CARD 2017: expansion and model-centric curation of the Comprehensive Antibiotic Resistance Database

USDA-ARS?s Scientific Manuscript database

The Comprehensive Antibiotic Resistance Database (CARD; http://arpcard.mcmaster.ca) is a manually curated resource containing high quality reference data on the molecular basis of antimicrobial resistance (AMR), with an emphasis on the genes, proteins, and mutations involved in AMR. CARD is ontologi...

Comprehensive Behavioral Health and School Psychology: An Implementation Agenda

ERIC Educational Resources Information Center

Forman, Susan G.; Ward, Caryn S.; Fixsen, Dean L.

2017-01-01

The preceding articles provide important examples and guidance for the provision of high-quality behavioral health services for children and adolescents in schools. In this article, we discuss (a) the conceptual framework that underlies the need to develop comprehensive integrated care, (b) the foundational implementation issues that need to be…

Comprehensive analysis of chemical constituents in Xingxiong injection by high performance liquid chromatography coupled with mass spectrometry.

PubMed

Guo, Long; Dou, Li-Li; Duan, Li; Liu, Ke; Bi, Zhi-Ming; Li, Ping; Liu, E-Hu

2015-09-01

Xingxiong injection (XXI) is a widely used Chinese herbal formula prepared by the folium ginkgo extract and ligustrazine for the treatment of cardiovascular and cerebrovascular diseases. Compared with the pharmacological studies, chemical analysis and quality control studies on this formula are relatively limited. In the present study, a high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (HPLC-QTOF MS) method was applied to comprehensive analysis of constituents in XXI. According to the fragmentation rules and previous reports, thirty ginkgo flavonoids, four ginkgo terpene lactones, and one alkaloid were identified. A high performance liquid chromatography coupled with triple quadrupole mass spectrometry (HPLC-QQQ MS) method was then applied to quantify ten major constituents in XXI. The method validation results indicated that the developed method had desirable specificity, linearity, precision and accuracy. The total contents of ginkgo flavonoids were about 22.05-25.51 μg·mL(-1) and the ginkgo terpene lactones amounts were about 4.41-8.70 μg·mL(-1) in six batches of XXI samples, respectively. Furthermore, cosine ratio algorithm and distance measurements were employed to evaluate the similarity of XXI samples, and the results demonstrated a high-quality consistency. This work could provide comprehensive information on the quality control of Xingxiong injection, which be helpful in the establishment of a rational quality control standard. Copyright © 2015 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

[Comprehensive and competition-oriented quality management in social medicine expert services].

PubMed

Seger, W

1996-05-01

In free competition expert services in Social Medicine must supply their expertise with high quality in a short time and at low cost. The demands by customers in respect of motivation of the staff and innovative organisation are as important competitive factors as high quality standards for expertise production. These guiding principles completed by "Kaizen" and "Lean production" are necessary requirements for the further existence of the enterprise in competition. Quality assurance must be promoted in a process looking to the future in active quality management.

42 CFR 417.410 - Qualifying conditions: General rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... groups and to deliver a specified comprehensive range of high quality services efficiently, effectively... services, and a quality assurance program. (c) Standards. Generally, each qualifying condition is... Section 417.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

77 FR 33563 - Applications for New Awards; Comprehensive Centers Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-06

... career-ready standards and aligned, high-quality assessments for all students; (2) identifying... outcomes for all students; close achievement gaps; and improve the quality of instruction. Regional...)) established Regional Advisory Committees (RACs) and charged them with conducting educational needs assessments...

A Comprehensive Quality Evaluation System for Complex Herbal Medicine Using PacBio Sequencing, PCR-Denaturing Gradient Gel Electrophoresis, and Several Chemical Approaches

PubMed Central

Zheng, Xiasheng; Zhang, Peng; Liao, Baosheng; Li, Jing; Liu, Xingyun; Shi, Yuhua; Cheng, Jinle; Lai, Zhitian; Xu, Jiang; Chen, Shilin

2017-01-01

Herbal medicine is a major component of complementary and alternative medicine, contributing significantly to the health of many people and communities. Quality control of herbal medicine is crucial to ensure that it is safe and sound for use. Here, we investigated a comprehensive quality evaluation system for a classic herbal medicine, Danggui Buxue Formula, by applying genetic-based and analytical chemistry approaches to authenticate and evaluate the quality of its samples. For authenticity, we successfully applied two novel technologies, third-generation sequencing and PCR-DGGE (denaturing gradient gel electrophoresis), to analyze the ingredient composition of the tested samples. For quality evaluation, we used high performance liquid chromatography assays to determine the content of chemical markers to help estimate the dosage relationship between its two raw materials, plant roots of Huangqi and Danggui. A series of surveys were then conducted against several exogenous contaminations, aiming to further access the efficacy and safety of the samples. In conclusion, the quality evaluation system demonstrated here can potentially address the authenticity, quality, and safety of herbal medicines, thus providing novel insight for enhancing their overall quality control. Highlight: We established a comprehensive quality evaluation system for herbal medicine, by combining two genetic-based approaches third-generation sequencing and DGGE (denaturing gradient gel electrophoresis) with analytical chemistry approaches to achieve the authentication and quality connotation of the samples. PMID:28955365

A Comprehensive Quality Evaluation System for Complex Herbal Medicine Using PacBio Sequencing, PCR-Denaturing Gradient Gel Electrophoresis, and Several Chemical Approaches.

PubMed

Zheng, Xiasheng; Zhang, Peng; Liao, Baosheng; Li, Jing; Liu, Xingyun; Shi, Yuhua; Cheng, Jinle; Lai, Zhitian; Xu, Jiang; Chen, Shilin

2017-01-01

Herbal medicine is a major component of complementary and alternative medicine, contributing significantly to the health of many people and communities. Quality control of herbal medicine is crucial to ensure that it is safe and sound for use. Here, we investigated a comprehensive quality evaluation system for a classic herbal medicine, Danggui Buxue Formula, by applying genetic-based and analytical chemistry approaches to authenticate and evaluate the quality of its samples. For authenticity, we successfully applied two novel technologies, third-generation sequencing and PCR-DGGE (denaturing gradient gel electrophoresis), to analyze the ingredient composition of the tested samples. For quality evaluation, we used high performance liquid chromatography assays to determine the content of chemical markers to help estimate the dosage relationship between its two raw materials, plant roots of Huangqi and Danggui. A series of surveys were then conducted against several exogenous contaminations, aiming to further access the efficacy and safety of the samples. In conclusion, the quality evaluation system demonstrated here can potentially address the authenticity, quality, and safety of herbal medicines, thus providing novel insight for enhancing their overall quality control. Highlight : We established a comprehensive quality evaluation system for herbal medicine, by combining two genetic-based approaches third-generation sequencing and DGGE (denaturing gradient gel electrophoresis) with analytical chemistry approaches to achieve the authentication and quality connotation of the samples.

School district wellness policy quality and weight-related outcomes among high school students in Minnesota.

PubMed

Hoffman, Pamela K; Davey, Cynthia S; Larson, Nicole; Grannon, Katherine Y; Hanson, Carlie; Nanney, Marilyn S

2016-04-01

Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between WellSAT scores and district-level means of high school student responses to a statewide survey of health behaviors were examined in this ecologic study. WellSAT Total Strength and Total Comprehensiveness scores were positively associated with both student mean Body Mass Index (BMI) percentile (Strength: P = 0.018, Comprehensiveness: P = 0.031) and mean percent overweight or obese (Strength: P = 0.008, Comprehensiveness: P = 0.026), but only in districts with > 50% of students eligible for Free or Reduced-Price Lunches (FRPLs), or 'high FRPL districts'. WellSAT Physical Education and Physical Activity subscale scores were also positively associated with the mean days per week students engaged in physical activity for ≥ 60 min in high FRPL districts (Strength: P = 0.008, Comprehensiveness: P = 0.003) and in low FRPL districts (< 35% eligible) for Strength score: (P = 0.027). In medium FRPL districts (35-50% eligible), Nutrition Education and Wellness Promotion Strength and Comprehensiveness subscale scores were positively associated with, respectively, daily servings of vegetables (P = 0.037) and fruit (P = 0.027); and WellSAT Total scores were positively associated with daily vegetable servings (Strength: P = 0.037, Comprehensiveness: P = 0.012). Administrators of economically disadvantaged school districts with a higher percentage of overweight students may be recognizing the need for stronger wellness policies and the specific importance of implementing policies pertaining to physical activity as a means to improve student health. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Water Quality Assessment for Deep-water Channel area of Guangzhou Port based on the Comprehensive Water Quality Identification Index Method

NASA Astrophysics Data System (ADS)

Chen, Yi

2018-03-01

The comprehensive water quality identification index method is able to assess the general water quality situation comprehensively and represent the water quality classification; water environment functional zone achieves pollution level and standard objectively and systematically. This paper selects 3 representative zones along deep-water channel of Guangzhou port and applies comprehensive water quality identification index method to calculate sea water quality monitoring data for different selected zones from year 2006 to 2014, in order to investigate the temporal variation of water quality along deep-water channel of Guangzhou port. The comprehensive water quality level from north to south presents an increased trend, and the water quality of the three zones in 2014 is much better than in 2006. This paper puts forward environmental protection measurements and suggestions for Pearl River Estuary, provides data support and theoretical basis for studied sea area pollution prevention and control.

Time for a Tune-Up: Comprehensive Curriculum Evaluation

ERIC Educational Resources Information Center

Meyers, Lisa H.

2005-01-01

How important is a high-quality curriculum? A school without a quality curriculum is like a car without an engine--neither goes anywhere. One responsibility of a school administrator is to ensure that quality curriculum is designed, adopted, and implemented. The No Child Left Behind act (NCLB) has focused the attention of an entire nation on the…

Evaluating Software Assurance Knowledge and Competency of Acquisition Professionals

DTIC Science & Technology

2014-10-01

of ISO 12207 -2008, both internationally and in the United States [7]. That standard documents a comprehensive set of activities and supporting...grows, organizations must ensure that their procurement agents acquire high quality, secure software. ISO 12207 and the Software Assurance Competency...cyberattacks grows, organizations must ensure that their procurement agents acquire high quality, secure software. ISO 12207 and the Software Assurance

High School Science Teachers' Perceptions of Teaching Content-Related Reading Comprehension Instruction

NASA Astrophysics Data System (ADS)

Williams, Theresa

In order to achieve academic success, students must be able to comprehend written material in content-area textbooks. However, a large number of high school students struggle to comprehend science content. Research findings have demonstrated that students make measurable gains in comprehending content-area textbooks when provided quality reading comprehension instruction. The purpose of this study was to gain an understanding of how high school science teachers perceived their responsibility to provide content-related comprehension instruction and 10 high school science teachers were interviewed for this study. Data analysis consisted of open, axial, and selective coding. The findings revealed that 8 out of the 10 participants believed that it is their responsibility to provide reading comprehension. However, the findings also revealed that the participants provided varying levels of reading comprehension instruction as an integral part of their science instruction. The potential for positive social change could be achieved by teachers and administrators. Teachers may use the findings to reflect upon their own personal feelings and beliefs about providing explicit reading comprehension. In addition to teachers' commitment to reading comprehension instruction, administrators could deliberate about professional development opportunities that might improve necessary skills, eventually leading to better comprehension skills for students and success in their education.

Putting Children and Families First: Head Start Programs in 2010. Brief No. 10

ERIC Educational Resources Information Center

Schmit, Stephanie; Ewen, Danielle

2012-01-01

Since its creation in 1965, Head Start has provided high quality early education and comprehensive support services to three- and four-year-olds in poor families. In addition to early learning opportunities, Head Start's comprehensive early childhood development program provides children and families with access to a range of services such as…

An Examination of Instructional Interactions between Volunteer-Tutors and Students Who Show Differential Gains in Reading Comprehension

ERIC Educational Resources Information Center

Newcomer, Laurie J.

2010-01-01

It is essential to provide high quality interventions designed to improve struggling readers' reading comprehension while making use of limited resources. This study explored, through an holistic, multiple-case study design, volunteer-student interactions and activities in an after school reading program utilizing minimally-trained volunteers. The…

Comprehensive Chemical Fingerprinting of High-Quality Cocoa at Early Stages of Processing: Effectiveness of Combined Untargeted and Targeted Approaches for Classification and Discrimination.

PubMed

Magagna, Federico; Guglielmetti, Alessandro; Liberto, Erica; Reichenbach, Stephen E; Allegrucci, Elena; Gobino, Guido; Bicchi, Carlo; Cordero, Chiara

2017-08-02

This study investigates chemical information of volatile fractions of high-quality cocoa (Theobroma cacao L. Malvaceae) from different origins (Mexico, Ecuador, Venezuela, Columbia, Java, Trinidad, and Sao Tomè) produced for fine chocolate. This study explores the evolution of the entire pattern of volatiles in relation to cocoa processing (raw, roasted, steamed, and ground beans). Advanced chemical fingerprinting (e.g., combined untargeted and targeted fingerprinting) with comprehensive two-dimensional gas chromatography coupled with mass spectrometry allows advanced pattern recognition for classification, discrimination, and sensory-quality characterization. The entire data set is analyzed for 595 reliable two-dimensional peak regions, including 130 known analytes and 13 potent odorants. Multivariate analysis with unsupervised exploration (principal component analysis) and simple supervised discrimination methods (Fisher ratios and linear regression trees) reveal informative patterns of similarities and differences and identify characteristic compounds related to sample origin and manufacturing step.

How logical reasoning mediates the relation between lexical quality and reading comprehension.

PubMed

Segers, Eliane; Verhoeven, Ludo

The present study aimed to examine the role of logical reasoning in the relation between lexical quality and reading comprehension in 146 fourth grade Dutch children. We assessed their standardized reading comprehension measure, along with their decoding efficiency and vocabulary as measures of lexical quality, syllogistic reasoning as measure of (verbal) logical reasoning, and nonverbal reasoning as a control measure. Syllogistic reasoning was divided into a measure tapping basic, coherence inferencing skill using logical syllogisms, and a measure tapping elaborative inferencing skill using indeterminate syllogisms. Results showed that both types of syllogisms partly mediated the relation between lexical quality and reading comprehension, but also had a unique additional effect on reading comprehension. The indirect effect of lexical quality on reading comprehension via syllogisms was driven by vocabulary knowledge. It is concluded that measures of syllogistic reasoning account for higher-order thinking processes that are needed to make inferences in reading comprehension. The role of lexical quality appears to be pivotal in explaining the variation in reading comprehension both directly and indirectly via syllogistic reasoning.

Classification and Quality Evaluation of Tobacco Leaves Based on Image Processing and Fuzzy Comprehensive Evaluation

PubMed Central

Zhang, Fan; Zhang, Xinhong

2011-01-01

Most of classification, quality evaluation or grading of the flue-cured tobacco leaves are manually operated, which relies on the judgmental experience of experts, and inevitably limited by personal, physical and environmental factors. The classification and the quality evaluation are therefore subjective and experientially based. In this paper, an automatic classification method of tobacco leaves based on the digital image processing and the fuzzy sets theory is presented. A grading system based on image processing techniques was developed for automatically inspecting and grading flue-cured tobacco leaves. This system uses machine vision for the extraction and analysis of color, size, shape and surface texture. Fuzzy comprehensive evaluation provides a high level of confidence in decision making based on the fuzzy logic. The neural network is used to estimate and forecast the membership function of the features of tobacco leaves in the fuzzy sets. The experimental results of the two-level fuzzy comprehensive evaluation (FCE) show that the accuracy rate of classification is about 94% for the trained tobacco leaves, and the accuracy rate of the non-trained tobacco leaves is about 72%. We believe that the fuzzy comprehensive evaluation is a viable way for the automatic classification and quality evaluation of the tobacco leaves. PMID:22163744

A high-quality annotated transcriptome of swine peripheral blood

USDA-ARS?s Scientific Manuscript database

Background: High throughput gene expression profiling assays of peripheral blood are widely used in biomedicine, as well as in animal genetics and physiology research. Accurate, comprehensive, and precise interpretation of such high throughput assays relies on well-characterized reference genomes an...

Key Features of High-Quality Policies and Guidelines to Support Social and Emotional Learning: Recommendations and Examples for the Collaborating States Initiative (CSI)

ERIC Educational Resources Information Center

Dusenbury, Linda; Yoder, Nick

2017-01-01

The current document serves two purposes. First, it provides an overview of six key features of a high-quality, comprehensive package of policies and guidance to support student social and emotional learning (SEL). These features are based on Collaborative for Academic Social, and Emotional Learning's (CASEL's) review of the research literature on…

Review of Comprehensive Evaluation Methods for Power Quality and Its Trend in New Generation Energy System

NASA Astrophysics Data System (ADS)

Liu, Ruihua; Wang, Rong; Liu, Qunying; Yang, Li; Xi, Chuan; Wang, Wei; Li, Lingzhou; Zhao, Zhoufang; Zhou, Ying

2018-02-01

With China’s new energy generation grid connected capacity being in the forefront of the world and the uncertainty of new energy sources, such as wind energy and solar energy, it is be of great significance to study scientific and comprehensive assessment of power quality. On the foundation of analysizing the current power quality index systematically and objectively, the new energy grid power quality analysis method and comprehensive evaluation method, this paper tentatively explored the trend of the new generation of energy system power quality comprehensive evaluation.

Content and Quality of Information Provided on Canadian Dementia Websites

PubMed Central

Dillon, Whitney A.; Prorok, Jeanette C.; Seitz, Dallas P.

2013-01-01

Purpose Information about dementia is important for persons with dementia (PWD) and their caregivers and the Internet has become the key source of health information. We reviewed the content and quality of information provided on Canadian websites for Alzheimer’s disease (AD). Methods We used the terms “dementia” and “Alzheimer” in Google to identify Canadian dementia websites. The contents of websites were compared to 16 guideline recommendations provided in Canadian Consensus Conference on Diagnosis and Treatment of Dementia. The quality of information provided on websites was evaluated using the DISCERN instrument. The content and quality of information provided on selected websites were then described. Results Seven websites were identified, three of which provided relatively comprehensive and high-quality information on dementia. Websites frequently provided information about diagnosis of dementia, its natural course, and types of dementia, while other topics were less commonly addressed. The quality of information provided on the websites varied, and many websites had several areas where the quality of information provided was relatively low according to the DISCERN instrument. Conclusions There is variation in the content and quality of dementia websites, although some websites provide high-quality and relatively comprehensive information which would serve as a useful resource for PWD, caregivers, and healthcare providers. Improvements in the content and quality of information provided on AD websites would provide PWD and their caregivers with access to better information. PMID:23440180

Supporting Our Youngest Children: Early Head Start Programs in 2010. Brief No. 11

ERIC Educational Resources Information Center

Schmit, Stephanie; Ewen, Danielle

2012-01-01

Since 1965, Head Start has provided high quality early education and comprehensive support services to the nation's poorest children from ages 3 through school age. In 1994, the federal Early Head Start (EHS) program was created to address the comprehensive needs of poor children under age 3 and pregnant women. Head Start and Early Head Start's…

"Every Child Ready": Exposure to a Comprehensive Instructional Model Improves Students' Growth Trajectories in Multiple Early Learning Domains

ERIC Educational Resources Information Center

Carlson, Abby G.; Curby, Timothy W.; Brown, Chavaughn A.; Truong, Felicia R.

2017-01-01

The current study investigates the impact of Every Child Ready (ECR), a comprehensive instructional model that includes: "What to teach, how to teach and how to know instruction is effective." The ECR instructional model is designed to provide high quality instruction to children via a play-based, thematic curriculum. Participants…

Who Has a Good Relationship with the Teachers? A Comparison of Comprehensive Education Systems with Education Systems Using Between-School Tracking

ERIC Educational Resources Information Center

Vieluf, Svenja; Hochweber, Jan; Klieme, Eckhard; Kunter, Mareike

2015-01-01

In the present study we compared comprehensive education systems and education systems using between-school tracking with regard to disparities in the quality of student-teacher relations between low and high achieving students, between students with different socioeconomic backgrounds, and between schools with different achievement and social…

COMAN: a web server for comprehensive metatranscriptomics analysis.

PubMed

Ni, Yueqiong; Li, Jun; Panagiotou, Gianni

2016-08-11

Microbiota-oriented studies based on metagenomic or metatranscriptomic sequencing have revolutionised our understanding on microbial ecology and the roles of both clinical and environmental microbes. The analysis of massive metatranscriptomic data requires extensive computational resources, a collection of bioinformatics tools and expertise in programming. We developed COMAN (Comprehensive Metatranscriptomics Analysis), a web-based tool dedicated to automatically and comprehensively analysing metatranscriptomic data. COMAN pipeline includes quality control of raw reads, removal of reads derived from non-coding RNA, followed by functional annotation, comparative statistical analysis, pathway enrichment analysis, co-expression network analysis and high-quality visualisation. The essential data generated by COMAN are also provided in tabular format for additional analysis and integration with other software. The web server has an easy-to-use interface and detailed instructions, and is freely available at http://sbb.hku.hk/COMAN/ CONCLUSIONS: COMAN is an integrated web server dedicated to comprehensive functional analysis of metatranscriptomic data, translating massive amount of reads to data tables and high-standard figures. It is expected to facilitate the researchers with less expertise in bioinformatics in answering microbiota-related biological questions and to increase the accessibility and interpretation of microbiota RNA-Seq data.

A comprehensive method for GNSS data quality determination to improve ionospheric data analysis.

PubMed

Kim, Minchan; Seo, Jiwon; Lee, Jiyun

2014-08-14

Global Navigation Satellite Systems (GNSS) are now recognized as cost-effective tools for ionospheric studies by providing the global coverage through worldwide networks of GNSS stations. While GNSS networks continue to expand to improve the observability of the ionosphere, the amount of poor quality GNSS observation data is also increasing and the use of poor-quality GNSS data degrades the accuracy of ionospheric measurements. This paper develops a comprehensive method to determine the quality of GNSS observations for the purpose of ionospheric studies. The algorithms are designed especially to compute key GNSS data quality parameters which affect the quality of ionospheric product. The quality of data collected from the Continuously Operating Reference Stations (CORS) network in the conterminous United States (CONUS) is analyzed. The resulting quality varies widely, depending on each station and the data quality of individual stations persists for an extended time period. When compared to conventional methods, the quality parameters obtained from the proposed method have a stronger correlation with the quality of ionospheric data. The results suggest that a set of data quality parameters when used in combination can effectively select stations with high-quality GNSS data and improve the performance of ionospheric data analysis.

A Comprehensive Method for GNSS Data Quality Determination to Improve Ionospheric Data Analysis

PubMed Central

Kim, Minchan; Seo, Jiwon; Lee, Jiyun

2014-01-01

Global Navigation Satellite Systems (GNSS) are now recognized as cost-effective tools for ionospheric studies by providing the global coverage through worldwide networks of GNSS stations. While GNSS networks continue to expand to improve the observability of the ionosphere, the amount of poor quality GNSS observation data is also increasing and the use of poor-quality GNSS data degrades the accuracy of ionospheric measurements. This paper develops a comprehensive method to determine the quality of GNSS observations for the purpose of ionospheric studies. The algorithms are designed especially to compute key GNSS data quality parameters which affect the quality of ionospheric product. The quality of data collected from the Continuously Operating Reference Stations (CORS) network in the conterminous United States (CONUS) is analyzed. The resulting quality varies widely, depending on each station and the data quality of individual stations persists for an extended time period. When compared to conventional methods, the quality parameters obtained from the proposed method have a stronger correlation with the quality of ionospheric data. The results suggest that a set of data quality parameters when used in combination can effectively select stations with high-quality GNSS data and improve the performance of ionospheric data analysis. PMID:25196005

Knowledge-based analysis of microarrays for the discovery of transcriptional regulation relationships

PubMed Central

2010-01-01

Background The large amount of high-throughput genomic data has facilitated the discovery of the regulatory relationships between transcription factors and their target genes. While early methods for discovery of transcriptional regulation relationships from microarray data often focused on the high-throughput experimental data alone, more recent approaches have explored the integration of external knowledge bases of gene interactions. Results In this work, we develop an algorithm that provides improved performance in the prediction of transcriptional regulatory relationships by supplementing the analysis of microarray data with a new method of integrating information from an existing knowledge base. Using a well-known dataset of yeast microarrays and the Yeast Proteome Database, a comprehensive collection of known information of yeast genes, we show that knowledge-based predictions demonstrate better sensitivity and specificity in inferring new transcriptional interactions than predictions from microarray data alone. We also show that comprehensive, direct and high-quality knowledge bases provide better prediction performance. Comparison of our results with ChIP-chip data and growth fitness data suggests that our predicted genome-wide regulatory pairs in yeast are reasonable candidates for follow-up biological verification. Conclusion High quality, comprehensive, and direct knowledge bases, when combined with appropriate bioinformatic algorithms, can significantly improve the discovery of gene regulatory relationships from high throughput gene expression data. PMID:20122245

Knowledge-based analysis of microarrays for the discovery of transcriptional regulation relationships.

PubMed

Seok, Junhee; Kaushal, Amit; Davis, Ronald W; Xiao, Wenzhong

2010-01-18

The large amount of high-throughput genomic data has facilitated the discovery of the regulatory relationships between transcription factors and their target genes. While early methods for discovery of transcriptional regulation relationships from microarray data often focused on the high-throughput experimental data alone, more recent approaches have explored the integration of external knowledge bases of gene interactions. In this work, we develop an algorithm that provides improved performance in the prediction of transcriptional regulatory relationships by supplementing the analysis of microarray data with a new method of integrating information from an existing knowledge base. Using a well-known dataset of yeast microarrays and the Yeast Proteome Database, a comprehensive collection of known information of yeast genes, we show that knowledge-based predictions demonstrate better sensitivity and specificity in inferring new transcriptional interactions than predictions from microarray data alone. We also show that comprehensive, direct and high-quality knowledge bases provide better prediction performance. Comparison of our results with ChIP-chip data and growth fitness data suggests that our predicted genome-wide regulatory pairs in yeast are reasonable candidates for follow-up biological verification. High quality, comprehensive, and direct knowledge bases, when combined with appropriate bioinformatic algorithms, can significantly improve the discovery of gene regulatory relationships from high throughput gene expression data.

The quality of school wellness policies and energy-balance behaviors of adolescent mothers.

PubMed

Haire-Joshu, Debra; Yount, Byron W; Budd, Elizabeth L; Schwarz, Cynthia; Schermbeck, Rebecca; Green, Scoie; Elliott, Michael

2011-03-01

In this study, we 1) compared the quality of school wellness policies among schools participating in Moms for a Healthy Balance (BALANCE), a school- and home-based weight loss study conducted with postpartum adolescents in 27 states; and 2) assessed the relationship between policy quality with energy-balance behaviors and body mass index z scores of postpartum adolescents. As a part of BALANCE, we collected data on high-calorie food and beverage consumption, minutes spent walking, and height and weight for 647 participants. The School Wellness Policy Coding Tool was used to assess the strength and comprehensiveness of school district wellness policies from 251 schools attended by participating adolescent mothers. Schools averaged low scores for wellness policy comprehensiveness and strength. When compared with participants in schools with the lowest policy comprehensiveness scores, adolescent mothers in schools with the highest scores reported consuming significantly fewer daily calories from sweetened beverages while reporting higher consumption of water (P = .04 and P = .01, respectively). School wellness policy strength was associated with lower BMI z scores among adolescent mothers (P = .01). School wellness policies associated with BALANCE may be limited in their ability to promote a healthy school environment. Future studies are needed to evaluate the effect of the strength and comprehensiveness of policy language on energy balance in high-risk postpartum adolescents. Evidence from this work can provide additional guidance to federal or state government in mandating not only policy content, but also systematic evaluation.

Validation of an instrument to measure inter-organisational linkages in general practice.

PubMed

Amoroso, Cheryl; Proudfoot, Judith; Bubner, Tanya; Jayasinghe, Upali W; Holton, Christine; Winstanley, Julie; Beilby, Justin; Harris, Mark F

2007-12-03

Linkages between general medical practices and external services are important for high quality chronic disease care. The purpose of this research is to describe the development, evaluation and use of a brief tool that measures the comprehensiveness and quality of a general practice's linkages with external providers for the management of patients with chronic disease. In this study, clinical linkages are defined as the communication, support, and referral arrangements between services for the care and assistance of patients with chronic disease. An interview to measure surgery-level (rather than individual clinician-level) clinical linkages was developed, piloted, reviewed, and evaluated with 97 Australian general practices. Two validated survey instruments were posted to patients, and a survey of locally available services was developed and posted to participating Divisions of General Practice (support organisations). Hypotheses regarding internal validity, association with local services, and patient satisfaction were tested using factor analysis, logistic regression and multilevel regression models. The resulting General Practice Clinical Linkages Interview (GP-CLI) is a nine-item tool with three underlying factors: referral and advice linkages, shared care and care planning linkages, and community access and awareness linkages. Local availability of chronic disease services has no affect on the comprehensiveness of services with which practices link, however, comprehensiveness of clinical linkages has an association with patient assessment of access, receptionist services, and of continuity of care in their general practice. The GP-CLI may be useful to researchers examining comparable health care systems for measuring the comprehensiveness and quality of linkages at a general practice-level with related services, possessing both internal and external validity. The tool can be used with large samples exploring the impact, outcomes, and facilitators of high quality clinical linkages in general practice.

Measuring the Quality of Early Childhood Programs--Guidelines for Effective Evaluation Tools.

ERIC Educational Resources Information Center

Epstein, Ann S.

2000-01-01

Summarizes what High/Scope discovered to be the critical characteristics of a comprehensive and valid measure of early childhood program quality. Provides suggestions for how the tool can be used, and highlights with examples. Asserts that the guidelines effectively assess efforts of child development, staff development, and soundness of…

Lexical Expertise and Reading Skill: Bottom-Up and Top-Down Processing of Lexical Ambiguity

ERIC Educational Resources Information Center

Andrews, Sally; Bond, Rachel

2009-01-01

The lexical quality hypothesis assumes that skilled readers rely on high quality lexical representations that afford autonomous lexical retrieval and reduce the need to rely on top-down context. This experiment investigated this hypothesis by comparing the performance of adults classified on reading comprehension and spelling performance. "Lexical…

Better data, better planning: the College of Emergency Medicine sentinel sites project.

PubMed

Moulton, Chris; Mann, Clifford; Tempest, Michelle

2014-11-01

This article describes the College of Emergency Medicine's initial attempt to gather high quality data from its own 'sentinel sites' rather than relying on more comprehensive national data of dubious quality. Such information is essential to inform and guide the planning of urgent and emergency care services in the future.

Properties of young massive clusters obtained with different massive-star evolutionary models

NASA Astrophysics Data System (ADS)

Wofford, Aida; Charlot, Stéphane

We undertake a comprehensive comparative test of seven widely-used spectral synthesis models using multi-band HST photometry of a sample of eight YMCs in two galaxies. We provide a first quantitative estimate of the accuracies and uncertainties of new models, show the good progress of models in fitting high-quality observations, and highlight the need of further comprehensive comparative tests.

Sensitive and comprehensive analysis of O-glycosylation in biotherapeutics: a case study of novel erythropoiesis stimulating protein.

PubMed

Kim, Unyong; Oh, Myung Jin; Seo, Youngsuk; Jeon, Yinae; Eom, Joon-Ho; An, Hyun Joo

2017-09-01

Glycosylation of recombinant human erythropoietins (rhEPOs) is significantly associated with drug's quality and potency. Thus, comprehensive characterization of glycosylation is vital to assess the biotherapeutic quality and establish the equivalency of biosimilar rhEPOs. However, current glycan analysis mainly focuses on the N-glycans due to the absence of analytical tools to liberate O-glycans with high sensitivity. We developed selective and sensitive method to profile native O-glycans on rhEPOs. O-glycosylation on rhEPO including O-acetylation on a sialic acid was comprehensively characterized. Details such as O-glycan structure and O-acetyl-modification site were obtained from tandem MS. This method may be applied to QC and batch analysis of not only rhEPOs but also other biotherapeutics bearing multiple O-glycosylations.

A multilingual assessment of melanoma information quality on the Internet.

PubMed

Bari, Lilla; Kemeny, Lajos; Bari, Ferenc

2014-06-01

This study aims to assess and compare melanoma information quality in Hungarian, Czech, and German languages on the Internet. We used country-specific Google search engines to retrieve the first 25 uniform resource locators (URLs) by searching the word "melanoma" in the given language. Using the automated toolbar of Health On the Net Foundation (HON), we assessed each Web site for HON certification based on the Health On the Net Foundation Code of Conduct (HONcode). Information quality was determined using a 35-point checklist created by Bichakjian et al. (J Clin Oncol 20:134-141, 2002), with the NCCN melanoma guideline as control. After excluding duplicate and link-only pages, a total of 24 Hungarian, 18 Czech, and 21 German melanoma Web sites were evaluated and rated. The amount of HON certified Web sites was the highest among the German Web pages (19%). One of the retrieved Hungarian and none of the Czech Web sites were HON certified. We found the highest number of Web sites containing comprehensive, correct melanoma information in German language, followed by Czech and Hungarian pages. Although the majority of the Web sites lacked data about incidence, risk factors, prevention, treatment, work-up, and follow-up, at least one comprehensive, high-quality Web site was found in each language. Several Web sites contained incorrect information in each language. While a small amount of comprehensive, quality melanoma-related Web sites was found, most of the retrieved Web content lacked basic disease information, such as risk factors, prevention, and treatment. A significant number of Web sites contained malinformation. In case of melanoma, primary and secondary preventions are of especially high importance; therefore, the improvement of disease information quality available on the Internet is necessary.

Towards a five-minute comprehensive cardiac MR examination using highly accelerated parallel imaging with a 32-element coil array: feasibility and initial comparative evaluation.

PubMed

Xu, Jian; Kim, Daniel; Otazo, Ricardo; Srichai, Monvadi B; Lim, Ruth P; Axel, Leon; Mcgorty, Kelly Anne; Niendorf, Thoralf; Sodickson, Daniel K

2013-07-01

To evaluate the feasibility and perform initial comparative evaluations of a 5-minute comprehensive whole-heart magnetic resonance imaging (MRI) protocol with four image acquisition types: perfusion (PERF), function (CINE), coronary artery imaging (CAI), and late gadolinium enhancement (LGE). This study protocol was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board-approved. A 5-minute comprehensive whole-heart MRI examination protocol (Accelerated) using 6-8-fold-accelerated volumetric parallel imaging was incorporated into and compared with a standard 2D clinical routine protocol (Standard). Following informed consent, 20 patients were imaged with both protocols. Datasets were reviewed for image quality using a 5-point Likert scale (0 = non-diagnostic, 4 = excellent) in blinded fashion by two readers. Good image quality with full whole-heart coverage was achieved using the accelerated protocol, particularly for CAI, although significant degradations in quality, as compared with traditional lengthy examinations, were observed for the other image types. Mean total scan time was significantly lower for the Accelerated as compared to Standard protocols (28.99 ± 4.59 min vs. 1.82 ± 0.05 min, P < 0.05). Overall image quality for the Standard vs. Accelerated protocol was 3.67 ± 0.29 vs. 1.5 ± 0.51 (P < 0.005) for PERF, 3.48 ± 0.64 vs. 2.6 ± 0.68 (P < 0.005) for CINE, 2.35 ± 1.01 vs. 2.48 ± 0.68 (P = 0.75) for CAI, and 3.67 ± 0.42 vs. 2.67 ± 0.84 (P < 0.005) for LGE. Diagnostic image quality for Standard vs. Accelerated protocols was 20/20 (100%) vs. 10/20 (50%) for PERF, 20/20 (100%) vs. 18/20 (90%) for CINE, 18/20 (90%) vs. 18/20 (90%) for CAI, and 20/20 (100%) vs. 18/20 (90%) for LGE. This study demonstrates the technical feasibility and promising image quality of 5-minute comprehensive whole-heart cardiac examinations, with simplified scan prescription and high spatial and temporal resolution enabled by highly parallel imaging technology. The study also highlights technical hurdles that remain to be addressed. Although image quality remained diagnostic for most scan types, the reduced image quality of PERF, CINE, and LGE scans in the Accelerated protocol remain a concern. Copyright © 2012 Wiley Periodicals, Inc.

How Logical Reasoning Mediates the Relation between Lexical Quality and Reading Comprehension

ERIC Educational Resources Information Center

Segers, Eliane; Verhoeven, Ludo

2016-01-01

The present study aimed to examine the role of logical reasoning in the relation between lexical quality and reading comprehension in 146 fourth grade Dutch children. We assessed their standardized reading comprehension measure, along with their decoding efficiency and vocabulary as measures of lexical quality, syllogistic reasoning as measure of…

THE ECOTOX DATABASE

EPA Science Inventory

The database provides chemical-specific toxicity information for aquatic life, terrestrial plants, and terrestrial wildlife. ECOTOX is a comprehensive ecotoxicology database and is therefore essential for providing and suppoirting high quality models needed to estimate population...

Strategies for Meeting High Standards: Quality Management and the Baldrige Criteria in Education. Lessons from the States.

ERIC Educational Resources Information Center

Barth, John; Burk, Zona Sharp; Serfass, Richard; Harms, Barbara Ann; Houlihan, G. Thomas; Anderson, Gerald; Farley, Raymond P.; Rigsby, Ken; O'Rourke, John

This document, one of a series of reports, focuses on the adoption of principles of quality management, originally developed by W. Edwards Deming, and the Baldrige Criteria for use in education. These processes and tools for systemic organizational management, when comprehensively applied, produce performance excellence and continuous improvement.…

At Issue: A Comprehensive Review and Synthesis of the Literature on Late Registration

ERIC Educational Resources Information Center

Tompkins, Patrick; Williams, Mitchell R.

2015-01-01

Using a literature review taxonomy described by Cooper and Hedges (2009), an analysis of 32 publicly available studies of late registrations was conducted to provide researchers and policymakers with an assessment of the extent, quality, and major findings of the studies. The reviewer asserted that few high-quality studies have been conducted on…

The relationship between the content and the form of metaphorical statements.

PubMed

Xu, Xu

2010-04-01

Recent research suggests that the quality of a metaphorical topic-vehicle pairing should be the determinant to the choice of a proper grammatical form, nominal metaphor versus simile. Two studies examined the relationship between the quality of the content of a metaphorical statement and its grammatical form. Study 1 showed that the two grammatical forms did not differ in aptness when the quality of topic-vehicle pairs and the conventionality of vehicles, a factor associated with the quality of metaphorical expressions, were controlled. With an online comprehension measure, Study 2 found that high quality metaphorical pairings were easier to process than low quality metaphorical pairings in both the metaphor form and the simile form. For high quality metaphorical pairings, information related to both the topics and the vehicles was highly activated at an early stage of processing. The relations among factors involved in the interpretive process of metaphorical language are discussed.

YouTube as an information source for pediatric adenotonsillectomy and ear tube surgery.

PubMed

Sorensen, Jeffrey A; Pusz, Max D; Brietzke, Scott E

2014-01-01

Assess the overall quality of information on adenotonsillectomy and ear tube surgery presented on YouTube (www.youtube.com) from the perspective of a parent or patient searching for information on surgery. The YouTube website was systematically searched on select dates with a formal search strategy to identify videos pertaining to pediatric adenotonsillectomy and ear tube surgery. Only videos with at least 5 (ear tube surgery) or 10 (adenotonsillectomy) views per day were included. Each video was viewed and scored by two independent scorers. Videos were categorized by goal and scored for video/audio quality, accuracy, comprehensiveness, and procedure-specific content. Cross-sectional study. Public domain website. Fifty-five videos were scored for adenotonsillectomy and forty-seven for ear tube surgery. The most common category was educational (65.3%) followed by testimonial (28.4%), and news program (9.8%). Testimonials were more common for adenotonsillectomy than ear tube surgery (41.8% vs. 12.8%, p=0.001). Testimonials had a significantly lower mean accuracy (2.23 vs. 2.62, p=0.02), comprehensiveness (1.71 vs. 2.22, p=0.007), and TA specific content (0.64 vs. 1.69, p=0.001) score than educational type videos. Only six videos (5.9%) received high scores in both video/audio quality and accuracy/comprehensiveness of content. There was no significant association between the accuracy and comprehensive score and views, posted "likes", posted "dislikes", and likes/dislikes ratio. There was an association between "likes" and mean video quality (Spearman's rho=0.262, p=0.008). Parents/patients searching YouTube for information on pediatric adenotonsillectomy and ear tube surgery will generally encounter low quality information with testimonials being common but of significantly lower quality. Viewer perceived quality ("likes") did not correlate to formally scored content quality. Published by Elsevier Ireland Ltd.

[Standardization of cancer biobank in precision medicine era].

PubMed

Ji, Jiafu

2016-05-25

Tumor specimens have a great role in basic and clinical translational researches on cancer, especially in the era of precision medicine. Thus the standardization of cancer biobank is of high importance. The establishment and maintenance of cancer biobank require comprehensive quality management, so as to provide high quality service for basic and clinical researches. At present, sample-oriented collection and management, and clinical and pathological data annotation are the main focuses of biobank standardization in China.

Protocol Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious

Incident learning in pursuit of high reliability: implementing a comprehensive, low-threshold reporting program in a large, multisite radiation oncology department.

PubMed

Gabriel, Peter E; Volz, Edna; Bergendahl, Howard W; Burke, Sean V; Solberg, Timothy D; Maity, Amit; Hahn, Stephen M

2015-04-01

Incident learning programs have been recognized as cornerstones of safety and quality assurance in so-called high reliability organizations in industries such as aviation and nuclear power. High reliability organizations are distinguished by their drive to continuously identify and proactively address a broad spectrum of latent safety issues. Many radiation oncology institutions have reported on their experience in tracking and analyzing adverse events and near misses but few have incorporated the principles of high reliability into their programs. Most programs have focused on the reporting and retrospective analysis of a relatively small number of significant adverse events and near misses. To advance a large, multisite radiation oncology department toward high reliability, a comprehensive, cost-effective, electronic condition reporting program was launched to enable the identification of a broad spectrum of latent system failures, which would then be addressed through a continuous quality improvement process. A comprehensive program, including policies, work flows, and information system, was designed and implemented, with use of a low reporting threshold to focus on precursors to adverse events. In a 46-month period from March 2011 through December 2014, a total of 8,504 conditions (average, 185 per month, 1 per patient treated, 3.9 per 100 fractions [individual treatments]) were reported. Some 77.9% of clinical staff members reported at least 1 condition. Ninety-eight percent of conditions were classified in the lowest two of four severity levels, providing the opportunity to address conditions before they contribute to adverse events. Results after approximately four years show excellent employee engagement, a sustained rate of reporting, and a focus on low-level issues leading to proactive quality improvement interventions.

Improving benchmarking by using an explicit framework for the development of composite indicators: an example using pediatric quality of care

PubMed Central

2010-01-01

Background The measurement of healthcare provider performance is becoming more widespread. Physicians have been guarded about performance measurement, in part because the methodology for comparative measurement of care quality is underdeveloped. Comprehensive quality improvement will require comprehensive measurement, implying the aggregation of multiple quality metrics into composite indicators. Objective To present a conceptual framework to develop comprehensive, robust, and transparent composite indicators of pediatric care quality, and to highlight aspects specific to quality measurement in children. Methods We reviewed the scientific literature on composite indicator development, health systems, and quality measurement in the pediatric healthcare setting. Frameworks were selected for explicitness and applicability to a hospital-based measurement system. Results We synthesized various frameworks into a comprehensive model for the development of composite indicators of quality of care. Among its key premises, the model proposes identifying structural, process, and outcome metrics for each of the Institute of Medicine's six domains of quality (safety, effectiveness, efficiency, patient-centeredness, timeliness, and equity) and presents a step-by-step framework for embedding the quality of care measurement model into composite indicator development. Conclusions The framework presented offers researchers an explicit path to composite indicator development. Without a scientifically robust and comprehensive approach to measurement of the quality of healthcare, performance measurement will ultimately fail to achieve its quality improvement goals. PMID:20181129

Workplace wellness recognition for optimizing workplace health: a presidential advisory from the American Heart Association.

PubMed

Fonarow, Gregg C; Calitz, Chris; Arena, Ross; Baase, Catherine; Isaac, Fikry W; Lloyd-Jones, Donald; Peterson, Eric D; Pronk, Nico; Sanchez, Eduardo; Terry, Paul E; Volpp, Kevin G; Antman, Elliott M

2015-05-19

The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life's Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous standards, facilitating access to high-quality comprehensive workplace wellness programs for both employees and dependents, and fostering innovation and additional research. © 2015 American Heart Association, Inc.

The impact of working memory and the “process of process modelling” on model quality: Investigating experienced versus inexperienced modellers

NASA Astrophysics Data System (ADS)

Martini, Markus; Pinggera, Jakob; Neurauter, Manuel; Sachse, Pierre; Furtner, Marco R.; Weber, Barbara

2016-05-01

A process model (PM) represents the graphical depiction of a business process, for instance, the entire process from online ordering a book until the parcel is delivered to the customer. Knowledge about relevant factors for creating PMs of high quality is lacking. The present study investigated the role of cognitive processes as well as modelling processes in creating a PM in experienced and inexperienced modellers. Specifically, two working memory (WM) functions (holding and processing of information and relational integration) and three process of process modelling phases (comprehension, modelling, and reconciliation) were related to PM quality. Our results show that the WM function of relational integration was positively related to PM quality in both modelling groups. The ratio of comprehension phases was negatively related to PM quality in inexperienced modellers and the ratio of reconciliation phases was positively related to PM quality in experienced modellers. Our research reveals central cognitive mechanisms in process modelling and has potential practical implications for the development of modelling software and teaching the craft of process modelling.

The impact of working memory and the “process of process modelling” on model quality: Investigating experienced versus inexperienced modellers

PubMed Central

Martini, Markus; Pinggera, Jakob; Neurauter, Manuel; Sachse, Pierre; Furtner, Marco R.; Weber, Barbara

2016-01-01

A process model (PM) represents the graphical depiction of a business process, for instance, the entire process from online ordering a book until the parcel is delivered to the customer. Knowledge about relevant factors for creating PMs of high quality is lacking. The present study investigated the role of cognitive processes as well as modelling processes in creating a PM in experienced and inexperienced modellers. Specifically, two working memory (WM) functions (holding and processing of information and relational integration) and three process of process modelling phases (comprehension, modelling, and reconciliation) were related to PM quality. Our results show that the WM function of relational integration was positively related to PM quality in both modelling groups. The ratio of comprehension phases was negatively related to PM quality in inexperienced modellers and the ratio of reconciliation phases was positively related to PM quality in experienced modellers. Our research reveals central cognitive mechanisms in process modelling and has potential practical implications for the development of modelling software and teaching the craft of process modelling. PMID:27157858

The impact of working memory and the "process of process modelling" on model quality: Investigating experienced versus inexperienced modellers.

PubMed

Martini, Markus; Pinggera, Jakob; Neurauter, Manuel; Sachse, Pierre; Furtner, Marco R; Weber, Barbara

2016-05-09

A process model (PM) represents the graphical depiction of a business process, for instance, the entire process from online ordering a book until the parcel is delivered to the customer. Knowledge about relevant factors for creating PMs of high quality is lacking. The present study investigated the role of cognitive processes as well as modelling processes in creating a PM in experienced and inexperienced modellers. Specifically, two working memory (WM) functions (holding and processing of information and relational integration) and three process of process modelling phases (comprehension, modelling, and reconciliation) were related to PM quality. Our results show that the WM function of relational integration was positively related to PM quality in both modelling groups. The ratio of comprehension phases was negatively related to PM quality in inexperienced modellers and the ratio of reconciliation phases was positively related to PM quality in experienced modellers. Our research reveals central cognitive mechanisms in process modelling and has potential practical implications for the development of modelling software and teaching the craft of process modelling.

Quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis: a systematic review of the literature.

PubMed

Vranceanu, Ana-Maria; Merker, Vanessa L; Park, Elyse; Plotkin, Scott R

2013-09-01

The aim of this study was to review the literature on quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis, and to identify the specific aspects of quality of life that were studied and reported in this population. We also set out to report predictors of quality of life. Published research reports were included if they described quality of life in this population and met methodological quality according to a list of predefined criteria. Eight studies (7 in NF1, 1 in NF2, 0 in schwannomatosis), conducted between 2001 and 2013, met inclusion criteria. The methodological quality of the eight studies was mostly high according to ratings by predefined criteria. Most studies reported that patients with NF experience decreased quality of life when compared to the general population. Visibility and disease severity were strong predictors of skin-specific quality of life in NF1 patients. However, the majority of findings regarding predictors of quality of life were weak or inconclusive. Given the decreased quality of life in NF patients, it is important to examine more comprehensively the psychosocial factors in this population, especially in patients with NF2 and schwannomatosis. Mind body interventions that address these domains may provide comprehensive and efficacious long term treatment.

The Effect of Image Quality Training on Reading Comprehension of EFL Students Using the Keyword Method

ERIC Educational Resources Information Center

Wang, Lihui; Lawson, Michael J.; Curtis, David D.

2015-01-01

Imagery training has been shown to improve reading comprehension. Recent research has also shown that the quality of visual mental imagery used is important for reading comprehension. A review of literature shows that there has been relatively little detailed research on the quality of imagery used by learners, especially in the case of students…

The business of palliative medicine--part 6: clinical operations in a comprehensive integrated program.

PubMed

Lagman, Ruth L; Walsh, Declan; LeGrand, Susan B; Davis, Mellar P

2011-03-01

The medical care of individuals with advanced disease is complex and has historically been fragmented and suboptimal. Palliative medicine attempts to address these needs. The Harry R. Horvitz Center for Palliative Medicine at the Cleveland Clinic is an established comprehensive integrated program. Structured and seamless clinical operations are important to ensure the best delivery of high-quality medical care and continuity for those affected by life-limiting illness.

Academic Language and the Quality of Written Arguments and Explanations of Chilean 8th Graders

ERIC Educational Resources Information Center

Figueroa, Javiera; Meneses, Alejandra; Chandia, Eugenio

2018-01-01

Writing is a task that entails high cognitive and linguistic efforts, especially when producing academic texts. Academic language might be one of the factors influencing the quality of written texts, given that prior research has shown its impact on reading comprehension. The purpose of this study is to examine the contribution of Spanish Core…

Comprehension and Writing Strategy Training Improves Performance on Content-Specific Source-Based Writing Tasks

ERIC Educational Resources Information Center

Weston-Sementelli, Jennifer L.; Allen, Laura K.; McNamara, Danielle S.

2016-01-01

Source-based essays are evaluated both on the quality of the writing and the content appropriate interpretation and use of source material. Hence, composing a high-quality source-based essay (an essay written based on source material) relies on skills related to both reading (the sources) and writing (the essay) skills. As such, source-based…

Comprehension and Writing Strategy Training Improves Performance on Content-Specific Source-Based Writing Tasks

ERIC Educational Resources Information Center

Weston-Sementelli, Jennifer L.; Allen, Laura K.; McNamara, Danielle S.

2018-01-01

Source-based essays are evaluated both on the quality of the writing and the content appropriate interpretation and use of source material. Hence, composing a high-quality source-based essay (an essay written based on source material) relies on skills related to both reading (the sources) and writing (the essay) skills. As such, source-based…

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.

Manufacturing/Cell Therapy Specialist | Center for Cancer Research

Cancer.gov

Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID),

Patient Care Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious

Generation of High-Quality SWATH® Acquisition Data for Label-free Quantitative Proteomics Studies Using TripleTOF® Mass Spectrometers

PubMed Central

Schilling, Birgit; Gibson, Bradford W.; Hunter, Christie L.

2017-01-01

Data-independent acquisition is a powerful mass spectrometry technique that enables comprehensive MS and MS/MS analysis of all detectable species, providing an information rich data file that can be mined deeply. Here, we describe how to acquire high-quality SWATH® Acquisition data to be used for large quantitative proteomic studies. We specifically focus on using variable sized Q1 windows for acquisition of MS/MS data for generating higher specificity quantitative data. PMID:28188533

Model regulations and plan amendments for multimodal transportation districts

DOT National Transportation Integrated Search

2004-02-01

In 1999, the Florida legislature enabled local governments to establish Multimodal Transportation Districts (MMTD) in their comprehensive plan as a means of promoting a high quality multimodal environment within selected urban areas. The Florida Depa...

[Quality by design approaches for pharmaceutical development and manufacturing of Chinese medicine].

PubMed

Xu, Bing; Shi, Xin-Yuan; Wu, Zhi-Sheng; Zhang, Yan-Ling; Wang, Yun; Qiao, Yan-Jiang

2017-03-01

The pharmaceutical quality was built by design, formed in the manufacturing process and improved during the product's lifecycle. Based on the comprehensive literature review of pharmaceutical quality by design (QbD), the essential ideas and implementation strategies of pharmaceutical QbD were interpreted. Considering the complex nature of Chinese medicine, the "4H" model was innovated and proposed for implementing QbD in pharmaceutical development and industrial manufacture of Chinese medicine product. "4H" corresponds to the acronym of holistic design, holistic information analysis, holistic quality control, and holistic process optimization, which is consistent with the holistic concept of Chinese medicine theory. The holistic design aims at constructing both the quality problem space from the patient requirement and the quality solution space from multidisciplinary knowledge. Holistic information analysis emphasizes understanding the quality pattern of Chinese medicine by integrating and mining multisource data and information at a relatively high level. The batch-to-batch quality consistence and manufacturing system reliability can be realized by comprehensive application of inspective quality control, statistical quality control, predictive quality control and intelligent quality control strategies. Holistic process optimization is to improve the product quality and process capability during the product lifecycle management. The implementation of QbD is useful to eliminate the ecosystem contradictions lying in the pharmaceutical development and manufacturing process of Chinese medicine product, and helps guarantee the cost effectiveness. Copyright© by the Chinese Pharmaceutical Association.

