[Development and validation of quality standards for colonoscopy].

PubMed

Sánchez Del Río, Antonio; Baudet, Juan Salvador; Naranjo Rodríguez, Antonio; Campo Fernández de Los Ríos, Rafael; Salces Franco, Inmaculada; Aparicio Tormo, Jose Ramón; Sánchez Muñoz, Diego; Llach, Joseph; Hervás Molina, Antonio; Parra-Blanco, Adolfo; Díaz Acosta, Juan Antonio

2010-01-30

Before starting programs for colorectal cancer screening it is necessary to evaluate the quality of colonoscopy. Our objectives were to develop a group of quality indicators of colonoscopy easily applicable and to determine the variability of their achievement. After reviewing the bibliography we prepared 21 potential indicators of quality that were submitted to a process of selection in which we measured their facial validity, content validity, reliability and viability of their measurement. We estimated the variability of their achievement by means of the coefficient of variability (CV) and the variability of the achievement of the standards by means of chi(2). Six indicators overcome the selection process: informed consent, medication administered, completed colonoscopy, complications, every polyp removed and recovered, and adenoma detection rate in patients older than 50 years. 1928 colonoscopies were included from eight endoscopy units. Every unit included the same number of colonoscopies selected by means of simple random sampling with substitution. There was an important variability in the achievement of some indicators and standards: medication administered (CV 43%, p<0.01), complications registered (CV 37%, p<0.01), every polyp removed and recovered (CV 12%, p<0.01) and adenoma detection rate in older than fifty years (CV 2%, p<0.01). We have validated six quality indicators for colonoscopy which are easily measurable. An important variability exists in the achievement of some indicators and standards. Our data highlight the importance of the development of continuous quality improvement programmes for colonoscopy before starting colorectal cancer screening. Copyright (c) 2009 Elsevier España, S.L. All rights reserved.

Quality in Higher Education: The Contribution of Edward Demings Principles

ERIC Educational Resources Information Center

Redmond, Richard; Curtis, Elizabeth; Noone, Tom; Keenan, Paul

2008-01-01

Purpose--There can be little doubt about the importance and relevance of quality for any service industry. One of the most influential contributors to service quality developments was W. Edwards Deming (1900-1993). An important component of Demings philosophy is reflected in his 14-principles for transforming a service as they indicate what…

Colonoscopy quality assurance in Ontario: Systematic review and clinical practice guideline

PubMed Central

Tinmouth, Jill; Kennedy, Erin B; Baron, David; Burke, Mae; Feinberg, Stanley; Gould, Michael; Baxter, Nancy; Lewis, Nancy

2014-01-01

Colonoscopy is fundamental to the diagnosis and management of digestive diseases and plays a key role in colorectal cancer (CRC) screening and diagnosis. Therefore, it is important to ensure that colonoscopy is of high quality. The present guidance document updates the evidence and recommendations in Cancer Care Ontario’s 2007 Colonoscopy Standards, and was conducted under the aegis of the Program in Evidence-Based Care. It is intended to support quality improvement for colonoscopies for all indications, including follow-up to a positive fecal occult blood test, screening for individuals who have a family history of CRC and those at average risk, investigation for symptomatic patients, and surveillance of those with a history of adenomatous polyps or CRC. A systematic review was performed to evaluate the existing evidence concerning the following three key aspects of colonoscopy: physician endoscopist training and maintenance of competency; institutional quality assurance parameters; and colonoscopy quality indicators and auditable outcomes. Where appropriate, indicators were designated quality indicators (where there was sufficient evidence to recommend a specific target) and auditable outcomes (insufficient evidence to recommend a specific target, but which should be monitored for quality assurance purposes). The guidance document may be used to support colonoscopy quality assurance programs to improve the quality of colonoscopy regardless of indication. Improvements in colonoscopy quality are anticipated to improve important outcomes in digestive diseases, such as reduction of the incidence of and mortality from CRC. PMID:24839621

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

PubMed Central

Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

2013-01-01

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

Comparing the information conveyed by envelope modulation for speech intelligibility, speech quality, and music quality.

PubMed

Kates, James M; Arehart, Kathryn H

2015-10-01

This paper uses mutual information to quantify the relationship between envelope modulation fidelity and perceptual responses. Data from several previous experiments that measured speech intelligibility, speech quality, and music quality are evaluated for normal-hearing and hearing-impaired listeners. A model of the auditory periphery is used to generate envelope signals, and envelope modulation fidelity is calculated using the normalized cross-covariance of the degraded signal envelope with that of a reference signal. Two procedures are used to describe the envelope modulation: (1) modulation within each auditory frequency band and (2) spectro-temporal processing that analyzes the modulation of spectral ripple components fit to successive short-time spectra. The results indicate that low modulation rates provide the highest information for intelligibility, while high modulation rates provide the highest information for speech and music quality. The low-to-mid auditory frequencies are most important for intelligibility, while mid frequencies are most important for speech quality and high frequencies are most important for music quality. Differences between the spectral ripple components used for the spectro-temporal analysis were not significant in five of the six experimental conditions evaluated. The results indicate that different modulation-rate and auditory-frequency weights may be appropriate for indices designed to predict different types of perceptual relationships.

Comparing the information conveyed by envelope modulation for speech intelligibility, speech quality, and music quality

PubMed Central

Kates, James M.; Arehart, Kathryn H.

2015-01-01

This paper uses mutual information to quantify the relationship between envelope modulation fidelity and perceptual responses. Data from several previous experiments that measured speech intelligibility, speech quality, and music quality are evaluated for normal-hearing and hearing-impaired listeners. A model of the auditory periphery is used to generate envelope signals, and envelope modulation fidelity is calculated using the normalized cross-covariance of the degraded signal envelope with that of a reference signal. Two procedures are used to describe the envelope modulation: (1) modulation within each auditory frequency band and (2) spectro-temporal processing that analyzes the modulation of spectral ripple components fit to successive short-time spectra. The results indicate that low modulation rates provide the highest information for intelligibility, while high modulation rates provide the highest information for speech and music quality. The low-to-mid auditory frequencies are most important for intelligibility, while mid frequencies are most important for speech quality and high frequencies are most important for music quality. Differences between the spectral ripple components used for the spectro-temporal analysis were not significant in five of the six experimental conditions evaluated. The results indicate that different modulation-rate and auditory-frequency weights may be appropriate for indices designed to predict different types of perceptual relationships. PMID:26520329

[High-quality nursing health care environment: the patient safety perspective].

PubMed

Tu, Yu-Ching; Wang, Ruey-Hsia

2011-06-01

Patient safety is regarded as an important indicator of nursing care quality, and nurses hold frontline responsibility to maintain patient safety. Many countries now face healthcare provider shortfalls, and recognize a close correlation between adequate manpower and patient safety. Many healthcare organizations work to foster positive work environments in order to improve health service quality. The active participation and "buy in" of nurses, patients and policymakers are critical to maximize healthcare environment quality and improve patient safety. This article adopts Donabedian's theoretical "Structure-Process-Outcome" model of quality (Donabedian, 1988) and presumes all high-quality healthcare environment indicators to be linked to patient safety. In addition to raising public awareness regarding the influence of healthcare environment quality on patient safety, this research suggests certain indicators for tracking and assessing healthcare environment quality. Future research may design an empirical study based on these indicators to help further enhance healthcare environment quality and the professional development of nurses.

Marital Quality, Gender, and Markers of Inflammation in the MIDUS Cohort

ERIC Educational Resources Information Center

Donoho, Carrie J.; Crimmins, Eileen M.; Seeman, Teresa E.

2013-01-01

Marital quality is an important factor for understanding the relationship between marriage and health. Low-quality relationships may not have the same health benefits as high-quality relationships. To understand the association between marital quality and health, we examined associations between two indicators of marital quality (marital support…

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

PubMed

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

2018-03-01

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

Effects of increased levels of atmospheric CO2 and high temperatures on rice growth and quality

PubMed Central

Waqas, Muhammad Ahmed; Wang, Song-he; Xiong, Xiang-yang; Wan, Yun-fan

2017-01-01

The increased atmospheric temperatures resulting from the increased concentration of atmospheric carbon dioxide (CO2) have had a profound influence on global rice production. China serves as an important area for producing and consuming rice. Therefore, exploring the effects of the simultaneously rising levels of atmospheric CO2 and temperatures on rice growth and quality in the future is very important. The present study was designed to measure the most important aspects of variation for rice-related physiological, ecological and quality indices in different growing periods under a simultaneous increase of CO2 and temperature, through simulation experiments in climate-controlled growth chambers, with southern rice as the study object. The results indicated that the ecological indices, rice phenology, and leaf area would decrease under a simultaneous increase of CO2 and temperature. For the physiological indices, Malondialdehyde (MDA) levels increased significantly in the seedling period. However, it showed the trend of increase and subsequent decrease in the heading and filling periods. In addition, the decomposition of soluble protein (SP) and soluble sugar (SS) accelerated in filling period. The rice quality index of the Head Rice Rate showed the decreasing trend and subsequent increase, but the Chalky Rice Rate and Protein Content indices gradually decreased while the Gel Consistency gradually increased. PMID:29145420

Water quality indicators: bacteria, coliphages, enteric viruses.

PubMed

Lin, Johnson; Ganesh, Atheesha

2013-12-01

Water quality through the presence of pathogenic enteric microorganisms may affect human health. Coliform bacteria, Escherichia coli and coliphages are normally used as indicators of water quality. However, the presence of above-mentioned indicators do not always suggest the presence of human enteric viruses. It is important to study human enteric viruses in water. Human enteric viruses can tolerate fluctuating environmental conditions and survive in the environment for long periods of time becoming causal agents of diarrhoeal diseases. Therefore, the potential of human pathogenic viruses as significant indicators of water quality is emerging. Human Adenoviruses and other viruses have been proposed as suitable indices for the effective identification of such organisms of human origin contaminating water systems. This article reports on the recent developments in the management of water quality specifically focusing on human enteric viruses as indicators.

Assessment of eco-environmental quality of Western Taiwan Straits Economic Zone.

PubMed

Ma, He; Shi, Longyu

2016-05-01

Regional eco-environmental quality is the key and foundation to the sustainable socio-economic development of a region. Eco-environmental quality assessment can reveal the capacity of sustainable socio-economic development in a region and the degree of coordination between social production and the living environment. As part of a new development strategy for Fujian Province, the Western Taiwan Straits Economic Zone (hereafter referred to as the Economic Zone) provides an important guarantee for the development of China's southeastern coastal area. Based on ecological and remote sensing data on the Economic Zone obtained in 2000, 2005, and 2010, this study investigated county-level administrative regions with a comprehensive index of eco-environmental indicators. An objective weighting method was used to determine the importance of each indicator. This led to the development of an indicator system to assess the eco-environmental quality of the economic zone. ArcGIS software was used to assess the eco-environmental quality of the economic zone based on each indicator. The eco-environmental quality index (EQI) of the county-level administrative regions was calculated. The overall eco-environmental quality of the Economic Zone during the period studied is described and analyzed. The results show that the overall eco-environmental quality of the Economic Zone is satisfactory, but significant intraregional differences still exist. The key to improving the overall eco-environmental quality of this area is to restore vegetation and preserve biodiversity.

University Rankings in Action? The Importance of Rankings and an Excellence Competition for University Choice of High-Ability Students

ERIC Educational Resources Information Center

Horstschraer, Julia

2012-01-01

This paper analyzes how high-ability students respond to different indicators of university quality when applying for a university. Are prospective students influenced by quality indicators of a university ranking or by an excellence status awarded within a nationwide competition? And if so, are some quality dimensions, e.g. research reputation,…

Importance of Quality of Life Issues: A Pilot Comparison of Teachers and Parents of Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Ivey-Hatz, Julie; Frederick, Karen

2014-01-01

Quality of life (QoL) issues for parents and teachers of children with autism spectrum disorders (ASD) are important to investigate. Independence, social functioning, school functioning and participating in leisure activities are some of the quality of life indicators that parents and teachers must agree upon to ensure effective communication and…

[Will publication of quality indicators in the health service improve the quality? International experiences and Danish perspectives].

PubMed

Endahl, Lars A; Utzon, Jan

2002-09-16

It is well known that publication of hospital quality indicators may lead to improving of treatments. But the publication can also have some negative side effects: Focus may shift to the evaluated areas at the expense of non-evaluated areas. The most ill patients may be sorted out and high risk patients may be transferred to other hospitals or discharged in order to avoid their dying during hospitalisation and improve statistics. Overestimation of patient risk in order to improve relative treatment outcome. Increasing flow of patients to hospitals with high scores on quality indicators may cause imbalance between activities and budgets and hence longer waiting times and reduced quality of treatment. Negative publicity due to low scores on quality indicators may lead to under-utilisation of hospital capacity, patient and staff insecurity and staff wastage. Thus, publication of quality indicators may improve quality within the health sector, but it is very important to recognise potential pitfalls and negative side effects.

[Indicators of water microbial pollution: problems and perspectives].

PubMed

Nusca, A; D'Alessandro, D; Funari, E

2008-01-01

Conventional indicators of fecal contamination provide a precious contribution in evaluating water microbiological quality. In recent years some important issues have sprung up which have risen doubts about their reliability and have suggested a revision of their function. In developed countries, where the law regarding water quality is very strict, there have been several outbreaks, even though conventional indicators of fecal pollution pointed an appropriate microbiological quality. These outbreaks have been imputed to new pathogenic microorganisms which are often characterized by a great resistance to disinfection treatments than conventional indicators. In order to obtain an appropriate microbiological quality of waters, various approaches have been started such as the Water Safety Plans by World Health Organization the revision of the functions of suitable indicators (of the water quality), the setting up of specific methods either for pathogen microorganisms and for a quick surveying of an inadequate microbiological water quality.

Quality of Life: An Exploratory Study.

ERIC Educational Resources Information Center

Lankhorst, Gustaaf J.

1989-01-01

A 12-item list of human abilities/activities was developed to measure quality of life of 9 rheumatoid arthritis adults from 2 aspects: "present condition" and "relative importance" of each item. Pilot testing indicated that importance and present condition represent different aspects. Differences between self-assessments and physicians'…

Improving Quality of Care in Patients with Liver Cirrhosis.

PubMed

Saberifiroozi, Mehdi

2017-10-01

Liver cirrhosis is a major chronic disease in the field of digestive diseases. It causes more than one million deaths per year. Despite established evidence based guidelines, the adherence to standard of care or quality indicators are variable. Complete adherence to the recommendations of guidelines is less than 50%. To improve the quality of care in patients with cirrhosis, we need a more holistic view. Because of high rate of death due to cardiovascular disease and neoplasms, the care of comorbid conditions and risk factors such as smoking, hypertension, high blood sugar or cholesterol, would be important in addition to the management of primary liver disease. Despite a holistic multidisciplinary approach for this goal, the management of such patients should be patient centered and individualized. The diagnosis of underlying etiology and its appropriate treatment is the most important step. Definition and customizing the quality indicators for quality measure in patients are needed. Because most suggested quality indicators are designed for measuring the quality of care in decompensated liver cirrhosis, we need special quality indicators for compensated and milder forms of chronic liver disease as well. Training the patients for participation in their own management, design of special clinics with dedicated health professionals in a form of chronic disease model, is suggested for improvement of quality of care in this group of patients. Special day care centers by a dedicated gastroenterologist and a trained nurse may be a practical model for better management of such patients.

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.

Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

PubMed

Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

2013-05-01

Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

Quality indicators for eye bank.

PubMed

Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

2018-03-01

The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

A Perceptually Weighted Rank Correlation Indicator for Objective Image Quality Assessment

NASA Astrophysics Data System (ADS)

Wu, Qingbo; Li, Hongliang; Meng, Fanman; Ngan, King N.

2018-05-01

In the field of objective image quality assessment (IQA), the Spearman's $\\rho$ and Kendall's $\\tau$ are two most popular rank correlation indicators, which straightforwardly assign uniform weight to all quality levels and assume each pair of images are sortable. They are successful for measuring the average accuracy of an IQA metric in ranking multiple processed images. However, two important perceptual properties are ignored by them as well. Firstly, the sorting accuracy (SA) of high quality images are usually more important than the poor quality ones in many real world applications, where only the top-ranked images would be pushed to the users. Secondly, due to the subjective uncertainty in making judgement, two perceptually similar images are usually hardly sortable, whose ranks do not contribute to the evaluation of an IQA metric. To more accurately compare different IQA algorithms, we explore a perceptually weighted rank correlation indicator in this paper, which rewards the capability of correctly ranking high quality images, and suppresses the attention towards insensitive rank mistakes. More specifically, we focus on activating `valid' pairwise comparison towards image quality, whose difference exceeds a given sensory threshold (ST). Meanwhile, each image pair is assigned an unique weight, which is determined by both the quality level and rank deviation. By modifying the perception threshold, we can illustrate the sorting accuracy with a more sophisticated SA-ST curve, rather than a single rank correlation coefficient. The proposed indicator offers a new insight for interpreting visual perception behaviors. Furthermore, the applicability of our indicator is validated in recommending robust IQA metrics for both the degraded and enhanced image data.

[Quality management in a clinical research facility: Evaluation of changes in quality in-house figures and the appraisal of in-house quality indicators].

PubMed

Aden, Bile; Allekotte, Silke; Mösges, Ralph

2016-12-01

For long-term maintenance and improvement of quality within a clinical research institute, the implementation and certification of a quality management system is suitable. Due to the implemented quality management system according to the still valid DIN EN ISO 9001:2008 desired quality objectives are achieved effectively. The evaluation of quality scores and the appraisal of in-house quality indicators make an important contribution in this regard. In order to achieve this and draw quality assurance conclusions, quality indicators as sensible and sensitive as possible are developed. For this, own key objectives, the retrospective evaluation of quality scores, a prospective follow-up and also discussions establish the basis. In the in-house clinical research institute the measures introduced by the quality management led to higher efficiency in work processes, improved staff skills, higher customer satisfaction and overall to more successful outcomes in relation to the self-defined key objectives. Copyright © 2016. Published by Elsevier GmbH.

Benchmarking the Quality of Education [Executive Summary

ERIC Educational Resources Information Center

Scheerens, Jaap, Ed.; Hendriks, Maria, Ed.

2004-01-01

The ultimate purpose of education indicators can be described as providing a basis for monitoring the quality of education. Even though the current indicator sets have become quite comprehensive, and there are clear signs of their use in policy-debates, there are still some important aspects in which their impact on educational policy and…

Opportunities for reproductive tourism: cost and quality advantages of Turkey in the provision of in-vitro Fertilization (IVF) services.

PubMed

Yildiz, M Said; Khan, M Mahmud

2016-08-12

The scale and scope of medical tourism have expanded rapidly over the last few decades. Turkey is becoming an important player in this market because of its relatively better service quality and large comparative cost advantage. This paper compares cost, quality and effectiveness of in-vitro fertilization (IVF) in the USA and in Turkey. The data from Turkey were obtained from a hospital specializing in IVF services and the US data came from secondary sources. Package price offered by the dominant IVF-service provider to international patients in Turkey was used as a measure of cost for Turkey while IVF-specific service prices were used to estimate the cost for USA. To compare quality and effectiveness of IVF services, a number of general clinical quality indicators and IVF success rate were used. Indicators of quality, cost and success rate in the Turkish hospital were found to be better than the corresponding indicators in US hospitals. The cost difference of IVF services between USA and Turkey is so significant that the overall cost of obtaining the service from Turkey remains lower even with additional expenses for travel and accommodation. Cost-effectiveness ratio of IVF treatment per successful clinical pregnancy was much lower in Turkey than in the USA. It appears that cost and quality are the two most important factors affecting demand for health care services by international patients in Turkey. Like other important players in the medical tourism market, Turkey should be able to take advantage of its success in IVF, a highly specialized niche market, to transform its health system into an important exporter of general health services.

Animals as indicators of ecosystem responses to air emissions

USGS Publications Warehouse

Newman, James R.; Schreiber, R. Kent

1984-01-01

With existing and proposed air-quality regulations, ecological disasters resulting from air emissions such as those observed at Copperhill, Tennessee, and Sudbury, Ontario, are unlikely. Current air-quality standards, however, may not protect ecosystems from subacute and chronic exposure to air emissions. The encouragement of the use of coal for energy production and the development of the fossil-fuel industries, including oil shales, tar sands, and coal liquification, point to an increase and spread of fossil-fuel emissions and the potential to influence a number of natural ecosystems. This paper reviews the reported responses of ecosystems to air-borne pollutants and discusses the use of animals as indicators of ecosystem responses to these pollutants. Animal species and populations can act as important indicators of biotic and abiotic responses of aquatic and terrestrial ecosystems. These responses can indicate long-term trends in ecosystem health and productivity, chemical cycling, genetics, and regulation. For short-term trends, fish and wildlife also serve as monitors of changes in community structure, signaling food-web contamination, as well as providing a measure of ecosystem vitality. Information is presented to show not only the importance of animals as indicators of ecosystem responses to air-quality degradation, but also their value as air-pollution indices, that is, as air-quality-related values (AQRV), required in current air-pollution regulation.

Quality of care for cancer patients on home parenteral nutrition: development of key interventions and outcome indicators using a two-round Delphi approach.

PubMed

Dreesen, Mira; Foulon, Veerle; Hiele, Martin; Vanhaecht, Kris; De Pourcq, Lutgart; Pironi, Loris; Van Gossum, André; Arends, Jann; Cuerda, Cristina; Thul, Paul; Bozzetti, Frederico; Willems, Ludo

2013-05-01

Clear recommendations on how to guide patients with cancer on home parenteral nutrition (HPN) are lacking as the use of HPN in this population remains a controversial issue. Therefore, the aims of this study were to rank treatment recommendations and main outcome indicators to ensure high-quality care and to indicate differences in care concerning benign versus malignant patients. Treatment recommendations, identified from published guidelines, were used as a starting point for a two-round Delphi approach. Comments and additional interventions proposed in the first round were reevaluated in the second round. Ordinal logistic regression with SPSS 2.0 was used to identify differences in care concerning benign versus malignant patients. Twenty-seven experts from five European countries completed two Delphi rounds. After the second Delphi round, the top three most important outcome indicators were (1) quality of life (QoL), (2) incidence of hospital readmission and (3) incidence of catheter-related infections. Forty-two interventions were considered as important for quality of care (28/42 based on published guidelines; 14/42 newly suggested by Delphi panel). The topics 'Liver disease' and 'Metabolic bone disease' were considered less important for cancer patients, together with use of infusion pumps (p = 0.004) and monitoring of vitamins and trace elements (p = 0.000). Monitoring of QoL is considered more important for cancer patients (p = 0.03). Using a two-round Delphi approach, we developed a minimal set of 42 interventions that may be used to determine quality of care in HPN patients with malignancies. This set of interventions differs from a similar set developed for benign patients.

OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion.

PubMed

Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

2006-09-01

This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health promotion, and which could be used to assess the performance of primary care systems. Existing quality indicators from around the world were mapped to an organizing framework which related primary care, prevention, and health promotion. The indicators were judged against the US Institute of Medicine's assessment criteria of importance and scientific soundness, and only those which met these criteria and were likely to be feasible were included. An initial large set of indicators was reduced by the primary care expert panel using a modified Delphi process. A set of 27 indicators was produced. Six of them were related to health promotion, covering health-related behaviours that are typically targeted by health education and outreach campaigns, 13 to preventive care with a focus on prenatal care and immunizations and eight to primary clinical care mainly addressing activities related to risk reduction. The indicators selected placed a strong emphasis on the public health aspects of primary care. This project represents an important but preliminary step towards a set of measures to evaluate and compare primary care quality. Further work is required to assess the operational feasibility of the indicators and the validity of any benchmarking data drawn from international comparisons. A conceptual framework needs to be developed that comprehensively captures the complex construct of primary care as a basis for the selection of additional indicators.

Quality indicators for family support services and their relationship to organizational social context.

PubMed

Olin, S Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E

2014-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs-those targeting the program and staff-were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed.

Quality Indicators for Family Support Services and Their Relationship to Organizational Social Context

PubMed Central

Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.

2013-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286

Air quality as respiratory health indicator: a critical review.

PubMed

Moshammer, Hanns; Wallner, Peter

2011-09-01

As part of the European Public Health project IMCA II validity and practicability of "air pollution" as a respiratory health indicator were analyzed. The definitions of air quality as an indicator proposed by the WHO project ECOEHIS and by IMCA I were compared. The public availability of the necessary data was checked through access to web-based data-bases. Practicability and interpretation of the indicator were discussed with project partners and external experts. Air quality serves as a kind of benchmark for the good health-related environmental policy. In this sense, it is a relevant health indicator. Although air quality is not directly in the responsibility of health policy, its vital importance for the population's health should not be neglected. In principle, data is available to calculate this IMCA indicator for any chosen area in Europe. The indicator is relevant and informative, but calculation and interpretation need input from local expert knowledge. The European health policy is well advised to take air quality into account. To that end, an interdisciplinary approach is warranted. The proposed definition of air quality as a (respiratory) health indicator is workable, but correct interpretation depends on expert and local knowledge.

User-Centered Evaluation of the Quality of Blogs

ERIC Educational Resources Information Center

Chuenchom, Sutthinan

2011-01-01

Blogs serve multiple purposes, resulting in several types of blogs that vary greatly in terms of quality and content. It is important to evaluate the quality of blogs, which requires appropriate evaluation criteria. Unfortunately, there are minimal studies on framework and the specific criteria and indicators for evaluating the quality of blogs.…

Quality in the provision of headache care. 2: defining quality and its indicators.

PubMed

Peters, Michele; Jenkinson, Crispin; Perera, Suraj; Loder, Elizabeth; Jensen, Rigmor; Katsarava, Zaza; Gil Gouveia, Raquel; Broner, Susan; Steiner, Timothy

2012-08-01

The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: "Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.

Historical water-quality data from the Harlem River, New York

USGS Publications Warehouse

Fisher, Shawn C.

2016-04-22

Data specific to the Harlem River, New York, have been summarized and are presented in this report. The data illustrate improvements in the quality of water for the past 65 years and emphasize the importance of a continuous water-quality record for establishing trends in environmental conditions. Although there is a paucity of sediment-quality data, the New York City Department of Environmental Protection (NYCDEP) Bureau of Wastewater Treatment has maintained a water-quality monitoring network in the Harlem River (and throughout the harbor of New York City) to which 61 combined sewer outfalls discharge effluent. In cooperation with the NYCDEP, the U.S. Geological Survey evaluated water-quality data collected by the NYCDEP dating back to 1945, which indicate trends in water quality and reveal improvement following the 1972 passage of the Clean Water Act. These improvements are indicated by the steady increase in median dissolved oxygen concentrations and an overall decrease in fecal indicator bacteria concentrations starting in the late 1970s. Further, the magnitude of the highest fecal indicator bacteria concentrations (that is, the 90th percentile) in samples collected from the Harlem River have decreased significantly over the past four decades. Other parameters of water quality used to gauge the health of a water body include total suspended solids and nutrient (inorganic forms of nitrogen and phosphorus) concentrations—mean concentrations for these indicators have also decreased in the past decades. The limited sediment data available for one sample in the Harlem River indicate concentrations of copper, zinc, and lead are above sediment-quality thresholds set by the New York State Department of Environmental Conservation. However, more data are needed to better understand the changes in both sediment and water quality in the Harlem River, both as the tide cycles and during precipitation events. As a partner in the Urban Waters Federal Partnership, the U.S. Geological Survey has worked to address the chronic water-quality concerns of the Harlem River by compiling relevant data and studies, which is an important component for understanding and rectifying water-quality problems within a watershed.

Does adoption of electronic health records improve the quality of care management in France? Results from the French e-SI (PREPS-SIPS) study.

PubMed

Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Biron, Pierre; Philip, Irène; Perrier, Lionel

2017-06-01

Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including the promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the quality of care management in acute care hospitals throughout France. This retrospective study was based on data derived from three national databases for the year 2011: IPAQSS (indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. Several multivariate models were used to examine the association between the use of EHRs and specific EHR features with four quality indicators: the quality of patient record, the delay in sending information at hospital discharge, the pain status evaluation, and the nutritional status evaluation, while also adjusting for hospital characteristics. The models revealed a significant positive impact of EHR use on the four quality indicators. Additionally, they showed a differential impact according to the functionality of the element of the health record that was computerized. All four quality indicators were also impacted by the type of hospital, the geographical region, and the severity of the pathology. These results suggest that, to improve the quality of care management in hospitals, EHR adoption represents an important lever. They complete previous work dealing with EHR and the organizational performance of hospital surgical units. Copyright © 2017 Elsevier B.V. All rights reserved.

[Extraction of management information from the national quality assurance program].

PubMed

Stausberg, Jürgen; Bartels, Claus; Bobrowski, Christoph

2007-07-15

Starting with clinically motivated projects, the national quality assurance program has established a legislative obligatory framework. Annual feedback of results is an important means of quality control. The annual reports cover quality-related information with high granularity. A synopsis for corporate management is missing, however. Therefore, the results of the University Clinics in Greifswald, Germany, have been analyzed and aggregated to support hospital management. Strengths were identified by the ranking of results within the state for each quality indicator, weaknesses by the comparison with national reference values. The assessment was aggregated per clinical discipline and per category (indication, process, and outcome). A composition of quality indicators was claimed multiple times. A coherent concept is still missing. The method presented establishes a plausible summary of strengths and weaknesses of a hospital from the point of view of the national quality assurance program. Nevertheless, further adaptation of the program is needed to better assist corporate management.

[Quality analysis of the statistical used resources (material and methods section) in thesis projects of a university department].

PubMed

Regojo Zapata, O; Lamata Hernández, F; Sánchez Zalabardo, J M; Elizalde Benito, A; Navarro Gil, J; Valdivia Uría, J G

2004-09-01

Studies about quality in thesis and investigation projects in biomedical sciences are unusual, but very important in university teaching because is necessary to improve the quality elaboration of the thesis. The objectives the study were to determine the project's quality of thesis in our department, according to the fulfillment of the scientific methodology and to establish, if it exists, a relation between the global quality of the project and the statistical used resources. Descriptive study of 273 thesis projects performed between 1995-2002 in surgery department of the Zaragoza University. The review realized for 15 observers that they analyzed 28 indicators of every project. Giving a value to each of the indicators, the projects qualified in a scale from 1 to 10 according to the quality in the fulfillment of the scientific methodology. The mean of the project's quality was 5.53 (D.E: 1.77). In 13.9% the thesis projects was concluded with the reading of the work. The three indicators of statistical used resources had a significant difference with the value of the quality projects. The quality of the statistical resources is very important when a project of thesis wants to be realized by good methodology, because it assures to come to certain conclusions. In our study we have thought that more of the third part of the variability in the quality of the project of thesis explains for three statistical above-mentioned articles.

Quality Indicators for Continuous Monitoring to Improve Maternal and Infant Health in Maternity Departments: A Modified Delphi Survey of an International Multidisciplinary Panel

PubMed Central

Boulkedid, Rym; Sibony, Olivier; Goffinet, François; Fauconnier, Arnaud; Branger, Bernard; Alberti, Corinne

2013-01-01

Objective Measuring the quality of inpatient obstetrical care using quality indicators is becoming increasingly important for both patients and healthcare providers. However, there is no consensus about which measures are optimal. We describe a modified Delphi method to identify a set of indicators for continuously monitoring the quality of maternity care by healthcare professionals. Methodology and Main Findings An international French-speaking multidisciplinary panel comprising 22 obstetricians-gynaecologists, 12 midwives, and 1 paediatrician assessed potential indicators extracted from a medical literature search, using a two-round Delphi procedure followed by a physical meeting. Each panellist rated each indicator based on validity and feasibility. In the first round, 35 panellists from 5 countries and 20 maternity units evaluated 26 indicators including 15 related to the management of the overall population of pregnant women, 3 to the management of women followed from the first trimester of pregnancy, 2 to the management of low-risk pregnant women, and 6 to the management of neonates. 25 quality indicators were kept for next step. In the second round, 27 (27/35: 77%) panellists selected 17 indicators; the remaining 8 indicators were discussed during a physical meeting. The final set comprised 18 indicators. Conclusion A multidisciplinary panel selected indicators that reflect the quality of obstetrical care. This set of indicators could be used to assess and monitor obstetrical care, with the goal of improving the quality of care in maternity units. PMID:23577143

Quantity, Quality, and Satisfaction with Mentoring: What Matters Most?

ERIC Educational Resources Information Center

Xu, Xiaohong; Payne, Stephanie C.

2014-01-01

According to Kram's mentor role theory, satisfaction with mentoring and mentorship quality are key indicators of effective and successful mentoring. We contribute to mentoring research by demonstrating the relative importance of mentorship quantity, mentorship quality, and satisfaction with mentoring to the prediction of job satisfaction,…

Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain.

PubMed

Gratacós, Jordi; Luelmo, Jesús; Rodríguez, Jesús; Notario, Jaume; Marco, Teresa Navío; de la Cueva, Pablo; Busquets, Manel Pujol; Font, Mercè García; Joven, Beatriz; Rivera, Raquel; Vega, Jose Luis Alvarez; Álvarez, Antonio Javier Chaves; Parera, Ricardo Sánchez; Carrascosa, Jose Carlos Ruiz; Martínez, Fernando José Rodríguez; Sánchez, José Pardo; Olmos, Carlos Feced; Pujol, Conrad; Galindez, Eva; Barrio, Silvia Pérez; Arana, Ana Urruticoechea; Hergueta, Mercedes; Coto, Pablo; Queiro, Rubén

2018-06-01

To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.

Dashboard report on performance on select quality indicators to cancer care providers.

PubMed

Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

2016-01-01

Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

Quality of Life and Philosophy of Life Determines Physical and Mental Health: Status Over Research Findings From The Quality of Life Research Center, Copenhagen, 1991-2007

PubMed Central

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2007-01-01

Quality of life (QOL) has over the past decade become an important part of health science and also increased public awareness. It has become increasingly apparent that illness is closely related to the individual perception of a good life, and therefore the exploration of indicators related to quality of life appears to be of broad importance for the prevention and treatment of diseases. Identifying, which factors constitute a good life may reveal an understanding about what areas in life should be encouraged, in order to enhance the global quality of life, health, and ability. In this paper we present results from studies initiated in 1989 to examine quality of life in relation to disease. The purpose of this presentation was to assemble the results from the study carried out in the years between 1993 and 1997, examining a total of 11.500 Danes, to show the association between quality of life and a wide series of social indicators. PMID:17982570

Quality of life and philosophy of life determines physical and mental health: status over research findings from the Quality of Life Research Center, Copenhagen, 1991-2007.

PubMed

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2007-10-22

Quality of life (QOL) has over the past decade become an important part of health science and also increased public awareness. It has become increasingly apparent that illness is closely related to the individual perception of a good life, and therefore the exploration of indicators related to quality of life appears to be of broad importance for the prevention and treatment of diseases. Identifying, which factors constitute a good life may reveal an understanding about what areas in life should be encouraged, in order to enhance the global quality of life, health, and ability. In this paper we present results from studies initiated in 1989 to examine quality of life in relation to disease. The purpose of this presentation was to assemble the results from the study carried out in the years between 1993 and 1997, examining a total of 11,500 Danes, to show the association between quality of life and a wide series of social indicators.

Nursing students' evaluation of quality indicators during learning in clinical practice.

PubMed

Jansson, Inger; Ene, Kerstin W

2016-09-01

A supportive clinical learning environment is important for nursing students' learning. In this study, a contract between a county and a university involving a preceptor model of clinical education for nursing students is described. The aim of this study was to describe nursing students' clinical education based on quality indicators and to describe the students' experiences of what facilitated or hindered the learning process during their clinical practice. During autumn 2012 and spring 2013, 269 student evaluations with quantitative and qualitative answers were filled out anonymously. Quantitative data from the questionnaires concerning the quality indicators: Administration/information, Assessments/examinations and Reflection were processed to generate descriptive statistics that revealed gaps in what the preceptor model demands and what the students reported. The answers from the qualitative questions concerning the quality indicator Learning were analysed using content analysis. Four categories emerged: Independence and responsibility, continuity of learning, time, and the competence and attitudes of the staff. The study underlines that reflection, continuity, communication and feedback were important for the students' learning process, whereas heavy workload among staff and being supervised by many different preceptors were experienced as stressful and hindering by students. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2014-01-01

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

CEER 2014 Dedicated Session Proposal: Restoring Water Quality along with Restoring the Gulf of Mexico

EPA Science Inventory

This session focuses on the importance of restoring water quality as part of the larger Gulf of Mexico restoration efforts. Water quality has been identified as a significant indicator of water body condition, and Gulf waters have been impacted by increased urban development, agr...

Assessing Quality in Early Childhood Education and Care

ERIC Educational Resources Information Center

Ishimine, Karin; Tayler, Collette

2014-01-01

Evaluating quality in early childhood education and care (ECEC) service internationally is increasingly important. Research to date indicates that it is "high-quality" programmes that boost and sustain children's achievement outcomes over time. There is also growing interest in the accountability of public funds used for ECEC…

Racial/ethnic disparities in the associations between environmental quality and mortality in the contiguous U.S.

EPA Science Inventory

Introduction: Understanding racial/ethnic disparities in mortality is an important goal for public health in the U.S. We examined the role environmental quality may have on mortality across race/ethnicity. Methods: The Environmental Quality Index (EQI) and its domain indices (air...

Developing quality indicators for general practice care for vulnerable elders; transfer from US to The Netherlands.

PubMed

van der Ploeg, E; Depla, M F I A; Shekelle, P; Rigter, H; Mackenbach, J P

2008-08-01

Measurement of the quality of healthcare is a first step for quality improvement. To measure quality of healthcare, a set of quality indicators is needed. We describe the adaptation of a set of systematically developed US quality indicators for healthcare for vulnerable elders in The Netherlands. We also compare the US and the Dutch set to see if quality indicators can be transferred between countries, as has been done in two studies in the UK, with mixed results. 108 US quality indicators on GP care for vulnerable elders, covering eight conditions, were assessed by a panel of nine clinical experts in The Netherlands. A modified version of the RAND/UCLA appropriateness method was used. The panel members received US literature reviews, extended with more recent and Dutch literature, summarising the evidence for each quality indicator. 72 indicators (67% of US set) were (nearly) identical in the Dutch and US sets. For some conditions, this percentage was much lower. For undernutrition, only half of the US indicators were included in the Dutch set. For depression, many indicators were discarded or changed in a significant way, with the result that only five of the original 17 indicators (29%) are the same in the Dutch and the US set. Quality indicators can be transferred between countries, but with caution, because in two of the three studies on transferring indicators between the US and Europe, 33-44% of the indicators were discarded. For some conditions in the current study, this percentage is much higher. For undernutrition, there is hardly any evidence, and differences between the indicator sets can be attributed to differences in expert opinion between the countries. For depression, it seems that different evidence is considered important in the US and in The Netherlands, of which the Dutch body of knowledge is not known in the US.

Using Qualitative and Quantitative Methods to Choose a Habitat Quality Metric for Air Pollution Policy Evaluation

PubMed Central

Ford, Adriana E. S.; Smart, Simon M.; Henrys, Peter A.; Ashmore, Mike R.

2016-01-01

Atmospheric nitrogen (N) deposition has had detrimental effects on species composition in a range of sensitive habitats, although N deposition can also increase agricultural productivity and carbon storage, and favours a few species considered of importance for conservation. Conservation targets are multiple, and increasingly incorporate services derived from nature as well as concepts of intrinsic value. Priorities vary. How then should changes in a set of species caused by drivers such as N deposition be assessed? We used a novel combination of qualitative semi-structured interviews and quantitative ranking to elucidate the views of conservation professionals specialising in grasslands, heathlands and mires. Although conservation management goals are varied, terrestrial habitat quality is mainly assessed by these specialists on the basis of plant species, since these are readily observed. The presence and abundance of plant species that are scarce, or have important functional roles, emerged as important criteria for judging overall habitat quality. However, species defined as ‘positive indicator-species’ (not particularly scarce, but distinctive for the habitat) were considered particularly important. Scarce species are by definition not always found, and the presence of functionally important species is not a sufficient indicator of site quality. Habitat quality as assessed by the key informants was rank-correlated with the number of positive indicator-species present at a site for seven of the nine habitat classes assessed. Other metrics such as species-richness or a metric of scarcity were inconsistently or not correlated with the specialists’ assessments. We recommend that metrics of habitat quality used to assess N pollution impacts are based on the occurrence of, or habitat-suitability for, distinctive species. Metrics of this type are likely to be widely applicable for assessing habitat change in response to different drivers. The novel combined qualitative and quantitative approach taken to elucidate the priorities of conservation professionals could be usefully applied in other contexts. PMID:27557277

Evaluating the quality of websites relating to diet and eating disorders.

PubMed

Guardiola-Wanden-Berghe, Rocío; Gil-Pérez, Josefa D; Sanz-Valero, Javier; Wanden-Berghe, Carmina

2011-12-01

To verify whether the Credibility Indicator is able to evaluate the quality of websites. This is a descriptive cross-sectional study of websites on diet and anorexia/bulimia, using searches on Google to access the study population. Quality was studied using 22 variables selected by consolidating international proposals. In addition, eight variables belonging to the Credibility Indicator were also studied. Three hundred and fifty four homepages relating to diet and 366 homepages relating to anorexia/bulimia were evaluated. None of the websites met all of the quality criteria; neither did any website satisfy all of the Credibility Indicators. A positive correlation was observed between fulfilment of the Quality items and the Credibility Indicator (R = 0.72; P < 0.001). Significant differences were found in the fulfilment of the Total Quality variables between the websites that had these variables and those that did not (t-test = -9.91, P < 0.001). The quality of websites covering issues of diet and anorexia/bulimia is still poor. The Credibility Indicator is a useful aid when determining the quality of a website. It is evident that identifying authorship and affiliation is an important factor in predicting the quality of the information. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Identification of regional soil quality factors and indicators: a case study on an alluvial plain (central Turkey)

NASA Astrophysics Data System (ADS)

Şeker, Cevdet; Hüseyin Özaytekin, Hasan; Negiş, Hamza; Gümüş, İlknur; Dedeoğlu, Mert; Atmaca, Emel; Karaca, Ümmühan

2017-05-01

Sustainable agriculture largely depends on soil quality. The evaluation of agricultural soil quality is essential for economic success and environmental stability in rapidly developing regions. In this context, a wide variety of methods using vastly different indicators are currently used to evaluate soil quality. This study was conducted in one of the most important irrigated agriculture areas of Konya in central Anatolia, Turkey, to analyze the soil quality indicators of Çumra County in combination with an indicator selection method, with the minimum data set using a total of 38 soil parameters. We therefore determined a minimum data set with principle component analysis to assess soil quality in the study area and soil quality was evaluated on the basis of a scoring function. From the broad range of soil properties analyzed, the following parameters were chosen: field capacity, bulk density, aggregate stability, and permanent wilting point (from physical soil properties); electrical conductivity, Mn, total nitrogen, available phosphorus, pH, and NO3-N (from chemical soil properties); and urease enzyme activity, root health value, organic carbon, respiration, and potentially mineralized nitrogen (from biological properties). According to the results, the chosen properties were found as the most sensitive indicators of soil quality and they can be used as indicators for evaluating and monitoring soil quality at a regional scale.

Key performance indicators to benchmark hospital information systems - a delphi study.

PubMed

Hübner-Bloder, G; Ammenwerth, E

2009-01-01

To identify the key performance indicators for hospital information systems (HIS) that can be used for HIS benchmarking. A Delphi survey with one qualitative and two quantitative rounds. Forty-four HIS experts from health care IT practice and academia participated in all three rounds. Seventy-seven performance indicators were identified and organized into eight categories: technical quality, software quality, architecture and interface quality, IT vendor quality, IT support and IT department quality, workflow support quality, IT outcome quality, and IT costs. The highest ranked indicators are related to clinical workflow support and user satisfaction. Isolated technical indicators or cost indicators were not seen as useful. The experts favored an interdisciplinary group of all the stakeholders, led by hospital management, to conduct the HIS benchmarking. They proposed benchmarking activities both in regular (annual) intervals as well as at defined events (for example after IT introduction). Most of the experts stated that in their institutions no HIS benchmarking activities are being performed at the moment. In the context of IT governance, IT benchmarking is gaining importance in the healthcare area. The found indicators reflect the view of health care IT professionals and researchers. Research is needed to further validate and operationalize key performance indicators, to provide an IT benchmarking framework, and to provide open repositories for a comparison of the HIS benchmarks of different hospitals.

The Role of Geographical Indication in Supporting Food Safety: A not Taken for Granted Nexus

PubMed Central

2014-01-01

The paper focuses on the role of geographical indication in supporting strategies of food safety. Starting from the distinction between generic and specific quality, the article analyses the main factors influencing food safety in cases of geographical indication products, by stressing the importance of traceability systems and biodiversity in securing generic and specific quality. In the second part, the paper investigates the coordination problems behind a designation of origin and conditions to foster an effective collective action, a prerequisite to grant food safety through geographical indications. PMID:27800417

Comparing the importance of quality measurement themes in juvenile idiopathic inflammatory myositis between patients and families and healthcare professionals.

PubMed

Tory, Heather O; Carrasco, Ruy; Griffin, Thomas; Huber, Adam M; Kahn, Philip; Robinson, Angela Byun; Zurakowski, David; Kim, Susan

2018-04-19

A standardized set of quality measures for juvenile idiopathic inflammatory myopathies (JIIM) is not in use. Discordance has been shown between the importance ascribed to quality measures between patients and families and physicians. The objective of this study was to assess and compare the importance of various aspects of high quality care to patients with JIIM and their families with healthcare providers, to aid in future development of comprehensive quality measures. Surveys were developed by members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Juvenile Dermatomyositis Workgroup through a consensus process and administered to patients and families through the CureJM Foundation and to healthcare professionals through CARRA. The survey asked respondents to rate the importance of 19 items related to aspects of high quality care, using a Likert scale. Patients and families gave generally higher scores for importance to most of the quality measurement themes compared with healthcare professionals, with ratings of 13 of the 19 measures reaching statistical significance (p < 0.05). Of particular importance, however, was consensus between the groups on the top five most important items: quality of life, timely diagnosis, access to rheumatology, normalization of functioning/strength, and ability for self care. Despite overall differences in the rating of importance of quality indicators between patients and families and healthcare professionals, the groups agreed on the most important aspects of care. Recognizing areas of particular importance to patients and families, and overlapping in importance with providers, will promote the development of standardized quality measures with the greatest potential for improving care and outcomes for children with JIIM.

Relations of surface-water quality to streamflow in the Atlantic Coastal, lower Delaware River, and Delaware Bay basins, New Jersey, water years 1976-93

USGS Publications Warehouse

Hunchak-Kariouk, Kathryn; Buxton, Debra E.; Hickman, R. Edward

1999-01-01

Relations of water quality to streamflow were determined for 18 water-quality constituents at 28 surface-water-quality stations within the drainage area of the Atlantic Coastal, lower Delaware River, and Delaware Bay Basins for water years 1976-93. Surface-water-quality and streamflow data were evaluated for trends (through time) in constituent concentrations during high and low flows, and relations between constituent concentration and streamflow, and between constituent load and streamflow, were determined. Median concentrations were calculated for the entire period of study (water years 1976-93) and for the last 5 years of the period of study (water years 1989-93) to determine whether any large variation in concentration exists between the two periods. Medians also were used to determine the seasonal Kendall\\'s tau statistic, which was then used to evaluate trends in concentrations during high and low flows. Trends in constituent concentrations during high and low flows were evaluated to determine whether the distribution of the observations changes through time for intermittent (nonpoint storm runoff) and constant (point sources and ground water) sources, respectively. High- and low-flow trends in concentrations were determined for some constituents at 26 of the 28 water-quality stations. Seasonal effects on the relations of concentration to streamflow are evident for 10 constituents at 14 or more stations. Dissolved oxygen shows seasonal dependency at all stations. Negative slopes of relations of concentration to streamflow, which indicate a decrease in concentration at high flows, predominate over positive slopes because of dilution of instream concentrations from storm runoff. The slopes of the regression lines of load to streamflow were determined in order to show the relative contributions to the instream load from constant (point sources and ground water) and intermittent sources (storm runoff). Greater slope values indicate larger contributions from storm runoff to instream load, which most likely indicate an increased relative importance of nonpoint sources. Load-to-streamflow relations along a stream reach that tend to increase in a downstream direction indicate the increased relative importance of contributions from storm runoff. Likewise, load-to-streamflow relations along a stream reach that tend to decrease in a downstream direction indicate the increased relative importance of point sources and ground-water discharge. The magnitudes of the load slopes for five constituents increase in the downstream direction along the Great Egg Harbor River, indicating an increased relative importance of storm runoff for these constituents along the river. The magnitudes of the load slopes for 11 constituents decrease in the downstream direction along the Assunpink Creek and for 5 constituents along the Maurice River, indicating a decreased relative importance of storm runoff for these constituents along the rivers.

