Update on value-based medicine.

PubMed

Brown, Melissa M; Brown, Gary C

2013-05-01

To update concepts in Value-Based Medicine, especially in view of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act assures that some variant of Value-Based Medicine cost-utility analysis will play a key role in the healthcare system. It identifies the highest quality care, thereby maximizing the most efficacious use of healthcare resources and empowering patients and physicians.Standardization is critical for the creation and acceptance of a Value-Based Medicine, cost-utility analysis, information system, since 27 million different input variants can go into a cost-utility analysis. Key among such standards is the use of patient preferences (utilities), as patients best understand the quality of life associated with their health states. The inclusion of societal costs, versus direct medical costs alone, demonstrates that medical interventions are more cost effective and, in many instances, provide a net financial return-on-investment to society referent to the direct medical costs expended. Value-Based Medicine provides a standardized methodology, integrating critical, patient, quality-of-life preferences, and societal costs, to allow the highest quality, most cost-effective care. Central to Value-Based Medicine is the concept that all patients deserve the interventions that provide the greatest patient value (improvement in quality of life and/or length of life).

AMT's Position on Physician's Office Laboratories.

ERIC Educational Resources Information Center

AMT Events, 1986

1986-01-01

The following standards are affirmed by the American Medical Technologists organization: (1) regardless of the size of the laboratory setting, the patient deserves the highest quality of laboratory service available; (2) certified personnel should be employed by physicians in office laboratories; (3) quality control should be mandatory and…

Health and Quality of Life in Northern Plains Indians

USDA-ARS?s Scientific Manuscript database

Quality of life and standard of living are consistently depicted as indigent among American Indian and Alaska Native (AI/AN) populations. American Indians (AI) are among the most heterogeneous and impoverished ethnic groups in the U.S.,have the highest per capita suicide rate at 247% of the national...

Lowest cost due to highest productivity and highest quality

NASA Astrophysics Data System (ADS)

Wenk, Daniel

2003-03-01

Since global purchasing in the automotive industry has been taken up all around the world there is one main key factor that makes a TB-supplier today successful: Producing highest quality at lowest cost. The fact that Tailored Blanks, which today may reach up to 1/3 of a car body weight, are purchased on the free market but from different steel suppliers, especially in Europe and NAFTA, the philosophy on OEM side has been changing gradually towards tough evaluation criteria. "No risk at the stamping side" calls for top quality Tailored- or Tubular Blank products. Outsourcing Tailored Blanks has been starting in Japan but up to now without any quality request from the OEM side like ISO 13919-1B (welding quality standard in Europe and USA). Increased competition will automatically push the quality level and the ongoing approach to combine high strength steel with Tailored- and Tubular Blanks will ask for even more reliable system concepts which enables to weld narrow seams at highest speed. Beside producing quality, which is the key to reduce one of the most important cost driver "material scrap," in-line quality systems with true and reliable evaluation is going to be a "must" on all weld systems. Traceability of all process related data submitted to interfaces according to customer request in combination with ghost-shift-operation of TB systems are tomorrow's state-of-the-art solutions of Tailored Blank-facilities.

NBS (National Bureau of Standards) calibration services users guide: Fee schedule

NASA Astrophysics Data System (ADS)

1987-04-01

The physical measurement services of the National Bureau of Standards are designed to help the makers and users of precision instruments achieve the highest possible levels of measurement quality and productivity. The hundreds of individual services found listed in the Fee Schedule constitute the highest-order calibration services available in the United States. These services directly link a customer's precision equipment or transfer standards to national measurement standards. These services are offered to public and private organizations and individuals alike. The Fee Schedule is a supplement to NBS Special Publication 250, Calibration Services Users Guide. These documents are designed to make the task of selecting and ordering an appropriate calibration service as quick and easy as possible.

Role of Science at EPA

EPA Pesticide Factsheets

Decision-making is driven by research with the highest standards for integrity, peer review, transparency, and ethics. Ongoing positive impacts include reducing pollution, improving air quality, defining exposure pathways, and protecting water sources.

76 FR 79579 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-22

... posting of the availability of the submittal on EPA's Adequacy Web site (at http://www.epa.gov/otaq... average annual fourth-highest daily maximum 8-hour average ozone concentration), if it had a 1-hour design... ozone standard is attained when the three-year average of the annual fourth-highest daily maximum 8-hour...

A New Approach to Teacher Education and Teacher Certification.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia. Div. of Teacher Education and Certification.

New certification standards adopted by the Washington State Board of Education in 1971 were designed to develop teacher education programs that ensure the highest quality of professional performance by teachers prepared within them. Teacher education programs under the new standards are approved by the State Board of Education only when three…

Nutritional quality of foods and non-alcoholic beverages advertised on Mexican television according to three nutrient profile models.

PubMed

Rincón-Gallardo Patiño, Sofía; Tolentino-Mayo, Lizbeth; Flores Monterrubio, Eric Alejandro; Harris, Jennifer L; Vandevijvere, Stefanie; Rivera, Juan A; Barquera, Simón

2016-08-05

Evidence supports that television food advertisements influence children's food preferences and their consumption. However, few studies have examined the extent and nature of food marketing to children in low and middle income countries. This study aims to assess the nutritional quality of foods and beverages advertised on Mexican TV, applying the Mexican, World Health Organization (WHO) European and United Kingdom (UKNPM) nutrient profile models, before the Mexican regulation on food marketing came into effect. We recorded 600 h on the four national public and free TV channels with the highest national ratings, from December 2012 to April 2013. Recordings were done for 40 randomly selected (week, weekend, school and vacation) days, from 7 am to 10 pm. Nutritional information per 100 g/ml of product was obtained from the product labels or company websites. A total of 2,544 food and non-alcoholic beverage advertisements were broadcast, for 275 different products. On average, the foods advertised during cartoon programming had the highest energy (367 kcal) and sugar (30.0 g) content, while foods advertised during sport programming had the highest amount of total fat (9.5 g) and sodium (412 mg) content. More than 60 % of the foods advertised did not meet any nutritional quality standards. 64.3 % of the products did not comply with the Mexican nutritional standards, as compared with 83.1 % and 78.7 % with WHO Europe and UKNPM standards, respectively. The food groups most frequently advertised were beverages (24.6 %), followed by chocolate and confectionery sugar (19.7 %), cakes, sweet biscuits and pastries (12.0 %), savory snacks (9.3 %), breakfast cereals (7.1 %), ready-made food (6.4 %) and dairy products (6.0 %). The majority of foods and beverages advertised on Mexican TV do not comply with any nutritional quality standards, and thus should not be marketed to children. The nutritional quality standards applied by the Mexican regulation are much weaker than those applied by the WHO Europe and United Kingdom. The Mexican government should improve the nutrition standards in its new regulation, especially the sugar cut off points.

Quality assurance in China: a sleeping tiger awakens

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

Baehr, R.M.

1996-12-31

The People`s Republic of China has undergone major economic reform in the past decade producing a new free-market system that is distinctly Chinese. The Chinese realize that to be successful in world trade, quality management and export trading must be given the highest priority in China`s strategic economic plans. Many manufacturing companies are now implementing Total Quality Management (TQM) and the ISO 9000 i quality management standards. A first hand survey of the quality movement in China today is the objective of this paper.

A national analytical quality assurance program: Developing guidelines and analytical tools for the forest inventory and analysis program

Treesearch

Phyllis C. Adams; Glenn A. Christensen

2012-01-01

A rigorous quality assurance (QA) process assures that the data and information provided by the Forest Inventory and Analysis (FIA) program meet the highest possible standards of precision, completeness, representativeness, comparability, and accuracy. FIA relies on its analysts to check the final data quality prior to release of a State’s data to the national FIA...

Variability in the chemistry of private drinking water supplies and the impact of domestic treatment systems on water quality.

PubMed

Ander, E L; Watts, M J; Smedley, P L; Hamilton, E M; Close, R; Crabbe, H; Fletcher, T; Rimell, A; Studden, M; Leonardi, G

2016-12-01

Tap water from 497 properties using private water supplies, in an area of metalliferous and arsenic mineralisation (Cornwall, UK), was measured to assess the extent of compliance with chemical drinking water quality standards, and how this is influenced by householder water treatment decisions. The proportion of analyses exceeding water quality standards were high, with 65 % of tap water samples exceeding one or more chemical standards. The highest exceedances for health-based standards were nitrate (11 %) and arsenic (5 %). Arsenic had a maximum observed concentration of 440 µg/L. Exceedances were also high for pH (47 %), manganese (12 %) and aluminium (7 %), for which standards are set primarily on aesthetic grounds. However, the highest observed concentrations of manganese and aluminium also exceeded relevant health-based guidelines. Significant reductions in concentrations of aluminium, cadmium, copper, lead and/or nickel were found in tap waters where households were successfully treating low-pH groundwaters, and similar adventitious results were found for arsenic and nickel where treatment was installed for iron and/or manganese removal, and successful treatment specifically to decrease tap water arsenic concentrations was observed at two properties where it was installed. However, 31 % of samples where pH treatment was reported had pH < 6.5 (the minimum value in the drinking water regulations), suggesting widespread problems with system maintenance. Other examples of ineffectual treatment are seen in failed responses post-treatment, including for nitrate. This demonstrates that even where the tap waters are considered to be treated, they may still fail one or more drinking water quality standards. We find that the degree of drinking water standard exceedances warrant further work to understand environmental controls and the location of high concentrations. We also found that residents were more willing to accept drinking water with high metal (iron and manganese) concentrations than international guidelines assume. These findings point to the need for regulators to reinforce the guidance on drinking water quality standards to private water supply users, and the benefits to long-term health of complying with these, even in areas where treated mains water is widely available.

Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement.

PubMed

Martin, Simon S; Albrecht, Moritz H; Wichmann, Julian L; Hüsers, Kristina; Scholtz, Jan-Erik; Booz, Christian; Bodelle, Boris; Bauer, Ralf W; Metzger, Sarah C; Vogl, Thomas J; Lehnert, Thomas

2017-02-01

To evaluate objective and subjective image quality of a noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique in dual-energy computed tomography (DECT) angiography prior to transcatheter aortic valve replacement (TAVR). Datasets of 47 patients (35 men; 64.1 ± 10.9 years) who underwent DECT angiography of heart and vascular access prior to TAVR were reconstructed with standard linear blending (F_0.5), VMI+, and traditional monoenergetic (VMI) algorithms in 10-keV intervals from 40-100 keV. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of 564 arterial segments were evaluated. Subjective analysis was rated by three blinded observers using a Likert scale. Mean SNR and CNR were highest in 40 keV VMI+ series (SNR, 27.8 ± 13.0; CNR, 26.3 ± 12.7), significantly (all p < 0.001) superior to all VMI series, which showed highest values at 70 keV (SNR, 18.5 ± 7.6; CNR, 16.0 ± 7.4), as well as linearly-blended F_0.5 series (SNR, 16.8 ± 7.3; CNR, 13.6 ± 6.9). Highest subjective image quality scores were observed for 40, 50, and 60 keV VMI+ reconstructions (all p > 0.05), significantly superior to all VMI and standard linearly-blended images (all p < 0.01). Low-keV VMI+ reconstructions significantly increase CNR and SNR compared to VMI and standard linear-blending image reconstruction and improve subjective image quality in preprocedural DECT angiography in the context of TAVR planning. • VMI+ combines increased contrast with reduced image noise. • VMI+ shows substantially less image noise than traditional VMI. • 40-keV reconstructions show highest SNR/CNR of the aortic and iliofemoral access route. • Observers overall prefer 60 keV VMI+ images. • VMI+ DECT imaging helps improve image quality for TAVR planning.

Health-Related Quality of Life Among US Workers: Variability Across Occupation Groups.

PubMed

Shockey, Taylor M; Zack, Matthew; Sussell, Aaron

2017-08-01

To examine the health-related quality of life among workers in 22 standard occupation groups using data from the 2013-2014 US Behavioral Risk Factor Surveillance System. We examined the health-related quality of life measures of self-rated health, frequent physical distress, frequent mental distress, frequent activity limitation, and frequent overall unhealthy days by occupation group for 155 839 currently employed adults among 17 states. We performed multiple logistic regression analyses that accounted for the Behavioral Risk Factor Surveillance System's complex survey design to obtain prevalence estimates adjusted for potential confounders. Among all occupation groups, the arts, design, entertainment, sports, and media occupation group reported the highest adjusted prevalence of frequent physical distress, frequent mental distress, frequent activity limitation, and frequent overall unhealthy days. The personal care and service occupation group had the highest adjusted prevalence for fair or poor self-rated health. Workers' jobs affect their health-related quality of life.

40 CFR 51.900 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... higher or lower, classifications are ranked from lowest to highest as follows: classification under... National Ambient Air Quality Standard § 51.900 Definitions. The following definitions apply for purposes of... 42 U.S.C. 7401-7671q (2003). (f) Applicable requirements means for an area the following requirements...

40 CFR 51.900 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... higher or lower, classifications are ranked from lowest to highest as follows: classification under... National Ambient Air Quality Standard § 51.900 Definitions. The following definitions apply for purposes of... 42 U.S.C. 7401-7671q (2003). (f) Applicable requirements means for an area the following requirements...

Global trends in testicular cancer incidence and mortality.

PubMed

Rosen, Alexandre; Jayram, Gautam; Drazer, Michael; Eggener, Scott E

2011-08-01

Epidemiologic studies on testicular cancer have focused primarily on European countries. Global incidence and mortality have been less thoroughly evaluated. Our goal was to gain a better understanding of the most recent global age-standardized incidence and mortality rates for testicular cancer and to use these values to estimate a region's health care quality. Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for testicular cancer were obtained for men of all ages in 172 countries by using the GLOBOCAN 2008 database, reflecting the annual rate of cancer incidence and mortality per 100,000 men. These data were evaluated on a regional level to compare incidence and mortality rates. Global plots of these values were constructed to better visualize geographic distributions. Finally, the ratio of ASIR to ASMR was calculated as a method to assess each region's proficiency in diagnosing and effectively treating testicular cancer. ASIR and ASMR were analyzed by region, and each region's ratio of ASIR to ASMR was calculated. Testicular cancer ASIR is highest in Western Europe (7.8%), Northern Europe (6.7%), and Australia (6.5%). Asia and Africa had the lowest incidence (<1.0%). ASMR was highest in Central America (0.7%), western Asia (0.6%), and Central and Eastern Europe (0.6%). Mortality was lowest in North America, Northern Europe, and Australia (0.1-0.2%). The ASIR-ASMR ratio was highest in Australia (65.0%) and lowest in western Africa (1.0%). National reporting systems varied by country, and data quality may have fluctuated between regions. Testicular cancer incidence remains highest in developed nations with primarily Caucasian populations. Variable ASIR-ASMR ratios suggest markedly different geographic-specific reporting mechanisms, access to care, and treatment capabilities. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

77 FR 60506 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... through Friday, except Federal holidays. SUPPLEMENTARY INFORMATION: Title: Customer Satisfaction Surveys. Background: Executive Order 12862, ``Setting Customer Service Standards'' requires that federal agencies provide the highest quality service to our customers by identifying them and determining what they think...

Evaluation of the quality of the college library websites in Iranian medical Universities based on the Stover model.

PubMed

Nasajpour, Mohammad Reza; Ashrafi-Rizi, Hasan; Soleymani, Mohammad Reza; Shahrzadi, Leila; Hassanzadeh, Akbar

2014-01-01

Today, the websites of college and university libraries play an important role in providing the necessary services for clients. These websites not only allow the users to access different collections of library resources, but also provide them with the necessary guidance in order to use the information. The goal of this study is the quality evaluation of the college library websites in Iranian Medical Universities based on the Stover model. This study uses an analytical survey method and is an applied study. The data gathering tool is the standard checklist provided by Stover, which was modified by the researchers for this study. The statistical population is the college library websites of the Iranian Medical Universities (146 websites) and census method was used for investigation. The data gathering method was a direct access to each website and filling of the checklist was based on the researchers' observations. Descriptive and analytical statistics (Analysis of Variance (ANOVA)) were used for data analysis with the help of the SPSS software. The findings showed that in the dimension of the quality of contents, the highest average belonged to type one universities (46.2%) and the lowest average belonged to type three universities (24.8%). In the search and research capabilities, the highest average belonged to type one universities (48.2%) and the lowest average belonged to type three universities. In the dimension of facilities provided for the users, type one universities again had the highest average (37.2%), while type three universities had the lowest average (15%). In general the library websites of type one universities had the highest quality (44.2%), while type three universities had the lowest quality (21.1%). Also the library websites of the College of Rehabilitation and the College of Paramedics, of the Shiraz University of Medical Science, had the highest quality scores. The results showed that there was a meaningful difference between the quality of the college library websites and the university types, resulting in college libraries of type one universities having the highest average score and the college libraries of type three universities having the lowest score.

Evaluation of the quality of the college library websites in Iranian medical Universities based on the Stover model

PubMed Central

Nasajpour, Mohammad Reza; Ashrafi-rizi, Hasan; Soleymani, Mohammad Reza; Shahrzadi, Leila; Hassanzadeh, Akbar

2014-01-01

Introduction: Today, the websites of college and university libraries play an important role in providing the necessary services for clients. These websites not only allow the users to access different collections of library resources, but also provide them with the necessary guidance in order to use the information. The goal of this study is the quality evaluation of the college library websites in Iranian Medical Universities based on the Stover model. Material and Methods: This study uses an analytical survey method and is an applied study. The data gathering tool is the standard checklist provided by Stover, which was modified by the researchers for this study. The statistical population is the college library websites of the Iranian Medical Universities (146 websites) and census method was used for investigation. The data gathering method was a direct access to each website and filling of the checklist was based on the researchers’ observations. Descriptive and analytical statistics (Analysis of Variance (ANOVA)) were used for data analysis with the help of the SPSS software. Findings: The findings showed that in the dimension of the quality of contents, the highest average belonged to type one universities (46.2%) and the lowest average belonged to type three universities (24.8%). In the search and research capabilities, the highest average belonged to type one universities (48.2%) and the lowest average belonged to type three universities. In the dimension of facilities provided for the users, type one universities again had the highest average (37.2%), while type three universities had the lowest average (15%). In general the library websites of type one universities had the highest quality (44.2%), while type three universities had the lowest quality (21.1%). Also the library websites of the College of Rehabilitation and the College of Paramedics, of the Shiraz University of Medical Science, had the highest quality scores. Discussion: The results showed that there was a meaningful difference between the quality of the college library websites and the university types, resulting in college libraries of type one universities having the highest average score and the college libraries of type three universities having the lowest score. PMID:25540794

Quality of reporting and risk of bias in therapeutic otolaryngology publications.

PubMed

Kaper, N M; Swart, K M A; Grolman, W; Van Der Heijden, G J M G

2018-01-01

High-quality trials have the potential to influence clinical practice. Ten otolaryngology journals with the highest 2011 impact factors were selected and publications from 2010 were extracted. From all medical journals, the 20 highest impact factor journals were selected, and publications related to otolaryngology for 2010 and 2011 were extracted. For all publications, the reporting quality and risk of bias were assessed. The impact factor was 1.8-2.8 for otolaryngology journals and 6.0-101.8 for medical journals. Of 1500 otolaryngology journal articles, 262 were therapeutic studies; 94 had a high reporting quality and 5 a low risk of bias. Of 10 967 medical journal articles, 76 were therapeutic studies; 57 had a high reporting quality and 8 a low risk of bias. Reporting quality was high for 45 per cent of otolaryngology-related publications and 9 per cent met quality standards. General journals had higher impact factors than otolaryngology journals. Reporting quality was higher and risk of bias lower in general journals than in otolaryngology journals. Nevertheless, 76 per cent of articles in high impact factor journals carried a high risk of bias. Better reported and designed studies are the goal, with less risk of bias, especially in otolaryngology journals.

Making Sense of Mathematics

ERIC Educational Resources Information Center

Umphrey, Jan

2011-01-01

The National Council of Teachers of Mathematics (NCTM) is a voice and advocate for mathematics educators, working to ensure that all students receive equitable mathematics learning of the highest quality. To help teachers and school leaders understand the Common Core State Standards for Mathematics (CCSSM) and to point out how the CCSSM can be…

Practice management/role of the medical director.

PubMed

Merrill, Douglas G

2014-06-01

Although the nature of ambulatory surgery has changed over the years, the ideal role of the medical director mirrors its earliest iterations, focusing on excellent customer service and high quality of care. These efforts are supported by 3 modern methods of quality management borrowed from industry: intentional process improvement, standard care pathways, and monitoring outcomes to determine the efficacy of each. These methods are critical to master in order to lead the facility and providers to the highest quality of care and service. Copyright © 2014 Elsevier Inc. All rights reserved.

Quality beyond compliance.

PubMed

Centanni, N; Monroe, M; White, L; Larson, R

1999-01-01

The service sector within the biopharmaceutical industry has experienced phenomenal growth over the past decade. In the highly regulated Good Laboratory Practices environment, the need for timely, high-quality service, accurate results, and on-time deliverables becomes paramount for the success and profitability of biopharmaceutical companies. The quality assurance process is a vital component of this drug product-development cycle and ensures compliance to the highest domestic and international regulatory standards. Quality-assurance professionals historically have held the role of independent auditors of the processes, who certify that results meet current standards of practice. Covance, a contract research organization that includes Good Laboratory Practices laboratories, reorganized and expanded the functional responsibilities of its quality assurance team in 1997. Auditors and quality assurance professionals have assumed roles beyond traditional compliance auditing and are forging new leadership and mentoring roles as process-improvement specialists. The results have been tangible, measurable benefits for clients and the Covance organization. This article provides an overview of this cultural change and the processes put in place to improve efficiency, productivity, and customer and employee satisfaction.

Probabilistic Analysis of Earthquake-Led Water Contamination: A Case of Sichuan, China

NASA Astrophysics Data System (ADS)

Yang, Yan; Li, Lin; Benjamin Zhan, F.; Zhuang, Yanhua

2016-06-01

The objective of this paper is to evaluate seismic-led point source and non-point source water pollution, under the seismic hazard of 10 % probability of exceedance in 50 years, and with the minimum value of the water quality standard in Sichuan, China. The soil conservation service curve number method of calculating the runoff depth in the single rainfall event combined with the seismic damage index were applied to estimate the potential degree of non-point source water pollution. To estimate the potential impact of point source water pollution, a comprehensive water pollution evaluation framework is constructed using a combination of Water Quality Index and Seismic Damage Index methods. The four key findings of this paper are: (1) The water catchment that has the highest factory concentration does not have the highest risk of non-point source water contamination induced by the outbreak of potential earthquake. (2) The water catchment that has the highest numbers of cumulative water pollutants types are typically located in the south western parts of Sichuan where the main river basins in the regions flow through. (3) The most common pollutants in sample factories studied is COD and NH3-N which are found in all catchments. The least common pollutant is pathogen—found present in W1 catchment which has the best rating in the water quality index. (4) Using water quality index as a standardization parameter, parallel comparisons is made among the 16 water catchments. Only catchment W1 reaches level II water quality status which has the rating of moderately polluted in events of earthquake induced water contamination. All other areas suffer from severe water contamination with multiple pollution sources. The results from the data model are significant to urban planning commissions and businesses to strategically choose their factory locations in order to minimize potential hazardous impact during the outbreak of earthquake.

Benchmarking Reference Desk Service in Academic Health Science Libraries: A Preliminary Survey.

ERIC Educational Resources Information Center

Robbins, Kathryn; Daniels, Kathleen

2001-01-01

This preliminary study was designed to benchmark patron perceptions of reference desk services at academic health science libraries, using a standard questionnaire. Responses were compared to determine the library that provided the highest-quality service overall and along five service dimensions. All libraries were rated very favorably, but none…

New Realities for Scholarly Presses in Trying Economic Times

ERIC Educational Resources Information Center

Blakesley, David

2014-01-01

The author explains that Parlor Press is an independent publisher and distributor of scholarly and trade books in print and digital formats. It was founded in 2002 to address the need for an alternative scholarly, academic press attentive to emergent ideas and forms while maintaining the highest possible standards of quality, credibility, and…

100 Years of inspiring quality at the ACS: how did we get here? Journal of Pediatric Surgery Lecture.

PubMed

Hoyt, David B; Schneidman, Diane S

2014-01-01

Throughout its 100-year history of working to ensure that surgical patients receive safe, high-quality, cost-effective care, the American College of Surgeons has adhered to four key principles: (1) Set the standards to identify and set the highest clinical standards based on the collection of outcomes data and other scientific evidence that can be customized to each patient's condition so that surgeons can offer the right care, at the right time, in the right setting. (2) Build the right infrastructure to provide the highest quality care with surgical facilities having in place appropriate and adequate staffing levels, a reasonable mix of specialists, and the right equipment. Checklists and health information technology, such as the electronic health record, are components of this infrastructure. (3) Collect robust data so that surgical decisions are based on clinical data drawn from medical charts that track patients after discharge from the hospital. Data should be risk-adjusted and collected in nationally benchmarked registries to allow institutions to compare their care with other providers. (4) Verify processes and infrastructure by having an external authority periodically affirm that the right systems are in place at health care institutions, that outcomes are being measured and benchmarked, and that hospitals and providers are proactively responding to these findings. © 2014.

Iterative metal artifact reduction: evaluation and optimization of technique.

PubMed

Subhas, Naveen; Primak, Andrew N; Obuchowski, Nancy A; Gupta, Amit; Polster, Joshua M; Krauss, Andreas; Iannotti, Joseph P

2014-12-01

Iterative metal artifact reduction (IMAR) is a sinogram inpainting technique that incorporates high-frequency data from standard weighted filtered back projection (WFBP) reconstructions to reduce metal artifact on computed tomography (CT). This study was designed to compare the image quality of IMAR and WFBP in total shoulder arthroplasties (TSA); determine the optimal amount of WFBP high-frequency data needed for IMAR; and compare image quality of the standard 3D technique with that of a faster 2D technique. Eight patients with nine TSA underwent CT with standardized parameters: 140 kVp, 300 mAs, 0.6 mm collimation and slice thickness, and B30 kernel. WFBP, three 3D IMAR algorithms with different amounts of WFBP high-frequency data (IMARlo, lowest; IMARmod, moderate; IMARhi, highest), and one 2D IMAR algorithm were reconstructed. Differences in attenuation near hardware and away from hardware were measured and compared using repeated measures ANOVA. Five readers independently graded image quality; scores were compared using Friedman's test. Attenuation differences were smaller with all 3D IMAR techniques than with WFBP (p < 0.0063). With increasing high-frequency data, the attenuation difference increased slightly (differences not statistically significant). All readers ranked IMARmod and IMARhi more favorably than WFBP (p < 0.05), with IMARmod ranked highest for most structures. The attenuation difference was slightly higher with 2D than with 3D IMAR, with no significant reader preference for 3D over 2D. IMAR significantly decreases metal artifact compared to WFBP both objectively and subjectively in TSA. The incorporation of a moderate amount of WFBP high-frequency data and use of a 2D reconstruction technique optimize image quality and allow for relatively short reconstruction times.

A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

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

Hacke, Peter; Lokanath, Sumanth; Williams, Paul

Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

DOE PAGES

Hacke, Peter; Lokanath, Sumanth; Williams, Paul; ...

2017-10-10

Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

Development of Instrumental Techniques for Color Assessment of Camouflage Patterns

ERIC Educational Resources Information Center

Fang, Gang

2012-01-01

Camouflage fabrics are produced on a large scale for use in the US military and other applications. One of the highest volume camouflage fabrics is known as the Universal Camouflage Pattern (UCP) which is produced for the US Department of Defense. At present, no standard measurement-based color quality control method exists for camouflage…

The Role of School Based Health Centers (SBHCs) in Improving Health Equity and Reducing Health Disparities. Position Statement

ERIC Educational Resources Information Center

Blacksin, Beth; Gall, Gail; Feldman, Elizabeth; Miller, Elizabeth

2010-01-01

Health inequities exist largely among socially disadvantaged people who are denied the highest attainable standard of health available to many Americans. Access to culturally competent, high quality, first-contact primary care through school-based health centers is an effective way to reduce health inequities and, therefore, improve health…

Linking land use with pesticides in Dutch surface waters.

PubMed

Van't, Zelfde M T; Tamis, W L M; Vijver, M G; De Snoo, G R

2012-01-01

Compared with other European countries The Netherlands has a relatively high level of pesticide consumption, particularly in agriculture. Many of the compounds concerned end up in surface waters. Surface water quality is routinely monitored and numerous pesticides are found to be present in high concentrations, with various standards being regularly exceeded. Many standards-breaching pesticides exhibit regional patterns that can be traced back to land use. These patterns have been statistically analysed by correlating surface area per land use category with standards exceedance per pesticide, thereby identifying numerous significant correlations with respect to breaches of both the ecotoxicological standard (Maximum Tolerable Risk, MTR) and the drinking water standard. In the case of the MTR, greenhouse horticulture, floriculture and bulb-growing have the highest number as well as percentage of standard-breaching pesticides, despite these market segments being relatively small in terms of area cropped. Cereals, onions, vegetables, perennial border plants and pulses are also associated with many pesticides that exceed the drinking water standard. When a correction is made for cropped acreage, cereals and potatoes also prove to be a major contributor to monitoring sites where the MTR standard is exceeded. Over the period 1998-2006 the land-use categories with the most and highest percentage of standards-exceeding pesticides (greenhouse horticulture, bulb-growing and flower cultivation) showed an increase in the percentage of standards-exceeding compounds.

An assessment of quality characteristics of randomised control trials published in dental journals.

PubMed

Pandis, Nikolaos; Polychronopoulou, Argy; Eliades, Theodore

2010-09-01

The purpose of this study was to investigate the quality of reporting of randomised clinical trials (RCTs) published in dental specialty journals. The journals possessing the highest impact factor (2008 data) in the six major dental specialties were included in the study. The contents of the 24 most recent issues of each journal were hand-searched and research articles identified as randomised controlled trials (RCTs) were selected. Quality evaluation was performed using the modified Consolidated Standards of Reporting Trials (CONSORT) statement checklist. The data were analysed using descriptive statistics followed by univariate and multivariate examination of statistical associations (alpha=0.05). Ninety-five RCTs were identified with generally suboptimal scores on quality reporting on key CONSORT areas. Significant differences were found among journals with the Journal of Clinical Periodontology achieving the highest score, followed by the American Journal of Orthodontics and Dentofacial Orthopedics. There was a positive association between quality score and number of authors, involvement of statistician/epidemiologist, and multicentre trials. The quality scores of RCTs in major dental journals are considered suboptimal in key CONSORT areas. This receives critical importance considering that improved quality of RCTs is a fundamental prerequisite for improved dental care. Copyright 2010 Elsevier Ltd. All rights reserved.

Effects of stick design features on perceptions of characteristics of cigarettes.

PubMed

Borland, Ron; Savvas, Steven

2013-09-01

To examine the extent (if any) that cigarette stick dimension, tipping paper design and other decorative design/branding have on Australian smokers' perceptions of those cigarettes. An internet survey of 160 young Australian adult ever-smokers who were shown computer images of three sets of cigarette sticks--five sticks of different lengths and diameters (set A), five sticks with different tipping paper design (set B) and four sticks of different decorative design (set C). Branding was a between-subjects randomised condition for set C. For each set, respondents ranked sticks on most and least attractive, highest and lowest quality and strongest and weakest taste. Cigarette sticks were perceived as different on attractiveness, quality and strength of taste. Standard stick length/diameter was perceived as the most attractive and highest quality stick, with men more inclined to rate a slim stick as less attractive. A stick with a cork-patterned tipping paper and a gold band was seen as most attractive, of highest quality and strongest in taste compared to other tipping designs. Branded sticks were seen as more attractive, higher in quality and stronger tasting than non-branded designs, regardless of brand, although the effects were stronger for a prestige compared with a budget brand. Characteristics of the cigarette stick affect smokers' perceptions of the attributes of those cigarettes and thus are a potential means by which product differentiation can occur. A comprehensive policy to eliminate promotional aspects of cigarette design and packaging needs to include rules about stick design.

Feasibility of biodiesel production by microalgae Chlorella sp. (FACHB-1748) under outdoor conditions.

PubMed

Zhou, XuPing; Xia, Ling; Ge, HongMei; Zhang, Delu; Hu, ChunXiang

2013-06-01

Chlorella sp. (FACHB-1748) was cultivated outdoors under natural sunlight to evaluate its potential for biofuel production. Urea was selected as nitrogen source, and the concentration was optimized. When the culture reached the late exponential stage, a triggering lipid accumulation test was conducted using different concentrations of sodium chloride and acetate. A scaling-up experiment was also conducted in a 70L photobioreactor. The highest biomass productivity (222.42, 154.48 mg/L/d) and lipid productivity (64.30, 33.69mg/L/d) were obtained with 0.1g/L urea in 5 and 70 L bioreactors, respectively. The highest lipid content (43.25%) and lipid yield (1243.98 mg/L) were acquired with the combination of 10 g/L sodium chloride and acetate. Moreover, the qualities of biodiesel, cetane number, saponification value, iodine value, and cold filter plugging point complied with the standards set by the National Petroleum Agency (ANP255), Standard ASTMD6751, and European Standard (EN 14214). Copyright © 2013 Elsevier Ltd. All rights reserved.

Nitrate in drinking water and colorectal cancer risk: A nationwide population-based cohort study.

PubMed

Schullehner, Jörg; Hansen, Birgitte; Thygesen, Malene; Pedersen, Carsten B; Sigsgaard, Torben

2018-07-01

Nitrate in drinking water may increase risk of colorectal cancer due to endogenous transformation into carcinogenic N-nitroso compounds. Epidemiological studies are few and often challenged by their limited ability of estimating long-term exposure on a detailed individual level. We exploited population-based health register data, linked in time and space with longitudinal drinking water quality data, on an individual level to study the association between long-term drinking water nitrate exposure and colorectal cancer (CRC) risk. Individual nitrate exposure was calculated for 2.7 million adults based on drinking water quality analyses at public waterworks and private wells between 1978 and 2011. For the main analyses, 1.7 million individuals with highest exposure assessment quality were included. Follow-up started at age 35. We identified 5,944 incident CRC cases during 23 million person-years at risk. We used Cox proportional hazards models to estimate hazard ratios (HRs) of nitrate exposure on the risk of CRC, colon and rectal cancer. Persons exposed to the highest level of drinking water nitrate had an HR of 1.16 (95% CI: 1.08-1.25) for CRC compared with persons exposed to the lowest level. We found statistically significant increased risks at drinking water levels above 3.87 mg/L, well below the current drinking water standard of 50 mg/L. Our results add to the existing evidence suggesting increased CRC risk at drinking water nitrate concentrations below the current drinking water standard. A discussion on the adequacy of the drinking water standard in regards to chronic effects is warranted. © 2018 UICC.

Environmental contamination due to shale gas development.

PubMed

Annevelink, M P J A; Meesters, J A J; Hendriks, A J

2016-04-15

Shale gas development potentially contaminates both air and water compartments. To assist in governmental decision-making on future explorations, we reviewed scattered information on activities, emissions and concentrations related to shale gas development. We compared concentrations from monitoring programmes to quality standards as a first indication of environmental risks. Emissions could not be estimated accurately because of incomparable and insufficient data. Air and water concentrations range widely. Poor wastewater treatment posed the highest risk with concentrations exceeding both Natural Background Values (NBVs) by a factor 1000-10,000 and Lowest Quality Standards (LQSs) by a factor 10-100. Concentrations of salts, metals, volatile organic compounds (VOCs) and hydrocarbons exceeded aquatic ecotoxicological water standards. Future research must focus on measuring aerial and aquatic emissions of toxic chemicals, generalisation of experimental setups and measurement technics and further human and ecological risk assessment. Copyright © 2016 Elsevier B.V. All rights reserved.

Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care.

PubMed

Torrejón, Antonio; Oltra, Lorena; Hernández-Sampelayo, Paloma; Marín, Laura; García-Sánchez, Valle; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; Vera, María Isabel

2013-01-01

nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool "Nursing Care Quality in IBD Assessment" (NCQ-IBD) based on these standards. a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committee´s expert opinion. the final NCQ-IBD consists of 90 items, organized in13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations.

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

PubMed

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

2016-11-01

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

Anthropometric standardisation and quality control protocols for the construction of new, international, fetal and newborn growth standards: the INTERGROWTH-21st Project.

PubMed

Cheikh Ismail, L; Knight, H E; Ohuma, E O; Hoch, L; Chumlea, W C

2013-09-01

The primary aim of the INTERGROWTH-21(st) Project is to construct new, prescriptive standards describing optimal fetal and preterm postnatal growth. The anthropometric measurements include the head circumference, recumbent length and weight of the infants, and the stature and weight of the parents. In such a large, international, multicentre project, it is critical that all study sites follow standardised protocols to ensure maximal validity of the growth and nutrition indicators used. This paper describes in detail the anthropometric training, standardisation and quality control procedures used to collect data for these new standards. The initial standardisation session was in Nairobi, Kenya, using newborns, which was followed by similar sessions in the eight participating study sites in Brazil, China, India, Italy, Kenya, Oman, UK and USA. The intraobserver and inter-observer technical error of measurement values for head circumference range from 0.3 to 0.4 cm, and for recumbent length from 0.3 to 0.5 cm. These standardisation protocols implemented at each study site worldwide ensure that the anthropometric data collected are of the highest quality to construct international growth standards. © 2013 Royal College of Obstetricians and Gynaecologists.

A Model for Integrating Ambulatory Surgery Centers Into an Academic Health System Using a Novel Ambulatory Surgery Coordinating Council.

PubMed

Ishii, Lisa; Pronovost, Peter J; Demski, Renee; Wylie, Gill; Zenilman, Michael

2016-06-01

An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations. Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs. Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies. The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.

Failure of Quality Control Measures To Prevent Reporting of False Resistance to Imipenem, Resulting in a Pseudo-Outbreak of Imipenem-Resistant Pseudomonas aeruginosa

PubMed Central

Carmeli, Yehuda; Eichelberger, Karen; Soja, Don; Dakos, Joanna; Venkataraman, Lata; DeGirolami, Paola; Samore, Matthew

1998-01-01

False results showing an outbreak of Pseudomonas aeruginosa with resistance to imipenem were traced to a defective lot of microdilution MIC testing panels. These panels contained two- to threefold lower concentrations of imipenem than expected and resulted in artifactual two- to fourfold increases in MICs of imipenem. The quality-control MIC results for Pseudomonas aeruginosa ATCC 27853 were 4 μg/ml, the highest value within the range recommended by the National Committee for Clinical Laboratory Standards. We recommend that this value be considered out of the quality-control range. PMID:9466787

Worldwide prevalence and incidence of osteoporotic vertebral fractures.

PubMed

Ballane, G; Cauley, J A; Luckey, M M; El-Hajj Fuleihan, G

2017-05-01

We investigated the prevalence and incidence of vertebral fractures worldwide. We used a systematic Medline search current to 2015 and updated as per authors' libraries. A total of 62 articles of fair to good quality and comparable methods for vertebral fracture identification were considered. The prevalence of morphometric vertebral fractures in European women is highest in Scandinavia (26%) and lowest in Eastern Europe (18%). Prevalence rates in North America (NA) for White women ≥50 are 20-24%, with a White/Black ratio of 1.6. Rates in women ≥50 years in Latin America are overall lower than Europe and NA (11-19%). In Asia, rates in women above ≥65 are highest in Japan (24%), lowest in Indonesia (9%), and in the Middle East, Lebanon, rates are 20%. The highest-lowest ratio between countries, within and across continents, varied from 1.4-2.6. Incidence data is less abundant and more heterogeneous. Age-standardized rates in studies combining hospitalized and ambulatory vertebral fractures are highest in South Korea, USA, and Hong Kong and lowest in the UK. Neither a North-South gradient nor a relation to urbanization is evident. Conversely, the incidence of hospitalized vertebral fractures in European patients ≥50 shows a North-South gradient with 3-3.7-fold variability. In the USA, rates in Whites are approximately 4-fold higher than in Blacks. Vertebral fractures variation worldwide is lower than observed with hip fractures, and some of highest rates are unexpectedly from Asia. Better quality representative studies are needed. We investigate the occurrence of vertebral fractures, worldwide, using published data current until the present. Worldwide, the variation in vertebral fractures is lower than observed for hip fractures. Some of the highest rates are from North America and unexpectedly Asia. The highest-lowest ratio between countries, within and across continents, varied from 1.4-2.6. Better quality representative data is needed.

Protein enrichment of corn cob heteroxylan waste slurry by thermophilic aerobic digestion using Bacillus stearothermophilus.

PubMed

Ugwuanyi, J Obeta; Harvey, Linda M; McNeil, Brian

2008-10-01

Thermophilic aerobic digestion (TAD) of heteroxylan waste was implemented at waste load of 30gL(-1) with mineral nitrogen supplementation to study effect of the process on waste degradation, protein accretion and quality. Digestions were carried out at 45 50, 55, 60 and 65 degrees C using Bacillusstearothermophilus in a CSTR under batch conditions at 1.0vvm aeration rate, pH 7.0 for a maximum of 120h. Amylase and xylanase activities appeared rapidly in the digest, while basal protease activity appeared early in the digestion and increased towards end of the processes. Highest degradation of volatile suspended solid, hemicellulose and fibre occurred at 55 degrees C while highest degradation of total suspended solid occurred at 60 degrees C. Highest protein accretion (258.8%) and assimilation of mineral nitrogen and soluble protein occurred at 55 degrees C. The % content of amino acids of digest crude protein increased relative to raw waste and with digestion temperature. Quality of digest protein was comparable to the FAO standard for feed use. TAD has potentials for use in the protein enrichment of waste.

Reporting Quality Assessment of Randomized Controlled Trials Published in Nephrology Urology Monthly Journal.

PubMed

Mehrazmay, Alireza; Karambakhsh, Alireza; Salesi, Mahmood

2015-07-01

Randomized controlled trials (RCTs) are important tools for evidence-based health care decisions. It is, therefore, important that they be conducted and reported with the highest possible standards. The aim of this study was to evaluate the reporting quality of the RCTs published in nephrology urology monthly journal and to examine whether there was a change over time in the reporting quality. The quality of each report was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement checklist and a 5-point quality assessment instrument, i.e. the Jadad scale. Eighteen (14 Iranian and 4 non-Iranian) RCTs were published from 2012 to 2014 on topics including renal stone (16.6%), hemodialysis and transplantation (38.8%), and prostate conditions (11.1%). Interventions comprised surgery, drugs, and teaching method in 7 (38 %), 10 (55%), and 1 (5%) of them, respectively. According to the CONSORT checklist, the weakest reported items were registration number, identification as a randomized trial in the title, and settings and locations where the data were collected. The mean Jadad score of the reports was 2.72 ± 1.36 (54% of their maximum possible total score). According to the Jadad and CONSORT scales, there was an increase in the quality of reporting from 2012 to 2014. This assessment shows low reporting quality scores in reports. Training courses for researchers, using standard reporting tools (e.g. CONSORT 2010 Statement checklist), and consultation with methodologists can improve the quality of published RCTs.

Spatial and temporal variations of the concentrations of PM10, PM2.5 and PM1 in China

NASA Astrophysics Data System (ADS)

Wang, Y. Q.; Zhang, X. Y.; Sun, J. Y.; Zhang, X. C.; Che, H. Z.; Li, Y.

2015-06-01

Concentrations of PM10, PM2.5 and PM1 were monitored at 24 stations of CAWNET (China Atmosphere Watch Network) from 2006 to 2014 using GRIMM 180 dust monitors. The highest particulate matter (PM) concentrations were observed at the stations of Xian, Zhengzhou and Gucheng, in Guanzhong and the Hua Bei Plain (HBP). The second highest PM concentrations were observed in northeast China, followed by southern China. According to the latest air quality standards of China, 14 stations reached the PM10 standard and only 7 stations, mainly rural and remote stations, reached the PM2.5 standard. The PM2.5 and PM10 ratios showed a clear increasing trend from northern to southern China, because of the substantial contribution of coarse mineral aerosol in northern China. The PM1 and PM2.5 ratios were higher than 80% at most stations. PM concentrations tended to be highest in winter and lowest in summer at most stations, and mineral dust impacts influenced the results in spring. A decreasing interannual trend was observed in the HBP and southern China from 2006 to 2014, but an increasing trend occurred at some stations in northeast China. Also diurnal variations of PM concentrations and meteorological factors effects were investigated.

The quest for quality blood banking program in the new millennium the American way.

PubMed

Kim, Dae Un

2002-08-01

For an industry to succeed and satisfy its customers, "QUALITY" must be a primary goal. Quality has been central to blood banking from its inception, with the evolution of a Quality Program since the opening of the first blood bank in U.S. at the Cook County Hospital in 1937. Over the ensuing decades, continuous scientific progress in blood preservation, filters, viral and blood group testing, crossmatching, automation, and computerization including bar coding, etc. has contributed to the quality and safety of the blood products and transfusion service. However, with the advent of the AIDS era, an increasingly sensitized and informed public is continuously demanding that the highest level of quality be achieved and maintained in all processes involved in providing all blood products. The Food and Drug Administration (FDA) introduced the concept of a "zero risk blood supply" as the industry goal. Furthermore, the cost containment and resource-constrained environment have changed the complexity of the quality practice. Both regulatory agencies such as the FDA, the Health Care Financing Administration [HCFA, which was recently renamed as the Centers for Medicare and Medicaid Services (CMS) in July, 2001], and the State Department of Health, and accrediting agencies, such as the American Association of Blood Banks (AABB), the College of American Pathologists (CAP), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), require blood banks and transfusion services to establish and follow a Quality Control and Quality Assurance Program for their licensing, certification and accreditation. Every laboratory has to comply with the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) quality requirements being implemented by the CMS. The FDA guidelines assist facilities in compliance with Current Good Manufacturing Practices (cGMP). The AABB's Quality System Essentials (QSE) are based on these specifications and provide additional guidance in implementing practices that assure quality and compliance with cGMP. AABB and CAP are granted "deemed status" as accrediting organizations under the CLIA '88 program by CMS, as well as JCAHO and some states. The International Standards Organization (ISO) has established international standards in most fields. The U.S. is represented in ISO by the American National Standards Institute (ANSI), and the National Committee for Clinical Laboratory Standards (NCCLS), as a global organization headquartered in the U.S., is a member of ANSI. The FDA and the AABB had begun incorporating many ISO principles into their own regulations and standards. The AABB's 10 QSEs are rooted in the 20 clauses of ISO 9000 series and compatible with their standards. In a Maslow-type model quality hierarchy by Tsiakals, so far the bottom three of the five progressive levels, Quality Control for method control, Quality Assurance for process control, and Quality System for system control have been implemented just to meet the regulatory and accrediting requirements. The next higher level, Quality Management for financial control, and the ultimate highest level, Total Quality Management for strategic control, should be our quest in this new millennium, and with the help of the AABB, ISO, FDA and all other organizations, we will achieve it. We should change our approach to quality issues from detection to prevention. We should improve the quality in transfusion practice itself by effective utilization of blood as a therapeutic resource with clear indication, maximum surgical blood order schedule, alternative transfusion such as autologous transfusion, hemodilution, and intra/post-operative blood salvage, surgical hemostasis, pharmacological hemostasis, and synthetic erythropoietin. Most importantly, implementation of the Quality Program should be something that we want to do rather than simply a burden that we have to do. A well-managed Quality Program is an effective and cost-efficient operation for the blood banks and transfusion services, and will enable us to better serve the patients for whom we exist.

Redefining and expanding quality assurance.

PubMed

Robins, J L

1992-12-01

To meet the current standards of excellence necessary for blood establishments, we have learned from industry that a movement toward organization-wide quality assurance/total quality management must be made. Everyone in the organization must accept responsibility for participating in providing the highest quality products and services. Quality must be built into processes and design systems to support these quality processes. Quality assurance has been redefined to include a quality planning function described as the most effective way of designing quality into processes. A formalized quality planning process must be part of quality assurance. Continuous quality improvement has been identified as the strategy every blood establishment must support while striving for error-free processing as the long-term objective. The auditing process has been realigned to support and facilitate this same objective. Implementing organization-wide quality assurance/total quality management is one proven plan for guaranteeing the quality of the 20 million products that are transfused into 4 million patients each year and for moving toward the new order.

Design of a medical and laboratory equipment management program for the new standards certification achievement in Mexico.

PubMed

Franco-Clark, D; Pimentel-Aguilar, A B; Rodriguez-Vera, R

2010-01-01

Certification for healthcare institutions in Mexico is ruled by 2009 standards homologated with the Joint Commission International criteria. Nowadays, healthcare requires of medical equipment and devices, so it has become necessary to implement guidelines for its adequate management in order to reach the highest level of quality and safety at the lowest cost. The objective of this work was to develop a Medical and Laboratory Equipment Management Program, oriented to the improvement of quality, effectiveness and efficiency of the technological resources in order to meet the certification requirements. The result of this work allows to have an auto evaluation tool that focuses the efforts of the National Institute for Respiratory Diseases to the achievement of the new requirements established for the certification.

Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma.

PubMed

Dente, Christopher J; Ashley, Dennis W; Dunne, James R; Henderson, Vernon; Ferdinand, Colville; Renz, Barry; Massoud, Romeo; Adamski, John; Hawke, Thomas; Gravlee, Mark; Cascone, John; Paynter, Steven; Medeiros, Regina; Atkins, Elizabeth; Nicholas, Jeffrey M

2016-03-01

Led by the American College of Surgeons Trauma Quality Improvement Program, performance improvement efforts have expanded to regional and national levels. The American College of Surgeons Trauma Quality Improvement Program recommends 5 audit filters to identify records with erroneous data, and the Georgia Committee on Trauma instituted standardized audit filter analysis in all Level I and II trauma centers in the state. Audit filter reports were performed from July 2013 to September 2014. Records were reviewed to determine whether there was erroneous data abstraction. Percent yield was defined as number of errors divided by number of charts captured. Twelve centers submitted complete datasets. During 15 months, 21,115 patient records were subjected to analysis. Audit filter captured 2,901 (14%) records and review yielded 549 (2.5%) records with erroneous data. Audit filter 1 had the highest number of records identified and audit filter 3 had the highest percent yield. Individual center error rates ranged from 0.4% to 5.2%. When comparing quarters 1 and 2 with quarters 4 and 5, there were 7 of 12 centers with substantial decreases in error rates. The most common missed complications were pneumonia, urinary tract infection, and acute renal failure. The most common missed comorbidities were hypertension, diabetes, and substance abuse. In Georgia, the prevalence of erroneous data in trauma registries varies among centers, leading to heterogeneity in data quality, and suggests that targeted educational opportunities exist at the institutional level. Standardized audit filter assessment improved data quality in the majority of participating centers. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Air pollution around schools is linked to poorer student health and academic performance.

PubMed

Mohai, Paul; Kweon, Byoung-Suk; Lee, Sangyun; Ard, Kerry

2011-05-01

Exposing children to environmental pollutants during important times of physiological development can lead to long-lasting health problems, dysfunction, and disease. The location of children's schools can increase their exposure. We examined the extent of air pollution from industrial sources around public schools in Michigan to find out whether air pollution jeopardizes children's health and academic success. We found that schools located in areas with the highest air pollution levels had the lowest attendance rates-a potential indicator of poor health-and the highest proportions of students who failed to meet state educational testing standards. Michigan and many other states currently do not require officials considering a site for a new school to analyze its environmental quality. Our results show that such requirements are needed. For schools already in existence, we recommend that their environmental quality should be investigated and improved if necessary.

[Bacteriological quality of drinking water in the City of Merida, Mexico].

PubMed

Flores-Abuxapqui, J J; Suárez-Hoil, G J; Puc-Franco, M A; Heredia-Navarrete, M R; Vivas-Rosel, M D; Franco-Monsreal, J

1995-01-01

With the aim of knowing the microbiological quality of drinking water in Merida, Yucatan, 383 paired samples of drinking water (two per house) were studied. Three hundred sixty four (95%) city water system samples and 283 (73.89%) tap water samples met the microbiological standards for drinking water. It was concluded that microbiological quality of drinking water from the city water system is satisfactory, except for the water system district Merida III, which has a significant aerobic plate count contamination level (21.7% of the samples). Domestic storage systems preserve water quality, with the exception of district Merida I, which has the highest level of contamination (4.8% of the samples) possibly from sewage water and fecal sources.

Assessing oral health-related quality of life in children and adolescents: a systematic review and standardized comparison of available instruments.

PubMed

Zaror, Carlos; Pardo, Yolanda; Espinoza-Espinoza, Gerardo; Pont, Àngels; Muñoz-Millán, Patricia; Martínez-Zapata, María José; Vilagut, Gemma; Forero, Carlos G; Garin, Olatz; Alonso, Jordi; Ferrer, Montse

2018-03-22

To obtain a systematic and standardized evaluation of the current evidence on development process, metric properties, and administration issues of oral health-related quality of life instruments available for children and adolescents. A systematic search until October 2016 was conducted in PubMed, Embase, Lilacs, SciELO, and Cochrane databases. Articles with information regarding the development process, metric properties, and administration issues of pediatric instruments measuring oral health-related quality of life were eligible for inclusion. Two researchers independently evaluated each instrument applying the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0-100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms. We identified 18 instruments evaluated in 132 articles. From five instruments designed for preschoolers, the Early Childhood Oral Health Impact Scale (ECOHIS) obtained the highest overall EMPRO score (82.2). Of nine identified for schoolchildren and adolescents, the best rated instrument was the Child Perceptions Questionnaire 11-14 (82.1). Among the four instruments developed for any age, the Family Impact Scale (FIS) obtained the highest scores (80.3). The evidence supports the use of the ECOHIS for preschoolers, while the age is a key factor when choosing among the four recommended instruments for schoolchildren and adolescents. Instruments for specific conditions, symptoms, or treatments need further research on metric properties. Our results facilitate decision-making on the correct oral health-related quality of life instrument selection for any certain study purpose and population during the childhood and adolescence life cycle.

Evarts A. Graham (1883--1957), surgeon and educator.

PubMed

Lischer, C E

1977-06-01

Evarts A. Graham achieved greatness through his many contributions to the art and science of surgery. He was also outstanding in promulgating the highest standards possible in areas of surgical education and ethics. The qualities of charcter that made him such an outstanding leader affected all who worked with him and helped immeasurably in the further evolution of surgery into a productive and valuable discipline.

40 CFR Appendix N to Part 50 - Interpretation of the National Ambient Air Quality Standards for PM2.5

Code of Federal Regulations, 2010 CFR

2010-07-01

... values in the composite site record are used in annual mean and 98th percentile calculations, however... highest to the lowest number. Using the left column of table 1, determine the appropriate range (i.e., row... column identifies the rank of the annual 98th percentile value in the descending sorted list of daily...

40 CFR Appendix N to Part 50 - Interpretation of the National Ambient Air Quality Standards for PM2.5

Code of Federal Regulations, 2011 CFR

2011-07-01

... values in the composite site record are used in annual mean and 98th percentile calculations, however... highest to the lowest number. Using the left column of table 1, determine the appropriate range (i.e., row... column identifies the rank of the annual 98th percentile value in the descending sorted list of daily...

Preparation of wholemount mouse intestine for high-resolution three-dimensional imaging using two-photon microscopy.

PubMed

Appleton, P L; Quyn, A J; Swift, S; Näthke, I

2009-05-01

Visualizing overall tissue architecture in three dimensions is fundamental for validating and integrating biochemical, cell biological and visual data from less complex systems such as cultured cells. Here, we describe a method to generate high-resolution three-dimensional image data of intact mouse gut tissue. Regions of highest interest lie between 50 and 200 mum within this tissue. The quality and usefulness of three-dimensional image data of tissue with such depth is limited owing to problems associated with scattered light, photobleaching and spherical aberration. Furthermore, the highest-quality oil-immersion lenses are designed to work at a maximum distance of

Surface-Water Quantity and Quality of the Upper Milwaukee River, Cedar Creek, and Root River Basins, Wisconsin, 2004

USGS Publications Warehouse

Hall, David W.

2006-01-01

The U.S. Geological Survey, in cooperation with the Southeastern Wisconsin Regional Planning Commission (SEWRPC), collected discharge and water-quality data at nine sites in previously monitored areas of the upper Milwaukee River, Cedar Creek, and Root River Basins, in Wisconsin from May 1 through November 15, 2004. The data were collected for calibration of hydrological models that will be used to simulate how various management strategies will affect the water quality of streams. The data also will support SEWRPC and Milwaukee Metropolitan Sewerage District (MMSD) managers in development of the SEWRPC Regional Water Quality Management Plan and the MMSD 2020 Facilities Plan. These management plans will provide a scientific basis for future management decisions regarding development and maintenance of public and private waste-disposal systems. In May 2004, parts of the study area received over 13 inches of precipitation (3.06 inches is normal). In June 2004, most of the study area received between 7 and 11 inches of rainfall (3.56 inches is normal). This excessive rainfall caused flooding throughout the study area and resultant high discharges were measured at all nine monitoring sites. For example, the mean daily discharge recorded at the Cedar Creek site on May 27, 2004, was 2,120 cubic feet per second. This discharge ranked ninth of the largest 10 mean daily discharges in the 75-year record, and was the highest discharge recorded since March 30, 1960. Discharge records from continuous monitoring on the Root River Canal near Franklin since October 1, 1963, indicated that the discharge recorded on May 23, 2004, ranked second highest on record, and was the highest discharge recorded since March 4, 1974. Water-quality samples were taken during two base-flow events and six storm events at each of the nine sites. Analysis of water-quality data indicated that most concentrations of dissolved oxygen, biological oxygen demand, fecal coliform bacteria, chloride, suspended solids, nitrate plus nitrite nitrogen, ammonia nitrogen, Kjeldahl nitrogen, total phosphorus, dissolved orthophosphorus, total copper, particulate mercury, dissolved mercury, particulate methylmercury, dissolved methylmercury, and total zinc were below U.S. Environmental Protection Agency (USEPA) and State of Wisconsin water-quality standards at all sites, with the exception of dissolved oxygen at the Kewaskum, Farmington, Root River Canal, Root River Racine, and Root River Mouth sites. Each of these sites had from several days to several weeks of daily average dissolved oxygen concentrations below the 5 milligrams per liter State of Wisconsin standard for aquatic life. The lowest dissolved oxygen concentrations were measured at the heavily urbanized Root River Mouth site in downtown Racine, Wisconsin, where elevated concentrations of ammonia may have contributed to oxygen consumption during oxidation of ammonia to nitrate. Additionally, the maximum concentrations of copper in several Root River samples exceeded draft USEPA Ambient Water-Quality Criteria (U.S. Environmental Protection Agency, 2003) for acute toxicity to several species of aquatic organisms. Substantial water-quality changes were not correlated with hydrologic changes at any of the nine sites. Base-flow water-quality was generally indistinguishable from that sampled during storm events. The sparsely developed upper Milwaukee River and Cedar Creek Basins had relatively low ranges of contamination for all laboratory-reported parameters. For all nine sites, the highest reported concentrations of chloride (216 mg/L), total phosphorus (0.627 mg/L), ortho-phosphorus (0.136 mg/L), nitrate plus nitrate (9.32 mg/L), and copper (38 ?g/L) were reported for samples collected at the Root River Canal site. The highest concentrations of fecal coliforms (3,600 colonies per 100 mL) and Escherichia coli (2,300 colonies per 100 mL) were reported in samples collected at Kewaskum. The highest concentrations of s

[Human rights of the physician].

PubMed

García-Romero, H

1995-01-01

The physician rights may be classified in those related with his quality as a person, and those derived from his relationship with his patients and the institution to which he belongs. Among the first, liberty of expression, legal security, right of free association, the right of a dignified social position and neutral attitude towards the commitment of giving medical attention to whomever the patient may be. He has the right to receive a full and up-to-date training oriented to serve the community, supported by health institutions, and to have the means of utmost quality to give medical attention of the highest standard.

Air quality and ocular discomfort aboard commercial aircraft.

PubMed

Backman, H; Haghighat, F

2000-10-01

Aircraft cabin air quality has been a subject of recent public health interest. Aircraft environments are designed according to standards to ensure the comfort and well-being of the occupants. The upper and lower limits of humidity set by ASHRAE standards are based on the maintenance of acceptable thermal conditions established solely on comfort considerations, including thermal sensation, skin wetness, skin dryness, dry eyes and ocular discomfort. The purpose of this study is to investigate the influence of air (carbon dioxide level, relative humidity, and temperature) aboard commercial aircraft on ocular discomfort and dry eye of aircraft personnel and passengers. Measurements of indoor air quality were performed in 15 different aircraft at different times and altitudes. Forty-two measurements of carbon dioxide, temperature, and humidity were performed with portable air samplers every 5 minutes. Passenger loads did not exceed 137 passengers. Thermal comfort rarely met ASHRAE standards. Low humidity levels and high carbon dioxide levels were found on the Airbus 320. The DC-9 had the highest humidity level and the Boeing-767 had the lowest carbon dioxide level. Air quality was poorest on the Airbus 320 aircraft. This poor level of air quality may cause intolerance to contact lenses, dry eyes, and may be a health hazard to both passengers and crew members. Improved ventilation and aircraft cabin micro-environments need to be made for the health and comfort of the occupants.

Methodological Quality of National Guidelines for Pediatric Inpatient Conditions

PubMed Central

Hester, Gabrielle; Nelson, Katherine; Mahant, Sanjay; Eresuma, Emily; Keren, Ron; Srivastava, Rajendu

2014-01-01

Background Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings (PRIS) network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children’s hospitals. The methodological quality of guidelines for priority conditions is unknown. Objective To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. Design We searched sources including PubMed for national guidelines published 2002–2012. Guidelines specific to one organism, test or treatment, or institution were excluded. Guidelines were rated by two raters using a validated tool (AGREE II) with an overall rating on a 7-point scale (7–highest). Inter-rater reliability was measured with a weighted kappa coefficient. Results 17 guidelines met inclusion criteria for 13 conditions, 7 conditions yielded no relevant national guidelines. The highest methodological quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5 and 6.5 respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3 respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78–0.87). Conclusions We identified a group of moderate to high methodological quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives. PMID:24677729

Classification and Quality Standards of Heart Failure Units: Scientific Consensus of the Spanish Society of Cardiology.