Soil quality assessment using weighted fuzzy association rules

USGS Publications Warehouse

Xue, Yue-Ju; Liu, Shu-Guang; Hu, Yue-Ming; Yang, Jing-Feng

2010-01-01

Fuzzy association rules (FARs) can be powerful in assessing regional soil quality, a critical step prior to land planning and utilization; however, traditional FARs mined from soil quality database, ignoring the importance variability of the rules, can be redundant and far from optimal. In this study, we developed a method applying different weights to traditional FARs to improve accuracy of soil quality assessment. After the FARs for soil quality assessment were mined, redundant rules were eliminated according to whether the rules were significant or not in reducing the complexity of the soil quality assessment models and in improving the comprehensibility of FARs. The global weights, each representing the importance of a FAR in soil quality assessment, were then introduced and refined using a gradient descent optimization method. This method was applied to the assessment of soil resources conditions in Guangdong Province, China. The new approach had an accuracy of 87%, when 15 rules were mined, as compared with 76% from the traditional approach. The accuracy increased to 96% when 32 rules were mined, in contrast to 88% from the traditional approach. These results demonstrated an improved comprehensibility of FARs and a high accuracy of the proposed method.

Recent developments in high-quality drying of vegetables, fruits, and aquatic products.

PubMed

Zhang, Min; Chen, Huizhi; Mujumdar, Arun S; Tang, Juming; Miao, Song; Wang, Yuchuan

2017-04-13

Fresh foods like vegetables, fruits, and aquatic products have high water activity and they are highly heat-sensitive and easily degradable. Dehydration is one of the most common methods used to improve food shelf-life. However, drying methods used for food dehydration must not only be efficient and economic but also yield high-quality products based on flavor, nutrients, color, rehydration, uniformity, appearance, and texture. This paper reviews some new drying technologies developed for dehydration of vegetables, fruits, and aquatic products. These include: infrared drying, microwave drying, radio frequency drying, electrohydrodynamic drying, etc., as well as hybrid drying methods combining two or more different drying techniques. A comprehensive review of recent developments in high-quality drying of vegetables, fruits and aquatic products is presented and recommendations are made for future research.

Rapid underway profiling of water quality in Queensland estuaries.

PubMed

Hodge, Jonathan; Longstaff, Ben; Steven, Andy; Thornton, Phillip; Ellis, Peter; McKelvie, Ian

2005-01-01

We present an overview of a portable underway water quality monitoring system (RUM-Rapid Underway Monitoring), developed by integrating several off-the-shelf water quality instruments to provide rapid, comprehensive, and spatially referenced 'snapshots' of water quality conditions. We demonstrate the utility of the system from studies in the Northern Great Barrier Reef (Daintree River) and the Moreton Bay region. The Brisbane dataset highlights RUM's utility in characterising plumes as well as its ability to identify the smaller scale structure of large areas. RUM is shown to be particularly useful when measuring indicators with large small-scale variability such as turbidity and chlorophyll-a. Additionally, the Daintree dataset shows the ability to integrate other technologies, resulting in a more comprehensive analysis, whilst sampling offshore highlights some of the analytical issues required for sampling low concentration data. RUM is a low cost, highly flexible solution that can be modified for use in any water type, on most vessels and is only limited by the available monitoring technologies.

A laser primer for orthopaedic nurses.

PubMed

Michelson, S A

1990-01-01

Laser therapy is an efficient surgical intervention that minimizes tissue manipulation and destruction; however meticulous nursing care is required to safeguard the patient from potential hazards inherent in the procedure. A solid grounding in basic laser concepts including biophysics, correct operation of the equipment, safety, and maintenance will assist the nurse in providing comprehensive, high quality care. The emphasis of nursing practice should be oriented toward comprehensive patient education, psychosocial support, and safeguarding the patient from potential laser hazards.

Modeling Best Management Practices (BMPs) with HSPF

EPA Science Inventory

The Hydrological Simulation Program-Fortran (HSPF) is a semi-distributed watershed model, which simulates hydrology and water quality processes at user-specified spatial and temporal scales. Although HSPF is a comprehensive and highly flexible model, a number of investigators not...

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

PubMed

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

2012-01-01

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

The Impact of Dysphonic Voices on Healthy Listeners: Listener Reaction Times, Speech Intelligibility, and Listener Comprehension.

PubMed

Evitts, Paul M; Starmer, Heather; Teets, Kristine; Montgomery, Christen; Calhoun, Lauren; Schulze, Allison; MacKenzie, Jenna; Adams, Lauren

2016-11-01

There is currently minimal information on the impact of dysphonia secondary to phonotrauma on listeners. Considering the high incidence of voice disorders with professional voice users, it is important to understand the impact of a dysphonic voice on their audiences. Ninety-one healthy listeners (39 men, 52 women; mean age = 23.62 years) were presented with speech stimuli from 5 healthy speakers and 5 speakers diagnosed with dysphonia secondary to phonotrauma. Dependent variables included processing speed (reaction time [RT] ratio), speech intelligibility, and listener comprehension. Voice quality ratings were also obtained for all speakers by 3 expert listeners. Statistical results showed significant differences between RT ratio and number of speech intelligibility errors between healthy and dysphonic voices. There was not a significant difference in listener comprehension errors. Multiple regression analyses showed that voice quality ratings from the Consensus Assessment Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were able to predict RT ratio and speech intelligibility but not listener comprehension. Results of the study suggest that although listeners require more time to process and have more intelligibility errors when presented with speech stimuli from speakers with dysphonia secondary to phonotrauma, listener comprehension may not be affected.

Lexical Quality and Reading Comprehension in Primary School Children

ERIC Educational Resources Information Center

Richter, Tobias; Isberner, Maj-Britt; Naumann, Johannes; Neeb, Yvonne

2013-01-01

In a cross-sectional study, we examined the relationship between the quality of lexical representations and text comprehension skill in German primary school children (Grades 1-4). We measured the efficiency and accuracy of orthographical, phonological, and meaning representations by means of computerized tests. Text comprehension skill was…

76 FR 16285 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Plan to update the Commission's human health and aquatic life stream quality objectives (also called... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for Toxic Pollutants in the Delaware...

78 FR 58985 - Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for pH AGENCY: Delaware River... public hearing to receive comments on proposed amendments to the Commission's Water Quality Regulations...

An Initial Evaluation of the Comprehensive Quality of Life Scale--Intellectual Disability.

ERIC Educational Resources Information Center

Cummins, Robert A.; And Others

1997-01-01

A study of 59 Australian people with an intellectual disability and 69 university students evaluated a new scale to measure the life quality of people with an intellectual disability. The Comprehensive Quality of Life Scale--Intellectual Disability was found to be a useful instrument to measure comparative life quality. (Author/CR)

Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

PubMed

Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

2017-09-01

Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Comprehensive two-dimensional gas chromatography and food sensory properties: potential and challenges.

PubMed

Cordero, Chiara; Kiefl, Johannes; Schieberle, Peter; Reichenbach, Stephen E; Bicchi, Carlo

2015-01-01

Modern omics disciplines dealing with food flavor focus the analytical efforts on the elucidation of sensory-active compounds, including all possible stimuli of multimodal perception (aroma, taste, texture, etc.) by means of a comprehensive, integrated treatment of sample constituents, such as physicochemical properties, concentration in the matrix, and sensory properties (odor/taste quality, perception threshold). Such analyses require detailed profiling of known bioactive components as well as advanced fingerprinting techniques to catalog sample constituents comprehensively, quantitatively, and comparably across samples. Multidimensional analytical platforms support comprehensive investigations required for flavor analysis by combining information on analytes' identities, physicochemical behaviors (volatility, polarity, partition coefficient, and solubility), concentration, and odor quality. Unlike other omics, flavor metabolomics and sensomics include the final output of the biological phenomenon (i.e., sensory perceptions) as an additional analytical dimension, which is specifically and exclusively triggered by the chemicals analyzed. However, advanced omics platforms, which are multidimensional by definition, pose challenging issues not only in terms of coupling with detection systems and sample preparation, but also in terms of data elaboration and processing. The large number of variables collected during each analytical run provides a high level of information, but requires appropriate strategies to exploit fully this potential. This review focuses on advances in comprehensive two-dimensional gas chromatography and analytical platforms combining two-dimensional gas chromatography with olfactometry, chemometrics, and quantitative assays for food sensory analysis to assess the quality of a given product. We review instrumental advances and couplings, automation in sample preparation, data elaboration, and a selection of applications.

Water Quality in Surface Water: A Preliminary Assessment of Heavy Metal Contamination of the Mashavera River, Georgia

PubMed Central

Urushadze, Teo

2018-01-01

Water quality contamination by heavy metal pollution has severe effects on public health. In the Mashavera River Basin, an important agricultural area for the national food system in Georgia (e.g., vegetable, dairy and wine production), water contamination has multiple influences on the regional and country-wide health. With new industrial activities in the region, sediment extraction, and discharge of untreated wastewater into the river, its tributaries and irrigation canals, a comprehensive study of water quality was greatly needed. This study examined sediment and water samples from 17 sampling sites in the Mashavera River Basin during the high and low precipitation seasons. The results were characterized utilizing the Geo-accumulation Index (Igeo), Enrichment Factor (EF), Pollution Load index (PLI), Contamination Factor (CF) and Metal Index (MI). According to the CFs, Cu > Cd > Zn > Pb > Fe > Mn > Ni > Cr > Hg is the descending order for the content of all observed heavy metals in sediments collected in both seasons. Fe and As were additionally examined in water samples. Overall, As, Cd and Pb, all highly toxic elements, were found in high concentrations in downstream sample sites. According to these results, comprehensive monitoring with narrow intervals between sampling dates, more sample sites along all waterways, and proximate observation of multiple trace metal elements are highly recommended. Moreover, as the part of the water quality governance system, an immediate and sustainable collective action by all stakeholders to control the pollution level is highly recommended, as this issue is linked to the security of the national food system and poses a local public health risk. PMID:29597320

Lexical quality and executive control predict children's first and second language reading comprehension.

PubMed

Raudszus, Henriette; Segers, Eliane; Verhoeven, Ludo

2018-01-01

This study compared how lexical quality (vocabulary and decoding) and executive control (working memory and inhibition) predict reading comprehension directly as well as indirectly, via syntactic integration, in monolingual and bilingual fourth grade children. The participants were 76 monolingual and 102 bilingual children (mean age 10 years, SD  = 5 months) learning to read Dutch in the Netherlands. Bilingual children showed lower Dutch vocabulary, syntactic integration and reading comprehension skills, but better decoding skills than their monolingual peers. There were no differences in working memory or inhibition. Multigroup path analysis showed relatively invariant connections between predictors and reading comprehension for monolingual and bilingual readers. For both groups, there was a direct effect of lexical quality on reading comprehension. In addition, lexical quality and executive control indirectly influenced reading comprehension via syntactic integration. The groups differed in that inhibition more strongly predicted syntactic integration for bilingual than for monolingual children. For a subgroup of bilingual children, for whom home language vocabulary data were available ( n  = 56), there was an additional positive effect of home language vocabulary on second language reading comprehension. Together, the results suggest that similar processes underlie reading comprehension in first and second language readers, but that syntactic integration requires more executive control in second language reading. Moreover, bilingual readers additionally benefit from first language vocabulary to arrive at second language reading comprehension.

Teaching the pharmacology of antiarrhythmic drugs.

PubMed

Zdanowicz, Martin M; Lynch, Launa M J

2011-09-10

To provide doctor of pharmacy (PharmD) students with highly integrated, comprehensive and up-to-date instruction related to the pharmacology of antiarrhythmic drugs. Students were taught the medicinal chemistry, pharmacology, and therapeutics of antiarrhythmic agents in the cardiology module presented in quarter 7 of the PharmD curriculum. Important foundational information for this topic was presented to students in prerequisite physiology courses and pathophysiology courses offered earlier in the curriculum. Emphasis was placed on student critical thinking and active involvement. Weekly recitation sessions afforded students the opportunity to apply the information they learned regarding arrhythmia pharmacotherapy to comprehensive patient cases. Student comprehension was measured using class exercises, short quizzes, case write-ups, comprehensive examinations, group exercises, and classroom discussion. Students were afforded the opportunity to evaluate the course, and the instructors as well as rate the degree to which the course achieved its educational outcomes. Students learned about cardiac arrhythmias through a high-quality, interdisciplinary series of classes presented by faculty members with extensive experience related to the pharmacology and pharmacotherapy of cardiac arrhythmias.

Accountable Talk in Reading Comprehension Instruction. CSE Technical Report 670

ERIC Educational Resources Information Center

Wolf, Mikyung Kim; Crosson, Amy C.; Resnick, Lauren B.

2006-01-01

This study examined the relationship between the quality of classroom talk and academic rigor in reading comprehension lessons. In addition, the study aimed to characterize effective questions to support rigorous reading comprehension lessons. The data were collected as a part of the Instructional Quality Assessment (IQA) pilot. The IQA is a…

Cluster randomized trial assessing the effects of rapid ethical assessment on informed consent comprehension in a low-resource setting.

PubMed

Addissie, Adamu; Abay, Serebe; Feleke, Yeweyenhareg; Newport, Melanie; Farsides, Bobbie; Davey, Gail

2016-07-12

Maximizing comprehension is a major challenge for informed consent processes in low-literacy and resource-limited settings. Application of rapid qualitative assessments to improve the informed consent process is increasingly considered useful. This study assessed the effects of Rapid Ethical Assessment (REA) on comprehension, retention and quality of the informed consent process. A cluster randomized trial was conducted among participants of HPV sero-prevalence study in two districts of Northern Ethiopia, in 2013. A total of 300 study participants, 150 in the intervention and 150 in the control group, were included in the study. For the intervention group, the informed consent process was designed with further revisions based on REA findings. Informed consent comprehension levels and quality of the consent process were measured using the Modular Informed Consent Comprehension Assessment (MICCA) and Quality of Informed Consent (QuIC) process assessment tools, respectively. Study recruitment rates were 88.7 % and 80.7 % (p = 0.05), while study retention rates were 85.7 % and 70.3 % (p < 0.005) for the intervention and control groups respectively. Overall, the mean informed consent comprehension scores for the intervention and control groups were 73.1 % and 45.2 %, respectively, with a mean difference in comprehension score of 27.9 % (95 % CI 24.0 % - 33.4 %; p < 0.001,). Mean scores for quality of informed consent for the intervention and control groups were 89.1 % and 78.5 %, respectively, with a mean difference of 10.5 % (95 % CI 6.8 -14.2 %; p < 0.001). Levels of informed consent comprehension, quality of the consent process, study recruitment and retention rates were significantly improved in the intervention group. We recommend REA as a potential modality to improve informed consent comprehension and quality of informed consent process in low resource settings.

A National Palliative Care Strategy for Canada

PubMed Central

2017-01-01

Abstract Objective: To identify barrier to achieving universal access to high quality palliative care in Canada, review published national strategies and frameworks to promote palliative care, examine key aspects that have been linked to successful outcomes, and make recommendations for Canada. Background: In 2014, the World Health Organization called on members to develop and implement policies to ensure palliative care is integrated into national health services. Methods: Rapid review supplemented by the author's personal files, outreach to colleagues within the international palliative care community, review of European Association for Palliative Care publications, and a subsequent search of the table of contents of the major palliative care journals. Results: Frameworks were found for 10 countries ranging from detailed and comprehensive multi-year strategies to more general approaches including laws guaranteeing access to palliative care services for “dying” patients or recommendations for the development of clinical infrastructure. Few formal evaluations were found minimal comparative data exist regarding the quality of care, access to palliative care services, timing of access in the disease trajectory, and patient and family satisfaction with care. Factors that appear to be associated with success include: 1) input and early involvement of senior policy makers; 2) comprehensive strategies that address major barriers to universal access and that involve the key constituents; 3) a focus on enhancing the evidence base and developing a national system of quality reporting; and 4) substantial and sustained government investment. Discussion: Comprehensive national strategies appear to improve access to high quality palliative care for persons with serious illness and their families. Such strategies require sustained government funding and address barriers related to infrastructure, professional and public education, workforce shortages, and an inadequate evidence base. PMID:29283876

Investigation of the emissions and profiles of a wide range of VOCs during the Clean air for London project

NASA Astrophysics Data System (ADS)

Holmes, Rachel; Lidster, Richard; Hamilton, Jacqueline; Lee, James; Hopkins, James; Whalley, Lisa; Lewis, Alistair

2014-05-01

The majority of the World's population live in polluted urbanized areas. Poor air quality is shortening life expectancy of people in the UK by an average 7-8 months and costs society around £20 billion per year.[1] Despite this, our understanding of atmospheric processing in urban environments and its effect on air quality is incomplete. Air quality models are used to predict how air quality changes given different concentrations of pollution precursors, such as volatile organic compounds (VOCs). The urban environment of megacities pose a unique challenge for air quality measurements and modelling, due to high population densities, pollution levels and complex infrastructure. For over 60 years the air quality in London has been monitored, however the existing measurements are limited to a small group of compounds. In order to fully understand the chemical and physical processes that occur in London, more intensive and comprehensive measurements should be made. The Clean air for London (ClearfLo) project was conducted to investigate the air quality, in particular the boundary layer pollution, of London. A relatively new technique, comprehensive two dimensional gas chromatography (GC×GC) [2] was combined with a well-established dual channel GC (DC-GC) [3] system to provide a more comprehensive measurement of VOCs. A total of 78 individual VOCs (36 aliphatics, 19 monoaromatics, 21 oxygenated and 2 halogenated) and 10 groups of VOCs (8 aliphatic, 1 monoaromatic and 1 monoterpene) from C1-C13+ were quantified. Seasonal and diurnal profiles of these VOCs have been found which show the influence of emission source and chemical processing. Including these extra VOCs should enhance the prediction capability of air quality models thus informing policy makers on how to potentially improve air quality in megacities. References 1. House of Commons Environmental Audit Committee, Air Quality: A follow-up report, Ninth Report of session 2012-12. 2. Lidster, R.T., J.F. Hamilton, and A.C. Lewis, The application of two total transfer valve modulators for comprehensive two-dimensional gas chromatography of volatile organic compounds. Journal of Separation Science, 2011. 34(7): p. 812-821. 3. Hopkins, J.R., C.E. Jones, and A.C. Lewis, A dual channel gas chromatograph for atmospheric analysis of volatile organic compounds including oxygenated and monoterpene compounds. Journal of Environmental Monitoring, 2011. 13(8): p. 2268-2276.

miRNet - dissecting miRNA-target interactions and functional associations through network-based visual analysis

PubMed Central

Fan, Yannan; Siklenka, Keith; Arora, Simran K.; Ribeiro, Paula; Kimmins, Sarah; Xia, Jianguo

2016-01-01

MicroRNAs (miRNAs) can regulate nearly all biological processes and their dysregulation is implicated in various complex diseases and pathological conditions. Recent years have seen a growing number of functional studies of miRNAs using high-throughput experimental technologies, which have produced a large amount of high-quality data regarding miRNA target genes and their interactions with small molecules, long non-coding RNAs, epigenetic modifiers, disease associations, etc. These rich sets of information have enabled the creation of comprehensive networks linking miRNAs with various biologically important entities to shed light on their collective functions and regulatory mechanisms. Here, we introduce miRNet, an easy-to-use web-based tool that offers statistical, visual and network-based approaches to help researchers understand miRNAs functions and regulatory mechanisms. The key features of miRNet include: (i) a comprehensive knowledge base integrating high-quality miRNA-target interaction data from 11 databases; (ii) support for differential expression analysis of data from microarray, RNA-seq and quantitative PCR; (iii) implementation of a flexible interface for data filtering, refinement and customization during network creation; (iv) a powerful fully featured network visualization system coupled with enrichment analysis. miRNet offers a comprehensive tool suite to enable statistical analysis and functional interpretation of various data generated from current miRNA studies. miRNet is freely available at http://www.mirnet.ca. PMID:27105848

Aerospace Education. NSTA Position Statement

ERIC Educational Resources Information Center

National Science Teachers Association (NJ1), 2008

2008-01-01

National Science Teachers Association (NSTA) has developed a new position statement, "Aerospace Education." NSTA believes that aerospace education is an important component of comprehensive preK-12 science education programs. This statement highlights key considerations that should be addressed when implementing a high quality aerospace education…

A comprehensive porcine blood transcriptome

USDA-ARS?s Scientific Manuscript database

Blood sample analyses are extensively used in high throughput assays in biomedicine, as well as animal genetics and physiology research. However, the draft quality of the current pig genome (Sscrofa 10.2) is insufficient for accurate interpretation of many of these assays because of incomplete gene ...

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

ChiLin: a comprehensive ChIP-seq and DNase-seq quality control and analysis pipeline.

PubMed

Qin, Qian; Mei, Shenglin; Wu, Qiu; Sun, Hanfei; Li, Lewyn; Taing, Len; Chen, Sujun; Li, Fugen; Liu, Tao; Zang, Chongzhi; Xu, Han; Chen, Yiwen; Meyer, Clifford A; Zhang, Yong; Brown, Myles; Long, Henry W; Liu, X Shirley

2016-10-03

Transcription factor binding, histone modification, and chromatin accessibility studies are important approaches to understanding the biology of gene regulation. ChIP-seq and DNase-seq have become the standard techniques for studying protein-DNA interactions and chromatin accessibility respectively, and comprehensive quality control (QC) and analysis tools are critical to extracting the most value from these assay types. Although many analysis and QC tools have been reported, few combine ChIP-seq and DNase-seq data analysis and quality control in a unified framework with a comprehensive and unbiased reference of data quality metrics. ChiLin is a computational pipeline that automates the quality control and data analyses of ChIP-seq and DNase-seq data. It is developed using a flexible and modular software framework that can be easily extended and modified. ChiLin is ideal for batch processing of many datasets and is well suited for large collaborative projects involving ChIP-seq and DNase-seq from different designs. ChiLin generates comprehensive quality control reports that include comparisons with historical data derived from over 23,677 public ChIP-seq and DNase-seq samples (11,265 datasets) from eight literature-based classified categories. To the best of our knowledge, this atlas represents the most comprehensive ChIP-seq and DNase-seq related quality metric resource currently available. These historical metrics provide useful heuristic quality references for experiment across all commonly used assay types. Using representative datasets, we demonstrate the versatility of the pipeline by applying it to different assay types of ChIP-seq data. The pipeline software is available open source at https://github.com/cfce/chilin . ChiLin is a scalable and powerful tool to process large batches of ChIP-seq and DNase-seq datasets. The analysis output and quality metrics have been structured into user-friendly directories and reports. We have successfully compiled 23,677 profiles into a comprehensive quality atlas with fine classification for users.

Comprehensive care plus creative architecture.

PubMed

Easter, James G

2005-01-01

The delivery of high-quality, comprehensive cancer care and the treatment environment go hand in hand with the patient's recovery. When the planning and design of a comprehensive cancer care program runs parallel to the operational expectations and functional standards, the building users (patients, staff, and physicians) benefit significantly. This behavioral response requires a sensitive interface during the campus master planning, architectural programming, and design phases. Each building component and user functioning along the "continuum of care" will have different expectations, programmatic needs, and design responses. This article addresses the community- and hospital-based elements of this continuum. The environment does affect the patient care and the care-giving team members. It may be a positive or, unfortunately, a negative response.

A quality assurance phantom for the performance evaluation of volumetric micro-CT systems

NASA Astrophysics Data System (ADS)

Du, Louise Y.; Umoh, Joseph; Nikolov, Hristo N.; Pollmann, Steven I.; Lee, Ting-Yim; Holdsworth, David W.

2007-12-01

Small-animal imaging has recently become an area of increased interest because more human diseases can be modeled in transgenic and knockout rodents. As a result, micro-computed tomography (micro-CT) systems are becoming more common in research laboratories, due to their ability to achieve spatial resolution as high as 10 µm, giving highly detailed anatomical information. Most recently, a volumetric cone-beam micro-CT system using a flat-panel detector (eXplore Ultra, GE Healthcare, London, ON) has been developed that combines the high resolution of micro-CT and the fast scanning speed of clinical CT, so that dynamic perfusion imaging can be performed in mice and rats, providing functional physiological information in addition to anatomical information. This and other commercially available micro-CT systems all promise to deliver precise and accurate high-resolution measurements in small animals. However, no comprehensive quality assurance phantom has been developed to evaluate the performance of these micro-CT systems on a routine basis. We have designed and fabricated a single comprehensive device for the purpose of performance evaluation of micro-CT systems. This quality assurance phantom was applied to assess multiple image-quality parameters of a current flat-panel cone-beam micro-CT system accurately and quantitatively, in terms of spatial resolution, geometric accuracy, CT number accuracy, linearity, noise and image uniformity. Our investigations show that 3D images can be obtained with a limiting spatial resolution of 2.5 mm-1 and noise of ±35 HU, using an acquisition interval of 8 s at an entrance dose of 6.4 cGy.

A screening approach for classroom acoustics using web-based listening tests and subjective ratings.

PubMed

Persson Waye, Kerstin; Magnusson, Lennart; Fredriksson, Sofie; Croy, Ilona

2015-01-01

Perception of speech is crucial in school where speech is the main mode of communication. The aim of the study was to evaluate whether a web based approach including listening tests and questionnaires could be used as a screening tool for poor classroom acoustics. The prime focus was the relation between pupils' comprehension of speech, the classroom acoustics and their description of the acoustic qualities of the classroom. In total, 1106 pupils aged 13-19, from 59 classes and 38 schools in Sweden participated in a listening study using Hagerman's sentences administered via Internet. Four listening conditions were applied: high and low background noise level and positions close and far away from the loudspeaker. The pupils described the acoustic quality of the classroom and teachers provided information on the physical features of the classroom using questionnaires. In 69% of the classes, at least three pupils described the sound environment as adverse and in 88% of the classes one or more pupil reported often having difficulties concentrating due to noise. The pupils' comprehension of speech was strongly influenced by the background noise level (p<0.001) and distance to the loudspeakers (p<0.001). Of the physical classroom features, presence of suspended acoustic panels (p<0.05) and length of the classroom (p<0.01) predicted speech comprehension. Of the pupils' descriptions of acoustic qualities, clattery significantly (p<0.05) predicted speech comprehension. Clattery was furthermore associated to difficulties understanding each other, while the description noisy was associated to concentration difficulties. The majority of classrooms do not seem to have an optimal sound environment. The pupil's descriptions of acoustic qualities and listening tests can be one way of predicting sound conditions in the classroom.

SURVEY AND ASSESSMENT OF CRITICAL WETLANDS IN LA PLATA COUNTY, COLORADO

EPA Science Inventory

The Products of this study will be to: 1) identify high-quality examples, and the corresponding natural heritage value, of all types of wetland/riparian areas in San Juan County (using CNHP's Comprehensive Statewide Wetland Classification); 2) coordinate efforts with the propose...

Promoting Continuous Quality Improvement in Online Teaching: The META Model

ERIC Educational Resources Information Center

Dittmar, Eileen; McCracken, Holly

2012-01-01

Experienced e-learning faculty members share strategies for implementing a comprehensive postsecondary faculty development program essential to continuous improvement of instructional skills. The high-impact META Model (centered around Mentoring, Engagement, Technology, and Assessment) promotes information sharing and content creation, and fosters…

Effective Schools. What Makes a Public School Work Well?

ERIC Educational Resources Information Center

Our Children, 1998

1998-01-01

Most effective schools share a number of key characteristics, including clear-cut goals and objectives, adequate funding and financial management, quality academic programs, valid assessment programs, parent and family involvement, teacher and staff development, high expectations for students, community involvement, comprehensive support services,…

The Comprehensive Primary Care Initiative: Effects On Spending, Quality, Patients, And Physicians.

PubMed

Peikes, Deborah; Dale, Stacy; Ghosh, Arkadipta; Taylor, Erin Fries; Swankoski, Kaylyn; O'Malley, Ann S; Day, Timothy J; Duda, Nancy; Singh, Pragya; Anglin, Grace; Sessums, Laura L; Brown, Randall S

2018-06-01

The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices. CPC practices reported improvements in primary care delivery, including care management for high-risk patients, enhanced access, and improved coordination of care transitions. The initiative slowed growth in emergency department visits by 2 percent in CPC practices, relative to comparison practices. However, it did not reduce Medicare spending enough to cover care management fees or appreciably improve physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures. As CMS and other payers increasingly use alternative payment models that reward quality and value, CPC provides important lessons about supporting practices in transforming care.

Renewable Energy Zones for the Africa Clean Energy Corridor

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

Wu, Grace C.; Deshmukh, Ranjit; Ndhlukula, Kudakwashe

Multi-criteria Analysis for Planning Renewable Energy (MapRE) is a study approach developed by the Lawrence Berkeley National Laboratory with the support of the International Renewable Energy Agency (IRENA). The approach combines geospatial, statistical, energy engineering, and economic methods to comprehensively identify and value high-quality wind, solar PV, and solar CSP resources for grid integration based on techno-economic criteria, generation profiles (for wind), and socio-environmental impacts. The Renewable Energy Zones for the Africa Clean Energy Corridor study sought to identify and comprehensively value high-quality wind, solar photovoltaic (PV), and concentrating solar power (CSP) resources in 21 countries in the East andmore » Southern Africa Power Pools to support the prioritization of areas for development through a multi-criteria planning process. These countries include Angola, Botswana, Burundi, Djibouti, Democratic Republic of Congo, Egypt, Ethiopia, Kenya, Lesotho, Libya, Malawi, Mozambique, Namibia, Rwanda, South Africa, Sudan, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. The study includes the methodology and the key results including renewable energy potential for each region.« less

Neural Mechanism Underling Comprehension of Narrative Speech and Its Heritability: Study in a Large Population.

PubMed

Babajani-Feremi, Abbas

2017-09-01

Comprehension of narratives constitutes a fundamental part of our everyday life experience. Although the neural mechanism of auditory narrative comprehension has been investigated in some studies, the neural correlates underlying this mechanism and its heritability remain poorly understood. We investigated comprehension of naturalistic speech in a large, healthy adult population (n = 429; 176/253 M/F; 22-36 years of age) consisting of 192 twin pairs (49 monozygotic and 47 dizygotic pairs) and 237 of their siblings. We used high quality functional MRI datasets from the Human Connectome Project (HCP) in which a story-based paradigm was utilized for the auditory narrative comprehension. Our results revealed that narrative comprehension was associated with activations of the classical language regions including superior temporal gyrus (STG), middle temporal gyrus (MTG), and inferior frontal gyrus (IFG) in both hemispheres, though STG and MTG were activated symmetrically and activation in IFG were left-lateralized. Our results further showed that the narrative comprehension was associated with activations in areas beyond the classical language regions, e.g. medial superior frontal gyrus (SFGmed), middle frontal gyrus (MFG), and supplementary motor area (SMA). Of subcortical structures, only the hippocampus was involved. The results of heritability analysis revealed that the oral reading recognition and picture vocabulary comprehension were significantly heritable (h 2  > 0.56, p < 10 - 13 ). In addition, the extent of activation of five areas in the left hemisphere, i.e. STG, IFG pars opercularis, SFGmed, SMA, and precuneus, and one area in the right hemisphere, i.e. MFG, were significantly heritable (h 2  > 0.33, p < 0.0004). The current study, to the best of our knowledge, is the first to investigate auditory narrative comprehension and its heritability in a large healthy population. Referring to the excellent quality of the HCP data, our results can clarify the functional contributions of linguistic and extra-linguistic cortices during narrative comprehension.

Naval Research Laboratory 1984 Review.

DTIC Science & Technology

1985-07-16

pulsed infrared comprehensive characterization of ultrahigh trans- sources and electronics for video signal process- parency fluoride glasses and...operates a video system through this port if desired. The optical bench in consisting of visible and infrared television cam- the trailer holds a high...resolution Fourier eras, a high-quality video cassette recorder and transform spectrometer to use in the receiving display, and a digitizer to convert

Relevance of graph literacy in the development of patient-centered communication tools.

PubMed

Nayak, Jasmir G; Hartzler, Andrea L; Macleod, Liam C; Izard, Jason P; Dalkin, Bruce M; Gore, John L

2016-03-01

To determine the literacy skill sets of patients in the context of graphical interpretation of interactive dashboards. We assessed literacy characteristics of prostate cancer patients and assessed comprehension of quality of life dashboards. Health literacy, numeracy and graph literacy were assessed with validated tools. We divided patients into low vs. high numeracy and graph literacy. We report descriptive statistics on literacy, dashboard comprehension, and relationships between groups. We used correlation and multiple linear regressions to examine factors associated with dashboard comprehension. Despite high health literacy in educated patients (78% college educated), there was variation in numeracy and graph literacy. Numeracy and graph literacy scores were correlated (r=0.37). In those with low literacy, graph literacy scores most strongly correlated with dashboard comprehension (r=0.59-0.90). On multivariate analysis, graph literacy was independently associated with dashboard comprehension, adjusting for age, education, and numeracy level. Even among higher educated patients; variation in the ability to comprehend graphs exists. Clinicians must be aware of these differential proficiencies when counseling patients. Tools for patient-centered communication that employ visual displays need to account for literacy capabilities to ensure that patients can effectively engage these resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Information presentation features and comprehensibility of hospital report cards: design analysis and online survey among users.

PubMed

Sander, Uwe; Emmert, Martin; Dickel, Jochen; Meszmer, Nina; Kolb, Benjamin

2015-03-16

Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents' hospital choices were associated with particular information design elements. Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data ("N/A" as a value). When investigating the RAMR in a sample of 10 hospitals' report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a "good quality" range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment.

PubMed

Faure, Marguerite E; Swart, Laurens E; Dijkshoorn, Marcel L; Bekkers, Jos A; van Straten, Marcel; Nieman, Koen; Parizel, Paul M; Krestin, Gabriel P; Budde, Ricardo P J

2018-05-01

Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP). We analysed 43 CT examinations. Mean image quality score was 4.1±1.4, 4.7±0.5 and 4.2±0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3±0.7. Mean image quality for leaflet motion was 3.9±1.4. Mean DLP was 28.2±17.1, 457.3±168.6 and 68.5±47.2 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569±208 mGy.cm and mean total radiation dose was 8.3±3.0 mSv (n=43). Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose. • Prosthetic heart valve dysfunction is a potentially life-threatening condition. • Dual-source CT can adequately assess valve leaflet motion and anatomy. • We assessed a comprehensive protocol with three acquisitions for PHV evaluation. • This protocol is associated with good image quality and limited dose.

The Mariner 6 and 7 pictures of Mars

NASA Technical Reports Server (NTRS)

Collins, S. A., Jr.

1971-01-01

A comprehensive set of high quality reproductions of the final, computer-processed television pictures of Mars is presented. The genesis and unique characteristics of the pictures are explained, interesting features are pointed out, and some indication of their significance in the history of Mars investigations is provided.

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

PubMed

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

2008-01-01

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

Students' Approaches to Essay-Writing and the Quality of the Written Product.

ERIC Educational Resources Information Center

Biggs, John B.

Studies of text comprehension have suggested that readers focus on different levels of ideational unit while reading, thereby affecting the quality of their comprehension of the text. A study examined the viability of the deep-surface categorization with regard to essay-writing and the relation of different approaches to writing to the quality of…

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

PubMed

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

2005-11-01

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

Measurement techniques of exposure to nanomaterials in the workplace for low- and medium-income countries: A systematic review.

PubMed

Boccuni, Fabio; Gagliardi, Diana; Ferrante, Riccardo; Rondinone, Bruna Maria; Iavicoli, Sergio

2017-10-01

Nanotechnology offers many opportunities but there is still considerable uncertainty about the health risks and how to assess these.In the field of risk analysis for workers potentially exposed to nano-objects and their agglomerates and aggregates (NOAA) different methodological approaches to measure airborne NOAA have been proposed.This study proposes a systematic review of scientific literature on occupational exposure to NOAA in the workplace with the aim to identify techniques of exposure measurement to be recommended in low- and medium-income countries.We gathered scientific papers reporting techniques of NOAA exposure measurements in the workplace, we summarized the data for each eligible technique according to PRISMA guidelines, and we rated the quality of evidence following an adapted GRADE approach.We found 69 eligible studies to be included in qualitative synthesis: the majority of studies reported a moderate quality and only two studies demonstrated the use of a high quality exposure measurement technique.The review demonstrates that a basic exposure measurement, i.e. evidence for the presence or absence of NOAA in the workplace air, can be achieved with moderate (40 techniques) to high (2 techniques) quality; comprehensive exposure measurement, that allow the quantification of NOAA in the workplace, can be achieved with moderate (11 techniques) to high (2 techniques) quality.The findings of the study also allowed to finalize a list of requirements that must be fulfilled by an effective measurement technique (either basic or comprehensive) and to highlight the main weaknesses that need to be tackled for an effective affordability evaluation of measurement techniques to be recommended in low- and medium-income countries. Copyright © 2017 Elsevier GmbH. All rights reserved.

Review and Process Effects of Spontaneous Note-Taking on Text Comprehension.

PubMed

Slotte; Lonka

1999-01-01

This study examines how quantitative and qualitative differences in spontaneously taken notes are related to text comprehension in combination with reviewing or not reviewing previously made notes. High school graduates (N = 226) were allowed to take notes in any way they desired while reading a philosophical text. Approximately half the participants were told that they could review their notes during writing tasks designed to measure the ability to define, compare, and evaluate text content. The other half of the participants answered the subsequent questions without their notes. The process of taking notes was rated on the basis of note quality and quantity. The results revealed significant review and process effects in spontaneous note-taking. Reviewing the notes during essay-writing generally resulted in good performance in an exam calling for deep-level text comprehension. However, this review effect was mainly limited to detailed learning instead of making one's own inferences. Results pertaining to note quality indicated that the participants who summarized the content of the text resulted in better performance in all tasks in comparison with those who produced notes following the text order or verbatim notes. The amount of note-taking was also positively related to text comprehension. The discussion focuses upon the situational appropriateness of note-taking effects that pose challenges to educators. Copyright 1999 Academic Press.

77 FR 64538 - Tualatin River National Wildlife Refuge, Washington and Yamhill Counties, OR, Draft Comprehensive...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... bordered by uplands. Habitats include rivers and streams, seasonal, scrub-shrub, and riparian forests; and... grasses, forbs, shrubs, and trees; and controlling weeds. The Refuge's high quality wildlife observation... (Preferred Alternative) The Tualatin River and Rock Creek Units' riparian forest, scrub- shrub wetland, and...

Roles beyond Instruction: Facilitating the Development of Preservice Teachers

ERIC Educational Resources Information Center

Franco, Yvonne

2014-01-01

Identifying a Signature Pedagogy that ensures high-quality teacher preparation is essential to the field of teacher education, as inconsistencies across programs throughout our country threaten our profession. Drawing on a comprehensive study of the professions, Lee Shulman (2005) provides a lens from which to identify Signature Pedagogy and the…

Balanced Literacy Instruction for Students with Significant Cognitive Disabilities: Barriers to Implementation

ERIC Educational Resources Information Center

Castelli, Courtney

2016-01-01

Currently, students with significant cognitive disabilities (SCD) are predominately exposed to a functional curriculum commonly delivered through behaviorists' methods (Keefe & Copeland, 2011). The most recent research has established that students with SCD who are presented with a high-quality comprehensive approach comparable to the best…

Office of Migrant Education: Program and Grant Information.

ERIC Educational Resources Information Center

Office of Elementary and Secondary Education (ED), Washington, DC. Migrant Education Programs.

This document describes programs available through the Office of Migrant Education for migratory children from preschool through grade 12 or up to age 22. The Migrant Education Program supports high-quality and comprehensive educational programs for migratory children to address disruptions in schooling. Funds, which are allocated to states on the…

Integration of Technology in Teaching and Learning: Comprehensive Initiatives Enhance Student Engagement and Learning

ERIC Educational Resources Information Center

Nebbergall, Allison

2012-01-01

As technology increasingly transforms our daily lives, educators too are seeking strategies and resources that leverage technology to improve student learning. Research demonstrates that high-quality professional development, digital standards-based content, and personalized learning plans can increase student achievement, engagement, and…

Literacy by Design: A Universal Design for Learning Approach for Students with Significant Intellectual Disabilities

ERIC Educational Resources Information Center

Coyne, Peggy; Pisha, Bart; Dalton, Bridget; Zeph, Lucille A.; Smith, Nancy Cook

2012-01-01

Literacy instruction for students with significant intellectual disabilities traditionally emphasizes isolated skills instruction focusing on sight words and basic vocabulary. Recent research suggests these students benefit from high-quality instruction that includes comprehension and storybook reading. This study examined the effect of a…

Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures

PubMed Central

Wang, Yiyang; Tang, Jun; Zhou, Feiya; Yang, Lei; Wu, Jianbin

2017-01-01

Abstract Background: The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. Methods: We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium. Odds ratios (ORs) and mean differences (MDs) were pooled using either a fixed-effects or a random-effects model, depending on the heterogeneity of the trials included in the analysis. Results: Six RCTs and 1 quasi-RCT provided data from 1840 patients. These data revealed that comprehensive geriatric care may reduce the incidence of perioperative delirium (OR = 0.71; 95% confidence interval [CI], 0.57–0.89; P = .003) and that it was associated with higher cognitive status during hospitalization or at 1 month postoperatively (MD = 1.03; 95% CI, 0.93–1.13; P ≤ .00001). There was no significant difference in duration of perioperative delirium between the 2 treatment groups (MD = −2.48; 95% CI, −7.36 to 2.40; P = .32). Conclusion: Based on the quality of evidence provided, comprehensive geriatric care may reduce the incidence of perioperative delirium. To obtain evidence regarding the merits of comprehensive geriatric care in reducing severity of delirium and shortening the duration of delirium, there is a need for multicenter RCTs with high methodological quality. PMID:28658156

Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures: A meta-analysis.

PubMed

Wang, Yiyang; Tang, Jun; Zhou, Feiya; Yang, Lei; Wu, Jianbin

2017-06-01

The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium. Odds ratios (ORs) and mean differences (MDs) were pooled using either a fixed-effects or a random-effects model, depending on the heterogeneity of the trials included in the analysis. Six RCTs and 1 quasi-RCT provided data from 1840 patients. These data revealed that comprehensive geriatric care may reduce the incidence of perioperative delirium (OR = 0.71; 95% confidence interval [CI], 0.57-0.89; P = .003) and that it was associated with higher cognitive status during hospitalization or at 1 month postoperatively (MD = 1.03; 95% CI, 0.93-1.13; P ≤ .00001). There was no significant difference in duration of perioperative delirium between the 2 treatment groups (MD = -2.48; 95% CI, -7.36 to 2.40; P = .32). Based on the quality of evidence provided, comprehensive geriatric care may reduce the incidence of perioperative delirium. To obtain evidence regarding the merits of comprehensive geriatric care in reducing severity of delirium and shortening the duration of delirium, there is a need for multicenter RCTs with high methodological quality.

Evaluation of the quality of information on the Internet available to patients undergoing cervical spine surgery.

PubMed

Weil, Alexander G; Bojanowski, Michel W; Jamart, Jacques; Gustin, Thierry; Lévêque, Marc

2014-01-01

To evaluate the quality of information available on the Internet to patients with a cervical pathology undergoing elective cervical spine surgery. Six key words ("cervical discectomy," "cervical foraminotomy," "cervical fusion," "cervical disc replacement," "cervical arthroplasty," "cervical artificial disc") were entered into two different search engines (Google, Yahoo!). For each key word, the first 50 websites were evaluated for accessibility, comprehensibility, and website quality using the DISCERN tool, transparency and honesty criteria, and an accuracy and exhaustivity scale. Of 5,098,500 evaluable websites, 600 were visited; 97 (16%) of these websites were evaluated for quality and comprehensiveness. Overall, 3% of sites obtained an excellent global quality score, 7% obtained a good score, 25% obtained an above average score, 15% obtained an average score, 37% obtained a poor score, and 13% obtained a very poor score. High-quality websites were affiliated with a professional society (P = 0.021), had bibliographical references (P = 0.030), and had a recent update within 6 months (r = 0.277, P < 0.001). No correlation between global quality score and other variables was observed. This study shows that the search for medical information on the Internet is time-consuming and often disappointing. The Internet is a potentially misleading source of information. Surgeons and professional societies must use the Internet as an ally in providing optimal information to patients. Copyright © 2014. Published by Elsevier Inc.

The Link between Learning and Earning: A Comprehensive Service Delivery Model Designed To Improve the Quality of Life of High School Dropouts and "At-Risk" Youth.

ERIC Educational Resources Information Center

Jackson, Cheryl D.

Many youth face the following educational and economic barriers to success: (1) increased high school dropout rates; (2) adolescent pregnancy; (3) chronic unemployment; (4) poverty; (5) drug abuse; (6) suicide; and (7) crime and delinquency. The Atlantic Community College (New Jersey) Youth Corps Program, a successful conservation and service…

[Evaluating comprehensive quality of sediment in Dianchi Lake using adjusted AHP method and 137Cs dating].

PubMed

Zhang, Yan; Deng, Xi-Hai; Peng, Bu-Zhuo

2006-08-01

It is difficult to evaluate comprehensive quality of sediment and to understand development trend of pollution because of absence of monitoring data, especially history data. Combining the method of 137Cs dating with the ways of general sampling and measurement can easily resolve the problem of absence of data and also provide the possibility for calculating weighted environmental quality comprehensive index using the adjusted analytical hierarchy process (AHP) method. In order to overcome the willfulness the judgment matrix is formed objectively based on calculating monitoring data. Based on the monitoring data of sediment pollution and the weights of various factors gained by adjusted AHP method the comprehensive quality of sediment in each zone of Dianchi Lake was evaluated and the results indicated that the pollution of sediments in each zone at the present be serious more than that in the history. The condition may be related to the industrial development and distribution of industries in Dianchi Lake basin. Therefore, in order to improve the comprehensive quality of sediment in Dianchi Lake and to prevent the secondary pollution of heavy metals in sediment from happening, it is necessary to control the pollutants discharge and to remove the pollutants with various ways.

Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review.

PubMed

Hopman, Petra; de Bruin, Simone R; Forjaz, Maria João; Rodriguez-Blazquez, Carmen; Tonnara, Giuseppe; Lemmens, Lidwien C; Onder, Graziano; Baan, Caroline A; Rijken, Mieke

2016-07-01

To describe comprehensive care programs targeting multimorbid and/or frail patients and to estimate their effectiveness regarding improvement of patient and caregiver related outcomes, healthcare utilization and costs. Systematic search in six electronic databases for scientific papers published between January 2011 and March 2014, supplemented by reference tracking. Wagner's Chronic Care Model (CCM) was used to operationalize comprehensive care. The quality of the included studies was assessed, and a best-evidence synthesis was applied. Nineteen publications were included describing effects of eighteen comprehensive care programs for multimorbid or frail patients, of which only one was implemented in a European country. Programs varied in target groups, settings, interventions and number of CCM components addressed. Providing comprehensive care might result in more patient satisfaction, less depressive symptoms, a better health-related quality of life or functioning of multimorbid or frail patients, but the evidence is insufficient. There is no evidence that comprehensive care reduces the number of primary care or GP visits or healthcare costs. Regarding the use of inpatient care, the evidence was insufficient. No evidence was found for a beneficial effect of comprehensive care on caregiver-related outcomes. Despite the fact that over the years several (good-quality) studies have been performed to estimate the value of comprehensive care for multimorbid and/or frail patients, evidence for their effectiveness remains insufficient. More good-quality studies and/or studies allowing meta-analysis are needed to determine which specific target groups at what moment will benefit from comprehensive care. Moreover, evaluation studies could improve by using more appropriate outcome measures, e.g. measures that relate to patient-defined (personal) goals of care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

PubMed

Hinson, Jessica L; Garofoli, Gretchen K; Elswick, Betsy M

To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. Independent community pharmacy in Morgantown, WV. Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach

PubMed Central

MONTANO, Diego

2016-01-01

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach. PMID:26860787

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

PubMed

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

PlantTFDB 4.0: toward a central hub for transcription factors and regulatory interactions in plants.

PubMed

Jin, Jinpu; Tian, Feng; Yang, De-Chang; Meng, Yu-Qi; Kong, Lei; Luo, Jingchu; Gao, Ge

2017-01-04

With the goal of providing a comprehensive, high-quality resource for both plant transcription factors (TFs) and their regulatory interactions with target genes, we upgraded plant TF database PlantTFDB to version 4.0 (http://planttfdb.cbi.pku.edu.cn/). In the new version, we identified 320 370 TFs from 165 species, presenting a more comprehensive genomic TF repertoires of green plants. Besides updating the pre-existing abundant functional and evolutionary annotation for identified TFs, we generated three new types of annotation which provide more directly clues to investigate functional mechanisms underlying: (i) a set of high-quality, non-redundant TF binding motifs derived from experiments; (ii) multiple types of regulatory elements identified from high-throughput sequencing data; (iii) regulatory interactions curated from literature and inferred by combining TF binding motifs and regulatory elements. In addition, we upgraded previous TF prediction server, and set up four novel tools for regulation prediction and functional enrichment analyses. Finally, we set up a novel companion portal PlantRegMap (http://plantregmap.cbi.pku.edu.cn) for users to access the regulation resource and analysis tools conveniently. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

Design and Testing of a Tool for Evaluating the Quality of Diabetes Consumer-Information Web Sites

PubMed Central

Steinwachs, Donald; Rubin, Haya R

2003-01-01

Background Most existing tools for measuring the quality of Internet health information focus almost exclusively on structural criteria or other proxies for quality information rather than evaluating actual accuracy and comprehensiveness. Objective This research sought to develop a new performance-measurement tool for evaluating the quality of Internet health information, test the validity and reliability of the tool, and assess the variability in diabetes Web site quality. Methods An objective, systematic tool was developed to evaluate Internet diabetes information based on a quality-of-care measurement framework. The principal investigator developed an abstraction tool and trained an external reviewer on its use. The tool included 7 structural measures and 34 performance measures created by using evidence-based practice guidelines and experts' judgments of accuracy and comprehensiveness. Results Substantial variation existed in all categories, with overall scores following a normal distribution and ranging from 15% to 95% (mean was 50% and median was 51%). Lin's concordance correlation coefficient to assess agreement between raters produced a rho of 0.761 (Pearson's r of 0.769), suggesting moderate to high agreement. The average agreement between raters for the performance measures was 0.80. Conclusions Diabetes Web site quality varies widely. Alpha testing of this new tool suggests that it could become a reliable and valid method for evaluating the quality of Internet health sites. Such an instrument could help lay people distinguish between beneficial and misleading information. PMID:14713658

Adherence to outpatient epilepsy quality indicators at a tertiary epilepsy center

PubMed Central

Pourdeyhimi, R.; Wolf, B.J.; Simpson, A.N.; Martz, G.U.

2014-01-01

Introduction Quality indicators for the treatment of people with epilepsy were published in 2010. This is the first report of adherence to all measures in routine care of people with epilepsy at a level 4 comprehensive epilepsy center in the US. Methods Two hundred patients with epilepsy were randomly selected from the clinics of our comprehensive epilepsy center, and all visits during 2011 were abstracted for documentation of adherence to the eight quality indicators. Alternative measures were constructed to evaluate failure of adherence. Detailed descriptions of all equations are provided. Results Objective measures (EEG, imaging) showed higher adherence than counseling measures (safety). Initial visits showed higher adherence. Variations in the interpretation of the quality measure result in different adherence values. Advanced practice providers and physicians had different adherence patterns. No patient-specific patterns of adherence were seen. Discussion This is the first report of adherence to all the epilepsy quality indicators for a sample of patients during routine care in a level 4 epilepsy center in the US. Overall adherence was similar to that previously reported on similar measures. Precise definitions of adherence equations are essential for accurate measurement. Complex measures result in lower adherence. Counseling measures showed low adherence, possibly highlighting a difference between practice and documentation. Adherence to the measures as written does not guarantee high quality care. Conclusion The current quality indicators have value in the process of improving quality of care. Future approaches may be refined to eliminate complex measures and incorporate features linked to outcomes. PMID:25171260

Readability, credibility and quality of patient information for hypogonadism and testosterone replacement therapy on the Internet.

PubMed

McBride, J A; Carson, C C; Coward, R M

2017-05-01

The incidence of hypogonadism and use of testosterone replacement therapy (TRT) are rising, while data evaluating the complexity and quality of health-care information available to patients on the Internet for hypogonadism or TRT are lacking. This study focuses on characterizing the readability, credibility and quality of patient-centered information for hypogonadism on the Internet. A Google search was performed to identify top-ranked websites offering patient-centered information on hypogonadism and TRT. Readability was quantified by reading grade level using several validated instruments. Credibility and quality were determined by several additional criteria, including authorship, references, health-care information quality certification and breadth of topic discussion. Twenty of 75 total sites identified (27%) met the inclusion and exclusion criteria and were evaluated. The mean reading grade level was 13.1 (interquartile range 11.7-15.1), with all websites demonstrating reading levels significantly above recommended levels. Less than half (45%) of the sites were neither authored nor reviewed by a physician, 60% contained at least one reference and 40% were certified for displaying quality health-care information. Over half (55%) did not comprehensively discuss management of hypogonadism or mention treatment-associated risks. In conclusion, the majority of patient-centered information available on the Internet regarding hypogonadism or TRT is of poor quality and too complex for the average patient to comprehend. These results highlight a critical shortage in easily accessible, high-quality, comprehensible online patient health-care information on hypogonadism and TRT.

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.

Quality Assurance in the Presence of Variability

NASA Astrophysics Data System (ADS)

Lauenroth, Kim; Metzger, Andreas; Pohl, Klaus

Software Product Line Engineering (SPLE) is a reuse-driven development paradigm that has been applied successfully in information system engineering and other domains. Quality assurance of the reusable artifacts of the product line (e.g. requirements, design, and code artifacts) is essential for successful product line engineering. As those artifacts are reused in several products, a defect in a reusable artifact can affect several products of the product line. A central challenge for quality assurance in product line engineering is how to consider product line variability. Since the reusable artifacts contain variability, quality assurance techniques from single-system engineering cannot directly be applied to those artifacts. Therefore, different strategies and techniques have been developed for quality assurance in the presence of variability. In this chapter, we describe those strategies and discuss in more detail one of those strategies, the so called comprehensive strategy. The comprehensive strategy aims at checking the quality of all possible products of the product line and thus offers the highest benefits, since it is able to uncover defects in all possible products of the product line. However, the central challenge for applying the comprehensive strategy is the complexity that results from the product line variability and the large number of potential products of a product line. In this chapter, we present one concrete technique that we have developed to implement the comprehensive strategy that addresses this challenge. The technique is based on model checking technology and allows for a comprehensive verification of domain artifacts against temporal logic properties.