Quality of Care and Job Satisfaction in the European Home Care Setting: Research Protocol

PubMed Central

van der Roest, Henriëtte; van Hout, Hein; Declercq, Anja

2016-01-01

Introduction: Since the European population is ageing, a growing number of elderly will need home care. Consequently, high quality home care for the elderly remains an important challenge. Job satisfaction among care professionals is regarded as an important aspect of the quality of home care. Aim: This paper describes a research protocol to identify elements that have an impact on job satisfaction among care professionals and on quality of care for older people in the home care setting of six European countries. Methods: Data on elements at the macro-level (policy), meso-level (care organisations) and micro-level (clients) are of importance in determining job satisfaction and quality of care. Macro-level indicators will be identified in a previously published literature review. At meso- and micro-level, data will be collected by means of two questionnaires utilsed with both care organisations and care professionals, and by means of interRAI Home Care assessments of clients. The client assessments will be used to calculate quality of care indicators. Subsequently, data will be analysed by means of linear and stepwise multiple regression analyses, correlations and multilevel techniques. Conclusions and Discussion: These results can guide health care policy makers in their decision making process in order to increase the quality of home care in their organisation, in their country or in Europe. PMID:28435423

Water supply, demand, and quality indicators for assessing the spatial distribution of water resource vulnerability in the Columbia River Basin

USGS Publications Warehouse

Chang, Heejun; Jung, Il-Won; Strecker, Angela L.; Wise, Daniel; Lafrenz, Martin; Shandas, Vivek; ,; Yeakley, Alan; Pan, Yangdong; Johnson, Gunnar; Psaris, Mike

2013-01-01

We investigated water resource vulnerability in the US portion of the Columbia River basin (CRB) using multiple indicators representing water supply, water demand, and water quality. Based on the US county scale, spatial analysis was conducted using various biophysical and socio-economic indicators that control water vulnerability. Water supply vulnerability and water demand vulnerability exhibited a similar spatial clustering of hotspots in areas where agricultural lands and variability of precipitation were high but dam storage capacity was low. The hotspots of water quality vulnerability were clustered around the main stem of the Columbia River where major population and agricultural centres are located. This multiple equal weight indicator approach confirmed that different drivers were associated with different vulnerability maps in the sub-basins of the CRB. Water quality variables are more important than water supply and water demand variables in the Willamette River basin, whereas water supply and demand variables are more important than water quality variables in the Upper Snake and Upper Columbia River basins. This result suggests that current water resources management and practices drive much of the vulnerability within the study area. The analysis suggests the need for increased coordination of water management across multiple levels of water governance to reduce water resource vulnerability in the CRB and a potentially different weighting scheme that explicitly takes into account the input of various water stakeholders.

ASSESSING WATER QUALITY: AN ENERGETICS PERPECTIVE

EPA Science Inventory

Integrated measures of food web dynamics could serve as important supplemental indicators of water quality that are well related with ecological integrity and environmental well-being. When the concern is a well-characterized pollutant (posing an established risk to human health...

Indicators of safety compromise in gastrointestinal endoscopy.

PubMed

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

2012-02-01

The importance of quality indicators has become increasingly recognized in gastrointestinal endoscopy. Patient safety requires the identification and monitoring of occurrences associated with harm or the potential for harm. The identification of relevant indicators of safety compromise is, therefore, a critical element that is key to the effective implementation of endoscopy quality improvement programs. To identify key indicators of safety compromise in gastrointestinal endoscopy. The Canadian Association of Gastroenterology Safety and Quality Indicators in Endoscopy Consensus Group was formed to address issues of quality in endoscopy. A subcommittee was formed to identify key safety indicators. A systematic literature review was undertaken, and articles pertinent to safety in endoscopy were identified and reviewed. All complications and measures used to document safety were recorded. From this, a preliminary list of 16 indicators was compiled and presented to the 35-person consensus group during a three-day meeting. A revised list of 20 items was subsequently put to the consensus group for vote for inclusion on the final list of safety indicators. Items were retained only if the consensus group highly agreed on their importance. A total of 19 indicators of safety compromise were retained and grouped into the three following categories: medication-related - the need for CPR, use of reversal agents, hypoxia, hypotension, hypertension, sedation doses in patients older than 70 years of age, allergic reactions and laryngospasm⁄bronchospasm; procedure-related early - perforation, immediate postpolypectomy bleeding, need for hospital admission or transfer to emergency department from the gastroenterology unit, instrument impaction, severe persistent abdominal pain requiring evaluation proven to not be perforation; and procedure-related delayed - death within 30 days of procedure, 14-day unplanned hospitalization, 14-day unplanned contact with a health provider, gastrointestinal bleeding within 14 days of procedure, infection or symptomatic metabolic complications. The 19 indicators of safety compromise in endoscopy, identified by a rigorous, evidence-based consensus process, provide clear outcomes to be recorded by all facilities as part of their continuing quality improvement programs.

Towards Integrating Soil Quality Monitoring Targets as Measures of Soil Natural Capital Stocks with the Provision of Ecosystem Services

NASA Astrophysics Data System (ADS)

Taylor, M. D.; Mackay, A. D.; Dominati, E.; Hill, R. B.

2012-04-01

This paper presents the process used to review soil quality monitoring in New Zealand to better align indicators and indicator target ranges with critical values of change in soil function. Since its inception in New Zealand 15 year ago, soil quality monitoring has become an important state of the environment reporting tool for Regional Councils. This tool assists councils to track the condition of soils resources, assess the impact of different land management practices, and provide timely warning of emerging issues to allow early intervention and avoid irreversible loss of natural capital stocks. Critical to the effectiveness of soil quality monitoring is setting relevant, validated thresholds or target ranges. Provisional Target Ranges were set in 2003 using expert knowledge available and data on production responses. Little information was available at that time for setting targets for soil natural capital stocks other than those for food production. The intention was to revise these provisional ranges as further information became available and extend target ranges to cover the regulating and cultural services provided by soils. A recently developed ecosystems service framework was used to explore the feasibility of linking soil natural capital stocks measured by the current suite of soil quality indicators to the provision of ecosystem services by soils. Importantly the new approach builds on and utilises the time series data sets collected by current suite of soil quality indicators, adding value to the current effort, and has the potential to set targets ranges based on the economic and environmental outcomes required for a given farm, catchment or region. It is now timely to develop a further group of environmental indicators for measuring specific soil issues. As with the soil quality indicators, these environmental indicators would be aligned with the provision of ecosystem services. The toolbox envisaged is a set of indicators for specific soil issues with appropriate targets tied to ecosystem services and changes in critical soil function. Such indicators would be used for specific purposes for limited periods, rather than long-term, continuous monitoring. Some examples will be presented. An important step needed to successfully initiate and complete the review was assigning national oversight. Reigniting scientific interest (which had declined with the cessation of funding in 2003) and documentation of the process were other important steps. We had to extend the recently developed ecosystem service approach to accommodate the catchment scale. This required additional attributes in the framework and recognition that some of the proxies will change with scale as will the techniques to value the services. The framework was originally developed for use at the farm scale. Macroporosity, one of the two indicators used to monitor the physical condition of the soil, was used to illustrate how the ecosystem service framework could be used to link a change in the physical condition of the soil with the provision of services. The sum of the dollar values of selected soil ecosystem services were used to inform the state of soil natural capital stocks. This estimate provides a new insight into the value of the soil quality indicators and existing target ranges. Doing so will enable targets to be more closely aligned and integrated with the provision of a range of ecosystem services, going far beyond food production.

The Early Communication Indicator for Infants and Toddlers: Early Head Start Growth Norms from Two States

ERIC Educational Resources Information Center

Greenwood, Charles R.; Walker, Dale; Buzhardt, Jay

2010-01-01

The Early Communication Indicator (ECI) is a measure relevant to intervention decision making and progress monitoring for infants and toddlers. With increasing recognition of the importance of quality early childhood education and intervention for all children, measurement plays an important role in documenting children's progress and outcomes of…

From landscapes to soundscapes: understanding and managing natural quiet in the national parks

Treesearch

Robert Manning; William Valliere; Jeffery Hallo; Peter Newman; Ericka Pilcher; Michael Savidge; Dan Dugan

2007-01-01

Research at Muir Woods Natural Monument suggests that soundscapes are an important component of parks and outdoor recreation, that human-caused noise is a potentially important indicator of quality for park soundscapes, and that visitors have normative standards for the maximum acceptable level of human-caused noise in parks. Formulating indicators and standards of...

Sleep and its association with aggression among prisoners: Quantity or quality?

PubMed

Barker, Lyndsie Fiona; Ireland, Jane L; Chu, Simon; Ireland, Carol A

2016-01-01

The current paper aims to examine the association between self-reported sleep quality and quantity and how these relate to aggression motivation and hostile cognition in a male prisoner sample. The cognitive component of sleep, namely perception, is consequently a variable of particular interest and one neglected by previous research. Two independent studies are presented. The first comprised 95 adult male prisoners who completed a sleep quality index along with measures of implicit and explicit aggression. The second study extended this to consider aggression motivation and hostile attribution biases using a sample of 141 young male adult prisoners. In study one, sleep quantity and indicators of sleep quality were found not to associate with aggression whereas the perception of poor sleep did; those perceiving poor sleep quality were more likely than those perceiving good sleep to report they had perpetrated aggression in the previous week and to report higher levels of implicit aggression. Study two found that while increased indicators of poor sleep quality were associated with lower prosocial attribution tendencies and higher levels of reactive and proactive aggression, sleep quantity was not associated. The perception of poor quality sleep was important; those perceiving poor sleep were more likely to report higher levels of reactive and proactive aggression than those reporting good sleep. Collectively the studies highlight the importance of accounting for the perception of sleep quality as an important cognitive component in understanding the association between sleep and aggression. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does one size fit all? Assessing the preferences of older and younger people for attributes of quality of life.

PubMed

Ratcliffe, Julie; Lancsar, Emily; Flint, Thomas; Kaambwa, Billingsley; Walker, Ruth; Lewin, Gill; Luszcz, Mary; Cameron, Ian D

2017-02-01

To systematically compare, via ranking and best worst tasks, the relative importance of key dimensions of quality of life for younger and older people. A web-based survey was developed for administration to two Australia-wide community-based samples comprising younger people aged 18-64 years and older people aged 65 years and above. Respondents were asked to rank 12 quality of life dimensions. Respondents also completed a successive best worst task using the same 12 quality of life dimensions. The relative importance of the quality of life dimensions differed for younger and older person samples. For older people, the ability to be independent and to have control over their daily lives were particularly important for their overall quality of life whereas for younger people, mental health was considered most important. Many interventions accessed by older people in geriatric medicine and aged care sectors have a broader impact upon quality of life beyond health status. The findings from this study indicate that a focus on broader aspects of quality of life may also be consistent with the preferences of older people themselves as to what constitutes quality of life from their perspective.

[Establishment and application of "multi-dimensional structure and process dynamic quality control technology system" in preparation products of traditional Chinese medicine (I)].

PubMed

Gu, Jun-Fei; Feng, Liang; Zhang, Ming-Hua; Wu, Chan; Jia, Xiao-Bin

2013-11-01

Safety is an important component of the quality control of traditional Chinese medicine (TCM) preparation products, as well as an important guarantee for clinical application. Currently, the quality control of TCMs in Chinese Pharmacopoeia mostly focuses on indicative compounds for TCM efficacy. TCM preparations are associated with multiple links, from raw materials to products, and each procedure may have impacts on the safety of preparation. We make a summary and analysis on the factors impacting safety during the preparation of TCM products, and then expound the important role of the "multi-dimensional structure and process dynamic quality control technology system" in the quality safety of TCM preparations. Because the product quality of TCM preparation is closely related to the safety, the control over safety-related material basis is an important component of the product quality control of TCM preparations. The implementation of the quality control over the dynamic process of TCM preparations from raw materials to products, and the improvement of the TCM quality safety control at the microcosmic level help lay a firm foundation for the development of the modernization process of TCM preparations.

Establishing nursing-sensitive quality indicators for the operating room: A cross-sectional Delphi survey conducted in China.

PubMed

Wu, Qi; Huang, Li-Hua; Xing, Mei-Yuan; Feng, Zhi-Xian; Shao, Le-Wen; Zhang, Mei-Yun; Shao, Rong-Ya

2017-01-01

Nursing-sensitive quality indicators comprise principles, procedures, and assessments to quantify the level of nursing quality in hospital departments. Although studies have demonstrated that quality indicators are essential for monitoring nursing practice in the operating room (OR), nursing quality in China is highly subjective and localised OR nursing-sensitive quality indicators are lacking. This study aimed to establish scientific, objective and comprehensive nursing-sensitive quality indicators for the OR to evaluate and monitor OR nursing care quality in China. Literature search for relevant evidence-based studies was performed using Cochrane, Medline, PubMed, Embase, and other databases, followed by literature review and group discussion by the expert panel. Two successive rounds of Delphi surveys were conducted using questionnaires completed by the expert panel to reach consensus and define nursing-sensitive quality indicators for the OR. Two rounds of Delphi surveys each had 100% questionnaire retrieval rate, with Kendall W coordination coefficients ranging from 0.096 to 0.263 (P<0.001). In round 1 of expert evaluation of 26 indicators, Kendall's W was 0.263 for importance, 0.126 for rationality, and 0.125 for feasibility of data collection (all P<0.001). After round 2, 23 items were established as OR nursing-sensitive quality indicators, including rates of work time wastage, surgery start-time delay, OR turnover time between surgeries, same-day surgery cancellation, and number of monthly surgeries in each OR; checking surgical patients, surgery site marking, allergy history, and antibiotics use 60min before incision; and also assessing expected surgical time, sterilisation indicator results, availability of surgical instruments and materials, and instrument count. Scientific, practical, and reliable OR nursing-sensitive quality indicators can be established based on evidence-based studies and expert consensus using the Delphi method. The quality indicators developed in this study may provide an objective and quantitative reference for evaluating nursing quality in Chinese ORs. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Assessing Quality of Kindergarten Classrooms in Singapore: Psychometric Properties of the Early Childhood Environment Rating Scale-Revised

ERIC Educational Resources Information Center

Bull, Rebecca; Yao, Shih-Ying; Ng, Ee Lynn

2017-01-01

The early childhood sector in Singapore has witnessed vast changes in the past two decades. One of the key policy aims is to improve classroom quality. To ensure a rigorous evaluation of the quality of early childhood environments in Singapore, it is important to determine whether commonly used assessments of quality are valid indicators across…

[Development of quality of care indicators to support chronic disease management].

PubMed

Beaulieu, Marie-dominique; Pomey, Marie-pascale; Del Grande, Claudio; Côté, Brigitte; Tremblay, Éric; Ghorbel, Monia; Hua, Phuong

2015-01-01

This article presents the results of a project conducted by the Institut national d'excellence en santé et en services sociaux of Québec to develop quality of care indicators for the management of six chronic illnesses. Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM). A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that they considered to be too subjective. The importance given to CPGs as the main source of indicators resulted in a great number of indicators of the technical quality ofcare. Using the CCM contributed to a broader perspective of quality. The consultation process identified some of the concerns of professionals about indicator measurement, thusguidingfuture implementation initiatives.

Regional differences in prescribing quality among elder veterans and the impact of rural residence

PubMed Central

Lund, BC; Charlton, ME; Steinman, MA; Kaboli, PJ

2014-01-01

Purpose Medication safety is a critical concern for older adults. Regional variation in potentially inappropriate prescribing practices may reflect important differences in health care quality. Therefore, the objectives of this study were to characterize prescribing quality variation among older adults across geographic region, and to compare prescribing quality across rural versus urban residence. Methods Cross-sectional study of 1,549,824 older adult veterans with regular Veterans Affairs (VA) primary care and medication use during fiscal year 2007. Prescribing quality was measured by 4 indicators of potentially inappropriate prescribing: Zhan criteria drugs to avoid, Fick criteria drugs to avoid, therapeutic duplication, and drug-drug interactions. Frequency differences across region and rural-urban residence were compared using adjusted odds-ratios. Findings Significant regional variation was observed for all indicators. Zhan criteria frequencies ranged from 13.2% in the Northeast to 21.2% in the South. Nationally, rural veterans had a significantly increased risk for inappropriate prescribing according to all quality indicators. However, regional analyses revealed this effect was limited to the South and Northeast, whereas rural residence was neutral in the Midwest and protective in the West. Conclusions Significant regional variation in prescribing quality was observed among older adult veterans, mirroring recent findings among Medicare beneficiaries. The association between rurality and prescribing quality is heterogeneous, and relying solely on national estimates may yield misleading conclusions. While we documented important variations in prescribing quality, the underlying factors driving these trends remain unknown, and they are a vital area for future research affecting older adults in both VA and non-VA health systems. PMID:23551647

[The importance of an early accompanying evaluation of new care forms for the development of indicators for quality assurance in outpatient psychiatric integrated care].

PubMed

Hausen, A; Glaeske, G

2015-05-01

Aim of this contribution is to illustrate the imp-ortance of an early accompanying evaluation of new care forms for the development of indicators. The illustration uses the experience of the accompanying evaluation of the integrated care model for optimisation of outpatient psychiatric care. For the integrated care model we could develop potential indicators by using medical-psychiatric and insured-related routine data, but all potential indicators need further development to enable reliable statements about achieved quality targets. It is shown that the development of indicators in the outpatient psychiatric integrated care is affected by many different factors such as vague target agreements in the contract and missing contractual agreements for the data. As a result it is illustrated that in this project the evaluation was introduced after implementation of this new form of care and the already established contract and the data management impeded the development of indicators. © Georg Thieme Verlag KG Stuttgart · New York.

Quality indicators for Transfusion Medicine in Spain: a survey among hospital transfusion services.

PubMed

Romon, Iñigo; Lozano, Miguel

2017-05-01

Transfusion services in the European Union must implement quality management systems to improve quality. Quality indicators (QI) play a key role in quality management because they can supply important information about the performance of the transfusion service, which can then be used for benchmarking. However, little is known about the actual use of QI in hospitals. We tried to ascertain the use and characteristics of QI in Spanish hospital transfusion services. We performed a survey among transfusion services in order to learn which QI they use. We classified indicators into categories and concepts, according to the steps of the transfusion process or the activities the indicators referred to. Seventy-six hospitals (17.9% of the hospitals actively transfusing in the country) reported 731 QI. Twenty-two of them (29%) were tertiary level hospitals. The number of indicators per hospital and by activity varied greatly. QI were assigned to some basic categories: transfusion process (23% of indicators), transfusion activity and stock management (22%), haemovigilance (20%), stem cell transplantation (9%), transfusion laboratory (9%), quality management system (8%), blood donation (3.4%), apheresis and therapeutic activities (2.5%) and immunohaematology of pregnancy (2%). Although most hospitals use QI in their quality management system and share a core group of indicators, we found a great dispersion in the number and characteristics of the indicators used. The use of a commonly agreed set of QI could be an aid to benchmarking among hospitals and to improving the transfusion process.

Results of a Quality of Work Life Index in Spain. A Comparison of Survey Results and Aggregate Social Indicators

ERIC Educational Resources Information Center

Royuela, Vicente; Lopez-Tamayo, Jordi; Surinach, Jordi

2009-01-01

The European Union launched the Lisbon Strategy in 2000 with the aim of establishing itself as the world's most powerful economy. The importance of job quality has returned to the top of the European employment and social policy agenda. As targets are set, significant progress has been made in the creation of indicators. In this study, we compute…

Effects of agricultural management on productivity, soil quality and climate change mitigation - evaluations within the EU Project (FP 7) CATCH-C

NASA Astrophysics Data System (ADS)

Spiegel, Heide; Schlatter, Norman; Haslmayr, Hans-Peter; Baumgarten, Andreas; ten Berge, Hein

2014-05-01

Soils are the main basis for the production of food and feed. Furthermore, the production of biomass for energy and material use is becoming increasingly important. Goals for an optimal management of agricultural soils are, on the one hand, the maintenance or improvement of soil quality and, on the other hand, high productivity and climate change mitigation (reduction of GHG emissions and C sequestration). Thus, the EU project CATCH-C aims to evaluate current management practices concerning these three goals based on indicators derived from long-term field experiments of the project partners and from literature data. A maximum of 72 indicators for productivity, soil quality and the potential for carbon storage in the soil and the reduction of greenhouse gas emissions were selected by the project partners. As indicators for productivity, crop yields are determined in almost all field trials. The content of soil organic carbon (SOC) is an indicator for chemical, physical and biological soil quality and was analysed in the topsoil in all field trials. Less data exist for SOC contents in the subsoil. An important physical soil quality indicator is the bulk density, however, it is not determined in all field trials of the project partners. Therefore, information on SOC stocks, with relevance to carbon storage and climate change mitigation, is not available in all field experiments. Other physical indicators, such as penetration resistance, runoff coefficient and soil losses are evaluated. Essential biological indicators are microbial biomass and the number and weight of earthworms, which have been tested in several field trials. The evaluation of all these indicators will help to select "best management practices" and to address trade-offs and synergies for all indicators under consideration of major European farm type zones. CATCH-C is funded within the 7th Framework Programme for Research, Technological Development and Demonstration, Theme 2 - Biotechnologies, Agriculture & Food. (Grant Agreement N° 289782).

Organic food quality: a framework for concept, definition and evaluation from the European perspective.

PubMed

Kahl, Johannes; Baars, Ton; Bügel, Susanne; Busscher, Nicolaas; Huber, Machteld; Kusche, Daniel; Rembiałkowska, Ewa; Schmid, Otto; Seidel, Kathrin; Taupier-Letage, Bruno; Velimirov, Alberta; Załecka, Aneta

2012-11-01

Consumers buy organic food because they believe in the high quality of the product. Furthermore, the EU legal regulatory framework for organic food and farming defines high quality of the products as an important goal of production. A major challenge is the need to define food quality concepts and methods for determination. A background is described which allows embedding of the quality definitions as well as evaluation methods into a conceptual framework connected to the vision and mission of organic agriculture and food production. Organic food quality is defined through specific aspects and criteria. For evaluation each criterion has to be described by indicators. The determination of indicators should be through parameters, where parameters are described by methods. Conversely, the conceptual framework is described according to underlying principles and starting definitions are given, but further work has do be done on the detailed scientific description of the indicators. Furthermore, parameters have to be defined for the evaluation of suitability of these indicators for organic food production. Copyright © 2012 Society of Chemical Industry.

Definition of Life Quality from a Patient versus Health Care Professional Perspective.

ERIC Educational Resources Information Center

Woodend, A. K.; And Others

1997-01-01

A survey of Canadian staff members (n=22), rehabilitation patients (N=27), pacemaker patients (n=31), and family members of the patients (N=34) asked what they considered important to the patients' quality of life. Results found marked differences between the groups in the physical, psychological, and activity domains, indicating that quality of…

[Access to prenatal care and quality of care in the Family Health Strategy: infrastructure, care, and management].

PubMed

Guimarães, Wilderi Sidney Gonçalves; Parente, Rosana Cristina Pereira; Guimarães, Thayanne Louzada Ferreira; Garnelo, Luiza

2018-05-10

This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care. In the distribution according to geopolitical regions, the findings pertaining to the units' infrastructure indicate a direct relationship between the infrastructure's adequacy and social contexts with higher municipal human development indices and income. For the clinical actions in patient care, the teams in all the regions scored low on adequacy, with slightly better results in the North and South regions of the country. There were important differences between the states of the North, and the states with higher mean income and human development scored higher on adequacy. The results indicate important organizational difficulties in both access and quality of care provided by the health teams, in addition to visible insufficiency in management activities aimed to improve access and quality of prenatal care.

Outcome quality standards in pancreatic oncologic surgery in Spain.

PubMed

Sabater, Luis; Mora, Isabel; Gámez Del Castillo, Juan Manuel; Escrig-Sos, Javier; Muñoz-Forner, Elena; Garcés-Albir, Marina; Dorcaratto, Dimitri; Ortega, Joaquín

2018-05-18

To establish quality standards in oncologic surgery is a complex but necessary challenge to improve surgical outcomes. Unlike other tumors, there are no well-defined quality standards in pancreatic cancer. The aim of this study is to identify quality indicators in pancreatic oncologic surgery in Spain as well as their acceptable limits of variability. Quality indicators were selected based on clinical practice guidelines, consensus conferences, reviews and national publications on oncologic pancreatic surgery between the years 2000 and 2016. Variability margins for each indicator have been determined by statistical process control techniques and graphically represented with the 99.8 and 95% confidence intervals above and below the weighted average according to sample size. The following indicators have been determined with their weighted average and acceptable quality limits: resectability rate 71% (>58%), morbidity 58% (<73%), mortality 4% (<10%), biliary leak 6% (<14%), pancreatic fistula rate 18% (<29%), hemorrhage 11% (<21%), reoperation rate 11% (<20%) and mean hospital stay (<21 days). To date, few related series have been published, and they present important methodological limitations. Among the selected indicators, the morbidity and mortality quality limits have come out higher than those obtained in international standards. It is necessary for Spanish pancreatic surgeons to adopt homogeneous criteria regarding indicators and their definitions to allow for the comparison of their results. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluation of water quality at the source of streams of the Sinos River Basin, southern Brazil.

PubMed

Benvenuti, T; Kieling-Rubio, M A; Klauck, C R; Rodrigues, M A S

2015-05-01

The Sinos River Basin (SRB) is located in the northeastern region of the state of Rio Grande do Sul (29º20' to 30º10'S and 50º15' to 51º20'W), southern Brazil, and covers two geomorphologic provinces: the southern plateau and the central depression. It is part of the Guaíba basin, has an area of approximately 800 km 2 and contains 32 counties. The basin provides drinking water for 1.6 million inhabitants in one of the most important industrial centres in Brazil. This study describes different water quality indices (WQI) used for the sub-basins of three important streams in the SRB: Pampa, Estância Velha/Portão and Schmidt streams. Physical, chemical and microbiological parameters assessed bimonthly using samples collected at each stream source were used to calculate the Horton Index (HI), the Dinius Index (DI) and the water quality index adopted by the US National Sanitation Foundation (NSF WQI) in the additive and multiplicative forms. These indices describe mean water quality levels at the streams sources. The results obtained for these 3 indexes showed a worrying scenario in which water quality has already been negatively affected at the sites where three important sub-basins in the Sinos River Basin begin to form.

The use of modern technologies in carbon dioxide monitoring

NASA Astrophysics Data System (ADS)

Komínek, Petr; Weyr, Jan; Hirš, Jiří

2017-12-01

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

Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

PubMed

Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

2016-01-01

To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice are completed, the indicator set can be used to guide meal and meal service quality improvement projects in collaboration with kitchen staff and health care professionals. These improvement projects will help to improve food intake and reduce the risk of malnutrition among elders living in residential facilities.

Evaluation of drinking quality of groundwater through multivariate techniques in urban area.

PubMed

Das, Madhumita; Kumar, A; Mohapatra, M; Muduli, S D

2010-07-01

Groundwater is a major source of drinking water in urban areas. Because of the growing threat of debasing water quality due to urbanization and development, monitoring water quality is a prerequisite to ensure its suitability for use in drinking. But analysis of a large number of properties and parameter to parameter basis evaluation of water quality is not feasible in a regular interval. Multivariate techniques could streamline the data without much loss of information to a reasonably manageable data set. In this study, using principal component analysis, 11 relevant properties of 58 water samples were grouped into three statistical factors. Discriminant analysis identified "pH influence" as the most distinguished factor and pH, Fe, and NO₃⁻ as the most discriminating variables and could be treated as water quality indicators. These were utilized to classify the sampling sites into homogeneous clusters that reflect location-wise importance of specific indicator/s for use to monitor drinking water quality in the whole study area.

The Role of Reliability, Vulnerability and Resilience in the Management of Water Quality Systems

NASA Astrophysics Data System (ADS)

Lence, B. J.; Maier, H. R.

2001-05-01

The risk based performance indicators reliability, vulnerability and resilience provide measures of the frequency, magnitude and duration of the failure of water resources systems, respectively. They have been applied primarily to water supply problems, including the assessment of the performance of reservoirs and water distribution systems. Applications to water quality case studies have been limited, although the need to consider the length and magnitude of violations of a particular water quality standard has been recognized for some time. In this research, the role of reliability, vulnerability and resilience in water quality management applications is investigated by examining their significance as performance measures for water quality systems and assessing their potential for assisting in decision making processes. The importance of each performance indicator is discussed and a framework for classifying such systems, based on the relative significance of each of these indicators, is introduced and illustrated qualitatively with various case studies. Quantitative examples drawn from both lake and river water quality modeling exercises are then provided.

Dynamic Assessment of Water Quality Based on a Variable Fuzzy Pattern Recognition Model

PubMed Central

Xu, Shiguo; Wang, Tianxiang; Hu, Suduan

2015-01-01

Water quality assessment is an important foundation of water resource protection and is affected by many indicators. The dynamic and fuzzy changes of water quality lead to problems for proper assessment. This paper explores a method which is in accordance with the water quality changes. The proposed method is based on the variable fuzzy pattern recognition (VFPR) model and combines the analytic hierarchy process (AHP) model with the entropy weight (EW) method. The proposed method was applied to dynamically assess the water quality of Biliuhe Reservoir (Dailan, China). The results show that the water quality level is between levels 2 and 3 and worse in August or September, caused by the increasing water temperature and rainfall. Weights and methods are compared and random errors of the values of indicators are analyzed. It is concluded that the proposed method has advantages of dynamism, fuzzification and stability by considering the interval influence of multiple indicators and using the average level characteristic values of four models as results. PMID:25689998

Dynamic assessment of water quality based on a variable fuzzy pattern recognition model.

PubMed

Xu, Shiguo; Wang, Tianxiang; Hu, Suduan

2015-02-16

Water quality assessment is an important foundation of water resource protection and is affected by many indicators. The dynamic and fuzzy changes of water quality lead to problems for proper assessment. This paper explores a method which is in accordance with the water quality changes. The proposed method is based on the variable fuzzy pattern recognition (VFPR) model and combines the analytic hierarchy process (AHP) model with the entropy weight (EW) method. The proposed method was applied to dynamically assess the water quality of Biliuhe Reservoir (Dailan, China). The results show that the water quality level is between levels 2 and 3 and worse in August or September, caused by the increasing water temperature and rainfall. Weights and methods are compared and random errors of the values of indicators are analyzed. It is concluded that the proposed method has advantages of dynamism, fuzzification and stability by considering the interval influence of multiple indicators and using the average level characteristic values of four models as results.

Sachet water quality and brand reputation in two low-income urban communities in greater Accra, Ghana.

PubMed

Stoler, Justin; Tutu, Raymond A; Ahmed, Hawa; Frimpong, Lady Asantewa; Bello, Mohammed

2014-02-01

Sachet water has become an important primary source of drinking water in western Africa, but little is known about bacteriologic quality and improvements to quality control given the recent, rapid evolution of this industry. This report examines basic bacteriologic indicators for 60 sachet water samples from two very low-income communities in Accra, Ghana, and explores the relationship between local perceptions of brand quality and bacteriologic quality after controlling for characteristics of the vending environment. No fecal contamination was detected in any sample, and 82% of total heterotrophic bacteria counts were below the recommended limit for packaged water. Sachets from brands with a positive reputation for quality were 90% less likely to present any level of total heterotrophic bacteria after controlling for confounding factors. These results contrast with much of the recent sachet water quality literature and may indicate substantial progress in sachet water regulation and quality control.

Sachet Water Quality and Brand Reputation in Two Low-Income Urban Communities in Greater Accra, Ghana

PubMed Central

Stoler, Justin; Tutu, Raymond A.; Ahmed, Hawa; Frimpong, Lady Asantewa; Bello, Mohammed

2014-01-01

Sachet water has become an important primary source of drinking water in western Africa, but little is known about bacteriologic quality and improvements to quality control given the recent, rapid evolution of this industry. This report examines basic bacteriologic indicators for 60 sachet water samples from two very low-income communities in Accra, Ghana, and explores the relationship between local perceptions of brand quality and bacteriologic quality after controlling for characteristics of the vending environment. No fecal contamination was detected in any sample, and 82% of total heterotrophic bacteria counts were below the recommended limit for packaged water. Sachets from brands with a positive reputation for quality were 90% less likely to present any level of total heterotrophic bacteria after controlling for confounding factors. These results contrast with much of the recent sachet water quality literature and may indicate substantial progress in sachet water regulation and quality control. PMID:24379244

Quality of Smartphone Apps Related to Alcohol Use Disorder.

PubMed

Penzenstadler, Louise; Chatton, Anne; Van Singer, Mathias; Khazaal, Yasser

2016-01-01

Apps for smartphones are opening an important range of opportunities for improving the care of people with alcohol use disorders (AUDs). This study aimed to evaluate the quality of English language apps for AUDs and to compare paid and free apps. The keywords 'alcohol', 'alcohol addiction', 'alcohol help' and 'stop drinking' were entered into the iTunes Store search engine. Apps were evaluated using a standardized assessment designed to rate the quality of apps in terms of accountability, interactivity, self-help score and evidence-based content. The Brief DISCERN score and the criteria of the 'Health on the Net' label were also used as content quality indicators. Of the 137 unique apps identified, 52 met the inclusion criteria. Overall, the content quality and self-help scores of these AUD apps were poor. The main quality indicators were not linked to payment status. Multiple linear regressions showed that the Brief DISCERN score significantly predicted content quality. Poor content quality and self-help scores of AUD smartphone apps underline the gap between their potential promises and the overall quality of available products in stores. The quality indicators used in the present study may be used for further app developments. © 2016 S. Karger AG, Basel.

Demographic and socioeconomic disparity in nutrition: application of a novel Correlated Component Regression approach

PubMed Central

Alkerwi, Ala'a; Vernier, Céderic; Sauvageot, Nicolas; Crichton, Georgina E; Elias, Merrill F

2015-01-01

Objectives This study aimed to examine the most important demographic and socioeconomic factors associated with diet quality, evaluated in terms of compliance with national dietary recommendations, selection of healthy and unhealthy food choices, energy density and food variety. We hypothesised that different demographic and socioeconomic factors may show disparate associations with diet quality. Study design A nationwide, cross-sectional, population-based study. Participants A total of 1352 apparently healthy and non-institutionalised subjects, aged 18–69 years, participated in the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study in 2007–2008. The participants attended the nearest study centre after a telephone appointment, and were interviewed by trained research staff. Outcome measures Diet quality as measured by 5 dietary indicators, namely, recommendation compliance index (RCI), recommended foods score (RFS), non-recommended foods score (non-RFS), energy density score (EDS), and dietary diversity score (DDS). The novel Correlated Component Regression (CCR) technique was used to determine the importance and magnitude of the association of each socioeconomic factor with diet quality, in a global analytic approach. Results Increasing age, being male and living below the poverty threshold were predominant factors associated with eating a high energy density diet. Education level was an important factor associated with healthy and adequate food choices, whereas economic resources were predominant factors associated with food diversity and energy density. Conclusions Multiple demographic and socioeconomic circumstances were associated with different diet quality indicators. Efforts to improve diet quality for high-risk groups need an important public health focus. PMID:25967988

Measuring, managing and maximizing performance of mineral processing plants

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

Bascur, O.A.; Kennedy, J.P.

1995-12-31

The implementation of continuous quality improvement is the confluence of Total Quality Management, People Empowerment, Performance Indicators and Information Engineering. The supporting information technologies allow a mineral processor to narrow the gap between management business objectives and the process control level. One of the most important contributors is the user friendliness and flexibility of the personal computer in a client/server environment. This synergistic combination when used for real time performance monitoring translates into production cost savings, improved communications and enhanced decision support. Other savings come from reduced time to collect data and perform tedious calculations, act quickly with fresh newmore » data, generate and validate data to be used by others. This paper presents an integrated view of plant management. The selection of the proper tools for continuous quality improvement are described. The process of selecting critical performance monitoring indices for improved plant performance are discussed. The importance of a well balanced technological improvement, personnel empowerment, total quality management and organizational assets are stressed.« less

How to Assess Quality of Research in Iran, From Input to Impact? Introduction of Peer-Based Research Evaluation Model in Iran.

PubMed

Ebadifar, Asghar; Baradaran Eftekhari, Monir; Owlia, Parviz; Habibi, Elham; Ghalenoee, Elham; Bagheri, Mohammad Reza; Falahat, Katayoun; Eltemasi, Masoumeh; Sobhani, Zahra; Akhondzadeh, Shahin

2017-11-01

Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing. This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact. The top 10% medical sciences research centers (RCs) were evaluated based on peer review. Adequate equipment and laboratory instruments, high quality research publication and national or international cooperation were the main strengths in medical sciences RCs and the most important weaknesses included failure to adhere to strategic plans, parallel actions in similar fields, problems in manpower recruitment, knowledge translation & exchange (KTE) in service providers and policy makers' levels. Peer review evaluation can improve the quality of research.

Multi-trait analysis of post-harvest storage in rocket salad (Diplotaxis tenuifolia) links sensorial, volatile and nutritional data.

PubMed

Spadafora, Natasha D; Amaro, Ana L; Pereira, Maria J; Müller, Carsten T; Pintado, Manuela; Rogers, Hilary J

2016-11-15

Rocket salad (Diplotaxis tenuifolia; wild rocket) is an important component of ready to eat salads providing a distinct peppery flavour and containing nutritionally relevant compounds. Quality deteriorates during post-harvest, in relation to time and storage temperature amongst other factors. Volatile organic compounds (VOCs) are easily measurable from rocket leaves and may provide useful quality indicators for e.g. changes in isothiocyanates derived from nutritionally important glucosinolates. VOC profiles discriminated storage temperatures (0, 5 and 10°C) and times (over 14days). More specifically, concentrations of aldehydes and isothiocyanates decreased with time paralleling a fall in vitamin C and a reduction in sensorial quality at the two higher temperatures. Sulphur containing compounds rise at later time-points and at higher temperatures coincident with an increase in microbial titre, mirroring a further drop in sensorial quality thus indicating their contribution to off-odours. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Geospatial Water Quality Analysis of Dilla Town, Gadeo Zone, Ethiopia - A Case Study

NASA Astrophysics Data System (ADS)

Pakhale, G. K.; Wakeyo, T. B.

2015-12-01

Dilla is a socio-economically important town in Ethiopia, established on the international highway joining capital cities of Ethiopia and Kenya. It serves as an administrative center of the Gedeo Zone in SNNPR region of Ethiopia accommodating around 65000 inhabitants and also as an important trade centre for coffee. Due to the recent developments and urbanization in town and surrounding area, waste and sewage discharge has been raised significantly into the water resources. Also frequent rainfall in the region worsens the problem of water quality. In this view, present study aims to analyze water quality profile of Dilla town using 12 physico-chemical parameters. 15 Sampling stations are identified amongst the open wells, bore wells and from surface water, which are being extensively used for drinking and other domestic purposes. Spectrophotometer is used to analyze data and Gaussian process regression is used to interpolate the same in GIS environment to represent spatial distribution of parameters. Based on observed and desirable values of parameters, water quality index (WQI); an indicator of weighted estimate of the quantities of various parameters ranging from 1 to 100, is developed in GIS. Higher value of WQI indicates better while low value indicates poor water quality. This geospatial analysis is carried out before and after rainfall to understand temporal variation with reference to rainfall which facilitates in identifying the potential zones of drinking water. WQI indicated that 8 out of 15 locations come under acceptable category indicating the suitability of water for human use, however remaining locations are unfit. For example: the water sample at main_campus_ustream_1 (site name) site has very low WQI after rainfall, making it unfit for human usage. This suggests undertaking of certain measures in town to enhance the water quality. These results are useful for town authorities to take corrective measures and ameliorate the water quality for human use.

Indicators: Dissolved Oxygen

EPA Pesticide Factsheets

Dissolved oxygen (DO) is the amount of oxygen that is present in water. It is an important measure of water quality as it indicates a water body's ability to support aquatic life. Water bodies receive oxygen from the atmosphere and from aquatic plants.

The use of citation indicators to identify and support high-quality research in Poland.

PubMed

Pilc, Andrzej

2008-01-01

In large, mostly English-speaking countries, where the "critical mass" of scientists working in different subfields of science is achieved, the peer review system may be sufficient to assess the quality of scientific research. However, in smaller countries, outside the Anglo-American circle, it is important to introduce different systems to identify research of high quality. In Poland, a parametric system for assessing the quality of research has been introduced. It was largely based on the impact factor of scientific journals. While the use of this indicator to assess research quality is highly questionable, the implementation of the system in the Polish reality is even worse. Therefore it is important to change and improve the system currently used by the Ministry of Science and Higher Education to both evaluate and, more importantly, finance science in Poland. Here, a system based on three factors, i.e. the impact factor, the institutional h-index, and the institutional number of citations, is proposed. The scientific quality of institutions in Division VI: Medical Sciences of the Polish Academy of Sciences were evaluated and the results were compared with the existing system. Moreover, a method to identify high-quality researchers and institutions at the national level based on the quantity of highly cited papers is shown. Additionally, an attempt to identify the highest quality Polish research on an international level is proposed. This is based on the number of individual citations, the individual h-index, the number of publications, and the priority of the discovery.

The Effects of Lecturer Commitment on Student Perceptions of Teaching Quality and Student Satisfaction in Chinese Higher Education

ERIC Educational Resources Information Center

Xiao, Jian; Wilkins, Stephen

2015-01-01

Student satisfaction has become an important concept in higher education because students are paying higher tuition fees and increasingly seeing themselves as customers and because satisfaction is commonly used as an indicator of quality by quality assurance agencies and the compilers of rankings and league tables. In business organisations, it…

Feeling Heard & Understood in the Hospital Environment: Benchmarking Communication Quality Among Patients with Advanced Cancer Before and After Palliative Care Consultation.

PubMed

Ingersoll, Luke T; Saeed, Fahad; Ladwig, Susan; Norton, Sally A; Anderson, Wendy; Alexander, Stewart C; Gramling, Robert

2018-05-02

Maximizing value in palliative care requires continued development and standardization of communication quality indicators. To describe the basic epidemiology of a newly-adopted patient-centered communication quality indicator for hospitalized palliative care patie9nts with advanced cancer. Cross-sectional analysis of 207 advanced cancer patients who received palliative care consultation at two medical centers in the United States. Participants completed the Heard & Understood quality indicator immediately before and the day following the initial palliative care consultation: "Over the past two days ["24 hours" for the post-consultation version], how much have you felt heard and understood by the doctors, nurses and hospital staff? Completely/Quite a Bit/Moderately/Slightly/Not at All". We categorized "Completely" as indicating ideal quality. Approximately one-third indicated ideal Heard & Understood quality before palliative care consultation. Age, financial security, emotional distress, preferences for comfort-longevity tradeoffs at end-of-life, and prognosis expectations were associated with pre-consultation quality. Among those with less-than-ideal quality at baseline, 56% rated feeling more Heard & Understood the day following palliative care consultation. The greatest pre-post improvement was among people who had unformed end-of-life treatment preferences or who reported having "no idea" about their prognosis at baseline. Most patients felt incompletely heard and understood at the time of referral to palliative care consultation and more than half improved following consultation. Feeling heard and understood is an important quality indicator sensitive to interventions to improve care and key variations in the patient experience. Copyright © 2018. Published by Elsevier Inc.

Does Satisfaction Reflect the Technical Quality of Mental Health Care?

PubMed Central

Edlund, Mark J; Young, Alexander S; Kung, Fuan Yue; Sherbourne, Cathy D; Wells, Kenneth B

2003-01-01

Objective To analyze the relationship between satisfaction and technical quality of care for common mental disorders. Data Source A nationally representative telephone survey of 9,585 individuals conducted in 1997–1998. Study Design Using multinomial logistic regression techniques we investigated the association between a five-level measure of satisfaction with the mental health care available for personal or emotional problems and two quality indicators. The first measure, appropriate technical quality, was defined as use of either appropriate counseling or psychotropic medications during the prior year for a probable depressive or anxiety disorder. The second, active treatment, indicated whether the respondent had received treatment for a psychiatric disorder in the past year. Covariates included measures of physical and mental health and sociodemographic indicators. Principal Findings Appropriate technical quality of care was significantly associated with higher levels of satisfaction. The strength of the association was moderate. Conclusions Satisfaction is associated with technical quality of care. However, profiling quality of care with satisfaction will likely require large samples and case-mix adjustment, which may be more difficult for plans or provider groups to implement than measuring technical indicators. More importantly, satisfaction is not the same as technical quality, and our results suggest that at this time they cannot be made to approach each other closely enough to eliminate either. PMID:12785565

Identifying Markers of Dignity-Conserving Care in Long-Term Care: A Modified Delphi Study

PubMed Central

Thompson, Genevieve N.; McArthur, Jennifer; Doupe, Malcolm

2016-01-01

Ensuring that people living in nursing homes (NHs) are afforded with dignity in their daily lives is an essential and humane concern. Promoting dignity-conserving care is fundamentally important. By nature, however, this care is all-encompassing and holistic, and from current knowledge it is challenging to create explicit strategies for measuring dignity-conserving care. In practice the majority of current NH indicators of quality care are derived from information that is routinely collected on NH residents using the RAI-Minimum Data Set (MDS). In this regard, issues that are more tangible to resident dignity such as being treated with respect, compassion, and having opportunities to engage with others are not adequately captured in current NH quality of care indicators. An initial set of markers was created by conducting an integrative literature review of existing markers and indicators of dignity in the NH setting. A modified Delphi process was used to prioritize essential dignity-conserving care markers for use by NH providers, based on factors such as the importance to fostering a culture of dignity, the impact it may have on the residents, and how achievable it is in practice. Through this consensus building technique, we were able to develop a comprehensive set of markers that capture the range and diversity of important dignity-conserving care strategies for use in NHs. The final 10 markers were judged as having high face validity by experts in the field and have explicit implications for enhancing the provision of daily dignified care to NH residents. These markers make an important addition to the traditional quality indicators used in the NH setting and as such, bridge an important gap in addressing the psychosocial and the less easily quantified needs of NH residents. PMID:27304853

Quality of life before and 6 weeks after treatment in a dermatological outpatient treatment unit.

PubMed

Maroti, M; Ulff, E; Wijma, B

2006-10-01

Dermatological disease affects quality of life to a great extent. Treatments are time-consuming and many patients have problems adhering to treatment. Attending an outpatient unit regularly during an intensive treatment period may enable patients to cope with their illness, adhere to treatment and thus improve their quality of life. To study the effect on quality of life of 6 weeks of regular treatment in the outpatient unit in the County Hospital of Jönköping, by means of a questionnaire and interviews. The Dermatology Life Quality Index (DLQI) was distributed to 50 consecutive patients with psoriasis, atopic dermatitis or pruritus attending our outpatient treatment unit. Nine of the patients were interviewed during treatment about factors that might influence their quality of life. The DLQI scores before treatment indicated a low quality of life. Women were more affected than men. After 6 weeks of treatment there was a clear improvement, with a 57% reduction in the scores. The answers from the interviews indicated important areas of concern such as withdrawal from public places, adoption of special clothing habits and concern about personal relationships. Dermatological diseases have an important influence on patients' quality of life. Attending an outpatient treatment unit was in this series of cases associated with improved quality of life as measured with the DLQI.

Influencing Database Use in Public Libraries.

ERIC Educational Resources Information Center

Tenopir, Carol

1999-01-01

Discusses results of a survey of factors influencing database use in public libraries. Highlights the importance of content; ease of use; and importance of instruction. Tabulates importance indications for number and location of workstations, library hours, availability of remote login, usefulness and quality of content, lack of other databases,…

Effect of phytoplankton on Escherichia coli survival in laboratory microcosms

USDA-ARS?s Scientific Manuscript database

Fecal contamination of water sources is an important water quality issue for agricultural irrigation ponds. Escherichia coli is a common microbial indicator used to evaluate recreational and irrigation water quality. Nuisance algae commonly grow in low- or no-flow irrigation water source The objecti...

Characterizing light attenuation within Northwest Florida Estuaries: Implications for RESTORE Act water quality monitoring

EPA Science Inventory

Water Quality (WQ) condition is based on ecosystem stressor indicators (e.g. water clarity) which are biogeochemically important and critical when considering the Deepwater Horizon oil spill restoration efforts under the 2012 RESTORE Act. Nearly all of the proposed RESTORE proj...