PubMed

Anguita Sánchez, Manuel; Lambert Rodríguez, José Luis; Bover Freire, Ramón; Comín Colet, Josep; Crespo Leiro, María G; González Vílchez, Francisco; Manito Lorite, Nicolás; Segovia Cubero, Javier; Ruiz Mateas, Francisco; Elola Somoza, Francisco Javier; Íñiguez Romo, Andrés

2016-10-01

The prevalence of heart failure remains high and represents the highest disease burden in Spain. Heart failure units have been developed to systematize the diagnosis, treatment, and clinical follow-up of heart failure patients, provide a structure to coordinate the actions of various entities and personnel involved in patient care, and improve prognosis and quality of life. There is ample evidence on the benefits of heart failure units or programs, which have become widespread in Spain. One of the challenges to the analysis of heart failure units is standardization of their classification, by determining which "programs" can be identified as heart failure "units" and by characterizing their complexity level. The aim of this article was to present the standards developed by the Spanish Society of Cardiology to classify and establish the requirements for heart failure units within the SEC-Excellence project. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Image quality comparison of two adaptive statistical iterative reconstruction (ASiR, ASiR-V) algorithms and filtered back projection in routine liver CT.

PubMed

Chen, Li-Hong; Jin, Chao; Li, Jian-Ying; Wang, Ge-Liang; Jia, Yong-Jun; Duan, Hai-Feng; Pan, Ning; Guo, Jianxin

2018-06-06

To compare image quality of two adaptive statistical iterative reconstruction (ASiR and ASiR-V) algorithms using objective and subjective metrics for routine liver CT, with the conventional filtered back projection (FBP) reconstructions as reference standards. This institutional review board-approved study included 52 patients with clinically suspected hepatic metastases. Patients were divided equally into ASiR and ASiR-V groups with same scan parameters. Images were reconstructed with ASiR and ASiR-V from 0 (FBP) to 100% blending percentages at 10% interval in its respective group. Mean and standard deviation of CT numbers for liver parenchyma were recorded. Two experienced radiologists reviewed all images for image quality blindly and independently. Data were statistically analyzed. There was no difference in CT dose index between ASiR and ASiR-V groups. As the percentage of ASiR and ASiR-V increased from 10 to 100% , image noise reduced by 8.6 -57.9% and 8.9-81.6%, respectively, compared with FBP. There was substantial interobserver agreement in image quality assessment for ASiR and ASiR-V images. Compared with FBP reconstruction, subjective image quality scores of ASiR and ASiR-V improved significantly as percentage increased from 10 to 80% for ASiR (peaked at 50% with 32.2% noise reduction) and from 10 to 90% (peaked at 60% with 51.5% noise reduction) for ASiR-V. Both ASiR and ASiR-V improved the objective and subjective image quality for routine liver CT compared with FBP. ASiR-V provided further image quality improvement with higher acceptable percentage than ASiR, and ASiR-V60% had the highest image quality score. Advances in knowledge: (1) Both ASiR and ASiR-V significantly reduce image noise compared with conventional FBP reconstruction. (2) ASiR-V with 60 blending percentage provides the highest image quality score in routine liver CT.

Relationship between land use and water quality in Pesanggrahan River

NASA Astrophysics Data System (ADS)

Effendi, Hefni; Muslimah, Sri; Ayu Permatasari, Prita

2018-05-01

Pesanggrahan River watershed has several activities such as residential and commercial area in its catchment area. The purpose of this study was to analyse water quality related to spatial land use in Pesanggrahan River using GIS Analysis. River water quality in some locations, did not meet water quality standard of class III. From pollution load estimation it was revealed that segment 2 (Bogor City) has the highest BOD, COD, and TSS of 15,043 kg/day, 25,619 kg/day, and 18,104 kg/day respectively. On the other hand, the most developed area in Pesanggrahan Watershed is located in segment 7 (24.5%). Hence, it can be concluded that although an area has a fairly small developed area, high urban activity can cause high BOD, COD, and TSS.

Anthropometric protocols for the construction of new international fetal and newborn growth standards: the INTERGROWTH-21st Project.

PubMed

Cheikh Ismail, L; Knight, H E; Bhutta, Z; Chumlea, W C

2013-09-01

The primary aim of the INTERGROWTH-21(st) Project is to construct new, prescriptive standards describing optimal fetal and preterm postnatal growth. The anthropometric measurements include the head circumference, recumbent length and weight of the infants, and the stature and weight of the parents. In such a large, international, multicentre project, it is critical that all study sites follow standardised protocols to ensure maximal validity of the growth and nutrition indicators used. This paper describes, in detail, the selection of anthropometric personnel, equipment, and measurement and calibration protocols used to construct the new standards. Implementing these protocols at each study site ensures that the anthropometric data are of the highest quality to construct the international standards. © 2013 Royal College of Obstetricians and Gynaecologists.

Associations of quality of sleep with lifestyle factors and profile of studies among Lithuanian students.

PubMed

Preišegolavičiūtė, Evelina; Leskauskas, Darius; Adomaitienė, Virginija

2010-01-01

The objective of the study was to analyze associations among quality of sleep, profile of the studies, and lifestyle factors among the students of three different study profiles (medicine, economics, and law). A total of 405 randomly selected students from the first and fourth years of studies from 4 different universities in Lithuania answered the standardized questionnaires consisting of two parts: 1) the Pittsburgh Sleep Quality Index (PSQI) for subjective evaluation of sleep quality; 2) the questionnaire about sleep and lifestyle habits and impact of poor sleep on the quality of life developed by the researchers. More than half (59.4%) of the students scored higher than 5 on the PSQI, which allowed suspecting sleep disorders. A significant difference in the frequency of poor sleepers was found regarding the profile of studies (P<0.05) showing the highest frequency of sleep disturbances among medical students. There was a significant correlation between quality of sleep and subjective evaluation of quality of life (P<0.01). Medical students experienced the highest impact of poor sleep on the quality of life (P=0.008). Students studying before going to sleep, spending more time studying, and having less leisure time had worse quality of sleep (P<0.01). A significant difference was found among three profiles of studies regarding the anxiety about studies (P<0.0005) and subjective estimation of success in studies (χ²=27.9, P<0.0005), showing the highest anxiety and worst satisfaction among students of medicine. The incidence of sleep problems is high among students in Lithuania, reaching 59.4%. Medical students have worse quality of sleep and worse impact of poor sleep on the quality of life compared to students of law and economics. A significant difference was found between medical students and their peers in other profiles of studies regarding their attitudes and habits related to studies: medical students spent more time for studying, were more anxious about studies and less satisfied with the results, studied more often before going to sleep.

Survey of quality, readability, and social reach of websites on osteosarcoma in adolescents.

PubMed

Lam, Catherine G; Roter, Debra L; Cohen, Kenneth J

2013-01-01

Little is known about Internet resources for adolescent patients. This study assessed the quality, readability, and social reach of websites on an illustrative adolescent cancer diagnosis, osteosarcoma. The top 50 results from four queries in two search engines were screened. Quality and readability were determined using standard DISCERN tool, Flesch Reading Ease and Flesch-Kinkaid Grade. Social reach was gauged by social networking links, global website traffic, and a pilot adolescent-specificity measure. Of 400 websites assessed, 56 (14%) met inclusion criteria. Websites' mean quality was fair (49.8 on 75-point scale; range 31.0-66.0, poor to excellent); 86% failed readability standards (Grade>8); 75% offered at least one social networking link; and 34% offered site-specific social media. More than 60% received over 50,000 visits in the past month. Only 12.5% included adolescent-specific content. Of the 10 websites ranked highest for quality, only one achieved both readability targets and adolescent-specific content. Although some patient-oriented websites on osteosarcoma are of acceptable quality, most failed readability targets, and few appeared to address adolescents. Better awareness of Internet health resources and social media for adolescents with cancer is needed to address gaps, promote health literacy and facilitate patient-provider communication. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Assessment of air quality in and around a steel industry with direct reduction iron route.

PubMed

Jena, Pradip K; Behera, Dillip K; Mishra, C S K; Mohanty, Saswat K

2011-10-01

The coal based Direct Reduced Iron (DRI) route for secondary steel production is now a preferred choice in India. Steel making is invariably associated with emission of air pollutants into the environment. Air quality monitoring was carried out in Winter, Summer and Rainy seasons of 2008 in eight monitoring stations in the work zone and five stations in the residential zone of an Integrated Steel Industry located in Orissa state, India. Four air quality parameters i.e. SPM, RSPM, SO2 and NO2 were monitored. Mean SPM and RSPM values were found to be significantly high (p < 0.01) at stations nearer to source in both work zone and residential zone .The highest average SPM and RSPM values in the work zone recorded were 4869 microg/m3 and 1420 microg/m3 and in the residential zone 294 microg/m3 and 198 microg/m3 respectively. No significant difference in the SO2 and NO2 levels was observed between the work and residential zones. In general, the values of air pollutants were highest in Winter followed by Summer and Rainy season. SPM and RSPM values exceeded the National Air Quality Standards (NAAQS) in both the residential and work zones.

Development of Indicators to Assess Quality of Care for Prostate Cancer.

PubMed

Nag, Nupur; Millar, Jeremy; Davis, Ian D; Costello, Shaun; Duthie, James B; Mark, Stephen; Delprado, Warick; Smith, David; Pryor, David; Galvin, David; Sullivan, Frank; Murphy, Áine C; Roder, David; Elsaleh, Hany; Currow, David; White, Craig; Skala, Marketa; Moretti, Kim L; Walker, Tony; De Ieso, Paolo; Brooks, Andrew; Heathcote, Peter; Frydenberg, Mark; Thavaseelan, Jeffery; Evans, Sue M

2016-02-20

The development, monitoring, and reporting of indicator measures that describe standard of care provide the gold standard for assessing quality of care and patient outcomes. Although indicator measures have been reported, little evidence of their use in measuring and benchmarking performance is available. A standard set, defining numerator, denominator, and risk adjustments, will enable global benchmarking of quality of care. To develop a set of indicators to enable assessment and reporting of quality of care for men with localised prostate cancer (PCa). Candidate indicators were identified from the literature. An international panel was invited to participate in a modified Delphi process. Teleconferences were held before and after each voting round to provide instruction and to review results. Panellists were asked to rate each proposed indicator on a Likert scale of 1-9 in a two-round iterative process. Calculations required to report on the endorsed indicators were evaluated and modified to reflect the data capture of the Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ). A total of 97 candidate indicators were identified, of which 12 were endorsed. The set includes indicators covering pre-, intra-, and post-treatment of PCa care, within the limits of the data captured by PCOR-ANZ. The 12 endorsed quality measures enable international benchmarking on the quality of care of men with localised PCa. Reporting on these indicators enhances safety and efficacy of treatment, reduces variation in care, and can improve patient outcomes. PCa has the highest incidence of all cancers in men. Early diagnosis and relatively high survival rates mean issues of quality of care and best possible health outcomes for patients are important. This paper identifies 12 important measurable quality indicators in PCa care. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Standard, Random, and Optimum Array conversions from Two-Pole resistance data

DOE PAGES

Rucker, D. F.; Glaser, Danney R.

2014-09-01

We present an array evaluation of standard and nonstandard arrays over a hydrogeological target. We develop the arrays by linearly combining data from the pole-pole (or 2-pole) array. The first test shows that reconstructed resistances for the standard Schlumberger and dipoledipole arrays are equivalent or superior to the measured arrays in terms of noise, especially at large geometric factors. The inverse models for the standard arrays also confirm what others have presented in terms of target resolvability, namely the dipole-dipole array has the highest resolution. In the second test, we reconstruct random electrode combinations from the 2-pole data segregated intomore » inner, outer, and overlapping dipoles. The resistance data and inverse models from these randomized arrays show those with inner dipoles to be superior in terms of noise and resolution and that overlapping dipoles can cause model instability and low resolution. Finally, we use the 2-pole data to create an optimized array that maximizes the model resolution matrix for a given electrode geometry. The optimized array produces the highest resolution and target detail. Thus, the tests demonstrate that high quality data and high model resolution can be achieved by acquiring field data from the pole-pole array.« less

Performance characterization of structured light-based fingerprint scanner

NASA Astrophysics Data System (ADS)

Hassebrook, Laurence G.; Wang, Minghao; Daley, Raymond C.

2013-05-01

Our group believes that the evolution of fingerprint capture technology is in transition to include 3-D non-contact fingerprint capture. More specifically we believe that systems based on structured light illumination provide the highest level of depth measurement accuracy. However, for these new technologies to be fully accepted by the biometric community, they must be compliant with federal standards of performance. At present these standards do not exist for this new biometric technology. We propose and define a set of test procedures to be used to verify compliance with the Federal Bureau of Investigation's image quality specification for Personal Identity Verification single fingerprint capture devices. The proposed test procedures include: geometric accuracy, lateral resolution based on intensity or depth, gray level uniformity and flattened fingerprint image quality. Several 2-D contact analogies, performance tradeoffs and optimization dilemmas are evaluated and proposed solutions are presented.

Reproducibility in light microscopy: Maintenance, standards and SOPs.

PubMed

Deagle, Rebecca C; Wee, Tse-Luen Erika; Brown, Claire M

2017-08-01

Light microscopy has grown to be a valuable asset in both the physical and life sciences. It is a highly quantitative method available in individual research laboratories and often centralized in core facilities. However, although quantitative microscopy is becoming a customary tool in research, it is rarely standardized. To achieve accurate quantitative microscopy data and reproducible results, three levels of standardization must be considered: (1) aspects of the microscope, (2) the sample, and (3) the detector. The accuracy of the data is only as reliable as the imaging system itself, thereby imposing the need for routine standard performance testing. Depending on the task some maintenance procedures should be performed once a month, some before each imaging session, while others conducted annually. This text should be implemented as a resource for researchers to integrate with their own standard operating procedures to ensure the highest quality quantitative microscopy data. Copyright © 2017. Published by Elsevier Ltd.

Evaluation of surface water quality indices and ecological risk assessment for heavy metals in scrap yard neighbourhood.

PubMed

Ojekunle, Olusheyi Z; Ojekunle, Olurotimi V; Adeyemi, Azeem A; Taiwo, Abayomi G; Sangowusi, Opeyemi R; Taiwo, Adewale M; Adekitan, Adetoun A

2016-01-01

Pollution of surface water with heavy metals from industrial activities especially those from scrap yard has caused a major threat to human life exposing man to series of hazard, diseases, disability and consequently death. This study focuses on water quality indices of Owode-Onirin and Lafenwa scrap yard with respect to its physicochemical parameters and heavy metal concentrations by evaluating Heavy Metal Pollution Index (HPI), Metal Index (MI) and Potential Ecological Risk Index (PERI). Fifteen water samples were selected randomly from two locations by purposive sampling methods. Five heavy metals which includes Nickel (Ni), Zinc (Zn), Copper (Cu), Cadmium (Cd), Lead (Pb) were analyzed using Atomic Absorption Spectroscopy and standard analytical procedure were follow to ensure accuracy. One way analysis of variance was carried out to analyse the data. The concentrations of the heavy metals were significantly different between sampling locations. However, the mean concentrations of Cd (0.0121 mg/L) were found to be above the highest permissible value of Standard Organization of Nigeria standards for drinking water (SON 2007) and WHO (Guidelines for drinking water quality: incorporating 1st and 2nd Addlenda. World Health Organization, Geneva, 2004) for drinking water. Although Pb was present in two out of the fifteen water samples with a mean value of (0.0324 mg/L) which was also above the highest permissible value. The mean concentrations of Zn (0.2149 mg/L) and Cu (0.0341 mg/L) are found to be below the highest permissible value of the mentioned guideline while no trace of Ni was found in the water samples across the two sampling locations. The mean HPI 518.55 is far above the critical value of 100, indicates that selected water samples are critically polluted with heavy metals. MI revealed low quality water with mean value 4.83, suggests that the selected water is seriously affected with the present of heavy metal. The Hakanson PERI indicated that of the five heavy metals, the risk coefficient of Zn, Pb, Cu, and Ni had light levels of contamination while the level of Cd contamination posed the most serious potential ecological risk, with an index value between 14.1 and 234. The study concluded that order of magnitude to this five heavy metals contamination is Cd > Pb > Zn > Cu > Ni.

The resonant body transistor.

PubMed

Weinstein, Dana; Bhave, Sunil A

2010-04-14

This paper introduces the resonant body transistor (RBT), a silicon-based dielectrically transduced nanoelectromechanical (NEM) resonator embedding a sense transistor directly into the resonator body. Combining the benefits of FET sensing with the frequency scaling capabilities and high quality factors (Q) of internal dielectrically transduced bar resonators, the resonant body transistor achieves >10 GHz frequencies and can be integrated into a standard CMOS process for on-chip clock generation, high-Q microwave circuits, fundamental quantum-state preparation and observation, and high-sensitivity measurements. An 11.7 GHz bulk-mode RBT is demonstrated with a quality factor Q of 1830, marking the highest frequency acoustic resonance measured to date on a silicon wafer.

Rapid Ascent From Zero Quality to International Organization for Standardization Accreditation: A Case Study of Hai Duong Preventive Medicine Center in Vietnam, 2012-2013.

PubMed

Duong, Cuong Ngoc; Bond, Kyle B; Carvalho, Humberto; Thi Thu, Hien Bui; Nguyen, Thuong; Rush, Thomas

2017-04-01

In 2012, the Vietnam Ministry of Health sought to improve the quality of health laboratories by introducing international quality standards. Strengthening Laboratory Management Toward Accreditation (SLMTA), a year-long, structured, quality improvement curriculum (including projects and mentorship) was piloted in 12 laboratories. Progress was measured using a standardized audit tool (Stepwise Laboratory Quality Improvement Process Towards Accreditation). All 12 pilot laboratories (a mix of hospital and public health) demonstrated improvement; median scores rose from 44% to 78% compliance. The public health laboratory in Hai Duong Province entered the program with the lowest score of the group (28%) yet concluded with the highest score (86%). Five months after the completion of the program, without any additional external support, they were accredited. Laboratory management/staff describe factors key to their success: support from the facility senior management, how-to guidance provided by SLMTA, support from the site mentor, and strong commitment of laboratory staff. Hai Duong preventive medical center is one of only a handful of laboratories to reach accreditation after participation in SLMTA and the only laboratory to do so without additional support. Due to the success seen in Hai Duong and other pilot laboratories, Vietnam has expanded the use of SLMTA. American Society for Clinical Pathology, 2017. This work is written by US Government employees and is in the public domain in the US.

Quality evaluation of no-reference MR images using multidirectional filters and image statistics.

PubMed

Jang, Jinseong; Bang, Kihun; Jang, Hanbyol; Hwang, Dosik

2018-09-01

This study aimed to develop a fully automatic, no-reference image-quality assessment (IQA) method for MR images. New quality-aware features were obtained by applying multidirectional filters to MR images and examining the feature statistics. A histogram of these features was then fitted to a generalized Gaussian distribution function for which the shape parameters yielded different values depending on the type of distortion in the MR image. Standard feature statistics were established through a training process based on high-quality MR images without distortion. Subsequently, the feature statistics of a test MR image were calculated and compared with the standards. The quality score was calculated as the difference between the shape parameters of the test image and the undistorted standard images. The proposed IQA method showed a >0.99 correlation with the conventional full-reference assessment methods; accordingly, this proposed method yielded the best performance among no-reference IQA methods for images containing six types of synthetic, MR-specific distortions. In addition, for authentically distorted images, the proposed method yielded the highest correlation with subjective assessments by human observers, thus demonstrating its superior performance over other no-reference IQAs. Our proposed IQA was designed to consider MR-specific features and outperformed other no-reference IQAs designed mainly for photographic images. Magn Reson Med 80:914-924, 2018. © 2018 International Society for Magnetic Resonance in Medicine. © 2018 International Society for Magnetic Resonance in Medicine.

Non-Hodgkin's lymphomas: clinical governance issues.

PubMed

Fields, P A; Goldstone, A H

2002-09-01

Every patient in every part of the world has the right to expect the best possible quality of care from health care providers. Non-Hodgkin's lymphomas (NHL) are an extremely heterogeneous group of conditions which require important decisions to be taken at many points along the treatment pathway. To get this right every time requires that high-quality standards are instituted and adhered to, so that the best possible outcome is achieved. In the past this has not always been the case because of the failure of clinicians sometimes to adhere to an optimal management plan. In 1995, the UK government commissioned an inquiry into the running of cancer services in the United Kingdom, which culminated in a series of recommendations to improve them. Subsequently, these recommendations were implemented as objectives of the NHS Cancer Plan which is the framework by which the UK government wishes to improve cancer services. Concurrently another general concept has emerged which is designed to ensure that the highest quality standards may be achieved for all patients across the whole National Health Service (NHS). This concept, termed 'clinical governance', brings together a corporate responsibility of all health care workers to deliver high quality standards, in the hope that this will translate into better long-term survival of patients with malignant disease. This chapter focuses on the issues surrounding clinical governance and how the principles of this concept relate to non-Hodgkin's lymphomas.

Efficacy and Tolerability of Two Different Kinds of Titration of Paroxetine Hydrocloride Solution: an Observational Study.

PubMed

Ielmini, Marta; Poloni, Nicola; Caselli, Ivano; Bianchi, Lucia; Diurni, Marcello; Vender, Simone; Callegari, Camilla

2018-03-13

Depressive disorders are expected to be the second highest cause of morbidity in the world until few years. Moreover, patients with depression frequently show many side effects and low compliance to therapy. To find a more tolerated and more efficacy therapy is a growing need. This observational study investigates the efficacy, safety and tolerability of paroxetine hydrochloride comparing slow versus standard titration in a population affected by Depressive Disoders (according to DSM 5). 186 outpatients were assessed throught the following scales: Hamilton Depression Rating Scale (HDRS) for depression and World Health Organization Quality of Life Scale Bref for the perceived quality of life (WHOQOL BREF). Treatment-emerged Adverse Events (TEAEs) were recorded throught self-reports. Statystical analysys was performed by GraphPad Prism Version 5.1. The efficacy of paroxetine was confirmed in both titrations by the number of clinical remitters (HDRS ≤ 7 at 12 weeks for 53% of the standard titration group and 58% of the slow titration group), without differences. About safety and tolerability there were more frequent TEAEs among the standard titration group (p < 0.01). Comparing WHOQOL BREF between the two groups at the recruitment and at the twelth week emerged a statistically significant difference (p = 0.003), with highest scores reached in slow titration group. Although the short observation period is an evident limit, this study is consistent to the literature about the efficacy of both titrations of paroxetine to improve depression and shows promising results about the increased tolerability of paroxetine slow titration.

Association between the application of ISO 9001:2008 alone or in combination with health-specific standards and quality-related activities in Hungarian hospitals.

PubMed

Dombrádi, Viktor; Csenteri, Orsolya Karola; Sándor, János; Godény, Sándor

2017-04-01

To investigate how International Organization for Standardization (ISO) 9001 and the Hungarian Health Care Standards (HHCS) certifications are associated with quality management, patient safety, patient rights and human resource management activities. A cross-sectional study was implemented using the 2009 Hungarian hospital survey's database. Hungary. Fifty-three general hospitals were included in the statistical analysis. No intervention was carried out in the study. The outcomes included the percentage of compliance in the dimensions of quality management, patient safety, patient rights, human resource management and the overall score for each hospital, and they were grouped according to the hospitals' certifications. Sixteen hospitals did not have either ISO 9001 or HHCS certifications, 19 had ISO 9001 certification only and 18 had both. Hospitals with ISO 9001 alone or in combination with the HHCS significantly outperformed hospitals with no certifications in terms of quality management and human resource management activities but not in terms of patient safety or patient rights activities. Combined, the two models provided the highest median levels in all cases. Nevertheless, no significant differences were observed when the hospitals with both certifications were compared with hospitals with ISO 9001 only. Although the combination of ISO 9001 and the HHCS showed the best results, the benefits were not decisive. Furthermore, although the HHCS include standards addressing patient safety, no direct association was found with regard to compliance. Thus, further investigation is required to understand this enigma. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Physicochemical quality and health implications of bottled water brands sold in Ethiopia.

PubMed

Amogne, Wossen T; Gizaw, Melaku; Abera, Daniel

2015-06-01

Water bottling companies often assert that their products are of the highest quality and are conforming to the standards. The objective of the study was to assess the physicochemical quality of bottled waters consumed in Ethiopia and to compare the findings with the national and international water quality standards. Eleven domestic and two imported bottled water brands were randomly purchased in Addis Ababa, Ethiopia at three different occasions from July 2013 to May 2014. A total of 39 composite samples were examined for aggregate parameters, major anions, and common cations in accordance with the procedures described in the standard methods. We found that 7.7% of the samples were containing higher levels of alkalinity, hardness, total dissolved solids, pH, HCO3-, Na+, and Ca2+ than the national standards and the WHO guidelines. However, the deviations from standards for all the above parameters were not statistically significant (one-sample t-test, P>0.05). Conversely, in some of the brands, some of the essential elements like Ca2+, K+, Mg2+, and F- were found at very low concentrations. The rest of the parameters, including CO3(2-), SO4(2-), PO4(3-) (orthophosphates), Cl-, F-, NO3-, NO2-, K+, Mg2+, Fe, Mn, Cr, Cd, Cu, Ni, and Pb were within the acceptable ranges in all the brands. Bottled water brands containing very high concentrations of dissolved substances may pose health risks for individuals living with heart and kidney related problems. On the other hand, brands having chemicals lower than the optimum level may also harm the health of consumers who choose those brands as a sole source of drinking water. Thus, we suggest those responsible authorities to ensure regular monitoring and testing for chemical compositions of bottled water.

Drinking water quality assessment.

PubMed

Aryal, J; Gautam, B; Sapkota, N

2012-09-01

Drinking water quality is the great public health concern because it is a major risk factor for high incidence of diarrheal diseases in Nepal. In the recent years, the prevalence rate of diarrhoea has been found the highest in Myagdi district. This study was carried out to assess the quality of drinking water from different natural sources, reservoirs and collection taps at Arthunge VDC of Myagdi district. A cross-sectional study was carried out using random sampling method in Arthunge VDC of Myagdi district from January to June,2010. 84 water samples representing natural sources, reservoirs and collection taps from the study area were collected. The physico-chemical and microbiological analysis was performed following standards technique set by APHA 1998 and statistical analysis was carried out using SPSS 11.5. The result was also compared with national and WHO guidelines. Out of 84 water samples (from natural source, reservoirs and tap water) analyzed, drinking water quality parameters (except arsenic and total coliform) of all water samples was found to be within the WHO standards and national standards.15.48% of water samples showed pH (13) higher than the WHO permissible guideline values. Similarly, 85.71% of water samples showed higher Arsenic value (72) than WHO value. Further, the statistical analysis showed no significant difference (P<0.05) of physico-chemical parameters and total coliform count of drinking water for collection taps water samples of winter (January, 2010) and summer (June, 2010). The microbiological examination of water samples revealed the presence of total coliform in 86.90% of water samples. The results obtained from physico-chemical analysis of water samples were within national standard and WHO standards except arsenic. The study also found the coliform contamination to be the key problem with drinking water.

Ground-Water Quality in the Delaware River Basin, New York, 2001 and 2005-2006

USGS Publications Warehouse

Nystrom, Elizabeth A.

2007-01-01

The Federal Clean Water Act Amendments of 1977 require that States monitor and report on the quality of ground water and surface water. To satisfy part of these requirements, the U.S. Geological Survey and New York State Department of Environmental Conservation have developed a program in which ground-water quality is assessed in 2 to 3 of New York State's 14 major basins each year. To characterize the quality of ground water in the Delaware River Basin in New York, water samples were collected from December 2005 to February 2006 from 10 wells finished in bedrock. Data from 9 samples collected from wells finished in sand and gravel in July and August 2001 for the National Water Quality Assessment Program also are included. Ground-water samples were collected and processed using standard U.S. Geological Survey procedures. Samples were analyzed for more than 230 properties and compounds, including physical properties, major ions, nutrients, trace elements, radon-222, pesticides and pesticide degradates, volatile organic compounds, and bacteria. Concentrations of most compounds were less than drinking-water standards established by the U.S. Environmental Protection Agency and New York State Department of Health; many of the organic analytes were not detected in any sample. Drinking-water standards that were exceeded at some sites include those for color, turbidity, pH, aluminum, arsenic, iron, manganese, radon-222, and bacteria. pH ranged from 5.6 to 8.3; the pH of nine samples was less than the U.S. Environmental Protection Agency secondary drinking-water standard range of 6.5 to 8.5. Water in the basin is generally soft to moderately hard (hardness 120 milligrams per liter as CaCO3 or less). The cation with the highest median concentration was calcium; the anion with the highest median concentrations was bicarbonate. Nitrate was the predominant nutrient detected but no sample exceeded the 10 mg/L U.S. Environmental Protection Agency maximum contaminant level. The trace elements detected with the highest median concentrations were strontium and iron in unfiltered water and strontium and barium in filtered water. Concentrations of trace elements in several samples exceeded U.S. Environmental Protection Agency secondary drinking-water standards, including aluminum (50-200 micrograms per liter, three wells), arsenic (10 micrograms per liter, one well), iron (300 micrograms per liter, three wells), and manganese (50 micrograms per liter, four wells). The median concentration of radon-222 was 1,580 picoCuries per liter. Radon-222 is not currently regulated, but the U.S. Environmental Protection Agency has proposed a maximum contaminant level of 300 picoCuries per liter along with an alternative maximum contaminant level of 4,000 picoCuries per liter, to be in effect in states that have programs to address radon in indoor air. Concentrations of radon-222 exceeded the proposed maximum contaminant level in all 19 of the samples and exceeded the proposed alternative maximum contaminant level in 1 sample. Eleven pesticides and pesticide degradates were detected in samples from ten wells; all were herbicides or herbicide degradates. Three volatile organic compounds were detected, including disinfection byproducts such as trichloromethane and gasoline components or additives such as methyl tert-butyl ether. No pesticides, pesticide degradates, or volatile organic compounds were detected above established limits. Coliform bacteria were detected in samples from five wells, four of which were finished in sand and gravel; Escherichia coli was not detected in any sample.

Quality of extra virgin olive oils produced in an emerging olive growing area in north-western Spain.

PubMed

Reboredo-Rodríguez, P; González-Barreiro, C; Cancho-Grande, B; Simal-Gándara, J

2014-12-01

Systematic studies of physico-chemical and stability-related properties, and chemical composition, of extra virgin olive oils (EVOOs) obtained from drupes cropped in specific regions are of special agricultural interest. This is particularly so with new production areas, where careful selection of the most suitable olive varieties for EVOO production is required. This paper reports the first comprehensive chemical characterisation of EVOOs obtained from three different olive varieties (viz., Picual, Morisca and Manzanilla de Sevilla) grown in a new cultivation area in Galicia (NW Spain). The Morisca variety was that providing the highest industrial oil yield (21%). However, the three types of EVOO exhibited no statistically significant differences in standard quality-related indices other than acidity. Morisca EVOO was that with the lowest content in oleic acid (mean=68%) and highest content in linoleic acid (mean=13%). Also, Morisca EVOO exhibited the highest sterol levels (mean=1,616 mg/kg) and Picual EVOO the lowest (mean=1,160 mg/kg). Picual EVOO contained greater amounts of the phenolic compounds luteolin and pinoresinol than both Morisca and Manzanilla de Sevilla EVOOs. Finally, Manzanilla de Sevilla EVOO exhibited differential attributes, with banana and olive fruit aromatic series prevailing predominantly over bitter-like, pungent-like and leaf series. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ground-water flow and quality in Wisconsin's shallow aquifer system

USGS Publications Warehouse

Kammerer, P.A.

1995-01-01

In terms of chemical quality, the water is suitable for potable supply and most other uses, but objectionable hardness in large areas and concen- trations of iron and manganese that exceed State drinking-water standards cause aesthetic problems that may require treatment of the water for some uses. Concentrations of major dissolved constitu- ents (calcium, magnesium, and bicarbonate), hard- ness, alkalinity, and dissolved solids are highest where the bedrock component of the aquifer is dolo- mite and lowest where the shallow aquifer is almost entirely sand and gravel. Concentrations of other minor constituents (sodium, potassium, sulfate, chloride, and fluoride) are less closely related to common minerals that compose the aquifer system. Sulfate and fluoride concentrations exceed State drinking-water standards locally. Extreme variability in concentrations of iron and manganese are common locally. Iron and manganese concentra- tions exceed State drinking-water standards in water from one-third and one-quarter of the wells, respectively. Likely causes of nitrate-nitrogen con- centrations that exceed State drinking-water stan- dards include local contamination from plant fertilizers, animal wastes, waste water disposed of on land, and septic systems. Water quality in the shallow aquifer system has been affected by saline water from underlying aquifers, primarily along the eastern and western boundaries of the State where the thickness of Paleozoic rocks is greatest.

[Characteristics and loads of key sources of pollutions discharged into Beishi River, Changzhou City].

PubMed

Li, Chun-Ping; Jiang, Jian-Guo; Chen, Ai-Mei; Wu, Jia-Ling; Fan, Xiu-Juan; Ye, Bin

2010-11-01

Choosing the Beishi river, Changzhou City as the study area, the sewage generation, pollutants characteristics and sewage discharge in catchment area of Beishi river were conducted, detailed investigated and monitored. After using pollution coefficients, the yearly loads of all sources of pollutions were calculated to determine the highest sewage. The results showed that: except pH, the high concentration of SS, COD, BOD5, ammonia nitrogen, TN and TP discharged from MSW collecting houses, MSW transfer stations, public toilets and dining in Changzhou city far exceeded the "Integrated Wastewater Discharge Standard" (GB 8978-1996) and "Effluent Discharged into the City Sewer Water Quality Standards" (CJ 3082-1999). Among which: the highest concentration of COD discharged from MSW transfer stations was up to 51 700 mg/L, while the ammonia nitrogen and TN were as high as 1 616 mg/L and 2 044 mg/L in the toilet wastewater. In addition to this, the ratio of wastewater discharged directly into the river through storm water pipe network was higher from MSW houses, MSW transfer stations, public toilets, dining and other waste in Changzhou city. The 125.2 t/a of COD and 40.53 t/a of BOD5 were the two highest concentrations of various sources of pollution. The highest annual polluting loads discharged into Beishi river is dining, followed by the sanitation facilities. Therefore, cutting pollution control of food and sanitation facilities along the river is particularly urgent.

Internal quality assurance in a clinical virology laboratory. II. Internal quality control.

PubMed Central

Gray, J J; Wreghitt, T G; McKee, T A; McIntyre, P; Roth, C E; Smith, D J; Sutehall, G; Higgins, G; Geraghty, R; Whetstone, R

1995-01-01

AIMS--In April 1991 additional quality control procedures were introduced into the virology section of the Clinical Microbiology and Public Health Laboratory, Cambridge. Internal quality control (IQC) samples were gradually included in the serological assays performed in the laboratory and supplemented kit controls and standard sera. METHODS--From April 1991 to December 1993, 2421 IQC procedures were carried out with reference sera. RESULTS--The IQC samples were evaluated according to the Westgard rules. Violations were recorded in 60 of 1808 (3.3%) controls and were highest in the IQC samples of complement fixation tests (25/312 (8%) of controls submitted for complement fixation tests). CONCLUSIONS--The inclusion of IQC samples in the serological assays performed in the laboratory has highlighted batch to batch variation in commercial assays. The setting of acceptable limits for the IQC samples has increased confidence in the validity of assay results. PMID:7730475

Benchmark matrix and guide: Part III.

PubMed

1992-01-01

The final article in the "Benchmark Matrix and Guide" series developed by Headquarters Air Force Logistics Command completes the discussion of the last three categories that are essential ingredients of a successful total quality management (TQM) program. Detailed behavioral objectives are listed in the areas of recognition, process improvement, and customer focus. These vertical categories are meant to be applied to the levels of the matrix that define the progressive stages of the TQM: business as usual, initiation, implementation, expansion, and integration. By charting the horizontal progress level and the vertical TQM category, the quality management professional can evaluate the current state of TQM in any given organization. As each category is completed, new goals can be defined in order to advance to a higher level. The benchmarking process is integral to quality improvement efforts because it focuses on the highest possible standards to evaluate quality programs.

Analysis of water quality on several waters affected by contamination in West Sumbawa Regency

NASA Astrophysics Data System (ADS)

Dewi, N. N.; Satyantini, W. H.; Sahidu, A. M.; Sari, L. A.; Mukti, A. T.

2018-04-01

This study reports the result of water quality in several waters in West Sumbawa Regency. The load of waste input from anthropogenic activity becomes an indication of the decrease of water quality in West Sumbawa Regency Waters. The existence of illegal mining activities around the water has the potential to cause water pollution. Sample of water were collected on April 2017 in four location such as Sejorong 1, Sejorong 2, Tongo, and Taliwang. Sample were analyzed as insitu and exsitu parameters. The result of this research showed that Sejorong 2 have the highest value of pollution index but generally four site on West Sumbawa Regency Waters were categorized lightly contaminated. Concentration of heavy metal cadmium at four locations exceed the water quality standard for fisheries and drinking water. However, the trophic classification using TSI and TRIX of all location was oligothropic water.

Groundwater quality in the Chemung River Basin, New York, 2008

USGS Publications Warehouse

Risen, Amy J.; Reddy, James E.

2011-01-01

The second groundwater quality study of the Chemung River Basin in south-central New York was conducted as part of the U.S. Geological Survey 305(b) water-quality-monitoring program. Water samples were collected from five production wells and five private residential wells from October through December 2008. The samples were analyzed to characterize the chemical quality of the groundwater. Five of the wells are screened in sand and gravel aquifers, and five are finished in bedrock aquifers. Two of these wells were also sampled for the first Chemung River Basin study of 2003. Samples were analyzed for 6 physical properties and 217 constituents, including nutrients, major inorganic ions, trace elements, radionuclides, pesticides, volatile organic compounds, phenolic compounds, organic carbon, and four types of bacterial analyses. Results of the water-quality analyses for individual wells are presented in tables, and summary statistics for specific constituents are presented by aquifer type. The results are compared with Federal and New York State drinking-water standards, which typically are identical. Water quality in the study area is generally good, but concentrations of some constituents equaled or exceeded current or proposed Federal or New York State drinking-water standards; these were: sodium (one sample), total dissolved solids (one sample), aluminum (one sample), iron (one sample), manganese (four samples), radon-222 (eight samples), trichloroethene (one sample), and bacteria (four samples). The pH of all samples was typically neutral or slightly basic (median 7.5); the median water temperature was 11.0 degrees Celsius (?C). The ions with the highest median concentrations were bicarbonate (median 202 milligrams per liter [mg/L]) and calcium (median 59.0 mg/L). Groundwater in the study area is moderately hard to very hard, but more samples were hard or very hard (121 mg/L as calcium carbonate (CaCO3) or greater) than were moderately hard (61-120 mg/L as CaCO3); the median hardness was 205 mg/L as CaCO3. The maximum concentration of nitrate plus nitrite was 3.67 mg/L as nitrogen, which did not exceed established drinking-water standards for nitrate plus nitrite (10 mg/L as nitrogen). The trace elements with the highest median concentrations were strontium (median 196.5 micrograms per liter [(u or mu)g/L]), barium (median 186 (u or mu)g/L), and iron (median 72.5 (u or mu)g/L in unfiltered water). Five pesticides and pesticide degradates were detected among four samples at concentrations of 0.11 (u or mu)g/L or less; they included herbicides and herbicide degradates. Six volatile organic compounds (VOCs) were detected among four samples; these included four solvents, methyl tert-butyl ether, and one trihalomethane. Trichloroethene, a solvent, was detected in one production well at 5.5 (u or mu)g/L; the Federal and New York State Maximum Contaminant Level (MCL) (5 (u or mu)g/L) was exceeded. The highest radon-222 activities were in samples from bedrock wells [maximum 1,740 picocuries per liter (pCi/L)]; eight of the wells sampled exceeded a proposed U.S. Environmental Protection Agency (USEPA) drinking-water standard of 300 pCi/L. Any detection of coliform bacteria indicates a potential violation of New York State health regulations; total coliform bacteria were detected in four samples, and fecal coliform bacteria were detected in one sample.μμμ

Long-Term Impact of Earthquakes on Sleep Quality

PubMed Central

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

Purpose We investigated the impact of the 6.3 magnitude 2009 L’Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Methods Self-reported sleep quality was assessed in 665 L’Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). Results The comparison between L’Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. Conclusions The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder. PMID:23418478

Long-term impact of earthquakes on sleep quality.

PubMed

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

We investigated the impact of the 6.3 magnitude 2009 L'Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Self-reported sleep quality was assessed in 665 L'Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). The comparison between L'Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder.

Quality assessment of recent evidence-based clinical practice guidelines for management of type 2 diabetes mellitus in adults using the AGREE II instrument.

PubMed

Anwer, Muhammad A; Al-Fahed, Ousama B; Arif, Samir I; Amer, Yasser S; Titi, Maher A; Al-Rukban, Mohammed O

2018-02-01

Type 2 diabetes mellitus (T2DM) is a worldwide and national public health problem that has a great impact on the population in Saudi Arabia. High-quality clinical practice guidelines (CPGs) are cornerstones in improving the health care provided for patients with diabetes. This study evaluated the methodological rigour, transparency, and applicability of recently published CPGs. Our group conducted a systematic search for recently published CPGs for T2DM. The searching and screening for Source CPGs were guided by tools from the ADAPTE methods with specific inclusion/exclusion criteria. Five reviewers using the second version of the Appraisal of Guidelines for Research and Evaluation (AGREE II) Instrument independently assessed the quality of the retrieved Source CPGs. Domains of Scope and purpose and Clarity of presentation received the highest scores in all CPGs. Most of the assessed CPGs (86%) were considered with high overall quality and were recommended for use. Rigour of development and applicability domains were together highest in 3 CPGs (43%). The overall high quality of DM CPGs published in the last 3 years demonstrated the continuous development and improvement in CPG methodologies and standards. Health care professionals should consider the quality of any CPG for T2DM before deciding to use it in their daily clinical practice. Three CPGs have been identified, using the AGREE criteria, as high-quality and trustworthy. Ideally, the resources provided by the AGREE trust including the AGREE II Instrument should be used by a clinician to scan through the large number of published T2DM CPGs to identify the CPGs with high methodological quality and applicability. © 2017 John Wiley & Sons, Ltd.

The principles and best practice of question writing for postgraduate examinations.

PubMed

Hayes, Kevin; McCrorie, Peter

2010-12-01

Postgraduate medical education has changed enormously in the last 10 years presenting huge logistical challenges for local, regional and national organisations. Assessment is under change in line with major revisions of postgraduate curricula. Old methods of assessment are changing to newer evidence-based methods supported by ongoing research into good practice. This review examines the purpose and practical considerations of written assessment, the pros and cons of different assessment methods and how good practice can be evaluated and quality assured. Good quality assessment comes at a cost in terms of time and money, and organisations need to invest in their assessment strategies to ensure the highest possible standards. Copyright © 2010 Elsevier Ltd. All rights reserved.

Dual-energy CT in patients with abdominal malignant lymphoma: impact of noise-optimised virtual monoenergetic imaging on objective and subjective image quality.

PubMed

Lenga, L; Czwikla, R; Wichmann, J L; Leithner, D; Albrecht, M H; D'Angelo, T; Arendt, C T; Booz, C; Hammerstingl, R; Vogl, T J; Martin, S S

2018-06-05

To investigate the impact of noise-optimised virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with malignant lymphoma at dual-energy computed tomography (DECT) examinations of the abdomen. Thirty-five consecutive patients (mean age, 53.8±18.6 years; range, 21-82 years) with histologically proven malignant lymphoma of the abdomen were included retrospectively. Images were post-processed with standard linear blending (M_0.6), traditional VMI, and VMI+ technique at energy levels ranging from 40 to 100 keV in 10 keV increments. Signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were objectively measured in lymphoma lesions. Image quality, lesion delineation, and image noise were rated subjectively by three blinded observers using five-point Likert scales. Quantitative image quality parameters peaked at 40-keV VMI+ (SNR, 15.77±7.74; CNR, 18.27±8.04) with significant differences compared to standard linearly blended M_0.6 (SNR, 7.96±3.26; CNR, 13.55±3.47) and all traditional VMI series (p<0.001). Qualitative image quality assessment revealed significantly superior ratings for image quality at 60-keV VMI+ (median, 5) in comparison with all other image series (p<0.001). Assessment of lesion delineation showed the highest rating scores for 40-keV VMI+ series (median, 5), while lowest subjective image noise was found for 100-keV VMI+ reconstructions (median, 5). Low-keV VMI+ reconstructions led to improved image quality and lesion delineation of malignant lymphoma lesions compared to standard image reconstruction and traditional VMI at abdominal DECT examinations. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Evaluation of pharmacy information system in teaching, private and social services Hospitals in 2011.

PubMed

Saghaeiannejad-Isfahani, Sakineh; Mirzaeian, Razieh; Jannesari, Hasan; Ehteshami, Asghar; Feizi, Awat; Raeisi, Ahmadreza

2014-01-01

Supporting a therapeutic approach and medication therapy management, the pharmacy information system (PIS) acts as one of the pillars of hospital information system. This ensures that medication therapy is being supported with an optimal level of safety and quality similar to other treatments and services. The present study is an applied, cross-sectional study conducted on the PIS in use in selected hospitals. The research population included all users of PIS. The research sample is the same as the research population. The data collection instrument was the self-designed checklist developed from the guidelines of the American Society of Health System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and PIS users and pharmacists. The findings of this study were revealed that regarding the degree of meeting the standards given in the guidelines issued by the Society of Pharmacists, the highest rank in observing input standards belonged to Social Services hospitals with a mean score of 32.75. Although teaching hospitals gained the highest score both in process standards with a mean score of 29.15 and output standards with a mean score of 43.95, the private hospitals had the lowest mean score of 23.32, 17.78, 24.25 in input, process and output standards, respectively. Based on the findings, it can be claimed that the studied hospitals had a minimal compliance with the input, output and processing standards related to the PIS.

Effects of different soil remediation methods on inhibition of lead absorption and growth and quality of Dianthus superbus L.

PubMed

Yang, Xiaoyu; Ma, Siyue; Li, Jianheng

2017-12-01

Heavy metal pollution in soil poses a serious threat to the growth of plants used in traditional Chinese medicine. Therefore, a pot experiment was conducted to study the effects of various soil remediation methods on the performance of Herba Dianthi (Dianthus superbus L.) grown on Pb-contaminated soil. The results show that inoculation of Herba Dianthi with arbuscular mycorrhizal fungi (AMF) led to a significant reduction in Pb uptake (P< 0.05), and increased root development and root-to-shoot ratio compared to untreated control plants, along with the highest content of active components. When planting with Trifolium repens, the reduction effect of Pb absorption was insignificant. Herba Dianthi showed improved growth and active ingredients, and the lowest Pb content, with AMF inoculation. The addition of EDTA decreased the growth of Herba Dianthi, but promoted the absorption of Pb. The inhibition of tumor cells was highest in E2. In conclusion, inoculation with AMF can ensure that plant lead content meets testing standards, helping to improve the quality of medicinal herbs.

Effects of AEC chamber selection on patient dose and image quality.

PubMed

Hawking, Nancy; Elmore, Angie

2009-01-01

To determine whether manipulation of the standard automatic exposure control (AEC) chamber selections reduces the patient's entrance skin exposure (ESE) without compromising image quality. Data for density and radiation dose were gathered at 2 clinical locations by exposing abdomen and pelvis phantoms to radiation using 3 AEC chamber selection configurations. ESE (skin dose) was measured using a multipurpose dosimeter. The experiment included both film-screen and computed radiography (CR) systems. For both phantoms, using the 2 outside chambers resulted in the lowest dose on the film-screen and CR systems. In general, optical density (OD) and exposure indicator (EI) remained within acceptable ranges and image quality was maintained using this chamber configuration. Using only the center chamber resulted in the highest dose increases and lowest image quality for film-screen and CR systems. When performing anteroposterior (AP) abdomen and AP pelvis examinations, radiographers can reduce patients' ESE and maintain image quality by selecting the 2 outside AEC chambers. Further research on AEC chamber selection should be conducted for additional anatomical regions.

George M. Low Trophy: NASA's quality and excellence award

NASA Technical Reports Server (NTRS)

1991-01-01

NASA's major goal is the preservation of America's position as a leader in the aerospace industry. To maintain that status, it is crucial that the products and services we depend upon from NASA contractors, subcontractors, and suppliers meet the highest quality standards to ensure the space program's success. The George M. Low Trophy: NASA's Quality and Excellence Award is the result of NASA's desire to encourage continuous improvement and Total Quality Management (TQM) in the aerospace industry and is awarded to members of NASA's contractor community that have demonstrated sustained excellence, customer orientation, and outstanding achievements in a Total Quality Management (TQM) environment. The purpose in presenting this award is to increase public awareness of the importance of quality and productivity to the nation's aerospace industry and the nation's leadership position overall; encourage domestic business to continuously pursue efforts that enhance quality and increase productivity which will strengthen the nation's competitiveness in the international arena; and provide a forum for sharing the successful techniques and strategies used by applicants with other American organizations. Awards to Rockwell International and Marotta Scientific Controls, Inc. are announced and discussed.

Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care

PubMed Central

Klemenc-Ketis, Zalika; Deilkås, Ellen Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2017-01-01

Purpose To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV). Results The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9±15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4±0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8±0.9). Conclusion Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided. PMID:29184416

Correlates of sleep quality in midlife and beyond: a machine learning analysis.

PubMed

Kaplan, Katherine A; Hardas, Prajesh P; Redline, Susan; Zeitzer, Jamie M

2017-06-01

In older adults, traditional metrics derived from polysomnography (PSG) are not well correlated with subjective sleep quality. Little is known about whether the association between PSG and subjective sleep quality changes with age, or whether quantitative electroencephalography (qEEG) is associated with sleep quality. Therefore, we examined the relationship between subjective sleep quality and objective sleep characteristics (standard PSG and qEEG) across middle to older adulthood. Using cross-sectional analyses of 3173 community-dwelling men and women aged between 39 and 90 participating in the Sleep Heart Health Study, we examined the relationship between a morning rating of the prior night's sleep quality (sleep depth and restfulness) and polysomnographic, and qEEG descriptors of that single night of sleep, along with clinical and demographic measures. Multivariable models were constructed using two machine learning methods, namely lasso penalized regressions and random forests. Little variance was explained across models. Greater objective sleep efficiency, reduced wake after sleep onset, and fewer sleep-to-wake stage transitions were each associated with higher sleep quality; qEEG variables contributed little explanatory power. The oldest adults reported the highest sleep quality even as objective sleep deteriorated such that they would rate their sleep better, given the same level of sleep efficiency. Despite this, there were no major differences in the predictors of subjective sleep across the age span. Standard metrics derived from PSG, including qEEG, contribute little to explaining subjective sleep quality in middle-aged to older adults. The objective correlates of subjective sleep quality do not appear to systematically change with age despite a change in the relationship between subjective sleep quality and objective sleep efficiency. Published by Elsevier B.V.

Dual-Energy Computed Tomography Angiography of the Lower Extremity Runoff: Impact of Noise-Optimized Virtual Monochromatic Imaging on Image Quality and Diagnostic Accuracy.

PubMed

Wichmann, Julian L; Gillott, Matthew R; De Cecco, Carlo N; Mangold, Stefanie; Varga-Szemes, Akos; Yamada, Ricardo; Otani, Katharina; Canstein, Christian; Fuller, Stephen R; Vogl, Thomas J; Todoran, Thomas M; Schoepf, U Joseph

2016-02-01

The aim of this study was to evaluate the impact of a noise-optimized virtual monochromatic imaging algorithm (VMI+) on image quality and diagnostic accuracy at dual-energy computed tomography angiography (CTA) of the lower extremity runoff. This retrospective Health Insurance Portability and Accountability Act-compliant study was approved by the local institutional review board. We evaluated dual-energy CTA studies of the lower extremity runoff in 48 patients (16 women; mean age, 63.3 ± 13.8 years) performed on a third-generation dual-source CT system. Images were reconstructed with standard linear blending (F_0.5), VMI+, and traditional monochromatic (VMI) algorithms at 40 to 120 keV in 10-keV intervals. Vascular attenuation and image noise in 18 artery segments were measured; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Five-point scales were used to subjectively evaluate vascular attenuation and image noise. In a subgroup of 21 patients who underwent additional invasive catheter angiography, diagnostic accuracy for the detection of significant stenosis (≥50% lumen restriction) of F_0.5, 50-keV VMI+, and 60-keV VMI data sets were assessed. Objective image quality metrics were highest in the 40- and 50-keV VMI+ series (SNR: 20.2 ± 10.7 and 19.0 ± 9.5, respectively; CNR: 18.5 ± 10.3 and 16.8 ± 9.1, respectively) and were significantly (all P < 0.001) higher than in the corresponding VMI data sets (SNR: 8.7 ± 4.1 and 10.8 ± 5.0; CNR: 8.0 ± 4.0 and 9.6 ± 4.9) and F_0.5 series (SNR: 10.7 ± 4.4; CNR: 8.3 ± 4.1). Subjective assessment of attenuation was highest in the 40- and 50-keV VMI and VMI+ image series (range, 4.84-4.91), superior to F_0.5 (4.07; P < 0.001). Corresponding subjective noise assessment was superior for 50-keV VMI+ (4.71; all P < 0.001) compared with VMI (2.60) and F_0.5 (4.11). Sensitivity and specificity for detection of 50% or greater stenoses were highest in VMI+ reconstructions (92% and 95%, respectively), significantly higher compared with standard F_0.5 (87% and 90%; both P ≤ 0.02). Image reconstruction using low-kiloelectron volt VMI+ improves image quality and diagnostic accuracy compared with traditional VMI technique and standard linear blending for evaluation of the lower extremity runoff using dual-energy CTA.

Groundwater quality in the Lake Champlain Basin, New York, 2009

USGS Publications Warehouse

Nystrom, Elizabeth A.

2011-01-01

Water was sampled from 20 production and domestic wells from August through November 2009 to characterize groundwater quality in the Lake Champlain Basin in New York. Of the 20 wells sampled, 8 were completed in sand and gravel, and 12 were completed in bedrock. The samples were collected and processed by standard U.S. Geological Survey procedures and were analyzed for 147 physiochemical properties and constituents, including major ions, nutrients, trace elements, pesticides, volatile organic compounds (VOCs), radionuclides, and indicator bacteria. Water quality in the study area is generally good, but concentrations of some constituents equaled or exceeded current or proposed Federal or New York State drinking-water standards; these were color (1 sample), pH (3 samples), sodium (3 samples), total dissolved solids (4 samples), iron (4 samples), manganese (3 samples), gross alpha radioactivity (1 sample), radon-222 (10 samples), and bacteria (5 samples). The pH of all samples was typically neutral or slightly basic (median 7.1); the median water temperature was 9.7°C. The ions with the highest median concentrations were bicarbonate [median 158 milligrams per liter (mg/L)] and calcium (median 45.5 mg/L). Groundwater in the study area is soft to very hard, but more samples were hard or very hard (121 mg/L or more as CaCO3) than were moderately hard or soft (120 mg/L or less as CaCO3); the median hardness was 180 mg/L as CaCO3. The maximum concentration of nitrate plus nitrite was 3.79 mg/L as nitrogen, which did not exceed established drinking-water standards for nitrate plus nitrite (10 mg/L as nitrogen). The trace elements with the highest median concentrations were strontium (median 202 micrograms per liter [μg/L]), and iron (median 55 μg/L in unfiltered water). Six pesticides and pesticide degradates, including atrazine, fipronil, disulfoton, prometon, and two pesticide degradates, CIAT and desulfinylfipronil, were detected among five samples at concentrations of 0.02 μg/L or less; they included herbicides, herbicide degradates, insecticides, and insecticide degradates. Six VOCs were detected among six samples; these included a solvent, the gasoline additive methyl tert-butyl ether (MTBE), and four trihalomethanes. The highest radon-222 activities were in samples from crystalline bedrock wells (maximum 4,100 picocuries per liter [pCi/L]); half of all samples exceeded a proposed U.S. Environmental Protection Agency (USEPA) drinking-water standard of 300 pCi/L. Total coliform bacteria were detected in five samples, fecal coliform bacteria were detected in one sample, and Escherichia coli (E. coli) were not detected in any sample.

Discrimination of synthesized English vowels by American and Korean listeners

NASA Astrophysics Data System (ADS)

Yang, Byunggon

2004-05-01

This study explored the discrimination of synthesized English vowel pairs by 27 American and Korean, male and female listeners. The average formant values of nine monophthongs produced by ten American English male speakers were employed to synthesize the vowels. Then, subjects were instructed explicitly to respond to AX discrimination tasks in which the standard vowel was followed by another one with the increment or decrement of the original formant values. The highest and lowest formant values of the same vowel quality were collected and compared to examine patterns of vowel discrimination. Results showed that the American and Korean groups discriminated the vowel pairs almost identically and their center formant frequency values of the high and low boundary fell almost exactly on those of the standards. In addition, the acceptable range of the same vowel quality was similar among the language and gender groups. The acceptable thresholds of each vowel formed an oval to maintain perceptual contrast from adjacent vowels. Pedagogical implications of those findings are discussed.

The agreement between 3D, standard 2D and triplane 2D speckle tracking: effects of image quality and 3D volume rate.

PubMed

Trache, Tudor; Stöbe, Stephan; Tarr, Adrienn; Pfeiffer, Dietrich; Hagendorff, Andreas

2014-12-01

Comparison of 3D and 2D speckle tracking performed on standard 2D and triplane 2D datasets of normal and pathological left ventricular (LV) wall-motion patterns with a focus on the effect that 3D volume rate (3DVR), image quality and tracking artifacts have on the agreement between 2D and 3D speckle tracking. 37 patients with normal LV function and 18 patients with ischaemic wall-motion abnormalities underwent 2D and 3D echocardiography, followed by offline speckle tracking measurements. The values of 3D global, regional and segmental strain were compared with the standard 2D and triplane 2D strain values. Correlation analysis with the LV ejection fraction (LVEF) was also performed. The 3D and 2D global strain values correlated good in both normally and abnormally contracting hearts, though systematic differences between the two methods were observed. Of the 3D strain parameters, the area strain showed the best correlation with the LVEF. The numerical agreement of 3D and 2D analyses varied significantly with the volume rate and image quality of the 3D datasets. The highest correlation between 2D and 3D peak systolic strain values was found between 3D area and standard 2D longitudinal strain. Regional wall-motion abnormalities were similarly detected by 2D and 3D speckle tracking. 2DST of triplane datasets showed similar results to those of conventional 2D datasets. 2D and 3D speckle tracking similarly detect normal and pathological wall-motion patterns. Limited image quality has a significant impact on the agreement between 3D and 2D numerical strain values.

Water-quality characteristics of urban storm runoff at selected sites in East Baton Rouge Parish, Louisiana, February 2006 through November 2009

USGS Publications Warehouse

Frederick, C. Paul

2011-01-01

Water samples were collected at three watersheds in East Baton Rouge Parish, Louisiana, during February 2006 through November 2009 for continued evaluation of urban storm runoff. The watersheds represented land uses characterized predominantly as established commercial, industrial, and residential. The following water-quality data are reported: physical and chemical-related properties, fecal coliform, nutrients, trace elements, and organic compounds. Results of water-quality analyses enabled calculation of event-mean concentrations and estimated annual contaminant loads and yields of storm runoff from nonpoint sources for 12 water-quality properties and constituents. Lead met or exceeded the U.S. Environmental Protection Agency Maximum Contaminant Level of 15 micrograms per liter for drinking water standards in 4 of 14 samples. Low level concentrations of mercury were detected in all 14 samples, and half were two to four times above the reporting limit of 0.02 micrograms per liter. The average dissolved phosphorus concentrations from each land use were two to four times the U.S. Environmental Protection Agency criterion of 0.05 milligrams per liter. Diazinon was detected in one sample at a concentration of 0.2 micrograms per liter. In the residential watershed, the largest at 216 acres, contaminant loads for 5 of the 12 water-quality properties and constituents were highest, with 4 of these being nutrients. The industrial watershed, 97 acres, had the highest contaminant loads for 6 of the 12 water-quality properties and constituents with 3 of these being metals, which is indicative of the type of land use. Zinc had the highest metal load (155 pounds per year) in the industrial watershed, compared to 36 pounds per year in the residential watershed, and 32 pounds per year in the established commercial watershed. The industrial watershed had the highest yields for 8 of the 12 water-quality properties and constituents, whereas the established commercial watershed had the lowest yield for 5 of the 12. Lower yields from the established commercial and residential watersheds could be from Best Management Practices in place that help control increased runoff from impervious areas and land development. Metal yields from all the watersheds were less than 1 pound per acre per year, except for the zinc from the industrial watershed, which was 2 pounds per acre per year. Nutrient yields in the established commercial watershed were lowest for total nitrogen, ammonia plus organic nitrogen (Kjeldahl nitrogen), and dissolved phosphorus.

The Technical Quality of Delivered Care for People with Inflammatory Bowel Disease in Tabriz Gastroenterology Clinics.