Monitoring the delivery of cancer care: Commission on Cancer and National Cancer Data Base.

PubMed

Williams, Richelle T; Stewart, Andrew K; Winchester, David P

2012-07-01

The primary objective of the Commission on Cancer (CoC) is to ensure the delivery of comprehensive, high-quality care that improves survival while maintaining quality of life for patients with cancer. This article examines the initiatives of the CoC toward achieving this goal, utilizing data from the National Cancer Data Base (NCDB) to monitor treatment patterns and outcomes, to develop quality measures, and to benchmark hospital performance. The article also highlights how these initiatives align with the Institute of Medicine's recommendations for improving the quality of cancer care and briefly explores future projects of the CoC and NCDB. Copyright © 2012 Elsevier Inc. All rights reserved.

Determining the market value of high-rise residential buildings based on evaluation of consumer properties

NASA Astrophysics Data System (ADS)

Kolobova, Svetlana

2018-03-01

As you know, high-rise construction is an indicator of the practical implementation of advanced innovative technologies in the construction industry of the country. High-rise building inevitably comes to the big cities, in connection with the shortage and value of land. The life cycle of any construction project, including high-rise buildings consists of chains: of engineering survey - design-construction-operation. In the process of operation of a tall building, decisions about major repairs or reconstruction of a building are made for decision-making on further use. This article describes methods of assessing the consumer quality of high-rise residential buildings and the establishment of prices based on consumer characteristics of a tall residential building. It is proposed to assess the premises under their quality characteristics. The study was conducted to establish the influence of individual, comprehensive and integral indicators of comparable quality for effective quality living spaces. Simultaneously, there was established a relationship of quality with the consumer cost of housing, ultimately with the potential needs of owners, tenants of the home, lessor dwelling, or buyers of residential properties and other participants in the residential real estate market. This relationship further creates consumer requirements to quality standard of premises at a certain stage of socio-economic development.

Comprehensive Child Welfare Information System. Final rule.

PubMed

2016-06-02

This final rule replaces the Statewide and Tribal Automated Child Welfare Information Systems (S/TACWIS) rule with the Comprehensive Child Welfare Information System (CCWIS) rule. The rule also makes conforming amendments in rules in related requirements. This rule will assist title IV-E agencies in developing information management systems that leverage new innovations and technology in order to better serve children and families. More specifically, this final rule supports the use of cost-effective, innovative technologies to automate the collection of high-quality case management data and to promote its analysis, distribution, and use by workers, supervisors, administrators, researchers, and policy makers.

Satisfaction with Sex Education in New Mexico High Schools: A Survey of College Students.

PubMed

Barlow, Meredith; Espey, Eve; Leeman, Lawrence; Scott, Ariel; Ogburn, Tony; Singh, Rameet

2016-01-01

To evaluate the perceived quality of and satisfaction with sex education among University of New Mexico (UNM) college students. Survey methods utilized with 18-21- year-old UNM freshmen and sophomores who graduated from a New Mexico high school. The survey included questions about type of sex education, satisfaction with sex education (on a 5-point Likert scale), and impact on sexual decision-making and was emailed to participants. A total of 9,866 surveys were emailed; 2,441 were returned (response rate = 24.7%); 415 did not attend high school in New Mexico, leaving 2,024 surveys in the analytic sample. Comprehensive sex education received higher ratings than abstinence-only or no sex education (3.29 ± 0.03 vs. 2.53 ± 0.07 vs. 1.87 ± 0.08, respectively, p<0.0001). More students receiving comprehensive sex education than abstinence-only education reported improved ability to make decisions about sexual initiation (66.6% vs. 54.0%; p = 0.0005), pregnancy prevention (92.7% vs. 72.9%; p < 0.0001), sexually transmitted, infection prevention (92.5% vs. 70.4%; p < 0.0001), and avoidance of unwanted sex (77.6% vs. 65.8%; p = 0.0003). New Mexico college students were more satisfied with comprehensive sex education in high school. New Mexico should consider establishing a state requirement for comprehensive sex education.

Creating a Statewide Educational Data System for Accountability and Improvement: A Comprehensive Information and Assessment System for Making Evidence-Based Change at School, District, and Policy Levels

ERIC Educational Resources Information Center

Felner, Robert D.; Bolton, Natalie; Seitsinger, Anne M.; Brand, Stephen; Burns, Amy

2008-01-01

This article reports on one ongoing statewide effort to create a high-quality data reporting and utilization system (i.e., High-Performance Learning Community [HiPlaces] Assessment) to inform educational accountability and improvement efforts system. This effort has undergoing refinement for more than a decade. The article describes the features…

Comprehensive Monitoring Program: Air Quality Data Assessment Report for FY90. Volume 2. Version 3.1

DTIC Science & Technology

1991-09-01

91311R01 If VERSION 3.10) VOLUME II Comm 2ND COPY COMPREHENSIVE MONITORING PROGRAM Contract Number DAAAI5-87-0095 AIR QUALITY DATA ASSESSMENT REPORT...MONITORING PROGRAM. FINAL AIR QUALITY DATA ASSESSMENT REPORT FOR FY90, VERSION 3.1 NONE 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRES.S(S) 8...RELEASE; DISTRIBUTION IS UNLIMITED 13. ABSTRACT (Maximum 200 words) THE OBJECTIVE OF THIS CMP IS TO: VERIFY AND EVALUATE POTENTIAL AIR QUALITY HEALTH

Towards a Canadian Educational Research Policy. (Vers une Politique Canadienne de la Recherche Pedagogique.)

ERIC Educational Resources Information Center

Canadian Council for Research in Education, Ottawa (Ontario).

Based on workshop discussions, this report attempts to lay down broad guidelines for Canadian educational research and development. The guidelines postulate that a comprehensive policy should include a pattern of priorities that (1) encourage the development of high quality scholarly institutions, (2) provide for risk capital for exploratory basic…

Physical Education PLC: Neoliberalism, Curriculum and Governance. New Directions for PESP Research

ERIC Educational Resources Information Center

Evans, John; Davies, Brian

2014-01-01

How might Physical Education and Sport Pedagogy (PESP) communities in the UK, Europe, Australasia and elsewhere go about researching the implications of neoliberalism and increasing privatisation of Education for the entitlements of young people to a common, comprehensive, high quality, equitable Physical Education (PE)? Our analyses suggest that…

On the Cultivation of Automation Majors' Research Innovation Ability Based on Scientific Research Projects

ERIC Educational Resources Information Center

Wang, Lipeng; Li, Mingqiu

2012-01-01

Currently, it has become a fundamental goal for the engineering major to cultivate high-quality engineering technicians with innovation ability in scientific research which is an important academic ability necessary for them. This paper mainly explores the development of comprehensive and designing experiments in automation based on scientific…

Using the SIOP Model for Effective Content Teaching with Second and Foreign Language Learners

ERIC Educational Resources Information Center

Kareva, Veronika; Echevarria, Jana

2013-01-01

In this paper we present a comprehensive model of instruction for providing consistent, high quality teaching to L2 students. This model, the SIOP Model (Sheltered Instruction Observation Protocol), provides an explicit framework for organizing instructional practices to optimize the effectiveness of teaching second and foreign language learners.…

Federal Home Visiting under the Affordable Care Act

ERIC Educational Resources Information Center

Strader, Kathleen; Counts, Jacqueline; Filene, Jill

2013-01-01

The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

A Comprehensive, Competency-Based Education Framework Using Medium-Sized ERP Systems

ERIC Educational Resources Information Center

Scholtz, Brenda; Cilliers, Charmain; Calitz, Andre

2012-01-01

Graduates with industry-relevant ERP competencies are highly sought after. This requirement is due to a dominance of Enterprise Resource Planning (ERP) systems and the positive affect which good quality ERP specialists have on the success rate of ERP system implementation projects. Universities are therefore increasingly pressurised to supply…

77 FR 73586 - Further Inquiry Into Issues Related to Mobility Fund Phase II

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... certain issues relating to the award of ongoing support for advanced mobile services. DATES: Comments are... availability of mobile broadband and high quality voice services in certain areas. Building on the comments... comprehensive record on certain issues related to the award of ongoing support for advanced mobile services. In...

Benefits and Drawbacks of Computer-Based Assessment and Feedback Systems: Student and Educator Perspectives

ERIC Educational Resources Information Center

Debuse, Justin C. W.; Lawley, Meredith

2016-01-01

Providing students with high quality feedback is important and can be achieved using computer-based systems. While student and educator perspectives of such systems have been investigated, a comprehensive multidisciplinary study has not yet been undertaken. This study examines student and educator perspectives of a computer-based assessment and…

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

Extension Agents' Perceptions of a Blended Approach to Onboarding

ERIC Educational Resources Information Center

Harder, Amy; Zelaya, Priscilla; Roberts, T. Grady

2016-01-01

Extension organizations are challenged to provide onboarding to new employees that is comprehensive and high quality, yet cost-effective. The purpose of this study was to explore Extension agents' perceptions of participating in an onboarding program that used a blended approach involving face-to-face and online learning components. The objectives…

Food Preparation and Service. An Introductory Course for Food Services Careers.

ERIC Educational Resources Information Center

Douma, Elaine L.

Intended for use in a comprehensive senior high school, this curriculum guide for an introductory laboratory course focuses on the development of abilities, attitudes, and personal qualities which would lead to job success at the entry level in the food service industry, including in the areas of cooking, waitressing, supermarkets, and similar…

Redesigning Continuing Education in the Health Professions

ERIC Educational Resources Information Center

National Academies Press, 2010

2010-01-01

Today in the United States, the professional health workforce is not consistently prepared to provide high quality health care and assure patient safety, even as the nation spends more per capita on health care than any other country. The absence of a comprehensive and well-integrated system of continuing education (CE) in the health professions…

Research and Application of an Air Quality Early Warning System Based on a Modified Least Squares Support Vector Machine and a Cloud Model.

PubMed

Wang, Jianzhou; Niu, Tong; Wang, Rui

2017-03-02

The worsening atmospheric pollution increases the necessity of air quality early warning systems (EWSs). Despite the fact that a massive amount of investigation about EWS in theory and practicality has been conducted by numerous researchers, studies concerning the quantification of uncertain information and comprehensive evaluation are still lacking, which impedes further development in the area. In this paper, firstly a comprehensive warning system is proposed, which consists of two vital indispensable modules, namely effective forecasting and scientific evaluation, respectively. For the forecasting module, a novel hybrid model combining the theory of data preprocessing and numerical optimization is first developed to implement effective forecasting for air pollutant concentration. Especially, in order to further enhance the accuracy and robustness of the warning system, interval forecasting is implemented to quantify the uncertainties generated by forecasts, which can provide significant risk signals by using point forecasting for decision-makers. For the evaluation module, a cloud model, based on probability and fuzzy set theory, is developed to perform comprehensive evaluations of air quality, which can realize the transformation between qualitative concept and quantitative data. To verify the effectiveness and efficiency of the warning system, extensive simulations based on air pollutants data from Dalian in China were effectively implemented, which illustrate that the warning system is not only remarkably high-performance, but also widely applicable.

Research and Application of an Air Quality Early Warning System Based on a Modified Least Squares Support Vector Machine and a Cloud Model

PubMed Central

Wang, Jianzhou; Niu, Tong; Wang, Rui

2017-01-01

The worsening atmospheric pollution increases the necessity of air quality early warning systems (EWSs). Despite the fact that a massive amount of investigation about EWS in theory and practicality has been conducted by numerous researchers, studies concerning the quantification of uncertain information and comprehensive evaluation are still lacking, which impedes further development in the area. In this paper, firstly a comprehensive warning system is proposed, which consists of two vital indispensable modules, namely effective forecasting and scientific evaluation, respectively. For the forecasting module, a novel hybrid model combining the theory of data preprocessing and numerical optimization is first developed to implement effective forecasting for air pollutant concentration. Especially, in order to further enhance the accuracy and robustness of the warning system, interval forecasting is implemented to quantify the uncertainties generated by forecasts, which can provide significant risk signals by using point forecasting for decision-makers. For the evaluation module, a cloud model, based on probability and fuzzy set theory, is developed to perform comprehensive evaluations of air quality, which can realize the transformation between qualitative concept and quantitative data. To verify the effectiveness and efficiency of the warning system, extensive simulations based on air pollutants data from Dalian in China were effectively implemented, which illustrate that the warning system is not only remarkably high-performance, but also widely applicable. PMID:28257122

Barriers to data quality resulting from the process of coding health information to administrative data: a qualitative study.

PubMed

Lucyk, Kelsey; Tang, Karen; Quan, Hude

2017-11-22

Administrative health data are increasingly used for research and surveillance to inform decision-making because of its large sample sizes, geographic coverage, comprehensivity, and possibility for longitudinal follow-up. Within Canadian provinces, individuals are assigned unique personal health numbers that allow for linkage of administrative health records in that jurisdiction. It is therefore necessary to ensure that these data are of high quality, and that chart information is accurately coded to meet this end. Our objective is to explore the potential barriers that exist for high quality data coding through qualitative inquiry into the roles and responsibilities of medical chart coders. We conducted semi-structured interviews with 28 medical chart coders from Alberta, Canada. We used thematic analysis and open-coded each transcript to understand the process of administrative health data generation and identify barriers to its quality. The process of generating administrative health data is highly complex and involves a diverse workforce. As such, there are multiple points in this process that introduce challenges for high quality data. For coders, the main barriers to data quality occurred around chart documentation, variability in the interpretation of chart information, and high quota expectations. This study illustrates the complex nature of barriers to high quality coding, in the context of administrative data generation. The findings from this study may be of use to data users, researchers, and decision-makers who wish to better understand the limitations of their data or pursue interventions to improve data quality.

Fundamental reform of payment for adult primary care: comprehensive payment for comprehensive care.

PubMed

Goroll, Allan H; Berenson, Robert A; Schoenbaum, Stephen C; Gardner, Laurence B

2007-03-01

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed.

Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care

PubMed Central

Berenson, Robert A.; Schoenbaum, Stephen C.; Gardner, Laurence B.

2007-01-01

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed. PMID:17356977

Inter-regional competition and quality in hospital care.

PubMed

Aiura, Hiroshi

2013-06-01

This study analyzes the effect of episode-of-care payment and patient choice on waiting time and the comprehensive quality of hospital care. The study assumes that two hospitals are located in two cities with different population sizes and compete with each other. We find that the comprehensive quality of hospital care as well as waiting time of both hospitals improve with an increase in payment per episode of care. However, we also find that the extent of these improvements differs according to the population size of the cities where the hospitals are located. Under the realistic assumptions that hospitals involve significant labor-intensive work, we find the improvements in comprehensive quality and waiting time in a hospital located in a small city to be greater than those in a hospital located in a large city. The result implies that regional disparity in the quality of hospital care decreases with an increase in payment per episode of care.

Quality of Care Provided by a Comprehensive Dementia Care Comanagement Program.

PubMed

Jennings, Lee A; Tan, Zaldy; Wenger, Neil S; Cook, Erin A; Han, Weijuan; McCreath, Heather E; Serrano, Katherine S; Roth, Carol P; Reuben, David B

2016-08-01

Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community-based organizations to provide comprehensive dementia care. The objective was to measure the quality of dementia care that nurse practitioner DCMs provide using the Assessing Care of Vulnerable Elders (ACOVE-3) and Physician Consortium for Performance Improvement QIs. Participants included 797 community-dwelling adults with dementia referred to the UCLA ADC program over a 2-year period. UCLA is an urban academic medical center with primarily fee-for-service reimbursement. The percentage of recommended care received for 17 dementia QIs was measured. The primary outcome was aggregate quality of care for the UCLA ADC cohort, calculated as the total number of recommended care processes received divided by the total number of eligible quality indicators. Secondary outcomes included aggregate quality of care in three domains of dementia care: assessment and screening (7 QIs), treatment (6 QIs), and counseling (4 QIs). QIs were abstracted from DCM notes over a 3-month period from date of initial assessment. Individuals were eligible for 9,895 QIs, of which 92% were passed. Overall pass rates of DCMs were similar (90-96%). All counseling and assessment QIs had pass rates greater than 80%, with most exceeding 90%. Wider variation in adherence was found among QIs addressing treatments for dementia, which patient-specific criteria triggered, ranging from 27% for discontinuation of medications associated with mental status changes to 86% for discussion about acetylcholinesterase inhibitors. Comprehensive dementia care comanagement with a nurse practitioner can result in high quality of care for dementia, especially for assessment, screening, and counseling. The effect on treatment QIs is more variable but higher than previous reports of physician-provided dementia care. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Signalling maps in cancer research: construction and data analysis

PubMed Central

Kondratova, Maria; Sompairac, Nicolas; Barillot, Emmanuel; Zinovyev, Andrei

2018-01-01

Abstract Generation and usage of high-quality molecular signalling network maps can be augmented by standardizing notations, establishing curation workflows and application of computational biology methods to exploit the knowledge contained in the maps. In this manuscript, we summarize the major aims and challenges of assembling information in the form of comprehensive maps of molecular interactions. Mainly, we share our experience gained while creating the Atlas of Cancer Signalling Network. In the step-by-step procedure, we describe the map construction process and suggest solutions for map complexity management by introducing a hierarchical modular map structure. In addition, we describe the NaviCell platform, a computational technology using Google Maps API to explore comprehensive molecular maps similar to geographical maps and explain the advantages of semantic zooming principles for map navigation. We also provide the outline to prepare signalling network maps for navigation using the NaviCell platform. Finally, several examples of cancer high-throughput data analysis and visualization in the context of comprehensive signalling maps are presented. PMID:29688383

Comprehensive care programs for patients with multiple chronic conditions: a systematic literature review.

PubMed

de Bruin, Simone R; Versnel, Nathalie; Lemmens, Lidwien C; Molema, Claudia C M; Schellevis, François G; Nijpels, Giel; Baan, Caroline A

2012-10-01

To provide insight into the characteristics of comprehensive care programs for patients with multiple chronic conditions and their impact on patients, informal caregivers, and professional caregivers. Systematic literature search in multiple electronic databases for English language papers published between January 1995 and January 2011, supplemented by reference tracking and a manual search on the internet. Wagner's chronic care model (CCM) was used to define comprehensive care. After inclusion, the methodological quality of each study was assessed. A best-evidence synthesis was applied to draw conclusions. Forty-two publications were selected describing thirty-three studies evaluating twenty-eight comprehensive care programs for multimorbid patients. Programs varied in the target patient groups, implementation settings, number of included interventions, and number of CCM components to which these interventions related. Moderate evidence was found for a beneficial effect of comprehensive care on inpatient healthcare utilization and healthcare costs, health behavior of patients, perceived quality of care, and satisfaction of patients and caregivers. Insufficient evidence was found for a beneficial effect of comprehensive care on health-related quality of life in terms of mental functioning, medication use, and outpatient healthcare utilization and healthcare costs. No evidence was found for a beneficial effect of comprehensive care on cognitive functioning, depressive symptoms, functional status, mortality, quality of life in terms of physical functioning, and caregiver burden. Because of the heterogeneity of comprehensive care programs, it is as yet too early to draw firm conclusions regarding their effectiveness. More rigorous evaluation studies are necessary to determine what constitutes best care for the increasing number of people with multiple chronic conditions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Bundled Payments in Total Joint Replacement: Keeping Our Care Affordable and High in Quality.

PubMed

McLawhorn, Alexander S; Buller, Leonard T

2017-09-01

The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control. Early results of bundled payments are promising, but preserving access to care for patients with high comorbidity burdens and those requiring more complex care is a lingering concern. Hospitals, regardless of current participation in bundled payments, should develop care pathways for TJA to maximize efficiency and patient safety.

The Value of Reliable Data: Interactive Data Tools from the National Comprehensive Center for Teacher Quality. Policy-to-Practice Brief. Number 1

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2008

2008-01-01

The National Comprehensive Center for Teacher Quality (TQ Center) designed the Interactive Data Tools to provide users with access to state and national data that can be helpful in assessing the qualifications of teachers in the states and the extent to which a state's teacher policy climate generally supports teacher quality. The Interactive Data…

Comprehensive assessment of cancer patients' concerns and the association with quality of life.

PubMed

Yokoo, Minori; Akechi, Tatsuo; Takayama, Tomoko; Karato, Atsuya; Kikuuchi, Yuki; Okamoto, Naoyuki; Katayama, Kayoko; Nakanotani, Takako; Ogawa, Asao

2014-07-01

Comprehensive assessment of perceived concerns can be used to guide supportive care appropriate to individual cancer patients. This study sought to determine the prevalence of cancer patients' concerns and the degree to which these concerns contribute to patients' quality of life. Participants were patients with all types of cancer, who completed an Internet survey questionnaire regarding comprehensive concerns about physical, psychological, psychosocial and economic aspects of having cancer. The questionnaire was based on the newly developed Comprehensive Concerns Assessment Tool and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. We obtained complete data from 807 patients. Factors related to 'self-management' concerns were the most common (61.2%), followed by concerns about 'psychological symptoms' (48.5%), 'medical information' (46.2%), 'daily living' (29.9%), 'pain' (17.6%), 'constipation' (15.6%) and other 'physical symptoms' (15.2%). Multiple regression analysis revealed that all concerns except those about 'medical information' significantly contributed to quality of life. Cancer patients' concerns were shown to be multidimensional and significantly associated with quality of life. Thus, assessment of patients' concerns should be multidimensional in nature, and a multidisciplinary care team should help patients improve their quality of life. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A new framework for designing programmes of assessment

PubMed Central

Van der Vleuten, C. P. M.; Schuwirth, L. W. T.

2009-01-01

Research on assessment in medical education has strongly focused on individual measurement instruments and their psychometric quality. Without detracting from the value of this research, such an approach is not sufficient to high quality assessment of competence as a whole. A programmatic approach is advocated which presupposes criteria for designing comprehensive assessment programmes and for assuring their quality. The paucity of research with relevance to programmatic assessment, and especially its development, prompted us to embark on a research project to develop design principles for programmes of assessment. We conducted focus group interviews to explore the experiences and views of nine assessment experts concerning good practices and new ideas about theoretical and practical issues in programmes of assessment. The discussion was analysed, mapping all aspects relevant for design onto a framework, which was iteratively adjusted to fit the data until saturation was reached. The overarching framework for designing programmes of assessment consists of six assessment programme dimensions: Goals, Programme in Action, Support, Documenting, Improving and Accounting. The model described in this paper can help to frame programmes of assessment; it not only provides a common language, but also a comprehensive picture of the dimensions to be covered when formulating design principles. It helps identifying areas concerning assessment in which ample research and development has been done. But, more importantly, it also helps to detect underserved areas. A guiding principle in design of assessment programmes is fitness for purpose. High quality assessment can only be defined in terms of its goals. PMID:19821042

A new framework for designing programmes of assessment.

PubMed

Dijkstra, J; Van der Vleuten, C P M; Schuwirth, L W T

2010-08-01

Research on assessment in medical education has strongly focused on individual measurement instruments and their psychometric quality. Without detracting from the value of this research, such an approach is not sufficient to high quality assessment of competence as a whole. A programmatic approach is advocated which presupposes criteria for designing comprehensive assessment programmes and for assuring their quality. The paucity of research with relevance to programmatic assessment, and especially its development, prompted us to embark on a research project to develop design principles for programmes of assessment. We conducted focus group interviews to explore the experiences and views of nine assessment experts concerning good practices and new ideas about theoretical and practical issues in programmes of assessment. The discussion was analysed, mapping all aspects relevant for design onto a framework, which was iteratively adjusted to fit the data until saturation was reached. The overarching framework for designing programmes of assessment consists of six assessment programme dimensions: Goals, Programme in Action, Support, Documenting, Improving and Accounting. The model described in this paper can help to frame programmes of assessment; it not only provides a common language, but also a comprehensive picture of the dimensions to be covered when formulating design principles. It helps identifying areas concerning assessment in which ample research and development has been done. But, more importantly, it also helps to detect underserved areas. A guiding principle in design of assessment programmes is fitness for purpose. High quality assessment can only be defined in terms of its goals.

A comprehensive global genotype-phenotype database for rare diseases.

PubMed

Trujillano, Daniel; Oprea, Gabriela-Elena; Schmitz, Yvonne; Bertoli-Avella, Aida M; Abou Jamra, Rami; Rolfs, Arndt

2017-01-01

The ability to discover genetic variants in a patient runs far ahead of the ability to interpret them. Databases with accurate descriptions of the causal relationship between the variants and the phenotype are valuable since these are critical tools in clinical genetic diagnostics. Here, we introduce a comprehensive and global genotype-phenotype database focusing on rare diseases. This database (CentoMD ® ) is a browser-based tool that enables access to a comprehensive, independently curated system utilizing stringent high-quality criteria and a quickly growing repository of genetic and human phenotype ontology (HPO)-based clinical information. Its main goals are to aid the evaluation of genetic variants, to enhance the validity of the genetic analytical workflow, to increase the quality of genetic diagnoses, and to improve evaluation of treatment options for patients with hereditary diseases. The database software correlates clinical information from consented patients and probands of different geographical backgrounds with a large dataset of genetic variants and, when available, biomarker information. An automated follow-up tool is incorporated that informs all users whenever a variant classification has changed. These unique features fully embedded in a CLIA/CAP-accredited quality management system allow appropriate data quality and enhanced patient safety. More than 100,000 genetically screened individuals are documented in the database, resulting in more than 470 million variant detections. Approximately, 57% of the clinically relevant and uncertain variants in the database are novel. Notably, 3% of the genetic variants identified and previously reported in the literature as being associated with a particular rare disease were reclassified, based on internal evidence, as clinically irrelevant. The database offers a comprehensive summary of the clinical validity and causality of detected gene variants with their associated phenotypes, and is a valuable tool for identifying new disease genes through the correlation of novel genetic variants with specific, well-defined phenotypes.

Comprehensive School Reform and Achievement: A Meta-Analysis

ERIC Educational Resources Information Center

Borman, Geoffrey D.; Hewes, Gina M.; Overman, Laura T.; Brown, Shelly

2003-01-01

This meta-analysis reviews research on the achievement effects of comprehensive school reform (CSR) and summarizes the specific effects of 29 widely implemented models. There are limitations on the overall quantity and quality of the research base, but the overall effects of CSR appear promising. The combined quantity, quality, and statistical…

Delivering quality of care while managing the interests of all stakeholders.

PubMed

Stopper, Andrea; Raddatz, Agnieszka; Grassmann, Aileen; Stuard, Stefano; Menzer, Marcus; Possnien, Gernot; Scatizzi, Laura; Marcelli, Daniele

2011-01-01

National healthcare systems worldwide face growing challenges to reconcile interests of patients for high-quality medical care and of payers for sustainable and affordable funding. Advances in the provision of renal replacement therapy can only be made by developing and implementing appropriate sophisticated and state-of-the-art business models that include reimbursement schemes for comprehensive care packages. Such business models must succeed in integrating and reconciling the interests of all stakeholders. NephroCare as dialysis provider has adopted and tailored recognized management techniques, i.e. Balanced Scorecard and Kaizen, to achieve these goals. Success of the complete business model package is tangible - strategies initiated to improve treatment quality even at the cost of providers have been translated into win-win scenarios for the complete stakeholder community. Room for improvement exists: the possibility to extend the portfolio of service offerings within the comprehensive care frame, as well as the challenge for achieving a balance between the stability of targets while keeping these up to date concerning new insights. Copyright © 2011 S. Karger AG, Basel.

Development and application of an integrated indoor air quality audit to an international hotel building in Taiwan.

PubMed

Kuo, Nae-Wen; Chiang, Hsin-Chen; Chiang, Che-Ming

2008-12-01

Indoor air quality (IAQ) has begun to surface as an important issue that affects the comfort and health of people; however, there is little research concerned about the IAQ monitoring of hotels up to now. Hotels are designed to provide comfortable spaces for guests. However, most complaints related to uncomfortable thermal environment and inadequate indoor air quality appear. In addition, microbial pollution can affect the health of tourists such as the Legionnaire's disease and SARS problems. This study is aimed to establish the comprehensive IAQ audit approach for hotel buildings with portable equipment, and one five-star international hotel in Taiwan was selected to exam this integrated approach. Finally, four major problems are identified after the comprehensive IAQ audit. They are: (1) low room temperature (21.8 degrees C), (2) insufficient air exchange rate (<1.5 h(-1)), (3) formaldehyde contamination (>0.02 ppm), and (4) the microbial pollution (total bacteria: 2,624-3,799 CFU/m(3)). The high level of formaldehyde may be due to the emission from the detergent and cleaning agents used for housekeeping.

Hospital-Based Comprehensive Care Programs for Children With Special Health Care Needs

PubMed Central

Cohen, Eyal; Jovcevska, Vesna; Kuo, Dennis Z.; Mahant, Sanjay

2014-01-01

Objective To examine the effectiveness of hospital-based comprehensive care programs in improving the quality of care for children with special health care needs. Data Sources A systematic review was conducted using Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Sociological Abstracts SocioFile, and Web of Science. Study Selection Evaluations of comprehensive care programs for categorical (those with single disease) and noncategorical groups of children with special health care needs were included. Selected articles were reviewed independently by 2 raters. Data Extraction Models of care focused on comprehensive care based at least partially in a hospital setting. The main outcome measures were the proportions of studies demonstrating improvement in the Institute of Medicine’s quality-of-care domains (effectiveness of care, efficiency of care, patient or family centeredness, patient safety, timeliness of care, and equity of care). Data Synthesis Thirty-three unique programs were included, 13 (39%) of which were randomized controlled trials. Improved outcomes most commonly reported were efficiency of care (64% [49 of 76 outcomes]), effectiveness of care (60% [57 of 95 outcomes]), and patient or family centeredness (53% [10 of 19 outcomes). Outcomes less commonly evaluated were patient safety (9% [3 of 33 programs]), timeliness of care (6% [2 of 33 programs]), and equity of care (0%). Randomized controlled trials occurred more frequently in studies evaluating categorical vs noncategorical disease populations (11 of 17 [65%] vs 2 of 16 [17%], P = .008). Conclusions Although positive, the evidence supporting comprehensive hospital-based programs for children with special health care needs is restricted primarily to nonexperimental studies of children with categorical diseases and is limited by inadequate outcome measures. Additional high-quality evidence with appropriate comparative groups and broad outcomes is necessary to justify continued development and growth of programs for broad groups of children with special health care needs. PMID:21646589

An integrated multiscale river basin observing system in the Heihe River Basin, northwest China

NASA Astrophysics Data System (ADS)

Li, X.; Liu, S.; Xiao, Q.; Ma, M.; Jin, R.; Che, T.

2015-12-01

Using the watershed as the unit to establish an integrated watershed observing system has been an important trend in integrated eco-hydrologic studies in the past ten years. Thus far, a relatively comprehensive watershed observing system has been established in the Heihe River Basin, northwest China. In addition, two comprehensive remote sensing hydrology experiments have been conducted sequentially in the Heihe River Basin, including the Watershed Allied Telemetry Experimental Research (WATER) (2007-2010) and the Heihe Watershed Allied Telemetry Experimental Research (HiWATER) (2012-2015). Among these two experiments, an important result of WATER has been the generation of some multi-scale, high-quality comprehensive datasets, which have greatly supported the development, improvement and validation of a series of ecological, hydrological and quantitative remote-sensing models. The goal of a breakthrough for solving the "data bottleneck" problem has been achieved. HiWATER was initiated in 2012. This project has established a world-class hydrological and meteorological observation network, a flux measurement matrix and an eco-hydrological wireless sensor network. A set of super high-resolution airborne remote-sensing data has also been obtained. In addition, there has been important progress with regard to the scaling research. Furthermore, the automatic acquisition, transmission, quality control and remote control of the observational data has been realized through the use of wireless sensor network technology. The observation and information systems have been highly integrated, which will provide a solid foundation for establishing a research platform that integrates observation, data management, model simulation, scenario analysis and decision-making support to foster 21st-century watershed science in China.

Recent development in mass spectrometry and its hyphenated techniques for the analysis of medicinal plants.

PubMed

Zhu, Ming-Zhi; Chen, Gui-Lin; Wu, Jian-Lin; Li, Na; Liu, Zhong-Hua; Guo, Ming-Quan

2018-04-23

Medicinal plants are gaining increasing attention worldwide due to their empirical therapeutic efficacy and being a huge natural compound pool for new drug discovery and development. The efficacy, safety and quality of medicinal plants are the main concerns, which are highly dependent on the comprehensive analysis of chemical components in the medicinal plants. With the advances in mass spectrometry (MS) techniques, comprehensive analysis and fast identification of complex phytochemical components have become feasible, and may meet the needs, for the analysis of medicinal plants. Our aim is to provide an overview on the latest developments in MS and its hyphenated technique and their applications for the comprehensive analysis of medicinal plants. Application of various MS and its hyphenated techniques for the analysis of medicinal plants, including but not limited to one-dimensional chromatography, multiple-dimensional chromatography coupled to MS, ambient ionisation MS, and mass spectral database, have been reviewed and compared in this work. Recent advancs in MS and its hyphenated techniques have made MS one of the most powerful tools for the analysis of complex extracts from medicinal plants due to its excellent separation and identification ability, high sensitivity and resolution, and wide detection dynamic range. To achieve high-throughput or multi-dimensional analysis of medicinal plants, the state-of-the-art MS and its hyphenated techniques have played, and will continue to play a great role in being the major platform for their further research in order to obtain insight into both their empirical therapeutic efficacy and quality control. Copyright © 2018 John Wiley & Sons, Ltd.

Development of a quality instrument for assessing the spontaneous reports of ADR/ADE using Delphi method in China.

PubMed

Chen, Lixun; Jiang, Ling; Shen, Aizong; Wei, Wei

2016-09-01

The frequently low quality of submitted spontaneous reports is of an increasing concern; to our knowledge, no validated instrument exists for assessing case reports' quality comprehensively enough. This work was conducted to develop such a quality instrument for assessing the spontaneous reports of adverse drug reaction (ADR)/adverse drug event (ADE) in China. Initial evaluation indicators were generated using systematic and literature data analysis. Final indicators and their weights were identified using Delphi method. The final quality instrument was developed by adopting the synthetic scoring method. A consensus was reached after four rounds of Delphi survey. The developed quality instrument consisted of 6 first-rank indicators, 18 second-rank indicators, and 115 third-rank indicators, and each rank indicator has been weighted. It evaluates the quality of spontaneous reports of ADR/ADE comprehensively and quantitatively on six parameters: authenticity, duplication, regulatory, completeness, vigilance level, and reporting time frame. The developed instrument was tested with good reliability and validity, which can be used to comprehensively and quantitatively assess the submitted spontaneous reports of ADR/ADE in China.

Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

PubMed Central

2011-01-01

Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT) aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB) at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914 PMID:21510886

[Text Comprehensibility of Hospital Report Cards].

PubMed

Sander, U; Kolb, B; Christoph, C; Emmert, M

2016-12-01

Objectives: Recently, the number of hospital report cards that compare quality of hospitals and present information from German quality reports has greatly increased. Objectives of this study were to a) identify suitable methods for measuring the readability and comprehensibility of hospital report cards, b) to obtain reliable information on the comprehensibility of texts for laymen, c) to give recommendations for improvements and d) to recommend public health actions. Methods: The readability and comprehensibility of the texts were tested with a) a computer-aided evaluation of formal text characteristics (readability indices Flesch (German formula) and 1. Wiener Sachtextformel formula), b) an expert-based heuristic analysis of readability and comprehensibility of texts (counting technical terms and analysis of text simplicity as well as brevity and conciseness using the Hamburg intelligibility model) and c) a survey of subjects about the comprehensibility of individual technical terms, the assessment of the comprehensibility of the presentations and the subjects' decisions in favour of one of the 5 presented clinics due to the better quality of data. In addition, the correlation between the results of the text analysis with the results from the survey of subjects was tested. Results: The assessment of texts with the computer-aided evaluations showed poor comprehensibility values. The assessment of text simplicity using the Hamburg intelligibility model showed poor comprehensibility values (-0.3). On average, 6.8% of the words used were technical terms. A review of 10 technical terms revealed that in all cases only a minority of respondents (from 4.4% to 39.1%) exactly knew what was meant by each of them. Most subjects (62.4%) also believed that unclear terms worsened their understanding of the information offered. The correlation analysis showed that presentations with a lower frequency of technical terms and better values for the text simplicity were better understood. Conclusion: The determination of the frequency of technical terms and the assessment of text simplicity using the Hamburg intelligibility model were suitable methods to determine the readability and comprehensibility of presentations of quality indicators. The analysis showed predominantly poor comprehensibility values and indicated the need to improve the texts of report cards. © Georg Thieme Verlag KG Stuttgart · New York.

Classroom Talk for Rigorous Reading Comprehension Instruction

ERIC Educational Resources Information Center

Wolf, Mikyung Kim; Crosson, Amy C.; Resnick, Lauren B.

2004-01-01

This study examined the quality of classroom talk and its relation to academic rigor in reading-comprehension lessons. Additionally, the study aimed to characterize effective questions to support rigorous reading comprehension lessons. The data for this study included 21 reading-comprehension lessons in several elementary and middle schools from…

Food and Drug Administration: Helping pharmacists ensure that patients receive high-quality medicines.

PubMed

Kremzner, Mary

2016-01-01

Ensuring that the drugs patients take are safe and effective is critical to the Food and Drug Administration (FDA) mission and a major reason for testing an active pharmaceutical ingredient or currently marketed drug product. To address gaps in the assessment of drug quality, FDA's Center for Drug Evaluation and Research (CDER) has created the Office of Pharmaceutical Quality (OPQ). This newly formed "super-office" within CDER launched a concerted new strategy that enhances the surveillance of drug manufacturing and will bring a comprehensive approach to quality oversight. With OPQ and these new performance measures in place, FDA can sharpen its focus on issues critical to quality and can identify and respond to manufacturing issues before they become major systemic problems. Published by Elsevier Inc.

78 FR 47241 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Revise the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

...The Delaware River Basin Commission (``DRBC'' or ``Commission'') will hold a public hearing to receive comments on proposed amendments to the Commission's Water Quality Regulations, Water Code and Comprehensive Plan to revise the water quality criteria for polychlorinated biphenyls (``PCBs'') in the Delaware Estuary and Bay, DRBC Water Quality Management Zones 2 through 6, for the protection of human health from carcinogenic effects. The Commission will simultaneously solicit comment on a draft implementation strategy to support achievement of the criteria.

How Do We Motivate Reading Comprehension?

ERIC Educational Resources Information Center

Shanahan, Timothy

1982-01-01

Considers the nature of motivation and its place in the development of reading comprehension. Uses A. Maslow's hierarchy of motivation as a heuristic for examining the motivational quality of several teaching methods commonly proposed for comprehension instruction. (FL)

Poverty Diagnostics Using Poor Data: Strengthening the Evidence Base for Pro-Poor Policy Making in Lesotho

ERIC Educational Resources Information Center

May, Julian; Roberts, Benjamin

2005-01-01

Increasingly national statistical agencies are being called upon to provide high quality data on a regular basis, to be used by governments for evidence-based policy development. Poverty Reduction Strategy Papers (PRSPs) give impetus to this, and bring a prerequisite for comprehensive "poverty diagnosis." Often the data that are required…

Does Higher Education Curriculum Contribute to Prospective Teachers' Attitudes, Self-Efficacy and Motivation?

ERIC Educational Resources Information Center

Koludrovic, Morana; Ercegovac, Ina Reic

2017-01-01

In Croatia, another comprehensive reform of the education system is being implemented. Although it proposes a number of reforms to the school system, we think that providing better training to future teachers during their studies would further contribute to the quality of education. The initial education of elementary and high school teachers is…

Three Key Issues in the Reform Programs for the Chinese College Entrance Examination

ERIC Educational Resources Information Center

Liu, Qinghua

2013-01-01

The new entrance exam reform programs that have been presented in a number of provinces and regions adhere to the direction of new curriculum reform. Within these programs, comprehensive evaluation serves as the weather vane for quality education. The high school academic proficiency test serves as a firmly fixed benchmark for learning ability,…

An International Perspective on Regulated Family Day Care Systems

ERIC Educational Resources Information Center

Davis, Elise; Freeman, Ramona; Doherty, Gillian; Karlsson, Malene; Everiss, Liz; Couch, Jane; Foote, Lyn; Murray, Patricia; Modigliani, Kathy; Owen, Sue; Griffin, Sue; Friendly, Martha; McDonald, Grace; Bohanna, India; Corr, Lara; Smyth, Lisa; Morkeseth, Elisabeth Ianke; Morreaunet, Sissel; Ogi, Mari; Fukukawa, Sumi; Hinke-Rahnau, Jutta

2012-01-01

Despite emerging evidence of the contributors to high-quality family day care, a comprehensive comparison of international family day care systems has not been undertaken. The aim of this paper is to compare regulated family day care (FDC) in Australia, Canada, England and Wales, Germany, Ireland, Japan, Norway, New Zealand, Sweden, and the USA,…

Adherence to outpatient epilepsy quality indicators at a tertiary epilepsy center.

PubMed

Pourdeyhimi, R; Wolf, B J; Simpson, A N; Martz, G U

2014-10-01

Quality indicators for the treatment of people with epilepsy were published in 2010. This is the first report of adherence to all measures in routine care of people with epilepsy at a level 4 comprehensive epilepsy center in the US. Two hundred patients with epilepsy were randomly selected from the clinics of our comprehensive epilepsy center, and all visits during 2011 were abstracted for documentation of adherence to the eight quality indicators. Alternative measures were constructed to evaluate failure of adherence. Detailed descriptions of all equations are provided. Objective measures (EEG, imaging) showed higher adherence than counseling measures (safety). Initial visits showed higher adherence. Variations in the interpretation of the quality measure result in different adherence values. Advanced practice providers and physicians had different adherence patterns. No patient-specific patterns of adherence were seen. This is the first report of adherence to all the epilepsy quality indicators for a sample of patients during routine care in a level 4 epilepsy center in the US. Overall adherence was similar to that previously reported on similar measures. Precise definitions of adherence equations are essential for accurate measurement. Complex measures result in lower adherence. Counseling measures showed low adherence, possibly highlighting a difference between practice and documentation. Adherence to the measures as written does not guarantee high quality care. The current quality indicators have value in the process of improving quality of care. Future approaches may be refined to eliminate complex measures and incorporate features linked to outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

An early warning system for groundwater pollution based on the assessment of groundwater pollution risks.

NASA Astrophysics Data System (ADS)

Zhang, Weihong.; Zhao, Yongsheng; Hong, Mei; Guo, Xiaodong

2009-04-01

Groundwater pollution usually is complex and concealed, remediation of which is difficult, high cost, time-consuming, and ineffective. An early warning system for groundwater pollution is needed that detects groundwater quality problems and gets the information necessary to make sound decisions before massive groundwater quality degradation occurs. Groundwater pollution early warning were performed by considering comprehensively the current groundwater quality, groundwater quality varying trend and groundwater pollution risk . The map of the basic quality of the groundwater was obtained by fuzzy comprehensive evaluation or BP neural network evaluation. Based on multi-annual groundwater monitoring datasets, Water quality state in sometime of the future was forecasted using time-sequenced analyzing methods. Water quality varying trend was analyzed by Spearman's rank correlative coefficient.The relative risk map of groundwater pollution was estimated through a procedure that identifies, cell by cell,the values of three factors, that is inherent vulnerability, load risk of pollution source and contamination hazard. DRASTIC method was used to assess inherent vulnerability of aquifer. Load risk of pollution source was analyzed based on the potential of contamination and pollution degree. Assessment index of load risk of pollution source which involves the variety of pollution source, quantity of contaminants, releasing potential of pollutants, and distance were determined. The load risks of all sources considered by GIS overlay technology. Early warning model of groundwater pollution combined with ComGIS technology organically, the regional groundwater pollution early-warning information system was developed, and applied it into Qiqiha'er groundwater early warning. It can be used to evaluate current water quality, to forecast water quality changing trend, and to analyze space-time influencing range of groundwater quality by natural process and human activities. Keywords: groundwater pollution, early warning, aquifer vulnerability, pollution load, pollution risk, ComGIS

Framework for a ground-water quality monitoring and assessment program for California

USGS Publications Warehouse

Belitz, Kenneth; Dubrovsky, Neil M.; Burow, Karen; Jurgens, Bryant C.; John, Tyler

2003-01-01

The State of California uses more ground water than any other State in the Nation. With a population of over 30 million people, an agricultural economy based on intensive irrigation, large urban industrial areas, and naturally elevated concentrations of some trace elements, there is a wide range of contaminant sources that have the potential to contaminate ground water and limit its beneficial uses. In response to the many-and different-potential sources of ground-water contamination, the State of California has evolved an extensive set of rules and programs to protect ground-water quality, and agencies to implement the rules and programs. These programs have in common a focus on compliance with regulations governing chemical use and (or) ground-water quality. Although appropriate for, and successful at, their specific missions, these programs do not at present provide a comprehensive view of ground-water quality in the State of California. In October 2001, The California Assembly passed a bill, AB 599, establishing the Ground-Water- Quality Monitoring Act of 2001.' The goal of AB 599 is to improve Statewide comprehensive ground-water monitoring and increase availability of information about ground-water quality to the public. AB 599 requires the State Water Resources Control Board (SWRCB), in collaboration with an interagency task force (ITF) and a public advisory committee (PAC), to develop a plan for a comprehensive ground-water monitoring program. AB 599 specifies that the comprehensive program should be capable of assessing each ground-water basin in the State through direct and other statistically reliable sampling approaches, and that the program should integrate existing monitoring programs and design new program elements, as necessary. AB 599 also stresses the importance of prioritizing ground-water basins that provide drinking water. The United States Geological Survey (USGS), in cooperation with the SWRCB, and in coordination with the ITF and PAC, has developed a framework for a comprehensive ground-water-quality monitoring and assessment program for California. The proposed framework relies extensively on previous work conducted by the USGS through its National Water-Quality Assessment (NAWQA) program. In particular, the NAWQA program defines three types of ground-water assessment: (1) status, the assessment of the current quality of the ground-water resource; (2) trends, the detection of changes in water quality, and (3) understanding, assessing the human and natural factors that affect ground-water quality. A Statewide, comprehensive ground-water quality-monitoring and assessment program is most efficiently accomplished by applying uniform and consistent study-design and data-collection protocols to the entire State. At the same time, a comprehensive program should be relevant at a variety of scales, and therefore needs to retain flexibility to address regional and local issues. Consequently, many of the program components include a predominant element that will be consistently applied in all basins, and a secondary element that may be applied in specific basins where local conditions warrant attention.

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management)

PubMed Central

Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

2007-01-01

Background Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. Methods/Design HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NT-proBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. Discussion As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care. Trial registration Current Controlled Trials ISRCTN30822978. PMID:17716364

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management).

PubMed

Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

2007-08-23

Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NT-proBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care.

Organic semiconductor crystals.

PubMed

Wang, Chengliang; Dong, Huanli; Jiang, Lang; Hu, Wenping

2018-01-22

Organic semiconductors have attracted a lot of attention since the discovery of highly doped conductive polymers, due to the potential application in field-effect transistors (OFETs), light-emitting diodes (OLEDs) and photovoltaic cells (OPVs). Single crystals of organic semiconductors are particularly intriguing because they are free of grain boundaries and have long-range periodic order as well as minimal traps and defects. Hence, organic semiconductor crystals provide a powerful tool for revealing the intrinsic properties, examining the structure-property relationships, demonstrating the important factors for high performance devices and uncovering fundamental physics in organic semiconductors. This review provides a comprehensive overview of the molecular packing, morphology and charge transport features of organic semiconductor crystals, the control of crystallization for achieving high quality crystals and the device physics in the three main applications. We hope that this comprehensive summary can give a clear picture of the state-of-art status and guide future work in this area.

[Environmental quality assessment of regional agro-ecosystem in Loess Plateau].

PubMed

Wang, Limei; Meng, Fanping; Zheng, Jiyong; Wang, Zhonglin

2004-03-01

Based on the detection and analysis of the contamination status of agro-ecosystem with apple-crops intercropping as the dominant cropping model in Loess Plateau, the individual factor and comprehensive environmental quality were assessed by multilevel fuzzy synthetic evaluation model, analytical hierarchy process(AHP), and improved standard weight deciding method. The results showed that the quality of soil, water and agricultural products was grade I, the social economical environmental quality was grade II, the ecological environmental quality was grade III, and the comprehensive environmental quality was grade I. The regional agro-ecosystem dominated by apple-crops intercropping was not the best model for the ecological benefits, but had the better social economical benefits.

Water Quality Evaluation of the Yellow River Basin Based on Gray Clustering Method

NASA Astrophysics Data System (ADS)

Fu, X. Q.; Zou, Z. H.

2018-03-01

Evaluating the water quality of 12 monitoring sections in the Yellow River Basin comprehensively by grey clustering method based on the water quality monitoring data from the Ministry of environmental protection of China in May 2016 and the environmental quality standard of surface water. The results can reflect the water quality of the Yellow River Basin objectively. Furthermore, the evaluation results are basically the same when compared with the fuzzy comprehensive evaluation method. The results also show that the overall water quality of the Yellow River Basin is good and coincident with the actual situation of the Yellow River basin. Overall, gray clustering method for water quality evaluation is reasonable and feasible and it is also convenient to calculate.

Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya.

PubMed

Keesara, Sirina R; Juma, Pamela A; Harper, Cynthia C

2015-08-20

Nearly 40% of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.

A Conceptual Framework for Quality of Care

PubMed Central

Mosadeghrad, Ali Mohammad

2012-01-01

Despite extensive research on defining and measuring health care quality, little attention has been given to different stakeholders’ perspectives of high-quality health care services. The main purpose of this study was to explore the attributes of quality healthcare in the Iranian context. Exploratory in-depth individual and focus group interviews were conducted with key healthcare stakeholders including clients, providers, managers, policy makers, payers, suppliers and accreditation panel members to identify the healthcare service quality attributes and dimensions. Data analysis was carried out by content analysis, with the constant comparative method. Over 100 attributes of quality healthcare service were elicited and grouped into five categories. The dimensions were: efficacy, effectiveness, efficiency, empathy, and environment. Consequently, a comprehensive model of service quality was developed for health care context. The findings of the current study led to a conceptual framework of healthcare quality. This model leads to a better understanding of the different aspects of quality in health care and provides a better basis for defining, measuring and controlling quality of health care services. PMID:23922534

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

The Royal College of Pathologists of Australasia Quality Assurance Program: Immunohistochemistry Breast Marker Audit Overview 2005-2015.

PubMed

Haffajee, Zenobia Ayesha Mohamed; Kumar, Beena; Francis, Glenn; Peck, Martyn; Badrick, Tony

2017-11-20

The Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) Anatomical Pathology provides a comprehensive External Quality Assurance (EQA) exercise to review the reporting of immunohistochemistry (IHC) and in-situ hybridization (ISH) breast markers through an audit of clinical results. The aim of this exercise was to provide information regarding the quality of breast marker testing within clinical laboratories from 2005 to 2015. This comprehensive audit included estrogen, progesterone, and HER2 marker reporting. This was an important quality assurance activity established in response to ongoing difficulties experienced in laboratories in this area of testing.

Quality evaluation of Shenmaidihuang Pills based on the chromatographic fingerprints and simultaneous determination of seven bioactive constituents.

PubMed

Liu, Sifei; Zhang, Guangrui; Qiu, Ying; Wang, Xiaobo; Guo, Lihan; Zhao, Yanxin; Tong, Meng; Wei, Lan; Sun, Lixin

2016-12-01

In this study, we aimed to establish a comprehensive and practical quality evaluation system for Shenmaidihuang pills. A simple and reliable high-performance liquid chromatography coupled with photodiode array detection method was developed both for fingerprint analysis and quantitative determination. In fingerprint analysis, relative retention time and relative peak area were used to identify the common peaks in 18 samples for investigation. Twenty one peaks were selected as the common peaks to evaluate the similarities of 18 Shenmaidihuang pills samples with different manufacture dates. Furthermore, similarity analysis was applied to evaluate the similarity of samples. Hierarchical cluster analysis and principal component analysis were also performed to evaluate the variation of Shenmaidihuang pills. In quantitative analysis, linear regressions, injection precisions, recovery, repeatability and sample stability were all tested and good results were obtained to simultaneously determine the seven identified compounds, namely, 5-hydroxymethylfurfural, morroniside, loganin, paeonol, paeoniflorin, psoralen, isopsoralen in Shenmaidihuang pills. The contents of some analytes in different batches of samples indicated significant difference, especially for 5-hydroxymethylfurfural. So, it was concluded that the chromatographic fingerprint method obtained by high-performance liquid chromatography coupled with photodiode array detection associated with multiple compounds determination is a powerful and meaningful tool to comprehensively conduct the quality control of Shenmaidihuang pills. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Comprehensive quality assurance phantom for cardiovascular imaging systems

NASA Astrophysics Data System (ADS)

Lin, Pei-Jan P.

1998-07-01

With the advent of high heat loading capacity x-ray tubes, high frequency inverter type generators, and the use of spectral shaping filters, the automatic brightness/exposure control (ABC) circuit logic employed in the new generation of angiographic imaging equipment has been significantly reprogrammed. These new angiographic imaging systems are designed to take advantage of the power train capabilities to yield higher contrast images while maintaining, or lower, the patient exposure. Since the emphasis of the imaging system design has been significantly altered, the system performance parameters one is interested and the phantoms employed for the quality assurance must also change in order to properly evaluate the imaging capability of the cardiovascular imaging systems. A quality assurance (QA) phantom has been under development in this institution and was submitted to various interested organizations such as American Association of Physicists in Medicine (AAPM), Society for Cardiac Angiography & Interventions (SCA&I), and National Electrical Manufacturers Association (NEMA) for their review and input. At the same time, in an effort to establish a unified standard phantom design for the cardiac catheterization laboratories (CCL), SCA&I and NEMA have formed a joint work group in early 1997 to develop a suitable phantom. The initial QA phantom design has since been accepted to serve as the base phantom by the SCA&I- NEMA Joint Work Group (JWG) from which a comprehensive QA Phantom is being developed.