USING COMPUTER MODELS TO DETERMINE THE EFFECT OF STORAGE ON WATER QUALITY

EPA Science Inventory

Studies have indicated that water quality is degraded as a result of long residence times in storage tanks, highlighting the importance of tank design, location, and operation. Computer models, developed to explain some of the mixing and distrribution issues associated with tank...

Predicting microbial water quality with models: over-arching questions for managing risk in agricultural catchments

USDA-ARS?s Scientific Manuscript database

Determining the microbial quality of recreational, irrigation and shellfish-harvesting waters is important to ensure compliance with health-related standards and associated legislation. Animal faeces represent a significant human health risk, and concentrations of fecal indicator organisms (FIOs) pr...

Aspects of Girls' Friendships: Practice Implications for Internalizing Problems

ERIC Educational Resources Information Center

Ralph, Leslie E. R.; Epkins, Catherine C.

2015-01-01

Background: Children's friendship quality is a particularly important risk or protective factor for internalizing problems and loneliness. Past research indicates that relationship satisfaction is related to perceived similarity; however, it is unclear whether this relation is seen in girls' friendship quality and whether this relation is…

Analysis of architect’s performance indicators in project delivery process

NASA Astrophysics Data System (ADS)

Marisa, A.

2018-03-01

Architect as a professional in the construction industry should possess a good performance in project delivery process. As a design professional, architect has an important role to ensure that the process is well-conducted by delivering a high-quality product for the clients. Thus, analyzing architect’s performance indicators is crucial in the project delivery process. This study aims to analyze the relative importance of architect performance indicators in project delivery process among registered architects in North Sumatera, Indonesia. A total of five indicators that measure architect performance in project delivery process were identified and 110 completed questionnaires were obtained and used for data analysis. A relative importance index is used to rank the relative importance of architect performance indicators. Results indicate that focus on the clients is the most important indicator of architect performance in project delivery process. This study demonstrates project communication as one of crucial indicators perceived by the architects for measuring their performance, and fills a knowledge gap on the importance of identifying the most important indicator for measuring architect performance from their own perspectives which previous studies have overlooked to improve performance assessment in project delivery process.

Methodology for developing quality indicators for the care of older people in the Emergency Department

PubMed Central

2013-01-01

Background Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important groups of older people, such as patients with cognitive impairment, residents of long term care and patients with palliative care needs. This project will develop a suite of quality indicators focused on the care of older persons in the emergency department. Methods/design Following input from an expert panel, an initial set of structural, process, and outcome indicators will be developed based on thorough systematic search in the scientific literature. All initial indicators will be tested in eight emergency departments for their validity and feasibility. Results of the data from the field studies will be presented to the expert panel at a second meeting. A suite of Quality Indicators for the older emergency department population will be finalised following a formal voting process. Discussion The predicted burgeoning in the number of older persons presenting to emergency departments combined with the recognised quality deficiencies in emergency department care delivery to this population, highlight the need for a quality framework for the care of older persons in emergency departments. Additionally, high quality of care is associated with improved survival & health outcomes of elderly patients. The development of well-selected, validated and economical quality indicators will allow appropriate targeting of resources (financial, education or quality management) to improve quality in areas with maximum potential for improvement. PMID:24314126

HOW FAR TO THE NEAREST ROAD?

EPA Science Inventory

Increases in impervious surface area lead to declines in chemical and biological indicators of water quality .Roads are an important aspect of impervious surface, and distance to roads is an indicator of the potential threat to aquatic and terrestrial ecosystems. Although roads a...

Influences of water quality and climate on the water-energy nexus: A spatial comparison of two water systems.

PubMed

Stang, Shannon; Wang, Haiying; Gardner, Kevin H; Mo, Weiwei

2018-07-15

As drinking water supply systems plan for sustainable management practices, impacts from future water quality and climate changes are a major concern. This study aims to understand the intraannual changes of energy consumption for water treatment, investigate the relative importance of water quality and climate indicators on energy consumption for water treatment, and predict the effects of climate change on the embodied energy of treated, potable water at two municipal drinking water systems located in the northeast and southeast US. To achieve this goal, a life cycle assessment was first performed to quantify the monthly energy consumption in the two drinking water systems. Regression and relative importance analyses were then performed between climate indicators, raw water quality indicators, and chemical and energy usages in the treatment processes to determine their correlations. These relationships were then used to project changes in embodied energy associated with the plants' processes, and the results were compared between the two regions. The projections of the southeastern US water plant were for an increase in energy demand resulted from an increase of treatment chemical usages. The northeastern US plant was projected to decrease its energy demand due to a reduced demand for heating the plant's infrastructure. The findings indicate that geographic location and treatment process may determine the way climate change affects drinking water systems. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

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

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

Effects of Streambank Fencing of Near-Stream Pasture Land on a Small Watershed in Lancaster County, Pennsylvania

USGS Publications Warehouse

Galeone, Daniel G.; Low, Dennis J.; Brightbill, Robin A.

2006-01-01

This study indicated that a small buffer width along a stream in pasture land can have a positive influence on surface-water quality, benthic macroinvertebrates, and near-stream shallow ground-water quality. Overland runoff processes that move suspended sediment to the stream were controlled (or reduced) to some extent by the vegetative buffer established. Results indicated streambank fencing resulted in decreases in N-species, total-P, and suspended-sediment concentrations and yields at the outlet of the treatment basin relative to untreated sites; however, dissolved-P concentrations and yields increased. These results indicate that nutrient management, in conjunction with streambank fencing, is important in helping to control nutrient loadings to streams in this agricultural setting. An upstream site (T-2) in the treatment basin showed post-treatment reductions in suspended-sediment yields and increases in N and P yields. The different results for these treated sites indicates the effects of streambank fencing should be studied at as large a scale as possible because field-scale influences on water quality as drainage area decreases can mute the effects of fencing. Benthic-macroinvertebrate data indicated streambank fencing had a positive influence on benthic macroinvertebrates and their habitat. More improvement was detected at the outlet of the treatment basin than the upstream sites. Probably the most important biological metric, taxa richness, indicated a greater number of benthic-macroinvertebrate taxa at treated relative to control sites after fencing. Results indicated fencing improved shallow ground-water quality (for the well nest in a stream-gaining area), as noted by decreased concentrations of N species and fecal-streptococcus counts. This improvement only occurred at the well nest where the stream was gaining water from the shallow ground-water system.

Direct detection of male quality can facilitate the evolution of female choosiness and indicators of good genes: Evolution across a continuum of indicator mechanisms.

PubMed

Dhole, Sumit; Stern, Caitlin A; Servedio, Maria R

2018-04-01

The evolution of mating displays as indicators of male quality has been the subject of extensive theoretical and empirical research for over four decades. Research has also addressed the evolution of female mate choice favoring such indicators. Yet, much debate still exists about whether displays can evolve through the indirect benefits of female mate choice. Here, we use a population genetic model to investigate how the extent to which females can directly detect male quality influences the evolution of female choosiness and male displays. We use a continuum framework that incorporates indicator mechanisms that are traditionally modeled separately. Counter to intuition, we find that intermediate levels of direct detection of male quality can facilitate, rather than impede, the evolution of female choosiness and male displays in broad regions of this continuum. We examine how this evolution is driven by selective forces on genetic quality and on the display, and find that direct detection of male quality results in stronger indirect selection favoring female choosiness. Our results imply that displays maybe more likely to evolve when female choosiness has already evolved to discriminate perceptible forms of male quality. They also highlight the importance of considering general female choosiness, as well as preference, in studies of "good genes." © 2018 The Author(s). Evolution © 2018 The Society for the Study of Evolution.

A MARINE RECREATIONAL WATER QUALITY CRITERION CONSISTENT WITH INDICATOR CONCEPTS AND RISK ANALYSIS

EPA Science Inventory

An overivew is provided of water quality criteria developed for marine recreational waters by EPA in 1979. The crierion used is the strength of the association with the rates of the important symptoms, such as those that correlate best with swimming in wastewater-polluted waters....

Temporal stability of Escherichia coli concentration patterns in two irrigation ponds in Maryland

USDA-ARS?s Scientific Manuscript database

Fecal contamination of water sources is an important water quality issue for agricultural irrigation ponds. Escherichia coli is a common microbial indicator used to evaluate recreational and irrigation water quality. We hypothesized that there is a temporally stable pattern of E.coli concentrations ...

[Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

PubMed

Ishibashi, Midori

2015-01-01

The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

National quality indicators and policies from 15 countries leading in adult end-of-life care: a systematic environmental scan.

PubMed

Virdun, Claudia; Luckett, Tim; Lorenz, Karl A; Phillips, Jane

2018-06-01

The importance of measuring the quality of end-of-life care provision is undisputed, but determining how best to achieve this is yet to be confirmed. This study sought to identify and describe national end-of-life care quality indicators and supporting policies used by countries leading in their end-of-life care provision. A systematic environmental scan that included a web search to identify relevant national policies and indicators; hand searching for additional materials; information from experts listed for the top 10 (n=15) countries ranked in the 'quality of care' category of the 2015 Quality of Death Index study; and snowballing from Index experts. Ten countries (66%) have national policy support for end-of-life care measurement, five have national indicator sets, with two indicator sets suitable for all service providers. No countries mandate indicator use, and there is limited evidence of consumer engagement in development of indicators. Two thirds of the 128 identified indicators are outcomes measures (62%), and 38% are process measures. Most indicators pertain to symptom management (38%), social care (32%) or care delivery (27%). Measurement of end-of-life care quality varies globally and rarely covers all care domains or service providers. There is a need to reduce duplication of indicator development, involve consumers, consider all care providers and ensure measurable and relevant indicators to improve end-of-life care experiences for patients and families. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Classification management plan of groundwater quality in Taiwan

NASA Astrophysics Data System (ADS)

Chen, Chun Ming; Chen, Yu Ying; Pan, Shih Cheng; Li, Hui Jun; Hsiao, Fang Ke

2017-04-01

Taiwan Environmental Protection Administration has been monitoring regional water quality for 14 years. Since the beginning of 2002 till now, there are 453 regional groundwater monitoring wells in ten groundwater subregions in Taiwan, and the monitoring of groundwater quality has been carried out for a long time. Currently, water quality monitoring project has reached 50 items, while the number of water quality monitoring data has reached more than 20,000. In order to use the monitoring data efficiently, this study constructed the localized groundwater quality indicators of Taiwan. This indicator takes into account the different users' point of view, incorporating the Taiwan groundwater pollution monitoring standards (Category II), irrigation water quality standard and drinking water source water quality standard. 50 items of water quality monitoring projects were simplified and classified. The groundwater quality parameters were divided into five items, such as potability for drinking water, salting, external influence, health influences and toxicity hazard. The weight of the five items of groundwater was calculated comprehensively, and the groundwater quality of each monitoring well was evaluated with three grades of good, ordinary, and poor. According to the monitoring results of the groundwater monitoring wells in October to December of 2016, about 70% of groundwater quality in Taiwan is in good to ordinary grades. The areas with poor groundwater quality were mostly distributed in coastal, agriculture and part of the urban areas. The conductivity or ammonia nitrogen concentration was higher in those regions, showing that groundwater may be salinized or affected by external influences. Groundwater quality indicators can clearly show the current comprehensive situation of the groundwater environment in Taiwan and can be used as a tool for groundwater quality classification management. The indicators can coordinate with the Taiwan land planning policy in the future, and will be able to effectively grasp the changes of the national sub-regional environmental resources, which can serve as one of the important references in national land zoning according to environmental resources. Keywords: Groundwater Quality Indicators, Groundwater Quality Classification management

Quality indicators for initial licensure and discipline in nursing laws in South Korea and North Carolina.

PubMed

Kim, K K; Kjervik, D K; Foster, B

2014-03-01

The Korean regulatory framework of nursing licensure reflects that of the USA, but its content differs in some of the powers related to quality assurance. This article compares regulatory quality indicators and describes core standards in nursing regulations that are related to both initial licensure and discipline for three groups: the National Council of State Boards of Nursing, the North Carolina and the South of Korea. A descriptive, comparative law design is used to examine the differences and similarities in the quality indicators and core standards found in three documents: the National Council of State Boards of Nursing Model Act, the North Carolina Nursing Practice Act and the Korean Medical Service Act for registered nurses. The findings indicate that ten quality indicators and two standards appear in study objects. Although most of the quality indicators are common to all documents, some differences are found in terms of the scope of criminal background checks and the range of grounds for disciplinary action. These findings cannot be generalized in the USA because although the North Carolina nursing act was selected as an example of US nursing laws, nursing laws differ somewhat across states. This comparative study shows a clear opportunity to develop indicators that acknowledge the important areas of competence and good moral character and how they can improve patient safety in Korea. This study provides recommendations for Korean nursing legislative redesign and pointers for other jurisdictions to consider. © 2013 International Council of Nurses.

Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study.

PubMed

Morar, Pritesh S; Hollingshead, James; Bemelman, Willem; Sevdalis, Nick; Pinkney, Thomas; Wilson, Graeme; Dunlop, Malcolm; Davies, R Justin; Guy, Richard; Fearnhead, Nicola; Brown, Steven; Warusavitarne, Janindra; Edwards, Cathryn; Faiz, Omar

2017-10-27

Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was ≤ 1, and items with a median score > 3 were considered for inclusion. A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery. This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Target for improvement: a cluster randomised trial of public involvement in quality-indicator prioritisation (intervention development and study protocol)

PubMed Central

2011-01-01

Background Public priorities for improvement often differ from those of clinicians and managers. Public involvement has been proposed as a way to bridge the gap between professional and public clinical care priorities but has not been studied in the context of quality-indicator choice. Our objective is to assess the feasibility and impact of public involvement on quality-indicator choice and agreement with public priorities. Methods We will conduct a cluster randomised controlled trial comparing quality-indicator prioritisation with and without public involvement. In preparation for the trial, we developed a 'menu' of quality indicators, based on a systematic review of existing validated indicator sets. Participants (public representatives, clinicians, and managers) will be recruited from six participating sites. In intervention sites, public representatives will be involved through direct participation (public representatives, clinicians, and managers will deliberate together to agree on quality-indicator choice and use) and consultation (individual public recommendations for improvement will be collected and presented to decision makers). In control sites, only clinicians and managers will take part in the prioritisation process. Data on quality-indicator choice and intended use will be collected. Our primary outcome will compare quality-indicator choice and agreement with public priorities between intervention and control groups. A process evaluation based on direct observation, videorecording, and participants' assessment will be conducted to help explain the study's results. The marginal cost of public involvement will also be assessed. Discussion We identified 801 quality indicators that met our inclusion criteria. An expert panel agreed on a final set of 37 items containing validated quality indicators relevant for chronic disease prevention and management in primary care. We pilot tested our public-involvement intervention with 27 participants (11 public representatives and 16 clinicians and managers) and our study instruments with an additional 21 participants, which demonstrated the feasibility of the intervention and generated important insights and adaptations to engage public representatives more effectively. To our knowledge, this study is the first trial of public involvement in quality-indicator prioritisation, and its results could foster more effective upstream engagement of patients and the public in clinical practice improvement. Trial registration NTR2496 (Netherlands National Trial Register, http://www.trialregister.nl). PMID:21554691

Impact of urban sprawl on water quality in eastern Massachusetts, USA.

PubMed

Tu, Jun; Xia, Zong-Guo; Clarke, Keith C; Frei, Allan

2007-08-01

A study of water quality, land use, and population variations over the past three decades was conducted in eastern Massachusetts to examine the impact of urban sprawl on water quality using geographic information system and statistical analyses. Since 1970, eastern Massachusetts has experienced pronounced urban sprawl, which has a substantial impact on water quality. High spatial correlations are found between water quality indicators (especially specific conductance, dissolved ions, including Ca, Mg, Na, and Cl, and dissolved solid) and urban sprawl indicators. Urbanized watersheds with high population density, high percentage of developed land use, and low per capita developed land use tended to have high concentrations of water pollutants. The impact of urban sprawl also shows clear spatial difference between suburban areas and central cities: The central cities experienced lower increases over time in specific conductance concentration, compared to suburban and rural areas. The impact of urban sprawl on water quality is attributed to the combined effects of population and land-use change. Per capita developed land use is a very important indicator for studying the impact of urban sprawl and improving land use and watershed management, because inclusion of this indicator can better explain the temporal and spatial variations of more water quality parameters than using individual land use or/and population density.

The effects of RN staffing hours on nursing home quality: a two-stage model.

PubMed

Lee, Hyang Yuol; Blegen, Mary A; Harrington, Charlene

2014-03-01

Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss). We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States - Colorado. Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences. Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators. The study finding shows the importance of understanding the role of 'nurse staffing' under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sound quality indicators for urban places in Paris cross-validated by Milan data.

PubMed

Ricciardi, Paola; Delaitre, Pauline; Lavandier, Catherine; Torchia, Francesca; Aumond, Pierre

2015-10-01

A specific smartphone application was developed to collect perceptive and acoustic data in Paris. About 3400 questionnaires were analyzed, regarding the global sound environment characterization, the perceived loudness of some emergent sources and the presence time ratio of sources that do not emerge from the background. Sound pressure level was recorded each second from the mobile phone's microphone during a 10-min period. The aim of this study is to propose indicators of urban sound quality based on linear regressions with perceptive variables. A cross validation of the quality models extracted from Paris data was carried out by conducting the same survey in Milan. The proposed sound quality general model is correlated with the real perceived sound quality (72%). Another model without visual amenity and familiarity is 58% correlated with perceived sound quality. In order to improve the sound quality indicator, a site classification was performed by Kohonen's Artificial Neural Network algorithm, and seven specific class models were developed. These specific models attribute more importance on source events and are slightly closer to the individual data than the global model. In general, the Parisian models underestimate the sound quality of Milan environments assessed by Italian people.

Monitoring grass nutrients and biomass as indicators of rangeland quality and quantity using random forest modelling and WorldView-2 data

NASA Astrophysics Data System (ADS)

Ramoelo, Abel; Cho, M. A.; Mathieu, R.; Madonsela, S.; van de Kerchove, R.; Kaszta, Z.; Wolff, E.

2015-12-01

Land use and climate change could have huge impacts on food security and the health of various ecosystems. Leaf nitrogen (N) and above-ground biomass are some of the key factors limiting agricultural production and ecosystem functioning. Leaf N and biomass can be used as indicators of rangeland quality and quantity. Conventional methods for assessing these vegetation parameters at landscape scale level are time consuming and tedious. Remote sensing provides a bird-eye view of the landscape, which creates an opportunity to assess these vegetation parameters over wider rangeland areas. Estimation of leaf N has been successful during peak productivity or high biomass and limited studies estimated leaf N in dry season. The estimation of above-ground biomass has been hindered by the signal saturation problems using conventional vegetation indices. The objective of this study is to monitor leaf N and above-ground biomass as an indicator of rangeland quality and quantity using WorldView-2 satellite images and random forest technique in the north-eastern part of South Africa. Series of field work to collect samples for leaf N and biomass were undertaken in March 2013, April or May 2012 (end of wet season) and July 2012 (dry season). Several conventional and red edge based vegetation indices were computed. Overall results indicate that random forest and vegetation indices explained over 89% of leaf N concentrations for grass and trees, and less than 89% for all the years of assessment. The red edge based vegetation indices were among the important variables for predicting leaf N. For the biomass, random forest model explained over 84% of biomass variation in all years, and visible bands including red edge based vegetation indices were found to be important. The study demonstrated that leaf N could be monitored using high spatial resolution with the red edge band capability, and is important for rangeland assessment and monitoring.

Expert study to select indicators of the occurrence of emerging mycotoxin hazards.

PubMed

Kandhai, M C; Booij, C J H; Van der Fels-Klerx, H J

2011-01-01

This article describes a Delphi-based expert judgment study aimed at the selection of indicators to identify the occurrence of emerging mycotoxin hazards related to Fusarium spp. in wheat supply chains. A panel of 29 experts from 12 European countries followed a holistic approach to evaluate the most important indicators for different chain stages (growth, transport and storage, and processing) and their relative importance. After three e-mailing rounds, the experts reached consensus on the most important indicators for each of the three stages: wheat growth, transport and storage, and processing. For wheat growth, these indicators include: relative humidity/rainfall, crop rotation, temperature, tillage practice, water activity of the kernels, and crop variety/cultivar. For the transport and storage stage, they include water activity in the kernels, relative humidity, ventilation, temperature, storage capacity, and logistics. For wheat processing, indicators include quality data, fraction of the cereal used, water activity in the kernels, quality management and traceability systems, and carryover of contamination. The indicators selected in this study can be used in an identification system for the occurrence of emerging mycotoxin hazards in wheat supply chains. Such a system can be used by risk managers within governmental (related) organizations and/or the food and feed industry in order to react proactively to the occurrence of these emerging mycotoxins. © 2010 Society for Risk Analysis.

Screening for important unwarranted variation in clinical practice: a triple-test of processes of care, costs and patient outcomes.

PubMed

Partington, Andrew; Chew, Derek P; Ben-Tovim, David; Horsfall, Matthew; Hakendorf, Paul; Karnon, Jonathan

2017-03-01

Objective Unwarranted variation in clinical practice is a target for quality improvement in health care, but there is no consensus on how to identify such variation or to assess the potential value of initiatives to improve quality in these areas. This study illustrates the use of a triple test, namely the comparative analysis of processes of care, costs and outcomes, to identify and assess the burden of unwarranted variation in clinical practice. Methods Routinely collected hospital and mortality data were linked for patients presenting with symptoms suggestive of acute coronary syndromes at the emergency departments of four public hospitals in South Australia. Multiple regression models analysed variation in re-admissions and mortality at 30 days and 12 months, patient costs and multiple process indicators. Results After casemix adjustment, an outlier hospital with statistically significantly poorer outcomes and higher costs was identified. Key process indicators included admission patterns, use of invasive diagnostic procedures and length of stay. Performance varied according to patients' presenting characteristics and time of presentation. Conclusions The joint analysis of processes, outcomes and costs as alternative measures of performance inform the importance of reducing variation in clinical practice, as well as identifying specific targets for quality improvement along clinical pathways. Such analyses could be undertaken across a wide range of clinical areas to inform the potential value and prioritisation of quality improvement initiatives. What is known about the topic? Variation in clinical practice is a long-standing issue that has been analysed from many different perspectives. It is neither possible nor desirable to address all forms of variation in clinical practice: the focus should be on identifying important unwarranted variation to inform actions to reduce variation and improve quality. What does this paper add? This paper proposes the comparative analysis of processes of care, costs and outcomes for patients with similar diagnoses presenting at alternative hospitals, using linked, routinely collected data. This triple test of performance indicators extracts maximum value from routine data to identify priority areas for quality improvement to reduce important and unwarranted variations in clinical practice. What are the implications for practitioners? The proposed analyses need to be applied to other clinical areas to demonstrate the general application of the methods. The outputs can then be validated through the application of quality improvement initiatives in clinical areas with identified important and unwarranted variation. Validated frameworks for the comparative analysis of clinical practice provide an efficient approach to valuing and prioritising actions to improve health service quality.

Relationship of cooked rice nutritionally-important starch fractions with other physicochemical properties.

USDA-ARS?s Scientific Manuscript database

Sixteen rice cultivars representing 5 cytosine-thymine repeat (CTn) microsatellite genetic marker groups were analyzed for their cooked rice nutritionally-important starch fractions (rapidly digestible, slowly digestible, and resistant starch), basic grain quality indices (apparent amylose, crude pr...

Improving HIV outcomes in resource-limited countries: the importance of quality indicators.

PubMed

Ahonkhai, Aima A; Bassett, Ingrid V; Ferris, Timothy G; Freedberg, Kenneth A

2012-11-24

Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow.

Evaluating health service quality: using importance performance analysis.

PubMed

Izadi, Azar; Jahani, Younes; Rafiei, Sima; Masoud, Ali; Vali, Leila

2017-08-14

Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item's importance from the patients' perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly. Findings Findings revealed a significant gap between service importance and performance. From the patients' viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively). Practical implications Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction. Originality/value The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.

Identification of Anxiety Symptom Clusters in Patients with COPD: Implications for Assessment and Treatment.

PubMed

Breland, Jessica Y; Hundt, Natalie E; Barrera, Terri L; Mignogna, Joseph; Petersen, Nancy J; Stanley, Melinda A; Cully, Jeffery A

2015-10-01

Treatment of chronic obstructive pulmonary disease (COPD) is palliative, and quality of life is important. Increased understanding of correlates of quality of life and its domains could help clinicians and researchers better tailor COPD treatments and better support patients engaging in those treatments or other important self-management behaviors. Anxiety is common in those with COPD; however, overlap of physical and emotional symptoms complicates its assessment. The current study aimed to identify anxiety symptom clusters and to assess the association of these symptom clusters with COPD-related quality of life. Participants (N = 162) with COPD completed the Beck Anxiety Inventory (BAI), Chronic Respiratory Disease Questionnaire, Patient Health Questionnaire-9, and Medical Research Council dyspnea scale. Anxiety clusters were identified, using principal component analysis (PCA) on the BAI's 21 items. Anxiety clusters, along with factors previously associated with quality of life, were entered into a multiple regression designed to predict COPD-related quality of life. PCA identified four symptom clusters related to (1) general somatic distress, (2) fear, (3) nervousness, and (4) respiration-related distress. Multiple regression analyses indicated that greater fear was associated with less perceived mastery over COPD (β = -0.19, t(149) = -2.69, p < 0.01). Anxiety symptoms associated with fear appear to be an important indicator of anxiety in patients with COPD. In particular, fear was associated with perceptions of mastery, an important psychological construct linked to disease self-management. Assessing the BAI symptom cluster associated with fear (five items) may be a valuable rapid assessment tool to improve COPD treatment and physical health outcomes.

Optical spectral signatures of liquids by means of fiber optic technology for product and quality parameter identification

NASA Astrophysics Data System (ADS)

Mignani, A. G.; Ciaccheri, L.; Mencaglia, A. A.; Diaz-Herrera, N.; Garcia-Allende, P. B.; Ottevaere, H.; Thienpont, H.; Attilio, C.; Cimato, A.; Francalanci, S.; Paccagnini, A.; Pavone, F. S.

2009-01-01

Absorption spectroscopy in the wide 200-1700 nm spectral range is carried out by means of optical fiber instrumentation to achieve a digital mapping of liquids for the prediction of important quality parameters. Extra virgin olive oils from Italy and lubricant oils from turbines with different degrees of degradation were considered as "case studies". The spectral data were processed by means of multivariate analysis so as to obtain a correlation to quality parameters. In practice, the wide range absorption spectra were considered as an optical signature of the liquids from which to extract product quality information. The optical signatures of extra virgin olive oils were used to predict the content of the most important fatty acids. The optical signatures of lubricant oils were used to predict the concentration of the most important parameters for indicating the oil's degree of degradation, such as TAN, JOAP anti-wear index, and water content.

Integrating biomass quality variability in stochastic supply chain modeling and optimization for large-scale biofuel production

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

Castillo-Villar, Krystel K.; Eksioglu, Sandra; Taherkhorsandi, Milad

The production of biofuels using second-generation feedstocks has been recognized as an important alternative source of sustainable energy and its demand is expected to increase due to regulations such as the Renewable Fuel Standard. However, the pathway to biofuel industry maturity faces unique, unaddressed challenges. Here, to address this challenges, this article presents an optimization model which quantifies and controls the impact of biomass quality variability on supply chain related decisions and technology selection. We propose a two-stage stochastic programming model and associated efficient solution procedures for solving large-scale problems to (1) better represent the random nature of the biomassmore » quality (defined by moisture and ash contents) in supply chain modeling, and (2) assess the impact of these uncertainties on the supply chain design and planning. The proposed model is then applied to a case study in the state of Tennessee. Results show that high moisture and ash contents negatively impact the unit delivery cost since poor biomass quality requires the addition of quality control activities. Experimental results indicate that supply chain cost could increase as much as 27%–31% when biomass quality is poor. We assess the impact of the biomass quality on the topological supply chain. Our case study indicates that biomass quality impacts supply chain costs; thus, it is important to consider the impact of biomass quality in supply chain design and management decisions.« less

Integrating biomass quality variability in stochastic supply chain modeling and optimization for large-scale biofuel production

DOE PAGES

Castillo-Villar, Krystel K.; Eksioglu, Sandra; Taherkhorsandi, Milad

2017-02-20

The production of biofuels using second-generation feedstocks has been recognized as an important alternative source of sustainable energy and its demand is expected to increase due to regulations such as the Renewable Fuel Standard. However, the pathway to biofuel industry maturity faces unique, unaddressed challenges. Here, to address this challenges, this article presents an optimization model which quantifies and controls the impact of biomass quality variability on supply chain related decisions and technology selection. We propose a two-stage stochastic programming model and associated efficient solution procedures for solving large-scale problems to (1) better represent the random nature of the biomassmore » quality (defined by moisture and ash contents) in supply chain modeling, and (2) assess the impact of these uncertainties on the supply chain design and planning. The proposed model is then applied to a case study in the state of Tennessee. Results show that high moisture and ash contents negatively impact the unit delivery cost since poor biomass quality requires the addition of quality control activities. Experimental results indicate that supply chain cost could increase as much as 27%–31% when biomass quality is poor. We assess the impact of the biomass quality on the topological supply chain. Our case study indicates that biomass quality impacts supply chain costs; thus, it is important to consider the impact of biomass quality in supply chain design and management decisions.« less

Indoor air quality and sources in schools and related health effects.

PubMed

Annesi-Maesano, Isabella; Baiz, Nour; Banerjee, Soutrik; Rudnai, Peter; Rive, Solenne; SINPHONIE Group

2013-01-01

Good indoor air quality in schools is important to provide a safe, healthy, productive, and comfortable environment for students, teachers, and other school staff. However, existing studies demonstrated that various air pollutants are found in classrooms, sometimes at elevated concentrations. Data also indicated that poor air quality may impact children's health, in particular respiratory health, attendance, and academic performance. Nevertheless, it should be noted that there are other adverse health effects that are less documented. Few data exist for teachers and other adults that work in schools. Allergic individuals seem to be at a higher risk for adverse respiratory health consequences. Air quality improvement represents an important measure for prevention of adverse health consequences in children and adults in schools.

Exploring the Quality Indicators of a Successful Full-Inclusion Preschool Program

ERIC Educational Resources Information Center

Warren, Susan R.; Martinez, Richard S.; Sortino, Lori A.

2016-01-01

A growing body of research and legislative policies support the importance of high-quality early intervention systems for preschool children with disabilities. Inclusion programs are viable means for providing this support, yet limited progress has been made in the past decade to increase the placements of children in inclusive settings or define…

An Analysis of Instruments that Measure the Quality of Mathematics Teaching in Early Childhood

ERIC Educational Resources Information Center

Kilday, Carolyn R.; Kinzie, Mable B.

2009-01-01

The evaluation of teaching quality in mathematics has become increasingly important following research reports indicating that preschoolers are developmentally able to engage in mathematic thought and that child performance in mathematics at this level is a strong predictor of later school achievement. As attention turns to early mathematics…

Enhancing Student Engagement in Student Experience Surveys: A Mixed Methods Study

ERIC Educational Resources Information Center

Webber, Martin; Lynch, Siobhan; Oluku, Jennifer

2013-01-01

Background: Measuring the student experience is becoming increasingly important in higher education in the UK. Student experience surveys are used as indicators of quality and form the basis of rankings of higher education institutions. They are also used by them as tools to assist their quality enhancement initiatives. However, these surveys…

Literacy of Teachers. Indicator of the Month.

ERIC Educational Resources Information Center

National Center for Education Statistics (ED), Washington, DC.

An important issue in the education reform debate is the effect of comparatively low salaries on teacher quality. Prose literacy scores are one of the best available measures of verbal ability, a factor identified by research as being associated with teacher quality. If teachers have lower prose literacy scores relative to college graduates in…

Exploring the Use of Best-Worst Scaling to Elicit Course Experience Questionnaire Responses

ERIC Educational Resources Information Center

Huybers, Twan

2017-01-01

Students are an important stakeholder group in the context of quality assurance in higher education. From their perspective as learners, students' views on educational experiences are increasingly used as an indicator of educational quality. The Course Experience Questionnaire (CEQ) is a widely used quantitative tool to gauge students' perceptions…

Breast cancer survivorship: the role of perceived discrimination and sexual orientation.

PubMed

Jabson, Jennifer M; Donatelle, Rebecca J; Bowen, Deborah

2011-03-01

Breast cancer disproportionately affects sexual minority women (SMW) compared to heterosexual women and a small but growing literature indicates that SMW may have diminished survivorship outcomes; outcomes that are measurably and importantly different from heterosexual breast cancer survivors. However, it remains unknown how sexual orientation influences breast cancer survivorship outcomes such as quality of life. One possible route of influence is SMW's perceived discrimination in the health care setting. This cross-sectional study examines SMW perceptions of discrimination as one of the multiple facets of the breast cancer survivorship process. This study assessed SMW breast cancer survivor's perceptions of discrimination during their breast cancer treatment experience and secondarily, examined the role of this perceived discrimination on SMW's quality of life. Sixty-eight purposefully sampled sexual minority breast cancer survivors completed assessments of quality of life, perceived discrimination, perceived social support and perceived stress via an online survey. Statistical analyses point to perceived discrimination and perceived social support as important indicators for predicting SMW's quality of life. Future research on SMW's breast cancer survivorship should include measures of perceived discrimination.

The Impacts of Spatiotemporal Landscape Changes on Water Quality in Shenzhen, China

PubMed Central

Liu, Zhenhuan; Yang, Haiyan

2018-01-01

The urban landscape in China has changed rapidly over the past four decades, which has led to various environmental consequences, such as water quality degradation at the regional scale. To improve water restoration strategies and policies, this study assessed the relationship between water quality and landscape change in Shenzhen, China, using panel regression analysis. The results show that decreases in natural and semi-natural landscape compositions have had significant negative effects on water quality. Landscape composition and configuration changes accounted for 39–58% of the variation in regional water quality degradation. Additionally, landscape fragmentation indices, such as patch density (PD) and the number of patches (NP), are important indicators of the drivers of water quality degradation. PD accounted for 2.03–5.44% of the variability in water quality, while NP accounted for −1.63% to −4.98% of the variability. These results indicate that reducing landscape fragmentation and enhancing natural landscape composition at the watershed scale are vital to improving regional water quality. The study findings suggest that urban landscape optimization is a promising strategy for mitigating urban water quality degradation, and the results can be used in policy making for the sustainable development of the hydrological environment in rapidly urbanizing areas. PMID:29786672

The Impacts of Spatiotemporal Landscape Changes on Water Quality in Shenzhen, China.

PubMed

Liu, Zhenhuan; Yang, Haiyan

2018-05-22

The urban landscape in China has changed rapidly over the past four decades, which has led to various environmental consequences, such as water quality degradation at the regional scale. To improve water restoration strategies and policies, this study assessed the relationship between water quality and landscape change in Shenzhen, China, using panel regression analysis. The results show that decreases in natural and semi-natural landscape compositions have had significant negative effects on water quality. Landscape composition and configuration changes accounted for 39⁻58% of the variation in regional water quality degradation. Additionally, landscape fragmentation indices, such as patch density (PD) and the number of patches (NP), are important indicators of the drivers of water quality degradation. PD accounted for 2.03⁻5.44% of the variability in water quality, while NP accounted for -1.63% to -4.98% of the variability. These results indicate that reducing landscape fragmentation and enhancing natural landscape composition at the watershed scale are vital to improving regional water quality. The study findings suggest that urban landscape optimization is a promising strategy for mitigating urban water quality degradation, and the results can be used in policy making for the sustainable development of the hydrological environment in rapidly urbanizing areas.

Developing Flanagan's critical incident technique to elicit indicators of high and low quality nursing care from patients and their nurses.

PubMed

Norman, I J; Redfern, S J; Tomalin, D A; Oliver, S

1992-05-01

This paper discusses a development of Flanagan's critical incident technique (CIT) to elicit indicators of high and low quality nursing from patients and their nurses on medical, surgical and elderly care wards. Stages in undertaking the CIT are identified and presuppositions held by most researchers about the nature of the technique are identified. The paper describes how the authors moved to a different set of presuppositions during the course of the study. Preliminary analysis of interview transcripts revealed that critical incidents need not always be demarcated scenes with a clear beginning and end, but may arise from respondents summarizing their overall experience within their description of one incident. Characteristically respondents were unable to give a detailed account of such incidents but validity may be established by the fact that respondents appear to recount what actually happened as they saw it, and what they said was clearly important to them. The researchers found that the most appropriate basic unit of analysis was not the incident itself but 'happenings' revealed by incidents that are 'critical' by virtue of being important to respondents with respect to the quality of nursing care. The importance of CIT researchers achieving an understanding of the 'meaning' of critical happenings to respondents is emphasized. Analysis of the interview transcripts is facilitated by the use of INGRES, a relational database computer program which should enable a 'personal theory' of quality nursing for each respondent, both patients and nurses, to be described. The study suggests that the CIT is a flexible technique which may be adapted to meet the demands of nursing research. If carefully applied, the CIT seems capable of capitalizing on respondents' own stories and avoids the loss of information which occurs when complex narratives are reduced to simple descriptive categories. Patients and nurses have unique perspectives on nursing and their views are of primary importance in understanding what quality means with respect to the interpersonal processes that are integral to nursing care. This paper discusses the identification of indicators of quality nursing from interviews with patients and nurses using the authors' development of Flanagan's critical incident technique.

Evaluation of the Impacts of Land Use on Water Quality: A Case Study in The Chaohu Lake Basin

PubMed Central

Yan, Haiming; Wu, Feng; Deng, Xiangzheng

2013-01-01

It has been widely accepted that there is a close relationship between the land use type and water quality. There have been some researches on this relationship from the perspective of the spatial configuration of land use in recent years. This study aims to analyze the influence of various land use types on the water quality within the Chaohu Lake Basin based on the water quality monitoring data and RS data from 2000 to 2008, with the small watershed as the basic unit of analysis. The results indicated that there was significant negative correlation between forest land and grassland and the water pollution, and the built-up area had negative impacts on the water quality, while the influence of the cultivated land on the water quality was very complex. Besides, the impacts of the landscape diversity on the indicators of water quality within the watershed were also analyzed, the result of which indicated there was a significant negative relationship between them. The results can provide important scientific reference for the local land use optimization and water pollution control and guidance for the formulation of policies to coordinate the exploitation and protection of the water resource. PMID:23970833

The construction of the indicators of professional competence for exercise instructors of the elderly.

PubMed

Lan, Hsiao-Ching; Li, Chih-Ping; Zheng, Hao-Wei

2015-09-25

The purpose of this study was to construct the quality indicators of professional competence for exercise instructors of the elderly, and then to rank the importance among those indicators. This study used the Delphi technique to integrate the opinions of 11 experts to construct the indicators, and then adopts the analytic hierarchy process (AHP) to calculate the relative rank among each individual indicator. Results revealed that the experts identified 3 first-degree indicators (professional attitude, professional skills, and professional knowledge), 10 second-degree indicators (teaching attitude, exercise knowledge, professional growth, exercise safety, personal characteristics, exercise instructor, gerontology knowledge, communicative competence, curriculum design, and motor skill), and 72 third-degree indicators. In the indicator weighting system, professional attitude was the most important among all other first-degree indicators, and the teaching attitude was the most important among all other second-degree indicators. The results provided will help in planning the curriculums of training, professional growth and evaluation. The results also provide a reference for future research.

The construction of the indicators of professional competence for exercise instructors of the elderly.

PubMed

Lan, Hsiao-Ching; Li, Chih-Ping; Zheng, Hao-Wei

2015-01-01

The purpose of this study was to construct the quality indicators of professional competence for exercise instructors of the elderly, and then to rank the importance among those indicators. This study used the Delphi technique to integrate the opinions of 11 experts to construct the indicators, and then adopts the analytic hierarchy process (AHP) to calculate the relative rank among each individual indicator. Results revealed that the experts identified 3 first-degree indicators (professional attitude, professional skills, and professional knowledge), 10 second-degree indicators (teaching attitude, exercise knowledge, professional growth, exercise safety, personal characteristics, exercise instructor, gerontology knowledge, communicative competence, curriculum design, and motor skill), and 72 third-degree indicators. In the indicator weighting system, professional attitude was the most important among all other first-degree indicators, and the teaching attitude was the most important among all other second-degree indicators. The results provided will help in planning the curriculums of training, professional growth and evaluation. The results also provide a reference for future research.

The Development of Performance Indicators for Prison Libraries.

ERIC Educational Resources Information Center

Lithgow, Susan D.

This report describes a study to investigate the improved efficiency and effectiveness of prison library provision in England and Wales, through the development and validation of relevant performance indicators to be used as part of quality assurance programs. Prison libraries perform important educational, rehabilitative, and recreational…

Are characteristics of team members important for quality management of chronic patients at primary care level?

PubMed

Klemenc-Ketis, Zalika; Poplas-Susič, Antonija

2017-12-01

To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients. We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements. © 2017 John Wiley & Sons Ltd.

Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature.

PubMed Central

Barbotte, E.; Guillemin, F.; Chau, N.

2001-01-01

OBJECTIVE: To determine the prevalence rates of morbidity in the general population through bibliographic research. METHODS: Articles relating to impairment, disability, handicap, quality of life and their prevalence in the general population, published between January 1990 and March 1998, were selected on the MEDLINE database. FINDINGS: The 20 articles retained out of 433 used 41 different indicators. Indicators of impairment, disability, handicap and low quality of life showed prevalence rates of 0.1-92%, 3.6-66%, 0.6-56% and 1.8-26% respectively, depending on age and the accuracy of indicators. The heterogeneity of the conceptual framework and insufficient recognition of the importance of indicator accuracy, the age factor and the socioeconomic characteristics of the studied populations impede reliable international comparison. CONCLUSION: Further standardization of indicators is therefore required. The revision of the International Classification of Impairments, Disabilities and Handicaps may make it possible to resolve some of the difficulties encountered. PMID:11731812

Quality of care indicators for the rehabilitation of children with traumatic brain injury.

PubMed

Rivara, Frederick P; Ennis, Stephanie K; Mangione-Smith, Rita; MacKenzie, Ellen J; Jaffe, Kenneth M

2012-03-01

To develop measurement tools for assessing compliance with identifiable processes of inpatient care for children with traumatic brain injury (TBI) that are reliable, valid, and amenable to implementation. Literature review and expert panel using the RAND/UCLA Appropriateness Method and a Delphi technique. Not applicable. Children with TBI. Not applicable. Quality of care indicators. A total of 119 indicators were developed across the domains of general management; family-centered care; cognitive-communication, speech, language, and swallowing impairments; gross and fine motor skill impairments; neuropsychologic, social, and behavioral impairments; school reentry; and community integration. There was a high degree of agreement on these indicators as valid and feasible quality measures for children with TBI. These indicators are an important step toward building a better base of evidence about the effectiveness and efficiency of the components of acute inpatient rehabilitation for pediatric patients with TBI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Developing clinical indicators for the secondary health system in India.

PubMed

Thakur, Harshad; Chavhan, S; Jotkar, Raju; Mukherjee, Kanchan

2008-08-01

One of the prime goals of any health system is to deliver good and competent quality of healthcare. Through World Bank-assisted Maharashtra Health Systems Development Project, Government of Maharashtra in India developed and implemented clinical indicators to improve quality. During this, clinical areas eligible for monitoring quality of care and roles of health staff working at various levels were identified. Brainstorming discussion sessions were conducted to refine list of potential clinical indicators and to identify implementation problems. It was implemented in four stages. (a) Self-explanatory tool of record, standard operating procedures and training manual were prepared during tools preparation stage. (b) Pilot implementation was done to monitor the usefulness of indicators, document the experiences and standardize the system accordingly. (c) The final selection of indicators was done taking into consideration points like data reliability, indicator usefulness etc. For final implementation, 15 indicators for district and 6 indicators for rural hospitals were selected. (d) Transfer of skills was done through training of various hospital functionaries. Selection and prioritization of clinical indicators is the most crucial part. Active participation of local employees is essential for sustainability of the scheme. It is also important to ensure that data recorded/reported is both reliable and valid, to conduct monthly review of the scheme at various levels and to link it with the quality improvement programme.

Quality indicators for hip fracture patients: a scoping review protocol

PubMed Central

Pitzul, Kristen B; Munce, Sarah E P; Perrier, Laure; Beaupre, Lauren; Morin, Suzanne N; McGlasson, Rhona; Jaglal, Susan B

2014-01-01

Introduction Hip fractures are a significant cause of morbidity and mortality and care of hip fracture patients places a heavy burden on healthcare systems due to prolonged recovery time. Measuring quality of care delivered to hip fracture patients is important to help target efforts to improve care for patients and efficiency of the health system. The purpose of this study is to synthesise the evidence surrounding quality of care indicators for patients who have sustained a hip fracture. Using a scoping review methodology, the research question that will be addressed is: “What patient, institutional, and system-level indicators are currently in use or proposed for measuring quality of care across the continuum for individuals following a hip fracture?”. Methods and analysis We will employ the methodological frameworks used by Arksey and O'Malley and Levac et al. The synthesis will be limited to quality of care indicators for individuals who suffered low trauma hip fracture. All English peer-reviewed studies published from the year 2000-most recent will be included. Literature search strategies will be developed using medical subject headings and text words related to hip fracture quality indicators and the search will be peer-reviewed. Numerous electronic databases will be searched. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potentially relevant articles to determine final inclusion. Abstracted data will include study characteristics and indicator definitions. Dissemination To improve quality of care for patients and create a more efficient healthcare system, mechanisms for the measurement of quality of care are required. The implementation of quality of care indicators enables stakeholders to target areas for improvement in service delivery. Knowledge translation activities will occur throughout the review with dissemination of the project goals and findings to local, national, and international stakeholders. PMID:25335964

Quality indicators for hip fracture patients: a scoping review protocol.

PubMed

Pitzul, Kristen B; Munce, Sarah E P; Perrier, Laure; Beaupre, Lauren; Morin, Suzanne N; McGlasson, Rhona; Jaglal, Susan B

2014-10-21

Hip fractures are a significant cause of morbidity and mortality and care of hip fracture patients places a heavy burden on healthcare systems due to prolonged recovery time. Measuring quality of care delivered to hip fracture patients is important to help target efforts to improve care for patients and efficiency of the health system. The purpose of this study is to synthesise the evidence surrounding quality of care indicators for patients who have sustained a hip fracture. Using a scoping review methodology, the research question that will be addressed is: "What patient, institutional, and system-level indicators are currently in use or proposed for measuring quality of care across the continuum for individuals following a hip fracture?". We will employ the methodological frameworks used by Arksey and O'Malley and Levac et al. The synthesis will be limited to quality of care indicators for individuals who suffered low trauma hip fracture. All English peer-reviewed studies published from the year 2000-most recent will be included. Literature search strategies will be developed using medical subject headings and text words related to hip fracture quality indicators and the search will be peer-reviewed. Numerous electronic databases will be searched. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potentially relevant articles to determine final inclusion. Abstracted data will include study characteristics and indicator definitions. To improve quality of care for patients and create a more efficient healthcare system, mechanisms for the measurement of quality of care are required. The implementation of quality of care indicators enables stakeholders to target areas for improvement in service delivery. Knowledge translation activities will occur throughout the review with dissemination of the project goals and findings to local, national, and international stakeholders. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Quality and price--impact on patient satisfaction.

PubMed

Pantouvakis, Angelos; Bouranta, Nancy

2014-01-01

The purpose of this paper is to synthesize existing quality-measurement models and applies them to healthcare by combining a Nordic service-quality with an American service performance model. Results are based on a questionnaire survey of 1,298 respondents. Service quality dimensions were derived and related to satisfaction by employing a multinomial logistic model, which allows prediction and service improvement. Qualitative and empirical evidence indicates that customer satisfaction and service quality are multi-dimensional constructs, whose quality components, together with convenience and cost, influence the customer's overall satisfaction. The proposed model identifies important quality and satisfaction issues. It also enables transitions between different responses in different studies to be compared.

Do treatment quality indicators predict cardiovascular outcomes in patients with diabetes?

