rouse, Tara Bristol; Olson, Christine K

2018-03-01

State Perinatal Quality Collaboratives (PQCs) are networks of multidisciplinary teams working to improve maternal and infant health outcomes. To address the shared needs across state PQCs and enable collaboration, Centers for Disease Control and Prevention (CDC), in partnership with March of Dimes and perinatal quality improvement experts from across the country, supported the development and launch of the National Network of Perinatal Quality Collaboratives (NNPQC). This process included assessing the status of PQCs in this country and identifying the needs and resources that would be most useful to support PQC development. National representatives from 48 states gathered for the first meeting of the NNPQC to share best practices for making measurable improvements in maternal and infant health. The number of state PQCs has grown considerably over the past decade, with an active PQC or a PQC in development in almost every state. However, PQCs have some common challenges that need to be addressed. After its successful launch, the NNPQC is positioned to ensure that every state PQC has access to key tools and resources that build capacity to actively improve maternal and infant health outcomes and healthcare quality.

The National Network of State Perinatal Quality Collaboratives: A Growing Movement to Improve Maternal and Infant Health.

PubMed

Henderson, Zsakeba T; Ernst, Kelly; Simpson, Kathleen Rice; Berns, Scott D; Suchdev, Danielle B; Main, Elliott; McCaffrey, Martin; Lee, Karyn; Rouse, Tara Bristol; Olson, Christine K

2018-02-01

State Perinatal Quality Collaboratives (PQCs) are networks of multidisciplinary teams working to improve maternal and infant health outcomes. To address the shared needs across state PQCs and enable collaboration, Centers for Disease Control and Prevention, in partnership with March of Dimes and perinatal quality improvement experts from across the country, supported the development and launch of the National Network of PQCs National Network of Perinatal Quality Collaboratives (NNPQC). This process included assessing the status of PQCs in this country and identifying the needs and resources that would be most useful to support PQC development. National representatives from 48 states gathered for the first meeting of the NNPQC to share best practices for making measurable improvements in maternal and infant health. The number of state PQCs has grown considerably over the past decade, with an active PQC or a PQC in development in almost every state. However, PQCs have some common challenges that need to be addressed. After its successful launch, the NNPQC is positioned to ensure that every state PQC has access to key tools and resources that build capacity to actively improve maternal and infant health outcomes and healthcare quality.

Wireless in-situ Sensor Network for Agriculture and Water Monitoring on a River Basin Scale in Southern Finland: Evaluation from a Data User’s Perspective

PubMed Central

Kotamäki, Niina; Thessler, Sirpa; Koskiaho, Jari; Hannukkala, Asko O.; Huitu, Hanna; Huttula, Timo; Havento, Jukka; Järvenpää, Markku

2009-01-01

Sensor networks are increasingly being implemented for environmental monitoring and agriculture to provide spatially accurate and continuous environmental information and (near) real-time applications. These networks provide a large amount of data which poses challenges for ensuring data quality and extracting relevant information. In the present paper we describe a river basin scale wireless sensor network for agriculture and water monitoring. The network, called SoilWeather, is unique and the first of this type in Finland. The performance of the network is assessed from the user and maintainer perspectives, concentrating on data quality, network maintenance and applications. The results showed that the SoilWeather network has been functioning in a relatively reliable way, but also that the maintenance and data quality assurance by automatic algorithms and calibration samples requires a lot of effort, especially in continuous water monitoring over large areas. We see great benefits on sensor networks enabling continuous, real-time monitoring, while data quality control and maintenance efforts highlight the need for tight collaboration between sensor and sensor network owners to decrease costs and increase the quality of the sensor data in large scale applications. PMID:22574050

Air Quality Management Alternatives: United States Air Force Firefighter Training Facilities

DTIC Science & Technology

1988-01-01

Pollution at LAX, JFK , and ORD," Impact of Aircraft Emissions on Air Quality in the Vicinity of Airports , Volume II, FAA-EE-80-09B, Federal...developed and applied . This method enabled fire prevention, and environmental management experts and professionals to provide data, opinions, and to...methodology utilizing questionnaires, interviews, and site visits is developed and applied . This method enabled fire prevention, and environmental

Health-Enabling and Ambient Assistive Technologies: Past, Present, Future.

PubMed

Haux, R; Koch, S; Lovell, N H; Marschollek, M; Nakashima, N; Wolf, K-H

2016-06-30

During the last decades, health-enabling and ambient assistive technologies became of considerable relevance for new informatics-based forms of diagnosis, prevention, and therapy. To describe the state of the art of health-enabling and ambient assistive technologies in 1992 and today, and its evolution over the last 25 years as well as to project where the field is expected to be in the next 25 years. In the context of this review, we define health-enabling and ambient assistive technologies as ambiently used sensor-based information and communication technologies, aiming at contributing to a person's health and health care as well as to her or his quality of life. Systematic review of all original articles with research focus in all volumes of the IMIA Yearbook of Medical Informatics. Surveying authors independently on key projects and visions as well as on their lessons learned in the context of health-enabling and ambient assistive technologies and summarizing their answers. Surveying authors independently on their expectations for the future and summarizing their answers. IMIA Yearbook papers containing statements on health-enabling and ambient assistive technologies appear first in 2002. These papers form a minor part of published research articles in medical informatics. However, during recent years the number of articles published has increased significantly. Key projects were identified. There was a clear progress on the use of technologies. However proof of diagnostic relevance and therapeutic efficacy remains still limited. Reforming health care processes and focussing more on patient needs are required. Health-enabling and ambient assistive technologies remain an important field for future health care and for interdisciplinary research. More and more publications assume that a person's home and their interaction therein, are becoming important components in health care provision, assessment, and management.

Health-Enabling and Ambient Assistive Technologies: Past, Present, Future

PubMed Central

2016-01-01

Summary Background During the last decades, health-enabling and ambient assistive technologies became of considerable relevance for new informatics-based forms of diagnosis, prevention, and therapy. Objectives To describe the state of the art of health-enabling and ambient assistive technologies in 1992 and today, and its evolution over the last 25 years as well as to project where the field is expected to be in the next 25 years. In the context of this review, we define health-enabling and ambient assistive technologies as ambiently used sensor-based information and communication technologies, aiming at contributing to a person’s health and health care as well as to her or his quality of life. Methods Systematic review of all original articles with research focus in all volumes of the IMIA Yearbook of Medical Informatics. Surveying authors independently on key projects and visions as well as on their lessons learned in the context of health-enabling and ambient assistive technologies and summarizing their answers. Surveying authors independently on their expectations for the future and summarizing their answers. Results IMIA Yearbook papers containing statements on health-enabling and ambient assistive technologies appear first in 2002. These papers form a minor part of published research articles in medical informatics. However, during recent years the number of articles published has increased significantly. Key projects were identified. There was a clear progress on the use of technologies. However proof of diagnostic relevance and therapeutic efficacy remains still limited. Reforming health care processes and focussing more on patient needs are required. Conclusions Health-enabling and ambient assistive technologies remain an important field for future health care and for interdisciplinary research. More and more publications assume that a person‘s home and their interaction therein, are becoming important components in health care provision, assessment, and management. PMID:27362588

SkySat-1: very high-resolution imagery from a small satellite

NASA Astrophysics Data System (ADS)

Murthy, Kiran; Shearn, Michael; Smiley, Byron D.; Chau, Alexandra H.; Levine, Josh; Robinson, M. Dirk

2014-10-01

This paper presents details of the SkySat-1 mission, which is the first microsatellite-class commercial earth- observation system to generate sub-meter resolution panchromatic imagery, in addition to sub-meter resolution 4-band pan-sharpened imagery. SkySat-1 was built and launched for an order of magnitude lower cost than similarly performing missions. The low-cost design enables the deployment of a large imaging constellation that can provide imagery with both high temporal resolution and high spatial resolution. One key enabler of the SkySat-1 mission was simplifying the spacecraft design and instead relying on ground- based image processing to achieve high-performance at the system level. The imaging instrument consists of a custom-designed high-quality optical telescope and commercially-available high frame rate CMOS image sen- sors. While each individually captured raw image frame shows moderate quality, ground-based image processing algorithms improve the raw data by combining data from multiple frames to boost image signal-to-noise ratio (SNR) and decrease the ground sample distance (GSD) in a process Skybox calls "digital TDI". Careful qual-ity assessment and tuning of the spacecraft, payload, and algorithms was necessary to generate high-quality panchromatic, multispectral, and pan-sharpened imagery. Furthermore, the framing sensor configuration en- abled the first commercial High-Definition full-frame rate panchromatic video to be captured from space, with approximately 1 meter ground sample distance. Details of the SkySat-1 imaging instrument and ground-based image processing system are presented, as well as an overview of the work involved with calibrating and validating the system. Examples of raw and processed imagery are shown, and the raw imagery is compared to pre-launch simulated imagery used to tune the image processing algorithms.

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.

Evaluation of available data sources to prioritize parishes for arsenic monitoring and outreach related to private well drinking water.

PubMed

Katner, Adrienne; Lackovic, Michelle; Streva, Kate; Paul, Vanessa; Trachtman, William Clay

2015-01-01

The objective of this assessment was to identify and evaluate data sets for use in the surveillance of arsenic hazards and private well drinking water use in Louisiana. Features, strengths, and limitations of the data sets are described, and prioritization criteria are applied to identify areas in need of further monitoring or outreach. Recent efforts have been made by the Environmental Public Health Tracking Network to evaluate the quality of private well water data for the purpose of supporting state and national surveillance activities. Like most states, Louisiana does not collect or mandate reporting of private well water quality data. Therefore, responding to public concerns about private well water quality requires an identification and evaluation of existing data. Data evaluated include measures of arsenic in groundwater and soil, private well water use, and biomonitoring results. The Environmental Protection Agency's Safe Drinking Water Information System and the US Geological Survey's Water Use data set were the most informative, nationally available data sets for conducting private well water arsenic surveillance. Three priority parishes were identified on the basis of a selection criteria, although all parishes require more private well sampling data. While the data reviewed enabled preliminary identification of parishes in need of monitoring and outreach, data limitations (particularly, a lack of statewide well water quality data) prevent a comprehensive evaluation of well water arsenic hazards and private well water use. A large number of unregistered wells further impede risk determination. Reliance on existing data sources is necessary, but development of metadata documentation is essential to prevent data misinterpretation. Increased outreach and policies to promote or mandate private well testing and reporting are needed to enable a comprehensive private well water tracking system.

Design of an instrument to measure the quality of care in Physical Therapy

PubMed Central

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; do Prado, Cristiane; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care. PMID:26154548

A Comprehensive Review of Spirit Drink Safety Standards and Regulations from an International Perspective.

PubMed

Pang, Xiao-Na; Li, Zhao-Jie; Chen, Jing-Yu; Gao, Li-Juan; Han, Bei-Zhong

2017-03-01

Standards and regulations related to spirit drinks have been established by different countries and international organizations to ensure the safety and quality of spirits. Here, we introduce the principles of food safety and quality standards for alcoholic beverages and then compare the key indicators used in the distinct standards of the Codex Alimentarius Commission, the European Union, the People's Republic of China, the United States, Canada, and Australia. We also discuss in detail the "maximum level" of the following main contaminants of spirit drinks: methanol, higher alcohols, ethyl carbamate, hydrocyanic acid, heavy metals, mycotoxins, phthalates, and aldehydes. Furthermore, the control measures used for potential hazards are introduced. Harmonization of the current requirements based on comprehensive scope analysis and the risk assessment approach will enhance both the trade and quality of distilled spirits. This review article provides valuable information that will enable producers, traders, governments, and researchers to increase their knowledge of spirit drink safety requirements, control measures, and research trends.

A systematic review of Markov models evaluating multicomponent disease management programs in diabetes.

PubMed

Kirsch, Florian

2015-01-01

Diabetes is the most expensive chronic disease; therefore, disease management programs (DMPs) were introduced. The aim of this review is to determine whether Markov models are adequate to evaluate the cost-effectiveness of complex interventions such as DMPs. Additionally, the quality of the models was evaluated using Philips and Caro quality appraisals. The five reviewed models incorporated the DMP into the model differently: two models integrated effectiveness rates derived from one clinical trial/meta-analysis and three models combined interventions from different sources into a DMP. The results range from cost savings and a QALY gain to costs of US$85,087 per QALY. The Spearman's rank coefficient assesses no correlation between the quality appraisals. With restrictions to the data selection process, Markov models are adequate to determine the cost-effectiveness of DMPs; however, to allow prioritization of medical services, more flexibility in the models is necessary to enable the evaluation of single additional interventions.

SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia

PubMed Central

Nguyen, Thuong T.; McKinney, Barbara; Pierson, Antoine; Luong, Khue N.; Hoang, Quynh T.; Meharwal, Sandeep; Carvalho, Humberto M.; Nguyen, Cuong Q.; Nguyen, Kim T.

2014-01-01

Background The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. However, the paper-based format of the checklist makes administration cumbersome and limits timely analysis and communication of results. Development of e-Tool In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors’ feedback about usability. Outcomes The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries. PMID:29043190

Big data and visual analytics in anaesthesia and health care.

PubMed

Simpao, A F; Ahumada, L M; Rehman, M A

2015-09-01

Advances in computer technology, patient monitoring systems, and electronic health record systems have enabled rapid accumulation of patient data in electronic form (i.e. big data). Organizations such as the Anesthesia Quality Institute and Multicenter Perioperative Outcomes Group have spearheaded large-scale efforts to collect anaesthesia big data for outcomes research and quality improvement. Analytics--the systematic use of data combined with quantitative and qualitative analysis to make decisions--can be applied to big data for quality and performance improvements, such as predictive risk assessment, clinical decision support, and resource management. Visual analytics is the science of analytical reasoning facilitated by interactive visual interfaces, and it can facilitate performance of cognitive activities involving big data. Ongoing integration of big data and analytics within anaesthesia and health care will increase demand for anaesthesia professionals who are well versed in both the medical and the information sciences. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Framework for Quantitative Assessment of Impacts Related to Energy and Mineral Resource Development

DOE PAGES

Haines, Seth S.; Diffendorfer, Jay E.; Balistrieri, Laurie; ...

2013-05-15

Natural resource planning at all scales demands methods for assessing the impacts of resource development and use, and in particular it requires standardized methods that yield robust and unbiased results. Building from existing probabilistic methods for assessing the volumes of energy and mineral resources, we provide an algorithm for consistent, reproducible, quantitative assessment of resource development impacts. The approach combines probabilistic input data with Monte Carlo statistical methods to determine probabilistic outputs that convey the uncertainties inherent in the data. For example, one can utilize our algorithm to combine data from a natural gas resource assessment with maps of sagemore » grouse leks and pinon-juniper woodlands in the same area to estimate possible future habitat impacts due to possible future gas development. As another example: one could combine geochemical data and maps of lynx habitat with data from a mineral deposit assessment in the same area to determine possible future mining impacts on water resources and lynx habitat. The approach can be applied to a broad range of positive and negative resource development impacts, such as water quantity or quality, economic benefits, or air quality, limited only by the availability of necessary input data and quantified relationships among geologic resources, development alternatives, and impacts. In conclusion, the framework enables quantitative evaluation of the trade-offs inherent in resource management decision-making, including cumulative impacts, to address societal concerns and policy aspects of resource development.« less

A framework for quantitative assessment of impacts related to energy and mineral resource development

USGS Publications Warehouse

Haines, Seth S.; Diffendorfer, James; Balistrieri, Laurie S.; Berger, Byron R.; Cook, Troy A.; Gautier, Donald L.; Gallegos, Tanya J.; Gerritsen, Margot; Graffy, Elisabeth; Hawkins, Sarah; Johnson, Kathleen; Macknick, Jordan; McMahon, Peter; Modde, Tim; Pierce, Brenda; Schuenemeyer, John H.; Semmens, Darius; Simon, Benjamin; Taylor, Jason; Walton-Day, Katherine

2013-01-01

Natural resource planning at all scales demands methods for assessing the impacts of resource development and use, and in particular it requires standardized methods that yield robust and unbiased results. Building from existing probabilistic methods for assessing the volumes of energy and mineral resources, we provide an algorithm for consistent, reproducible, quantitative assessment of resource development impacts. The approach combines probabilistic input data with Monte Carlo statistical methods to determine probabilistic outputs that convey the uncertainties inherent in the data. For example, one can utilize our algorithm to combine data from a natural gas resource assessment with maps of sage grouse leks and piñon-juniper woodlands in the same area to estimate possible future habitat impacts due to possible future gas development. As another example: one could combine geochemical data and maps of lynx habitat with data from a mineral deposit assessment in the same area to determine possible future mining impacts on water resources and lynx habitat. The approach can be applied to a broad range of positive and negative resource development impacts, such as water quantity or quality, economic benefits, or air quality, limited only by the availability of necessary input data and quantified relationships among geologic resources, development alternatives, and impacts. The framework enables quantitative evaluation of the trade-offs inherent in resource management decision-making, including cumulative impacts, to address societal concerns and policy aspects of resource development.

The impact of mHealth interventions on health systems: a systematic review protocol.

PubMed

Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

2016-11-25

Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

The Linear Programming to evaluate the performance of Oral Health in Primary Care.

PubMed

Colussi, Claudia Flemming; Calvo, Maria Cristina Marino; Freitas, Sergio Fernando Torres de

2013-01-01

To show the use of Linear Programming to evaluate the performance of Oral Health in Primary Care. This study used data from 19 municipalities of Santa Catarina city that participated of the state evaluation in 2009 and have more than 50,000 habitants. A total of 40 indicators were evaluated, calculated using the Microsoft Excel 2007, and converted to the interval [0, 1] in ascending order (one indicating the best situation and zero indicating the worst situation). Applying the Linear Programming technique municipalities were assessed and compared among them according to performance curve named "quality estimated frontier". Municipalities included in the frontier were classified as excellent. Indicators were gathered, and became synthetic indicators. The majority of municipalities not included in the quality frontier (values different of 1.0) had lower values than 0.5, indicating poor performance. The model applied to the municipalities of Santa Catarina city assessed municipal management and local priorities rather than the goals imposed by pre-defined parameters. In the final analysis three municipalities were included in the "perceived quality frontier". The Linear Programming technique allowed to identify gaps that must be addressed by city managers to enhance actions taken. It also enabled to observe each municipal performance and compare results among similar municipalities.

A quality of life study in 20 adult long-term survivors of unrelated donor bone marrow transplantation.

PubMed

Marks, D I; Gale, D J; Vedhara, K; Bird, J M

1999-07-01

There are few specific data available concerning quality of life (QOL) of survivors of unrelated donor bone marrow transplantation (UD-BMT). The procedure is expensive, difficult and is being employed increasingly yet we have little information concerning the QOL of survivors to justify this intervention. In this study, 20 long-term (>1 year post-BMT) survivors were studied with four self report questionnaires designed to assess quality of life, satisfaction with life, social support and employment status. Overall, satisfaction with life measures was above average but there was dissatisfaction with physical strength and appearance. The post-transplant employment data indicates that 60% of long-term survivors returned to full-time work and 15% to part-time work. Failure to return to work was not correlated with graft-versus-host disease (GVHD), relapse, age at or time since transplant. In general, there was a good correlation between the clinician's and patient's view of their health but the clinician's assessment of the patients mental health and energy was higher than the patients reported. Further research is required in the area of QOL post-UD-BMT. This will enable transplant physicians to counsel patients better pre-BMT and to evaluate fully the results achieved by different centres performing the procedure.

Rational quality assessment procedure for less-investigated herbal medicines: Case of a Congolese antimalarial drug with an analytical report.

PubMed

Tshitenge, Dieudonné Tshitenge; Ioset, Karine Ndjoko; Lami, José Nzunzu; Ndelo-di-Phanzu, Josaphat; Mufusama, Jean-Pierre Koy Sita; Bringmann, Gerhard

2016-04-01

Herbal medicines are the most globally used type of medical drugs. Their high cultural acceptability is due to the experienced safety and efficiency over centuries of use. Many of them are still phytochemically less-investigated, and are used without standardization or quality control. Choosing SIROP KILMA, an authorized Congolese antimalarial phytomedicine, as a model case, our study describes an interdisciplinary approach for a rational quality assessment of herbal drugs in general. It combines an authentication step of the herbal remedy prior to any fingerprinting, the isolation of the major constituents, the development and validation of an HPLC-DAD analytical method with internal markers, and the application of the method to several batches of the herbal medicine (here KILMA) thus permitting the establishment of a quantitative fingerprint. From the constitutive plants of KILMA, acteoside, isoacteoside, stachannin A, and pectolinarigenin-7-O-glucoside were isolated, and acteoside was used as the prime marker for the validation of an analytical method. This study contributes to the efforts of the WHO for the establishment of standards enabling the analytical evaluation of herbal materials. Moreover, the paper describes the first phytochemical and analytical report on a marketed Congolese phytomedicine. Copyright © 2016 Elsevier B.V. All rights reserved.

Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

PubMed

Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

2015-05-01

Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

Measuring Cognition of Students with Disabilities Using Technology-Enabled Assessments: Recommendations for a National Research Agenda

ERIC Educational Resources Information Center

Bechard, Sue; Sheinker, Jan; Abell, Rosemary; Barton, Karen; Burling, Kelly; Camacho, Christopher; Cameto, Renee; Haertel, Geneva; Hansen, Eric; Johnstone, Chris; Kingston, Neal; Murray, Elizabeth; Parker, Caroline E.; Redfield, Doris; Tucker, Bill

2010-01-01

This article represents one outcome from the "Invitational Research Symposium on Technology-Enabled and Universally Designed Assessments," which examined technology-enabled assessments (TEA) and universal design (UD) as they relate to students with disabilities (SWD). It was developed to stimulate research into TEAs designed to better understand…

[Benefit Assessment for Examination and Treatment Methods with Medical Devices of High Hisk: Trade-off between Patient Benefit, Evidence and Access].