Comprehensive Strategies to Reduce Readmissions in Older Patients With Cardiovascular Disease.

PubMed

Dharmarajan, Kumar

2016-11-01

Older adults are frequently readmitted to the hospital soon after hospitalization for common cardiovascular conditions. Yet there are few high-quality data on the best strategies to reduce short-term readmissions because most studies have involved small numbers of participants, single-centre design, and strong susceptibility to bias. Despite these limitations in the literature, a clear signal exists that most studies involving a singular type of intervention, a singular type of health provider, or a low intensity of intervention have failed to reduce readmissions. In contrast, interventions that are most likely to lower readmissions have used comprehensive approaches, including combined hospital and postacute care, multimodal interventions, multidisciplinary teams, or frequent longitudinal contact. Components of a comprehensive approach with the highest level of evidence include high-quality, disease-specific care; multiple transitional care interventions; involvement of multidisciplinary teams; early and frequent outpatient follow-up; and, when possible, home visits. These findings are consistent with data demonstrating that older adults have multiple sources of vulnerability and experience elevated readmission risk from a broad spectrum of medical conditions for an extended time after hospital discharge. Because readmission reduction is difficult and requires new ways of conceptualizing links between inpatient and postacute care, financial incentives may ultimately be required to motivate hospitals and health systems to redesign care processes, deploy new resources, and collaborate with out-of-hospital providers and organizations. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

FISH Oracle 2: a web server for integrative visualization of genomic data in cancer research.

PubMed

Mader, Malte; Simon, Ronald; Kurtz, Stefan

2014-03-31

A comprehensive view on all relevant genomic data is instrumental for understanding the complex patterns of molecular alterations typically found in cancer cells. One of the most effective ways to rapidly obtain an overview of genomic alterations in large amounts of genomic data is the integrative visualization of genomic events. We developed FISH Oracle 2, a web server for the interactive visualization of different kinds of downstream processed genomics data typically available in cancer research. A powerful search interface and a fast visualization engine provide a highly interactive visualization for such data. High quality image export enables the life scientist to easily communicate their results. A comprehensive data administration allows to keep track of the available data sets. We applied FISH Oracle 2 to published data and found evidence that, in colorectal cancer cells, the gene TTC28 may be inactivated in two different ways, a fact that has not been published before. The interactive nature of FISH Oracle 2 and the possibility to store, select and visualize large amounts of downstream processed data support life scientists in generating hypotheses. The export of high quality images supports explanatory data visualization, simplifying the communication of new biological findings. A FISH Oracle 2 demo server and the software is available at http://www.zbh.uni-hamburg.de/fishoracle.

Primary treatments for clinically localised prostate cancer: a comprehensive lifetime cost-utility analysis.

PubMed

Cooperberg, Matthew R; Ramakrishna, Naren R; Duff, Steven B; Hughes, Kathleen E; Sadownik, Sara; Smith, Joseph A; Tewari, Ashutosh K

2013-03-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Multiple treatment alternatives exist for localised prostate cancer, with few high-quality studies directly comparing their comparative effectiveness and costs. The present study is the most comprehensive cost-effectiveness analysis to date for localised prostate cancer, conducted with a lifetime horizon and accounting for survival, health-related quality-of-life, and cost impact of secondary treatments and other downstream events, as well as primary treatment choices. The analysis found minor differences, generally slightly favouring surgical methods, in quality-adjusted life years across treatment options. However, radiation therapy (RT) was consistently more expensive than surgery, and some alternatives, e.g. intensity-modulated RT for low-risk disease, were dominated - that is, both more expensive and less effective than competing alternatives. To characterise the costs and outcomes associated with radical prostatectomy (open, laparoscopic, or robot-assisted) and radiation therapy (RT: dose-escalated three-dimensional conformal RT, intensity-modulated RT, brachytherapy, or combination), using a comprehensive, lifetime decision analytical model. A Markov model was constructed to follow hypothetical men with low-, intermediate-, and high-risk prostate cancer over their lifetimes after primary treatment; probabilities of outcomes were based on an exhaustive literature search yielding 232 unique publications. In each Markov cycle, patients could have remission, recurrence, salvage treatment, metastasis, death from prostate cancer, and death from other causes. Utilities for each health state were determined, and disutilities were applied for complications and toxicities of treatment. Costs were determined from the USA payer perspective, with incorporation of patient costs in a sensitivity analysis. Differences across treatments in quality-adjusted life years across methods were modest, ranging from 10.3 to 11.3 for low-risk patients, 9.6-10.5 for intermediate-risk patients and 7.8-9.3 for high-risk patients. There were no statistically significant differences among surgical methods, which tended to be more effective than RT methods, with the exception of combined external beam + brachytherapy for high-risk disease. RT methods were consistently more expensive than surgical methods; costs ranged from $19 901 (robot-assisted prostatectomy for low-risk disease) to $50 276 (combined RT for high-risk disease). These findings were robust to an extensive set of sensitivity analyses. Our analysis found small differences in outcomes and substantial differences in payer and patient costs across treatment alternatives. These findings may inform future policy discussions about strategies to improve efficiency of treatment selection for localised prostate cancer. © 2012 BJU International.

Physicochemical and biological quality of soil in hexavalent chromium-contaminated soils as affected by chemical and microbial remediation.

PubMed

Liao, Yingping; Min, Xiaobo; Yang, Zhihui; Chai, Liyuan; Zhang, Shujuan; Wang, Yangyang

2014-01-01

Chemical and microbial methods are the main remediation technologies for chromium-contaminated soil. These technologies have progressed rapidly in recent years; however, there is still a lack of methods for evaluating the chemical and biological quality of soil after different remediation technologies have been applied. In this paper, microbial remediation with indigenous bacteria and chemical remediation with ferrous sulphate were used for the remediation of soils contaminated with Cr(VI) at two levels (80 and 1,276 mg kg(-1)) through a column leaching experiment. After microbial remediation with indigenous bacteria, the average concentration of water-soluble Cr(VI) in the soils was reduced to less than 5.0 mg kg(-1). Soil quality was evaluated based on 11 soil properties and the fuzzy comprehensive assessment method, including fuzzy mathematics and correlative analysis. The chemical fertility quality index was improved by one grade using microbial remediation with indigenous bacteria, and the biological fertility quality index increased by at least a factor of 6. Chemical remediation with ferrous sulphate, however, resulted in lower levels of available phosphorus, dehydrogenase, catalase and polyphenol oxidase. The result showed that microbial remediation with indigenous bacteria was more effective for remedying Cr(VI)-contaminated soils with high pH value than chemical remediation with ferrous sulphate. In addition, the fuzzy comprehensive evaluation method was proven to be a useful tool for monitoring the quality change in chromium-contaminated soils.

Measuring school health center impact on access to and quality of primary care.

PubMed

Gibson, Erica J; Santelli, John S; Minguez, Mara; Lord, Alyssa; Schuyler, Ashley C

2013-12-01

School health centers (SHC) that provide comprehensive health care may improve access and quality of care for students; however, published impact data are limited. We evaluated access and quality of health services at an urban high school with a SHC compared with a school without a SHC, using a quasiexperimental research design. Data were collected at the beginning of the school year, using a paper and pencil classroom questionnaire (n = 2,076 students). We measured SHC impact in several ways including grade by school interaction terms. Students at the SHC school were more likely to report having a regular healthcare provider, awareness of confidential services, support for health services in their school, and willingness to utilize those services. Students in the SHC school reported higher quality of care as measured by: respect for their health concerns, adequate time with the healthcare provider, understandable provider communications, and greater provider discussion at their last visit on topics such as sexual activity, birth control, emotions, future plans, diet, and exercise. Users of the SHC were also more likely to report higher quality of care, compared with either nonusers or students in the comparison school. Access to comprehensive health services via a SHC led to improved access to health care and improved quality of care. Impact was measureable on a school-wide basis but was greater among SHC users. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A comprehensive and efficient daily quality assurance for PBS proton therapy

NASA Astrophysics Data System (ADS)

Actis, O.; Meer, D.; König, S.; Weber, D. C.; Mayor, A.

2017-03-01

There are several general recommendations for quality assurance (QA) measures, which have to be performed at proton therapy centres. However, almost each centre uses a different therapy system. In particular, there is no standard procedure for centres employing pencil beam scanning and each centre applies a specific QA program. Gantry 2 is an operating therapy system which was developed at PSI and relies on the most advanced technological innovations. We developed a comprehensive daily QA program in order to verify the main beam characteristics to assure the functionality of the therapy delivery system and the patient safety system. The daily QA program entails new hardware and software solutions for a highly efficient clinical operation. In this paper, we describe a dosimetric phantom used for verifying the most critical beam parameters and the software architecture developed for a fully automated QA procedure. The connection between our QA software and the database allows us to store the data collected on a daily basis and use it for trend analysis over longer periods of time. All the data presented here have been collected during a time span of over two years, since the beginning of the Gantry 2 clinical operation in 2013. Our procedure operates in a stable way and delivers the expected beam quality. The daily QA program takes only 20 min. At the same time, the comprehensive approach allows us to avoid most of the weekly and monthly QA checks and increases the clinical beam availability.

The Effect of Content-Focused Coaching on the Quality of Classroom Text Discussions

ERIC Educational Resources Information Center

Matsumura, Lindsay Clare; Garnier, Helen E.; Spybrook, Jessaca

2012-01-01

This study examines the effect of a comprehensive literacy-coaching program focused on enacting a discussion-based approach to reading comprehension instruction (content-focused coaching [CFC]) on the quality of classroom text discussions over 2 years. The study used a cluster-randomized trial in which schools were assigned to either CFC or…

Do Live versus Audio-Recorded Narrative Stimuli Influence Young Children's Narrative Comprehension and Retell Quality?

ERIC Educational Resources Information Center

Kim, Young-Suk Grace

2016-01-01

Purpose: The primary aim of the present study was to examine whether different ways of presenting narrative stimuli (i.e., live narrative stimuli versus audio-recorded narrative stimuli) influence children's performances on narrative comprehension and oral-retell quality. Method: Children in kindergarten (n = 54), second grade (n = 74), and fourth…

Do Live versus Audio-Recorded Narrative Stimuli Influence Young Children's Narrative Comprehension and Retell Quality?

ERIC Educational Resources Information Center

Kim, Young-Suk Grace

2016-01-01

Purpose: The primary aim of the present study was to examine whether different ways of presenting narrative stimuli (i.e., live narrative stimuli versus audio-recorded narrative stimuli) influence children's performances on narrative comprehension and oral-retell quality. Method: Children in kindergarten (n = 54), second grade (n = 74), and fourth…

Lexical Quality and Executive Control Predict Children's First and Second Language Reading Comprehension

ERIC Educational Resources Information Center

Raudszus, Henriette; Segers, Eliane; Verhoeven, Ludo

2018-01-01

This study compared how lexical quality (vocabulary and decoding) and executive control (working memory and inhibition) predict reading comprehension directly as well as indirectly, via syntactic integration, in monolingual and bilingual fourth grade children. The participants were 76 monolingual and 102 bilingual children (mean age 10 years,…

Structural approaches to the study of oligosaccharides in glycoprotein quality control.

PubMed

Ito, Yukishige; Hagihara, Shinya; Matsuo, Ichiro; Totani, Kiichiro

2005-10-01

High-mannose-type oligosaccharides have been shown to play important roles in protein quality control. Several intracellular proteins, such as lectins, chaperones and glycan-processing enzymes, are involved in this process. These include calnexin/calreticulin, UDP-glucose:glycoprotein glucosyltransferase (UGGT), cargo receptors (such as VIP36 and ERGIC-53), mannosidase-like proteins (e.g. EDEM and Htm1p) and ubiquitin ligase (Fbs). They are thought to recognize high-mannose-type glycans with subtly different structures, although the precise specificities are yet to be clarified. In order to gain a clear understanding of these protein-carbohydrate interactions, comprehensive synthesis of high-mannose-type glycans was conducted. In addition, two approaches to the synthesis of artificial glycoproteins with homogeneous oligosaccharides were investigated. Furthermore, a novel substrate of UGGT was discovered.

Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

PubMed

Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

2015-09-01

To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

A failure modes and effects analysis study for gynecologic high-dose-rate brachytherapy.

PubMed

Mayadev, Jyoti; Dieterich, Sonja; Harse, Rick; Lentz, Susan; Mathai, Mathew; Boddu, Sunita; Kern, Marianne; Courquin, Jean; Stern, Robin L

2015-01-01

To improve the quality of our gynecologic brachytherapy practice and reduce reportable events, we performed a process analysis after the failure modes and effects analysis (FMEA). The FMEA included a multidisciplinary team specifically targeting the tandem and ring brachytherapy procedure. The treatment process was divided into six subprocesses and failure modes (FMs). A scoring guideline was developed based on published FMEA studies and assigned through team consensus. FMs were ranked according to overall and severity scores. FM ranking >5% of the highest risk priority number (RPN) score was selected for in-depth analysis. The efficiency of each existing quality assurance to detect each FM was analyzed. We identified 170 FMs, and 99 were scored. RPN scores ranged from 1 to 192. Of the 13 highest-ranking FMs with RPN scores >80, half had severity scores of 8 or 9, with no mode having severity of 10. Of these FM, the originating process steps were simulation (5), treatment planning (5), treatment delivery (2), and insertion (1). Our high-ranking FM focused on communication and the potential for applicator movement. Evaluation of the efficiency and the comprehensiveness of our quality assurance program showed coverage of all but three of the top 49 FMs ranked by RPN. This is the first reported FMEA process for a comprehensive gynecologic brachytherapy procedure overview. We were able to identify FMs that could potentially and severely impact the patient's treatment. We continue to adjust our quality assurance program based on the results of our FMEA analysis. Published by Elsevier Inc.

Chemical analysis of Panax quinquefolius (North American ginseng): A review.

PubMed

Wang, Yaping; Choi, Hyung-Kyoon; Brinckmann, Josef A; Jiang, Xue; Huang, Linfang

2015-12-24

Panax quinquefolius (PQ) is one of the best-selling natural health products due to its proposed beneficial anti-aging, anti-cancer, anti-stress, anti-fatigue, and anxiolytic effects. In recent years, the quality of PQ has received considerable attention. Sensitive and accurate methods for qualitative and quantitative analyses of chemical constituents are necessary for the comprehensive quality control to ensure the safety and efficacy of PQ. This article reviews recent progress in the chemical analysis of PQ and its preparations. Numerous analytical techniques, including spectroscopy, thin-layer chromatography (TLC), gas chromatography (GC), high-performance liquid chromatography (HPLC), liquid chromatography/mass spectrometry (LC/MS), high-speed centrifugal partition chromatography (HSCPC), high-performance counter-current chromatography (HPCCC), nuclear magnetic resonance spectroscopy (NMR), and immunoassay, are described. Among these techniques, HPLC coupled with mass spectrometry (MS) is the most promising method for quality control. The challenges encountered in the chemical analysis of PQ are also briefly discussed, and the remaining questions regarding the quality control of PQ that require further investigation are highlighted. Copyright © 2015 Elsevier B.V. All rights reserved.

Wellness Promotion Strategies. Selected Proceedings of the Annual National Wellness Conference (8th, Stevens Point, Wisconsin).

ERIC Educational Resources Information Center

Opatz, Joseph P., Ed.

A major concern to practitioners in the wellness movement has been the dearth of high quality up-to-date information about their field. This book provides a comprehensive and current look at the wellness field. Presentations in part 1 include: (1) "The History and Future of the Wellness Movement" (Donald B. Ardell); (2) "Presenting…

On the Road to Success: How States Collaborate and Use Data to Improve Student Outcomes. Executive Summary

ERIC Educational Resources Information Center

Jobs for the Future, 2012

2012-01-01

Enrollment is rising across the nation's community colleges, but completion rates remain untenably low. Reformers are focusing on the importance of using comprehensive, high-quality data on student progress and completion to bring about change. A core tenet of Achieving the Dream: Community Colleges Count has been to embed a culture of…

Partnerships, Not Pushouts. A Guide for School Board Members: Community Partnerships for Student Success. Version 1.0

ERIC Educational Resources Information Center

Institute for Educational Leadership, 2014

2014-01-01

In today's global economy, a high-quality, comprehensive education is no longer just a pathway to opportunity--it is a prerequisite for success. Such an education must promote academic knowledge and skills, as well as the kind of individual and social competencies that are essential for navigating the relationships and challenges of the modern…

Alignment of Sexuality Education with Self Determination for People with Significant Disabilities: A Review of Research and Future Directions

ERIC Educational Resources Information Center

Travers, Jason; Tincani, Matt; Whitby, Peggy Schaefer; Boutot, E. Amanda

2014-01-01

Sexual development is a complex but vital part of the human experience. People with significant disabilities are not excluded from this principle, but often may be prevented from receiving high-quality and comprehensive instruction necessary for a healthy sexual life. The functional model of self-determination emphasizes increasing knowledge,…

Health Inequalities and Access to Health Care for Adults with Learning Disabilities in Lincolnshire

ERIC Educational Resources Information Center

Walker, Carol; Beck, Charles R.; Eccles, Richard; Weston, Chris

2016-01-01

The NHS Constitution requires all NHS organisations to provide high-quality comprehensive services, based on clinical need, which do not discriminate between patients (DH 2010a). Together with its health and social care partners, the NHS also has a statutory duty of care to meet the needs of all patients with dignity and compassion. Recent…

Leveraging long read sequencing from a single individual to provide a comprehensive resource for benchmarking variant calling methods

PubMed Central

Mu, John C.; Tootoonchi Afshar, Pegah; Mohiyuddin, Marghoob; Chen, Xi; Li, Jian; Bani Asadi, Narges; Gerstein, Mark B.; Wong, Wing H.; Lam, Hugo Y. K.

2015-01-01

A high-confidence, comprehensive human variant set is critical in assessing accuracy of sequencing algorithms, which are crucial in precision medicine based on high-throughput sequencing. Although recent works have attempted to provide such a resource, they still do not encompass all major types of variants including structural variants (SVs). Thus, we leveraged the massive high-quality Sanger sequences from the HuRef genome to construct by far the most comprehensive gold set of a single individual, which was cross validated with deep Illumina sequencing, population datasets, and well-established algorithms. It was a necessary effort to completely reanalyze the HuRef genome as its previously published variants were mostly reported five years ago, suffering from compatibility, organization, and accuracy issues that prevent their direct use in benchmarking. Our extensive analysis and validation resulted in a gold set with high specificity and sensitivity. In contrast to the current gold sets of the NA12878 or HS1011 genomes, our gold set is the first that includes small variants, deletion SVs and insertion SVs up to a hundred thousand base-pairs. We demonstrate the utility of our HuRef gold set to benchmark several published SV detection tools. PMID:26412485

Quantitative phosphoproteomic analysis of caprine muscle with high and low meat quality.

PubMed

Liu, Manshun; Wei, Yanchao; Li, Xin; Quek, Siew Young; Zhao, Jing; Zhong, Huazhen; Zhang, Dequan; Liu, Yongfeng

2018-07-01

During the conversion of muscle to meat, protein phosphorylation can regulate various biological processes that have important effects on meat quality. To investigate the phosphorylation pattern of protein on rigor mortis, goat longissimus thoracis and external intercostals were classified into two groups (high quality and low quality), and meat quality was evaluated according to meat quality attributes (Warner-Bratzler shear force, Color, pH and drip loss). A quantitative mass spectrometry-based phosphoproteomic study was conducted to analyze the caprine muscle at 12h postmortem applying the TiO 2 -SIMAC-HILIC (TiSH) phosphopeptide enrichment strategy. A total of 2125 phosphopeptides were identified from 750 phosphoproteins. Among them, 96 proteins had differed in phosphorylation levels. The majority of these proteins are involved in glucose metabolism and muscle contraction. The differential phosphorylation level of proteins (PFK, MYL2 and HSP27) in two groups may be the crucial factors of regulating muscle rigor mortis. This study provides a comprehensive view for the phosphorylation status of caprine muscle at rigor mortis, it also gives a better understanding of the regulation of protein phosphorylation on various biological processes that affect the final meat quality attributes. Copyright © 2018. Published by Elsevier Ltd.

Students' Daily Physical Activity Behaviors: The Role of Quality Physical Education in a Comprehensive School Physical Activity Program

ERIC Educational Resources Information Center

Chen, Wiyun; Hypnar, Andrew J.; Mason, Steve A.; Zalmout, Sandy

2014-01-01

The purpose of this study was to examine the contribution of quality physical education (QPET) in a Comprehensive School Physical Activity Program (CSPAP) which is intended to promote physical activity (PA) behaviors in and outside of schools. Participants were nine elementary physical education teachers and their fourth- and fifth-grade students…

A semi-active suspension control algorithm for vehicle comprehensive vertical dynamics performance

NASA Astrophysics Data System (ADS)

Nie, Shida; Zhuang, Ye; Liu, Weiping; Chen, Fan

2017-08-01

Comprehensive performance of the vehicle, including ride qualities and road-holding, is essentially of great value in practice. Many up-to-date semi-active control algorithms improve vehicle dynamics performance effectively. However, it is hard to improve comprehensive performance for the conflict between ride qualities and road-holding around the second-order resonance. Hence, a new control algorithm is proposed to achieve a good trade-off between ride qualities and road-holding. In this paper, the properties of the invariant points are analysed, which gives an insight into the performance conflicting around the second-order resonance. Based on it, a new control algorithm is proposed. The algorithm employs a novel frequency selector to balance suspension ride and handling performance by adopting a medium damping around the second-order resonance. The results of this study show that the proposed control algorithm could improve the performance of ride qualities and suspension working space up to 18.3% and 8.2%, respectively, with little loss of road-holding compared to the passive suspension. Consequently, the comprehensive performance can be improved by 6.6%. Hence, the proposed algorithm is of great potential to be implemented in practice.

The effect of voice quality and competing speakers in a passage comprehension task: performance in relation to cognitive functioning in children with normal hearing.

PubMed

von Lochow, Heike; Lyberg-Åhlander, Viveka; Sahlén, Birgitta; Kastberg, Tobias; Brännström, K Jonas

2018-04-01

This study explores the effect of voice quality and competing speaker/-s on children's performance in a passage comprehension task. Furthermore, it explores the interaction between passage comprehension and cognitive functioning. Forty-nine children (27 girls and 22 boys) with normal hearing (aged 7-12 years) participated. Passage comprehension was tested in six different listening conditions; a typical voice (non-dysphonic voice) in quiet, a typical voice with one competing speaker, a typical voice with four competing speakers, a dysphonic voice in quiet, a dysphonic voice with one competing speaker, and a dysphonic voice with four competing speakers. The children's working memory capacity and executive functioning were also assessed. The findings indicate no direct effect of voice quality on the children's performance, but a significant effect of background listening condition. Interaction effects were seen between voice quality, background listening condition, and executive functioning. The children's susceptibility to the effect of the dysphonic voice and the background listening conditions are related to the individual's executive functions. The findings have several implications for design of interventions in language learning environments such as classrooms.

Air quality impacts of transit improvement, preferential lane, and carpool programs: an annotated bibliography of demonstration and analytical experience. Final report

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

DiRenzo, J.F.; Rubin, R.B.

1978-03-01

In accordance with the Clean Air Act Amendments of 1977, the Environmental Protection Agency is evaluating the use and cost-effectiveness of alternative short-range transit fare and service improvement strategies, carpool and vanpool strategies, and strategies involving the preferential treatment of high occupancy vehicles to improve air quality in urban areas. The evaluation of individual strategies and combinations of the above strategies includes their emission and air quality impacts and their related energy, noise, and economic impacts. A comprehensive literature review was also conducted, as part of this evaluation, to identify both observed and projected travel, emission, air quality, energy, noise,more » and economic impacts of the short-range low-cost strategies of interest.« less

Cryopreservation in fish: current status and pathways to quality assurance and quality control in repository development

PubMed Central

Torres, Leticia; Hu, E.; Tiersch, Terrence R.

2017-01-01

Cryopreservation in aquatic species in general has been constrained to research activities for more than 60 years. Although the need for application and commercialisation pathways has become clear, the lack of comprehensive quality assurance and quality control programs has impeded the progress of the field, delaying the establishment of germplasm repositories and commercial-scale applications. In this review we focus on the opportunities for standardisation in the practices involved in the four main stages of the cryopreservation process: (1) source, housing and conditioning of fish; (2) sample collection and preparation; (3) freezing and cryogenic storage of samples; and (4) egg collection and use of thawed sperm samples. In addition, we introduce some key factors that would assist the transition to commercial-scale, high-throughput application. PMID:26739583

Comprehensive Schooling: In Need of Definition?

ERIC Educational Resources Information Center

Heath, Natalie

2004-01-01

Comprehensive secondary schooling is currently beset by changes and challenges. The creation of specialist schools and emphasis upon league tables and parental choice appears to be undermining comprehensive schooling. Inequalities within the current system are highlighted by increased variation of perceived quality between schools, the existence…

Interventions for improving upper limb function after stroke.

PubMed

Pollock, Alex; Farmer, Sybil E; Brady, Marian C; Langhorne, Peter; Mead, Gillian E; Mehrholz, Jan; van Wijck, Frederike

2014-11-12

Improving upper limb function is a core element of stroke rehabilitation needed to maximise patient outcomes and reduce disability. Evidence about effects of individual treatment techniques and modalities is synthesised within many reviews. For selection of effective rehabilitation treatment, the relative effectiveness of interventions must be known. However, a comprehensive overview of systematic reviews in this area is currently lacking. To carry out a Cochrane overview by synthesising systematic reviews of interventions provided to improve upper limb function after stroke. We comprehensively searched the Cochrane Database of Systematic Reviews; the Database of Reviews of Effects; and PROSPERO (an international prospective register of systematic reviews) (June 2013). We also contacted review authors in an effort to identify further relevant reviews. We included Cochrane and non-Cochrane reviews of randomised controlled trials (RCTs) of patients with stroke comparing upper limb interventions with no treatment, usual care or alternative treatments. Our primary outcome of interest was upper limb function; secondary outcomes included motor impairment and performance of activities of daily living. When we identified overlapping reviews, we systematically identified the most up-to-date and comprehensive review and excluded reviews that overlapped with this. Two overview authors independently applied the selection criteria, excluding reviews that were superseded by more up-to-date reviews including the same (or similar) studies. Two overview authors independently assessed the methodological quality of reviews (using a modified version of the AMSTAR tool) and extracted data. Quality of evidence within each comparison in each review was determined using objective criteria (based on numbers of participants, risk of bias, heterogeneity and review quality) to apply GRADE (Grades of Recommendation, Assessment, Development and Evaluation) levels of evidence. We resolved disagreements through discussion. We systematically tabulated the effects of interventions and used quality of evidence to determine implications for clinical practice and to make recommendations for future research. Our searches identified 1840 records, from which we included 40 completed reviews (19 Cochrane; 21 non-Cochrane), covering 18 individual interventions and dose and setting of interventions. The 40 reviews contain 503 studies (18,078 participants). We extracted pooled data from 31 reviews related to 127 comparisons. We judged the quality of evidence to be high for 1/127 comparisons (transcranial direct current stimulation (tDCS) demonstrating no benefit for outcomes of activities of daily living (ADLs)); moderate for 49/127 comparisons (covering seven individual interventions) and low or very low for 77/127 comparisons.Moderate-quality evidence showed a beneficial effect of constraint-induced movement therapy (CIMT), mental practice, mirror therapy, interventions for sensory impairment, virtual reality and a relatively high dose of repetitive task practice, suggesting that these may be effective interventions; moderate-quality evidence also indicated that unilateral arm training may be more effective than bilateral arm training. Information was insufficient to reveal the relative effectiveness of different interventions.Moderate-quality evidence from subgroup analyses comparing greater and lesser doses of mental practice, repetitive task training and virtual reality demonstrates a beneficial effect for the group given the greater dose, although not for the group given the smaller dose; however tests for subgroup differences do not suggest a statistically significant difference between these groups. Future research related to dose is essential.Specific recommendations for future research are derived from current evidence. These recommendations include but are not limited to adequately powered, high-quality RCTs to confirm the benefit of CIMT, mental practice, mirror therapy, virtual reality and a relatively high dose of repetitive task practice; high-quality RCTs to explore the effects of repetitive transcranial magnetic stimulation (rTMS), tDCS, hands-on therapy, music therapy, pharmacological interventions and interventions for sensory impairment; and up-to-date reviews related to biofeedback, Bobath therapy, electrical stimulation, reach-to-grasp exercise, repetitive task training, strength training and stretching and positioning. Large numbers of overlapping reviews related to interventions to improve upper limb function following stroke have been identified, and this overview serves to signpost clinicians and policy makers toward relevant systematic reviews to support clinical decisions, providing one accessible, comprehensive document, which should support clinicians and policy makers in clinical decision making for stroke rehabilitation.Currently, no high-quality evidence can be found for any interventions that are currently used as part of routine practice, and evidence is insufficient to enable comparison of the relative effectiveness of interventions. Effective collaboration is urgently needed to support large, robust RCTs of interventions currently used routinely within clinical practice. Evidence related to dose of interventions is particularly needed, as this information has widespread clinical and research implications.

[Study on the optimization of monitoring indicators of drinking water quality during health supervision].

PubMed

Ye, Bixiong; E, Xueli; Zhang, Lan

2015-01-01

To optimize non-regular drinking water quality indices (except Giardia and Cryptosporidium) of urban drinking water. Several methods including drinking water quality exceed the standard, the risk of exceeding standard, the frequency of detecting concentrations below the detection limit, water quality comprehensive index evaluation method, and attribute reduction algorithm of rough set theory were applied, redundancy factor of water quality indicators were eliminated, control factors that play a leading role in drinking water safety were found. Optimization results showed in 62 unconventional water quality monitoring indicators of urban drinking water, 42 water quality indicators could be optimized reduction by comprehensively evaluation combined with attribute reduction of rough set. Optimization of the water quality monitoring indicators and reduction of monitoring indicators and monitoring frequency could ensure the safety of drinking water quality while lowering monitoring costs and reducing monitoring pressure of the sanitation supervision departments.

Third Molars on the Internet: A Guide for Assessing Information Quality and Readability

PubMed Central

Brennan, David; Sambrook, Paul; Armfield, Jason

2015-01-01

Background 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. Objectives 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. Methods 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). Results 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. Conclusion 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. PMID:26443470

a Comprehensive Review of Pansharpening Algorithms for GÖKTÜRK-2 Satellite Images

NASA Astrophysics Data System (ADS)

Kahraman, S.; Ertürk, A.

2017-11-01

In this paper, a comprehensive review and performance evaluation of pansharpening algorithms for GÖKTÜRK-2 images is presented. GÖKTÜRK-2 is the first high resolution remote sensing satellite of Turkey which was designed and built in Turkey, by The Ministry of Defence, TUBITAK-UZAY and Turkish Aerospace Industry (TUSAŞ) collectively. GÖKTÜRK-2 was launched at 18th. December 2012 in Jinguan, China and provides 2.5 meter panchromatic (PAN) and 5 meter multispectral (MS) spatial resolution satellite images. In this study, a large number of pansharpening algorithms are implemented and evaluated for performance on multiple GÖKTÜRK-2 satellite images. Quality assessments are conducted both qualitatively through visual results and quantitatively using Root Mean Square Error (RMSE), Correlation Coefficient (CC), Spectral Angle Mapper (SAM), Erreur Relative Globale Adimensionnelle de Synthése (ERGAS), Peak Signal to Noise Ratio (PSNR), Structural Similarity Index (SSIM) and Universal Image Quality Index (UIQI).

Does the speaker's voice quality influence children's performance on a language comprehension test?

PubMed

Lyberg-Åhlander, Viveka; Haake, Magnus; Brännström, Jonas; Schötz, Susanne; Sahlén, Birgitta

2015-02-01

A small number of studies have explored children's perception of speakers' voice quality and its possible influence on language comprehension. The aim of this explorative study was to investigate the relationship between the examiner's voice quality, the child's performance on a digital version of a language comprehension test, the Test for Reception of Grammar (TROG-2), and two measures of cognitive functioning. The participants were (n = 86) mainstreamed 8-year old children with typical language development. Two groups of children (n = 41/45) were presented with the TROG-2 through recordings of one female speaker: one group was presented with a typical voice and the other with a simulated dysphonic voice. Significant associations were found between executive functioning and language comprehension. The results also showed that children listening to the dysphonic voice achieved significantly lower scores for more difficult sentences ("the man but not the horse jumps") and used more self-corrections on simpler sentences ("the girl is sitting"). Findings suggest that a dysphonic speaker's voice may force the child to allocate capacity to the processing of the voice signal at the expense of comprehension. The findings have implications for clinical and research settings where standardized language tests are used.

Systematic review of recent dementia practice guidelines.

PubMed

Ngo, Jennifer; Holroyd-Leduc, Jayna M

2015-01-01

dementia is a highly prevalent acquired cognitive disorder that interferes with activities of daily living, relationships and quality of life. Recognition and effective management strategies are necessary to provide comprehensive care for these patients and their families. High-quality clinical practice guidelines can improve the quality and consistency of care in all aspects of dementia diagnosis and management by clarifying interventions supported by sound evidence and by alerting clinicians to interventions without proven benefit. we aimed to offer a synthesis of existing practice recommendations for the diagnosis and management of dementia, based upon moderate-to-high quality dementia guidelines. we performed a systematic search in EMBASE and MEDLINE as well as the grey literature for guidelines produced between 2008 and 2013. thirty-nine retrieved practice guidelines were included for quality appraisal by the Appraisal of Guidelines Research and Evaluation II (AGREE-II) tool, performed by two independent reviewers. From the 12 moderate-to-high quality guidelines included, specific practice recommendations for the diagnosis and/or management of any aspect of dementia were extracted for comparison based upon the level of evidence and strength of recommendation. there was a general agreement between guidelines for many practice recommendations. However, direct comparisons between guidelines were challenging due to variations in grading schemes. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[National health resources for highly specialised medicine].

PubMed

Bratlid, Dag; Rasmussen, Knut

2005-11-03

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

Manipulating Google's Knowledge Graph Box to Counter Biased Information Processing During an Online Search on Vaccination: Application of a Technological Debiasing Strategy.

PubMed

Ludolph, Ramona; Allam, Ahmed; Schulz, Peter J

2016-06-02

One of people's major motives for going online is the search for health-related information. Most consumers start their search with a general search engine but are unaware of the fact that its sorting and ranking criteria do not mirror information quality. This misconception can lead to distorted search outcomes, especially when the information processing is characterized by heuristic principles and resulting cognitive biases instead of a systematic elaboration. As vaccination opponents are vocal on the Web, the chance of encountering their non‒evidence-based views on immunization is high. Therefore, biased information processing in this context can cause subsequent impaired judgment and decision making. A technological debiasing strategy could counter this by changing people's search environment. This study aims at testing a technological debiasing strategy to reduce the negative effects of biased information processing when using a general search engine on people's vaccination-related knowledge and attitudes. This strategy is to manipulate the content of Google's knowledge graph box, which is integrated in the search interface and provides basic information about the search topic. A full 3x2 factorial, posttest-only design was employed with availability of basic factual information (comprehensible vs hardly comprehensible vs not present) as the first factor and a warning message as the second factor of experimental manipulation. Outcome variables were the evaluation of the knowledge graph box, vaccination-related knowledge, as well as beliefs and attitudes toward vaccination, as represented by three latent variables emerged from an exploratory factor analysis. Two-way analysis of variance revealed a significant main effect of availability of basic information in the knowledge graph box on participants' vaccination knowledge scores (F2,273=4.86, P=.01), skepticism/fear of vaccination side effects (F2,273=3.5, P=.03), and perceived information quality (F2,273=3.73, P=.02). More specifically, respondents receiving comprehensible information appeared to be more knowledgeable, less skeptical of vaccination, and more critical of information quality compared to participants exposed to hardly comprehensible information. Although, there was no significant interaction effect between the availability of information and the presence of the warning, there was a dominant pattern in which the presence of the warning appeared to have a positive influence on the group receiving comprehensible information while the opposite was true for the groups exposed to hardly comprehensible information and no information at all. Participants evaluated the knowledge graph box as moderately to highly useful, with no significant differences among the experimental groups. Overall, the results suggest that comprehensible information in the knowledge graph box positively affects participants' vaccination-related knowledge and attitudes. A small change in the content retrieval procedure currently used by Google could already make a valuable difference in the pursuit of an unbiased online information search. Further research is needed to gain insights into the knowledge graph box's entire potential.

New tools for sculpting cranial implants in a shared haptic augmented reality environment.

PubMed

Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

2006-01-01

New volumetric tools were developed for the design and fabrication of high quality cranial implants from patient CT data. These virtual tools replace time consuming physical sculpting, mold making and casting steps. The implant is designed by medical professionals in tele-immersive collaboration. Virtual clay is added in the virtual defect area on the CT data using the adding tool. With force feedback the modeler can feel the edge of the defect and fill only the space where no bone is present. A carving tool and a smoothing tool are then used to sculpt and refine the implant. To make a physical evaluation, the skull with simulated defect and the implant are fabricated via stereolithography to allow neurosurgeons to evaluate the quality of the implant. Initial tests demonstrate a very high quality fit. These new haptic volumetric sculpting tools are a critical component of a comprehensive tele-immersive system.

A protocol for generating a high-quality genome-scale metabolic reconstruction.

PubMed

Thiele, Ines; Palsson, Bernhard Ø

2010-01-01

Network reconstructions are a common denominator in systems biology. Bottom-up metabolic network reconstructions have been developed over the last 10 years. These reconstructions represent structured knowledge bases that abstract pertinent information on the biochemical transformations taking place within specific target organisms. The conversion of a reconstruction into a mathematical format facilitates a myriad of computational biological studies, including evaluation of network content, hypothesis testing and generation, analysis of phenotypic characteristics and metabolic engineering. To date, genome-scale metabolic reconstructions for more than 30 organisms have been published and this number is expected to increase rapidly. However, these reconstructions differ in quality and coverage that may minimize their predictive potential and use as knowledge bases. Here we present a comprehensive protocol describing each step necessary to build a high-quality genome-scale metabolic reconstruction, as well as the common trials and tribulations. Therefore, this protocol provides a helpful manual for all stages of the reconstruction process.

A protocol for generating a high-quality genome-scale metabolic reconstruction

PubMed Central

Thiele, Ines; Palsson, Bernhard Ø.

2011-01-01

Network reconstructions are a common denominator in systems biology. Bottom-up metabolic network reconstructions have developed over the past 10 years. These reconstructions represent structured knowledge-bases that abstract pertinent information on the biochemical transformations taking place within specific target organisms. The conversion of a reconstruction into a mathematical format facilitates myriad computational biological studies including evaluation of network content, hypothesis testing and generation, analysis of phenotypic characteristics, and metabolic engineering. To date, genome-scale metabolic reconstructions for more than 30 organisms have been published and this number is expected to increase rapidly. However, these reconstructions differ in quality and coverage that may minimize their predictive potential and use as knowledge-bases. Here, we present a comprehensive protocol describing each step necessary to build a high-quality genome-scale metabolic reconstruction as well as common trials and tribulations. Therefore, this protocol provides a helpful manual for all stages of the reconstruction process. PMID:20057383

Assessing coastal reclamation suitability based on a fuzzy-AHP comprehensive evaluation framework: A case study of Lianyungang, China.

PubMed

Feng, Lan; Zhu, Xiaodong; Sun, Xiang

2014-12-15

Coastal reclamation suitability evaluation (CRSE) is a difficult, complex and protracted process requiring the evaluation of many different criteria. In this paper, an integrated framework employing a fuzzy comprehensive evaluation method and analytic hierarchy process (AHP) was applied to the suitability evaluation for coastal reclamation for future sustainable development in the coastal area of Lianyungang, China. The evaluation results classified 6.63%, 22.99%, 31.59% and 38.79% of the coastline as suitable, weakly suitable, unsuitable and forbidden, respectively. The evaluation results were verified by the marine pollution data and highly consistent with the water quality status. The fuzzy-AHP comprehensive evaluation method (FACEM) was found to be suitable for the CRSE. This CRSE can also be applied to other coastal areas in China and thereby be used for the better management of coastal reclamation and coastline protection projects. Copyright © 2014 Elsevier Ltd. All rights reserved.

Deaf Education Teacher Preparation: A Phenomenological Case Study of a Graduate Program With a Comprehensive Philosophy.

PubMed

Engler, Karen S; MacGregor, Cynthia J

2018-01-01

At a time when deaf education teacher preparation programs are declining in number, little is known about their actual effectiveness. A phenomenological case study of a graduate-level comprehensive deaf education teacher preparation program at a midwestern university explored empowered and enabled learning of teacher candidates using the Missouri Department of Elementary and Secondary Education educator pillars: (a) commitment to the profession, (b) proficiency in practice, and (c) learning impact, all deemed critical to developing quality teachers. A strong connection was found between the program's comprehensive philosophy and its practice. Embracing diversity of d/Deafness and differentiated instruction were the most prevalent themes expressed by participants. Teacher candidates displayed outstanding commitment to the profession and high proficiency in practice. The findings suggest that additional consideration should be given to classroom and behavior management, teacher candidate workload, teaching beyond academics, and preparation for navigating the public school system.

Monitoring and Assessment of Youshui River Water Quality in Youyang

NASA Astrophysics Data System (ADS)

Wang, Xue-qin; Wen, Juan; Chen, Ping-hua; Liu, Na-na

2018-02-01

By monitoring the water quality of Youshui River from January 2016 to December 2016, according to the indicator grading and the assessment standard of water quality, the formulas for 3 types water quality indexes are established. These 3 types water quality indexes, the single indicator index Ai, single moment index Ak and the comprehensive water quality index A, were used to quantitatively evaluate the quality of single indicator, the water quality and the change of water quality with time. The results show that, both total phosphorus and fecal coliform indicators exceeded the standard, while the other 16 indicators measured up to the standard. The water quality index of Youshui River is 0.93 and the grade of water quality comprehensive assessment is level 2, which indicated that the water quality of Youshui River is good, and there is room for further improvement. To this end, several protection measures for Youshui River environmental management and pollution treatment are proposed.

[Quality assurance and total quality management in residential home care].

PubMed

Nübling, R; Schrempp, C; Kress, G; Löschmann, C; Neubart, R; Kuhlmey, A

2004-02-01

Quality, quality assurance, and quality management have been important topics in residential care homes for several years. However, only as a result of reform processes in the German legislation (long-term care insurance, care quality assurance) is a systematic discussion taking place. Furthermore, initiatives and holistic model projects, which deal with the assessment and improvement of service quality, were developed in the field of care for the elderly. The present article gives a critical overview of essential developments. Different comprehensive approaches such as the implementation of quality management systems, nationwide expert-based initiatives, and developments towards professionalizing care are discussed. Empirically based approaches, especially those emphasizing the assessment of outcome quality, are focused on in this work. Overall, the authors conclude that in the past few years comprehensive efforts have been made to improve the quality of care. However, the current situation still requires much work to establish a nationwide launch and implementation of evidence-based quality assurance and quality management.

Uncovering the Fundamental Nature of Tribological Interfaces: High Resolution Tribology and Spectroscopy of Ultrahard Nanostructured Diamond Films for MEMS and Beyond

DTIC Science & Technology

2007-12-31

Wisconsin-Madison) for 2? ol !> o "S \\ % M 31 Statement of Objectives The original objectives of the proposal were as follows: 1. Obtain high-quality...performed multiple PEEM experiments on wear tracks on carbon-based films and polysilicon micro-electro mechanical systems (MEMS) devices, a comprehensive... polysilicon MEMS device known as the "nanotractor", and studies of the structure and composition of UNCD, ta-C, and nanocrystalline diamond (NCD) films. They

Comprehensive Performance Study of Magneto Cantilevers as a Candidate Model for Biological Sensors used in Lab-on-a-Chip Applications

PubMed Central

Saberkari, Hamidreza; Ghavifekr, Habib Badri; Shamsi, Mousa

2015-01-01

In recent years, demand for biological sensors which are capable of fast and accurate detection of minor amounts of pathogens in real-time form has been intensified. Acoustic wave (AW) devices whose performance is determined by mass sensitivity parameters and quality factor are used in biological sensors as platforms with high quality. Yet, current AW devices are facing many challenges such as the low value of their quality factor in practical applications and also their difficulty to use in liquids. The main focus of this article is to study on the magnetostrictive sensors which include milli/microcantilever (MSMC) type. In comparison with AW devices, MSMC has a lot of advantages; (1) its actuation and sensing unit is wirelessly controlled. (2) Its fabrication process is easy. (3) It works well in liquids. (4) It has a high-quality factor (in the air > 500). Simulation results demonstrate that the amount of quality factor depends on environment properties (density and viscosity), MSMC geometry, and its resonant behavior of harmonic modes. PMID:26120566

Management decision of optimal recharge water in groundwater artificial recharge conditions- A case study in an artificial recharge test site

NASA Astrophysics Data System (ADS)

He, H. Y.; Shi, X. F.; Zhu, W.; Wang, C. Q.; Ma, H. W.; Zhang, W. J.

2017-11-01

The city conducted groundwater artificial recharge test which was taken a typical site as an example, and the purpose is to prevent and control land subsidence, increase the amount of groundwater resources. To protect groundwater environmental quality and safety, the city chose tap water as recharge water, however, the high cost makes it not conducive to the optimal allocation of water resources and not suitable to popularize widely. To solve this, the city selects two major surface water of River A and B as the proposed recharge water, to explore its feasibility. According to a comprehensive analysis of the cost of recharge, the distance of the water transport, the quality of recharge water and others. Entropy weight Fuzzy Comprehensive Evaluation Method is used to prefer tap water and water of River A and B. Evaluation results show that water of River B is the optimal recharge water, if used; recharge cost will be from 0.4724/m3 to 0.3696/m3. Using Entropy weight Fuzzy Comprehensive Evaluation Method to confirm water of River B as optimal water is scientific and reasonable. The optimal water management decisions can provide technical support for the city to carry out overall groundwater artificial recharge engineering in deep aquifer.

Low working memory capacity is only spuriously related to poor reading comprehension

PubMed Central

Van Dyke, Julie A.; Johns, Clinton L.; Kukona, Anuenue

2014-01-01

Accounts of comprehension failure, whether in the case of readers with poor skill or when syntactic complexity is high, have overwhelmingly implicated working memory capacity as the key causal factor. However, extant research suggests that this position is not well supported by evidence on the span of active memory during online sentence processing, nor is it well motivated by models that make explicit claims about the memory mechanisms that support language processing. The current study suggests that sensitivity to interference from similar items in memory may provide a better explanation of comprehension failure. Through administration of a comprehensive skill battery, we found that the previously observed association of working memory with comprehension is likely due to the collinearity of working memory with many other reading-related skills, especially IQ. In analyses which removed variance shared with IQ, we found that receptive vocabulary knowledge was the only significant predictor of comprehension performance in our task out of a battery of 24 skill measures. In addition, receptive vocabulary and non-verbal memory for serial order—but not simple verbal memory or working memory—were the only predictors of reading times in the region where interference had its primary affect. We interpret these results in light of a model that emphasizes retrieval interference and the quality of lexical representations as key determinants of successful comprehension. PMID:24657820

Low working memory capacity is only spuriously related to poor reading comprehension.

PubMed

Van Dyke, Julie A; Johns, Clinton L; Kukona, Anuenue

2014-06-01

Accounts of comprehension failure, whether in the case of readers with poor skill or when syntactic complexity is high, have overwhelmingly implicated working memory capacity as the key causal factor. However, extant research suggests that this position is not well supported by evidence on the span of active memory during online sentence processing, nor is it well motivated by models that make explicit claims about the memory mechanisms that support language processing. The current study suggests that sensitivity to interference from similar items in memory may provide a better explanation of comprehension failure. Through administration of a comprehensive skill battery, we found that the previously observed association of working memory with comprehension is likely due to the collinearity of working memory with many other reading-related skills, especially IQ. In analyses which removed variance shared with IQ, we found that receptive vocabulary knowledge was the only significant predictor of comprehension performance in our task out of a battery of 24 skill measures. In addition, receptive vocabulary and non-verbal memory for serial order-but not simple verbal memory or working memory-were the only predictors of reading times in the region where interference had its primary affect. We interpret these results in light of a model that emphasizes retrieval interference and the quality of lexical representations as key determinants of successful comprehension. Copyright © 2014 Elsevier B.V. All rights reserved.

Implementation of occupational health service improvements through application of total quality management processes.

PubMed

Thomas, Elizabeth Anne

2011-06-01

The occupational health services department for a manufacturing division of a high-technology firm was redesigned from an outsourced model, in which most services were provided by an outside clinic vendor, to an in-house service model, in which services were provided by an on-site nurse practitioner. The redesign and implementation, accomplished by a cross-functional team using Total Quality Management processes, resulted in a comprehensive occupational health services department that realized significant cost reduction, increased compliance with regulatory and company requirements, and improved employee satisfaction. Implications of this project for occupational health nurses are discussed.

A new method for water quality assessment: by harmony degree equation.

PubMed

Zuo, Qiting; Han, Chunhui; Liu, Jing; Ma, Junxia

2018-02-22

Water quality assessment is an important basic work in the development, utilization, management, and protection of water resources, and also a prerequisite for water safety. In this paper, the harmony degree equation (HDE) was introduced into the research of water quality assessment, and a new method for water quality assessment was proposed according to the HDE: by harmony degree equation (WQA-HDE). First of all, the calculation steps and ideas of this method were described in detail, and then, this method with some other important methods of water quality assessment (single factor assessment method, mean-type comprehensive index assessment method, and multi-level gray correlation assessment method) were used to assess the water quality of the Shaying River (the largest tributary of the Huaihe in China). For this purpose, 2 years (2013-2014) dataset of nine water quality variables covering seven monitoring sites, and approximately 189 observations were used to compare and analyze the characteristics and advantages of the new method. The results showed that the calculation steps of WQA-HDE are similar to the comprehensive assessment method, and WQA-HDE is more operational comparing with the results of other water quality assessment methods. In addition, this new method shows good flexibility by setting the judgment criteria value HD 0 of water quality; when HD 0  = 0.8, the results are closer to reality, and more realistic and reliable. Particularly, when HD 0  = 1, the results of WQA-HDE are consistent with the single factor assessment method, both methods are subject to the most stringent "one vote veto" judgment condition. So, WQA-HDE is a composite method that combines the single factor assessment and comprehensive assessment. This research not only broadens the research field of theoretical method system of harmony theory but also promotes the unity of water quality assessment method and can be used for reference in other comprehensive assessment.

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality

PubMed Central

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G.; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H.; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

Objective To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. Study design and setting We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Results Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Conclusion Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders’ individual perspectives is desirable to facilitate discussion, assessment, and improvement of quality at all stages of clinical research. PMID:28715491

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality.

PubMed

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders' individual perspectives is desirable to facilitate discussion, assessment, and improvement of quality at all stages of clinical research.

The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units.

PubMed

Li, Dan

2016-08-01

To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete picture of patients' care needs that require nursing interventions. The implication of this study involves pressure ulcer prevention and litigable risk of nursing documentation. © 2016 John Wiley & Sons Ltd.

Lexical quality and eye movements: individual differences in the perceptual span of skilled adult readers.

PubMed

Veldre, Aaron; Andrews, Sally

2014-01-01

Two experiments used the gaze-contingent moving-window paradigm to investigate whether reading comprehension and spelling ability modulate the perceptual span of skilled adult readers during sentence reading. Highly proficient reading and spelling were both associated with increased use information to the right of fixation, but did not systematically modulate the extraction of information to the left of fixation. Individuals who were high in both reading and spelling ability showed the greatest benefit from window sizes larger than 11 characters, primarily because of increases in forward saccade length. They were also significantly more disrupted by being denied close parafoveal information than those poor in reading and/or spelling. These results suggest that, in addition to supporting rapid lexical retrieval of fixated words, the high quality lexical representations indexed by the combination of high reading and spelling ability support efficient processing of parafoveal information and effective saccadic targeting.

Evaluative methodology for comprehensive water quality management planning

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

Dyer, H. L.

Computer-based evaluative methodologies have been developed to provide for the analysis of coupled phenomena associated with natural resource comprehensive planning requirements. Provisions for planner/computer interaction have been included. Each of the simulation models developed is described in terms of its coded procedures. An application of the models for water quality management planning is presented; and the data requirements for each of the models are noted.

[The comprehensive approach to ensure the quality of forensic medical examination of a cadaver].

PubMed

Mel'nikov, O V; Mal'tsev, A E; Petrov, S B; Petrov, B A

2015-01-01

The objective of the present work was to estimate the effectiveness of the comprehensive monitoring system designed to enhance the quality of forensic medical expertise for determining the cause of death in the hanging cases. It was shown that the practical application of the algorithmization and automated quality control system improves the effectiveness of forensic medical examination of the cadavers in the hanging cases. The system performs the control, directing, and teaching functions. Moreover, it allows to estimate the completeness of the examination of the cadaver.

Individual Variation in Children's Reading Comprehension across Digital Text Types

ERIC Educational Resources Information Center

Fesel, Sabine S.; Segers, Eliane; Verhoeven, Ludo

2018-01-01

The present study examined children's digital text comprehension of digital text types linear digital text vs hypertext, with or without graphical navigable overviews. We investigated to what extent individual variation in children's comprehension could be explained by lexical quality (word reading efficiency and vocabulary knowledge), cognitive…

Very Low Intravenous Contrast Volume Protocol for Computed Tomography Angiography Providing Comprehensive Cardiac and Vascular Assessment Prior to Transcatheter Aortic Valve Replacement in Patients with Chronic Kidney Disease

PubMed Central

Pulerwitz, Todd C.; Khalique, Omar K.; Nazif, Tamim N.; Rozenshtein, Anna; Pearson, Gregory D.N.; Hahn, Rebecca T.; Vahl, Torsten P.; Kodali, Susheel K.; George, Isaac; Leon, Martin B.; D'Souza, Belinda; Po, Ming Jack; Einstein, Andrew J.