PubMed

Sidorenkov, Grigory; Voorham, Jaco; de Zeeuw, Dick; Haaijer-Ruskamp, Flora M; Denig, Petra

2013-01-01

Landmark clinical trials have led to optimal treatment recommendations for patients with diabetes. Whether optimal treatment is actually delivered in practice is even more important than the efficacy of the drugs tested in trials. To this end, treatment quality indicators have been developed and tested against intermediate outcomes. No studies have tested whether these treatment quality indicators also predict hard patient outcomes. A cohort study was conducted using data collected from >10.000 diabetes patients in the Groningen Initiative to Analyze Type 2 Treatment (GIANTT) database and Dutch Hospital Data register. Included quality indicators measured glucose-, lipid-, blood pressure- and albuminuria-lowering treatment status and treatment intensification. Hard patient outcome was the composite of cardiovascular events and all-cause death. Associations were tested using Cox regression adjusting for confounding, reporting hazard ratios (HR) with 95% confidence intervals. Lipid and albuminuria treatment status, but not blood pressure lowering treatment status, were associated with the composite outcome (HR = 0.77, 0.67-0.88; HR = 0.75, 0.59-0.94). Glucose lowering treatment status was associated with the composite outcome only in patients with an elevated HbA1c level (HR = 0.72, 0.56-0.93). Treatment intensification with glucose-lowering but not with lipid-, blood pressure- and albuminuria-lowering drugs was associated with the outcome (HR = 0.73, 0.60-0.89). Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient outcomes. These results question whether all treatment indicators are valid measures to judge quality of health care and its economics.

Effects of Internship Predictors on Successful Field Experience.

ERIC Educational Resources Information Center

Beard, Fred; Morton, Linda

1999-01-01

Finds that a majority of advertising and public-relations interns found their internships successful. Indicates that successful internships depend on predictors given the least attention by school programs: quality of supervision was the most important single predictor variable, followed in importance by organizational practices/policies, positive…

Increase in competitiveness of housing-and-communal services

NASA Astrophysics Data System (ADS)

Skripnik, Oksana

2017-10-01

The problems, interfering effective activity of housing-and-communal complex are considered in the article. Some factors of the increase in competitiveness and the importance of transactional expenses are revealed. The assessment of competitiveness of the organizations of the sphere of housing-and-communal services is considered as the set of the following basic elements organizational and administrative, marketing, financial, production, indicators of quality, indicators of development, labor indicators interconnected with processes of the organization. The author proves that the increase in competitiveness is possible by carrying out organizational and administrative, innovative, technological, economic transformations, increasing quality of services, reducing costs for production and realization of services, providing new services.

Evaluation of beef eating quality by Irish consumers.

PubMed

McCarthy, S N; Henchion, M; White, A; Brandon, K; Allen, P

2017-10-01

A consumer's decision to purchase beef is strongly linked to its sensory properties and consistent eating quality is one of the most important attributes. Consumer taste panels were held according to the Meat Standards Australia guidelines and consumers scored beef according to its palatability attributes and completed a socio-demographic questionnaire. Consumers were able to distinguish between beef quality on a scale from unsatisfactory to premium with high accuracy. Premium cuts of beef scored significantly higher on all of the scales compared to poorer quality cuts. Men rated grilled beef higher on juiciness and flavour scales compared to women. Being the main purchaser of beef had no impact on rating scores. Overall the results show that consumers can judge eating quality with high accuracy. Further research is needed to determine how best to communicate inherent benefits that are not visible into extrinsic eating quality indicators, to provide the consumer with consistent indications of quality at the point of purchase. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of High and Low Density Airborne LIDAR Data for Forest Road Quality Assessment

NASA Astrophysics Data System (ADS)

Kiss, K.; Malinen, J.; Tokola, T.

2016-06-01

Good quality forest roads are important for forest management. Airborne laser scanning data can help create automatized road quality detection, thus avoiding field visits. Two different pulse density datasets have been used to assess road quality: high-density airborne laser scanning data from Kiihtelysvaara and low-density data from Tuusniemi, Finland. The field inventory mainly focused on the surface wear condition, structural condition, flatness, road side vegetation and drying of the road. Observations were divided into poor, satisfactory and good categories based on the current Finnish quality standards used for forest roads. Digital Elevation Models were derived from the laser point cloud, and indices were calculated to determine road quality. The calculated indices assessed the topographic differences on the road surface and road sides. The topographic position index works well in flat terrain only, while the standardized elevation index described the road surface better if the differences are bigger. Both indices require at least a 1 metre resolution. High-density data is necessary for analysis of the road surface, and the indices relate mostly to the surface wear and flatness. The classification was more precise (31-92%) than on low-density data (25-40%). However, ditch detection and classification can be carried out using the sparse dataset as well (with a success rate of 69%). The use of airborne laser scanning data can provide quality information on forest roads.

Water quality.

USGS Publications Warehouse

Steele, T.D.; Stefan, H.G.

1979-01-01

Significant contributions in the broad area of water quality over the quadrennium 1975-78 are highlighted. This summare is concerned primarily with physical and chemical aspects of water quality. The diversity of subject areas within the topic heading and the large volume of published research results necessitated the selection of representative contributions. Over 400 references are cited which are believed to be indicative of general trends in research and of the more important developments during this period.- from Authors

Quality of life in patients with Parkinson's disease: development of a questionnaire.

PubMed Central

de Boer, A G; Wijker, W; Speelman, J D; de Haes, J C

1996-01-01

OBJECTIVES--To develop and test a questionnaire for measuring quality of life in patients with Parkinson's disease. METHODS--An item pool was developed based on the experience of patients with Parkinson's disease and of neurologists; medical literature on the problems of patients with Parkinson's disease; and other quality of life questionnaires. To reduce the item pool, 13 patients identified items that were a problem to them and rated their importance. Items which were most often chosen and rated most important were included in the Parkinson's disease quality of life questionnaire (PDQL). The PDQL consists of 37 items. To evaluate the discriminant validity of the PDQL three groups of severity of disease were compared. To test for convergent validity, the scores of the PDQL were tested for correlation with standard indices of quality of life. RESULTS--The PDQL was filled out by 384 patients with Parkinson's disease. It consisted of four subscales: parkinsonian symptoms, systemic symptoms, emotional functioning, and social functioning. The internal-consistency reliability coefficients of the PDQL subscales were high (0.80-0.87). Patients with higher disease severity had significantly lower quality of life on all PDQL subscales (P < 0.05). Almost all PDQL subscales correlated highly (P < 0.001) with the corresponding scales of the standard quality of life indices. CONCLUSION--The PDQL is a relevant, reliable, and valid measure of the quality of life of patients with Parkinson's disease. Images PMID:8676165

Identifying models of delivery, care domains and quality indicators relevant to palliative day services: a scoping review protocol.

PubMed

O'Connor, Seán R; Dempster, Martin; McCorry, Noleen K

2017-05-16

With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services. Electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials) will be searched for evidence using consensus development methods; randomised or quasi-randomised controlled trials; mixed methods; and prospective, longitudinal or retrospective case-control studies to develop or test quality indicators for evaluating palliative care within non-residential settings, including day hospices and community or primary care settings. At least two researchers will independently conduct all searches, study selection and data abstraction procedures. Meta-analyses and statistical methods of synthesis are not planned as part of the review. Results will be reported using numerical counts, including number of indicators in each care domain and by using qualitative approach to describe important indicator characteristics. A conceptual model will also be developed to summarise the impact of different aspects of quality in a palliative day service context. Methodological quality relating to indicator development will be assessed using the Appraisal of Indicators through Research and Evaluation (AIRE) tool. Overall strength of evidence will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Final decisions on quality assessment will be made via consensus between review authors. Identifying, developing and implementing evidence-based quality indicators is critical to the evaluation and continued improvement of palliative care. Review findings will be used to support clinicians and policymakers make decisions on which quality indicators are most appropriate for evaluating day services at the patient and service level, and to identify areas for further research.

Selecting indicators for patient safety at the health system level in OECD countries.

PubMed

McLoughlin, Vivienne; Millar, John; Mattke, Soeren; Franca, Margarida; Jonsson, Pia Maria; Somekh, David; Bates, David

2006-09-01

Concerns about patient safety have arisen with growing documentation of the extent and nature of harm. Yet there are no robust and meaningful data that can be used internationally to assess the extent of the problem and considerable methodological difficulties. This article describes a project undertaken as part of the Organization for Economic Cooperation and Development (OECD) Quality Indicator Project, which aimed at developing an initial set of patient safety indicators. Patient safety indicators from OECD countries were identified and then rated against three principal criteria: importance to patient safety, scientific soundness, and potential feasibility. Although some countries are developing multi-source monitoring systems, these are not yet mature enough for international exchange. This project reviewed routine data collections as a starting point. Of an initial set of 59 candidate indicators identified, 21 were selected which cover known areas of harm to patients. This project is an important initial step towards defining a usable set of patient safety indicators that will allow comparisons to be made internationally and will support mutual learning and quality improvement in health care. Measures of harm should be complemented over time with measures of effective improvement factors.

Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

PubMed

Medina-Mirapeix, Francesc; Jimeno-Serrano, Francisco J; Escolar-Reina, Pilar; Del Baño-Aledo, M Elena

2013-06-01

To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings. A cross-sectional, self-reported survey carried out in the year 2009. Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics. Satisfaction and service quality were highly correlated (rho = 0.72, P< 0.001). Two multivariate logistic regression models using satisfaction and service quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied. Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.

Testing the Value of Information of Climate Change Indicators that use Earth Observations

NASA Astrophysics Data System (ADS)

Kenney, M. A.

2012-12-01

Indicators are usually thought of as measurements or calculations that represent important features of the status, trend, or performance of a system of interest (e.g. the economy, agriculture, air quality). They are often used for the most practical of reasons - one cannot measure everything important about systems of interest, so there is a practical need to identify major features that can be reported periodically and used to guide both research and decisions (National Research Council (NRC). 2000. Ecological Indicators for the Nation. National Academy Press. Washington, DC). The use of indicators to track the status and trends of many features of environmental or economic performance, quality of life, and a host of other social concerns is embedded in the fabric of our everyday lives. Businesses, governments, and consumers regularly use the common economic indices - e.g. the unemployment index or consumer price index - as guides for decision-making on investments and hiring. There is an analogous demand for indicators of environmental conditions and performance - everything from agricultural yields to air and water quality to weather and climate - that are currently less publicly visible than the common economic indicators, but that can have critically important uses in such areas as natural resource management, improvement of environmental quality, emergency planning, and infrastructure development. A number of these environmental indicators, be it physical or ecological, use a range of data sources including earth observations. Despite the extensive development and use of indicators, there is little testing of these indicators to assure that they indeed provide the assumed positive information benefit. This is particularly concerning because if these indicators are systematically misunderstood by the intended audience or a sub-group of that audience, such individuals could make decisions that are consistent with their incorrect understanding of the indicator. Such a result would mean that the indicator has a negative value of information. Granted the value of information depends on the intended audience(s), with some groups being able to understand and want more technically sophisticated and detailed information presented as an indicator. However, if the goal of an indicator is to provide information to a wide range of groups, it is essential to assure that these groups have a correct understanding of the indicator, its assumptions, and the ability to use the indicator (as presented or modified) for decision-making contexts. In this talk, I will present the preliminary results of a study that is testing the value of information of a range of climate change indicators, and I will focus on indicators that use earth observations. Such results contribute to a richer understanding of the value of information of indicators, and can shape the development of both individual indicators and systems of indicators, such as the development of the indicator system for the U.S. Global Change Research Program, National Climate Assessment.

The development of education indicators for measuring quality in the English-speaking Caribbean: how far have we come?

PubMed

Bowe, Anica G

2015-02-01

Education evaluation has become increasingly important in the English-speaking Caribbean. This has been in response to assessing the progress of four regional initiatives aimed at improving the equity, efficiency, and quality of education. Both special interest groups and local evaluators have been responsible for assessing the progress of education and providing an overall synthesis and summary of what is taking place in the English-speaking Caribbean. This study employed content analysis to examine the indicators used in these education evaluation studies since the declaration of the Caribbean Plan of Action 2000-2015 to determine these indicators' appropriateness to the Caribbean context in measuring education progress. Findings demonstrate that the English-speaking Caribbean has made strides in operationalizing quality input, process, and output indicators; however quality outcome indicators beyond test scores are yet to be realized in a systematic manner. This study also compared the types of collaborative partnerships in conducting evaluation studies used by special interest groups and local evaluators and pinpointed the one that appears most suitable for special interest groups in this region. Copyright © 2014 Elsevier Ltd. All rights reserved.

Forest fuels, prescribed fire, and air quality

Treesearch

J. Alfred Hall

1972-01-01

The combustion products (smoke) from forest wildfires or prescribed burns are often considered on a par with any other emission that might affect air quality. But enough is known about smoke from woody fuels to indicate that its importance is limited almost entirely to visibility obstruction, an effect that can be minimized by proper timing and preparation for burning...

A method of evaluating forest site quality from soil, forest cover, and indicator plants

Treesearch

Marinus Westveld

1952-01-01

Foresters have overlooked too long the importance of soil as a factor in successful timber production. Greatest production in amount and quality of wood at the smallest cost can be attained by growing the tree species that are best suited to the climate and the soil of the locality in question.

Bidirectional Associations between Sleep (Quality and Duration) and Psychosocial Functioning across the University Years

ERIC Educational Resources Information Center

Tavernier, Royette; Willoughby, Teena

2014-01-01

Despite extensive research on sleep and psychosocial functioning, an important gap within the literature is the lack of inquiry into the direction of effects between these 2 constructs. The purpose of the present 3-year longitudinal study was to examine bidirectional associations between sleep (quality and duration) and 3 indices of psychosocial…

The use of medical quality indices as a performance-enhancement tool for community clinics.

PubMed

Elhayany, A

2001-12-01

One of the most important issues for a country, its population and doctors is the effective use of its health system. The extensive variation in doctors' performance leads to a tremendous waste of resources. To combat this, and at the same time ensure that medical quality plays a role when making decisions on interventions, it is essential to equip doctors and clinic directors with information on the quality of the medical care they are providing. In order to assist clinic directors in maintaining medical quality, Clalit Health Services has developed comparative medical indices enabling doctors to compare their performance to that of their colleagues, as well as to the standard and their performance over time. The development of an index to evaluate the quality of medical treatment offered in clinics provides doctors and the health system with an essential tool to lessen the existing variation among doctors and to enhance and evaluate performance.

Re-evaluation of peroxide value as an indicator of the quality of edible oils.

PubMed

Shiozawa, Satoshi; Tanaka, Masaharu; Ohno, Katsutoshi; Nagao, Yasuhiro; Yamada, Toshihiro

2007-06-01

The oxidation of oils has important effects on the quality of oily foods, such as instant noodles. In particular, the generation of aldehydes, which accompanies the oxidation of oils, is one of the first factors to reduce food quality. We examined various indicators of oil quality during temperature-accelerated storage and found that peroxide value (POV) was highly correlated with the total concentration of major odorants. Moreover, the correlation of POV with the total concentration of five unsaturated aldehydes (t-2-heptenal, t-2-octenal, t-2-decenal, t-2-undecenal and t,t-2,4-decadienal) that show strong cytotoxicity was greater than the correlation of POV with the total concentration of major odorants. The maximum allowable concentration of the five aldehydes was calculated based on the 'no observed adverse-effect level' of the aldehyde that showed the highest cytotoxicity, t,t-2,4-decadienal, along with the human daily oil intake. We showed that it is useful to utilize POV as an indicator to control food quality and safety.

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

PubMed

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

2017-06-30

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

Quantitative assessment of desertification in south of Iran using MEDALUS method.

PubMed

Sepehr, A; Hassanli, A M; Ekhtesasi, M R; Jamali, J B

2007-11-01

The main aim of this study was the quantitative assessment of desertification process in the case study area of the Fidoye-Garmosht plain (Southern Iran). Based on the MEDALUS approach and the characteristics of study area a regional model developed using GIS. Six main factors or indicators of desertification including: soil, climate, erosion, plant cover, groundwater and management were considered for evaluation. Then several sub-indicators affecting the quality of each main indicator were identified. Based on the MEDALUS approach, each sub-indicator was quantified according to its quality and given a weighting of between 1.0 and 2.0. ArcGIS 9 was used to analyze and prepare the layers of quality maps using the geometric mean to integrate the individual sub-indicator maps. In turn the geometric mean of all six quality maps was used to generate a single desertification status map. Results showed that 12% of the area is classified as very severe, 81% as severe and 7% as moderately affected by desertification. In addition the plant cover and groundwater indicators were the most important factors affecting desertification process in the study area. The model developed may be used to assess desertification process and distinguish the areas sensitive to desertification in the study region and in regions with the similar characteristics.

An evaluation of the relative quality of dike pools for benthic macroinvertebrates in the Lower Missouri River, USA

USGS Publications Warehouse

Poulton, B.C.; Allert, A.L.

2012-01-01

A habitat-based aquatic macroinvertebrate study was initiated in the Lower Missouri River to evaluate relative quality and biological condition of dike pool habitats. Water-quality and sediment-quality parameters and macroinvertebrate assemblage structure were measured from depositional substrates at 18 sites. Sediment porewater was analysed for ammonia, sulphide, pH and oxidation-reduction potential. Whole sediments were analysed for particle-size distribution, organic carbon and contaminants. Field water-quality parameters were measured at subsurface and at the sediment-water interface. Pool area adjacent and downstream from each dike was estimated from aerial photography. Macroinvertebrate biotic condition scores were determined by integrating the following indicator response metrics: % of Ephemeroptera (mayflies), % of Oligochaeta worms, Shannon Diversity Index and total taxa richness. Regression models were developed for predicting macroinvertebrate scores based on individual water-quality and sediment-quality variables and a water/sediment-quality score that integrated all variables. Macroinvertebrate scores generated significant determination coefficients with dike pool area (R2=0.56), oxidation–reduction potential (R2=0.81) and water/sediment-quality score (R2=0.71). Dissolved oxygen saturation, oxidation-reduction potential and total ammonia in sediment porewater were most important in explaining variation in macroinvertebrate scores. The best two-variable regression models included dike pool size + the water/sediment-quality score (R2=0.84) and dike pool size + oxidation-reduction potential (R2=0.93). Results indicate that dike pool size and chemistry of sediments and overlying water can be used to evaluate dike pool quality and identify environmental conditions necessary for optimizing diversity and productivity of important aquatic macroinvertebrates. A combination of these variables could be utilized for measuring the success of habitat enhancement activities currently being implemented in this system.

National indicators for quality of drug therapy in older persons: the Swedish experience from the first 10 years.

PubMed

Fastbom, Johan; Johnell, Kristina

2015-03-01

Inappropriate drug use is an important health problem in elderly persons. Beginning with the Beers' criteria in the early 1990s, explicit criteria have been extensively used to measure and improve quality of drug use in older people. This article describes the Swedish indicators for quality of drug therapy in the elderly, introduced in 2004 and updated in 2010. These indicators were designed to be applied to people aged 75 years and over, regardless of residence and other characteristics. The indicators are divided into drug specific, covering choice, indication and dosage of drugs, polypharmacy, drug-drug interactions (DDIs), drug use in decreased renal function and in some symptoms; and diagnosis specific, covering the rational, irrational and hazardous drug use in common disorders in elderly people. During the 10 years since introduction, the Swedish indicators have several applications. They form the basis for recommendations for drug therapy in older people, are implemented in prescribing supports and drug utilisation reviews, are used in national benchmarking of the quality of Swedish healthcare and have contributed to initiatives from pensioner organisations. The indicators have also been used in several pharmacoepidemiological studies. Since 2005, there have been signs of improvement of the quality of drug prescribing to elderly persons in Sweden. For example, the prescribing of drugs that should be avoided in older persons decreased by 36 % between 2006 and 2012 in persons aged 80 years and older. Similarly, drug combinations that may cause DDIs decreased by 26 % and antipsychotics by 41 %. The indicators have likely contributed to this.

Pressure ulcer prevention in frail older people.

PubMed

Barry, Maree; Nugent, Linda

2015-12-16

Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork.

Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

PubMed

Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

2016-01-01

People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG) worked with researchers to co-produce a set of self-report, patient-generated QIs for OA. The QIs were intended for use in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE guidelines. We report on 1) the co-development of the OA QI (UK) questionnaire for primary care; and 2) the comparison of the content of the OA QI (UK) questionnaire with a parallel questionnaire developed in Norway for the Musculoskeletal Pain in Ullensaker (MUST) study. Methods Researchers were invited to OA RUG meetings. Firstly, RUG members were asked to consider factors important to patients consulting their general practitioner (GP) for OA and then each person rated their five most important. RUG members then discussed these in relation to a systematic review of OA QIs in order to form a list of OA QIs from a patient perspective. RUG members suggested wording and response options for a draft OA QI (UK) questionnaire to assess the QIs. Finally RUG members commented on draft and final versions of the questionnaire and how it compared with a translated Norwegian OA-QI questionnaire. Results RUG members (5 males, 5 females; aged 52-80 years) attended up to four meetings. RUG members ranked 20 factors considered most important to patients consulting their GP for joint pain. Following discussion, a list of eleven patient-reported QIs for OA consultations were formed. RUG members then suggested the wording and response options of 16 draft items - four QIs were split into two or more questionnaire items to avoid multiple dimensions of care quality within a single item. On comparison of this to the Norwegian OA-QI questionnaire, RUG members commented that both questionnaires contained seven similar QIs. The RUG members and researchers agreed to adopt the Norwegian OA-QI wording for four of these items. RUG members also recommended adopting an additional seven items from the Norwegian OA-QI with some minor word changes to improve their suitability for patients in the UK. One other item from the draft OA QI (UK) questionnaire was retained and eight items were excluded, resulting in a 15-item final version. Conclusions This study describes the development of patient-reported quality indicators for OA primary care derived by members of a RUG group, working in partnership with the research team throughout the study. The OA QI (UK) supports the NICE quality standards for OA and they have been successfully used to assess the quality of OA consultations in primary care in the MOSAICS study. The OA QI (UK) has the potential for routine use in primary care to assess the quality of OA care provided to patients. Ongoing research using both the UK and Norwegian OA-QI questionnaires is assessing the self-reported quality of OA care in different European populations.

[Study of long-term water quality of stocked drinking water].

PubMed

Kataoka, Hiromi; Kanaoka, Miki; Yamamura, Sayo; Mine, Takanori; Nishikawa, Jun-ichi; Semma, Masanori

2013-01-01

We examined changes in the quality of drinking water stockpiled under various conditions for emergency use. The results indicated that the change in the quality of the stocked water was influenced mainly by the preservation period and not by the amount of water in the bottle. To maintain water quality, the amount of residual chlorine is less important than using sufficiently sterilized water, bottles and caps in the bottling process. Washing the bottles with a small amount of boiling water was not sufficient to ensure complete inhibition of microbial growth.

Relating landscape characteristics to non-point source pollution in mine waste-located watersheds using geospatial techniques.

PubMed

Xiao, Huaguo; Ji, Wei

2007-01-01

Landscape characteristics of a watershed are important variables that influence surface water quality. Understanding the relationship between these variables and surface water quality is critical in predicting pollution potential and developing watershed management practices to eliminate or reduce pollution risk. To understand the impacts of landscape characteristics on water quality in mine waste-located watersheds, we conducted a case study in the Tri-State Mining District which is located in the conjunction of three states (Missouri, Kansas and Oklahoma). Severe heavy metal pollution exists in that area resulting from historical mining activities. We characterized land use/land cover over the last three decades by classifying historical multi-temporal Landsat imagery. Landscape metrics such as proportion, edge density and contagion were calculated based on the classified imagery. In-stream water quality data over three decades were collected, including lead, zinc, iron, cadmium, aluminum and conductivity which were used as key water quality indicators. Statistical analyses were performed to quantify the relationship between landscape metrics and surface water quality. Results showed that landscape characteristics in mine waste-located watersheds could account for as much as 77% of the variation of water quality indicators. A single landscape metric alone, such as proportion of mine waste area, could be used to predict surface water quality; but its predicting power is limited, usually accounting for less than 60% of the variance of water quality indicators.

Is higher nursing home quality more costly?

PubMed

Giorgio, L Di; Filippini, M; Masiero, G

2016-11-01

Widespread issues regarding quality in nursing homes call for an improved understanding of the relationship with costs. This relationship may differ in European countries, where care is mainly delivered by nonprofit providers. In accordance with the economic theory of production, we estimate a total cost function for nursing home services using data from 45 nursing homes in Switzerland between 2006 and 2010. Quality is measured by means of clinical indicators regarding process and outcome derived from the minimum data set. We consider both composite and single quality indicators. Contrary to most previous studies, we use panel data and control for omitted variables bias. This allows us to capture features specific to nursing homes that may explain differences in structural quality or cost levels. Additional analysis is provided to address simultaneity bias using an instrumental variable approach. We find evidence that poor levels of quality regarding outcome, as measured by the prevalence of severe pain and weight loss, lead to higher costs. This may have important implications for the design of payment schemes for nursing homes.

Detection of Microbial Water Quality Indicators and Fecal Waterborne Pathogens in Environmental Waters: A Review of Methods, Applications, and Limitations

EPA Science Inventory

Environmental waters are important reservoirs of pathogenic microorganisms, many of which are of fecal origin. In most cases, the presence of pathogens is determined using surrogate bacterial indicators. In other cases, direct detection of the pathogen in question is required. M...

Show Me: Diversity and Isolation Indicators of Spatial Segregation within and across Missouri's School Districts

ERIC Educational Resources Information Center

Tate, William F.; Hogrebe, Mark C.

2018-01-01

Our study examines patterns of spatial segregation using diversity and isolation indicators within and across Missouri school districts. Evaluating segregation from a critical spatial perspective emphasizes the importance of place when evaluating the quality of educational opportunity for diverse student populations. The methodology involves the…

Friends Also Matter: Examining Friendship Adjustment Indices as Moderators of Anxious-Withdrawal and Trajectories of Change in Psychological Maladjustment

ERIC Educational Resources Information Center

Markovic, Andrea; Bowker, Julie C.

2017-01-01

The present study evaluated whether 3 indices of friendship adjustment (mutual friendship involvement, friendship stability, friendship quality) are important, but overlooked, moderators of the impact of anxious-withdrawal on trajectories of psychological maladjustment during early adolescence. Participants included 271 young adolescents (51%…

Water Quality, Weather and Environmental Factors Associated with Fecal Indicator Organism Density in Beach Sand at Two Recreational Marine Beaches

EPA Science Inventory

Recent studies showing an association between fecal indicator organisms (FIOs and gastrointestinal (GI) illness among beachgoers wit sand contact have important public health implicatons because of the large numbers of people who recreate at beaches and engage in sand contact act...

Audit and feedback intervention: An examination of differences in chiropractic record-keeping compliance.

PubMed

Homb, Nicole M; Sheybani, Shayan; Derby, Dustin; Wood, Kurt

2014-10-01

Objective : The objective of this study was to investigate the association of a clinical documentation quality improvement program using audit-feedback with clinical compliance to indicators of quality chart documentation. Methods : This was an analysis of differences between adherence to quality indicators of chiropractic record documentation and audit-feedback intervention (feedback report only vs. feedback report with one-on-one educational consultation) at different campuses. Comparisons among groups were analyzed using analysis of variance (ANOVA), Tukey or Dunnett post hoc tests, and Cohen's d effect size estimates. Results : There was a significant increase in the mean percentile compliance in 2 of 5 compliance areas and 1 of 11 compliance objectives. Campus B demonstrated significantly higher levels of compliance relative to campus A and/or campus C in 5 of 5 compliance areas and 7 of 11 compliance objectives. Across-campus comparisons indicated that the compliance area Review (Non-Medicare) Treatment Plan [F(2,18) = 17.537, p < .001] and compliance objective Treatment Plan Goals [F(2,26) = 5.653, p < .001] exhibited the highest practical importance for clinical compliance practice. Conclusions : Feedback of performance improved compliance to indicators of quality health record documentation, especially when baseline adherence is relatively low. Required educational consultations with clinicians combined with audit-feedback were no more effective at increasing compliance to indicators of quality health record documentation than audit-feedback alone.

Using standard treatment protocols to manage costs and quality of hospital services.

PubMed

Meyer, J W; Feingold, M G

1993-06-01

The current health care environment has made it critically important that hospital costs and quality be managed in an integrated fashion. Promised health care reforms are expected to make cost reduction and quality enhancement only more important. Traditional methods of hospital cost and quality control have largely been replaced by such approaches as practice parameters, outcomes measurement, clinical indicators, clinical paths, benchmarking, patient-centered care, and a focus on patient selection criteria. This Special Report describes an integrated process for strategically managing costs and quality simultaneously, incorporating key elements of many important new quality and cost control tools. By using a multidisciplinary group process to develop standard treatment protocols, hospitals and their medical staffs address the most important services provided within major product lines. Using both clinical and financial data, groups of physicians, nurses, department managers, financial analysts, and administrators redesign key patterns of care within their hospital, incorporating the best practices of their own and other institutions. The outcome of this process is a new, standardized set of clinical guidelines that reduce unnecessary variation in care, eliminate redundant interventions, establish clear lines of communication for all caregivers, and reduce the cost of each stay. The hospital, medical staff, and patients benefit from the improved opportunities for managed care contracting, more efficient hospital systems, consensus-based quality measures, and reductions in the cost of care. STPs offer a workable and worthwhile approach to positioning the hospital of the 1990s for operational efficiency and cost and quality competitiveness.

Brand Name, Store Image, and Country-of-Origin: The Effects on Consumers' Perception of Quality and Price.

ERIC Educational Resources Information Center

King, Margaret C. A.

1993-01-01

A review of literature indicated that, with regard to brand labels, consumers' perception of price, but not of quality, was affected. Consumers expected to pay more for goods bought in a higher status store and rated imported goods as being more expensive than domestically produced goods. Products from developing countries received lower quality…

The Impact of Imports and Exports on a Country's Quality of Life

ERIC Educational Resources Information Center

Sirgy, M. Joseph; Lee, Dong-Jin; Miller, Chad; Littlefield, James E.; Atay, Eda Gurel

2007-01-01

This paper is a sequel to Sirgy et al. ("Social Ind. Res." 68(3) (2004) 251), "The Impact of Globalization on a Country's Quality of Life: Toward an Integrated Model" published in "Social Indicators Research." That paper conceptualized globalization in terms of the free flow of four major components: (1) goods and services, (2) people, (3)…

Identification of Important Parameter from Leachate Solid Waste Landfill on Water Quality, Case Study of Pesanggrahan River

NASA Astrophysics Data System (ADS)

Yanidar, R.; Hartono, D. M.; Moersidik, S. S.

2018-03-01

Cipayung Landfill takes waste generation from Depok City approximately ± 750 tons/day of solid waste. The south and west boundaries of the landfill is Pesanggarahan River which 200m faraway. The objectives of this study are to indicate an important parameter which greatly affects the water quality of Pesanggrahan River and purpose the dynamic model for improving our understanding of the dynamic behavior that captures the interactions and feedbacks important parameter in river in order to identify and assess the effects of the treated leachate from final solid waste disposal activity as it responds to changes over time in the river. The high concentrations of BOD and COD are not the only cause significantly affect the quality of the pesanggrahan water, it also because the river has been contaminated in the upstream area. It need the water quality model to support the effectiveness calculation of activities for preventing a selected the pollutant sources the model should be developed for simulating and predicting the trend of water quality performance in Pesanggrahan River which can potentially be used by policy makers in strategic management to sustain river water quality as raw drinking water.

What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

PubMed

Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

2018-02-17

For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal risk assessment, rather than competing with economic value, enhances it.

Profilograph specification study.

DOT National Transportation Integrated Search

2010-10-01

Pavement smoothness is probably the single most important indicator of pavement performance according to the traveling public. Rough or uneven pavements adversely affect driver safety, ride quality, fuel efficiency, and vehicle wear and tear. Rough p...

Strategies to accelerate translation of research into primary care within practices using electronic medical records.

PubMed

Nemeth, Lynne S; Wessell, Andrea M; Jenkins, Ruth G; Nietert, Paul J; Liszka, Heather A; Ornstein, Steven M

2007-01-01

This research describes implementation strategies used by primary care practices using electronic medical records in a national quality improvement demonstration project, Accelerating Translation of Research into Practice, conducted within the Practice Partner Research Network. Qualitative methods enabled identification of strategies to improve 36 quality indicators. Quantitative survey results provide mean scores reflecting the integration of these strategies by practices. Nursing staff plays important roles to facilitate quality improvement within collaborative primary care practices.

[Time-Temperature indicators (TTI). A means of quality control of produce].

PubMed

Durand, M P

1996-11-01

The author, after having dwelt on the mediatic importance of bacterial food poisonings, analyses their reasons, insisting on the importance of the temperature as a factor of bacterial growth. Among the cures for the association temperature-bacterial growth, the author draws attention to the benefits of the use of the time temperature indicators (TTI). He describes the purposes, the required qualities, the principles of activity. The "Lifelines TTI" proves to be interesting. The author describes the principles of activity, the directions for reading the results, the practical application. Finally he describes the remarks following on its use in large scale in a group of chain-stores. In the conclusion, the author points that these TTI are an attractive technical innovation regarding to the fresh foods, for the control of coldness in the human nutrition.

Psychological well-being of older Chinese immigrants living in Australia: a comparison with older Caucasians.

PubMed

Lin, Xiaoping; Bryant, Christina; Boldero, Jennifer; Dow, Briony

2016-10-01

Few current studies explore psychological well-being among older Chinese immigrants in Australia. The study addressed this gap and provided preliminary data on psychological well-being among this group. Four indicators, namely depression, anxiety, loneliness, and quality of life, were used to present a comprehensive picture of psychological well-being. Participants were two groups of community-dwelling older people, specifically 59 Chinese immigrants and 60 Australian-born people (median age=77 and 73, respectively). Data were collected through standardized interviews. The Geriatric Depression Scale, the Hospital Anxiety and Depression Scale, the de Jong Gierveld Loneliness Scale and the WHO Quality of Life questionnaire were used to measure depression, anxiety, loneliness, and quality of life, respectively. Chinese participants' median quality of life score was higher than the scale mid-point, indicating relatively high levels of quality of life. However, 10% exhibited symptoms of depression, 6% had symptoms of anxiety, and 49% felt lonely. Compared to Australian participants, Chinese participants reported poorer quality of life and higher levels of loneliness. Importantly, the difference in quality of life remained when the impact of socio-demographic factors was controlled for. This study was the first to use multiple indicators to explore psychological well-being among older Chinese immigrants in Australia. Its results suggest that their psychological well-being might be worse than that of Australian-born people when using loneliness and quality of life as indicators. In particular, loneliness is a common psychological problem among this group, and there is a need for public awareness of this problem.

Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units

PubMed Central

Güler, Sertaç Ata; Güllüoğlu, Bahadır M.

2014-01-01

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a “reviewing/auditing” procedure that checks if all of these functions existing in the health system are carried out at the desired level and an “accreditation” system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5–10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer. PMID:28331658

Quality Assurance in Breast Health Care and Requirement for Accreditation in Specialized Units.

PubMed

Güler, Sertaç Ata; Güllüoğlu, Bahadır M

2014-07-01

Breast health is a subject of increasing importance. The statistical increase in the frequency of breast cancer and the consequent increase in death rate increase the importance of quality of services to be provided for breast health. For these reasons, the minimum standards and optimum quality metrics of breast care provided to the community are determined. The quality parameters for breast care service include the results, the structure and the operation of services. Within this group, the results of breast health services are determined according to clinical results, patient satisfaction and financial condition. The structure of quality services should include interdisciplinary meetings, written standards for specific procedures and the existence of standardized reporting systems. Establishing breast centers that adopt integrated multidisciplinary working principles and their cost-effective maintenance are important in terms of operation of breast health services. The importance of using a "reviewing/auditing" procedure that checks if all of these functions existing in the health system are carried out at the desired level and an "accreditation" system indicating that the working breast units/centers provide minimum quality adequacy in all aspects, is undeniable. Currently, the accreditation system for breast centers is being used in the European Union and the United States for the last 5-10 years. This system is thought to provide standardization in breast care services, and is accepted as one of the important factors that resulted in reduction in mortality associated with breast cancer.

Socioeconomic dynamics of water quality in the Egyptian Nile

NASA Astrophysics Data System (ADS)

Malik, Maheen; Nisar, Zainab; Karakatsanis, Georgios

2016-04-01

The Nile River remains the most important source of freshwater for Egypt as it accounts for nearly all of the country's drinking and irrigation water. About 95% of the total population is accounted to live along the Banks of the Nile(1). Therefore, water quality deterioration in addition to general natural scarcity of water in the region(2) is the main driver for carrying out this study. What further aggravates this issue is the water conflict in the Blue Nile region. The study evaluates different water quality parameters and their concentrations in the Egyptian Nile; further assessing the temporal dynamics of water quality in the area with (a) the Environmental Kuznets Curve (EKC)(3) and (b) the Jevons Paradox (JP)(4) in order to identify water quality improvements or degradations using selected socioeconomic variables(5). For this purpose various environmental indicators including BOD, COD, DO, Phosphorus and TDS were plotted against different economic variables including Population, Gross Domestic Product (GDP), Annual Fresh Water Withdrawal and Improved Water Source. Mathematically, this was expressed by 2nd and 3rd degree polynomial regressions generating the EKC and JP respectively. The basic goal of the regression analysis is to model and highlight the dynamic trend of water quality indicators in relation to their established permissible limits, which will allow the identification of optimal future water quality policies. The results clearly indicate that the dependency of water quality indicators on socioeconomic variables differs for every indicator; while COD was above the permissible limits in all the cases despite of its decreasing trend in each case, BOD and phosphate signified increasing concentrations for the future, if they continue to follow the present trend. This could be an indication of rebound effect explained by the Jevons Paradox i.e. water quality deterioration after its improvement, either due to increase of population or intensification of economic activities related to these indicators. Keywords: Water quality dynamics, Environmental Kuznets Curve (EKC), Jevons Paradox (JP), economic variables, polynomial regressions, environmental indicators, permissible limit References: (1)Evans, A. (2007). River of Life River Nile. (2)Egypt's Water Crisis - Recipe for Disaster. (2016). [Blog] EcoMENA- Echoing Sustainability. (3)Alstine, J. and Neumayer, E. (2010). The Environmental Kuznets Curve. (4)Garrett, T. (2014). Rebound, Backfire, and the Jevons Paradox. [Blog] (5)Data.worldbank.org

Respite Care, Stress, Uplifts, and Marital Quality in Parents of Children with Down Syndrome.

PubMed

Norton, Michelle; Dyches, Tina Taylor; Harper, James M; Roper, Susanne Olsen; Caldarella, Paul

2016-12-01

Parents of children with disabilities are at risk for high stress and low marital quality; therefore, this study surveyed couples (n = 112) of children with Down syndrome (n = 120), assessing whether respite hours, stress, and uplifts were related to marital quality. Structural equation modeling indicated that respite hours were negatively related to wife/husband stress, which was in turn negatively related to wife/husband marital quality. Also, wife uplifts were positively related to both wife and husband marital quality. Husband uplifts were positively related to husband marital quality. Therefore, it is important that respite care is provided and accessible to parents of children with Down syndrome.

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.

Perceived importance and responsibility for market-driven pig welfare: Literature review.

PubMed

Thorslund, Cecilie A H; Aaslyng, Margit Dall; Lassen, Jesper

2017-03-01

This review explores barriers and opportunities for market-driven pig welfare in Europe. It finds, first, that consumers generally rank animal welfare as important, but they also rank it low relative to other societal problems. Second, consumers have a wide range of concerns about pig welfare, but they focus especially on naturalness. Third, pig welfare is seen as an important indicator of meat quality. Fourth, consumers tend to think that responsibility for pig welfare lies with several actors: farmers, governments and themselves. The paper concludes that there is an opportunity for the market-driven strategy to sell a narrative about naturalness supplemented with other attractive qualities (such as eating quality). It also emphasizes that pig welfare needs to be on the political/societal agenda permanently if it is to be viewed as an important issue by consumers and if consumers are to assume some sort of responsibility for it. Copyright © 2016 Elsevier Ltd. All rights reserved.

SOLID PHASE EXTRACTION AND HIGH PERFORMANCE LIQUID CHROMATOGRAPHY WITH PHOTODIODE ARRAY DETECTION OF CHEMICAL INDICATORS OF HUMAN FECAL CONTAMINATION IN WATER

EPA Science Inventory

Faster and more sensitive analysis of water that is contaminated by human fecal matter is very important for health. The current microbiological methods to assess water quality do not meet this need. Alternate non-microbial human fecal indicators have been proposed by various r...

Monitoring social indicators in the Bear Trap Canyon Wilderness 1988-1998

Treesearch

Joe L. Ashor

2000-01-01

Since its inception as a wilderness planning and management tool almost 15 years ago, the Limits of Acceptable Change (LAC) process has stressed the importance of monitoring. Monitoring social conditions is critical to ensure that quality visitor experiences are maintained. Ten years of data collected from monitoring three river corridor-related social indicators in...

Comparison of an enhanced versus a written feedback model on the management of Medicare inpatients with venous thrombosis.

PubMed

Hayes, R; Bratzler, D; Armour, B; Moore, L; Murray, C; Stevens, B R; Radford, M; Fitzgerald, D; Elward, K; Ballard, D J

2001-03-01

A multistate randomized study conducted under the Health Care Financing Administration's (HCFA's) Health Care Quality Improvement Program (HCQIP) offered the opportunity to compare the effect of a written feedback intervention (WFI) with that of an enhanced feedback intervention (EFI) on improving the anticoagulant management of Medicare beneficiaries who present to the hospital with venous thromboembolic disease. Twenty-nine hospitals in five states were randomly assigned to receive written hospital-specific feedback (WFI) of feedback enhanced by the participation of a trained physician, quality improvement tools, and an Anticoagulant Management of Venous Thrombosis (AMVT) project liaison (EFI). Differences in the performance of five quality indicators between baseline and remeasurement were assessed. Quality managers were interviewed to determine perceptions of project implementation. No significant differences in the change from baseline to remeasurement were found between the two intervention groups. Significant improvement in one indicator and significant decline in two indicators were found for one or both groups. Yet 59% of all quality managers perceived the AMVT project as being successful to very successful, and more EFI quality managers perceived success than did WFI managers (71% versus 40%). In the majority of EFI hospitals, physician liaisons played an important role in project implementation. Study results indicated that the addition of a physician liaison, quality improvement tools, and a project liaison did not provide incremental value to hospital-specific feedback for improving quality of care. Future studies with larger sample sizes, lengthier follow-up periods, and interventions that include more of the elements shown to affect practice behavior change are needed to identify an optimal feedback model for use by external quality management organizations.

[Advances in the use of instrumental measurement of colour in the development, production and quality control of drugs, medicinal preparations and pharmaceutical auxiliary substances I ].

PubMed

Subert, Jan; Cižmárik, Jozef

2013-04-01

Colour is one of the important indices of the quality of drugs, medicinal preparations and pharmaceutical auxiliary substances. The paper summarizes the development and use of instrumental measurement of colour in pharmacy in recent ten years focusing on the drugs of synthetic origin and pharmaceutical auxiliary substances including their control.

Mating System and Sexual Selection in the Scorpionfly Panorpa vulgaris (Mecoptera: Panorpidae)

NASA Astrophysics Data System (ADS)

Sauer, Klaus Peter; Lubjuhn, Thomas; Sindern, Jörn; Kullmann, Harald; Kurtz, Joachim; Epplen, Conny; Epplen, Jörg Thomas

1998-05-01

has become a model insect for testing theories of sexual selection. This contribution summarizes that which has been learned in recent years and presents new data that clearly show that the mating system of P. vulgaris is not simply a resource-defense polygyny, as has previously been thought. In P. vulgaris neither the pattern in food exploitation nor the ratio of variance in the lifetime reproductive success of the two sexes is in accordance with that expected in resource defense polygynous mating systems. Lifetime mating duration is the most important proximate determinant of male fitness. Males employing alternative mating tactics obtain copulations of varying duration in relation to the following sequence: saliva secretion 1 food offering 1 no gift. The number of salivary masses which males provide to females during their lifetime is significantly correlated with the lifetime condition index. The condition index depends on the fighting prowess of males and their ability to find food items. Thus saliva secretion of Panorpa is considered a Zahavian handicap, which can serve as an honest quality indicator used by mating females. Our results confirm four main predictions of the indicator model of the theory of sexual selection: (a) the indicator signals high ecological quality of its bearer, (b) the indicator value increases with phenotypic quality, (c) the indicator value is positively correlated with the genetic quality affecting offspring fitness in a natural selection context, and (d) the quality indicator is more costly for low- than for high-quality individuals. The evolutionary consequences of the mating pattern and the sperm competition mechanism in P. vulgaris are discussed in the context the way in which sexual selection creates and maintains sperm mixing and the evolution of a promiscuous mating system.

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

PubMed

Cole, Donald C; Robson, Lynda S; Lemieux-Charles, Louise; McGuire, Wendy; Sicotte, Claude; Champagne, Francois

2005-01-01

Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Evaluation of quality indicators and disease damage in childhood-onset systemic lupus erythematosus patients.

PubMed

Harris, Julia G; Maletta, Kristyn I; Kuhn, Evelyn M; Olson, Judyann C

2017-02-01

The aim of this study was to describe compliance with select quality indicators and assess organ-specific dysfunction in a childhood-onset systemic lupus erythematosus population by using a validated damage index and to evaluate associations between compliance with quality indicators and disease damage. A retrospective chart review was performed on patients diagnosed with systemic lupus erythematosus prior to age 18 followed at a single center in the USA from 1999 to 2012 (n = 75). Data regarding quality indicators and outcome variables, including the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, were collected. The median disease duration was 3.8 years. The proportion of patients or patient-years in which care complied with the proposed quality measures was 94.4% for hydroxychloroquine use, 84.3% for vitamin D recommendation,75.8% for influenza vaccination (patient-years), 67.2% for meningococcal vaccination, 49.0% for ophthalmologic examination (patient-years), 31.7% for pneumococcal vaccination, and 28.6% for bone mineral density evaluation. Disease damage was present in 41.3% of patients at last follow-up, with an average damage index score of 0.81. Disease damage at last follow-up was associated with minority race/ethnicity (p = 0.008), bone mineral density evaluation (p = 0.035), and vitamin D recommendation (p = 0.018). Adherence to quality indicators in a childhood-onset systemic lupus erythematosus population is varied, and disease damage is prevalent. This study highlights the importance of quality improvement initiatives aimed at optimizing care delivery to reduce disease damage in pediatric lupus patients.

Effect of economic growth and environmental quality on tourism in Southeast Asian Countries

NASA Astrophysics Data System (ADS)

Firmansyah

2017-02-01

The tourism is an important sector in generating income for a country, nevertheless, tourism is sensitive toward the changes in economy, as well as changes in environmental quality. By employing econometric models of error correction on annual data, this study examines the influence of environmental quality, domestic and global economic growth on foreign tourist arrivals in selected Southeast Asian countries, namely Indonesia, Malaysia, Thailand, Philippines, and Singapore. The findings of this study showed that all of countries long run model were proved statistically, indicated that world economic growth as well as environmental quality affect foreign tourism arrivals.

Quality assessment of Isfahan Medical Faculty web site electronic services and prioritizing solutions using analytic hierarchy process approach

PubMed Central

Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Hajrahimi, Nargess; Sarmadi, Sima

2014-01-01

Context: Implementing information technology in the best possible way can bring many advantages such as applying electronic services and facilitating tasks. Therefore, assessment of service providing systems is a way to improve the quality and elevate these systems including e-commerce, e-government, e-banking, and e-learning. Aims: This study was aimed to evaluate the electronic services in the website of Isfahan University of Medical Sciences in order to propose solutions to improve them. Furthermore, we aim to rank the solutions based on the factors that enhance the quality of electronic services by using analytic hierarchy process (AHP) method. Materials and Methods: Non-parametric test was used to assess the quality of electronic services. The assessment of propositions was based on Aqual model and they were prioritized using AHP approach. The AHP approach was used because it directly applies experts’ deductions in the model, and lead to more objective results in the analysis and prioritizing the risks. After evaluating the quality of the electronic services, a multi-criteria decision making frame-work was used to prioritize the proposed solutions. Statistical Analysis Used: Non-parametric tests and AHP approach using Expert Choice software. Results: The results showed that students were satisfied in most of the indicators. Only a few indicators received low satisfaction from students including, design attractiveness, the amount of explanation and details of information, honesty and responsiveness of authorities, and the role of e-services in the user's relationship with university. After interviewing with Information and Communications Technology (ICT) experts at the university, measurement criteria, and solutions to improve the quality were collected. The best solutions were selected by EC software. According to the results, the solution “controlling and improving the process in handling users complaints” is of the utmost importance and authorities have to have it on the website and place great importance on updating this process. Conclusions: Although, 4 out of the 22 indicators used in the test hypothesis were not confirmed, the results show that these assumptions are accepted at 95% confidence level. To improve the quality of electronic services, special attention should be paid to “services interaction.” As the results showed having “controlling and improving the process in handling users complaints” on the website is the first and most important one and the process of “changing brand/factory name/address in the text of the factory license/renewal or modification of manufacturing license/changing the formula” is the least important one. PMID:25540790

Quality assessment of Isfahan Medical Faculty web site electronic services and prioritizing solutions using analytic hierarchy process approach.