PubMed

Tabrizi, Jafar Sadegh; Somi, Mohammad Hossein; Asghari, Sima; Asghari Jafarabadi, Mohammad; Gharibi, Farid; Alidoost, Saeideh

2015-01-01

The Inflammatory Bowel Disease (IBD) is considered as one of the chronic diseasesre-quiring complicated treatment. This study aimed to assess technical quality of providing care for pa-tients with IBD. This cross-sectional study was conducted on 94 people with IBD using interviews and simple random sampling methods in Gastroenterology, Endoscopy and clinic of Imam Reza Hospital and Golgasht Clinic in Tabriz in 2012. The data collection tool was a researcher-designed questionnaire whose validity and reliability had been confirmed. In order to investigate the statistical relationship between the background variables and compliance with the standards the Chi-square test was applied using SPSS 17 Software. "visit by the physician" and "diet advice by the dietitian" have had the highest and the lowest levels of compliance with the standard respectively, and "the care related to the disease exacerbation" and "the care provided by the other physicians" were not compatible with the standards in 80% of the cases. Data analyses also showed that there was a significant relationship between participant's age, job, education and the smoking status and compliance of some care with the relevant standards (P<0.05). The results indicate a substantial gap between provided care for the people with IBD and the relevant standards. This indicates the areas that need of improvement and requires the serious attention of the authorities.

Groundwater quality in the Lower Hudson River Basin, New York, 2008

USGS Publications Warehouse

Nystrom, Elizabeth A.

2010-01-01

Water samples were collected from 32 production and domestic wells in the study area from August through November 2008 to characterize the groundwater quality. The study area, which covers 5,607 square miles, encompasses the part of the Lower Hudson River Basin that lies within New York plus the parts of the Housatonic, Hackensack, Bronx, and Saugatuck River Basins that are in New York. The study area is underlain by mainly clastic bedrock, predominantly shale, with carbonate and crystalline rock present locally. The bedrock is generally overlain by till, but surficial deposits of saturated sand and gravel are present in some areas. Of the 32 wells sampled, 16 were finished in sand and gravel deposits and 16 were finished in bedrock. The samples were collected and processed by standard U.S. Geological Survey procedures and were analyzed for 225 physiochemical properties and constituents, including major ions, nutrients, trace elements, radon-222, pesticides, and volatile organic compounds (VOCs); indicator bacteria were collected and analyzed by New York State Department of Health procedures. Water quality in the study area is generally good, but concentrations of some constituents exceeded current or proposed Federal or New York State primary or secondary drinking-water standards; the standards exceeded were color (2 samples), pH (6 samples), sodium (8 samples), fluoride (1 sample), aluminum (3 samples), arsenic (1 sample), iron (7 samples), manganese (14 samples), radon-222 (17 samples), tetrachloroethene (1 sample), and bacteria (7 samples). The pH of all samples was typically neutral or slightly basic (median 7.2); the median water temperature was 11.8 degrees C. The ions with the highest concentrations were bicarbonate [median 167 milligrams per liter (mg/L)] and calcium (median 38.2 mg/L). Groundwater in the study area ranged from very soft to very hard, but more samples were classified as very hard (181 mg/L as CaCO3 or more) than soft (60 mg/L as CaCO3 or less); the median hardness was 140 mg/L as CaCO3. The maximum concentration of nitrate plus nitrite was 2.38 mg/L as nitrogen, which did not exceed established drinking-water standards for nitrate plus nitrite (10 mg/L as nitrogen). The trace elements with the highest concentrations were strontium [median 189 micrograms per liter ((u or mu)g/L)] and barium (median 50.6 (u or mu)g/L). The highest radon-222 activities were in samples from crystalline bedrock wells [maximum 13,800 picocuries per liter (pCi/L)]. Seventeen samples had radon-222 activities that exceeded a proposed U.S. Environmental Protection Agency (USEPA) drinking-water standard of 300 pCi/L; activities in two samples exceeded a proposed alternative drinking-water standard of 4,000 pCi/L. Ten pesticides and pesticide degradates were detected among 14 samples at concentrations of 0.183 (u or mu)g/L or less; most were herbicides or their degradates. Eight VOCs were detected among six samples; these included solvents, gasoline components, and a trihalomethane. Total coliform bacteria were detected in seven samples; fecal coliform bacteria, including Escherichia coli, were detected in one sample.

Egg production and egg quality in free-range laying hens housed at different outdoor stocking densities.

PubMed

Campbell, D L M; Lee, C; Hinch, G N; Roberts, J R

2017-09-01

Free-range laying hen systems are increasing in number within Australia. Variation in outdoor stocking densities has led to development of a national information standard on free-range egg labeling, including setting a maximum density of 10,000 hens per hectare. However, there are few data on the impacts of differing outdoor densities on production and egg quality. ISA Brown hens in small (150 hens) flocks were housed in identical indoor pens, each with access (from 21 weeks) to different sized ranges simulating one of three outdoor stocking densities (2 replicates each: 2,000 hens/hectare (ha), 10,000 hens/ha, 20,000 hens/ha). Hen-day production was tracked from 21 through 35 weeks with eggs visually graded daily for external deformities. All eggs laid on one day were weighed each week. Eggs were collected from each pen at 25, 30, and 36 weeks and analyzed for egg quality. There were no effects of outdoor stocking density on average hen-day percentage production (P = 0.67), egg weight (P = 0.09), percentages of deformed eggs (P = 0.30), shell reflectivity (P = 0.74), shell breaking strength (P = 0.07), shell deformation (P = 0.83), or shell thickness (P = 0.24). Eggs from hens in the highest density had the highest percentage shell weight (P = 0.004) and eggs from the lowest density had the highest yolk color score (P < 0.001). The amount of cuticle present did not differ between densities (P = 0.95) but some aspects of shell colors (P ≤ 0.01) and location of protoporphyrin IX (P = 0.046) varied. Hen age affected the majority of measurements. Stocking density differences may be related to hen diet as previous radio-frequency identification tracking of individual hens in these flocks showed birds used the range for longer in the lowest density and the least in the highest density, including depleting the range of vegetation sooner in the smaller ranges. An additional study assessing the relationship between individual hen range use, nutrition, and egg quality is warranted. © 2017 Poultry Science Association Inc.

Impact of effluents from a car battery manufacturing plant in Nigeria on water, soil, and food qualities.

PubMed

Orisakwe, Orish Ebere; Asomugha, Rose; Afonne, Onyenmechi Johnson; Anisi, C N; Obi, Ejeatuluchukwualo; Dioka, Chudi Emma

2004-01-01

The authors investigated the impact of effluents from a car battery manufacturing plant in Nnewi, Nigeria, on water, soil, and food qualities. The authors analyzed heavy metals mercury, arsenic, lead, cadmium and nickel in tap and cassava waters, soil, dried cassava tuber, and edible fruit samples from the company, using an atomic absorption spectrophotometer. Other parameters the authors analyzed include pH, electrical conductivity (EC), salinity (SAL), total hardness (TH), biological oxygen demand (BOD), volatile and non-volatile solids, and bacterial and fungal loads of the soil samples. Results show that lead had the highest concentration in all the samples, with the soil samples having the highest lead concentration (38-12 ppm, 102 ppm) and the water samples having the lowest (0.02-0.20 ppm). Mercury had the lowest concentration (<0.0002 ppm) in all the samples. Soil sample B had the highest concentration of all the metals tested. Cassava water had higher levels of EC, SAL, TH, BOD, and volatile and nonvolatile solids, but lower pH than tap water. Bacterial loads were higher than fungal loads in all the soil samples. Because there was moderate contamination of the environment by some of the metals studied, with lead being exceptionally high and above the specified international standards, the authors recommend control measures to reduce lead exposure to the local populace within and around this industry.

Assessment of groundwater quality at a MSW landfill site using standard and AHP based water quality index: a case study from Ranchi, Jharkhand, India.

PubMed

Chakraborty, Shubhrasekhar; Kumar, R Naresh

2016-06-01

Landfill leachate generated from open MSW dumpsite can cause groundwater contamination. The impact of open dumping of MSW on the groundwater of adjacent area was studied. To assess the spatial and temporal variations in groundwater quality, samples were collected around an open MSW dumping site in Ranchi city, Jharkhand, India. Groundwater samples were analysed for various physicochemical and bacteriological parameters for 1 year. Results indicated that the groundwater is getting contaminated due to vertical and horizontal migration of landfill leachate. Extent of contamination was higher in areas closer to the landfill as indicated by high alkalinity, total dissolved solids and ammonia concentration. Metals such as lead, iron, and manganese were present at concentrations of 0.097, 0.97 and 0.36 mg/L, respectively exceeding the Bureau of Indian Standards (BIS) 10,500 for drinking water. Enterobacteriaceae were also detected in several groundwater samples and highest coliform count of 2.1×10(4) CFU/mL was recorded from a dug well. In order to determine the overall groundwater quality, water quality index (WQI) was calculated using weighted arithmetic index method and this index was further modified by coupling with the analytical hierarchy process (AHP) to get specific information. WQI values indicated that the overall groundwater quality of the region came under "poor" category while zone wise classification indicated the extent of impact of landfill leachate on groundwater.

Development of the Korean framework for senior-friendly hospitals: a Delphi study.

PubMed

Kim, Yoon-Sook; Han, Seol-Heui; Hwang, Jeong-Hae; Park, Jae-Min; Lee, Jongmin; Choi, Jaekyung; Moon, Yeonsil; Kim, Hee Joung; Shin, Grace Jung Eun; Lee, Ji-Sun; Choi, Ye Ji; Uhm, Kyeong Eun; Kim, In Ae; Nam, Ji-Won

2017-08-04

Aging is an inevitable part of life. One can maintain well-being and wellness even after discharge and/or transition if his or her functional decline is minimized, sudden decline is prevented, and functioning is promoted during hospitalization. Caring appropriately for elderly patients requires the systematic application of Senior-Friendly Hospital principles to all operating systems, including medical centres' organization and environment, as well as patient treatment processes. The Senior-Friendly Hospital framework is valid and important for patient safety and quality improvement. This study aimed to make recommendations regarding the development of the Korean Framework for Senior-Friendly Hospitals for older patients' care management, patient safety interventions, and health promotion, via a Delphi survey. Two rounds of Delphi surveying were conducted with 15 participants who had at least 3 years' experience in accreditation surveying and medical accreditation standards, survey methods, and accreditation investigator education. In each round, we calculated statistics describing each standard's validity and feasibility. The Korean Framework for Senior-Friendly Hospitals included 4 Chapters, 11 categories, and 67 standards through consensus of the Senior-Friendly Hospitals task force and experts' peer review. After the two rounds of Delphi surveying, validity evaluation led to no changes in standards of the Senior-Friendly Hospitals; however, the number of standards showing adequate validity decreased from 67 to 58. Regarding feasibility, no changes were necessary in the standards; however, the number of categories showing adequate feasibility decreased from 11 to 8 and from 67 to 30, respectively. The excluded categories were 3.2, 4.2, and 4.3 (service, transportation, and signage and identification). The highest feasibility values were given to standards 2.1.1, 4.1.4, and 4.1.6. The highest feasibility score was given to standard 2.4.2. The Korean Framework for Senior-Friendly Hospitals needs to include 4 Chapters, 8 categories, and 30 standards. The Accreditation Program for Healthcare Organizations should include Senior-Friendly Hospitals -relevant standards considering Korea's medical environment.

Bioreactor expansion of human mesenchymal stem cells according to GMP requirements.

PubMed

Elseberg, Christiane L; Salzig, Denise; Czermak, Peter

2015-01-01

In cell therapy, the use of autologous and allogenic human mesenchymal stem cells is rising. Accordingly, the supply of cells for clinical applications in highest quality is required. As hMSCs are considered as an advanced therapy medicinal products (ATMP), they underlie the requirements of GMP and PAT according to the authorities (FDA and EMA). The production process of these cells must therefore be documented according to GMP, which is usually performed via a GMP protocol based on standard operating procedures. This chapter provides an example of such a GMP protocol for hMSC, here a genetically modified allogenic cell line, based on a production process in a microcarrier-based stirred tank reactor including process monitoring according to PAT and final product quality assurance.

Nuchal translucency and first trimester risk assessment: a systematic review.

PubMed

Sheppard, Celeste; Platt, Lawrence D

2007-06-01

First-trimester risk assessment for fetal aneuploidy using nuchal translucency (NT) measurement is rapidly gaining popularity in the United States. In combination with maternal serum markers in the first trimester, the screening performance is exceptionally good, with detection rates of more than 80% at a screen positive rate of 5%. Recently, the method has been validated for screening for Down syndrome and other aneuploidies in multicenter trials in the United States and elsewhere. Compliance with established criteria for measurement of the NT is essential to achieve uniform reliability and high screening test sensitivity. There is an international consensus about the importance of specific training in the NT examination, conformity to standards of NT measurement, and regular audit for quality assurance. In the United States, the Nuchal Translucency Quality Review program has been developed to administer credentialing and quality review for registered practitioners. The Nuchal Translucency Quality Review credentials signify the proficiency of the sonographer or sonologist in NT measurement and participation in a regular quality assurance audit. We encourage accreditation of clinical sites offering first-trimester risk assessment to ensure the highest quality care.

The design and content of orthodontic practise websites in the UK is suboptimal and does not correlate with search ranking.

PubMed

Patel, Annika; Cobourne, Martyn T

2015-08-01

This study investigated standards of ethical advertising; design and content; and information quality associated with UK dental practice websites offering orthodontic treatment. The World Wide Web was searched from a UK-based computer using the Google search engine combined with the term 'orthodontic braces'. The first 100 UK-based dental practice websites were pooled and saved following duplicate removal. Websites were evaluated for compliance with current General Dental Council ethical advertising guidelines; accessibility, usability, and reliability using the LIDA instrument (a validated outcome tool for healthcare website design and content evaluation); and quality of information using the DISCERN toolkit (a validated method of quality assessment for online written patient information). Nine per cent of websites demonstrated full compliance with current guidelines on ethical advertising. Mean total LIDA score was 110/144 (76%) [range: 51-135; 35-94%]. Eleven websites reached a gold standard of 90% or more for total LIDA score. Mean total DISCERN score was 48/75 (64%) [range: 19-73; 25-97%]. Five websites achieved a total DISCERN score above 90%. Spearman's rank correlation coefficients demonstrated no significant correlations between LIDA (0.1669; P = 0.4252, confidence interval [CI]: -0.2560 to 0.5362) or DISCERN (0.3572; P = 0.0796, CI: -0.0565 to 0.663) score and ranking amongst the 25 highest ranked websites. Most UK websites offering orthodontic services are not fully compliant with national guidelines relating to ethical advertising. Validated measures of website design (LIDA) and information quality (DISCERN) showed wide variation amongst sites. No correlation existed between ranking amongst the highest 25 sites and either of these measures. This investigation was limited to a subsample of UK-only websites; and whilst not representative of European-wide sites, it does suggest that in the UK at least website quality can be improved. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review.

PubMed

Carney, Patricia A; Palmer, Ryan T; Fuqua Miller, Marissa; Thayer, Erin K; Estroff, Sue E; Litzelman, Debra K; Biagioli, Frances E; Teal, Cayla R; Lambros, Ann; Hatt, William J; Satterfield, Jason M

2016-05-01

Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development.

Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review

PubMed Central

Carney, Patricia A.; Palmer, Ryan T.; Miller, Marissa Fuqua; Thayer, Erin K.; Estroff, Sue E.; Litzelman, Debra K.; Biagioli, Frances E.; Teal, Cayla R.; Lambros, Ann; Hatt, William J.; Satterfield, Jason M.

2015-01-01

Purpose Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. Method The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final, included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. Results Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. Conclusions These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development. PMID:26796091

Rural drinking water at supply and household levels: quality and management.

PubMed

Hoque, Bilqis A; Hallman, Kelly; Levy, Jason; Bouis, Howarth; Ali, Nahid; Khan, Feroze; Khanam, Sufia; Kabir, Mamun; Hossain, Sanower; Shah Alam, Mohammad

2006-09-01

Access to safe drinking water has been an important national goal in Bangladesh and other developing countries. While Bangladesh has almost achieved accepted bacteriological drinking water standards for water supply, high rates of diarrheal disease morbidity indicate that pathogen transmission continues through water supply chain (and other modes). This paper investigates the association between water quality and selected management practices by users at both the supply and household levels in rural Bangladesh. Two hundred and seventy tube-well water samples and 300 water samples from household storage containers were tested for fecal coliform (FC) concentrations over three surveys (during different seasons). The tube-well water samples were tested for arsenic concentration during the first survey. Overall, the FC was low (the median value ranged from 0 to 4 cfu/100ml) in water at the supply point (tube-well water samples) but significantly higher in water samples stored in households. At the supply point, 61% of tube-well water samples met the Bangladesh and WHO standards of FC; however, only 37% of stored water samples met the standards during the first survey. When arsenic contamination was also taken into account, only 52% of the samples met both the minimum microbiological and arsenic content standards of safety. The contamination rate for water samples from covered household storage containers was significantly lower than that of uncovered containers. The rate of water contamination in storage containers was highest during the February-May period. It is shown that safe drinking water was achieved by a combination of a protected and high quality source at the initial point and maintaining quality from the initial supply (source) point through to final consumption. It is recommended that the government and other relevant actors in Bangladesh establish a comprehensive drinking water system that integrates water supply, quality, handling and related educational programs in order to ensure the safety of drinking water supplies.

Influence of reconstruction algorithms on image quality in SPECT myocardial perfusion imaging.

PubMed

Davidsson, Anette; Olsson, Eva; Engvall, Jan; Gustafsson, Agnetha

2017-11-01

We investigated if image- and diagnostic quality in SPECT MPI could be maintained despite a reduced acquisition time adding Depth Dependent Resolution Recovery (DDRR) for image reconstruction. Images were compared with filtered back projection (FBP) and iterative reconstruction using Ordered Subsets Expectation Maximization with (IRAC) and without (IRNC) attenuation correction (AC). Stress- and rest imaging for 15 min was performed on 21 subjects with a dual head gamma camera (Infinia Hawkeye; GE Healthcare), ECG-gating with 8 frames/cardiac cycle and a low-dose CT-scan. A 9 min acquisition was generated using five instead of eight gated frames and was reconstructed with DDRR, with (IRACRR) and without AC (IRNCRR) as well as with FBP. Three experienced nuclear medicine specialists visually assessed anonymized images according to eight criteria on a four point scale, three related to image quality and five to diagnostic confidence. Statistical analysis was performed using Visual Grading Regression (VGR). Observer confidence in statements on image quality was highest for the images that were reconstructed using DDRR (P<0·01 compared to FBP). Iterative reconstruction without DDRR was not superior to FBP. Interobserver variability was significant for statements on image quality (P<0·05) but lower in the diagnostic statements on ischemia and scar. The confidence in assessing ischemia and scar was not different between the reconstruction techniques (P = n.s.). SPECT MPI collected in 9 min, reconstructed with DDRR and AC, produced better image quality than the standard procedure. The observers expressed the highest diagnostic confidence in the DDRR reconstruction. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Antero-posterior (AP) pelvis x-ray imaging on a trolley: Impact of trolley design, mattress design and radiographer practice on image quality and radiation dose.

PubMed

Tugwell, J R; England, A; Hogg, P

2017-08-01

Physical and technical differences exist between imaging on an x-ray tabletop and imaging on a trolley. This study evaluates how trolley imaging impacts image quality and radiation dose for an antero-posterior (AP) pelvis projection whilst subsequently exploring means of optimising this imaging examination. An anthropomorphic pelvis phantom was imaged on a commercially available trolley under various conditions. Variables explored included two mattresses, two image receptor holder positions, three source to image distances (SIDs) and four mAs values. Image quality was evaluated using relative visual grading analysis with the reference image acquired on the x-ray tabletop. Contrast to noise ratio (CNR) was calculated. Effective dose was established using Monte Carlo simulation. Optimisation scores were derived as a figure of merit by dividing effective dose with visual image quality scores. Visual image quality reduced significantly (p < 0.05) whilst effective dose increased significantly (p < 0.05) for images acquired on the trolley using identical acquisition parameters to the reference image. The trolley image with the highest optimisation score was acquired using 130 cm SID, 20 mAs, the standard mattress and platform not elevated. A difference of 12.8 mm was found between the image with the lowest and highest magnification factor (18%). The acquisition parameters used for AP pelvis on the x-ray tabletop are not transferable to trolley imaging and should be modified accordingly to compensate for the differences that exist. Exposure charts should be developed for trolley imaging to ensure optimal image quality at lowest possible dose. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Improved Image Quality in Head and Neck CT Using a 3D Iterative Approach to Reduce Metal Artifact.

PubMed

Wuest, W; May, M S; Brand, M; Bayerl, N; Krauss, A; Uder, M; Lell, M

2015-10-01

Metal artifacts from dental fillings and other devices degrade image quality and may compromise the detection and evaluation of lesions in the oral cavity and oropharynx by CT. The aim of this study was to evaluate the effect of iterative metal artifact reduction on CT of the oral cavity and oropharynx. Data from 50 consecutive patients with metal artifacts from dental hardware were reconstructed with standard filtered back-projection, linear interpolation metal artifact reduction (LIMAR), and iterative metal artifact reduction. The image quality of sections that contained metal was analyzed for the severity of artifacts and diagnostic value. A total of 455 sections (mean ± standard deviation, 9.1 ± 4.1 sections per patient) contained metal and were evaluated with each reconstruction method. Sections without metal were not affected by the algorithms and demonstrated image quality identical to each other. Of these sections, 38% were considered nondiagnostic with filtered back-projection, 31% with LIMAR, and only 7% with iterative metal artifact reduction. Thirty-three percent of the sections had poor image quality with filtered back-projection, 46% with LIMAR, and 10% with iterative metal artifact reduction. Thirteen percent of the sections with filtered back-projection, 17% with LIMAR, and 22% with iterative metal artifact reduction were of moderate image quality, 16% of the sections with filtered back-projection, 5% with LIMAR, and 30% with iterative metal artifact reduction were of good image quality, and 1% of the sections with LIMAR and 31% with iterative metal artifact reduction were of excellent image quality. Iterative metal artifact reduction yields the highest image quality in comparison with filtered back-projection and linear interpolation metal artifact reduction in patients with metal hardware in the head and neck area. © 2015 by American Journal of Neuroradiology.

Categorical Indicator Kriging for assessing the risk of groundwater nitrate pollution: the case of Vega de Granada aquifer (SE Spain).

PubMed

Chica-Olmo, Mario; Luque-Espinar, Juan Antonio; Rodriguez-Galiano, Victor; Pardo-Igúzquiza, Eulogio; Chica-Rivas, Lucía

2014-02-01

Groundwater nitrate pollution associated with agricultural activity is an important environmental problem in the management of this natural resource, as acknowledged by the European Water Framework Directive. Therefore, specific measures aimed to control the risk of water pollution by nitrates must be implemented to minimise its impact on the environment and potential risk to human health. The spatial probability distribution of nitrate contents exceeding a threshold or limit value, established within the quality standard, will be helpful to managers and decision-makers. A methodology based on non-parametric and non-linear methods of Indicator Kriging was used in the elaboration of a nitrate pollution categorical map for the aquifer of Vega de Granada (SE Spain). The map has been obtained from the local estimation of the probability that a nitrate content in an unsampled location belongs to one of the three categories established by the European Water Framework Directive: CL. 1 good quality [Min - 37.5 ppm], CL. 2 intermediate quality [37.5-50 ppm] and CL. 3 poor quality [50 ppm - Max]. The obtained results show that the areas exceeding nitrate concentrations of 50 ppm, poor quality waters, occupy more than 50% of the aquifer area. A great proportion of the area's municipalities are located in these poor quality water areas. The intermediate quality and good quality areas correspond to 21% and 28%, respectively, but with the highest population density. These results are coherent with the experimental data, which show an average nitrate concentration value of 72 ppm, significantly higher than the quality standard limit of 50 ppm. Consequently, the results suggest the importance of planning actions in order to control and monitor aquifer nitrate pollution. © 2013.

Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

PubMed

Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

2015-01-01

Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

Total integrated performance excellence system (TIPES): A true north direction for a clinical trial support center.

PubMed

Sather, Mike R; Parsons, Sherry; Boardman, Kathy D; Warren, Stuart R; Davis-Karim, Anne; Griffin, Kevin; Betterton, Jane A; Jones, Mark S; Johnson, Stanley H; Vertrees, Julia E; Hickey, Jan H; Salazar, Thelma P; Huang, Grant D

2018-03-01

This paper presents the quality journey taken by a Federal organization over more than 20 years. These efforts have resulted in the implementation of a Total Integrated Performance Excellence System (TIPES) that combines key principles and practices of established quality systems. The Center has progressively integrated quality system frameworks including the Malcom Baldrige National Quality Award (MBNQA) Framework and Criteria for Performance Excellence, ISO 9001, and the Organizational Project Management Maturity Model (OPM3), as well as supplemental quality systems of ISO 15378 (packaging for medicinal products) and ISO 21500 (guide to project management) to systematically improve all areas of operations. These frameworks were selected for applicability to Center processes and systems, consistency and reinforcement of complimentary approaches, and international acceptance. External validations include the MBNQA, the highest quality award in the US, continued registration and conformance to ISO standards and guidelines, and multiple VA and state awards. With a focus on a holistic approach to quality involving processes, systems and personnel, this paper presents activities and lessons that were critical to building TIPES and establishing the quality environment for conducting clinical research in support of Veterans and national health care.

DNA Commission of the International Society for Forensic Genetics: revised and extended guidelines for mitochondrial DNA typing.

PubMed

Parson, W; Gusmão, L; Hares, D R; Irwin, J A; Mayr, W R; Morling, N; Pokorak, E; Prinz, M; Salas, A; Schneider, P M; Parsons, T J

2014-11-01

The DNA Commission of the International Society of Forensic Genetics (ISFG) regularly publishes guidelines and recommendations concerning the application of DNA polymorphisms to the question of human identification. Previous recommendations published in 2000 addressed the analysis and interpretation of mitochondrial DNA (mtDNA) in forensic casework. While the foundations set forth in the earlier recommendations still apply, new approaches to the quality control, alignment and nomenclature of mitochondrial sequences, as well as the establishment of mtDNA reference population databases, have been developed. Here, we describe these developments and discuss their application to both mtDNA casework and mtDNA reference population databasing applications. While the generation of mtDNA for forensic casework has always been guided by specific standards, it is now well-established that data of the same quality are required for the mtDNA reference population data used to assess the statistical weight of the evidence. As a result, we introduce guidelines regarding sequence generation, as well as quality control measures based on the known worldwide mtDNA phylogeny, that can be applied to ensure the highest quality population data possible. For both casework and reference population databasing applications, the alignment and nomenclature of haplotypes is revised here and the phylogenetic alignment proffered as acceptable standard. In addition, the interpretation of heteroplasmy in the forensic context is updated, and the utility of alignment-free database searches for unbiased probability estimates is highlighted. Finally, we discuss statistical issues and define minimal standards for mtDNA database searches. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

An approach to optimize sample preparation for MALDI imaging MS of FFPE sections using fractional factorial design of experiments.

PubMed

Oetjen, Janina; Lachmund, Delf; Palmer, Andrew; Alexandrov, Theodore; Becker, Michael; Boskamp, Tobias; Maass, Peter

2016-09-01

A standardized workflow for matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI imaging MS) is a prerequisite for the routine use of this promising technology in clinical applications. We present an approach to develop standard operating procedures for MALDI imaging MS sample preparation of formalin-fixed and paraffin-embedded (FFPE) tissue sections based on a novel quantitative measure of dataset quality. To cover many parts of the complex workflow and simultaneously test several parameters, experiments were planned according to a fractional factorial design of experiments (DoE). The effect of ten different experiment parameters was investigated in two distinct DoE sets, each consisting of eight experiments. FFPE rat brain sections were used as standard material because of low biological variance. The mean peak intensity and a recently proposed spatial complexity measure were calculated for a list of 26 predefined peptides obtained by in silico digestion of five different proteins and served as quality criteria. A five-way analysis of variance (ANOVA) was applied on the final scores to retrieve a ranking of experiment parameters with increasing impact on data variance. Graphical abstract MALDI imaging experiments were planned according to fractional factorial design of experiments for the parameters under study. Selected peptide images were evaluated by the chosen quality metric (structure and intensity for a given peak list), and the calculated values were used as an input for the ANOVA. The parameters with the highest impact on the quality were deduced and SOPs recommended.

Moving the worksite health promotion profession forward: is the time right for requiring standards? A review of the literature.

PubMed

Watkins, Cecilia; English, Gary

2015-01-01

Standards in any profession are adopted to assure that the individuals hired are adequately trained and the programs that they oversee are of the highest quality. Worksite health promotion should be no different from any other field. A review of the research conducted by experts in worksite health promotion is examined, along with an assessment of skills needed to ensure that wellness programs are effective and employees, their families, and even their communities are educated on the ways to best prevent chronic diseases and occupational incidences through healthy and safe behaviors. This article is consistent with Health Promotion Practice's mission and focuses on the exploration of the processes used to plan effective worksite health promotion programs, and it suggests initial discussions on whether these processes should become standards for professionals in the worksite health promotion field. © 2014 Society for Public Health Education.

SU-E-T-421: Failure Mode and Effects Analysis (FMEA) of Xoft Electronic Brachytherapy for the Treatment of Superficial Skin Cancers

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

Hoisak, J; Manger, R; Dragojevic, I

Purpose: To perform a failure mode and effects analysis (FMEA) of the process for treating superficial skin cancers with the Xoft Axxent electronic brachytherapy (eBx) system, given the recent introduction of expanded quality control (QC) initiatives at our institution. Methods: A process map was developed listing all steps in superficial treatments with Xoft eBx, from the initial patient consult to the completion of the treatment course. The process map guided the FMEA to identify the failure modes for each step in the treatment workflow and assign Risk Priority Numbers (RPN), calculated as the product of the failure mode’s probability ofmore » occurrence (O), severity (S) and lack of detectability (D). FMEA was done with and without the inclusion of recent QC initiatives such as increased staffing, physics oversight, standardized source calibration, treatment planning and documentation. The failure modes with the highest RPNs were identified and contrasted before and after introduction of the QC initiatives. Results: Based on the FMEA, the failure modes with the highest RPN were related to source calibration, treatment planning, and patient setup/treatment delivery (Fig. 1). The introduction of additional physics oversight, standardized planning and safety initiatives such as checklists and time-outs reduced the RPNs of these failure modes. High-risk failure modes that could be mitigated with improved hardware and software interlocks were identified. Conclusion: The FMEA analysis identified the steps in the treatment process presenting the highest risk. The introduction of enhanced QC initiatives mitigated the risk of some of these failure modes by decreasing their probability of occurrence and increasing their detectability. This analysis demonstrates the importance of well-designed QC policies, procedures and oversight in a Xoft eBx programme for treatment of superficial skin cancers. Unresolved high risk failure modes highlight the need for non-procedural quality initiatives such as improved planning software and more robust hardware interlock systems.« less

Wine Chemical Composition and Radical Scavenging Activity of Some Cabernet Franc Clones.

PubMed

Popovic-Djordjevic, Jelena; Pejin, Boris; Dramicanin, Aleksandra; Jovic, Sonja; Vujovic, Dragan; Zunic, Dragoljub; Ristic, Renata

2017-01-01

Three clones of Cabernet Franc (Nos. 02, 010 and 012) were selected in the last phase of clonal selection in Serbia. Wines made from each clone were assessed for quality parameters and taste during five consecutive vintages (2008-2012) and compared to the standard. The wine quality was determined based on the following parameters: alcohol, total extract, anthocyanins, tannins, pH, titratable acidity, volatile acidity, aldehydes, esters and reducing sugars, relative density, ash, colour, tonality, and tasting score. In the last year of the study, grapes and wines of Cabernet Franc clones and a standard were subjected to a chemical analysis of their phenolic composition, resveratrol and radical scavenging activity. In the last year of the study, grapes and wines of Cabernet Franc clones and a standard were subjected to a chemical analysis of their phenolic composition, resveratrol and radical scavenging activity. Chemical analyses of grapes and wines along with sensory and radical scavenging activity evaluations were done according to the standard procedures. The wines of the clone No. 010 showed some superior properties compared to the other two clones and the standard; in five-year period the average concentration of anthocyanins (179±3.8 mg/L) and polyphenolics (1.85±0.02 g/L) was significantly higher than in wines of clones and the standard, (168-173 mg/L and 1.63-1.74 g/L for anthocyanins and phenolics, respectively). Furthermore, the same clone had a higher alcohol content (13.97±0.03%) in each year of the study, which indicated that it ripened faster than other clones (13.06-13.08 %) and compared to the standard (13.04±0.07%). This finding suggested that the clone No. 010 could possibly have a significant economic impact and further increase popularity of Cabernet Franc in a cooler climate viticultural region. It was also found to have the highest contents of aldehydes (488±1.54 mg/L) and esters (322±0.71 mg/L) compared to aldehydes (452-467 mg/L) and esters (290-310 mg/L) measured in other wines. Finally, the highest amount of phenolic compounds (1220±40 mg/kg) and resveratrol (70±3.3 mg/kg) were found in the grapes of the clone No. 010. The present study revealed a strong correlation of total phenolic contents and anthocyanins with radical scavenging activities (0.936 and 0.929, P<0.001, respectively) indicating that this activity of wines was derived mainly from their phenolic compounds. The wine of the clone No. 010 contained the highest concentration of aldehydes, esters, anthocyanins, polyphenolics and resveratrol and consequently achieved the best tasting score. This clone may offer a new Cabernet Franc wine with geographical indication. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Ground-Water Quality and Potential Effects of Individual Sewage Disposal System Effluent on Ground-Water Quality in Park County, Colorado, 2001-2004

USGS Publications Warehouse

Miller, Lisa D.; Ortiz, Roderick F.

2007-01-01

In 2000, the U.S. Geological Survey, in cooperation with Park County, Colorado, began a study to evaluate ground-water quality in the various aquifers in Park County that supply water to domestic wells. The focus of this study was to identify and describe the principal natural and human factors that affect ground-water quality. In addition, the potential effects of individual sewage disposal system (ISDS) effluent on ground-water quality were evaluated. Ground-water samples were collected from domestic water-supply wells from July 2001 through October 2004 in the alluvial, crystalline-rock, sedimentary-rock, and volcanic-rock aquifers to assess general ground-water quality and effects of ISDS's on ground-water quality throughout Park County. Samples were analyzed for physical properties, major ions, nutrients, bacteria, and boron; and selected samples also were analyzed for dissolved organic carbon, human-related (wastewater) compounds, trace elements, radionuclides, and age-dating constituents (tritium and chlorofluorocarbons). Drinking-water quality is adequate for domestic use throughout Park County with a few exceptions. Only about 3 percent of wells had concentrations of fluoride, nitrate, and (or) uranium that exceeded U.S. Environmental Protection Agency national, primary drinking-water standards. These primary drinking-water standards were exceeded only in wells completed in the crystalline-rock aquifers in eastern Park County. Escherichia coli bacteria were detected in one well near Guffey, and total coliform bacteria were detected in about 11 percent of wells sampled throughout the county. The highest total coliform concentrations were measured southeast of the city of Jefferson and west of Tarryall Reservoir. Secondary drinking-water standards were exceeded more frequently. About 19 percent of wells had concentrations of one or more constituents (pH, chloride, fluoride, sulfate, and dissolved solids) that exceeded secondary drinking-water standards. Currently (2004), there is no federally enforced drinking-water standard for radon in public water-supply systems, but proposed regulations suggest a maximum contaminant level of 300 picocuries per liter (pCi/L) and an alternative maximum contaminant level of 4,000 pCi/L contingent on other mitigating remedial activities to reduce radon levels in indoor air. Radon concentrations in about 91 percent of ground-water samples were greater than or equal to 300 pCi/L, and about 25 percent had radon concentrations greater than or equal to 4,000 pCi/L. Generally, the highest radon concentrations were measured in samples collected from wells completed in the crystalline-rock aquifers. Analyses of ground-water-quality data indicate that recharge from ISDS effluent has affected some local ground-water systems in Park County. Because roughly 90 percent of domestic water used is assumed to be recharged by ISDS's, detections of human-related (wastewater) compounds in ground water in Park County are not surprising; however, concentrations of constituents associated with ISDS effluent generally are low (concentrations near the laboratory reporting levels). Thirty-eight different organic wastewater compounds were detected in 46 percent of ground-water samples, and the number of compounds detected per sample ranged from 1 to 17 compounds. Samples collected from wells with detections of wastewater compounds also had significantly higher (p-value < 0.05) chloride and boron concentrations than samples from wells with no detections of wastewater compounds. ISDS density (average subdivision lot size used to estimate ISDS density) was related to ground-water quality in Park County. Chloride and boron concentrations were significantly higher in ground-water samples collected from wells located in areas that had average subdivision lot sizes of less than 1 acre than in areas that had average subdivision lot sizes greater than or equal to 1 acre. For wells completed in the crystalline-

Connoted hazard and perceived importance of fluorescent, neon, and standard safety colors.

PubMed

Zielinska, O A; Mayhorn, C B; Wogalter, M S

2017-11-01

The perceived hazard and rated importance of standard safety, fluorescent, and neon colors are investigated. Colors are used in warnings to enhance hazard communication. Red has consistently been rated as the highest in perceived hazard. Orange, yellow, and black are the next highest in connoted hazard; however, there is discrepancy in their ordering. Safety standards, such as ANSI Z535.1, also list colors to convey important information, but little research has examined the perceived importance of colors. In addition to standard safety colors, fluorescent colors are more commonly used in warnings. Understanding hazard and importance perceptions of standard safety and fluorescent colors is necessary to create effective warnings. Ninety participants rated and ranked a total of 33 colors on both perceived hazard and perceived importance. Rated highest were the safety red colors from the American National Standard Institute (ANSI), International Organization for Standardization (ISO), and Federal Highway Administration (FHWA) together with three fluorescent colors (orange, yellow, and yellow-green) from 3 M on both dimensions. Rankings were similar to ratings except that fluorescent orange was the highest on perceived hazard, while fluorescent orange and safety red from the ANSI were ranked as the highest in perceived importance. Fluorescent colors convey hazard and importance levels as high as the standard safety red colors. Implications for conveying hazard and importance in warnings through color are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Waste utilization of red snapper (Lutjanus sp.) fish bone to improve phosphorus contents in compost

NASA Astrophysics Data System (ADS)

Ramadhani, S.; Iswanto, B.; Purwaningrum, P.

2018-01-01

The purpose of this research is to get the idea that bone waste will be the P content enhancer in compost so that the compost produced meets the standard P levels specified in SNI 19-7030-2004 which regulating compost quality standard. Nutrient levels were obtained in fish bone meal (FBM) are C (3.35%), N (0.48%), P (30.90%) and K (0.02%). Effects of fish bone meal to the rising levels of P in the compost has been known. P levels of compost B, C, D, and E increased at 428.57; 542.85; 657.14 and 914.28% against the compost A (blank). FBM ideal addition indicated in compost B, as much as 15 gr, with a P content of 0.37% and has been passed according standards (0.10% for P). C/N ratio decreased over the 21 days period of composting, with the greatest decline was compost E with a ratio of 16:1. Highest nitrogen (N) levels recorded respectively in compost B and C with value of 1.09% and the lowest of recorded N content was compost A, D and E (1.08%). N content in all samples of compost were eligible minimum N of 0.40%. Carbon (C) is the highest recorded in compost B; 20.20% and the lowest in the compost E; 17.34%. Highest and lowest C levels on the compost has met the minimum C of 9.80%. Composting is done in a bucket as an aerobic composter (with air holes), compost pile turnover for each sample is controlled as much as once/2 days. Mesophilic period (23-450C) occurs during the 21-day period of composting. Compost B has P content of 0.37%, so it has fulfilled the provisions of SNI 19-7030-2004 about the recommended compost standard.

The quality assessment of radial and tangential neutron radiography beamlines of TRR

NASA Astrophysics Data System (ADS)

Choopan Dastjerdi, M. H.; Movafeghi, A.; Khalafi, H.; Kasesaz, Y.

2017-07-01

To achieve a quality neutron radiographic image in a relatively short exposure time, the neutron radiography beam must be of good quality and relatively high neutron flux. Characterization of a neutron radiography beam, such as determination of the image quality and the neutron flux, is vital for producing quality radiographic images and also provides a means to compare the quality of different neutron radiography facilities. This paper provides a characterization of the radial and tangential neutron radiography beamlines at the Tehran research reactor. This work includes determination of the facilities category according to the American Society for Testing and Materials (ASTM) standards, and also uses the gold foils to determine the neutron beam flux. The radial neutron beam is a Category I neutron radiography facility, the highest possible quality level according to the ASTM. The tangential beam is a Category IV neutron radiography facility. Gold foil activation experiments show that the measured neutron flux for radial beamline with length-to-diameter ratio (L/D) =150 is 6.1× 106 n cm-2 s-1 and for tangential beamline with (L/D)=115 is 2.4× 104 n cm-2 s-1.

Temperature and light conditions at different latitudes affect sensory quality of broccoli florets (Brassica oleracea L. var. italica).

PubMed

Johansen, Tor J; Mølmann, Jørgen Ab; Bengtsson, Gunnar B; Schreiner, Monica; Velasco, Pablo; Hykkerud, Anne L; Cartea, Elena; Lea, Per; Skaret, Josefine; Seljåsen, Randi

2017-08-01

Broccoli (Brassica oleracea L. var. italica) is a popular vegetable grown at a wide range of latitudes. Plants were grown in 2009-2011 in pots with standardized soil, irrigation and nutrient supply under natural temperature and light conditions at four locations (42-70° N). A descriptive sensory analysis of broccoli florets was performed by a trained panel to examine any differences along the latitudinal gradient for 30 attributes within appearance, odour, taste/flavour and texture. Average results over three summer seasons in Germany, southern Norway and northern Norway showed that the northernmost location with low temperatures and long days had highest scores for bud coarseness and uniform colour, while broccoli from the German location, with high temperatures and shorter days, had highest intensity of colour hue, whiteness, bitter taste, cabbage flavour, stale flavour and watery flavour. Results from two autumn seasons at the fourth location (42° N, Spain), with low temperatures and short days, tended toward results from the two northernmost locations, with an exception for most texture attributes. Results clearly demonstrate that temperature and light conditions related to latitude and season affect the sensory quality of broccoli florets. Results may be used in marketing special quality regional or seasonal products. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Effect of different new packaging materials on biscuit quality during accelerated storage.

PubMed

Romani, Santina; Tappi, Silvia; Balestra, Federica; Rodriguez Estrada, Maria Teresa; Siracusa, Valentina; Rocculi, Pietro; Dalla Rosa, Marco

2015-06-01

The effect of innovative multilayer packaging materials versus a standard one on biscuit quality was studied during accelerated storage at 25, 35, 45 °C and 50% relative humidity for 92 days. Three different packaging materials were used: metalized orientated polypropylene (OPP)/paper (control); metalized poly-lactic acid (PLA)/paper; metalized OPP with ethylene vinyl acetate pro-oxidant additive (EVA-POA)/paper. EVA-POA additive is used to make the plastic layer biodegradable. Various quality sample parameters (moisture, water activity (aw ), texture, peroxide value (PV), hexanal) were analysed during storage. Rate constants (k) and activation energies (Ea ) of hydration reactions and hexanal formation were calculated. No remarkable differences in the evolution of primary and secondary lipid oxidation were observed among differently packed biscuits during storage. All samples maintained PV levels between 4 and 14 meq O2 kg(-1) oil. The product in flexible packaging with PLA reached the highest moisture and aw levels, but they did not significantly and adversely affect the other quality characteristics. The obtained results demonstrate that the new tested packaging materials were suitable for commercial biscuit storage, having similar performance and preservation effects on the overall product quality to those of the standard one. Furthermore, these results could make a contribution to the food industry, encouraging the use of packaging materials with a negligible environmental impact as an alternative to petroleum-based ones. © 2014 Society of Chemical Industry.

Materials for Heated Head Automated Thermoplastic Tape Placement

NASA Technical Reports Server (NTRS)

Jensen, Brian J.; Kinney, Megan C.; Cano, Roberto J.; Grimsley, Brian W.

2012-01-01

NASA Langley Research Center (LaRC) is currently pursuing multiple paths to develop out of autoclave (OOA) polymeric composite materials and processes. Polymeric composite materials development includes the synthesis of new and/or modified thermosetting and thermoplastic matrix resins designed for specific OOA processes. OOA processes currently under investigation include vacuum bag only (VBO) prepreg/composite fabrication, resin transfer molding (RTM), vacuum assisted resin transfer molding (VARTM) and heated head automated thermoplastic tape placement (HHATP). This paper will discuss the NASA Langley HHATP facility and capabilities and recent work on characterizing thermoplastic tape quality and requirements for quality part production. Samples of three distinct versions of APC-2 (AS4/PEEK) thermoplastic dry tape were obtained from two materials vendors, TENCATE, Inc. and CYTEC Engineered Materials** (standard grade and an experimental batch). Random specimens were taken from each of these samples and subjected to photo-microscopy and surface profilometry. The CYTEC standard grade of APC-2 tape had the most voids and splits and the highest surface roughness and/or waviness. Since the APC-2 tape is composed of a thermoplastic matrix, it offers the flexibility of reprocessing to improve quality, and thereby improve final quality of HHATP laminates. Discussions will also include potential research areas and future work that is required to advance the state of the art in the HHATP process for composite fabrication.

Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS

PubMed Central

Beaussier, Anne-Laure; Demeritt, David; Griffiths, Alex; Rothstein, Henry

2016-01-01

In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013–2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes. PMID:27499677

Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS.

PubMed

Beaussier, Anne-Laure; Demeritt, David; Griffiths, Alex; Rothstein, Henry

2016-05-18

In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013-2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes.

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

Singer, Brett C.; Pass, Rebecca Zarin; Delp, William W.

Combustion pollutant concentrations were measured during the scripted operation of natural gas cooking burners in nine homes. Boiling and simmering activities were conducted on the stovetop and in the oven with and without range hood exhaust ventilation or air mixing via a forced air system. Time-resolved concentrations of carbon dioxide (CO 2), nitric oxide (NO), nitrogen oxides (NO x), nitrogen dioxide (NO 2), particles with diameters of 6 nm or larger (PN), carbon monoxide (CO), and fine particulate matter (PM 2.5) were measured in the kitchen and bedroom area of each home. Four of the nine homes had kitchen 1more » h NO 2 exceed the national ambient air quality standard (100 ppb). In all homes, the highest 1 h integrated PN exceeded 2 × 10 5 cm -3-h, and the highest 4 h PN exceeded 3 × 10 5 cm -3-hr in the kitchen. Range hood performance varied widely, but one with a large capture volume and a measured flow of 108 L/s reduced concentrations 80–95%. Increased awareness of the need to ventilate when cooking, along with building standards for minimum range hood flow rates and volume, could substantially reduce exposures to NO 2 and ultrafine particles in homes.« less

Reporting Quality of Social and Psychological Intervention Trials: A Systematic Review of Reporting Guidelines and Trial Publications

PubMed Central

Grant, Sean P.; Mayo-Wilson, Evan; Melendez-Torres, G. J.; Montgomery, Paul

2013-01-01

Background Previous reviews show that reporting guidelines have improved the quality of trial reports in medicine, yet existing guidelines may not be fully suited for social and psychological intervention trials. Objective/Design We conducted a two-part study that reviewed (1) reporting guidelines for and (2) the reporting quality of social and psychological intervention trials. Data Sources (1) To identify reporting guidelines, we systematically searched multiple electronic databases and reporting guideline registries. (2) To identify trials, we hand-searched 40 journals with the 10 highest impact factors in clinical psychology, criminology, education, and social work. Eligibility (1) Reporting guidelines consisted of articles introducing a checklist of reporting standards relevant to social and psychological intervention trials. (2) Trials reported randomised experiments of complex interventions with psychological, social, or health outcomes. Results (1) We identified 19 reporting guidelines that yielded 147 reporting standards relevant to social and psychological interventions. Social and behavioural science guidelines included 89 standards not found in CONSORT guidelines. However, CONSORT guidelines used more recommended techniques for development and dissemination compared to other guidelines. (2) Our review of trials (n = 239) revealed that many standards were poorly reported, such as identification as a randomised trial in titles (20% reported the information) and abstracts (55%); information about blinding (15%), sequence generation (23%), and allocation concealment (17%); and details about actual delivery of experimental (43%) and control interventions (34%), participant uptake (25%), and service environment (28%). Only 11 of 40 journals referenced reporting guidelines in “Instructions to Authors.” Conclusion Existing reporting guidelines have important limitations in content, development, and/or dissemination. Important details are routinely missing from trial publications; most leading journals in social and behavioural sciences do not ask authors to follow reporting standards. Findings demonstrate a need to develop a CONSORT extension with updated standards for social and psychological intervention trials. PMID:23734256

Assessing Data Quality in Emergent Domains of Earth Sciences

NASA Astrophysics Data System (ADS)

Darch, P. T.; Borgman, C.

2016-12-01

As earth scientists seek to study known phenomena in new ways, and to study new phenomena, they often develop new technologies and new methods such as embedded network sensing, or reapply extant technologies, such as seafloor drilling. Emergent domains are often highly multidisciplinary as researchers from many backgrounds converge on new research questions. They may adapt existing methods, or develop methods de novo. As a result, emerging domains tend to be methodologically heterogeneous. As these domains mature, pressure to standardize methods increases. Standardization promotes trust, reliability, accuracy, and reproducibility, and simplifies data management. However, for standardization to occur, researchers must be able to assess which of the competing methods produces the highest quality data. The exploratory nature of emerging domains discourages standardization. Because competing methods originate in different disciplinary backgrounds, their scientific credibility is difficult to compare. Instead of direct comparison, researchers attempt to conduct meta-analyses. Scientists compare datasets produced by different methods to assess their consistency and efficiency. This paper presents findings from a long-term qualitative case study of research on the deep subseafloor biosphere, an emergent domain. A diverse community converged on the study of microbes in the seafloor and those microbes' interactions with the physical environments they inhabit. Data on this problem are scarce, leading to calls for standardization as a means to acquire and analyze greater volumes of data. Lacking consistent methods, scientists attempted to conduct meta-analyses to determine the most promising methods on which to standardize. Among the factors that inhibited meta-analyses were disparate approaches to metadata and to curating data. Datasets may be deposited in a variety of databases or kept on individual scientists' servers. Associated metadata may be inconsistent or hard to interpret. Incentive structures, including prospects for journal publication, often favor new data over reanalyzing extant datasets. Assessing data quality in emergent domains is extremely difficult and will require adaptations in infrastructure, culture, and incentives.

The predictors of quality of life in women with polycystic ovarian syndrome.

PubMed

Aliasghari, Fatemeh; Mirghafourvand, Mojgan; Charandabi, Sakineh Mohammad-Alizadeh; Lak, Tahereh Behroozi

2017-06-01

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorder that may be effective in reducing the quality of life. This study aimed to determine the predictors of quality of life in women with PCOS. This cross-sectional study was conducted on 174 women with PCOS who attended in public and private fertility clinics in Urmia (West Azerbaijan, Iran), 2015. The data were collected through the questionnaires of sociodemographic and obstetrics characteristics, quality of life and Beck depression inventory-II. Multivariate linear regression was used to estimate the effect rate of the independent variables (depression and sociodemographic characteristics) on the dependent variable (quality of life). In this study, the mean (standard deviation) of total score of the quality of life was obtained, 45.8 (11.3) in the range 0-100. The highest and lowest mean scores were in the subdomains of weight and hirsutism. The variables of depression, body mass index, woman's job, menstrual cycle intervals, and sexual satisfaction were predictors of the quality of life in women with PCOS. Because of various effective factors on quality of life in these women such as depression, necessary strategies must be implemented to control these factors and improve the quality of life. © 2017 John Wiley & Sons Australia, Ltd.

A history of the American Board of Surgery: vignettes from the certifying examination: The Edgar J. Poth Memorial Lecture.

PubMed

Walker, John Patrick

2015-12-01

The American Board of Surgery was established in 1937 to certify surgeons who through training, experience, and examination meet the highest standards of surgical care. This lecture was given as the Edgar Poth lecture at the April 2015 meeting of the Southwestern Surgical Congress. Dr Poth was a surgical educator from the University of Texas Medical Branch, Galveston who was President of the Southwestern in 1963. The paper presents the history of the founding of the American Board of Surgery, with particular emphasis on the certifying examination-Part 2. Vignettes of occurrences associated with the "Oral" examination are given. The examination has changed substantially from a 2-day event involving an actual surgical procedure to the 90-minute quiz given today. The oral examinations remain an important part in the process of certification of surgeons of the highest quality. Copyright © 2015 Elsevier Inc. All rights reserved.

Temporal and spatial trends of total petroleum hydrocarbons and heavy metals in the surface sediment of Caofeidian Sea Area, China from 2011 to 2016

NASA Astrophysics Data System (ADS)

Huang, Wei

2018-05-01

The temporal and spatial distribution of total petroleum hydrocarbons (TPH) and four heavy metals in the surface sediments of Caofeidian Sea Area during 2011–2016 was investigated. The sediment concentration of TPH, Cu, Zn, Pb and Cd were 10.07-186.4 mg/L, 16.5-84.9 mg/L, 11.1-135 mg/L, 6.8-24.6 mg/L, and 0.07-0.199 mg/L, respectively. The pollution level in Caofeidian sea area is lower than those in other area in China. These results reached the highest marine sediment quality standards in China, indicating that the sediment was fairly clean. In addition, TPH at all stations decreased during 2011-2016. The highest values obtained were at stations near the port areas and estuary region.

A simple procedure to analyze positions of interest in infectious cell cultures by correlative light and electron microscopy.

PubMed

Madela, Kazimierz; Banhart, Sebastian; Zimmermann, Anja; Piesker, Janett; Bannert, Norbert; Laue, Michael

2014-01-01

Plastic cell culture dishes that contain a thin bottom of highest optical quality including an imprinted finder grid (μ-Dish Grid-500) are optimally suited for routine correlative light and electron microscopy using chemical fixation. Such dishes allow high-resolution fluorescence and bright-field imaging using fixed and living cells and are compatible with standard protocols for scanning and transmission electron microscopy. Ease of use during cell culture and imaging, as well as a tight cover render the dishes particularly suitable for working with infectious organisms up to the highest biosafety level. Detailed protocols are provided and demonstrated by showing two examples: monitoring the production of virus-like particles of the Human Endogenous Retrovirus HERV-K(HML-2) by HeLa cells and investigation of Rab11-positive membrane-compartments of HeLa cells after infection with Chlamydia trachomatis. © 2014 Elsevier Inc. All rights reserved.

The importance of standard operating procedures in clinical trials.

PubMed

Sajdak, Rebecca; Trembath, Lisaann; Thomas, Kathy S

2013-09-01

This special contribution provides insight into the role that standard operating procedures (SOPs) play in an imaging department and their value in building a high-quality research site. If you have ever participated in a clinical trial, many of the principles described in this article should be familiar. However, this article goes a step further by presenting information from a pharmaceutical or device sponsor's point of view-what the sponsor expects from a site during the course of a research study. This article is intended not to provide a complete set of instructions on how to create a great SOP but, instead, to present guidelines to ensure that the key elements are included. After reading the article, you will be able to define SOPs as they pertain to the clinical trial environment, describe key components of an SOP, list the clinical research SOPs that exist in your institution and imaging department, identify which additional SOPs might improve site performance, and describe how the sponsor relies on SOPs to ensure that the highest quality of research is attained.

Adaptability and stability of soybean cultivars for grain yield and seed quality.

PubMed

Silva, K B; Bruzi, A T; Zambiazzi, E V; Soares, I O; Pereira, J L A R; Carvalho, M L M

2017-05-10

This study aimed at verifying the adaptability and stability of soybean cultivars, considering the grain yield and quality of seeds, adopting univariate and multivariate approaches. The experiments were conducted in two crops, three environments, in 2013/2014 and 2014/2015 crop seasons, in the county of Inconfidentes, Lavras, and Patos de Minas, in the Minas Gerais State, Brazil. We evaluated 17 commercial soybean cultivars. For adaptability and stability evaluations, the Graphic and GGE biplot methods were employed. Previously, a selection index was estimated based on the sum of the standardized variables (Z index). The data relative to grain yield, mass of one thousand grain, uniformity test (sieve retention), and germination test were standardized (Z ij ) per cultivar. With the sum of Z ij , we obtained the selection index for the four traits evaluated together. In the Graphic method evaluation, cultivars NA 7200 RR and CD 2737 RR presented the highest values for selection index Z. By the GGE biplot method, we verified that cultivar NA 7200 RR presented greater stability in both univariate evaluations, for grain yield, and for selection index Z.

Producing and marketing a specialty egg.

PubMed

Michella, S M; Slaugh, B T

2000-07-01

Eggland's Best, Inc. markets premium quality shell eggs under the Eggland's Best (EB) brand name. The company, started in 1988, is comprised of a franchise network of established egg producers and covers most of the United States. Eggland's Best provides its franchisees with marketing and technical support. The franchisees produce, process, and distribute EB eggs according to the strict program established and monitored by EB. Production follows the all-natural vegetarian feed program in accordance with the company's US patent entitled "Eggs Compatible with a Cholesterol Reducing Diet and Method of Producing the Same." The EB program excludes animal fat and other animal byproducts. Eggland's Best eggs have seven times the generic level of vitamin E, nearly three times more omega-3 fatty acids and iodine, and 25% less saturated fat than regular generic eggs. Eggland's Best has one of the finest shell egg quality assurance programs anywhere. Eggland's Best franchisees submit weekly egg samples that are analyzed for shell quality, interior quality, vitamin E, iodine, cholesterol and fatty acids. Samples of feed and the EB-patented feed supplement are also analyzed. Approximately 28,000 total laboratory tests are conducted annually. Nationwide product and display retail evaluations are contracted through an outside audit company (40 to 50 cities evaluated four times per year). All EB eggs are USDA graded according to EB's strict quality standards. Producers must follow a food safety quality assurance program (United Egg Producers Association 5-Star or equivalent state or company program). Each egg is stamped "EB" as assurance of meeting EB's highest standards of flavor, quality, and nutrition. Eggland's Best has enjoyed record sales growth for the past 3 yr.

Coronary Artery Disease - Reporting and Data System (CAD-RADS): An Expert Consensus Document of SCCT, ACR and NASCI: Endorsed by the ACC.

PubMed

Cury, Ricardo C; Abbara, Suhny; Achenbach, Stephan; Agatston, Arthur; Berman, Daniel S; Budoff, Matthew J; Dill, Karin E; Jacobs, Jill E; Maroules, Christopher D; Rubin, Geoffrey D; Rybicki, Frank J; Schoepf, U Joseph; Shaw, Leslee J; Stillman, Arthur E; White, Charles S; Woodard, Pamela K; Leipsic, Jonathon A

2016-09-01

The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report. Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD-RADS classification. The main goal of CAD-RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will provide a framework of standardization that may benefit education, research, peer-review and quality assurance with the potential to ultimately result in improved quality of care. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Quality assessment of pharmaceutical tablet samples using Fourier transform near infrared spectroscopy and multivariate analysis

NASA Astrophysics Data System (ADS)

Kandpal, Lalit Mohan; Tewari, Jagdish; Gopinathan, Nishanth; Stolee, Jessica; Strong, Rick; Boulas, Pierre; Cho, Byoung-Kwan

2017-09-01

Determination of the content uniformity, assessed by the amount of an active pharmaceutical ingredient (API), and hardness of pharmaceutical materials is important for achieving a high-quality formulation and to ensure the intended therapeutic effects of the end-product. In this work, Fourier transform near infrared (FT-NIR) spectroscopy was used to determine the content uniformity and hardness of a pharmaceutical mini-tablet and standard tablet samples. Tablet samples were scanned using an FT-NIR instrument and tablet spectra were collected at wavelengths of 1000-2500 nm. Furthermore, multivariate analysis was applied to extract the relationship between the FT-NIR spectra and the measured parameters. The results of FT-NIR spectroscopy for API and hardness prediction were as precise as the reference high-performance liquid chromatography and mechanical hardness tests. For the prediction of mini-tablet API content, the highest coefficient of determination for the prediction (R2p) was found to be 0.99 with a standard error of prediction (SEP) of 0.72 mg. Moreover, the standard tablet hardness measurement had a R2p value of 0.91 with an SEP of 0.25 kg. These results suggest that FT-NIR spectroscopy is an alternative and accurate nondestructive measurement tool for the detection of the chemical and physical properties of pharmaceutical samples.

Air Quality and Heart Health: An Emerging Topic for Heart ...

EPA Pesticide Factsheets

Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanisms are under investigation and are likely related to oxidative stress, inflammation and effects on autonomic control. Improvements in air pollution levels reduce health impacts and increase life expectancy. Reductions of short-term exposure in those at highest risk are predicted to mitigate adverse health effects. EPA regularly evaluates the standards, health risks and issues improved standards when needed. Public health action is needed along with EPA standards to reduce the public health burden of short- and long-term adverse health effects of air pollution. Health risks remain and need to be addressed through integrated efforts of public health, health care, environmental health, individuals and communities. Presented at Webinar for the National Association of Clean Air Agencies, February 2, 2017, Chapel Hill, NC- This webinar provided an update of environmental health information related to the effects of air pollution and heart and blood vessel disease. Such information is critically important for the Clean Air Agencies to understand as it provides the justification of their actions.

Ground-Water Quality in the St. Lawrence River Basin, New York, 2005-06

USGS Publications Warehouse

Nystrom, Elizabeth A.