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2018-03-01

The lately inured § 137 h SGB V aims to assess the benefit of new examination and treatment methods with medical devices of class IIb and III. In the future, the decision on the reimbursement eligibility will be marked by high requirements in terms of documentation of benefits and harm. The objective of benefit assessment is the operationalization of benefit to patients. A comparative determination of benefit enables rational decision by regulatory authorities. The process of benefit assessment should guarantee transparent decision-making, and the underlying medical and health economic fundamentals should be documented. In principle, benefit assessment can be divided into 3 phases: measuring causal effects of an intervention, assessment of the measured effects and decision on reimbursement based on the aggregation of an overall benefit. To address the peculiarities of medical devices in this process, adaptive study designs, MCDA and adaptive benefit assessment provide a sustainable concept for rapid access by patients to innovative treatments of high quality and safety. © Georg Thieme Verlag KG Stuttgart · New York.

Towards Assisted Moderation in Online Healthcare Social Networks: Improving Trust in YouTube Searches.

PubMed

Cañon, Daniel E; Lopez, Diego M; Blobel, Bernd

2014-01-01

Moderation of content in online Health Social Networks (HSN) is critical because information is not only published and produced by experts or health professionals, but also by users of that information. The objective of this paper is to propose a semi-automatic moderation Web Service for assessing the quality (trustworthiness) of health-related videos published on the YouTube social network. The service is relevant for moderators or community managers, who get enabled to control the quality of videos published on their online HSN sites. The HealthTrust metric was selected as the metric to be implemented in the service in order to support the assessment of trustworthiness of videos in Online HSN. The service is a RESTful service which can be integrated into open source Virtual Social Network Platforms, therefore improving trust in the process of searching and publishing content extracted from YouTube. A preliminary pilot evaluation in a simple use case demonstrated that the relevance of videos retrieved using the moderation service was higher compared to the relevance of the videos retrieved using the YouTube search engine.

A scoring metric for multivariate data for reproducibility analysis using chemometric methods

PubMed Central

Sheen, David A.; de Carvalho Rocha, Werickson Fortunato; Lippa, Katrice A.; Bearden, Daniel W.

2017-01-01

Process quality control and reproducibility in emerging measurement fields such as metabolomics is normally assured by interlaboratory comparison testing. As a part of this testing process, spectral features from a spectroscopic method such as nuclear magnetic resonance (NMR) spectroscopy are attributed to particular analytes within a mixture, and it is the metabolite concentrations that are returned for comparison between laboratories. However, data quality may also be assessed directly by using binned spectral data before the time-consuming identification and quantification. Use of the binned spectra has some advantages, including preserving information about trace constituents and enabling identification of process difficulties. In this paper, we demonstrate the use of binned NMR spectra to conduct a detailed interlaboratory comparison and composition analysis. Spectra of synthetic and biologically-obtained metabolite mixtures, taken from a previous interlaboratory study, are compared with cluster analysis using a variety of distance and entropy metrics. The individual measurements are then evaluated based on where they fall within their clusters, and a laboratory-level scoring metric is developed, which provides an assessment of each laboratory’s individual performance. PMID:28694553

Phenoliner: A New Field Phenotyping Platform for Grapevine Research

PubMed Central

Kicherer, Anna; Herzog, Katja; Bendel, Nele; Klück, Hans-Christian; Backhaus, Andreas; Wieland, Markus; Klingbeil, Lasse; Läbe, Thomas; Hohl, Christian; Petry, Willi; Kuhlmann, Heiner; Seiffert, Udo; Töpfer, Reinhard

2017-01-01

In grapevine research the acquisition of phenotypic data is largely restricted to the field due to its perennial nature and size. The methodologies used to assess morphological traits and phenology are mainly limited to visual scoring. Some measurements for biotic and abiotic stress, as well as for quality assessments, are done by invasive measures. The new evolving sensor technologies provide the opportunity to perform non-destructive evaluations of phenotypic traits using different field phenotyping platforms. One of the biggest technical challenges for field phenotyping of grapevines are the varying light conditions and the background. In the present study the Phenoliner is presented, which represents a novel type of a robust field phenotyping platform. The vehicle is based on a grape harvester following the concept of a moveable tunnel. The tunnel it is equipped with different sensor systems (RGB and NIR camera system, hyperspectral camera, RTK-GPS, orientation sensor) and an artificial broadband light source. It is independent from external light conditions and in combination with artificial background, the Phenoliner enables standardised acquisition of high-quality, geo-referenced sensor data. PMID:28708080

Phenoliner: A New Field Phenotyping Platform for Grapevine Research.

PubMed

Kicherer, Anna; Herzog, Katja; Bendel, Nele; Klück, Hans-Christian; Backhaus, Andreas; Wieland, Markus; Rose, Johann Christian; Klingbeil, Lasse; Läbe, Thomas; Hohl, Christian; Petry, Willi; Kuhlmann, Heiner; Seiffert, Udo; Töpfer, Reinhard

2017-07-14

In grapevine research the acquisition of phenotypic data is largely restricted to the field due to its perennial nature and size. The methodologies used to assess morphological traits and phenology are mainly limited to visual scoring. Some measurements for biotic and abiotic stress, as well as for quality assessments, are done by invasive measures. The new evolving sensor technologies provide the opportunity to perform non-destructive evaluations of phenotypic traits using different field phenotyping platforms. One of the biggest technical challenges for field phenotyping of grapevines are the varying light conditions and the background. In the present study the Phenoliner is presented, which represents a novel type of a robust field phenotyping platform. The vehicle is based on a grape harvester following the concept of a moveable tunnel. The tunnel it is equipped with different sensor systems (RGB and NIR camera system, hyperspectral camera, RTK-GPS, orientation sensor) and an artificial broadband light source. It is independent from external light conditions and in combination with artificial background, the Phenoliner enables standardised acquisition of high-quality, geo-referenced sensor data.

Software Requirements Analysis as Fault Predictor

NASA Technical Reports Server (NTRS)

Wallace, Dolores

2003-01-01

Waiting until the integration and system test phase to discover errors leads to more costly rework than resolving those same errors earlier in the lifecycle. Costs increase even more significantly once a software system has become operational. WE can assess the quality of system requirements, but do little to correlate this information either to system assurance activities or long-term reliability projections - both of which remain unclear and anecdotal. Extending earlier work on requirements accomplished by the ARM tool, measuring requirements quality information against code complexity and test data for the same system may be used to predict specific software modules containing high impact or deeply embedded faults now escaping in operational systems. Such knowledge would lead to more effective and efficient test programs. It may enable insight into whether a program should be maintained or started over.

Progress with enhancing veterinary surveillance in the United Kingdom.

PubMed

Lysons, R E; Gibbens, J C; Smith, L H

2007-01-27

The UK has experienced various animal health events that have had national impact in recent years. In response, a ;Veterinary Surveillance Strategy' (VSS) was published in 2003, with the objective of enhancing and coordinating national veterinary surveillance practice in a way that would enable important animal health events to be detected and assessed more rapidly and reliably. The VSS adopts an integrated UK-wide approach, which includes widespread engagement with interested parties both within government and beyond. It proposes enhancing surveillance through improved collaboration; transparent and defensible prioritisation of government resources to surveillance; deriving better value from existing resources, and assuring quality of the surveillance reports and source data. This article describes progress with implementing the VSS, in particular the methodology for developing a functional network and creating an effective, quality-assured, information management system, RADAR.

A Control Law Design Method Facilitating Control Power, Robustness, Agility, and Flying Qualities Tradeoffs: CRAFT

NASA Technical Reports Server (NTRS)

Murphy, Patrick C.; Davidson, John B.

1998-01-01

A multi-input, multi-output control law design methodology, named "CRAFT", is presented. CRAFT stands for the design objectives addressed, namely, Control power, Robustness, Agility, and Flying Qualities Tradeoffs. The methodology makes use of control law design metrics from each of the four design objective areas. It combines eigenspace assignment, which allows for direct specification of eigenvalues and eigenvectors, with a graphical approach for representing the metrics that captures numerous design goals in one composite illustration. Sensitivity of the metrics to eigenspace choice is clearly displayed, enabling the designer to assess the cost of design tradeoffs. This approach enhances the designer's ability to make informed design tradeoffs and to reach effective final designs. An example of the CRAFT methodology applied to an advanced experimental fighter and discussion of associated design issues are provided.

Patients' evaluation of hospital foodservice quality in Italy: what do patients really value?

PubMed

Messina, Gabriele; Fenucci, Roberto; Vencia, Francesco; Niccolini, Fabrizio; Quercioli, Cecilia; Nante, Nicola

2013-04-01

Patients often do not eat/drink enough during hospitalization. To enable patients to meet their energy and nutritional requirements, food and catering service quality and staff support are therefore important. We assessed patients' satisfaction with hospital food and investigated aspects influencing it. We conducted a cross-sectional study collecting patients' preferences using a slightly modified version of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Factor analysis was carried out to reduce the number of food-quality and staff-issue variables. Univariate and multivariate ordinal categorical regression models were used to assess the association between food quality, staff issues, patients' characteristics, hospital recovery aspects and overall foodservice satisfaction (OS). A university hospital in Florence, Italy, in the period November-December 2009. Hospital patients aged 18+ years (n 927). Of the 1288 questionnaires distributed, 927 were returned completely or partially filled in by patients and 603 were considered eligible for analysis. Four factors (explained variance 64·3 %, Cronbach's alpha α(C) = 0.856), i.e. food quality (FQ; α(C) = 0·74), meal service quality (MSQ; α(C) = 0·73), hunger and quantity (HQ; α(C) = 0·74) and staff/service issues (SI; α(C) = 0·65), were extracted from seventeen items. Items investigating staff/service issues were the most positively rated while certain items investigating food quality were the least positively rated. After ordinal multiple regression analysis, OS was only significantly associated with the four factors: FQ, MSQ, HQ and SI (OR = 17·2, 6·16, 3·09 and 1·75, respectively, P < 0·001), and gender (OR = 1·53, P = 0·024). The most positively scored aspects of foodservice concerned staff/service, whereas food quality was considered less positive. The aspects that most influenced patients' satisfaction were those related to food quality.

Illness consequences after myocardial infarction: problems with physical functioning and return to work.

PubMed

Brink, Eva; Brändström, Yvonne; Cliffordsson, Christina; Herlitz, Johan; Karlson, Björn W

2008-12-01

This paper is a report of a study to explore health problems, physical and mental functioning, and physical activity in working-age patients after myocardial infarction, in order to assess the possible effects of these factors on return to work. A diagnosis of myocardial infarction may discourage patients from continuing an active working life. Enabling myocardial infarction patients to return to work has benefits for both individuals and society. A convenience sample was recruited of 88 patients,

Post-Surgical Quality of Life, Psychological State and what Patients Think about the Effectiveness of Heller Myotomy in the Treatment of Achalasia.

PubMed

Vale-Fonseca, Telma; Ferreira-Pinto, Luis; Figueiredo-Braga, Margarida; Carneiro, Silvestre

2016-02-01

The disruption of esophageal motility that characterizes achalasia typically provokes dysphagia, pain, loss of weight and malnutrition. Therefore, patients frequently report a reduction in quality of life and negative emotional states. Laparoscopic Heller myotomy proved to be an effective therapy, enabling the resumption of good quality of life. The authors studied 45 patients previously submitted to laparoscopic Heller myotomy. Postoperative evaluation was performed using a customized version of the achalasia disease-specific quality of life questionnaire. Quality of life and the presence of depressive and anxiety symptoms were assessed using the Portuguese versions of the Medical Outcomes Study SF-36 and the Hospital Anxiety and Depression Scale. Thirty-one patients responded to the survey. Dysphagia was the main clinical symptom before surgery. A clear improvement in dysphagia, regurgitation, pain and weight loss was found after surgery (p < 0.001). The Mental Health domain of SF-36 presented a Pearson correlation coefficient of -0.689 with HADS-D and of -0.557 with HADS-A (p < 0.001 and p = 0.002, respectively). This study demonstrates that the Heller myotomy is associated with a good quality of life in patients with achalasia and strengthens the evidence that this is a safe and reliable procedure.

Soft-lithography fabrication of microfluidic features using thiol-ene formulations.

PubMed

Ashley, John F; Cramer, Neil B; Davis, Robert H; Bowman, Christopher N

2011-08-21

In this work, a novel thiol-ene based photopolymerizable resin formulation was shown to exhibit highly desirable characteristics, such as low cure time and the ability to overcome oxygen inhibition, for the photolithographic fabrication of microfluidic devices. The feature fidelity, as well as various aspects of the feature shape and quality, were assessed as functions of various resin attributes, particularly the exposure conditions, initiator concentration and inhibitor to initiator ratio. An optical technique was utilized to evaluate the feature fidelity as well as the feature shape and quality. These results were used to optimize the thiol-ene resin formulation to produce high fidelity, high aspect ratio features without significant reductions in feature quality. For structures with aspect ratios below 2, little difference (<3%) in feature quality was observed between thiol-ene and acrylate based formulations. However, at higher aspect ratios, the thiol-ene resin exhibited significantly improved feature quality. At an aspect ratio of 8, raised feature quality for the thiol-ene resin was dramatically better than that achieved by using the acrylate resin. The use of the thiol-ene based resin enabled fabrication of a pinched-flow microfluidic device that has complex channel geometry, small (50 μm) channel dimensions, and high aspect ratio (14) features. This journal is © The Royal Society of Chemistry 2011

An Integrated Decision Support System for Water Quality Management of Songhua River Basin

NASA Astrophysics Data System (ADS)

Zhang, Haiping; Yin, Qiuxiao; Chen, Ling

2010-11-01

In the Songhua River Basin of China, many water resource and water environment conflicts interact. A Decision Support System (DSS) for the water quality management has been established for the Basin. The System is featured by the incorporation of a numerical water quality model system into a conventional water quality management system which usually consists of geographic information system (GIS), WebGIS technology, database system and network technology. The model system is built based on DHI MIKE software comprising of a basin rainfall-runoff module, a basin pollution load evaluation module, a river hydrodynamic module and a river water quality module. The DSS provides a friendly graphical user interface that enables the rapid and transparent calculation of various water quality management scenarios, and also enables the convenient access and interpretation of the modeling results to assist the decision-making.

Water use data to enhance scientific and policy insight

NASA Astrophysics Data System (ADS)

Konar, M.

2017-12-01

We live in an era of big data. However, water use data remains sparse. There is an urgent need to enhance both the quality and resolution of water data. Metered water use information - as opposed to estimated water use, typically based on climate - would enhance the quality of existing water databases. Metered water use data would enable the research community to evaluate the "who, where, and when" of water use. Importantly, this information would enable the scientific community to better understand decision making related to water use (i.e. the "why"), providing the insight necessary to guide policies that promote water conservation. Metered water use data is needed at a sufficient resolution (i.e. spatial, temporal, and water user) to fully resolve how water is used throughout the economy and society. Improving the quality and resolution of water use data will enable scientific understanding that can inform policy.

Multi-Robot Assembly Strategies and Metrics.

PubMed

Marvel, Jeremy A; Bostelman, Roger; Falco, Joe

2018-02-01

We present a survey of multi-robot assembly applications and methods and describe trends and general insights into the multi-robot assembly problem for industrial applications. We focus on fixtureless assembly strategies featuring two or more robotic systems. Such robotic systems include industrial robot arms, dexterous robotic hands, and autonomous mobile platforms, such as automated guided vehicles. In this survey, we identify the types of assemblies that are enabled by utilizing multiple robots, the algorithms that synchronize the motions of the robots to complete the assembly operations, and the metrics used to assess the quality and performance of the assemblies.

Improving the care of older persons in Australian prisons using the Policy Delphi method.

PubMed

Patterson, Karen; Newman, Claire; Doona, Katherine

2016-09-01

There are currently no internationally recognised and approved processes relating to the care of older persons with dementia in prison. This research aimed to develop tools and procedures related to managing the care of, including the identification and assessment of, older persons with dementia who are imprisoned in New South Wales, Australia. A modified approach to the Policy Delphi method, using both surveys and facilitated discussion groups, enabled experts to come together to discuss improving the quality of care provision for older persons with dementia in prison and achieve research aims. © The Author(s) 2014.

Multi-Robot Assembly Strategies and Metrics

PubMed Central

MARVEL, JEREMY A.; BOSTELMAN, ROGER; FALCO, JOE

2018-01-01

We present a survey of multi-robot assembly applications and methods and describe trends and general insights into the multi-robot assembly problem for industrial applications. We focus on fixtureless assembly strategies featuring two or more robotic systems. Such robotic systems include industrial robot arms, dexterous robotic hands, and autonomous mobile platforms, such as automated guided vehicles. In this survey, we identify the types of assemblies that are enabled by utilizing multiple robots, the algorithms that synchronize the motions of the robots to complete the assembly operations, and the metrics used to assess the quality and performance of the assemblies. PMID:29497234

Effect of Peer-to-Peer Nurse-Physician Collaboration on Attitudes Toward the Nurse-Physician Relationship.

PubMed

Edwards, Pamela B; Rea, Jean B; Oermann, Marilyn H; Hegarty, Ellen J; Prewitt, Judy R; Rudd, Mariah; Silva, Susan; Nagler, Alisa; Turner, David A; DeMeo, Stephen D

The goal of this study was to pilot a novel peer-to-peer nurse-physician collaboration program and assess for changes in attitudes toward collaboration among a group of newly licensed nurses and resident physicians (n = 39). The program included large group meetings, with discussion of key concepts related to interprofessional collaboration. In unit-based teams, the registered nurses and physicians developed a quality improvement project to meet a need on their unit. Creating learning activities like this program enable nursing professional development specialists to promote interprofessional collaboration and learning.

Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review

PubMed Central

Luckett, Tim; Disler, Rebecca; Hosie, Annmarie; Johnson, Miriam; Davidson, Patricia; Currow, David; Sumah, Anthony; Phillips, Jane

2016-01-01

Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch–Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade ⩾9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability. PMID:27225898

Quality control of colonoscopy procedures: a prospective validated method for the evaluation of professional practices applicable to all endoscopic units.

PubMed

Coriat, R; Pommaret, E; Chryssostalis, A; Viennot, S; Gaudric, M; Brezault, C; Lamarque, D; Roche, H; Verdier, D; Parlier, D; Prat, F; Chaussade, S

2009-02-01

To produce valid information, an evaluation of professional practices has to assess the quality of all practices before, during and after the procedure under study. Several auditing techniques have been proposed for colonoscopy. The purpose of this work is to describe a straightforward original validated method for the prospective evaluation of professional practices in the field of colonoscopy applicable in all endoscopy units without increasing the staff work load. Pertinent quality-control criteria (14 items) were identified by the endoscopists at the Cochin Hospital and were compatible with: findings in the available literature; guidelines proposed by the Superior Health Authority; and application in any endoscopy unit. Prospective routine data were collected and the methodology validated by evaluating 50 colonoscopies every quarter for one year. The relevance of the criteria was assessed using data collected during four separate periods. The standard checklist was complete for 57% of the colonoscopy procedures. The colonoscopy procedure was appropriate according to national guidelines in 94% of cases. These observations were particularly noteworthy: the quality of the colonic preparation was insufficient for 9% of the procedures; complete colonoscopy was achieved for 93% of patients; and 0.38 adenomas and 0.045 carcinomas were identified per colonoscopy. This simple and reproducible method can be used for valid quality-control audits in all endoscopy units. In France, unit-wide application of this method enables endoscopists to validate 100 of the 250 points required for continuous medical training. This is a quality-control tool that can be applied annually, using a random month to evaluate any changes in routine practices.

The 3D Elevation Program: summary for Hawaii

USGS Publications Warehouse

Carswell, William J.

2016-01-01

Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Hawaii, elevation data are critical for infrastructure and construction management, flood risk management, geologic resource assessment and hazard mitigation, natural resources conservation, coastal zone management, and other business uses. Today, high-density light detection and ranging (lidar) data are the primary sources for deriving elevation models and other datasets. Federal, State, Tribal, U.S. territorial, and local agencies work in partnership to (1) replace data that are older and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data.The National Enhanced Elevation Assessment evaluated multiple elevation data acquisition options to determine the optimal data quality and data replacement cycle relative to cost to meet the identified requirements of the user community. The evaluation demonstrated that lidar acquisition at quality level 2 for the conterminous United States, Hawaii, and selected U.S. territories, and quality level 5 interferometric synthetic aperture radar (IfSAR) data for Alaska, all with a 6- to 10-year acquisition cycle, provided the highest benefit/cost ratios. The 3D Elevation Program (3DEP) initiative selected an 8-year acquisition cycle for the respective quality levels. 3DEP, managed by the U.S. Geological Survey, the Office of Management and Budget Circular A–16 lead agency for terrestrial elevation data, responds to the growing need for high-quality topographic data and a wide range of other three-dimensional (3D) representations of the Nation’s natural and constructed features.

Technology-Enabled and Universally Designed Assessment: Considering Access in Measuring the Achievement of Students with Disabilities--A Foundation for Research

ERIC Educational Resources Information Center

Almond, Patricia; Winter, Phoebe; Cameto, Renee; Russell, Michael; Sato, Edynn; Clarke-Midura, Jody; Torres, Chloe; Haertel, Geneva; Dolan, Robert; Beddow, Peter; Lazarus, Sheryl

2010-01-01

This paper represents one outcome from the "Invitational Research Symposium on Technology-Enabled and Universally Designed Assessments," which examined technology-enabled assessments (TEA) and universal design (UD) as they relate to students with disabilities (SWD). It was developed to stimulate research into TEAs designed to make tests…

Image-based teleconsultation using smartphones or tablets: qualitative assessment of medical experts.

PubMed

Boissin, Constance; Blom, Lisa; Wallis, Lee; Laflamme, Lucie

2017-02-01

Mobile health has promising potential in improving healthcare delivery by facilitating access to expert advice. Enabling experts to review images on their smartphone or tablet may save valuable time. This study aims at assessing whether images viewed by medical specialists on handheld devices such as smartphones and tablets are perceived to be of comparable quality as when viewed on a computer screen. This was a prospective study comparing the perceived quality of 18 images on three different display devices (smartphone, tablet and computer) by 27 participants (4 burn surgeons and 23 emergency medicine specialists). The images, presented in random order, covered clinical (dermatological conditions, burns, ECGs and X-rays) and non-clinical subjects and their perceived quality was assessed using a 7-point Likert scale. Differences in devices' quality ratings were analysed using linear regression models for clustered data adjusting for image type and participants' characteristics (age, gender and medical specialty). Overall, the images were rated good or very good in most instances and more so for the smartphone (83.1%, mean score 5.7) and tablet (78.2%, mean 5.5) than for a standard computer (70.6%, mean 5.2). Both handheld devices had significantly higher ratings than the computer screen, even after controlling for image type and participants' characteristics. Nearly all experts expressed that they would be comfortable using smartphones (n=25) or tablets (n=26) for image-based teleconsultation. This study suggests that handheld devices could be a substitute for computer screens for teleconsultation by physicians working in emergency settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evidence-Based Practice Point-of-Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content.