PubMed

Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Hajrahimi, Nargess; Sarmadi, Sima

2014-01-01

Implementing information technology in the best possible way can bring many advantages such as applying electronic services and facilitating tasks. Therefore, assessment of service providing systems is a way to improve the quality and elevate these systems including e-commerce, e-government, e-banking, and e-learning. This study was aimed to evaluate the electronic services in the website of Isfahan University of Medical Sciences in order to propose solutions to improve them. Furthermore, we aim to rank the solutions based on the factors that enhance the quality of electronic services by using analytic hierarchy process (AHP) method. Non-parametric test was used to assess the quality of electronic services. The assessment of propositions was based on Aqual model and they were prioritized using AHP approach. The AHP approach was used because it directly applies experts' deductions in the model, and lead to more objective results in the analysis and prioritizing the risks. After evaluating the quality of the electronic services, a multi-criteria decision making frame-work was used to prioritize the proposed solutions. Non-parametric tests and AHP approach using Expert Choice software. The results showed that students were satisfied in most of the indicators. Only a few indicators received low satisfaction from students including, design attractiveness, the amount of explanation and details of information, honesty and responsiveness of authorities, and the role of e-services in the user's relationship with university. After interviewing with Information and Communications Technology (ICT) experts at the university, measurement criteria, and solutions to improve the quality were collected. The best solutions were selected by EC software. According to the results, the solution "controlling and improving the process in handling users complaints" is of the utmost importance and authorities have to have it on the website and place great importance on updating this process. Although, 4 out of the 22 indicators used in the test hypothesis were not confirmed, the results show that these assumptions are accepted at 95% confidence level. To improve the quality of electronic services, special attention should be paid to "services interaction." As the results showed having "controlling and improving the process in handling users complaints" on the website is the first and most important one and the process of "changing brand/factory name/address in the text of the factory license/renewal or modification of manufacturing license/changing the formula" is the least important one.

Drinking Patterns Among Older Couples: Longitudinal Associations With Negative Marital Quality.

PubMed

Birditt, Kira S; Cranford, James A; Manalel, Jasmine A; Antonucci, Toni C

2018-04-16

Research with younger couples indicates that alcohol use has powerful effects on marital quality, but less work has examined the effects of drinking among older couples. This study examined whether dyadic patterns of drinking status among older couples are associated with negative marital quality over time. Married participants (N = 4864) from the Health and Retirement Study reported on alcohol consumption (whether they drink alcohol and average amount consumed per week) and negative marital quality (e.g., criticism and demands) across two waves (Wave 1 2006/2008 and Wave 2 2010/2012). Concordant drinking couples reported decreased negative marital quality over time, and these links were significantly greater among wives. Wives who reported drinking alcohol reported decreased negative marital quality over time when husbands also reported drinking and increased negative marital quality over time when husbands reported not drinking. The present findings stress the importance of considering the drinking status rather than the amount of alcohol consumed of both members of the couple when attempting to understand drinking and marital quality among older couples. These findings are particularly salient given the increased drinking among baby boomers and the importance of marital quality for health among older couples.

The Value of Clean Air: Comparing Discounting of Delayed Air Quality and Money Across Magnitudes.

PubMed

Berry, Meredith S; Friedel, Jonathan E; DeHart, William B; Mahamane, Salif; Jordan, Kerry E; Odum, Amy L

2017-06-01

The detrimental health effects of exposure to air pollution are well established. Fostering behavioral change concerning air quality may be challenging because the detrimental health effects of exposure to air pollution are delayed. Delay discounting, a measure of impulsive choice, encapsulates this process of choosing between the immediate conveniences of behaviors that increase pollution and the delayed consequences of prolonged exposure to poor air quality. In Experiment 1, participants completed a series of delay-discounting tasks for air quality and money. We found that participants discounted delayed air quality more than money. In Experiment 2, we investigated whether the common finding that large amounts of money are discounted less steeply than small amounts of money generalized to larger and smaller improvements in air quality. Participants discounted larger improvements in air quality less steeply than smaller improvements, indicating that the discounting of air quality shares a similar process as the discounting of money. Our results indicate that the discounting of delayed money is strongly related to the discounting of delayed air quality and that similar mechanisms may be involved in the discounting of these qualitatively different outcomes. These data are also the first to demonstrate the malleability of delay discounting of air quality, and provide important public health implications for decreasing delay discounting of air quality.

Notes on the Iran Caddisflies and Role of Annulipalpian Hydropsychid Caddisflies as a Bio-monitoring Agent

PubMed Central

Malekei-Ravasan, Naseh; Bahrami, Abbas; Shayeghi, Mansoreh; Oshaghi, Mohamad Ali; Malek, Masomeh; Mansoorian, Allah Bedasht; Vatandoost, Hassan

2013-01-01

Background: Eco-faunistic studies are inevitable step in environmental researches. Aquatic organisms like caddisflies are known as biological indicators for water quality assessment and water resource management. They have special role for energy flow in the freshwater habitats as food web and food chain among aquatic creatures. Methods: In addition to an extensive literature review on Iran Caddisflies, a field study was carried out in Lavasan river flows in north east of Tehran to collect aquatic insects using D-frame nets and or direct search on stone beneath. The water quality was measured using analytical method. Results: Literature revealed record of 62 trichopterid species in the country comprising 14 families. The most abundant species belonged to the Hydropsychidae. Herein we report presence of the Annulipalpian Hydropsyche sciligra H Malicky, 1977 in the study area. Habitat water quality of H. sciligra resembled human drinkable water. However presence of snail, Physa acuta and fish Capoeta buhsei in the water sampling area indicated inferior quality. Conclusion: From ecological point of view caddisfly larvae are predators of most important medical vectors like mosquitoes, blackflies and midges. Also they are useful and important indicator for monitoring physicochemical effects in the nature, so that they can be used for bio-monitoring program. From medical point of view, wing hairs or other body parts of caddisflies can be inhalant and contact allergens in Trichopterists and in sensitive individuals who come in contact. PMID:23785697

Urban environment and well-being: cross-cultural studies on Perceived Residential Environment Quality Indicators (PREQIs).

PubMed

Bonaiuto, Marino; Fornara, Ferdinando; Alves, Susana; Ferreira, Ines; Mao, Yanhui; Moffat, Eva; Piccinin, Gloria; Rahimi, Leila

2015-09-01

Architectural and environmental psychology literature has shown the importance of urban design in provoking stress feelings or enhancing well-being and quality of life. The aim of this contribution is to show the main results of a set of cross-cultural survey studies concerning the perceived quality of urban features at the neighbourhood level. A questionnaire was used including the extended or the short version of the 11 scales measuring Perceived Residential Environment Quality Indicators (PREQIs), which cover architectural, social, functional, and contextual aspects. Both versions of PREQIs showed a similar factorial structure and a good (or at least acceptable) reliability across different geographical contexts, even though some differences emerged in those countries that are more distant from the Western linguistic and cultural milieu. The development of tools like PREQIs should increase a "user-centred" vision on urban issues.

Evaluation of food drying with air dehumidification system: a short review

NASA Astrophysics Data System (ADS)

Djaeni, M.; Utari, F. D.; Sasongko, S. B.; Kumoro, A. C.

2018-01-01

Energy efficient drying for food and agriculture products resulting high quality products has been an important issue. Currently, about 50% of total energy for postharvest treatment was used for drying. This paper presents the evaluation of new approach namely air dehumidification system with zeolite for food drying. Zeolite is a material having affinity to water in which reduced the moisture in air. With low moisture content and relative humidity, the air can improve driving force for drying even at low temperature. Thus, the energy efficiency can be potentially enhanced and the product quality can be well retained. For proving the hypothesis, the paddy and onion have been dried using dehumidified air. As performance indicators, the drying time, product quality, and heat efficiency were evaluated. Results indicated that the drying with zeolite improved the performances significantly. At operating temperature ranging 50 - 60°C, the efficiency of drying system can reach 75% with reasonable product quality.

THE ROLE OF PERSONALITY CHARACTERISTICS OF ATHLETES IN COACH-ATHLETE RELATIONSHIPS.

PubMed

Hülya Aşçı, F; Kelecek, Selen; AltintaŞ, Atahan

2015-10-01

This study investigated the relationship between athletes' personality characteristics and the quality of the coach-athlete relationship. 84 female (M age = 20.6 yr., SD = 2.8) and 129 male (M age = 22.0 yr., SD = 3.3) elite youth athletes competing at least for 7 yr. participated in this study. The Five-Factor Personality Inventory (short version) and the Quality of Relationships Inventory were administered to all participants. Stepwise multiple regression analysis assessed which of the five personality factors predicted scores for the different subscales of the Quality of Relationships Inventory (Depth, Support, and Conflict). Results indicated that depth of relationship was not predicted by personality factors. On the other hand, neuroticism and extraversion were significant predictors of support dimension of relationship. Analysis indicated that conscientiousness was the strongest predictor of conflict. In conclusion, athletes' personality characteristics may be important in determining the quality of the coach-athlete relationship.

The Construction and Pilot Application of a Scoring Rubric for Creative Drama Lesson Planning

ERIC Educational Resources Information Center

Korkut, Perihan

2018-01-01

Instructional planning is an important part of successful teaching. Therefore, quality lesson planning is accepted as an important indicator of teacher knowledge and ability. This is no different for creative drama. Although drama is strongly rooted in the participating group's creativity and spontaneity, its success depends on a careful and…

Are Education and Skills Being Distributed More Inclusively? Education Indicators in Focus. No. 32

ERIC Educational Resources Information Center

OECD Publishing, 2015

2015-01-01

Educational opportunities have a very important impact on a person's life. Employment, earnings, well-being, health and trust are all strongly related to education and skills. A lack of high-quality educational opportunities is the most important way in which poverty, social inequality and exclusion are transmitted from one generation to another.…

Use of comparative performance indicators in rehabilitation.

PubMed

Zidarov, Diana; Poissant, Lise; Sicotte, Claude

The development of performance indicators that enable benchmarking between organizations is an important mechanism for accountability, organizational learning, and performance improvement. In the province of Quebec (Canada), 21 rehabilitation organizations developed a common set of performance indicators through interorganizational collaboration. The aims of this study were to describe the rehabilitation organizations' use of a common set of performance indicators and to identify the factors influencing such use. A qualitative survey was performed. Individual semistructured interviews were conducted with executives (n = 18) working at 16 rehabilitation organizations using a common set of performance indicators. A thematic analysis of the factors of use was performed according to the Consolidated Framework for Implementation Research. The use of performance indicators was categorized as purposeful, political, or passive. Our results showed that all organizations used the common set of performance indicators. Four factors were identified as important to all the rehabilitation organizations to explain their interest in comparative performance indicators: the need to develop their own performance indicators, the compatibility of performance information with organizational needs, complexity/simplicity of performance information, and the support offered by their common association. Sixty-three percent of rehabilitation organizations made purposeful or political use of performance indicators. Three main factors contributed to typify those organizations from the others: the perceived quality of the performance indicators, the leadership of decision makers, and the resources available. Our results showed that use of performance indicators can support the initiation of projects for improving the quality of care. Key recommendations are proposed to decision makers that may enhance performance indicators' use.

Protein and quality analyses of accessions from the USDA soybean germplasm collection for tofu production.

PubMed

Meng, Shi; Chang, Sam; Gillen, Anne M; Zhang, Yan

2016-12-15

Food-grade soybeans with large seed size, uniformity, clear hilum and a high 11S/7S ratio are favoured by the food industry for making tofu. In order to search for soybean lines with desirable characteristics for making foods, 22 soybean lines were selected from the USDA-Soybean Germplasm Collection, were grown in Stoneville, MS for biochemical analysis and tofu texture and sensory quality tests. Eight lines were identified, from 22 lines harvested in 2014, to be suitable for tofu making, as judged by chemical composition and sensory quality of pressed tofu. In the filled tofu making and texture analysis study, the correlation between A3 subunit content and filled tofu firmness was significant (N=22, r=0.77, P<0.001). The results indicated that the A3 subunit could be an indicator for predicting the firmness of tofu. The results provided important food quality information for the selection of soybean genotypes for improving food quality. Copyright © 2016 Elsevier Ltd. All rights reserved.

Natural language processing in an intelligent writing strategy tutoring system.

PubMed

McNamara, Danielle S; Crossley, Scott A; Roscoe, Rod

2013-06-01

The Writing Pal is an intelligent tutoring system that provides writing strategy training. A large part of its artificial intelligence resides in the natural language processing algorithms to assess essay quality and guide feedback to students. Because writing is often highly nuanced and subjective, the development of these algorithms must consider a broad array of linguistic, rhetorical, and contextual features. This study assesses the potential for computational indices to predict human ratings of essay quality. Past studies have demonstrated that linguistic indices related to lexical diversity, word frequency, and syntactic complexity are significant predictors of human judgments of essay quality but that indices of cohesion are not. The present study extends prior work by including a larger data sample and an expanded set of indices to assess new lexical, syntactic, cohesion, rhetorical, and reading ease indices. Three models were assessed. The model reported by McNamara, Crossley, and McCarthy (Written Communication 27:57-86, 2010) including three indices of lexical diversity, word frequency, and syntactic complexity accounted for only 6% of the variance in the larger data set. A regression model including the full set of indices examined in prior studies of writing predicted 38% of the variance in human scores of essay quality with 91% adjacent accuracy (i.e., within 1 point). A regression model that also included new indices related to rhetoric and cohesion predicted 44% of the variance with 94% adjacent accuracy. The new indices increased accuracy but, more importantly, afford the means to provide more meaningful feedback in the context of a writing tutoring system.

Doctors or technicians: assessing quality of medical education

PubMed Central

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products. PMID:23745059

Doctors or technicians: assessing quality of medical education.

PubMed

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.

Quality of omeprazole purchased via the Internet and personally imported into Japan: comparison with products sampled in other Asian countries.

PubMed

Rahman, Mohammad Sofiqur; Yoshida, Naoko; Sugiura, Sakura; Tsuboi, Hirohito; Keila, Tep; Kiet, Heng Bun; Zin, Theingi; Tanimoto, Tsuyoshi; Kimura, Kazuko

2018-03-01

To evaluate the quality of omeprazole personally imported into Japan via the Internet and to compare the quality of these samples with previously collected samples from two other Asian countries. The samples were evaluated by observation, authenticity investigation and pharmacopoeial quality analysis. Quality comparison of some selected samples was carried out by dissolution profiling, Raman spectroscopy and principle component analysis (PCA). Observation of the Internet sites and samples revealed some discrepancies including the delivery of a wrong sample and the selling of omeprazole without a prescription, although it is a prescription medicine. Among the 28 samples analysed, all passed the identification test, 26 (93%) passed the quantity and content uniformity tests and all passed the dissolution test. Dissolution profiling confirmed that all the personally imported omeprazole samples remained intact in the acid medium. On the other hand, six samples from two of the same manufacturers, previously collected during surveys in Cambodia and Myanmar, frequently showed premature omeprazole release in acid. Raman spectroscopy and PCA showed significant variation between omeprazole formulations in personally imported samples and the samples from Cambodia and Myanmar. Our results indicate that the pharmaceutical quality of omeprazole purchased through the Internet was sufficient, as determined by pharmacopeial tests. However, omeprazole formulations distributed in different market segments by the same manufacturers were of diverse quality. Measures are needed to ensure consistent quality of products and to prevent entry of substandard products into the legitimate supply chain. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Which factors determine our quality of life, health and ability? Results from a Danish population sample and the Copenhagen perinatal cohort.

PubMed

Ventegodt, Søren; Flensborg-Madsen, Trine; Andersen, Niels Jørgen; Merrick, Joav

2008-07-01

To examine the statistical associations between Global Quality of Life (QOL) and a series of indicators representing health, ability, philosophy of life, sexuality, quality of working life and other medically relevant aspects of life. Cross-sectional comparative study using the self-administered SEQOL questionnaire. The Quality of Life Research Center, the University Hospital Copenhagen, Denmark. (1) A representative sample of 2,500 Danes (18-88 years) randomly selected from the CPR register, (2) Follow-up survey of members of the Copenhagen Perinatal Birth Cohort, 4,648 Danes (31-33 years). The associations were measured qualitatively as well as quantitatively calculating the difference in percentage and using the method of weight modified linear regression. QOL, measured by SEQOL (self-evaluation of quality of life), containing eight global QOL measures: well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life's potentials and objective factors. Strongest was the association between QOL, overall view of life (41.5% / 59.1%), relationship to self (39.3% / 56.8%), partner (32.2% / 31.7%) and friends (33.3% / 42.7%). Different aspects of physical as well as psychological health were also strongly correlated with QOL: self-perceived physical health (33.2% /29.4%), satisfaction with own health (27.3% / 29.0%), self-perceived mental health (38.4/51.0), number of severe health problems (29.8% / 35.3%). Objective factors such as income, age, sex, weight and social group did not have any noteworthy relationship to QOL, and neither did lifestyle factors such as tobacco and alcohol consumption, drug use, exercise, and diet. It seems that the factors important for present QOL and health is derived from good relations, with the close as well as the distant world, and overall view of life. What one possesses in objective terms--money, status, work--does not seem to be important to global quality of life and of little importance to self-assessed health. Our results indicate that what is really important is not what one has, but how he sees, evaluates and experiences what he has. The person's level of consciousness and responsible attitude towards life and others seem far more important for the global quality of life and health.

Mind over matter? The role of individual perceptions in understanding the social ecology of housing environments for individuals with psychiatric disabilities.

PubMed

Townley, Greg; Kloos, Bret

2014-12-01

There is a disagreement in place-based research regarding whether objective indicators or individual perceptions of environments are better predictors of well-being. This study assessed environmental influences on well-being for 373 individuals with psychiatric disabilities living independently in 66 neighborhoods in the southeastern United States. Three questions were examined utilizing random effects models: (1) How much variance in personal and neighborhood well-being can be explained by neighborhood membership? (2) What is the relationship between participant perceptions of neighborhood quality and researcher ratings of neighborhood quality? and (3) What is the relative influence of individual perceptions, perceptions aggregated by neighborhood, and researcher ratings of neighborhood quality in predicting personal and neighborhood well-being? Results indicate that individual perceptions of neighborhood quality were more closely related to well-being than either aggregated perceptions or researcher ratings. Thus, participants' perceptions of their neighborhoods were more important indicators of their well-being than objective ratings made by researchers. Findings have implications for measurement approaches and intervention design in placed-based research.

Voice symptoms and voice-related quality of life in college students.

PubMed

Merrill, Ray M; Tanner, Kristine; Merrill, Joseph G; McCord, Matthew D; Beardsley, Melissa M; Steele, Brittanie A

2013-08-01

The purpose of this study was to examine the prevalence of voice disorders in college students and their effect on the students as shown by quality-of-life indicators. A cross-sectional survey was completed by 545 college students in 2012. The survey included 10 questions from the Voice-Related Quality of Life (V-RQOL), selected voice symptoms, and quality-of-life indicators of functional health and well-being based on the Short Form 36-item Health Survey (SF-36). Twenty-nine percent of the college students (mean age, 22.7 years) reported a history of a voice disorder. Hoarseness was the most prevalent voice symptom, but was not correlated with V-RQOL scores. A wobbly or shaky voice, throat dryness, vocal fatigue, and vocal effort explained a significant amount of variance on the social-emotional and physical domains of the V-RQOL index (p < 0.05). Voice symptoms limited emotional and physical functioning as indicated by SF-36 scores. Voice disorders significantly influence psychosocial and physical functioning in college students. These findings have important implications for voice-care services in this population.

Habitat quality affects the incidence of morphological abnormalities in the endangered salamander Ambystoma ordinarium

PubMed Central

2017-01-01

Identification of early warning signals previous to the occurrence of population decline or extinction is a major challenge for the conservation of animal species. Prevalence of morphological abnormalities in a population can be one of these signals. We registered morphological abnormalities in the salamander Ambystoma ordinarium. We also evaluated the relation between habitat quality and the prevalence of abnormalities in this species. We used scores from rapid bioassessment protocols (RBPs) to assess the habitat quality of streams inhabited by A. ordinarium. A preliminary survey indicated that of 29 streams where this species has been historically registered, 13 might have few or no A. ordinarium. The association between habitat quality and the incidence of morphological abnormalities was evaluated in these 16 streams. Of 502 sampled individuals, 224 (44.62%) had at least one body abnormality. Of the 224 individuals with body abnormalities, 84 (37.5%) presented more than one abnormality. Of a total of 5,522 evaluated morphological characters, 344 (6.74%) were abnormal. Partial loss of gills and missing digits were the most frequent abnormalities. Results of a binomial logistic regression indicated that the probability of a character of an individual to be abnormal was significantly associated with habitat quality; as the levels of the quality of the habitat increased, the prevalence of morphological abnormalities decreased. These results suggest that RBPs are a quick and useful method for assessing the habitat quality of streams inhabited by A. ordinarium. Given that RBPs provide rapid and cost-effective assessments of the ecological health of aquatic ecosystems, it will be important to test if the RBPs protocols can be used to rapidly assess habitat quality for other species of stream amphibians. The negative association between habitat quality and the prevalence of morpohological abnormalities that we found indicates that habitat condition plays an important role in the high number of abnormalities registered in A. ordinarium. Therefore, our results suggest that one of the several negative effects of habitat degradation on amphibians is an increase in the frequency of morphological abnormalities with marked consequences for the survival and general fitness of aquatic amphibians. PMID:28846723

Is perceived athlete leadership quality related to team effectiveness? A comparison of three professional sports teams.

PubMed

Fransen, Katrien; Haslam, S Alexander; Mallett, Clifford J; Steffens, Niklas K; Peters, Kim; Boen, Filip

2017-08-01

Researchers have argued that leadership is one of the most important determinants of team effectiveness. The present study examined the extent to which the perceived quality of athlete leadership was related to the effectiveness of elite sports teams. Three professional football teams (N=135) participated in our study during the preparation phase for the Australian 2016 season. Players and coaching staff were asked to assess players' leadership quality in four leadership roles (as task, motivational, social, and external leader) via an online survey. The leadership quality in each of these roles was then calculated in a social network analysis by averaging the indegree centralities of the three best leaders in that particular role. Participants also rated their team's performance and its functioning on multiple indicators. As hypothesized, the team with the highest-quality athlete leadership on each of the four leadership roles excelled in all indicators of team effectiveness. More specifically, athletes in this team had a stronger shared sense of the team's purpose, they were more highly committed to realizing the team's goals, and they had a greater confidence in their team's abilities than athletes in the other teams. Moreover, this team demonstrated a higher task-involving and a lower ego-involving climate, and excelled on all measures of performance. High-quality athlete leadership is positively related to team effectiveness. Given the importance of high-quality athlete leadership, the study highlights the need for well-designed empirically-based leadership development programs. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Understanding the role of personality in explaining associations between marital quality and parenting

PubMed Central

Ganiban, Jody M.; Ulbricht, Jennifer A.; Spotts, Erica L.; Lichtenstein, Paul; Reiss, David; Hansson, Kjell; Neiderhiser, Jenae M.

2010-01-01

This study examined the contributions of personality to the emotional and behavior dynamics of families. Analyses assessed the degrees to which personality accounts for associations between marital quality and parenting, and mediates genetic contributions to these relationships. Participants included 318 male and 544 female same-sex twin pairs from the Twin and Offspring Study in Sweden. All twins completed self-report measures of marital quality and personality (anxiousness, aggression, sociability). Composite measures of parent negativity and warmth were derived from the twins' and their adolescent children's ratings of the twins' disciplinary styles and the emotional tone of the parent-child relationship. Observational ratings of marital quality and parenting were also obtained for a subset of twins. Analyses indicated that personality characteristics explain 33% to 42% of the covariance between reported marital quality and parenting, and 26% to 28% of the covariance between observed marital quality and parenting. For both sets of analyses personality accounted for more than half of the genetic contributions to covariance between marital quality and parenting. Results indicate that personality significantly contributes to associations between marital quality and parenting, and that personality is an important path through which genetic factors contribute to family relationships. PMID:19803601

Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries

PubMed Central

Burnett, Susan; Renz, Anna; Wiig, Siri; Fernandes, Alexandra; Weggelaar, Anne Marie; Calltorp, Johan; Anderson, Janet E.; Robert, Glenn; Vincent, Charles; Fulop, Naomi

2013-01-01

Purpose Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). Main Challenges Identified The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. Conclusion Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries. PMID:23292003

Study on an Air Quality Evaluation Model for Beijing City Under Haze-Fog Pollution Based on New Ambient Air Quality Standards

PubMed Central

Li, Li; Liu, Dong-Jun

2014-01-01

Since 2012, China has been facing haze-fog weather conditions, and haze-fog pollution and PM2.5 have become hot topics. It is very necessary to evaluate and analyze the ecological status of the air environment of China, which is of great significance for environmental protection measures. In this study the current situation of haze-fog pollution in China was analyzed first, and the new Ambient Air Quality Standards were introduced. For the issue of air quality evaluation, a comprehensive evaluation model based on an entropy weighting method and nearest neighbor method was developed. The entropy weighting method was used to determine the weights of indicators, and the nearest neighbor method was utilized to evaluate the air quality levels. Then the comprehensive evaluation model was applied into the practical evaluation problems of air quality in Beijing to analyze the haze-fog pollution. Two simulation experiments were implemented in this study. One experiment included the indicator of PM2.5 and was carried out based on the new Ambient Air Quality Standards (GB 3095-2012); the other experiment excluded PM2.5 and was carried out based on the old Ambient Air Quality Standards (GB 3095-1996). Their results were compared, and the simulation results showed that PM2.5 was an important indicator for air quality and the evaluation results of the new Air Quality Standards were more scientific than the old ones. The haze-fog pollution situation in Beijing City was also analyzed based on these results, and the corresponding management measures were suggested. PMID:25170682

Influence of land use on water quality in a tropical landscape: a multi-scale analysis

PubMed Central

Yackulic, Charles B.; Lim, Yili; Arce-Nazario, Javier A.

2015-01-01

There is a pressing need to understand the consequences of human activities, such as land transformations, on watershed ecosystem services. This is a challenging task because different indicators of water quality and yield are expected to vary in their responsiveness to large versus local-scale heterogeneity in land use and land cover (LUC). Here we rely on water quality data collected between 1977 and 2000 from dozens of gauge stations in Puerto Rico together with precipitation data and land cover maps to (1) quantify impacts of spatial heterogeneity in LUC on several water quality indicators; (2) determine the spatial scale at which this heterogeneity influences water quality; and (3) examine how antecedent precipitation modulates these impacts. Our models explained 30–58% of observed variance in water quality metrics. Temporal variation in antecedent precipitation and changes in LUC between measurements periods rather than spatial variation in LUC accounted for the majority of variation in water quality. Urbanization and pasture development generally degraded water quality while agriculture and secondary forest re-growth had mixed impacts. The spatial scale over which LUC influenced water quality differed across indicators. Turbidity and dissolved oxygen (DO) responded to LUC in large-scale watersheds, in-stream nitrogen concentrations to LUC in riparian buffers of large watersheds, and fecal matter content and in-stream phosphorus concentration to LUC at the sub-watershed scale. Stream discharge modulated impacts of LUC on water quality for most of the metrics. Our findings highlight the importance of considering multiple spatial scales for understanding the impacts of human activities on watershed ecosystem services. PMID:26146455

A comparison of the effect of work stress on burnout and quality of life between female nurses and female doctors.

PubMed

Wu, Si-Ying; Li, Huang-Yuan; Wang, Xiao-Rong; Yang, Shu-Juan; Qiu, Hong

2011-01-01

The objective of this study was to compare the effect of work stress on job burnout and quality of life between female nurses and doctors in China. The participants were 947 female nurses and 685 female doctors selected from Fujian provinces by using stratified cluster sampling method. The Chinese version of Short Form-36 Health Survey was used to measure quality of life; the Occupation Stress Inventory-Revised Edition was applied for occupational stress; and the Maslach Burnout Inventory-General Survey was used to assess job burnout. Occupational stress (indicated by different stressors) played an important role in job burnout and quality of life among female nurses and female doctors when taking into account other potential influencing factors simultaneously. These results show that it is important to adopt different preventive measures to prevent burnout and improve quality of life among the 2 populations according to the different stressors.

The contribution of individual psychological resilience in determining the professional quality of life of Australian nurses

PubMed Central

Hegney, Desley G.; Rees, Clare S.; Eley, Robert; Osseiran-Moisson, Rebecca; Francis, Karen

2015-01-01

Research Topic: The aim of this study was to determine the relative contribution of trait negative affect and individual psychological resilience in explaining the professional quality of life of nurses. Materials and Methods: One thousand, seven hundred and forty-three Australian nurses from the public, private, and aged care sectors completed an online Qualtrics survey. The survey collected demographic data as well as measures of depression, anxiety and stress, trait negative affect, resilience, and professional quality of life. Results: Significant positive relationships were observed between anxiety, depression and stress, trait negative affectivity, burnout, and secondary traumatic stress (compassion fatigue). Significant negative relationships were observed between each of the aforementioned variables and resilience and compassion satisfaction (CS). Results of mediated regression analysis indicated that resilience partially mediates the relationship between trait negative affect and CS. Conclusion: Results confirm the importance of both trait negative affect and resilience in explaining positive aspects of professional quality of life. Importantly, resilience was confirmed as a key variable impacting levels of CS and thus a potentially important variable to target in interventions aimed at improving nurse’s professional quality of life. PMID:26539150

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

PubMed

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

2016-01-01

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

Classifying indicators of quality: a collaboration between Dutch and English regulators.

PubMed

Mears, Alex; Vesseur, Jan; Hamblin, Richard; Long, Paul; Den Ouden, Lya

2011-12-01

Many approaches to measuring quality in healthcare exist, generally employing indicators or metrics. While there are important differences, most of these approaches share three key areas of measurement: safety, effectiveness and patient experience. The European Partnership for Supervisory Organisations in Health Services and Social Care (EPSO) exists as a working group and discussion forum for European regulators. This group undertook to identify a common framework within which European approaches to indicators could be compared. A framework was developed to classify indicators, using four sets of criteria: conceptualization of quality, Donabedian definition (structure, process, outcome), data type (derivable, collectable from routine sources, special collections, samples) and data use (judgement (singular or part of framework) benchmarking, risk assessment). Indicators from English and Dutch hospital measurement programmes were put into the framework, showing areas of agreement and levels of comparability. In the first instance, results are only illustrative. The EPSO has been a powerful driver for undertaking cross-European research, and this project is the first of many to take advantage of the access to international expertize. It has shown that through development of a framework that deconstructs national indicators, commonalities can be identified. Future work will attempt to incorporate other nations' indicators, and attempt cross-national comparison.

Exploring Rating Quality in Rater-Mediated Assessments Using Mokken Scale Analysis

PubMed Central

Wind, Stefanie A.; Engelhard, George

2015-01-01

Mokken scale analysis is a probabilistic nonparametric approach that offers statistical and graphical tools for evaluating the quality of social science measurement without placing potentially inappropriate restrictions on the structure of a data set. In particular, Mokken scaling provides a useful method for evaluating important measurement properties, such as invariance, in contexts where response processes are not well understood. Because rater-mediated assessments involve complex interactions among many variables, including assessment contexts, student artifacts, rubrics, individual rater characteristics, and others, rater-assigned scores are suitable candidates for Mokken scale analysis. The purposes of this study are to describe a suite of indices that can be used to explore the psychometric quality of data from rater-mediated assessments and to illustrate the substantive interpretation of Mokken-based statistics and displays in this context. Techniques that are commonly used in polytomous applications of Mokken scaling are adapted for use with rater-mediated assessments, with a focus on the substantive interpretation related to individual raters. Overall, the findings suggest that indices of rater monotonicity, rater scalability, and invariant rater ordering based on Mokken scaling provide diagnostic information at the level of individual raters related to the requirements for invariant measurement. These Mokken-based indices serve as an additional suite of diagnostic tools for exploring the quality of data from rater-mediated assessments that can supplement rating quality indices based on parametric models. PMID:29795883

Comparing Effects of Forestland conversion to Tea Farming on Soil Quality Indices

NASA Astrophysics Data System (ADS)

Gholoubi, A.; Emami, H.; Alizadeh, A.; Jones, S. B.

2017-12-01

The effect of land use type on soil function within an ecosystem can be assessed and monitored using soil quality indices. The research examined effects of land use change from natural forest to tea farming (with the same physiography and parent materials) on soil properties in different regions of the Guilan province, northern Iran. Two universally-accepted methods of soil quality evaluation were used to understand soil conditions in these two land uses. Thirty-six soil samples (0 -30 cm) were randomly collected from six sites with 3 replications. The soil quality of forestland and tea farms was determined using the cumulative rating (CR) index and the Cornell Comprehensive Assessment of Soil Health (CASH) scoring functions. Effects of Land use change on soil quality or health were significant (P <0.01) using both methods. In the CR method, a relative weighting factor (RWF) from 1 to 5 was assigned each key soil property. The results of both methods for all regions showed that the forestland use was more sustainable (lower CR and higher CASH score) than tea farm soils. forestland use affected most soil properties and thus their scores in both evaluation methods. Soil organic carbon and pH were the most important indicators reduced by land use change at all locations. There were significant correlations between these indicators and other soil chemical, physical and biological factors affected by changing forestland use.

Artificial neural networks for defining the water quality determinants of groundwater abstraction in coastal aquifer

NASA Astrophysics Data System (ADS)

Lallahem, S.; Hani, A.

2017-02-01

Water sustainability in the lower Seybouse River basin, eastern Algeria, must take into account the importance of water quantity and quality integration. So, there is a need for a better knowledge and understanding of the water quality determinants of groundwater abstraction to meet the municipal and agricultural uses. In this paper, the artificial neural network (ANN) models were used to model and predict the relationship between groundwater abstraction and water quality determinants in the lower Seybouse River basin. The study area chosen is the lower Seybouse River basin and real data were collected from forty five wells for reference year 2006. Results indicate that the feed-forward multilayer perceptron models with back-propagation are useful tools to define and prioritize the important water quality parameters of groundwater abstraction and use. The model evaluation shows that the correlation coefficients are more than 95% for training, verification and testing data. The model aims to link the water quantity and quality with the objective to strengthen the Integrated Water Resources Management approach. It assists water planners and managers to better assess the water quality parameters and progress towards the provision of appropriate quantities of water of suitable quality.

Physical properties of forest soils

Treesearch

Charles H. Perry; Michael C. Amacher

2007-01-01

Why Are Physical Properties of the Soil Important? The soil quality indicator, when combined with other data collected by the FIA program, can indicate the current rates of soil erosion, the extent and intensity of soil compaction, and some basic physical properties of the forest floor and the top 20 cm of soil. In this report, two particular physical properties of the...

Assessing soil compaction on Forest Inventory & Analysis phase 3 field plots using a pocket penetrometer

Treesearch

Michael C. Amacher; Katherine P. O' Neill

2004-01-01

Soil compaction is an important indicator of soil quality, yet few practical methods are available to quantitatively measure this variable. Although an assessment of the areal extent of soil compaction is included as part of the soil indicator portion of the Forest Inventory & Analysis (FIA) program, no quantitative measurement of the degree of soil compaction...

Motivational Qualities of Instructional Strategies and Computer Use for Mathematics Teaching in Japan and the United States: Results from the Timss 1999 Assessment.

ERIC Educational Resources Information Center

House, J. Daniel

2005-01-01

Recent mathematics assessments have indicated that students in several Asian countries have tended to score above international averages. Research findings indicate that there are cultural differences in expectations for student achievement in mathematics and in classroom practices and instructional strategies. The importance of the motivational…

Identifying Factors that Influence State-Specific Hunger Rates in the U.S.: A Simple Analytic Method for Understanding a Persistent Problem

ERIC Educational Resources Information Center

Edwards, Mark Evan; Weber, Bruce; Bernell, Stephanie

2007-01-01

An existing measure of food insecurity with hunger in the United States may serve as an effective indicator of quality of life. State level differences in that measure can reveal important differences in quality of life across places. In this study, we advocate and demonstrate two simple methods by which analysts can explore state-specific…

Moving beyond Green: Exploring the Relationship of Environment Type and Indicators of Perceived Environmental Quality on Emotional Well-Being following Group Walks

PubMed Central

Marselle, Melissa R.; Irvine, Katherine N.; Lorenzo-Arribas, Altea; Warber, Sara L.

2014-01-01

Against the backdrop of increasing interest in the relationship between Nature and health, this study examined the effect of perceived environment type and indicators of perceived environmental quality on short-term emotional well-being following outdoor group walks. Participants (n = 127) of a national group walk program completed pre- and post-walk questionnaires for each walk attended (n = 1009) within a 13-week study period. Multilevel linear modelling was used to examine the main and moderation effects. To isolate the environmental from the physical activity elements, analyses controlled for walk duration and perceived intensity. Analyses revealed that perceived restorativeness and perceived walk intensity predicted greater positive affect and happiness following an outdoor group walk. Perceived restorativeness and perceived bird biodiversity predicted post-walk negative affect. Perceived restorativeness moderated the relationship between perceived naturalness and positive affect. Results suggest that restorative quality of an environment may be an important element for enhancing well-being, and that perceived restorativeness and naturalness of an environment may interact to amplify positive affect. These findings highlight the importance of further research on the contribution of environment type and quality on well-being, and the need to control for effects of physical activity in green exercise research. PMID:25546275

Moving beyond green: exploring the relationship of environment type and indicators of perceived environmental quality on emotional well-being following group walks.

PubMed

Marselle, Melissa R; Irvine, Katherine N; Lorenzo-Arribas, Altea; Warber, Sara L

2014-12-23

Against the backdrop of increasing interest in the relationship between Nature and health, this study examined the effect of perceived environment type and indicators of perceived environmental quality on short-term emotional well-being following outdoor group walks. Participants (n = 127) of a national group walk program completed pre- and post-walk questionnaires for each walk attended (n = 1009) within a 13-week study period. Multilevel linear modelling was used to examine the main and moderation effects. To isolate the environmental from the physical activity elements, analyses controlled for walk duration and perceived intensity. Analyses revealed that perceived restorativeness and perceived walk intensity predicted greater positive affect and happiness following an outdoor group walk. Perceived restorativeness and perceived bird biodiversity predicted post-walk negative affect. Perceived restorativeness moderated the relationship between perceived naturalness and positive affect. Results suggest that restorative quality of an environment may be an important element for enhancing well-being, and that perceived restorativeness and naturalness of an environment may interact to amplify positive affect. These findings highlight the importance of further research on the contribution of environment type and quality on well-being, and the need to control for effects of physical activity in green exercise research.

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

PubMed

Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

2013-01-01

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived. Copyright © 2013. Published by Elsevier GmbH.

Use of quality indicators in physical therapist practice: an observational study.

PubMed

Jette, Diane U; Jewell, Dianne V

2012-04-01

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 contain provisions specific to health care quality that apply to physical therapists. Published evidence examining gaps in the quality of physical therapy services is limited. The primary purpose of this study was to determine the use of quality indicators in physical therapist practice. This was an observational study. All members of the Orthopaedic and Private Practice sections of the American Physical Therapy Association were invited to participate by completing an electronic survey. The survey included 22 brief patient descriptions, each followed by questions regarding the use of examinations and interventions based on the 2009 list of Medicare-approved quality measures. Separate multivariate logistic regression models were used to determine the odds ratios related to the performance of each examination and intervention on more than 90% of patients, given perceptions of its importance to care, the burden of performing it, and the level of evidence supporting its use. Participants (n=2,544) reported a relatively low frequency of performing examinations and interventions supporting primary and secondary prevention (3.6%-51.3%) and use of standardized measures (5.5%-35.8%). Perceptions of high importance and low burden were associated with greater odds of performing an examination or intervention. Importance and burden were more influential factors than the perceived availability of evidence to support use of identified techniques. The survey was not assessed for test-retest reliability. A low response rate was a source of potential bias. The study findings suggest that physical therapists may not see themselves as providers of primary or secondary prevention services. Patient management strategies associated with these types of services also may be perceived as relatively unimportant or burdensome.

Quality Control of the Print with the Application of Statistical Methods

NASA Astrophysics Data System (ADS)

Simonenko, K. V.; Bulatova, G. S.; Antropova, L. B.; Varepo, L. G.

2018-04-01

The basis for standardizing the process of offset printing is the control of print quality indicators. The solution of this problem has various approaches, among which the most important are statistical methods. Practical implementation of them for managing the quality of the printing process is very relevant and is reflected in this paper. The possibility of using the method of constructing a Control Card to identify the reasons for the deviation of the optical density for a triad of inks in offset printing is shown.

Indicator methods to evaluate the hygienic performance of industrial scale operating Biowaste Composting Plants.

PubMed

Martens, Jürgen

2005-01-01

The hygienic performance of biowaste composting plants to ensure the quality of compost is of high importance. Existing compost quality assurance systems reflect this importance through intensive testing of hygienic parameters. In many countries, compost quality assurance systems are under construction and it is necessary to check and to optimize the methods to state the hygienic performance of composting plants. A set of indicator methods to evaluate the hygienic performance of normal operating biowaste composting plants was developed. The indicator methods were developed by investigating temperature measurements from indirect process tests from 23 composting plants belonging to 11 design types of the Hygiene Design Type Testing System of the German Compost Quality Association (BGK e.V.). The presented indicator methods are the grade of hygienization, the basic curve shape, and the hygienic risk area. The temperature courses of single plants are not distributed normally, but they were grouped by cluster analysis in normal distributed subgroups. That was a precondition to develop the mentioned indicator methods. For each plant the grade of hygienization was calculated through transformation into the standard normal distribution. It shows the part in percent of the entire data set which meet the legal temperature requirements. The hygienization grade differs widely within the design types and falls below 50% for about one fourth of the plants. The subgroups are divided visually into basic curve shapes which stand for different process courses. For each plant the composition of the entire data set out of the various basic curve shapes can be used as an indicator for the basic process conditions. Some basic curve shapes indicate abnormal process courses which can be emended through process optimization. A hygienic risk area concept using the 90% range of variation of the normal temperature courses was introduced. Comparing the design type range of variation with the legal temperature defaults showed hygienic risk areas over the temperature courses which could be minimized through process optimization. The hygienic risk area of four design types shows a suboptimal hygienic performance.

Identification of sensitive indicators to assess the interrelationship between soil quality, management practices and human health

NASA Astrophysics Data System (ADS)

Zornoza, R.; Acosta, J. A.; Bastida, F.; Domínguez, S. G.; Toledo, D. M.; Faz, A.

2014-09-01

Soil quality (SQ) assessment has been a challenging issue since soils present high variability in properties and functions. This paper aims to increase understanding of SQ through review of SQ assessments in different scenarios providing evidence about the interrelationship between SQ, land use and human health. There is a general consensus that there is a need to develop methods to assess and monitor SQ for assuring sustainable land use with no prejudicial effects on human health. This review points out the importance of adopting indicators of different nature (physical, chemical and biological) to achieve a holistic image of SQ. Most authors use single indicators to assess SQ and its relationship with land uses, being the most used indicators soil organic carbon and pH. The use of nitrogen and nutrients content has resulted sensitive for agricultural and forest systems, together with physical properties such as texture, bulk density, available water and aggregate stability. These physical indicators have also been widely used to assess SQ after land use changes. The use of biological indicators is less generalized, being microbial biomass and enzyme activities the most selected indicators. Although most authors assess SQ using independent indicators, it is preferable to combine some of them into models to create a soil quality index (SQI), since it provides integrated information about soil processes and functioning. The majority of revised articles used the same methodology to establish a SQI, based on scoring and weighting of different soil indicators, selected by multivariate analyses. The use of multiple linear regressions has been successfully used under forest land use. Urban soil quality has been poorly assessed, with lack of adoption of SQIs. In addition, SQ assessments were human health indicators or exposure pathways are incorporated are practically inexistent. Thus, new efforts should be carried out to establish new methodologies not only to assess soil quality in terms of sustainability, productivity and ecosystems quality, but also human health. Additionally, new challenges arise with the use and integration into SQIs of stable isotopic, genomic, proteomic and spectroscopy data.

Identification of sensitive indicators to assess the interrelationship between soil quality, management practices and human health

NASA Astrophysics Data System (ADS)

Zornoza, R.; Acosta, J. A.; Bastida, F.; Domínguez, S. G.; Toledo, D. M.; Faz, A.

2015-02-01

Soil quality (SQ) assessment has long been a challenging issue, since soils present high variability in properties and functions. This paper aims to increase the understanding of SQ through the review of SQ assessments in different scenarios providing evidence about the interrelationship between SQ, land use and human health. There is a general consensus that there is a need to develop methods to assess and monitor SQ for assuring sustainable land use with no prejudicial effects on human health. This review points out the importance of adopting indicators of different nature (physical, chemical and biological) to achieve a holistic image of SQ. Most authors use single indicators to assess SQ and its relationship with land uses - soil organic carbon and pH being the most used indicators. The use of nitrogen and nutrient content has resulted sensitive for agricultural and forest systems, together with physical properties such as texture, bulk density, available water and aggregate stability. These physical indicators have also been widely used to assess SQ after land use changes. The use of biological indicators is less generalized, with microbial biomass and enzyme activities being the most selected indicators. Although most authors assess SQ using independent indicators, it is preferable to combine some of them into models to create a soil quality index (SQI), since it provides integrated information about soil processes and functioning. The majority of revised articles used the same methodology to establish an SQI, based on scoring and weighting of different soil indicators, selected by means of multivariate analyses. The use of multiple linear regressions has been successfully used for forest land use. Urban soil quality has been poorly assessed, with a lack of adoption of SQIs. In addition, SQ assessments where human health indicators or exposure pathways are incorporated are practically inexistent. Thus, further efforts should be carried out to establish new methodologies to assess soil quality not only in terms of sustainability, productivity and ecosystem quality but also human health. Additionally, new challenges arise with the use and integration of stable isotopic, genomic, proteomic and spectroscopic data into SQIs.

Desert amphibian selection of arid land breeding habitat undermines reproductive effort.

PubMed

Kiesow, Anja B; Griffis-Kyle, Kerry L

2017-12-01

Understanding how animals select habitat is important for understanding how to better conserve those species. As droughts become more frequent and water availability declines in many systems, understanding selection of water sources becomes even more important for conservation. Tinajas and anthropogenic catchments are critical ephemeral breeding sites for Sonoran Desert anurans. Tadpoles have been documented in both water types even though anthropogenic catchments can contain very high concentrations of ammonia. We currently do not know how amphibians are selecting breeding habitat. We tested three hypotheses of habitat selection based on resource quality, resource quality and territoriality, and proximity of water site to other water sites. Male Anaxyrus punctatus called from all sites regardless of habitat quality or male quality; however, they were found more often at sites within 2 km of other sites. This suggests that male desert anurans are selecting close breeding habitat regardless of quality for breeding, indicating ammoniated sites are likely either population sinks or ecological traps. Consequently, adding anthropogenic water sites, without managing to reduce ammonia, will provide low quality habitat that could cause long-term declines in desert anuran populations.

Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

PubMed

Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

2017-07-14

Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier findings. The fact that privately operated homes, including those operated by for-profit companies, had higher processual quality is more unexpected, given previous research. Finally, no significant quality differences were found between private ownership types, i.e. for-profit, non-profit, and private equity companies, which indicates that profit motives are less important for determining quality in Swedish nursing home care than in other countries where similar studies have been carried out.

What Does Professional Rank Mean to Teachers? A Survey of the Multiple Impacts of Professional Rank on Urban and Rural Compulsory Education Teachers

ERIC Educational Resources Information Center

Yuyou, Qin; Wenjing, Zeng

2018-01-01

Professional rank is an important indicator of the professional capacity of compulsory education teachers. A rational professional rank evaluation system plays an important role in mobilizing the enthusiasm of teachers, improving the overall quality of teachers, and promoting the development of education. Based on stratified random sample data…

Performance and quality indicators for the management of non-cancer chronic pain: a scoping review protocol.