2016-01-01

Background Transcatheter aortic valve replacement (TAVR) is a lifesaving procedure for many patients high risk for surgical aortic valve replacement. The prevalence of chronic kidney disease (CKD) is high in this population, and thus a very low contrast volume (VLCV) computed tomography angiography (CTA) protocol providing comprehensive cardiac and vascular imaging would be valuable. Methods 52 patients with severe, symptomatic aortic valve disease, undergoing pre-TAVR CTA assessment from 2013-4 at Columbia University Medical Center were studied, including all 26 patients with CKD (eGFR<30mL/min) who underwent a novel VLCV protocol (20mL of iohexol at 2.5mL/s), and 26 standard-contrast-volume (SCV) protocol patients. Using a 320-slice volumetric scanner, the protocol included ECG-gated volume scanning of the aortic root followed by medium-pitch helical vascular scanning through the femoral arteries. Two experienced cardiologists performed aortic annulus and root measurements. Vascular image quality was assessed by two radiologists using a 4-point scale. Results VLCV patients had mean(±SD) age 86±6.5, BMI 23.9±3.4 kg/m2 with 54% men; SCV patients age 83±8.8, BMI 28.7±5.3 kg/m2, 65% men. There was excellent intra- and inter-observer agreement for annular and root measurements, and excellent agreement with 3D-transesophageal echocardiographic measurements. Both radiologists found diagnostic-quality vascular imaging in 96% of VLCV and 100% of SCV cases, with excellent inter-observer agreement. Conclusions This study is the first of its kind to report the feasibility and reproducibility of measurements for a VLCV protocol for comprehensive pre-TAVR CTA. There was excellent agreement of cardiac measurements and almost all studies were diagnostic quality for vascular access assessment. PMID:27061253

School Readiness Act of 1991. Report to Accompany S.911. Senate, 102d Congress, 1st Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

The School Readiness Act of 1991 (S. 911) amends the Head Start Act to expand the availability of the comprehensive health, educational, nutritional, and social services of Head Start to all eligible children and their families by 1997. This senate report on S. 911 begins by affirming the effectiveness of high quality early childhood development…

Assessing Civic Competency and Engagement in Higher Education: Research Background, Frameworks, and Directions for Next-Generation Assessment. Research Report. ETS RR-15-34

ERIC Educational Resources Information Center

Torney-Purta, Judith; Cabrera, Julio C.; Roohr, Katrina Crotts; Liu, Ou Lydia; Rios, Joseph A.

2015-01-01

Civic learning is increasingly recognized as important by the higher education and workforce communities. The development of high-quality assessments that can be used to evaluate students' civic learning during the college years has become a priority. This paper presents a comprehensive review of existing frameworks, definitions, and assessments…

Guide for machine tool task force members

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

Sutton, G.P.

1978-09-01

The purpose of the guide is to assist members of the Machine Tool Task Force (MTTF) in doing the job, preparing technical summary papers, and helping to achieve a uniform, high-quality output from this comprehensive study effort. It supplements the MTTF Plan (UCRL-52552) which contains other important information on the method of operation of MTTF that is related to the preparation of MTTF reports.

The initial development of the WebMedQual scale: domain assessment of the construct of quality of health web sites.

PubMed

Provost, Mélanie; Koompalum, Dayin; Dong, Diane; Martin, Bradley C

2006-01-01

To develop a comprehensive instrument assessing quality of health-related web sites. Phase I consisted of a literature review to identify constructs thought to indicate web site quality and to identify items. During content analysis, duplicate items were eliminated and items that were not clear, meaningful, or measurable were reworded or removed. Some items were generated by the authors. Phase II: a panel consisting of six healthcare and MIS reviewers was convened to assess each item for its relevance and importance to the construct and to assess item clarity and measurement feasibility. Three hundred and eighty-four items were generated from 26 sources. The initial content analysis reduced the scale to 104 items. Four of the six expert reviewers responded; high concordance on the relevance, importance and measurement feasibility of each item was observed: 3 out of 4, or all raters agreed on 76-85% of items. Based on the panel ratings, 9 items were removed, 3 added, and 10 revised. The WebMedQual consists of 8 categories, 8 sub-categories, 95 items and 3 supplemental items to assess web site quality. The constructs are: content (19 items), authority of source (18 items), design (19 items), accessibility and availability (6 items), links (4 items), user support (9 items), confidentiality and privacy (17 items), e-commerce (6 items). The "WebMedQual" represents a first step toward a comprehensive and standard quality assessment of health web sites. This scale will allow relatively easy assessment of quality with possible numeric scoring.

Scalable, sustainable cost-effective surgical care: a model for safety and quality in the developing world, part III: impact and sustainability.

PubMed

Campbell, Alex; Restrepo, Carolina; Mackay, Don; Sherman, Randy; Varma, Ajit; Ayala, Ruben; Sarma, Hiteswar; Deshpande, Gaurav; Magee, William

2014-09-01

The Guwahati Comprehensive Cleft Care Center (GCCCC) utilizes a high-volume, subspecialized institution to provide safe, quality, and comprehensive and cost-effective surgical care to a highly vulnerable patient population. The GCCCC utilized a diagonal model of surgical care delivery, with vertical inputs of mission-based care transitioning to investments in infrastructure and human capital to create a sustainable, local care delivery system. Over the first 2.5 years of service (May 2011-November 2013), the GCCCC made significant advances in numerous areas. Progress was meticulously documented to evaluate performance and provide transparency to stakeholders including donors, government officials, medical oversight bodies, employees, and patients. During this time period, the GCCCC provided free operations to 7,034 patients, with improved safety, outcomes, and multidisciplinary services while dramatically decreasing costs and increasing investments in the local community. The center has become a regional referral cleft center, and governments of surrounding states have contracted the GCCCC to provide care for their citizens with cleft lip and cleft palate. Additional regional and global impact is anticipated through continued investments into education and training, comprehensive services, and research and outcomes. The success of this public private partnership demonstrates the value of this model of surgical care in the developing world, and offers a blueprint for reproduction. The GCCCC experience has been consistent with previous studies demonstrating a positive volume-outcomes relationship, and provides evidence for the value of the specialty hospital model for surgical delivery in the developing world.

Learning essentials: what graduates of mental health nursing programmes need to know from an industry perspective.

PubMed

McAllister, Margaret; Happell, Brenda; Flynn, Trudi

2014-12-01

To explore the perspectives of nursing directors in mental health in Queensland, Australia, regarding the skills and attributes of graduates of comprehensive nursing programme to provide an industry perspective and thus augment knowledge from theoretical and professional dimensions. There is a worldwide shortage of appropriately qualified nurses with the knowledge, skills and attitudes to work effectively in mental health services. Within Australia, this has been well documented since the introduction of comprehensive nursing education. The underrepresentation of mental health content in undergraduate curricula has been identified as the primary reason for nursing graduates not being adequately prepared for practice in this field. To date, this issue has primarily been addressed from the perspective of university academics, with the voice of industry relatively silent in the published literature. Qualitative exploratory. In-depth telephone interviews with Director of Nursing (Mental Health) in Queensland, Australia. The concerns of participants were expressed in six main themes: (1) foundational knowledge of mental health and disorders, (2) recovery-oriented skills, (3) physical as well as mental health skills, (4) therapeutic strategies, (5) resilience and self-development and (6) advanced knowledge and skills. The education of comprehensive nursing education needs to be reviewed as a matter of priority to ensure graduates with the attributes required to provide high-quality care for consumers of mental health services. A skilled and knowledgeable workforce is an essential component of high-quality mental health services. Research highlighting the current deficits and issues is therefore of the highest priority. © 2014 John Wiley & Sons Ltd.

Strength of smoke-free air laws and indoor air quality.

PubMed

Lee, Kiyoung; Hahn, Ellen J; Robertson, Heather E; Lee, Seongjik; Vogel, Suzann L; Travers, Mark J

2009-04-01

Smoke-free air laws have been implemented in many Kentucky communities to protect the public from the harmful effects of secondhand smoke exposure. The impact of different strengths of smoke-free air laws on indoor air quality was assessed. Indoor air quality in hospitality venues was assessed in seven communities before and after comprehensive smoke-free air laws and in two communities only after partial smoke-free air laws. One community was measured three times: before any smoke-free air law, after the initial partial law, and after the law was strengthened to cover all workplaces and public places with few exemptions. Real-time measurements of particulate matters with 2.5 mum aerodynamic diameter or smaller (PM(2.5)) were obtained. When comprehensive smoke-free air laws were implemented, indoor PM(2.5) concentrations decreased significantly from 161 to 20 microg/m3. In one community that implemented a comprehensive smoke-free law after initially passing a partial law, indoor PM(2.5) concentrations were 304 microg/m3 before the law, 338 microg/m3 after the partial law, and 9 microg/m3 after the comprehensive law. The study clearly demonstrated that partial smoke-free air laws do not improve indoor air quality. A significant linear trend indicated that PM(2.5) levels in the establishments decreased with fewer numbers of burning cigarettes. Only comprehensive smoke-free air laws are effective in reducing indoor air pollution from secondhand tobacco smoke.

Strength of smoke-free air laws and indoor air quality

PubMed Central

Hahn, Ellen J.; Robertson, Heather E.; Vogel, Suzann L.; Travers, Mark J.

2009-01-01

Introduction: Smoke-free air laws have been implemented in many Kentucky communities to protect the public from the harmful effects of secondhand smoke exposure. The impact of different strengths of smoke-free air laws on indoor air quality was assessed. Methods: Indoor air quality in hospitality venues was assessed in seven communities before and after comprehensive smoke-free air laws and in two communities only after partial smoke-free air laws. One community was measured three times: before any smoke-free air law, after the initial partial law, and after the law was strengthened to cover all workplaces and public places with few exemptions. Real-time measurements of particulate matters with 2.5 μm aerodynamic diameter or smaller (PM2.5) were obtained. Results: When comprehensive smoke-free air laws were implemented, indoor PM2.5 concentrations decreased significantly from 161 to 20 μg/m3. In one community that implemented a comprehensive smoke-free law after initially passing a partial law, indoor PM2.5 concentrations were 304 μg/m3 before the law, 338 μg/m3 after the partial law, and 9 μg/m3 after the comprehensive law. Discussion: The study clearly demonstrated that partial smoke-free air laws do not improve indoor air quality. A significant linear trend indicated that PM2.5 levels in the establishments decreased with fewer numbers of burning cigarettes. Only comprehensive smoke-free air laws are effective in reducing indoor air pollution from secondhand tobacco smoke. PMID:19346510

Effects of Patient-Centered Medical Home Attributes on Patients’ Perceptions of Quality in Federally Supported Health Centers

PubMed Central

Lebrun-Harris, Lydie A.; Shi, Leiyu; Zhu, Jinsheng; Burke, Matthew T.; Sripipatana, Alek; Ngo-Metzger, Quyen

2013-01-01

PURPOSE We sought to assess patients’ ratings of patient-centered medical home (PCMH) attributes and overall quality of care within federally supported health centers. METHODS Data were collected through the 2009 Health Center Patient Survey (n = 4,562), which consisted of in-person interviews and included a nationally representative sample of patients seen in health centers. Quality measures included patients’ perceptions of overall quality of services, perceptions of quality of clinician advice/treatment, and likelihood of referring friends and relatives to the health center. PCMH attributes included (1) access to care getting to health center, (2) access to care during visit, (3) patient-centered communication with health care clinicians, (4) patient-centered communication with support staff, (5) self-management support for chronic conditions, (6) self-management support for behavioral risks, and (7) comprehensive preventive care. Bivariate analysis and logistic regressions were used to examine associations between patients’ perceptions of PCMH attributes and patient-reported quality of care. RESULTS Eighty-four percent of patients reported excellent/very good overall quality of services, 81% reported excellent/very good quality of clinician care, and 84% were very likely to refer friends and relatives. Higher patient ratings on the access to care and patient-centered communication attributes were associated with higher odds of patient-reported high quality of care on the 3 outcome measures. CONCLUSIONS More than 80% of patients perceived high quality of care in health centers. PCMH attributes related to access to care and communication were associated with greater likelihood of patients reporting high-quality care. PMID:24218374

Recommendations for a mixed methods approach to evaluating the patient-centered medical home.

PubMed

Goldman, Roberta E; Parker, Donna R; Brown, Joanna; Walker, Judith; Eaton, Charles B; Borkan, Jeffrey M

2015-03-01

There is a strong push in the United States to evaluate whether the patient-centered medical home (PCMH) model produces desired results. The explanatory and contextually based questions of how and why PCMH succeeds in different practice settings are often neglected. We report the development of a comprehensive, mixed qualitative-quantitative evaluation set for researchers, policy makers, and clinician groups. To develop an evaluation set, the Brown Primary Care Transformation Initiative convened a multidisciplinary group of PCMH experts, reviewed the PCMH literature and evaluation strategies, developed key domains for evaluation, and selected or created methods and measures for inclusion. The measures and methods in the evaluation set (survey instruments, PCMH meta-measures, patient outcomes, quality measures, qualitative interviews, participant observation, and process evaluation) are meant to be used together. PCMH evaluation must be sufficiently comprehensive to assess and explain both the context of transformation in different primary care practices and the experiences of diverse stakeholders. In addition to commonly assessed patient outcomes, quality, and cost, it is critical to include PCMH components integral to practice culture transformation: patient and family centeredness, authentic patient activation, mutual trust among practice employees and patients, and transparency, joy, and collaboration in delivering and receiving care in a changing environment. This evaluation set offers a comprehensive methodology to enable understanding of how PCMH transformation occurs in different practice settings. This approach can foster insights about how transformation affects critical outcomes to achieve meaningful, patient-centered, high-quality, and cost-effective sustainable change among diverse primary care practices. © 2015 Annals of Family Medicine, Inc.

Healthcare service quality: towards a broad definition.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

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

Do we need a national incident reporting system for medical imaging?

PubMed

Itri, Jason N; Krishnaraj, Arun

2012-05-01

The essential role of an incident reporting system as a tool to improve safety and reliability has been described in high-risk industries such as aviation and nuclear power, with anesthesia being the first medical specialty to successfully integrate incident reporting into a comprehensive quality improvement strategy. Establishing an incident reporting system for medical imaging that effectively captures system errors and drives improvement in the delivery of imaging services is a key component of developing and evaluating national quality improvement initiatives in radiology. Such a national incident reporting system would be most effective if implemented as one piece of a comprehensive quality improvement strategy designed to enhance knowledge about safety, identify and learn from errors, raise standards and expectations for improvement, and create safer systems through implementation of safe practices. The potential benefits of a national incident reporting system for medical imaging include reduced morbidity and mortality, improved patient and referring physician satisfaction, reduced health care expenses and medical liability costs, and improved radiologist satisfaction. The purposes of this article are to highlight the positive impact of external reporting systems, discuss how similar advancements in quality and safety can be achieved with an incident reporting system for medical imaging in the United States, and describe current efforts within the imaging community toward achieving this goal. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

FISH Oracle 2: a web server for integrative visualization of genomic data in cancer research

PubMed Central

2014-01-01

Background A comprehensive view on all relevant genomic data is instrumental for understanding the complex patterns of molecular alterations typically found in cancer cells. One of the most effective ways to rapidly obtain an overview of genomic alterations in large amounts of genomic data is the integrative visualization of genomic events. Results We developed FISH Oracle 2, a web server for the interactive visualization of different kinds of downstream processed genomics data typically available in cancer research. A powerful search interface and a fast visualization engine provide a highly interactive visualization for such data. High quality image export enables the life scientist to easily communicate their results. A comprehensive data administration allows to keep track of the available data sets. We applied FISH Oracle 2 to published data and found evidence that, in colorectal cancer cells, the gene TTC28 may be inactivated in two different ways, a fact that has not been published before. Conclusions The interactive nature of FISH Oracle 2 and the possibility to store, select and visualize large amounts of downstream processed data support life scientists in generating hypotheses. The export of high quality images supports explanatory data visualization, simplifying the communication of new biological findings. A FISH Oracle 2 demo server and the software is available at http://www.zbh.uni-hamburg.de/fishoracle. PMID:24684958

English-language videos on YouTube as a source of information on self-administer subcutaneous anti-tumour necrosis factor agent injections.

PubMed

Tolu, Sena; Yurdakul, Ozan Volkan; Basaran, Betul; Rezvani, Aylin

2018-05-14

The aim of this study was to evaluate the reliability, content, and quality of videos for patients available on YouTube for learning how to self-administer subcutaneous anti-tumour necrosis factor (TNF) injections. We searched for the terms Humira injection, Enbrel injection, Simponi injection, and Cimzia injection. Videos were categorised as useful information, misleading information, useful patient opinion, and misleading patient opinion by two physicians. Videos were rated for quality on a 5-point global quality scale (GQS; 1 = poor quality, 5 = excellent quality) and reliability and content using the 5-point DISCERN scale (higher scores represent greater reliability and more comprehensive videos). Of the 142 English videos, 24 (16.9%) videos were classified as useful information, 6 (4.2%) as misleading information, 47 (33.1%) as useful patient opinion, and 65 (45.8%) as misleading patient opinion. Useful videos were the most comprehensive and had the highest reliability and quality scores. The useful information and useful patient opinion videos had the highest numbers of views per day (median 8.32, IQR: 3.40-14.28 and 5.46, IQR: 3.06-14.44), as compared with 2.32, IQR: 1.63-6.26 for misleading information videos and 2.15, IQR: 1.17-7.43 for misleading patient opinion videos (p = 0.001). Almost all (91.5%) misleading videos were uploaded by individual users. There are a substantial number of English-language YouTube videos, with high quality, and rich content and reliability that can be sources of information on proper technique of anti-TNF self-injections. Physicians should direct patients to the reliable resources of information and educate them in online resource assessment, thereby improving treatment outcomes.

Advancing a comprehensive cancer care agenda for children and their families: Institute of Medicine Workshop highlights and next steps.

PubMed

Kirch, Rebecca; Reaman, Gregory; Feudtner, Chris; Wiener, Lori; Schwartz, Lisa A; Sung, Lillian; Wolfe, Joanne

2016-09-01

This article highlights key findings from the "Comprehensive Cancer Care for Children and Their Families" March 2015 joint workshop by the Institute of Medicine (IOM) and the American Cancer Society. This initiative convened more than 100 family members, clinician investigators, advocates, and members of the public to discuss emerging evidence and care models and to determine the next steps for optimizing quality-of-life outcomes and well-being for children and families during pediatric cancer treatment, after treatment completion, and across the life spectrum. Participants affirmed the triple aim of pediatric oncology that strives for every child with cancer to be cured; provides high-quality palliative and psychosocial supportive, restorative, and rehabilitative care to children and families throughout the illness course and survivorship; and assures receipt of high-quality end-of-life care for patients with advancing disease. Workshop outcomes emphasized the need for new pediatric cancer drug development and identified critical opportunities to prioritize palliative care and psychosocial support as an integral part of pediatric cancer research and treatment, including the necessity for adequately resourcing these supportive services to minimize suffering and distress, effectively address quality-of-life needs for children and families at all stages of illness, and mitigate the long-term health risks associated with childhood cancer and its treatment. Next steps include dismantling existing silos and enhancing collaboration between clinical investigators, disease-directed specialists, and supportive care services; expanding the use of patient-reported and parent-reported outcomes; effectively integrating palliative and psychosocial care; and clinical communication skills development. CA Cancer J Clin 2016;66:398-407. © 2016 American Cancer Society. © 2016 American Cancer Society.

USSR Report, International Affairs

DTIC Science & Technology

1986-10-07

the comprehensive utilization of coal and devel- opment of improved methods assuring a more effective use of low-quality coals, low- calory lignites...promising trend of the joint activity in this sphere. Thus, cyclone furnaces for burning low-quality fuel and fuel wastes save up to 10-20 per cent of...structure of the developing countries should be refined and made concrete and we should move from studying particular classes and strata to a comprehensive

76 FR 6727 - Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

...The Delaware River Basin Commission published in the Federal Register of January 4, 2011 a proposed rule containing tentative dates and locations for public hearings on proposed amendments to its Water Quality Regulations, Water Code and Comprehensive Plan relating to natural gas development projects. The public hearing dates have been changed and locations and times established, as set forth below.

Core components of a comprehensive quality assurance program in anatomic pathology.

PubMed

Nakhleh, Raouf E

2009-11-01

In this article the core components of a comprehensive quality assurance and improvement plan are outlined. Quality anatomic pathology work comes with focus on accurate, timely, and complete reports. A commitment to continuous quality improvement and a systems approach with a persistent effort helps to achieve this end. Departments should have a quality assurance and improvement plan that includes a risk assessment of real and potential problems facing the laboratory. The plan should also list the individuals responsible for carrying out the program with adequate resources, a defined timetable, and annual assessment for progress and future directions. Quality assurance monitors should address regulatory requirements and be organized by laboratory division (surgical pathology, cytology, etc) as well as 5 segments (preanalytic, analytic, postanalytic phases of the test cycle, turn-around-time, and customer satisfaction). Quality assurance data can also be used to evaluate individual pathologists using multiple parameters with peer group comparison.

18 CFR 801.7 - Water quality.

Code of Federal Regulations, 2010 CFR

2010-04-01

... water quality management and control. However, protection of the water resources of the basin from... quality program in the comprehensive plan. (c) The Commission's role in water quality management and... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Water quality. 801.7...

TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

EPA Science Inventory

This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. he document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic drai...

TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

EPA Science Inventory

This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. The document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic dr...

Reading Argumentative Texts: Comprehension and Evaluation Goals and Outcomes

ERIC Educational Resources Information Center

Diakidoy, Irene-Anna N.; Ioannou, Melina C.; Christodoulou, Stelios A.

2017-01-01

The study is situated at the interface between reading comprehension and critical thinking research. Its purpose was to examine the influence of reading goals and argument quality on the comprehension and critical evaluation of argumentative texts. Young adult readers read to comprehend or evaluate texts on two different controversial issues.…

The Comprehensive Evaluation of Electronic Learning Tools and Educational Software (CEELTES)

ERIC Educational Resources Information Center

Karolcík, Štefan; Cipková, Elena; Hrušecký, Roman; Veselský, Milan

2015-01-01

Despite the fact that digital technologies are more and more used in the learning and education process, there is still lack of professional evaluation tools capable of assessing the quality of used digital teaching aids in a comprehensive and objective manner. Construction of the Comprehensive Evaluation of Electronic Learning Tools and…

America's Challenge: Effective Teachers for At-Risk Schools and Students

ERIC Educational Resources Information Center

Dwyer, Carol A., Ed.

2007-01-01

The National Comprehensive Center for Teacher Quality (NCCTQ) was launched in 2005 as part of a comprehensive system of content-based technical assistance to support states in implementing the priorities of the No Child Left Behind (NCLB) Act. NCCTQ's mission is to support Regional Comprehensive Centers (RCCs), states, and other education…

Financial planning on a comprehensive scale.

PubMed

Mishra, Simita

2013-04-01

Hospitals and health systems that wish to explore the shift to comprehensive care management should: Assess the investments in infrastructure necessary to support comprehensive care management, Gauge the financial implications and set quality and financial goals, Monitor performance using metrics such as patient satisfaction, avoidable admissions, out-of-group referrals, and average length of stay.

The association between physical activity and renal cancer: systematic review and meta-analysis

PubMed Central

Behrens, G; Leitzmann, M F

2013-01-01

Background: Physical activity may decrease renal cancer risk by reducing obesity, blood pressure, insulin resistance, and lipid peroxidation. Despite plausible biologic mechanisms linking increased physical activity to decreased risk for renal cancer, few epidemiologic studies have been able to report a clear inverse association between physical activity and renal cancer, and no meta-analysis is available on the topic. Methods: We searched the literature using PubMed and Web of Knowledge to identify published non-ecologic epidemiologic studies quantifying the relationship between physical activity and renal cancer risk in individuals without a cancer history. Following the PRISMA guidelines, we conducted a systematic review and meta-analysis, including information from 19 studies based on a total of 2 327 322 subjects and 10 756 cases. The methodologic quality of the studies was examined using a comprehensive scoring system. Results: Comparing high vs low levels of physical activity, we observed an inverse association between physical activity and renal cancer risk (summary relative risk (RR) from random-effects meta-analysis=0.88; 95% confidence interval (CI)=0.79–0.97). Summarising risk estimates from high-quality studies strengthened the inverse association between physical activity and renal cancer risk (RR=0.78; 95% CI=0.66–0.92). Effect modification by adiposity, hypertension, type 2 diabetes, smoking, gender, or geographic region was not observed. Conclusion: Our comprehensive meta-analysis provides strong support for an inverse relation of physical activity to renal cancer risk. Future high-quality studies are required to discern which specific types, intensities, frequencies, and durations of physical activity are needed for renal cancer risk reduction. PMID:23412105

Two-year comprehensive medical management of degenerative lumbar spine disease (lumbar spondylolisthesis, stenosis, or disc herniation): a value analysis of cost, pain, disability, and quality of life: clinical article.

PubMed

Parker, Scott L; Godil, Saniya S; Mendenhall, Stephen K; Zuckerman, Scott L; Shau, David N; McGirt, Matthew J

2014-08-01

Current health care reform calls for a reduction of procedures and treatments that are less effective, more costly, and of little value (high cost/low quality). The authors assessed the 2-year cost and effectiveness of comprehensive medical management for lumbar spondylolisthesis, stenosis, and herniation by utilizing a prospective single-center multidisciplinary spine center registry in a real-world practice setting. Analysis was performed on a prospective longitudinal quality of life spine registry. Patients with lumbar spondylolisthesis (n = 50), stenosis (n = 50), and disc herniation (n = 50) who had symptoms persisting after 6 weeks of medical management and who were eligible for surgical treatment were entered into a prospective registry after deciding on nonsurgical treatment. In all cases, comprehensive medical management included spinal steroid injections, physical therapy, muscle relaxants, antiinflammatory medication, and narcotic oral agents. Two-year patient-reported outcomes, back-related medical resource utilization, and occupational work-day losses were prospectively collected and used to calculate Medicare fee-based direct and indirect costs from the payer and societal perspectives. The maximum health gain associated with medical management was defined as the improvement in pain, disability, and quality of life experienced after 2 years of medical treatment or at the time a patient decided to cross over to surgery. The maximum health gain in back pain, leg pain, disability, quality of life, depression, and general health state did not achieve statistical significance by 2 years of medical management, except for pain and disability in patients with disc herniation and back pain in patients with lumbar stenosis. Eighteen patients (36%) with spondylolisthesis, 11 (22%) with stenosis, and 17 (34%) with disc herniation eventually required surgical management due to lack of improvement. The 2-year improvement did not achieve a minimum clinically important difference in any outcome measure. The mean 2-year total cost (direct plus indirect) of medical management was $6606 for spondylolisthesis, $7747 for stenosis, and $7097 for herniation. In an institution-wide, prospective, longitudinal quality of life registry that measures cost and effectiveness of all spine care provided, comprehensive medical management did not result in sustained improvement in pain, disability, or quality of life for patients with surgically eligible degenerative lumbar spondylolisthesis, stenosis, or disc herniation. From both the societal and payer perspective, continued medical management of patients with these lumbar pathologies in whom 6 weeks of conservative therapy failed was of minimal value given its lack of health utility and effectiveness and its health care costs. The findings from this real-world practice setting may more accurately reflect the true value and effectiveness of nonoperative care in surgically eligible patient populations.

Evaluating the content and quality of information about premature ejaculation on the Internet: what are men being exposed to ?

PubMed

Gul, M; Kaynar, M

2017-03-01

Premature ejaculation is one of the most common male sexual dysfunctions; however, only a few patients with premature ejaculation are seeking professional help or advice. Internet has become an important source of knowledge, and thus, more patients are looking online for health information. According to our best knowledge, no study has evaluated the content and quality of websites on premature ejaculation. We, therefore, aimed to evaluate the content and quality of currently available Internet-based information on premature ejaculation. A sample was obtained comprising the 50 top sites retrieved from Google, Bing and Yahoo search engines using the terms 'premature ejaculation'. Each site then was reviewed based on some predefined evaluation criteria to determine the general quality, condition-specific content quality, popularity index and ownership. The websites reviewed were differed highly in terms of quality and ownership. Only a few sites provided comprehensive medical and complete information on premature ejaculation. The online information available is often of uncertain calibre; therefore, men are being exposed to information about premature ejaculation with a highly variable degree quality. This fact should be considered both by health professionals and website owners, and better online resources should be provided for these patients. © 2016 Blackwell Verlag GmbH.

Quality evaluation of Hypericum ascyron extract by two-dimensional high-performance liquid chromatography coupled with the colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method.

PubMed

Li, Xiu-Mei; Luo, Xue-Gang; Zhang, Chao-Zheng; Wang, Nan; Zhang, Tong-Cun

2015-02-01

In this paper, a heart-cutting two-dimensional high-performance liquid chromatography coupled with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method was established for controlling the quality of different batches of Hypericum ascyron extract for the first time. In comparison with the common one-dimensional fingerprint, the second-dimensional fingerprint compiled additional spectral data and was hence more informative. The quality of H. ascyron extract was further evaluated by similarity measures and the same results were achieved, the correlation coefficients of the similarity of ten batches of H. ascyron extract were ＞0.99. Furthermore, we also evaluated the quality of the ten batches of H. ascyron extract by antibacterial activity. The result demonstrated that the quality of the ten batches of H. ascyron extract was not significantly different by MTT. Finally, we demonstrated that the second-dimensional fingerprint coupled with the MTT method was a more powerful tool to characterize the quality of samples of batch to batch. Therefore the proposed method could be used to comprehensively conduct the quality control of traditional Chinese medicines. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Improving Quality and Efficiency of Postpartum Hospital Education

PubMed Central

Buchko, Barbara L.; Gutshall, Connie H.; Jordan, Elizabeth T.

2012-01-01

The purpose of this study was to investigate the implementation of an evidence-based, streamlined, education process (comprehensive education booklet, individualized education plan, and integration of education into the clinical pathway) and nurse education to improve the quality and efficiency of postpartum education during hospitalization. A one-group pretest–posttest design was used to measure the quality of discharge teaching for new mothers and efficiency of the education process for registered nurses before and after implementation of an intervention. Results indicated that a comprehensive educational booklet and enhanced documentation can improve efficiency in the patient education process for nurses. PMID:23997552

Methodology of Artistic Identification on the Path of the Comprehension of Composer's Works in a Piano Class

ERIC Educational Resources Information Center

Meleshkina, Elena Anatolyevna; Scherbakova, Anna Iosifovna; Korsakova, Irina Anatolyevna; Slavina, Elena Vladimirovna; Kazakova, Irina Sergeevna

2016-01-01

The article is devoted to the reflection on the problem of the "immersion" in the artistic world of a composer's creative work in a piano class in the beginning of the 21st century. The wealth and diversity of the music material for piano players determine the new quality of understanding music and set high goals and objectives for a…

A User's Guide to the Meta-Analysis of Research Studies. Meta-Stat: Software To Aid in the Meta-Analysis of Research Findings.

ERIC Educational Resources Information Center

Rudner, Lawrence M.; Glass Gene V.; Evartt, David L.; Emery, Patrick J.

This manual and the accompanying software are intended to provide a step-by-step guide to conducting a meta-analytic study along with references for further reading and free high-quality software, "Meta-Stat.""Meta-Stat" is a comprehensive package designed to help in the meta-analysis of research studies in the social and behavioral sciences.…

Comparing Diverse Southeast Asian Reactions to the Trans-Pacific Partnership (TPP)

DTIC Science & Technology

2017-09-01

The ambitious TPP comes with its own set of challenges. Especially in the agricultural sector and in the area of intellectual property, domestic...favor of high-quality comprehensive FTAs, save for stalled negotiations in provisions on the agricultural sector due to the domestic political...strength and influence of the Ministry of Agriculture , Forestry and Fisheries.16 Capling and Ravenhill note that although the United States succeeded in

Formative Evaluation of a Sociotechnical System Intervention at an Army Maintenance Depot

DTIC Science & Technology

1986-07-01

periodically reassess itself to determine if the balance between the technical and social systems remains adaptive and responsive to the requirements...developed a comprehensive set of recommendations for improving the balance between the social and technical systems of the depot. During 1983, most of...ity and quality of worklife . However, the nature and extent of the impact is highly elusive and resistant to quantification. 1-4 FORMATIVE

A Noble Bet in Early Care and Education: Lessons from One Community’s Experience

DTIC Science & Technology

2002-01-01

Finally, the RAND study team explored existing empirical literature on ECE. Although ECI led to the establishment of new , high-quality ECE ser...objectives and articulates the breadth of the initiative’s ambition to create a comprehensive new system for delivering ECE to low-income chil- dren in...70 Incentives to Neighborhood Agencies .............. 71 Who Would Provide ECI Services? . . . . . . . . . . . . . . . . . . 73 New Providers and

Improvement of rolling 6 mm thin plates in plate rolling mill PT. Krakatau Posco

NASA Astrophysics Data System (ADS)

Pujiyanto, Hamdani

2017-01-01

A 6-mm thin plate is difficult to produce especially if the product requires wide size and high strength. Flatness is the main quality issue in rolling 6-mm plate using a 4-high reversing mill which use ±1100-mm work roll. Thus some methods are applied to overcome such issue in order to comply to customer quality requirement. Pre-rolling, rolling, and post-rolling conditions have to be considered comprehensively. Roll unit management will be the key factor before rolling condition. The roll unit itself has a significant impact on work roll crown wearness in relation with work roll intial crown and thermal crown. Work roll crown along with the modification of hydraulic gap control (HGC) could directly alter the flatness of the plate.

proGenomes: a resource for consistent functional and taxonomic annotations of prokaryotic genomes.

PubMed

Mende, Daniel R; Letunic, Ivica; Huerta-Cepas, Jaime; Li, Simone S; Forslund, Kristoffer; Sunagawa, Shinichi; Bork, Peer

2017-01-04

The availability of microbial genomes has opened many new avenues of research within microbiology. This has been driven primarily by comparative genomics approaches, which rely on accurate and consistent characterization of genomic sequences. It is nevertheless difficult to obtain consistent taxonomic and integrated functional annotations for defined prokaryotic clades. Thus, we developed proGenomes, a resource that provides user-friendly access to currently 25 038 high-quality genomes whose sequences and consistent annotations can be retrieved individually or by taxonomic clade. These genomes are assigned to 5306 consistent and accurate taxonomic species clusters based on previously established methodology. proGenomes also contains functional information for almost 80 million protein-coding genes, including a comprehensive set of general annotations and more focused annotations for carbohydrate-active enzymes and antibiotic resistance genes. Additionally, broad habitat information is provided for many genomes. All genomes and associated information can be downloaded by user-selected clade or multiple habitat-specific sets of representative genomes. We expect that the availability of high-quality genomes with comprehensive functional annotations will promote advances in clinical microbial genomics, functional evolution and other subfields of microbiology. proGenomes is available at http://progenomes.embl.de. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

History as narrative: the nature and quality of historical understanding for students with LD.

PubMed

Espin, Christine A; Cevasco, Jazmin; van den Broek, Paul; Baker, Scott; Gersten, Russell

2007-01-01

In this study, we examine the nature and quality of students' comprehension of history. Specifically, we explore whether cognitive-psychological theories developed to capture the comprehension of narrative text can be used to capture the comprehension of history. Participants were 36 students with learning disabilities who had taken part in an earlier study designed to investigate the effects of an interactive instructional intervention in history. The results of the original study supported the effectiveness of the intervention in terms of amount recalled. The results of the present study reveal that historical understanding can be characterized as the construction of meaning through the creation of a causal network of events. The study of history within a causal network framework has implications for understanding the nature and quality of students' learning of history, and for potentially identifying sources of failure in learning.

Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors.

PubMed

Mahmood, Mohammad Afzal; Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien; Wahabi, Hayfaa A

2018-01-01

Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped.

Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors

PubMed Central

Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien

2018-01-01

Background Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Method Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. Findings The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. Conclusion There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped. PMID:29682538

Do prominent quality measurement surveys capture the concerns of persons with disability?

PubMed

Iezzoni, Lisa I; Marsella, Sarah A; Lopinsky, Tiffany; Heaphy, Dennis; Warsett, Kimberley S

2017-04-01

Demonstration programs nationwide aim to control costs and improve care for people dually-eligible for Medicare and Medicaid, including many persons with disability. Ensuring these initiatives maintain or improve care quality requires comprehensive evaluation of quality of care. To examine whether the common quality measures being used to evaluate the Massachusetts One Care duals demonstration program comprehensively address the concerns of persons with disability. Drawing upon existing conceptual frameworks, we developed a model of interrelationships of personal, health care, and environmental factors for achieving wellness for persons with disability. Based on this model, we specified a scheme to code individual quality measurement items and coded the items contained in 12 measures being used to assess Massachusetts One Care, which exclusively enrolls non-elderly adults with disability. Across these 12 measures, we assigned 376 codes to 302 items; some items received two codes. Taken together, the 12 measures contain items addressing most factors in our conceptual model that affect health care quality for persons with disability, including long-term services and supports. Some important gaps exist. No items examine sexual or reproductive health care, peer support, housing security, disability stigmatization, and specific services obtained outside the home like adult day care. Certain key concepts are covered only by a single or several of the 12 quality measures. Common quality metrics cover most - although not all-health care quality concerns of persons with disability. However, multiple different quality measures are required for this comprehensive coverage, raising questions about respondent burden. Copyright © 2017 Elsevier Inc. All rights reserved.

Comprehensive planning of data archive in Japanese planetary missions

NASA Astrophysics Data System (ADS)

Yamamoto, Yukio; Shinohara, Iku; Hoshino, Hirokazu; Tateno, Naoki; Hareyama, Makoto; Okada, Naoki; Ebisawa, Ken

Comprehensive planning of data archive in Japanese planetary missions Japan Aerospace Exploration Agency (JAXA) provides HAYABUSA and KAGUYA data as planetary data archives. These data archives, however, were prepared independently. Therefore the inconsistency of data format has occurred, and the knowledge of data archiving activity is not inherited. Recently, the discussion of comprehensive planning of data archive has started to prepare up-coming planetary missions, which indicates the comprehensive plan of data archive is required in several steps. The framework of the comprehensive plan is divided into four items: Preparation, Evaluation, Preservation, and Service. 1. PREPARATION FRAMEWORK Data is classified into several types: raw data, level-0, 1, 2 processing data, ancillary data, and etc. The task of mission data preparation is responsible for instrument teams, but preparations beside mission data and support of data management are essential to make unified conventions and formats over instruments in a mission, and over missions. 2. EVALUATION FRAMEWORK There are two meanings of evaluation: format and quality. The format evaluation is often discussed in the preparation framework. The data quality evaluation which is often called quality assurance (QA) or quality control (QC) must be performed by third party apart from preparation teams. An instrument team has the initiative for the preparation itself, and the third-party group is organized to evaluate the instrument team's activity. 3. PRESERVATION FRAMEWORK The main topic of this framework is document management, archiving structure, and simple access method. The mission produces many documents in the process of the development. Instrument de-velopment is no exception. During long-term development of a mission, many documents are obsoleted and updated repeatedly. A smart system will help instrument team to reduce some troubles of document management and archiving task. JAXA attempts to follow PDS manners to do this management since PDS has highly sophisticated archiving structure. In addition, the access method to archived data must be simple and standard well over a decade. 4. SERVICE FRAMEWORK The service framework including planetary data access protocol, PDAP, has been developed to share a stored data effectively. The sophisticated service framework will work not only for publication data, but also for low-level data. JAXA's data query services is under developed based on PDAP, which means that the low-level data can be published in the same manner as level 2 data. In this presentation, we report the detail structure of these four frameworks adopting upcoming Planet-C, Venus Climate Orbiter, mission.

Guidelines for reading literature reviews.

PubMed Central

Oxman, A D; Guyatt, G H

1988-01-01

One strategy for dealing with the burgeoning medical literature is to rely on reviews of the literature. Although this strategy is efficient, readers may be misled if the review does not meet scientific standards. Therefore, guidelines that will help readers assess the scientific quality of the review are proposed. The guidelines focus on the definition of the question, the comprehensiveness of the search strategy, the methods of choosing and assessing the primary studies, and the methods of combining the results and reaching appropriate conclusions. Application of the guidelines will allow clinicians to spend their valuable reading time on high-quality material and to judge the validity of an author's conclusions. PMID:3355948

Development of an asthma disease management program in a children's hospital.

PubMed

Miller, Kelly; Ward-Smith, Peggy; Cox, Karen; Jones, Erika M; Portnoy, Jay M

2003-11-01

The incidence, morbidity, and mortality of asthma have been increasing at an alarming rate, making asthma the most common chronic illness of childhood. An asthma disease management program was developed to improve the care and management of patients with asthma--a comprehensive health care delivery model that was designed to improve the management of patients with asthma was designed and implemented. The goal of the program was to provide high-quality interventions for those children diagnosed with asthma. The asthma disease management program at Children's Mercy Hospital improved the care received, decreased costs, and improved the quality of life for those children with asthma.

Patient Safety Reporting Systems: Sustained Quality Improvement Using a Multidisciplinary Team and “Good Catch” Awards

PubMed Central

Herzer, Kurt R.; Mirrer, Meredith; Xie, Yanjun; Steppan, Jochen; Li, Matthew; Jung, Clinton; Cover, Renee; Doyle, Peter A.; Mark, Lynette J.

2014-01-01

Background Since 1999, hospitals have made substantial commitments to healthcare quality and patient safety through individual initiatives of executive leadership involvement in quality, investments in safety culture, education and training for medical students and residents in quality and safety, the creation of patient safety committees, and implementation of patient safety reporting systems. Cohesive quality and safety approaches have become comprehensive programs to identify and mitigate hazards that could harm patients. This article moves to the next level with an intense refocusing of attention on one of the individual components of a comprehensive program--the patient safety reporting system—with a goal of maximized usefulness of the reports and long-term sustainability of quality improvements arising from them. Methods A six-phase framework was developed to deal with patient safety hazards: identify, report, analyze, mitigate, reward, and follow up. Unique features of this process included a multidisciplinary team to review reports, mitigate hazards, educate and empower providers, recognize the identifying/reporting individuals or groups with “Good Catch” awards, and follow up to determine if quality improvements were sustained over time. Results To date, 29 patient safety hazards have gone through this process with “Good Catch” awards being granted at our institution. These awards were presented at various times over the past 4 years since the process began in 2008. Follow-up revealed that 86% of the associated quality improvements have been sustained over time since the awards were given. We present the details of two of these “Good Catch” awards: vials of heparin with an unusually high concentration of the drug that posed a potential overdose hazard and a rapid infusion device that resisted practitioner control. Conclusion A multidisciplinary team's analysis and mitigation of hazards identified in a patient safety reporting system, positive recognition with a “Good Catch” award, education of practitioners, and long-term follow-up resulted in an outcome of sustained quality improvement initiatives. PMID:22946251

Implementation and utilization of a comprehensive information network in an integrated private not-for-profit regional health care system

NASA Astrophysics Data System (ADS)

Long, James M., III

1995-10-01

The capacity to access, integrate, and analyze demographic, financial, and clinical data within a regional health care system represents an opportunity to ensure and enhance clinical quality and to reduce costs in a carefully planned and controlled manner. Properly used, such capability should improve health care delivery for local populations and provide the institution with a level of integration of services achieved by few health care organizations. The Baptist Health System (BHS), based in Birmingham, Alabama, is currently standardizing operating procedures among its various components and implementing a comprehensive, enterprise-wide information network. Clinical quality improvement and case management are being promulgated throughout the enterprise using a continuum-of-care model developed internally. Having successfully completed a pilot project using teleconferences for core lectures in internal medicine between two large teaching hospitals, BHS is taking advantage of enterprise- wide teleconference capability using a combination of fiberoptic (T3) and standard digital telephone (T1) transmission to speed installation and reduce the cost of implementation into two office buildings and eleven hospitals. The information system will serve to prepare BHS for the advent of managed care and other anticipated changes in health care, while ensuring continued ability to deliver high quality, cost-effective medical and health-related services.

pGlyco 2.0 enables precision N-glycoproteomics with comprehensive quality control and one-step mass spectrometry for intact glycopeptide identification.

PubMed

Liu, Ming-Qi; Zeng, Wen-Feng; Fang, Pan; Cao, Wei-Qian; Liu, Chao; Yan, Guo-Quan; Zhang, Yang; Peng, Chao; Wu, Jian-Qiang; Zhang, Xiao-Jin; Tu, Hui-Jun; Chi, Hao; Sun, Rui-Xiang; Cao, Yong; Dong, Meng-Qiu; Jiang, Bi-Yun; Huang, Jiang-Ming; Shen, Hua-Li; Wong, Catherine C L; He, Si-Min; Yang, Peng-Yuan

2017-09-05

The precise and large-scale identification of intact glycopeptides is a critical step in glycoproteomics. Owing to the complexity of glycosylation, the current overall throughput, data quality and accessibility of intact glycopeptide identification lack behind those in routine proteomic analyses. Here, we propose a workflow for the precise high-throughput identification of intact N-glycopeptides at the proteome scale using stepped-energy fragmentation and a dedicated search engine. pGlyco 2.0 conducts comprehensive quality control including false discovery rate evaluation at all three levels of matches to glycans, peptides and glycopeptides, improving the current level of accuracy of intact glycopeptide identification. The N-glycoproteome of samples metabolically labeled with 15 N/ 13 C were analyzed quantitatively and utilized to validate the glycopeptide identification, which could be used as a novel benchmark pipeline to compare different search engines. Finally, we report a large-scale glycoproteome dataset consisting of 10,009 distinct site-specific N-glycans on 1988 glycosylation sites from 955 glycoproteins in five mouse tissues.Protein glycosylation is a heterogeneous post-translational modification that generates greater proteomic diversity that is difficult to analyze. Here the authors describe pGlyco 2.0, a workflow for the precise one step identification of intact N-glycopeptides at the proteome scale.

The front end test stand high performance H- ion source at Rutherford Appleton Laboratory.

PubMed

Faircloth, D C; Lawrie, S; Letchford, A P; Gabor, C; Wise, P; Whitehead, M; Wood, T; Westall, M; Findlay, D; Perkins, M; Savage, P J; Lee, D A; Pozimski, J K

2010-02-01

The aim of the front end test stand (FETS) project is to demonstrate that chopped low energy beams of high quality can be produced. FETS consists of a 60 mA Penning Surface Plasma Ion Source, a three solenoid low energy beam transport, a 3 MeV radio frequency quadrupole, a chopper, and a comprehensive suite of diagnostics. This paper details the design and initial performance of the ion source and the laser profile measurement system. Beam current, profile, and emittance measurements are shown for different operating conditions.

Development and Validity of the Rating Scales of Academic Skills for Reading Comprehension

ERIC Educational Resources Information Center

Shapiro, Edward S.; Gebhardt, Sarah; Flatley, Katie; Guard, Kirra B.; Fu, Qiong; Leichman, Erin S.; Calhoon, Mary Beth; Hojnoski, Robin

2017-01-01

The development and psychometric qualities of a measure using teacher judgment to rate performance in reading comprehension for narrative text is described--the Rating Scales for Academic Skills-Reading Comprehension Narrative (RSAS-RCN). Sixty-five teachers from the third, fourth, and fifth grades of 8 elementary schools completed the measure on…

What can be Learned from Silage Breeding Programs?

NASA Astrophysics Data System (ADS)

Lorenz, Aaron J.; Coors, James G.

Improving the quality of cellulosic ethanol feedstocks through breeding and genetic manipulation could significantly impact the economics of this industry. Attaining this will require comprehensive and rapid characterization of large numbers of samples. There are many similarities between improving corn silage quality for dairy production and improving feedstock quality for cellulosic ethanol. It was our objective to provide insight into what is needed for genetic improvement of cellulosic feedstocks by reviewing the development and operation of a corn silage breeding program. We discuss the evolving definition of silage quality and relate what we have learned about silage quality to what is needed for measuring and improving feedstock quality. In addition, repeatability estimates of corn stover traits are reported for a set of hybrids. Repeatability of theoretical ethanol potential measured by near-infrared spectroscopy is high, suggesting that this trait may be easily improved through breeding. Just as cell wall digestibility has been factored into the latest measurements of silage quality, conversion efficiency should be standardized and included in indices of feedstock quality to maximize overall, economical energy availability.

Manipulating Google’s Knowledge Graph Box to Counter Biased Information Processing During an Online Search on Vaccination: Application of a Technological Debiasing Strategy

PubMed Central

Allam, Ahmed; Schulz, Peter J

2016-01-01

Background One of people’s major motives for going online is the search for health-related information. Most consumers start their search with a general search engine but are unaware of the fact that its sorting and ranking criteria do not mirror information quality. This misconception can lead to distorted search outcomes, especially when the information processing is characterized by heuristic principles and resulting cognitive biases instead of a systematic elaboration. As vaccination opponents are vocal on the Web, the chance of encountering their non‒evidence-based views on immunization is high. Therefore, biased information processing in this context can cause subsequent impaired judgment and decision making. A technological debiasing strategy could counter this by changing people’s search environment. Objective This study aims at testing a technological debiasing strategy to reduce the negative effects of biased information processing when using a general search engine on people’s vaccination-related knowledge and attitudes. This strategy is to manipulate the content of Google’s knowledge graph box, which is integrated in the search interface and provides basic information about the search topic. Methods A full 3x2 factorial, posttest-only design was employed with availability of basic factual information (comprehensible vs hardly comprehensible vs not present) as the first factor and a warning message as the second factor of experimental manipulation. Outcome variables were the evaluation of the knowledge graph box, vaccination-related knowledge, as well as beliefs and attitudes toward vaccination, as represented by three latent variables emerged from an exploratory factor analysis. Results Two-way analysis of variance revealed a significant main effect of availability of basic information in the knowledge graph box on participants’ vaccination knowledge scores (F2,273=4.86, P=.01), skepticism/fear of vaccination side effects (F2,273=3.5, P=.03), and perceived information quality (F2,273=3.73, P=.02). More specifically, respondents receiving comprehensible information appeared to be more knowledgeable, less skeptical of vaccination, and more critical of information quality compared to participants exposed to hardly comprehensible information. Although, there was no significant interaction effect between the availability of information and the presence of the warning, there was a dominant pattern in which the presence of the warning appeared to have a positive influence on the group receiving comprehensible information while the opposite was true for the groups exposed to hardly comprehensible information and no information at all. Participants evaluated the knowledge graph box as moderately to highly useful, with no significant differences among the experimental groups. Conclusion Overall, the results suggest that comprehensible information in the knowledge graph box positively affects participants’ vaccination-related knowledge and attitudes. A small change in the content retrieval procedure currently used by Google could already make a valuable difference in the pursuit of an unbiased online information search. Further research is needed to gain insights into the knowledge graph box’s entire potential. PMID:27255736

Comparative mass spectrometry & nuclear magnetic resonance metabolomic approaches for nutraceuticals quality control analysis: a brief review.

PubMed

Farag, Mohamed A

2014-01-01

The number of botanical dietary supplements in the market has recently increased primarily due to increased health awareness. Standardization and quality control of the constituents of these plant extracts is an important topic, particularly when such ingredients are used long term as dietary supplements, or in cases where higher doses are marketed as drugs. The development of fast, comprehensive, and effective untargeted analytical methods for plant extracts is of high interest. Nuclear magnetic resonance spectroscopy and mass spectrometry are the most informative tools, each of which enables high-throughput and global analysis of hundreds of metabolites in a single step. Although only one of the two techniques is utilized in the majority of plant metabolomics applications, there is a growing interest in combining the data from both platforms to effectively unravel the complexity of plant samples. The application of combined MS and NMR in the quality control of nutraceuticals forms the major part of this review. Finally I will look at the future developments and perspectives of these two technologies for the quality control of herbal materials.

Nutritional modifications in male infertility: a systematic review covering 2 decades

PubMed Central

Mohammadmoradi, Shayan; Javidan, Aida; Sadeghi, Mohammad Reza

2016-01-01

Context: Studies suggest that appropriate nutritional modifications can improve the natural conception rate of infertile couples. Objectives: The purpose of this study was to review the human trials that investigated the relation between nutrition and male infertility. Data Sources: A comprehensive systematic review of published human studies was carried out by searching scientific databases. Article selection was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The American Dietetic Association Research Design and Implementation Checklist was also used for quality assessment. Data Extraction: A total of 502 articles were identified, of which 23 studies met the inclusion criteria. Data Synthesis: Results indicated that a healthy diet improves at least one measure of semen quality, while diets high in lipophilic foods, soy isoflavones, and sweets lower semen quality. Conclusion: The role of daily nutrient exposure and dietary quality needs to be highlighted in male infertility. Mechanistic studies addressing the responsible underlying mechanisms of action of dietary modifications are highly warranted. Systematic Review Registration: PROSPERO 2013: CRD42013005953. Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013005953. PMID:26705308

[Correspondence analysis between traditional commercial specifications and quantitative quality indices of Notopterygii Rhizoma et Radix].

PubMed

Jiang, Shun-Yuan; Sun, Hong-Bing; Sun, Hui; Ma, Yu-Ying; Chen, Hong-Yu; Zhu, Wen-Tao; Zhou, Yi

2016-03-01

This paper aims to explore a comprehensive assessment method combined traditional Chinese medicinal material specifications with quantitative quality indicators. Seventy-six samples of Notopterygii Rhizoma et Radix were collected on market and at producing areas. Traditional commercial specifications were described and assigned, and 10 chemical components and volatile oils were determined for each sample. Cluster analysis, Fisher discriminant analysis and correspondence analysis were used to establish the relationship between the traditional qualitative commercial specifications and quantitative chemical indices for comprehensive evaluating quality of medicinal materials, and quantitative classification of commercial grade and quality grade. A herb quality index (HQI) including traditional commercial specifications and chemical components for quantitative grade classification were established, and corresponding discriminant function were figured out for precise determination of quality grade and sub-grade of Notopterygii Rhizoma et Radix. The result showed that notopterol, isoimperatorin and volatile oil were the major components for determination of chemical quality, and their dividing values were specified for every grade and sub-grade of the commercial materials of Notopterygii Rhizoma et Radix. According to the result, essential relationship between traditional medicinal indicators, qualitative commercial specifications, and quantitative chemical composition indicators can be examined by K-mean cluster, Fisher discriminant analysis and correspondence analysis, which provide a new method for comprehensive quantitative evaluation of traditional Chinese medicine quality integrated traditional commodity specifications and quantitative modern chemical index. Copyright© by the Chinese Pharmaceutical Association.