PubMed

Campbell, Jared M; Umapathysivam, Kandiah; Xue, Yifan; Lockwood, Craig

2015-12-01

Clinicians and other healthcare professionals need access to summaries of evidence-based information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP point-of-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources. A comprehensive and systematic search (Pubmed, CINAHL, and Cochrane Central) was undertaken to identify available EBP point-of-care resources, defined as "web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information (and possibly also guidance) to clinicians." A pair of investigators independently extracted information on general characteristics, content presentation, editorial quality, evidence-based methodology, and breadth and volume. Twenty-seven summary resources were identified, of which 22 met the predefined inclusion criteria for EBP point-of-care resources, and 20 could be accessed for description and assessment. Overall, the upper quartile of EBP point-of-care providers was assessed to be UpToDate, Nursing Reference Centre, Mosby's Nursing Consult, BMJ Best Practice, and JBI COnNECT+. The choice of which EBP point-of-care resources are suitable for an organization is a decision that depends heavily on the unique requirements of that organization and the resources it has available. However, the results presented in this study should enable healthcare providers to make that assessment in a clear, evidence-based manner, and provide a comprehensive list of the available options. © 2015 Sigma Theta Tau International.

Impact of knowledge-based iterative model reconstruction on myocardial late iodine enhancement in computed tomography and comparison with cardiac magnetic resonance.

PubMed

Tanabe, Yuki; Kido, Teruhito; Kurata, Akira; Fukuyama, Naoki; Yokoi, Takahiro; Kido, Tomoyuki; Uetani, Teruyoshi; Vembar, Mani; Dhanantwari, Amar; Tokuyasu, Shinichi; Yamashita, Natsumi; Mochizuki, Teruhito

2017-10-01

We evaluated the image quality and diagnostic performance of late iodine enhancement computed tomography (LIE-CT) with knowledge-based iterative model reconstruction (IMR) for the detection of myocardial infarction (MI) in comparison with late gadolinium enhancement magnetic resonance imaging (LGE-MRI). The study investigated 35 patients who underwent a comprehensive cardiac CT protocol and LGE-MRI for the assessment of coronary artery disease. The CT protocol consisted of stress dynamic myocardial CT perfusion, coronary CT angiography (CTA) and LIE-CT using 256-slice CT. LIE-CT scans were acquired 5 min after CTA without additional contrast medium and reconstructed with filtered back projection (FBP), a hybrid iterative reconstruction (HIR), and IMR. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed. Sensitivity and specificity of LIE-CT for detecting MI were assessed according to the 16-segment model. Image quality scores, and diagnostic performance were compared among LIE-CT with FBP, HIR and IMR. Among the 35 patients, 139 of 560 segments showed MI in LGE-MRI. On LIE-CT with FBP, HIR, and IMR, the median SNRs were 2.1, 2.9, and 6.1; and the median CNRs were 1.7, 2.2, and 4.7, respectively. Sensitivity and specificity were 56 and 93% for FBP, 62 and 91% for HIR, and 80 and 91% for IMR. LIE-CT with IMR showed the highest image quality and sensitivity (p < 0.05). The use of IMR enables significant improvement of image quality and diagnostic performance of LIE-CT for detecting MI in comparison with FBP and HIR.

Epilepsy-related clinical factors and psychosocial functions in pediatric epilepsy.

PubMed

Eom, Soyong; Eun, So-Hee; Kang, Hoon-Chul; Eun, Baik-Lin; Nam, Sang Ook; Kim, Sun Jun; Chung, Hee Jung; Kwon, Soon Hak; Lee, Young-Mock; Lee, Joon Soo; Kim, Dong Wook; Oh, Kyung Ja; Kim, Heung Dong

2014-08-01

The aim of this study was to identify the different influencing patterns of demographic and epilepsy-related variables on various aspects of psychosocial function in pediatric epilepsy. Five hundred ninety-eight patients with pediatric epilepsy between the ages of 4 and 18 years (boys=360, 60% and girls=238, 40%) and their parents participated in the study. Parents completed the Social Maturity Scale (SMS), the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire (K-QOLCE) to assess daily living function, behavior, and quality of life. The Children's Global Assessment Scale (CGAS) was completed by clinicians to assess general adaptive function. Demographic variables, such as age and sex of child, and epilepsy-related clinical variables, including seizure type, seizure frequency, duration of epilepsy, and number of medications, were obtained from medical records. Demographic and epilepsy-related clinical variables had a strong influence (22-32%) on the cognition-related domain such as general adaptive function, school/total competence, and quality of life for cognitive function while a comparatively smaller effect (2-16%) on the more psychological domain including behavioral, emotional, and social variables. Younger age, shorter duration of illness, and smaller number of medications showed a strong positive impact on psychosocial function in pediatric epilepsy, particularly for adaptive function, competence, and quality-of-life aspects. Given the wide range of impact of demographic and clinical variables on various facets of psychosocial functions, more specific understanding of the various aspects of factors and their particular pattern of influence may enable more effective therapeutic approaches that address both the medical and psychological needs in pediatric epilepsy. Copyright © 2014 Elsevier Inc. All rights reserved.

Is the evaluation of "traditional" physicochemical parameters sufficient to explain the potential toxicity of the treated wastewater at sewage treatment plants?

PubMed

Vasquez, M I; Fatta-Kassinos, D

2013-06-01

Water scarcity is one of the most important environmental and public health problems of our century. Treated wastewater reuse seems to be the most attractive option for the enhancement of water resources. However, the lack of uniform guidelines at European and/or Mediterranean level leaves room for application of varying guidelines and regulations, usually not based on risk assessment towards humans and the environment. The benefits of complementing the physicochemical evaluation of wastewater with a biological one are demonstrated in the present study using Cyprus, a country with extended water reuse applications, as an example. Four organisms from different trophic levels were used for the biological assessment of the wastewater, namely, Pseudokirchneriella subcapitata, Daphnia magna, Artemia salina and Vibrio fischeri. The physicochemical assessment of wastewater based on "traditional" chemical parameters indicated that the quality of the wastewater complies with the limits set by the relevant national guidelines for disposal. The ecotoxicological assessment, however, indicated the presence of toxicity throughout the sampling periods and most importantly an increase of the toxicity of the treated wastewater during summer compared to winter. The resulting poor correlation between the physicochemical and biological assessments demonstrates that the two assessments are necessary and should be performed in parallel in order to be able to obtain concrete results on the overall quality of the treated effluent. Moreover, a hazard classification scheme for wastewater is proposed, which can enable the comparison of the data sets of the various parameters deriving from the biological assessment in a comprehensive way.

Interdisciplinary collaboration and the electronic medical record.

PubMed

Green, Shayla D; Thomas, Joan D

2008-01-01

To examine interdisciplinary collaboration via electronic medical records (EMRs) with a focus on physicians' perception of nursing documentation. Quality improvement project using a survey instrument. Tertiary care pediatric hospital. Thirty-seven physicians. Physicians perceptions of nursing documentation after EMR implementation Physicians desire nursing documentation with greater clarity and additional information. Physicians indicate checklists alone for patient assessment and intervention data are insufficient for effective nurse/physician collaboration. Narrative nursing summaries are invaluable references that guide medical treatment decisions. Physicians see detailed assessments and well-described interventions of nurses' as critical to their ability to effectively practice medicine. Health care technology is called to develop EMRs that enable nurses to document detailed patient data in a swift and straightforward manner. Joint collaboration between nurses, physicians, and technology specialists is recommended to develop effective EMR systems.

Issues and advances in the management and pathogenesis of cutaneous lupus erythematosus.

PubMed

Pelle, Michelle T

2006-01-01

Evidence-based therapy for cutaneous lupus is lacking. A new clinical assessment tool for cutaneous lupus, the CLASI score, will enable more standardized assessments of response to therapy. Anti-Ro autoantibodies are associated with photosensitive SLE and SCLE, and they play a role in cell survival following ultraviolet exposure. Ro also functions in quality control of small RNAs, important in the prevention of autoimmune disease. Drug-induced lupus erythematosus can be anti-Ro- or anti-dsDNA-associated; SCLE and photosensitivity are characteristic of Ro-positive drug-induced lupus. Biologic therapies and IVIg are being studied for the treatment of SLE and cutaneous lupus. Large, controlled trials are needed, not only to evaluate newer therapies, but also to substantiate and define the usage of traditional therapies for cutaneous lupus erythematosus.

Ecological assessment of nano-enabled supercapacitors for automotive applications

NASA Astrophysics Data System (ADS)

Weil, M.; Dura, H.; Shimon, B.; Baumann, M.; Zimmermann, B.; Ziemann, S.; Lei, C.; Markoulidis, F.; Lekakou, T.; Decker, M.

2012-09-01

New materials on nano scale have the potential to overcome existing technical barriers and are one of the most promising key technologies to enable the decoupling of economic growth and resource consumption. Developing these innovative materials for industrial applications means facing a complex quality profile, which includes among others technical, economic, and ecological aspects. So far the two latter aspects are not sufficiently included in technology development, especially from a life cycle point of view. Supercapacitors are considered a promising option for electric energy storage in hybrid and full electric cars. In comparison with presently used lithium based electro chemical storage systems supercapacitors possess a high specific power, but a relatively low specific energy. Therefore, the goal of ongoing research is to develop a new generation of supercapacitors with high specific power and high specific energy. To reach this goal particularly nano materials are developed and tested on cell level. In the presented study the ecological implications (regarding known environmental effects) of carbon based nano materials are analysed using Life Cycle Assessment (LCA). Major attention is paid to efficiency gains of nano particle production due to scaling up of such processes from laboratory to industrial production scales. Furthermore, a developed approach will be displayed, how to assess the environmental impact of nano materials on an automotive system level over the whole life cycle.

Enabling automated magnetic resonance imaging-based targeting assessment during dipole field navigation

NASA Astrophysics Data System (ADS)

Latulippe, Maxime; Felfoul, Ouajdi; Dupont, Pierre E.; Martel, Sylvain

2016-02-01

The magnetic navigation of drugs in the vascular network promises to increase the efficacy and reduce the secondary toxicity of cancer treatments by targeting tumors directly. Recently, dipole field navigation (DFN) was proposed as the first method achieving both high field and high navigation gradient strengths for whole-body interventions in deep tissues. This is achieved by introducing large ferromagnetic cores around the patient inside a magnetic resonance imaging (MRI) scanner. However, doing so distorts the static field inside the scanner, which prevents imaging during the intervention. This limitation constrains DFN to open-loop navigation, thus exposing the risk of a harmful toxicity in case of a navigation failure. Here, we are interested in periodically assessing drug targeting efficiency using MRI even in the presence of a core. We demonstrate, using a clinical scanner, that it is in fact possible to acquire, in specific regions around a core, images of sufficient quality to perform this task. We show that the core can be moved inside the scanner to a position minimizing the distortion effect in the region of interest for imaging. Moving the core can be done automatically using the gradient coils of the scanner, which then also enables the core to be repositioned to perform navigation to additional targets. The feasibility and potential of the approach are validated in an in vitro experiment demonstrating navigation and assessment at two targets.

Improving education and supervision of Queensland X-ray Operators through video conference technology: A teleradiography pilot project.

PubMed

Rawle, Marnie; Oliver, Tanya; Pighills, Alison; Lindsay, Daniel

2017-12-01

X-ray Operator (XO) supervision in Queensland is performed by radiographers in a site removed from the XO site. This has historically been performed by telephone when the XO requires immediate help, as well as post-examination through radiographer review and the provision of written feedback on images produced. This project aimed to improve image quality through the provision of real-time support of XOs by the introduction of video conference (VC) supervision. A 6-month pilot project compared image quality with and without VC supervision. VC equipment was installed in the X-ray room at two rural sites, as well as at the radiographer site, to enable visual and oral supervision. The VC unit enabled visualisation of the X-ray examination technique as it was being undertaken, as well as the images produced prior to transmission to the Picture Archiving and Communication System (PACS). Statistically significant improvement in image quality criteria measures were seen for patient positioning (P = 0.008), image quality (P < 0.001) and diagnostic value (P < 0.001) of images taken during this project. No statistically significant differences were seen during case level assessment in the inclusion of only appropriate imaging (P = 0.06), and the inclusion of unacceptable imaging (P = 0.06), however improvements were seen in both of these criteria. The survey revealed 24.6% of examinations performed would normally have involved the XO contacting the radiographer for assistance, although, assistance was actually provided in 88.3% of examinations. This project has demonstrated that significant improvement in image quality is achievable with VC supervision. A larger study with a control arm that did not receive direct supervision should be used to validate the findings of this study. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Coral Bleaching Assessment Through Remote Sensing and Integrated Citizen Science (CoralBASICS): Engaging Dive Instructors on Reef Characterization in Southwest, Puerto Rico Coupled with the Analysis of Water Quality Using NASA Earth Observations

NASA Astrophysics Data System (ADS)

Torres-Perez, J. L.; Armstrong, R.; Detres, Y.; Aragones-Fred, C.; Melendez, J.

2017-12-01

As recurrences of extreme sea water thermal events increase with climate change, the need for continuous monitoring of coral reefs becomes even more evident. Enabling properly trained members from the local communities to actively participate in scientific programs/research projects, provides for such monitoring at little cost once the citizens are properly trained and committed. Further, the possibility of obtaining high temporal resolution data with citizen scientists can provide for new venues to answer questions that may not be answered with traditional research approaches. The CoralBASICS project engages members of the local diving industry in Puerto Rico on the assessment of coastal water quality and the status of Puerto Rico's coral reefs in an age of climate change and in particular, an increase in the frequency and magnitude of coral bleaching events. The project complements remote sensing data with community-based field assessments strictly supervised by the PI's. The study focuses on training citizen scientists (dive instructors) on the collection of benthic information related to the state of coral reefs using the Reef Check (fish and invertebrates ID and substrate composition) and video transects methodologies, monitoring of coral bleaching events, and collecting of water quality data using a smartphone ocean color application. The data collected by citizen scientists complements the validation of Landsat-8 (OLI) imagery for water quality assessment. At the same time, researchers from the University of Puerto Rico conduct field assessment of the bio-optical properties of waters surrounding the coral reef study areas. Dive instructors have been collecting benthic and water quality data for the past 4 months. Initial analysis using the Coral Point Count with excel extension (CPCe) software showed a dominance of gorgonians at most sites (up to 32.8%) with hard coral cover ranging between 5.5-13.2% of the hard substrates. No coral diseases or bleaching have been observed so far. However, nutrient indicator algae were observed at most sites. As such, the project provides for technology and data transfer between the academia, government (NASA), researchers and local members of the community for a better assessment of environmental conditions affecting important coral reef areas in PR.

[Analysis of the Cochrane Review: Interventions for Improving Upper Limb Function after Stroke. Cochrane Database Syst Rev. 2014,11:CD010820].

PubMed

Sousa Nanji, Liliana; Torres Cardoso, André; Costa, João; Vaz-Carneiro, António

2015-01-01

Impairment of the upper limbs is quite frequent after stroke, making rehabilitation an essential step towards clinical recovery and patient empowerment. This review aimed to synthetize existing evidence regarding interventions for upper limb function improvement after Stroke and to assess which would bring some benefit. The Cochrane Database of Systematic Reviews, the Database of Reviews of Effects and PROSPERO databases were searched until June 2013 and 40 reviews have been included, covering 503 studies, 18 078 participants and 18 interventions, as well as different doses and settings of interventions. The main results were: 1- Information currently available is insufficient to assess effectiveness of each intervention and to enable comparison of interventions; 2- Transcranial direct current stimulation brings no benefit for outcomes of activities of daily living; 3- Moderate-quality evidence showed a beneficial effect of constraint-induced movement therapy, mental practice, mirror therapy, interventions for sensory impairment, virtual reality and repetitive task practice; 4- Unilateral arm training may be more effective than bilateral arm training; 5- Moderate-quality evidence showed a beneficial effect of robotics on measures of impairment and ADLs; 6- There is no evidence of benefit or harm for technics such as repetitive transcranial magnetic stimulation, music therapy, pharmacological interventions, electrical stimulation and other therapies. Currently available evidence is insufficient and of low quality, not supporting clear clinical decisions. High-quality studies are still needed.

The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms.

PubMed

Ivetić, Vojislav; Pašić, Klemen; Selič, Polona

2017-06-01

Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI. The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05). It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients' self-rated health status.

Advances in Non-Destructive Early Assessment of Fruit Ripeness towards Defining Optimal Time of Harvest and Yield Prediction—A Review

PubMed Central

Lecourt, Julien; Bishop, Gerard

2018-01-01

Global food security for the increasing world population not only requires increased sustainable production of food but a significant reduction in pre- and post-harvest waste. The timing of when a fruit is harvested is critical for reducing waste along the supply chain and increasing fruit quality for consumers. The early in-field assessment of fruit ripeness and prediction of the harvest date and yield by non-destructive technologies have the potential to revolutionize farming practices and enable the consumer to eat the tastiest and freshest fruit possible. A variety of non-destructive techniques have been applied to estimate the ripeness or maturity but not all of them are applicable for in situ (field or glasshouse) assessment. This review focuses on the non-destructive methods which are promising for, or have already been applied to, the pre-harvest in-field measurements including colorimetry, visible imaging, spectroscopy and spectroscopic imaging. Machine learning and regression models used in assessing ripeness are also discussed. PMID:29320410

Oncologists’ Perspectives on Concurrent Palliative Care in an NCI-designated Comprehensive Cancer Center

PubMed Central

Bakitas, Marie; Lyons, Kathleen Doyle; Hegel, Mark T.; Ahles, Tim

2013-01-01

Purpose To understand oncology clinicians’ perspectives about the care of advanced cancer patients following the completion of the ENABLE II (Educate, Nurture, Advise, Before Life Ends) randomized clinical trial (RCT) of a concurrent oncology palliative care model. Methods Qualitative interview study of 35 oncology clinicians about their approach to patients with advanced cancer and the effect of the ENABLE II RCT. Results Oncologists believed that integrating palliative care at the time of an advanced cancer diagnosis enhanced patient care and complemented their practice. Self-assessment of their practice with advanced cancer patients comprised four themes: 1) treating the whole patient, 2) focusing on quality versus quantity of life, 3) “some patients just want to fight”, and 4) helping with transitions; timing is everything. Five themes comprised oncologists’ views on the complementary role of palliative care: 1) “refer early and often”, 2) referral challenges: “Palliative” equals hospice; “Heme patients are different”, 3) palliative care as consultants or co-managers, 4) palliative care “shares the load”, and 5) ENABLE II facilitated palliative care integration. Conclusions Oncologists described the RCT as holistic and complementary, and as a significant factor in adopting concurrent care as a standard of care. PMID:23040412

Controlled Environments Enable Adaptive Management in Aquatic Ecosystems Under Altered Environments

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2016-01-01

Ecosystems worldwide are impacted by altered environment conditions resulting from climate, drought, and land use changes. Gaps in the science knowledge base regarding plant community response to these novel and rapid changes limit both science understanding and management of ecosystems. We describe how CE Technologies have enabled the rapid supply of gap-filling science, development of ecosystem simulation models, and remote sensing assessment tools to provide science-informed, adaptive management methods in the impacted aquatic ecosystem of the California Sacramento-San Joaquin River Delta. The Delta is the hub for California's water, supplying Southern California agriculture and urban communities as well as the San Francisco Bay area. The changes in environmental conditions including temperature, light, and water quality and associated expansion of invasive aquatic plants negatively impact water distribution and ecology of the San Francisco Bay/Delta complex. CE technologies define changes in resource use efficiencies, photosynthetic productivity, evapotranspiration, phenology, reproductive strategies, and spectral reflectance modifications in native and invasive species in response to altered conditions. We will discuss how the CE technologies play an enabling role in filling knowledge gaps regarding plant response to altered environments, parameterization and validation of ecosystem models, development of satellite-based, remote sensing tools, and operational management strategies.

Chronic kidney-disease screening service quality: questionnaire survey research evidence from Taichung City.

PubMed

Lin, Deng-Juin; Li, Ya-Hsin; Pai, Jar-Yuan; Sheu, Ing-Cheau; Glen, Robert; Chou, Ming-Jen; Lee, Ching-Yi

2009-12-19

Chronic kidney disease (CKD) is a serious public health problem in Taiwan and the world. The most effective, affordable treatments involve early prevention/detection/intervention, requiring screening. Successfully implementing CKD programs requires good patient participation, affected by patient perceptions of screening service quality. Service quality improvements can help make such programs more successful. Thus, good tools for assessing service quality perceptions are important. to investigate using a modified SERVQUAL questionnaire in assessing patient expectations, perceptions, and loyalty towards kidney disease screening service quality. 1595 kidney disease screening program patients in Taichung City were requested to complete and return a modified kidney disease screening SERVQUAL questionnaire. 1187 returned them. Incomplete ones (102) were culled and 1085 were chosen as effective for use. Paired t-tests, correlation tests, ANOVA, LSD test, and factor analysis identified the characteristics and factors of service quality. The paired t-test tested expectation score and perception score gaps. A structural equation modeling system examined satisfaction-based components' relationships. The effective response rate was 91.4%. Several methods verified validity. Cronbach's alpha on internal reliability was above 0.902. On patient satisfaction, expectation scores are high: 6.50 (0.82), but perception scores are significantly lower 6.14 (1.02). Older patients' perception scores are lower than younger patients'. Expectation and perception scores for patients with different types of jobs are significantly different. Patients higher on education have lower scores for expectation (r = -0.09) and perception (r = -0.26). Factor analysis identified three factors in the 22 item SERVQUAL form, which account for 80.8% of the total variance for the expectation scores and 86.9% of the total variance for the satisfaction scores. Expectation and perception score gaps in all 22 items are significant. The goodness-of-fit summary of the SEM results indicates that expectations and perceptions are positively correlated, perceptions and loyalty are positively correlated, but expectations and loyalty are not positively correlated. The results of this research suggest that the SERVQUAL instrument is a useful measurement tool in assessing and monitoring service quality in kidney disease screening services, enabling the staff to identify where service improvements are needed from the patients' perspectives.