2007-01-01

The Federal Clean Water Act requires that States monitor and report on the quality of ground water and surface water. To satisfy part of these requirements, the U.S. Geological Survey and New York State Department of Environmental Conservation have developed a program in which ground-water quality is assessed in 2 to 3 of New York State's 14 major river basins each year. To characterize the quality of ground water in the St. Lawrence River Basin in northern New York, water samples were collected from 14 domestic and 11 production wells between August 2005 and January 2006. Eight of the wells were finished in sand and gravel and 17 wells were finished in bedrock. Ground-water samples were collected and processed using standard U.S. Geological Survey procedures and were analyzed for 229 constituents and physical properties, including inorganic constituents, nutrients, trace elements, radon-222, pesticides and pesticide degradates, volatile organic compounds, and bacteria. Sixty-six constituents were detected above laboratory reporting levels. Concentrations of most compounds at most sites were within drinking water standards established by the U.S. Environmental Protection Agency and New York State Department of Health, but a few compounds exceeded drinking water standards at some sites. Water in the basin is generally hard to very hard (hardness equal to 121 mg/L as CaCO3 or greater); hardness and alkalinity were generally higher in the St. Lawrence Valley than in the Adirondack Mountains. The cation with the highest median concentration was calcium; the anion with the highest median concentration was bicarbonate. The concentration of chloride in one sample exceeded the 250 milligrams per liter U.S. Environmental Protection Agency Secondary Drinking Water Standard; the concentration of sulfate in one sample also exceeded the 250 milligrams per liter U.S. Environmental Protection Agency Secondary Drinking Water Standard. Nitrate was the predominant nutrient detected but no sample exceeded the 10 mg/L U.S. Environmental Protection Agency Maximum Contaminant Level. The trace elements detected with the highest median concentrations were strontium, barium, and iron. Concentration of trace elements in several samples exceeded U.S. Environmental Protection Agency Secondary Drinking Water Standards, including aluminum (50 micrograms per liter, 4 samples), iron (300 micrograms per liter, 5 samples), and manganese (50 micrograms per liter, 4 samples). The concentration of uranium in one sample from a domestic well finished in crystalline bedrock was three times the U.S. Environmental Protection Agency Maximum Contaminant Level of 30 micrograms per liter. The median concentration of radon-222 was 600 picoCuries per liter, but concentrations as high as 18,800 picoCuries per liter were detected; two wells with high radon concentrations also had high uranium concentrations. Radon-222 is not currently regulated, but the U.S. Environmental Protection Agency has proposed a Maximum Contaminant Level of 300 picoCuries per liter along with an Alternative Maximum Contaminant Level of 4,000 picoCuries per liter, to be in effect in states that have programs to address radon in indoor air. Concentrations of radon-222 exceeded the proposed Maximum Contaminant Level in 60 percent of samples and exceeded the proposed Alternative Maximum Contaminant Level in 8 percent of samples. Six pesticides and pesticide degradates were detected; all were amide or triazine herbicides or degradates. Five volatile organic compounds were detected, including disinfection byproducts such as trichloromethane and gasoline components or additives such as methyl tert-butyl ether. No pesticides, pesticide degradates, or volatile organic compounds were detected above established limits. Coliform bacteria, including Escherichia coli, were detected in three wells finished in carbonate bedrock.

Antimalarial drug quality in Africa.

PubMed

Amin, A A; Kokwaro, G O

2007-10-01

There are several reports of sub-standard and counterfeit antimalarial drugs circulating in the markets of developing countries; we aimed to review the literature for the African continent. A search was conducted in PubMed in English using the medical subject headings (MeSH) terms: 'Antimalarials/analysis'[MeSH] OR 'Antimalarials/standards'[MeSH] AND 'Africa'[MeSH]' to include articles published up to and including 26 February 2007. Data were augmented with reports on the quality of antimalarial drugs in Africa obtained from colleagues in the World Health Organization. We summarized the data under the following themes: content and dissolution; relative bioavailability of antimalarial products; antimalarial stability and shelf life; general tests on pharmaceutical dosage forms; and the presence of degradation or unidentifiable impurities in formulations. The search yielded 21 relevant peer-reviewed articles and three reports on the quality of antimalarial drugs in Africa. The literature was varied in the quality and breadth of data presented, with most bioavailability studies poorly designed and executed. The review highlights the common finding in drug quality studies that (i) most antimalarial products pass the basic tests for pharmaceutical dosage forms, such as the uniformity of weight for tablets, (ii) most antimalarial drugs pass the content test and (iii) in vitro product dissolution is the main problem area where most drugs fail to meet required pharmacopoeial specifications, especially with regard to sulfadoxine-pyrimethamine products. In addition, there are worryingly high quality failure rates for artemisinin monotherapies such as dihydroartemisinin (DHA); for instance all five DHA sampled products in one study in Nairobi, Kenya, were reported to have failed the requisite tests. There is an urgent need to strengthen pharmaceutical management systems such as post-marketing surveillance and the broader health systems in Africa to ensure populations in the continent have access to antimalarial drugs that are safe, of the highest quality standards and that retain their integrity throughout the distribution chain through adequate enforcement of existing legislation and enactment of new ones if necessary, and provision of the necessary resources for drug quality assurance.

Characteristics of knowledge content in a curated online evidence library.

PubMed

Varada, Sowmya; Lacson, Ronilda; Raja, Ali S; Ip, Ivan K; Schneider, Louise; Osterbur, David; Bain, Paul; Vetrano, Nicole; Cellini, Jacqueline; Mita, Carol; Coletti, Margaret; Whelan, Julia; Khorasani, Ramin

2018-05-01

To describe types of recommendations represented in a curated online evidence library, report on the quality of evidence-based recommendations pertaining to diagnostic imaging exams, and assess underlying knowledge representation. The evidence library is populated with clinical decision rules, professional society guidelines, and locally developed best practice guidelines. Individual recommendations were graded based on a standard methodology and compared using chi-square test. Strength of evidence ranged from grade 1 (systematic review) through grade 5 (recommendations based on expert opinion). Finally, variations in the underlying representation of these recommendations were identified. The library contains 546 individual imaging-related recommendations. Only 15% (16/106) of recommendations from clinical decision rules were grade 5 vs 83% (526/636) from professional society practice guidelines and local best practice guidelines that cited grade 5 studies (P < .0001). Minor head trauma, pulmonary embolism, and appendicitis were topic areas supported by the highest quality of evidence. Three main variations in underlying representations of recommendations were "single-decision," "branching," and "score-based." Most recommendations were grade 5, largely because studies to test and validate many recommendations were absent. Recommendation types vary in amount and complexity and, accordingly, the structure and syntax of statements they generate. However, they can be represented in single-decision, branching, and score-based representations. In a curated evidence library with graded imaging-based recommendations, evidence quality varied widely, with decision rules providing the highest-quality recommendations. The library may be helpful in highlighting evidence gaps, comparing recommendations from varied sources on similar clinical topics, and prioritizing imaging recommendations to inform clinical decision support implementation.

Composition and design of vegetative filter strips instrumental in improving water quality by mass reduction of suspended sediment, nutrients and Escherichia coli in overland flows in eastern escarpment of Mau Forest, Njoro River Watershed, Kenya

PubMed Central

Olilo, C. O.; Onyando, J. O.; Moturi, W. N.; Muia, A. W.; Roegner, Amber F.; Ogari, Z.; Ombui, P. N.; Shivoga, W. A.

2016-01-01

This study assessed the effect of vegetative filter strip (VFS) in removal of suspended sediment (SS), total nitrogen, total phosphorus and Escherichia coli (E. coli) in overland flow to improve receiving water quality standards. Four and half kilograms of cowpat manure was applied to the model pasture 14 m beyond the edge of vegetated filter strip (VFS) comprising 10-m Napier grass draining into 20-m Kikuyu grass (VFS II), 10-m Kikuyu grass draining into 20-m Napier grass (VFS III) and native grass mixture of Couch–Buffel (VFS I-control). Overland flow water samples were collected from the sites at positions 0, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25 and 30 m along the length of VFSs. E. coli removal by Napier grass VFS was on the order of log unit, which provided an important level of protection and reduced surface-flow concentrations of E. coli to below the 200 (CFU 100 mL−1) recommended water quality standards, but not for nutrients and SS. The Napier grass showed highest efficiency (99.6 %), thus outperforming both Kikuyu grass (85.8 %) and Couch–Buffel grasses VFS (67.9 ± 4.2 %) in removing E. coli from overland flow. The low-level efficiency of native Couch–Buffel grasses in reducing E. coli in overland flow was because of preferential flow. Composition and design of VFS was instrumental and could be applied with a high potential of contracting the uncertainty in improving water quality standards through mass reduction of SS, nutrients and E. coli load in watersheds. PMID:28133624

Quality Control and Reproducibility in M-mode, Two-dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year-25 Examination Experience

PubMed Central

Armstrong, Anderson C.; Ricketts, Erin P.; Cox, Christopher; Adler, Paul; Arynchyn, Alexander; Liu, Kiang; Stengel, Ellen; RDCS; Sidney, Stephen; Lewis, Cora E.; Schreiner, Pamela J.; Shikany, James M.; Keck, Kimberly; Merlo, Jamie; Gidding, Samuel S.; Lima, João A. C.

2014-01-01

Introduction Few large studies describe quality control procedures and reproducibility findings in cardiovascular ultra-sound, particularly in novel techniques such as Speckle Tracking (STE). We evaluate the echocardiography assessment performance in the CARDIA study Y25 examination (2010-2011) and report findings from a quality control and reproducibility program conducted to assess Field Center image acquisition and Reading Center (RC) accuracy. Methods The CARDIA Y25 examination had 3,475 echocardiograms performed in 4 US Field Centers and analyzed in a Reading Center, assessing standard echocardiography (LA dimension, aortic root, LV mass, LV end-diastolic volume [LVEDV], ejection fraction [LVEF]), and STE (2- and 4-chamber longitudinal, circumferential, and radial strains). Reproducibility was assessed using intra-class correlation coefficients (ICC), coefficients of variation (CV), and Bland-Altman plots. Results For standard echocardiography reproducibility, LV mass and LVEDV consistently had CV above 10% and aortic root below 6%. Intra-sonographer aortic root and LV mass had the most robust values of ICC in standard echocardiography. For STE, the number of properly tracking segments was above 80% in short-axis and 4-chamber and 58% in 2-chamber. Longitudinal strain parameters were the most robust and radial strain showed the highest variation. Comparing Field Centers with Echo RC STE readings, mean differences ranged from 0.4% to 4.1% and ICC from 0.37 to 0.66, with robust results for longitudinal strains. Conclusion Echocardiography image acquisition and reading processes in the CARDIA study were highly reproducible, including robust results for STE analysis. Consistent quality control may increase the reliability of echocardiography measurements in large cohort studies. PMID:25382818

Quality Control and Reproducibility in M-Mode, Two-Dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year 25 Examination Experience.

PubMed

Armstrong, Anderson C; Ricketts, Erin P; Cox, Christopher; Adler, Paul; Arynchyn, Alexander; Liu, Kiang; Stengel, Ellen; Sidney, Stephen; Lewis, Cora E; Schreiner, Pamela J; Shikany, James M; Keck, Kimberly; Merlo, Jamie; Gidding, Samuel S; Lima, João A C

2015-08-01

Few large studies describe quality control procedures and reproducibility findings in cardiovascular ultrasound, particularly in novel techniques such as speckle tracking echocardiography (STE). We evaluate the echocardiography assessment performance in the Coronary Artery Risk Development in Young Adults (CARDIA) study Year 25 (Y25) examination (2010-2011) and report findings from a quality control and reproducibility program conducted to assess Field Center image acquisition and reading center (RC) accuracy. The CARDIA Y25 examination had 3475 echocardiograms performed in 4 US Field Centers and analyzed in a RC, assessing standard echocardiography (LA dimension, aortic root, LV mass, LV end-diastolic volume [LVEDV], ejection fraction [LVEF]), and STE (two- and four-chamber longitudinal, circumferential, and radial strains). Reproducibility was assessed using intraclass correlation coefficients (ICC), coefficients of variation (CV), and Bland-Altman plots. For standard echocardiography reproducibility, LV mass and LVEDV consistently had CV above 10% and aortic root below 6%. Intra-sonographer aortic root and LV mass had the most robust values of ICC in standard echocardiography. For STE, the number of properly tracking segments was above 80% in short-axis and four-chamber and 58% in two-chamber views. Longitudinal strain parameters were the most robust and radial strain showed the highest variation. Comparing Field Centers with echocardiography RC STE readings, mean differences ranged from 0.4% to 4.1% and ICC from 0.37 to 0.66, with robust results for longitudinal strains. Echocardiography image acquisition and reading processes in the CARDIA study were highly reproducible, including robust results for STE analysis. Consistent quality control may increase the reliability of echocardiography measurements in large cohort studies. © 2014, Wiley Periodicals, Inc.

A critical care network pressure ulcer prevention quality improvement project.

PubMed

McBride, Joanna; Richardson, Annette

2015-03-30

Pressure ulcer prevention is an important safety issue, often underrated and an extremely painful event harming patients. Critically ill patients are one of the highest risk groups in hospital. The impact of pressure ulcers are wide ranging, and they can result in increased critical care and the hospital length of stay, significant interference with functional recovery and rehabilitation and increase cost. This quality improvement project had four aims: (1) to establish a critical care network pressure ulcer prevention group; (2) to establish baseline pressure ulcer prevention practices; (3) to measure, compare and monitor pressure ulcers prevalence; (4) to develop network pressure ulcer prevention standards. The approach used to improve quality included strong critical care nursing leadership to develop a cross-organisational pressure ulcer prevention group and a benchmarking exercise of current practices across a well-established critical care Network in the North of England. The National Safety Thermometer tool was used to measure pressure ulcer prevalence in 23 critical care units, and best available evidence, local consensus and another Critical Care Networks' bundle of interventions were used to develop a local pressure ulcer prevention standards document. The aims of the quality improvement project were achieved. This project was driven by successful leadership and had an agreed common goal. The National Safety Thermometer tool was an innovative approach to measure and compare pressure ulcer prevalence rates at a regional level. A limitation was the exclusion of moisture lesions. The project showed excellent engagement and collaborate working in the quest to prevent pressure ulcers from many critical care nurses with the North of England Critical Care Network. A concise set of Network standards was developed for use in conjunction with local guidelines to enhance pressure ulcer prevention. © 2015 British Association of Critical Care Nurses.

Assessing the standards of online oral hygiene instructions for patients with fixed orthodontic appliances.

PubMed

Verhoef, Willem A; Livas, Christos; Delli, Konstantina; Ren, Yijin

2015-05-01

The authors conducted this study to assess the quality of the information available on the Web about oral hygiene for patients with fixed orthodontic appliances. The authors entered the search terms "cleaning braces," "brushing braces," and "oral hygiene and braces" into Google, Yahoo, and Bing search engines. They analyzed Web sites satisfying the inclusion criteria from the first 20 hits of each search for accessibility, usability, and reliability by using the LIDA instrument; for readability by using the Flesch Reading Ease (FRE) score; and for the completeness of oral hygiene instructions. Sixty-two Web sites met the inclusion criteria. The mean total LIDA score of 71.2 indicated the moderate quality of the design of the reviewed Web sites. The mean (standard deviation [SD]) values of LIDA scores for accessibility, usability, and reliability were 85.9 (7.0), 63.4 (16.1), and 48.0 (10.4), respectively. The mean (SD) FRE Score of 68.6 (9.7) applied to standard reading skills. The completeness of information (mean [SD] = 67.1 [27.8]) presented the highest variability. Overall, the authors found that the standards of online oral hygiene materials for orthodontic patients with fixed appliances exhibited modest scores. Readability appeared to be appropriate for young adolescents, whereas the comprehensiveness of the displayed information was highly variable. Further improvement of the infrastructure of electronic health information (that is, e-health) in orthodontics is necessary to meet patients' needs. Given the moderate quality of oral hygiene instruction available on the Web for patients with fixed appliances, orthodontic patients and caregivers should be cautious when browsing the Internet for relevant information. Dental professionals should refer patients to valid Web-based educational materials. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

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

Comparison of health care professionals' self-assessments of standards of care and patients' opinions on the care they received in hospital: observational study

PubMed Central

Durieux, P; Bissery, A; Dubois, S; Gasquet, I; Coste, J

2004-01-01

Objectives: To compare the views of healthcare professionals and patients regarding compliance with standards of care concerning patient information. Design: Self-rated questionnaire survey. Setting: Nine wards in short stay French hospitals. Participants: 939 patients and 359 healthcare professionals (physicians, nurses, assistants and other professionals). Main outcome measure: Patients' and healthcare professionals' views of compliance with 20 standards of patient care described in the French accreditation manual. Comparison of the rank order of the standards within the two samples. Results: The response rate was 61.5% in the patient group and 85.8% in the healthcare professionals. The rank orders for the 20 items were similar in both groups (Spearman rank order correlation 0.6, p = 0.004). The two items ranked highest by healthcare professionals ("consent request for a surgical procedure" and "the doctors ask the visitors to leave the room before examining a patient") were also the two ranked highest by the patients. Three items were ranked low by both groups: "consent request for students to be present", "health education given to patients", and "possibility to express satisfaction during discharge". Patients were more satisfied with their pain management than were healthcare providers. Professionals were more satisfied with the social services than the patients. Conclusion: There are both similarities and differences between patients' and healthcare professionals' views of care. Accurate assessments of quality performed during the accreditation procedure require that both patients' and professionals' views be taken into account. PMID:15175490

Error measure comparison of currently employed dose-modulation schemes for e-beam proximity effect control

NASA Astrophysics Data System (ADS)

Peckerar, Martin C.; Marrian, Christie R.

1995-05-01

Standard matrix inversion methods of e-beam proximity correction are compared with a variety of pseudoinverse approaches based on gradient descent. It is shown that the gradient descent methods can be modified using 'regularizers' (terms added to the cost function minimized during gradient descent). This modification solves the 'negative dose' problem in a mathematically sound way. Different techniques are contrasted using a weighted error measure approach. It is shown that the regularization approach leads to the highest quality images. In some cases, ignoring negative doses yields results which are worse than employing an uncorrected dose file.

Global human capital: integrating education and population.

PubMed

Lutz, Wolfgang; KC, Samir

2011-07-29

Almost universally, women with higher levels of education have fewer children. Better education is associated with lower mortality, better health, and different migration patterns. Hence, the global population outlook depends greatly on further progress in education, particularly of young women. By 2050, the highest and lowest education scenarios--assuming identical education-specific fertility rates--result in world population sizes of 8.9 and 10.0 billion, respectively. Better education also matters for human development, including health, economic growth, and democracy. Existing methods of multi-state demography can quantitatively integrate education into standard demographic analysis, thus adding the "quality" dimension.

Evaluating Service Quality from Patients' Perceptions: Application of Importance-performance Analysis Method.

PubMed

Mohebifar, Rafat; Hasani, Hana; Barikani, Ameneh; Rafiei, Sima

2016-08-01

Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance-performance analysis matrix. A descriptive-analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance-performance analysis matrix. The results showed a significant gap between importance and performance in all five dimensions of service quality (p < 0.05). In reviewing the gap, "reliability" (2.36) and "assurance" (2.24) dimensions had the highest quality gap and "responsiveness" had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance-performance matrix. The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance-performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.

Effects of Carcass Weight and Back-fat Thickness on Carcass Properties of Korean Native Pigs.

PubMed

Kim, Gye-Woong; Kim, Hack-Youn

2017-01-01

Our study analyzed the carcass properties of 170 Korean native pigs in relation to carcass weight and back-fat thickness to provide general data for the production and distribution of high quality pig meat. The 70-74 kg group showed highest yield (73.41%). The ≥80 kg group showed the highest thickest back-fat (24.13 mm) ( p <0.05). The ≥80 kg group showed the best quality grade (1.00). Back-fat thickness showed significant differences in the weight among groups ( p <0.05). The ≥25 mm group showed the highest carcass weight (75.93 kg). The thickest back-fat group (≥25 mm) showed the highest yield (73.03%). There were significant differences in back-fat thickness among groups ( p <0.05), and the ≥25 mm group showed the highest thickness back-fat (27.60 mm). We found a strong positive correlation between carcass weight and back-fat thickness (r=0.346) as well as meat quality grade (r=0.739). Back-fat thickness had a relatively strong positive correlation with meat quality grade (r=0.444). Therefore, there are required to manage the breeding through selection of excellent native species for increasing their carcass weight and enhance meat quality.

Effects of Carcass Weight and Back-fat Thickness on Carcass Properties of Korean Native Pigs

PubMed Central

2017-01-01

Our study analyzed the carcass properties of 170 Korean native pigs in relation to carcass weight and back-fat thickness to provide general data for the production and distribution of high quality pig meat. The 70-74 kg group showed highest yield (73.41%). The ≥80 kg group showed the highest thickest back-fat (24.13 mm) (p<0.05). The ≥80 kg group showed the best quality grade (1.00). Back-fat thickness showed significant differences in the weight among groups (p<0.05). The ≥25 mm group showed the highest carcass weight (75.93 kg). The thickest back-fat group (≥25 mm) showed the highest yield (73.03%). There were significant differences in back-fat thickness among groups (p<0.05), and the ≥25 mm group showed the highest thickness back-fat (27.60 mm). We found a strong positive correlation between carcass weight and back-fat thickness (r=0.346) as well as meat quality grade (r=0.739). Back-fat thickness had a relatively strong positive correlation with meat quality grade (r=0.444). Therefore, there are required to manage the breeding through selection of excellent native species for increasing their carcass weight and enhance meat quality. PMID:28747824

Public health impacts of combustion emissions in the United Kingdom.

PubMed

Yim, Steve H L; Barrett, Steven R H

2012-04-17

Combustion emissions are a major contributor to degradation of air quality and pose a risk to human health. We evaluate and apply a multiscale air quality modeling system to assess the impact of combustion emissions on UK air quality. Epidemiological evidence is used to quantitatively relate PM(2.5) exposure to risk of early death. We find that UK combustion emissions cause ∼13,000 premature deaths in the UK per year, while an additional ∼6000 deaths in the UK are caused by non-UK European Union (EU) combustion emissions. The leading domestic contributor is transport, which causes ∼7500 early deaths per year, while power generation and industrial emissions result in ∼2500 and ∼830 early deaths per year, respectively. We estimate the uncertainty in premature mortality calculations at -80% to +50%, where results have been corrected by a low modeling bias of 28%. The total monetized life loss in the UK is estimated at £6-62bn/year or 0.4-3.5% of gross domestic product. In Greater London, where PM concentrations are highest and are currently in exceedance of EU standards, we estimate that non-UK EU emissions account for 30% of the ∼3200 air quality-related deaths per year. In the context of the European Commission having launched infringement proceedings against the UK Government over exceedances of EU PM air quality standards in London, these results indicate that further policy measures should be coordinated at an EU-level because of the strength of the transboundary component of PM pollution.

A comparison of the performance of digital mammography systems.

PubMed

Monnin, P; Gutierrez, D; Bulling, S; Guntern, D; Verdun, F R

2007-03-01

An objective analysis of image quality parameters was performed for six digital mammography systems. The presampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) for the systems were determined at different doses, for 28 kVp with a Mo/Mo or W/Al target/filter combination and 2 mm of additional aluminium filtration. The flat-panel units have higher MTF and DQE in the mid to high frequency range than standard CR systems. The highest DQE, over the whole dose range, is for the slit-scanning direct photon counting system. Dual-side read CR can overcome the inherent x-ray absorption and signal collection limitations of standard CR mammography, improving the low-frequency DQE by 40%, to the same level as full-field systems, but it does not improve the poor spatial resolution of phosphor.

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

PubMed

Gelb, Adrian W; Morriss, Wayne W; Johnson, Walter; Merry, Alan F; Abayadeera, Anuja; Belîi, Natalia; Brull, Sorin J; Chibana, Aline; Evans, Faye; Goddia, Cyril; Haylock-Loor, Carolina; Khan, Fauzia; Leal, Sandra; Lin, Nan; Merchant, Richard; Newton, Mark W; Rowles, Jackie S; Sanusi, Arinola; Wilson, Iain; Velazquez Berumen, Adriana

2018-06-01

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a nonprofit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

PubMed

Gelb, Adrian W; Morriss, Wayne W; Johnson, Walter; Merry, Alan F

2018-05-07

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a non-profit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.

Particulate Matter Levels in Ambient Air Adjacent to Industrial Area

NASA Astrophysics Data System (ADS)

Mohamed, R. M. S. R.; Nizam, N. M. S.; Al-Gheethi, A. A.; Lajis, A.; Kassim, A. H. M.

2016-07-01

Air quality in the residential areas adjacent to the industrial regions is of great concern due to the association with human health risks. In this work, the concentrations of particulate matter (PM10) in the ambient air of UTHM campus was investigated tostudy the air qualityand their compliance to the Malaysian Ambient Air Quality Guidelines (AAQG). The PM10 samples were taken over 24 hours from the most significant area at UTHM including Stadium, KolejKediamanTunDr. Ismail (KKTDI) and MakmalBahan. The meteorological parameters; temperature, relative humidity, wind speed and wind direction as well as particulate matterwere estimated by using E-Sampler Particulate Matter (PM10) Collector. The highest concentrations of PM10 (55.56 µg/m3) was recorded at MakmalBahan during the working and weekend days. However, these concentrations are less than 150 pg/m3. It can be concluded that although UTHM is surrounded by the industrial area, the air quality in the campus still within the standards limits.

Consumer palatability scores and volatile beef flavor compounds of five USDA quality grades and four muscles.

PubMed

Legako, J F; Brooks, J C; O'Quinn, T G; Hagan, T D J; Polkinghorne, R; Farmer, L J; Miller, M F

2015-02-01

Proximate data, consumer palatability scores and volatile compounds were investigated for four beef muscles (Longissimus lumborum, Psoas major, Semimembranosus and Gluteus medius) and five USDA quality grades(Prime, Upper 2/3 Choice, Low Choice, Select, and Standard). Quality grade did not directly affect consumer scores or volatiles but interactions (P < 0.05) between muscle and grade were determined. Consumer scores and volatiles differed (P < 0.05) between muscles. Consumers scored Psoas major highest for tenderness, juiciness, flavor liking and overall liking, followed by Longissimus lumborum, Gluteus medius, and Semimembranosus (P < 0.05). Principal component analysis revealed clustering of compound classes, formed by related mechanisms. Volatile n-aldehydes were inversely related to percent fat. Increases in lipid oxidation compounds were associated with Gluteus medius and Semimembranosus, while greater quantities of sulfur-containing compounds were associated with Psoas major. Relationships between palatability scores and volatile compound classes suggest that differences in the pattern of volatile compounds may play a valuable role in explaining consumer liking.

Pharmaceutical Price Controls and Minimum Efficacy Regulation: Evidence from the United States and Italy

PubMed Central

Atella, Vincenzo; Bhattacharya, Jay; Carbonari, Lorenzo

2012-01-01

Objective This article examines the relationship between drug price and drug quality and how it varies across two of the most common regulatory regimes in the pharmaceutical market: minimum efficacy standards (MES) and a mix of MES and price control mechanisms (MES + PC). Data Sources Our primary data source is the Tufts-New England Medical Center-Cost Effectiveness Analysis Registry which have been merged with price data taken from MEPS (for the United States) and AIFA (for Italy). Study Design Through a simple model of adverse selection we model the interaction between firms, heterogeneous buyers, and the regulator. Principal Findings The theoretical analysis provides two results. First, an MES regime provides greater incentives to produce high-quality drugs. Second, an MES + PC mix reduces the difference in price between the highest and lowest quality drugs on the market. Conclusion The empirical analysis based on United States and Italian data corroborates these results. PMID:22091623

Effects of processing conditions on mammographic image quality.

PubMed

Braeuning, M P; Cooper, H W; O'Brien, S; Burns, C B; Washburn, D B; Schell, M J; Pisano, E D

1999-08-01

Any given mammographic film will exhibit changes in sensitometric response and image resolution as processing variables are altered. Developer type, immersion time, and temperature have been shown to affect the contrast of the mammographic image and thus lesion visibility. The authors evaluated the effect of altering processing variables, including film type, developer type, and immersion time, on the visibility of masses, fibrils, and speaks in a standard mammographic phantom. Images of a phantom obtained with two screen types (Kodak Min-R and Fuji) and five film types (Kodak Min-R M, Min-R E, Min-R H; Fuji UM-MA HC, and DuPont Microvision-C) were processed with five different developer chemicals (Autex SE, DuPont HSD, Kodak RP, Picker 3-7-90, and White Mountain) at four different immersion times (24, 30, 36, and 46 seconds). Processor chemical activity was monitored with sensitometric strips, and developer temperatures were continuously measured. The film images were reviewed by two board-certified radiologists and two physicists with expertise in mammography quality control and were scored based on the visibility of calcifications, masses, and fibrils. Although the differences in the absolute scores were not large, the Kodak Min-R M and Fuji films exhibited the highest scores, and images developed in White Mountain and Autex chemicals exhibited the highest scores. For any film, several processing chemicals may be used to produce images of similar quality. Extended processing may no longer be necessary.

Yield and protein quality of thermophilic Bacillus spp. biomass related to thermophilic aerobic digestion of agricultural wastes for animal feed supplementation.

PubMed

Ugwuanyi, J Obeta

2008-05-01

Bacillus spp. responsible for thermophilic aerobic digestion (TAD) of agricultural wastes were studied for their growth rate, yield and protein quality (amino acid profile) under conditions that approximate full-scale waste digestion as pointers to the capacity of TAD to achieve protein enrichment of wastes for reuse in animal feeding. Specific growth rates of the thermophiles varied with temperature and aeration rates. For Bacillus coagulans, the highest specific growth rate was 1.98 muh(-1); for Bacillus licheniformis 2.56 muh(-1) and for Bacillus stearothermophilus 2.63 muh(-1). Molar yield of B. stearothermophilus on glucose increased with temperature to a peak of 0.404 g g(-1) at 50 degrees C before declining. Peak concentration of overflow metabolite (acetate) increased from 10 mmol at 45 degrees C to 34 mmol at 65 degrees C before declining. Accumulation of biomass in all three isolates decreased with increase in temperature while protein content of biomass increased. Highest biomass protein (79%) was obtained in B. stearothermophilus at 70 degrees C. Content of most essential amino acids of the biomass improved with temperature. Amino acid profile of the biomass was comparable to or superior to the FAO standard for SCP intended for use in animal feeding. Culture condition (waste digestion condition) may be manipulated to optimize protein yield and quality of waste digested by TAD for recycling in animal feed.

Enhancing the Evidence for Behavioral Counseling

PubMed Central

Alcántara, Carmela; Klesges, Lisa M.; Resnicow, Ken; Stone, Amy; Davidson, Karina W.

2015-01-01

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care–focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)—a multidisciplinary scientific organization committed to improving population health through behavior change—we review the USPSTF mandate and current recommendations for behavioral counseling interventions, and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care–focused behavioral counseling interventions. This perspective highlights five areas for further development, including: (1) behavioral counseling–focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care–based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice. PMID:26296553

e-Calibrations: using the Internet to deliver calibration services in real time at lower cost

NASA Astrophysics Data System (ADS)

Desrosiers, Marc; Nagy, Vitaly; Puhl, James; Glenn, Robert; Densock, Robert; Stieren, David; Lang, Brian; Kamlowski, Andreas; Maier, Diether; Heiss, Arthur

2002-03-01

The National Institute of Standards and Technology (NIST) is expanding into a new frontier in the delivery of measurement services. The Internet will be employed to provide industry with electronic traceability to national standards. This is a radical departure from the traditional modes of traceability and presents many new challenges. The traditional mail-based calibration service relies on sending artifacts to the user, who then mails them back to NIST for evaluation. The new service will deliver calibration results to the industry customer on-demand, in real-time, at a lower cost. The calibration results can be incorporated rapidly into the production process to ensure the highest quality manufacturing. The service would provide the US radiation processing industry with a direct link to the NIST calibration facilities and its expertise, and provide an interactive feedback process between industrial processing and the national measurement standard. Moreover, an Internet calibration system should contribute to the removal of measurement-related trade barriers.

Dual-layer DECT for multiphasic hepatic CT with 50 percent iodine load: a matched-pair comparison with a 120 kVp protocol.

PubMed

Nagayama, Yasunori; Nakaura, Takeshi; Oda, Seitaro; Utsunomiya, Daisuke; Funama, Yoshinori; Iyama, Yuji; Taguchi, Narumi; Namimoto, Tomohiro; Yuki, Hideaki; Kidoh, Masafumi; Hirata, Kenichiro; Nakagawa, Masataka; Yamashita, Yasuyuki

2018-04-01

To evaluate the image quality and lesion conspicuity of virtual-monochromatic-imaging (VMI) with dual-layer DECT (DL-DECT) for reduced-iodine-load multiphasic-hepatic CT. Forty-five adults with renal dysfunction who had undergone hepatic DL-DECT with 300-mgI/kg were included. VMI (40-70-keV, DL-DECT-VMI) was generated at each enhancement phase. As controls, 45 matched patients undergoing standard 120-kVp protocol (120-kVp, 600-mgI/kg, and iterative reconstruction) were included. We compared the size-specific dose estimate (SSDE), image noise, CT attenuation, and contrast-to-noise ratio (CNR) between protocols. Two radiologists scored the image quality and lesion conspicuity. SSDE was significantly lower in DL-DECT group (p < 0.01). Image noise of DL-DECT-VMI was almost constant at each keV (differences of ≤15%) and equivalent to or lower than of 120-kVp. As the energy decreased, CT attenuation and CNR gradually increased; the values of 55-60 keV images were almost equivalent to those of standard 120-kVp. The highest scores for overall quality and lesion conspicuity were assigned at 40-keV followed by 45 to 55-keV, all of which were similar to or better than of 120-kVp. For multiphasic-hepatic CT with 50% iodine-load, DL-DECT-VMI at 40- to 55-keV provides equivalent or better image quality and lesion conspicuity without increasing radiation dose compared with standard 120-kVp protocol. • 40-55-keV yields optimal image quality for half-iodine-load multiphasic-hepatic CT with DL-DECT. • DL-DECT protocol decreases radiation exposure compared with 120-kVp scans with iterative reconstruction. • 40-keV images maximise conspicuity of hepatocellular carcinoma especially at hepatic-arterial phase.

Development of a standardized measure to assess food quality: a proof of concept.

PubMed

Jomaa, L H; Hwalla, N C; Zidek, J M

2016-11-09

Food-based dietary guidelines are promoted to improve diet quality. In applying dietary recommendations, such as the MyPlate, the number of servings in a food group is the unit of measure used to make food selections. However, within each food group, different foods can vary greatly in their nutritional quality despite often having similar energy (caloric) values. This study aimed to develop a novel unit of measure that accounts for both the quantity of energy and the quality of nutrients, as defined by caloric and micronutrient density, respectively, in foods and to demonstrate its usability in identifying high quality foods within a food group. A standardized unit of measure reflecting the quality of kilocalories for nutrition (qCaln) was developed through a mathematical function dependent on the energy content (kilocalories per 100 g) and micronutrient density of foods items within a food group. Nutrition composition of 1806 food items was extracted from the USDA nutrient database. For each food item analyzed, qCaln ratios were calculated to compare qCaln to its caloric content. Finally, a case example was developed comparing two plates adapted from the MyPlate. Examples of food items with highest and lowest qCaln ratios were displayed for five food groups: vegetables, fruits/fruit juices, milk/dairy products, meats/meat alternatives, and breads/cereals. Additionally, the applicability of the qCaln was presented through comparing two plates, adopted from the USDA MyPlate, to show differences in food quality. The newly developed qCaln measure can be used to rank foods in terms of their nutrient density while accounting for their energy content. The proposed metric can provide consumers, public health professionals, researchers, and policy makers with an easy-to-understand measure of food quality and a practical tool to assess diet quality among individuals and population groups.

Intra-patient comparison of reduced-dose model-based iterative reconstruction with standard-dose adaptive statistical iterative reconstruction in the CT diagnosis and follow-up of urolithiasis.

PubMed

Tenant, Sean; Pang, Chun Lap; Dissanayake, Prageeth; Vardhanabhuti, Varut; Stuckey, Colin; Gutteridge, Catherine; Hyde, Christopher; Roobottom, Carl

2017-10-01

To evaluate the accuracy of reduced-dose CT scans reconstructed using a new generation of model-based iterative reconstruction (MBIR) in the imaging of urinary tract stone disease, compared with a standard-dose CT using 30% adaptive statistical iterative reconstruction. This single-institution prospective study recruited 125 patients presenting either with acute renal colic or for follow-up of known urinary tract stones. They underwent two immediately consecutive scans, one at standard dose settings and one at the lowest dose (highest noise index) the scanner would allow. The reduced-dose scans were reconstructed using both ASIR 30% and MBIR algorithms and reviewed independently by two radiologists. Objective and subjective image quality measures as well as diagnostic data were obtained. The reduced-dose MBIR scan was 100% concordant with the reference standard for the assessment of ureteric stones. It was extremely accurate at identifying calculi of 3 mm and above. The algorithm allowed a dose reduction of 58% without any loss of scan quality. A reduced-dose CT scan using MBIR is accurate in acute imaging for renal colic symptoms and for urolithiasis follow-up and allows a significant reduction in dose. • MBIR allows reduced CT dose with similar diagnostic accuracy • MBIR outperforms ASIR when used for the reconstruction of reduced-dose scans • MBIR can be used to accurately assess stones 3 mm and above.

Clinical trials in Brazilian journals of ophthalmology: where we are.

PubMed

Lira, Rodrigo Pessoa Cavalcanti; Leal, Franz Schubert; Gonçalves, Fauze Abdulmassih; Amorim, Fernando Henrique Ramos; Felix, João Paulo Fernandes; Arieta, Carlos Eduardo Leite

2013-01-01

To compare clinical trials published in Brazilian journals of ophthalmology and in foreign journals of ophthalmology with respect to the number of citations and the quality of reporting [by applying the Consolidated Standards for Reporting Trials (CONSORT) statement writing standards]. The sample of this systematic review comprised the two Brazilian journals of ophthalmology indexed at Science Citation Index Expanded and six of the foreign journals of ophthalmology with highest Impact Factor® according ISI. All clinical trials (CTs) published from January 2009 to December 2010 at the Brazilians journals and a 1:1 randomized sample of the foreign journals were included. The primary outcome was the number of citations through the end of 2011. Subgroup analysis included language. The secondary outcome included likelihood of citation (cited at least once versus no citation), and presence or absence of CONSORT statement indicators. The citation counts were statistically significantly higher (P<0.001) in the Foreign Group (10.50) compared with the Brazilian Group (0.45). The likelihood citation was statistically significantly higher (P<0.001) in the Foreign Group (20/20 - 100%) compared with the Brazilian Group (8/20 - 40%). The subgroup analysis of the language influence in Brazilian articles showed that the citation counts were statistically significantly higher in the papers published in English (P<0.04). Of 37 possible CONSORT items, the mean for the Foreign Group was 20.55 and for the Brazilian Group was 13.65 (P<0.003). The number of citations and the quality of reporting of clinical trials in Brazilian journals of ophthalmology still are low when compared with the foreign journals of ophthalmology with highest Impact Factor®.

[Diagnostic radiology in the technological era. Comparison between two models].

PubMed

Andrade-Barreto, O A; Villa-Caballero, Leonel

2005-01-01

Diagnostic Radiology is a medical specialty that has played a dynamic role in the medical arena during the last three decades of the XX century. As a part of the evolution of this specialty, medicine and society at large have received diverse benefits in areas of diagnosis and for the decision making process in the clinical practice. Modern radiology has provided numerous advances and refined tools that give more convenience speed and precise diagnosis in the current medical practice. At the present time, these technologies are part of the standard of care in the US and other industrialized countries, representing the ultimate desire or goal to reach for other healthcare systems in developing countries as well. Unfortunately, many of the clinical skills in the health care personal have not evolved at the same pace of those modern technologies, conditioning a reduction in the performance of sensitive areas to the patient's interest, such as the caring, compassion and quality of health care. It is unquestionable the value and benefits that technologies such as CAT and MRI scans have brought to the standard practice in the recent time. Nonetheless, it is desirable to maintain the highest possible level of clinical skills despite the extended use of modern technologies by the health personnel, without compromising the quality of care. Yet is pending the future role and rational use for those technologies in radiology, especially in times when delivering good, reliable health care have become a priority for many health institutions worldwide. This approach would be the ultimate goal to reach in times and circumstances where health for all is the highest precious value to obtain at global level.

Dual-energy computed tomography in patients with cutaneous malignant melanoma: Comparison of noise-optimized and traditional virtual monoenergetic imaging.

PubMed

Martin, Simon S; Wichmann, Julian L; Weyer, Hendrik; Albrecht, Moritz H; D'Angelo, Tommaso; Leithner, Doris; Lenga, Lukas; Booz, Christian; Scholtz, Jan-Erik; Bodelle, Boris; Vogl, Thomas J; Hammerstingl, Renate

2017-10-01

The aim of this study was to investigate the impact of noise-optimized virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with cutaneous malignant melanoma at thoracoabdominal dual-energy computed tomography (DECT). Seventy-six patients (48 men; 66.6±13.8years) with metastatic cutaneous malignant melanoma underwent DECT of the thorax and abdomen. Images were post-processed with standard linear blending (M_0.6), traditional virtual monoenergetic (VMI), and VMI+ technique. VMI and VMI+ images were reconstructed in 10-keV intervals from 40 to 100keV. Attenuation measurements were performed in cutaneous melanoma lesions, as well as in regional lymph node, subcutaneous and in-transit metastases to calculate objective signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. Five-point scales were used to evaluate overall image quality and lesion delineation by three radiologists with different levels of experience. Objective indices SNR and CNR were highest at 40-keV VMI+ series (5.6±2.6 and 12.4±3.4), significantly superior to all other reconstructions (all P<0.001). Qualitative image parameters showed highest values for 50-keV and 60-keV VMI+ reconstructions (median 5, respectively; P≤0.019) regarding overall image quality. Moreover, qualitative assessment of lesion delineation peaked in 40-keV VMI+ (median 5) and 50-keV VMI+ (median 4; P=0.055), significantly superior to all other reconstructions (all P<0.001). Low-keV noise-optimized VMI+ reconstructions substantially increase quantitative and qualitative image parameters, as well as subjective lesion delineation compared to standard image reconstruction and traditional VMI in patients with cutaneous malignant melanoma at thoracoabdominal DECT. Copyright © 2017 Elsevier B.V. All rights reserved.

Reliability of Pressure Ulcer Rates: How Precisely Can We Differentiate Among Hospital Units, and Does the Standard Signal‐Noise Reliability Measure Reflect This Precision?

PubMed Central

Cramer, Emily

2016-01-01

Abstract Hospital performance reports often include rankings of unit pressure ulcer rates. Differentiating among units on the basis of quality requires reliable measurement. Our objectives were to describe and apply methods for assessing reliability of hospital‐acquired pressure ulcer rates and evaluate a standard signal‐noise reliability measure as an indicator of precision of differentiation among units. Quarterly pressure ulcer data from 8,199 critical care, step‐down, medical, surgical, and medical‐surgical nursing units from 1,299 US hospitals were analyzed. Using beta‐binomial models, we estimated between‐unit variability (signal) and within‐unit variability (noise) in annual unit pressure ulcer rates. Signal‐noise reliability was computed as the ratio of between‐unit variability to the total of between‐ and within‐unit variability. To assess precision of differentiation among units based on ranked pressure ulcer rates, we simulated data to estimate the probabilities of a unit's observed pressure ulcer rate rank in a given sample falling within five and ten percentiles of its true rank, and the probabilities of units with ulcer rates in the highest quartile and highest decile being identified as such. We assessed the signal‐noise measure as an indicator of differentiation precision by computing its correlations with these probabilities. Pressure ulcer rates based on a single year of quarterly or weekly prevalence surveys were too susceptible to noise to allow for precise differentiation among units, and signal‐noise reliability was a poor indicator of precision of differentiation. To ensure precise differentiation on the basis of true differences, alternative methods of assessing reliability should be applied to measures purported to differentiate among providers or units based on quality. © 2016 The Authors. Research in Nursing & Health published by Wiley Periodicals, Inc. PMID:27223598

Ground-Water Quality in the Mohawk River Basin, New York, 2006

USGS Publications Warehouse

Nystrom, Elizabeth A.

2008-01-01

Water samples were collected from 27 wells from August through November 2006 to characterize ground-water quality in the Mohawk River Basin. The Mohawk River Basin covers 3,500 square miles in central New York; most of the basin is underlain by sedimentary bedrock, including shale, sandstone, and carbonates. Sand and gravel form the most productive aquifers in the basin. Samples were collected from 13 sand and gravel wells and 14 bedrock wells, including production and domestic wells. The samples were collected and processed through standard U.S. Geological Survey procedures and were analyzed for 226 physical properties and constituents, including physical properties, major ions, nutrients, trace elements, radon-222, pesticides, volatile organic compounds, and bacteria. Many constituents were not detected in any sample, but concentrations of some constituents exceeded current or proposed Federal or New York State drinking-water quality standards, including color (1 sample), pH (2 samples), sodium (11 samples), chloride (2 samples), fluoride (1 sample), sulfate (1 sample), aluminum (2 samples), arsenic (2 samples), iron (10 samples), manganese (10 samples), radon-222 (12 samples), and bacteria (6 samples). Dissolved oxygen concentrations were greater in samples from sand and gravel wells (median 5.6 milligrams per liter [mg/L]) than from bedrock wells (median 0.2 mg/L). The pH was typically neutral or slightly basic (median 7.3); the median water temperature was 11?C. The ions with the highest concentrations were bicarbonate (median 276 mg/L), calcium (median 58.9 mg/L), and sodium (median 41.9 mg/L). Ground water in the basin is generally very hard (180 mg/L as CaCO3 or greater), especially in the Mohawk Valley and areas with carbonate bedrock. Nitrate-plus-nitrite concentrations were generally higher samples from sand and gravel wells (median concentration 0.28 mg/L as N) than in samples from bedrock wells (median < 0.06 mg/L as N), although no concentrations exceeded established State or Federal drinking-water standards of 10 mg/L as N for nitrate and 1 mg/L as N for nitrite. Ammonia concentrations were higher in samples from bedrock wells (median 0.349 mg/L as N) than in those from samples from sand and gravel wells (median 0.006 mg/L as N). The trace elements with the highest concentrations were strontium (median 549 micrograms per liter [?g/L]), iron (median 143 ?g/L), boron (median 35 ?g/L), and manganese (median 31.1 ?g/L). Concentrations of several trace elements, including boron, copper, iron, manganese, and strontium, were higher in samples from bedrock wells than those from sand and gravel wells. The highest radon-222 activities were in samples from bedrock wells (maximum 1,360 pCi/L); 44 percent of all samples exceeded a proposed U.S. Environmental Protection Agency drinking water standard of 300 pCi/L. Nine pesticides and pesticide degradates were detected in six samples at concentrations of 0.42 ?g/L or less; all were herbicides or their degradates, and most were degradates of alachlor, atrazine, and metolachlor. Six volatile organic compounds were detected in four samples at concentrations of 0.8 ?g/L or less, including four trihalomethanes, tetrachloroethene, and toluene; most detections were in sand and gravel wells and none of the concentrations exceeded drinking water standards. Coliform bacteria were detected in six samples but fecal coliform bacteria, including Escherichia coli, were not detected in any sample.

Ground-Water Quality in the Upper Hudson River Basin, New York, 2007

USGS Publications Warehouse

Nystrom, Elizabeth A.

2009-01-01

Water samples were collected from 25 production and domestic wells in the Upper Hudson River Basin (north of the Federal Dam at Troy, N.Y.) from August through November 2007 to characterize the ground-water quality. The Upper Hudson River Basin covers 4,600 square miles in upstate New York, Vermont, and Massachusetts; the study area encompasses the 4,000 square miles that lie within New York. The basin is underlain by crystalline and sedimentary bedrock, including gneiss, shale, and slate; some sandstone and carbonate rocks are present locally. The bedrock in some areas is overlain by surficial deposits of saturated sand and gravel. Of the 25 wells sampled, 13 were finished in sand and gravel deposits, and 12 were finished in bedrock. The samples were collected and processed by standard U.S. Geological Survey procedures and were analyzed for 225 physical properties and constituents, including major ions, nutrients, trace elements, radon-222, pesticides, volatile organic compounds (VOCs), and indicator bacteria. Water quality in the study area is generally good, but concentrations of some constituents exceeded current or proposed Federal or New York State drinking-water standards; these were: color (1 sample), pH (2 samples), sodium (5 samples), nitrate plus nitrite (2 samples), aluminum (3 samples), iron (1 sample), manganese (7 samples), radon-222 (11 samples), and bacteria (1 sample). Dissolved-oxygen concentrations in samples from wells finished in sand and gravel [median 5.4 milligrams per liter (mg/L)] were greater than those from wells finished in bedrock (median 0.4 mg/L). The pH of all samples was typically neutral or slightly basic (median 7.6); the median water temperature was 9.7 deg C. The ions with the highest concentrations were bicarbonate (median 123 mg/L) and calcium (median 33.9 mg/L). Ground water in the basin is generally soft to moderately hard (less than or equal to 120 mg/L as CaCO3) (median hardness 110 mg/L as CaCO3). Concentrations of nitrate plus nitrite in samples from sand and gravel wells (median concentration 0.47 mg/L as nitrogen) were generally higher than those in samples from bedrock wells (median estimated 0.05 mg/L as nitrogen), and concentrations in two samples exceeded established drinking-water standards for nitrate (10 mg/L as nitrogen). The trace elements with the highest concentrations were strontium [median 217 micrograms per liter (ug/L)] and iron (median 39 ug/L). The highest radon-222 activities were in samples from bedrock wells [maximum 2,930 picocuries per liter (pCi/L)] and 44 percent of all samples exceeded a proposed U.S. Environmental Protection Agency (USEPA) drinking-water standard of 300 pCi/L. Ten pesticides and pesticide degradates were detected among 11 samples at concentrations of 1.47 ug/L or less; most were herbicides or their degradates. Six VOCs were detected among 10 samples at concentrations of 4.2 ug/L or less; these included three trihalomethanes and methyl tert-butyl ether, tetrachloroethene, and toluene. Most detections were in samples from sand and gravel wells and none exceeded drinking-water standards. Total coliform bacteria were detected in only one sample, and fecal coliform bacteria, including Escherichia coli, were not detected in any sample.

Significance of Psychological Stress Response and Health-related Quality of Life in Spouses of Cancer Patients When Given Bad News

PubMed Central

Kugimoto, Toyoko; Katsuki, Ryo; Kosugi, Toshifumi; Ohta, Akihide; Sato, Hidetoshi

2017-01-01

Objective: This study illuminates the degree of psychological stress response experienced by spouses of cancer patients when given bad news at three different times (notification of the name of the disease, notification of recurrence, and notification of terminality) as well as the factors that influence the response and the health status of the spouse as measured by health-related quality of life (QOL). Methods: A total of 203 individuals (57 men and 146 women) who had received the three types of news were surveyed using a self-report questionnaire on psychological stress response, marital satisfaction, and health-related QOL scales. Results: The degree of the psychological stress response was the highest for notification of terminality, followed by notification of the name of the disease, and notification of recurrence. The influencing factors varied depending on the notification period. Although no significant difference was observed for health-related QOL among the three notification types, significant differences were observed for certain items when compared with national standard values. Conclusions: When a notification of terminality, which produced the highest psychological stress response, is given, providing care that considers health-related QOL is necessary not only for patients but also for their spouses. PMID:28503648

The effects of using shell filters in the process of depuration for the survival of Anadara sp.

NASA Astrophysics Data System (ADS)

Pursetyo, K. T.; Sulmartiwi, L.; Alamsjah, M. A.; Tjahjaningsih, W.; Rosmarini, A. S.; Nikmah, M.

2018-04-01

Anadara sp. is one of the shellfish that has a source of animal protein is high and has a high economic value. However, to obtain a safe source of food, the products must meet the standard by the government, one of which is the limitations in heavy metals in the shells. In the standard of sanitation of shellfish is required to do the depuration process to remove the contaminants be it bacteria or heavy metals. In this study, randomized design with 5 treatments was used: P0 (control / without filter), P1 (25 % filter with shells), P2 (50 % filter with shells), P3 (75 % filter with shells), P4 (100 % filter with shells). Each treatment was replicated 4 times. The results showed that filtering of shell in depuration process could cause the highest shell death for 24 hours occurred in P4 of 24.39 % and the highest death during 48 hours also happened at the treatment of P4 which was equal to 61.71 %. During the research, water quality measurement was measured at 29-30 °C, pH 7.2-7.7, dissolved oxygen (DO) 4-4.4 mg/L and salinity 28-30 ppt.

[Body composition investigation of 2321 Shenzhen government and enterprise staffs].

PubMed

Liu, Xiaoli; Zhou, Jichang; Sun, Shiqiang; Xu, Jiazhang; Zhou, Xiaoying; Huang, Changhua; He, Shan; Liu, Can; Xu, Jian; Gong, Chunmei

2016-01-01

To understand the laws of human body composition change and the status of the overweight and obesity of government and enterprise staffs. In July 2013 - January 2014, 2321 adults more than 20-year-old healthy check-up crowd with complete human body composition and height as well as weight data in a medical center in Shenzhen were collected by convenience sampling method. The overweight rates of male and female were 46.41% and 18.94% respectively (standardized overweight rates were 44.02% and 14.51%, respectively), and the difference between them was statisically significant (Χ2 = 201.01, P = 0. 000). The obesity rates of male and female were 12.13% and 3.57%, respectively (standardized overweight rates were 11.11% (see symbol) 2.63%, respectively), and the difference between them was statisically significant (X2 = 48.45, P = 0.000). The parameters of bone mineral quality, visceral fat area, body fat, body fat percentage, abdominal obesity, body moisture and free fat weight increased with body weight, and there were statistical significance among normal weight, overweight and obesity groups (P = 0.000). Bone mineral quality was highest at the age of 30 to 40 for men and women, and there was the statistical significance. There was statistical significance in visceral fat area between different ages in the same gender. Body fat percentage (34.24 + 5.39)% of all ages 50 to 59 years old and body moisture (28.53 + 3.77)% of age 40 - 49 group were highest in women. Male body fat percentage (27.08 + 5.01)% at the age of 60-age group was the highest. Male and female visceral fat area increasesd with age, but there was no statistical difference between men and women at the same age. The human body composition had not a statistically significant difference among normal weight and overweight groups, but a significant difference between normal weight and obesity groups (P = 0.000). Overweight and obesity rates in Shenzhen government and enterprise staffs increase with age. Body composition increase with the weight.

Changing ethnic inequalities in mortality in New Zealand over 30 years: linked cohort studies with 68.9 million person-years of follow-up.

PubMed

Disney, George; Teng, Andrea; Atkinson, June; Wilson, Nick; Blakely, Tony

2017-01-01

Internationally, ethnic inequalities in mortality within countries are increasingly recognized as a public health concern. But few countries have data to monitor such inequalities. We aimed to provide a detailed description of ethnic inequalities (Māori [indigenous], Pacific, and European/Other) in mortality for a country with high quality ethnicity data, using both standard and novel visualization methods. Cohort studies of the entire New Zealand population were conducted, using probabilistically-linked Census and mortality data from 1981 to 2011 (68.9 million person years). Absolute (standardized rate difference) and relative (standardized rate ratio) inequalities were calculated, in 1-74-year-olds, for Māori and Pacific peoples in comparison to European/Other. All-cause mortality rates were highest for Māori, followed by Pacific peoples then European/Other, and declined in all three ethnic groups over time. Pacific peoples experienced the slowest annual percentage fall in mortality rates, then Māori, with European/Other having the highest percentage falls - resulting in widening relative inequalities. Absolute inequalities, however, for both Māori and Pacific males compared to European/Other have been falling since 1996. But for females, only Māori absolute inequalities (compared with European/Other) have been falling. Regarding cause of death, cancer is becoming a more important contributor than cardiovascular disease (CVD) to absolute inequalities, especially for Māori females. We found declines in all-cause mortality rates, over time, for each ethnic group of interest. Ethnic mortality inequalities are generally stable or even falling in absolute terms, but have increased on a relative scale. The drivers of these inequalities in mortality are transitioning over time, away from CVD to cancer and diabetes; such transitions are likely in other countries, and warrant further research. To address these inequalities, policymakers need to enhance prevention activities and health care delivery, but also support wider improvements in educational achievement and socioeconomic position for highest need populations.

Changing ethnic inequalities in mortality in New Zealand over 30 years: linked cohort studies with 68.9 million person-years of follow-up.

PubMed

Disney, George; Teng, Andrea; Atkinson, June; Wilson, Nick; Blakely, Tony

2017-04-26

Internationally, ethnic inequalities in mortality within countries are increasingly recognized as a public health concern. But few countries have data to monitor such inequalities. We aimed to provide a detailed description of ethnic inequalities (Māori [indigenous], Pacific, and European/Other) in mortality for a country with high quality ethnicity data, using both standard and novel visualization methods. Cohort studies of the entire New Zealand population were conducted, using probabilistically-linked Census and mortality data from 1981 to 2011 (68.9 million person years). Absolute (standardized rate difference) and relative (standardized rate ratio) inequalities were calculated, in 1-74-year-olds, for Māori and Pacific peoples in comparison to European/Other. All-cause mortality rates were highest for Māori, followed by Pacific peoples then European/Other, and declined in all three ethnic groups over time. Pacific peoples experienced the slowest annual percentage fall in mortality rates, then Māori, with European/Other having the highest percentage falls - resulting in widening relative inequalities. Absolute inequalities, however, for both Māori and Pacific males compared to European/Other have been falling since 1996. But for females, only Māori absolute inequalities (compared with European/Other) have been falling. Regarding cause of death, cancer is becoming a more important contributor than cardiovascular disease (CVD) to absolute inequalities, especially for Māori females. We found declines in all-cause mortality rates, over time, for each ethnic group of interest. Ethnic mortality inequalities are generally stable or even falling in absolute terms, but have increased on a relative scale. The drivers of these inequalities in mortality are transitioning over time, away from CVD to cancer and diabetes; such transitions are likely in other countries, and warrant further research. To address these inequalities, policymakers need to enhance prevention activities and health care delivery, but also support wider improvements in educational achievement and socioeconomic position for highest need populations.

The role of open-air inhalatoria in the air quality improvement in spa towns.

PubMed

Burkowska-But, Aleksandra; Kalwasińska, Agnieszka; Brzezinska, Maria Swiontek

2014-08-01

The present study was aimed at evaluating microbiological contamination of air in Ciechocinek and Inowrocław - Polish lowland spa towns. Additionally, the impact of open-air inhalatoria on the quality of air was evaluated. Air samples were collected seasonally in the urban areas, in the recreation areas and in the vicinity of inhalatoria in both towns using impaction. The numbers of mesophilic bacteria, staphylococci, hemolytic bacteria and actinomycetes were determined on media according to the Polish Standard PN-86/Z-04111/02. The number of moulds was determined on media according to the Polish Standard PN-86/Z-04111/03. While the highest numbers of microorganisms were noted at the sites located in the urban areas, the lowest numbers were noted in the vicinity of the open-air inhalatoria. In all the investigated air samples the values of bioaerosol concentrations were below the recommended TLVs (≤ 5000 CFU×m(-3) for both bacteria and fungi in outdoor environments). Location of the sampling site was invariably a decisive factor in determining the number of microorganisms in the air. The aerosol which is formed in the open-air inhalatoria has a positive influence on microbiological air quality. Owing to a unique microclimate and low air contamination, Ciechocinek and Inowrocław comply with all necessary requirements set for health resorts specializing in treating upper respiratory tract infections.

Comparison of IPSM 1990 photon dosimetry code of practice with IAEA TRS‐398 and AAPM TG‐51.

PubMed Central

Henríquez, Francisco Cutanda

2009-01-01

Several codes of practice for photon dosimetry are currently used around the world, supported by different organizations. A comparison of IPSM 1990 with both IAEA TRS‐398 and AAPM TG‐51 has been performed. All three protocols are based on the calibration of ionization chambers in terms of standards of absorbed dose to water, as it is the case with other modern codes of practice. This comparison has been carried out for photon beams of nominal energies: 4 MV, 6 MV, 8 MV, 10 MV and 18 MV. An NE 2571 graphite ionization chamber was used in this study, cross‐calibrated against an NE 2611A Secondary Standard, calibrated in the National Physical Laboratory (NPL). Absolute dose in reference conditions was obtained using each of these three protocols including: beam quality indices, beam quality conversion factors both theoretical and NPL experimental ones, correction factors for influence quantities and absolute dose measurements. Each protocol recommendations have been strictly followed. Uncertainties have been obtained according to the ISO Guide to the Expression of Uncertainty in Measurement. Absorbed dose obtained according to all three protocols agree within experimental uncertainty. The largest difference between absolute dose results for two protocols is obtained for the highest energy: 0.7% between IPSM 1990 and IAEA TRS‐398 using theoretical beam quality conversion factors. PACS number: 87.55.tm

Screening and Characterization of Oleaginous Microalgal Species from Northern Xinjiang.

PubMed

Wu, Lei; Xu, Liangliang; Hu, Chunxiang

2015-06-01

A total of 646 strains, including green algae and diatoms, were isolated from 220 samples to screen microalgae with high lipid productivity (LP). The samples were obtained from nine habitats in Northern Xinjiang, China in June 2013. This study initially identified eight lipidrich strains, namely, Desmodesmus intermedius XJ-498, D. intermedius XJ-145, D. intermedius XJ- 99, Monoraphidium pusillum XJ-489, M. dybowskii XJ-435, M. dybowskii XJ-151, Mychonastes homosphaera XJ-488, and Podohedriella falcata XJ-176, based on 18S rDNA sequencing. The strains were cultured in a photobioreactor for the same period. Results showed that the specific growth rate (day(-1)) of M. pusillum XJ-489 was the highest (1.14 ± 0.06), and the biomass concentration (g/l) of D. intermedius XJ-99 was the highest (2.84 ± 0.3). Futhermore, the lipid content (%) of M. dybowskii XJ-151 was the highest (33.5 ± 4.38), and the lipid productivity (mg l(-1) day(-1)) of My. homosphaera XJ-488 was the highest (86.41 ± 9.04). C16 to C18 accounted for 86% to 98% of the total lipid, and the biodiesel qualities of the selected algae corresponded to international standards. This study suggests that My. homosphaera XJ-488, D. intermedius XJ-99, and M. dybowskii XJ-151 are the most potential strains for biodiesel production among all the isolated strains.