Building a comprehensive team for the longitudinal care of single ventricle heart defects: Building blocks and initial results.

PubMed

Texter, Karen; Davis, Jo Ann M; Phelps, Christina; Cheatham, Sharon; Cheatham, John; Galantowicz, Mark; Feltes, Timothy F

2017-07-01

With increasing survival of children with HLHS and other single ventricle lesions, the complexity of medical care for these patients is substantial. Establishing and adhering to best practice models may improve outcome, but requires careful coordination and monitoring. In 2013 our Heart Center began a process to build a comprehensive Single Ventricle Team designed to target these difficult issues. Comprehensive Single Ventricle Team in 2014 was begun, to standardize care for children with single ventricle heart defects from diagnosis to adulthood within our institution. The team is a multidisciplinary group of providers committed to improving outcomes and quality of life for children with single ventricle heart defects, all functioning within the medical home of our heart center. Standards of care were developed and implemented in five target areas to standardize medical management and patient and family support. Under the team 100 patients have been cared for. Since 2014 a decrease in interstage mortality for HLHS were seen. Using a team approach and the tools of Quality Improvement they have been successful in reaching high protocol compliance for each of these areas. This article describes the process of building a successful Single Ventricle team, our initial results, and lessons learned. Additional study is ongoing to demonstrate the effects of these interventions on patient outcomes. © 2017 Wiley Periodicals, Inc.

General introduction for the “National Field Manual for the Collection of Water-Quality Data”

USGS Publications Warehouse

,

2018-02-28

BackgroundAs part of its mission, the U.S. Geological Survey (USGS) collects data to assess the quality of our Nation’s water resources. A high degree of reliability and standardization of these data are paramount to fulfilling this mission. Documentation of nationally accepted methods used by USGS personnel serves to maintain consistency and technical quality in data-collection activities. “The National Field Manual for the Collection of Water-Quality Data” (NFM) provides documented guidelines and protocols for USGS field personnel who collect water-quality data. The NFM provides detailed, comprehensive, and citable procedures for monitoring the quality of surface water and groundwater. Topics in the NFM include (1) methods and protocols for sampling water resources, (2) methods for processing samples for analysis of water quality, (3) methods for measuring field parameters, and (4) specialized procedures, such as sampling water for low levels of mercury and organic wastewater chemicals, measuring biological indicators, and sampling bottom sediment for chemistry. Personnel who collect water-quality data for national USGS programs and projects, including projects supported by USGS cooperative programs, are mandated to use protocols provided in the NFM per USGS Office of Water Quality Technical Memorandum 2002.13. Formal training, for example, as provided in the USGS class, “Field Water-Quality Methods for Groundwater and Surface Water,” and field apprenticeships supplement the guidance provided in the NFM and ensure that the data collected are high quality, accurate, and scientifically defensible.

Water Quality Monitoring

NASA Technical Reports Server (NTRS)

2002-01-01

With the backing of NASA, researchers at Michigan State University, the University of Minnesota, and the University of Wisconsin have begun using satellite data to measure lake water quality and clarity of the lakes in the Upper Midwest. This false color IKONOS image displays the water clarity of the lakes in Eagan, Minnesota. Scientists measure the lake quality in satellite data by observing the ratio of blue to red light in the satellite data. When the amount of blue light reflecting off of the lake is high and the red light is low, a lake generally had high water quality. Lakes loaded with algae and sediments, on the other hand, reflect less blue light and more red light. In this image, scientists used false coloring to depict the level of clarity of the water. Clear lakes are blue, moderately clear lakes are green and yellow, and murky lakes are orange and red. Using images such as these along with data from the Landsat satellites and NASA's Terra satellite, the scientists plan to create a comprehensive water quality map for the entire Great Lakes region in the next few years. For more information, read: Testing the Waters (Image courtesy Upper Great Lakes Regional Earth Science Applications Center, based on data copyright Space Imaging)

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

PubMed

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

2015-08-01

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

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

PubMed Central

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

2017-01-01

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

Quality of care provided in a special needs plan using a nurse care manager model.

PubMed

Wenger, Neil S; Roth, Carol P; Martin, David; Nickels, Lorraine; Beckman, Robin; Kamberg, Caren; Mach, John; Ganz, David A

2011-10-01

To comprehensively evaluate the quality of care provided in special needs plans (SNPs; Medicare Advantage plans that aim to provide specialized care for complex older adults) and specifically the nurse care management model in the community setting. We adapted 107 process-of-care quality measures across 12 conditions from the Assessing Care of Vulnerable Elders set to obtain a clinically detailed evaluation of the quality of care received by complex older enrollees in a dual eligible Evercare SNP. We abstracted 13 months of primary care medical records to delineate quality of care provided by physicians and whether there was value added from the nurse care manager model. Dual eligible Evercare SNP located in central Florida. Two-hundred thirty-one vulnerable older enrollees in the SNP who had complex disease. Based on physician medical records alone, the 231 high-risk participants (mean age 77, 67% women) received recommended care for 53% of 5,569 evaluated clinical circumstances, ranging from 12% for end-of-life care to 78% for diabetes mellitus. In fewer than 40% of these clinical circumstances was recommended care provided for dementia, falls, and urinary incontinence. In a second analysis accounting for care provided by both the Evercare nurse and the physician, recommended care was provided to patients in 69% of the 5,684 evaluated clinical circumstances. Comprehensive quality measurement applied to vulnerable older adults enrolled in one mature SNP showed that the Evercare nurse model addresses important deficits in physician care for geriatric conditions. Such measurement should be applied to other SNP models and to compare SNP care with that for complex, older, fee-for-service Medicare cohorts. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Search engine ranking, quality, and content of webpages that are critical vs noncritical of HPV vaccine

PubMed Central

Fu, Linda Y.; Zook, Kathleen; Spoehr-Labutta, Zachary; Hu, Pamela; Joseph, Jill G.

2015-01-01

Purpose Online information can influence attitudes toward vaccination. The aim of the present study is to provide a systematic evaluation of the search engine ranking, quality, and content of webpages that are critical versus noncritical of HPV vaccination. Methods We identified HPV vaccine-related webpages with the Google search engine by entering 20 terms. We then assessed each webpage for critical versus noncritical bias as well as for the following quality indicators: authorship disclosure, source disclosure, attribution of at least one reference, currency, exclusion of testimonial accounts, and readability level less than 9th grade. We also determined webpage comprehensiveness in terms of mention of 14 HPV vaccine relevant topics. Results Twenty searches yielded 116 unique webpages. HPV vaccine-critical webpages comprised roughly a third of the top, top 5 and top 10-ranking webpages. The prevalence of HPV vaccine-critical webpages was higher for queries that included term modifiers in addition to root terms. Compared with noncritical webpages, webpages critical of HPV vaccine overall had a lower quality score than those with a noncritical bias (p<.01) and covered fewer important HPV-related topics (p<.001). Critical webpages required viewers to have higher reading skills, were less likely to include an author byline, and were more likely to include testimonial accounts. They also were more likely to raise unsubstantiated concerns about vaccination. Conclusion Webpages critical of HPV vaccine may be frequently returned and highly ranked by search engine queries despite being of lower quality and less comprehensive than noncritical webpages. PMID:26559742

Prognostic Value of National Comprehensive Cancer Network Lung Cancer Resection Quality Parameters

PubMed Central

Osarogiagbon, Raymond U.; Ray, Meredith A.; Faris, Nicholas R.; Div, M.; Smeltzer, Matthew P.; Stat, M.; Fehnel, Carrie; Houston-Harris, Cheryl; Signore, Raymond S.; McHugh, Laura M.; Levy, Paul; Wiggins, Lynn; Sachdev, Vishal; Robbins, Edward T.

2017-01-01

Background The National Comprehensive Cancer Network (NCCN) surgical resection guidelines for non-small-cell lung cancer (NSCLC) recommend anatomic resection, negative margins, examination of hilar/intrapulmonary lymph nodes, and examination of 3 or more mediastinal nodal stations. We examined the survival impact of these guidelines. Methods Population-based observational study using patient-level data from all curative-intent NSCLC resections from 2004–2013 at 11 institutions in 4 contiguous Dartmouth Hospital Referral Regions in 3 US states. We used an adjusted Cox proportional hazards model to assess the overall survival impact of attaining NCCN guidelines. Results Of 2,429 eligible resections,91% were anatomic, 94% had negative margins, 51% sampled hilar nodes, and 26% examined three or more mediastinal nodal stations. Only 17% of resections met all four criteria, however there was a significant increasing trend from 2% in 2004 to 39% in 2013 (p<0.001). Compared to patients whose surgery missed one or more parameters, the hazard ratio for patients whose surgery met all four criteria was 0.71 (95% confidence interval: 0.59–0.86, p<0.001). Margin status and the nodal staging parameters were most strongly linked with survival. Conclusions Attainment of NCCN surgical quality guidelines was low, but improving, over the past decade in this cohort from a high lung cancer mortality region of the US. The NCCN quality criteria, especially the nodal examination criteria, were strongly associated with survival. The quality of nodal examination should be a focus of quality improvement in NSCLC care. PMID:28366464

Providing Effective Speech-Language Pathology Group Treatment in the Comprehensive Inpatient Rehabilitation Setting.

PubMed

Baron, Christine; Holcombe, Molly; van der Stelt, Candace

2018-02-01

Group treatment is an integral part of speech-language pathology (SLP) practice. The majority of SLP literature concerns group treatment provided in outpatient settings. This article describes the goals, procedures, and benefits of providing quality SLP group therapy in the comprehensive inpatient rehabilitation (CIR) setting. Effective CIR groups must be designed with attention to type and severity of communication impairment, as well physical stamina of group members. Group leaders need to target individualized patient goals while creating a challenging, complex, and dynamic group context that supports participation by all group members. Direct patient-to-patient interaction is fostered as much as possible. Peer feedback supports goal acquisition by fellow group members. The rich, complex group context fosters improved insight, initiation, social connectedness, and generalization of communication skills. Group treatment provides a unique type of treatment not easily replicated with individual treatment. SLP group treatment in a CIR is an essential component of an intensive, high-quality program. Continued advocacy for group therapy provision and research into its efficacy and effectiveness are warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

42 CFR § 510.315 - Composite quality scores for determining reconciliation payment eligibility and quality incentive...

Code of Federal Regulations, 2010 CFR

2016-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.315 Composite quality scores for determining reconciliation payment eligibility and quality incentive payments... reconciliation payment eligibility and quality incentive payments. § 510.315 Section § 510.315 Public Health...

42 CFR § 510.315 - Composite quality scores for determining reconciliation payment eligibility and quality incentive...

Code of Federal Regulations, 2010 CFR

2017-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.315 Composite quality scores for determining reconciliation payment eligibility and quality incentive payments... reconciliation payment eligibility and quality incentive payments. § 510.315 Section § 510.315 Public Health...

Urgency of increasing the quantity and quality of student creativity program

NASA Astrophysics Data System (ADS)

Sarmini; Prasetya, Ketut; Nadiroh, Ulin

2018-01-01

Student creativity is very important to improve the quality and quantity. The purpose of this paper is to identify the quality and quantity of the Student Creativity Program. The method in this research is exploratory study. The subjects taken are the leaders of deans and vice deans at the State University of Surabaya. Data collection techniques used are kusioner. The result of this research is creativity program in student is very important. Not only improve the quality and quantity of creativity, but also affect the image of the institution. It is necessary to have written rules on the regulations on the Student Creativity Program and to take a comprehensive and comprehensive approach, and to organize the budget is the main thing.

42 CFR 441.585 - Quality assurance system.

Code of Federal Regulations, 2012 CFR

2012-10-01

... provides information about the provisions of quality improvement and assurance to each individual receiving... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assurance system. 441.585 Section 441.585...) § 441.585 Quality assurance system. (a) States must establish and maintain a comprehensive, continuous...

An Amazing Medical Discovery! A Comprehensive Neighborhood Quality of Life Enrichment Program. An Intensive Prevention Program To Address the Social Causes of Individual and Community Pathology in an Inner-City Neighborhood. Revised.

ERIC Educational Resources Information Center

Miami-Dade Community Coll., FL. Medical Center Campus.

In 1991, Miami-Dade Community College (MDCC) developed a proposal for the Comprehensive Neighborhood Quality of Life Enrichment Program, a program to be based on the principles of holism, prevention, and community synergy, focusing on the treatment of individuals with many, complex, and "all-at-once" needs. The program will operate in a poor…

Evaluation of the structural, physicochemical, and biological characteristics of SB4, a biosimilar of etanercept

PubMed Central

Cho, Ick Hyun; Lee, Nayoung; Song, Dami; Jung, Seong Young; Bou-Assaf, George; Sosic, Zoran; Zhang, Wei; Lyubarskaya, Yelena

2016-01-01

ABSTRACT A biosimilar is a biological medicinal product that is comparable to a reference medicinal product in terms of quality, safety, and efficacy. SB4 was developed as a biosimilar to Enbrel® (etanercept) and was approved as Benepali®, the first biosimilar of etanercept licensed in the European Union (EU). The quality assessment of SB4 was performed in accordance with the ICH comparability guideline and the biosimilar guidelines of the European Medicines Agency and Food and Drug Administration. Extensive structural, physicochemical, and biological testing was performed with state-of-the-art technologies during a side-by-side comparison of the products. Similarity of critical quality attributes (CQAs) was evaluated on the basis of tolerance intervals established from quality data obtained from more than 60 lots of EU-sourced and US-sourced etanercept. Additional quality assessment was focused on a detailed investigation of immunogenicity-related quality attributes, including hydrophobic variants, high-molecular-weight (HMW) species, N-glycolylneuraminic acid (NGNA), and α-1,3-galactose. This comprehensive characterization study demonstrated that SB4 is highly similar to the reference product, Enbrel®, in structural, physicochemical, and biological quality attributes. In addition, the levels of potential immunogenicity-related quality attributes of SB4 such as hydrophobic variants, HMW aggregates, and α-1,3-galactose were less than those of the reference product. PMID:27246928

Indoor Air Quality in Schools

EPA Pesticide Factsheets

This web site will educate the public about indoor environmental issues specific to educational facilities and the importance of developing and sustaining comprehensive indoor air quality management programs.

Family Support: Fostering Leadership and Partnership to Improve Access and Quality. Building State Early Childhood Comprehensive Systems Series, Number 14

ERIC Educational Resources Information Center

Thompson, Lisa; Uyeda, Kimberly

2004-01-01

The federal Maternal and Child Health Bureau (MCHB) has launched a five-year initiative that will support state efforts to build comprehensive early childhood service systems. This initiative--the State Early Childhood Comprehensive Systems (SECCS) Initiative--provides planning and implementation grants to the state and territory Maternal and…

On the Road to Success: How States Collaborate and Use Data to Improve Student Outcomes. A Working Paper by the Achieving the Dream Cross-State Data Work Group

ERIC Educational Resources Information Center

Baldwin, Chris; Borcoman, Gabriela; Chappell-Long, Cheryl; Coperthwaite, Corby A.; Glenn, Darrell; Hutchinson, Tony; Hughes, John; Jenkins, Rick; Jovanovich, Donna; Keller, Jonathan; Klimczak, Benjamin; Schneider, Bill; Stewart, Carmen; Stuart, Debra; Yeager, Michael

2012-01-01

Enrollment is rising across the nation's community colleges, but completion rates remain untenably low. Reformers are focusing on the importance of using comprehensive, high-quality data on student progress and completion to bring about change. A core tenet of Achieving the Dream: Community Colleges Count has been to embed a culture of…

How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

PubMed

Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

2013-09-01

To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

PubMed

Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

2015-06-01

Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

Qualitative characterization of Desmodium adscendens constituents by high-performance liquid chromatography-diode array ultraviolet-electrospray ionization multistage mass spectrometry.

PubMed

Baiocchi, Claudio; Medana, Claudio; Giancotti, Valeria; Aigotti, Riccardo; Dal Bello, Frederica; Massolino, Cristina; Gastaldi, Daniela; Grandi, Maurizio

2013-01-01

The many effects of the African medicinal herb Desmodium adscendens were studied in the 1980s and 1990s. In spite of this, a comprehensive analytical protocol for the quality control of its constituents (soyasaponins, alkaloids and flavonoids) has not yet been formulated and reported. This study deals with the optimization of extraction conditions from the plant and qualitative identification of the constituents by HPLC-diode array UV and multistage mass spectrometry. Plant constituents were extracted from leaves by liquid-liquid and solid matrix dispersion extraction. Separation was achieved via RP-C18 liquid chromatographywith UV and MS(n) detection and mass spectrometry analysis was conducted by electrospray ionization ion trap or orbitrap mass spectrometry. High resolution mass spectrometry (HRMS) was used for structural identification of active molecules relating to soyasaponins and alkaloids. The flavonoid fragmentations were preliminarily studied by HRMS in order to accurately characterize the more common neutral losses. However, the high number of isomeric species induced us to make recourse to a more extended chromatographic separation in order to enable useful tandem mass spectrometry and ultraviolet spectral interpretation to propose a reasonable chemical classification of these polyphenols. 35 compounds of this class were identified herein with respect to the five reported in literature in this way we made up a comprehensive protocol for the qualitative analysis of the high complexity content of this plant. This result paves the way for both reliable quality control of potential phytochemical medicaments and possible future systematic clinical studies.

[Do laymen understand information about hospital quality? An empirical verification using risk-adjusted mortality rates as an example].

PubMed

Sander, Uwe; Kolb, Benjamin; Taheri, Fatemeh; Patzelt, Christiane; Emmert, Martin

2017-11-01

The effect of public reporting to improve quality in healthcare is reduced by the limited intelligibility of information about the quality of healthcare providers. This may result in worse health-related choices especially for older people and those with lower levels of education. There is, as yet, little information as to whether laymen understand the concepts behind quality comparisons and if this comprehension is correlated with hospital choices. An instrument with 20 items was developed to analyze the intelligibility of five technical terms which were used in German hospital report cards to explain risk-adjusted death rates. Two online presentations of risk-adjusted death rates for five hospitals in the style of hospital report cards were developed. An online survey of 353 volunteers tested the comprehension of the risk-adjusted mortality rates and included an experimental hospital choice. The intelligibility of five technical terms was tested: risk-adjusted, actual and expected death rate, reference range and national average. The percentages of correct answers for the five technical terms were in the range of 75.0-60.2%. Between 23.8% and 5.1% of the respondents were not able to answer the question about the technical term itself. The least comprehensible technical terms were "risk-adjusted death rate" and "reference range". The intelligibility of the 20 items that were used to test the comprehension of the risk-adjusted mortality was between 89.5% and 14.2%. The two items that proved to be least comprehensible were related to the technical terms "risk-adjusted death rate" and "reference range". For all five technical terms it was found that a better comprehension correlated significantly with better hospital choices. We found a better than average intelligibility for the technical terms "actual and expected death rate" and for "national average". The least understandable were "risk-adjusted death rate" and "reference range". Since the self-explanatory technical terms "actual and expected death rate" and "national average" are easy to understand and the comprehension is correlated with hospitals choices, we recommend using them for the presentation of measures which contain risk-adjusted mortality. The technical terms "risk-adjusted death rate" and "reference range" should stay in the background, since comprehension problems can be expected and explanations would have to be provided. Copyright © 2017. Published by Elsevier GmbH.

The integrated quality assessment of Chinese commercial dry red wine based on a method of online HPLC-DAD-CL combined with HPLC-ESI-MS.

PubMed

Yu, Hai-Xiang; Sun, Li-Qiong; Qi, Jin

2014-07-01

To apply an integrated quality assessment strategy to investigate the quality of multiple Chinese commercial dry red wine samples. A comprehensive method was developed by combining a high performance liquid chromatography-diode array detector-chemiluminescence (HPLC-DAD-CL) online hyphenated system with an HPLC-ESI-MS technique. Chromatographic and H2O2-scavenging active fingerprints of thirteen batches of different, commercially available Chinese dry red wine samples were obtained and analyzed. Twenty-five compounds, including eighteen antioxidants were identified and evaluated. The dominant and characteristic antioxidants in the samples were identified. The relationships between antioxidant potency and the cultivated variety of grape, producing area, cellaring period, and trade mark are also discussed. The results provide the feasibility for an integrated quality assessment strategy to be efficiently and objectively used in quality (especially antioxidant activity) assessment and identification of dry red wine. Copyright © 2014 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

Assessment of air quality in Haora River basin using fuzzy multiple-attribute decision making techniques.

PubMed

Singh, Ajit Pratap; Chakrabarti, Sumanta; Kumar, Sumit; Singh, Anjaney

2017-08-01

This paper deals with assessment of air quality in Haora River basin using two techniques. Initially, air quality indices were evaluated using a modified EPA method. The indices were also evaluated using a fuzzy comprehensive assessment (FCA) method. The results obtained from the fuzzy comprehensive assessment method were compared to that obtained from the modified EPA method. To illustrate the applicability of the methodology proposed herein, a case study has been presented. Air samples have been collected at 10 sampling sites located along Haora River. Six important air pollutants, namely, carbon monoxide, sulfur dioxide, nitrogen dioxide, suspended particulate matter (SPM), PM 10 , and lead, were monitored continuously, and air quality maps were generated on the GIS platform. Comparison of the methodologies has clearly highlighted superiority and robustness of the fuzzy comprehensive assessment method in determining air quality indices under study. It has effectively addressed the inherent uncertainties involved in the evaluation, modeling, and interpretation of sampling data, which was beyond the scope of the traditional weighted approaches employed otherwise. The FCA method is robust and prepares a credible platform of air quality evaluation and identification, in face of the uncertainties that remain eclipsed in the traditional approaches like the modified EPA method. The insights gained through the present study are believed to be of pivotal significance in guiding the development and implementation of effective environmental remedial action plans in the study area.

75 FR 41106 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan to Update Water...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-15

... (also called water quality criteria) for human health and aquatic life for toxic pollutants in the... Commission in 1996 adopted water quality criteria for human health and aquatic life for Water Quality Zones 2... Objectives for Toxic Pollutants for the Protection of Aquatic Life'', Table 6, ``Stream Quality Objectives...

A comprehensive study on the relationship between the image quality and imaging dose in low-dose cone beam CT

NASA Astrophysics Data System (ADS)

Yan, Hao; Cervino, Laura; Jia, Xun; Jiang, Steve B.

2012-04-01

While compressed sensing (CS)-based algorithms have been developed for the low-dose cone beam CT (CBCT) reconstruction, a clear understanding of the relationship between the image quality and imaging dose at low-dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot both the image quality and imaging dose together as functions of the number of projections and mAs per projection over the whole clinically relevant range. On this basis, a clear understanding of the tradeoff between the image quality and imaging dose can be achieved and optimal low-dose CBCT scan protocols can be developed to maximize the dose reduction while minimizing the image quality loss for various imaging tasks in image-guided radiation therapy (IGRT). Main findings of this work include (1) under the CS-based reconstruction framework, image quality has little degradation over a large range of dose variation. Image quality degradation becomes evident when the imaging dose (approximated with the x-ray tube load) is decreased below 100 total mAs. An imaging dose lower than 40 total mAs leads to a dramatic image degradation, and thus should be used cautiously. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40-100 total mAs, depending on the specific IGRT applications. (2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with the projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with low mAs protocols. (3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. (4) The clinically acceptable lowest imaging dose level is task dependent. In our study, 72.8 mAs is a safe dose level for visualizing low-contrast objects, while 12.2 total mAs is sufficient for detecting high-contrast objects of diameter greater than 3 mm.

Relation Between the Level of American Indian and Alaska Native Diabetes Education Program Services and Quality-of-Care Indicators

PubMed Central

Noonan, Carolyn; Goldberg, Jack H.; Valdez, S. Lorraine; Brown, Tammy L.; Manson, Spero M.; Acton, Kelly

2008-01-01

Objectives. We examined the relation between the level of diabetes education program services in the Indian Health Service (IHS) and indicators of the quality of diabetes care to determine if more-comprehensive diabetes services were associated with better quality of diabetes care. Methods. In this cross-sectional study, we used the IHS Integrated Diabetes Education Recognition Program to rank program services into 1 of 3 levels of comprehensiveness, ranging from lowest (developmental) to highest (integrated). We compared quality-of-care indicators among programs of differing levels with the 2001 IHS Diabetes Care and Outcomes Audit. Quality indicators included patients having recommended yearly examinations, education, and laboratory tests and achieving recommended levels of intermediate outcomes of care. Results. Most of the 86 participating programs were classified at or below the developmental level; only 9 programs (11%) were ranked at higher levels. After adjusting for patient characteristics, program factors, and correlation of patients within programs, we associated programs that were more comprehensive with higher completion rates of yearly lipid and hemoglobin A1C tests (P < .05). Conclusions. System-wide improvements in diabetes education are associated with better diabetes care. The results can help inform the development of diabetes education programs. PMID:18511737

Comprehensive optimization process of paranasal sinus radiography.

PubMed

Saarakkala, S; Nironen, K; Hermunen, H; Aarnio, J; Heikkinen, J O

2009-04-01

The optimization of radiological examinations is important in order to reduce unnecessary patient radiation exposure. To perform a comprehensive optimization process for paranasal sinus radiography at Mikkeli Central Hospital, Finland. Patients with suspicion of acute sinusitis were imaged with a Kodak computed radiography (CR) system (n=20) and with a Philips digital radiography (DR) system (n=30) using focus-detector distances (FDDs) of 110 cm, 150 cm, or 200 cm. Patients' radiation exposure was determined in terms of entrance surface dose and dose-area product. Furthermore, an anatomical phantom was used for the estimation of point doses inside the head. Clinical image quality was evaluated by an experienced radiologist, and physical image quality was evaluated from the digital radiography phantom. Patient doses were significantly lower and image quality better with the DR system compared to the CR system. The differences in patient dose and physical image quality were small with varying FDD. Clinical image quality of the DR system was lowest with FDD of 200 cm. Further, imaging with FDD of 150 cm was technically easier for the technologist to perform than with FDD of 110 cm. After optimization, it was recommended that the DR system with FDD of 150 cm should always be used at Mikkeli Central Hospital. We recommend this kind of comprehensive approach in all optimization processes of radiological examinations.

Comparative transcriptome analysis to investigate the potential role of miRNAs in milk protein/fat quality.

PubMed

Wang, Xuehui; Zhang, Li; Jin, Jing; Xia, Anting; Wang, Chunmei; Cui, Yingjun; Qu, Bo; Li, Qingzhang; Sheng, Chunyan

2018-04-19

miRNAs play an important role in the processes of cell differentiation, biological development, and physiology. Here we investigated the molecular mechanisms regulating milk secretion and quality in dairy cows via transcriptome analyses of mammary gland tissues from dairy cows during the high-protein/high-fat, low-protein/low-fat or dry periods. To characterize the important roles of miRNAs and mRNAs in milk quality and to elucidate their regulatory networks in relation to milk secretion and quality, an integrated analysis was performed. A total of 25 core miRNAs were found to be differentially expressed (DE) during lactation compared to non-lactation, and these miRNAs were involved in epithelial cell terminal differentiation and mammary gland development. In addition, comprehensive analysis of mRNA and miRNA expression between high-protein/high-fat group and low-protein/low-fat groups indicated that, 38 miRNAs and 944 mRNAs were differentially expressed between them. Furthermore, 38 DE miRNAs putatively negatively regulated 253 DE mRNAs. The putative genes (253 DE mRNAs) were enriched in lipid biosynthetic process and amino acid transmembrane transporter activity. Moreover, putative DE genes were significantly enriched in fatty acid (FA) metabolism, biosynthesis of amino acids, synthesis and degradation of ketone bodies and biosynthesis of unsaturated FAs. Our results suggest that DE miRNAs might play roles as regulators of milk quality and milk secretion during mammary gland differentiation.

Behavior Therapy for Tourette Syndrome: A Systematic Review and Meta-analysis.

PubMed

Wile, Daryl J; Pringsheim, Tamara M

2013-08-01

When tics caused by Tourette Syndrome cause meaningful impairment for patients, a comprehensive treatment approach includes education of patients, peers, and family, treatment of comorbid behavioral disorders if present, and consideration of behavior therapy and pharmacotherapy for tics themselves. This systematic review and meta-analysis demonstrates that behavior therapies based on Habit Reversal Therapy, including the Comprehensive Behavioral Intervention for Tics are effective in reducing tic severity when compared with supportive psychotherapy. When these behavior therapies are unavailable, Exposure with Response Prevention may also be effective. Both face-to-face and telehealth delivery methods for behavior therapy improve tic severity, and broader distribution of behavior therapy through increased training or telehealth methods is encouraged. High-quality randomized trials comparing behavior therapies for tics with pharmacotherapy are needed.

EPA Facility Registry Service (FRS): CERCLIS

EPA Pesticide Factsheets

This data provides location and attribute information on Facilities regulated under the Comprehensive Environmental Responsibility Compensation and Liability Information System (CERCLIS) for a intranet web feature service . The data provided in this service are obtained from EPA's Facility Registry Service (FRS). The FRS is an integrated source of comprehensive (air, water, and waste) environmental information about facilities, sites or places. This service connects directly to the FRS database to provide this data as a feature service. FRS creates high-quality, accurate, and authoritative facility identification records through rigorous verification and management procedures that incorporate information from program national systems, state master facility records, data collected from EPA's Central Data Exchange registrations and data management personnel. Additional Information on FRS is available at the EPA website https://www.epa.gov/enviro/facility-registry-service-frs.

Maternal Quality Standards for Children's Television Programs.

ERIC Educational Resources Information Center

Nikken, Peter; And Others

1996-01-01

Investigates the standards mothers use to evaluate four types of children's television programs: (1) cartoons; (2) news programs for children; (3) educational children's programs; and (4) dramatic children's programs. Three quality standards considered most important were comprehensibility, aesthetic quality, and elicitation of involvement.…

Using the Community Readiness Model to Examine the Built and Social Environment: A Case Study of the High Point Neighborhood, Seattle, Washington, 2000–2010

PubMed Central

Sharify, Denise Tung; Blake, Bonita; Phillips, Tom; Whitten, Kathleen

2014-01-01

Background Residents of many cities lack affordable, quality housing. Economically disadvantaged neighborhoods often have high rates of poverty and crime, few institutions that enhance the quality of its residents’ lives, and unsafe environments for walking and other physical activity. Deteriorating housing contributes to asthma-related illness. We describe the redevelopment of High Point, a West Seattle neighborhood, to improve its built environment, increase neighborhood physical activity, and reduce indoor asthma triggers. Community Context High Point is one of Seattle’s most demographically diverse neighborhoods. Prior to redevelopment, it had a distressed infrastructure, rising crime rates, and indoor environments that increased asthma-related illness in children and adolescents. High Point residents and partners developed and implemented a comprehensive redevelopment plan to create a sustainable built environment to increase outdoor physical activity and improve indoor environments. Methods We conducted a retrospective analysis of the High Point redevelopment, organized by the different stages of change in the Community Readiness Model. We also examined the multisector partnerships among government and community groups that contributed to the success of the High Point project. Outcome Overall quality of life for residents improved as a result of neighborhood redevelopment. Physical activity increased, residents reported fewer days of poor physical or mental health, and social connectedness between neighbors grew. Asthma-friendly homes significantly decreased asthma-related illness among children and adolescents. Interpretation Providing affordable, quality housing to low-income families improved individual and neighborhood quality of life. Efforts to create social change and improve the health outcomes for entire populations are more effective when multiple organizations work together to improve neighborhood health. PMID:25376016

Using the community readiness model to examine the built and social environment: a case study of the High Point neighborhood, Seattle, Washington, 2000-2010.

PubMed

Buckner-Brown, Joyce; Sharify, Denise Tung; Blake, Bonita; Phillips, Tom; Whitten, Kathleen

2014-11-06

Residents of many cities lack affordable, quality housing. Economically disadvantaged neighborhoods often have high rates of poverty and crime, few institutions that enhance the quality of its residents' lives, and unsafe environments for walking and other physical activity. Deteriorating housing contributes to asthma-related illness. We describe the redevelopment of High Point, a West Seattle neighborhood, to improve its built environment, increase neighborhood physical activity, and reduce indoor asthma triggers. High Point is one of Seattle's most demographically diverse neighborhoods. Prior to redevelopment, it had a distressed infrastructure, rising crime rates, and indoor environments that increased asthma-related illness in children and adolescents. High Point residents and partners developed and implemented a comprehensive redevelopment plan to create a sustainable built environment to increase outdoor physical activity and improve indoor environments. We conducted a retrospective analysis of the High Point redevelopment, organized by the different stages of change in the Community Readiness Model. We also examined the multisector partnerships among government and community groups that contributed to the success of the High Point project. Overall quality of life for residents improved as a result of neighborhood redevelopment. Physical activity increased, residents reported fewer days of poor physical or mental health, and social connectedness between neighbors grew. Asthma-friendly homes significantly decreased asthma-related illness among children and adolescents. Providing affordable, quality housing to low-income families improved individual and neighborhood quality of life. Efforts to create social change and improve the health outcomes for entire populations are more effective when multiple organizations work together to improve neighborhood health.

Exposure–Response Relationship Between Aircraft Noise and Sleep Quality: A Community-based Cross-sectional Study

PubMed Central

Kim, Soo Jeong; Chai, Sang Kug; Lee, Keou Won; Park, Jae-Beom; Min, Kyoung-Bok; Kil, Hyun Gwon; Lee, Chan; Lee, Kyung Jong

2014-01-01

Objectives Exposure to aircraft noise has been shown to have adverse health effects, causing annoyance and affecting the health-related quality of life, sleep, and mental states of those exposed to it. This study aimed to determine sleep quality in participants residing near an airfield and to evaluate the relationship between the levels of aircraft noise and sleep quality. Methods Neighboring regions of a military airfield were divided into three groups: a high exposure group, a low exposure group, and a control group. A total of 1082 participants (aged 30–79 years) completed a comprehensive self-administered questionnaire requesting information about demographics, medical history, lifestyle, and the Pittsburgh Sleep Quality Index. Results Of the 1082 participants, 1005 qualified for this study. The prevalence of sleep disturbance was 45.5% in the control group, 71.8% in the low exposure group, and 77.1% in the high exposure group (p for trend < 0.001). After adjusting for potential confounding factors, we determined the exposure–response relationship between the degree of aircraft noise and sleep quality. Of the participants with a normal mental status, the prevalence of sleep disturbance was 2.61-fold higher in the low exposure group and 3.52-fold higher in the high exposure group than in the control group. Conclusion The relationship between aircraft noise and health should be further evaluated through a large-scale follow-up study. PMID:24955321

Comprehensive Flood Plain Studies Using Spatial Data Management Techniques.

DTIC Science & Technology

1978-06-01

Hydrologic Engineer- ing Center computer programs that forecast urban storm water quality and dynamic in- stream water quality response to waste...determination. Water Quality The water quality analysis planned for the pilot study includes urban storm water quality forecasting and in-streamn...analysis is performed under the direction of Tony Thomas. Chief, Research Branch, by Jess Abbott for storm water quality analysis, R. G. Willey for

Multiple Criteria Evaluation of Quality and Optimisation of e-Learning System Components

ERIC Educational Resources Information Center

Kurilovas, Eugenijus; Dagiene, Valentina

2010-01-01

The main research object of the paper is investigation and proposal of the comprehensive Learning Object Repositories (LORs) quality evaluation tool suitable for their multiple criteria decision analysis, evaluation and optimisation. Both LORs "internal quality" and "quality in use" evaluation (decision making) criteria are analysed in the paper.…

A comprehensive audit of nursing record keeping practice.

PubMed

Griffiths, Paul; Debbage, Samantha; Smith, Alison

Good quality record keeping is essential to safe and effective patient care. To ensure that high standards of record keeping are maintained, regular clinical audit should be undertaken. This article describes an audit and re-audit of nursing record keeping at Sheffield Teaching Hospital NHS Foundation Trust. The article demonstrates improving audit data in 2005 and 2006 and describes how audit and the resulting recommendations and action plans can result in real improvements in the quality of record keeping. The keys to success in this ongoing audit programme are identified as stakeholder involvement, support from the senior nurses in the organization and the use of the data for both local and trust-wide purposes.

Flying qualities design criteria applicable to supersonic cruise aircraft

NASA Technical Reports Server (NTRS)

Chalk, C. R.

1980-01-01

A comprehensive set of flying qualities design criteria was prepared for use in the supersonic cruise research program. The framework for stating the design criteria is established and design criteria are included which address specific failures, approach to dangerous flight conditions, flight at high angle of attack, longitudinal and lateral directional stability and control, the primary flight control system, and secondary flight controls. Examples are given of lateral directional design criteria limiting lateral accelerations at the cockpit, time to roll through 30 deg of bank, and time delay in the pilot's command path. Flight test data from the Concorde certification program are used to substantiate a number of the proposed design criteria.

Quality focus shining on corporate ethics.

PubMed

2003-01-01

Compliance just scratches the surface of a comprehensive ethics policy. Being true to your mission is a critical component of governance responsibilities. Quality managers play an important role in feedback, implementation.

Very low intravenous contrast volume protocol for computed tomography angiography providing comprehensive cardiac and vascular assessment prior to transcatheter aortic valve replacement in patients with chronic kidney disease.

PubMed

Pulerwitz, Todd C; Khalique, Omar K; Nazif, Tamim N; Rozenshtein, Anna; Pearson, Gregory D N; Hahn, Rebecca T; Vahl, Torsten P; Kodali, Susheel K; George, Isaac; Leon, Martin B; D'Souza, Belinda; Po, Ming Jack; Einstein, Andrew J

2016-01-01

Transcatheter aortic valve replacement (TAVR) is a lifesaving procedure for many patients high risk for surgical aortic valve replacement. The prevalence of chronic kidney disease (CKD) is high in this population, and thus a very low contrast volume (VLCV) computed tomography angiography (CTA) protocol providing comprehensive cardiac and vascular imaging would be valuable. 52 patients with severe, symptomatic aortic valve disease, undergoing pre-TAVR CTA assessment from 2013-4 at Columbia University Medical Center were studied, including all 26 patients with CKD (eGFR<30 mL/min) who underwent a novel VLCV protocol (20 mL of iohexol at 2.5 mL/s), and 26 standard-contrast-volume (SCV) protocol patients. Using a 320-slice volumetric scanner, the protocol included ECG-gated volume scanning of the aortic root followed by medium-pitch helical vascular scanning through the femoral arteries. Two experienced cardiologists performed aortic annulus and root measurements. Vascular image quality was assessed by two radiologists using a 4-point scale. VLCV patients had mean (±SD) age 86 ± 6.5, BMI 23.9 ± 3.4 kg/m(2) with 54% men; SCV patients age 83 ± 8.8, BMI 28.7 ± 5.3 kg/m(2), 65% men. There was excellent intra- and inter-observer agreement for annular and root measurements, and excellent agreement with 3D-transesophageal echocardiographic measurements. Both radiologists found diagnostic-quality vascular imaging in 96% of VLCV and 100% of SCV cases, with excellent inter-observer agreement. This study is the first of its kind to report the feasibility and reproducibility of measurements for a VLCV protocol for comprehensive pre-TAVR CTA. There was excellent agreement of cardiac measurements and almost all studies were diagnostic quality for vascular access assessment. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Effect of phonological and morphological awareness on reading comprehension in Hebrew-speaking adolescents with reading disabilities.

PubMed

Schiff, Rachel; Schwartz-Nahshon, Sarit; Nagar, Revital

2011-06-01

This research explored phonological and morphological awareness among Hebrew-speaking adolescents with reading disabilities (RD) and its effect on reading comprehension beyond phonological and word-reading abilities. Participants included 39 seventh graders with RD and two matched control groups of normal readers: 40 seventh graders matched for chronological age (CA) and 38 third graders matched for reading age (RA). We assessed phonological awareness, word reading, morphological awareness, and reading comprehension. Findings indicated that the RD group performed similarly to the RA group on phonological awareness but lower on phonological decoding. On the decontextualized morphological task, RD functioned on par with RA, whereas in a contextualized task RD performed above RA but lower than CA. In reading comprehension, RD performed as well as RA. Finally, results indicated that for normal readers contextual morphological awareness uniquely contributed to reading comprehension beyond phonological and word-reading abilities, whereas no such unique contribution emerged for the RD group. The absence of an effect of morphological awareness in predicting reading comprehension was suggested to be related to a different recognition process employed by RD readers which hinder the ability of these readers to use morphosemantic structures. The lexical quality hypothesis was proposed as further support to the findings, suggesting that a low quality of lexical representation in RD students leads to ineffective reading skills and comprehension. Lexical representation is thus critical for both lexical as well as comprehension abilities.

Using ZIP Code Business Patterns Data to Measure Alcohol Outlet Density

PubMed Central

Matthews, Stephen A.; McCarthy, John D.; Rafail, Patrick S.

2014-01-01

Some states maintain high-quality alcohol outlet databases but quality varies by state, making comprehensive comparative analysis across US communities difficult. This study assesses the adequacy of using ZIP Code Business Patterns (ZIP-BP) data on establishments as estimates of the number of alcohol outlets by ZIP code. Specifically we compare ZIP-BP alcohol outlet counts with high-quality data from state and local records surrounding 44 college campus communities across 10 states plus the District of Columbia. Results show that a composite measure is strongly correlated (R=0.89) with counts of alcohol outlets generated from official state records. Analyses based on Generalized Estimation Equation models show that community and contextual factors have little impact on the concordance between the two data sources. There are also minimal inter-state differences in the level of agreement. To validate the use of a convenient secondary data set (ZIP-BP) it is important to have a high correlation with the more complex, high quality and more costly data product (i.e., datasets based on the acquisition and geocoding of state and local records) and then to clearly demonstrate that the discrepancy between the two to be unrelated to relevant explanatory variables. Thus our overall findings support the adequacy of using a conveniently available data set (ZIP-BP data) to estimate alcohol outlet densities in ZIP code areas in future research. PMID:21411233

Management of MSW in Spain and recovery of packaging steel scrap.

PubMed

Tayibi, Hanan; Peña, Carmen; López, Félix A; López-Delgado, Aurora

2007-01-01

Packaging steel is more advantageously recovered and recycled than other packaging material due to its magnetic properties. The steel used for packaging is of high quality, and post-consumer waste therefore produces high-grade ferrous scrap. Recycling is thus an important issue for reducing raw material consumption, including iron ore, coal and energy. Household refuse management consists of collection/disposal, transport, and processing and treatment - incineration and composting being the most widely used methods in Spain. Total Spanish MSW production exceeds 21 million tons per year, of which 28.1% and 6.2% are treated in compost and incineration plants, respectively. This paper presents a comprehensive study of incineration and compost plants in Spain, including a review of the different processes and technologies employed and the characteristics and quality of the recovered ferrous scrap. Of the total amount of packaging steel scrap recovered from MSW, 38% comes from compost plants and 14% from incineration plants. Ferrous scrap from incineration plants presents a high degree of chemical alteration as a consequence of the thermal process to which the MSW is subjected, particularly the conditions in which the slag is cooled, and accordingly its quality diminishes. Fragmentation and magnetic separation processes produce an enhancement of the scrap quality. Ferrous scrap from compost plants has a high tin content, which negatively affects its recycling. Cleaning and detinning processes are required prior to recycling.

Using ZIP code business patterns data to measure alcohol outlet density.

PubMed

Matthews, Stephen A; McCarthy, John D; Rafail, Patrick S

2011-07-01

Some states maintain high-quality alcohol outlet databases but quality varies by state, making comprehensive comparative analysis across US communities difficult. This study assesses the adequacy of using ZIP Code Business Patterns (ZIP-BP) data on establishments as estimates of the number of alcohol outlets by ZIP code. Specifically we compare ZIP-BP alcohol outlet counts with high-quality data from state and local records surrounding 44 college campus communities across 10 states plus the District of Columbia. Results show that a composite measure is strongly correlated (R=0.89) with counts of alcohol outlets generated from official state records. Analyses based on Generalized Estimation Equation models show that community and contextual factors have little impact on the concordance between the two data sources. There are also minimal inter-state differences in the level of agreement. To validate the use of a convenient secondary data set (ZIP-BP) it is important to have a high correlation with the more complex, high quality and more costly data product (i.e., datasets based on the acquisition and geocoding of state and local records) and then to clearly demonstrate that the discrepancy between the two to be unrelated to relevant explanatory variables. Thus our overall findings support the adequacy of using a conveniently available data set (ZIP-BP data) to estimate alcohol outlet densities in ZIP code areas in future research. Copyright © 2011 Elsevier Ltd. All rights reserved.

Addressing Palliative Care Clinician Burnout in Organizations: A Workforce Necessity, an Ethical Imperative.

PubMed

Harrison, Krista L; Dzeng, Elizabeth; Ritchie, Christine S; Shanafelt, Tait D; Kamal, Arif H; Bull, Janet H; Tilburt, Jon C; Swetz, Keith M

2017-06-01

Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. This is especially problematic in hospice and palliative care: patients are often frail, elderly, vulnerable, and complex; access to care is often outstripped by need; and demand for clinical experts will increase as palliative care further integrates into usual care. Efforts to mitigate and prevent burnout currently focus on individual clinicians. However, analysis of the problem of burnout should be expanded to include both individual- and systems-level factors as well as solutions; comprehensive interventions must address both. As a society, we hold organizations responsible for acting ethically, especially when it relates to deployment and protection of valuable and constrained resources. We should similarly hold organizations responsible for being ethical stewards of the resource of highly trained and talented clinicians through comprehensive programs to address burnout. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Back-support large laser mirror unit: mounting modeling and analysis

NASA Astrophysics Data System (ADS)

Wang, Hui; Zhang, Zheng; Long, Kai; Liu, Tianye; Li, Jun; Liu, Changchun; Xiong, Zhao; Yuan, Xiaodong

2018-01-01

In high-power laser system, the surface wavefront of large optics has a close link with its structure design and mounting method. The back-support transport mirror design is presently being investigated as a means in China's high-power laser system to hold the optical component firmly while minimizing the distortion of its reflecting surface. We have proposed a comprehensive analytical framework integrated numerical modeling and precise metrology for the mirror's mounting performance evaluation while treating the surface distortion as a key decision variable. The combination of numerical simulation and field tests demonstrates that the comprehensive analytical framework provides a detailed and accurate approach to evaluate the performance of the transport mirror. It is also verified that the back-support transport mirror is effectively compatible with state-of-the-art optical quality specifications. This study will pave the way for future research to solidify the design of back-support large laser optics in China's next generation inertial confinement fusion facility.

A Relationship between the Florida Comprehensive Assessment Test 2.0 Mathematics Scores and Racial and Ethnic Concentration when Considering Socio-Economic Status, ESOL Student Population, and School Climate

ERIC Educational Resources Information Center

Galindo, Marilys

2013-01-01

From the moment children are born, they begin a lifetime journey of learning about themselves and their surroundings. With the establishment of the No Child Left Behind Act of 2001, it mandates that all children receive a high-quality education in a positive school climate. Regardless of the school the child attends or the neighborhood in which…

Multisyllabic Word Reading as a Moderator of Morphological Awareness and Reading Comprehension

PubMed Central

Gilbert, Jennifer K.; Goodwin, Amanda P.; Compton, Donald L.; Kearns, Devin M.

2013-01-01

The purpose of this study was to investigate whether the relation between morphological awareness on reading comprehension is moderated by multisyllabic word reading ability in fifth grade students (N = 169, 53.7% female, 65.2% minority status, 69.2% free/reduced lunch status), oversampled for poor reading skill, when controlling for general knowledge and vocabulary. Based on the lexical quality hypothesis (Perfetti, 2007), it was expected that morphological awareness would have a stronger effect on comprehension for children with poor word reading skills, suggesting possible use of morphological awareness for word identification support. Results indicated that neither morphological awareness nor word reading was uniquely associated with reading comprehension when both were included in the model along with vocabulary and general knowledge. Instead, the interaction between word reading and morphological awareness explained significant additional variance in reading comprehension. By probing this interaction, it was determined that the effect of morphological awareness on reading comprehension was significant for the 39% of the sample that had more difficulty reading multisyllabic words), but not for students at the higher end of the multisyllabic word reading continuum. We conclude from these results that the relation between morphological awareness and reading comprehension is moderated by multisyllabic word reading ability, providing support for the lexical quality hypothesis (Perfetti, 2007). Although we have only correlational data, we suggest tentative instructional practices for improving the reading skill of upper elementary struggling readers. PMID:24219914

Watching Galaxy Evolution in High Definition

NASA Technical Reports Server (NTRS)

Rigby, Jane

2011-01-01

As Einstein predicted, mass deflects light. In hundreds of known cases, "gravitational lenses" have deflected, distorted, and amplified images of galaxies or quasars behind them. As such, gravitational lensing is a way to "cheat" at studying how galaxies evolve, because lensing can magnify galaxies by factors of 10--100 times, transforming them from objects we can barely detect to bright objects we can study in detail. I'll summarize new results from a comprehensive program, using multi-wavelength, high-quality spectroscopy, to study how galaxies formed stars at redshifts of 1--3, the epoch when most of the Universe's stars were formed.

Watching Galaxy Evolution in High Definition

NASA Technical Reports Server (NTRS)

Rigby, Jane R.

2012-01-01

As Einstein predicted, mass deflects light. In hundreds of known cases, "gravitational lenses" have deflected, distorted, and amplified images of galaxies or quasars behind them. As such, gravitational lensing is a way to "cheat" at studying how galaxies evolve, because lensing can magnify galaxies by factors of 10-100 times, transforming them from objects we can barely detect to bright objects we can study in detail. I'll summarize new results from a comprehensive program, using multi-wavelength, high-quality spectroscopy, to study how galaxies formed stars at redshifts of 1-3, the epoch when most of the Universe's stars were formed.

Construction of an environmental quality index for public health research

EPA Science Inventory

A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. The EQI was developed in four parts: doma...

The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review

PubMed Central

2016-01-01

Background Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. Objective The aim of this paper was to perform a comprehensive literature review on nurses’ quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Methods Using publications from 2004–2014, contributing factors to American and Canadian nurses’ QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Results Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses’ quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. Conclusions This review’s findings support the importance of QWL as an indicator of nurses’ broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system. PMID:27734769

The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review.

PubMed

Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer

2016-10-01

Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.

[Application of fingerprint chromatogram in quality control of Shen-Mai injection].

PubMed

Shi, Xian-zhe; Yang, Jun; Zhao, Chun-xia; Xiong, Jian-hui; Xu, Guo-wang

2002-07-01

The theory and practice of traditional Chinese medicine require some comprehensive methods to assess quality of the Chinese herbal medication. Fingerprint chromatogram is one of the feasible approaches to evaluate the quality of Chinese herbal medication. So the fingerprint chromatogram of Shen-Mai injection was established by using reversed-phase high performance liquid chromatography. The chromatographic conditions were as follows: a Hypersil C18 column was used; the mobile phase was composed of water (A) and acetontrile (B) with linear gradient elution (0-50 min, 5%-95% B, volume fraction); the flow rate was 1.0 mL/min and the UV absorbance detection was set at 202 nm. The peak-area ratios of twenty-three fingerprint peaks and internal standard (diphenyl) were taken as the criteria for quality control. The quality differences in various batches and various manufacturers of Shen-Mai injections were investigated by projection discriminance based on principal component analysis. The results show the method developed is convenient, reliable and applicable for the quality control analysis of Shen-Mai injection.

Epidemiological characteristics and methodological quality of meta-analyses on diabetes mellitus treatment: a systematic review.

PubMed

Wu, Xin Yin; Lam, Victor C K; Yu, Yue Feng; Ho, Robin S T; Feng, Ye; Wong, Charlene H L; Yip, Benjamin H K; Tsoi, Kelvin K F; Wong, Samuel Y S; Chung, Vincent C H

2016-11-01

Well-conducted meta-analyses (MAs) are considered as one of the best sources of clinical evidence for treatment decision. MA with methodological flaws may introduce bias and mislead evidence users. The aim of this study is to investigate the characteristics and methodological quality of MAs on diabetes mellitus (DM) treatments. Systematic review. Cochrane Database of Systematic Review and Database of Abstract of Reviews of Effects were searched for relevant MAs. Assessing methodological quality of systematic reviews (AMSTAR) tool was used to evaluate the methodological quality of included MAs. Logistic regression analysis was used to identify association between characteristics of MA and AMSTAR results. A total of 252 MAs including 4999 primary studies and 13,577,025 patients were included. Over half of the MAs (65.1%) only included type 2 DM patients and 160 MAs (63.5%) focused on pharmacological treatments. About 89.7% MAs performed comprehensive literature search and 89.3% provided characteristics of included studies. Included MAs generally had poor performance on the remaining AMSTAR items, especially in assessing publication bias (39.3%), providing lists of studies (19.0%) and declaring source of support comprehensively (7.5%). Only 62.7% MAs mentioned about harm of interventions. MAs with corresponding author from Asia performed less well in providing MA protocol than those from Europe. Methodological quality of MA on DM treatments was unsatisfactory. There is considerable room for improvement, especially in assessing publication bias, providing lists of studies and declaring source of support comprehensively. Also, there is an urgent need for MA authors to report treatment harm comprehensively. © 2016 European Society of Endocrinology.

Application of quality by design for 3D printed bone prostheses and scaffolds

PubMed Central

Martinez-Marquez, Daniel; Mirnajafizadeh, Ali; Carty, Christopher P.