Quality of diabetes care worldwide and feasibility of implementation of the Alphabet Strategy: GAIA project (Global Alphabet Strategy Implementation Audit).

PubMed

Lee, James D; Saravanan, Ponnusamy; Varadhan, Lakshminarayanan; Morrissey, John R; Patel, Vinod

2014-10-11

The Alphabet Strategy (AS) is a diabetes care checklist ensuring "important, simple things are done right all the time." Current audits of diabetes care in developed countries reveal wide variations in quality with performance of care processes frequently sub-optimal. This study had three components:• an audit to assess diabetes care quality worldwide,• a questionnaire study seeking opinions on the merits of the AS,• a pilot study to assess the practicality of implementation of the AS in a low socioeconomic setting. Audit data was collected from 52 centres across 32 countries. Data from 4537 patients were converted to Quality and Outcome Framework (QOF) scores to enable inter-centre comparison. These were compared to each country's Gross Domestic Product (GDP), and Total Health Expenditure percentage per capita (THE%). The opinions of diabetes patients and healthcare professionals from the diabetes care team at each of these centres were sought through a structured questionnaire. A retrospective audit on 100 randomly selected case notes was conducted prior to AS implementation in a diabetes outpatient clinic in India, followed by a prospective audit after four months to assess its impact on care quality. QOF scores showed wide variation across the centres (mean 49.0, range 10.2-90.1). Although there was a positive relationship between GDP and THE% to QOF scores, there were exceptions. 91% of healthcare professionals felt the AS approach was practical. Patients found the checklist to be a useful education tool. Significant improvements in several aspects of care as well as 36% improvement in QOF score were seen following implementation. International centres observed large variations in care quality, with standards frequently sub-optimal. 71% of health care professionals would consider adopting the AS in their daily practice. Implementation in a low resource country resulted in significant improvements in some aspects of diabetes care. The AS checklist for diabetes care is a freely available in the public domain encompassing patient education, care plans, and educational resources for healthcare professionals including summary guidelines. The AS may provide a unique approach in delivering high quality diabetes care in countries with limited resources.

Discriminating Talent Identified Junior Australian Footballers Using a Fundamental Gross Athletic Movement Assessment

PubMed Central

Woods, Carl T.; Banyard, Harry G.; McKeown, Ian; Fransen, Job; Robertson, Sam

2016-01-01

Talent identification (TID) is a pertinent component of the sports sciences, affording practitioners the opportunity to target developmental interventions to a select few; optimising financial investments. However, TID is multi-componential, requiring the recognition of immediate and prospective performance. The measurement of athletic movement skill may afford practitioners insight into the latter component given its augmented relationship with functional sport specific qualities. It is currently unknown whether athletic movement skill is a discriminant quality in junior Australian football (AF). This study aimed to discriminate talent identified junior AF players from their non-talent identified counterparts using a fundamental gross athletic movement assessment. From a total of 50 under 18 (U18) AF players; two groups were classified a priori based on selection level; talent identified (n = 25; state academy representatives) and non-talent identified (n = 25; state-based competition representatives). Players performed a fundamental gross athletic movement assessment based on the Athletic Ability Assessment (AAA), consisting of an overhead squat, double lunge (left and right legs), single leg Romanian deadlift (left and right legs), and a push up (six movement criterions). Movements were scored across three assessment points using a three-point scale (resulting in a possible score of nine for each movement). A multivariate analysis of variance revealed significant between group effects on four of the six movement criterions (d = 0.56 – 0.87; p = 0.01 – 0.02). Binary logistic regression models and a receiver operating characteristic curve inspection revealed that the overhead squat score provided the greatest group discrimination (β(SE) = -0.89(0.44); p < 0.05), with a score of 4.5 classifying 64% and 88% of the talent identified and non-talent identified groups, respectively. Results support the integration of this assessment into contemporary talent identification approaches in junior AF, as it may provide coaches with insight into a juniors developmental potential. Key points On average, talent identified junior AF players possess superior athletic movement qualities relative to their non-talent identified counterparts. The integration of this gross athletic movement assessment into contemporary multidimensional approaches to talent identification may enable insight into a juniors developmental potential. The athletic qualities underpinning the production of the overhead squat movement could augment functional physical qualities in junior Australian footballers. Assessing movement competency in junior contexts may afford practitioners with the opportunity to rectify inefficient fundamental movement patterns prior to entrance into elite senior ranks. PMID:27803635

Sharpening policy instruments with catchment evaluations and the water quality continuum

NASA Astrophysics Data System (ADS)

Jordan, P.; Melland, A. R.; Mellander, P.-E.; Murphy, P.; Shortle, G.; Wall, D.; Mechan, S.; Shine, O.

2012-04-01

There is a scale dichotomy in water quality management in European agricultural catchments due to the fact that impacts identified at river basin scale are mitigated by management that is typically asserted from research at field or plot scale and implemented at farm scale. Evaluations of management impact are then undertaken back at the river basin scale. The policy instruments in place to mitigate water quality impacts are also based on the integration of scientific research and stakeholder negotiations and can sometimes be blunt compromises. Nevertheless, expectations of accruing water quality benefits remain high and sometimes unchallenged. Evaluating all catchment components of a pollution transfer continuum from source to impact enables important elements such as lag time between policy implementation and water quality response, water body sampling frequency and allocation of correct dose-response mechanisms to be assessed. These points are particularly important in complex agricultural catchments where multiple nutrient pollution sources have variable impacts on different water body types - and at different times of year. The tools of catchment water quality policy evaluation are diverse and include metrics of natural resource management, soil and water chemistry, hydrology, ecology and palaeolimnology. Used in combination and with river basin scale and site-specific data inventories, they can provide a powerful suite of evidence for further iterations of water quality policy and projecting realistic expectations of policy success.

Feasibility of a Dynamic Web Guidance Approach for Personalized Physical Activity Prescription Based on Daily Information From Wearable Technology

PubMed Central

Coolbaugh, Crystal L; Raymond Jr, Stephen C

2015-01-01

Background Computer tailored, Web-based interventions have emerged as an effective approach to promote physical activity. Existing programs, however, do not adjust activities according to the participant’s compliance or physiologic adaptations, which may increase risk of injury and program attrition in sedentary adults. To address this limitation, objective activity monitor (AM) and heart rate data could be used to guide personalization of physical activity, but improved Web-based frameworks are needed to test such interventions. Objective The objective of this study is to (1) develop a personalized physical activity prescription (PPAP) app that combines dynamic Web-based guidance with multi-sensor AM data to promote physical activity and (2) to assess the feasibility of using this system in the field. Methods The PPAP app was constructed using an open-source software platform and a custom, multi-sensor AM capable of accurately measuring heart rate and physical activity. A novel algorithm was written to use a participant’s compliance and physiologic response to aerobic training (ie, changes in daily resting heart rate) recorded by the AM to create daily, personalized physical activity prescriptions. In addition, the PPAP app was designed to (1) manage the transfer of files from the AM to data processing software and a relational database, (2) provide interactive visualization features such as calendars and training tables to encourage physical activity, and (3) enable remote administrative monitoring of data quality and participant compliance. A 12-week feasibility study was performed to assess the utility and limitations of the PPAP app used by sedentary adults in the field. Changes in physical activity level and resting heart rate were monitored throughout the intervention. Results The PPAP app successfully created daily, personalized physical activity prescriptions and an interactive Web environment to guide and promote physical activity by the participants. The varied compliance of the participants enabled evaluation of administrative features of the app including the generation of automated email reminders, participation surveys, and daily AM file upload logs. Conclusions This study describes the development of the PPAP app, a closed-loop technology framework that enables personalized physical activity prescription and remote monitoring of an individual’s compliance and health response to the intervention. Data obtained during a 12-week feasibility study demonstrated the ability of the PPAP app to use objective AM data to create daily, personalized physical activity guidance, provide interactive feedback to users, and enable remote administrative monitoring of data quality and subject compliance. Using this approach, public health professionals, clinicians, and researchers can adapt the PPAP app to facilitate a range of personalized physical activity interventions to improve health outcomes, assess injury risk, and achieve fitness performance goals in diverse populations. PMID:26043793

Indigenous Community Tree Inventory: Assessment of Data Quality

NASA Astrophysics Data System (ADS)

Fauzi, M. F.; Idris, N. H.; Din, A. H. M.; Osman, M. J.; Idris, N. H.; Ishak, M. H. I.

2016-09-01

The citizen science program to supplement authoritative data in tree inventory has been well implemented in various countries. However, there is a lack of study that assesses correctness and accuracy of tree data supplied by citizens. This paper addresses the issue of tree data quality supplied by semi-literate indigenous group. The aim of this paper is to assess the correctness of attributes (tree species name, height and diameter at breast height) and the accuracy of tree horizontal positioning data supplied by indigenous people. The accuracy of the tree horizontal position recorded by GNSS-enable smart phone was found to have a RMSE value of ± 8m which is not suitable to accurately locate individual tree position in tropical rainforest such as the Royal Belum State Park. Consequently, the tree species names contributed by indigenous people were only 20 to 30 percent correct as compared with the reference data. However, the combination of indigenous respondents comprising of different ages, experience and knowledge working in a group influence less attribute error in data entry and increase the use of free text rather than audio methods. The indigenous community has a big potential to engage with scientific study due to their local knowledge with the research area, however intensive training must be given to empower their skills and several challenges need to be addressed.

MODIS imagery as a tool for synoptic water quality assessments in the southern California coastal ocean

USGS Publications Warehouse

Nezlin, N.P.; DiGiacomo, P.M.; Jones, B.H.; Reifel, K.M.; Warrick, J.A.; Johnson, S.C.; Mengel, M.J.

2007-01-01

The dynamics of rainstorm plumes in the coastal waters of southern California was studied during the Bight'03 Regional Water Quality Program surveys. Measurements of surface salinity and bacterial counts collected from research vessels were compared to MODIS-Aqua satellite imagery. The spectra of normalized water-leaving radiation (nLw) were different in plumes and ambient ocean waters, enabling plumes discrimination and plume area size assessments from remotely-sensed data. The plume/ocean nLw differences (i.e., plume optical signatures) were most evident during first days after the rainstorm over the San Pedro shelf and in the San Diego region and less evident in Santa Monica Bay, where suspended sediments concentration in discharged water was lower than in other regions. In the Ventura area, plumes contained more suspended sediments than in other regions, but the grid of ship-based stations covered only a small part of the freshwater plume and was insufficient to reveal the differences between the plume and ocean optical signatures. The accuracy of plume area assessments from satellite imagery was not high (77% on average), seemingly because of inexactitude in satellite data processing. Nevertheless, satellite imagery is a useful tool for the estimation of the extent of polluted plumes, which is hardly achievable by contact methods.

From reactive to proactive: developing a valid clinical ethics needs assessment survey to support ethics program strategic planning (part 1 of 2).

PubMed

Frolic, Andrea; Jennings, Barb; Seidlitz, Wendy; Andreychuk, Sandy; Djuric-Paulin, Angela; Flaherty, Barb; Peace, Donna

2013-03-01

As ethics committees and programs become integrated into the "usual business" of healthcare organizations, they are likely to face the predicament of responding to greater demands for service and higher expectations, without an influx of additional resources. This situation demands that ethics committees and programs allocate their scarce resources (including their time, skills and funds) strategically, rather than lurching from one ad hoc request to another; finding ways to maximize the effectiveness, efficiency, impact and quality of ethics services is essential in today's competitive environment. How can Hospital Ethics Committees (HECs) begin the process of strategic priority-setting to ensure they are delivering services where and how they are most needed? This paper describes the creation of the Clinical Ethics Needs Assessment Survey (CENAS) as a tool to understand interprofessional staff perceptions of the organization's ethical climate, challenging ethical issues and educational priorities. The CENAS was designed to support informed resource allocation and advocacy by HECs. By sharing our process of developing and validating this ethics needs assessment survey we hope to enable strategic priority-setting in other resource-strapped ethics programs, and to empower HECs to shift their focus to more proactive, quality-focused initiatives.

The Quality of Life in Hand Eczema Questionnaire (QOLHEQ): validation of the German version of a new disease-specific measure of quality of life for patients with hand eczema.

PubMed

Ofenloch, R F; Weisshaar, E; Dumke, A-K; Molin, S; Diepgen, T L; Apfelbacher, C

2014-08-01

Health-related quality of life (HRQOL) is widely used as a patient-reported outcome to evaluate clinical trials. In routine care it can also be used to improve treatment strategies or to enhance patients' self-awareness and empowerment. Therefore a disease-specific instrument is needed that assesses in detail all the impairments caused by the disease of interest. For patients with hand eczema (HE) such an instrument was developed by an international expert group, but its measurement properties are unknown. To validate the German version of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ), which covers the domains of (i) symptoms, (ii) emotions, (iii) functioning and (iv) treatment and prevention. The QOLHEQ was assessed up to three times in 316 patients with HE to test reliability and sensitivity to change. To test construct validity we also assessed several reference measures. The scale structure was analysed using the Rasch model for each subscale and a structural equation model was used to test the multi domain structure of the QOLHEQ. After minor adaptions of the scoring structure, all four subscales of the QOLHEQ did not significantly misfit the Rasch model (α > 0·05). The fit indices of the structural equation model showed a good fit of the multi domain construct with four subscales assessing HRQOL. Nearly all a priori-defined hypotheses relating to construct validity could be confirmed. The QOLHEQ showed a sensitivity to change that was superior compared with all reference measures. The QOLHEQ is ready to be used in its German version as a sensitive outcome measure in clinical trials and for routine monitoring. The treatment-relevant subscales enable its use to enhance patients' self-awareness and to monitor treatment decisions. © 2014 British Association of Dermatologists.

Assessing the Impacts of Land Use Change from Cotton to Perennial Bioenergy Grasses on Hydrological Fluxes and Water Quality in a Semi-Arid Agricultural Watershed Using the APEX Model

NASA Astrophysics Data System (ADS)

Chen, Y.; Ale, S.; Rajan, N.

2015-12-01

The semi-arid Texas High Plains (THP) region, where cotton (Gossypium hirsutum L.) is grown in vast acreage, has the potential to grow perennial bioenergy grasses. A change in land use from cotton cropping systems to perennial grasses such as Alamo switchgrass (Panicum virgatum L.) and Miscanthus giganteus (Miscanthus sinensis Anderss. [Poaceae]) can significantly affect regional hydrologic cycle and water quality. Assessing the impacts of this potential land use change on hydrology and water quality enables the environmental assessment of feasibility to grow perennial grasses in this region to meet the U.S. national bioenergy target of 2022. The Agricultural Policy/Environmental eXtender (APEX) model was used in this study to assess the impacts of replacing cotton with switchgrass and Miscanthus on water and nitrogen balances in the upstream subwatershed of the Double Mountain Fork Brazos watershed in the THP, which contains 52% cotton land use. The APEX model was initially calibrated against observed streamflow and crop yield data. Since observed data on nitrogen loads in streamflow was not available for this subwatershed, we calibrated the APEX model against the SWAT-simulated nitrogen loads at the outlet of this subwatershed, which were obtained in a parallel study. The calibrated APEX model was used to simulate the impacts of land use change from cotton to Miscanthus and switchgrass on surface and subsurface water and nitrogen balances. Preliminary results revealed that the average (1994-2009) annual surface runoff decreased by 84% and 66% under the irrigated and dryland switchgrass scenarios compared to the baseline scenarios. Average annual percolation increased by 106% and 57% under the irrigated and dryland switchgrass scenarios relative to the baseline scenarios. Preliminary results also indicated Miscanthus and switchgrass appeared to be superior to cotton in terms of better water conservation and water quality, and minimum crop management requirements.

Uncertainty in exposure to air pollution

NASA Astrophysics Data System (ADS)

Pebesma, Edzer; Helle, Kristina; Christoph, Stasch; Rasouli, Soora; Timmermans, Harry; Walker, Sam-Erik; Denby, Bruce

2013-04-01

To assess exposure to air pollution for a person or for a group of people, one needs to know where the person or group is as a function of time, and what the air pollution is at these times and locations. In this study we used the Albatross activity-based model to assess the whereabouts of people and the uncertainties in this, and a probabilistic air quality system based on TAPM/EPISODE to assess air quality probabilistically. The outcomes of the two models were combined to assess exposure to air pollution, and the errors in it. We used the area around Rotterdam (Netherlands) as a case study. As the outcomes of both models come as Monte Carlo realizations, it was relatively easy to cancel one of the sources of uncertainty (movement of persons, air pollution) in order to identify their respective contributions, and also to compare evaluations for individuals with averages for a population of persons. As the output is probabilistic, and in addition spatially and temporally varying, the visual analysis of the complete results poses some challenges. This case study was one of the test cases in the UncertWeb project, which has built concepts and tools to realize the uncertainty-enabled model web. Some of the tools and protocols will be shown and evaluated in this presentation. For the uncertainty of exposure, the uncertainty of air quality was more important than the uncertainty of peoples locations. This difference was stronger for PM10 than for NO2. The workflow was implemented as generic Web services in UncertWeb that also allow for other inputs than the simulated activity schedules and air quality with other resolution. However, due to this flexibility, the Web services require standardized formats and the overlay algorithm is not optimized for the specific use case resulting in a data and processing overhead. Hence, we implemented the full analysis in parallel in R, for this specific case as the model web solution had difficulties with massive data.

Using Computational Toxicology to Enable Risk-Based ...

EPA Pesticide Factsheets

presentation at Drug Safety Gordon Research Conference 2016 on research efforts in NCCT to enable Computational Toxicology to support risk assessment. Slide presentation at Drug Safety Gordon Research Conference 2016 on research efforts in NCCT to enable Computational Toxicology to support risk assessment.

The Metadata Coverage Index (MCI): A standardized metric for quantifying database metadata richness.

PubMed

Liolios, Konstantinos; Schriml, Lynn; Hirschman, Lynette; Pagani, Ioanna; Nosrat, Bahador; Sterk, Peter; White, Owen; Rocca-Serra, Philippe; Sansone, Susanna-Assunta; Taylor, Chris; Kyrpides, Nikos C; Field, Dawn

2012-07-30

Variability in the extent of the descriptions of data ('metadata') held in public repositories forces users to assess the quality of records individually, which rapidly becomes impractical. The scoring of records on the richness of their description provides a simple, objective proxy measure for quality that enables filtering that supports downstream analysis. Pivotally, such descriptions should spur on improvements. Here, we introduce such a measure - the 'Metadata Coverage Index' (MCI): the percentage of available fields actually filled in a record or description. MCI scores can be calculated across a database, for individual records or for their component parts (e.g., fields of interest). There are many potential uses for this simple metric: for example; to filter, rank or search for records; to assess the metadata availability of an ad hoc collection; to determine the frequency with which fields in a particular record type are filled, especially with respect to standards compliance; to assess the utility of specific tools and resources, and of data capture practice more generally; to prioritize records for further curation; to serve as performance metrics of funded projects; or to quantify the value added by curation. Here we demonstrate the utility of MCI scores using metadata from the Genomes Online Database (GOLD), including records compliant with the 'Minimum Information about a Genome Sequence' (MIGS) standard developed by the Genomic Standards Consortium. We discuss challenges and address the further application of MCI scores; to show improvements in annotation quality over time, to inform the work of standards bodies and repository providers on the usability and popularity of their products, and to assess and credit the work of curators. Such an index provides a step towards putting metadata capture practices and in the future, standards compliance, into a quantitative and objective framework.

Synthesising quantitative and qualitative research in evidence-based patient information.

PubMed

Goldsmith, Megan R; Bankhead, Clare R; Austoker, Joan

2007-03-01

Systematic reviews have, in the past, focused on quantitative studies and clinical effectiveness, while excluding qualitative evidence. Qualitative research can inform evidence-based practice independently of other research methodologies but methods for the synthesis of such data are currently evolving. Synthesising quantitative and qualitative research in a single review is an important methodological challenge. This paper describes the review methods developed and the difficulties encountered during the process of updating a systematic review of evidence to inform guidelines for the content of patient information related to cervical screening. Systematic searches of 12 electronic databases (January 1996 to July 2004) were conducted. Studies that evaluated the content of information provided to women about cervical screening or that addressed women's information needs were assessed for inclusion. A data extraction form and quality assessment criteria were developed from published resources. A non-quantitative synthesis was conducted and a tabular evidence profile for each important outcome (eg "explain what the test involves") was prepared. The overall quality of evidence for each outcome was then assessed using an approach published by the GRADE working group, which was adapted to suit the review questions and modified to include qualitative research evidence. Quantitative and qualitative studies were considered separately for every outcome. 32 papers were included in the systematic review following data extraction and assessment of methodological quality. The review questions were best answered by evidence from a range of data sources. The inclusion of qualitative research, which was often highly relevant and specific to many components of the screening information materials, enabled the production of a set of recommendations that will directly affect policy within the NHS Cervical Screening Programme. A practical example is provided of how quantitative and qualitative data sources might successfully be brought together and considered in one review.