Decision analysis with cumulative prospect theory.

PubMed

Bayoumi, A M; Redelmeier, D A

2000-01-01

Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

CAD-RADS(TM) Coronary Artery Disease - Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology.

PubMed

Cury, Ricardo C; Abbara, Suhny; Achenbach, Stephan; Agatston, Arthur; Berman, Daniel S; Budoff, Matthew J; Dill, Karin E; Jacobs, Jill E; Maroules, Christopher D; Rubin, Geoffrey D; Rybicki, Frank J; Schoepf, U Joseph; Shaw, Leslee J; Stillman, Arthur E; White, Charles S; Woodard, Pamela K; Leipsic, Jonathon A

2016-01-01

The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report. Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD-RADS classification. The main goal of CAD-RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will provide a framework of standardization that may benefit education, research, peer-review and quality assurance with the potential to ultimately result in improved quality of care. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Can constructed wetlands treat wastewater for reuse in agriculture? Review of guidelines and examples in South Europe.

PubMed

Lavrnić, Stevo; Mancini, Maurizio L

2016-01-01

South Europe is one of the areas negatively affected by climate change. Issues with water shortage are already visible, and are likely to increase. Since agriculture is the biggest freshwater consumer, it is important to find new water sources that could mitigate the climate change impact. In order to overcome problems and protect the environment, a better approach towards wastewater management is needed. That includes an increase in the volume of wastewater that is treated and a paradigm shift towards a more sustainable system where wastewater is actually considered as a resource. This study evaluates the potential of constructed wetlands (CWs) to treat domestic wastewater and produce effluent that will be suitable for reuse in agriculture. In South Europe, four countries (Greece, Italy, Portugal and Spain) have national standards that regulate wastewater reuse in agriculture. Wastewater treatment plants (WWTPs) that are based on CWs in these four countries were analysed and their effluents compared with the quality needed for reuse. In general, it was found that CWs have trouble reaching the strictest standards, especially regarding microbiological parameters. However, their effluents are found to be suitable for reuse in areas that do not require water of the highest quality.

Factors affecting job satisfaction and their correlation with educational standards among dental assistants.

PubMed

Al Jazairy, Yousra H; Halawany, Hassan Suliman; Hussainan, Nawaf Al; Maflehi, Nassr Al; Abraham, Nimmi Biju; Jacob, Vimal

2014-01-01

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.

Trial production of fuel pellet from Acacia mangium bark waste biomass

NASA Astrophysics Data System (ADS)

Amirta, R.; Anwar, T.; Sudrajat; Yuliansyah; Suwinarti, W.

2018-04-01

Fuel pellet is one of the innovation products that can be produced from various sources of biomass such as agricultural residues, forestry and also wood industries including wood bark. Herein this paper, the potential fuel pellet production using Acacia mangium bark that abundant wasted from chip mill industry was studied. Fuel pellet was produced using a modified animal feed pellet press machine equipped with rotating roller-cylinders. The international standards quality of fuel pellet such as ONORM (Austria), SS (Sweden), DIN (Germany), EN (European) and ITEBE (Italy) were used to evaluate the optimum composition of feedstock and additive used. Theresults showed the quality offuel pellet produced were good compared to commercial sawdust pellet. Mixed of Acacia bark (dust) with 10% of tapioca and 20% of glycerol (w/w) was increased the stable form of pellet and the highest heating value to reached 4,383 Kcal/kg (calorific value). Blending of Acacia bark with tapioca and glycerol was positively improved its physical, chemical and combustion properties to met the international standards requirement for export market. Based on this finding, production of fuel pellet from Acacia bark waste biomass was promising to be developed as an alternative substitution of fossil energy in the future.

Factors Affecting Job Satisfaction and Their Correlation with Educational Standards among Dental Assistants

PubMed Central

JAZAIRY, Yousra H. AL; HALAWANY, Hassan Suliman; HUSSAINAN, Nawaf AL; MAFLEHI, Nassr AL; ABRAHAM, Nimmi Biju; JACOB, Vimal

2014-01-01

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs. PMID:24747371

The effect of ionizing radiation on microbiological decontamination of medical herbs and biologically active compounds

NASA Astrophysics Data System (ADS)

Migdal, W.; Owczarczyk, B.; Kedzia, B.; Holderna-Kedzia, E.; Segiet-Kujawa, E.

1998-06-01

Several thousand tons of medical herbs are produced annually by pharmaceutical industry in Poland. This product should be of highest quality and microbial purity. Recently, chemical methods of decontamination are recognized as less safe, thus irradiation technique was chosen to replace them in use. In the Institute of Nuclear Chemistry and Technology the national program on the application of irradiation to the decontamination of medical herbs is in progress now. The purpose of the program is to elaborate, on the basis of research work, the facility standards and technological instructions indispensable for the practice of radiation technology.

The public role in promoting child health information technology.

PubMed

Conway, Patrick H; White, P Jonathan; Clancy, Carolyn

2009-01-01

The public sector plays an important role in promoting child health information technology. Public sector support is essential in 5 main aspects of child health information technology, namely, data standards, pediatric functions in health information systems, privacy policies, research and implementation funding, and incentives for technology adoption. Some innovations in health information technology for adult populations can be transferred to or adapted for children, but there also are unique needs in the pediatric population. Development of health information technology that addresses children's needs and effective adoption of that technology are critical for US children to receive care of the highest possible quality in the future.

Formation of disinfection byproducts in typical Chinese drinking water.

PubMed

Liu, Wenbo; Zhao, Yanmei; Chow, Christopher W K; Wang, Dongsheng

2011-01-01

Eight typical drinking water supplies in China were selected in this study. Both source and tap water were used to investigate the occurrence of chlorinated disinfection byproducts (DBPs), and seasonal variation in the concentrations of trihalomethanes (THMs) of seven water sources was compared. The results showed that the pollution level for source water in China, as shown by DBP formation potential, was low. The most encountered DBPs were chloroform, dichloroacetic acid, trichloroacetic acid, and chlorodibromoacetic acid. The concentration of every THMs and haloacetic acid (HAA) compound was under the limit of standards for drinking water quality. The highest total THMs concentrations were detected in spring.

A New Paradigm for Tissue Diagnostics: Tools and Techniques to Standardize Tissue Collection, Transport, and Fixation.

PubMed

Bauer, Daniel R; Otter, Michael; Chafin, David R

2018-01-01

Studying and developing preanalytical tools and technologies for the purpose of obtaining high-quality samples for histological assays is a growing field. Currently, there does not exist a standard practice for collecting, fixing, and monitoring these precious samples. There has been some advancement in standardizing collection for the highest profile tumor types, such as breast, where HER2 testing drives therapeutic decisions. This review examines the area of tissue collection, transport, and monitoring of formalin diffusion and details a prototype system that could be used to help standardize tissue collection efforts. We have surveyed recent primary literature sources and conducted several site visits to understand the most error-prone processes in histology laboratories. This effort identified errors that resulted from sample collection techniques and subsequent transport delays from the operating room (OR) to the histology laboratories. We have therefore devised a prototype sample collection and transport concept. The system consists of a custom data logger and cold transport box and takes advantage of a novel cold + warm (named 2 + 2) fixation method. This review highlights the beneficial aspects of standardizing tissue collection, fixation, and monitoring. In addition, a prototype system is introduced that could help standardize these processes and is compatible with use directly in the OR and from remote sites.

Simultaneous determination of nine saponins from Panax notoginseng using HPLC and pressurized liquid extraction.

PubMed

Wan, J B; Lai, C M; Li, S P; Lee, M Y; Kong, L Y; Wang, Y T

2006-04-11

A HPLC and pressurized liquid extraction (PLE) method was developed for simultaneous determination of nine saponins, including notoginsenoside R1, ginsenoside Rg1, Re, Rf, Rb1, Rc, Rb2, Rb3 and Rd in Panax notoginseng. The analysis was performed on C18 column with water-acetonitrile gradient elution and the investigated saponins were authenticated by comparing retention time and mass spectra with their reference compounds. Several methods including PLE, ultrasonication, soxhlet extraction and immersion were used for sample preparation and their extraction efficiency was compared. The results showed that PLE has the highest extraction efficiency and repeatability, which would be valuable on standardization of sample preparation for quality control of Chinese medicines. The developed HPLC and PLE is an effective approach for simultaneously quantitative determination of sapoinins in P. notoginseng, which could be used for quality control of P. notoginseng and its preparations.

Romantic Relationship Length and its Perceived Quality: Mediating Role of Facebook-Related Conflict

PubMed Central

Rahaman, H. M. Saidur

2015-01-01

The purpose of this study was to investigate how Facebook use is leading to negative relationship outcomes such as cheating and breakup by assessing users’ perceived relationship qualities. It was hypothesized that Facebook-related conflict will be negatively related with users’ relationship length and will also be negatively related with their perceived relationship satisfaction, commitment, and love. Facebook-related conflict further mediates the relationship between relationship length and perceived relationship satisfaction, commitment, and love. Self-report data were gathered from participants (N = 101) in an online survey by employing standard questionnaires. A set of regression and mediation analyses confirmed all the hypotheses of the study. That is, Facebook-related conflict mediates the relationship between relationship length and perceived relationship satisfaction, commitment, and love. Moreover, the magnitude of mediation was highest for relationship satisfaction. Implications for future research and contributions are discussed. PMID:27247665

PS1-32: Doctor’s Role in Their Patient’s Healing: Practices of the Highest Performing Physicians by Patient Survey

PubMed Central

Sutherland, Elizabeth; Vuckovic, Nancy; Hsu, John; Tallman, Karen; Frankel, Richard; Stein, Terry; Sung, Sue Hee

2010-01-01

Background: The MD Patient Communication Study aims were to improve the best practice communication behaviors of physicians during outpatient clinic visits and to collect physician perspectives of communication behaviors. Researchers have consistently found the top predictors of overall patient satisfaction are quality of the physician-patient relationship and contributing communications. There is limited understanding however, of the range of specific behaviors in the interaction associated with positive and negative patient perceptions and reactions. Methods: In phase 1, we conducted a naturalistic, observational study of 55 Kaiser Permanente Primary Care physician-patient visits using videotape recordings, and incorporating patient and physician reactions to the tape. The physicians, who practiced in Los Angeles and Honolulu, spanned the three strata of high, medium, and low historical patient satisfaction scores. In phase 2, a standardized six-question set was posed in semi-structured, 60-minute interviews to 77 of the highest-performing physicians on this patient survey, including 20 of the highest performers (top 5%) from the LA and Honolulu groups and 42 and 15, respectively, of the highest performing physicians in Portland and Oakland. These interviews were audio taped with permission, transcribed and coded for patterns. Results: This abstract addresses the 4th question: What role do you feel you play in your patients’ healing? Do you think you, as a doctor, contribute to your patients’ healing through non-technical, non-physical, or non-scientific ways? All physicians agreed but varied in their role. Representative quotes: Giving people the confidence to go through something. People feel better coming in and seeing/talking to you. People realizing they have the power to heal themselves their involvement is essential. Our relationship: Interpersonal connection is so powerful. The art of medicine is the art of healing. These narratives provide deep, coherent learning about physicians’ role in healing: relationship, education, empowerment, emotion, personal connection, hope. Conclusions: With primary care in crisis nationally, and specialists increasingly procedure-focused, understanding physicians’ role in patients’ healing, especially as it creates high patient satisfaction, is of great importance to sustaining the highest quality medical care and service.

[Quality of water for human consumption and its association with morbimortality in Colombia, 2008-2012].

PubMed

Guzmán, Blanca Lisseth; Nava, Gerardo; Díaz, Paula

2015-08-01

The quality of water for human consumption has been correlated with the occurrence of different diseases. Studying the relationship between these parameters would allow determining the impact of water quality on human health, and to direct preventative measures and promote environmental health. To analyze the quality of water intended for human consumption and its association with morbimortality in Colombia, 2008-2012. The database for surveillance of water quality was analyzed by means of descriptive statistics of the principal indicators (total coliforms, Escherichia coli , turbidity, color, pH, free residual chlorine and water quality risk index). The results were correlated with infant mortality and morbidity due to acute diarrheal diseases, foodborne diseases and hepatitis A. A risk map was prepared to identify those municipalities with the highest risk of water contamination and infant mortality. A high percentage of municipalities did not conform to existing standards for water potability values. Problems were identified that were related to presence of E. coli and total coliforms, as well as absence of free residual chlorine, a situation that was exacerbated in rural areas. Water quality showed a high correlation with infant mortality, highlighting its importance for children's health. Water quality was found to have an important impact on infant mortality. Improving water quality in Colombia will require policies that strengthen water supply systems in this country. Strengthening of environmental health surveillance programs is essential to guide actions aimed at improving water quality and exert a positive impact on health.

Factors affecting dental service quality.

PubMed

Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

2015-01-01

Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

Water Quality Assessment using Satellite Remote Sensing

NASA Astrophysics Data System (ADS)

Haque, Saad Ul

2016-07-01

The two main global issues related to water are its declining quality and quantity. Population growth, industrialization, increase in agriculture land and urbanization are the main causes upon which the inland water bodies are confronted with the increasing water demand. The quality of surface water has also been degraded in many countries over the past few decades due to the inputs of nutrients and sediments especially in the lakes and reservoirs. Since water is essential for not only meeting the human needs but also to maintain natural ecosystem health and integrity, there are efforts worldwide to assess and restore quality of surface waters. Remote sensing techniques provide a tool for continuous water quality information in order to identify and minimize sources of pollutants that are harmful for human and aquatic life. The proposed methodology is focused on assessing quality of water at selected lakes in Pakistan (Sindh); namely, HUBDAM, KEENJHAR LAKE, HALEEJI and HADEERO. These lakes are drinking water sources for several major cities of Pakistan including Karachi. Satellite imagery of Landsat 7 (ETM+) is used to identify the variation in water quality of these lakes in terms of their optical properties. All bands of Landsat 7 (ETM+) image are analyzed to select only those that may be correlated with some water quality parameters (e.g. suspended solids, chlorophyll a). The Optimum Index Factor (OIF) developed by Chavez et al. (1982) is used for selection of the optimum combination of bands. The OIF is calculated by dividing the sum of standard deviations of any three bands with the sum of their respective correlation coefficients (absolute values). It is assumed that the band with the higher standard deviation contains the higher amount of 'information' than other bands. Therefore, OIF values are ranked and three bands with the highest OIF are selected for the visual interpretation. A color composite image is created using these three bands. The water quality of these lakes are assessed by comparing their reflectance values with the spectral signatures of distilled water. The layout water quality maps of these lakes are prepared in terms of these deviations. The results of the study can be utilized for preliminary water quality monitoring of the selected lakes.

Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

PubMed

Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

2016-01-01

Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P < 0.0001). The intervention was equally beneficial irrespective of training level. Although the magnitude of improvement was comparable, the mean compliance score was highest in year 2 at 81% (year 1: 72% [P = 0.019] and year 3: 70% [P = 0.002]). Fellows expressed a high degree of satisfaction with the educational intervention and emphasized the value in reviewing the conceptual bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

Assessing health-related quality of life in patients with breast cancer: a systematic and standardized comparison of available instruments using the EMPRO tool.

PubMed

Maratia, Stefano; Cedillo, Sergio; Rejas, Javier

2016-10-01

The objective was to obtain a standardized evaluation of available specific and generic breast cancer health-related quality-of-life instruments. We carried out systematic literature reviews in the PubMed and EMBASE databases to identify manuscripts which contained information regarding either the development process or metric properties of health-related quality-of-life instruments used among breast cancer patients. Each instrument was evaluated independently by two researchers, and occasionally a third one, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall score and seven attribute-specific EMPRO scores were calculated (range 0-100, worst to best): concept and measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms. FACT-B was the instrument with the best global performance, obtaining an overall EMPRO score of 79.27. It was also the most accurate instrument on the Concept and Measurement Model, Reliability, and Interpretability attributes. Four more instruments scored over 50 points on the overall score, which summarizes the five attribute-specific scores: EORTC BR-23, IBCSG, WHO-QOL BREF, and SF-36. An overall score of at least 50 points implies that the use of these instruments could be recommended for assessing health-related quality of life in breast cancer patients. The FACT-B scored the highest on overall on our EMPRO evaluation of instruments measuring health-related quality of life among breast cancer patients. However, depending on the purpose of the study, several instruments (EORTC BR-23, IBCSG, SF-36, and WHO-QOL BREF) have shown good performance in some of the specific individual dimensions included in the EMPRO.

The consistency approach for quality control of vaccines - a strategy to improve quality control and implement 3Rs.

PubMed

De Mattia, Fabrizio; Chapsal, Jean-Michel; Descamps, Johan; Halder, Marlies; Jarrett, Nicholas; Kross, Imke; Mortiaux, Frederic; Ponsar, Cecile; Redhead, Keith; McKelvie, Jo; Hendriksen, Coenraad

2011-01-01

Current batch release testing of established vaccines emphasizes quality control of the final product and is often characterized by extensive use of animals. This report summarises the discussions of a joint ECVAM/EPAA workshop on the applicability of the consistency approach for routine release of human and veterinary vaccines and its potential to reduce animal use. The consistency approach is based upon thorough characterization of the vaccine during development and the principle that the quality of subsequent batches is the consequence of the strict application of a quality system and of a consistent production of batches. The concept of consistency of production is state-of-the-art for new-generation vaccines, where batch release is mainly based on non-animal methods. There is now the opportunity to introduce the approach into established vaccine production, where it has the potential to replace in vivo tests with non-animal tests designed to demonstrate batch quality while maintaining the highest quality standards. The report indicates how this approach may be further developed for application to established human and veterinary vaccines and emphasizes the continuing need for co-ordination and harmonization. It also gives recommendations for work to be undertaken in order to encourage acceptance and implementation of the consistency approach. Copyright © 2011. Published by Elsevier Ltd.. All rights reserved.

[Quality of the anesthesiologist written record during the transfer of postoperative patients: Influence of implementing a structured communication tool].

PubMed

García-Sánchez, M J; Fernández-Guerrero, C; López-Toribio, P; Bueno-Cavanillas, A; Prieto-Cuéllar, M; Guzmán-Malpica, E M; Cuevas-Valenzuela, P; Moreno-Abril, E; Lara-Ramos, P

2014-01-01

The lack of communication is a major cause of health care errors, especially during patient transfer between practitioners and/or healthcare units, when standardization of communication is a recommended practice. In our study we wanted to assess whether the application of the structured communication SBAR tool could influence the quality of the information written on the progress sheet by the anesthesiologist involved in the transfer of the patient after surgery. This is an observational, retrospective, randomized, quality review of the written record made by the anesthesiologist during the transfer of patients from the surgical area to the postoperative recovery unit, by applying a validated list. We evaluated three observation periods: a control period of two months in 2011 (preSBAR) and a second period of two months in 2012 (postSBAR); in the latter two groups of patients were transferred (postSBAR +) or without SBAR (postSBAR-). The strength of agreement between raters obtained an intraclass correlation coefficient of 0.8459 (p <0.001). There were significant differences in the study group, with highest average score in the group with SBAR (postSBAR + group: mean ± SD 7.56 ± 1.20 versus postSBAR-group: 5.41 ± 2.98, p <0.001) and depending on the anesthesiologist responsible for the intervention participated in the study (mean ± SD: 7.00 ± 1.99, compared to 4.81 ± 3.24 in the non-participants, p <0.001). There was an improvement in the quality of written records made in 2012 during the implementation of the SBAR, without the actual application of this instrument appearing to influence it. The anesthesiologists that were involved in new forms of patient safety were also those who made written records of highest quality. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

Systematic analysis underlying the quality of the scientific evidence and conflicts of interest in gastroenterology practice guidelines.

PubMed

Feuerstein, Joseph D; Gifford, Anne E; Akbari, Mona; Goldman, Jonathan; Leffler, Daniel A; Sheth, Sunil G; Cheifetz, Adam S

2013-11-01

The practice guidelines published by the American Gastroenterological Association (AGA) and the American College of Gastroenterology (ACG) are used to establish standards of care and improve patient outcomes. We examined the guidelines for quality of evidence, methods of grading evidence, and conflicts of interest (COIs). All 81 (AGA and ACG) guidelines available online on 26 July 2012 were reviewed for the presence of grading of evidence and COIs. In total, 570 recommendations were evaluated for level of evidence and methods used to grade the evidence. The data were evaluated in aggregate and by society. Only 31% (n=25) of the guidelines graded the levels of evidence. A total of 12 systems were used to grade the quality of evidence in these 25 guidelines. Of the 570 recommendations reviewed, only 29% (n=165) were supported by the highest quality of evidence, level A; 37% (n=210) level B, 29% (n=165) level C, and 5% (n=30) level D. Since 2007, 87% (n=13/15) of the ACG guidelines graded the evidence compared with only 33% of the AGA guidelines (n=4/12). Furthermore, 70% (n=57/81) of the guidelines failed to disclose any information regarding COIs. Of the 24 articles commenting on COIs, 67% reported COIs. Although the majority of the gastroenterology guidelines fail to grade the quality of evidence, more recent ACG guidelines grade majority of their recommendations. When the evidence is graded, most of the supporting evidence is based on lower-quality evidence. In addition, most of the guidelines fail to comment on COIs, and when disclosed, numerous COIs were present. This study highlights the critical need to revise the guideline development process. Future guidelines should clearly state the quality of evidence for their recommendations, utilize a standard grading system, and be transparent regarding all COIs.

Enhancing the Evidence for Behavioral Counseling: A Perspective From the Society of Behavioral Medicine.

PubMed

Alcántara, Carmela; Klesges, Lisa M; Resnicow, Ken; Stone, Amy; Davidson, Karina W

2015-09-01

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care-focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)--a multidisciplinary scientific organization committed to improving population health through behavior change--we review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions. This perspective highlights five areas for further development, including (1) behavioral counseling-focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care-based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Image quality improvements using adaptive statistical iterative reconstruction for evaluating chronic myocardial infarction using iodine density images with spectral CT.

PubMed

Kishimoto, Junichi; Ohta, Yasutoshi; Kitao, Shinichiro; Watanabe, Tomomi; Ogawa, Toshihide

2018-04-01

Single-source dual-energy CT (ssDECT) allows the reconstruction of iodine density images (IDIs) from projection based computing. We hypothesized that adding adaptive statistical iterative reconstruction (ASiR) could improve image quality. The aim of our study was to evaluate the effect and determine the optimal blend percentages of ASiR for IDI of myocardial late iodine enhancement (LIE) in the evaluation of chronic myocardial infarction using ssDECT. A total of 28 patients underwent cardiac LIE using a ssDECT scanner. IDIs between 0 and 100% of ASiR contributions in 10% increments were reconstructed. The signal-to-noise ratio (SNR) of remote myocardia and the contrast-to-noise ratio (CNR) of infarcted myocardia were measured. Transmural extent of infarction was graded using a 5-point scale. The SNR, CNR, and transmural extent were assessed for each ASiR contribution ratio. The transmural extents were compared with MRI as a reference standard. Compared to 0% ASiR, the use of 20-100% ASiR resulted in a reduction of image noise (p < 0.01) without significant differences in the signal. Compared with 0% ASiR images, reconstruction with 100% ASiR image showed the highest improvement in SNR (229%; p < 0.001) and CNR (199%; p < 0.001). ASiR above 80% showed the highest ratio (73.7%) of accurate transmural extent classification. In conclusion, ASiR intensity of 80-100% in IDIs can improve image quality without changes in signal and maximizes the accuracy of transmural extent in infarcted myocardium.

Safety of clinical and non-clinical decision makers in telephone triage: a narrative review.

PubMed

Wheeler, Sheila Q; Greenberg, Mary E; Mahlmeister, Laura; Wolfe, Nicole

2015-09-01

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians' and non-clinicians' respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002-2012, we applied Donabedian's structure-process-outcome model to examine groups' systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) - (right time, right place with the right person), we measured each groups' corresponding AR rate percentages (outcomes). We analyzed each group's respective decision-making process as a safe match to the telephone triage task, based on each group's system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians' AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians' safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard. © The Author(s) 2015.

Delivering a quality-assured fracture liaison service in a UK teaching hospital-is it achievable?

PubMed

Shipman, K E; Stammers, J; Doyle, A; Gittoes, N

2016-10-01

To determine whether new national guidance on the specifications of a fracture liaison service are realistically deliverable, 1 year of data on the performance of such a service were audited. Audit targets were mostly met. This audit demonstrates that these standards are deliverable in a real world setting. UK service specifications for a fracture liaison service (FLS) have been produced (National Osteoporosis Society, NOS) to promote effective commissioning and delivery of the highest quality care to patients with fragility fractures. How deliverable these standards are has not as yet been methodically reported. Our FLS was modelled on the ten NOS standards; performance was audited after 1 year to determine whether these standards could be delivered and to describe the lessons learnt. Performance was audited against the NOS FLS Service Standards, with management based on the Fracture Risk Assessment Tool (FRAX®), the four-item Falls Risk Assessment Tool (FRAT), National Institute for Health and Care Excellence (NICE) and the National Osteoporosis Guideline Groups (NOGG) guidance. Data were recorded prospectively on a database. The FLS commenced in May 2014, was fully operational in August 2014 and data were captured from 1 September 2014 to 1 September 2015. The FLS detected 1773 patients and standards were largely achieved. Most, 94 %, patients were seen within 6 weeks, 533 DXA requests were generated, 804 outpatient FRAT assessments were recorded (134 required falls intervention) and 773 patients had bone treatments started. On follow-up at 3 months, between 78-79 % were still taking medication. Preliminary evaluation of a FLS implemented according to UK NOS standards demonstrates that the model is practical to apply to a large teaching hospital population. Collection and review of outcome and cost effectiveness data is required to determine the performance of this model in comparison with existing models.

Is PM(10) mass measurement a reliable index for air quality assessment? An environmental study in a geographical area of north-eastern Italy.

PubMed

Cozzi, F; Adami, G; Barbieri, P; Reisenhofer, E; Bovenzi, M

2008-09-01

The aim of this study was to measure the concentration of some metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Ti) in PM(10) samples collected in one urban and one industrial site and to assess that PM(10) total mass measurement may be not sufficient as air quality index due to its complex composition. Metals were determined by inductively coupled plasma-atomic emission spectroscopy (ICP-AES) and differential pulsed anodic stripping voltammetry (DPASV). The measured concentrations were used to calculate the content of metals in the PM(10) total mass, and to estimate the enrichment factors and the correlations between PM(10), metal concentrations and meteorological data for the two sites. The mean PM10 concentration during the sampling period in the urban site exceeded the annual European Union (EU) standard (40 microg/m(3)) and, for some sampling days, the daily EU standard (50 microg/m(3)) was also exceeded. In opposite, both EU standards were never exceeded in the industrial site. The overall metal content was nearly double in the industrial site compared to the urban one, and the mean Ni concentration exceeded the EU annual limit value (10 ng/m(3)). The metals with the highest enrichment factor were Cd, Cu, Ni and Pb for both sites, suggesting a dominant anthropogenic source for these metals. Metal concentrations were very low and typical of rural background during Christmas holidays, when factories were closed. PM(10) total mass measurement is not a sufficient air quality index since the metal content of PM(10) is not related to its total mass, especially in sites with industrial activities. This measurement should be associated with the analysis of toxic metals.

The burden of prostate cancer in Trinidad and Tobago: one of the highest mortality rates in the world.

PubMed

Warner, Wayne A; Lee, Tammy Y; Fang, Fang; Llanos, Adana A M; Bajracharya, Smriti; Sundaram, Vasavi; Badal, Kimberly; Sookdeo, Vandana Devika; Roach, Veronica; Lamont-Greene, Marjorie; Ragin, Camille; Slovacek, Simeon; Ramsoobhag, Krishan; Brown, Jasmine; Rebbeck, Timothy R; Maharaj, Ravi; Drake, Bettina F

2018-07-01

In Trinidad and Tobago (TT), prostate cancer (CaP) is the most commonly diagnosed malignancy and the leading cause of cancer deaths among men. TT currently has one of the highest CaP mortality rates in the world. 6,064 incident and 3,704 mortality cases of CaP occurring in TT from January 1995 to 31 December 2009 reported to the Dr. Elizabeth Quamina Cancer population-based cancer registry for TT, were analyzed to examine CaP survival, incidence, and mortality rates and trends by ancestry and geography. The age-standardized CaP incidence and mortality rates (per 100,000) based on the 1960 world-standardized in 2009 were 64.2 and 47.1 per 100,000. The mortality rate in TT increased between 1995 (37.9 per 100,000) and 2009 (79.4 per 100,000), while the rate in the US decreased from 37.3 per 100,000 to 22.1 per 100,000 over the same period. Fewer African ancestry patients received treatment relative to those of Indian and mixed ancestry (45.7%, 60.3%, and 60.9%, respectively). Notwithstanding the limitations surrounding data quality, our findings highlight the increasing burden of CaP in TT and the need for improved surveillance and standard of care. Our findings highlight the need for optimized models to project cancer rates in developing countries like TT. This study also provides the rationale for targeted screening and optimized treatment for CaP to ameliorate the rates we report.

Assessment of a New High-Performance Small-Animal X-Ray Tomograph

NASA Astrophysics Data System (ADS)

Vaquero, J. J.; Redondo, S.; Lage, E.; Abella, M.; Sisniega, A.; Tapias, G.; Montenegro, M. L. Soto; Desco, M.

2008-06-01

We have developed a new X-ray cone-beam tomograph for in vivo small-animal imaging using a flat panel detector (CMOS technology with a microcolumnar CsI scintillator plate) and a microfocus X-ray source. The geometrical configuration was designed to achieve a spatial resolution of about 12 lpmm with a field of view appropriate for laboratory rodents. In order to achieve high performance with regard to per-animal screening time and cost, the acquisition software takes advantage of the highest frame rate of the detector and performs on-the-fly corrections on the detector raw data. These corrections include geometrical misalignments, sensor non-uniformities, and defective elements. The resulting image is then converted to attenuation values. We measured detector modulation transfer function (MTF), detector stability, system resolution, quality of the reconstructed tomographic images and radiated dose. The system resolution was measured following the standard test method ASTM E 1695 -95. For image quality evaluation, we assessed signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) as a function of the radiated dose. Dose studies for different imaging protocols were performed by introducing TLD dosimeters in representative organs of euthanized laboratory rats. Noise figure, measured as standard deviation, was 50 HU for a dose of 10 cGy. Effective dose with standard research protocols is below 200 mGy, confirming that the system is appropriate for in vivo imaging. Maximum spatial resolution achieved was better than 50 micron. Our experimental results obtained with image quality phantoms as well as with in-vivo studies show that the proposed configuration based on a CMOS flat panel detector and a small micro-focus X-ray tube leads to a compact design that provides good image quality and low radiated dose, and it could be used as an add-on for existing PET or SPECT scanners.

Particulate Matter and Gaseous Pollutions in Three Metropolises along the Chinese Yangtze River: Situation and Implications.

PubMed

Mao, Mao; Zhang, Xiaolin; Yin, Yan

2018-05-28

The situation of criteria atmospheric pollutants, including particulate matter and trace gases (SO₂, NO₂, CO and O₃), over three metropolises (Chongqing, Wuhan, and Nanjing), representing the upstream, midstream and downstream portions of the Yangtze River Basin from September 2015 to August 2016 were analyzed. The maximum annual mean PM 2.5 and PM 10 concentrations were 61.3 and 102.7 μg/m³ in Wuhan, while highest annual average gaseous pollutions occurred in Nanjing, with 49.6 and 22.9 ppb for 8 h O₃ and NO₂, respectively. Compared to a few years ago, SO₂ and CO mass concentrations have dropped to well below the qualification standards, and the O₃ and NO₂ concentrations basically meet the requirements though occasionally is still high. In contrary, about 13%, 25%, 22% for PM 2.5 , and 4%, 17%, 15% for PM 10 exceed the Chinese Ambient Air Quality Standard (CAAQS) Grade II. Particulate matter, especially PM 2.5 , is the most frequent major pollutant to poor air quality with 73%, 64% and 88% accounting for substandard days. Mean PM 2.5 concentrations on PM 2.5 episode days are 2⁻3 times greater than non-episode days. On the basis of calculation of PM 2.5 /PM 10 and PM 2.5 /CO ratios, the enhanced particulate matter pollution on episode days is closely related to secondary aerosol production. Except for O₃, the remaining five pollutants exhibit analogous seasonal patterns, with the highest magnitude in winter and lowest in summer. The results of back trajectories show that air pollution displays synergistic effects on local emissions and long range transport. O₃ commonly demonstrated negative correlations with other pollutants, especially during winter, while moderate to strong positive correlation between particulate matter and NO₂, SO₂, CO were seen. Compared to pollutant substandard ratios over three megacities in eastern China (Beijing, Shanghai, and Guangzhou), the situation in our studied second-tier cities are also severe. The results in this paper provide basic knowledge for pollution status of three cities along Chinese Yangtze River and are conductive to mitigating future negative air quality levels.

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

Sparks, W.E. Jr.

One of Exxon`s goals is to pursue the highest quality exploration opportunities worldwide. To accomplish this goal, we use an approach that allows us to systematically compare the different exploration areas worldwide in order to identify and focus on the highest quality basins and plays, prioritize investment opportunities that are identified in these areas, and allocate our resources appropriately. The process begins with the development of a list of basins that are ranked according to their assessed undiscovered potential and the geotechnical characteristics of their hydrocarbon systems. This basin scale seriatim or rank list is then used to identify themore » highest quality {open_quotes}focus{close_quotes} plays within the higher potential basins and hydrocarbon systems. The ranked list of basins and plays becomes the foundation for development of an {open_quotes}Opportunity Seriatim.{close_quotes} There are three principal components incorporated into Exxon`s Opportunity Seriatim: (1) Geotechnical appraisal - How good is the resource?, (2) Accessibility - Can we or will we be able to access the resource?, and (3) Economics - will we make an acceptable profit if we access the resource? After these components are considered, additional adjustments are made to the Opportunity Seriatim. The Opportunity Seriatim is then used to develop strategies which are globally consistent to build and maintain a broad portfolio of the highest quality opportunities, and finally, to select the best quality prospects in our highest quality plays for funding. Prospects are selected based on risk vs. reward ratio, drilling commitments, and appropriate economic yardsticks. Using this process, Exxon has steadily improved its exploration performance. Over the last ten years, the volume of reserves Exxon discovers has increased, our drilling success rate has improved substantially, and our finding costs have continued to fall.« less

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine Program. Part 2: Analysis of Results.

PubMed

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Ordonez, Felix Barajas; Paez, Diana; Pascual, Thomas

2017-11-01

The International Atomic Energy Agency has developed a program, named Quality Management Audits in Nuclear Medicine (QUANUM), to help its Member States to check the status of their nuclear medicine practices and their adherence to international reference standards, covering all aspects of nuclear medicine, including quality assurance/quality control of instrumentation, radiopharmacy (further subdivided into levels 1, 2, and 3, according to complexity of work), radiation safety, clinical applications, as well as managerial aspects. The QUANUM program is based on both internal and external audits and, with specifically developed Excel spreadsheets, it helps assess the level of conformance (LoC) to those previously defined quality standards. According to their level of implementation, the level of conformance to requested standards; 0 (absent) up to 4 (full conformance). Items scored 0, 1, and 2 are considered non-conformance; items scored 3 and 4 are considered conformance. To assess results of the audit missions performed worldwide over the last 8 years, a retrospective analysis has been run on reports from a total of 42 audit missions in 39 centers, three of which had been re-audited. The analysis of all audit reports has shown an overall LoC of 73.9 ± 8.3% (mean ± standard deviation), ranging between 56.6% and 87.9%. The highest LoC has been found in the area of clinical services (83.7% for imaging and 87.9% for therapy), whereas the lowest levels have been found for Radiopharmacy Level 2 (56.6%); Computer Systems and Data Handling (66.6%); and Evaluation of the Quality Management System (67.6%). Prioritization of non-conformances produced a total of 1687 recommendations in the final audit report. Depending on the impact on safety and daily clinical activities, they were further classified as critical (requiring immediate action; n = 276; 16% of the total); major (requiring action in relatively short time, typically from 3 to 6 months; n = 604; 36%); whereas the remaining 807 (48%) were classified as minor, that is, to be addressed whenever possible. The greatest proportion of recommendations has been found in the category "Managerial, Organization and Documentation" (26%); "Staff Radiation Protection and Safety" (17.3%); "Radiopharmaceuticals Preparation, Dispensing and Handling" (15.8%); and "Quality Assurance/Quality Control" and "Management of Equipment and Software" (11.4%). The lowest level of recommendations belongs to the item "Human Resources" (4%). The QUANUM program proved applicable to a wide variety of institutions, from small practices to larger centers with PET/CT and cyclotrons. Clinical services rendered to patients showed a good compliance with international standards, whereas issues related to radiation protection of both staff and patients will require a higher degree of attention. This is a relevant feedback for the International Atomic Energy Agency with regard to the effective translation of safety recommendations into routine practice. Training on drafting and application of standard operating procedures should also be considered a priority. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Prevalence of overweight and obesity among adolescents in eight Arab countries: comparison between two international standards (ARABEAT-2).

PubMed

Musaiger, Abdulrahman O; Al-Mannai, Mariam; Al-Haifi, Ahmad R; Nabag, Fatima; Elati, Jalila; Abahussain, Nada; Tayyem, Reema; Jalambo, Marwan; Benhamad, Mofida; Al-Mufty, Berivan

2016-09-20

The aim of this study was to highlight the prevalence of overweight and obesity among adolescents in eight Arab countries. A school-based cross-sectional study was conducted in eight Arab countries: Iraq, Jordan, Kuwait, Libya, Palestine, Saudi Arabia, Sudan and Tunisia. The total sample included was 6,447 adolescents aged 15-18 years (3,111 males, 3,336 females). The International Obesity Task Force (IOTF) and World Health Organization (WHO) reference standards were used to determine obesity levels. The WHO standard provided lower prevalence of overweight but higher prevalence of obesity than the IOTF standard. According to the IOTF standard, overweight among males was highest in Kuwaiti adolescents (24.8%), followed by Saudi Arabian (23.2%). Among females, the highest prevalence was reported in Kuwaiti adolescents (22.1%), followed by Jordanian (20.0%). Regarding obesity, Kuwaiti adolescents showed the highest prevalence of obesity for both males (28.6%) and females (21.1%). Findings revealed no progress in reducing prevalence of obesity.

Influence of scanning parameters on the estimation accuracy of control points of B-spline surfaces

NASA Astrophysics Data System (ADS)

Aichinger, Julia; Schwieger, Volker

2018-04-01

This contribution deals with the influence of scanning parameters like scanning distance, incidence angle, surface quality and sampling width on the average estimated standard deviations of the position of control points from B-spline surfaces which are used to model surfaces from terrestrial laser scanning data. The influence of the scanning parameters is analyzed by the Monte Carlo based variance analysis. The samples were generated for non-correlated and correlated data, leading to the samples generated by Latin hypercube and replicated Latin hypercube sampling algorithms. Finally, the investigations show that the most influential scanning parameter is the distance from the laser scanner to the object. The angle of incidence shows a significant effect for distances of 50 m and longer, while the surface quality contributes only negligible effects. The sampling width has no influence. Optimal scanning parameters can be found in the smallest possible object distance at an angle of incidence close to 0° in the highest surface quality. The consideration of correlations improves the estimation accuracy and underlines the importance of complete stochastic models for TLS measurements.

Mixed methods research in music therapy research.

PubMed

Bradt, Joke; Burns, Debra S; Creswell, John W

2013-01-01

Music therapists have an ethical and professional responsibility to provide the highest quality care possible to their patients. Much of the time, high quality care is guided by evidence-based practice standards that integrate the most current, available research in making decisions. Accordingly, music therapists need research that integrates multiple ways of knowing and forms of evidence. Mixed methods research holds great promise for facilitating such integration. At this time, there have not been any methodological articles published on mixed methods research in music therapy. The purpose of this article is to introduce mixed methods research as an approach to address research questions relevant to music therapy practice. This article describes the core characteristics of mixed methods research, considers paradigmatic issues related to this research approach, articulates major challenges in conducting mixed methods research, illustrates four basic designs, and provides criteria for evaluating the quality of mixed methods articles using examples of mixed methods research from the music therapy literature. Mixed methods research offers unique opportunities for strengthening the evidence base in music therapy. Recommendations are provided to ensure rigorous implementation of this research approach.

Addressing standards of care in resource-limited settings.

PubMed

Dawson, Liza; Klingman, Karin L; Marrazzo, Jeanne

2014-01-01

: The choice between "best-known" standards of care (SOC) or "best available" standards as the control arm in a clinical trial is a fundamental dilemma in clinical research in resource-limited settings (RLS). When the health system is delivering less than an optimal level of care, using highest standard of care in a clinical trial may produce results that cannot be implemented or sustained locally. On the other hand, using interventions that are more feasible in the local setting may involve suboptimal care, and clinical outcomes may be affected. The need for improved standards in health systems in RLS, and the difficulty in securing them, has led many researchers advocate for policy changes at the national or international level to improve clinical care more systemically. SOC decisions in a clinical trial affect the level of benefit provided to study participants and the policy implications of the trial findings. SOC choices should provide high-quality care to help advance the health care system in host countries participating in the trial, but balancing the scientific and ethical objectives of SOC choices is difficult, and there is no single formula for selecting the appropriate SOC. Despite the challenges, well-designed and conducted clinical trials can and should make significant contributions to health systems in RLS.

Critical Software for Human Spaceflight

NASA Technical Reports Server (NTRS)

Preden, Antonio; Kaschner, Jens; Rettig, Felix; Rodriggs, Michael

2017-01-01

The NASA Orion vehicle that will fly to the moon in the next years is propelled along its mission by the European Service Module (ESM), developed by ESA and its prime contractor Airbus Defense and Space. This paper describes the development of the Propulsion Drive Electronics (PDE) Software that provides the interface between the propulsion hardware of the European Service Module with the Orion flight computers, and highlights the challenges that have been faced during the development. Particularly, the specific aspects relevant to Human Spaceflight in an international cooperation are presented, as the compliance to both European and US standards and the software criticality classification to the highest category A. An innovative aspect of the PDE SW is its Time- Triggered Ethernet interface with the Orion Flight Computers, which has never been flown so far on any European spacecraft. Finally the verification aspects are presented, applying the most exigent quality requirements defined in the European Cooperation for Space Standardization (ECSS) standards such as the structural coverage analysis of the object code and the recourse to an independent software verification and validation activity carried on in parallel by a different team.

Investigation of water quality in the Great Sand Dunes National Monument and Preserve, Saguache County, Colorado, February 1999 through September 2000: Qualifying for outstanding waters designation

USGS Publications Warehouse

Ferguson, Sheryl A.

2003-01-01

Great Sand Dunes National Monument and Preserve is located on the eastern side of the San Luis Valley in south-central Colorado. The monument covers 60.4 square miles in Saguache and Alamosa Counties and lies at the base of the Sangre de Cristo Mountains, where a unique combination of climate, topography, and hydrology has created and maintained the Nation?s tallest inland sand dunes. The Sangre de Cristo Mountains, which rise to more than 14,000 feet to the north and east of the dunes, are the source of several streams that flow around the dunes and eventually recharge the aquifer beneath the valley. Sand Creek and Medano Creeks are the largest of the streams in the monument that originate in the Sangre de Cristo Mountains; several ephemeral streams flow into Sand Creek and Medano Creek. Maintaining the high surface-water quality in the Great Sand Dunes National Monument and Preserve is identified as a critical issue by the National Park Service. Additionally, the National Park Service has indicated a desire to pursue an Outstanding Waters Designation, which offers the highest level of water-quality protection available under the Clean Water Act and Colorado regulations. This designation is designed to prevent any degradation from existing conditions (Chatman and others, 1997). Assessment is needed to evaluate whether the water quality of the streams in the monument meets the requirements for an Outstanding Waters Designation. Historically, prospecting and mining activities have occurred in the watersheds of Sand and Medano Creeks; currently, however, there is no mining activity in those watersheds. In addition, the camping and recreation that occur upstream from the monument on national preserve lands and water activities that occur in Medano Creek during the summer are a potential source of human-waste contamination. Figure 1. Location of study area, sampling sites, and indication of sites that meet or exceed instream standards. The U.S. Geological Survey (USGS), in cooperation with the National Park Service, investigated the water quality at 15 sites (fig. 1) from February 1999 through September 2000 to identify baseline water-quality conditions and to determine if the water met standards to qualify for the Outstanding Waters Designation. This report describes current water-quality conditions in streams in the monument and compares the water-quality data to Colorado instream standards to assist the State of Colorado Water Quality Control Commission in the determination of qualification for Outstanding Waters Designation.

40 CFR 131.21 - EPA review and approval of water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.21 EPA review and approval of water quality standards. (a) After the State submits its... analysis. (b) The Regional Administrator's approval or disapproval of a State water quality standard shall...

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall...

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall...

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall...

Is self-sufficiency financially viable and ethically justifiable?--a commercial viewpoint.

PubMed

Christie, R B

1994-12-01

Manufacturers of blood products have to maintain the highest possible standards for plasma screening and good manufacturing practices to ensure maximum purity and viral safety. The private sector companies have much experience in implementing and complying with national and international regulations. These requirements involve considerable cost in the areas of (1) plasma collection facilities, (2) research and clinical research, (3) manufacture, and (4) quality control. Total self-sufficiency would mean the loss of many existing resources. An alternative would be a collaboration between the public and private sectors to meet the needs of all patients who require plasma derived products. The current definition of self-sufficiency suggests that it is not financially viable.

Establishing an Iso-Compliant Modern Cancer-Biobank in a Developing Country: A Model for International Cooperation.

PubMed

Sughayer, Maher A; Souan, Lina

2015-01-01

King Hussein Cancer (KHCC) is a specialized cancer center that treats both adult and pediatric cancer patients from Jordan and the neighboring countries. KHCC is acknowledged as a leader in cancer treatment in the Middle East and its vision is to maintain its leading position in cancer therapy and research. Hence, KHCC embarked on establishing the first ISO compliant cancer biobank (KHCCBIO) in Jordan.Currently, there are very few biobanks in the Middle East, hence, KHCC wanted to change this situation by establishing an ISO-compliant cancer biobank which would incorporate all current international guidelines and best-in class practices under an approved quality management system for the benefit of researchers in Jordan, its neighboring countries, and throughout the world. The established biobank would follow the highest ethical standards in collecting, processing, storing and distributing high-quality, clinically annotated biospecimens.The strategy used in establishing KHCCBIO was based on taking advantage of international networking and collaboration. This in essence led to knowledge transfer between well established organizations, institutions and individuals from Europe and Jordan, in existing technological innovation and internationally recognized quality standards. KHCC efforts were facilitated by a grant from the European Union under the seventh frame work program.Future aims of KHCCBIO are to develop KHCC's research infrastructure, increase its scope and visibility and improve its competitiveness throughout the biomedical science arena. Moreover, KHCCBIO is aiming to establish a platform for future knowledge transfer and collaborative research; develop partnerships between European and Middle Eastern organizations.

Houston’s Novel Strategy to Control Hazardous Air Pollutants: A Case Study in Policy Innovation and Political Stalemate

PubMed Central

Sexton, Ken; Linder, Stephen H

2015-01-01

Although ambient concentrations have declined steadily over the past 30 years, Houston has recorded some of the highest levels of hazardous air pollutants in the United States. Nevertheless, federal and state regulatory efforts historically have emphasized compliance with the National Ambient Air Quality Standard for ozone, treating “air toxics” in Houston as a residual problem to be solved through application of technology-based standards. Between 2004 and 2009, Mayor Bill White and his administration challenged the well-established hierarchy of air quality management spelled out in the Clean Air Act, whereby federal and state authorities are assigned primacy over local municipalities for the purpose of designing and implementing air pollution control strategies. The White Administration believed that existing regulations were not sufficient to protect the health of Houstonians and took a diversity of both collaborative and combative policy actions to mitigate air toxic emissions from stationary sources. Opposition was substantial from a local coalition of entrenched interests satisfied with the status quo, which hindered the city’s attempts to take unilateral policy actions. In the short term, the White Administration successfully raised the profile of the air toxics issue, pushed federal and state regulators to pay more attention, and induced a few polluting facilities to reduce emissions. But since White left office in 2010, air quality management in Houston has returned to the way it was before, and today there is scant evidence that his policies have had any lasting impact. PMID:25698880

Contextual factors are associated with diet quality in youth with type 1 diabetes

PubMed Central

Nansel, Tonja R.; Lipsky, Leah M.; Liu, Aiyi; Laffel, Lori M.B.; Mehta, Sanjeev N.

2014-01-01

This study examined differences in diet quality by meal type, location, and time of week in youth with type 1 diabetes (T1D). A sample of youth with T1D (n=252; 48% female) age 8 to 18 years (13.2±2.8) with diabetes duration ≥1 year (6.3±3.4) completed 3-day diet records. Multilevel linear regression models tested for differences in diet quality indicators by meal type, location and time of week (weekdays versus weekends). Participants showed greater energy intake and poorer diet quality on weekends relative to weekdays, with lower intake of fruit and vegetables, and higher intake of total and saturated fat. Differences in diet quality were seen across meal types, with higher nutrient density at breakfast and dinner than at lunch and snacks. Participants reported the highest whole grain and lowest fat intake at breakfast, but higher added sugar than at lunch or dinner. Dinner was characterized by the highest fruit intake, lowest added sugar, and lowest glycemic load, but also the highest sodium intake. The poorest nutrient density and highest added sugar occurred during snacks. Diet quality was poorer for meals consumed away from home than those consumed at home for breakfast, dinner, and snacks. Findings regarding lunch meal location were mixed, with higher nutrient density, lower glycemic load, and less added sugar at home lunches, and lower total fat, saturated fat, and sodium at lunches away from home. Findings indicate impacts of meal type, location and time of week on diet quality, suggesting targets for nutrition education and behavioral interventions. PMID:24651028

The quality of free antenatal and delivery services in Northern Sierra Leone.

PubMed

Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

2017-07-12

The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of consumables, non-functional basic emergency obstetric care facilities, and geographic inequities in access to CEOC facilities. These findings suggest that the health sector needs to urgently investigate continuing inequities adversely influencing the uptake of these services, and explore more sustainable funding mechanisms. Without this, the country is unlikely to achieve its goal of reducing maternal deaths.

Comparative assessment of the physico-chemical and bacteriological qualities of selected streams in Louisiana.

PubMed

Hill, Dagne D; Owens, William E; Tchounwou, Paul B

2005-04-01

The objective of this research was to compare the chemical/physical parameters and bacterial qualities of selected surface water streams in Louisiana, including a natural stream (control) and an animal waste related stream. Samples were collected and analyzed for fecal coliforms. Fecal coliforms isolated from these samples were identified to the species level. Chemical analysis was performed following standard test protocols (LaMotte 2002). An analysis of biological oxygen demand (BOD), chemical oxygen demand (COD), total organic carbon (TOC), total dissolved solids (TDS), conductivity, pH, temperature, ammonia nitrogen, nitrate nitrogen, iron, copper, phosphate, potassium, sulfate, turbidity, zinc and bacterial levels was performed following standard test protocols as presented in Standard Methods for the Examination of Water and Wastewater [9]. Results of the comparisons of the various surface water streams showed that phosphate levels, according to Mitchell and Stapp, were considered good for Lake Claiborne (control) and Bayou Dorcheat. The levels were found to be .001 mg/L and .007 mg/L respectively. Other streams associated with animal waste, had higher phosphate levels of 2.07 mg/L and 2.78 mg/L, respectively. Conductivity and total dissolved solids (TDS) levels were the lowest in Lake Claiborne and highest in the Hill Farm Research Station stream. It can be concluded from the data that some bacterial levels and various nutrient levels can be affected in water resources due to non-point source pollution. Many of these levels will remain unaffected.

CAD-RADS™: Coronary Artery Disease - Reporting and Data System: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology.

PubMed

Cury, Ricardo C; Abbara, Suhny; Achenbach, Stephan; Agatston, Arthur; Berman, Daniel S; Budoff, Matthew J; Dill, Karin E; Jacobs, Jill E; Maroules, Christopher D; Rubin, Geoffrey D; Rybicki, Frank J; Schoepf, U Joseph; Shaw, Leslee J; Stillman, Arthur E; White, Charles S; Woodard, Pamela K; Leipsic, Jonathon A

2016-12-01

The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report. Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD-RADS classification. The main goal of CAD-RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will provide a framework of standardization that may benefit education, research, peer-review and quality assurance with the potential to ultimately result in improved quality of care. Copyright © 2016 Society of Cardiovascular Computed Tomography and the American College of Radiology. Published by Elsevier Inc. All rights reserved.

Evaluation of water quality, suspended sediment, and stream morphology with an emphasis on effects of stormwater on Fountain and Monument Creek basins, Colorado Springs and vicinity, Colorado, 1981-2001

USGS Publications Warehouse

Edelmann, Patrick; Ferguson, Sheryl A.; Stogner, Sr., Robert W.; August, Marianne; Payne, William F.; Bruce, James F.

2002-01-01

This report documents water quality and suspended sediment with an emphasis on evaluating the effects of stormflow on Fountain Creek Basin in the vicinity of Colorado Springs, Colorado. Water-quality data collected at 11 sites between 1981 and 2001 were used to evaluate the effects of stormflow on water quality. Suspended-sediment data collected at seven sites from 1998 through 2001 were used to evaluate effects of stormflow on suspended-sediment concentrations, discharges, and yields. Data were separated into three flow regimes: base flow, normal flow, and stormflow. A comparison of stormwater-quality concentrations measured between 1981 and 2001 to Colorado acute instream standards indicated that, except for isolated occurrences, stormwater quality met acute instream standards. At several sites, 5-day biochemical oxygen demand, fecal coliform, and selected nutrient concentrations tended to be highest during stormflow and lowest during base flow. Dissimilar to the other nutrients, dissolved nitrite plus nitrate concentrations generally were highest during base flow and lowest during stormflow. Most dissolved trace-element concentrations associated with stormflow decreased or showed little change compared to base flow. However, median concentrations of total copper, iron, lead, nickel, manganese, and zinc for stormflow samples generally were much larger than nonstorm samples. The substantially larger concentrations of total copper, iron, lead, nickel, manganese, and zinc measured at site 5800 during stormflow as compared to other sites indicates a relatively large source of these metals in the reach between sites 5530 and 5800. Semi-volatile organic compounds in samples collected during stormflow were detected relatively infrequently at the four sites monitored; however, analysis of pesticide data collected during stormflow showed a relatively frequent detection of pesticides at low levels. Nitrogen, phosphorus, and particulate trace-element loads substantially increased during stormflow. Suspended-sediment concentrations, discharges, and yields associated with stormflow were significantly greater than during normal flow. Depending on the site and year, suspended-sediment concentrations associated with storm-flow generally were 3 to10 times greater than concentrations measured during normal flow, and suspended-sediment discharges were usually more than 10 times greater during stormflow. The April through October cumulative suspended-sediment discharges and streamflows were largest in 1999 at all sites. Although large spatial variations in suspended-sediment yields occurred during normal flows, the suspended-sediment yields associated with stormflow generally were more than 10 times greater than the suspended-sediment yields that occurred during normal flow. The smallest suspended-sediment yields generally were less than 1 ton per day per square mile during stormflow. The largest suspended-sediment yields occurred at sites located in the Cottonwood Creek Basin and were greater than 10 tons per day per square mile.

The desirable qualities of future doctors--a study of medical student perceptions.

PubMed

Hurwitz, Steven; Kelly, Brian; Powis, David; Smyth, Robyn; Lewin, Terry

2013-07-01

There is a lack of consensus regarding the qualities possessed by the ideal doctor, and very limited research regarding the views of medical students on these qualities. To investigate the views of commencing medical students regarding the desirable qualities of doctors. A survey containing a set of proposed desirable qualities of doctors identified from the existing literature was completed by 158 first-year medical students. The survey had a 75% response rate. Students rated the individual qualities of empathy, motivation to be a doctor, good verbal communication, ethically sound, integrity and honesty as the most important. A factor analysis identified six categories of qualities: methodical processing, cognitive capacity, people skills, generic work ethic, role certainty and warmth. Significant differences in factor scores were found across subgroups of students (international and domestic students, with and without prior tertiary studies) on the following factors: methodical processing, which was scored highest by domestic students with prior tertiary studies, cognitive capacity, which was scored highest by domestic students without prior tertiary studies and generic work ethic, which was scored highest by international students. Medical students identified a range of desirable personal qualities of a doctor which varied according to student characteristics, including their prior educational experience. Future research aiming to define such desirable qualities should include a broader range of stakeholders, including students at different training levels and institutions.

The association between demographic and oral health-related quality of life factors and dental care attendance among underprivileged older people.

PubMed

Zini, Avi; Vered, Yuval; Sgan-Cohen, Harold D

2011-06-01

In order to identify whether demographic and oral health-related quality of life factors are associated with dental care attendance among an underprivileged older population, a comparison was performed between people who have and have not attended dental care. A cross-sectional purposive sample of 344 older underprivileged people comprised the study population. The dependent variable was dental care attendance. The 14-item version of the Oral Health Impact Profile index (OHIP-14) was used as the independent variable, together with other social and general variables, using a structured interview. The variables that were significantly associated with dental care attendance were family status (not married, the highest attendance), dwelling location (living at home, the highest attendance), caregiver (family member, the highest attendance), place of birth (Western countries, the highest attendance) and income (pension, the highest attendance). Sex, welfare support, functional ability, education, age and OHIP-14 were not associated with dental care attendance. Attending dental care was not associated with oral health-related quality of life measured by OHIP-14. Several socioeconomic variables were strongly associated. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

Characterization and optimization of image quality as a function of reconstruction algorithms and parameter settings in a Siemens Inveon small-animal PET scanner using the NEMA NU 4-2008 standards

NASA Astrophysics Data System (ADS)

Visser, Eric P.; Disselhorst, Jonathan A.; van Lier, Monique G. J. T. B.; Laverman, Peter; de Jong, Gabie M.; Oyen, Wim J. G.; Boerman, Otto C.

2011-02-01

The image reconstruction algorithms provided with the Siemens Inveon small-animal PET scanner are filtered backprojection (FBP), 3-dimensional reprojection (3DRP), ordered subset expectation maximization in 2 or 3 dimensions (OSEM2D/3D) and maximum a posteriori (MAP) reconstruction. This study aimed at optimizing the reconstruction parameter settings with regard to image quality (IQ) as defined by the NEMA NU 4-2008 standards. The NEMA NU 4-2008 image quality phantom was used to determine image noise, expressed as percentage standard deviation in the uniform phantom region (%STD unif), activity recovery coefficients for the FDG-filled rods (RC rod), and spill-over ratios for the non-radioactive water- and air-filled phantom compartments (SOR wat and SOR air). Although not required by NEMA NU 4, we also determined a contrast-to-noise ratio for each rod (CNR rod), expressing the trade-off between activity recovery and image noise. For FBP and 3DRP the cut-off frequency of the applied filters, and for OSEM2D and OSEM3D, the number of iterations was varied. For MAP, the "smoothing parameter" β and the type of uniformity constraint (variance or resolution) were varied. Results of these analyses were demonstrated in images of an FDG-injected rat showing tumours in the liver, and of a mouse injected with an 18F-labeled peptide, showing a small subcutaneous tumour and the cortex structure of the kidneys. Optimum IQ in terms of CNR rod for the small-diameter rods was obtained using MAP with uniform variance and β=0.4. This setting led to RC rod,1 mm=0.21, RC rod,2 mm=0.57, %STD unif=1.38, SOR wat=0.0011, and SOR air=0.00086. However, the highest activity recovery for the smallest rods with still very small %STD unif was obtained using β=0.075, for which these IQ parameters were 0.31, 0.74, 2.67, 0.0041, and 0.0030, respectively. The different settings of reconstruction parameters were clearly reflected in the rat and mouse images as the trade-off between the recovery of small structures (blood vessels, small tumours, kidney cortex structure) and image noise in homogeneous body parts (healthy liver background). Highest IQ for the Inveon PET scanner was obtained using MAP reconstruction with uniform variance. The setting of β depended on the specific imaging goals.

Disorders of Sex Development (DSD): Networking and Standardization Considerations.

PubMed

Sandberg, D E; Callens, N; Wisniewski, A B

2015-05-01

Syndromes resulting in Disorders of Sex Development (DSD) are individually rare. Historically, this fact has hindered both clinical research and the delivery of evidence-based care. Recognizing the need for advancement, members of European and North American medical societies produced policy statements, notably the Consensus Statement on Management of Intersex Disorders, which recognize that optimal healthcare in DSD requires multidisciplinary teams in conjunction with networking of treatment centers and continued development of patient registries. This paper summarizes efforts in Europe and the U.S. toward creating networks focused on expanding discovery and improving healthcare and quality of life outcomes in DSD. The objectives and function of registry-based networks (EuroDSD/I-DSD), learning collaboratives (DSD-net), clinical outcomes research (DSD-Life), and networking hybrids (DSD-TRN) are reviewed. Opportunities for, and barriers to standardization in research and care are highlighted in light of practical considerations, for example, limitations in reliably classifying anatomic phenotypes and gaps in behavioral health staffing resources. The role of patient-reported outcomes is considered, with emphasis on integrating patient perspectives, given findings of limited agreement in outcome ratings by healthcare providers and patients. Finally, the characteristics of clinical centers likely to deliver the highest quality outcomes are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of plant size, temperature, and light intensity on flowering of Phalaenopsis hybrids in Mediterranean greenhouses.