PubMed

Zidarov, Diana; Visca, Regina; Gogovor, Amédé; Ahmed, Sara

2016-02-19

Chronic pain is a public health problem of epidemic proportion in most countries with important physical, psychological, social and economic consequences. The management of chronic pain is complex and requires an integrated network approach between all levels of the healthcare system and the involvement of several health professionals from different disciplines. Measuring the performance of organisations that provide care to individuals with chronic pain is essential to improve quality of care and requires the use of relevant performance and quality indicators. A scoping review methodology will be used to synthesise the evidence on performance and quality indicators developed for non-cancer chronic pain management across the continuum of care. The following electronic databases will be searched from 2000 onwards: Cochrane Effective Practice and Organisation of Care (EPOC) Review Group Specialised Register; Cochrane Library; EMBASE; PubMed; CINAHL; PsycINFO; ProQuest Dissertations and Theses. All types of studies will be included if these are concerned with performance or quality indicators in adults with chronic non-cancer pain. In addition, searches will be conducted on provincial, national and international health organisations as well as health professional and scientific associations' websites. A qualitative descriptive approach will be used to describe characteristics of each indicator. All identified indicators will be classified according to dimensions covered by Donabedian and the Triple Aim frameworks. The scoping review findings will inform the development of a performance measurement system comprising a list of performance indicators with their level of evidence which can be used by stakeholders to evaluate the quality of care for individuals with chronic non-cancer pain at the patient, institutional and system level. The results will be disseminated via several knowledge translation strategies, including 2 stakeholder meetings, publication and presentation at conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Primary expectations of secondary metabolites

USDA-ARS?s Scientific Manuscript database

My program examines the plant secondary metabolites (i.e. phenolics) important for human health, and which impart the organoleptic properties that are quality indicators for fresh and processed foods. Consumer expectations such as appearance, taste, or texture influence their purchasing decisions; a...

Structure and earthworms

USDA-ARS?s Scientific Manuscript database

Earthworms are an important part of the soil ecosystem and an indicator of soil quality. Sometimes referred to as ecosystem engineers, they play a pivotal role in maintaining soil productivity. Their burrowing, feeding, and casting activities alter the physical, chemical, and biological properties o...

The effect on patient loyalty of service quality, patient visit experience and perceived switching costs: lessons from one Taiwan university hospital.

PubMed

Wang, Hsiu-Ling; Huang, Jun-Ying; Howng, Shen-Long

2011-02-01

The reimbursement system changed from fee-for-service to fixed prospective payments in Taiwan, the effect on the physician-patient's relationship is worth being studied. We examined the relationship between patient visit experience, cost perceptions and the two important aspects of quality of care, curing and interpersonal performance, and patients' loyalty to the hospital physicians. A total of 404 patients from an acute care hospital in Taiwan, Kaohsiung Medical University Hospital (KMUH), were investigated using a self-administered mailing survey. All measures including patient loyalty (PL), curing service quality (CSQ), interpersonal service quality (ISQ), visit experience (VE) and perceived switching costs (PSC), were adapted and modified from existing scales. Our results showed that the physician's CSQ and ISQ positively affected patients' loyalty to KMUH. The interaction between the main effects of service quality, patients' VE and three types of switching visit costs, yielded additional insights into the importance of service quality for patient retention. The CSQ of physicians becomes a more important determinant of loyalty than ISQ as patients' VE increases. The importance of CSQ and ISQ increases in relation to PL as the perceived procedural and relational costs of changing care providers increases. Neither CSQ nor ISQ has a reduced relationship with PL as the perceived financial costs of switching hospitals increase. Our study indicates that the impact of CSQ and ISQ on loyalty varies according to the perceived visit costs of changing hospitals and the patients' VE.

Quality of nursing doctoral education in seven countries: survey of faculty and students/graduates.

PubMed

Kim, Mi Ja; Park, Chang Gi; McKenna, Hugh; Ketefian, Shake; Park, So Hyun; Klopper, Hester; Lee, Hyeonkyeong; Kunaviktikul, Wipada; Gregg, Misuzu F; Daly, John; Coetzee, Siedine; Juntasopeepun, Phanida; Murashima, Sachiyo; Keeney, Sinead; Khan, Shaheen

2015-05-01

This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. A descriptive, cross-country, comparative design was employed. Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. © 2015 John Wiley & Sons Ltd.

The link between water quality and tidal marshes in a highly impacted estuary.

NASA Astrophysics Data System (ADS)

Meire, Patrick; Maris, Tom; van Damme, Stefan; Jacobs, Sander; Cox, Tom; Struyf, Eric

2010-05-01

The Schelde estuary is one of the most heavily impacted estuaries in Europe. During several decades, untreated waste water from large cities (e.g. Brussels, Antwerp, Valenciennes, Lille) and industries was discharged in the river. As a result, the Schelde estuary has the reputation of being one of the most polluted estuaries in Europe. For a long time (approx. 1950 - 1995) all forms of higher life (macro-invertebrates and fish) were absent in the fresh and brackish parts of the estuary. Due to European legislation, a large part of the sewage water is now treated resulting in a significant recovery of water quality in the estuary. However, next to water quality, the estuary also suffered serious habitat losses during the last decades, mostly due to economic development and changing hydrological conditions causing more erosion. Over the last fifteen years, the management of the estuary has changed fundamentally. It is now more and more focused on the restoration of ecosystem services. In this presentation we will document the changes in water quality over the last 50 years and summarize recent work on the role of tidal marshes on water quality within the freshwater part of the Schelde estuary. Our results stress the important of taking into account ecosystem services and habitat restoration for long-term estuarine management. .After decades of high inorganic nutrient concentrations and recurring anoxia and hypoxia, we observed a paradoxical increase in chlorophyll-a concentrations with decreasing nutrient inputs, indicating a regime shift. Our results indicate that the recovery of a hypereutrophied systems towards a classical eutrophied state, needs the reduction of waste loads below certain thresholds. Paradoxically, phytoplankton production was inhibited by high ammonia or low oxygen concentrations. The system state change is accompanied by large fluctuations in oxygen concentrations. The improved water quality resulted in a remarkable recovery of different groups of higher organisms, especially fish populations. It is clear that the improved water quality is to a large part due to improved waste water treatment. However detailed studies of the exchange between tidal marshes and the estuary clearly proved also the importance of these habitats for water quality. A whole ecosystem labeling experiment gave evidence on the sink function of these marshes for nitrogen. Detailed mass balance studies show also the importance of mashes in the silica cycle. Amorphous biogenic silica is imported into marshes were it accumulates in the soil, while dissolved silica is exported again to the pelagic. At times when the concentrations of dissolved silica in the estuary are limiting (during plankton blooms), the export of DSi from the marshes is highest. These results clearly indicate the crucial role tidal marshes play in the estuarine biogeochemical cycles and in their resilience against imbalanced nutrient inputs. Based on these insights new tidal marshes have been developed along the Schelde, their design being so that the delivery of ecosystems services (eg impact on water quality) is maximal.

Identifying Watershed Regions Sensitive to Soil Erosion and Contributing to Lake Eutrophication--A Case Study in the Taihu Lake Basin (China).

PubMed

Lin, Chen; Ma, Ronghua; He, Bin

2015-12-24

Taihu Lake in China is suffering from severe eutrophication partly due to non-point pollution from the watershed. There is an increasing need to identify the regions within the watershed that most contribute to lake water degradation. The selection of appropriate temporal scales and lake indicators is important to identify sensitive watershed regions. This study selected three eutrophic lake areas, including Meiliang Bay (ML), Zhushan Bay (ZS), and the Western Coastal region (WC), as well as multiple buffer zones next to the lake boundary as the study sites. Soil erosion intensity was designated as a watershed indicator, and the lake algae area was designated as a lake quality indicator. The sensitive watershed region was identified based on the relationship between these two indicators among different lake divisions for a temporal sequence from 2000 to 2012. The results show that the relationship between soil erosion modulus and lake quality varied among different lake areas. Soil erosion from the two bay areas was more closely correlated with water quality than soil erosion from the WC region. This was most apparent at distances of 5 km to 10 km from the lake, where the r² was as high as 0.764. Results indicate that soil erosion could be used as an indicator for identifying key watershed protection areas. Different lake areas need to be considered separately due to differences in geographical features, land use, and the corresponding effects on lake water quality.

Identifying Watershed Regions Sensitive to Soil Erosion and Contributing to Lake Eutrophication—A Case Study in the Taihu Lake Basin (China)

PubMed Central

Lin, Chen; Ma, Ronghua; He, Bin

2015-01-01

Taihu Lake in China is suffering from severe eutrophication partly due to non-point pollution from the watershed. There is an increasing need to identify the regions within the watershed that most contribute to lake water degradation. The selection of appropriate temporal scales and lake indicators is important to identify sensitive watershed regions. This study selected three eutrophic lake areas, including Meiliang Bay (ML), Zhushan Bay (ZS), and the Western Coastal region (WC), as well as multiple buffer zones next to the lake boundary as the study sites. Soil erosion intensity was designated as a watershed indicator, and the lake algae area was designated as a lake quality indicator. The sensitive watershed region was identified based on the relationship between these two indicators among different lake divisions for a temporal sequence from 2000 to 2012. The results show that the relationship between soil erosion modulus and lake quality varied among different lake areas. Soil erosion from the two bay areas was more closely correlated with water quality than soil erosion from the WC region. This was most apparent at distances of 5 km to 10 km from the lake, where the r2 was as high as 0.764. Results indicate that soil erosion could be used as an indicator for identifying key watershed protection areas. Different lake areas need to be considered separately due to differences in geographical features, land use, and the corresponding effects on lake water quality. PMID:26712772

Continuous quality improvement for the clinical decision unit.

PubMed

Mace, Sharon E

2004-01-01

Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

What really matters to healthcare consumers.

PubMed

Jennings, Bonnie Mowinski; Heiner, Stacy L; Loan, Lori A; Hemman, Eileen A; Swanson, Kristen M

2005-04-01

Consumer satisfaction with healthcare is an important quality and outcome indicator. Satisfaction may be at the crux of survival for healthcare delivery systems because it creates the competitive edge in healthcare. To better understand patient satisfaction by examining consumer healthcare experiences and expectations, a study was conducted. An important concept identified in the data, MY CARE, refers to a constellation of quality healthcare features that were wished for by all participants and realized by only some of them. The features of MY CARE offer lessons for all healthcare leaders to use when making improvements in care delivery systems-improvements that could create a more patient-centered healthcare system and boost patient satisfaction.

GIS based procedure of cumulative environmental impact assessment.

PubMed

Balakrishna Reddy, M; Blah, Baiantimon

2009-07-01

Scale and spatial limits of impact assessment study in a GIS platform are two very important factors that could have a bearing on the genuineness and quality of impact assessment. While effect of scale has been documented and well understood, no significant study has been carried out on spatial considerations in an impact assessment study employing GIS technique. A novel technique of impact assessment demonstrable through GIS approach termed hereby as 'spatial data integrated GIS impact assessment method (SGIAM)' is narrated in this paper. The technique makes a fundamental presumption that the importance of environmental impacts is dependent, among other things, on spatial distribution of the effects of the proposed action and of the affected receptors in a study area. For each environmental component considered (e.g., air quality), impact indices are calculated through aggregation of impact indicators which are measures of the severity of the impact. The presence and spread of environmental descriptors are suitably quantified through modeling techniques and depicted. The environmental impact index is calculated from data exported from ArcINFO, thus giving significant importance to spatial data in the impact assessment exercise.

The Value of Clean Air: Comparing Discounting of Delayed Air Quality and Money Across Magnitudes

PubMed Central

Friedel, Jonathan E.; DeHart, William B.; Mahamane, Salif; Jordan, Kerry E.; Odum, Amy L.

2018-01-01

The detrimental health effects of exposure to air pollution are well established. Fostering behavioral change concerning air quality may be challenging because the detrimental health effects of exposure to air pollution are delayed. Delay discounting, a measure of impulsive choice, encapsulates this process of choosing between the immediate conveniences of behaviors that increase pollution and the delayed consequences of prolonged exposure to poor air quality. In Experiment 1, participants completed a series of delay-discounting tasks for air quality and money. We found that participants discounted delayed air quality more than money. In Experiment 2, we investigated whether the common finding that large amounts of money are discounted less steeply than small amounts of money generalized to larger and smaller improvements in air quality. Participants discounted larger improvements in air quality less steeply than smaller improvements, indicating that the discounting of air quality shares a similar process as the discounting of money. Our results indicate that the discounting of delayed money is strongly related to the discounting of delayed air quality and that similar mechanisms may be involved in the discounting of these qualitatively different outcomes. These data are also the first to demonstrate the malleability of delay discounting of air quality, and provide important public health implications for decreasing delay discounting of air quality. PMID:29606776

Quantity vs. quality: an exploration of the predictors of posttreatment sexual adjustment for women affected by early stage cervical and endometrial cancer.

PubMed

Juraskova, Ilona; Bonner, Carissa; Bell, Melanie L; Sharpe, Louise; Robertson, Rosalind; Butow, Phyllis

2012-11-01

Women with early stage cervical and endometrial cancer may experience complex posttreatment changes to their sexual function, but clinical practice and past research have focused more on the quantity than the perceived quality of sexual life. The aims of this prospective study were to explore the following: (i) the relative importance of quantity vs. quality of sexual life over the first year posttreatment; (ii) the psychological and sexual predictors of overall sexual function; and (iii) the relationship between sexual function and quality of life (QoL). Fifty-three cancer patients completed standardized measures at baseline, with follow-up at 6 and 12 months posttreatment. Analyses were based on prespecified linear mixed models with overall sexual function and QoL as outcomes, and quality and quantity of sexual life, anxiety, and depression as the main predictors of interest. Radiotherapy, age, and relationship satisfaction were controlled for as potential confounders. Derogatis Sexual Functioning Inventory subscales to assess quantity (Drive) and quality (Satisfaction) of sexual life, and overall sexual function (Global Sexual Satisfaction Index); Functional Assessment of Cancer Therapy--General to assess QoL; Hospital Anxiety and Depression Scale to assess psychological distress; and Relationship Satisfaction Interaction Scale to assess relationship satisfaction. The models demonstrated that: (i) overall sexual function was predicted more strongly by the perceived quality than the quantity of sexual interactions, (ii) a small change in perceived quality had a large impact on overall sexual function, and (iii) overall sexual function was a predictor of QoL. This study found that quality rather than quantity of sexual life is the best predictor of overall sexual function among women treated for early stage cervical and endometrial cancer, indicating the importance of including quality indices in posttreatment sexual assessment in clinical practice and research studies. © 2012 International Society for Sexual Medicine.

Pollutant fate and spatio-temporal variability in the choptank river estuary: Factors influencing water quality

USGS Publications Warehouse

Whitall, D.; Hively, W.D.; Leight, A.K.; Hapeman, C.J.; McConnell, L.L.; Fisher, T.; Rice, C.P.; Codling, E.; McCarty, G.W.; Sadeghi, A.M.; Gustafson, A.; Bialek, K.

2010-01-01

Restoration of the Chesapeake Bay, the largest estuary in the United States, is a national priority. Documentation of progress of this restoration effort is needed. A study was conducted to examine water quality in the Choptank River estuary, a tributary of the Chesapeake Bay that since 1998 has been classified as impaired waters under the Federal Clean Water Act. Multiple water quality parameters (salinity, temperature, dissolved oxygen, chlorophyll a) and analyte concentrations (nutrients, herbicide and herbicide degradation products, arsenic, and copper) were measured at seven sampling stations in the Choptank River estuary. Samples were collected under base flow conditions in the basin on thirteen dates between March 2005 and April 2008. As commonly observed, results indicate that agriculture is a primary source of nitrate in the estuary and that both agriculture and wastewater treatment plants are important sources of phosphorus. Concentrations of copper in the lower estuary consistently exceeded both chronic and acute water quality criteria, possibly due to use of copper in antifouling boat paint. Concentrations of copper in the upstream watersheds were low, indicating that agriculture is not a significant source of copper loading to the estuary. Concentrations of herbicides (atrazine, simazine, and metolachlor) peaked during early-summer, indicating a rapid surface-transport delivery pathway from agricultural areas, while their degradation products (CIAT, CEAT, MESA, and MOA) appeared to be delivered via groundwater transport. Some in-river processing of CEAT occurred, whereas MESA was conservative. Observed concentrations of herbicide residues did not approach established levels of concern for aquatic organisms. Results of this study highlight the importance of continued implementation of best management practices to improve water quality in the estuary. This work provides a baseline against which to compare future changes in water quality and may be used to design future monitoring programs needed to assess restoration strategy efficacy.

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

NASA Astrophysics Data System (ADS)

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

2015-09-01

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

A Pilot Study of Microbial Contamination of Subtropical Recreational Waters

PubMed Central

Fleming, Lora E; Solo, Gabriele H.; Elmir, Samir; Shibata, Tomoyuki; Squicciarini, Dominick; Quirino, Wendy; Arguello, Margia; Van de Bogart, Gayl

2009-01-01

Microbial water quality indicators are used to determine whether a water body is safe for recreational purposes. There have been concerns raised about the appropriate use of microbial indicators to regulate recreational uses of water bodies, in particular those located in tropical and sub-tropical environments. This prospective cohort pilot study evaluated the relationship between microbial water quality indicators and public health within two public beaches without known sewage discharge, but with historically high microbial levels for one beach, in subtropical Miami-Dade County (Florida). Monitoring was conducted in three phases: daily water monitoring, beach sand sampling, and spatially intense water sampling. An epidemiological questionnaire from a Los Angeles recreational beach-goer study was used to assess the self-reported swimming-related symptoms and exposures. There was no significant association between the number nor the type of reported symptoms and the different sampling months or beach sites, although persons who returned repeatedly to the beach were more likely to report symptoms. The number of indicator organisms correlated negatively with the frequency of symptoms reported by recreational beach goers. Results of the daily monitoring indicated that different indicators provided conflicting results concerning beach water quality. Larger epidemiologic studies with individual exposure monitoring are recommended to further evaluate these potentially important associations in subtropical recreational waters. PMID:20151031

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

PubMed

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

2017-08-01

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

Mobility Device Quality Affects Participation Outcomes for People With Disabilities: A Structural Equation Modeling Analysis.

PubMed

Magasi, Susan; Wong, Alex; Miskovic, Ana; Tulsky, David; Heinemann, Allen W

2018-01-01

To test the effect that indicators of mobility device quality have on participation outcomes in community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke by using structural equation modeling. Survey, cross-sectional study, and model testing. Clinical research space at 2 academic medical centers and 1 free-standing rehabilitation hospital. Community-dwelling adults (N=250; mean age, 48±14.3y) with spinal cord injury, traumatic brain injury, and stroke. Not applicable. The Mobility Device Impact Scale, Patient-Reported Outcomes Measurement Information System Social Function (version 2.0) scale, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities, and the 2 Community Participation Indicators' enfranchisement scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected. Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating effect on participation outcomes, with 3 device quality variables (repairability, ease of maintenance, device reliability) accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than did ambulation aid users. Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Landscape-scale modeling of water quality in Lake Superior and Lake Michigan watersheds: How useful are forest-based indicators? Journal of Great Lakes Research

Treesearch

Titus S. Seilheimer; Patrick L. Zimmerman; Kirk M. Stueve; Charles H. Perry

2013-01-01

The Great Lakes watersheds have an important influence on the water quality of the nearshore environment, therefore, watershed characteristics can be used to predict what will be observed in the streams. We used novel landscape information describing the forest cover change, along with forest census data and established land cover data to predict total phosphorus and...

Use of a C-SITS Approach to Estimating the Impact of the Receipt of a Teacher Recruitment Incentive Grant on an IHE's Production of Certified STEM Teachers--Problems and Solutions

ERIC Educational Resources Information Center

Bobronnikov, Ellen; Price, Cris

2013-01-01

Improving the quality of teacher preparation is an important national issue, because the quality of teaching plays such a large role in students' learning. One key indicator of students' academic success is the competence and capability of their teachers. However, the availability of well-prepared and effective teachers varies widely across the…

Adiposity, compared with masculinity, serves as a more valid cue to immunocompetence in human mate choice.

PubMed

Rantala, Markus J; Coetzee, Vinet; Moore, Fhionna R; Skrinda, Ilona; Kecko, Sanita; Krama, Tatjana; Kivleniece, Inese; Krams, Indrikis

2013-01-22

According to the 'good genes' hypothesis, females choose males based on traits that indicate the male's genetic quality in terms of disease resistance. The 'immunocompetence handicap hypothesis' proposed that secondary sexual traits serve as indicators of male genetic quality, because they indicate that males can contend with the immunosuppressive effects of testosterone. Masculinity is commonly assumed to serve as such a secondary sexual trait. Yet, women do not consistently prefer masculine looking men, nor is masculinity consistently related to health across studies. Here, we show that adiposity, but not masculinity, significantly mediates the relationship between a direct measure of immune response (hepatitis B antibody response) and attractiveness for both body and facial measurements. In addition, we show that circulating testosterone is more closely associated with adiposity than masculinity. These findings indicate that adiposity, compared with masculinity, serves as a more important cue to immunocompetence in female mate choice.

Racial Barrier Socialization and the Well-being of African American Adolescents: The Moderating Role of Mother-Adolescent Relationship Quality

PubMed Central

Cooper, Shauna M.; McLoyd, Vonnie C.

2012-01-01

Racial socialization has been suggested as an important factor in helping African American adolescents cope effectively with racism and discrimination. Although multiple studies have reported a positive link between racial pride socialization and psychological adjustment among African American youth, assessments of the association between adolescent adjustment and another dimension of racial socialization—racial barrier socialization—have yielded inconsistent findings. Using a sample of 190 African American adolescents, the present study focuses attention on the quality of mother-adolescent relations as an indicator of affective context, and examines its moderating influence on the association between racial barrier socialization and adolescent adjustment. Regression analyses indicated that the link between racial barrier socialization and adolescent adjustment is moderated by mother-adolescent relationship quality. However, these associations varied by gender. PMID:23152648

Blueberry juices: a rapid multi-analysis of quality indicators by means of dispersive Raman spectroscopy excited at 1064 nm

NASA Astrophysics Data System (ADS)

Ciaccheri, L.; Yuan, T.; Zhang, S.; Mencaglia, A. A.; Trono, C.; Yuan, L.; Mignani, A. G.

2017-04-01

Blueberry juices produced in China and in Italy were analyzed by means of Raman spectroscopy. The reference data of important nutraceutical indicators such as degrees Brix and carbohydrates were available. Some juices were produced from fresh organic fruits, while others were industrial grade, differing in qualities and prices. Raman spectra obtained with excitation at 1064 nm were acquired using a dispersive fiber-optic spectrometer. Degrees Brix were measured by means of a commercial refractometer, while carbohydrate contents were available from the producers. Multivariate processing was used for predicting Brix and carbohydrates from Raman spectra and from the reference data. Determination coefficients equal to 0.88 and 0.84, respectively, were obtained. This experiment further confirms the excellent potentials of Raman spectroscopy for both non-destructive and rapid assessments of food quality.

Reductions in Gull Populations Improve Beachwater Quality.

EPA Science Inventory

BACKGROUND. Gulls are often cited as an important source of fecal pollution to surface waters, and fecal indicator bacteria (FIB) concentrations have been shown to be significantly correlated with gull populations. However, it is unclear whether gull contamination poses a risk to...

The association between role overload and women's mental health.

PubMed

Glynn, Keva; Maclean, Heather; Forte, Tonia; Cohen, Marsha

2009-02-01

To determine the importance of role overload (the extent to which a person feels overwhelmed by her total responsibilities) relative to other known social determinants of women's mental health. A Canadian national, random sample, cross-sectional telephone survey in 2003 assessed the association among role overload, types and quality of roles (parent, employee, spouse), sociodemographics, and mental health (using the SF-12) using linear regression. Analysis included 716 women aged 25-54 who indicated that their youngest child living in the household was aged < or =17 years. Perceptions of greater role overload were associated with poorer mental health (p < 0.0001). Women working <35 hours per week (p = 0.04) or 35-40 hours per week (p 5 0.002) reported better mental health than nonemployed women, as did women with the highest annual household income ($70,000+)(p = 0.001). Also associated with better mental health were higher marital status quality scores for both married and single women (p < 0.001), higher job quality scores among employed women (p = 0.02), greater homemaking quality scores among unemployed women (p = 0.03), and women reporting high parental quality (p = 0.04) Role overload showed a stronger relationship to mental health than other sociodemographic variables, including income. Our findings indicate the importance of measuring women's experience of their multiple roles rather than focusing on single roles. More research is warranted on the totality of women's experiences of their many social role obligations.

Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.

PubMed

Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M

2015-10-01

The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to benchmark and guide their quality improvement activities.

Redox processes and water quality of selected principal aquifer systems

USGS Publications Warehouse

McMahon, P.B.; Chapelle, F.H.

2008-01-01

Reduction/oxidation (redox) conditions in 15 principal aquifer (PA) systems of the United States, and their impact on several water quality issues, were assessed from a large data base collected by the National Water-Quality Assessment Program of the USGS. The logic of these assessments was based on the observed ecological succession of electron acceptors such as dissolved oxygen, nitrate, and sulfate and threshold concentrations of these substrates needed to support active microbial metabolism. Similarly, the utilization of solid-phase electron acceptors such as Mn(IV) and Fe(III) is indicated by the production of dissolved manganese and iron. An internally consistent set of threshold concentration criteria was developed and applied to a large data set of 1692 water samples from the PAs to assess ambient redox conditions. The indicated redox conditions then were related to the occurrence of selected natural (arsenic) and anthropogenic (nitrate and volatile organic compounds) contaminants in ground water. For the natural and anthropogenic contaminants assessed in this study, considering redox conditions as defined by this framework of redox indicator species and threshold concentrations explained many water quality trends observed at a regional scale. An important finding of this study was that samples indicating mixed redox processes provide information on redox heterogeneity that is useful for assessing common water quality issues. Given the interpretive power of the redox framework and given that it is relatively inexpensive and easy to measure the chemical parameters included in the framework, those parameters should be included in routine water quality monitoring programs whenever possible.

Chemical quality and regulatory compliance of drinking water in Iceland.

PubMed

Gunnarsdottir, Maria J; Gardarsson, Sigurdur M; Jonsson, Gunnar St; Bartram, Jamie

2016-11-01

Assuring sufficient quality of drinking water is of great importance for public wellbeing and prosperity. Nations have developed regulatory system with the aim of providing drinking water of sufficient quality and to minimize the risk of contamination of the water supply in the first place. In this study the chemical quality of Icelandic drinking water was evaluated by systematically analyzing results from audit monitoring where 53 parameters were assessed for 345 samples from 79 aquifers, serving 74 water supply systems. Compliance to the Icelandic Drinking Water Regulation (IDWR) was evaluated with regard to parametric values, minimum requirement of sampling, and limit of detection. Water quality compliance was divided according to health-related chemicals and indicators, and analyzed according to size. Samples from few individual locations were benchmarked against natural background levels (NBLs) in order to identify potential pollution sources. The results show that drinking compliance was 99.97% in health-related chemicals and 99.44% in indicator parameters indicating that Icelandic groundwater abstracted for drinking water supply is generally of high quality with no expected health risks. In 10 water supply systems, of the 74 tested, there was an indication of anthropogenic chemical pollution, either at the source or in the network, and in another 6 water supplies there was a need to improve the water intake to prevent surface water intrusion. Benchmarking against the NBLs proved to be useful in tracing potential pollution sources, providing a useful tool for identifying pollution at an early stage. Copyright © 2016 Elsevier GmbH. All rights reserved.

Lack of evidence and standardization in care pathway documents for patients with ST-elevated myocardial infarction.

PubMed

Aeyels, Daan; Van Vugt, Stijn; Sinnaeve, Peter R; Panella, Massimiliano; Van Zelm, Ruben; Sermeus, Walter; Vanhaecht, Kris

2016-04-01

Clinical practice variation and the subsequent burden on health care quality has been documented for patients with ST-elevated myocardial infarction (STEMI). Reduction of clinical practice variation is possible by increasing guideline adherence. Care pathway documents can increase guideline adherence by implementing evidence-based key interventions and quality indicators in daily practice. This study aims to examine guideline adherence of care pathway documents for patients with STEMI. Lay-out, size and timeframe of submitted care pathways documents were analysed. Two independent reviewers used a checklist to systematically assess the guideline adherence of care pathway documents. The checklist comprised a set of key interventions and quality indicators extracted from evidence and international guidelines. The checklist distinguished the evidence level for each item and was validated by expert consensus. Results were verified by inviting participating hospitals to provide feedback. Fifteen out of 25 invited hospitals submitted care pathway documents for STEMI. The care pathway documents differed in timeframe, lay-out and size. Analysis of the care pathway documents showed important variation in formalizing adherence to evidence: between hospitals, inclusion of 24 key interventions in care pathway documents varied from 13 to 97%. Inclusion of 11 essential quality indicators varied from 0 to 40%. Care pathway documents for patients with STEMI differ considerably in lay-out, timeframe and size. This study showed variation in, and suboptimal inclusion of, evidence-based key interventions and quality indicators in care pathway documents. The use of these care pathway documents might result in suboptimal quality of care for STEMI patients. © The European Society of Cardiology 2015.

Development of innovative computer software to facilitate the setup and computation of water quality index.

PubMed

Nabizadeh, Ramin; Valadi Amin, Maryam; Alimohammadi, Mahmood; Naddafi, Kazem; Mahvi, Amir Hossein; Yousefzadeh, Samira

2013-04-26

Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases.

A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan.

PubMed

El-Jardali, Fadi; Fadlallah, Racha

2017-08-16

Improving quality of care and patient safety practices can strengthen health care delivery systems, improve health sector performance, and accelerate attainment of health-related Sustainability Development Goals. Although quality improvement is now prominent on the health policy agendas of governments in low- and middle-income countries (LMICs), including countries of the Eastern Mediterranean Region (EMR), progress to date has not been optimal. The objective of this study is to comprehensively review existing quality improvement and patient safety policies and strategies in two selected countries of the EMR (Lebanon and Jordan) to determine the extent to which these have been institutionalized within existing health systems. We used a mixed methods approach that combined documentation review, stakeholder surveys and key informant interviews. Existing quality improvement and patient safety initiatives were assessed across five components of an analytical framework for assessing health care quality and patient safety: health systems context; national policies and legislation; organizations and institutions; methods, techniques and tools; and health care infrastructure and resources. Both Lebanon and Jordan have made important progress in terms of increased attention to quality and accreditation in national health plans and strategies, licensing requirements for health care professionals and organizations (albeit to varying extents), and investments in health information systems. A key deficiency in both countries is the absence of an explicit national policy for quality improvement and patient safety across the health system. Instead, there is a spread of several (disjointed) pieces of legal measures and national plans leading to fragmentation and lack of clear articulation of responsibilities across the entire continuum of care. Moreover, both countries lack national sets of standardized and applicable quality indicators for performance measurement and benchmarking. Importantly, incentive systems that link contractual agreement, regulations, accreditation, and performance indicators are underutilized in Lebanon and absent in Jordan. At the healthcare organizational level, there is a need to instill a culture of continuous quality improvement and promote professional training in quality improvement and patient safety. Study findings highlight the importance of aligning policies, organizations, methods, capacities and resources in order to institutionalize quality improvement and patient safety practices in health systems. Gaps and dysfunctions identified can help inform national deliberations and dialogues among key stakeholders in each study country. Findings can also inform future quality improvement efforts in the EMR and beyond, with a particular emphasis on LMICs.

Improving on national quality indicators of breast cancer care in a large public hospital as a means to decrease disparities for African American women.

PubMed

Rizzo, Monica; Bumpers, Harvey; Okoli, Joel; Senior-Crosby, Diana; O'Regan, Ruth; Zelnak, Amelia; Pan, Lin; Mosunjac, Marina; Patterson, Sharla Gayle; Gabram, Sheryl G A

2011-01-01

In April 2007, the National Quality Forum (NQF) endorsed the first nationally recognized hospital-based performance measures for stage I, II, and III breast cancer. The purpose of this study was to document compliance with the 3 NQF breast quality indicators during 2 time intervals in a metropolitan public hospital. Tumor registry and medical records were used to identify patient demographics and treatments before (2005-2006) and after (2008) implementations in 2007 as a result of the NQF audit. Program changes included: hiring a dedicated medical oncology nurse practitioner, requiring the radiation oncology case manager to attend weekly multidisciplinary conferences, educating Patient Navigators of the importance of multimodal care, and providing support groups for patients addressing importance of completion of all treatment options. A total of 213 female patients were diagnosed with and treated for stage I, II, or III breast cancer in 2005-2006 and 2008. Of these, 189 (89%) were African American (AA) women. Also, 70 patients of 86 (81.3%) received radiation therapy, 60 of 77 (77.9%) received or were considered for adjuvant chemotherapy, and 124 of 144 (86.1%) for hormonal therapy according to NQF indicators. After 2007, patients receiving radiation therapy increased from 75.8 to 95.8%. Patients receiving or considered for adjuvant chemotherapy or hormonal therapy increased from 73.7 to 93.7% and from 84.1 to 90.0%, respectively. NQF breast cancer indicators provided a mechanism to improve compliance of multimodal treatment in our center. Raising awareness of these indicators in the multidisciplinary conference, hiring dedicated personnel, and educating patients has led to major improvements in breast cancer care.

Effect of Habitat Size, Quality, and Isolation on Functional Groups of Beetles in Hollow Oaks

PubMed Central

Pilskog, Hanne Eik; Birkemoe, Tone; Framstad, Erik; Sverdrup-Thygeson, Anne

2016-01-01

One of the largest threats to biodiversity is land use change and habitat loss. Hollow oaks (Quercus spp. L.) are well-defined patches that are hotspots for biodiversity and red-listed species, but they are often rare and fragmented in the landscape. We investigated the effect of patch size, habitat quality, and isolation on functional groups and red-listed saproxylic beetles in hollow oaks (n = 40) in Norway. The groups were defined by host tree association, trophic grouping, and red-listed status. Habitat quality, represented by tree form was most important in explaining species richness for most groups. Patch size, represented by circumference and amount of dead branches, was most important in explaining abundance. Isolation, that is single oaks compared with oaks in groups, had a negative effect on the abundance of beetles feeding both on wood and fungi (xylomycethopagous), as well as on species associated with broadleaved trees (oak semi-specialists), but did not affect species richness. This indicates that at this scale and in this landscape, isolated oaks are as species rich and valuable for conservation as other oaks, although some functional groups may be more vulnerable to isolation than others. The red-listed species only responded to patch size, indicating that oaks with large circumference and many dead branches are especially important for red-listed species and for conservation. PMID:26945089

[QUALITY MEASURES IN MEDICINE-- A PLEA FOR NEW, VALUE BASED THINKING].

PubMed

Fisher, Menachem; Wagner, Oded; Keinarl, Talia; Solt, Ido

2015-09-01

Quality is an important and basic conduct of complex systems in general and health systems in particular. Quality is a cornerstone of medicine, necessary in the eyes of the community of consumers, caregivers, and the systems that manage both. In Israel, the Ministry of Health has set the quality issue on the agenda of healthcare organizations in all existing frameworks. In this article we seek to offer an acceptable alternative perspective, in examining the quality of public health. We suggest highlighting the ethical aspect of medical care, while reducing the quantitative monitoring component of existing quality metrics. Relying solely on indices has negative effects that might cause damage. The proposed alternative focuses on the personal responsibility of health care providers, using. values and moral reasonin.

Supportive and Stressful Relationships with Teachers, Peers and Family and Their Influence on Students' Social/emotional and Academic Experience of School

ERIC Educational Resources Information Center

Murray-Harvey, Rosalind; Slee, Phillip T.

2007-01-01

Judgments about the quality of students' experience of school generally focus on their academic performance and indeed this is an important indicator but closer attention needs to be paid to equally important, more broadly based outcomes that include social/emotional adjustment as they also are shown to impact on students' lives at, and beyond…

Validation of quality indicators for the organization of palliative care: a modified RAND Delphi study in seven European countries (the Europall project).

PubMed

Woitha, Kathrin; Van Beek, Karen; Ahmed, Nisar; Jaspers, Birgit; Mollard, Jean M; Ahmedzai, Sam H; Hasselaar, Jeroen; Menten, Johan; Vissers, Kris; Engels, Yvonne

2014-02-01

Validated quality indicators can help health-care professionals to evaluate their medical practices in a comparative manner to deliver optimal clinical care. No international set of quality indicators to measure the organizational aspects of palliative care settings exists. To develop and validate a set of structure and process indicators for palliative care settings in Europe. A two-round modified RAND Delphi process was conducted to rate clarity and usefulness of a previously developed set of 110 quality indicators. In total, 20 multi-professional palliative care teams of centers of excellence from seven European countries. In total, 56 quality indicators were rated as useful. These valid quality indicators concerned the following domains: the definition of a palliative care service (2 quality indicators), accessibility to palliative care (16 quality indicators), specific infrastructure to deliver palliative care (8 quality indicators), symptom assessment tools (1 quality indicator), specific personnel in palliative care services (9 quality indicators), documentation methodology of clinical data (14 quality indicators), evaluation of quality and safety procedures (1 quality indicator), reporting of clinical activities (1 quality indicator), and education in palliative care (4 quality indicator). The modified RAND Delphi process resulted in 56 international face-validated quality indicators to measure and compare organizational aspects of palliative care. These quality indicators, aimed to assess and improve the organization of palliative care, will be pilot tested in palliative care settings all over Europe and be used in the EU FP7 funded IMPACT project.

Assessment of river quality in a subtropical Austral river system: a combined approach using benthic diatoms and macroinvertebrates

NASA Astrophysics Data System (ADS)

Nhiwatiwa, Tamuka; Dalu, Tatenda; Sithole, Tatenda

2017-12-01

River systems constitute areas of high human population densities owing to their favourable conditions for agriculture, water supply and transportation network. Despite human dependence on river systems, anthropogenic activities severely degrade water quality. The main aim of this study was to assess the river health of Ngamo River using diatom and macroinvertebrate community structure based on multivariate analyses and community metrics. Ammonia, pH, salinity, total phosphorus and temperature were found to be significantly different among the study seasons. The diatom and macroinvertebrate taxa richness increased downstream suggesting an improvement in water as we moved away from the pollution point sources. Canonical correspondence analyses identified nutrients (total nitrogen and reactive phosphorus) as important variables structuring diatom and macroinvertebrate community. The community metrics and diversity indices for both bioindicators highlighted that the water quality of the river system was very poor. These findings indicate that both methods can be used for water quality assessments, e.g. sewage and agricultural pollution, and they show high potential for use during water quality monitoring programmes in other regions.

Quality indicators for musculoskeletal injury management in the emergency department: a systematic review.

PubMed

Strudwick, Kirsten; Nelson, Mark; Martin-Khan, Melinda; Bourke, Michael; Bell, Anthony; Russell, Trevor

2015-02-01

There is increasing importance placed on quality of health care for musculoskeletal injuries in emergency departments (EDs). This systematic review aimed to identify existing musculoskeletal quality indicators (QIs) developed for ED use and to critically evaluate their methodological quality. MEDLINE, EMBASE, CINAHL, and the gray literature, including relevant organizational websites, were searched in 2013. English-language articles were included that described the development of at least one QI related to the ED care of musculoskeletal injuries. Data extraction of each included article was conducted. A quality assessment was then performed by rating each relevant QI against the Appraisal of Indicators through Research and Evaluation (AIRE) Instrument. QIs with similar definitions were grouped together and categorized according to the health care quality frameworks of Donabedian and the Institute of Medicine. The search revealed 1,805 potentially relevant articles, of which 15 were finally included in the review. The number of relevant QIs per article ranged from one to 11, resulting in a total of 71 QIs overall. Pain (n = 17) and fracture management (n = 13) QIs were predominant. Ten QIs scored at least 50% across all AIRE Instrument domains, and these related to pain management and appropriate imaging of the spine. Methodological quality of the development of most QIs is poor. Recommendations for a core set of QIs that address the complete spectrum of musculoskeletal injury management in emergency medicine is not possible, and more work is needed. Currently, QIs with highest methodological quality are in the areas of pain management and medical imaging. © 2015 by the Society for Academic Emergency Medicine.

Toward youth self-report of health and quality of life in population monitoring.

PubMed

Topolski, Tari D; Edwards, Todd C; Patrick, Donald L

2004-01-01

This paper addresses population monitoring of youth health and quality of life, including the concepts used, methodological and practical criteria for indicators, and existing surveys and measures. Current population surveys of youth generally focus on poor health, such as disability or health-risk behaviors. Although these are important end points, indicators of illness or risk do not reflect the health or life perspective of the majority of youth who do not experience health problems. The measures used to monitor youth health should be appropriate and sensitive to future needs and capture the perspectives of youths. Two potential concepts for this "scorecard" are self-perceived health and quality of life, which have been shown to be useful in adults. For youth, the quality of life framework seems particularly relevant as it incorporates both positive and negative aspects of health and well-being and also captures salient aspects of health other than physical health, such as sense of self, social relationships, environment and culture, and life satisfaction.

Water Environment Assessment as an Ecological Red Line Management Tool for Marine Wetland Protection.

PubMed

Zhang, Yinan; Chu, Chunli; Liu, Lei; Xu, Shengguo; Ruan, Xiaoxue; Ju, Meiting

2017-08-02

A 'red line' was established, identifying an area requiring for ecological protection in Tianjin, China. Within the protected area of the red line area, the Qilihai wetland is an important ecotope with complex ecological functions, although the ecosystem is seriously disturbed due to anthropogenic activities in the surrounding areas. This study assesses the water quality status of the Qilihai wetlands to identify the pollution sources and potential improvements based on the ecological red line policy, to improve and protect the waters of the Qilihai wetlands. An indicator system was established to assess water quality status using single factor evaluation and a comprehensive evaluation method, supported by data from 2010 to 2013. Assessment results show that not all indicators met the requirement of the Environmental Quality Standards for Surface Water (GB3838-2002) and that overall, waters in the Qilihai wetland were seriously polluted. Based on these findings we propose restrictions on all polluting anthropogenic activities in the red line area and implementation of restoration projects to improve water quality.

Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review

PubMed Central

de Boer, Karin; Burggraaf, Henriëtte; Derks, Jan B.; van Dijk, Det; van Dillen, Jeroen; Dirksen, Carmen D.; Duvekot, Johannes J.; Franx, Arie; Hasaart, Tom H. M.; Huisjes, Anjoke J. M.; Kolkman, Diny; Kwee, Anneke; Mol, Ben W.; van Pampus, Mariëlle G.; de Roon-Immerzeel, Alieke; van Roosmalen, Jos J. M.; Roumen, Frans J. M. E.; Smid-Koopman, Ellen; Spaans, Wilbert A.; Visser, Harry; van Wijngaarden, Wim J.; Willekes, Christine; Wouters, Maurice G. A. J.

2016-01-01

Background There is an ongoing discussion on the rising CS rate worldwide. Suboptimal guideline adherence may be an important contributor to this rise. Before improvement of care can be established, optimal CS care in different settings has to be defined. This study aimed to develop and measure quality indicators to determine guideline adherence and identify target groups for improvement of care with direct effect on caesarean section (CS) rates. Method Eighteen obstetricians and midwives participated in an expert panel for systematic CS quality indicator development according to the RAND-modified Delphi method. A multi-center study was performed and medical charts of 1024 women with a CS and a stratified and weighted randomly selected group of 1036 women with a vaginal delivery were analysed. Quality indicator frequency and adherence were scored in 2060 women with a CS or vaginal delivery. Results The expert panel developed 16 indicators on planned CS and 11 indicators on unplanned CS. Indicator adherence was calculated, defined as the number of women in a specific obstetrical situation in which care was performed as recommended in both planned and unplanned CS settings. The most frequently occurring obstetrical situations with low indicator adherence were: 1) suspected fetal distress (frequency 17%, adherence 46%), 2) non-progressive labour (frequency 12%, CS performed too early in over 75%), 3) continuous support during labour (frequency 88%, adherence 37%) and 4) previous CS (frequency 12%), with adequate counselling in 15%. Conclusions We identified four concrete target groups for improvement of obstetrical care, which can be used as a starting point to reduce CS rates worldwide. PMID:26783742

Physician level reporting of surgical and pathology performance indicators: a regional study to assess feasibility and impact on quality.

PubMed

McFadyen, Craig; Lankshear, Sara; Divaris, Dimitrios; Berry, Mark; Hunter, Amber; Srigley, John; Irish, Jonathan

2015-02-01

There is increased awareness that, to minimize variation in clinician practice and improve quality, performance reporting should be implemented at the provider level. This optimizes physician engagement and creates a sense of professional responsibility for quality and performance measurement at the individual and organizational levels. Individual provider level reporting was implemented within a provincial health region involving 56 clinicians (general surgeons, surgical oncologists, urologists and pathologists). The 2 surgical pathology indicators chosen were colorectal cancer (CRC) lymph node retrieval rate and pT2 prostate cancer margin positivity rate. Surgical resections for all prostate and colorectal cancer performed between Jan. 1, 2011, and Mar. 30, 2012, were included. We used a pre- and postsurvey design to obtain physician perceptions and focus groups with program leadership to determine organizational impact. Survey results showed that respondents felt the data provided in the reports were valid (67%), consistent with expectations (70%), maintained confidentiality (80%) and were not used in a punitive manner (77%). During the study period the pT2 prostate margin positivity rate decreased from 57.1% to 27.5%. For the CRC lymph node retrieval rate indicator, high baseline performance was maintained. We developed a robust process for providing physicians with confidential, individualized surgical and pathology quality indicator reports. Our results reinforce the importance of individual physician feedback as a strategy for improving and sustaining quality in surgical and diagnostic oncology.

Development, evaluation, and application of sediment quality targets for assessing and managing contaminated sediments in Tampa Bay, Florida

USGS Publications Warehouse

MacDonald, D.D.; Carr, R.S.; Eckenrod, D.; Greening, H.; Grabe, S.; Ingersoll, C.G.; Janicki, S.; Janicki, T.; Lindskoog, R.A.; Long, E.R.; Pribble, R.; Sloane, G.; Smorong, D.E.

2004-01-01

Tampa Bay is a large, urban estuary that is located in west central Florida. Although water quality conditions represent an important concern in this estuary, information from numerous sources indicates that sediment contamination also has the potential to adversely affect aquatic organisms, aquatic-dependent wildlife, and human health. As such, protecting relatively uncontaminated areas of the bay from contamination and reducing the amount of toxic chemicals in contaminated sediments have been identified as high-priority sediment management objectives for Tampa Bay. To address concerns related to sediment contamination in the bay, an ecosystem-based framework for assessing and managing sediment quality conditions was developed that included identification of sediment quality issues and concerns, development of ecosystem goals and objectives, selection of ecosystem health indicators, establishment of metrics and targets for key indicators, and incorporation of key indicators, metrics, and targets into watershed management plans and decision-making processes. This paper describes the process that was used to select and evaluate numerical sediment quality targets (SQTs) for assessing and managing contaminated sediments. These SQTs included measures of sediment chemistry, whole-sediment and pore-water toxicity, and benthic invertebrate community structure. In addition, the paper describes how the SQTs were used to develop site-specific concentration-response models that describe how the frequency of adverse biological effects changes with increasing concentrations of chemicals of potential concern. Finally, a key application of the SQTs for defining sediment management areas is discussed.

[Efficiency versus quality in the NHS, in Portugal: methodologies for evaluation].