MO-C-18A-01: Advances in Model-Based 3D Image Reconstruction

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

Chen, G; Pan, X; Stayman, J

2014-06-15

Recent years have seen the emergence of CT image reconstruction techniques that exploit physical models of the imaging system, photon statistics, and even the patient to achieve improved 3D image quality and/or reduction of radiation dose. With numerous advantages in comparison to conventional 3D filtered backprojection, such techniques bring a variety of challenges as well, including: a demanding computational load associated with sophisticated forward models and iterative optimization methods; nonlinearity and nonstationarity in image quality characteristics; a complex dependency on multiple free parameters; and the need to understand how best to incorporate prior information (including patient-specific prior images) within themore » reconstruction process. The advantages, however, are even greater – for example: improved image quality; reduced dose; robustness to noise and artifacts; task-specific reconstruction protocols; suitability to novel CT imaging platforms and noncircular orbits; and incorporation of known characteristics of the imager and patient that are conventionally discarded. This symposium features experts in 3D image reconstruction, image quality assessment, and the translation of such methods to emerging clinical applications. Dr. Chen will address novel methods for the incorporation of prior information in 3D and 4D CT reconstruction techniques. Dr. Pan will show recent advances in optimization-based reconstruction that enable potential reduction of dose and sampling requirements. Dr. Stayman will describe a “task-based imaging” approach that leverages models of the imaging system and patient in combination with a specification of the imaging task to optimize both the acquisition and reconstruction process. Dr. Samei will describe the development of methods for image quality assessment in such nonlinear reconstruction techniques and the use of these methods to characterize and optimize image quality and dose in a spectrum of clinical applications. Learning Objectives: Learn the general methodologies associated with model-based 3D image reconstruction. Learn the potential advantages in image quality and dose associated with model-based image reconstruction. Learn the challenges associated with computational load and image quality assessment for such reconstruction methods. Learn how imaging task can be incorporated as a means to drive optimal image acquisition and reconstruction techniques. Learn how model-based reconstruction methods can incorporate prior information to improve image quality, ease sampling requirements, and reduce dose.« less

A water quality management strategy for regionally protected water through health risk assessment and spatial distribution of heavy metal pollution in 3 marine reserves.

PubMed

Zhang, Yinan; Chu, Chunli; Li, Tong; Xu, Shengguo; Liu, Lei; Ju, Meiting

2017-12-01

Severe water pollution and resource scarcity is a major problem in China, where it is necessary to establish water quality-oriented monitoring and intelligent watershed management. In this study, an effective watershed management method is explored, in which water quality is first assessed using the heavy metal pollution index and the human health risk index, and then by classifying the pollution and management grade based on cluster analysis and GIS visualization. Three marine reserves in Tianjin were selected and analyzed, namely the Tianjin Ancient Coastal Wetland National Nature Reserve (Qilihai Natural Reserve), the Tianjin DaShentang Oyster Reef National Marine Special Reserve (DaShentang Reserve), and the Tianjin Coastal Wetland National Marine Special Reserve (BinHai Wetland Reserve) which is under construction. The water quality and potential human health risks of 5 heavy metals (Pb, As, Cd, Hg, Cr) in the three reserves were assessed using the Nemerow index and USEPA methods. Moreover, ArcGIS10.2 software was used to visualize the heavy metal index and display their spatial distribution. Cluster analysis enabled classification of the heavy metals into 4 categories, which allowed for identification of the heavy metals whose pollution index and health risks were highest, and, thus, whose control in the reserve is a priority. Results indicate that heavy metal pollution exists in the Qilihai Natural Reserve and in the north and east of the DaShentang Reserve; furthermore, human health risks exist in the Qilihai Natural Reserve and in the BinHai Wetland Reserve. In each reserve, the main factor influencing the pollution and health risk were high concentrations of As and Pb that exceed the corresponding standards. Measures must be adopted to control and remediate the pollutants. Furthermore, to protect the marine reserves, management policies must be implemented to improve water quality, which is an urgent task for both local and national governments. Copyright © 2017 Elsevier B.V. All rights reserved.

Using direct clinical observation to assess the quality of cesarean delivery in Afghanistan: an exploratory study

PubMed Central

2014-01-01

Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical of providers and facilities and detect potential Hawthorne effects. PMID:24886143

Tips and tricks for the assembly of a Corynebacterium pseudotuberculosis genome using a semiconductor sequencer.

PubMed

Ramos, Rommel Thiago Jucá; Carneiro, Adriana Ribeiro; Soares, Siomar de Castro; dos Santos, Anderson Rodrigues; Almeida, Sintia; Guimarães, Luis; Figueira, Flávia; Barbosa, Eudes; Tauch, Andreas; Azevedo, Vasco; Silva, Artur

2013-03-01

New sequencing platforms have enabled rapid decoding of complete prokaryotic genomes at relatively low cost. The Ion Torrent platform is an example of these technologies, characterized by lower coverage, generating challenges for the genome assembly. One particular problem is the lack of genomes that enable reference-based assembly, such as the one used in the present study, Corynebacterium pseudotuberculosis biovar equi, which causes high economic losses in the US equine industry. The quality treatment strategy incorporated into the assembly pipeline enabled a 16-fold greater use of the sequencing data obtained compared with traditional quality filter approaches. Data preprocessing prior to the de novo assembly enabled the use of known methodologies in the next-generation sequencing data assembly. Moreover, manual curation was proved to be essential for ensuring a quality assembly, which was validated by comparative genomics with other species of the genus Corynebacterium. The present study presents a modus operandi that enables a greater and better use of data obtained from semiconductor sequencing for obtaining the complete genome from a prokaryotic microorganism, C. pseudotuberculosis, which is not a traditional biological model such as Escherichia coli. © 2012 The Authors. Published by Society for Applied Microbiology and Blackwell Publishing Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Prediction and inter-dependence of stock and change of soil quality, function and diversity at a national scale and implications for ecosystem services

NASA Astrophysics Data System (ADS)

Reynolds, B.; Emmett, B.; Spurgeon, D.; Rowe, E. C.; Mills, R.; Griffiths, R.; Jones, D.; Simfukwe, P.

2011-12-01

A soils monitoring programme which uses an ecosystem approach has been in place in Great Britain for 30 years.The findings from the latest survey in 2007 has been interpreted within a natural capital and ecosystem services context to assess the outcome of a range of policies to protect the natural environment and increase sustainability. Issues of interest included the impacts of declines in atmospheric deposition of acidity, nitrogen and metals, the benefits of agri-environment schemes and climate change on carbon storage in soils and soil biodiversity, and reduced fertiliser applications on eutrophication of soils and waters. Topsoil samples (0-15cm) were taken within 600 1km squares across the country stratified to cover all major habitat types. At the same time botanical surveys in permanent vegetation plots were recorded together with change in land use and management and stream and pond water quality and ecology. These data are used together with satellite images, digital cartography, and ancillary datasets to assess change in landcover for all of GB and upscaling of change data from the samples squares. Changes in topsoil were assessed in 1978, 1998 and again in 2007. An increase in pH but no change in soil carbon was observed between 1978 and 2007. Additional measures added in 1998 enabled a decline in Olsen-P,increase in C:N, decline in soil mesofauna diversity and decline in many metal concentrations to be identified over the last 10 years. In 2007, futher measurements were added to include carbon substrate utilisation, nitrogen mineralisation and bacterial diversity (fungi is in progress)enabling national maps to be created for the first time for these important soil parameters. Multi-variate statistics were used to explore the relationship between the different soil measures, the predictive capability of soil and vegetation type, and drivers of change to be identified. In addition, assigning measurements to specific functions which underpinned individual supporting and regulation services provided a method for assessing direction of change of a range of ecosystem services at national scale for the first time.

A new approach to power quality and electricity reliability monitoring-case study illustrations of the capabilities of the I-GridTM system

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

Divan, Deepak; Brumsickle, William; Eto, Joseph

2003-04-01

This report describes a new approach for collecting information on power quality and reliability and making it available in the public domain. Making this information readily available in a form that is meaningful to electricity consumers is necessary for enabling more informed private and public decisions regarding electricity reliability. The system dramatically reduces the cost (and expertise) needed for customers to obtain information on the most significant power quality events, called voltage sags and interruptions. The system also offers widespread access to information on power quality collected from multiple sites and the potential for capturing information on the impacts ofmore » power quality problems, together enabling a wide variety of analysis and benchmarking to improve system reliability. Six case studies demonstrate selected functionality and capabilities of the system, including: Linking measured power quality events to process interruption and downtime; Demonstrating the ability to correlate events recorded by multiple monitors to narrow and confirm the causes of power quality events; and Benchmarking power quality and reliability on a firm and regional basis.« less

Integrating Science and Land Management for the Conservation Effects Assessment Project (CEAP) in Southwestern Rangelands

NASA Astrophysics Data System (ADS)

Goodrich, D. C.; Heilman, P.; Nearing, M.; Speath, K.; Hernandez, M.; Wei, H.; Holifield-Collins, C.; Kautz, M.; Nichols, M.; Barlow, J.; Guertin, P.; Burns, S.; Stone, J. J.; Weltz, M.; Metz, L.; Norfleet, L.; Duriancik, L.; Johnson, M.

2013-12-01

Farm Bill legislation enacted by Congress in 2002 directed the U.S. Department of Agriculture to assess of the benefits and efficacy of conservation practices provided by a variety of USDA programs. Benefits include improved agricultural production, reduction of erosion and associated nutrient losses, improved water quality, improved soil resilience, and improved habitat among others. To conduct the assessment, the USDA initiated CEAP or the Conservation Effects Assessment Project in 2003, which included a national assessment complemented by small watershed studies. The national assessment started in eastern and midwestern cultivated croplands and has now progressed to western rangelands. This presentation will discuss the challenges of assessing the effects of rangeland conservation practices in a period of unusually hot and dry climatic conditions in the Cienega Creek Watershed (CCW) located southeast of Tucson, Arizona. As is common in the western U.S., the CCW consists of a patchwork of private and public lands in the west with much of the public lands leased for grazing cattle. The watershed also has high recreational value and provides many ecosystem services, including wildlife habitat qualities and flood protection to Tucson. A combination of monitoring, modeling, and remote sensing was utilized in the assessment. Conservation spending in the watershed ramped up in 1997. However, the 16-year period from 1997-2012 contains almost half of the 23 driest seasons (lowest 20 percentile) from the 117-year observed precipitation record. Initial results indicate that Landsat remotely sensed images can be effectively used to estimate both green and senescent canopy cover. This enabled detection of the impacts of drought and changes in canopy cover from practices such as prescribed fire and mechanical brush removal. Cienega Creek Watershed - Land Ownership

Towards a collaborative, global infrastructure for biodiversity assessment

PubMed Central

Guralnick, Robert P; Hill, Andrew W; Lane, Meredith

2007-01-01

Biodiversity data are rapidly becoming available over the Internet in common formats that promote sharing and exchange. Currently, these data are somewhat problematic, primarily with regard to geographic and taxonomic accuracy, for use in ecological research, natural resources management and conservation decision-making. However, web-based georeferencing tools that utilize best practices and gazetteer databases can be employed to improve geographic data. Taxonomic data quality can be improved through web-enabled valid taxon names databases and services, as well as more efficient mechanisms to return systematic research results and taxonomic misidentification rates back to the biodiversity community. Both of these are under construction. A separate but related challenge will be developing web-based visualization and analysis tools for tracking biodiversity change. Our aim was to discuss how such tools, combined with data of enhanced quality, will help transform today's portals to raw biodiversity data into nexuses of collaborative creation and sharing of biodiversity knowledge. PMID:17594421

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.

Novel Hyperspectral Sun Photometer for Satellite Remote Sensing Data Radiometric Calibration and Atmospheric Aerosol Studies

NASA Technical Reports Server (NTRS)

Pagnutti, Mary; Ryan, Robert E.; Holekamp, Kara; Harrington, Gary; Frisbie, Troy

2006-01-01

A simple and cost-effective, hyperspectral sun photometer for radiometric vicarious remote sensing system calibration, air quality monitoring, and potentially in-situ planetary climatological studies, was developed. The device was constructed solely from off the shelf components and was designed to be easily deployable for support of short-term verification and validation data collects. This sun photometer not only provides the same data products as existing multi-band sun photometers, this device requires a simpler setup, less data acquisition time and allows for a more direct calibration approach. Fielding this instrument has also enabled Stennis Space Center (SSC) Applied Sciences Directorate personnel to cross calibrate existing sun photometers. This innovative research will position SSC personnel to perform air quality assessments in support of the NASA Applied Sciences Program's National Applications program element as well as to develop techniques to evaluate aerosols in a Martian or other planetary atmosphere.

Development and validation of an APCI-MS/GC–MS approach for the classification and prediction of Cheddar cheese maturity

PubMed Central

Gan, Heng Hui; Yan, Bingnan; Linforth, Robert S.T.; Fisk, Ian D.

2016-01-01

Headspace techniques have been extensively employed in food analysis to measure volatile compounds, which play a central role in the perceived quality of food. In this study atmospheric pressure chemical ionisation-mass spectrometry (APCI-MS), coupled with gas chromatography–mass spectrometry (GC–MS), was used to investigate the complex mix of volatile compounds present in Cheddar cheeses of different maturity, processing and recipes to enable characterisation of the cheeses based on their ripening stages. Partial least squares-linear discriminant analysis (PLS-DA) provided a 70% success rate in correct prediction of the age of the cheeses based on their key headspace volatile profiles. In addition to predicting maturity, the analytical results coupled with chemometrics offered a rapid and detailed profiling of the volatile component of Cheddar cheeses, which could offer a new tool for quality assessment and accelerate product development. PMID:26212994

[Not Available].

PubMed

Abril, Encarnación; Gómez-Conesa, Antonia; Gutiérrez-Santos, Manuel

2008-05-01

To assess the quality of physiotherapeutic care in patients treated for low back pain in a Primary Health Care physiotherapy unit, and to improve the quality of the care provided to these patients. The first assessment includes all patients treated in 2002 (n=83). Five criteria corresponding to the initial physiotherapeutic assessment were chosen: C1, pain; C2, disability; C3, mobility, muscle examination, and C5, palpation. In order to detect non-compliance, the Ishikawa Fishbone diagram was used. Corrective measures were established in November 2003: publication of an Oswestry questionnaire model for assessing disability and reflecting on the results obtained. The second assessment includes the period of time from 1st November 2003 to 6th April 2004 (n=32). In the initial assessment, compliances observed were: C1: 21.69%; C2: 0; C3: 69.87%; C4: 78.31%, and C5: 84.33%. After implementing corrective measures a significant improvement was observed in the compliance of C1, C2, and C3. In C4 there was an improvement, and in C5 there was a decrease in compliance, both of them without statistical significance. The carrying out of an improvement cycle has enabled non-compliances in the application of this protocol to be detected and corrected. The corrective measures implemented have led to a reduction of the variability in the records. It is advisable to ensure that compliance does not decrease in the areas that initially showed a high level of compliance. Copyright © 2008 Sociedad Española de Calidad Asistencial. Published by Elsevier Espana. All rights reserved.

Vision and operational concept for enabling advanced traveler information services : market readiness assessment (EnableATIS).

DOT National Transportation Integrated Search

2012-05-01

The purpose of this market readiness assessment is to identify next steps for USDOT to research, demonstrate and advance the objectives of EnableATIS. This will include demonstrating those key concepts that will be within the USDOT and agency sphere ...

Dual-color Proteomic Profiling of Complex Samples with a Microarray of 810 Cancer-related Antibodies*

PubMed Central

Schröder, Christoph; Jacob, Anette; Tonack, Sarah; Radon, Tomasz P.; Sill, Martin; Zucknick, Manuela; Rüffer, Sven; Costello, Eithne; Neoptolemos, John P.; Crnogorac-Jurcevic, Tatjana; Bauer, Andrea; Fellenberg, Kurt; Hoheisel, Jörg D.

2010-01-01

Antibody microarrays have the potential to enable comprehensive proteomic analysis of small amounts of sample material. Here, protocols are presented for the production, quality assessment, and reproducible application of antibody microarrays in a two-color mode with an array of 1,800 features, representing 810 antibodies that were directed at 741 cancer-related proteins. In addition to measures of array quality, we implemented indicators for the accuracy and significance of dual-color detection. Dual-color measurements outperform a single-color approach concerning assay reproducibility and discriminative power. In the analysis of serum samples, depletion of high-abundance proteins did not improve technical assay quality. On the contrary, depletion introduced a strong bias in protein representation. In an initial study, we demonstrated the applicability of the protocols to proteins derived from urine samples. We identified differences between urine samples from pancreatic cancer patients and healthy subjects and between sexes. This study demonstrates that biomedically relevant data can be produced. As demonstrated by the thorough quality analysis, the dual-color antibody array approach proved to be competitive with other proteomic techniques and comparable in performance to transcriptional microarray analyses. PMID:20164060

Solving the Problem: Genome Annotation Standards before the Data Deluge.

PubMed

Klimke, William; O'Donovan, Claire; White, Owen; Brister, J Rodney; Clark, Karen; Fedorov, Boris; Mizrachi, Ilene; Pruitt, Kim D; Tatusova, Tatiana

2011-10-15

The promise of genome sequencing was that the vast undiscovered country would be mapped out by comparison of the multitude of sequences available and would aid researchers in deciphering the role of each gene in every organism. Researchers recognize that there is a need for high quality data. However, different annotation procedures, numerous databases, and a diminishing percentage of experimentally determined gene functions have resulted in a spectrum of annotation quality. NCBI in collaboration with sequencing centers, archival databases, and researchers, has developed the first international annotation standards, a fundamental step in ensuring that high quality complete prokaryotic genomes are available as gold standard references. Highlights include the development of annotation assessment tools, community acceptance of protein naming standards, comparison of annotation resources to provide consistent annotation, and improved tracking of the evidence used to generate a particular annotation. The development of a set of minimal standards, including the requirement for annotated complete prokaryotic genomes to contain a full set of ribosomal RNAs, transfer RNAs, and proteins encoding core conserved functions, is an historic milestone. The use of these standards in existing genomes and future submissions will increase the quality of databases, enabling researchers to make accurate biological discoveries.

Solving the Problem: Genome Annotation Standards before the Data Deluge

PubMed Central

Klimke, William; O'Donovan, Claire; White, Owen; Brister, J. Rodney; Clark, Karen; Fedorov, Boris; Mizrachi, Ilene; Pruitt, Kim D.; Tatusova, Tatiana

2011-01-01

The promise of genome sequencing was that the vast undiscovered country would be mapped out by comparison of the multitude of sequences available and would aid researchers in deciphering the role of each gene in every organism. Researchers recognize that there is a need for high quality data. However, different annotation procedures, numerous databases, and a diminishing percentage of experimentally determined gene functions have resulted in a spectrum of annotation quality. NCBI in collaboration with sequencing centers, archival databases, and researchers, has developed the first international annotation standards, a fundamental step in ensuring that high quality complete prokaryotic genomes are available as gold standard references. Highlights include the development of annotation assessment tools, community acceptance of protein naming standards, comparison of annotation resources to provide consistent annotation, and improved tracking of the evidence used to generate a particular annotation. The development of a set of minimal standards, including the requirement for annotated complete prokaryotic genomes to contain a full set of ribosomal RNAs, transfer RNAs, and proteins encoding core conserved functions, is an historic milestone. The use of these standards in existing genomes and future submissions will increase the quality of databases, enabling researchers to make accurate biological discoveries. PMID:22180819

Workflow for Criticality Assessment Applied in Biopharmaceutical Process Validation Stage 1.

PubMed

Zahel, Thomas; Marschall, Lukas; Abad, Sandra; Vasilieva, Elena; Maurer, Daniel; Mueller, Eric M; Murphy, Patrick; Natschläger, Thomas; Brocard, Cécile; Reinisch, Daniela; Sagmeister, Patrick; Herwig, Christoph

2017-10-12

Identification of critical process parameters that impact product quality is a central task during regulatory requested process validation. Commonly, this is done via design of experiments and identification of parameters significantly impacting product quality (rejection of the null hypothesis that the effect equals 0). However, parameters which show a large uncertainty and might result in an undesirable product quality limit critical to the product, may be missed. This might occur during the evaluation of experiments since residual/un-modelled variance in the experiments is larger than expected a priori. Estimation of such a risk is the task of the presented novel retrospective power analysis permutation test. This is evaluated using a data set for two unit operations established during characterization of a biopharmaceutical process in industry. The results show that, for one unit operation, the observed variance in the experiments is much larger than expected a priori, resulting in low power levels for all non-significant parameters. Moreover, we present a workflow of how to mitigate the risk associated with overlooked parameter effects. This enables a statistically sound identification of critical process parameters. The developed workflow will substantially support industry in delivering constant product quality, reduce process variance and increase patient safety.

From Theory to Practice: Measuring end-of-life communication quality using multiple goals theory.

PubMed

Van Scoy, L J; Scott, A M; Reading, J M; Chuang, C H; Chinchilli, V M; Levi, B H; Green, M J

2017-05-01

To describe how multiple goals theory can be used as a reliable and valid measure (i.e., coding scheme) of the quality of conversations about end-of-life issues. We analyzed conversations from 17 conversations in which 68 participants (mean age=51years) played a game that prompted discussion in response to open-ended questions about end-of-life issues. Conversations (mean duration=91min) were audio-recorded and transcribed. Communication quality was assessed by three coders who assigned numeric scores rating how well individuals accomplished task, relational, and identity goals in the conversation. The coding measure, which results in a quantifiable outcome, yielded strong reliability (intra-class correlation range=0.73-0.89 and Cronbach's alpha range=0.69-0.89 for each of the coded domains) and validity (using multilevel nonlinear modeling, we detected significant variability in scores between games for each of the coded domains, all p-values <0.02). Our coding scheme provides a theory-based measure of end-of-life conversation quality that is superior to other methods of measuring communication quality. Our description of the coding method enables researches to adapt and apply this measure to communication interventions in other clinical contexts. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Enabling nutrient security and sustainability through systems research.

PubMed

Kaput, Jim; Kussmann, Martin; Mendoza, Yery; Le Coutre, Ronit; Cooper, Karen; Roulin, Anne

2015-05-01

Human and companion animal health depends upon nutritional quality of foods. Seed varieties, seasonal and local growing conditions, transportation, food processing, and storage, and local food customs can influence the nutrient content of food. A new and intensive area of investigation is emerging that recognizes many factors in these agri-food systems that influence the maintenance of nutrient quality which is fundamental to ensure nutrient security for world populations. Modeling how these systems function requires data from different sectors including agricultural, environmental, social, and economic, but also must incorporate basic nutrition and other biomedical sciences. Improving the agri-food system through advances in pre- and post-harvest processing methods, biofortification, or fortifying processed foods will aid in targeting nutrition for populations and individuals. The challenge to maintain and improve nutrient quality is magnified by the need to produce food locally and globally in a sustainable and consumer-acceptable manner for current and future populations. An unmet requirement for assessing how to improve nutrient quality, however, is the basic knowledge of how to define health. That is, health cannot be maintained or improved by altering nutrient quality without an adequate definition of what health means for individuals and populations. Defining and measuring health therefore becomes a critical objective for basic nutritional and other biomedical sciences.