PubMed

Paradiso, Roberta; De Pascale, Stefania

2014-01-01

Mediterranean greenhouses for cultivation of Phalaenopsis orchids reproduce the warm, humid, and shaded environment of tropical underbrush. Heating represents the highest production cost, due to the high thermal requirements and the long unproductive phase of juvenility, in which plants attain the critical size for flowering. Our researches aimed to investigate the effect of plant size, temperature, and light intensity, during the phase of flower induction, on flowering of modern genotypes selected for Mediterranean greenhouses. Three experiments were carried out to compare (i) plant size: reduced size versus size considered optimal for flowering (hybrids "Sogo Yukidian," "Chain Xen Diamond," and "Pinlong"); (ii) temperature: moderate reduction of temperature versus standard thermal regime (hybrid "Premium"); (iii) light intensity: supplemental lighting versus reference light intensity (hybrid "Premium"). The premature exposure of plants to the inductive treatment delayed the beginning of flowering and reduced the flower stem quality, in all the tested hybrids. In "Premium," the lower temperature did not affect flowering earliness and commercial quality of flower stems compared to the standard regime, whereas it promoted stem branching. In the same hybrid, supplemental lighting anticipated flowering and promoted the emission of the second stem and the stem branching, compared to the reference light regime.

[Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

PubMed

Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

2010-12-01

Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance standards, and providing other services in the field of healthcare quality assurance, improvement, promotion and monitoring, according to the Act. Formal activities of the Agency in the field of HTA actually began in summer 2009. In the field of quality and accreditation, the plan and program of healthcare quality assurance, improvement, promotion and monitoring was finished and published in October 2010; preparation of the healthcare quality standards as well as the accreditation standards is still in process, with the aim to start accreditation process at 10 hospitals in 2011. Education in the field of healthcare quality assurance, improvement and promotion has been established as a continuous process from the beginning. The Agency is member of the International Society for Quality in Health Care (ISQua) and participates in the work of the European Accreditation Network (EAN). In the field of HTA, the Agency has established international collaboration and support, which resulted in its appointment and participation in the European network for Health Technology Assessment (EUnetHTA) Joint Action Project as a EUnetHTA Partner, as well as its membership in the international society, HTAi. TAIEX project has been approved as a two-day workshop in December 2010. The Croatian HTA Guidelines have been issued with the aim to start the HTA process and reports that should serve as recommendations, as a support to policy-makers at the national level, in particular the Croatian Ministry of Health and Social Welfare, and Croatian Institute of Health Insurance, in making evidence-informed decisions on the strategic planning, investment, management and implementation of technologies in health care, on funding (reimbursement) and coverage of health technologies, and at hospital level on the request from hospital directors and policy teams. In conclusion, establishment of all these measures in Croatia is by no means an easy and quick process, however, we do believe that it is feasible through continuous and close collaboration of all those involved.

40 CFR 131.35 - Colville Confederated Tribes Indian Reservation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality Standards § 131.35 Colville Confederated Tribes Indian Reservation. The water quality standards applicable to the waters within the... these Federal water quality standards to prescribe minimum water quality requirements for the surface...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Ground-water quality, Cook Inlet Basin, Alaska, 1999

USGS Publications Warehouse

Glass, Roy L.

2001-01-01

As part of the U.S. Geological Survey?s National Water-Quality Assessment Program, ground-water samples were collected from 34 existing wells in the Cook Inlet Basin in south-central Alaska during 1999. All ground-water samples were from aquifers composed of glacial or alluvial sediments. The water samples were used to determine the occurrence and distribution of selected major ions, nutrients, trace elements, volatile organic compounds, pesticides, radioisotopes, and environmental isotopes. Of 34 samples, 29 were from wells chosen by using a grid-based random-selection process. Water samples from five major public-supply wells also were collected. Radon-222 and arsenic concentrations exceeded drinking-water standards proposed by the U.S. Environmental Protection Agency in 39 and 18 percent of sampled wells, respectively. The highest radon concentration measured during this study was 610 picocuries per liter; 12 of 31 samples exceeded the proposed maximum contaminant level of 300 picocuries per liter. The highest arsenic concentration was 29 micrograms per liter; 6 of 34 samples exceeded the proposed maximum contaminant level of 10 micrograms per liter. Human activities may be increasing the concen- tration of nitrate in ground water, but nitrate concentrations in all samples were less than the maximum contaminant level of 10 milligrams per liter as nitrogen. Concentrations of nitrate were highest in Anchorage and were as great as 4.8 milligrams per liter as nitrogen. Dissolved-solids concentrations ranged from 77 to 986 milligrams per liter; only 2 of 34 wells yielded water having greater than 500 milligrams per liter. Iron and manganese concentrations exceeded secondary maximum contaminant levels in 18 and 42 percent of samples, respectively. Concentrations of all pesticides and volatile organic compounds detected in ground-water samples were very low, less than 1 microgram per liter. No pesticide or volatile organic compounds were detected at concentrations exceeding drinking-water standards or guidelines. Water samples from one-half of the wells sampled had no detectable concentrations of pesticides or volatile organic carbons, at the parts-per-billion level. Concentrations of stable isotopes of hydrogen and oxygen in ground-water samples were similar to concentrations expected for modern precipitation and for water that has been affected by evaporation. Tritium activities and concentrations of chlorofluorocarbons indicated that the water samples collected from most wells were recharged less than 50 years ago.

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

Application and Utility of iPads in Pediatric Tele-echocardiography.

PubMed

Colombo, Jamie N; Seckeler, Michael D; Barber, Brent J; Krupinski, Elizabeth A; Weinstein, Ronald S; Sisk, David; Lax, Daniela

2016-05-01

Telemedicine is used with increasing frequency to improve patient care in remote areas. The interpretation of medical imaging on iPad(®) (Apple, Cupertino, CA) tablets has been reported to be accurate. There are no studies on the use of iPads for interpretation of pediatric echocardiograms. We compared the quality of echo images, diagnostic accuracy, and review time using three different modalities: remote access on an iPad Air (iPad), remote access via a computer (Remote), and direct access on a computer linked through Ethernet to the server, the "gold standard" (Direct). Fifty consecutive archived pediatric echocardiograms were interpreted using the three modalities. Studies were analyzed blindly by three pediatric cardiologists; review time, diagnostic accuracy, and image quality were documented. Diagnostic accuracy was assessed by comparing the study diagnoses with the official diagnosis in the patient's chart. Discrepancies between diagnoses were graded as major (more than one grade difference) or minor (one grade difference in severity of lesion). There were no significant differences in accuracy among the three modalities. There was one major discrepancy (size of patent ductus arteriosus); all others were minor, hemodynamically insignificant. Image quality ratings were better for iPad than Remote; Direct had the highest ratings. Review times (mean [standard deviation] minutes) were longest for iPad (5.89 [3.87]) and then Remote (4.72 [2.69]), with Direct having the shortest times (3.52 [1.42]) (p < 0.0001). Pediatric echocardiograms can be interpreted using convenient, portable devices while preserving accuracy and quality with slightly longer review times (1-2 min). These findings are important in the current era of increasing need for mobile health.

Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

PubMed

Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

2017-08-01

Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

CIDR

Science.gov Websites

Statistics Quality Control Statistics CIDR is dedicated to producing the highest quality data for our investigators. These cumulative quality control statistics are based on data from 419 released CIDR Program

ANTIMALARIAL DRUG QUALITY IN AFRICA

PubMed Central

Amin, AA; Kokwaro, GO

2009-01-01

Background and objective There are several reports of sub-standard and counterfeit antimalarial drugs circulating in the markets of developing countries; we aimed to review the literature for the African continent. Methods A search was conducted in PubMED in English using the medical subject headings (MeSH) terms: “Antimalarials/analysis”[MeSH] OR “Antimalarials/standards”[MeSH] AND “Africa”[MeSH]” to include articles published up to and including 26/02/07. Data were augmented with reports on the quality of antimalarial drugs in Africa obtained from colleagues in the World Health Organization. We summarised the data under the following themes: content and dissolution; relative bioavalability of antimalarial products; antimalarial stability and shelf life; general tests on pharmaceutical dosage forms; and the presence of degradation or unidentifiable impurities in formulations. Results and discussion The search yielded 21 relevant peer-reviewed articles and three reports on the quality of antimalarial drugs in Africa. The literature was varied in the quality and breadth of data presented, with most bioavailability studies poorly designed and executed. The review highlights the common finding in drug quality studies that 1) most antimalarial products pass the basic tests for pharmaceutical dosage forms, such as the uniformity of weight for tablets 2) most antimalarial drugs pass the content test 3) in vitro product dissolution is the main problem area where most drugs fail to meet required pharmacopoeial specifications, especially with regard to sulfadoxine-pyrimethamine products. In addition, there are worryingly high quality failure rates for artemisinin monotherapies such as dihydroartemisin (DHA); for instance all five DHA sampled products in one study in Nairobi, Kenya, were reported to have failed the requisite tests. Conclusions There is an urgent need to strengthen pharmaceutical management systems such as post-marketing surveillance and the broader health systems in Africa to ensure populations in the continent have access to antimalarial drugs that are safe, of the highest quality standards and that retain their integrity throughout the distribution chain through adequate enforcement of existing legislation and enactment of new ones if necessary, and provision of the necessary resources for drug quality assurance. PMID:17875107

Content, Quality, and Assessment Tools of Physician-Rating Websites in 12 Countries: Quantitative Analysis.

PubMed

Rothenfluh, Fabia; Schulz, Peter J

2018-06-14

Websites on which users can rate their physician are becoming increasingly popular, but little is known about the website quality, the information content, and the tools they offer users to assess physicians. This study assesses these aspects on physician-rating websites in German- and English-speaking countries. The objective of this study was to collect information on websites with a physician rating or review tool in 12 countries in terms of metadata, website quality (transparency, privacy and freedom of speech of physicians and patients, check mechanisms for appropriateness and accuracy of reviews, and ease of page navigation), professional information about the physician, rating scales and tools, as well as traffic rank. A systematic Web search based on a set of predefined keywords was conducted on Google, Bing, and Yahoo in August 2016. A final sample of 143 physician-rating websites was analyzed and coded for metadata, quality, information content, and the physician-rating tools. The majority of websites were registered in the United States (40/143) or Germany (25/143). The vast majority were commercially owned (120/143, 83.9%), and 69.9% (100/143) displayed some form of physician advertisement. Overall, information content (mean 9.95/25) as well as quality were low (mean 18.67/47). Websites registered in the United Kingdom obtained the highest quality scores (mean 26.50/47), followed by Australian websites (mean 21.50/47). In terms of rating tools, physician-rating websites were most frequently asking users to score overall performance, punctuality, or wait time in practice. This study evidences that websites that provide physician rating should improve and communicate their quality standards, especially in terms of physician and user protection, as well as transparency. In addition, given that quality standards on physician-rating websites are low overall, the development of transparent guidelines is required. Furthermore, attention should be paid to the financial goals that the majority of physician-rating websites, especially the ones that are commercially owned, pursue. ©Fabia Rothenfluh, Peter J Schulz. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.06.2018.

Water-quality and algal conditions in the Clackamas River basin, Oregon, and their relations to land and water management

USGS Publications Warehouse

Carpenter, Kurt D.

2003-01-01

In 1998, the U.S. Geological Survey sampled the Clackamas River, its major tributaries, and reservoirs to characterize basic water quality (nutrients, dissolved oxygen, pH, temperature, and conductance), water quantity (water sources within the basin), and algal conditions (biomass and species composition). Sampling locations reflected the dominant land uses in the basin (forest management, agriculture, and urban development) as well as the influence of hydroelectric projects, to examine how these human influences might be affecting water quality and algal conditions. Nuisance algal growths, with accompanying negative effects on water quality, were observed at several locations in the basin during this study. Algal biomass in the lower Clackamas River reached a maximum of 300 mg/m2 chlorophyll a, producing nuisance algal conditions, including fouled stream channels and daily fluctuations in pH and dissolved oxygen concentrations to levels that did not meet water-quality standards. Algal biomass was highest at sites immediately downstream from the hydroelectric project's reservoirs and/or powerhouses. Nuisance algal conditions also were observed in some of the tributaries, including the North Fork of the Clackamas River, Clear Creek, Rock Creek, and Sieben Creek. High amounts of drifting algae increased turbidity levels in the Clackamas River during June, which coincided with a general increase in the concentration of disinfection by-products found in treated Clackamas River water used for drinking, presumably due to the greater amounts of organic matter in the river. The highest nutrient concentrations were found in the four lowermost tributaries (Deep, Richardson, Rock, and Sieben Creeks), where most of the agriculture and urban development is concentrated. Of these, the greatest load of nutrients came from Deep Creek, which had both high nutrient concentrations and relatively high streamflow. Streams draining forestland in the upper basin (upper Clackamas River and Oak Grove Fork) had the highest concentrations of phosphorus (and lowest concentrations of nitrogen), and streams draining forestland in the middle basin (Clear Creek, Eagle Creek, and the North Fork of the Clackamas River) had relatively high concentrations of nitrogen (and low concentrations of phosphorus). In contrast, relatively low concentrations of both nitrogen and phosphorus were found at the two reference streams, reflecting their pristine condition. Relatively high phosphorus levels in the upper basin are probably due to the erosion of naturally occurring phosphorus deposits in this area. Likely sources of nitrogen (mostly nitrate) in the forested watersheds include nitrogen-fixing plants, atmospheric deposition, timber harvesting, and applications of urea fertilizers.

Patient-reported outcomes in adults with congenital heart disease: Inter-country variation, standard of living and healthcare system factors.

PubMed

Moons, Philip; Kovacs, Adrienne H; Luyckx, Koen; Thomet, Corina; Budts, Werner; Enomoto, Junko; Sluman, Maayke A; Yang, Hsiao-Ling; Jackson, Jamie L; Khairy, Paul; Cook, Stephen C; Subramanyan, Raghavan; Alday, Luis; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Johansson, Bengt; Mackie, Andrew S; Menahem, Samuel; Caruana, Maryanne; Veldtman, Gruschen; Soufi, Alexandra; Fernandes, Susan M; White, Kamila; Callus, Edward; Kutty, Shelby; Van Bulck, Liesbet; Apers, Silke

2018-01-15

Geographical differences in patient-reported outcomes (PROs) of adults with congenital heart disease (ConHD) have been observed, but are poorly understood. We aimed to: (1) investigate inter-country variation in PROs in adults with ConHD; (2) identify patient-related predictors of PROs; and (3) explore standard of living and healthcare system characteristics as predictors of PROs. Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS) was a cross-sectional, observational study, in which 4028 patients from 15 countries in 5 continents were enrolled. Self-report questionnaires were administered: patient-reported health (12-item Short Form Health Survey; EuroQOL-5D Visual Analog Scale); psychological functioning (Hospital Anxiety and Depression Scale); health behaviors (Health Behavior Scale-Congenital Heart Disease) and quality of life (Linear Analog Scale for quality of life; Satisfaction With Life Scale). A composite PRO score was calculated. Standard of living was expressed as Gross Domestic Product per capita and Human Development Index. Healthcare systems were operationalized as the total health expenditure per capita and the overall health system performance. Substantial inter-country variation in PROs was observed, with Switzerland having the highest composite PRO score (81.0) and India the lowest (71.3). Functional class, age, and unemployment status were patient-related factors that independently and consistently predicted PROs. Standard of living and healthcare system characteristics predicted PROs above and beyond patient characteristics. This international collaboration allowed us to determine that PROs in ConHD vary as a function of patient-related factors as well as the countries in which patients live. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of an iterative model-based CT reconstruction algorithm by intra-patient comparison of standard and ultra-low-dose examinations.

PubMed

Noël, Peter B; Engels, Stephan; Köhler, Thomas; Muenzel, Daniela; Franz, Daniela; Rasper, Michael; Rummeny, Ernst J; Dobritz, Martin; Fingerle, Alexander A

2018-01-01

Background The explosive growth of computer tomography (CT) has led to a growing public health concern about patient and population radiation dose. A recently introduced technique for dose reduction, which can be combined with tube-current modulation, over-beam reduction, and organ-specific dose reduction, is iterative reconstruction (IR). Purpose To evaluate the quality, at different radiation dose levels, of three reconstruction algorithms for diagnostics of patients with proven liver metastases under tumor follow-up. Material and Methods A total of 40 thorax-abdomen-pelvis CT examinations acquired from 20 patients in a tumor follow-up were included. All patients were imaged using the standard-dose and a specific low-dose CT protocol. Reconstructed slices were generated by using three different reconstruction algorithms: a classical filtered back projection (FBP); a first-generation iterative noise-reduction algorithm (iDose4); and a next generation model-based IR algorithm (IMR). Results The overall detection of liver lesions tended to be higher with the IMR algorithm than with FBP or iDose4. The IMR dataset at standard dose yielded the highest overall detectability, while the low-dose FBP dataset showed the lowest detectability. For the low-dose protocols, a significantly improved detectability of the liver lesion can be reported compared to FBP or iDose 4 ( P = 0.01). The radiation dose decreased by an approximate factor of 5 between the standard-dose and the low-dose protocol. Conclusion The latest generation of IR algorithms significantly improved the diagnostic image quality and provided virtually noise-free images for ultra-low-dose CT imaging.

Willingness to pay and quality of life in patients with rosacea.

PubMed

Beikert, F C; Langenbruch, A K; Radtke, M A; Augustin, M

2013-06-01

Rosacea is a chronic inflammatory dermatosis affecting >2% of the population. Willingness to pay (WTP) is a well established method which reflects the individual burden of disease. Evaluation of WTP and quality of life (QoL) in patients with rosacea. Nationwide postal survey on adult patients with rosacea affiliated with the German rosacea patient advocacy group. WTP was evaluated by three standardized items and compared to historical data on vitiligo (n = 1023). QoL was assessed using the Dermatology Life Quality Index (DLQI). Data from n = 475 rosacea patients (79.9% women, mean age 56.3, range 26-90) were analysed. On average, patients were willing to pay € 2880 (median € 500) for complete healing compared with € 7360 (median € 3000) in vitiligo. Relative WTP was higher in women; the highest sums were registered for the age group 21-30 years. The extent of facial involvement predicted a higher relative WTP, whereas WTP decreased with the duration of symptoms and age. Mean DLQI total score was 4.3 compared to 7.0 in vitiligo. In rosacea, the highest values were observed in patients <30 years. Severe QoL reductions (DLQI>10) were less frequent (11%) than in vitiligo (24.6%). The correlation between WTP and DLQI was significant (e.g. r = 0.249, P = 0.000 for relative WTP). Rosacea patients show a moderate WTP and average QoL reduction is mild. WTP proved to be a valid tool to assess patients' burden of disease. Patient education and the development of effective treatment options might still improve patients' satisfaction. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Update of the Mexican College of Rheumatology guidelines for the pharmacologic treatment of rheumatoid arthritis.

PubMed

Cardiel, Mario H; Díaz-Borjón, Alejandro; Vázquez del Mercado Espinosa, Mónica; Gámez-Nava, Jorge Iván; Barile Fabris, Leonor A; Pacheco Tena, César; Silveira Torre, Luis H; Pascual Ramos, Virginia; Goycochea Robles, María Victoria; Aguilar Arreola, Jorge Enrique; González Díaz, Verónica; Alvarez Nemegyei, José; González-López, Laura del Carmen; Salazar Páramo, Mario; Portela Hernández, Margarita; Castro Colín, Zully; Xibillé Friedman, Daniel Xavier; Alvarez Hernández, Everardo; Casasola Vargas, Julio; Cortés Hernández, Miguel; Flores-Alvarado, Diana E; Martínez Martínez, Laura A; Vega-Morales, David; Flores-Suárez, Luis Felipe; Medrano Ramírez, Gabriel; Barrera Cruz, Antonio; García González, Adolfo; López López, Susana Marisela; Rosete Reyes, Alejandra; Espinosa Morales, Rolando

2014-01-01

The pharmacologic management of rheumatoid arthritis has progressed substantially over the past years. It is therefore desirable that existing information be periodically updated. There are several published international guidelines for the treatment of rheumatoid arthritis that hardly adapt to the Mexican health system because of its limited healthcare resources. Hence, it is imperative to unify the existing recommendations and to incorporate them to a set of clinical, updated recommendations; the Mexican College of Rheumatology developed these recommendations in order to offer an integral management approach of rheumatoid arthritis according to the resources of the Mexican health system. To review, update and improve the available evidence within clinical practice guidelines on the pharmacological management of rheumatoid arthritis and produce a set of recommendations adapted to the Mexican health system, according to evidence available through December 2012. The working group was composed of 30 trained and experienced rheumatologists with a high quality of clinical knowledge and judgment. Recommendations were based on the highest quality evidence from the previously established treatment guidelines, meta-analysis and controlled clinical trials for the adult population with rheumatoid arthritis. During the conformation of this document, each working group settled the existing evidence from the different topics according to their experience. Finally, all the evidence and decisions were unified into a single document, treatment algorithm and drug standardization tables. This update of the Mexican Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis provides the highest quality information available at the time the working group undertook this review and contextualizes its use for the complex Mexican health system. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Performance evaluation of the CT component of the IRIS PET/CT preclinical tomograph

NASA Astrophysics Data System (ADS)

Panetta, Daniele; Belcari, Nicola; Tripodi, Maria; Burchielli, Silvia; Salvadori, Piero A.; Del Guerra, Alberto

2016-01-01

In this paper, we evaluate the physical performance of the CT component of the IRIS scanner, a novel combined PET/CT scanner for preclinical imaging. The performance assessment is based on phantom measurement for the determination of image quality parameters (spatial resolution, linearity, geometric accuracy, contrast to noise ratio) and reproducibility in dynamic (4D) imaging. The CTDI100 has been measured free in air with a pencil ionization chamber, and the animal dose was calculated using Monte Carlo derived conversion factors taken from the literature. The spatial resolution at the highest quality protocol was 6.9 lp/mm at 10% of the MTF, using the smallest reconstruction voxel size of 58.8 μm. The accuracy of the reconstruction voxel size was within 0.1%. The linearity of the CT numbers as a function of the concentration of iodine was very good, with R2>0.996 for all the tube voltages. The animal dose depended strongly on the scanning protocol, ranging from 158 mGy for the highest quality protocol (2 min, 80 kV) to about 12 mGy for the fastest protocol (7.3 s, 80 kV). In 4D dynamic modality, the maximum scanning rate reached was 3.1 frames per minute, using a short-scan protocol with 7.3 s of scan time per frame at the isotropic voxel size of 235 μm. The reproducibility of the system was high throughout the 10 frames acquired in dynamic modality, with a standard deviation of the CT values of all frames <8 HU and an average spatial reproducibility within 30% of the voxel size across all the field of view. Example images obtained during animal experiments are also shown.

Bacteriological quality of vegetables from organic and conventional production in different areas of Korea.

PubMed

Tango, Charles Nkufi; Choi, Na-Jung; Chung, Myung-Sub; Oh, Deog Hwan

2014-08-01

Foods grown in organic production systems have been described as representing an increased risk to public health compared with foods from conventional production. Leafy vegetables (spinach, romaine lettuce, and green sesame leaves) grown in organic and conventional systems were collected from various areas in Korea and examined using standard culture methods to compare the microbiological quality of the produce grown in the two agricultural systems. The 354 samples of these leafy vegetables were analyzed for levels of indicator bacteria (aerobic bacteria, coliforms, and Escherichia coli) and the prevalence of the pathogens Staphylococcus aureus, E. coli O157:H7, Listeria monocytogenes, Bacillus cereus, and Salmonella. Aerobic bacteria and coliforms were detected in all vegetable types, but nonpathogenic E. coli was below the limit of detection in all samples. B. cereus was the most prevalent pathogen, found on 7 (11.1%) of the 63 organic spinach samples. The prevalence of S. aureus was highest in organic sesame leaves; it was found on 5 (8.0%) of the 63 samples. The prevalence of L. monocytogenes was highest on organic romaine lettuce and spinach; it was found in 4 (6.4%) of 63 samples of each type of vegetable. E. coli O157:H7 found on only 1 (1.58%) of 55 conventional spinach samples. These results suggest that farming type at most only slightly affects the hygienic quality of leafy vegetables, and no effect was found for sample collection area. Salmonella was not isolated from any of the conventional or organic leafy vegetables. These results do not support the hypothesis that organic produce poses a substantially greater risk of pathogen contamination than does conventional produce.

Reliability of Pressure Ulcer Rates: How Precisely Can We Differentiate Among Hospital Units, and Does the Standard Signal-Noise Reliability Measure Reflect This Precision?

PubMed

Staggs, Vincent S; Cramer, Emily

2016-08-01

Hospital performance reports often include rankings of unit pressure ulcer rates. Differentiating among units on the basis of quality requires reliable measurement. Our objectives were to describe and apply methods for assessing reliability of hospital-acquired pressure ulcer rates and evaluate a standard signal-noise reliability measure as an indicator of precision of differentiation among units. Quarterly pressure ulcer data from 8,199 critical care, step-down, medical, surgical, and medical-surgical nursing units from 1,299 US hospitals were analyzed. Using beta-binomial models, we estimated between-unit variability (signal) and within-unit variability (noise) in annual unit pressure ulcer rates. Signal-noise reliability was computed as the ratio of between-unit variability to the total of between- and within-unit variability. To assess precision of differentiation among units based on ranked pressure ulcer rates, we simulated data to estimate the probabilities of a unit's observed pressure ulcer rate rank in a given sample falling within five and ten percentiles of its true rank, and the probabilities of units with ulcer rates in the highest quartile and highest decile being identified as such. We assessed the signal-noise measure as an indicator of differentiation precision by computing its correlations with these probabilities. Pressure ulcer rates based on a single year of quarterly or weekly prevalence surveys were too susceptible to noise to allow for precise differentiation among units, and signal-noise reliability was a poor indicator of precision of differentiation. To ensure precise differentiation on the basis of true differences, alternative methods of assessing reliability should be applied to measures purported to differentiate among providers or units based on quality. © 2016 The Authors. Research in Nursing & Health published by Wiley Periodicals, Inc. © 2016 The Authors. Research in Nursing & Health published by Wiley Periodicals, Inc.

Low-dose or standard-dose proton pump inhibitors for maintenance therapy of gastro-oesophageal reflux disease: a cost-effectiveness analysis.

PubMed

You, J H S; Lee, A C M; Wong, S C Y; Chan, F K L

2003-03-15

Studies on the use of low-dose proton pump inhibitor for the maintenance therapy of gastro-oesophageal reflux disease have shown that it might be comparable with standard-dose proton pump inhibitor treatment and superior to standard-dose histamine-2 receptor antagonist therapy. To compare the impact of standard-dose histamine-2 receptor antagonist, low-dose proton pump inhibitor and standard-dose proton pump inhibitor treatment for the maintenance therapy of gastro-oesophageal reflux disease on symptom control and health care resource utilization from the perspective of a public health organization in Hong Kong. A Markov model was designed to simulate, over 12 months, the economic and clinical outcomes of gastro-oesophageal reflux disease patients treated with standard-dose histamine-2 receptor antagonist, low-dose proton pump inhibitor and standard-dose proton pump inhibitor. The transition probabilities were derived from the literature. Resource utilization was retrieved from a group of gastro-oesophageal reflux disease patients in Hong Kong. Sensitivity analysis was conducted to examine the robustness of the model. The standard-dose proton pump inhibitor strategy was associated with the highest numbers of symptom-free patient-years (0.954 years) and quality-adjusted life-years gained (0.999 years), followed by low-dose proton pump inhibitor and standard-dose histamine-2 receptor antagonist. The direct medical cost per patient in the standard-dose proton pump inhibitor group (904 US dollars) was lower than those of the low-dose proton pump inhibitor and standard-dose histamine-2 receptor antagonist groups. The standard-dose proton pump inhibitor strategy appears to be the most effective and least costly for the maintenance management of patients with gastro-oesophageal reflux disease in Hong Kong.

Prevalence of vertebral fracture in Asian men and women: comparison between Hong Kong, Thailand, Indonesia and Japan.

PubMed

Kwok, A W L; Leung, J C S; Chan, A Y H; Au, B S K; Lau, E M C; Yurianto, H; Yuktanandana, P; Yoshimura, N; Muraki, S; Oka, H; Akune, T; Leung, P C

2012-06-01

Little is known about the prevalence of vertebral fracture among Asians. This study investigated the prevalence of radiographically defined vertebral fracture, and identified associated risk factors in the aged population of four Asian countries. In total, 1588 males and females aged ≥ 65 years were recruited from Hong Kong, Thailand, Indonesia and Japan. Standard X-rays for the spine were taken and vertebral heights were measured. Vertebral fracture was defined as a reduction of >3 standard deviations in vertebral height ratio. Bone mineral density (BMD) of the hip was measured by dual energy X-ray absorptiometry, and anthropometric measurements were taken in Hong Kong and Japan. Other relevant data were entered in a standard questionnaire. The prevalence of vertebral fracture for both males and females was highest in Japan for younger (65-74 years) and older (≥ 75 years) age groups (36.6% and 37.6% for males; 18.8% and 28.7% for females). Lower hip BMD was associated with vertebral fracture in both sexes. Older age, lower quality of life score on Short Form-12 (physical), past longest occupation as a farmer, and history of cataract were significantly associated with vertebral fracture in females. However, smoking did not appear to be an important risk factor for vertebral fracture. Radiographic assessments for vertebral fracture were performed in all four Asian countries. The prevalence of vertebral fracture was highest in Japan. Lower hip BMD, poorer physical condition and past longest occupation as a farmer were associated with vertebral fracture. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

NEMA image quality phantom measurements and attenuation correction in integrated PET/MR hybrid imaging.

PubMed

Ziegler, Susanne; Jakoby, Bjoern W; Braun, Harald; Paulus, Daniel H; Quick, Harald H

2015-12-01

In integrated PET/MR hybrid imaging the evaluation of PET performance characteristics according to the NEMA standard NU 2-2007 is challenging because of incomplete MR-based attenuation correction (AC) for phantom imaging. In this study, a strategy for CT-based AC of the NEMA image quality (IQ) phantom is assessed. The method is systematically evaluated in NEMA IQ phantom measurements on an integrated PET/MR system. NEMA IQ measurements were performed on the integrated 3.0 Tesla PET/MR hybrid system (Biograph mMR, Siemens Healthcare). AC of the NEMA IQ phantom was realized by an MR-based and by a CT-based method. The suggested CT-based AC uses a template μ-map of the NEMA IQ phantom and a phantom holder for exact repositioning of the phantom on the systems patient table. The PET image quality parameters contrast recovery, background variability, and signal-to-noise ratio (SNR) were determined and compared for both phantom AC methods. Reconstruction parameters of an iterative 3D OP-OSEM reconstruction were optimized for highest lesion SNR in NEMA IQ phantom imaging. Using a CT-based NEMA IQ phantom μ-map on the PET/MR system is straightforward and allowed performing accurate NEMA IQ measurements on the hybrid system. MR-based AC was determined to be insufficient for PET quantification in the tested NEMA IQ phantom because only photon attenuation caused by the MR-visible phantom filling but not the phantom housing is considered. Using the suggested CT-based AC, the highest SNR in this phantom experiment for small lesions (<= 13 mm) was obtained with 3 iterations, 21 subsets and 4 mm Gaussian filtering. This study suggests CT-based AC for the NEMA IQ phantom when performing PET NEMA IQ measurements on an integrated PET/MR hybrid system. The superiority of CT-based AC for this phantom is demonstrated by comparison to measurements using MR-based AC. Furthermore, optimized PET image reconstruction parameters are provided for the highest lesion SNR in NEMA IQ phantom measurements.

Bacteriological contamination of well water in Makurdi town, Benue State, Nigeria.

PubMed

Mile, I I; Jande, J A; Dagba, B I

2012-11-01

Bacteriological contamination of well water in Makurdi town, of Benue State, Nigeria was investigated. A total of 15 water samples were collected from hand dug wells and analyzed for total bacteria count as it affect the quality of drinking water for both wet and dry season. The analysis was done according to standard methods of water examination and as reported in WHO guide limit for drinking water. The investigation revealed that the wells examined were highly contaminated with bacteria. Wells 6 and 7 showed highest total bacteria counts of 7.0 x 10(5)/100 mL and 8.2 x 10(5)/100 mL in the wet season, while wells 7 and 2 showed highest total bacteria counts of 8.0 x 10(5)/100 mL and 5.5 x 10(5)/100 mL in the dry season. The contamination of all wells could be due to improper construction of wells, refuse dumping sites and various human activities around the wells. Water generally from these wells is not safe for drinking except some form of treatment is carried out.

On evaluating compliance with air pollution levels not to be exceeded more than once per year

NASA Technical Reports Server (NTRS)

Neustadter, H. E.; Sidik, S. M.

1974-01-01

The adequacy is considered of currently practiced monitoring and data reduction techniques for assessing compliance with 24-hour Air Quality Standards (AQS) not to be exceeded more than once per year. The present situation for suspended particulates is discussed. The following conclusions are reached: (1) For typical less than daily sampling (i.e., 60 to 120 24-hour samples per year) the deviation from independence of the data set should not be substantial. (2) The interchange of exponentiation and expectation operations in the EPA data reduction model, underestimates the second highest level by about 4 to 8 percent for typical sigma values. (3) Estimates of the second highest pollution level have associated with them a large statistical variability arising from the finite size of the sample. The 0.95 confidence interval ranges from + or - 40 percent for 120 samples per year to + or - 84 percent for 30 samples per year. (4) The design value suggested by EPA for abatement and/or control planning purposes typically gives a margin of safety of 60 to 120 percent.

Using National Ambient Air Quality Standards for fine particulate matter to assess regional wildland fire smoke and air quality management.

PubMed

Schweizer, Don; Cisneros, Ricardo; Traina, Samuel; Ghezzehei, Teamrat A; Shaw, Glenn

2017-10-01

Wildland fire is an important ecological process in the California Sierra Nevada. Personal accounts from pre-20th century describe a much smokier environment than present day. The policy of suppression beginning in the early 20th century and climate change are contributing to increased megafires. We use a single particulate monitoring site at the wildland urban interface to explore impacts from prescribed, managed, and full suppression wildland fires from 2006 to 2015 producing a contextual assessment of smoke impacts over time at the landscape level. Prescribed fire had little effect on local fine particulate matter (PM 2.5 ) air quality with readings typical of similar non-fire times; hourly and daily good to moderate Air Quality Index (AQI) for PM 2.5 , maximum hourly concentrations 21-103 μg m -3 , and mean concentrations between 7.7 and 13.2 μg m -3 . Hourly and daily AQI was typically good or moderate during managed fires with 3 h and one day reaching unhealthy while the site remained below National Ambient Air Quality Standards (NAAQS), with maximum hourly concentrations 27-244 μg m -3 , and mean concentrations 6.7-11.7 μg m -3 . The large high intensity fire in this area created the highest short term impacts (AQI unhealthy for 4 h and very unhealthy for 1 h), 11 unhealthy for sensitive days, and produced the only annual value (43.9 μg m -3 ) over the NAAQS 98th percentile for PM 2.5 (35 μg m -3 ). Pinehurst remained below the federal standards for PM 2.5 when wildland fire in the local area was managed to 7800 ha (8-22% of the historic burn area). Considering air quality impacts from smoke using the NAAQS at a landscape level over time can give land and air managers a metric for broader evaluation of smoke impacts particularly when assessing ecologically beneficial fire. Allowing managers to control the amount and timing of individual wildland fire emissions can help lessen large smoke impacts to public health from a megafire. Published by Elsevier Ltd.

Assessment of medication adherence app features, functionality, and health literacy level and the creation of a searchable Web-based adherence app resource for health care professionals and patients.

PubMed

Heldenbrand, Seth; Martin, Bradley C; Gubbins, Paul O; Hadden, Kristie; Renna, Catherine; Shilling, Rebecca; Dayer, Lindsey

2016-01-01

To assess the features and level of health literacy (HL) of available medication adherence apps and to create a searchable website to assist health care providers (HCP) and patients identify quality adherence apps. Medication nonadherence continues to be a significant problem and leads to poor health outcomes and avoidable health care expense. The average adherence rate for chronic medications, regardless of disease state, is approximately 50% leaving significant room for improvement. Smartphone adherence apps are a novel resource to address medication nonadherence. With widespread smartphone use and the growing number of adherence apps, both HCP and patients should be able to identify quality adherence apps to maximize potential benefits. Assess the features, functionality and level of HL of available adherence apps and create a searchable website to help both HCP and patients identify quality adherence apps. Online marketplaces (iTunes, Google Play, Blackberry) were searched in June of 2014 to identify available adherence apps. Online descriptions were recorded and scored based on 28 author-identified features across 4 domains. The 100 highest-scoring apps were user-tested with a standardized regimen to evaluate their functionality and level of HL. 461 adherence apps were identified. 367 unique apps were evaluated after removing "Lite/Trial" versions. The median initial score based on descriptions was 15 (max of 68; range: 3 to 47). Only 77 apps of the top 100 highest-scoring apps completed user-testing and HL evaluations. The median overall user-testing score was 30 (max of 73; range: 16 to 55). App design, functionality, and level of HL varies widely among adherence apps. While no app is perfect, several apps scored highly across all domains. The website www.medappfinder.com is a searchable tool that helps HCP and patients identify quality apps in a crowded marketplace. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Can nurse innovation improve customer perception of service quality and experience?

PubMed

Weng, Rhay-Hung; Chen, Wan-Ping; Huang, Ching-Yuan; Hung, Chiu-Hsia; Hsu, Ching-Tai

2016-07-01

This study aimed to clarify how nurse innovation is related to customer perception of medical service quality and experience. Recently, many hospitals have put much emphasis upon the development of nurse innovation. A cross-sectional study was employed. This study adopted questionnaire survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilised to test the possible impact of nurse innovation on medical service quality and experience. In terms of the dimensions of nurse innovation, 'innovation behaviour' ranked the highest (3·24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4·35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4·44). All dimensions of nurse innovation have no significant effects on medical service quality and experience. Of these three dimensions of nurse innovation, the level of innovation behaviour was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on customer perception of service quality and experience. Hospitals shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on 'patient-centred' shall be enhanced among hospital nurses. Healthcare managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses. © 2016 John Wiley & Sons Ltd.

Air pollution and vulnerability: solving the puzzle of prioritization.

PubMed

Wright, Caradee Y; Diab, Roseanne

2011-01-01

While ambient air pollution levels in excess of prescribed health standards are generally unacceptable, the exceedance is even more serious in areas where people reside. Vulnerability caused by poverty, disease, lack of education, and poor living conditions exacerbates the problem. Air quality management plans identify prioritized strategies for improved air quality independent of consideration of vulnerability. A population exposure and vulnerability risk prioritization framework comprising five themes (air pollution sources; air pollution levels; air pollution potential; community awareness, observations, perceptions, and actions; and vulnerability factors) was proposed and applied to the eThekwini Municipality (Durban, South Africa). Data were scored according to predetermined risk threshold values to ascertain at-risk communities. While those urban wards located in a known air pollution hotspot had the highest air pollution levels, a periurban ward with moderate exposure levels was most vulnerable. This framework will prove invaluable for the development of focused interventions to reduce vulnerability and air pollution-associated adverse health impacts.

Redrawing the frontiers in the age of post-publication review

PubMed Central

Galbraith, David W.

2015-01-01

Publication forms the core structure supporting the development and transmission of scientific knowledge. For this reason, it is essential that the highest standards of quality control be maintained, in particular to ensure that the information being transmitted allows reproducible replication of the described experiments, and that the interpretation of the results is sound. Quality control has traditionally involved editorial decisions based on anonymous pre-publication peer review. Post-publication review of individual articles took the lesser role since it did not feed directly back to the original literature. Rapid advances in computer and communications technologies over the last thirty years have revolutionized scientific publication, and the role and scope of post-publication review has greatly expanded. This perspective examines the ways in which pre- and post-publication peer review influence the scientific literature, and in particular how they might best be redrawn to deal with the twin problems of scientific non-reproducibility and fraud increasingly encountered at the frontiers of science. PMID:26097488

Olive oil pilot-production assisted by pulsed electric field: impact on extraction yield, chemical parameters and sensory properties.

PubMed

Puértolas, Eduardo; Martínez de Marañón, Iñigo

2015-01-15

The impact of the use of pulsed electric field (PEF) technology on Arroniz olive oil production in terms of extraction yield and chemical and sensory quality has been studied at pilot scale in an industrial oil mill. The application of a PEF treatment (2 kV/cm; 11.25 kJ/kg) to the olive paste significantly increased the extraction yield by 13.3%, with respect to a control. Furthermore, olive oil obtained by PEF showed total phenolic content, total phytosterols and total tocopherols significantly higher than control (11.5%, 9.9% and 15.0%, respectively). The use of PEF had no negative effects on general chemical and sensory characteristics of the olive oil, maintaining the highest quality according to EU legal standards (EVOO; extra virgin olive oil). Therefore, PEF could be an appropriate technology to improve olive oil yield and produce EVOO enriched in human-health-related compounds, such as polyphenols, phytosterols and tocopherols. Copyright © 2014 Elsevier Ltd. All rights reserved.

Respiratory Protection Toolkit: Providing Guidance Without Changing Requirements-Can We Make an Impact?

PubMed

Bien, Elizabeth Ann; Gillespie, Gordon Lee; Betcher, Cynthia Ann; Thrasher, Terri L; Mingerink, Donna R

2016-12-01

International travel and infectious respiratory illnesses worldwide place health care workers (HCWs) at increasing risk of respiratory exposures. To ensure the highest quality safety initiatives, one health care system used a quality improvement model of Plan-Do-Study-Act and guidance from Occupational Safety and Health Administration's (OSHA) May 2015 Hospital Respiratory Protection Program (RPP) Toolkit to assess a current program. The toolkit aided in identification of opportunities for improvement within their well-designed RPP. One opportunity was requiring respirator use during aerosol-generating procedures for specific infectious illnesses. Observation data demonstrated opportunities to mitigate controllable risks including strap placement, user seal check, and reuse of disposable N95 filtering facepiece respirators. Subsequent interdisciplinary collaboration resulted in other ideas to decrease risks and increase protection from potentially infectious respiratory illnesses. The toolkit's comprehensive document to evaluate the program showed that while the OSHA standards have not changed, the addition of the toolkit can better protect HCWs. © 2016 The Author(s).

Re-cycling of sugar-ash: a raw feed material for rotary kilns.

PubMed

Kantiranis, Nikolaos

2004-01-01

Large amounts of sugar-ash, a material rich in calcium carbonate, are produced as a by-product in the Greek Sugar Industry. This work explores the possibility of re-cycling sugar-ash for use in the lime industry. A representative sample of sugar-ash from the Plati Imathias sugar plant was studied by PXRD, TG/DTG, calcination experiments at temperatures between 650 and 1150 degrees C and experiments to determine the quality of the quicklime produced at temperatures between 850 and 1150 degrees C following methods described in ASTM C110 standard. The sugar-ash was found to consist of 90 wt% calcium rich minerals (calcite and monohydrocalcite) and 10 wt% amorphous material. Traces of quartz were also detected. The quicklime of highest quality was produced at 950 degrees C. It is concluded that this "useless" material (sugar-ash) can be re-cycled for use in rotary kilns in the lime industry at calcination temperatures up to 950-1000 degrees C.

Effect of germination and fermentation on the nutritional quality of bambara nut (Voandzeia subterranea L. Thouars) and its product (milk).

PubMed

Obizoba, I C; Egbuna, H I

1992-01-01

Five cultivars of bambara groundnut were selected on which to study the effects of germination and fermentation on their proximate composition. The cultivar that had the highest protein content was chosen to prepare unfermented and fermented milk. Standard assay techniques were adopted to determine the parameters selected for use. Germination caused a decrease in the protein, carbohydrate and starch; it increased sugar content, and had varied effects on the lipids contents of the dry samples. The anti-nutritional factor-tannin concentration was decreased. Germination and fermentation had varied effects on the nutrient compositions of the milk. Compared to the control, germination had the same effect as in the seeds. Fermentation further decreased some of the nitrogenous constituents, sugar and starch content of the milk and much more drastically the tannin content. Hydrolysis and other metabolic changes freed the nutrients from their bound forms while decreasing the quantity, but increasing the quality and availability of the nutrients.

Systematic and progressive implementation of the centers of excellence for rheumatoid arthritis: a methodological proposal.

PubMed

Santos-Moreno, Pedro; Caballero-Uribe, Carlo V; Massardo, Maria Loreto; Maldonado, Claudio Galarza; Soriano, Enrique R; Pineda, Carlos; Cardiel, Mario; Benavides, Juan Alberto; Beltrán, Paula Andrea

2017-12-01

The implementation of excellence centers in specific diseases has been gaining recognition in the field of health; specifically in rheumatoid arthritis, where the prognosis of the disease is related to an early diagnosis and a timely intervention, it is necessary that the provision of health services is developed in an environment of quality, opportunity, and safety with the highest standards of care. A methodology that allows this implementation in such a way that is achievable by the most of the care centers is a priority to achieve a better attention to populations with this disease. In this paper, we propose a systematic and progressive methodology that will help all the institutions to develop successful models without faltering in the process. The expected impact on public health is defined by a better effective coverage of high-quality treatments, obtaining better health outcomes with safety and accessibility that reduces the budgetary impact for the health systems of our countries.

Removal of chromophore in enzymatic hydrolysis by acid precipitation to improve the quality of xylo-oligosaccharides from corn stalk.

PubMed

Wang, Yue-Hai; Zhang, Jie; Qu, Yong-Shui; Li, Hong-Qiang

2018-02-01

As the most representative functional sugar, the application areas and market demands of xylo-oligosaccharides (XOS) have been expanding year by year. Owing to the complex structure of corn stalk (CS), XOS obtained from CS are accompanied by problems such as low purity and high color value, which degrade the product. To improve the quality of XOS from CS, the enzymatic hydrolysis was precipitated by acid; then, the ethanol elution concentration was systematically investigated after optimizing the adsorption conditions. The results showed that the purity of XOS was increased to 87.28% from 67.31%, and the color value was decreased to 1050 from 4682 when the acid precipitation pH was 2. On the basis of acid precipitation, if the corresponding optimal conditions of XOS adsorption and elution were used, the highest purity of XOS was 97.87% obtained, with the lowest color value, 780, which reached the standard of the commercial XOS. Copyright © 2017. Published by Elsevier Ltd.

Spotting optimization for oligo microarrays on aldehyde-glass.

PubMed

Dawson, Erica D; Reppert, Amy E; Rowlen, Kathy L; Kuck, Laura R

2005-06-15

Low-density microarrays that utilize short oligos (<100 nt) for capture are highly attractive for use in diagnostic applications, yet these experiments require strict quality control and meticulous reproducibility. However, a survey of current literature indicates vast inconsistencies in the spotting and processing procedures. In this study, spotting and processing protocols were optimized for aldehyde-functionalized glass substrates. Figures of merit were developed for quantitative comparison of spot quality and reproducibility. Experimental variables examined included oligo concentration in the spotting buffer, composition of the spotting buffer, postspotting "curing" conditions, and postspotting wash conditions. Optimized conditions included the use of 3-4 microM oligo in a 3x standard saline citrate/0.05% sodium dodecyl sulfate/0.001% (3-[(3-cholamidopropyl) dimethylammonia]-1-propane sulfonate) spotting buffer, 24-h postspotting reaction at 100% relative humidity, and a four-step wash procedure. Evaluation of six types of aldehyde-functionalized glass substrates indicated that those manufactured by CEL Associates, Inc. yield the highest oligo coverage.

Assessment of TBT and organic booster biocide contamination in seawater from coastal areas of South Korea.

PubMed

Kim, Nam Sook; Shim, Won Joon; Yim, Un Hyuk; Hong, Sang Hee; Ha, Sung Yong; Han, Gi Myung; Shin, Kyung-Hoon

2014-01-15

Seawater samples from major enclosed bays, fishing ports, and harbors of Korea were analyzed to determine levels of tributyltin (TBT) and booster biocides, which are antifouling agents used as alternatives to TBT. TBT levels were in the range of not detected (nd) to 23.9 ng Sn/L. Diuron and Irgarol 1051, at concentration ranges of 35-1360 ng/L and nd to 14 ng/L, respectively, were the most common alternative biocides present in seawater, with the highest concentrations detected in fishing ports. Hot spots were identified where TBT levels exceeded environmental quality targets even 6 years after a total ban on its use in Korea. Diuron exceeded the UK environmental quality standard (EQS) value in 73% of the fishing port samples, 64% of the major bays, and 42% of the harbors. Irgarol 1051 levels were marginally below the Dutch and UK EQS values at all sites. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prediction of pork loin quality using online computer vision system and artificial intelligence model.

PubMed

Sun, Xin; Young, Jennifer; Liu, Jeng-Hung; Newman, David

2018-06-01

The objective of this project was to develop a computer vision system (CVS) for objective measurement of pork loin under industry speed requirement. Color images of pork loin samples were acquired using a CVS. Subjective color and marbling scores were determined according to the National Pork Board standards by a trained evaluator. Instrument color measurement and crude fat percentage were used as control measurements. Image features (18 color features; 1 marbling feature; 88 texture features) were extracted from whole pork loin color images. Artificial intelligence prediction model (support vector machine) was established for pork color and marbling quality grades. The results showed that CVS with support vector machine modeling reached the highest prediction accuracy of 92.5% for measured pork color score and 75.0% for measured pork marbling score. This research shows that the proposed artificial intelligence prediction model with CVS can provide an effective tool for predicting color and marbling in the pork industry at online speeds. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Extreme-Technology Industry

NASA Astrophysics Data System (ADS)

Hoefflinger, Bernd

The persistent annual R&D quota of >15% of revenue in the semiconductor industry has been and continues to be more than twice as high as the OECD definition for High-Technology Industry. At the frontiers of miniaturization, the Cost-of-Ownership (COO) continues to rise upwards to beyond 10 billion for a Gigafactory. Only leaders in the world market for selected processors and memories or for foundry services can afford this. Others can succeed with high-value custom products equipped with high-performance application-specific standard products acquired from the leaders in their specific fields or as fabless original-device manufacturers buying wafers from top foundries and packaging/testing from contract manufacturers, thus eliminating the fixed cost for a factory. An overview is offered on the leaders in these different business models. In view of the coming highly diversified and heterogeneous world of nanoelectronic-systems competence, the point is made for global networks of manufacturing and services with the highest standards for product quality and liability.

Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients.

PubMed

Downey, Lois; Engelberg, Ruth A; Standish, Leanna J; Kozak, Leila; Lafferty, William E

2009-01-01

Improving end-of-life care is a priority in the United States, but assigning priorities for standard care services requires evaluations using appropriate study design and appropriate outcome indicators. A recent randomized controlled trial with terminally ill patients produced no evidence of benefit from massage or guided meditation, when evaluated with measures of global quality of life or pain distress over the course of patient participation. However, reanalysis using a more targeted outcome, surrogates' assessment of patients' benefit from the study intervention, suggested significant gains from massage-the treatment patients gave their highest preassignment preference ratings. The authors conclude that adding a menu of complementary therapies as part of standard end-of-life care may yield significant benefit, that patient preference is an important predictor of outcome, and that modifications in trial design may be appropriate for end-of-life studies.

Outdoor air pollutants and patient health.

PubMed

Laumbach, Robert J

2010-01-15

Almost 160 million persons live in areas of the United States that exceed federal health-based air pollution standards. The two air pollutants that most commonly exceed standards are ozone and particulate matter. Ozone and particulate matter can harm anyone if levels are sufficiently elevated, but health risk from air pollution is greatest among vulnerable populations. Both ozone and particulate matter can cause pulmonary inflammation, decreased lung function, and exacerbation of asthma and chronic obstructive pulmonary disease. Particulate matter is also strongly associated with increased cardiovascular morbidity and mortality. Children, older adults, and other vulnerable persons may be sensitive to lower levels of air pollution. Persons who are aware of local air pollution levels, reported daily by the U.S. Environmental Protection Agency as the Air Quality Index, can take action to reduce exposure. These actions include simple measures to limit exertion and time spent outdoors when air pollution levels are highest, and to reduce the infiltration of outdoor air pollutants into indoor spaces.

Treatment of chromium contaminated soil using bioremediation

NASA Astrophysics Data System (ADS)

Purwanti, Ipung Fitri; Putri, Tesya Paramita; Kurniawan, Setyo Budi

2017-11-01

Chromium contamination in soil occurs due to the disposal of chromium industrial wastewater or sludge that excess the quality standard. Chromium concentration in soil is ranged between 1 to 300 mg/kg while the maximum health standard is 2.5 mg/kg. Bioremediation is one of technology that could be used for remediating heavy metal contamination in soil. Bacteria have an ability to remove heavy metal from soil. One bacteria species that capable to remove chromium from soil is Bacillus subtilis. The aim of this research was to know the chromium removal percentage in contaminated soil by Bacillus subtilis. Artificial chromium contaminated soil was used by mixing 425gram sand and chromium trichloride solution. Concentration of chromium added into the spiked soil were 50, 75, and 100 mg/L. During 14 days, pH, soil temperature and soil moisture were tested. Initial and final number of bacterial colony and chromium concentration analysed. The result showed that the highest percentage of chromium removal was 11% at a chromium concentration of 75 mg/L

Shallow ground-water quality beneath a major urban center: Denver, Colorado, USA

USGS Publications Warehouse

Bruce, B.W.; McMahon, P.B.

1996-01-01

A survey of the chemical quality of ground water in the unconsolidated alluvial aquifer beneath a major urban center (Denver, Colorado, USA) was performed in 1993 with the objective of characterizing the quality of shallow ground-water in the urban area and relating water quality to land use. Thirty randomly selected alluvial wells were each sampled once for a broad range of dissolved constituents. The urban land use at each well site was sub- classified into one of three land-use settings: residential, commercial, and industrial. Shallow ground-water quality was highly variable in the urban area and the variability could be related to these land-use setting classifications. Sulfate (SO4) was the predominant anion in most samples from the residential and commercial land-use settings, whereas bicarbonate (HCO3) was the predominant anion in samples from the industrial land-use setting, indicating a possible shift in redox conditions associated with land use. Only three of 30 samples had nitrate concentrations that exceeded the US national drinking-water standard of 10 mg l-1 as nitrogen, indicating that nitrate contamination of shallow ground water may not be a serious problem in this urban area. However, the highest median nitrate concentration (4.2 mg l-1) was in samples from the residential setting, where fertilizer application is assumed to be most intense. Twenty-seven of 30 samples had detectable pesticides and nine of 82 analyzed pesticide compounds were detected at low concentrations, indicating that pesticides are widely distributed in shallow ground water in this urban area. Although the highest median total pesticide concentration (0.17 ??g l-1) was in the commercial setting, the herbicides prometon and atrazine were found in each land-use setting. Similarly, 25 of 29 samples analyzed had detectable volatile organic compounds (VOCs) indicating these compounds are also widely distributed in this urban area. The total VOC concentrations in sampled wells ranged from nondetectable to 23 442 ??g l-1. Widespread detections and occasionally high concentrations point to VOCs as the major anthropogenic ground-water impact in this urban environment. Generally, the highest VOC concentrations occurred in samples from the industrial setting. The most frequently detected VOC was the gasoline additive methyl tertbutyl ether (MTBE, in 23 of 29 wells). Results from this study indicate that the quality of shallow ground water in major urban areas can be related to land-use settings. Moreover, some VOCs and pesticides may be widely distributed at low concentrations in shallow ground water throughout major urban areas. As a result, the differentiation between point and non-point sources for these compounds in urban areas may be difficult.

40 CFR 131.22 - EPA promulgation of water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false EPA promulgation of water quality standards. 131.22 Section 131.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.22 EPA promulgation of water quality...

40 CFR 131.22 - EPA promulgation of water quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false EPA promulgation of water quality standards. 131.22 Section 131.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.22 EPA promulgation of water quality...

Identification of suitable fundus images using automated quality assessment methods.

PubMed

Şevik, Uğur; Köse, Cemal; Berber, Tolga; Erdöl, Hidayet

2014-04-01

Retinal image quality assessment (IQA) is a crucial process for automated retinal image analysis systems to obtain an accurate and successful diagnosis of retinal diseases. Consequently, the first step in a good retinal image analysis system is measuring the quality of the input image. We present an approach for finding medically suitable retinal images for retinal diagnosis. We used a three-class grading system that consists of good, bad, and outlier classes. We created a retinal image quality dataset with a total of 216 consecutive images called the Diabetic Retinopathy Image Database. We identified the suitable images within the good images for automatic retinal image analysis systems using a novel method. Subsequently, we evaluated our retinal image suitability approach using the Digital Retinal Images for Vessel Extraction and Standard Diabetic Retinopathy Database Calibration level 1 public datasets. The results were measured through the F1 metric, which is a harmonic mean of precision and recall metrics. The highest F1 scores of the IQA tests were 99.60%, 96.50%, and 85.00% for good, bad, and outlier classes, respectively. Additionally, the accuracy of our suitable image detection approach was 98.08%. Our approach can be integrated into any automatic retinal analysis system with sufficient performance scores.

Using Computer-Extracted Data from Electronic Health Records to Measure the Quality of Adolescent Well-Care

PubMed Central

Gardner, William; Morton, Suzanne; Byron, Sepheen C; Tinoco, Aldo; Canan, Benjamin D; Leonhart, Karen; Kong, Vivian; Scholle, Sarah Hudson

2014-01-01

Objective To determine whether quality measures based on computer-extracted EHR data can reproduce findings based on data manually extracted by reviewers. Data Sources We studied 12 measures of care indicated for adolescent well-care visits for 597 patients in three pediatric health systems. Study Design Observational study. Data Collection/Extraction Methods Manual reviewers collected quality data from the EHR. Site personnel programmed their EHR systems to extract the same data from structured fields in the EHR according to national health IT standards. Principal Findings Overall performance measured via computer-extracted data was 21.9 percent, compared with 53.2 percent for manual data. Agreement measures were high for immunizations. Otherwise, agreement between computer extraction and manual review was modest (Kappa = 0.36) because computer-extracted data frequently missed care events (sensitivity = 39.5 percent). Measure validity varied by health care domain and setting. A limitation of our findings is that we studied only three domains and three sites. Conclusions The accuracy of computer-extracted EHR quality reporting depends on the use of structured data fields, with the highest agreement found for measures and in the setting that had the greatest concentration of structured fields. We need to improve documentation of care, data extraction, and adaptation of EHR systems to practice workflow. PMID:24471935

Freshness indices of roasted coffee: monitoring the loss of freshness for single serve capsules and roasted whole beans in different packaging.

PubMed

Glöss, Alexia N; Schönbächler, Barbara; Rast, Markus; Deuber, Louis; Yeretzian, Chahan

2014-01-01

With the growing demand for high-quality coffee, it is becoming increasingly important to establish quantitative measures of the freshness of coffee, or the loss thereof, over time. Indeed, freshness has become a critical quality criterion in the specialty coffee scene, where the aim is to deliver the most pleasant flavor in the cup, from highest quality beans. A series of intensity ratios of selected volatile organic compounds (VOC) in the headspace of coffee (by gas chromatography-mass spectrometry) were revisited, with the aim to establish robust indicators of freshness of coffee - called freshness indices. Roasted whole beans in four different packaging materials and four commercial capsule systems from the Swiss market were investigated over a period of up to one year of storage time. These measurements revealed three types of insight. First, a clear link between barrier properties of the packaging material and the evolution of selected freshness indices was observed. Packaging materials that contain an aluminum layer offer better protection. Second, processing steps prior to packaging are reflected in the absolute values of freshness indices. Third, differences in the standard deviations of freshness-indices for single serve coffee capsule systems are indicative of differences in the consistency among systems, consistency being an important quality attribute of capsules.

24 CFR 982.605 - SRO: Housing quality standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false SRO: Housing quality standards. 982... Types Single Room Occupancy (sro) § 982.605 SRO: Housing quality standards. (a) HQS standards for SRO...) (space and security). Since the SRO units will not house children, the housing quality standards in § 982...

British Thoracic Society quality standards for home oxygen use in adults

PubMed Central

Suntharalingam, Jay; Wilkinson, Tom; Annandale, Joseph; Davey, Claire; Fielding, Rhea; Freeman, Daryl; Gibbons, Michael; Hardinge, Maxine; Hippolyte, Sabrine; Knowles, Vikki; Lee, Cassandra; MacNee, William; Pollington, Jacqueline; Vora, Vandana; Watts, Trefor; Wijesinghe, Meme

2017-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for home oxygen provision in the UK, together with measurable markers of good practice. Quality statements are based on the British Thoracic Society (BTS) Guideline for Home Oxygen Use in Adults. Methods Development of BTS Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 10 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for home oxygen use, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. Discussion BTS Quality Standards for home oxygen use in adults form a key part of the range of supporting materials that the society produces to assist in the dissemination and implementation of a guideline’s recommendations. PMID:29018527

Blood cell mRNAs and microRNAs: optimized protocols for extraction and preservation.

PubMed

Eikmans, Michael; Rekers, Niels V; Anholts, Jacqueline D H; Heidt, Sebastiaan; Claas, Frans H J

2013-03-14

Assessing messenger RNA (mRNA) and microRNA levels in peripheral blood cells may complement conventional parameters in clinical practice. Working with small, precious samples requires optimal RNA yields and minimal RNA degradation. Several procedures for RNA extraction and complementary DNA (cDNA) synthesis were compared for their efficiency. The effect on RNA quality of freeze-thawing peripheral blood cells and storage in preserving reagents was investigated. In terms of RNA yield and convenience, quality quantitative polymerase chain reaction signals per nanogram of total RNA and using NucleoSpin and mirVana columns is preferable. The SuperScript III protocol results in the highest cDNA yields. During conventional procedures of storing peripheral blood cells at -180°C and thawing them thereafter, RNA integrity is maintained. TRIzol preserves RNA in cells stored at -20°C. Detection of mRNA levels significantly decreases in degraded RNA samples, whereas microRNA molecules remain relatively stable. When standardized to reference targets, mRNA transcripts and microRNAs can be reliably quantified in moderately degraded (quality index 4-7) and severely degraded (quality index <4) RNA samples, respectively. We describe a strategy for obtaining high-quality and quantity RNA from fresh and stored cells from blood. The results serve as a guideline for sensitive mRNA and microRNA expression assessment in clinical material.