PubMed

Giraldes, Maria do Rosário

2008-01-01

To proceed to the evaluation of the efficiency and quality in the NHS, based in methodologies of evaluation of management, indicators of benchmarking and indicators of process and outcome. The 1980 and 1990 decades have seen the proliferation of all forms of process indicators as a way to control health services. It is not a coincidence that the increase in managed care has been accompanied by an explosion of process indicators, as it has happened in the health system of the USA. More recently the attention has turned away from measures of performance, which measure the process (what has been done) to those which measure outcomes (what was the result). Quality indicators have been developed in Europe, first to be used in hospitals, but also to be used in primary health care. Conceptually the justification for the introduction of process indicators comes from the principle that their use will reinforce a modification in the quality of the proceedings, which will give origin to better outcomes as well at population level, as resource saving. Outcome indicators compared with process indicators in health care shows that process indicators have the advantage of being more sensitive than outcome indicators to differences in the quality. Optimizing health care quality has the objective of establishing a quantitative relationship between the quality of the health services and cost-effectiveness. To identify quality indicators and benchmarking and to implement plans to measure the quality of health care. In a study made in a group of senior GP, in the UK, with the objective of determining which process indicators better reflect the quality of the services in primary health care services a Delphi method was used. Only seven indicators were chosen by 75% of the respondents: the percentage of eligible patients receiving cervical screening; the percentage of generic prescribing; the percentage of eligible patients receiving childhood immunization; the percentage of eligible patients receiving influenza vaccinations; ability to see GP within 48 hours; percentage prescribing antibacterial drugs; primary care management (diabetes and asthma). The main characteristics of health indicators are: acceptability--The acceptability of the data collected using a measure will depend upon the extent to which the findings are acceptable to both those being assessed and those undertaking the assessment; feasibility--information about the quality of services is often driven by data availability rather than by epidemiological and clinical considerations. Quality measurement cannot be achieved without accurate and consistent information systems; reliability--indicators should be used to compare organisations/practitioners with similar organisations/practitioners; sensitivity to change--quality measures must be capable of detecting changes in quality of care in order to discriminate between and within subjects; validity--there has been little methodological scrutiny of the validity of consensus methods. Outcome indicators are not good performance indicators in health care. Which causes the variation in outcomes between deliverers of primary health care services are the observed differences due to differences in users, due to age, sex, co-morbidity, severity and socio-economic situation. The Medical Outcomes Study, published in 1989, has brought, for the first time, subjective indicators, based in the evaluation of users, as an important outcome indicator. Clinical indicators are those that are more associated with the outcomes. A few studies exist of the effects of management indicators in outcomes. Several indicators, however, reflect norms related with the local of work. The use of a Composite Indicator presents advantages. In England it has been used a Composite Indicator of process indicators in 302 organizations of primary health care, in 2001-2002. This study has used a mathematical model to select the best indicators which allow the evaluation of performance. It has concluded that the use of a Composite Indicator is of easy construction, interpretation, and acceptable and that has validity. Giraldes (2007) has done an evaluation of health centres in a perspective of management and quality of deliver using a Composite Indicator of Efficiency and Quality. It includes the efficiency indicators concerned with the main activities of the health centre, preventive activities, curative activities and drugs, by main pharmaco therapeutic groups, and auxiliary means of diagnosis (analysis, X Ray, ecographies and CAT by user, weighted according to the relevance of the expenditure in total expenditure). The Composite Quality Indicator includes 12 performance and 5 outcome indicators. From the 10 best health centres in an efficiency and quality perspective 3 are from the Porto Sub-Region (Negrelos, Rebordosa and Paredes) and 2 from the Braga Sub-Region (Vila Verde and Vila Nova de Famalicão I), Leiria (Pedrogão Grande and Batalha), and Vila Real (Mesão Frio and Sabrosa), while 1 belongs to the Aveiro Sub-Region (Sever do Vouga). The more efficient health centres are from the Aveiro Sub-Region, followed by Braga, Porto, and Lisboa. Sub-Regions with very similar values. Giraldes (2007) has made an evaluation of the hospital expenditure by user in an efficiency perspective and to evaluate the quality of the health system process indicators and outcome indicators. In an efficiency perspective the concept of technical efficiency has been chosen, and a correction has been made, as well, in what concerns a case-mix index (CMI). The indicators have been calculated by user in what concerns the main hospital activities (the expenditure in inpatient care by treated patient, in day hospital by treated patient, in outpatient care by consultation, etc.) and as well the auxiliary sections of clinic support and the hotel support services. All the indicators have been corrected according to the relevance of its expenditure in total expenditure. In a quality perspective two types of indicators have been considered; process indicators and outcome indicators. Process indicators, as the percentage of surgeries in ambulatory care, the percentage of cesareans in total deliveries and the rate of autopsy. The outcome indicator number of episodes of inpatient care due to surgery infection in total days of inpatient care. Those indicators have been aggregated, by a mean. The Composite Indicator of Efficiency and Quality is the mean of the Composite Indicator of Efficiency and the Composite Indicator of Quality, having this one been converted in inverse base.

Quality of Streams in Johnson County, Kansas, and Relations to Environmental Variables, 2003-07

USGS Publications Warehouse

Rasmussen, Teresa J.; Poulton, Barry C.; Graham, Jennifer L.

2009-01-01

The quality of streams and relations to environmental variables in Johnson County, northeastern Kansas, were evaluated using water, streambed sediment, land use, streamflow, habitat, algal periphyton (benthic algae), and benthic macroinvertebrate data. Water, streambed sediment, and macroinvertebrate samples were collected in March 2007 during base flow at 20 stream sites that represent 11 different watersheds in the county. In addition, algal periphyton samples were collected twice (spring and summer 2007) at one-half of the sites. Environmental data including water and streambed-sediment chemistry data (primarily nutrients, fecal-indicator bacteria, and organic wastewater compounds), land use, streamflow, and habitat data were used in statistical analyses to evaluate relations between biological conditions and variables that may affect them. This report includes an evaluation of water and streambed-sediment chemistry, assessment of habitat conditions, comparison of biological community attributes (such as composition, diversity, and abundance) among sampling sites, placement of sampling sites into impairment categories, evaluation of biological data relative to environmental variables, and evaluation of changes in biological communities and effects of urbanization. This evaluation is useful for understanding factors that affect stream quality, for improving water-quality management programs, and for documenting changing conditions over time. The information will become increasingly important for protecting streams in the future as urbanization continues. Results of this study indicate that the biological quality at nearly all biological sampling sites in Johnson County has some level of impairment. Periphyton taxa generally were indicative of somewhat degraded conditions with small to moderate amounts of organic enrichment. Camp Branch in the Blue River watershed was the only site that met State criteria for full support of aquatic life in 2007. Since 2003, biological quality improved at one rural sampling site, possibly because of changes in wastewater affecting the site, and declined at three urban sites possibly because of the combined effects of ongoing development. Rural streams in the western and southern parts of the county, with land-use conditions similar to those found at the State reference site (Captain Creek), continue to support some organisms normally associated with healthy streams. Several environmental factors contribute to biological indicators of stream quality. The primary factor explaining biological quality at sites in Johnson County was the amount of urbanization upstream in the watershed. Specific conductance of stream water, which is a measure of dissolved solids in water and is determined primarily by the amount of groundwater contributing to streamflow, the amount of urbanization, and discharges from wastewater and industrial sites, was strongly negatively correlated with biological stream quality as indicated by macroinvertebrate metrics. Concentration of polycyclic aromatic hydrocarbons (PAHs) in streambed sediment also was negatively correlated with biological stream quality. Individual habitat variables that most commonly were positively correlated with biological indicators included stream sinuosity, buffer length, and substrate cover diversity. Riffle substrate embeddedness and sediment deposition commonly were negatively correlated with favorable metric scores. Statistical analysis indicated that specific conductance, impervious surface area (a measure of urbanization), and stream sinuosity explained 85 percent of the variance in macroinvertebrate communities. Management practices affecting environmental variables that appear to be most important for Johnson County streams include protection of stream corridors, measures that reduce the effects of impervious surfaces associated with urbanization, reduction of dissolved solids in stream water, reduction of PAHs entering streams and

Perioperative Care and the Importance of Continuous Quality Improvement—A Controlled Intervention Study in Three Tanzanian Hospitals

PubMed Central

Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia

2015-01-01

Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Discussion Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392

Perioperative Care and the Importance of Continuous Quality Improvement--A Controlled Intervention Study in Three Tanzanian Hospitals.

PubMed

Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia

2015-01-01

Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.

Measuring quality of care: considering conceptual approaches to quality indicator development and evaluation.

PubMed

Stelfox, Henry T; Straus, Sharon E

2013-12-01

In this article, we describe one approach for developing and evaluating quality indicators. We focus on describing different conceptual approaches to quality indicator development, review one approach for developing quality indicators, outline how to evaluate quality indicators once developed, and discuss quality indicator maintenance. The key steps for developing quality indicators include specifying a clear goal for the indicators; using methodologies to incorporate evidence, expertise, and patient perspectives; and considering contextual factors and logistics of implementation. The Strategic Framework Board and the National Quality Measure Clearinghouse have developed criteria for evaluating quality indicators that complement traditional psychometric evaluations. Optimal strategies for quality indicator maintenance and dissemination have not been determined, but experiences with clinical guideline maintenance may be informative. For quality indicators to effectively guide quality improvement efforts, they must be developed, evaluated, maintained, and implemented using rigorous evidence-informed practices. Copyright © 2013 Elsevier Inc. All rights reserved.

Multiphase Modelling of Bacteria Removal in a CSO Stream

EPA Science Inventory

Indicator bacteria are an important determinant of water quality in many water resources management situations. They are also one of the more complex phenomena to model and predict. Sources abound, the populations are dynamic and influenced by many factors, and mobility through...

Home on the Big River, Part II: Great River Habitat Quality Indices

EPA Science Inventory

USEPA’s EMAP sampled the Upper Mississippi, Missouri, and Ohio Rivers from 2004 through 2006 as part of an integrated assessment of ecological condition. These Great Rivers are important human recreational destinations and transportation corridors, and represent significant wild...

THE U.S. EPA PROMULGATES NEW STANDARDS FOR FINE PARTICLES

EPA Science Inventory

This presentation will describe the following items: the process used by EPA to review the National Ambient Air Quality Standards for Particular Matter, indicator and levels for the new fine particle standards, important epidemiologic data establishing the need for new particulat...

Quest for quality care and patient safety: the case of Singapore

PubMed Central

Lim, M

2004-01-01



 Quality of care in Singapore has seen a paradigm shift from a traditional focus on structural approaches to a broader multidimensional concept which includes the monitoring of clinical indicators and medical errors. Strong political commitment and institutional capacities have been important factors for making the transition. What is still lacking, however, is a culture of rigorous programme evaluation, public involvement, and patient empowerment. Despite these imperfections, Singapore has made considerable strides and its experience may hold lessons for other small developing countries in the common quest for quality care and patient safety. PMID:14757804

Surface evaluation of orthopedic hip implants marketed in Brazil

NASA Astrophysics Data System (ADS)

Souza, M. M.; Trommer, R. M.; Maru, M. M.; Roesler, C. R. M.; Barros, W. S.; Dutra, M. S.

2016-07-01

One of the factors that contribute to the quality of total hip prostheses is the degree of accuracy in the manufacturing of the joint surfaces. The dimensional control of joint components is important because of its direct influence on the durability and, consequently, in the patients’ life quality. This work presents studies on the form and roughness of orthopedic hip prostheses marketed in Brazil. The results provide data for quality control of the surfaces of the femoral heads and acetabular components of hip prostheses and indicate the need of improvement in the procedures used to this control.

The Psychometric Properties and the Development of the Indicators of Quality Nursing Work Environments in Taiwan.

PubMed

Lin, Chiou-Fen; Lu, Meei-Shiow; Huang, Hsiu-Ying

2016-03-01

The nursing shortage in medical institutions in Taiwan averaged 9% in 2012, considerably higher than the 5% indicated in the literature. As a result, many hospitals have been forced to close wards or reduce beds. Despite the acute need, the percentage of registered nurses who are employed as nurses in Taiwan (60.4%) is considerably lower than those in Canada or the United States. This low rate may be because of the poor working environment for nurses in Taiwan. This study aimed to develop a set of nursing work environment quality indicators for Taiwan and to test the reliability and validity of the resulting survey tool. Multiple methods were used in this study. In Phase 1, we organized an expert panel, reviewed the literature, and conducted seven rounds of expert panel discussion and six focus group discussions with nursing directors. The goal was to draft indicators representing a quality nursing work environment to fit current conditions in Taiwan. In Phase 2, we conducted an expert review for content validity, held three public hearings, and conducted a survey. Four hundred twenty-seven questionnaires were sent out, with 381 returned. The goal was to test the content validity, construct validity, and internal consistency reliability. The study produced a set of indicators of a quality nursing work environment with eight dimensions and 65 items. The content validity index for importance and suitability dimensions were 1.0, whereas the internal consistency was 0.91. The eight dimensions were safe practice environment (16 items), quality and quantity of staff (four items), salary and welfare (seven items), professional specialization and teamwork (seven items), work simplification (five items), informatics (five items), career development (nine items), and support and caring (12 items). The overall load for the indicators was 77.57%. The developed indicators may be used to evaluate the quality of nursing work environments. Furthermore, the indicators may be used in hospital surveys to establish baseline conditions and for outcome research that measures improvement in nursing work environments after interventions.

Urban and industrial land uses have a higher soil biological quality than expected from physicochemical quality.

PubMed

Joimel, Sophie; Schwartz, Christophe; Hedde, Mickaël; Kiyota, Sayuri; Krogh, Paul Henning; Nahmani, Johanne; Pérès, Guénola; Vergnes, Alan; Cortet, Jérôme

2017-04-15

Despite their importance both in soil functioning and as soil indicators, the response of microarthropods to various land uses is still unclear. The aim of this study is to assess the effect of land use on microarthropod diversity and determine whether a soil's biological quality follows the same physicochemical quality-based gradient from forest, agriculture-grassland, agriculture-arable land, vineyards, urban vegetable gardens to urban, industrial, traffic, mining and military areas. A database compiling the characteristics of 758 communities has been established. We calculated Collembola community indices including: species richness, Pielou's evenness index, collembolan life forms, the abundance of Collembola and of Acari, the Acari/Collembola abundance ratio, and the Collembolan ecomorphological index. Results show that agricultural land use was the most harmful for soil microarthropod biodiversity, whilst urban and industrial land uses give the same level of soil biological quality as forests do. Furthermore, differences between the proportions of Acari and ecomorphological groups were observed between land uses. This study, defining soil microarthropod diversity baselines for current land uses, should therefore help in managing and preserving soil microarthropod biodiversity, especially by supporting the preservation of soil quality. Copyright © 2017 Elsevier B.V. All rights reserved.

Self-perception and quality of life among overweight and obese rural housewives in Kelantan, Malaysia.

PubMed

Muda, Wan Abdul Manan Wan; Kuate, Dieudonne; Jalil, Rohana Abdul; Nik, Wan Suriati Wan; Awang, Siti Azima

2015-02-12

Obesity, in the past was perceived to be the problem of the rich, but recent studies have reported that the problem of obesity is a worldwide problem and rural population is no less affected. Self-perceived health and weight appropriateness is an important component of weight-loss and eating behaviors and may be mediated by local, social and cultural patterning. In addition to the quality of life assessment, it should therefore be an important focal point for the design and implementation of clinical and public health policies. The present study was carried out to assess the self-perception of weight appropriateness as well as the quality of life of overweight and obese individual among the rural population particularly among housewives. A total of 421 respondents participated in the study which consisted of 36.6% in the overweight and 63.4% in the obese categories. the analysis of the survey revealed that self-perception regarding obesity among respondents show common similarities, particularly in self reporting on health, dietary habit and also the concept of beauty and a beautiful body. Character and behavior are highly regarded in evaluating a person's self-worth in society. The results on the quality of life using the ORWELL 97 instrument show that the quality of life of respondents was moderate. Most of the respondents were aware of their body weight and indicated an intention to lose weight but also reported themselves as healthy or very healthy. The results of the survey indicated that perception on obesity did not differed very much between respondents, in fact there existed a lot of similarities in their perception about health, quality of life, personal health and self-satisfaction with own body. However, their quality of life was within the normal or moderate level based on the ORWELL 97 assessment. Even though most of the respondents were aware of their body weight and indicated an intention to lose weight they also reported themselves as healthy or very healthy, suggesting that public health messages intended for rural housewives need to be more tailored to health-related consequences of fatness.

Conservation practice establishment in two northeast Iowa watersheds: Strategies, water quality implications, and lessons learned

USGS Publications Warehouse

Gassman, Philip W.; Tisl, J.A.; Palas, E.A.; Fields, C.L.; Isenhart, T.M.; Schilling, K.E.; Wolter, C.F.; Seigley, L.S.; Helmers, M.J.

2010-01-01

Coldwater trout streams are important natural resources in northeast Iowa. Extensive efforts have been made by state and federal agencies to protect and improve water quality in northeast Iowa streams that include Sny Magill Creek and Bloody Run Creek, which are located in Clayton County. A series of three water quality projects were implemented in Sny Magill Creek watershed during 1988 to 1999, which were supported by multiple agencies and focused on best management practice (BMP) adoption. Water quality monitoring was performed during 1992 to 2001 to assess the impact of these installed BMPs in the Sny Magill Creek watershed using a paired watershed approach, where the Bloody Run Creek watershed served as the control. Conservation practice adoption still occurred in the Bloody Run Creek watershed during the 10-year monitoring project and accelerated after the project ended, when a multiagency supported water quality project was implemented during 2002 to 2007. Statistical analysis of the paired watershed results using a pre/post model indicated that discharge increased 8% in Sny Magill Creek watershed relative to the Bloody Run Creek watershed, turbidity declined 41%, total suspended sediment declined 7%, and NOx-N (nitrate-nitrogen plus nitrite-nitrogen) increased 15%. Similar results were obtained with a gradual change statistical model.The weak sediment reductions and increased NOx-N levels were both unexpected and indicate that dynamics between adopted BMPs and stream systems need to be better understood. Fish surveys indicate that conditions for supporting trout fisheries have improved in both streams. Important lessons to be taken from the overall study include (1) committed project coordinators, agency collaborators, and landowners/producers are all needed for successful water quality projects; (2) smaller watershed areas should be used in paired studies; (3) reductions in stream discharge may be required in these systems in order for significant sediment load decreases to occur; (4) long-term monitoring on the order of decades can be required to detect meaningful changes in water quality in response to BMP implementation; and (5) all consequences of specific BMPs need to be considered when considering strategies for watershed protection.

The quality improvement attitude survey: Development and preliminary psychometric characteristics.

PubMed

Dunagan, Pamela B

2017-12-01

To report the development of a tool to measure nurse's attitudes about quality improvement in their practice setting and to examine preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Human factors such as nursing attitudes of complacency have been identified as root causes of sentinel events. Attitudes of nurses concerning use of Quality and Safety Education for nurse's competencies can be most challenging to teach and to change. No tool has been developed measuring attitudes of nurses concerning their role in quality improvement. A descriptive study design with preliminary psychometric evaluation was used to examine the preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Registered bedside clinical nurses comprised the sample for the study (n = 57). Quantitative data were analysed using descriptive statistics and Cronbach's alpha reliability. Total score and individual item statistics were evaluated. Two open-ended items were used to collect statements about nurses' feelings regarding their experience in quality improvement efforts. Strong support for the internal consistency reliability and face validity of the Quality Improvement Nursing Attitude Scale was found. Total scale scores were high indicating nurse participants valued Quality and Safety Education for Nurse competencies in practice. However, item-level statistics indicated nurses felt powerless when other nurses deviate from care standards. Additionally, the sample indicated they did not consistently report patient safety issues and did not have a feeling of value in efforts to improve care. Findings suggested organisational culture fosters nurses' reporting safety issues and feeling valued in efforts to improve care. Participants' narrative comments and item analysis revealed the need to generate new items for the Quality Improvement Nursing Attitude Scale focused on nurses' perception of their importance in quality and safety and their power to enact principles. The Quality Improvement Nursing Attitude Scale-Revised edition was designed to help in understanding nurses' attitudes and values. It can be used to further explore broad concepts of quality improvement efforts. © 2017 John Wiley & Sons Ltd.

Neglected environmental health impacts of China's supply-side structural reform.

PubMed

Zhang, Wei; Zhang, Lei; Li, Ying; Tian, Yuling; Li, Xiaoran; Zhang, Xue; Mol, Arthur P J; Sonnenfeld, David A; Liu, Jianguo; Ping, Zeyu; Chen, Long

2018-06-01

"Supply-side structural reform" (SSSR) has been the most important ongoing economic reform in China since 2015, but its important environmental health effects have not been properly assessed. The present study addresses that gap by focusing on reduction of overcapacity in the coal, steel, and iron sectors, combined with reduction of emissions of sulfur dioxide (SO 2 ), nitrogen oxide (NO x ), and fine particulate matter (PM 2.5 ), and projecting resultant effects on air quality and public health across cities and regions in China. Modeling results indicate that effects on air quality and public health are visible and distributed unevenly across the country. This assessment provides quantitative evidence supporting projections of the transregional distribution of such effects. Such uneven transregional distribution complicates management of air quality and health risks in China. The results challenge approaches that rely solely on cities to improve air quality. The article concludes with suggestions on how to integrate SSSR measures with cities' air quality improvement attainment planning and management performance evaluation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Quality of Health Care for Children in Australia, 2012-2013.

PubMed

Braithwaite, Jeffrey; Hibbert, Peter D; Jaffe, Adam; White, Les; Cowell, Christopher T; Harris, Mark F; Runciman, William B; Hallahan, Andrew R; Wheaton, Gavin; Williams, Helena M; Murphy, Elisabeth; Molloy, Charlotte J; Wiles, Louise K; Ramanathan, Shanthi; Arnolda, Gaston; Ting, Hsuen P; Hooper, Tamara D; Szabo, Natalie; Wakefield, John G; Hughes, Clifford F; Schmiede, Annette; Dalton, Chris; Dalton, Sarah; Holt, Joanna; Donaldson, Liam; Kelley, Ed; Lilford, Richard; Lachman, Peter; Muething, Stephen

2018-03-20

The quality of routine care for children is rarely assessed, and then usually in single settings or for single clinical conditions. To estimate the quality of health care for children in Australia in inpatient and ambulatory health care settings. Multistage stratified sample with medical record review to assess adherence with quality indicators extracted from clinical practice guidelines for 17 common, high-burden clinical conditions (noncommunicable [n = 5], mental health [n = 4], acute infection [n = 7], and injury [n = 1]), such as asthma, attention-deficit/hyperactivity disorder, tonsillitis, and head injury. For these 17 conditions, 479 quality indicators were identified, with the number varying by condition, ranging from 9 for eczema to 54 for head injury. Four hundred medical records were targeted for sampling for each of 15 conditions while 267 records were targeted for anxiety and 133 for depression. Within each selected medical record, all visits for the 17 targeted conditions were identified, and separate quality assessments made for each. Care was evaluated for 6689 children 15 years of age and younger who had 15 240 visits to emergency departments, for inpatient admissions, or to pediatricians and general practitioners in selected urban and rural locations in 3 Australian states. These visits generated 160 202 quality indicator assessments. Quality indicators were identified through a systematic search of local and international guidelines. Individual indicators were extracted from guidelines and assessed using a 2-stage Delphi process. Quality of care for each clinical condition and overall. Of 6689 children with surveyed medical records, 53.6% were aged 0 to 4 years and 55.5% were male. Adherence to quality of care indicators was estimated at 59.8% (95% CI, 57.5%-62.0%; n = 160 202) across the 17 conditions, ranging from a high of 88.8% (95% CI, 83.0%-93.1%; n = 2638) for autism to a low of 43.5% (95% CI, 36.8%-50.4%; n = 2354) for tonsillitis. The mean adherence by condition category was estimated as 60.5% (95% CI, 57.2%-63.8%; n = 41 265) for noncommunicable conditions (range, 52.8%-75.8%); 82.4% (95% CI, 79.0%-85.5%; n = 14 622) for mental health conditions (range, 71.5%-88.8%); 56.3% (95% CI, 53.2%-59.4%; n = 94 037) for acute infections (range, 43.5%-69.8%); and 78.3% (95% CI, 75.1%-81.2%; n = 10 278) for injury. Among a sample of children receiving care in Australia in 2012-2013, the overall prevalence of adherence to quality of care indicators for important conditions was not high. For many of these conditions, the quality of care may be inadequate.

Monitoring the quality of welding based on welding current and ste analysis

NASA Astrophysics Data System (ADS)

Mazlan, Afidatusshimah; Daniyal, Hamdan; Izzani Mohamed, Amir; Ishak, Mahadzir; Hadi, Amran Abdul

2017-10-01

Qualities of welding play an important part in industry especially in manufacturing field. Post-welding non-destructive test is one of the importance process to ensure the quality of welding but it is time consuming and costly. To reduce the chance of defects, online monitoring had been utilized by continuously sense some of welding parameters and predict welding quality. One of the parameters is welding current, which is rich of information but lack of study focus on extract them at signal analysis level. This paper presents the analysis of welding current using Short Time Energy (STE) signal processing to quantify the pattern of the current. GMAW set with carbon steel specimens are used in this experimental study with high-bandwidth and high sampling rate oscilloscope capturing the welding current. The results indicate welding current as signatures have high correlation with the welding process. Continue with STE analysis, the value below 5000 is declare as good welding, meanwhile the STE value more than 6000 is contained defect.

Evaluating the multiple benefits of marine water quality improvements: how important are health risk reductions?

PubMed

Machado, Fernando S; Mourato, Susana

2002-07-01

Marine water pollution affects many recreational sites around the world. It has impacts not only on recreational activities but also on health risks for those who come into direct contact with the water. Few economic studies have explicitly considered the health risks of bathing in polluted marine waters and none have attempted to separate health benefits from other benefits of marine water quality improvements. This paper uses stated preference techniques to separately evaluate the multiple benefits of improving the quality of marine recreational waters at the Estoril Coast in Portugal. The results indicate that health risk reductions are only a small fraction of the total social benefits of water quality improvements.

Baseline results from the Lichen Community Indicator Program in the Pacific Northwest: Air quality patterns and evidence of a nitrogen pollution problem

Treesearch

Sarah Jovan

2009-01-01

Why Are Epiphytic Lichen Communities Important? Lichens are one of the bioindicators used by the Forest Inventory and Analysis (FIA) Program to monitor forest health. To obtain data for use in its Lichen Community Indicator Program, FIA samples a regular network of permanent field plots to determine the composition of epiphytic, i.e., tree dwelling, lichen communities...

The Relationship Between Land Management, Fecal Indicator Bacteria, and the Occurrence of Campylobacter and Listeria Spp. in Water and Sediments During Synoptic Sampling In The South Fork Broad River Watershed, Northeast Georgia, U.S.A.

EPA Science Inventory

Fecal indicator bacteria (FIB) and pathogens stored in the bed sediments of streams and rivers may be mobilized into the water column affecting overall water quality. Furthermore, land management may play an important role in the concentrations of FIB and the occurrence of pathog...

Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007-2010.

PubMed

Aggarwal, Anju; Rehm, Colin D; Monsivais, Pablo; Drewnowski, Adam

2016-09-01

Concerns with taste, nutrition, cost, and convenience are said to be key influences on food choices. This study examined the importance of food-related attitudes in relation to diet quality using US national level data. Interactions by socioeconomic status (SES), gender and race/ethnicity were tested. Analyses of 8957 adults from National Health and Nutrition Examination Survey (NHANES 2007-2010) were conducted in 2014-15. Perceived importance of taste, nutrition, cost, and convenience in dietary choices were assessed using 4-point Likert scales. Education and family income-to-poverty ratio (FIPR) were SES indicators. Healthy Eating Index (HEI-2010), a measure of adherence to 2010 dietary guidelines, was the diet quality measure. Survey-weighted regressions examined associations between attitudes and HEI, and tested for interactions. Taste was rated as "very important" by 77.0% of the US adults, followed by nutrition (59.9%), cost (39.9%), and convenience (29.8%). However, it was the perceived importance of nutrition that most strongly predicted HEI (β: +8.0 HEI scores among "very important" vs. "not at all important"). By contrast, greater importance for taste and convenience had a weak inverse relation with HEI (β: -5.1 and -1.5 respectively), adjusting for SES. Significant interactions were observed by race/ethnicity, but not SES and gender. Those who prioritized nutrition during food shopping had higher-quality diets regardless of gender, education and income in the US. Certain racial/ethnic groups managed to eat healthy despite attaching importance to cost and convenience. This is the first evidence of nutrition resilience among US adults using national data, which has huge implications for nutrition interventions. Published by Elsevier Inc.

Item generation in the development of an inpatient experience questionnaire: a qualitative study

PubMed Central

2013-01-01

Background Patient experience is a key feature of quality improvement in modern health-care delivery. Measuring patient experience is one of several tools used to assess and monitor the quality of health services. This study aims to develop a tool for assessing patient experience with inpatient care in public hospitals in Hong Kong. Methods Based on the General Inpatient Questionnaire (GIQ) framework of the Care Quality Commission as a discussion guide, a qualitative study involving focus group discussions and in-depth individual interviews with patients was employed to develop a tool for measuring inpatient experience in Hong Kong. Results All participants agreed that a patient satisfaction survey is an important platform for collecting patients’ views on improving the quality of health-care services. Findings of the focus group discussions and in-depth individual interviews identified nine key themes as important hospital quality indicators: prompt access, information provision, care and involvement in decision making, physical and emotional needs, coordination of care, respect and privacy, environment and facilities, handling of patient feedback, and overall care from health-care professionals and quality of care. Privacy, complaint mechanisms, patient involvement, and information provision were further highlighted as particularly important areas for item revision by the in-depth individual interviews. Thus, the initial version of the Hong Kong Inpatient Experience Questionnaire (HKIEQ), comprising 58 core items under nine themes, was developed. Conclusions A set of dimensions and core items of the HKIEQ was developed and the instrument will undergo validity and reliability tests through a validation survey. A valid and reliable tool is important in accurately assessing patient experience with care delivery in hospitals to improve the quality of health-care services. PMID:23835186

The relationships among sport self-perceptions and social well-being in athletes with physical disabilities.

PubMed

Shapiro, Deborah R; Martin, Jeffery J

2014-01-01

Peer relationships account for a significant motivational influence on sport participation among youth athletes with and without disabilities. The primary purpose of this study was to determine if the quality of friendships, physical self-perceptions and general self-worth predicted close friendship, loneliness and social acceptance among 46 athletes with physical disabilities (males = 35, female = 11) between the ages of 12 and 21 (M age = 15.37, SD = 2.45). Second, this study examined descriptive information on the quality of friendships inside and outside of an adapted sport setting, feelings of loneliness, social acceptance, close friendships, athletic competence, physical appearance, and self-worth among youth athletes with physical disabilities. Participants completed the Sport Friendship Quality Scale (SFQS), a Loneliness Rating Scale and the Self-Perception Profile for Adolescents (SPPA). Three regression analyses used positive and negative aspects of non-sport friendship quality, positive aspects of sport friendship quality, physical appearance, athletic competence, and self-worth as predictors and accounted for 57%, 41%, and 31% of the variance in loneliness, close friendships, and social acceptance, respectively. Athletic competence and self-worth were the most important predictors of loneliness and close friendships with significant (p < .10) beta weights. No single predictor had a significant beta weight in predicting social acceptance. Negative and positive elements of friendship quality were not important predictors. These findings highlight the importance of global psychological (i.e., self-worth) and sport specific psychological (i.e., athletic competence) constructs in predicting important social well-being indices (i.e., close friendships & loneliness). Published by Elsevier Inc.

Association between nutritional awareness and diet quality: evidence from the observation of cardiovascular risk factors in Luxembourg (ORISCAV-LUX) study.

PubMed

Alkerwi, Ala'a; Sauvageot, Nicolas; Malan, Leoné; Shivappa, Nitin; Hébert, James R

2015-04-14

This study examined the association between nutritional awareness and diet quality, as indicated by energy density, dietary diversity and adequacy to achieve dietary recommendations, while considering the potentially important role of socioeconomic status (SES). Data were derived from 1351 subjects, aged 18-69 years and enrolled in the ORISCAV-LUX study. Energy density score (EDS), dietary diversity score (DDS) and Recommendation Compliance Index (RCI) were calculated based on data derived from a food frequency questionnaire. Nutritional awareness was defined as self-perception of the importance assigned to eating balanced meals, and classified as high, moderate, or of little importance. Initially, a General Linear Model was fit that adjusted for age, sex, country of birth, and body mass index (BMI). Furthermore, simultaneous contributions to diet quality of individual-level socioeconomic factors, education, and household income were examined across levels of nutritional awareness. Attributing high importance was associated inversely with energy density (p = 0.02), positively with both dietary diversity (p < 0.0001), and adequacy to dietary recommendations (p < 0.0001), independent of demographic factors, weight status and SES. Further adjustment for household income in the EDS-related multivariable model, reduced the β coefficient by 47% for the "moderate importance" category and 36% for the "high importance" category. Likewise, the β coefficient decreased by 13.6% and 10.7% in the DDS-related model, and by 12.5%, and 7.1% in the RCI-related model, respectively, across awareness categories. Nutritional awareness has a direct effect on diet quality, with a minor component of variance explained by improved income. The impact of nutritional awareness on diet quality seems to be a promising area for both health promotion and health policy research.

The 2005 meta-analysis of homeopathy: the importance of post-publication data.

PubMed

Rutten, A L B; Stolper, C F

2008-10-01

There is a discrepancy between the outcome of a meta-analysis published in 1997 of 89 trials of homeopathy by Linde et al and an analysis of 110 trials by Shang et al published in 2005, these reached opposite conclusions. Important data were not mentioned in Shang et al's paper, but only provided subsequently. What was the outcome of Shang et al's predefined hypotheses? Were the homeopathic and conventional trials comparable? Was subgroup selection justified? The possible role of ineffective treatments. Was the conclusion about effect justified? Were essential data missing in the original article? Analysis of post-publication data. Re-extraction and analysis of 21 higher quality trials selected by Shang et al with sensitivity analysis for the influence of single indications. Analysis of comparability. Sensitivity analysis of influence of subjective choices, like quality of single indications and of cut-off values for 'larger samples'. The quality of trials of homeopathy was better than of conventional trials. Regarding smaller trials, homeopathy accounted for 14 out of 83 and conventional medicine 2 out of 78 good quality trials with n<100. There was selective inclusion of unpublished trials only for homeopathy. Quality was assessed differently from previous analyses. Selecting subgroups on sample size and quality caused incomplete matching of homeopathy and conventional trials. Cut-off values for larger trials differed between homeopathy and conventional medicine without plausible reason. Sensitivity analyses for the influence of heterogeneity and the cut-off value for 'larger higher quality studies' were missing. Homeopathy is not effective for muscle soreness after long distance running, OR=1.30 (95% CI 0.96-1.76). The subset of homeopathy trials on which the conclusion was based was heterogeneous, comprising 8 trials on 8 different indications, and was not matched on indication with those of conventional medicine. Essential data were missing in the original paper. Re-analysis of Shang's post-publication data did not support the conclusion that homeopathy is a placebo effect. The conclusion that homeopathy is and that conventional is not a placebo effect was not based on comparative analysis and not justified because of heterogeneity and lack of sensitivity analysis. If we confine ourselves to the predefined hypotheses and the part of the analysis that is indeed comparative, the conclusion should be that quality of homeopathic trials is better than of conventional trials, for all trials (p=0.03) as well as for smaller trials (p=0.003).

Quality of care and quality of life of people with dementia living at green care farms: a cross-sectional study.

PubMed

de Boer, Bram; Hamers, Jan P H; Zwakhalen, Sandra M G; Tan, Frans E S; Verbeek, Hilde

2017-07-19

Many countries are introducing smaller, more home-like care facilities that represent a radically new approach to nursing home care for people with dementia. The green care farm is a new type of nursing home developed in the Netherlands. The goal of this study was to compare quality of care, quality of life and related outcomes in green care farms, regular small-scale living facilities and traditional nursing homes for people with dementia. A cross-sectional design was used. Three types of nursing homes were included: (1) green care farms; (2) regular small-scale living facilities; (3) traditional nursing homes. All participating nursing homes were non-profit, collectively funded nursing homes in the south of the Netherlands. One hundred and fifteen residents with a formal diagnosis of dementia were included in the study. Data on quality of care was gathered and consisted of outcome indicators (e.g. falling incidents, pressure ulcers), structure indicators (e.g. hours per resident per day), and process indicators (e.g. presence, accessibility and content of protocols on care delivery). Furthermore, questionnaires on cognition, dependence in activities of daily living, quality of life, social engagement, neuropsychiatric symptoms, agitation, and depression were used. Data showed that quality of care was comparable across settings. No large differences were found on clinical outcome measures, hours per resident per day, or process indicators. Higher quality of life scores were reported for residents of green care farms in comparison with residents of traditional nursing homes. They scored significantly higher on the Quality of Life - Alzheimer's disease Scale (p < 0.05, ES = 0.8) indicating a better quality of life. In addition, residents of green care farms scored higher on three quality of life domains of the Qualidem: positive affect, social relations and having something to do (p < 0.05, ES > 0.7). No differences with regular small-scale living facilities were found. Green care farms seem to be a valuable alternative to existing nursing homes. This is important as people with dementia are a heterogeneous group with varying needs. In order to provide tailored care there also is a need for a variety of living environments.

The Use of Remote Sensing Data for Modeling Air Quality in the Cities

NASA Astrophysics Data System (ADS)

Putrenko, V. V.; Pashynska, N. M.

2017-12-01

Monitoring of environmental pollution in the cities by the methods of remote sensing of the Earth is actual area of research for sustainable development. Ukraine has a poorly developed network of monitoring stations for air quality, the technical condition of which is deteriorating in recent years. Therefore, the possibility of obtaining data about the condition of air by remote sensing methods is of great importance. The paper considers the possibility of using the data about condition of atmosphere of the project AERONET to assess the air quality in Ukraine. The main pollution indicators were used data on fine particulate matter (PM2.5) and nitrogen dioxide (NO2) content in the atmosphere. The main indicator of air quality in Ukraine is the air pollution index (API). We have built regression models the relationship between indicators of NO2, which are measured by remote sensing methods and ground-based measurements of indicators. There have also been built regression models, the relationship between the data given to the land of NO2 and API. To simulate the relationship between the API and PM2.5 were used geographically weighted regression model, which allows to take into account the territorial differentiation between these indicators. As a result, the maps that show the distribution of the main types of pollution in the territory of Ukraine, were constructed. PM2.5 data modeling is complicated with using existing indicators, which requires a separate organization observation network for PM2.5 content in the atmosphere for sustainable development in cities of Ukraine.

Improving cancer patient care: development of a generic cancer consumer quality index questionnaire for cancer patients.

PubMed

Booij, Judith C; Zegers, Marieke; Evers, Pauline M P J; Hendriks, Michelle; Delnoij, Diana M J; Rademakers, Jany J D J M

2013-04-23

To develop a Consumer Quality Index (CQI) Cancer Care questionnaire for measuring experiences with hospital care of patients with different types of cancer. We derived quality aspects from focus group discussions, existing questionnaires and literature. We developed an experience questionnaire and sent it to 1,498 Dutch cancer patients. Another questionnaire measuring the importance of the quality aspects was sent to 600 cancer patients. Data were psychometrically analysed. The response to the experience questionnaire was 50 percent. Psychometric analysis revealed 12 reliable scales. Patients rated rapid and adequate referral, rapid start of the treatment after diagnosis, enough information and confidence in the healthcare professionals as most important themes. Hospitals received high scores for skills and cooperation of healthcare professionals and a patient-centered approach by doctors; and low scores for psychosocial guidance and information at completion of the treatment. The CQI Cancer Care questionnaire is a valuable tool for the evaluation of the quality of cancer care from the patient's perspective. Large scale implementation is necessary to determine the discriminatory powers of the questionnaire and may enable healthcare providers to improve the quality of cancer care. Preliminary results indicate that hospitals could improve their psychosocial guidance and information provision.

Body weight and health-related quality of life in Catalonia, Spain.

PubMed

Oliva-Moreno, Juan; Gil-Lacruz, Ana

2013-02-01

Obesity poses important burdens not only on the individuals whose quality of life is reduced but on national welfare systems that have to face growing premature mortality rates, increase healthcare expenditures to treat obesity-related diseases, and earmark vast amounts of healthcare resources for prevention. The main goal of this paper is to analyze the relationship between excess body weight and different dimensions of health-related quality of life for people 16 years and older and to identify the health dimensions most affected by excess weight. We have drawn data from the Catalonia Health Survey (2006). Our results reveal a relationship between excess weight and health-related quality of life. Even after controlling for socio-economic status and objective health variables, excess weight is shown to have a significant negative effect on health-related quality of life. Subjects responses revealed that the negative effect of excess weight was felt the strongest in the health-related quality of life dimensions of mobility and pain/discomfort. Our results indicate there are important differences among gender and age groups. Women and older people are more likely to suffer from the negative consequences of excess weight.

Potential impacts of climate change on water quality in a shallow reservoir in China.

PubMed

Zhang, Chen; Lai, Shiyu; Gao, Xueping; Xu, Liping

2015-10-01

To study the potential effects of climate change on water quality in a shallow reservoir in China, the field data analysis method is applied to data collected over a given monitoring period. Nine water quality parameters (water temperature, ammonia nitrogen, nitrate nitrogen, nitrite nitrogen, total nitrogen, total phosphorus, chemical oxygen demand, biochemical oxygen demand and dissolved oxygen) and three climate indicators for 20 years (1992-2011) are considered. The annual trends exhibit significant trends with respect to certain water quality and climate parameters. Five parameters exhibit significant seasonality differences in the monthly means between the two decades (1992-2001 and 2002-2011) of the monitoring period. Non-parametric regression of the statistical analyses is performed to explore potential key climate drivers of water quality in the reservoir. The results indicate that seasonal changes in temperature and rainfall may have positive impacts on water quality. However, an extremely cold spring and high wind speed are likely to affect the self-stabilising equilibrium states of the reservoir, which requires attention in the future. The results suggest that land use changes have important impact on nitrogen load. This study provides useful information regarding the potential effects of climate change on water quality in developing countries.

Identifying unintended consequences of quality indicators: a qualitative study.

PubMed

Lester, Helen E; Hannon, Kerin L; Campbell, Stephen M

2011-12-01

For the first 5 years of the UK primary care pay for performance scheme, the Quality and Outcomes Framework (QOF), quality indicators were introduced without piloting. However, in 2009, potential new indicators were piloted in a nationally representative sample of practices. This paper describes an in-depth exploration of family physician, nurse and other primary-care practice staff views of the value of piloting with a particular focus on unintended consequences of 13 potential new QOF indicators. Fifty-seven family-practice professionals were interviewed in 24 representative practices across England. Almost all interviewees emphasised the value of piloting in terms of an opportunity to identify unintended consequences of potential QOF indicators in 'real world' settings with staff who deliver day-to-day care to patients. Four particular types of unintended consequences were identified: measure fixation, tunnel vision, misinterpretation and potential gaming. 'Measure fixation,' an inappropriate attention on isolated aspects of care, appeared to be the key unintended consequence. In particular, if the palliative care indicator had been introduced without piloting, this might have incentivised poorer care in a minority of practices with potential harm to vulnerable patients. It is important to identify concerns and experiences about unintended consequences of indicators at an early stage when there is time to remove or adapt problem indicators. Since the UK government currently spends over £1 billion each year on QOF, the £150,000 spent on each piloting cohort (0.0005% of the total QOF budget) appears to be good value for money.

INTEGRATING MODELS WITH STAKEHOLDER PREFERENCE OF WATER QUALITY INDICATORS: A CASE STUDY OF LAKE LANIER, GEORGIA, USA

EPA Science Inventory

One important aspect of Integrated Environmental Assessment is combining a scientific expertise and stakeholder concerns. Here, we propose a method to integrate stakeholder preferences, in particular preferences of stakeholders with differing environmental perspectives with a se...

Sustainability Indicators for Chemical Processes: III. Biodiesel Case Study

EPA Science Inventory

The chemical industry is one of the most important business sectors, not only economically, but also societally; as it allows humanity to attain higher standards and quality of life. Simultaneously, chemical products and processes can be the origin of potential human health and ...

Quantifying Error in Survey Measures of School and Classroom Environments

ERIC Educational Resources Information Center

Schweig, Jonathan David

2014-01-01

Developing indicators that reflect important aspects of school and classroom environments has become central in a nationwide effort to develop comprehensive programs that measure teacher quality and effectiveness. Formulating teacher evaluation policy necessitates accurate and reliable methods for measuring these environmental variables. This…

Personality and Job Performance: Evidence of Incremental Validity.

ERIC Educational Resources Information Center

Day, David V.; Silverman, Stanley B.

1989-01-01

Investigated relationship between personality variables and job performance in 43 accountants. Results indicated that, even with effects of cognitive ability taken into account, 3 personality scales (orientation toward work, degree of ascendancy, and degree and quality of interpersonal orientation) were significantly related to important aspects…

Headspace Analysis of Philippine Civet Coffee Beans Using Gas Chromatography-Mass Spectrometry and Electronic Nose

NASA Astrophysics Data System (ADS)

Ongo, E.; Sevilla, F.; Antonelli, A.; Sberveglieri, G.; Montevecchi, G.; Sberveglieri, V.; de Paola, E. L.; Concina, I.; Falasconi, M.

2011-11-01

Civet coffee, the most expensive and best coffee in the world, is an economically important export product of the Philippines. With a growing threat of food adulteration and counterfeiting, a need for quality authentication is essential to protect the integrity and strong market value of Philippine civet coffee. At present, there is no internationally accepted method of verifying whether a bean is an authentic civet coffee. This study presented a practical and promising approach to identify and establish the headspace qualitative profile of Philippine civet coffee using electronic nose (E-nose) and gas chromatography-mass spectrometry (GC-MS). E-nose analysis revealed that aroma characteristic is one of the most important quality indicators of civet coffee. The findings were supported by GC-MS analysis. Principal component analysis (PCA) exhibited a clearly separated civet coffees from their control beans. The chromatographic fingerprints indicated that civet coffees differed with their control beans in terms of composition and concentration of individual volatile constituents.

Effects of hedgerows on bats and bush crickets at different spatial scales

NASA Astrophysics Data System (ADS)

Lacoeuilhe, Aurélie; Machon, Nathalie; Julien, Jean-François; Kerbiriou, Christian

2016-02-01

Biodiversity is threatened by the loss and fragmentation of habitats. The role of hedgerows in maintaining biodiversity is well established, but few studies have addressed the importance for biodiversity of the intrinsic characteristics of hedgerows and the quality of hedgerow networks along a spatial scale. We examined three quality indices providing information at different territorial levels: density in the landscape, structural diversity and wood production. We performed an acoustic survey in a grassland to estimate the species abundance and community composition of bats (9 taxa) and bush crickets (11 species). Using an approach based on species and traits, we assessed how hedgerow quality influenced the activity of these taxa at different spatial scales (from 50 to 1000 m) and focused on three types of traits: bush cricket mobility ability, bat foraging strategy and habitat specialization. In general, our results showed the importance of hedgerow quality for bats and bush crickets, but the strength of the association between taxa and hedgerows varied substantially among the species and the spatial scales. Although it depends on the taxa, the production, density and structural diversity of hedgerows each had an overall positive effect. Our results suggested that these effects were generally more important at large scales. The scale effect of the production index is the best predictor of activity for bat and bush cricket taxa and traits. Our results showed the importance of hedgerow quality for the ecology of bat and bush cricket communities and could be used to improve conservation management.

Dynamics of microbial communities during decomposition of litter from pioneering plants in initial soil ecosystems

NASA Astrophysics Data System (ADS)

Esperschütz, J.; Zimmermann, C.; Dümig, A.; Welzl, G.; Buegger, F.; Elmer, M.; Munch, J. C.; Schloter, M.

2013-07-01

In initial ecosystems, concentrations of all macro- and micronutrients can be considered as extremely low. Plant litter therefore strongly influences the development of a degrader's food web and is an important source for C and N input into soil in such ecosystems. In the present study, a 13C litter decomposition field experiment was performed for 30 weeks in initial soils from a post-mining area near the city of Cottbus (Germany). Two of this region's dominant but contrasting pioneering plant species (Lotus corniculatus L. and Calamagrostis epigejos L.) were chosen to investigate the effects of litter quality on the litter decomposing microbial food web in initially nutrient-poor substrates. The results clearly indicate the importance of litter quality, as indicated by its N content, its bioavailability for the degradation process and the development of microbial communities in the detritusphere and soil. The degradation of the L. corniculatus litter, which had a low C / N ratio, was fast and showed pronounced changes in the microbial community structure 1-4 weeks after litter addition. The degradation of the C. epigejos litter material was slow and microbial community changes mainly occurred between 4 and 30 weeks after litter addition to the soil. However, for both litter materials a clear indication of the importance of fungi for the degradation process was observed both in terms of fungal abundance and activity (13C incorporation activity)

Quality Indicators in Laboratory Medicine: from theory to practice. Preliminary data from the IFCC Working Group Project "Laboratory Errors and Patient Safety".