Retinal Prosthesis System for Advanced Retinitis Pigmentosa: A Health Technology Assessment Update

PubMed Central

Lee, Christine; Tu, Hong Anh; Wells, David; Holubowich, Corinne

2017-01-01

Background Retinitis pigmentosa is a group of inherited disorders characterized by the degeneration of the photoreceptors in the retina, resulting in progressive vision loss. The Argus II system is designed to restore partial functional vision in patients with profound vision loss from advanced retinitis pigmentosa. At present, it is the only treatment option approved by Health Canada for this patient population. In June 2016, Health Quality Ontario published a health technology assessment of the Argus II retinal prosthesis system for patients with advanced retinitis pigmentosa. Based on that assessment, the Ontario Health Technology Advisory Committee recommended against publicly funding the Argus II system for this population. It also recommended that Health Quality Ontario re-evaluate the evidence in 1 year. The objective of this report was to examine new evidence published since the 2016 health technology assessment. Methods We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences related to the Argus II system. We performed a systematic literature search for studies published since the 2016 Argus II health technology assessment. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care, and we calculated incremental cost-effectiveness ratios over a 20-year time horizon. We also conducted a five-year budget impact analysis. Finally, we interviewed people with retinitis pigmentosa about their lived experience with vision loss, and with the Argus II system. Results Four publications from one multicentre international study were included in the clinical review. Patients showed significant improvements in visual function and functional outcomes with the Argus II system, and these outcomes were sustained up to a 5-year follow-up (moderate quality of evidence). The safety profile was generally acceptable. In the base case economic analysis, the Argus II system was cost-effective compared with standard care if the willingness to pay was more than $97,429 per quality-adjusted life-year. We estimated that funding the Argus II system would cost the province $0.71 to $0.78 million per year over 5 years, assuming 4 implants per year. People with lived experience spoke about the challenges of retinitis pigmentosa, including the gradual but persistent progression of the disease; its impact on their quality of life and their families; and the accessibility challenges they faced. Those who used the Argus II system spoke about its positive impact on their quality of life. Conclusions Based on evidence of moderate quality, the Argus II retinal prosthesis system improved visual function, real-life functional outcomes, and quality of life in patients with advanced retinitis pigmentosa. The Argus II system is expensive, but the cost to publicly fund it would be low, because of the small number of eligible patients. The Argus II system can only enable perception of light/dark and shapes/objects, but these advancements represent important gains for people with retinitis pigmentosa in terms of mobility and quality of life. PMID:29201260

Remote Sensing of Water Quality in the Niger River Basin

NASA Astrophysics Data System (ADS)

Mueller, C.; Palacios, S. L.; Milesi, C.; Schmidt, C.; Baney, O. N.; Mitchell, Å. R.; Kislik, E.; Palmer-Moloney, L. J.

2015-12-01

An overarching goal of the National Geospatial Intelligence Agency (NGA) Anticipatory Analytics- -GEOnarrative program is to establish water linkages with energy, food, and climate and to understand how these linkages relate to national security and stability. Recognizing that geopolitical stability is tied to human health, agricultural productivity, and natural ecosystems' vitality, NGA partnered with NASA Ames Research Center to use satellite remote sensing to assess water quality in West Africa, specifically the Niger River Basin. Researchers from NASA Ames used MODIS and Landsat imagery to apply two water quality indices-- the Floating Algal Index (FAI) and the Turbidity Index (TI)--to large rivers, lakes and reservoirs within the Niger Basin. These indices were selected to evaluate which observations were most suitable for monitoring water quality in a region where coincident in situ measurements are not available. In addition, the FAI and TI indices were derived using data from the Hyperspectral Imagery for the Coastal Ocean (HICO) sensor for Lake Erie in the United States to determine how increased spectral resolution and in-situ measurements would improve the ability to measure the spatio-temporal variations in water quality. Results included the comparison of outputs from sensors with different spectral and spatial resolution characteristics for water quality monitoring. Approaches, such as the GEOnarrative, that incorporate water quality will enable analysts and decision-makers to recognize the current and potentially future impacts of changing water quality on regional security and stability.

Nursing implications: symptom presentation and quality of life in rectal cancer patients.

PubMed

O'Gorman, Claire; Barry, Amanda; Denieffe, Suzanne; Sasiadek, Wojciech; Gooney, Martina

2016-05-01

To determine the changes in symptoms experienced by rectal cancer patients during preoperative chemoradiotherapy, with a specific focus on fatigue and to explore how symptoms impact the quality of life. Rectal cancer continues to be a healthcare issue internationally, despite advances in management strategies, which includes the administration of preoperative chemoradiotherapy to improve locoregional control. It is known that this treatment may cause adverse effects; however, there is a paucity of literature that specifically examines fatigue, symptoms and quality of life in this patient cohort. A prospective, quantitative correlational design using purposive sampling was adopted. Symptoms and quality of life were measured with validated questionnaires in 35 patients at four time points. Symptoms that changed significantly over time as examined using rm-anova include fatigue, bowel function issues, nutritional issues, pain, dermatological issues and urinary function issues. Findings indicate that fatigue leads to poorer quality of life, with constipation, bloating, stool frequency, appetite loss, weight worry, nausea and vomiting, dry mouth and pain also identified as influencing factors on quality of life. Findings have highlighted the importance of thorough symptom assessment and management of patients receiving preoperative chemoradiotherapy, particularly midway through treatment, in order to optimise quality of life and minimise interruptions to treatment. Close monitoring of symptoms during preoperative chemoradiotherapy, particularly at week 4, will enable the implementation of timely interventions so that interruptions to treatment are prevented and the quality of life is optimised, which may hasten postoperative recovery times. © 2016 John Wiley & Sons Ltd.

Developing Water Quality Critera for Suspended and Bedded Sediments-Illustrative Example Application.

EPA Science Inventory

The U. S. EPA's Framework for Developing Suspended and Bedded Sediments (SABS) Water Quality Criteria (SABS Framework) provides a consistent process, technical methods, and supporting materials to enable resource managers to develop ambient water quality criteria for one of the m...

Enabling Research Tools for Sustained Climate Assessment

NASA Technical Reports Server (NTRS)

Leidner, Allison K.; Bosilovich, Michael G.; Jasinski, Michael F.; Nemani, Ramakrishna R.; Waliser, Duane Edward; Lee, Tsengdar J.

2016-01-01

The U.S. Global Change Research Program Sustained Assessment process benefits from long-term investments in Earth science research that enable the scientific community to conduct assessment-relevant science. To this end, NASA initiated several research programs over the past five years to support the Earth observation community in developing indicators, datasets, research products, and tools to support ongoing and future National Climate Assessments. These activities complement NASA's ongoing Earth science research programs. One aspect of the assessment portfolio funds four "enabling tools" projects at NASA research centers. Each tool leverages existing capacity within the center, but has developed tailored applications and products for National Climate Assessments. The four projects build on the capabilities of a global atmospheric reanalysis (MERRA-2), a continental U.S. land surface reanalysis (NCA-LDAS), the NASA Earth Exchange (NEX), and a Regional Climate Model Evaluation System (RCMES). Here, we provide a brief overview of each enabling tool, highlighting the ways in which it has advanced assessment science to date. We also discuss how the assessment community can access and utilize these tools for National Climate Assessments and other sustained assessment activities.

P-MartCancer–Interactive Online Software to Enable Analysis of Shotgun Cancer Proteomic Datasets

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

Webb-Robertson, Bobbie-Jo M.; Bramer, Lisa M.; Jensen, Jeffrey L.

P-MartCancer is a new interactive web-based software environment that enables biomedical and biological scientists to perform in-depth analyses of global proteomics data without requiring direct interaction with the data or with statistical software. P-MartCancer offers a series of statistical modules associated with quality assessment, peptide and protein statistics, protein quantification and exploratory data analyses driven by the user via customized workflows and interactive visualization. Currently, P-MartCancer offers access to multiple cancer proteomic datasets generated through the Clinical Proteomics Tumor Analysis Consortium (CPTAC) at the peptide, gene and protein levels. P-MartCancer is deployed using Azure technologies (http://pmart.labworks.org/cptac.html), the web-service is alternativelymore » available via Docker Hub (https://hub.docker.com/r/pnnl/pmart-web/) and many statistical functions can be utilized directly from an R package available on GitHub (https://github.com/pmartR).« less

Resilience Among Patients Across the Cancer Continuum: Diverse Perspectives

PubMed Central

Molina, Yamile; Yi, Jean C.; Martinez-Gutierrez, Javiera; Reding, Kerryn W.; Yi-Frazier, Joyce P.; Rosenberg, Abby R.

2014-01-01

Each phase of the cancer experience profoundly affects patients’ lives. Much of the literature has focused on negative consequences of cancer; however, the study of resilience may enable providers to promote more positive psychosocial outcomes before, during, and after the cancer experience. The current review describes the ways in which elements of resilience have been defined and studied at each phase of the cancer continuum. Extensive literature searches were conducted to find studies assessing resilience during one or more stages of the adult cancer continuum. For all phases of the cancer continuum, resilience descriptions included preexisting or baseline characteristics, such as demographics and personal attributes (e.g., optimism, social support), mechanisms of adaptation, such as coping and medical experiences (e.g., positive provider communication), as well as psychosocial outcomes, such as growth and quality of life. Promoting resilience is a critical element of patient psychosocial care. Nurses may enable resilience by recognizing and promoting certain baseline characteristics and optimizing mechanisms of adaptation. PMID:24476731

Towards Knowledge Management for Smart Manufacturing.

PubMed

Feng, Shaw C; Bernstein, William Z; Hedberg, Thomas; Feeney, Allison Barnard

2017-09-01

The need for capturing knowledge in the digital form in design, process planning, production, and inspection has increasingly become an issue in manufacturing industries as the variety and complexity of product lifecycle applications increase. Both knowledge and data need to be well managed for quality assurance, lifecycle-impact assessment, and design improvement. Some technical barriers exist today that inhibit industry from fully utilizing design, planning, processing, and inspection knowledge. The primary barrier is a lack of a well-accepted mechanism that enables users to integrate data and knowledge. This paper prescribes knowledge management to address a lack of mechanisms for integrating, sharing, and updating domain-specific knowledge in smart manufacturing. Aspects of the knowledge constructs include conceptual design, detailed design, process planning, material property, production, and inspection. The main contribution of this paper is to provide a methodology on what knowledge manufacturing organizations access, update, and archive in the context of smart manufacturing. The case study in this paper provides some example knowledge objects to enable smart manufacturing.

Cognitive remediation in schizophrenia: A methodological appraisal of systematic reviews and meta-analyses.

PubMed

Bryce, Shayden; Sloan, Elise; Lee, Stuart; Ponsford, Jennie; Rossell, Susan

2016-04-01

Systematic reviews and meta-analyses are a primary source of evidence when evaluating the benefit(s) of cognitive remediation (CR) in schizophrenia. These studies are designed to rigorously synthesize scientific literature; however, cannot be assumed to be of high methodological quality. The aims of this report were to: 1) review the use of systematic reviews and meta-analyses regarding CR in schizophrenia; 2) conduct a systematic methodological appraisal of published reports examining the benefits of this intervention on core outcome domains; and 3) compare the correspondence between methodological and reporting quality. Electronic databases were searched for relevant articles. Twenty-one reviews met inclusion criteria and were scored according to the AMSTAR checklist-a validated scale of methodological quality. Five meta-analyses were also scored according to PRISMA statement to compare 'quality of conduct' with 'quality of reporting'. Most systematic reviews and meta-analyses shared strengths and fell within a 'medium' level of methodological quality. Nevertheless, there were consistent areas of potential weakness that were not addressed by most reviews. These included the lack of protocol registration, uncertainty regarding independent data extraction and consensus procedures, and the minimal assessment of publication bias. Moreover, quality of conduct may not necessarily parallel quality of reporting, suggesting that consideration of these methods independently may be important. Reviews concerning CR for schizophrenia are a valuable source of evidence. However, the methodological quality of these reports may require additional consideration. Enhancing quality of conduct is essential for enabling research literature to be interpreted with confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Shaping quality: the use of performance polygons for multidimensional presentation and interpretation of qualitative performance data.

PubMed

Cook, T M; Coupe, M; Ku, T

2012-06-01

Measuring outcomes and quality in anaesthesia is challenging. In the UK, there is increased focus on these as a result of changes in Department of Health strategy and the imminent introduction of mandatory revalidation for all doctors. A definition of quality may differ according to the observer's standpoint and numerous performance measures may contribute to overall quality. Patients, surgeons, anaesthetic assistants, recovery nurses, managers, and anaesthetic peers are each likely to have their own perspective on 'anaesthetic quality' and would perhaps suggest different metrics to measure it. Speed, efficiency, cost, interpersonal skills, complication rates, patient recorded outcome measures, and satisfaction are all valid as quality measures, but none alone captures anaesthetic quality. Performance data are frequently presented as single-dimension measurements (e.g. pain, postoperative nausea and vomiting, patient satisfaction), but this does not address the fact that two or more domains may be closely related (e.g. use of regional anaesthesia and quality of analgesia) or in opposition (e.g. use of regional anaesthesia and speed). We introduce the concept of a 'performance polygon' as a tool to represent multidimensional performance assessment. This method of data presentation encourages balanced appraisal of anaesthetic quality. Performance polygons may be used to compare individual performance with peers, published outcome norms, trends in performance over time, to explore aspects of team performance and potentially capture data that are required for medical revalidation. Performance polygons enable easy comparison with any relevant data set and are a visual tool that potentially has wider applications in healthcare quality improvement.

Scorecards and social accountability for improved maternal and newborn health services: A pilot in the Ashanti and Volta regions of Ghana.

PubMed

Blake, Carolyn; Annorbah-Sarpei, Nii Ankonu; Bailey, Claire; Ismaila, Yakubu; Deganus, Sylvia; Bosomprah, Samuel; Galli, Francesco; Clark, Sarah

2016-12-01

With the limited availability of quality emergency obstetric and newborn care (EmONC) in Ghana, and a lack of dialogue on the issue at district level, the Evidence for Action (E4A) program (2011-2015) initiated a pilot intervention using a social accountability approach in two regions of Ghana. Using scorecards to assess and improve maternal and newborn health services, the intervention study evaluated the effectiveness of engaging multiple, health and non-health sector stakeholders at district level to improve the enabling environment for quality EmONC. The quantitative study component comprised two rounds of assessments in 37 health facilities. The qualitative component is based on an independent prospective policy study. Results show a marked growth in a culture of accountability, with heightened levels of community participation, transparency, and improved clarity of lines of accountability among decision-makers. The breadth and type of quality of care improvements were dependent on the strength of community and government engagement in the process, especially in regard to more complex systemic changes. Engaging a broad network of stakeholders to support MNH services has great potential if implemented in ways that are context-appropriate and that build around full collaboration with government and civil society stakeholders. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

GEO-CAPE Coastal Ocean Ecosystem Dynamics White Paper ...

EPA Pesticide Factsheets

The Clean Water Act protects all navigable waters in the United States (CWA, 1988). The objective of the CWA is to "restore and maintain the chemical, physical, and biological integrity of the Nation's waters." This Federal mandate authorizes states, tribes, and U.S. territories, with guidance and oversight from the U.S. Environmental Protection Agency (EPA), to develop and implement water quality standards to protect the human and aquatic life uses of the Nation’s waterways. Water quality standards include designated uses, defined as the services that a water body supports such as drinking water, aquatic life, harvestable species, and recreation. These standards under the CWA Section 304(a) are applicable within state waters, defined as less than 3 nautical miles from shore. Therefore, a majority of research by the EPA addresses near-shore coastal waters within 3 nautical miles, estuaries and lakes where applicable water quality regulation could be implemented. Policy makers and environmental managers in EPA’s program and regional offices need tools enabling them to assess the sustainability of watershed ecosystems, and the services they provide, under current and future land use practices. The typical 1km resolution and current Case 1 algorithms of SeaWiFS, MODIS, and VIIRS provide limited assessments of near-shore coastal waters, estuaries and lakes. It has proven difficult to adequately resolve and derive products in smaller estuaries or waters in proxim

Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal.

PubMed

Issen, Laurel; Woodcock, Thomas; McNicholas, Christopher; Lennox, Laura; Reed, Julie E

2018-04-09

Despite criticisms that many quality improvement (QI) initiatives fail due to incomplete programme theory, there is no defined way to evaluate how programme theory has been articulated. The objective of this research was to develop, and assess the usability and reliability of scoring criteria to evaluate programme theory diagrams. Criteria development was informed by published literature and QI experts. Inter-rater reliability was tested between two evaluators. About 63 programme theory diagrams (42 driver diagrams and 21 action-effect diagrams) were reviewed to establish whether the criteria could support comparative analysis of different approaches to constructing diagrams. Components of the scoring criteria include: assessment of overall aim, logical overview, clarity of components, cause-effect relationships, evidence and measurement. Independent reviewers had 78% inter-rater reliability. Scoring enabled direct comparison of different approaches to developing programme theory; action-effect diagrams were found to have had a statistically significant but moderate improvement in programme theory quality over driver diagrams; no significant differences were observed based on the setting in which driver diagrams were developed. The scoring criteria summarise the necessary components of programme theory that are thought to contribute to successful QI projects. The viability of the scoring criteria for practical application was demonstrated. Future uses include assessment of individual programme theory diagrams and comparison of different approaches (e.g. methodological, teaching or other QI support) to produce programme theory. The criteria can be used as a tool to guide the production of better programme theory diagrams, and also highlights where additional support for QI teams could be needed.

Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

PubMed

Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

2017-01-01

Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Third Molars on the Internet: A Guide for Assessing Information Quality and Readability.

PubMed

Hanna, Kamal; Brennan, David; Sambrook, Paul; Armfield, Jason

2015-10-06

Directing patients suffering from third molars (TMs) problems to high-quality online information is not only medically important, but also could enable better engagement in shared decision making. This study aimed to develop a scale that measures the scientific information quality (SIQ) for online information concerning wisdom tooth problems and to conduct a quality evaluation for online TMs resources. In addition, the study evaluated whether a specific piece of readability software (Readability Studio Professional 2012) might be reliable in measuring information comprehension, and explored predictors for the SIQ Scale. A cross-sectional sample of websites was retrieved using certain keywords and phrases such as "impacted wisdom tooth problems" using 3 popular search engines. The retrieved websites (n=150) were filtered. The retained 50 websites were evaluated to assess their characteristics, usability, accessibility, trust, readability, SIQ, and their credibility using DISCERN and Health on the Net Code (HoNCode). Websites' mean scale scores varied significantly across website affiliation groups such as governmental, commercial, and treatment provider bodies. The SIQ Scale had a good internal consistency (alpha=.85) and was significantly correlated with DISCERN (r=.82, P<.01) and HoNCode (r=.38, P<.01). Less than 25% of websites had SIQ scores above 75%. The mean readability grade (10.3, SD 1.9) was above the recommended level, and was significantly correlated with the Scientific Information Comprehension Scale (r=.45. P<.01), which provides evidence for convergent validity. Website affiliation and DISCERN were significantly associated with SIQ (P<.01) and explained 76% of the SIQ variance. The developed SIQ Scale was found to demonstrate reliability and initial validity. Website affiliation, DISCERN, and HoNCode were significant predictors for the quality of scientific information. The Readability Studio software estimates were associated with scientific information comprehensiveness measures.

Data Quality Control Tools Applied to Seismo-Acoustic Arrays in Korea

NASA Astrophysics Data System (ADS)

Park, J.; Hayward, C.; Stump, B. W.

2017-12-01

We assess data quality (data gap, seismometer orientation, timing error, noise level and coherence between co-located sensors) for seismic and infrasound data in South Korea using six seismo-acoustic arrays, BRDAR, CHNAR, KSGAR, KMPAR, TJIAR, and YPDAR, cooperatively operated by Southern Methodist University and Korea Institute for Geosciences and Mineral Resources. Timing errors associated with seismometers can be found based on estimated changes in instrument orientation calculated from RMS errors between the reference array and each array seismometer using waveforms filtered from 0.1 to 0.35 Hz. Noise levels of seismic and infrasound data are analyzed to investigate local environmental effects and seasonal noise variation. In order to examine the spectral properties of the noise, the waveform are analyzed using Welch's method (Welch, 1967) that produces a single power spectral estimate from an average of spectra taken at regular intervals over a specific time period. This analysis quantifies the range of noise conditions found at each of the arrays over the given time period. We take an advantage of the fact that infrasound sensors are co-located or closely located to one another, which allows for a direct comparison of sensors, following the method by Ringler et al. (2010). The power level differences between two sensors at the same array in the frequency band of interest are used to monitor temporal changes in data quality and instrument conditions. A data quality factor is assigned to stations based on the average values of temporal changes estimated in the frequency and time domains. These monitoring tools enable us to automatically assess technical issue related to the instruments and data quality at each seismo-acoustic array as well as to investigate local environmental effects and seasonal variations in both seismic and infrasound data.

The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature.

PubMed

Edwards, Katherine; Jones, Natasha; Newton, Julia; Foster, Charlie; Judge, Andrew; Jackson, Kate; Arden, Nigel K; Pinedo-Villanueva, Rafael

2017-10-19

This descriptive review aimed to assess the characteristics and methodological quality of economic evaluations of cardiac rehabilitation (CR) programs according to updated economic guidelines for healthcare interventions. Recommendations will be made to inform future research addressing the impact of a physical exercise component on cost-effectiveness. Electronic databases were searched for economic evaluations of exercise-based CR programs published in English between 2000 and 2014. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to review the methodological quality of included economic evaluations. Fifteen economic evaluations met the review inclusion criteria. Assessed study characteristics exhibited wide variability, particularly in their economic perspective, time horizon, setting, comparators and included costs, with significant heterogeneity in exercise dose across interventions. Ten evaluations were based on randomised controlled trials (RCTs) spanning 6-24 months but often with weak or inconclusive results; two were modelling studies; and the final three utilised longer time horizons of 3.5-5 years from which findings suggest that long-term exercise-based CR results in lower costs, reduced hospitalisations and a longer cumulative patient lifetime. None of the 15 articles met all the CHEERS quality criteria, with the majority either fully or partially meeting a selection of the assessed variables. Evidence exists supporting the cost-effectiveness of exercise-based CR for cardiovascular disease patients. However, variability in CR program delivery and weak consistency between study perspective and design limits study comparability and therefore the accumulation of evidence in support of a particular exercise regime. The generalisability of study findings was limited due to the exclusion of patients with comorbidities as would typically be found in a real-world setting. The use of longer time-horizons would be more comparable with a chronic condition and enable economic assessments of the long-term effects of CR. As none of the articles met recent reporting standards for the economic assessment of healthcare interventions, it is recommended that future studies adhere to such guidelines.