Comparison of wheat- versus corn-based dried distillers' grains with solubles on meat quality of feedlot cattle.

PubMed

Aldai, N; Aalhus, J L; Dugan, M E R; Robertson, W M; McAllister, T A; Walter, L J; McKinnon, J J

2010-03-01

A considerable amount of information has been generated on the feeding value and impact of corn dried distillers' grains with solubles (DDGS) on meat quality, whereas little is known about the effects of wheat DDGS on meat quality, and no direct comparison of these two sources of DDGS has been completed. The current study was conducted to examine the objective and subjective carcass and meat quality traits of cattle fed diets containing corn or wheat (20% or 40%) DDGS (DM basis) as compared to a standard barley-based finishing diet (control). In general, meat obtained from animals fed the barley-based control diet was slightly darker in colour (lower chroma and hue at 24 h, P<0.01) and less tender (highest proportion of tough shears at 2 d and lowest proportion of tender shears at 20 d). Meat from corn DDGS was rated as more tender and palatable than control samples (P<0.05), and 20% corn samples were rated better for beef flavour intensity (P<0.01) and desirability (P<0.05) than 40% corn DDGS samples. In contrast, meat from steers fed wheat DDGS showed intermediate characteristics between steers fed control and corn DDGS diets. Hence, feeding wheat DDGS had no negative effects, and feeding corn DDGS had some positive effects on meat quality characteristics of beef. Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.

Environmental Health Standards for Human Spacecraft

NASA Technical Reports Server (NTRS)

James John T.

2010-01-01

The discussion of air and water quality standards includes evidence-based standards, factors unique to spaceflight, effects from exposures to combinations of compounds, contingency versus nominal standards, tables of ISO standards for air quality (ppm) and water quality (mg/L), and updating of standards.

Comparison of reconstruction methods and quantitative accuracy in Siemens Inveon PET scanner

NASA Astrophysics Data System (ADS)

Ram Yu, A.; Kim, Jin Su; Kang, Joo Hyun; Moo Lim, Sang

2015-04-01

PET reconstruction is key to the quantification of PET data. To our knowledge, no comparative study of reconstruction methods has been performed to date. In this study, we compared reconstruction methods with various filters in terms of their spatial resolution, non-uniformities (NU), recovery coefficients (RCs), and spillover ratios (SORs). In addition, the linearity of reconstructed radioactivity between linearity of measured and true concentrations were also assessed. A Siemens Inveon PET scanner was used in this study. Spatial resolution was measured with NEMA standard by using a 1 mm3 sized 18F point source. Image quality was assessed in terms of NU, RC and SOR. To measure the effect of reconstruction algorithms and filters, data was reconstructed using FBP, 3D reprojection algorithm (3DRP), ordered subset expectation maximization 2D (OSEM 2D), and maximum a posteriori (MAP) with various filters or smoothing factors (β). To assess the linearity of reconstructed radioactivity, image quality phantom filled with 18F was used using FBP, OSEM and MAP (β =1.5 & 5 × 10-5). The highest achievable volumetric resolution was 2.31 mm3 and the highest RCs were obtained when OSEM 2D was used. SOR was 4.87% for air and 3.97% for water, obtained OSEM 2D reconstruction was used. The measured radioactivity of reconstruction image was proportional to the injected one for radioactivity below 16 MBq/ml when FBP or OSEM 2D reconstruction methods were used. By contrast, when the MAP reconstruction method was used, activity of reconstruction image increased proportionally, regardless of the amount of injected radioactivity. When OSEM 2D or FBP were used, the measured radioactivity concentration was reduced by 53% compared with true injected radioactivity for radioactivity <16 MBq/ml. The OSEM 2D reconstruction method provides the highest achievable volumetric resolution and highest RC among all the tested methods and yields a linear relation between the measured and true concentrations for radioactivity Our data collectively showed that OSEM 2D reconstruction method provides quantitatively accurate reconstructed PET data results.

Sensitivity of fish density estimates to standard analytical procedures applied to Great Lakes hydroacoustic data

USGS Publications Warehouse

Kocovsky, Patrick M.; Rudstam, Lars G.; Yule, Daniel L.; Warner, David M.; Schaner, Ted; Pientka, Bernie; Deller, John W.; Waterfield, Holly A.; Witzel, Larry D.; Sullivan, Patrick J.

2013-01-01

Standardized methods of data collection and analysis ensure quality and facilitate comparisons among systems. We evaluated the importance of three recommendations from the Standard Operating Procedure for hydroacoustics in the Laurentian Great Lakes (GLSOP) on density estimates of target species: noise subtraction; setting volume backscattering strength (Sv) thresholds from user-defined minimum target strength (TS) of interest (TS-based Sv threshold); and calculations of an index for multiple targets (Nv index) to identify and remove biased TS values. Eliminating noise had the predictable effect of decreasing density estimates in most lakes. Using the TS-based Sv threshold decreased fish densities in the middle and lower layers in the deepest lakes with abundant invertebrates (e.g., Mysis diluviana). Correcting for biased in situ TS increased measured density up to 86% in the shallower lakes, which had the highest fish densities. The current recommendations by the GLSOP significantly influence acoustic density estimates, but the degree of importance is lake dependent. Applying GLSOP recommendations, whether in the Laurentian Great Lakes or elsewhere, will improve our ability to compare results among lakes. We recommend further development of standards, including minimum TS and analytical cell size, for reducing the effect of biased in situ TS on density estimates.

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

Barton, C.; Vowinkel, E.F.; Nawyn, J.P.

The relation of water quality to hydrogeology and land use was evaluated using analysis of water samples from 71 wells in the northern part of the Potomac-Raritan-Magothy aquifer system in New Jersey. The sampling network was evaluated for variations in hydrogeology. Well depths, pumping rates, and the number of wells in the confined and unconfined parts of the aquifer system did not differ among land-use groups. The influences of hydrogeologic factors on water quality were evaluated without considering land use. Shallow wells had the highest specific conductance and major ion concentrations. Water from wells in the unconfined part of themore » aquifer system had the highest dissolved organic carbon concentration. Dissolved oxygen and nitrate concentrations were lowest, trace metals concentrations were highest, and phenols were detected most frequently in groundwater from undeveloped land. Major ions and trace metals concentrations were lowest, dissolved oxygen and copper concentrations were highest, and pesticides were most frequently detected in groundwater from agricultural land. Nitrate concentrations were highest and orthophosphate, nitrite, and purgeable organics were detected most frequently in groundwater from urban land. These water quality data were compared to data from the same aquifer system in southern New Jersey. Frequencies of detection of purgeable organics among land-use groups were similar in the northern and southern areas. 69 refs., 23 figs., 16 tab.« less

The effects of postharvest application of lecithin to improve storage potential and quality of fresh goji (Lycium barbarum L.) berries.

PubMed

Jatoi, Mushtaque Ahmed; Jurić, Slaven; Vidrih, Rajko; Vinceković, Marko; Vuković, Marko; Jemrić, Tomislav

2017-09-01

To enhance storage life and post-storage quality of fresh goji berries, three treatments with lecithin (1, 5, 10g·L -1 ) and two storage times (8, 16days) were evaluated. The significant effects on the physiological and biochemical parameters were varied. 1g·L -1 lecithin showed its main effects after 8days of storage by reduction in total weight loss and decay, SSC/TA ratio (also at 16days), and chlorophyll content and with highest scores of sensory attributes (also at 16days). 5g·L -1 lecithin showed its main effects after 16days of storage: highest SSC, highest TA (also at 8days), highest TPC, only significant reduction in DPPH antioxidant activity, and highest total flavonoid content. 10g·L -1 lecithin showed its main effects after 8days of storage with highest SSC, chlorophyll content, total flavonoid, DPPH, and ABTS antioxidant activity (also at 16days), but with least scores of sensory attributes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of Portable Venturi Kiln for Agricultural Waste Utilization by Carbonization Process

NASA Astrophysics Data System (ADS)

Agustina, S. E.; Chasanah, N.; Eris, A. P.

2018-05-01

Many types of kiln or carbonization equipment have been developed, but most of them were designed for big capacity and some also having low performance. This research aims to develop kiln, especially portable metal kiln, which has higher performance, more environmental- friendly, and can be used for several kinds of biomass or agricultural waste (not exclusive for one kind of biomass) as feeding material. To improve the kiln performance, a venturi drum type of portable kiln has been designed with an optimum capacity of 12.45 kg coconut shells. Basic idea of those design is heat flow improvement causing by venturi effect. The performance test for coconut shell carbonization shows that the carbonization process takes about 60-90 minutes to produce average yields of 23.8%., and the highest temperature of the process was 441 °C. The optimum performance has been achieved in the 4th test, which was producing 24% yield of highest charcoal quality (represented by LHV) in 65 minutes process at average temperature level 485 °C. For pecan shell and palm shell, design modification has been done by adding 6 air inlet holes and 3 ignition column to get better performance. While operation procedure should be modified on loading and air supply, depending on each biomass characteristic. The result of performance test showed that carbonization process of pecan shell produce 17 % yield, and palm shell produce 15% yield. Based on Indonesian Standard (SNI), all charcoal produced in those carbonization has good quality level.

High-definition computed tomography for coronary artery stents imaging: Initial evaluation of the optimal reconstruction algorithm.

PubMed

Cui, Xiaoming; Li, Tao; Li, Xin; Zhou, Weihua

2015-05-01

The aim of this study was to evaluate the in vivo performance of four image reconstruction algorithms in a high-definition CT (HDCT) scanner with improved spatial resolution for the evaluation of coronary artery stents and intrastent lumina. Thirty-nine consecutive patients with a total of 71 implanted coronary stents underwent coronary CT angiography (CCTA) on a HDCT (Discovery CT 750 HD; GE Healthcare) with the high-resolution scanning mode. Four different reconstruction algorithms (HD-stand, HD-detail; HD-stand-plus; HD-detail-plus) were applied to reconstruct the stented coronary arteries. Image quality for stent characterization was assessed. Image noise and intrastent luminal diameter were measured. The relationship between the measurement of inner stent diameter (ISD) and the true stent diameter (TSD) and stent type were analysed. The stent-dedicated kernel (HD-detail) offered the highest percentage (53.5%) of good image quality for stent characterization and the highest ratio (68.0±8.4%) of visible stent lumen/true stent lumen for luminal diameter measurement at the expense of an increased overall image noise. The Pearson correlation coefficient between the ISD and TSD measurement and spearman correlation coefficient between the ISD measurement and stent type were 0.83 and 0.48, respectively. Compared with standard reconstruction algorithms, high-definition CT imaging technique with dedicated high-resolution reconstruction algorithm provides more accurate stent characterization and intrastent luminal diameter measurement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Quality of water and sediment in streams affected by historical mining, and quality of Mine Tailings, in the Rio Grande/Rio Bravo Basin, Big Bend Area of the United States and Mexico, August 2002

USGS Publications Warehouse

Lambert, Rebecca B.; Kolbe, Christine M.; Belzer, Wayne

2008-01-01

The U.S. Geological Survey, in cooperation with the International Boundary and Water Commission - U.S. and Mexican Sections, the National Park Service, the Texas Commission on Environmental Quality, the Secretaria de Medio Ambiente y Recursos Naturales in Mexico, the Area de Proteccion de Flora y Fauna Canon de Santa Elena in Mexico, and the Area de Proteccion de Flora y Fauna Maderas del Carmen in Mexico, collected samples of stream water, streambed sediment, and mine tailings during August 2002 for a study to determine whether trace elements from abandoned mines in the area in and around Big Bend National Park have affected the water and sediment quality in the Rio Grande/Rio Bravo Basin of the United States and Mexico. Samples were collected from eight sites on the main stem of the Rio Grande/Rio Bravo, four Rio Grande/Rio Bravo tributary sites downstream from abandoned mines or mine-tailing sites, and 11 mine-tailing sites. Mines in the area were operated to produce fluorite, germanium, iron, lead, mercury, silver, and zinc during the late 1800s through at least the late 1970s. Moderate (relatively neutral) pHs in stream-water samples collected at the 12 Rio Grande/Rio Bravo main-stem and tributary sites indicate that water is well mixed, diluted, and buffered with respect to the solubility of trace elements. The highest sulfate concentrations were in water samples from tributaries draining the Terlingua mining district. Only the sample from the Rough Run Draw site exceeded the Texas Surface Water Quality Standards general-use protection criterion for sulfate. All chloride and dissolved solids concentrations in water samples were less than the general-use protection criteria. Aluminum, copper, mercury, nickel, selenium, and zinc were detected in all water samples for which each element was analyzed. Cadmium, chromium, and lead were detected in samples less frequently, and silver was not detected in any of the samples. None of the sample concentrations of aluminum, cadmium, chromium, nickel, selenium, and zinc exceeded the Texas Surface Water Quality Standards criteria for aquatic life-use protection or human health. The only trace elements detected in the water samples at concentrations exceeding the Texas Surface Water Quality Standards criterion for human health (fish consumption use) was lead at one site and mercury at 10 of 12 sites. Relatively high mercury concentrations distributed throughout the area might indicate sources of mercury in addition to abandoned mining areas. Streambed-sediment samples were collected from 12 sites and analyzed for 44 major and trace elements. In general, the trace elements detected in streambed-sediment samples were low in concentration, interpreted as consistent with background concentrations. Concentrations at two sites, however, were elevated compared to Texas Commission on Environmental Quality criteria. Concentrations of antimony, arsenic, cadmium, lead, silver, and zinc in the sample from San Carlos Creek downstream from La Esperanza (San Carlos) Mine exceeded the Texas Commission on Environmental Quality screening levels for sediment. The sample from Rough Run Draw, downstream from the Study Butte Mine, also showed elevated concentrations of arsenic, cadmium, and lead, but these concentrations were much lower than those in the San Carlos Creek sample and did not exceed screening levels. Elevated concentrations of multiple trace elements in streambed-sediment samples from San Carlos Creek and Rough Run Draw indicate that San Carlos Creek, and probably Rough Run Draw, have been adversely affected by mining activities. Fourteen mine-tailing samples from 11 mines were analyzed for 25 major and trace elements. All trace elements except selenium and thallium were detected in one or more samples. The highest lead concentrations were detected in tailings samples from the Boquillas, Puerto Rico, La Esperanza (San Carlos), and Tres Marias Mines, as might be expected because the tailings ar

Physicochemical and Microbiological Qualities’ Assessment of Popular Bangladeshi Mango Fruit Juice

PubMed Central

Amin, Ruhul; Rahman, Shafkat S.; Hossain, Mahboob; Choudhury, Naiyyum

2018-01-01

Introduction: Mango juice has always been considered as a delicious, nutritious popular drink, but processed juice may not always be safe due to chemical and microbial risks. Determination of physicochemical and microbiological qualities of some packed mango juices of Bangladesh will help consumers to know the present scenario. Material and Methods: Six commercially available different juice samples were collected from the market. Carbohydrate profiles were determined using HPLC, crude protein content was calculated using the Kjeldahl method and other parameters were determined by standard AOAC methods. Standard culture techniques were followed to assess the total viable count (TVC), E. coli and other fecal coliforms. Results: The highest quantity of monosaccharide (58.88%) was recorded in the AC1ME5 brand, while the lowest in Homemade (5.648%) and MN1GL2 (9.867%). The maximum content of acidity recorded was 0.24% and minimum 0.21%. The TSS content of all samples varied from 19% to 12%. The highest quantity 6.87% and the lowest 3.62% of reducing sugar were recorded. Most of the mango juices were low in protein and very low/negligible in fat content. Total viable count of different types of fruit juices varied from 1×103 - 3×103 CFU/ml. No significant amount of E. coli and fecal coliform was detected. Conclusion: It can be concluded that the locally available mango juices contain a safe level of nutritional and microbial elements for human consumption, but not highly satisfactory. PMID:29785220

How standard is standard care? Exploring control group outcomes in behaviour change interventions for young people with type 1 diabetes.

PubMed

Ayling, K; Brierley, S; Johnson, B; Heller, S; Eiser, C

2015-01-01

Poor descriptions of standard care may compromise interpretation of results in randomised controlled trials (RCTs) of health interventions. We investigated quality of standard care in RCTs of behaviour change interventions for young people with type 1 diabetes and consider implications for evaluating trial outcomes. We conducted systematic searches for articles published between 1999 and 2012. We extracted standard care descriptions and contacted trial authors to complete a checklist of standard care activities. The relationship between standard care quality and outcomes was examined via subgroup meta-analyses and meta-regression. Standard care descriptions, standard care quality, and relationships between standard care quality with medical and psychological outcomes. We identified 20 RCTs described across 26 articles. Published descriptions of standard care were limited to service-level features. Author responses indicated standard care provision extended beyond published accounts. Subgroup analyses suggested control groups receiving higher standard care quality showed larger improvements in both medical and psychological outcomes, although standard care quality did not predict outcomes significantly. The quality of care delivered to control group participants can influence outcomes of RCTs. Inadequate reporting exacerbates this issue by masking variations between trials. We argue for increased clarity in reporting standard care in future trials.

British Thoracic Society Quality Standards for acute non-invasive ventilation in adults

PubMed Central

Davies, Michael; Allen, Martin; Bentley, Andrew; Bourke, Stephen C; Creagh-Brown, Ben; D’Oliveiro, Rachel; Glossop, Alastair; Gray, Alasdair; Jacobs, Phillip; Mahadeva, Ravi; Moses, Rachael; Setchfield, Ian

2018-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the provision of acute non-invasive ventilation in adults together with measurable markers of good practice. Methods Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 6 quality statements have been developed, each describing a standard of care for the provision of acute non-invasive ventilation in the UK, together with measurable markers of good practice. Conclusion BTS Quality Standards for acute non-invasive ventilation in adults form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline’s recommendations. PMID:29636979

7 CFR 996.30 - Incoming quality standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Incoming quality standards. 996.30 Section 996.30... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE MINIMUM QUALITY AND HANDLING STANDARDS FOR DOMESTIC AND IMPORTED PEANUTS MARKETED IN THE UNITED STATES Quality and Handling Standards...

Cancer incidence and mortality in China, 2014

PubMed Central

Chen, Wanqing; Sun, Kexin; Zheng, Rongshou; Zeng, Hongmei; Zhang, Siwei; Xia, Changfa; Yang, Zhixun; Li, He; Zou, Xiaonong; He, Jie

2018-01-01

Background National Central Cancer Registry of China (NCCRC) updated nationwide cancer statistics using population-based cancer registry data in 2014 collected from all available cancer registries. Methods In 2017, 449 cancer registries submitted cancer registry data in 2014, among which 339 registries’ data met the criteria of quality control and were included in analysis. These cancer registries covered 288,243,347 population, accounting for about 21.07% of the national population in 2014. Numbers of nationwide new cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer type. The world Segi’s population was applied for age-standardized rates. Results A total of 3,804,000 new cancer cases were diagnosed, the crude incidence rate was 278.07/100,000 (301.67/100,000 in males, 253.29/100,000 in females) and the age-standardized incidence rate by world standard population (ASIRW) was 186.53/100,000. Calculated age-standardized incidence rate was higher in urban areas than in rural areas (191.6/100,000 vs. 179.2/100,000). South China had the highest cancer incidence rate while Southwest China had the lowest incidence rate. Cancer incidence rate was higher in female for population between 20 to 54 years but was higher in male for population younger than 20 years or over 54 years. A total of 2,296,000 cancer deaths were reported, the crude mortality rate was 167.89/100,000 (207.24/100,000 in males, 126.54/100,000 in females) and the age-standardized mortality rate by world standard population (ASMRW) was 106.09/100,000. Calculated age-standardized mortality rate was higher in rural areas than in urban areas (110.3/100,000 vs. 102.5/100,000). East China had the highest cancer mortality rate while North China had the lowest mortality rate. The mortality rate in male was higher than that in female. Common cancer types and major causes of cancer death differed between age group and sex. Conclusions Heavy cancer burden and its disparities between area, sex and age group pose a major challenge to public health in China. Nationwide cancer registry plays a crucial role in cancer prevention and control. PMID:29545714

The Early Development and Evolution of the QARTOD for In-Situ Wave Measurements

NASA Astrophysics Data System (ADS)

Bouchard, R. H.; Thomas, J.; Teng, C. C.; Burnett, W.; Castel, D.

2017-12-01

In 2013 the US Integrated Ocean Observing System (IOOS) Program Office issued manual was for the Real-Time Quality Control of In-Situ Surface Wave Data. This was one of the first Quality Assurance/Quality Control of Real-Time Oceanographic Data (QARTOD) manuals that now cover 11 different in situ measurements. This landmark document was the product of an effort initiated at a 2002 OCEANS.US workshop. The workshop identified and prioritized ocean variables with directional waves ranked as one of the highest key variables for inclusion into a national backbone of observations. The workshop was the impetus that led to the first QARTOD meeting in 2003 that involved over 80 participants and developed minimum standards for real-time observations. Over three more QARTOD meetings, two ad hoc meetings, and many hours of coordination and review involving dozens of wave measurement users and providers, consensus was reached on a list of essential "must Do's" for quality control tests that eventually formed the basis of the manual. The IOOS QARTOD manual established a standard format, provided greater detail, included codeable examples of the algorithms and established a framework for periodic reviews and updates. While the bulk of the quality control procedures originated with those being used by the Coastal Data Information Program (CDIP) and by NOAA's National Data Buoy Center (NDBC), QARTOD also enlisted the expertise of federal, academic, and industry partners. CDIP and NDBC each operated more than 100 wave measuring buoys and had long histories of wave buoy measurements. In addition to buoy measurements, users and providers of fixed and bottom-mounted wave systems were also included. This paper examines the individual contributions, early developments, and the evolution of the QARTOD wave measurement efforts that culminated in the US IOOS manual. These efforts serve as an example of how individuals with a common interest and dedication can achieve results for the common good. Quality control algorithms of value, but not included in the essential list and further quality control advancements outside of the QARTOD will also be reviewed.

Long-term observations of tropospheric ozone: GAW Measurement Guidelines

NASA Astrophysics Data System (ADS)

Tarasova, Oksana; Galbally, Ian E.; Schultz, Martin G.

2013-04-01

The Global Atmosphere Watch (GAW) Programme of the World Meteorological Organization (WMO) coordinates long-term observations of the chemical composition and physical properties of the atmosphere which are relevant for understanding of atmospheric chemistry and climate change. Atmospheric observations of reactive gases (tropospheric ozone, carbon monoxide, volatile organic compounds and nitrogen oxides) coordinated by the GAW Programme complement local and regional scale air quality monitoring efforts. As part of the GAW quality assurance (QA) system detailed measurement guidelines for atmospheric trace species are developed by international expert teams at irregular intervals. The most recent report focuses on continuous in-situ measurements of ozone in the troposphere, performed in particular at continental or island sites with altitudes ranging from sea level to mountain tops. Data Quality Objectives (DQOs) are defined for different applications of the data (e.g. trend analysis and verification of global model forecasts). These DQOs include a thorough discussion of the tolerable level of measurement uncertainty and data completeness. The guidelines present the best practices and practical arrangements adopted by the GAW Programme in order to enable the GAW station network to approach or achieve the defined tropospheric ozone DQOs. The document includes information on the selection of station and measurement locations, required skills and training of staff, recommendations on the measurement technique and the necessary equipment to perform highest quality measurements, rules for conducting the measurements, preparing the data and archiving them, and more. Much emphasis is given to discussions about how to ensure the quality of the data through tracing calibrations back to primary standards, proper calibration and data analysis, etc. In the GAW Programme the QA system is implemented through Central Facilities (Central Calibration Laboratories, World and Regional Calibration Centers and World Data Centers), Scientific Advisory Groups and GAW Training and Education Center. These bodies support primary standards, provide calibration and data archiving facilities, coordinate comparison campaigns, perform stations audit, provide documentation and training of personnel.

Effect of fermentation on the nutritional quality and functional properties of infant food formulations prepared from bambarra-groundnut, fluted-pumpkin and millet seeds.

PubMed

Ezeji, C; Ojimelukwe, P C

1993-11-01

Weaning foods were formulated by complementation of millet with bambarra groundnut seeds and fluted pumkin seeds. The proximate composition of the individual seeds and the formulations were determined. The composite flour blend containing the highest quantity of fluted pumkin seeds was found to have the highest protein and fat contents (24 and 8% respectively). Functional properties of formulated weaning foods were evaluated. The effect of fermentation on the nutritional quality of the products were determined by animal feeding experiments. The feed intake, weight gain and PER values were evaluated. Fermentation was found to improve the nutritional quality of the formulations. The fermented composite mixture of millet, bambarra groundnut and fluted pumpkin flour (1:1:2) was found to have the highest PER value of 2.1. This suggests that this fermented product will support growth in children better than other formulations.

High-quality JPEG compression history detection for fake uncompressed images

NASA Astrophysics Data System (ADS)

Zhang, Rong; Wang, Rang-Ding; Guo, Li-Jun; Jiang, Bao-Chuan

2017-05-01

Authenticity is one of the most important evaluation factors of images for photography competitions or journalism. Unusual compression history of an image often implies the illicit intent of its author. Our work aims at distinguishing real uncompressed images from fake uncompressed images that are saved in uncompressed formats but have been previously compressed. To detect the potential image JPEG compression, we analyze the JPEG compression artifacts based on the tetrolet covering, which corresponds to the local image geometrical structure. Since the compression can alter the structure information, the tetrolet covering indexes may be changed if a compression is performed on the test image. Such changes can provide valuable clues about the image compression history. To be specific, the test image is first compressed with different quality factors to generate a set of temporary images. Then, the test image is compared with each temporary image block-by-block to investigate whether the tetrolet covering index of each 4×4 block is different between them. The percentages of the changed tetrolet covering indexes corresponding to the quality factors (from low to high) are computed and used to form the p-curve, the local minimum of which may indicate the potential compression. Our experimental results demonstrate the advantage of our method to detect JPEG compressions of high quality, even the highest quality factors such as 98, 99, or 100 of the standard JPEG compression, from uncompressed-format images. At the same time, our detection algorithm can accurately identify the corresponding compression quality factor.

A high-throughput Sanger strategy for human mitochondrial genome sequencing

PubMed Central

2013-01-01

Background A population reference database of complete human mitochondrial genome (mtGenome) sequences is needed to enable the use of mitochondrial DNA (mtDNA) coding region data in forensic casework applications. However, the development of entire mtGenome haplotypes to forensic data quality standards is difficult and laborious. A Sanger-based amplification and sequencing strategy that is designed for automated processing, yet routinely produces high quality sequences, is needed to facilitate high-volume production of these mtGenome data sets. Results We developed a robust 8-amplicon Sanger sequencing strategy that regularly produces complete, forensic-quality mtGenome haplotypes in the first pass of data generation. The protocol works equally well on samples representing diverse mtDNA haplogroups and DNA input quantities ranging from 50 pg to 1 ng, and can be applied to specimens of varying DNA quality. The complete workflow was specifically designed for implementation on robotic instrumentation, which increases throughput and reduces both the opportunities for error inherent to manual processing and the cost of generating full mtGenome sequences. Conclusions The described strategy will assist efforts to generate complete mtGenome haplotypes which meet the highest data quality expectations for forensic genetic and other applications. Additionally, high-quality data produced using this protocol can be used to assess mtDNA data developed using newer technologies and chemistries. Further, the amplification strategy can be used to enrich for mtDNA as a first step in sample preparation for targeted next-generation sequencing. PMID:24341507

Improving Quality and Reducing Waste in Allied Health Workplace Education Programs: A Pragmatic Operational Education Framework Approach.

PubMed

Golder, Janet; Farlie, Melanie K; Sevenhuysen, Samantha

2016-01-01

Efficient utilisation of education resources is required for the delivery of effective learning opportunities for allied health professionals. This study aimed to develop an education framework to support delivery of high-quality education within existing education resources. This study was conducted in a large metropolitan health service. Homogenous and purposive sampling methods were utilised in Phase 1 (n=43) and 2 (n=14) consultation stages. Participants included 25 allied health professionals, 22 managers, 1 educator, and 3 executives. Field notes taken during 43 semi-structured interviews and 4 focus groups were member-checked, and semantic thematic analysis methods were utilised. Framework design was informed by existing published framework development guides. The framework model contains governance, planning, delivery, and evaluation and research elements and identifies performance indicators, practice examples, and support tools for a range of stakeholders. Themes integrated into framework content include improving quality of education and training provided and delivery efficiency, greater understanding of education role requirements, and workforce support for education-specific knowledge and skill development. This framework supports efficient delivery of allied health workforce education and training to the highest standard, whilst pragmatically considering current allied health education workforce demands.

British Thoracic Society quality standards for the investigation and management of pulmonary nodules.

PubMed

Baldwin, David; Callister, Matthew; Akram, Ahsan; Cane, Paul; Draffan, Jeanette; Franks, Kevin; Gleeson, Fergus; Graham, Richard; Malhotra, Puneet; Pearson, Philip; Subesinghe, Manil; Waller, David; Woolhouse, Ian

2018-01-01

The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. 7 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for the investigation and management of pulmonary nodules, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. BTS Quality Standards for the investigation and management of pulmonary nodules form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline recommendations.

British Thoracic Society quality standards for the investigation and management of pulmonary nodules

PubMed Central

Baldwin, David; Callister, Matthew; Akram, Ahsan; Cane, Paul; Draffan, Jeanette; Franks, Kevin; Gleeson, Fergus; Graham, Richard; Malhotra, Puneet; Pearson, Philip; Subesinghe, Manil; Waller, David; Woolhouse, Ian

2018-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Methods Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 7 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for the investigation and management of pulmonary nodules, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. Discussion BTS Quality Standards for the investigation and management of pulmonary nodules form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline recommendations. PMID:29682290

Lessons Learned on Quality (of) Standards

NASA Astrophysics Data System (ADS)

Gerlich, Rainer; Gerlich, Ralf

2011-08-01

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

Standards of Conditions During Preparations for the Summer Paralympic Games Between 2004 and 2012 Assessed by Polish Athletes.

PubMed

Sobiecka, Joanna; Gawroński, Wojciech; Kądziołka, Marta; Kruszelnicki, Paweł; Kłodecka-Różalska, Jadwiga; Plinta, Ryszard

2015-11-22

The quality of training conditions affects sporting success, injuries and health. The aim of the work was to present the conditions during the preparations of Polish athletes for the Summer Paralympic Games 2004-2012. The study encompassed 271 paralympians: Athens (91), Beijing (89) and London (91), competing in 13 disciplines. The research was based on a two-part questionnaire by Kłodecka-Różalska adjusted for disabled sports, and was conducted one month before each PG. Part 1 contained 20 closed-ended questions regarding conditions during preparations, while Part 2 concerned socio-demographic and sports-related data. Three levels of conditions: good, satisfactory and poor, were identified. The analysis showed that while the relationships between the athletes were good in all the preparatory periods, the co-operation with the paralympic coaches worsened. The standards of accommodation, food and sports facilities lowered. Personal orthopaedic supply was satisfactory in London; personal sporting equipment was good at all PG. The quality of medical care was the highest in London. The co-operation with physicians, physiotherapists and massage therapists was satisfactory. Consultations with the dietician were sporadic and assessed as poor. Psychological consultations were rare but satisfactory in Beijing and London. Contacts with the mass media were poor at all PG. Although combining private life, work, and education with sport was satisfactory, it was increasingly difficult to manage, particularly before London. The conditions during preparations for the PG 2004-2012 varied. Improvement was noticed only in the quality of medical care and personal orthopaedic supply.

Honey collected from different floras of Chandigarh Tricity: a comparative study involving physicochemical parameters and biochemical activities.

PubMed

Kumar, Pradeep; Sindhu, Rakesh K; Narayan, Shridhar; Singh, Inderbir

2010-12-01

Different monofloral honeys have a distinctive flavor and color because of differences in physicochemical parameters because of their principal nectar sources or floral types. Honey samples were collected from Apis mellifera colonies forged on 10 floras to analyze the quality of honey in terms of standards laid by Honey Grading and Marking Rules (HGMR), India, 2008 and Codex Alimentarious Commission (CAC), 1969 . The honey samples were analyzed for various physicochemical parameters of honey quality control, i.e., pH, total acidity, moisture, reducing sugars, non-reducing sugars, total sugars, water insoluble solids (WIS), ash content, 5-hydroxymethylfurfural content, and diastase value. The antioxidant potential was estimated using Folin-Ciocalteu reagent. Further, honey samples were assayed for antibacterial activities against clinical isolates of Staphylococcus aureus and Escherichia coli using the hole-plate diffusion method. The physicochemical variation in the composition of honey because of floral source shows Ziziphus honey with high pH and diastase values along with low acidity, whereas Helianthus honey contained high reducing sugar and low moisture content. Amomum, Brassica, Acacia, and Citrus contained lowest amount of non-reducing sugars, ash, WIS, and moisture, respectively. Lowest 5-hydroxymethylfurfural (HMF) value was detected in Amomum honey, while highest HMF value was observed with Eucalyptus. The maximum antibacterial and antioxidant potential was observed in Azadirachta and Citrus, respectively. The quality of honey produced by local beekeepers met HGMR and CAC standards, and the chemical composition and biological properties of honey were dependent on the floral source from which it was produced.

Standards of Conditions During Preparations for the Summer Paralympic Games Between 2004 and 2012 Assessed by Polish Athletes

PubMed Central

Sobiecka, Joanna; Gawroński, Wojciech; Kądziołka, Marta; Kruszelnicki, Paweł; Kłodecka-Różalska, Jadwiga; Plinta, Ryszard

2015-01-01

The quality of training conditions affects sporting success, injuries and health. The aim of the work was to present the conditions during the preparations of Polish athletes for the Summer Paralympic Games 2004–2012. The study encompassed 271 paralympians: Athens (91), Beijing (89) and London (91), competing in 13 disciplines. The research was based on a two-part questionnaire by Kłodecka-Różalska adjusted for disabled sports, and was conducted one month before each PG. Part 1 contained 20 closed-ended questions regarding conditions during preparations, while Part 2 concerned socio-demographic and sports-related data. Three levels of conditions: good, satisfactory and poor, were identified. The analysis showed that while the relationships between the athletes were good in all the preparatory periods, the co-operation with the paralympic coaches worsened. The standards of accommodation, food and sports facilities lowered. Personal orthopaedic supply was satisfactory in London; personal sporting equipment was good at all PG. The quality of medical care was the highest in London. The co-operation with physicians, physiotherapists and massage therapists was satisfactory. Consultations with the dietician were sporadic and assessed as poor. Psychological consultations were rare but satisfactory in Beijing and London. Contacts with the mass media were poor at all PG. Although combining private life, work, and education with sport was satisfactory, it was increasingly difficult to manage, particularly before London. The conditions during preparations for the PG 2004–2012 varied. Improvement was noticed only in the quality of medical care and personal orthopaedic supply. PMID:26834879

40 CFR 131.10 - Designation of uses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... QUALITY STANDARDS Establishment of Water Quality Standards § 131.10 Designation of uses. (a) Each State... and the appropriate criteria for those uses, the State shall take into consideration the water quality standards of downstream waters and shall ensure that its water quality standards provide for the attainment...

40 CFR 131.10 - Designation of uses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... QUALITY STANDARDS Establishment of Water Quality Standards § 131.10 Designation of uses. (a) Each State... and the appropriate criteria for those uses, the State shall take into consideration the water quality standards of downstream waters and shall ensure that its water quality standards provide for the attainment...

75 FR 44930 - Stakeholder Input; Revisions to Water Quality Standards Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... Input; Revisions to Water Quality Standards Regulation AGENCY: Environmental Protection Agency. ACTION... national rulemaking to make a limited set of targeted changes to EPA's water quality standards regulation... rulemaking, and to hear views from the public regarding possible changes to EPA's water quality standards...

Development of a Medication Safety and Quality Survey for Small Rural Hospitals.

PubMed

Winterstein, Almut G; Johns, Thomas E; Campbell, Kyle N; Libby, Joel; Pannell, Bob

2017-12-01

We summarize the development and initial implementation of a survey tool to assess medication safety in small rural hospitals. As part of an ongoing rural hospital medication safety improvement program, we developed a survey tool in all 13 critical access hospitals (CAHs) in Florida. The survey was compiled from existing medication safety assessments and standards, clinical practice guidelines, and published literature. Survey items were selected based on considerations regarding practicality and relevance to the CAH setting.The final survey instrument included 134 items representing 17 medication safety domains. Overall hospital scores ranged from 41% to 95%, with a median of 59%. Most hospitals showed large variation in scores across domains, with 5 hospitals having at least 1 domain with scores less than 10%. Highest scores across all facilities were seen for safety procedures concerning high-alert or look-alike medications and the assembly of emergency carts. The lowest median scores included availability and consistent use of standardized order sets and the effective implementation of medication safety committees. Most hospitals used the survey results to identify and prioritize quality improvement activities. The survey can be used to conduct a short medication safety assessment specific to a limited number of areas and services in CAHs. It showed good ability to discriminate medication safety levels across participating sites and highlighted opportunities for improvement. It may need modification if case mix or services differ in other states or if the status quo of medication safety in CAHs or related standards advance. The described process of survey development might be helpful to support such modifications.

78 FR 30770 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... Illinois state implementation plan (SIP) to reflect current National Ambient Air Quality Standards (NAAQS... Implementation Plan at 35 Illinois Administrative Code part 243, which updates National Ambient Air Quality...

75 FR 65572 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards... apply to Ohio's SIP. Incorporating the air quality standards into Ohio's SIP helps assure that...

Six sigma tools for a patient safety-oriented, quality-checklist driven radiation medicine department.

PubMed

Kapur, Ajay; Potters, Louis

2012-01-01

The purpose of this work was to develop and implement six sigma practices toward the enhancement of patient safety in an electronic, quality checklist-driven, multicenter, paperless radiation medicine department. A quality checklist process map (QPM), stratified into consultation through treatment-completion stages was incorporated into an oncology information systems platform. A cross-functional quality management team conducted quality-function-deployment and define-measure-analyze-improve-control (DMAIC) six sigma exercises with a focus on patient safety. QPM procedures were Pareto-sorted in order of decreasing patient safety risk with failure mode and effects analysis (FMEA). Quantitative metrics for a grouped set of highest risk procedures were established. These included procedural delays, associated standard deviations and six sigma Z scores. Baseline performance of the QPM was established over the previous year of usage. Data-driven analysis led to simplification, standardization, and refinement of the QPM with standard deviation, slip-day reduction, and Z-score enhancement goals. A no-fly policy (NFP) for patient safety was introduced at the improve-control DMAIC phase, with a process map interlock imposed on treatment initiation in the event of FMEA-identified high-risk tasks being delayed or not completed. The NFP was introduced in a pilot phase with specific stopping rules and the same metrics used for performance assessments. A custom root-cause analysis database was deployed to monitor patient safety events. Relative to the baseline period, average slip days and standard deviations for the risk-enhanced QPM procedures improved by over threefold factors in the NFP period. The Z scores improved by approximately 20%. A trend for proactive delays instead of reactive hard stops was observed with no adverse effects of the NFP. The number of computed potential no-fly delays per month dropped from 60 to 20 over a total of 520 cases. The fraction of computed potential no-fly cases that were delayed in NFP compliance rose from 28% to 45%. Proactive delays rose to 80% of all delayed cases. For potential no-fly cases, event reporting rose from 18% to 50%, while for actually delayed cases, event reporting rose from 65% to 100%. With complex technologies, resource-compromised staff, and pressures to hasten treatment initiation, the use of the six sigma driven process interlocks may mitigate potential patient safety risks as demonstrated in this study. Copyright © 2012 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Faecal indicator bacteria enumeration in beach sand: a comparison study of extraction methods in medium to coarse sands.

PubMed

Boehm, A B; Griffith, J; McGee, C; Edge, T A; Solo-Gabriele, H M; Whitman, R; Cao, Y; Getrich, M; Jay, J A; Ferguson, D; Goodwin, K D; Lee, C M; Madison, M; Weisberg, S B

2009-11-01

The absence of standardized methods for quantifying faecal indicator bacteria (FIB) in sand hinders comparison of results across studies. The purpose of the study was to compare methods for extraction of faecal bacteria from sands and recommend a standardized extraction technique. Twenty-two methods of extracting enterococci and Escherichia coli from sand were evaluated, including multiple permutations of hand shaking, mechanical shaking, blending, sonication, number of rinses, settling time, eluant-to-sand ratio, eluant composition, prefiltration and type of decantation. Tests were performed on sands from California, Florida and Lake Michigan. Most extraction parameters did not significantly affect bacterial enumeration. anova revealed significant effects of eluant composition and blending; with both sodium metaphosphate buffer and blending producing reduced counts. The simplest extraction method that produced the highest FIB recoveries consisted of 2 min of hand shaking in phosphate-buffered saline or deionized water, a 30-s settling time, one-rinse step and a 10 : 1 eluant volume to sand weight ratio. This result was consistent across the sand compositions tested in this study but could vary for other sand types. Method standardization will improve the understanding of how sands affect surface water quality.

Standard Setting Methods for Pass/Fail Decisions on High-Stakes Objective Structured Clinical Examinations: A Validity Study.

PubMed

Yousuf, Naveed; Violato, Claudio; Zuberi, Rukhsana W

2015-01-01

CONSTRUCT: Authentic standard setting methods will demonstrate high convergent validity evidence of their outcomes, that is, cutoff scores and pass/fail decisions, with most other methods when compared with each other. The objective structured clinical examination (OSCE) was established for valid, reliable, and objective assessment of clinical skills in health professions education. Various standard setting methods have been proposed to identify objective, reliable, and valid cutoff scores on OSCEs. These methods may identify different cutoff scores for the same examinations. Identification of valid and reliable cutoff scores for OSCEs remains an important issue and a challenge. Thirty OSCE stations administered at least twice in the years 2010-2012 to 393 medical students in Years 2 and 3 at Aga Khan University are included. Psychometric properties of the scores are determined. Cutoff scores and pass/fail decisions of Wijnen, Cohen, Mean-1.5SD, Mean-1SD, Angoff, borderline group and borderline regression (BL-R) methods are compared with each other and with three variants of cluster analysis using repeated measures analysis of variance and Cohen's kappa. The mean psychometric indices on the 30 OSCE stations are reliability coefficient = 0.76 (SD = 0.12); standard error of measurement = 5.66 (SD = 1.38); coefficient of determination = 0.47 (SD = 0.19), and intergrade discrimination = 7.19 (SD = 1.89). BL-R and Wijnen methods show the highest convergent validity evidence among other methods on the defined criteria. Angoff and Mean-1.5SD demonstrated least convergent validity evidence. The three cluster variants showed substantial convergent validity with borderline methods. Although there was a high level of convergent validity of Wijnen method, it lacks the theoretical strength to be used for competency-based assessments. The BL-R method is found to show the highest convergent validity evidences for OSCEs with other standard setting methods used in the present study. We also found that cluster analysis using mean method can be used for quality assurance of borderline methods. These findings should be further confirmed by studies in other settings.

78 FR 34964 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

...] Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan... Ambient Air Quality Standards for Ozone: State Implementation Plan Requirements'' which published in the... the 2008 ozone national ambient air quality standards (NAAQS) (the ``2008 ozone NAAQS'') that were...

78 FR 54517 - Water Quality Standards Regulatory Clarifications

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... 131 Water Quality Standards Regulatory Clarifications; Proposed Rule #0;#0;Federal Register / Vol. 78... AGENCY 40 CFR Part 131 [EPA-HQ-OW-2010-0606; FRL-9839-7] RIN 2040-AF 16 Water Quality Standards... Environmental Protection Agency (EPA) is proposing changes to the federal water quality standards (WQS...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...

24 CFR 983.101 - Housing quality standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Housing quality standards. 983.101... DEVELOPMENT PROJECT-BASED VOUCHER (PBV) PROGRAM Dwelling Units § 983.101 Housing quality standards. (a) HQS applicability. Except as otherwise provided in this section, 24 CFR 982.401 (housing quality standards) applies...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 3 2013-07-01 2013-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

75 FR 16459 - Draft Document Related to the Review of the National Ambient Air Quality Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... Review of the National Ambient Air Quality Standards for Particulate Matter AGENCY: Environmental... Review of the Particulate Matter National Ambient Air Quality Standards--First External Review Draft (75... Particulate Matter National Ambient Air Quality Standards--First External Review Draft (March 2010), please...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 3 2010-07-01 2010-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

Quality assurance in military medical research and medical radiation accident management.

PubMed

Hotz, Mark E; Meineke, Viktor

2012-08-01

The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within the scope of external quality assurance, but also in the exchange of special diagnosis data among international research networks. In summary, the acknowledged standard for a quality management system to ensure quality assurance is the very generic standard ISO 9001.Health Phys. 103(2):221-225; 2012.

A cross-sectional assessment of quality of life of breast cancer patients in Saudi Arabia.

PubMed

Almutairi, K M; Mansour, E A; Vinluan, J M

2016-07-01

This aim of this study was to assess the quality of life of Saudi female breast cancer patients and determine the effects of the sociodemographic and clinical characteristics on the quality of life of those patients. This study was designed as a cross-sectional study. The data were collected from 145 female cancer patients who were recruited from outpatient units in different clinical settings in Riyadh, Saudi Arabia, from September 2014 to February 2015. Questionnaires were distributed to the patients during their visits to the outpatient clinics after obtaining informed consent. Quality of life was assessed using a validated Arabic version of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life. Among functional scales, emotional functioning scored the highest (83.25 [95% CI 79.53-86.98]). The most distressing symptom on the symptom scale was insomnia (mean 84.14 [95% CI 79.95-88.32]), followed by appetite loss (mean 80.92 [95% CI 76.51-85.33]) and dyspnoea (mean 80.00 [95% CI 75.51-84.49]). Poor functioning was found in sexual enjoyment (mean 22.52 [95% CI 17.97-27.08]) while future perspective scored the highest (mean 76.32 [95% CI 70.52-82.12]). This study shows breast cancer survivors in Saudi had a low overall global quality of life. Saudi women showed average scores on all the functional scales but the emotional ones scored the highest. Insomnia, appetite loss, and dyspnoea were the distressing symptoms on symptom scales while future perspective domain scored the highest in item of QLQ-BR23. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Use Teacher Effectiveness Tools to Enhance Your Coaching Quality

ERIC Educational Resources Information Center

Newman, Richard E.

2012-01-01

Coaching is one of the highest profile positions that schools and colleges employ. At the collegiate level, these individuals can even be the highest paid public employees in their states, and successful coaches are often the highest paid individuals in their school districts. But successful coaches can be defined in a number of ways, and…

Moving Forward--Shaping a Career Development Culture: Quality Standards, Quality Practice, Quality Outcomes

ERIC Educational Resources Information Center

McMahon, Mary

2004-01-01

This paper represents the second of two papers written as part of the National Standards and Accreditation of Career Practitioners project. The first, a scoping paper titled Shaping a career development culture: Quality standards, quality practice, quality outcomes (McMahon, 2004), provided information for and guided discussion at the National…

78 FR 19990 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards; Correction AGENCY... approved revisions to Ohio regulations that consolidated air quality standards in a new chapter of rules... State's air quality standards into Ohio Administrative Code (OAC) 3745-25 and modifying an assortment of...

40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2011 CFR

2011-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2014 CFR

2014-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2013 CFR

2013-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2012 CFR

2012-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2010 CFR

2010-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

Quality of Voluntary Medical Male Circumcision Services during Scale-Up: A Comparative Process Evaluation in Kenya, South Africa, Tanzania and Zimbabwe

PubMed Central

Jennings, Larissa; Bertrand, Jane; Rech, Dino; Harvey, Steven A.; Hatzold, Karin; Samkange, Christopher A.; Omondi Aduda, Dickens S.; Fimbo, Bennett; Cherutich, Peter; Perry, Linnea; Castor, Delivette; Njeuhmeli, Emmanuel

2014-01-01

Background The rapid expansion of voluntary medical male circumcision (VMMC) has raised concerns whether health systems can deliver and sustain VMMC according to minimum quality criteria. Methods and Findings A comparative process evaluation was used to examine data from SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-Up, among health facilities providing VMMC across two years of program scale-up. Site-level assessments examined the availability of guidelines, supplies and equipment, infection control, and continuity of care services. Direct observation of VMMC surgeries were used to assess care quality. Two sample tests of proportions and t-tests were used to examine differences in the percent of facilities meeting requisite preparedness standards and the mean number of directly-observed surgical tasks performed correctly. Results showed that safe, high quality VMMC can be implemented and sustained at-scale, although substantial variability was observed over time. In some settings, facility preparedness and VMMC service quality improved as the number of VMMC facilities increased. Yet, lapses in high performance and expansion of considerably deficient services were also observed. Surgical tasks had the highest quality scores, with lower performance levels in infection control, pre-operative examinations, and post-operative patient monitoring and counseling. The range of scale-up models used across countries additionally underscored the complexity of delivering high quality VMMC. Conclusions Greater efforts are needed to integrate VMMC scale-up and quality improvement processes in sub-Saharan African settings. Monitoring of service quality, not just adverse events reporting, will be essential in realizing the full health impact of VMMC for HIV prevention. PMID:24801073

Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012)

PubMed Central

Flores-Hernández, Sergio; Saturno-Hernández, Pedro J.; Reyes-Morales, Hortensia; Barrientos-Gutiérrez, Tonatiuh; Villalpando, Salvador; Hernández-Ávila, Mauricio

2015-01-01

Background The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico. Methods We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years) with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c) was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear) with combined data files, including survey year as covariate to assess change. Results Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension) were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94). Age more than 65 years old, the type of health subsystem, gender (males), and high socio-economic status were also significantly associated to glycemic control. Conclusions Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care. PMID:26230991

Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012).

PubMed

Flores-Hernández, Sergio; Saturno-Hernández, Pedro J; Reyes-Morales, Hortensia; Barrientos-Gutiérrez, Tonatiuh; Villalpando, Salvador; Hernández-Ávila, Mauricio

2015-01-01

The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico. We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years) with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c) was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear) with combined data files, including survey year as covariate to assess change. Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension) were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94). Age more than 65 years old, the type of health subsystem, gender (males), and high socio-economic status were also significantly associated to glycemic control. Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care.

Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014.

PubMed

Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

2016-03-01

Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach's Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors' offices had the highest quality gap of -1.420 ± 0.82 and -1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were -0.883 ± 0.67, -0.882 ± 0.83, and -0.804 ± 0.62, respectively. There was a significant relationship between peoples' perceptions and expectations concerning the quality of health services and their educational levels. The higher gaps in quality in hospitals and in doctors' offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors.

Variable Quality and Readability of Patient-oriented Websites on Colorectal Cancer Screening.

PubMed

Schreuders, Eline H; Grobbee, Esmée J; Kuipers, Ernst J; Spaander, Manon C W; Veldhuyzen van Zanten, Sander J O

2017-01-01

The efficacy of colorectal cancer (CRC) screening is dependent on participation and subsequent adherence to surveillance. The internet increasingly is used for health information and is important to support decision making. We evaluated the accuracy, quality, and readability of online information on CRC screening and surveillance. A Website Accuracy Score and Polyp Score were developed, which awarded points for various aspects of CRC screening and surveillance. Websites also were evaluated using validated internet quality instruments (Global Quality Score, LIDA, and DISCERN), and reading scores. Two raters independently assessed the top 30 websites appearing on Google.com. Portals, duplicates, and news articles were excluded. Twenty websites were included. The mean website accuracy score was 26 of 44 (range, 9-41). Websites with the highest scores were www.cancer.org, www.bowelcanceraustralia.org, and www.uptodate.com. The median polyp score was 3 of 10. The median global quality score was 3 of 5 (range, 2-5). The median overall LIDA score was 74% and the median DISCERN score was 45, both indicating moderate quality. The mean Flesch-Kincaid grade level was 11th grade, rating the websites as difficult to read, 30% had a reading level acceptable for the general public (Flesch Reading Ease > 60). There was no correlation between the Google rank and the website accuracy score (r s  = -0.31; P = .18). There is marked variation in quality and readability of websites on CRC screening. Most websites do not address polyp surveillance. The poor correlation between quality and Google ranking suggests that screenees will miss out on high-quality websites using standard search strategies. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014

PubMed Central

Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran

2016-01-01

Introduction Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. Methods This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach’s Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. Results The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors’ offices had the highest quality gap of −1.420 ± 0.82 and −1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were −0.883 ± 0.67, −0.882 ± 0.83, and −0.804 ± 0.62, respectively. There was a significant relationship between peoples’ perceptions and expectations concerning the quality of health services and their educational levels. Conclusion The higher gaps in quality in hospitals and in doctors’ offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors. PMID:27123214

Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals.

PubMed

Nadi, Aliasghar; Shojaee, Jalil; Abedi, Ghassem; Siamian, Hasan; Abedini, Ehsan; Rostami, Farideh

2016-04-01

Hospital's success depends on patients' expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients' perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive - analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients' perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal-Wallis test, the difference observed in these three hospitals were significant. The results showed that patients' expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed that necessary for managers and relevant authorities to plan and pay special attention to this important issue.

78 FR 51463 - Energy Conservation Program: Energy Conservation Standards for Metal Halide Lamp Fixtures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... Efficiency at all Possible Voltages b. Posting the Highest and Lowest Efficiencies c. Test at Single Manufacturer-Declared Voltage d. Test at Highest-Rated Voltage e. Test on Input Voltage Based on Wattage and... at the highest voltage for which the ballast is designed to operate. [Dagger] P is defined as the...

Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation.

PubMed

Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

2017-02-01

To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Palestinian Primary Healthcare Centres. Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological quality of diabetic guideline. The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach's α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains 'Scope and Purpose' and 'Clarity of Presentation' had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for 'Applicability', 'Stakeholder Involvement', 'Rigour of Development' and 'Editorial Independence' were the lowest (27%, 35%, 36.5%, and 40%, respectively). The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

50 CFR 270.15 - Quality standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Quality standards. 270.15 Section 270.15... Quality standards. (a) Each Council may develop and submit to NMFS for approval or, upon the request of a Council, NMFS will develop quality standards for the species of fish or fish products described in the...

40 CFR 131.6 - Minimum requirements for water quality standards submission.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Minimum requirements for water quality standards submission. 131.6 Section 131.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS General Provisions § 131.6 Minimum requirements for water quality standards submission. The...

40 CFR 131.6 - Minimum requirements for water quality standards submission.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Minimum requirements for water quality standards submission. 131.6 Section 131.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS General Provisions § 131.6 Minimum requirements for water quality standards submission. The...

40 CFR 50.16 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for lead. 50.16 Section 50.16 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) The national primary and secondary ambient air quality standards for lead (Pb) and its compounds are 0.15 micrograms per cubic meter...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2013 CFR

2013-07-01

... air quality standards for lead. 50.12 Section 50.12 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) National primary and secondary ambient air quality standards for lead and its compounds, measured as elemental lead by a reference method...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2012 CFR

2012-07-01

... air quality standards for lead. 50.12 Section 50.12 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) National primary and secondary ambient air quality standards for lead and its compounds, measured as elemental lead by a reference method...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for lead. 50.12 Section 50.12 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) National primary and secondary ambient air quality standards for lead and its compounds, measured as elemental lead by a reference method...

CCHDO: Data Management for US and International GO-SHIP and Related Programs

NASA Astrophysics Data System (ADS)

Diggs, S. C.

2016-02-01

An ever-expanding universe of oceanographic data that includes ship-based measurements (CTD, Nutrients, CFCs, etc.) - as well as the data collected from floats, drifters, gliders and moorings - are continuously gathered, scrutinized, documented and disseminated by the CLIVAR and Carbon Hydrographic Data Office (CCHDO) at Scripps Institution of Oceanography. As the official data assembly center for US GO-SHIP (a decadal global hydrography program) the CCHDO is involved in setting and promoting standards of modern data exchange - from observations at sea to final archive. Established in 1996, the CCHDO has a solid history of curating the highest quality full-depth hydrographic data and associated documentation, metadata and DOIs on an API-based web site that provides data in multiple formats and platforms that have been specifically requested by the hydrographic research community. The CCHDO's website, programming platforms, and documentation standards constantly evolve, based on the feedback we receive from the hydrographic community. Technical convergence and collaboration with organizations that include CDIAC, Princeton, NOAA/NCEI, Argo, OceanSITES, BCO-DMO and GO-SHIP is central to our success. We were early adopters of small crowd-sourcing for quality control, and by being involved in all aspects of data use we reintegrate suggested changes to the data, flags and documentation supplied by the most highly recognized and regarded hydrography researchers and institutions in the world.

Editorial development

NASA Astrophysics Data System (ADS)

Wileman, Chris

2013-01-01

We are delighted to announce that from January 2013, Professor Edgar Knobloch of the University of California, Berkeley, USA, will be the new co-Editor-in-Chief of Nonlinearity, joining current co-Editor-in-Chief Professor Anatoly Neishtadt. Edgar comes to the position with a wealth of experience, including a spell as a valued member of the Editorial Board of Nonlinearity, and wide respect from across the nonlinear science community. We very much look forward to working with Edgar to continue to develop the journal's high standards of quality and interest to the readership. Whilst welcoming Edgar to the position, we would also like to extend our gratitude to Professor Jon Keating for his tremendous contribution to Nonlinearity during his time as co-Editor-in-Chief. Jon joined the journal in 1997 as a member of the Editorial Board, taking over as co-Editor-in-Chief in 2004. Throughout his time as both a member of the Editorial Board and as a co-Editor-in-Chief, Jon worked tirelessly to uphold the highest quality standards and to ensure that Nonlinearity is a place where researchers can both read and publish the most stimulating work in nonlinear science. His joint leadership with Professor Anatoly Neishtadt has seen Nonlinearity continue from strength to strength. Jon will be sorely missed. On behalf of the London Mathematical Society, Institute of Physics and the entire Editorial Board we wish him all the best in the future.

[Evaluation of volatile organic compounds (VOCs) emitted from household products by small chamber test method].

PubMed

Tanaka-Kagawa, Toshiko; Jinno, Hideto; Obama, Tomoko; Miyagawa, Makoto; Yoshikawa, Jun; Komatsu, Kazuhiro; Tokunaga, Hiroshi

2007-01-01

Identification and removal/replacement of sources of indoor air pollutants, such as volatile organic compounds (VOCs) and aldehydes, are most effective measures to reduce indoor chemical exposures. For instance, formaldehyde emissions from building materials have been successfully decreased by the restrictions on interior finishing materials under the amended Building Standard Low in Japan. This study was performed to estimate quantitatively influence of household products on indoor air quality. VOC emissions were investigated for 51 products including interior materials, bedclothes, stationeries, toys and printed matters by the small chamber test method (JIS A 1901) under the standard conditions of 28 degrees C, 50% relative humidity and 0.5 times/h ventilation. Total VOC (TVOC) emissions from the tablecloth and gloves, both of which were made of polyvinyl chloride, showed the highest emission rates; over 2000 microg/(m2 x h) after 1 day, and then rapidly decreased to less than 500 microg/(m2 x h) in a week. Among stationeries/toys for schoolchildren and infants, jigsaw puzzle and play mat exhibited higher TVOC emission rates (38 and 24 microg/(m2 x h) after 1 day, respectively). As for VOCs emitted from printed matters, high boiling-point compounds (higher than that of n-tridecane) were typically identified along with toluene, xylenes and ethylbenzene. These results revealed that VOC emissions from household products may influence significantly indoor air quality.

Optimization of alginate alkaline extraction technology from Sargassum polycystum and its antioxidant properties

NASA Astrophysics Data System (ADS)

Yudiati, E.; Santosa, G. W.; Tontowi, M. R.; Sedjati, S.; Supriyantini, E.; Khakimah, M.

2018-03-01

The quality of alginate may differ considerably depending on several aspects. The aims of this research were to identify, characterize the alginate, examine the quality and determine the antioxidant properties. Identification was done phenotypically. Characterization was done by FT-IR spectroscopy by comparing the samples to standard alginate (Sigma, USA). The extraction was done in two treatments: soaked with 5 % NaOCl, extraction of Na2CO3 (3.0; 5.0; 7.0 and 9.0 %)/EDTA, KCl and precipitated with ethanol (T1) and dried. T2 was pretreated with KOH, HCl, boiled by Na2CO3 (3.0; 5.0; 7.0 and 9.0 %), depigmented, HCl and NaOH addition precipitated with ethanol absolute and then sundried. Antioxidant properties test were done by DPPH and NBT radical scavenging assays. Phenotypic identification showed that the species was Sargassum polycystum. There were similarities in signal vibration between the samples and the standard. The highest yield was produced from 7.0 % Na2CO3, while the average yield of T1 (37.56 %) was significantly higher (P ≤ 0.05) than T2 (21.77 %). The level of dynamic viscosity was correlated with alkali concentration. Indication in T1 results showed that the higher alkali concentration, the better yield. The best yield was the lowest viscosity, produced the strongest antioxidant activity.

Per- and Polyfluoroalkyl Substances in Swedish Groundwater and Surface Water: Implications for Environmental Quality Standards and Drinking Water Guidelines.

PubMed

Gobelius, Laura; Hedlund, Johanna; Dürig, Wiebke; Tröger, Rikard; Lilja, Karl; Wiberg, Karin; Ahrens, Lutz

2018-04-03

The aim of this study was to assess per- and polyfluoroalkyl substances (PFASs) in the Swedish aquatic environment, identify emission sources, and compare measured concentrations with environmental quality standards (EQS) and (drinking) water guideline values. In total, 493 samples were analyzed in 2015 for 26 PFASs (∑ 26 PFASs) in surface water, groundwater, landfill leachate, sewage treatment plant effluents and reference lakes, focusing on hot spots and drinking water sources. Highest ∑ 26 PFAS concentrations were detected in surface water (13 000 ng L -1 ) and groundwater (6400 ng L -1 ). The dominating fraction of PFASs in surface water were perfluoroalkyl carboxylates (PFCAs; 64% of ∑ 26 PFASs), with high contributions from C 4 -C 8 PFCAs (94% of ∑PFCAs), indicating high mobility of shorter chain PFCAs. In inland surface water, the annual average (AA)-EQS of the EU Water Framework Directive of 0.65 ng L -1 for ∑PFOS (linear and branched isomers) was exceeded in 46% of the samples. The drinking water guideline value of 90 ng L -1 for ∑ 11 PFASs recommended by the Swedish EPA was exceeded in 3% of the water samples from drinking water sources ( n = 169). The branched isomers had a noticeable fraction in surface- and groundwater for perfluorooctanesulfonamide, perfluorohexanesulfonate, and perfluorooctanesulfonate, highlighting the need to include branched isomers in future guidelines.