2018-01-01

3D printing is an emergent manufacturing technology recently being applied in the medical field for the development of custom bone prostheses and scaffolds. However, successful industry transformation to this new design and manufacturing approach requires technology integration, concurrent multi-disciplinary collaboration, and a robust quality management framework. This latter change enabler is the focus of this study. While a number of comprehensive quality frameworks have been developed in recent decades to ensure that the manufacturing of medical devices produces reliable products, they are centred on the traditional context of standardised manufacturing techniques. The advent of 3D printing technologies and the prospects for mass customisation provides significant market opportunities, but also presents a serious challenge to regulatory bodies tasked with managing and assuring product quality and safety. Before 3D printing bone prostheses and scaffolds can gain traction, industry stakeholders, such as regulators, clients, medical practitioners, insurers, lawyers, and manufacturers, would all require a high degree of confidence that customised manufacturing can achieve the same quality outcomes as standardised manufacturing. A Quality by Design (QbD) approach to custom 3D printed prostheses can help to ensure that products are designed and manufactured correctly from the beginning without errors. This paper reports on the adaptation of the QbD approach for the development process of 3D printed custom bone prosthesis and scaffolds. This was achieved through the identification of the Critical Quality Attributes of such products, and an extensive review of different design and fabrication methods for 3D printed bone prostheses. Research outcomes include the development of a comprehensive design and fabrication process flow diagram, and categorised risks associated with the design and fabrication processes of such products. An extensive systematic literature review and post-hoc evaluation survey with experts was completed to evaluate the likely effectiveness of the herein suggested QbD framework. PMID:29649231

Application of quality by design for 3D printed bone prostheses and scaffolds.

PubMed

Martinez-Marquez, Daniel; Mirnajafizadeh, Ali; Carty, Christopher P; Stewart, Rodney A

2018-01-01

3D printing is an emergent manufacturing technology recently being applied in the medical field for the development of custom bone prostheses and scaffolds. However, successful industry transformation to this new design and manufacturing approach requires technology integration, concurrent multi-disciplinary collaboration, and a robust quality management framework. This latter change enabler is the focus of this study. While a number of comprehensive quality frameworks have been developed in recent decades to ensure that the manufacturing of medical devices produces reliable products, they are centred on the traditional context of standardised manufacturing techniques. The advent of 3D printing technologies and the prospects for mass customisation provides significant market opportunities, but also presents a serious challenge to regulatory bodies tasked with managing and assuring product quality and safety. Before 3D printing bone prostheses and scaffolds can gain traction, industry stakeholders, such as regulators, clients, medical practitioners, insurers, lawyers, and manufacturers, would all require a high degree of confidence that customised manufacturing can achieve the same quality outcomes as standardised manufacturing. A Quality by Design (QbD) approach to custom 3D printed prostheses can help to ensure that products are designed and manufactured correctly from the beginning without errors. This paper reports on the adaptation of the QbD approach for the development process of 3D printed custom bone prosthesis and scaffolds. This was achieved through the identification of the Critical Quality Attributes of such products, and an extensive review of different design and fabrication methods for 3D printed bone prostheses. Research outcomes include the development of a comprehensive design and fabrication process flow diagram, and categorised risks associated with the design and fabrication processes of such products. An extensive systematic literature review and post-hoc evaluation survey with experts was completed to evaluate the likely effectiveness of the herein suggested QbD framework.

Search Engine Ranking, Quality, and Content of Web Pages That Are Critical Versus Noncritical of Human Papillomavirus Vaccine.

PubMed

Fu, Linda Y; Zook, Kathleen; Spoehr-Labutta, Zachary; Hu, Pamela; Joseph, Jill G

2016-01-01

Online information can influence attitudes toward vaccination. The aim of the present study was to provide a systematic evaluation of the search engine ranking, quality, and content of Web pages that are critical versus noncritical of human papillomavirus (HPV) vaccination. We identified HPV vaccine-related Web pages with the Google search engine by entering 20 terms. We then assessed each Web page for critical versus noncritical bias and for the following quality indicators: authorship disclosure, source disclosure, attribution of at least one reference, currency, exclusion of testimonial accounts, and readability level less than ninth grade. We also determined Web page comprehensiveness in terms of mention of 14 HPV vaccine-relevant topics. Twenty searches yielded 116 unique Web pages. HPV vaccine-critical Web pages comprised roughly a third of the top, top 5- and top 10-ranking Web pages. The prevalence of HPV vaccine-critical Web pages was higher for queries that included term modifiers in addition to root terms. Compared with noncritical Web pages, Web pages critical of HPV vaccine overall had a lower quality score than those with a noncritical bias (p < .01) and covered fewer important HPV-related topics (p < .001). Critical Web pages required viewers to have higher reading skills, were less likely to include an author byline, and were more likely to include testimonial accounts. They also were more likely to raise unsubstantiated concerns about vaccination. Web pages critical of HPV vaccine may be frequently returned and highly ranked by search engine queries despite being of lower quality and less comprehensive than noncritical Web pages. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of the Informational Content, Readability and Comprehensibility of Online Health Information on Monogenic Diabetes.

PubMed

Guan, Yue; Maloney, Kristin A; Roter, Debra L; Pollin, Toni I

2018-06-01

The purpose of this study was to assess the informational content, readability, suitability and comprehensibility of websites offering educational information about monogenic diabetes available to patients. The top 20 results from 15 queries in four search engines were screened. Content analysis was performed by two independent coders. Readability was determined using Flesch-Kincaid grade level (FKGL) and Simplified Measure of Goobledygook (SMOG). The Comprehensibility Assessment of Materials (SAM + CAM) scale was utilized to evaluate website suitability and comprehensibility. Only 2% (N = 29) of 1200 screened websites met inclusion criteria. Content analysis showed that 16 websites presented information on at least the most common forms of MODY (1, 2 and 3), four addressed the utility of genetic counseling, and none included support resources for patients. All websites exceeded the consensus readability level (6th grade) as assessed by FKGL (10.1 grade) and SMOG (12.8 ± 1.5 grades). Although the majority (N = 20) of websites had an overall "adequate" to "superior" quality score (SAM + CAM score > = 40%), more than one-third scored "not suitable" in categories of content, literacy demand, graphics, and learning motivation. The online educational resources for monogenic diabetes have a high readability level and require improvement in ease of use and comprehensibility for patients with diabetes.

Physicochemical and sensorial characteristics of noodle enriched with oyster mushroom (Pleorotus ostreatus) powder

NASA Astrophysics Data System (ADS)

Wahyono, A.; Novianti; Bakri, A.; Kasutjianingati

2018-01-01

Oyster Mushroom is a mushroom that can be used for food and medicine. It contains highly nutritious and functional substances such as statins and beta-glucan. A comprehensive evaluation of noodle-enriched with Oyster Mushroom powder has not been performed so far. In this study, we performed a comprehensive evaluation of noodle-enriched with Oyster Mushroom powder. The aim of this study was to assess the effects of enrichment of Oyster Mushroom Powder (OMP) on the quality of noodle. The quality of noodle was evaluated based on physical, chemical and sensorial characteristics. This study was done by substituting wheat flour with OMP at the level of 0 (control); 5; 7.5; 10; 12.5; and 15%. The results showed that OMP significantly affected (P<0.05) the chemical, physical and sensorial quality of enriched noodles. Increased OMP level concurrently increased ash, crude fiber content and water activity (Aw) of resulting noodles. The enrichment was significantly raised the redness and yellowness of noodles, but decreased whiteness index. In addition, the enrichment of OMP significantly affected the sensorial properties of enriched noodles including color, taste, aroma and texture. OMP enrichment can be done at the level of 5% without compromising color, aroma, and texture of noodle, but 12.5% for taste attribute. Thus, OMP enrichment is feasible to enhance the nutritional values of noodle.

The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

PubMed

Wilde, J T

2012-07-01

Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute's Comprehensive Research Needs Assessment

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

Jagsi, Reshma, E-mail: rjagsi@med.umich.edu; Bekelman, Justin E.; Brawley, Otis W.

Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patientsmore » and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.« less

Methods to Develop the Eye-tem Bank to Measure Ophthalmic Quality of Life.

PubMed

Khadka, Jyoti; Fenwick, Eva; Lamoureux, Ecosse; Pesudovs, Konrad

2016-12-01

There is an increasing demand for high-standard, comprehensive, and reliable patient-reported outcome (PRO) instruments in all the disciplines of health care including in ophthalmology and optometry. Over the past two decades, a plethora of PRO instruments have been developed to assess the impact of eye diseases and their treatments. Despite this large number of instruments, significant shortcomings exist for the measurement of ophthalmic quality of life (QoL). Most PRO instruments are short-form instruments designed for clinical use, but this limits their content coverage often poorly targeting any study population other than that which they were developed for. Also, existing instruments are static paper and pencil based and unable to be updated easily leading to outdated and irrelevant item content. Scores obtained from different PRO instruments may not be directly comparable. These shortcomings can be addressed using item banking implemented with computer-adaptive testing (CAT). Therefore, we designed a multicenter project (The Eye-tem Bank project) to develop and validate such PROs to enable comprehensive measurement of ophthalmic QoL in eye diseases. Development of the Eye-tem Bank follows four phases: Phase I, Content Development; Phase II, Pilot Testing and Item Calibration; Phase III, Validation; and Phase IV, Evaluation. This project will deliver technologically advanced comprehensive QoL PROs in the form of item banking implemented via a CAT system in eye diseases. Here, we present a detailed methodological framework of this project.

Providing Comprehensive Educational Opportunity to Low Income Students. Part 5: A Proposal for Essential Standards and Resources. A Report of the Task Force on Comprehensive Educational Opportunity

ERIC Educational Resources Information Center

Rebell, Michael A.; Wolff, Jessica R.

2011-01-01

This fifth in a five part series, states that, if comprehensive educational opportunity is conceived as a right, then the state must commit to providing it and must develop a policy infrastructure to assure broad access, uniform quality, regularized funding, and firm accountability strictures to ensure all students a meaningful opportunity to…

Evaluating the quality of perinatal anxiety information available online.

PubMed

Kirby, Paige L; Reynolds, Kristin A; Walker, John R; Furer, Patricia; Pryor, Teaghan A M

2018-06-22

The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.

Assessing the content and quality of information on the treatment of postmenopausal osteoporosis on the World Wide Web.

PubMed

Pérez-López, Faustino R; Pérez Roncero, Gonzalo R

2006-12-01

To evaluate the content and quality of currently available Internet-based information on the treatment of postmenopausal osteoporosis. A sample was obtained comprising the 75 top sites retrieved with the Google search engine using 'treatment of postmenopausal osteoporosis' and then evaluated according to predefined general and specific criteria, content type, language and quality. Using a systematic scoring tool, each site was assessed for factual information provided and site quality. The sites studied were heterogeneous in content and quality. The most frequent type of website corresponded to non-profit organizations (n = 40), followed by commercial sites (n = 19), professional sites (n = 8) and government sites (n = 8). There were no significant differences in the popularity index, medical content score or quality score among the four groups of sites. Twelve websites were papers published in peer-reviewed medical journals. Few sites provided comprehensive medical and complete information on the treatment of postmenopausal osteoporosis oriented towards consumers. The consumer-oriented webpage with the most balanced and complete information was that of the National Osteoporosis Foundation which, at the same time, had the highest popularity index of all the resources studied. The content and quality of websites concerning the treatment of postmenopausal osteoporosis are highly varied and sometimes biased. The most frequent high-quality information corresponds to peer-reviewed medical journals. It is necessary to increase the number of resources, with rigorous language that is understandable for consumers, in relation to the treatment of postmenopausal osteoporosis.

Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency.

PubMed

von Krogh, Gunn; Nåden, Dagfinn; Aasland, Olaf Gjerløw

2012-10-01

To present the results from the test site application of the documentation model KPO (quality assurance, problem solving and caring) designed to impact the quality of nursing information in electronic patient record (EPR). The KPO model was developed by means of consensus group and clinical testing. Four documentation arenas and eight content categories, nursing terminologies and a decision-support system were designed to impact the completeness, comprehensiveness and consistency of nursing information. The testing was performed in a pre-test/post-test time series design, three times at a one-year interval. Content analysis of nursing documentation was accomplished through the identification, interpretation and coding of information units. Data from the pre-test and post-test 2 were subjected to statistical analyses. To estimate the differences, paired t-tests were used. At post-test 2, the information is found to be more complete, comprehensive and consistent than at pre-test. The findings indicate that documentation arenas combining work flow and content categories deduced from theories on nursing practice can influence the quality of nursing information. The KPO model can be used as guide when shifting from paper-based to electronic-based nursing documentation with the aim of obtaining complete, comprehensive and consistent nursing information. © 2012 Blackwell Publishing Ltd.

The relationship between ground conditions and injury: what level of evidence do we have?

PubMed

Petrass, Lauren A; Twomey, Dara M

2013-03-01

To identify studies which address the relationship between ground conditions and injury, in a sporting context and to evaluate current practice and provide recommendations for future studies that measure ground conditions and injury risk. Systematic review. A comprehensive search of electronic databases from the earliest records available until the end of 2011, and supplemental hand searching was conducted to identify relevant studies. A classification scale was used to rate the methodological quality of studies. 79 potentially relevant articles were identified, and 27 met all inclusion criteria. They varied in methodological quality, with analytical observational studies the most common design, although four descriptive observational studies, considered to be of lower quality were also identified. Only five studies objectively measured ground conditions, and of studies that used subjective assessment, only one provided descriptors to explain their classifications. It appears that harder/drier grounds are associated with an increased injury risk but the presence of major limitations necessitates cautious interpretation of many key findings. There is limited high quality evidence of the relationship between injury risk and ground conditions. Further research with high quality designs, and measurement of ground conditions are required to draw more definitive conclusions regarding this relationship. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Quality Assurance Made Easy.

ERIC Educational Resources Information Center

Villemaire, Lorry

Designed to help adult learners realize the importance and necessity of implementing continuous quality improvement (CQI) in a rapidly changing, competitive, and modern world of work, this document presents a comprehensive explanation of CQI. The following topics are discussed in the book's introduction and seven chapters: importance of quality in…

EPA RESEARCH HIGHLIGHTS -- MODELS-3/CMAQ OFFERS COMPREHENSIVE APPROACH TO AIR QUALITY MODELING

EPA Science Inventory

Regional and global coordinated efforts are needed to address air quality problems that are growing in complexity and scope. Models-3 CMAQ contains a community multi-scale air quality modeling system for simulating urban to regional scale pollution problems relating to troposphe...

U.S. EPA MODELS-3/CMAQ - STATUS AND APPLICATIONS

EPA Science Inventory

An advanced third-generation air quality modeling system has been developed by the Atmospheric Modeling Division of the U.S. EPA. The air quality simulation model at the heart of the system is known as the Community Multiscale Air Quality (CMAQ) Model. It is comprehensive in ...

Nutritional modifications in male infertility: a systematic review covering 2 decades.

PubMed

Giahi, Ladan; Mohammadmoradi, Shayan; Javidan, Aida; Sadeghi, Mohammad Reza

2016-02-01

Studies suggest that appropriate nutritional modifications can improve the natural conception rate of infertile couples. The purpose of this study was to review the human trials that investigated the relation between nutrition and male infertility. A comprehensive systematic review of published human studies was carried out by searching scientific databases. Article selection was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The American Dietetic Association Research Design and Implementation Checklist was also used for quality assessment. A total of 502 articles were identified, of which 23 studies met the inclusion criteria. Results indicated that a healthy diet improves at least one measure of semen quality, while diets high in lipophilic foods, soy isoflavones, and sweets lower semen quality. The role of daily nutrient exposure and dietary quality needs to be highlighted in male infertility. Mechanistic studies addressing the responsible underlying mechanisms of action of dietary modifications are highly warranted. PROSPERO 2013: CRD42013005953. Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013005953. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Nationwide assessment of nonpoint source threats to water quality

Treesearch

Thomas C. Brown; Pamela Froemke

2012-01-01

Water quality is a continuing national concern, in part because the containment of pollution from nonpoint (diffuse) sources remains a challenge. We examine the spatial distribution of nonpoint-source threats to water quality. On the basis of comprehensive data sets for a series of watershed stressors, the relative risk of water-quality impairment was estimated for the...

[Progress of treatments in non-small cell lung cancer with brain metastases].

PubMed

Ma, Chunhua; Jiang, Rong

2012-05-01

Brain metastases is one of the most common complications of non-small cell lung cancer, whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), surgery and chemotherapy are standard methods in the treatment of brain metastases. But the effect of those treatments are still sad. Comprehensive treatment can prolong the survival and improve the quality of life. Recently, the improvement of technology, targeted therapy, survival time and the quality of life are in increasingly concerned. The paper make a summary of current situation and progress for comprehensive therapy of brain metastases.

A Cross-Sectional Comparison of Perceived Quality of Primary Care by Hypertensive Patients in Shanghai and Shenzhen, China

PubMed Central

Li, Haitao; Wei, Xiaolin; Wong, Martin Chi-Sang; Wong, Samuel Yeung-Shan; Yang, Nan; Griffiths, Sian M.

2015-01-01

Abstract Hypertension should be best managed under primary care settings. This study aimed to compare, between Shanghai and Shenzhen, the perceived quality of primary care in terms of accessibility, continuity, co-ordination, and comprehensiveness among hypertensive patients. A cross-sectional study was conducted in Shanghai and Shenzhen, China. Multistage random sampling method was used to select 8 community health centers. Data from primary care users were collected through on-site face-to-face interviews using the primary care assessment tool. Good quality standard was set as a value of 3 for each attribute and a value of 18 for total score. We included 568 patients in Shanghai and 128 patients in Shenzhen. Compared with those in Shenzhen, hypertensive patients in Shanghai reported a higher score in co-ordination of information (3.37 vs 3.66; P < 0.001), but lower scores in continuity of care (3.36 vs 3.27; P < 0.001), and comprehensiveness-service provision (3.26 vs 2.79; P < 0.001). There was no statistically significant difference in total scores between the 2 cities (18.19 vs 18.15). Over 3-quarters of hypertensive patients in both cities reported accessibility (97.2% vs 91.4%) and co-ordination of services (76.1% vs 80.5%) under good quality standard, while <1-quarter of them rated continuity of care (23.6% vs 22.7%), co-ordination of information (4.8% vs 21.1%), and comprehensiveness-service availability (15.1% vs 25.0%) under that standard. Compared with Shenzhen, the perceived quality of primary care for hypertensive patients in Shanghai was better in terms of co-ordination of information, but poorer on continuity of care and comprehensiveness-service provision. Our study suggests that there is room for quality improvement in both cities. PMID:26313780

Development of a method for comprehensive water quality forecasting and its application in Miyun reservoir of Beijing, China.

PubMed

Zhang, Lei; Zou, Zhihong; Shan, Wei

2017-06-01

Water quality forecasting is an essential part of water resource management. Spatiotemporal variations of water quality and their inherent constraints make it very complex. This study explored a data-based method for short-term water quality forecasting. Prediction of water quality indicators including dissolved oxygen, chemical oxygen demand by KMnO 4 and ammonia nitrogen using support vector machine was taken as inputs of the particle swarm algorithm based optimal wavelet neural network to forecast the whole status index of water quality. Gubeikou monitoring section of Miyun reservoir in Beijing, China was taken as the study case to examine effectiveness of this approach. The experiment results also revealed that the proposed model has advantages of stability and time reduction in comparison with other data-driven models including traditional BP neural network model, wavelet neural network model and Gradient Boosting Decision Tree model. It can be used as an effective approach to perform short-term comprehensive water quality prediction. Copyright © 2016. Published by Elsevier B.V.

Indoor air quality in green buildings: A case-study in a residential high-rise building in the northeastern United States.

PubMed

Xiong, Youyou; Krogmann, Uta; Mainelis, Gediminas; Rodenburg, Lisa A; Andrews, Clinton J

2015-01-01

Improved indoor air quality (IAQ) is one of the critical components of green building design. Green building tax credit (e.g., New York State Green Building Tax Credit (GBTC)) and certification programs (e.g., Leadership in Energy & Environmental Design (LEED)) require indoor air quality measures and compliance with allowable maximum concentrations of common indoor air pollutants. It is not yet entirely clear whether compliance with these programs results in improved IAQ and ultimately human health. As a case in point, annual indoor air quality measurements were conducted in a residential green high-rise building for five consecutive years by an industrial hygiene contractor to comply with the building's GBTC requirements. The implementation of green design measures resulted in better IAQ compared to data in references of conventional homes for some parameters, but could not be confirmed for others. Relative humidity and carbon dioxide were satisfactory according to existing standards. Formaldehyde levels during four out of five years were below the most recent proposed exposure limits found in the literature. To some degree, particulate matter (PM) levels were lower than that in studies from conventional residential buildings. Concentrations of Volatile Organic Compounds (VOCs) with known permissible exposure limits were below levels known to cause chronic health effects, but their concentrations were inconclusive regarding cancer health effects due to relatively high detection limits. Although measured indoor air parameters met all IAQ maximum allowable concentrations in GBTC and applicable LEED requirements at the time of sampling, we argue that these measurements were not sufficient to assess IAQ comprehensively because more sensitive sampling/analytical methods for PM and VOCs are needed; in addition, there is a need for a formal process to ensure rigor and adequacy of sampling and analysis methods. Also, we suggest that a comprehensive IAQ assessment should include mixed mode thermal comfort models, semi-volatile organic compounds, assessment of new chemicals, and permissible exposure levels of many known indoor VOCs and bioaerosols. Plus, the relationship between energy consumption and IAQ, and tenant education on health effects of indoor pollutants and their sources may need more attention in IAQ investigations in green buildings.

Long-term effect of the self-management comprehensive coping strategy program on quality of life in patients with breast cancer treated with high-dose chemotherapy.

PubMed

Gaston-Johansson, Fannie; Fall-Dickson, Jane M; Nanda, Joy P; Sarenmalm, Elisabeth Kenne; Browall, Maria; Goldstein, Nancy

2013-03-01

This study aims to examine the effectiveness of a self-management multimodal comprehensive coping strategy program (CCSP) on quality of life (QOL) among breast cancer patients 1 year after treatment. Patients (n = 110) with stage II, III, or IV breast cancer scheduled to receive high dose chemotherapy and autologous hematopoietic stem cell transplantation were randomized to either CCSP treatment or control group. The CCSP intervention was taught 2 week before hospital admission with reinforcement at specified times during treatment and 3 months after discharge. The CCSP components included educational information, cognitive restructuring, coping skills enhancement, and relaxation with guided imagery. Instruments administered at baseline included the following: Quality of Life Index-Cancer Version (QOLI-CV), State-Trait Anxiety Inventory, Beck Depression Inventory, and Coping Strategies Questionnaire. At 1-year follow-up, patients (n = 73) completed and returned the follow-up QOLI-CV. Patients were mainly ≥ 40 years of age, married, Caucasian, and diagnosed with advanced breast cancer. A model measuring effectiveness of CCSP on QOL (total and subscale) at 1-year follow-up showed that the CCSP group (n = 38) had significant improvement in overall QOL (p < 0.01), health and functioning (p < 0.05), and socioeconomic (p < 0.05) and psychological/spiritual well-being (p < 0.01) compared with the control group (n = 35). The CCSP patients frequently used the CCSP to manage psychological (51%) and sleep problems (60%). The CCSP improved QOL for patients at 1-year follow-up. Patients overwhelmingly reported that CCSP was beneficial. The CCSP as an effective coping intervention has potential as a self-management program for breast cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.

Patient safety--worker safety: building a culture of safety to improve healthcare worker and patient well-being.

PubMed

Yassi, Annalee; Hancock, Tina

2005-01-01

Patient safety within the Canadian healthcare system is currently a high national priority, which merits a comprehensive understanding of the underlying causes of adverse events. Not least among these is worker health and safety, which is linked to patient outcomes. Healthcare workers have a high risk of workplace injuries and more mental health problems than most other occupational groups. Many healthcare professionals feel fatigued, stressed, in pain, or at risk of illness or injury-factors they feel impede their ability to provide consistent quality care. With this background, the Occupational Health and Safety Agency for Healthcare (OHSAH) in British Columbia, jointly governed by healthcare unions and healthcare employers, launched several major initiatives to improve the healthcare workplace. These included the promotion of safe patient handling, adaptive clothing, scheduled toileting, stroke management training, measures to improve management of aggressive behaviour and, of course, infection control-all intended to improve the safety of workers, but also to improve patient safety and quality of care. Other projects also explicitly promoting physical and mental health at work, as well as patient safety are also underway. Results of the projects are at various stages of completion, but ample evidence has already been obtained to indicate that looking after the well-being of healthcare workers results in safer and better quality patient care. While more research is needed, our work to date suggests that a comprehensive systems approach to promoting a climate of safety, which includes taking into account workplace organizational factors and physical and psychological hazards for workers, is the best way to improve the healthcare workplace and thereby patient safety.

Safety in construction--a comprehensive description of the characteristics of high safety standards in construction work, from the combined perspective of supervisors and experienced workers.

PubMed

Törner, Marianne; Pousette, Anders

2009-01-01

The often applied engineering approach to safety management in the construction industry needs to be supplemented by organizational measures and measures based on how people conceive and react to their social environment. This requires in-depth knowledge of the broad preconditions for high safety standards in construction. The aim of the study was to comprehensively describe the preconditions and components of high safety standards in the construction industry from the perspective of both experienced construction workers and first-line managers. Five worker safety representatives and 19 first-line managers were interviewed, all strategically selected from within a large Swedish construction project. Phenomenographic methodology was used for data acquisition and analysis and to categorize the information. Nine informants verified the results. The study identified four main categories of work safety preconditions and components: (1) Project characteristics and nature of the work, which set the limits of safety management; (2) Organization and structures, with the subcategories planning, work roles, procedures, and resources; (3) Collective values, norms, and behaviors, with the subcategories climate and culture, and interaction and cooperation; and (4) Individual competence and attitudes, with the subcategories knowledge, ability and experience, and individual attitudes. The results comprehensively describe high safety standards in construction, incorporating organizational, group, individual, and technical aspects. High-quality interaction between different organizational functions and hierarchical levels stood out as important aspects of safety. The results are discussed in relation to previous research into safety and into the social-psychological preconditions for other desired outcomes in occupational settings. The results can guide construction companies in planning and executing construction projects to a high safety standard.

Process quality indicators in family medicine: results of an international comparison.

PubMed

Pavlič, Danica Rotar; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor

2015-12-02

The aim of our study was to describe variability in process quality in family medicine among 31 European countries plus Australia, New Zealand, and Canada. The quality of family medicine was measured in terms of continuity, coordination, community orientation, and comprehensiveness of care. The QUALICOPC study (Quality and Costs of Primary Care in Europe) was carried out among family physicians in 31 European countries (the EU 27 except for France, plus Macedonia, Iceland, Norway, Switzerland, and Turkey) and three non-European countries (Australia, Canada, and New Zealand). We used random sampling when national registers of practitioners were available. Regional registers or lists of facilities were used for some countries. A standardized questionnaire was distributed to the physicians, resulting in a sample of 6734 participants. Data collection took place between October 2011 and December 2013. Based on completed questionnaires, a three-dimensional framework was established to measure continuity, coordination, community orientation, and comprehensiveness of care. Multilevel linear regression analysis was performed to evaluate the variation of quality attributable to the family physician level and the country level. None of the 34 countries in this study consistently scored the best or worst in all categories. Continuity of care was perceived by family physicians as the most important dimension of quality. Some components of comprehensiveness of care, including medical technical procedures, preventive care and health care promotion, varied substantially between countries. Coordination of care was identified as the weakest part of quality. We found that physician-level characteristics contributed to the majority of variation. A comparison of process quality indicators in family medicine revealed similarities and differences within and between countries. The researchers found that the major proportion of variation can be explained by physicians' characteristics.

Air ionization as a control technology for off-gas emissions of volatile organic compounds.

PubMed

Kim, Ki-Hyun; Szulejko, Jan E; Kumar, Pawan; Kwon, Eilhann E; Adelodun, Adedeji A; Reddy, Police Anil Kumar

2017-06-01

High energy electron-impact ionizers have found applications mainly in industry to reduce off-gas emissions from waste gas streams at low cost and high efficiency because of their ability to oxidize many airborne organic pollutants (e.g., volatile organic compounds (VOCs)) to CO 2 and H 2 O. Applications of air ionizers in indoor air quality management are limited due to poor removal efficiency and production of noxious side products, e.g., ozone (O 3 ). In this paper, we provide a critical evaluation of the pollutant removal performance of air ionizing system through comprehensive review of the literature. In particular, we focus on removal of VOCs and odorants. We also discuss the generation of unwanted air ionization byproducts such as O 3 , NOx, and VOC oxidation intermediates that limit the use of air-ionizers in indoor air quality management. Copyright © 2017. Published by Elsevier Ltd.

Comprehensive growth and characterization study on highly n-doped InGaAs as a contact layer for quantum cascade laser applications

NASA Astrophysics Data System (ADS)

Demir, Ilkay; Altuntas, Ismail; Bulut, Baris; Ezzedini, Maher; Ergun, Yuksel; Elagoz, Sezai

2018-05-01

We present growth and characterization studies of highly n-doped InGaAs epilayers on InP substrate by metal organic vapor phase epitaxy to use as an n-contact layer in quantum cascade laser applications. We have introduced quasi two-dimensional electrons between 10 s pulsed growth n-doped InGaAs epilayers to improve both carrier concentration and mobility of structure by applying pulsed growth and doping methods towards increasing the Si dopant concentration in InGaAs. Additionally, the V/III ratio optimization under fixed group III source flow has been investigated with this new method to understand the effects on both crystalline quality and electrical properties of n-InGaAs epilayers. Finally, we have obtained high crystalline quality of n-InGaAs epilayers grown by 10 s pulsed as a contact layer with 2.8 × 1019 cm‑3 carrier concentration and 1530 cm2 V‑1 s‑1 mobility.

A roadmap for improving healthcare service quality.

PubMed

Kennedy, Denise M; Caselli, Richard J; Berry, Leonard L

2011-01-01

A data-driven, comprehensive model for improving service and creating long-term value was developed and implemented at Mayo Clinic Arizona (MCA). Healthcare organizations can use this model to prepare for value-based purchasing, a payment system in which quality and patient experience measures will influence reimbursement. Surviving and thriving in such a system will require a comprehensive approach to sustaining excellent service performance from physicians and allied health staff (e.g., nurses, technicians, nonclinical staff). The seven prongs in MCA's service quality improvement model are (1) multiple data sources to drive improvement, (2) accountability for service quality, (3) service consultation and improvement tools, (4) service values and behaviors, (5) education and training, (6) ongoing monitoring and control, and (7) recognition and reward. The model was fully implemented and tested in five departments in which patient perception of provider-specific service attributes and/or overall quality of care were below the 90th percentile for patient satisfaction in the vendor's database. Extent of the implementation was at the discretion of department leadership. Perception data rating various service attributes were collected from randomly selected patients and monitored over a 24-month period. The largest increases in patient perception of excellence over the pilot period were realized when all seven prongs of the model were implemented as a comprehensive improvement approach. The results of this pilot may help other healthcare organizations prepare for value-based purchasing.

User's perspectives of barriers and facilitators to implementing quality colonoscopy services in Canada: a study protocol.

PubMed

Jobin, Gilles; Gagnon, Marie Pierre; Candas, Bernard; Dubé, Catherine; Ben Abdeljelil, Anis; Grenier, Sonya

2010-11-02

Colorectal cancer (CRC) represents a serious and growing health problem in Canada. Colonoscopy is used for screening and diagnosis of symptomatic or high CRC risk individuals. Although a number of countries are now implementing quality colonoscopy services, knowledge synthesis of barriers and facilitators perceived by healthcare professionals and patients during implementation has not been carried out. In addition, the perspectives of various stakeholders towards the implementation of quality colonoscopy services and the need of an efficient organisation of such services have been reported in the literature but have not been synthesised yet. The present study aims to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators perceived by all stakeholders to the implementation of quality colonoscopy services in Canada. First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to implementing quality colonoscopy services. Standardised literature searches and data extraction methods will be used. The quality of the studies and their relevance to informing decisions on colonoscopy services implementation will be assessed. For each group of users identified, barriers and facilitators will be categorised and compiled using narrative synthesis and meta-analytical techniques. The principle factors identified for each group of users will then be validated for its applicability to various Canadian contexts using the Delphi study method. Following this study, a set of strategies will be identified to inform decision makers involved in the implementation of quality colonoscopy services across Canadian jurisdictions. This study will be the first to systematically summarise the barriers and facilitators to implementation of quality colonoscopy services perceived by different groups and to consider the local contexts in order to ensure the applicability of this knowledge to the particular realities of various Canadian jurisdictions. Linkages with strategic partners and decision makers in the realisation of this project will favour the utilisation of its results to support strategies for implementing quality colonoscopy services and CRC screening programs in the Canadian health system.

Are university rankings useful to improve research? A systematic review.

PubMed

Vernon, Marlo M; Balas, E Andrew; Momani, Shaher

2018-01-01

Concerns about reproducibility and impact of research urge improvement initiatives. Current university ranking systems evaluate and compare universities on measures of academic and research performance. Although often useful for marketing purposes, the value of ranking systems when examining quality and outcomes is unclear. The purpose of this study was to evaluate usefulness of ranking systems and identify opportunities to support research quality and performance improvement. A systematic review of university ranking systems was conducted to investigate research performance and academic quality measures. Eligibility requirements included: inclusion of at least 100 doctoral granting institutions, be currently produced on an ongoing basis and include both global and US universities, publish rank calculation methodology in English and independently calculate ranks. Ranking systems must also include some measures of research outcomes. Indicators were abstracted and contrasted with basic quality improvement requirements. Exploration of aggregation methods, validity of research and academic quality indicators, and suitability for quality improvement within ranking systems were also conducted. A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Six of the 13 rankings are 100% focused on research performance. For those reporting weighting, 76% of the total ranks are attributed to research indicators, with 24% attributed to academic or teaching quality. Seven systems rely on reputation surveys and/or faculty and alumni awards. Rankings influence academic choice yet research performance measures are the most weighted indicators. There are no generally accepted academic quality indicators in ranking systems. No single ranking system provides a comprehensive evaluation of research and academic quality. Utilizing a combined approach of the Leiden, Thomson Reuters Most Innovative Universities, and the SCImago ranking systems may provide institutions with a more effective feedback for research improvement. Rankings which extensively rely on subjective reputation and "luxury" indicators, such as award winning faculty or alumni who are high ranking executives, are not well suited for academic or research performance improvement initiatives. Future efforts should better explore measurement of the university research performance through comprehensive and standardized indicators. This paper could serve as a general literature citation when one or more of university ranking systems are used in efforts to improve academic prominence and research performance.

Quality evaluation of extracted ion chromatograms and chromatographic peaks in liquid chromatography/mass spectrometry-based metabolomics data

PubMed Central

2014-01-01

Background Extracted ion chromatogram (EIC) extraction and chromatographic peak detection are two important processing procedures in liquid chromatography/mass spectrometry (LC/MS)-based metabolomics data analysis. Most commonly, the LC/MS technique employs electrospray ionization as the ionization method. The EICs from LC/MS data are often noisy and contain high background signals. Furthermore, the chromatographic peak quality varies with respect to its location in the chromatogram and most peaks have zigzag shapes. Therefore, there is a critical need to develop effective metrics for quality evaluation of EICs and chromatographic peaks in LC/MS based metabolomics data analysis. Results We investigated a comprehensive set of potential quality evaluation metrics for extracted EICs and detected chromatographic peaks. Specifically, for EIC quality evaluation, we analyzed the mass chromatographic quality index (MCQ index) and propose a novel quality evaluation metric, the EIC-related global zigzag index, which is based on an EIC's first order derivatives. For chromatographic peak quality evaluation, we analyzed and compared six metrics: sharpness, Gaussian similarity, signal-to-noise ratio, peak significance level, triangle peak area similarity ratio and the local peak-related local zigzag index. Conclusions Although the MCQ index is suited for selecting and aligning analyte components, it cannot fairly evaluate EICs with high background signals or those containing only a single peak. Our proposed EIC related global zigzag index is robust enough to evaluate EIC qualities in both scenarios. Of the six peak quality evaluation metrics, the sharpness, peak significance level, and zigzag index outperform the others due to the zigzag nature of LC/MS chromatographic peaks. Furthermore, using several peak quality metrics in combination is more efficient than individual metrics in peak quality evaluation. PMID:25350128

Quality evaluation of extracted ion chromatograms and chromatographic peaks in liquid chromatography/mass spectrometry-based metabolomics data.

PubMed

Zhang, Wenchao; Zhao, Patrick X

2014-01-01

Extracted ion chromatogram (EIC) extraction and chromatographic peak detection are two important processing procedures in liquid chromatography/mass spectrometry (LC/MS)-based metabolomics data analysis. Most commonly, the LC/MS technique employs electrospray ionization as the ionization method. The EICs from LC/MS data are often noisy and contain high background signals. Furthermore, the chromatographic peak quality varies with respect to its location in the chromatogram and most peaks have zigzag shapes. Therefore, there is a critical need to develop effective metrics for quality evaluation of EICs and chromatographic peaks in LC/MS based metabolomics data analysis. We investigated a comprehensive set of potential quality evaluation metrics for extracted EICs and detected chromatographic peaks. Specifically, for EIC quality evaluation, we analyzed the mass chromatographic quality index (MCQ index) and propose a novel quality evaluation metric, the EIC-related global zigzag index, which is based on an EIC's first order derivatives. For chromatographic peak quality evaluation, we analyzed and compared six metrics: sharpness, Gaussian similarity, signal-to-noise ratio, peak significance level, triangle peak area similarity ratio and the local peak-related local zigzag index. Although the MCQ index is suited for selecting and aligning analyte components, it cannot fairly evaluate EICs with high background signals or those containing only a single peak. Our proposed EIC related global zigzag index is robust enough to evaluate EIC qualities in both scenarios. Of the six peak quality evaluation metrics, the sharpness, peak significance level, and zigzag index outperform the others due to the zigzag nature of LC/MS chromatographic peaks. Furthermore, using several peak quality metrics in combination is more efficient than individual metrics in peak quality evaluation.

Quality of Life for Marines at Camp Pendleton

DTIC Science & Technology

1995-12-01

A comprehensive assessment of Quality of Life (QOL) in the Marine Corps, using a life domain framework, in which were included the domains of...other relatives, income/standard of living, job, and self, was conducted in 1993. This report focuses on data for Camp Pendleton only. Global quality of life was

Quality of Life for Marines at Camp Lejeune.

DTIC Science & Technology

1996-02-01

A comprehensive assessment of Quality of Life (QOL) in the Marine Corps, using a life domain framework, in which were included the domains of...other relatives, income/standard of living, job, and self, was conducted in 1993. This report focuses on data for Camp Lejeune only. Global quality of life was

Quality of Life for Marines at COMCABEAST.

DTIC Science & Technology

1996-03-01

A comprehensive assessment of Quality of Life (QOL) in the Marine Corps, using a life domain framework, in which were included the domains of...other relatives, income/standard of living, job, and self, was conducted in 1993. This report focuses on data for COMCABEAST only. Global quality of life was

Quality of Life for Marines on Okinawa.

DTIC Science & Technology

1996-03-01

A comprehensive assessment of Quality of Life (QOL) in the Marine Corps, using a life domain framework, in which were included the domains of...other relatives, income/standard of living, job, and self, was conducted in 1993. This report focuses on data for Okinawa only. Global quality of life was

Quality of Life for Marines at COMCABWEST.

DTIC Science & Technology

1996-03-01

A comprehensive assessment of Quality of Life (QOL) in the Marine Corps, using a life domain framework, in which were included the domains of...other relatives, income/standard of living, job, and self, was conducted in 1993. This report focuses on data for COMCABWEST only. Global quality of life was

Description and evaluation of the Community Multiscale Air Quality (CMAQ) modeling system version 5.1

EPA Science Inventory

The Community Multiscale Air Quality (CMAQ) model is a comprehensive multipollutant air quality modeling system developed and maintained by the US Environmental Protection Agency's (EPA) Office of Research and Development (ORD). Recently, version 5.1 of the CMAQ model (v5.1) was ...

Managing Change from a Quality Perspective.

ERIC Educational Resources Information Center

Snyder, Karolyn J.

This paper presents findings of a study that examined the change process in 28 schools, with a focus on how principals went about transforming traditional school-work cultures into quality systems. The principals had participated in Managing Productive Schools (MPS), a comprehensive systems-approach program based on quality management concepts.…

Post-harvest and post-milling changes in wheat grain and flour quality characteristics

USDA-ARS?s Scientific Manuscript database

Soft red winter (SRW) wheat grain immediately after harvest and flour after milling were stored for 26 weeks and analyzed for comprehensive milling and baking quality characteristics at different time points to examine the consistency of the quality test results. Increases in falling number (FN) of ...

42 CFR § 510.300 - Determination of episode quality-adjusted target prices.

Code of Federal Regulations, 2010 CFR

2017-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.300 Determination of episode quality... hospitals for each performance year of the model as specified in this section. Episode quality-adjusted...

Investigating Profiles of Lexical Quality in Preschool and Their Contribution to First Grade Reading

ERIC Educational Resources Information Center

Murphy, Kimberly A.; Farquharson, Kelly

2016-01-01

This longitudinal study investigated profiles of lexical quality domains in preschool children and the extent to which profile membership predicted reading comprehension in first grade. A latent profile analysis was conducted to classify 420 preschool children on lexical quality domains, including orthography, phonology, morphosyntax, and…

A systematic indoor air quality audit approach for public buildings.

PubMed

Asadi, Ehsan; da Silva, Manuel C Gameiro; Costa, J J

2013-01-01

Good indoor air quality (IAQ) in buildings provides a comfortable and healthy environment for the occupants to work, learn, study, etc. Therefore, it is important to ascertain the IAQ status in the buildings. This study is aimed to establish and demonstrate the comprehensive IAQ audit approach for public buildings, based on Portugal national laws. Four public buildings in Portugal are used to demonstrate the IAQ audit application. The systematic approach involves the measurement of physical parameters (temperature, relative humidity, and concentration of the suspended particulate matter), monitoring of the concentrations of selected chemical indicators [carbon dioxide (CO(2)), carbon monoxide, formaldehyde, ozone, and total volatile organic compounds], and the measurements of biological indicators (bacteria and fungi). In addition, air exchange rates are measured by the concentration decay method using metabolic CO(2) as the tracer gas. The comprehensive audits indicated some situations of common IAQ problems in buildings, namely: (1) insufficient ventilation rate, (2) too high particle concentration; and (3) poor filtration effectiveness and hygienic conditions in most of the air handling units. Accordingly, a set of recommendations for the improvement of IAQ conditions were advised to the building owner/managers.

Patient assessment of medication information leaflets and validation of the Evaluative Linguistic Framework (ELF).

PubMed

Hirsh, Di; Clerehan, Rosemary; Staples, Margaret; Osborne, Richard H; Buchbinder, Rachelle

2009-11-01

To obtain patient feedback about the structure and quality of medication information leaflets and validate the usefulness of the Evaluative Linguistic Framework (ELF) for improving written communication with patients. Triangulated feedback about a set of rheumatoid arthritis (RA) medication leaflets, some developed with knowledge of the ELF, was obtained from 27 people with RA from interviews, focus group discussion and self-administered questionnaires. The principal elements of the framework were investigated: overall generic structure and functions of each stage, interpersonal relationship between writer and reader, technicality of language and density of information. Participant assessments of the leaflets aligned with the framework in terms of what constituted a good leaflet. While the main purpose of the leaflets was identified as being information provision, participants also wanted clear instructions, benefits to be highlighted and side effects to be comprehensively listed. For comprehensiveness and user-friendliness, leaflets developed with guidance of the ELF were consistently preferred. According to people with RA, leaflets generated from a linguistic framework are clearer and more effective in communicating information about medications. The ELF is a user-friendly, structured analytic system that can assist with the development of effective high quality patient information materials.

Research on improvement strategies of elite culture, mass culture and the comprehensive quality of undergraduates

NASA Astrophysics Data System (ADS)

Wang, Hongling

2011-10-01

This article, placed the comprehensive quality improvement of undergraduates under the background of elite culture and mass culture, analyzed the influences and challenges brought by elite culture and mass culture on the undergraduate education from multiple perspectives of philosophy, ethics, economics, education, sociology and etc. and combing some foreign developed countries' experiences proposed the principles should be insisted by high schools in the context of elite culture and mass culture. With the development of times, undergraduate education should also constantly develop into new historical starting points and thoroughly reform the undergraduate education from content to essence, perception to format with a globalized horizon, so as to be able to reflect the time characteristics and better promote the overall development of undergraduates. Exactly based on such a view, this article, on the premise of full recognition that the flourishing and development of elite culture and mass culture has promoted China into a multicultural situation, proposed the principles for university moral education, such as education should promote the integration of undergraduate multi-values, sticking to the integration of unary guidance with diverse development, insisting on seeking common points while reserving differences and harmony but with differences, and etc.

Fuzzy comprehensive evaluation of multiple environmental factors for swine building assessment and control.

PubMed

Xie, Qiuju; Ni, Ji-Qin; Su, Zhongbin

2017-10-15

In confined swine buildings, temperature, humidity, and air quality are all important for animal health and productivity. However, the current swine building environmental control is only based on temperature; and evaluation and control methods based on multiple environmental factors are needed. In this paper, fuzzy comprehensive evaluation (FCE) theory was adopted for multi-factor assessment of environmental quality in two commercial swine buildings using real measurement data. An assessment index system and membership functions were established; and predetermined weights were given using analytic hierarchy process (AHP) combined with knowledge of experts. The results show that multi-factors such as temperature, humidity, and concentrations of ammonia (NH 3 ), carbon dioxide (CO 2 ), and hydrogen sulfide (H 2 S) can be successfully integrated in FCE for swine building environment assessment. The FCE method has a high correlation coefficient of 0.737 compared with the method of single-factor evaluation (SFE). The FCE method can significantly increase the sensitivity and perform an effective and integrative assessment. It can be used as part of environmental controlling and warning systems for swine building environment management to improve swine production and welfare. Copyright © 2017 Elsevier B.V. All rights reserved.

Role of Knowledge Management in Development and Lifecycle Management of Biopharmaceuticals.

PubMed

Rathore, Anurag S; Garcia-Aponte, Oscar Fabián; Golabgir, Aydin; Vallejo-Diaz, Bibiana Margarita; Herwig, Christoph

2017-02-01

Knowledge Management (KM) is a key enabler for achieving quality in a lifecycle approach for production of biopharmaceuticals. Due to the important role that it plays towards successful implementation of Quality by Design (QbD), an analysis of KM solutions is needed. This work provides a comprehensive review of the interface between KM and QbD-driven biopharmaceutical production systems as perceived by academic as well as industrial viewpoints. A comprehensive set of 356 publications addressing the applications of KM tools to QbD-related tasks were screened and a query to gather industrial inputs from 17 major biopharmaceutical organizations was performed. Three KM tool classes were identified as having high relevance for biopharmaceutical production systems and have been further explored: knowledge indicators, ontologies, and process modeling. A proposed categorization of 16 distinct KM tool classes allowed for the identification of holistic technologies supporting QbD. In addition, the classification allowed for addressing the disparity between industrial and academic expectations regarding the application of KM methodologies. This is a first of a kind attempt and thus we think that this paper would be of considerable interest to those in academia and industry that are engaged in accelerating development and commercialization of biopharmaceuticals.

Linking Cognition and Literacy in Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Carnahan, Christina R.; Williamson, Pamela S.; Christman, Jennifer

2011-01-01

Literacy skills, especially silent reading comprehension, serve as the foundation for learning, independence, and quality of life for all individuals. It is well documented that students on the autism spectrum have difficulties with reading comprehension even though they demonstrate adequate decoding skills. Unfortunately, communication…

18 CFR 801.5 - Comprehensive plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... multiobjectives of national economy, regional development and environmental quality; and multipurpose use of... comprehensive plan for the immediate and long-range development and use of the water resources of the basin. (1... extent feasible, with existing and proposed land uses. The development of a basinwide land use study to...

18 CFR 430.9 - Comprehensive plan policies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ground water levels, water quality degradation, permanent loss of storage capacity, or substantial impact... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Comprehensive plan policies. 430.9 Section 430.9 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION...

Measurement of fatigue: Comparison of the reliability and validity of single-item and short measures to a comprehensive measure.

PubMed

Kim, Hee-Ju; Abraham, Ivo

2017-01-01

Evidence is needed on the clinicometric properties of single-item or short measures as alternatives to comprehensive measures. We examined whether two single-item fatigue measures (i.e., Likert scale, numeric rating scale) or a short fatigue measure were comparable to a comprehensive measure in reliability (i.e., internal consistency and test-retest reliability) and validity (i.e., convergent, concurrent, and predictive validity) in Korean young adults. For this quantitative study, we selected the Functional Assessment of Chronic Illness Therapy-Fatigue for the comprehensive measure and the Profile of Mood States-Brief, Fatigue subscale for the short measure; and constructed two single-item measures. A total of 368 students from four nursing colleges in South Korea participated. We used Cronbach's alpha and item-total correlation for internal consistency reliability and intraclass correlation coefficient for test-retest reliability. We assessed Pearson's correlation with a comprehensive measure for convergent validity, with perceived stress level and sleep quality for concurrent validity and the receiver operating characteristic curve for predictive validity. The short measure was comparable to the comprehensive measure in internal consistency reliability (Cronbach's alpha=0.81 vs. 0.88); test-retest reliability (intraclass correlation coefficient=0.66 vs. 0.61); convergent validity (r with comprehensive measure=0.79); concurrent validity (r with perceived stress=0.55, r with sleep quality=0.39) and predictive validity (area under curve=0.88). Single-item measures were not comparable to the comprehensive measure. A short fatigue measure exhibited similar levels of reliability and validity to the comprehensive measure in Korean young adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Maintenance quality assurance peer exchange 2.

DOT National Transportation Integrated Search

2009-04-01

This report documents a comprehensive study of twenty three maintenance quality assurance : (MQA) programs throughout the United States and Canada. The policies and standards of : each program were synthesized to create a general assessment on the co...

Optimal procedures for quality assurance specifications

DOT National Transportation Integrated Search

2003-04-01

This manual is a comprehensive guide that a highway agency can use when developing new, or modifying existing, acceptance plans and quality assurance specifications. It provides necessary instruction and illustrative examples to lead the agency throu...

Evaluation of procedures for quality assurance specifications

DOT National Transportation Integrated Search

2004-10-01

The objective of this project was to develop a comprehensive quality assurance (QA) manual, supported by scientific evidence and statistical theory, which provides step-by-step procedures and instructions for developing effective and efficient QA spe...

Characterizing Quality Factor of Niobium Resonators Using a Markov Chain Monte Carlo Approach

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

Basu Thakur, Ritoban; Tang, Qing Yang; McGeehan, Ryan

The next generation of radiation detectors in high precision Cosmology, Astronomy, and particle-astrophysics experiments will rely heavily on superconducting microwave resonators and kinetic inductance devices. Understanding the physics of energy loss in these devices, in particular at low temperatures and powers, is vital. We present a comprehensive analysis framework, using Markov Chain Monte Carlo methods, to characterize loss due to two-level system in concert with quasi-particle dynamics in thin-film Nb resonators in the GHz range.

A Comprehensive Approach to Phonon Control for Enhanced Device Performance

DTIC Science & Technology

2006-07-12

substantially on parameters of the transit space . 300 kV/cm (drift region) but also specifically on the AC com- >, k\\/cm ponent of the tunnel emission... reseracher to grow well-controlled and high quality -, N2/Ar: V 35x 10 (old) multilayers and heterostructures, resulting in record electron . V 3 x 109...reflected from the sample, back through the viewport, and into a CCD camera. Monitoring fractional changes in the spacing between these re- flected spots

Setting Standards for Medically-Based Running Analysis

PubMed Central

Vincent, Heather K.; Herman, Daniel C.; Lear-Barnes, Leslie; Barnes, Robert; Chen, Cong; Greenberg, Scott; Vincent, Kevin R.

2015-01-01

Setting standards for medically based running analyses is necessary to ensure that runners receive a high-quality service from practitioners. Medical and training history, physical and functional tests, and motion analysis of running at self-selected and faster speeds are key features of a comprehensive analysis. Self-reported history and movement symmetry are critical factors that require follow-up therapy or long-term management. Pain or injury is typically the result of a functional deficit above or below the site along the kinematic chain. PMID:25014394

[Usefulness of the comprehensive geriatric assessment for evaluating the health of older adults].

PubMed

Gálvez-Cano, Miguel; Chávez-Jimeno, Helver; Aliaga-Diaz, Elizabeth

2016-06-01

Older adults comprise a heterogeneous population group that usually has a high disease burden, comorbidities, and, in many cases, subclinical conditions that compromise their health and quality of life. In addition to the physical component, the health conditions of elderly individuals are significantly influenced by cognitive and affective components, social and family factors such as abandonment, and functional factors including the ability to perform everyday activities. In response to this complex scenario, the comprehensive geriatric evaluation constitutes a multidimensional and interdisciplinary diagnostic tool that assesses the health of older adults in all of its complexity by considering the physical, mental, social/family, and functional needs to obtain full knowledge of older person's health status and creating a plan that consists of appropriate and individualized interventions that considers the preferences and values of older individuals and their families.

Commentary on "The association between physical activity and renal cancer: systematic review and meta-analysis." Behrens G, Leitzmann MF, Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany. Br J Cancer 2013; 108(4):798-811. [Epub 2013 Feb 14]. doi: 10.1038/bjc.2013.37.