Ultra-low-dose lung screening CT with model-based iterative reconstruction: an assessment of image quality and lesion conspicuity.

PubMed

Ju, Yun Hye; Lee, Geewon; Lee, Ji Won; Hong, Seung Baek; Suh, Young Ju; Jeong, Yeon Joo

2018-05-01

Background Reducing radiation dose inevitably increases image noise, and thus, it is important in low-dose computed tomography (CT) to maintain image quality and lesion detection performance. Purpose To assess image quality and lesion conspicuity of ultra-low-dose CT with model-based iterative reconstruction (MBIR) and to determine a suitable protocol for lung screening CT. Material and Methods A total of 120 heavy smokers underwent lung screening CT and were randomly and equally assigned to one of five groups: group 1 = 120 kVp, 25 mAs, with FBP reconstruction; group 2 = 120 kVp, 10 mAs, with MBIR; group 3 = 100 kVp, 15 mAs, with MBIR; group 4 = 100 kVp, 10 mAs, with MBIR; and group 5 = 100 kVp, 5 mAs, with MBIR. Two radiologists evaluated intergroup differences with respect to radiation dose, image noise, image quality, and lesion conspicuity using the Kruskal-Wallis test and the Chi-square test. Results Effective doses were 61-87% lower in groups 2-5 than in group 1. Image noises in groups 1 and 5 were significantly higher than in the other groups ( P < 0.001). Overall image quality was best in group 1, but diagnostic acceptability of overall image qualities in groups 1-3 was not significantly different (all P values > 0.05). Lesion conspicuities were similar in groups 1-4, but were significantly poorer in group 5. Conclusion Lung screening CT with MBIR obtained at 100 kVp and 15 mAs enables a ∼60% reduction in radiation dose versus low-dose CT, while maintaining image quality and lesion conspicuity.

Office of Student Financial Aid Quality Improvement Program: Design and Implementation Plan.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

The purpose and direction of the Office of Student Financial Aid (OSFA) quality improvement program are described. The background and context for the Pell Grant quality control (QC) design study and the meaning of QC are reviewed. The general approach to quality improvement consists of the following elements: a strategic approach that enables OSFA…

Implementing subgrid-scale cloudiness into the Model for Prediction Across Scales-Atmosphere (MPAS-A) for next generation global air quality modeling

EPA Science Inventory

A next generation air quality modeling system is being developed at the U.S. EPA to enable seamless modeling of air quality from global to regional to (eventually) local scales. State of the science chemistry and aerosol modules from the Community Multiscale Air Quality (CMAQ) mo...

Attenuation-based automatic kilovolt (kV)-selection in computed tomography of the chest: effects on radiation exposure and image quality.

PubMed

Eller, Achim; Wuest, Wolfgang; Scharf, Michael; Brand, Michael; Achenbach, Stephan; Uder, Michael; Lell, Michael M

2013-12-01

To evaluate an automated attenuation-based kV-selection in computed tomography of the chest in respect to radiation dose and image quality, compared to a standard 120 kV protocol. 104 patients were examined using a 128-slice scanner. Fifty examinations (58 ± 15 years, study group) were performed using the automated adaption of tube potential (100-140 kV), based on the attenuation profile of the scout scan, 54 examinations (62 ± 14 years, control group) with fixed 120 kV. Estimated CT dose index (CTDI) of the software-proposed setting was compared with a 120 kV protocol. After the scan CTDI volume (CTDIvol) and dose length product (DLP) were recorded. Image quality was assessed by region of interest (ROI) measurements, subjective image quality by two observers with a 4-point scale (3--excellent, 0--not diagnostic). The algorithm selected 100 kV in 78% and 120 kV in 22%. Overall CTDIvol reduction was 26.6% (34% in 100 kV) overall DLP reduction was 22.8% (32.1% in 100 kV) (all p<0.001). Subjective image quality was excellent in both groups. The attenuation based kV-selection algorithm enables relevant dose reduction (~27%) in chest-CT while keeping image quality parameters at high levels. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effects of tear film dynamics on quality of vision.

PubMed

Koh, Shizuka; Tung, Cynthia I; Inoue, Yasushi; Jhanji, Vishal

2018-06-15

The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessing Gas-Hydrate Prospects on the North Slope of Alaska - Theoretical Considerations

USGS Publications Warehouse

Lee, Myung W.; Collett, Timothy S.; Agena, Warren F.

2008-01-01

Gas-hydrate resource assessment on the Alaska North Slope using 3-D and 2-D seismic data involved six important steps: (1) determining the top and base of the gas-hydrate stability zone, (2) 'tying' well log information to seismic data through synthetic seismograms, (3) differentiating ice from gas hydrate in the permafrost interval, (4) developing an acoustic model for the reservoir and seal, (5) developing a method to estimate gas-hydrate saturation and thickness from seismic attributes, and (6) assessing the potential gas-hydrate prospects from seismic data based on potential migration pathways, source, reservoir quality, and other relevant geological information. This report describes the first five steps in detail using well logs and provides theoretical backgrounds for resource assessments carried out by the U.S. Geological Survey. Measured and predicted P-wave velocities enabled us to tie synthetic seismograms to the seismic data. The calculated gas-hydrate stability zone from subsurface wellbore temperature data enabled us to focus our effort on the most promising depth intervals in the seismic data. A typical reservoir in this area is characterized by the P-wave velocity of 1.88 km/s, porosity of 42 percent, and clay volume content of 5 percent, whereas seal sediments encasing the reservoir are characterized by the P-wave velocity of 2.2 km/s, porosity of 32 percent, and clay volume content of 20 percent. Because the impedance of a reservoir without gas hydrate is less than that of the seal, a complex amplitude variation with respect to gas-hydrate saturation is predicted, namely polarity change, amplitude blanking, and high seismic amplitude (a bright spot). This amplitude variation with gas-hydrate saturation is the physical basis for the method used to quantify the resource potential of gas hydrates in this assessment.

Review of NASA's(TradeMark) Exploration Technology Development Program

NASA Technical Reports Server (NTRS)

2008-01-01

To meet the objectives of the Vision for Space Exploration (VSE), NASA must develop a wide array of enabling technologies. For this purpose, NASA established the Exploration Technology Development Program (ETDP). Currently, ETDP has 22 projects underway. In the report accompanying the House-passed version of the FY2007 appropriations bill, the agency was directed to request from the NRC an independent assessment of the ETDP. This interim report provides an assessment of each of the 22 projects including a quality rating, an analysis of how effectively the research is being carried out, and the degree to which the research is aligned with the VSE. To the extent possible, the identification and discussion of various cross-cutting issues are also presented. Those issues will be explored and discussed in more detail in the final report.

Computational methods for evaluation of cell-based data assessment--Bioconductor.

PubMed

Le Meur, Nolwenn

2013-02-01

Recent advances in miniaturization and automation of technologies have enabled cell-based assay high-throughput screening, bringing along new challenges in data analysis. Automation, standardization, reproducibility have become requirements for qualitative research. The Bioconductor community has worked in that direction proposing several R packages to handle high-throughput data including flow cytometry (FCM) experiment. Altogether, these packages cover the main steps of a FCM analysis workflow, that is, data management, quality assessment, normalization, outlier detection, automated gating, cluster labeling, and feature extraction. Additionally, the open-source philosophy of R and Bioconductor, which offers room for new development, continuously drives research and improvement of theses analysis methods, especially in the field of clustering and data mining. This review presents the principal FCM packages currently available in R and Bioconductor, their advantages and their limits. Copyright © 2012 Elsevier Ltd. All rights reserved.

Quality Assessment of 3d Reconstruction Using Fisheye and Perspective Sensors

NASA Astrophysics Data System (ADS)

Strecha, C.; Zoller, R.; Rutishauser, S.; Brot, B.; Schneider-Zapp, K.; Chovancova, V.; Krull, M.; Glassey, L.

2015-03-01

Recent mathematical advances, growing alongside the use of unmanned aerial vehicles, have not only overcome the restriction of roll and pitch angles during flight but also enabled us to apply non-metric cameras in photogrammetric method, providing more flexibility for sensor selection. Fisheye cameras, for example, advantageously provide images with wide coverage; however, these images are extremely distorted and their non-uniform resolutions make them more difficult to use for mapping or terrestrial 3D modelling. In this paper, we compare the usability of different camera-lens combinations, using the complete workflow implemented in Pix4Dmapper to achieve the final terrestrial reconstruction result of a well-known historical site in Switzerland: the Chillon Castle. We assess the accuracy of the outcome acquired by consumer cameras with perspective and fisheye lenses, comparing the results to a laser scanner point cloud.

Development of the Next Generation Air Quality Modeling System

EPA Science Inventory

A next generation air quality modeling system is being developed at the U.S. EPA to enable modeling of air quality from global to regional to (eventually) local scales. We envision that the system will have three configurations: 1. Global meteorology with seamless mesh refinemen...

Dispersive Raman spectroscopy excited at 1064nm to classify the botanic origin of honeys from Calabria and quantify the sugar profile

NASA Astrophysics Data System (ADS)

Mignani, A. G.; Ciaccheri, L.; Mencaglia, A. A.; Di Sanzo, R.; Carabetta, S.; Russo, M. T.

2005-05-01

Raman spectroscopy performed using optical fibers, with excitation at 1064 nm and a dispersive detection scheme, was utilized to analyze a selection of unifloral honeys produced in the Italian region of Calabria. The honey samples had three different botanical origins: chestnut, citrus, and acacia, respectively. A multivariate processing of the spectroscopic data enabled us to distinguish their botanical origin, and to build predictive models for quantifying their main sugars. This experiment indicates the excellent potentials of Raman spectroscopy as an analytical tool for the nondestructive and rapid assessment of food-quality indicators.

Telestroke network fundamentals.

PubMed

Meyer, Brett C; Demaerschalk, Bart M

2012-10-01

The objectives of this manuscript are to identify key components to maintaining the logistic and/or operational sustainability of a telestroke network, to identify best practices to be considered for assessment and management of acute stroke when planning for and developing a telestroke network, to show practical steps to enable progress toward implementing a telestroke solution for optimizing acute stroke care, to incorporate evidence-based practice guidelines and care pathways into a telestroke network, to emphasize technology variables and options, and to propose metrics to use when determining the performance, outcomes, and quality of a telestroke network. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Characterization of Atmospheric Turbulence as a Function of Altitude

NASA Technical Reports Server (NTRS)

Prasad, Suparnamaaya; Ivanco, Marie L.; Ivanco, Thomas G.; Ancel, Ersin

2017-01-01

A novel radical shape change approach (Aerodynamically Actuated Radical Shape Change concept) was developed at NASA Langley Research Center. The radical shape change enables cruise at a lowered altitude of 15-25,000 feet and yields substantial performance and environmental benefits. This lowered altitude has however raised concerns in the community due to past experience with decreased ride quality in this altitude range. This paper describes the analysis performed by the team to address this concern. First, the team assessed and quantified turbulence occurrence as a function of altitude. Secondly, the team analyzed the effects of turbulence gust loads on the proposed concept when compared to conventional aircraft.

Standards for Cell Line Authentication and Beyond

PubMed Central

Cole, Kenneth D.; Plant, Anne L.

2016-01-01

Different genomic technologies have been applied to cell line authentication, but only one method (short tandem repeat [STR] profiling) has been the subject of a comprehensive and definitive standard (ASN-0002). Here we discuss the power of this document and why standards such as this are so critical for establishing the consensus technical criteria and practices that can enable progress in the fields of research that use cell lines. We also examine other methods that could be used for authentication and discuss how a combination of methods could be used in a holistic fashion to assess various critical aspects of the quality of cell lines. PMID:27300367

The 3D Elevation Program: summary for California

USGS Publications Warehouse

Carswell, William J.

2013-01-01

Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of California, elevation data are critical for infrastructure and construction management; natural resources conservation; flood risk management; wildfire management, planning, and response; agriculture and precision farming; geologic resource assessment and hazard mitigation; and other business uses. Today, high-quality light detection and ranging (lidar) data are the sources for creating elevation models and other elevation datasets. Federal, State, and local agencies work in partnership to (1) replace data, on a national basis, that are (on average) 30 years old and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data. The new 3D Elevation Program (3DEP) initiative, managed by the U.S. Geological Survey (USGS), responds to the growing need for high-quality topographic data and a wide range of other three-dimensional representations of the Nation’s natural and constructed features.

Reliability and validity of a GPS-enabled iPhone "app" to measure physical activity.

PubMed

Benson, Amanda Clare; Bruce, Lyndell; Gordon, Brett Ashley

2015-01-01

This study assessed the validity and reliability of an iPhone "app" and two sport-specific global positioning system (GPS) units to monitor distance, intensity and contextual physical activity. Forty (23 female, 17 male) 18-55-year-olds completed two trials of six laps around a 400-m athletics track wearing GPSports Pro and WiSpi units (5 and 1 Hz) and an iPhone(TM) with a Motion X GPS(TM) "app" that used the inbuilt iPhone location services application programming interface to obtain its sampling rate (which is likely to be ≤1 Hz). Overall, the statistical agreement, assessed using t-tests and Bland-Altman plots, indicated an underestimation of the known track distance (2.400 km) and average speed by the Motion X GPS "app" and GPSports Pro while the GPSports WiSpi(TM) device overestimated these outcomes. There was a ≤3% variation between trials for distance and average speed when measured by any of the GPS devices. Thus, the smartphone "app" trialled could be considered as an accessible alternative to provide high-quality contextualised data to enable ubiquitous monitoring and modification of programmes to ensure appropriate intensity and type of physical activity is prescribed and more importantly adhered to.

Assessing telemedicine: a systematic review of the literature.

PubMed

Roine, R; Ohinmaa, A; Hailey, D

2001-09-18

To clarify the current status of telemedicine, we carried out a systematic review of the literature. We identified controlled assessment studies of telemedicine that reported patient outcomes, administrative changes or economic assessments and assessed the quality of that literature. We carried out a systematic electronic search for articles published from 1966 to early 2000 using the MEDLINE (1966-April 2000), HEALTHSTAR (1975-January 2000), EMBASE (1988-February 2000) and CINALH (1982-January 2000) databases. In addition, the HSTAT database (Health Services/Technology Assessment Text, US National Library of Medicine), the Database of Abstracts of Reviews of Effectiveness (DARE, NHS Centre for Reviews and Dissemination, United Kingdom), the NHS Economic Evaluation Database and the Cochrane Controlled Trials Register were searched. We consulted experts in the field and did a manual search of the reference lists of review articles. A total of 1124 studies were identified. Based on a review of the abstracts, 133 full-text articles were obtained for closer inspection. Of these, 50 were deemed to represent assessment studies fulfilling the inclusion criteria of the review. Thirty-four of the articles assessed at least some clinical outcomes; the remaining 16 were mainly economic analyses. Most of the available literature referred only to pilot projects and short-term outcomes, and most of the studies were of low quality. Relatively convincing evidence of effectiveness was found only for teleradiology, teleneurosurgery, telepsychiatry, transmission of echocardiographic images, and the use of electronic referrals enabling e-mail consultations and video conferencing between primary and secondary health care providers. Economic analyses suggested that teleradiology, especially transmission of CT images, can be cost-saving. Evidence regarding the effectiveness or cost-effectiveness of telemedicine is still limited. Based on current scientific evidence, only a few telemedicine applications can be recommended for broader use.

A method for the design and development of medical or health care information websites to optimize search engine results page rankings on Google.

PubMed

Dunne, Suzanne; Cummins, Niamh Maria; Hannigan, Ailish; Shannon, Bill; Dunne, Colum; Cullen, Walter

2013-08-27

The Internet is a widely used source of information for patients searching for medical/health care information. While many studies have assessed existing medical/health care information on the Internet, relatively few have examined methods for design and delivery of such websites, particularly those aimed at the general public. This study describes a method of evaluating material for new medical/health care websites, or for assessing those already in existence, which is correlated with higher rankings on Google's Search Engine Results Pages (SERPs). A website quality assessment (WQA) tool was developed using criteria related to the quality of the information to be contained in the website in addition to an assessment of the readability of the text. This was retrospectively applied to assess existing websites that provide information about generic medicines. The reproducibility of the WQA tool and its predictive validity were assessed in this study. The WQA tool demonstrated very high reproducibility (intraclass correlation coefficient=0.95) between 2 independent users. A moderate to strong correlation was found between WQA scores and rankings on Google SERPs. Analogous correlations were seen between rankings and readability of websites as determined by Flesch Reading Ease and Flesch-Kincaid Grade Level scores. The use of the WQA tool developed in this study is recommended as part of the design phase of a medical or health care information provision website, along with assessment of readability of the material to be used. This may ensure that the website performs better on Google searches. The tool can also be used retrospectively to make improvements to existing websites, thus, potentially enabling better Google search result positions without incurring the costs associated with Search Engine Optimization (SEO) professionals or paid promotion.

Ambivalence in pregnancy intentions: The effect of quality of care and context among a cohort of women attending family planning clinics in Kenya.

PubMed

Wekesa, Eliud; Askew, Ian; Abuya, Timothy

2018-01-01

Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya. This paper uses data drawn from a prospective cohort study of FP clients to investigate the relationship between the quality of care received during FP service delivery and the decisiveness of their pregnancy intentions over time. The study tests the hypothesis that higher quality of care enables women to be less ambivalent about their pregnancy intentions. Binary logistic regression with random effects and multinomial logistic regression were used to assess the predictive effect of the quality of care received by a woman on the decisiveness or ambivalence of her pregnancy intentions, and on any shifts in ambivalence over time, controlling for background characteristics. The study recruited 1,957 women aged 15-49 years attending twelve family planning clinics in four counties in Central Kenya; of these, 1,053 women were observed for four rounds of data collection over a period of 24 months and form the sample for analysis. A substantial proportion (43%) of women expressed ambivalence about their intentions to become pregnant at some point during the study period, while over half (57%) remained unequivocal throughout the study. Almost one third of women (31%) shifted from being unequivocal to ambivalent and 12% shifted from ambivalence to being unequivocal. Women experiencing higher quality of care have lower odds of ever expressing ambivalence and higher odds of remaining unequivocal over time, net of other factors. Quality of care was not associated with a shift in ambivalence over time. FP programs offering higher quality of care are likely to support women to be more decisive in their pregnancy intentions. Improving the quality of care can contribute to reduced ambivalence and consequently reduced likelihood of unintended pregnancy among contraceptive users. This study provides further evidence of the benefits gained through providing high quality services. ClinicalTrials.gov NCT01694862.

The development of evidence-based guidelines in dentistry.

PubMed

Faggion, C M

2013-02-01

Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review.

PubMed

Carruthers, Helen; Astin, Felicity; Munro, Wendy

2017-10-01

To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised. Due to the heterogeneity of interventions and outcome measures findings were narratively reviewed. Twelve studies met the inclusion criteria and were included in the review reporting outcomes from 1981 patient and 454 health professional participants. The quality of included studies were moderate to weak. AAC communication strategies increased the number of communication interactions, improved patient satisfaction with communication and reduced communication difficulties. Barriers to usage were device characteristics, the clinical condition of the patient, lack of timeliness in communication and staff constraints. There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychological factors determining success in a medical career: a 10-year longitudinal study.

PubMed

Tartas, Malgorzata; Walkiewicz, Maciej; Majkowicz, Mikolaj; Budzinski, Waldemar

2011-01-01

Systemic review of predictors of success in medical career is an important tool to recognize the indicators of proper training. To determine psychological factors that predict success in a medical career. The success is defined as professional competence, satisfaction with medicine as a career, occupational stress and burnout and quality of life (QOF). Part I (1999-2005), medical students were examined each subsequent year, beginning with admission. Assessment included academic achievement (high school final examination results, entrance exam results, academic results during medical school) and psychological characteristics (sense of coherence (SOC), depression, anxiety, coping styles, value system and need for social approval). Part II (2008-2009), the same participants completed an Internet survey 4 years after graduation. Results of the postgraduate medical exam were taken under consideration. Academic achievement predicts only professional competence. Coping styles are significant indicators of satisfaction with medicine as a career. SOC, while assessed with anxiety and depression during studies, enabled us to recognize future QOF of medical graduates. Professional stress is not predictable to such an extent as other success indicators. There are significant psychological qualities useful to draw the outline of the future job and life performance of medical graduates.

A simulated "Night-onCall" to assess and address the readiness-for-internship of transitioning medical students.

PubMed

Kalet, Adina; Zabar, Sondra; Szyld, Demian; Yavner, Steven D; Song, Hyuksoon; Nick, Michael W; Ng, Grace; Pusic, Martin V; Denicola, Christine; Blum, Cary; Eliasz, Kinga L; Nicholson, Joey; Riles, Thomas S

2017-01-01

Transitioning medical students are anxious about their readiness-for-internship, as are their residency program directors and teaching hospital leadership responsible for care quality and patient safety. A readiness-for-internship assessment program could contribute to ensuring optimal quality and safety and be a key element in implementing competency-based, time-variable medical education. In this paper, we describe the development of the Night-onCall program (NOC), a 4-h readiness-for-internship multi-instructional method simulation event. NOC was designed and implemented over the course of 3 years to provide an authentic "night on call" experience for near graduating students and build measurements of students' readiness for this transition framed by the Association of American Medical College's Core Entrustable Professional Activities for Entering Residency. The NOC is a product of a program of research focused on questions related to enabling individualized pathways through medical training. The lessons learned and modifications made to create a feasible, acceptable, flexible, and educationally rich NOC are shared to inform the discussion about transition to residency curriculum and best practices regarding educational handoffs from undergraduate to graduate education.