Time to harmonize national ambient air quality standards.

PubMed

Kutlar Joss, Meltem; Eeftens, Marloes; Gintowt, Emily; Kappeler, Ron; Künzli, Nino

2017-05-01

The World Health Organization has developed ambient air quality guidelines at levels considered to be safe or of acceptable risk for human health. These guidelines are meant to support governments in defining national standards. It is unclear how they are followed. We compiled an inventory of ambient air quality standards for 194 countries worldwide for six air pollutants: PM 2.5 , PM 10 , ozone, nitrogen dioxide, sulphur dioxide and carbon monoxide. We conducted literature and internet searches and asked country representatives about national ambient air quality standards. We found information on 170 countries including 57 countries that did not set any air quality standards. Levels varied greatly by country and by pollutant. Ambient air quality standards for PM 2.5 , PM 10 and SO 2 poorly complied with WHO guideline values. The agreement was higher for CO, SO 2 (10-min averaging time) and NO 2 . Regulatory differences mirror the differences in air quality and the related burden of disease around the globe. Governments worldwide should adopt science based air quality standards and clean air management plans to continuously improve air quality locally, nationally, and globally.

Reviewing the Review: An Assessment of Dissertation Reviewer Feedback Quality

ERIC Educational Resources Information Center

Lehan, Tara; Hussey, Heather; Mika, Eva

2016-01-01

Throughout the dissertation process, the chair and committee members provide feedback regarding quality to help the doctoral candidate to produce the highest-quality document and become an independent scholar. Nevertheless, results of previous research suggest that overall dissertation quality generally is poor. Because much of the feedback about…

Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study.

PubMed

Tudor Car, Lorainne; Papachristou, Nikolaos; Gallagher, Joseph; Samra, Rajvinder; Wazny, Kerri; El-Khatib, Mona; Bull, Adrian; Majeed, Azeem; Aylin, Paul; Atun, Rifat; Rudan, Igor; Car, Josip; Bell, Helen; Vincent, Charles; Franklin, Bryony Dean

2016-11-16

Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014. The top three problems were incomplete reconciliation of medication during patient 'hand-overs', inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score. Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method, and merits further exploration with a view to becoming a part of a routine preventative patient safety monitoring mechanism.

Multivariate Analysis of the Determinants of the End-Product Quality of Manure-Based Composts and Vermicomposts Using Bayesian Network Modelling.

PubMed

Faverial, Julie; Cornet, Denis; Paul, Jacky; Sierra, Jorge

2016-01-01

Previous studies indicated that the quality of tropical composts is poorer than that of composts produced in temperate regions. The aim of this study was to test the type of manure, the use of co-composting with green waste, and the stabilization method for their ability to improve compost quality in the tropics. We produced 68 composts and vermicomposts that were analysed for their C, lignin and NPK contents throughout the composting process. Bayesian networks were used to assess the mechanisms controlling compost quality. The concentration effect, for C and lignin, and the initial blend quality, for NPK content, were the main factors affecting compost quality. Cattle manure composts presented the highest C and lignin contents, and poultry litter composts exhibited the highest NPK content. Co-composting improved quality by enhancing the concentration effect, which reduced the impact of C and nutrient losses. Vermicomposting did not improve compost quality; co-composting without earthworms thus appears to be a suitable stabilization method under the conditions of this study because it produced high quality composts and is easier to implement.

Relationships Among Student Ability, School Performance, and Fleet Supervisor Ratings for Navy ’A’ School Graduates.

DTIC Science & Technology

1982-11-01

April 1980. 9 NEMA ._ Technical Report 136 Subsequent reports in the series will present: " an analysis of relationships among training effectiveness...individualized courses were above the standardized norm (i.e., 50). Graduates 20 Technical Report 136 of the TO and MM600 courses had the highest...Ability Characteristics. The average AFQT percentile scores for all the conventional courses were above the standardized norm (50). Graduates of the FTM

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... accordance with provisions of State law, EPA's water quality management regulation (40 CFR 130.3(b)(6)) and... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality...

Air Quality Modeling | Air Quality Planning & Standards | US ...

EPA Pesticide Factsheets

2016-06-08

The basic mission of the Office of Air Quality Planning and Standards is to preserve and improve the quality of our nation's air. One facet of accomplishing this goal requires that new and existing air pollution sources be modeled for compliance with the National Ambient Air Quality Standards (NAAQS).

77 FR 10423 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Amendments to West...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

... Promulgation of Air Quality Implementation Plans; West Virginia; Amendments to West Virginia's Ambient Air... ambient air quality standards (45CSR8- Ambient Air Quality Standards). These amendments incorporate by reference the National Ambient Air Quality Standards (NAAQS) for sulfur dioxide, particulate matter, carbon...

78 FR 30829 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... the Illinois State Implementation Plan (SIP) to reflect current national ambient air quality standards...) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U...

75 FR 19886 - Approval and Promulgation of Air Quality Implementation Plans; Wyoming; Revisions to the Wyoming...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... Promulgation of Air Quality Implementation Plans; Wyoming; Revisions to the Wyoming Air Quality Standards and.... Wyoming has revised its Air Quality Standards and Regulations, specifically Chapter 1, Section 5... Wyoming's State Implementation Plan (SIP). These revisions amend Wyoming's Air Quality Standards and...

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-12-24

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

Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study.

PubMed

Livingstone, Katherine M; McNaughton, Sarah A

2016-10-01

Poor diet, characterized by a low diet quality score, has been associated with greater prevelence of obesity and hypertension. However, the evidence is inconsistent across diet quality scores and by sex. The aim was to investigate the relationship between diet quality and obesity and hypertension. Adults (n = 4908; age 45.2 ± 0.24 years) were included from the cross-sectional Australian Health Survey 2011-2013. Two 24-h dietary recalls were used to derive the dietary guideline index (DGI) and recommended food score (RFS). Logistic regression investigated relationships between diet quality score and odds ratio of obesity, hypertension and obesity-associated hypertension. In the highest tertile of DGI, but not RFS, individuals were less likely to be obese (men: OR 0.64, CI: 0.45, 0.92, P-trend = 0.014; women: 0.68, 0.48, 0.96, P-trend = 0.025) and to have central adiposity (men: 0.68, 0.48, 0.97, P-trend = 0.030; women: 0.53, 0.37, 0.77, P-trend = 0.001) compared with the lowest tertile. Men, but not women, in the highest tertile of DGI and RFS were less likely to be hypertensive (DGI: 0.56, 0.37, 0.85, P-trend = 0.006; RFS: 0.62, 0.41, 0.94, P-trend = 0.021) compared with the lowest tertile. In men with obesity, but not normal weight men or women, those in the highest tertile of DGI were less likely to be hypertensive (0.53, 0.36, 0.78, P-trend = 0.001) compared with the highest tertile. Higher diet quality, as estimated using DGI, was associated with lower odds ratio of obesity in men and women. Odds ratio of hypertension was lower in men, but not women, with a high diet quality score compared with a low score, while obesity-associated hypertension was only associated with diet quality score in men with obesity. Longitudinal studies are needed to evaluate whether diet quality predicts risk of obesity and hypertension.

An Air Quality Data Analysis System for Interrelating Effects, Standards and Needed Source Reductions

ERIC Educational Resources Information Center

Larsen, Ralph I.

1973-01-01

Makes recommendations for a single air quality data system (using average time) for interrelating air pollution effects, air quality standards, air quality monitoring, diffusion calculations, source-reduction calculations, and emission standards. (JR)

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

Code of Federal Regulations, 2014 CFR

2014-07-01

... air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section... quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). (a) The level of the national primary annual ambient air quality standard for oxides of nitrogen is 53 parts per billion (ppb...

40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

Code of Federal Regulations, 2012 CFR

2012-07-01

... air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section... quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). (a) The level of the national primary annual ambient air quality standard for oxides of nitrogen is 53 parts per billion (ppb...

40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

Code of Federal Regulations, 2013 CFR

2013-07-01

... air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section... quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). (a) The level of the national primary annual ambient air quality standard for oxides of nitrogen is 53 parts per billion (ppb...

Evaluating Education Quality in Terms of ISO9000 Standards

ERIC Educational Resources Information Center

Fengchun, Cheng; Vogel, Linda R.; Zhaoyu, Zheng

2014-01-01

While nations measure the quality of educational systems by different standards, many nations, such as China, have adopted the ISO9000 quality standards to assess the quality of schools. This article explores the various elements of the the ISO9000 standards and how each element relates to the various groups that are consumers or stakeholders in…

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false State review and revision of water quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of...

Irrigation dose and plant density affect the volatile composition and sensory quality of dill (Anethum graveolens L.).

PubMed

El-Zaeddi, Hussein; Martínez-Tomé, Juan; Calín-Sánchez, Ángel; Burló, Francisco; Carbonell-Barrachina, Ángel A

2017-01-01

Two independent field experiments were carried out to investigate the influence of (i) three irrigation treatments (ID0 = 1585 m 3 ha -1 , considered as a control; ID1 = 1015 m 3 ha -1 ; and ID2 = 2180 m 3 ha -1 ) and (ii) three plant density treatments (PD0 = 5.56 plants m -2 , considered as a control; PD1 = 4.44 plants m -2 ; and PD2 = 7.41 plants m -2 ) on the production, volatile composition of essential oil, and sensory quality of dill. The highest plant yield was obtained with intermediate conditions of both irrigation dose (ID0) and plant density (PD0). The main compounds of the essential oil were α-phellandrene, dill ether and β-phellandrene. The highest irrigation dose (ID2) produced the highest concentrations of most of the main compounds: α-phellandrene (49.5 mg per 100 g), β-phellandrene (6.89 mg per 100 g) and limonene (2.49 mg per 100 g). A similar pattern was found for the highest plant density (PD2): α-phellandrene (71.0 mg per 100 g), dill ether (16.7 mg per 100 g) and β-phellandrene (9.70 mg per 100 g). The use of descriptive sensory analysis helped in reaching a final decision, and the dill plants with the highest sensory quality were those of the ID2 and PD0 treatments. The final recommendation is to use the irrigation dose ID2 and the plant density PD2 if the objective is to produce dill samples with the highest aromatic and sensory quality; however, if the only objective is to produce high amounts of dill, the best options are ID0 and PD0. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Identification of water-quality trends using sediment cores from Dillon Reservoir, Summit County, Colorado

USGS Publications Warehouse

Greve, Adrienne I.; Spahr, Norman E.; Van Metre, Peter C.; Wilson, Jennifer T.

2001-01-01

Since the construction of Dillon Reservoir, in Summit County, Colorado, in 1963, its drainage area has been the site of rapid urban development and the continued influence of historical mining. In an effort to assess changes in water quality within the drainage area, sediment cores were collected from Dillon Reservoir in 1997. The sediment cores were analyzed for pesticides, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and trace elements. Pesticides, PCBs, and PAHs were used to determine the effects of urban development, and trace elements were used to identify mining contributions. Water-quality and streambed-sediment samples, collected at the mouth of three streams that drain into Dillon Reservoir, were analyzed for trace elements. Of the 14 pesticides and 3 PCBs for which the sediment samples were analyzed, only 2 pesticides were detected. Low amounts of dichloro-diphenyldichloroethylene (DDE) and dichloro-diphenyldichloroethane (DDD), metabolites of dichlorodiphenyltrichloroethane (DDT), were found at core depths of 5 centimeters and below 15 centimeters in a core collected near the dam. The longest core, which was collected near the dam, spanned the entire sedimentation history of the reservoir. Concentrations of total combustion PAH and the ratio of fluoranthene to pyrene in the core sample decreased with core depth and increased over time. This relation is likely due to growth in residential and tourist populations in the region. Comparisons between core samples gathered in each arm of the reservoir showed the highest PAH concentrations were found in the Tenmile Creek arm, the only arm that has an urban area on its shores, the town of Frisco. All PAH concentrations, except the pyrene concentration in one segment in the core near the dam and acenaphthylene concentrations in the tops of three cores taken in the reservoir arms, were below Canadian interim freshwater sediment-quality guidelines. Concentrations of arsenic, cadmium, chromium, copper, lead, and zinc in sediment samples from Dillon Reservoir exceeded the Canadian interim freshwater sediment-quality guidelines. Copper, iron, lithium, nickel, scandium, titanium, and vanadium concentrations in sediment samples decreased over time. Other elements, while no trend was evident, displayed concentration spikes in the down-core profiles, indicating loads entering the reservoir may have been larger than they were in 1997. The highest concentrations of copper, lead, manganese, mercury, and zinc were detected during the late 1970's and early 1980's. Elevated concentrations of trace elements in sediment in Dillon Reservoir likely resulted from historical mining in the drainage area. The downward trend identified for copper, iron, lithium, nickel, scandium, titanium, and vanadium may be due in part to restoration efforts in mining-affected areas and a decrease in active mining in the Dillon Reservoir watershed. Although many trace-element core-sediment concentrations exceeded the Canadian probable effect level for freshwater lakes, under current limnological conditions, the high core-sediment concentrations do not adversely affect water quality in Dillon Reservoir. The trace-element concentrations in the reservoir water column meet the standards established by the Colorado Water Quality Control Commission. Although many trace-element core-sediment concentrations exceeded the Canadian probable effect level for freshwater lakes, under current limnological conditions, the high core-sediment concentrations do not adversely affect water quality in Dillon Reservoir. The trace-element concentrations in the reservoir water column meet the standards established by the Colorado Water Quality Control Commission.

[Application of traditional Chinese medicine reference standards in quality control of Chinese herbal pieces].

PubMed

Lu, Tu-Lin; Li, Jin-Ci; Yu, Jiang-Yong; Cai, Bao-Chang; Mao, Chun-Qin; Yin, Fang-Zhou

2014-01-01

Traditional Chinese medicine (TCM) reference standards plays an important role in the quality control of Chinese herbal pieces. This paper overviewed the development of TCM reference standards. By analyzing the 2010 edition of Chinese pharmacopoeia, the application of TCM reference standards in the quality control of Chinese herbal pieces was summarized, and the problems exiting in the system were put forward. In the process of improving the quality control level of Chinese herbal pieces, various kinds of advanced methods and technology should be used to research the characteristic reference standards of Chinese herbal pieces, more and more reasonable reference standards should be introduced in the quality control system of Chinese herbal pieces. This article discussed the solutions in the aspect of TCM reference standards, and future development of quality control on Chinese herbal pieces is prospected.

The relationship between quality of life and methods of delivery: A systematic review and meta-analysis.

PubMed

Rezaei, Nazanin; Tavalaee, Zahra; Sayehmiri, Kourosh; Sharifi, Nasibeh; Daliri, Salman

2018-04-01

Some physical, emotional and social changes arise in mothers during the postpartum periods which can affect the quality of life (QOL) of the mother and family. Given the importance of the quality of life in the postpartum period and its influencing factors such as method of delivery, the present study aimed at investigating the relationship between the quality of life and methods of delivery in the world, using a systematic review and meta-analysis method. The present study is a systematic review and meta-analysis on the relationship between aspects of quality of life and method of delivery in the world conducted in Persian and English language articles published by the end of 2015. For this purpose, the databases of Medlib, SID, Scopus, ISI Web of Science, PubMed, Google scholar, Irandoc, Magiran and Iranmedex were searched using key words and their compounds. The results of studies were combined using the random effects model in the meta-analysis. Heterogeneity of studies was assessed using I2 index and Cochran test and data were analyzed using STATA Version 11.1 and SPSS Version 16. Based on the results of the meta-analysis of studies, the aspect of physical functioning had the highest quality of life mean score in women with vaginal delivery: 74.37 (95% CI: 67.7-81) and mental health had the highest QOL mean score in women with cesarean delivery: 65.8 (95% CI: 62.7-69). Also, based on the time elapsed since delivery, mental health had the highest mean score in less than 1 month, 2 months and 4 months' postpartum. Physical pain had the highest mean score 6 months after giving birth, and mental functioning in 8 months after giving birth. The results of the present meta-analysis showed that the mean scores for most dimensions of quality of life in women with vaginal delivery were higher than in women with cesarean delivery.

National BTS bronchiectasis audit 2012: is the quality standard being adhered to in adult secondary care?

PubMed

Hill, Adam T; Routh, Chris; Welham, Sally

2014-03-01

A significant step towards improving care of patients with non-cystic fibrosis bronchiectasis was the creation of the British Thoracic Society (BTS) national guidelines and the quality standard. A BTS bronchiectasis audit was conducted between 1 October and 30 November 2012, in adult patients with bronchiectasis attending secondary care, against the BTS quality standard. Ninety-eight institutions took part, submitting a total of 3147 patient records. The audit highlighted the variable adoption of the quality standard. It will allow the host institutions to benchmark against UK figures and drive quality improvement programmes to promote the quality standard and improve patient care.

45 CFR 73.735-1002 - Ethical standards of conduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Ethical standards of conduct. 73.735-1002 Section... Ethical standards of conduct. (a) Like other Federal employees, an individual serving in a consultant capacity must conduct himself or herself according to ethical behavior standards of the highest order. In...

45 CFR 73.735-1002 - Ethical standards of conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Ethical standards of conduct. 73.735-1002 Section... Ethical standards of conduct. (a) Like other Federal employees, an individual serving in a consultant capacity must conduct himself or herself according to ethical behavior standards of the highest order. In...

BASIS FOR PRIMARY AIR QUALITY CRITERIA AND STANDARDS

EPA Science Inventory

The Environmental Criteria and Assessment Office and the Office of Air Quality Planning and Standards are charged with responsibility for reviewing and assessing air quality criteria and air quality standards, respectively. Since adoption of the 1977 Clean Air Act Amendments, the...

New Federal Air Quality Standards.

ERIC Educational Resources Information Center

Stopinski, O. W.

The report discusses the current procedures for establishing air quality standards, the bases for standards, and, finally, proposed and final National Primary and Secondary Ambient Air Quality Standards for sulfur dioxide, particulate matter, carbon monoxide, nonmethane hydrocarbons, photochemical oxidants, and nitrogen dioxide. (Author/RH)

78 FR 23492 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Particulate Matter Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... Promulgation of Air Quality Implementation Plans; Indiana; Particulate Matter Air Quality Standards AGENCY... submission contains the 24-hour fine particle (PM 2.5 ) National Ambient Air Quality Standards (NAAQS..., ``National primary and secondary ambient air quality standards for PM 2.5 .'' In the submission, IDEM has...

75 FR 81477 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Amendments to Ambient...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... Promulgation of Air Quality Implementation Plans; Virginia; Amendments to Ambient Air Quality Standards for... revision consists of amendments to the Commonwealth of Virginia's ambient air quality standards for... Chapter 30) that contains the ambient air quality standards set out in 40 CFR 50. The SIP revision made...

A Study on Students' Satisfaction Based on Quality Standards of Accreditation in Higher Education

ERIC Educational Resources Information Center

Neelaveni, C.; Manimaran S.

2015-01-01

Quality standards are evaluated by the Higher Educational Institutions by self evaluation at different levels and are also assessed by external agencies. Application of quality standards in administrative practices have been associated with the quality of higher education. To improve the quality of administrative practices, evaluation scales are…

Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review

PubMed Central

Al-Thomali, Yousef; Mohamed, Roshan-Noor; Basha, Sakeenabi

2017-01-01

Background To evaluate the torque expression of self ligating (SL) orthodontic brackets and conventionally ligated brackets and the torque expression in active and passive SL brackets. Material and Methods Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was April 4th 2016. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). Results In total, 87 studies were identified for screening, and 9 studies were eligible. The quality assessment rated one of the study as being of strong quality, 7 (77.78%) of these studies as being of moderate quality. Three out of 7 studies which compared SL and conventionally ligated brackets showed, conventionally ligated brackets with highest torque expression compared to SL brackets. Badawi showed active SL brackets with highest torque expression compared to passive SL brackets. Major and Brauchli showed no significant differences in torque expression of active and passive SL brackets. Conclusions Conventionally ligated brackets presented with highest torque expression compared to SL brackets. Minor difference was recorded in a torque expression of active and passive SL brackets. Key words:Systematic review, self ligation, torque expression, conventional ligation. PMID:28149476

Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review.

PubMed

Al-Thomali, Yousef; Mohamed, Roshan-Noor; Basha, Sakeenabi

2017-01-01

To evaluate the torque expression of self ligating (SL) orthodontic brackets and conventionally ligated brackets and the torque expression in active and passive SL brackets. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was April 4th 2016. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). In total, 87 studies were identified for screening, and 9 studies were eligible. The quality assessment rated one of the study as being of strong quality, 7 (77.78%) of these studies as being of moderate quality. Three out of 7 studies which compared SL and conventionally ligated brackets showed, conventionally ligated brackets with highest torque expression compared to SL brackets. Badawi showed active SL brackets with highest torque expression compared to passive SL brackets. Major and Brauchli showed no significant differences in torque expression of active and passive SL brackets. Conventionally ligated brackets presented with highest torque expression compared to SL brackets. Minor difference was recorded in a torque expression of active and passive SL brackets. Key words: Systematic review, self ligation, torque expression, conventional ligation.

Assessment of pharmacy information system performance in selected hospitals in isfahan city during 2011.

PubMed

Saqaeian Nejad Isfahani, Sakineh; Mirzaeian, Razieh; Habibi, Mahbobe

2013-01-01

In supporting a therapeutic approach and medication therapy management, pharmacy information system acts as one of the central pillars of information system. This ensures that medication therapy is being supported and evaluated with an optimal level of safety and quality similar to other treatments and services. This research aims to evaluate the performance of pharmacy information system in three types of teaching, private and social affiliated hospitals. The present study is an applied, descriptive and analytical study which was conducted on the pharmacy information system in use in the selected hospitals. The research population included all the users of pharmacy information systems in the selected hospitals. The research sample is the same as the research population. Researchers collected data using a self-designed checklist developed following the guidelines of the American Society of Health-System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and pharmacy information system pharmacists and users. To collect data besides observation, the questionnaires were distributed among pharmacy information system pharmacists and users. Finally, the analysis of the data was performed using the SPSS software. Pharmacy information system was found to be semi-automated in 16 hospitals and automated in 3 ones. Regarding the standards in the guidelines issued by the Society of Pharmacists, the highest rank in observing the input standards belonged to the Social Services associated hospitals with a mean score of 32.75. While teaching hospitals gained the highest score both in processing standards with a mean score of 29.15 and output standards with a mean score of 43.95, and the private hospitals had the lowest mean scores of 23.32, 17.78, 24.25 in input, process and output standards respectively. Based on the findings, the studied hospitals had minimal compliance with the input, output and processing standards related to the pharmacy information system. It is suggested that the establishment of a team composed of operational managers, computer fields experts, health information managers, pharmacists as well as physicians may contribute to the promotion of the capabilities of pharmacy information system to be able to focus on health care practitioners' and users' requirements.

Water Quality Standards Handbook

EPA Pesticide Factsheets

The Water Quality Standards Handbook is a compilation of the EPA's water quality standards (WQS) program guidance including recommendations for states, authorized tribes, and territories in reviewing, revising, and implementing WQS.

Self-Confidence and Quality of Life in Women Undergoing Treatment for Breast Cancer

PubMed Central

Shafaee, Fahimeh Sehati; Mirghafourvand, Mojgan; Harischi, Sepideh; Esfahani, Ali; Amirzehni, Jalileh

2018-01-01

Introduction: Quality of life is an important topic in the study of chronic diseases, especially cancer which can have a major effect on patient self-confidence. This study was conducted to determine quality of life and its relationship with self-confidence in women undergoing treatment for breast cancer. Methods: This cross-sectional, descriptive, analytical study was conducted in 2016 on 166 women with breast cancer undergoing treatment at Ghazi, Al-Zahra, International and/or Shams hospitals in Tabriz. The subjects were selected through convenience sampling. A personal-demographic questionnaire, the Cancer Quality of Life Questionnaire (QLQ-C30), and the Rosenberg Self-Esteem Scale (RSES) were completed for each patient. The data obtained were analyzed using independent t-tests, one-way ANOVA, multivariate linear regression and Pearson’s correlation coefficients. Findings: The mean total score of quality of life was 59.1±17.4, ranging from 0 to 100. The highest mean score was obtained in the cognitive subscale (74.9±23.8) and the lowest in the emotional subscale (51.4±21.1). The mean score for self-confidence was 0.3 with a standard deviation of 0.1, ranging from -1 to +1. There was a significant positive relationship between self-confidence and quality of life, except in three symptom subscales for diarrhea, constipation and loss of appetite (P<0.05). Self-confidence, disease duration, lifestyle, marital satisfaction and caregiver status were among the predictors of quality of life. Discussion: Given the significant relationship between quality of life and self-confidence, health care providers may need to pay special attention to women undergoing treatment for breast cancer and perform timely measures to maintain their belief in themselves. PMID:29582628

Geospatial modelling for groundwater quality mapping: a case study of Rupnagar district, Punjab, India

NASA Astrophysics Data System (ADS)

Sahoo, S.; Kaur, A.; Litoria, P.; Pateriya, B.

2014-11-01

Over period of time, the water usage and management is under stress for various reasons including pollution in both surface and subsurface. The groundwater quality decreases due to the solid waste from urban and industrial nodes, rapid use of insecticides and pesticides in agricultural practices. In this study, ground water quality maps for Rupnagar district of Punjab has been prepared using geospatial interpolation technique through Inverse Distance Weighted (IDW) approach. IDW technique has been used for major ground water quality parameters observed from the field samples like Arsenic, Hardness, pH, Iron, Fluoride, TDS, and Sulphate. To assess the ground water quality of the Rupnagar district, total 280 numbers of samples from various sources of tubewells for both pre and post monsoon have collected. Out of which, 80 to 113 samples found Iron with non potable limits ranging 0.3-1.1mg/l and 0.3-1.02mg/l according to BIS standard for both the seasons respectively. Chamkaur Sahib, Rupnagar, Morinda blocks have been found non potable limit of iron in both pre & post-monsoon. 11 to 52 samples in this region have sulphate with permissible limits in both the season ranging 200-400mg/l and 201-400mg/l. But arsenic had acceptable limit in both the season. Various parameters-wise ground water quality map is generated using the range values of drinking water quality to know the distribution of different parameters and diversification in the concentration of different elements. These maps are very much needful for human being to expand awareness among the people to maintain the Cleanness of water at their highest quality and purity levels to achieve a healthy life.

The development and validation of the speech quality instrument.

PubMed

Chen, Stephanie Y; Griffin, Brianna M; Mancuso, Dean; Shiau, Stephanie; DiMattia, Michelle; Cellum, Ilana; Harvey Boyd, Kelly; Prevoteau, Charlotte; Kohlberg, Gavriel D; Spitzer, Jaclyn B; Lalwani, Anil K

2017-12-08

Although speech perception tests are available to evaluate hearing, there is no standardized validated tool to quantify speech quality. The objective of this study is to develop a validated tool to measure quality of speech heard. Prospective instrument validation study of 35 normal hearing adults recruited at a tertiary referral center. Participants listened to 44 speech clips of male/female voices reciting the Rainbow Passage. Speech clips included original and manipulated excerpts capturing goal qualities such as mechanical and garbled. Listeners rated clips on a 10-point visual analog scale (VAS) of 18 characteristics (e.g. cartoonish, garbled). Skewed distribution analysis identified mean ratings in the upper and lower 2-point limits of the VAS (ratings of 8-10, 0-2, respectively); items with inconsistent responses were eliminated. The test was pruned to a final instrument of nine speech clips that clearly define qualities of interest: speech-like, male/female, cartoonish, echo-y, garbled, tinny, mechanical, rough, breathy, soothing, hoarse, like, pleasant, natural. Mean ratings were highest for original female clips (8.8) and lowest for not-speech manipulation (2.1). Factor analysis identified two subsets of characteristics: internal consistency demonstrated Cronbach's alpha of 0.95 and 0.82 per subset. Test-retest reliability of total scores was high, with an intraclass correlation coefficient of 0.76. The Speech Quality Instrument (SQI) is a concise, valid tool for assessing speech quality as an indicator for hearing performance. SQI may be a valuable outcome measure for cochlear implant recipients who, despite achieving excellent speech perception, often experience poor speech quality. 2b. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

40 CFR Appendix H to Part 50 - Interpretation of the 1-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Secondary National Ambient Air Quality Standards for Ozone H Appendix H to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General This appendix explains how to... associated examples are contained in the “Guideline for Interpretation of Ozone Air Quality Standards.” For...

40 CFR Appendix H to Part 50 - Interpretation of the 1-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Secondary National Ambient Air Quality Standards for Ozone H Appendix H to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General This appendix explains how to... associated examples are contained in the “Guideline for Interpretation of Ozone Air Quality Standards.” For...

40 CFR Appendix H to Part 50 - Interpretation of the 1-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2012 CFR

2012-07-01

... and Secondary National Ambient Air Quality Standards for Ozone H Appendix H to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General This appendix explains how to... associated examples are contained in the “Guideline for Interpretation of Ozone Air Quality Standards.” For...

40 CFR Appendix H to Part 50 - Interpretation of the 1-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Secondary National Ambient Air Quality Standards for Ozone H Appendix H to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General This appendix explains how to... associated examples are contained in the “Guideline for Interpretation of Ozone Air Quality Standards.” For...

40 CFR 131.2 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

40 CFR 131.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

7 CFR 58.142 - Product quality and stability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... production of the highest quality of finished product and improve product stability. Milk should not be more... 7 Agriculture 3 2010-01-01 2010-01-01 false Product quality and stability. 58.142 Section 58.142... Procedures § 58.142 Product quality and stability. The receiving, holding and processing of milk and cream...

Health benefits from large-scale ozone reduction in the United States.

PubMed

Berman, Jesse D; Fann, Neal; Hollingsworth, John W; Pinkerton, Kent E; Rom, William N; Szema, Anthony M; Breysse, Patrick N; White, Ronald H; Curriero, Frank C

2012-10-01

Exposure to ozone has been associated with adverse health effects, including premature mortality and cardiopulmonary and respiratory morbidity. In 2008, the U.S. Environmental Protection Agency (EPA) lowered the primary (health-based) National Ambient Air Quality Standard (NAAQS) for ozone to 75 ppb, expressed as the fourth-highest daily maximum 8-hr average over a 24-hr period. Based on recent monitoring data, U.S. ozone levels still exceed this standard in numerous locations, resulting in avoidable adverse health consequences. We sought to quantify the potential human health benefits from achieving the current primary NAAQS standard of 75 ppb and two alternative standard levels, 70 and 60 ppb, which represent the range recommended by the U.S. EPA Clean Air Scientific Advisory Committee (CASAC). We applied health impact assessment methodology to estimate numbers of deaths and other adverse health outcomes that would have been avoided during 2005, 2006, and 2007 if the current (or lower) NAAQS ozone standards had been met. Estimated reductions in ozone concentrations were interpolated according to geographic area and year, and concentration-response functions were obtained or derived from the epidemiological literature. We estimated that annual numbers of avoided ozone-related premature deaths would have ranged from 1,410 to 2,480 at 75 ppb to 2,450 to 4,130 at 70 ppb, and 5,210 to 7,990 at 60 ppb. Acute respiratory symptoms would have been reduced by 3 million cases and school-loss days by 1 million cases annually if the current 75-ppb standard had been attained. Substantially greater health benefits would have resulted if the CASAC-recommended range of standards (70-60 ppb) had been met. Attaining a more stringent primary ozone standard would significantly reduce ozone-related premature mortality and morbidity.

Health Benefits from Large-Scale Ozone Reduction in the United States

PubMed Central

Berman, Jesse D.; Fann, Neal; Hollingsworth, John W.; Pinkerton, Kent E.; Rom, William N.; Szema, Anthony M.; Breysse, Patrick N.; White, Ronald H.

2012-01-01

Background: Exposure to ozone has been associated with adverse health effects, including premature mortality and cardiopulmonary and respiratory morbidity. In 2008, the U.S. Environmental Protection Agency (EPA) lowered the primary (health-based) National Ambient Air Quality Standard (NAAQS) for ozone to 75 ppb, expressed as the fourth-highest daily maximum 8-hr average over a 24-hr period. Based on recent monitoring data, U.S. ozone levels still exceed this standard in numerous locations, resulting in avoidable adverse health consequences. Objectives: We sought to quantify the potential human health benefits from achieving the current primary NAAQS standard of 75 ppb and two alternative standard levels, 70 and 60 ppb, which represent the range recommended by the U.S. EPA Clean Air Scientific Advisory Committee (CASAC). Methods: We applied health impact assessment methodology to estimate numbers of deaths and other adverse health outcomes that would have been avoided during 2005, 2006, and 2007 if the current (or lower) NAAQS ozone standards had been met. Estimated reductions in ozone concentrations were interpolated according to geographic area and year, and concentration–response functions were obtained or derived from the epidemiological literature. Results: We estimated that annual numbers of avoided ozone-related premature deaths would have ranged from 1,410 to 2,480 at 75 ppb to 2,450 to 4,130 at 70 ppb, and 5,210 to 7,990 at 60 ppb. Acute respiratory symptoms would have been reduced by 3 million cases and school-loss days by 1 million cases annually if the current 75-ppb standard had been attained. Substantially greater health benefits would have resulted if the CASAC-recommended range of standards (70–60 ppb) had been met. Conclusions: Attaining a more stringent primary ozone standard would significantly reduce ozone-related premature mortality and morbidity. PMID:22809899

Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality

PubMed Central

Smith, Jane R.; Samaha, Laya; Abraham, Charles

2016-01-01

Abstract Background : The use of Internet and related technologies for promoting weight management (WM), physical activity (PA), or dietary-related behaviours has been examined in many articles and systematic reviews. This overview aims to summarize and assess the quality of the review evidence specifically focusing on mobile and Web 2.0 technologies, which are the most utilized, currently available technologies. Methods: Following a registered protocol (CRD42014010323), we searched 16 databases for articles published in English until 31 December 2014 discussing the use of either mobile or Web 2.0 technologies to promote WM or related behaviors, i.e. diet and physical activity (PA). Two reviewers independently selected reviews and assessed their methodological quality using the AMSTAR checklist. Citation matrices were used to determine the overlap among reviews. Results: Forty-four eligible reviews were identified, 39 of which evaluated the effects of interventions using mobile or Web 2.0 technologies. Methodological quality was generally low with only 7 reviews (16%) meeting the highest standards. Suggestive evidence exists for positive effects of mobile technologies on weight-related outcomes and, to a lesser extent, PA. Evidence is inconclusive regarding Web 2.0 technologies. Conclusions : Reviews on mobile and Web 2.0 interventions for WM and related behaviors suggest that these technologies can, under certain circumstances, be effective, but conclusions are limited by poor review quality based on a heterogeneous evidence base. PMID:27335330

Risk for Depression, Burnout and Low Quality of Life Among Personnel of a University Hospital in Italy is a Consequence of the Impact One Economic Crisis in the Welfare System?

PubMed

Carta, M G; Preti, A; Portoghese, I; Pisanu, E; Moro, D; Pintus, M; Pintus, E; Perra, A; D'Oca, S; Atzeni, M; Campagna, M; Pascolo, E Fabrici; Sancassiani, F; Finco, G; D'Aloja, E; Grassi, L

2017-01-01

Research literature suggests that burnout, depression, and a low mental quality of life (QOL) are common among health care workers. Economic crisis might have increased the burden of burnout, depression and low QOL in health care workers. To identify depression risk, burnout levels, and quality of life in a sample of workers of an Italian university hospital. Cross sectional study with comparison with two community surveys database results (n = 2000 and 1500, respectively). Overall, 522 workers accepted to take part in the study, representing a 78% response rate (out of 669 individuals). The frequency of positivity at the screener for Major Depressive Disorder among health care workers was more than double than that in the standardized community sample (33.3% vs 14.1%, p<0.0001). All professionals, except the administrative staff and technicians ( i.e. those who do not have contact with patients), showed a statistically higher frequency of positivity for depressive episodes compared to the controls. Among the medical staff, the highest risk was found in the surgeon units, while the lowest one was in the laboratories. Surgeons also were those most exposed to high risk of burnout, as measured by the Maslach Burnout Inventory. Since burnout is linked to patient safety and quality of patient care, and contribute to medical errors, dedicated interventions aimed at reducing poor mental health and low quality of life in medical staff are indicated.

Radiation dose optimization in pediatric temporal bone computed tomography: influence of tube tension on image contrast and image quality.

PubMed

Nauer, Claude Bertrand; Zubler, Christoph; Weisstanner, Christian; Stieger, Christof; Senn, Pascal; Arnold, Andreas

2012-03-01

The purpose of this experimental study was to investigate the effect of tube tension reduction on image contrast and image quality in pediatric temporal bone computed tomography (CT). Seven lamb heads with infant-equivalent sizes were scanned repeatedly, using four tube tensions from 140 to 80 kV while the CT-Dose Index (CTDI) was held constant. Scanning was repeated with four CTDI values from 30 to 3 mGy. Image contrast was calculated for the middle ear as the Hounsfield unit (HU) difference between bone and air and for the inner ear as the HU difference between bone and fluid. The influence of tube tension on high-contrast detail delineation was evaluated using a phantom. The subjective image quality of eight middle and inner ear structures was assessed using a 4-point scale (scores 1-2 = insufficient; scores 3-4 = sufficient). Middle and inner ear contrast showed a near linear increase with tube tension reduction (r = -0.94/-0.88) and was highest at 80 kV. Tube tension had no influence on spatial resolution. Subjective image quality analysis showed significantly better scoring at lower tube tensions, with highest image quality at 80 kV. However, image quality improvement was most relevant for low-dose scans. Image contrast in the temporal bone is significantly higher at low tube tensions, leading to a better subjective image quality. Highest contrast and best quality were found at 80 kV. This image quality improvement might be utilized to further reduce the radiation dose in pediatric low-dose CT protocols.

Compact Quantum Random Number Generator with Silicon Nanocrystals Light Emitting Device Coupled to a Silicon Photomultiplier

NASA Astrophysics Data System (ADS)

Bisadi, Zahra; Acerbi, Fabio; Fontana, Giorgio; Zorzi, Nicola; Piemonte, Claudio; Pucker, Georg; Pavesi, Lorenzo

2018-02-01

A small-sized photonic quantum random number generator, easy to be implemented in small electronic devices for secure data encryption and other applications, is highly demanding nowadays. Here, we propose a compact configuration with Silicon nanocrystals large area light emitting device (LED) coupled to a Silicon photomultiplier to generate random numbers. The random number generation methodology is based on the photon arrival time and is robust against the non-idealities of the detector and the source of quantum entropy. The raw data show high quality of randomness and pass all the statistical tests in national institute of standards and technology tests (NIST) suite without a post-processing algorithm. The highest bit rate is 0.5 Mbps with the efficiency of 4 bits per detected photon.

Leishmania infection: laboratory diagnosing in the absence of a "gold standard".

PubMed

Rodríguez-Cortés, Alhelí; Ojeda, Ana; Francino, Olga; López-Fuertes, Laura; Timón, Marcos; Alberola, Jordi

2010-02-01

There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the highest sensitivity was achieved by protein A (ProtA), immunoglobulin (Ig)G2, indirect fluorescenece antibody test (IFAT), lymphocyte proliferation assay, quantitative real-time polymerase chain reaction of bone marrow (qPCR-BM), qPCR-Blood, and IgG; and the highest specificity by IgG1, IgM, IgA, qPCR-Blood, IgG, IgG2, and qPCR-BM. Maximum positive predictive value was obtained simultaneously by IgG2, qPCR-Blood, and IgG; and maximum negative predictive value by qPCR-BM. Best positive and negative likelihood ratios were obtained by IgG2. The test having the greatest, statistically significant, area under the receiver operating characteristics curve was IgG2 enzyme-linked immunosorbent assay (ELISA). Thus, according to the gold standard used, IFAT and qPCR are far from fulfilling the requirements to be considered gold standards, and the test showing the highest potential to detect Leishmania infection is Leishmania-specific ELISA IgG2.

40 CFR 136.7 - Quality assurance and quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

40 CFR 136.7 - Quality assurance and quality control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

40 CFR 136.7 - Quality assurance and quality control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

15 CFR 996.11 - Development of standards for a hydrographic product or class.

Code of Federal Regulations, 2010 CFR

2010-01-01

... COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The Quality... adopt or reject the standard as the NOAA Quality Assurance Program Standard for the particular...

40 CFR 121.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... certify compliance with applicable water quality standards. If an interstate agency has sole authority to... agency shall be the certifying agency. Where water quality standards have been promulgated by the... Control Act, 33 U.S.C. 1151 et seq. (g) Water quality standards means standards established pursuant to...

40 CFR 121.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... certify compliance with applicable water quality standards. If an interstate agency has sole authority to... agency shall be the certifying agency. Where water quality standards have been promulgated by the... Control Act, 33 U.S.C. 1151 et seq. (g) Water quality standards means standards established pursuant to...

Value of semen parameters, with special reference to TNF-α, in predicting the quality of boar semen after short-term storage.

PubMed

Mrkun, Janko; Kosec, Marjan; Zrimšek, Petra

2013-06-01

The aim of this study was to address the question whether changes in boar semen quality after short-term storage could be predicted on the basis of standard semen parameters and TNF-α level determined on the day of semen collection under commercial conditions. Progressive motility showed the highest positive correlation with morphology on day 0 of collection, and progressive motility on day 3 (P < 0.05) showed a negative correlation with acrosome abnormalities (P < 0.05). According to the area under receiver operating characteristics (ROC) curves (AUCs), progressive motility could also be used in predicting semen quality after 3 days of storage (AUC > 0.5; P < 0.05). TNF-α in seminal plasma is the only parameter measured on day 0 to show a significant correlation with the percentage of viable spermatozoa after 3 days of semen storage (r = 0.495, P < 0.05). ROC analysis shows that TNF-α level is helpful in discriminating viability outcome after semen storage (AUC = 0.94, P < 0.001). We can predict with 92.35% certainty that fresh semen samples with more than 150 pg/ml of TNF-α in the seminal plasma will retain more than 85% of viable spermatozoa after 3 days of storage. Thus, TNF-α can contribute to predicting the quality of short-term stored semen.

Effect of nitrogen fertilisation on the overall quality of minimally processed globe artichoke heads.

PubMed

Lombardo, Sara; Restuccia, Cristina; Muratore, Giuseppe; Barbagallo, Riccardo N; Licciardello, Fabio; Pandino, Gaetano; Scifò, Giovanna O; Mazzaglia, Agata; Ragonese, Francesca; Mauromicale, Giovanni

2017-01-01

Although nitrogen (N) fertilisation is essential for promoting crop yield, it may also affect the produce quality. Here, the influence of three N fertiliser rates (0 kg ha -1 as a control, 200 kg ha -1 and 400 kg ha -1 referred to as N 0 , N 200 and N 400 , respectively) on the overall quality of minimally processed globe artichoke heads was investigated during refrigerated storage for 12 days. Throughout the storage time, N fertilised samples had higher inulin contents than those unfertilised. In addition, the respiratory quotient of N 200 and N 400 samples was 2-fold and 2.5-fold lower than N 0 ones, whose values were close to the normal range for vegetables. All the samples reported good microbiological standards, although N 200 and N 400 achieved lower mesophilic and psychotropic counts than N 0 throughout the storage time. After 8 and 12 days of refrigerated storage, the N 200 samples showed the highest scores of positive sensory descriptors. A fertiliser level of 200 kg N ha -1 is suitable for obtaining minimally processed globe artichoke heads with good nutritional, sensory and microbiological quality, characterised by low endogenous oxidase activities. Proper packaging systems and procedures are, however, crucial for extending the product shelf-life and, thus, promoting its exportation on a wider scale. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

High performance thin layer chromatography fingerprinting, phytochemical and physico-chemical studies of anti-diabetic herbal extracts

PubMed Central

Itankar, Prakash R.; Sawant, Dattatray B.; Tauqeer, Mohd.; Charde, Sonal S.

2015-01-01

Introduction: Herbal medicines have gained increasing popularity in the last few decades, and this global resurgence of herbal medicines increases their commercial value. However, this increasing demand has resulted in a decline in their quality, primarily due to a lack of adequate regulations pertaining to herbal medicines. Aim: To develop an optimized methodology for the standardization of herbal raw materials. Materials and Methods: The present study has been designed to examine each of the five herbal anti-diabetic drugs, Gymnema sylvester R. Br., Pterocarpus marsupium Roxburgh., Enicostema littorale Blume., Syzygium cumini (L.) Skeels. and Emblica officinalis Gaertn. The in-house extracts and marketed extracts were evaluated using physicochemical parameters, preliminary phytochemical screening, quantification of polyphenols (Folin–Ciocalteu colorimetric method) and high performance thin layer chromatography (HPTLC) fingerprint profiling with reference to marker compounds in plant extracts. Results: All the plants mainly contain polyphenolic compounds and are quantified in the range of 3.6–21.72% w/w. E. officinalis contain the highest and E. littorale contain the lowest content of polyphenol among plant extracts analyzed. HPTLC fingerprinting showed that the in-house extracts were of better quality than marketed extracts. Conclusion: The results obtained from the study could be utilized for setting limits for the reference phytoconstituents (biomarker) for the quality control and quality assurance of these anti-diabetic drugs. PMID:27011722

Reporting quality of randomised controlled trials published in prosthodontic and implantology journals.

PubMed

Kloukos, D; Papageorgiou, S N; Doulis, I; Petridis, H; Pandis, N

2015-12-01

The purpose of this study was to examine the reporting quality of randomised controlled trials (RCTs) published in prosthodontic and implantology journals. Thirty issues of nine journals in prosthodontics and implant dentistry were searched for RCTs, covering the years 2005-2012: The Journal of Prosthetic Dentistry, Journal of Oral Rehabilitation, The International Journal of Prosthodontics, The International Journal of Periodontics & Restorative Dentistry, Clinical Oral Implants Research, Clinical Implant Dentistry & Related Research, The International Journal of Oral & Maxillofacial Implants, Implant Dentistry and Journal of Dentistry. The reporting quality was assessed using a modified Consolidated Standards of Reporting Trials (CONSORT) statement checklist. Data were analysed using descriptive statistics followed by univariable and multivariable examination of statistical associations (α = 0·05). A total of 147 RCTs were identified with a mean CONSORT score of 69·4 (s.d. = 9·7). Significant differences were found among journals with the Journal of Oral Rehabilitation achieving the highest score (80·6, s.d. = 5·5) followed by Clinical Oral Implants Research (73·7, s.d. = 8·3). Involvement of a statistician/methodologist was significantly associated with increased CONSORT scores. Overall, the reporting quality of RCTs in major prosthodontic and implantology journals requires improvement. This is of paramount importance considering that optimal reporting of RCTs is an important prerequisite for clinical decision-making. © 2015 John Wiley & Sons Ltd.

Microbiological evaluation of South Australian rock lobster meat.

PubMed

Yap, A S

1977-12-01

Samples of frozen precooked rock lobster meat from five South Australian fish-processing plants situated in the West Coast and south-east regions were tested over a period of six months during the 1974/5 lobster fishing season. The most probable number (MPN) of E. coli and coliforms, Staphylococcus aureus and Salmonella, as well as total plate count (TPC) were determined in 480 samples. Monthly geometric mean TPC ranged from 1600/g to 25,000/g. The highest geometric mean of the MPN of coliforms and E. coli were 4.9/g and 1.8/g respectively. The highest geometric mean number of staphylococci was 18.6/g. Salmonella was not detected in the 480 units tested. Only 0.4% of the samples had TPC exceeding 100,000/g. Coliforms and E. coli were not present in 76.1% and 92.7% respectively of the samples tested. Staphylococcus aureus was not detected in 67.7% of the samples. The numbers of organisms in 82% of the samples fall within the microbiological standards proposed by the National Health and Medical Research Council of Australia for frozen precooked foods. The results of this study demonstrate the microbial quality of precooked lobster meat attainable when good manufacturing practices are used.

Prevalence of hepatitis C and B virus among patients infected with HIV: a cross-sectional analysis of a large HIV care programme in Myanmar.

PubMed

Zaw, Sai Ko Ko; Tun, Sai Thein Than; Thida, Aye; Aung, Thet Ko; Maung, Win; Shwe, Myint; Aye, Mar Mar; Clevenbergh, Phillipe

2013-07-01

Co-infection with the hepatitis C virus (HCV) and/or hepatitis B virus (HBV) influences the morbidity and mortality of patients with HIV. A cross sectional analysis was of 11,032 HIV-infected patients enrolled in the Integrated HIV Care Program from May 2005 to April 2012 and Epi-info 3.5 was used to determine the serological prevalence of chronic hepatitis B and hepatitis C. The mean ± standard deviation age of patients was 36 ± 8.4 years (adult cohort) and 7 ± 3 years (paediatric cohort). The sero prevalence of hepatitis B surface antigen, hepatitis C (anti HCV antibodies) and triple infection are 8.7%, 5.3% and 0.35%, respectively. Men who have sex with men are at the highest risk of being co-infected with hepatitis B while intravenous drug users are at the highest risk of being co-infected with hepatitis C. It is important to screen for hepatitis B and C in HIV infected people in order to provide quality care for HIV patients with co-infection.

The health status of Russian-speaking immigrants in Germany.

PubMed

Tselmin, S; Korenblum, W; Reimann, M; Bornstein, S R; Schwarz, P E H

2007-12-01

Germany developed today into a country of immigration, which creates an additional burden for the social security system and results in a new challenge for the healthcare. In the last 17 years more than two million "Russia Germans" have been repatriated and about two hundred thousand Jewish refugees have resettled in Germany from the former Soviet Union. Nevertheless relevant data concerning migration-related public health care are very scare. Search of PubMed and Journals extracts combined with the own researches, analysing the health status indices of the Russian-speaking immigrants in Germany. Both repatriates of German origin and Jewish refugees demonstrated higher prevalence of impaired lipid metabolism in comparison with native population. 42 % of the 503,040 HBsAg (hepatitis B s-Antigen) carriers in Germany were migrants. The Jewish refugees demonstrated the highest rates of depression and anxiety and the highest levels of awakening cortisol. On the other side German resettlers showed lower cardiovascular as well as all-cause death rates compared to the native Germans. The development of adequate health care programmes to address migratory aspects as well as the establishment of quality standards will realistically enhance the capability of responding rapidly to migrant health aspects and help to tackle inequalities in health.

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2012 CFR

2012-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

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

Spickett, Jeffery, E-mail: J.Spickett@curtin.edu.au; Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia; Katscherian, Dianne

The approaches used for setting or reviewing air quality standards vary from country to country. The purpose of this research was to consider the potential to improve decision-making through integration of HIA into the processes to review and set air quality standards used in Australia. To assess the value of HIA in this policy process, its strengths and weaknesses were evaluated aligned with review of international processes for setting air quality standards. Air quality standard setting programmes elsewhere have either used HIA or have amalgamated and incorporated factors normally found within HIA frameworks. They clearly demonstrate the value of amore » formalised HIA process for setting air quality standards in Australia. The following elements should be taken into consideration when using HIA in standard setting. (a) The adequacy of a mainly technical approach in current standard setting procedures to consider social determinants of health. (b) The importance of risk assessment criteria and information within the HIA process. The assessment of risk should consider equity, the distribution of variations in air quality in different locations and the potential impacts on health. (c) The uncertainties in extrapolating evidence from one population to another or to subpopulations, especially the more vulnerable, due to differing environmental factors and population variables. (d) The significance of communication with all potential stakeholders on issues associated with the management of air quality. In Australia there is also an opportunity for HIA to be used in conjunction with the NEPM to develop local air quality standard measures. The outcomes of this research indicated that the use of HIA for air quality standard setting at the national and local levels would prove advantageous. -- Highlights: • Health Impact Assessment framework has been applied to a policy development process. • HIA process was evaluated for application in air quality standard setting. • Advantages of HIA in the air quality standard setting process are demonstrated.« less

Sediment quantity and quality in three impoundments in Massachusetts

USGS Publications Warehouse

Zimmerman, Marc James; Breault, Robert F.

2003-01-01

As part of a study with an overriding goal of providing information that would assist State and Federal agencies in developing screening protocols for managing sediments impounded behind dams that are potential candidates for removal, the U.S Geological Survey determined sediment quantity and quality at three locations: one on the French River and two on Yokum Brook, a tributary to the west branch of the Westfield River. Data collected with a global positioning system, a geographic information system, and sediment-thickness data aided in the creation of sediment maps and the calculation of sediment volumes at Perryville Pond on the French River in Webster, Massachusetts, and at the Silk Mill and Ballou Dams on Yokum Brook in Becket, Massachusetts. From these data the following sediment volumes were determined: Perryville Pond, 71,000 cubic yards, Silk Mill, 1,600 cubic yards, and Ballou, 800 cubic yards. Sediment characteristics were assessed in terms of grain size and concentrations of potentially hazardous organic compounds and metals. Assessment of the approaches and methods used at study sites indicated that ground-penetrating radar produced data that were extremely difficult and time-consuming to interpret for the three study sites. Because of these difficulties, a steel probe was ultimately used to determine sediment depth and extent for inclusion in the sediment maps. Use of these methods showed that, where sampling sites were accessible, a machine-driven coring device would be preferable to the physically exhausting, manual sediment-coring methods used in this investigation. Enzyme-linked immunosorbent assays were an effective tool for screening large numbers of samples for a range of organic contaminant compounds. An example calculation of the number of samples needed to characterize mean concentrations of contaminants indicated that the number of samples collected for most analytes was adequate; however, additional analyses for lead, copper, silver, arsenic, total petroleum hydrocarbons, and chlordane are needed to meet the criteria determined from the calculations. Particle-size analysis did not reveal a clear spatial distribution pattern at Perryville Pond. On average, less than 65 percent of each sample was greater in size than very fine sand. The sample with the highest percentage of clay-sized particles (24.3 percent) was collected just upstream from the dam and generally had the highest concentrations of contaminants determined here. In contrast, more than 90 percent of the sediment samples in the Becket impoundments had grain sizes larger than very fine sand; as determined by direct observation, rocks, cobbles, and boulders constituted a substantial amount of the material impounded at Becket. In general, the highest percentages of the finest particles, clays, occurred in association with the highest concentrations of contaminants. Enzyme-linked immunosorbent assays of the Perryville samples showed the widespread presence of petroleum hydrocarbons (16 out of 26 samples), polycyclic aromatic hydrocarbons (23 out of 26 samples), and chlordane (18 out of 26 samples); polychlorinated biphenyls were detected in five samples from four locations. Neither petroleum hydrocarbons nor polychlorinated biphenyls were detected at Becket, and chlordane was detected in only one sample. All 14 Becket samples contained polycyclic aromatic hydrocarbons. Replicate quality-control analyses revealed consistent results between paired samples. Samples from throughout Perryville Pond contained a number of metals at potentially toxic concentrations. These metals included arsenic, cadmium, copper, lead, nickel, and zinc. At Becket, no metals were found in elevated concentrations. In general, most of the concentrations of organic compounds and metals detected in Perryville Pond exceeded standards for benthic organisms, but only rarely exceeded standards for human contact. The most highly contaminated samples were

[Correlation between quality of life and morbidity of the caregivers of elderly stroke patients].

PubMed

Santos, Nilce Maria de Freitas; Tavares, Darlene Mara Dos Santos

2012-08-01

The objective of this study was to describe the sociodemographic characteristics and the quality of life of the caregivers of elderly individuals with a stroke history, and correlate morbidity with the caregivers' quality of life scores. This is a cross-sectional household survey that interviewed the caregivers of elderly individuals using the following tools: a semi-structured instrument; the World Health Organization Quality of life-BREF; and the Brazilian Multidimensional Functional Assessment Questionnaire. Descriptive analysis and Pearson's correlation (p<0.05) were performed. Most participants were female (93.5%), with a mean age of 55.4±14.17 years, married or living with a partner (58.7%), with four to eight years of education (28.3%), and an income equivalent to one minimum wage salary (34.8%). The highest quality of life score was in the social relations domain (67.57) and the lowest was in the environmental domain (54.82). The highest number of caregiver morbidities correlated with the lowest scores in all quality of life domains.

76 FR 38384 - Agency Information Collection Activities; Proposed Collection; Comment Request; Water Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... Activities; Proposed Collection; Comment Request; Water Quality Standards (Renewal) AGENCY: Environmental... States and certain authorized Indian Tribes that adopt water quality standards under the Clean Water Act; and water dischargers subject to certain requirements related to water quality standards in the Great...

42 CFR 493.1299 - Standard: Postanalytic systems quality assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Postanalytic systems quality assessment... Nonwaived Testing Postanalytic Systems § 493.1299 Standard: Postanalytic systems quality assessment. (a) The....1291. (b) The postanalytic systems quality assessment must include a review of the effectiveness of...

42 CFR 493.1249 - Standard: Preanalytic systems quality assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Preanalytic systems quality assessment... Nonwaived Testing Preanalytic Systems § 493.1249 Standard: Preanalytic systems quality assessment. (a) The....1241 through 493.1242. (b) The preanalytic systems quality assessment must include a review of the...

Pharmacist perceptions of new competency standards

PubMed Central

Maitreemit, Pagamas; Pongcharoensuk, Petcharat; Kapol, Nattiya; Armstrong, Edward P.

2008-01-01

Objective To suggest revisions to the Thai pharmacy competency standards and determine the perceptions of Thai pharmacy practitioners and faculty about the proposed pharmacy competency standards. Methods The current competency standards were revised by brainstorming session with nine Thai pharmacy experts according to their perceptions of society’s pharmacy needs. The revised standards were proposed and validated by 574 pharmacy practitioners and faculty members by using a written questionnaire. The respondents were classified based on their practice setting. Results The revision of pharmacy competency standard proposed the integration and addition to current competencies. Of 830 distributed questionnaires, 574 completed questionnaires were received (69.2% response rate). The proposed new competency standards contained 7 domains and 46 competencies. The majority of the respondents were supportive of all 46 proposed competencies. The highest ranked domain was Domain 1 (Practice Pharmacy within Laws, Professional Standards, and Ethics). The second and third highest expectations of pharmacy graduates were Domain 4 (Provide pharmaceutical care) and Domain 3 (Communicate and disseminate knowledge effectively). Conclusion The expectation for pharmacy graduates’ competencies were high and respondents encouraged additional growth in multidisciplinary efforts to improve patient care. PMID:25177401

21 CFR 900.21 - Application for approval as a certification agency.

Code of Federal Regulations, 2010 CFR

2010-04-01

... description of the mammography quality standards the applicant will require facilities to meet and, for those... certification standards the applicant will require facilities to meet are the quality standards published under... SERVICES (CONTINUED) MAMMOGRAPHY QUALITY STANDARDS ACT MAMMOGRAPHY States as Certifiers § 900.21...

[Discussion on research thinking of traditional Chinese medicine standardization system based on whole process quality control].

PubMed

Dong, Ling; Sun, Yu; Pei, Wen-Xuan; Dai, Jun-Dong; Wang, Zi-Yu; Pan, Meng; Chen, Jiang-Peng; Wang, Yun

2017-12-01

The concept of "Quality by design" indicates that good design for the whole life cycle of pharmaceutical production enables the drug to meet the expected quality requirements. Aiming at the existing problems of the traditional Chinese medicine (TCM) industry, the TCM standardization system was put forward in this paper from the national strategic level, under the guidance by the idea of quality control in international manufacturing industry and with considerations of TCM industry's own characteristics and development status. The connotation of this strategy was to establish five interrelated systems: multi-indicators system based on tri-indicators system, quality standard and specification system of TCM herbal materials and decoction pieces, quality traceability system, data monitoring system based on whole-process quality control, and whole-process quality management system of TCM, and achieve the whole process systematic and scientific study in TCM industry through "top-level design-implement in steps-system integration" workflow. This article analyzed the correlation between the quality standards of all links, established standard operating procedures of each link and whole process, and constructed a high standard overall quality management system for TCM industry chains, in order to provide a demonstration for the establishment of TCM whole-process quality control system and provide systematic reference and basis for standardization strategy in TCM industry. Copyright© by the Chinese Pharmaceutical Association.

Relationships between social support and depression, and quality of life of the elderly in a rural community in Malaysia.

PubMed

Ibrahim, Norhayati; Din, Normah Che; Ahmad, Mahadir; Ghazali, Shazli Ezzat; Said, Zaini; Shahar, Suzana; Ghazali, Ahmad Rohi; Razali, Rosdinom

2013-04-01

This study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia. A total of 162 elderly settlers of FELDA Sungai Tengi, aged 60 years and above, were selected by universal sampling method in this cross-sectional study. Three standardized instruments - the 12-item Short Form (SF-12), 15-item Geriatric Depression Scale (GDS-15) and Medical Outcome Study Social Support (MOS-Social Support) - were used to assess for quality of life, depression and social support. Quality of life of the elderly people in this community was high, especially in terms of physical components as compared to mental components. The mean scores for emotional role in the SF-12 was relatively the highest (90.74 ± 21.59) with social functioning being the lowest (30.35 ± 22.29). The results also showed that the mean value was higher for physical component summary (74.40) as compared to mental component summary (51.51). Approximately 23.5% suffered mild depression and only 2.5% had severe depression. This study showed that the elderly FELDA settlers have a high quality of life, mainly on the physical components of life and low rate of severe depression, a positive indicator of their psychological well-being. Social support in the form of emotional/informational support, and depression were significant factors related to their good quality of life. Copyright © 2013 Wiley Publishing Asia Pty Ltd.