PubMed

Boorjian, Stephen

2014-08-01

Physical activity may decrease renal cancer risk by reducing obesity, blood pressure, insulin resistance, and lipid peroxidation. Despite plausible biologic mechanisms linking increased physical activity to decreased risk for renal cancer, few epidemiologic studies have been able to report a clear inverse association between physical activity and renal cancer, and no meta-analysis is available on the topic. We searched the literature using PubMed and Web of Knowledge to identify published non-ecologic epidemiologic studies quantifying the relationship between physical activity and renal cancer risk in individuals without a cancer history. Following the PRISMA guidelines, we conducted a systematic review and meta-analysis, including information from 19 studies based on a total of 2,327,322 subjects and 10,756 cases. The methodologic quality of the studies was examined using a comprehensive scoring system. Comparing high vs low levels of physical activity, we observed an inverse association between physical activity and renal cancer risk (summary relative risk (RR) from random-effects meta-analysis=0.88; 95% confidence interval (CI)=0.79-0.97). Summarising risk estimates from high-quality studies strengthened the inverse association between physical activity and renal cancer risk (RR=0.78; 95% CI=0.66-0.92). Effect modification by adiposity, hypertension, type 2 diabetes, smoking, gender, or geographic region was not observed. Our comprehensive meta-analysis provides strong support for an inverse relation of physical activity to renal cancer risk. Future high-quality studies are required to discern which specific types, intensities, frequencies, and durations of physical activity are needed for renal cancer risk reduction. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

PubMed Central

Baeumler, Petra I.; Fleckenstein, Johannes; Takayama, Shin; Simang, Michael; Seki, Takashi; Irnich, Dominik

2014-01-01

Background The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Methods Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Results Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception. Conclusions Our findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its effect on sensory perception and to explore the predictive value of sensory profiles for the effectiveness of acupuncture. PMID:25502787

Effects of acupuncture on sensory perception: a systematic review and meta-analysis.

PubMed

Baeumler, Petra I; Fleckenstein, Johannes; Takayama, Shin; Simang, Michael; Seki, Takashi; Irnich, Dominik

2014-01-01

The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception. Our findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its effect on sensory perception and to explore the predictive value of sensory profiles for the effectiveness of acupuncture.

Development and Validation of the Scan of Postgraduate Educational Environment Domains (SPEED): A Brief Instrument to Assess the Educational Environment in Postgraduate Medical Education

PubMed Central

Schönrock-Adema, Johanna; Visscher, Maartje; Raat, A. N. Janet; Brand, Paul L. P.

2015-01-01

Introduction Current instruments to evaluate the postgraduate medical educational environment lack theoretical frameworks and are relatively long, which may reduce response rates. We aimed to develop and validate a brief instrument that, based on a solid theoretical framework for educational environments, solicits resident feedback to screen the postgraduate medical educational environment quality. Methods Stepwise, we developed a screening instrument, using existing instruments to assess educational environment quality and adopting a theoretical framework that defines three educational environment domains: content, atmosphere and organization. First, items from relevant existing instruments were collected and, after deleting duplicates and items not specifically addressing educational environment, grouped into the three domains. In a Delphi procedure, the item list was reduced to a set of items considered most important and comprehensively covering the three domains. These items were triangulated against the results of semi-structured interviews with 26 residents from three teaching hospitals to achieve face validity. This draft version of the Scan of Postgraduate Educational Environment Domains (SPEED) was administered to residents in a general and university hospital and further reduced and validated based on the data collected. Results Two hundred twenty-three residents completed the 43-item draft SPEED. We used half of the dataset for item reduction, and the other half for validating the resulting SPEED (15 items, 5 per domain). Internal consistencies were high. Correlations between domain scores in the draft and brief versions of SPEED were high (>0.85) and highly significant (p<0.001). Domain score variance of the draft instrument was explained for ≥80% by the items representing the domains in the final SPEED. Conclusions The SPEED comprehensively covers the three educational environment domains defined in the theoretical framework. Because of its validity and brevity, the SPEED is promising as useful and easily applicable tool to regularly screen educational environment quality in postgraduate medical education. PMID:26413836

Image guided IMRT dosimetry using anatomy specific MOSFET configurations.

PubMed

Amin, Md Nurul; Norrlinger, Bern; Heaton, Robert; Islam, Mohammad

2008-06-23

We have investigated the feasibility of using a set of multiple MOSFETs in conjunction with the mobile MOSFET wireless dosimetry system, to perform a comprehensive and efficient quality assurance (QA) of IMRT plans. Anatomy specific MOSFET configurations incorporating 5 MOSFETs have been developed for a specially designed IMRT dosimetry phantom. Kilovoltage cone beam computed tomography (kV CBCT) imaging was used to increase the positional precision and accuracy of the detectors and phantom, and so minimize dosimetric uncertainties in high dose gradient regions. The effectiveness of the MOSFET based dose measurements was evaluated by comparing the corresponding doses measured by an ion chamber. For 20 head and neck IMRT plans the agreement between the MOSFET and ionization chamber dose measurements was found to be within -0.26 +/- 0.88% and 0.06 +/- 1.94% (1 sigma) for measurement points in the high dose and low dose respectively. A precision of 1 mm in detector positioning was achieved by using the X-Ray Volume Imaging (XVI) kV CBCT system available with the Elekta Synergy Linear Accelerator. Using the anatomy specific MOSFET configurations, simultaneous measurements were made at five strategically located points covering high dose and low dose regions. The agreement between measurements and calculated doses by the treatment planning system for head and neck and prostate IMRT plans was found to be within 0.47 +/- 2.45%. The results indicate that a cylindrical phantom incorporating multiple MOSFET detectors arranged in an anatomy specific configuration, in conjunction with image guidance, can be utilized to perform a comprehensive and efficient quality assurance of IMRT plans.

Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest and bibliometric indices as predictors of methodological quality.

PubMed

Gómez-García, F; Ruano, J; Aguilar-Luque, M; Gay-Mimbrera, J; Maestre-Lopez, B; Sanz-Cabanillas, J L; Carmona-Fernández, P J; González-Padilla, M; Vélez García-Nieto, A; Isla-Tejera, B

2017-06-01

The quality of systematic reviews and meta-analyses on psoriasis, a chronic inflammatory skin disease that severely impairs quality of life and is associated with high costs, remains unknown. To assess the methodological quality of systematic reviews published on psoriasis. After a comprehensive search in MEDLINE, Embase and the Cochrane Database (PROSPERO: CDR42016041611), the quality of studies was assessed by two raters using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Article metadata and journal-related bibliometric indices were also obtained. Systematic reviews were classified as low (0-4), moderate (5-8) or high (9-11) quality. A prediction model for methodological quality was fitted using principal component and multivariate ordinal logistic regression analyses. We classified 220 studies as high (17·2%), moderate (55·0%) or low (27·8%) quality. Lower compliance rates were found for AMSTAR question (Q)5 (list of studies provided, 11·4%), Q10 (publication bias assessed, 27·7%), Q4 (status of publication included, 39·5%) and Q1 (a priori design provided, 40·9%). Factors such as meta-analysis inclusion [odds ratio (OR) 6·22; 95% confidence interval (CI) 2·78-14·86], funding by academic institutions (OR 2·90, 95% CI 1·11-7·89), Article Influence score (OR 2·14, 95% CI 1·05-6·67), 5-year impact factor (OR 1·34, 95% CI 1·02-1·40) and article page count (OR 1·08, 95% CI 1·02-1·15) significantly predicted higher quality. A high number of authors with a conflict of interest (OR 0·90, 95% CI 0·82-0·99) was significantly associated with lower quality. The methodological quality of systematic reviews published about psoriasis remains suboptimal. The type of funding sources and author conflicts may compromise study quality, increasing the risk of bias. © 2017 British Association of Dermatologists.

Using a complex audit tool to measure workload, staffing and quality in district nursing.

PubMed

Kirby, Esther; Hurst, Keith

2014-05-01

This major community, workload, staffing and quality study is thought to be the most comprehensive community staffing project in England. It involved over 400 staff from 46 teams in 6 localities and is unique because it ties community staffing activity to workload and quality. Scotland was used to benchmark since the same evidence-based Safer Nursing Care Tool methodology developed by the second-named author was used (apart from quality) and took into account population and geographical similarities. The data collection method tested quality standards, acuity, dependency and nursing interventions by looking at caseloads, staff activity and service quality and funded, actual, temporary and recommended staffing. Key findings showed that 4 out of 6 localities had a heavy workload index that stretched staffing numbers and time spent with patients. The acuity and dependency of patients leaned heavily towards the most dependent and acute categories requiring more face-to-face care. Some areas across the localities had high levels of temporary staff, which affected quality and increased cost. Skill and competency shortages meant that a small number of staff had to travel significantly across the county to deliver complex care to some patients.

Gap analysis: synergies and opportunities for effective nursing leadership.

PubMed

Davis-Ajami, Mary Lynn; Costa, Linda; Kulik, Susan

2014-01-01

Gap analysis encompasses a comprehensive process to identify, understand, address, and bridge gaps in service delivery and nursing practice. onducting gap analysis provides structure to information gathering and the process of finding sustainable solutions to important deficiencies. Nursing leaders need to recognize, measure, monitor, and execute on feasible actionable solutions to help organizations make adjustments to address gaps between what is desired and the actual real-world conditions contributing to the quality chasm in health care. Gap analysis represents a functional and comprehensive tool to address organizational deficiencies. Using gap analysis proactively helps organizations map out and sustain corrective efforts to close the quality chasm. Gaining facility in gap analysis should help the nursing profession's contribution to narrowing the quality chasm.

Long-term quality assurance of [(18)F]-fluorodeoxyglucose (FDG) manufacturing.

PubMed

Gaspar, Ludovit; Reich, Michal; Kassai, Zoltan; Macasek, Fedor; Rodrigo, Luis; Kruzliak, Peter; Kovac, Peter

2016-01-01

Nine years of experience with 2286 commercial synthesis allowed us to deliver comprehensive information on the quality of (18)F-FDG production. Semi-automated FDG production line using Cyclone 18/9 machine (IBA Belgium), TRACERLab MXFDG synthesiser (GE Health, USA) using alkalic hydrolysis, grade "A" isolator with dispensing robotic unit (Tema Sinergie, Italy), and automatic control system under GAMP5 (minus2, Slovakia) was assessed by TQM tools as highly reliable aseptic production line, fully compliant with Good Manufacturing Practice and just-in-time delivery of FDG radiopharmaceutical. Fluoride-18 is received in steady yield and of very high radioactive purity. Synthesis yields exhibited high variance connected probably with quality of disposable cassettes and chemicals sets. Most performance non-conformities within the manufacturing cycle occur at mechanical nodes of dispensing unit. The long-term monitoring of 2286 commercial synthesis indicated high reliability of automatic synthesizers. Shewhart chart and ANOVA analysis showed that minor non-compliances occurred were mostly caused by the declinations of less experienced staff from standard operation procedures, and also by quality of automatic cassettes. Only 15 syntheses were found unfinished and in 4 cases the product was out-of-specification of European Pharmacopoeia. Most vulnerable step of manufacturing was dispensing and filling in grade "A" isolator. Its cleanliness and sterility was fully controlled under the investigated period by applying hydrogen peroxide vapours (VHP). Our experience with quality assurance in the production of [(18)F]-fluorodeoxyglucose (FDG) at production facility of BIONT based on TRACERlab MXFDG production module can be used for bench-marking of the emerging manufacturing and automated manufacturing systems.

Long-term quality assurance of [18F]-fluorodeoxyglucose (FDG) manufacturing

PubMed Central

Gaspar, Ludovit; Reich, Michal; Kassai, Zoltan; Macasek, Fedor; Rodrigo, Luis; Kruzliak, Peter; Kovac, Peter

2016-01-01

Nine years of experience with 2286 commercial synthesis allowed us to deliver comprehensive information on the quality of 18F-FDG production. Semi-automated FDG production line using Cyclone 18/9 machine (IBA Belgium), TRACERLab MXFDG synthesiser (GE Health, USA) using alkalic hydrolysis, grade “A” isolator with dispensing robotic unit (Tema Sinergie, Italy), and automatic control system under GAMP5 (minus2, Slovakia) was assessed by TQM tools as highly reliable aseptic production line, fully compliant with Good Manufacturing Practice and just-in-time delivery of FDG radiopharmaceutical. Fluoride-18 is received in steady yield and of very high radioactive purity. Synthesis yields exhibited high variance connected probably with quality of disposable cassettes and chemicals sets. Most performance non-conformities within the manufacturing cycle occur at mechanical nodes of dispensing unit. The long-term monitoring of 2286 commercial synthesis indicated high reliability of automatic synthesizers. Shewhart chart and ANOVA analysis showed that minor non-compliances occurred were mostly caused by the declinations of less experienced staff from standard operation procedures, and also by quality of automatic cassettes. Only 15 syntheses were found unfinished and in 4 cases the product was out-of-specification of European Pharmacopoeia. Most vulnerable step of manufacturing was dispensing and filling in grade “A” isolator. Its cleanliness and sterility was fully controlled under the investigated period by applying hydrogen peroxide vapours (VHP). Our experience with quality assurance in the production of [18F]-fluorodeoxyglucose (FDG) at production facility of BIONT based on TRACERlab MXFDG production module can be used for bench-marking of the emerging manufacturing and automated manufacturing systems. PMID:27508102

Primary Health Care Evaluation: the view of clients and professionals about the Family Health Strategy.

PubMed

da Silva, Simone Albino; Baitelo, Tamara Cristina; Fracolli, Lislaine Aparecida

2015-01-01

to evaluate the attributes of primary health care as for access; longitudinality; comprehensiveness; coordination; family counseling and community counseling in the Family Health Strategy, triangulating and comparing the views of stakeholders involved in the care process. evaluative research with a quantitative approach and cross-sectional design. Data collected using the Primary Care Assessment Tool for interviews with 527 adult clients, 34 health professionals, and 330 parents of children up to two years old, related to 33 family health teams, in eleven municipalities. Analysis conducted in the Statistical Package for Social Sciences software, with a confidence interval of 95% and error of 0.1. the three groups assessed the first contact access - accessibility with low scores. Professionals evaluated with a high score the other attributes. Clients assigned low score evaluations for the attributes: community counseling; family counseling; comprehensiveness - services rendered; comprehensiveness - available services. the quality of performance self-reported by the professionals of the Family Health Strategy is not perceived or valued by clients, and the actions and services may have been developed inappropriately or insufficiently to be apprehended by the experience of clients.

Geostationary Coastal and Air Pollution Events (GEO-CAPE) Sensitivity Analysis Experiment

NASA Technical Reports Server (NTRS)

Lee, Meemong; Bowman, Kevin

2014-01-01

Geostationary Coastal and Air pollution Events (GEO-CAPE) is a NASA decadal survey mission to be designed to provide surface reflectance at high spectral, spatial, and temporal resolutions from a geostationary orbit necessary for studying regional-scale air quality issues and their impact on global atmospheric composition processes. GEO-CAPE's Atmospheric Science Questions explore the influence of both gases and particles on air quality, atmospheric composition, and climate. The objective of the GEO-CAPE Observing System Simulation Experiment (OSSE) is to analyze the sensitivity of ozone to the global and regional NOx emissions and improve the science impact of GEO-CAPE with respect to the global air quality. The GEO-CAPE OSSE team at Jet propulsion Laboratory has developed a comprehensive OSSE framework that can perform adjoint-sensitivity analysis for a wide range of observation scenarios and measurement qualities. This report discusses the OSSE framework and presents the sensitivity analysis results obtained from the GEO-CAPE OSSE framework for seven observation scenarios and three instrument systems.

Promoting Good Clinical Laboratory Practices and Laboratory Accreditation to Support Clinical Trials in Sub-Saharan Africa

PubMed Central

Shott, Joseph P.; Saye, Renion; Diakité, Moussa L.; Sanogo, Sintry; Dembele, Moussa B.; Keita, Sekouba; Nagel, Mary C.; Ellis, Ruth D.; Aebig, Joan A.; Diallo, Dapa A.; Doumbo, Ogobara K.

2012-01-01

Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices. PMID:22492138

Study on Quality Standard of Processed Curcuma Longa Radix

PubMed Central

Zhao, Yongfeng; Quan, Liang; Zhou, Haiting; Cao, Dong; Li, Wenbing; Yang, Zhuo

2017-01-01

To control the quality of Curcuma Longa Radix by establishing quality standards, this paper increased the contents of extract and volatile oil determination. Meanwhile, the curcumin was selected as the internal marker, and the relative correlation factors (RCFs) of demethoxycurcumin and bisdemethoxycurcumin were established by high performance liquid chromatography (HPLC). The contents of multicomponents were calculated based on their RCFs. The rationality and feasibility of the methods were evaluated by comparison of the quantitative results between external standard method (ESM) and quantitative analysis of multicomponents by single-marker (QAMS). Ethanol extracts ranged from 9.749 to 15.644% and the mean value was 13.473%. The volatile oil ranged from 0.45 to 0.90 mL/100 g and the mean value was 0.66 mL/100 g. This method was accurate and feasible and could provide a reference for further comprehensive and effective control of the quality standard of Curcuma Longa Radix and its processed products. PMID:29375640

[How to establish a good acupuncture-moxibustion standard?].

PubMed

Wu, Xiao-dong; Xiao, Hui

2014-10-01

At the beginning of a standard item, the standardized objects and involved contents should be demonstrated thoroughly, which is the precondition of establishing a good standard. After the proposal of this standard, a high-level drafting group should be built, led by top specialists who also draft the standard, which is essential to guarantee the quality of the standard. Before drafting the standard, literature regarding this standard should be searched completely, and Directives for Standardization should be learned to understand the basic requirements of establishing a standard; in the meanwhile, selections on standardized contents and quantitative boundaries of technical indices should be comprehensively and deeply studied. At the stage of consultation, focus should be paid on the scope of the consultation departments, level and personnel quality. As for standard review, it should be precise and truth-seeking. At the stage of submitting and authorization, it is necessary to have timely communication. Only by full cooperations of all parties, and by strictly following the procedure, method and rule of standard establishment, can a high-quality acupuncture-moxibustion standard be established.

Three-dimensional brain MRI for DBS patients within ultra-low radiofrequency power limits.

PubMed

Sarkar, Subhendra N; Papavassiliou, Efstathios; Hackney, David B; Alsop, David C; Shih, Ludy C; Madhuranthakam, Ananth J; Busse, Reed F; La Ruche, Susan; Bhadelia, Rafeeque A

2014-04-01

For patients with deep brain stimulators (DBS), local absorbed radiofrequency (RF) power is unknown and is much higher than what the system estimates. We developed a comprehensive, high-quality brain magnetic resonance imaging (MRI) protocol for DBS patients utilizing three-dimensional (3D) magnetic resonance sequences at very low RF power. Six patients with DBS were imaged (10 sessions) using a transmit/receive head coil at 1.5 Tesla with modified 3D sequences within ultra-low specific absorption rate (SAR) limits (0.1 W/kg) using T2 , fast fluid-attenuated inversion recovery (FLAIR) and T1 -weighted image contrast. Tissue signal and tissue contrast from the low-SAR images were subjectively and objectively compared with routine clinical images of six age-matched controls. Low-SAR images of DBS patients demonstrated tissue contrast comparable to high-SAR images and were of diagnostic quality except for slightly reduced signal. Although preliminary, we demonstrated diagnostic quality brain MRI with optimized, volumetric sequences in DBS patients within very conservative RF safety guidelines offering a greater safety margin. © 2014 International Parkinson and Movement Disorder Society.

An investigation of the effects of pitch-roll (de)coupling on helicopter handling qualities

NASA Technical Reports Server (NTRS)

Blanken, C. L.; Pausder, H. J.; Ockier, C. J.

1995-01-01

An extensive investigation of the effects of pitch-roll coupling on helicopter handling qualities was performed by the U.S. Army and Deutsche Forschungsanstalt fur Luft- und Raumfahrt (DLR), using a NASA ground-based and a DLR in-flight simulator. Over 90 different coupling configurations were evaluated using a high gain roll-axis tracking task. The results show that although the current ADS-33C coupling criterion discriminates against those types of coupling typical of conventionally controlled helicopters, it is not always suited for the prediction of handling qualities of helicopters with modern control systems. Based on the observation that high frequency inputs during tracking are used to alleviate coupling, a frequency domain pitch-roll coupling criterion that uses the average coupling ratio between the bandwidth and neutral stability frequency is formulated. This criterion provides a more comprehensive coverage with respect to the different types of coupling, shows excellent consistency, and has the additional benefit that compliance testing data are obtained from the bandwidth/phase delay tests, so that no additional flight testing is needed.

Nurse-led HIV services and quality of care at health facilities in Kenya, 2014-2016.

PubMed

Rabkin, Miriam; Lamb, Matthew; Osakwe, Zainab T; Mwangi, Peter R; El-Sadr, Wafaa M; Michaels-Strasser, Susan

2017-05-01

To develop a novel measure to characterize human immunodeficiency virus (HIV) programme quality at health facilities in Kenya and explore its associations with patient- and facility-level characteristics. We developed a composite indicator to measure quality of HIV care, comprising: assessment of eligibility for antiretroviral therapy (ART); initiation of ART; and retention on ART or in care, if ineligible for ART, for 12 months. We applied the comprehensive retention indicator to routinely collected clinical data from 13 331 patients enrolled in HIV care and treatment at 63 health facilities in the Eastern and Nyanza regions of Kenya from 1 January 2014 to 31 March 2016. We explored the association between facility- and patient-level characteristics and the primary outcome: appropriate staging and management of HIV, and retention in care over 12 months. Of the enrolled patients, 8404 (63%) achieved comprehensive retention 12 months after enrolment in care. In univariate analyses, patients at facilities where nurses delivered HIV treatment services (including eligibility assessment, initiation and follow up of ART) had significantly higher comprehensive retention rates at 12 months. In multivariate analyses, after adjusting for both facility- and patient-level characteristics, patients at facilities where nurses initiated ART had significantly higher comprehensive retention in care at 12 months (relative risk, RR: 1.22; 95% confidence interval, CI: 1.00-1.48). Nurse-led HIV services were significantly associated with quality of care, confirming the central role of nurses in the achievement of global health goals, and the need for further investment in nursing education, training and mentoring.

Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP)

PubMed Central

Jermoumi, M.; Korideck, H.; Bhagwat, M.; Zygmanski, P.; Makrigiogos, G.M.; Berbeco, R.I.; Cormack, R.C.; Ngwa, W.

2016-01-01

Purpose To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). Methods and materials A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm3) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. Results Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. Conclusions The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests. PMID:25964129

Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP).

PubMed

Jermoumi, M; Korideck, H; Bhagwat, M; Zygmanski, P; Makrigiogos, G M; Berbeco, R I; Cormack, R C; Ngwa, W

2015-07-01

To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm(3)) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

The Dutch Review Process for Evaluating the Quality of Psychological Tests: History, Procedure, and Results

ERIC Educational Resources Information Center

Evers, Arne; Sijtsma, Klaas; Lucassen, Wouter; Meijer, Rob R.

2010-01-01

This article describes the 2009 revision of the Dutch Rating System for Test Quality and presents the results of test ratings from almost 30 years. The rating system evaluates the quality of a test on seven criteria: theoretical basis, quality of the testing materials, comprehensiveness of the manual, norms, reliability, construct validity, and…

Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators.

PubMed

Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard

2016-04-01

The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.

[Evaluation of comprehensive capacity of resources and environments in Poyang Lake Eco-economic Zone].

PubMed

Song, Yan-Chun; Yu, Dan

2014-10-01

With the development of the society and economy, the contradictions among population, resources and environment are increasingly worse. As a result, the capacity of resources and environment becomes one of the focal issues for many countries and regions. Through investigating and analyzing the present situation and the existing problems of resources and environment in Poyang Lake Eco-economic Zone, seven factors were chosen as the evaluation criterion layer, namely, land resources, water resources, biological resources, mineral resources, ecological-geological environment, water environment and atmospheric environment. Based on the single factor evaluation results and with the county as the evaluation unit, the comprehensive capacity of resources and environment was evaluated by using the state space method in Poyang Lake Eco-economic Zone. The results showed that it boasted abundant biological resources, quality atmosphere and water environment, and relatively stable geological environment, while restricted by land resource, water resource and mineral resource. Currently, although the comprehensive capacity of the resources and environments in Poyang Lake Eco-economic Zone was not overloaded as a whole, it has been the case in some counties/districts. State space model, with clear indication and high accuracy, could serve as another approach to evaluating comprehensive capacity of regional resources and environment.

A peptide resource for the analysis of Staphylococcus aureus in host pathogen interaction studies

PubMed Central

Depke, Maren; Michalik, Stephan; Rabe, Alexander; Surmann, Kristin; Brinkmann, Lars; Jehmlich, Nico; Bernhardt, Jörg; Hecker, Michael; Wollscheid, Bernd; Sun, Zhi; Moritz, Robert L.; Völker, Uwe; Schmidt, Frank

2016-01-01

Staphylococcus aureus is an opportunistic human pathogen, which can cause life-threatening disease. Proteome analyses of the bacterium can provide new insights into its pathophysiology and important facets of metabolic adaptation and, thus, aid the recognition of targets for intervention. However, the value of such proteome studies increases with their comprehensiveness. We present an MS–driven, proteome-wide characterization of the strain S. aureus HG001. Combining 144 high precision proteomic data sets, we identified 19 109 peptides from 2088 distinct S. aureus HG001 proteins, which account for 72% of the predicted ORFs. Peptides were further characterized concerning pI, GRAVY, and detectability scores in order to understand the low peptide coverage of 8.7% (19 109 out of 220 245 theoretical peptides). The high quality peptide-centric spectra have been organized into a comprehensive peptide fragmentation library (SpectraST) and used for identification of S. aureus-typic peptides in highly complex host–pathogen interaction experiments, which significantly improved the number of identified S. aureus proteins compared to a MASCOT search. This effort now allows the elucidation of crucial pathophysiological questions in S. aureus-specific host–pathogen interaction studies through comprehensive proteome analysis. The S. aureus-specific spectra resource developed here also represents an important spectral repository for SRM or for data-independent acquisition MS approaches. All MS data have been deposited in the ProteomeXchange with identifier PXD000702 (http://proteomecentral.proteomexchange.org/dataset/PXD000702). PMID:26224020

A peptide resource for the analysis of Staphylococcus aureus in host-pathogen interaction studies.

PubMed

Depke, Maren; Michalik, Stephan; Rabe, Alexander; Surmann, Kristin; Brinkmann, Lars; Jehmlich, Nico; Bernhardt, Jörg; Hecker, Michael; Wollscheid, Bernd; Sun, Zhi; Moritz, Robert L; Völker, Uwe; Schmidt, Frank

2015-11-01

Staphylococcus aureus is an opportunistic human pathogen, which can cause life-threatening disease. Proteome analyses of the bacterium can provide new insights into its pathophysiology and important facets of metabolic adaptation and, thus, aid the recognition of targets for intervention. However, the value of such proteome studies increases with their comprehensiveness. We present an MS-driven, proteome-wide characterization of the strain S. aureus HG001. Combining 144 high precision proteomic data sets, we identified 19 109 peptides from 2088 distinct S. aureus HG001 proteins, which account for 72% of the predicted ORFs. Peptides were further characterized concerning pI, GRAVY, and detectability scores in order to understand the low peptide coverage of 8.7% (19 109 out of 220 245 theoretical peptides). The high quality peptide-centric spectra have been organized into a comprehensive peptide fragmentation library (SpectraST) and used for identification of S. aureus-typic peptides in highly complex host-pathogen interaction experiments, which significantly improved the number of identified S. aureus proteins compared to a MASCOT search. This effort now allows the elucidation of crucial pathophysiological questions in S. aureus-specific host-pathogen interaction studies through comprehensive proteome analysis. The S. aureus-specific spectra resource developed here also represents an important spectral repository for SRM or for data-independent acquisition MS approaches. All MS data have been deposited in the ProteomeXchange with identifier PXD000702 (http://proteomecentral.proteomexchange.org/dataset/PXD000702). © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

78 FR 38247 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Redesignation of the Ohio...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... proposing that the inventories for ammonia and volatile organic compounds (VOC), in conjunction with the... and Evaluation of Precursors B. Ammonia and VOC Comprehensive Emissions Inventories IV. Summary of..., and Ohio's supplemental submission of comprehensive ammonia and VOC emissions inventories. On January...

Plain Language in Environmental Policy Documents: An Assessment of Reader Comprehension and Perceptions

ERIC Educational Resources Information Center

Jones, Natasha; McDavid, Justin; Derthick, Katie; Dowell, Randy; Spyridakis, Jan

2012-01-01

Several government agencies are seeking quality improvement in environmental policy documents by asking for the implementation of Plain Language (PL) guidelines. Our mixed-methods research examines whether the application of certain PL guidelines affects the comprehension and perceptions of readers of environmental policy documents. Results show…

Change@ucsc.edu: Managing a Comprehensive Change Effort.

ERIC Educational Resources Information Center

Coate, L. Edwin

This monograph describes how team- and process-oriented change techniques such as Total Quality Management (TQM) and Business Process Reengineering (BPR), were adapted to an academic environment to effect a comprehensive change program at the University of California Santa Cruz (UCSC). The $3 million program, begun in 1993, produced radical…

Differential Lexical Predictors of Reading Comprehension in Fourth Graders

ERIC Educational Resources Information Center

Swart, Nicole M.; Muijselaar, Marloes M. L.; Steenbeek-Planting, Esther G.; Droop, Mienke; de Jong, Peter F.; Verhoeven, L.

2017-01-01

The mental lexicon plays a central role in reading comprehension (Perfetti & Stafura, 2014). It encompasses the number of lexical entries in spoken and written language (vocabulary breadth), the semantic quality of these entries (vocabulary depth), and the connection strength between lexical representations (semantic relatedness); as such, it…

Improving couples' quality of life through a Web-based prostate cancer education intervention.

PubMed

Song, Lixin; Rini, Christine; Deal, Allison M; Nielsen, Matthew E; Chang, Hao; Kinneer, Patty; Teal, Randall; Johnson, David C; Dunn, Mary W; Mark, Barbara; Palmer, Mary H

2015-03-01

To evaluate the feasibility and acceptability of a newly developed web-based, couple-oriented intervention called Prostate Cancer Education and Resources for Couples (PERC). Quantitative, qualitative, mixed-methods approach. Oncology outpatient clinics at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center at UNC–Chapel Hill. 26 patients with localized prostate cancer (PCa) and their partners. Pre- and postpilot quantitative assessments and a postpilot qualitative interview were conducted. General and PCa-specific symptoms, quality of life, psychosocial factors, PERC’s ease of use, and web activities. Improvement was shown in some PCa-specific and general symptoms (small effect sizes for patients and small-to-medium effect sizes for partners), overall quality of life, and physical and social domains of quality of life for patients (small effect sizes). Web activity data indicated high PERC use. Qualitative and quantitative analyses indicated that participants found PERC easy to use and understand,as well as engaging, of high quality, and relevant. Overall, participants were satisfied with PERC and reported that PERC improved their knowledge about symptom management and communication as a couple. PERC was a feasible, acceptable method of reducing the side effects of PCa treatment–related symptoms and improving quality of life. PERC has the potential to reduce the negative impacts of symptoms and enhance quality of life for patients with localized PCa and their partners, particularly for those who live in rural areas and have limited access to post-treatment supportive care.

Identification of long-term trends and seasonality in high-frequency water quality data from the Yangtze River basin, China.

PubMed

Duan, Weili; He, Bin; Chen, Yaning; Zou, Shan; Wang, Yi; Nover, Daniel; Chen, Wen; Yang, Guishan

2018-01-01

Comprehensive understanding of the long-term trends and seasonality of water quality is important for controlling water pollution. This study focuses on spatio-temporal distributions, long-term trends, and seasonality of water quality in the Yangtze River basin using a combination of the seasonal Mann-Kendall test and time-series decomposition. The used weekly water quality data were from 17 environmental stations for the period January 2004 to December 2015. Results show gradual improvement in water quality during this period in the Yangtze River basin and greater improvement in the Uppermost Yangtze River basin. The larger cities, with high GDP and population density, experienced relatively higher pollution levels due to discharge of industrial and household wastewater. There are higher pollution levels in Xiang and Gan River basins, as indicated by higher NH4-N and CODMn concentrations measured at the stations within these basins. Significant trends in water quality were identified for the 2004-2015 period. Operations of the three Gorges Reservoir (TGR) enhanced pH fluctuations and possibly attenuated CODMn, and NH4-N transportation. Finally, seasonal cycles of varying strength were detected for time-series of pollutants in river discharge. Seasonal patterns in pH indicate that maxima appear in winter, and minima in summer, with the opposite true for CODMn. Accurate understanding of long-term trends and seasonality are necessary goals of water quality monitoring system efforts and the analysis methods described here provide essential information for effectively controlling water pollution.

An investigation of the effects of pitch-roll (de)-coupling on helicopter handling qualities

NASA Technical Reports Server (NTRS)

Ockier, C. J.; Pausder, H. J.; Blanken, C. L.

1995-01-01

An investigation of the effects of pitch-roll coupling on helicopter handling qualities was performed by the US Army and DLR, using a NASA ground-based and a DLR inflight simulator. Over 90 different coupling configurations were evaluated using a roll-axis tracking task. The results show that although the current ADS-33C coupling criterion discriminates against those types of coupling typical of conventionally controlled helicopters, it not always suited for the prediction of handling qualities of helicopters with modern control systems. Based on the observation that high frequency inputs during tracking are used to alleviate coupling, a frequency domain pitch-roll coupling criterion that uses the average coupling ratio between the bandwidth and neutral stability frequency is formulated. This criterion provides a more comprehensive coverage with respect to the different types of coupling and shows excellent consistency.

SEER*Educate: Use of Abstracting Quality Index Scores to Monitor Improvement of All Employees.

PubMed

Potts, Mary S; Scott, Tim; Hafterson, Jennifer L

2016-01-01

Integral parts of the Seattle-Puget Sound's Cancer Surveillance System registry's continuous improvement model include the incorporation of SEER*Educate into its training program for all staff and analyzing assessment results using the Abstracting Quality Index (AQI). The AQI offers a comprehensive measure of overall performance in SEER*Educate, which is a Web-based application used to personalize learning and diagnostically pinpoint each staff member's place on the AQI continuum. The assessment results are tallied from 6 abstracting standards within 2 domains: incidence reporting and coding accuracy. More than 100 data items are aligned to 1 or more of the 6 standards to build an aggregated score that is placed on a continuum for continuous improvement. The AQI score accurately identifies those individuals who have a good understanding of how to apply the 6 abstracting standards to reliably generate high quality abstracts.

Innovative Ingredients and Emerging Technologies for Controlling Ice Recrystallization, Texture, and Structure Stability in Frozen Dairy Desserts: A Review.

PubMed

Soukoulis, Christos; Fisk, Ian

2016-11-17

Over the past decade, ice cream manufacturers have developed a strong understanding of the functionality of key ingredients and processing, developing effective explanations for the link between structure forming agents, stability mechanisms, and perceived quality. Increasing demand for products perceived as healthier/more natural with minimal processing has identified a number of new tools to improve quality and storage stability of frozen dairy desserts. Ingredients such as dietary fiber, polysaccharides, prebiotics, alternate sweeteners, fat sources rich in unsaturated fatty acids and ice strucsturing proteins (ISP) have been successfully applied as cryoprotective, texturizing, and structuring agents. Emerging minimal processing technologies including hydrostatic pressure processing, ultrasonic or high pressure assisted freezing, low temperature extrusion and enzymatically induced biopolymers crosslinking have been evaluated for their ability to improve colloidal stability, texture and sensory quality. It is therefore timely for a comprehensive review.

An integrated approach to improving noisy speech perception

NASA Astrophysics Data System (ADS)

Koval, Serguei; Stolbov, Mikhail; Smirnova, Natalia; Khitrov, Mikhail

2002-05-01

For a number of practical purposes and tasks, experts have to decode speech recordings of very poor quality. A combination of techniques is proposed to improve intelligibility and quality of distorted speech messages and thus facilitate their comprehension. Along with the application of noise cancellation and speech signal enhancement techniques removing and/or reducing various kinds of distortions and interference (primarily unmasking and normalization in time and frequency fields), the approach incorporates optimal listener expert tactics based on selective listening, nonstandard binaural listening, accounting for short-term and long-term human ear adaptation to noisy speech, as well as some methods of speech signal enhancement to support speech decoding during listening. The approach integrating the suggested techniques ensures high-quality ultimate results and has successfully been applied by Speech Technology Center experts and by numerous other users, mainly forensic institutions, to perform noisy speech records decoding for courts, law enforcement and emergency services, accident investigation bodies, etc.

Counselling by primary care physicians may help patients with heartburn-predominant uninvestigated dyspepsia.

PubMed

Paré, Pierre; Lee, Joanna; Hawes, Ian A

2010-03-01

To determine whether strategies to counsel and empower patients with heartburn-predominant dyspepsia could improve health-related quality of life. Using a cluster randomized, parallel group, multicentre design, nine centres were assigned to provide either basic or comprehensive counselling to patients (age range 18 to 50 years) presenting with heartburn-predominant upper gastrointestinal symptoms, who would be considered for drug therapy without further investigation. Patients were treated for four weeks with esomeprazole 40 mg once daily, followed by six months of treatment that was at the physician's discretion. The primary end point was the baseline change in Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire score. A total of 135 patients from nine centres were included in the intention-to-treat analysis. There was a statistically significant baseline improvement in all domains of the QOLRAD questionnaire in both study arms at four and seven months (P<0.0001). After four months, the overall mean change in QOLRAD score appeared greater in the comprehensive counselling group than in the basic counselling group (1.77 versus 1.47, respectively); however, this difference was not statistically significant (P=0.07). After seven months, the overall mean baseline change in QOLRAD score between the comprehensive and basic counselling groups was not statistically significant (1.69 versus 1.56, respectively; P=0.63). A standardized, comprehensive counselling intervention showed a positive initial trend in improving quality of life in patients with heartburn-predominant uninvestigated dyspepsia. Further investigation is needed to confirm the potential benefits of providing patients with comprehensive counselling regarding disease management.

Building a comprehensive syntactic and semantic corpus of Chinese clinical texts.

PubMed

He, Bin; Dong, Bin; Guan, Yi; Yang, Jinfeng; Jiang, Zhipeng; Yu, Qiubin; Cheng, Jianyi; Qu, Chunyan

2017-05-01

To build a comprehensive corpus covering syntactic and semantic annotations of Chinese clinical texts with corresponding annotation guidelines and methods as well as to develop tools trained on the annotated corpus, which supplies baselines for research on Chinese texts in the clinical domain. An iterative annotation method was proposed to train annotators and to develop annotation guidelines. Then, by using annotation quality assurance measures, a comprehensive corpus was built, containing annotations of part-of-speech (POS) tags, syntactic tags, entities, assertions, and relations. Inter-annotator agreement (IAA) was calculated to evaluate the annotation quality and a Chinese clinical text processing and information extraction system (CCTPIES) was developed based on our annotated corpus. The syntactic corpus consists of 138 Chinese clinical documents with 47,426 tokens and 2612 full parsing trees, while the semantic corpus includes 992 documents that annotated 39,511 entities with their assertions and 7693 relations. IAA evaluation shows that this comprehensive corpus is of good quality, and the system modules are effective. The annotated corpus makes a considerable contribution to natural language processing (NLP) research into Chinese texts in the clinical domain. However, this corpus has a number of limitations. Some additional types of clinical text should be introduced to improve corpus coverage and active learning methods should be utilized to promote annotation efficiency. In this study, several annotation guidelines and an annotation method for Chinese clinical texts were proposed, and a comprehensive corpus with its NLP modules were constructed, providing a foundation for further study of applying NLP techniques to Chinese texts in the clinical domain. Copyright © 2017. Published by Elsevier Inc.

Counselling by primary care physicians may help patients with heartburn-predominant uninvestigated dyspepsia

PubMed Central

Paré, Pierre; Math, Joanna Lee M; Hawes, Ian A

2010-01-01

OBJECTIVE: To determine whether strategies to counsel and empower patients with heartburn-predominant dyspepsia could improve health-related quality of life. METHODS: Using a cluster randomized, parallel group, multicentre design, nine centres were assigned to provide either basic or comprehensive counselling to patients (age range 18 to 50 years) presenting with heartburn-predominant upper gastrointestinal symptoms, who would be considered for drug therapy without further investigation. Patients were treated for four weeks with esomeprazole 40 mg once daily, followed by six months of treatment that was at the physician’s discretion. The primary end point was the baseline change in Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire score. RESULTS: A total of 135 patients from nine centres were included in the intention-to-treat analysis. There was a statistically significant baseline improvement in all domains of the QOLRAD questionnaire in both study arms at four and seven months (P<0.0001). After four months, the overall mean change in QOLRAD score appeared greater in the comprehensive counselling group than in the basic counselling group (1.77 versus 1.47, respectively); however, this difference was not statistically significant (P=0.07). After seven months, the overall mean baseline change in QOLRAD score between the comprehensive and basic counselling groups was not statistically significant (1.69 versus 1.56, respectively; P=0.63). CONCLUSIONS: A standardized, comprehensive counselling intervention showed a positive initial trend in improving quality of life in patients with heartburn-predominant uninvestigated dyspepsia. Further investigation is needed to confirm the potential benefits of providing patients with comprehensive counselling regarding disease management. PMID:20352148

Frequency analysis of urban runoff quality in an urbanizing catchment of Shenzhen, China

NASA Astrophysics Data System (ADS)

Qin, Huapeng; Tan, Xiaolong; Fu, Guangtao; Zhang, Yingying; Huang, Yuefei

2013-07-01

This paper investigates the frequency distribution of urban runoff quality indicators using a long-term continuous simulation approach and evaluates the impacts of proposed runoff control schemes on runoff quality in an urbanizing catchment in Shenzhen, China. Four different indicators are considered to provide a comprehensive assessment of the potential impacts: total runoff depth, event pollutant load, Event Mean Concentration, and peak concentration during a rainfall event. The results obtained indicate that urban runoff quantity and quality in the catchment have significant variations in rainfall events and a very high rate of non-compliance with surface water quality regulations. Three runoff control schemes with the capacity to intercept an initial runoff depth of 5 mm, 10 mm, and 15 mm are evaluated, respectively, and diminishing marginal benefits are found with increasing interception levels in terms of water quality improvement. The effects of seasonal variation in rainfall events are investigated to provide a better understanding of the performance of the runoff control schemes. The pre-flood season has higher risk of poor water quality than other seasons after runoff control. This study demonstrates that frequency analysis of urban runoff quantity and quality provides a probabilistic evaluation of pollution control measures, and thus helps frame a risk-based decision making for urban runoff quality management in an urbanizing catchment.

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

PubMed

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

2016-09-01

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

Beyond teacher training: the critical role of professional development in maintaining curriculum fidelity.

PubMed

LaChausse, Robert G; Clark, Kim R; Chapple, Sabrina

2014-03-01

To examine how teacher characteristics affected program fidelity in an impact evaluation study of the Positive Prevention PLUS program, and to propose a comprehensive teacher training and professional development structure to increase program fidelity. Curriculum fidelity logs, lesson observations, and teacher surveys were used to measure teacher characteristics and implementation fidelity including adherence, adaptation, and lesson quality. Compared with non-health credentialed teachers, credential health education teachers had greater comfort and self-efficacy regarding sex-related instruction. Teacher self-efficacy and comfort were significant predictors of adherence. Implementation fidelity may be linked to teacher characteristics that can be enhanced during curriculum training. A 2-day teacher training may not adequately address teacher facilitation skills or the maintenance of institutional supports for implementing a program with fidelity and quality. A new model of comprehensive teacher training and support is offered. This new training infrastructure is intended to contribute to the school district's institutionalization of higher-quality comprehensive sexual health education and increase program fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Epidemiology of insomnia in college students: relationship with mental health, quality of life, and substance use difficulties.

PubMed

Taylor, Daniel J; Bramoweth, Adam D; Grieser, Emily A; Tatum, Jolyn I; Roane, Brandy M

2013-09-01

The purpose of this study was to evaluate the prevalence and correlates of insomnia using rigorous diagnostic criteria and a comprehensive assessment battery. In a large sample (N=1,074) of college students (mean age 20.39years), participants were asked to complete a week-long sleep diary and comprehensive questionnaire packet assessing recommended daytime functioning domains (i.e., fatigue, quality of life, depression, anxiety, stress, academic performance, substance use) during the academic year. A significant portion of this sample of college students met proposed DSM-5 criteria for chronic insomnia (9.5%). The chronic insomnia group reported significantly worse sleep, fatigue, depression, anxiety, stress, and quality of life, and greater hypnotic and stimulant use for sleep problems. There were no differences between groups on excessive daytime sleepiness, academic performance, or substance use. This was a rigorous and comprehensive assessment of the prevalence and psychosocial correlates of insomnia. Insomnia is a significant problem in college students and should be regularly assessed. More research is also needed to guide treatment in this population. Copyright © 2012. Published by Elsevier Ltd.

[Comprehensive quality management in hospitals--experience and recommendations].

PubMed

Schubert, H J

1999-03-01

Total quality management concepts, increasingly being introduced into hospitals, offer opportunities for integrative leadership concepts because of their multidimensional character viewed from the aspects of results and from the standpoint of organisational design. Customized for leadership and organisation of hospitals in Germany, questions of introduction strategies as well as recommendations for the integration of total quality understanding into the daily practice of management and employees are discussed. The active support of top and middle management and a combination of radical change in selected problem areas and continual incremental improvements on a broad base have been proven as significant factors for the success in the introductory phase. For a lasting integration of the principles of a comprehensive quality management concept in a hospital, it will be necessary to carry out regularly relevant measurements of success. The results become an important part of agreements with management.

Comprehensive national database of tree effects on air quality and human health in the United States.

PubMed

Hirabayashi, Satoshi; Nowak, David J

2016-08-01

Trees remove air pollutants through dry deposition processes depending upon forest structure, meteorology, and air quality that vary across space and time. Employing nationally available forest, weather, air pollution and human population data for 2010, computer simulations were performed for deciduous and evergreen trees with varying leaf area index for rural and urban areas in every county in the conterminous United States. The results populated a national database of annual air pollutant removal, concentration changes, and reductions in adverse health incidences and costs for NO2, O3, PM2.5 and SO2. The developed database enabled a first order approximation of air quality and associated human health benefits provided by trees with any forest configurations anywhere in the conterminous United States over time. Comprehensive national database of tree effects on air quality and human health in the United States was developed. Copyright © 2016 Elsevier Ltd. All rights reserved.

What is a good life? Selecting capabilities to assess women's quality of life in rural Malawi.

PubMed

Greco, Giulia; Skordis-Worrall, Jolene; Mkandawire, Bryan; Mills, Anne

2015-04-01

There is growing interest in using Sen's Capability Approach to assess quality of life and to evaluate social policies. This paper describes the formative stages of developing a quality of life measure: the selection of the relevant capabilities. This measure is intended to provide a more comprehensive outcome measure for the evaluation of complex interventions such as Maimwana womens' groups, a community based participatory intervention to improve maternal health in rural Malawi. Fifteen focus group discussions with 129 women were conducted to explore relevant concepts of quality of life in rural Malawi. Data collection started in October 2009. Findings were elicited based on framework analysis. The findings portray a complex and highly nuanced perception that women in rural Malawi have of their life and wellbeing. Quality of life was described using a variety of dimensions that are highly interconnected. Quality of life emerges to be not only shaped by the realisation of basic material needs such as being sufficiently nourished and adequately sheltered, but is also highly dependent on complex feelings, relations and social norms. The full exposition of wellbeing with its domains was organised into a framework constituting six different spheres of wellbeing: physical strength, inner wellbeing, household wellbeing, community relations, economic security and happiness. Despite the list being developed in a specific context and for a specific group of people, the similarities with lists developed in other contexts, with different methods and for different purposes, are considerable. This suggests that there are a number of core aspects of wellbeing considered a minimum requirement for a life of human dignity, that should be included in any attempt to assess quality of life and human development across populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

77 FR 3783 - Collection; Comment Request: Revision of the National Diabetes Education Program Comprehensive...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... improve quality of life; (3) decrease the number of Americans with undiagnosed diabetes; (4) Among people... and resources that support behavior change, improved quality of life, and better diabetes outcomes; (3..., including the validity of the methodology and assumptions used; (3) Ways to enhance the quality, utility...

Institutionalisation of Internal Quality Assurance: Focusing on Institutional Work and the Significance of Disciplinary Differences

ERIC Educational Resources Information Center

Vukasovic, Martina

2014-01-01

The study suggests that institutionalisation of a comprehensive and systematic approach to internal quality assurance of higher education institutions inspired by the Bologna Process has regulative, normative and cultural-cognitive dimensions. It includes development of structures and procedures for quality assurance, as well as boosting of the…

From Planning to Improvement: Monash University Library's Quality Review

ERIC Educational Resources Information Center

Pernat, Marie

2004-01-01

During 2003, Monash University Library conducted a comprehensive quality review as part of the university's program of reviews. A quality management group was established in September 2002 to drive the process. All staff were given the opportunity to contribute input to the initial self-review. Methods of collecting data, collating responses and…

Relationship of Fiber Properties to Vortex Yarn Quality via Partial Least Squares

USDA-ARS?s Scientific Manuscript database

The Cotton Quality Research Station (CQRS) of the USDA-ARS, recently completed a comprehensive study of the relationship of cotton fiber properties to the quality of spun yarn. The five year study, began in 2001, utilized commercial variety cotton grown, harvested and ginned in each of three major ...

Modeling the impacts of green infrastructure land use changes on air quality and meteorology case study and sensitivity analysis in Kansas City

EPA Science Inventory

Changes in vegetation cover associated with urban planning efforts may affect regional meteorology and air quality. Here we use a comprehensive coupled meteorology-air quality model (WRF-CMAQ) to simulate the influence of planned land use changes from green infrastructure impleme...

Characteristics and Methodological Quality of Meta-Analyses on Hypertension Treatments-A Cross-Sectional Study.

PubMed

Wu, Xin Yin; Du, Xin Jian; Ho, Robin S T; Lee, Clarence C Y; Yip, Benjamin H K; Wong, Martin C S; Wong, Samuel Y S; Chung, Vincent C H

2017-02-01

Methodological quality of meta-analyses on hypertension treatments can affect treatment decision-making. The authors conducted a cross-sectional study to investigate the methodological quality of meta-analyses on hypertension treatments. One hundred and fifty-eight meta-analyses were identified. Overall, methodological quality was unsatisfactory in the following aspects: comprehensive reporting of financial support (1.9%), provision of included and excluded lists of studies (22.8%), inclusion of grey literature (27.2%), and inclusion of protocols (32.9%). The 126 non-Cochrane meta-analyses had poor performance on almost all the methodological items. Non-Cochrane meta-analyses focused on nonpharmacologic treatments were more likely to consider scientific quality of included studies when making conclusions. The 32 Cochrane meta-analyses generally had good methodological quality except for comprehensive reporting of the sources of support. These results highlight the need for cautious interpretation of these meta-analyses, especially among physicians and policy makers when guidelines are formulated. Future meta-analyses should pay attention to improving these methodological aspects. ©2016 Wiley Periodicals, Inc.

Commentary on "Reading Comprehension Is Not a Single Ability": Implications for Child Language Intervention.

PubMed

Ukrainetz, Teresa A

2017-04-20

This commentary responds to the implications for child language intervention of Catts and Kamhi's (2017) call to move from viewing reading comprehension as a single ability to recognizing it as a complex constellation of reader, text, and activity. Reading comprehension, as Catts and Kamhi explain, is very complicated. In this commentary, I consider how comprehension has been taught and the directions in which it is moving. I consider how speech-language pathologists (SLPs), with their distinctive expertise and resources, can contribute to effective reading comprehension instruction. I build from Catts and Kamhi's emphasis on the importance of context and knowledge, using the approaches of staying on topic, close reading, and incorporating quality features of intervention. I consider whether and how SLPs should treat language skills and comprehension strategies to achieve noticeable changes in their students' reading comprehension. Within this multidimensional view of reading comprehension, SLPs can make strategic, meaningful contributions to improving the reading comprehension of students with language impairments.

[Quality in rehabilitation].

PubMed

Jäckel, W H

2010-12-01

Particularly in the context of introduction of quality assurance programmes 15 years ago, "quality" became a central issue for rehabilitation, and its importance is bound to grow in the years to come. After giving a general definition of quality, this article deals more closely with 3 aspects of quality: quality development, quality assurance, and data on quality. Quality development in rehabilitation centres demands an atmosphere that supports change, encourages creativity, courage, transparency and involvement, and reduces fear. The creation of such an atmosphere is, in particular, the responsibility of a centre's management. Routine interviews regarding patient as well as employee satisfaction, and the use of strategic planning and management systems have proven successful instruments in the practice of quality development. Compared with other sectors of the health system, quality assurance in rehabilitation is marked by its comprehensive approach, intense patient orientation, scientific underpinning, and nationwide implementation. Regarding the benefits of these programmes for the health system at large, however, no clear scientific proof is available yet. Data gained from quality assurance programmes on the whole show a high amount of patient satisfaction, good quality of structures and processes as well as an improvement of the patients' health status. Between centres, however, there are marked differences of quality in a number of cases, and long-term effectiveness could be improved in some indications. Finally, suggestions are offered concerning further development of quality in rehabilitation as well as of the quality assurance programmes. © Georg Thieme Verlag KG Stuttgart · New York.

Artificial intelligence and robotics in high throughput post-genomics.

PubMed

Laghaee, Aroosha; Malcolm, Chris; Hallam, John; Ghazal, Peter

2005-09-15

The shift of post-genomics towards a systems approach has offered an ever-increasing role for artificial intelligence (AI) and robotics. Many disciplines (e.g. engineering, robotics, computer science) bear on the problem of automating the different stages involved in post-genomic research with a view to developing quality assured high-dimensional data. We review some of the latest contributions of AI and robotics to this end and note the limitations arising from the current independent, exploratory way in which specific solutions are being presented for specific problems without regard to how these could be eventually integrated into one comprehensible integrated intelligent system.

Emissions versus climate change

EPA Science Inventory

Climate change is likely to offset some of the improvements in air quality expected from reductions in pollutant emissions. A comprehensive analysis of future air quality over North America suggests that, on balance, the air will still be cleaner in coming decades.

Air quality procedures for civilian airports and air force bases

DOT National Transportation Integrated Search

1997-04-01

Air Quality assessments for proposed Federal actions are required for compliance with the National Environmental Policy Act, the Clean Air Act and other environment-related regulations and directives. This handbook is a comprehensive guide intended t...