EnableATIS strategy assessment.

DOT National Transportation Integrated Search

2014-02-01

Enabling Advanced Traveler Information Systems (EnableATIS) is the traveler information component of the Dynamic Mobility Application (DMA) program. The objective of the EnableATIS effort is to foster transformative traveler information applications ...

Quality of Life for Individuals with Disabilities: A Conceptual Framework.

ERIC Educational Resources Information Center

Marinoble, Rita; Hegenauer, Judy

One of the desired outcomes of transition planning for students with disabilities is to enable the students to lead a quality adult life. This report contains a literature review which outlines recent approaches to addressing quality of life issues, including conceptualizations, methodologies, and ethical concerns. A field inquiry report…

Effectiveness of a family-oriented rehabilitation program on the quality of life of parents of chronically ill children.

PubMed

West, C A; Besier, T; Borth-Bruhns, T; Goldbeck, L

2009-01-01

Parents of chronically ill children face numerous burdens in daily life, which can impair their quality of life (QoL) significantly. Therefore in family-oriented rehabilitation, not only the children themselves, but also their parents receive interventions. These aim at stabilizing parents both mentally and physically to enable them to support their children in the best possible way. This study investigates the effects of an inpatient family-oriented rehabilitation program on the QoL of parents of chronically ill children. A consecutive sample of 231 mothers and 155 fathers of children suffering from cancer, cardiac diseases or cystic fibrosis participated in the study. In a prospective longitudinal study, parental QoL was repeatedly assessed using the Ulm Quality of Life Inventory for Parents (ULQIE) at three different time points: admission to the rehabilitation clinic, discharge after four weeks of inpatient treatment, and at a six-month follow-up. Parental QoL increased markedly during rehabilitation treatment (mothers eta (2)=.326, fathers eta (2)=.249). Moreover, six months after the intervention, parental quality of life was still markedly improved compared to baseline assessment (mothers eta (2)=.259, fathers eta (2)=.069). The child's diagnosis had no effect on the level and course of parental QoL. Taking part in family-oriented rehabilitation can improve the QoL of parents of children suffering from cancer, cardiac diseases or cystic fibrosis. Such programs could be expected to affect the way chronically ill children cope with their condition and this should be examined in future studies.

Quality of life and female sexual function after skinning vulvectomy with split-thickness skin graft in women with vulvar intraepithelial neoplasia or vulvar Paget disease.

PubMed

Lavoué, V; Lemarrec, A; Bertheuil, N; Henno, S; Mesbah, H; Watier, E; Levêque, J; Morcel, K

2013-12-01

Vulvar intraepithelial neoplasia (VIN) and vulvar Paget disease are managed with either vulvectomy, destructive treatments (laser, antimitotic drugs) or immunostimulants. All these options are associated with functional complications. The purpose of this study was to evaluate the surgical technique consisting of skinning vulvectomy with split-thickness skin graft, and its effect on overall quality of life and sexual function. A retrospective study was conducted on thirteen patients who underwent skinning vulvectomy with split-thickness skin graft between 1999 and 2009. Overall quality of life and sexual function were assessed with the Medical Outcome Study Short Form 36 (MOS SF-36) and Female Sexual Function Index (FSFI), respectively. The median age of patients was 54 (range: 33-77) years. Three patients had Paget disease and 10 patients had VIN lesions. The excision margins were clear in 46% of cases. The incidence of occult cancer was 31%. The mean follow-up period was 77 (±35) months. Four patients experienced a relapse of their intraepithelial disease. The mean disease-free survival was 58 (±44) months. There was no significant difference in MOS SF-36 scores between the study population and the general population. The patients assessed with the FSFI regained normal sexual function after the surgical procedure. Skinning vulvectomy with split-thickness skin graft is a feasible technique yielding good results in terms of quality of life and sexual function. It enables occult cancer to be diagnosed in patients with VIN or Paget disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using Remote Sensing Mapping and Growth Response to Environmental Variability to Aide Aquatic Invasive Plant Management

NASA Technical Reports Server (NTRS)

Bubenheim, David L.; Schlick, Greg; Genovese, Vanessa; Wilson, Kenneth D.

2018-01-01

Management of aquatic weeds in complex watersheds and river systems present many challenges to assessment, planning and implementation of management practices for floating and submerged aquatic invasive plants. The Delta Region Areawide Aquatic Weed Project (DRAAWP), a USDA sponsored area-wide project, is working to enhance planning, decision-making and operational efficiency in the California Sacramento-San Joaquin Delta. Satellite and airborne remote sensing are used map (area coverage and biomass density), direct operations, and assess management impacts on plant communities. Archived satellite records enable review of results following previous climate and management events and aide in developing long-term strategies. Examples of remote sensing aiding effectiveness of aquatic weed management will be discussed as well as areas for potential technological improvement. Modeling at local and watershed scales using the SWAT modeling tool provides insight into land-use effects on water quality (described by Zhang in same Symposium). Controlled environment growth studies have been conducted to quantify the growth response of invasive aquatic plants to water quality and other environmental factors. Environmental variability occurs across a range of time scales from long-term climate and seasonal trends to short-term water flow mediated variations. Response time for invasive species response are examined at time scales of weeks, day, and hours using a combination of study duration and growth assessment techniques to assess water quality, temperature (air and water), nitrogen, phosphorus, and light effects. These provide response parameters for plant growth models in response to the variation and interact with management and economic models associated with aquatic weed management. Plant growth models are to be informed by remote sensing and applied spatially across the Delta to balance location and type of aquatic plant, growth response to altered environments and phenology. Initial utilization of remote sensing tools developed for mapping of aquatic invasive plants improved operational efficiency in management practices. These assessment methods provide a comprehensive and quantitative view of aquatic invasive plants communities in the California Delta.

Assessing perceptions of oral health related quality of life in dental implant patients. Experience of a tertiary care center in India.

PubMed

Paul S, Arun; Simon S, Sibu; Kumar, Saurabh; Chacko, Rabin K

2018-01-01

Patients perception of treatment outcomes are invaluable assessment tools and are effective indicators for future prognosis. Various tools of measurement have been used to assess the same. The oral health impact profile questionnaire (OHIP 14) has been effectively used to evaluate the oral health-related quality of life (OHRQoL) with regards to individual perceptions. This study was conducted to assess OHRQoL in patients who have had dental implants to replace missing teeth in the Department of Dental Surgery, Unit 1, Christian Medical College and Hospital, Vellore, TN, India by using the OHIP 14 questionnaire. A total of 107 patients who had treatment with dental implants were sent a modified form of the OHIP 14 questionnaire. An attempt was made to draw an inference by correlating scores of the OHIP 14 with data pertaining to key independent variables. Gamma regression was applied to the results as the outcome score distribution was skewed. All statistical analyses were performed using SPSS Version 21.0. The mean score for the OHIP 14 was 16.82 with the highest score of 30 for a total score of 70. OHIP 14 scores were higher in patients with implant-supported fixed dental prosthesis as compared to patients with single implant supported crowns (P = 0.0069). Patients with no complaints scored 9% lesser than those who reported complaints (P = 0.0438). Assessing quality of life with regards to specific treatment interventions may help to draw critical inferences that determine overall success. Results from the study enabled us to delineate and appreciate the success imparted by esthetics and function from the general well being imparted by treatment with dental implants. Social media could be used to positively improve responses in questionnaire based studies. Future studies using implant specific OHRQoL questionnaire may help to elicit unbiased patient perception in dental implant patients.

Development of a model web-based system to support a statewide quality consortium in radiation oncology.

PubMed

Moran, Jean M; Feng, Mary; Benedetti, Lisa A; Marsh, Robin; Griffith, Kent A; Matuszak, Martha M; Hess, Michael; McMullen, Matthew; Fisher, Jennifer H; Nurushev, Teamour; Grubb, Margaret; Gardner, Stephen; Nielsen, Daniel; Jagsi, Reshma; Hayman, James A; Pierce, Lori J

A database in which patient data are compiled allows analytic opportunities for continuous improvements in treatment quality and comparative effectiveness research. We describe the development of a novel, web-based system that supports the collection of complex radiation treatment planning information from centers that use diverse techniques, software, and hardware for radiation oncology care in a statewide quality collaborative, the Michigan Radiation Oncology Quality Consortium (MROQC). The MROQC database seeks to enable assessment of physician- and patient-reported outcomes and quality improvement as a function of treatment planning and delivery techniques for breast and lung cancer patients. We created tools to collect anonymized data based on all plans. The MROQC system representing 24 institutions has been successfully deployed in the state of Michigan. Since 2012, dose-volume histogram and Digital Imaging and Communications in Medicine-radiation therapy plan data and information on simulation, planning, and delivery techniques have been collected. Audits indicated >90% accurate data submission and spurred refinements to data collection methodology. This model web-based system captures detailed, high-quality radiation therapy dosimetry data along with patient- and physician-reported outcomes and clinical data for a radiation therapy collaborative quality initiative. The collaborative nature of the project has been integral to its success. Our methodology can be applied to setting up analogous consortiums and databases. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Cost Models for MMC Manufacturing Processes

NASA Technical Reports Server (NTRS)

Elzey, Dana M.; Wadley, Haydn N. G.

1996-01-01

The quality cost modeling (QCM) tool is intended to be a relatively simple-to-use device for obtaining a first-order assessment of the quality-cost relationship for a given process-material combination. The QCM curve is a plot of cost versus quality (an index indicating microstructural quality), which is unique for a given process-material combination. The QCM curve indicates the tradeoff between cost and performance, thus enabling one to evaluate affordability. Additionally, the effect of changes in process design, raw materials, and process conditions on the cost-quality relationship can be evaluated. Such results might indicate the most efficient means to obtain improved quality at reduced cost by process design refinements, the implementation of sensors and models for closed loop process control, or improvement in the properties of raw materials being fed into the process. QCM also allows alternative processes for producing the same or similar material to be compared in terms of their potential for producing competitively priced, high quality material. Aside from demonstrating the usefulness of the QCM concept, this is one of the main foci of the present research program, namely to compare processes for making continuous fiber reinforced, metal matrix composites (MMC's). Two processes, low pressure plasma spray deposition and tape casting are considered for QCM development. This document consists of a detailed look at the design of the QCM approach, followed by discussion of the application of QCM to each of the selected MMC manufacturing processes along with results, comparison of processes, and finally, a summary of findings and recommendations.

QTIMaps: A Model to Enable Web Maps in Assessment

ERIC Educational Resources Information Center

Navarrete, Toni; Santos, Patricia; Hernandez-Leo, Davinia; Blat, Josep

2011-01-01

Test-based e-Assessment approaches are mostly focused on the assessment of knowledge and not on that of other skills, which could be supported by multimedia interactive services. This paper presents the QTIMaps model, which combines the IMS QTI standard with web maps services enabling the computational assessment of geographical skills. We…

Assessing the environmental impacts of aircraft noise and emissions

NASA Astrophysics Data System (ADS)

Mahashabde, Anuja; Wolfe, Philip; Ashok, Akshay; Dorbian, Christopher; He, Qinxian; Fan, Alice; Lukachko, Stephen; Mozdzanowska, Aleksandra; Wollersheim, Christoph; Barrett, Steven R. H.; Locke, Maryalice; Waitz, Ian A.

2011-01-01

With the projected growth in demand for commercial aviation, many anticipate increased environmental impacts associated with noise, air quality, and climate change. Therefore, decision-makers and stakeholders are seeking policies, technologies, and operational procedures that balance environmental and economic interests. The main objective of this paper is to address shortcomings in current decision-making practices for aviation environmental policies. We review knowledge of the noise, air quality, and climate impacts of aviation, and demonstrate how including environmental impact assessment and quantifying uncertainties can enable a more comprehensive evaluation of aviation environmental policies. A comparison is presented between the cost-effectiveness analysis currently used for aviation environmental policy decision-making and an illustrative cost-benefit analysis. We focus on assessing a subset of the engine NO X emissions certification stringency options considered at the eighth meeting of the International Civil Aviation Organization’s Committee on Aviation Environmental Protection. The FAA Aviation environmental Portfolio Management Tool (APMT) is employed to conduct the policy assessments. We show that different conclusions may be drawn about the same policy options depending on whether benefits and interdependencies are estimated in terms of health and welfare impacts versus changes in NO X emissions inventories as is the typical practice. We also show that these conclusions are sensitive to a variety of modeling uncertainties. While our more comprehensive analysis makes the best policy option less clear, it represents a more accurate characterization of the scientific and economic uncertainties underlying impacts and the policy choices.

Affordable non-traditional source data mining for context assessment to improve distributed fusion system robustness

NASA Astrophysics Data System (ADS)

Bowman, Christopher; Haith, Gary; Steinberg, Alan; Morefield, Charles; Morefield, Michael

2013-05-01

This paper describes methods to affordably improve the robustness of distributed fusion systems by opportunistically leveraging non-traditional data sources. Adaptive methods help find relevant data, create models, and characterize the model quality. These methods also can measure the conformity of this non-traditional data with fusion system products including situation modeling and mission impact prediction. Non-traditional data can improve the quantity, quality, availability, timeliness, and diversity of the baseline fusion system sources and therefore can improve prediction and estimation accuracy and robustness at all levels of fusion. Techniques are described that automatically learn to characterize and search non-traditional contextual data to enable operators integrate the data with the high-level fusion systems and ontologies. These techniques apply the extension of the Data Fusion & Resource Management Dual Node Network (DNN) technical architecture at Level 4. The DNN architecture supports effectively assessment and management of the expanded portfolio of data sources, entities of interest, models, and algorithms including data pattern discovery and context conformity. Affordable model-driven and data-driven data mining methods to discover unknown models from non-traditional and `big data' sources are used to automatically learn entity behaviors and correlations with fusion products, [14 and 15]. This paper describes our context assessment software development, and the demonstration of context assessment of non-traditional data to compare to an intelligence surveillance and reconnaissance fusion product based upon an IED POIs workflow.

Advances in Patient-Reported Outcomes: The NIH PROMIS® Measures

PubMed Central

Broderick, Joan E.; DeWitt, Esi Morgan; Rothrock, Nan; Crane, Paul K.; Forrest, Christopher B.

2013-01-01

Patient-reported outcomes (PRO) are questionnaire measures of patients’ symptoms, functioning, and health-related quality of life. They are designed to provide important clinical information that generally cannot be captured with objective medical testing. In 2004, the National Institutes of Health launched a research initiative to improve the clinical research enterprise by developing state-of-the-art PROs. The NIH Patient-Reported Outcomes Measurement System (PROMIS) and Assessment Center are the products of that initiative. Adult, pediatric, and parent-proxy item banks have been developed by using contemporary psychometric methods, yielding rapid, accurate measurements. PROMIS currently provides tools for assessing physical, mental, and social health using short-form and computer-adaptive testing methods. The PROMIS tools are being adopted for use in clinical trials and translational research. They are also being introduced in clinical medicine to assess a broad range of disease outcomes. Recent legislative developments in the United States support greater efforts to include patients’ reports of health experience in order to evaluate treatment outcomes, engage in shared decision-making, and prioritize the focus of treatment. PROs have garnered increased attention by the Food and Drug Administration (FDA) for evaluating drugs and medical devices. Recent calls for comparative effectiveness research favor inclusion of PROs. PROs could also potentially improve quality of care and disease outcomes, provide patient-centered assessment for comparative effectiveness research, and enable a common metric for tracking outcomes across providers and medical systems. PMID:25848562

Injection-controlled laser resonator

DOEpatents

Chang, J.J.

1995-07-18

A new injection-controlled laser resonator incorporates self-filtering and self-imaging characteristics with an efficient injection scheme. A low-divergence laser signal is injected into the resonator, which enables the injection signal to be converted to the desired resonator modes before the main laser pulse starts. This injection technique and resonator design enable the laser cavity to improve the quality of the injection signal through self-filtering before the main laser pulse starts. The self-imaging property of the present resonator reduces the cavity induced diffraction effects and, in turn, improves the laser beam quality. 5 figs.

Injection-controlled laser resonator

DOEpatents

Chang, Jim J.

1995-07-18

A new injection-controlled laser resonator incorporates self-filtering and self-imaging characteristics with an efficient injection scheme. A low-divergence laser signal is injected into the resonator, which enables the injection signal to be converted to the desired resonator modes before the main laser pulse starts. This injection technique and resonator design enable the laser cavity to improve the quality of the injection signal through self-filtering before the main laser pulse starts. The self-imaging property of the present resonator reduces the cavity induced diffraction effects and, in turn, improves the laser beam quality.

Predicting rheological behavior and baking quality of wheat flour using a GlutoPeak test.

PubMed

Rakita, Slađana; Dokić, Ljubica; Dapčević Hadnađev, Tamara; Hadnađev, Miroslav; Torbica, Aleksandra

2018-06-01

The purpose of this research was to gain an insight into the ability of the GlutoPeak instrument to predict flour functionality for bread making, as well as to determine which of the GlutoPeak parameters show the best potential in predicting dough rheological behavior and baking performance. Obtained results showed that GlutoPeak parameters correlated better with the indices of extensional rheological tests which consider constant dough hydration than with those which were performed at constant dough consistency. The GlutoPeak test showed that it is suitable for discriminating wheat varieties of good quality from those of poor quality, while the most discriminating index was maximum torque (MT). Moreover, MT value of 50 BU and aggregation energy value of 1,300 GPU were set as limits of wheat flour quality. The backward stepwise regression analysis revealed that a high-level prediction of indices which are highly affected by protein content (gluten content, flour water absorption, and dough tenacity) was achieved by using the GlutoPeak indices. Concerning bread quality, a moderate prediction of specific loaf volume and an intense level prediction of breadcrumb textural properties were accomplished by using the GlutoPeak parameters. The presented results indicated that the application of this quick test in wheat transformation chain for the assessment of baking quality would be useful. Baking test is considered as the most reliable method for assessing wheat-baking quality. However, baking test requires trained stuff, time, and large sample amount. These disadvantages have led to a growing demand to develop new rapid tests which would enable prediction of baked product quality with a limited flour size. Therefore, we tested the possibility of using a GlutoPeak tester to predict loaf volume and breadcrumb textural properties. Discrimination of wheat varieties according to quality with a restricted flour amount was also examined. Furthermore, we proposed the limit values of GlutoPeak parameters which would be highly beneficial for millers and bakers when determine suitability of flour for end-use. © 2017 Wiley Periodicals, Inc.

The relationship between building design and residents' quality of life in extra care housing schemes.

PubMed

Orrell, Alison; McKee, Kevin; Torrington, Judith; Barnes, Sarah; Darton, Robin; Netten, Ann; Lewis, Alan

2013-05-01

Well-designed housing is recognised as being an important factor in promoting a good quality of life. Specialised housing models incorporating care services, such as extra care housing (ECH) schemes are seen as enabling older people to maintain a good quality of life despite increasing health problems that can accompany ageing. Despite the variation in ECH building design little is known about the impact of ECH building design on the quality of life of building users. The evaluation of older people's living environments (EVOLVE) study collected cross-sectional data on building design and quality of life in 23 ECH schemes in England, UK. Residents' quality of life was assessed using the schedule for the evaluation of individual quality of life-direct weighting (SEIQoL-DW) and on the four domains of control, autonomy, self-realisation and pleasure on the CASP-19. Building design was measured on 12 user-related domains by means of a new tool; the EVOLVE tool. Using multilevel linear regression, significant associations were found between several aspects of building design and quality of life. Furthermore, there was evidence that the relationship between building design and quality of life was partly mediated by the dependency of participants and scheme size (number of living units). Our findings suggest that good quality building design in ECH can support the quality of life of residents, but that designing features that support the needs of both relatively independent and frail users is problematic, with the needs of highly dependent users not currently supported as well as could be hoped by ECH schemes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Measurement of effective detective quantum efficiency for a photon counting scanning mammography system and comparison with two flat panel full-field digital mammography systems

NASA Astrophysics Data System (ADS)

Wood, Tim J.; Moore, Craig S.; Saunderson, John R.; Beavis, Andrew W.

2018-01-01

Effective detective quantum efficiency (eDQE) describes the resolution and noise properties of an imaging system along with scatter and primary transmission, all measured under clinically appropriate conditions. Effective dose efficiency (eDE) is the eDQE normalised to mean glandular dose and has been proposed as a useful metric for the optimisation of clinical imaging systems. The aim of this study was to develop a methodology for measuring eDQE and eDE on a Philips microdose mammography (MDM) L30 photon counting scanning system, and to compare performance with two conventional flat panel systems. A custom made lead-blocker was manufactured to enable the accurate determination of dose measurements, and modulation transfer functions were determined free-in-air at heights of 2, 4 and 6 cm above the breast support platform. eDQE were calculated for a Philips MDM L30, Hologic Dimensions and Siemens Inspiration digital mammography system for 2, 4 and 6 cm thick poly(methyl methacrylate) (PMMA). The beam qualities (target/filter and kilovoltage) assessed were those selected by the automatic exposure control, and anti-scatter grids were used where available. Measurements of eDQE demonstrate significant differences in performance between the slit- and scan-directions for the photon counting imaging system. MTF has been shown to be the limiting factor in the scan-direction, which results in a rapid fall in eDQE at mid-to-high spatial frequencies. A comparison with two flat panel mammography systems demonstrates that this may limit image quality for small details, such as micro-calcifications, which correlates with a more conventional image quality assessment with the CDMAM phantom. eDE has shown the scanning photon counting system offers superior performance for low spatial frequencies, which will be important for the detection of large low contrast masses. Both eDQE and eDE are proposed as useful metrics that should enable optimisation of the Philips MDM L30.

Oral Health Status of Older Adults in Sweden Receiving Elder Care: Findings From Nursing Assessments.

PubMed

Johansson, Isabelle; Jansson, Henrik; Lindmark, Ulrika

2016-01-01

Frail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life. The aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care. Data were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care. Individuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p < .01); at the subsequent assessment, gender differences in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006) were observed. Most participants had good oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.