PubMed

Sciacovelli, Laura; O'Kane, Maurice; Skaik, Younis Abdelwahab; Caciagli, Patrizio; Pellegrini, Cristina; Da Rin, Giorgio; Ivanov, Agnes; Ghys, Timothy; Plebani, Mario

2011-05-01

The adoption of Quality Indicators (QIs) has prompted the development of tools to measure and evaluate the quality and effectiveness of laboratory testing, first in the hospital setting and subsequently in ambulatory and other care settings. While Laboratory Medicine has an important role in the delivery of high-quality care, no consensus exists as yet on the use of QIs focussing on all steps of the laboratory total testing process (TTP), and further research in this area is required. In order to reduce errors in laboratory testing, the IFCC Working Group on "Laboratory Errors and Patient Safety" (WG-LEPS) developed a series of Quality Indicators, specifically designed for clinical laboratories. In the first phase of the project, specific QIs for key processes of the TTP were identified, including all the pre-, intra- and post-analytic steps. The overall aim of the project is to create a common reporting system for clinical laboratories based on standardized data collection, and to define state-of-the-art and Quality Specifications (QSs) for each QI independent of: a) the size of organization and type of activities; b) the complexity of processes undertaken; and c) different degree of knowledge and ability of the staff. The aim of the present paper is to report the results collected from participating laboratories from February 2008 to December 2009 and to identify preliminary QSs. The results demonstrate that a Model of Quality Indicators managed as an External Quality Assurance Program can serve as a tool to monitor and control the pre-, intra- and post-analytical activities. It might also allow clinical laboratories to identify risks that lead to errors resulting in patient harm: identification and design of practices that eliminate medical errors; the sharing of information and education of clinical and laboratory teams on practices that reduce or prevent errors; the monitoring and evaluation of improvement activities.

Outcomes research in cancer clinical trial cooperative groups: the RTOG model.

PubMed

Bruner, D W; Movsas, B; Konski, A; Roach, M; Bondy, M; Scarintino, C; Scott, C; Curran, W

2004-08-01

The Radiation Therapy Oncology Group (RTOG), a National Cancer Institute sponsored cancer clinical trials research cooperative, has recently formed an Outcomes Committee to assess a comprehensive array of clinical trial endpoints and factors impacting the net effect of therapy. To study outcomes in a consistent, comprehensive and coordinated manner, the RTOG Outcomes Committee developed a model to assess clinical, humanistic, and economic outcomes important in clinical trials. This paper reviews how the RTOG incorporates outcomes research into cancer clinical trials, and demonstrates utilization of the RTOG Outcomes Model to test hypotheses related to non-small-cell lung cancer (NSCLC). In this example, the clinical component of the model indicates that the addition of chemotherapy to radiotherapy (RT) improves survival but increases the risk of toxicity. The humanistic component indicates that esophagitis is the symptom impacting quality of life the greatest and may outweigh the benefits in elderly (> or =70 years) patients. The economic component of the model indicates that accounting for quality-adjusted survival, concurrent chemoRT for the treatment of NSCLC is within the range of economically acceptable recommendations. The RTOG Outcomes Model guides a comprehensive program of research that systematically measures a triad of endpoints considered important to clinical trials research.

Characterising droughts in Central America with uncertain hydro-meteorological data

NASA Astrophysics Data System (ADS)

Quesada Montano, B.; Westerberg, I.; Wetterhall, F.; Hidalgo, H. G.; Halldin, S.

2015-12-01

Droughts studies are scarce in Central America, a region frequently affected by droughts that cause significant socio-economic and environmental problems. Drought characterisation is important for water management and planning and can be done with the help of drought indices. Many indices have been developed in the last decades but their ability to suitably characterise droughts depends on the region of application. In Central America, comprehensive and high-quality observational networks of meteorological and hydrological data are not available. This limits the choice of drought indices and denotes the need to evaluate the quality of the data used in their calculation. This paper aimed to find which combination(s) of drought index and meteorological database are most suitable for characterising droughts in Central America. The drought indices evaluated were the standardised precipitation index (SPI), deciles (DI), the standardised precipitation evapotranspiration index (SPEI) and the effective drought index (EDI). These were calculated using precipitation data from the Climate Hazards Group Infra-Red Precipitation with station (CHIRPS), CRN073, the Climate Research Unit (CRU), ERA-Interim and station databases, and temperature data from the CRU database. All the indices were calculated at 1-, 3-, 6-, 9- and 12-month accumulation times. As a first step, the large-scale meteorological precipitation datasets were compared to have an overview of the level of agreement between them and find possible quality problems. Then, the performance of all the combinations of drought indices and meteorological datasets were evaluated against independent river discharge data, in form of the standardised streamflow index (SSI). Results revealed the large disagreement between the precipitation datasets; we found the selection of database to be more important than the selection of drought index. We found that the best combinations of meteorological drought index and database were obtained using the SPI and DI, calculated with CHIRPS and station data.

Fractionation and reconstitution experiments provide insight into the role of starch gelatinization and pasting properties in pasta quality.

PubMed

Delcour, J A; Vansteelandt, J; Hythier, M; Abécassis, J

2000-09-01

Commercial durum wheat semolina was fractionated into protein, starch, water-extractable, and sludge fractions. The starch fraction was hydroxypropylated, annealed, or cross-linked to change its gelatinization and pasting properties. Spaghettis were made by reconstitution of the fractions, and their quality was assessed. Hydroxypropylated starches were detrimental for cooked pasta quality. Cross-linked starches made the reconstituted pasta firmer and even brittle when the degree of cross-linking was too high. These results indicate that starch properties play a role in pasta quality, although the gluten remains very important as an ultrastructure agent. It was concluded that, given a certain gluten ultrastructure, starch water uptake and gel properties and/or its interference with or breakdown of the continuous gluten network during cooking determine pasta quality.

Improving Students’ Evaluation of Informal Arguments

PubMed Central

LARSON, AARON A.; BRITT, M. ANNE; KURBY, CHRISTOPHER A.

2010-01-01

Evaluating the structural quality of arguments is a skill important to students’ ability to comprehend the arguments of others and produce their own. The authors examined college and high school students’ ability to evaluate the quality of 2-clause (claim-reason) arguments and tested a tutorial to improve this ability. These experiments indicated that college and high school students had difficulty evaluating arguments on the basis of their quality. Experiments 1 and 2 showed that a tutorial explaining skills important to overall argument evaluation increased performance but that immediate feedback during training was necessary for teaching students to evaluate the claim-reason connection. Using a Web-based version of the tutorial, Experiment 3 extended this finding to the performance of high-school students. The study suggests that teaching the structure of an argument and teaching students to pay attention to the precise message of the claim can improve argument evaluation. PMID:20174611

The effect of JPEG compression on automated detection of microaneurysms in retinal images

NASA Astrophysics Data System (ADS)

Cree, M. J.; Jelinek, H. F.

2008-02-01

As JPEG compression at source is ubiquitous in retinal imaging, and the block artefacts introduced are known to be of similar size to microaneurysms (an important indicator of diabetic retinopathy) it is prudent to evaluate the effect of JPEG compression on automated detection of retinal pathology. Retinal images were acquired at high quality and then compressed to various lower qualities. An automated microaneurysm detector was run on the retinal images of various qualities of JPEG compression and the ability to predict the presence of diabetic retinopathy based on the detected presence of microaneurysms was evaluated with receiver operating characteristic (ROC) methodology. The negative effect of JPEG compression on automated detection was observed even at levels of compression sometimes used in retinal eye-screening programmes and these may have important clinical implications for deciding on acceptable levels of compression for a fully automated eye-screening programme.

Culture-specific patterns in the prediction of life satisfaction: roles of emotion, relationship quality, and self-esteem.

PubMed

Kang, Sun-Mee; Shaver, Phillip R; Sue, Stanley; Min, Kyung-Hwan; Jing, Hauibin

2003-12-01

This study was conducted to explore the culture-specific roles of emotion, relationship quality, and self-esteem in determining life satisfaction. It was hypothesized that maintaining good interpersonal relationships would make individuals in collectivistic cultures not only feel good about their lives but also feel better about themselves. Furthermore, two emotion variables--emotional expression and emotion differentiation--were proposed as possible determinants of relationship quality. It was hypothesized that emotional expressiveness would be more important for maintaining good interpersonal relationships in individualistic societies but emotion differentiation would be more important in collectivistic cultures. These hypotheses were tested with Euro-American, Asian American, Korean, and Chinese groups using multigroup analyses in a structural equation model. Results supported all proposed hypotheses and indicated that emotion differentiation contributes to maintaining good interpersonal relationships in collectivistic cultures, which contributes to self-esteem and satisfaction with life.

Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study.

PubMed

Dupuis, Marc; Meier, Emanuele; Rudaz, Dominique; Strippoli, Marie-Pierre F; Castelao, Enrique; Preisig, Martin; Capel, Roland; Vandeleur, Caroline L

2017-06-01

Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges.

PubMed

Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W

2017-08-08

A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products' quality, availability, safety, as well as challenges related to a GFD are discussed.

The Design and Implementation of a Public Relations Program in Support of the Composite Health Care System at Ireland Army Community Hospital, Fort Knox, Kentucky

DTIC Science & Technology

1987-10-01

effectiveness of a particular health care provider or treatment procedure (Doering, 1983; Ben-Sira, 1983; Kotler & Clarke, 1986). Instead, much of a...criteria for quality of care ( Kotler & Clarke, 1986). There is great potential for positively influencing a patient’s percep- tion of care through a...important quality of care indicator for patients (Doering, 1983; Kotler & Clarke, 1986). Personal attention of the patient must remain a primary

Cover crops and crop residue management under no-till systems improve soils and environmental quality

NASA Astrophysics Data System (ADS)

Kumar, Sandeep; Wegner, Brianna; Vahyala, Ibrahim; Osborne, Shannon; Schumacher, Thomas; Lehman, Michael

2015-04-01

Crop residue harvest is a common practice in the Midwestern USA for the ethanol production. However, excessive removal of crop residues from the soil surface contributes to the degradation of important soil quality indicators such as soil organic carbon (SOC). Addition of a cover crop may help to mitigate these negative effects. The present study was set up to assess the impacts of corn (Zea mays L.) residue removal and cover crops on various soil quality indicators and surface greenhouse gas (GHG) fluxes. The study was being conducted on plots located at the North Central Agricultural Research Laboratory (NCARL) in Brookings, South Dakota, USA. Three plots of a corn and soybean (Glycine max (L.) Merr.) rotation under a no-till (NT) system are being monitored for soils and surface gas fluxes. Each plot has three residue removal (high residue removal, HRR; medium residue removal, MRR; and low residue removal, LRR) treatments and two cover crops (cover crops and no cover crops) treatments. Both corn and soybean are represented every year. Gas flux measurements were taken weekly using a closed static chamber method. Data show that residue removal significantly impacted soil quality indicators while more time was needed for an affect from cover crop treatments to be noticed. The LRR treatment resulted in higher SOC concentrations, increased aggregate stability, and increased microbial activity. The LRR treatment also increased soil organic matter (SOM) and particulate organic matter (POM) concentrations. Cover crops used in HRR (high corn residue removal) improved SOC (27 g kg-1) by 6% compared to that without cover crops (25.4 g kg-1). Cover crops significantly impacted POM concentration directly after the residue removal treatments were applied in 2012. CO2 fluxes were observed to increase as temperature increased, while N2O fluxes increased as soil moisture increased. CH4 fluxes were responsive to both increases in temperature and moisture. On average, soils under cover crop management had lower N2O fluxes than soils that did not have a cover crop. Results from this study concluded that it is important to allow crop residues to return to the soil as they help to improve soil quality indicators. The presence of cover crops also will contribute to the improvement of these indicators once established and may help mitigate greenhouse gas emissions.

Quality of life in pathological gamblers in a multiethnic Asian setting.

PubMed

Mythily, Subramaniam; Edimansyah, Abdin; Qiu, Shijia; Munidasa, Winslow

2011-06-01

Few studies have examined the impact of pathological gambling on quality of life especially in the Asian context. The aim of the current study was to examine the quality of life in pathological gamblers in a multiracial population in Singapore and we hypothesised that those with pathological gambling would have poorer quality of life as compared to controls. Forty subjects with "compulsive gambling behaviour" were recruited and matched (for gender and age) with 40 controls. Subjects with pathological gambling were compared with control subjects with regard to sociodemographic data as well as on the World Health Organization Quality of Life assessment - abbreviated version (WHOQOL-BREF). A one-way MANOVA revealed that pathological gamblers had significantly diminished quality of life as compared with the healthy controls using the summary scores of the 4 domains of quality of life (Pillai's Trace = 0.338, F = 9.5, P <0.001). Univariate tests indicated subjects with pathological gambling scored significantly lower on physical health, psychological, social relationships and environment domains of quality of life compared with subjects without pathological gambling. Our study found that those with pathological gambling had lower scores than the controls in all the domains of the quality of life scale. The impact and the extent of pathological gambling on the quality of life should be borne in mind -- not only as a consideration in the management but also as an important indicator of treatment outcome of pathological gamblers.

Measuring quality in maternal-newborn care: developing a clinical dashboard.

PubMed

Sprague, Ann E; Dunn, Sandra I; Fell, Deshayne B; Harrold, Joann; Walker, Mark C; Kelly, Sherrie; Smith, Graeme N

2013-01-01

Pregnancy, birth, and the early newborn period are times of high use of health care services. As well as opportunities for providing quality care, there are potential missed opportunities for health promotion, safety issues, and increased costs for the individual and the system when quality is not well defined or measured. There has been a need to identify key performance indicators (KPIs) to measure quality care within the provincial maternal-newborn system. We also wanted to provide automated audit and feedback about these KPIs to support quality improvement initiatives in a large Canadian province with approximately 140 000 births per year. We therefore worked to develop a maternal-newborn dashboard to increase awareness about selected KPIs and to inform and support hospitals and care providers about areas for quality improvement. We mapped maternal-newborn data elements to a quality domain framework, sought feedback via survey for the relevance and feasibility of change, and examined current data and the literature to assist in setting provincial benchmarks. Six clinical performance indicators of maternal-newborn quality care were identified and evidence-informed benchmarks were set. A maternal-newborn dashboard with "drill down" capacity for detailed analysis to enhance audit and feedback is now available for implementation. While audit and feedback does not guarantee individuals or institutions will make practice changes and move towards quality improvement, it is an important first step. Practice change and quality improvement will not occur without an awareness of the issues.

Academic Standards and Regulatory Frameworks: Necessary Compromises?

ERIC Educational Resources Information Center

Stowell, Marie; Falahee, Marie; Woolf, Harvey

2016-01-01

Assessment regulations in higher education, which are important for assuring threshold academic standards, reflect institutional cultures and histories, and are shaped by pragmatic concerns about quality indicators such as retention and progression rates, as well as principles of equity. This paper articulates some of the tensions that confront…

Bases of Marital Satisfaction among Men and Women.

ERIC Educational Resources Information Center

Rhyne, Darla

1981-01-01

Investigated possible gender differences in bases of marital satisfaction. Data indicated that marital quality of men and women differ in degree rather than in kind. Suggests men may be more satisfied with their marriages than women but the same factors are important in their assessments. (Author/RC)

RECREATIONAL BEACH WATER QUALITY MONITORING WITH QUANTITATIVE POLYMERASE CHAIN

EPA Science Inventory

Recreational beaches are an important economic and aesthetic asset to communities, states and the nation as a whole. Considerable resources are expended each year in monitoring the water at these beaches for fecal indicator bacteria as a means of determining if it is safe for pu...

THE TWO FACES OF WATER CHEMISTRY: STRESSOR ON, AND INDICATOR OF, THE ECOLOGICAL CONDITION OF THE GREAT RIVERS.

EPA Science Inventory

This poster presentation is designed to enlighten the interested masses about water quality assessment tools. It is not intended for policy, rather to stimulate thought on the importance of developing water chemistry as as assessment tool.

The influence of post-veraison foliar potassium applications on table grape quality

USDA-ARS?s Scientific Manuscript database

Sugar concentration and skin color (for pigmented table grape cultivars) are primary indicators of maturity and are important for marketing purposes. Treatments that accelerate sugar and pigment development enable earlier harvest. Early harvest not only improves marketing, it reduces risks of losses...

ATTITUDES TOWARD ENVIRONMENTAL QUALITY: AREA, ETHNICITY AND SES

EPA Science Inventory

In a study of the San Antonio, Texas, SMSA, this report indicates that, while respondents believe the environment is deteriorating, they do not believe environmental problems are among the most important faced by the Nation. Analysis of the data shows that: (1) there is a signifi...

Environmental and Water Quality Operational Studies. Evaluating Changes in Dike Field Fishes with Community Information Indices.

DTIC Science & Technology

1983-06-01

large species lists into single numerical expressions. Species diversity is usually - defined as a function of the number of species (i.e. species...1958, Lloyd and Ghelardi 1964, Pielou 1969). The primary motivation * for calculating species diversity indices based on richness or abundance is...diversity was an intrinsic property in ecological processes and an important factor in defining ecosystem structure and function (McArthur 1955

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

Tracy, Jenny; Jacobson, Arne; Mills, Evan

Flashlights that use LED technology have quickly emerged as the dominant source of portable lighting in Kenya. While flashlights do not normally provide a substitute for kerosene and other highly inefficient fuels, they are an important early manifestation of LED lighting in the developing world that can serve as a platform - or deterrent - to the diffusion of the technology into the broader off-grid lighting market. The lead acid batteries embedded in flashlights also represent an important source of hazardous waste, and flashlight durability is thus an important determinant of the rate of waste disposal. Low-cost LED flashlights withmore » prices from $1 to $4 are now widely available in shops and markets throughout Kenya. The increased penetration of LED technology in the flashlight market is significant, as over half of all Kenyan households report owning a flashlight (Kamfor, 2002). While this shift from conventional incandescent technology to modern LEDs may appear to be a promising development, end users that our research team interviewed expressed a number of complaints about the quality and performance of these new flashlights. This raises concerns about the interests of low-income flashlight users, and it may also indicate the onset of a broader market spoiling effect for off-grid lighting products based on LED technology (Mills and Jacobson, 2008; Lighting Africa, 2007). The quality of low-cost LED flashlights can contribute to market spoiling because these products appear to represent the first contact that most Kenyans have with LED technology. In this report, our team uses interviews with 46 end users of flashlights to collect information about their experiences, perceptions, and preferences. We focus especially on highlighting common complaints from respondents about the flashlights that they have used, as well as on noting the features that they indicated were important when evaluating the quality of a flashlight. In previous laboratory tests, researchers from our team found a wide range of quality and performance among battery powered LED lights (Granderson, et al. 2008).« less

The influence of corporate structure and quality improvement activities on outcome improvement in residential care homes.

PubMed

Winters, S; Kool, R B; Klazinga, N S; Huijsman, R

2014-08-01

To examine the impact of corporate structure and quality improvement (QI) activities on improvements in client-reported and professional indicators between 2007 and 2009. A cross-sectional study using organizational survey and indicator multilevel modelling to test relationships between corporate structure, QI activities and performance improvements on indicators. In total, 169 residential care homes for the elderly in the Netherlands. Change between 2007 and 2009 in client-reported and professional indicators. A middle-size corporate structure was associated with QI. The QI activity 'multidisciplinary team meetings' was positively correlated with the indicator 'safety environment' for somatic and psycho-geriatric care. The QI activities 'educational material' and 'direct work instructions' were associated negatively with the indicator 'availability of personnel' for somatic clients, but positively for psycho-geriatric clients. QI activities such as 'health plan activities', 'clinical lessons' and 'financial activities' had no relationship to improved performance. For psycho-geriatric clients mainly organizational QI activities were positively associated with QI. The mediating role of the corporate structure for performing QI activities appeared stronger for the change in client-reported than for professional indicators. This study reveals associations between QI activities and corporate structure and changes in indicator performance. A corporate structure was associated with improvement in client-reported indicators, but less on professional indicators, which assumes a central policy at corporate level with impact on client-reported indicators, in contrast to a more local level approach towards activities that result in QI on professional indicators. Tailoring QI activities at the right managerial level may be important to achieve improvement. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Characteristics of good quality pharmaceutical services common to community pharmacies and dispensing general practices.

PubMed

Grey, Elisabeth; Harris, Michael; Rodham, Karen; Weiss, Marjorie C

2016-10-01

In the United Kingdom, pharmaceutical services can be delivered by both community pharmacies (CPs) and dispensing doctor practices (DPs). Both must adhere to minimum standards set out in NHS regulations; however, no common framework exists to guide quality improvement. Previous phases of this research had developed a set of characteristics indicative of good pharmaceutical service provision. To ask key stakeholders to confirm, and rank the importance of, a set of characteristics of good pharmaceutical service provision. A two-round Delphi-type survey was conducted in south-west England and was sent to participants representing three stakeholder groups: DPs, CPs and patients/lay members. Participants were asked to confirm, and rank, the importance of these characteristics as representing good quality pharmaceutical services. Thirty people were sent the first round survey; 22 participants completed both rounds. Median ratings for the 23 characteristics showed that all were seen to represent important aspects of pharmaceutical service provision. Participants' comments highlighted potential problems with the practicality of the characteristics. Characteristics relating to patient safety were deemed to be the most important and those relating to public health the least important. A set of 23 characteristics for providing good pharmaceutical services in CPs and DPs was developed and attained approval from a sample of stakeholders. With further testing and wider discussion, it is hoped that the characteristics will form the basis of a quality improvement tool for CPs and DPs. © 2016 Royal Pharmaceutical Society.

Development of innovative computer software to facilitate the setup and computation of water quality index

PubMed Central

2013-01-01

Background Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. Findings In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. Conclusion A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases. PMID:24499556

[HYGIENIC JUSTIFICATION OF OPTIMIZATION OF THE INTEGRATED ASSESSMENT OF DRINKING WATER ACCORDING TO THE WATER QUALITY INDEX].

PubMed

Krasovskiy, G N; Rakhmanin, Yu; Egorova, N

2015-01-01

The present study is devoted to theoretical questions of optimization of integrated assessment of the composition and properties of drinking water with the use of the Water Quality Index (WQI) and considering in it all 4 criteria for its hygienic quality-sanitary-toxicological, microbiological, radiation and organoleptic. There is presented a sequence of the analysis of benchmark data of the laboratory study of drinking water, including the selection of priority indices, their distribution into 4 groups according to hygienic criteria, calculations the ratios of real values (C) of indices to their hygiene MPC and the final calculation of the WQI. There is emphasized the importance of classes of hazard of substances, and the need for the special attention to the substances-carcinogens in the integrated assessment of water quality. To overcome the non-equivalence of contributions to the assessment of water quality factors, measured in different units, often disparated in their effect on human health, there are used the principles of combined action at levels below the MCL:C/MPC indices of performance of the unidirectional action are summed (e.g. carcinogenic substances), from indices of the independent action there are selected the most significant ones with the highest values of C/MPC, besides that there are also used counterbalancing factors K determined accordingly to Delphi method, with a maximum values of 5 for carcinogens and the minimum value of 1 for the substances affecting the organoleptic properties ofwater. There is presented the scheme of the final calculation of the value of WQI.

Evaluation of feedback interventions for improving the quality assurance of cancer screening in Japan: study design and report of the baseline survey.

PubMed

Machii, Ryoko; Saika, Kumiko; Higashi, Takahiro; Aoki, Ayako; Hamashima, Chisato; Saito, Hiroshi

2012-02-01

The importance of quality assurance in cancer screening has recently gained increasing attention in Japan. To evaluate and improve quality, checklists and process indicators have been developed. To explore effective methods of enhancing quality in cancer screening, we started a randomized control study of the methods of evaluation and feedback for cancer control from 2009 to 2014. We randomly assigned 1270 municipal governments, equivalent to 71% of all Japanese municipal governments that performed screening programs, into three groups. The high-intensity intervention groups (n = 425) were individually evaluated using both checklist performance and process indicator values, while the low-intensity intervention groups (n= 421) were individually evaluated on the basis of only checklist performance. The control group (n = 424) received only a basic report that included the national average of checklist performance scores. We repeated the survey for each municipality's quality assurance activity performance using checklists and process indicators. In this paper, we report our study design and the result of the baseline survey. The checklist adherence rates were especially low in the checklist elements related to invitation of individuals, detailed monitoring of process indicators such as cancer detection rates according to screening histories and appropriate selection of screening facilities. Screening rate and percentage of examinees who underwent detailed examination tended to be lower for large cities when compared with smaller cities for all cancer sites. The performance of the Japanese cancer screening program in 2009 was identified for the first time.

Operationalizing the Measuring What Matters Spirituality Quality Metric in a Population of Hospitalized, Critically Ill Patients and Their Family Members.

PubMed

Aslakson, Rebecca A; Kweku, Josephine; Kinnison, Malonnie; Singh, Sarabdeep; Crowe, Thomas Y

2017-03-01

Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired. The objective of this study was to 1) determine the ease of, and barriers to, prospectively collecting MWM spirituality quality measure data and 2) further explore the importance of spirituality in a seriously ill, hospitalized population of critically ill patients and their family members. Electronic medical record (EMR) review and cross-sectional survey of intensive care unit (ICU) patients and their family members from October to December 2015. Participants were in four adult ICUs totaling 68 beds at a single academic, urban, tertiary care center which has ICU-assigned chaplains and an in-house, 24-hour, on-call chaplain. All patients had a "Spiritual Risk Screen" which included two questions identifying patient religion and whether a chaplain visit was desired. Approximately 2/3 of ICU patients were eligible, and there were 144 respondents (50% female; 57% patient and 43% family member), with the majority being Caucasian or African American (68% and 21%, respectively). Common religious identifications were Christian or no faith tradition (76% and 11%, respectively). Approximately half of patients had an EMR chaplain note although it did not document presence of a "spiritual discussion." No study patients received palliative care consultation. A majority (85%) noted that spirituality was "important to them" and that prevalence remained high across respondent age, race, faith tradition, or admitting ICU. Operationalizing the MWM spirituality quality indicator was challenging as elements of a "spiritual screening" or documentation of a "spiritual discussion" were not clearly documented in the EMR. The high prevalence of spirituality among respondents validates the importance of spirituality as a potential quality metric. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The spatial and seasonal variability of the groundwater chemistry and quality in the exploited aquifer in the Daxing District, Beijing, China.

PubMed

Zhai, Yuanzheng; Lei, Yan; Zhou, Jun; Li, Muzi; Wang, Jinsheng; Teng, Yanguo

2015-02-01

The aquifer in the Beijing Plain is intensively used as a primary source to meet the growing needs of the various sectors (drinking, agricultural, and industrial purposes). The analysis of groundwater chemical characteristics provides much important information useful in water resources management. To characterize the groundwater chemistry, reveal its spatial and seasonal variability, and determine its quality suitability for domestic and agricultural uses, a total of 200 groundwater samples were collected in June and October 2012 from 100 exploited wells in Daxing District, Beijing, China. All of the indices (39 items) listed in the Quality Standard for Groundwater of China (QSGC) as well as eight additional common parameters were tested and analyzed for all samples, based on which research target was achieved. The seasonal effect on the groundwater chemistry and quality was very slight, whereas the spatial changes were very obvious. The aquifer is mainly dominated by HCO3-Ca·Mg-type water. Of the 39 quality indices listed in QSGC, 28 indices of all of the samples for the 2 months can be classified into the excellent level, whereas the remaining 11 indices can be classified into different levels with the total hardness, NO3, NO2, and Fe being the worst, mainly distributed in the residential and industrial land. According to the general quality index, the groundwater can be classified from good to a relatively poor level, mainly from southeast to northwest. Furthermore, the relatively poor-level area in the northwest expands to the southeast more than in the past years, to which people should pay attention because this reverse spatial distribution relative to the natural law indicates an obvious, anthropogenic impact on the groundwater. In addition, the groundwater in this area is generally very suitable for irrigation year-round. Nevertheless, we recommend performing agricultural water-saving measures for the sustainable development of water and urbanization, groundwater recovery, and ecological safety.

Understanding the relationships among phytoplankton, benthic macroinvertebrates, and water quality variables in peri-urban river systems.

PubMed

Pinto, Uthpala; Maheshwari, Basant L; Morris, E Charles

2014-12-01

In this article, using the Hawkesbury-Nepean River as a case study, the spatial and temporal trends of water quality variables over three sampling surveys in a peri-urban situation are examined for their effect on benthic macroinvertebrate communities and phytoplankton communities and whether phytoplankton and benthic macroinvertebrate species can be used as indicators for river health assessment. For this, the authors monitored the spatial and temporal difference of 10 water quality parameters: temperature, turbidity, pH, dissolved oxygen, electrical conductivity, oxidation reduction potential, total nitrogen, total phosphorus, manganese, and suspended solids. The variability in water quality parameters clearly indicated a complex pattern, depending on the season (interaction p = 0.001), which highlighted how the river condition is stressed at multiple points as a result of anthropogenic effects. In particular, the downstream locations indicated an accumulation of nutrients, the presence of increased sediments, and phytoplankton related variables such as total counts, bio-volumes, chlorophyll-a, and total phosphorus. The patterns of phytoplankton communities varied in a complex way depending on the season (interaction p = 0.001). Abundances of phytoplankton were also found in low concentrations where the water column is not severely disturbed by flow and tide. However, when the water clarity drops resulting from tidal cycles, inflows from tributaries, and intense boating activities, the phytoplankton abundances also increased considerably. On the other hand, benthic macroinvertebrates compositions were significantly different between locations (p = 0.001) with increased abundances associated with upstream sites. Aphanocapsa holsatica and chironomid larvae appeared as the important indicators for upstream and downstream site differences in water quality. Water temperature influenced the phytoplankton community pattern (ρ(w) = 0.408), whereas pH influenced the benthic macroinvertebrate community pattern (ρ(w) = 0.437). The findings of this study provide valuable insights into the interactions of water quality parameters on biotic assemblages and to the extent that benthic macroinvertebrates and phytoplankton assemblages are suitable as indicators for monitoring and assessing peri-urban river health.

Patient-provider relationship predicts mental and physical health indicators for HIV-positive men who have sex with men.

PubMed

Bankoff, Sarah M; McCullough, Mary B; Pantalone, David W

2013-06-01

We used secondary data analysis to examine associations among aspects of patient-provider relationships and mental and physical health indicators. Positive patient perceptions of patient-provider relationships were associated with fewer mental health symptoms in this outpatient sample of HIV-positive men who have sex with men (N = 171). Regression analyses revealed the role of anxiety and depression in explaining associations between two aspects of patient-provider relationships (i.e. quality of information offered and provider interactional style) and health-related quality of life. The findings demonstrated the importance of patient-provider relationships to improving physical health and functioning and maintaining engagement in care, among HIV-positive men who have sex with men.

Using SERVQUAL and Kano research techniques in a patient service quality survey.

PubMed

Christoglou, Konstantinos; Vassiliadis, Chris; Sigalas, Ioakim

2006-01-01

This article presents the results of a service quality study. After an introduction to the SERVQUAL and the Kano research techniques, a Kano analysis of 75 patients from the General Hospital of Katerini in Greece is presented. The service quality criterion used satisfaction and dissatisfaction indices. The Kano statistical analysis process results strengthened the hypothesis of previous research regarding the importance of personal knowledge, the courtesy of the hospital employees and their ability to convey trust and confidence (assurance dimension). Managerial suggestions are made regarding the best way of acting and approaching hospital patients based on the basic SERVQUAL model.

Quality indicators for hip fracture care, a systematic review.

PubMed

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

2018-05-17

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

Operation quality assessment model for video conference system

NASA Astrophysics Data System (ADS)

Du, Bangshi; Qi, Feng; Shao, Sujie; Wang, Ying; Li, Weijian

2018-01-01

Video conference system has become an important support platform for smart grid operation and management, its operation quality is gradually concerning grid enterprise. First, the evaluation indicator system covering network, business and operation maintenance aspects was established on basis of video conference system's operation statistics. Then, the operation quality assessment model combining genetic algorithm with regularized BP neural network was proposed, which outputs operation quality level of the system within a time period and provides company manager with some optimization advice. The simulation results show that the proposed evaluation model offers the advantages of fast convergence and high prediction accuracy in contrast with regularized BP neural network, and its generalization ability is superior to LM-BP neural network and Bayesian BP neural network.

[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.

Adiposity, compared with masculinity, serves as a more valid cue to immunocompetence in human mate choice

PubMed Central

Rantala, Markus J.; Coetzee, Vinet; Moore, Fhionna R.; Skrinda, Ilona; Kecko, Sanita; Krama, Tatjana; Kivleniece, Inese; Krams, Indrikis

2013-01-01

According to the ‘good genes’ hypothesis, females choose males based on traits that indicate the male's genetic quality in terms of disease resistance. The ‘immunocompetence handicap hypothesis’ proposed that secondary sexual traits serve as indicators of male genetic quality, because they indicate that males can contend with the immunosuppressive effects of testosterone. Masculinity is commonly assumed to serve as such a secondary sexual trait. Yet, women do not consistently prefer masculine looking men, nor is masculinity consistently related to health across studies. Here, we show that adiposity, but not masculinity, significantly mediates the relationship between a direct measure of immune response (hepatitis B antibody response) and attractiveness for both body and facial measurements. In addition, we show that circulating testosterone is more closely associated with adiposity than masculinity. These findings indicate that adiposity, compared with masculinity, serves as a more important cue to immunocompetence in female mate choice. PMID:23193134

Predictors of health-related quality of life in children with chronic heart disease.

PubMed

Niemitz, Mandy; Gunst, Diana C M; Hövels-Gürich, Hedwig H; Hofbeck, Michael; Kaulitz, Renate; Galm, Christoph; Berger, Felix; Nagdyman, Nicole; Stiller, Brigitte; Borth-Bruhns, Thomas; Konzag, Ines; Balmer, Christian; Goldbeck, Lutz

2017-10-01

Chronic paediatric heart disease is often associated with residual symptoms, persisting functional restrictions, and late sequelae for psychosocial development. It is, therefore, increasingly important to evaluate the health-related quality of life of children and adolescents with chronic heart disease. The aim of this study was to determine medical and socio-demographic variables affecting health-related quality of life in school-aged children and adolescents with chronic heart disease. Patients and methods The Pediatric Cardiac Quality of Life Inventory was administered to 375 children and adolescents and 386 parental caregivers. Medical information was obtained from the charts. The socio-demographic information was provided by the patients and caregivers. Greater disease severity, low school attendance, current cardiac medication, current parental employment, uncertain or limited prognosis, history of connection to a heart-lung machine, number of nights spent in a hospital, and need for treatment in a paediatric aftercare clinic independently contributed to lower health-related quality of life (self-report: R2=0.41; proxy-report: R2=0.46). High correlations between self-reports and parent-proxy reports indicated concordance regarding the evaluation of a child's health-related quality of life. Beyond medical treatment, integration into school is important to increase health-related quality of life in children and adolescents surviving with chronic heart disease. Regular screening of health-related quality of life is recommended to identify patients with special needs.

Cost of living dictates what whales, dolphins and porpoises eat: the importance of prey quality on predator foraging strategies.

PubMed

Spitz, Jérôme; Trites, Andrew W; Becquet, Vanessa; Brind'Amour, Anik; Cherel, Yves; Galois, Robert; Ridoux, Vincent

2012-01-01

Understanding the mechanisms that drive prey selection is a major challenge in foraging ecology. Most studies of foraging strategies have focused on behavioural costs, and have generally failed to recognize that differences in the quality of prey may be as important to predators as the costs of acquisition. Here, we tested whether there is a relationship between the quality of diets (kJ · g(-1)) consumed by cetaceans in the North Atlantic and their metabolic costs of living as estimated by indicators of muscle performance (mitochondrial density, n = 60, and lipid content, n = 37). We found that the cost of living of 11 cetacean species is tightly coupled with the quality of prey they consume. This relationship between diet quality and cost of living appears to be independent of phylogeny and body size, and runs counter to predictions that stem from the well-known scaling relationships between mass and metabolic rates. Our finding suggests that the quality of prey rather than the sheer quantity of food is a major determinant of foraging strategies employed by predators to meet their specific energy requirements. This predator-specific dependence on food quality appears to reflect the evolution of ecological strategies at a species level, and has implications for risk assessment associated with the consequences of changing the quality and quantities of prey available to top predators in marine ecosystems.

Quality of online information on type 2 diabetes: a cross-sectional study.

PubMed

Weymann, Nina; Härter, Martin; Dirmaier, Jörg

2015-12-01

Evidence-based health information is a prerequisite for patients with type 2 diabetes to engage in self-management and to make informed medical decisions. The Internet is an important source of health information. In the present study, we systematically assessed formal quality, quality of decision support and usability of German and English language websites on type 2 diabetes. The search term 'type 2 diabetes' was entered in the two most popular search engines. Descriptive data on website quality are presented. Additionally, associations between website quality and affiliation (commercial vs. non-commercial), presence of the HON code quality seal and website traffic were explored. Forty-six websites were included. Most websites provided basic information necessary for decision-making, while only one website also provided decision support. Websites with a HON code had significantly better formal quality than websites without HON code. We found a highly significant correlation between usability and website traffic and a significant correlation between formal quality and website traffic. Most websites do not provide sufficient information to support patients in medical decision-making. Our finding that usability and website traffic are tightly associated is consistent with previous research indicating that design is the most important cue for users assessing website credibility. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Family relations and health over the life course. A Lebanese perspective.

PubMed

Ajrouch, Kristine J; Abdulrahim, Sawsan; Antonucci, Toni C

2015-01-01

The link between family relations and well-being in old age has received ample attention in the international literature, but remains least examined in the Arab region where cultural ideals assume positive intergenerational relations within families as the norm. In this paper, we employ survey data collected in Greater Beirut in 2009 to explore associations between family relations and health. over the life course. We tested (1) the extent to which age and social relation characteristics predict health; and (2) whether the association between age and health is stronger for those who report: smaller social networks and poorer relationship quality. We employed self-rated health and self-reported chronic illness as the health outcome measures and:social network size, positive quality and negative quality with family members as the social relations measures. Our findings suggest that social relations are differentially important depending on the health status indicator examined. The single dimension that influenced both self-rated health and the probability of reporting a chronic illness was positive relationship quality with spouse. Further, social relations, particularly having a negative relationship quality with spouse and adult child, exert stronger effects on both self-rated health and chronic illness for older compared to younger adults. The findings of the present study are important for clinical practitioners who often consider the role and importance of available social resources as they address the health needs of older adults.

Haptoglobin and serum amyloid A in bulk tank milk in relation to raw milk quality.

PubMed

Akerstedt, Maria; Waller, Karin Persson; Sternesjö, Ase

2009-11-01

The aim of the present study was to evaluate relationships between the presence of the two major bovine acute phase proteins haptoglobin (Hp) and serum amyloid A (SAA) and raw milk quality parameters in bulk tank milk samples. Hp and SAA have been suggested as specific markers of mastitis but recently also as markers for raw milk quality. Since mastitis has detrimental effects on milk quality, it is important to investigate whether the presence of Hp or SAA indicates such changes in the composition and properties of the milk. Bulk tank milk samples (n=91) were analysed for Hp, SAA, total protein, casein, whey protein, proteolysis, fat, lactose, somatic cell count and coagulating properties. Samples with detectable levels of Hp had lower casein content, casein number and lactose content, but higher proteolysis than samples without Hp. Samples with detectable levels of SAA had lower casein number and lactose content, but higher whey protein content than samples without SAA. The presence of acute phase proteins in bulk tank milk is suggested as an indicator for unfavourable changes in the milk composition, e.g. protein quality, due to udder health disturbances, with economical implications for the dairy industry.

A Tiered Analytical Approach for Investigating Poor Quality Emergency Contraceptives

PubMed Central

Monge, María Eugenia; Dwivedi, Prabha; Zhou, Manshui; Payne, Michael; Harris, Chris; House, Blaine; Juggins, Yvonne; Cizmarik, Peter; Newton, Paul N.; Fernández, Facundo M.; Jenkins, David

2014-01-01

Reproductive health has been deleteriously affected by poor quality medicines. Emergency contraceptive pills (ECPs) are an important birth control method that women can use after unprotected coitus for reducing the risk of pregnancy. In response to the detection of poor quality ECPs commercially available in the Peruvian market we developed a tiered multi-platform analytical strategy. In a survey to assess ECP medicine quality in Peru, 7 out of 25 different batches showed inadequate release of levonorgestrel by dissolution testing or improper amounts of active ingredient. One batch was found to contain a wrong active ingredient, with no detectable levonorgestrel. By combining ultrahigh performance liquid chromatography-ion mobility spectrometry-mass spectrometry (UHPLC-IMS-MS) and direct analysis in real time MS (DART-MS) the unknown compound was identified as the antibiotic sulfamethoxazole. Quantitation by UHPLC-triple quadrupole tandem MS (QqQ-MS/MS) indicated that the wrong ingredient was present in the ECP sample at levels which could have significant physiological effects. Further chemical characterization of the poor quality ECP samples included the identification of the excipients by 2D Diffusion-Ordered Nuclear Magnetic Resonance Spectroscopy (DOSY 1H NMR) indicating the presence of lactose and magnesium stearate. PMID:24748219

Catchment process affecting drinking water quality, including the significance of rainfall events, using factor analysis and event mean concentrations.

PubMed

Cinque, Kathy; Jayasuriya, Niranjali

2010-12-01

To ensure the protection of drinking water an understanding of the catchment processes which can affect water quality is important as it enables targeted catchment management actions to be implemented. In this study factor analysis (FA) and comparing event mean concentrations (EMCs) with baseline values were techniques used to asses the relationships between water quality parameters and linking those parameters to processes within an agricultural drinking water catchment. FA found that 55% of the variance in the water quality data could be explained by the first factor, which was dominated by parameters usually associated with erosion. Inclusion of pathogenic indicators in an additional FA showed that Enterococcus and Clostridium perfringens (C. perfringens) were also related to the erosion factor. Analysis of the EMCs found that most parameters were significantly higher during periods of rainfall runoff. This study shows that the most dominant processes in an agricultural catchment are surface runoff and erosion. It also shows that it is these processes which mobilise pathogenic indicators and are therefore most likely to influence the transport of pathogens. Catchment management efforts need to focus on reducing the effect of these processes on water quality.

Social Relationships in Young Adults at Ultra High Risk For Psychosis

PubMed Central

Robustelli, Briana L.; Newberry, Raeana E.; Whisman, Mark A.; Mittal, Vijay A.

2016-01-01

Studies suggest that individuals with schizophrenia have smaller social networks and less satisfying relationships. However, much is still unknown about the typical quantity and quality of social relationships in young adults during the ultra high-risk (UHR) period. Investigating these relationships holds significant importance for improving understanding of etiological processes, mapping the social environment, and highlighting treatment targets in a critical period. A total of 85 participants (44 UHR and 41 healthy controls) completed measures examining the participants’ social relationships, social support, and loneliness. Mean differences between the UHR and healthy control participants and associations between social relationships and symptoms and functioning were examined. Results indicated significant differences between groups on several indices. Specifically, the UHR youth reported fewer close friends, less diverse social networks, less perceived social support, poorer relationship quality with family and friends, and more loneliness. Notably, within the UHR group, being lonely and having fewer and worse quality relationships was associated with greater symptom severity and lower overall functioning. This study suggests that youth at high-risk of developing psychosis have fewer and poorer quality social relationships. Interventions that focus on increasing the quantity and quality of young adults’ social networks may be beneficial for this population. PMID:27987484

Global sensitivity analysis for urban water quality modelling: Terminology, convergence and comparison of different methods

NASA Astrophysics Data System (ADS)

Vanrolleghem, Peter A.; Mannina, Giorgio; Cosenza, Alida; Neumann, Marc B.

2015-03-01

Sensitivity analysis represents an important step in improving the understanding and use of environmental models. Indeed, by means of global sensitivity analysis (GSA), modellers may identify both important (factor prioritisation) and non-influential (factor fixing) model factors. No general rule has yet been defined for verifying the convergence of the GSA methods. In order to fill this gap this paper presents a convergence analysis of three widely used GSA methods (SRC, Extended FAST and Morris screening) for an urban drainage stormwater quality-quantity model. After the convergence was achieved the results of each method were compared. In particular, a discussion on peculiarities, applicability, and reliability of the three methods is presented. Moreover, a graphical Venn diagram based classification scheme and a precise terminology for better identifying important, interacting and non-influential factors for each method is proposed. In terms of convergence, it was shown that sensitivity indices related to factors of the quantity model achieve convergence faster. Results for the Morris screening method deviated considerably from the other methods. Factors related to the quality model require a much higher number of simulations than the number suggested in literature for achieving convergence with this method. In fact, the results have shown that the term "screening" is improperly used as the method may exclude important factors from further analysis. Moreover, for the presented application the convergence analysis shows more stable sensitivity coefficients for the Extended-FAST method compared to SRC and Morris screening. Substantial agreement in terms of factor fixing was found between the Morris screening and Extended FAST methods. In general, the water quality related factors exhibited more important interactions than factors related to water quantity. Furthermore, in contrast to water quantity model outputs, water quality model outputs were found to be characterised by high non-linearity.

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits

PubMed Central

Milojevich, Helen M.; Lukowski, Angela F.

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning. PMID:27280714

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits.

PubMed

Milojevich, Helen M; Lukowski, Angela F

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning.

Gambling, Drinking and Quality of Life: Evidence from Macao and Australia.

PubMed

Loo, Jasmine M Y; Shi, Yongdong; Pu, Xiaohong

2016-06-01

The investigation of the interface between psychological constructs, compulsive consumption of alcohol and pathological gambling is an important avenue for development of future initiatives in social marketing or prevention programs. This cross-cultural study attempts to bridge the gap in literature by providing an evaluation of the predictive ability of psychological variables such as gambling urge, gambling-related erroneous cognitions and comorbid alcohol consumption on pathological gambling behaviour and its impact on overall quality of life indicators. Participants consist of 445 Macao and Australian young adults (Mean age = 23 years). Results indicate that probable pathological gamblers as compared with non-gamblers reported significantly lower quality of life in all domains-physical health, psychological well-being, social relationships and environment. Adults who drank more alcohol and have stronger erroneous cognitions evidenced higher pathological gambling behavior. Our research model fits both cohorts and interestingly, erroneous gambling-related cognitions serve as a full mediator for the predictive relationship between gambling urge and pathological gambling in the Macao sample, but serve as a partial mediator in the Australian sample. Targeting erroneous cognitions in future social marketing or preventive campaigns should demonstrate to be an important strategy in reducing the effects of urge to gamble among at-risk individuals. Further implications for the industry, marketing and governmental strategies are discussed.

Image: Reflecting the National Face of Community Colleges.

ERIC Educational Resources Information Center

Kent, Norma

1996-01-01

Suggests that there is a "low-to-no-profile syndrome" afflicting community colleges at the national level that must be rectified, highlighting the importance of a national image campaign. Describes results from focus groups indicating doubt over the colleges' quality. Reviews strategies for financing an image campaign and presents potential…

What Makes a Good Educator? The Relevance of Meta Programmes

ERIC Educational Resources Information Center

Brown, Nigel

2004-01-01

This paper reports the results of a qualitative study which explores the relevance of meta programmes to students' perceptions of teaching quality. Meta programmes are a model of personality preferences from the discipline of Neuro Linguistic Programming (NLP). Research into teaching effectiveness indicates that students rate as important "hygiene…

Temporal stability of E. coli concentration patterns in two irrigation ponds in Maryland

USDA-ARS?s Scientific Manuscript database

There are about nine millions ponds in USA, and many of them serve as an important agricultural surface water source. E. coli concentrations are commonly used as indicator organisms to evaluate microbial water quality for irrigation and recreation. Our hypothesis was that there exists a temporally ...

A REGIONAL MODEL FOR PCDD/F'S BASED ON A PHOTOCHEMICAL MODEL FOR AIR QUALITY AND PARTICULATE MATTER

EPA Science Inventory

How important is gas to particle partitioning in predicting air concentrations and deposition of Poly-Chlorinated Dibenzo-p-Dioxins and Furans (PCDD/F's)? Literature indicates that the fate of emissions changes because the summation of atmospheric processes has a different balanc...

Volatile organic compounds of whole grain soft winter wheat

USDA-ARS?s Scientific Manuscript database

The aroma from volatile organic compounds (VOCs) is an indicator of grain soundness and also an important quality attribute of grain foods. To identify the inherent VOCs of wheat grain unaffected by fungal infestation and other extrinsic factors, grains of nine soft wheat varieties were collected at...

STATUS OF THE AMPHIPOD DIPOREIA SPP. IN LAKE SUPERIOR, 1994-2000

EPA Science Inventory

The amphipod Diporeia spp. is the dominant component of the Great Lakes benthic macroinvertebrate fauna in terms of both numbers and biomass, and plays an important role in the ecosystem. The Great Lakes Water Quality Agreement calls for the use of Diporeia as an indicator of ec...

Retention in Art Teacher Education Programs.

ERIC Educational Resources Information Center

Even, Robert

1988-01-01

Discusses the demand for K-12 art teachers, the college admission criteria for art teacher education, and whether the best students are those who graduate and enter the field as teachers. Describes the qualities that characterize the best students, stating that talent and love of subject are important teaching success indicators. (GEA)

Nutrient Loading Impacts on Culturable E. coli and other Heterotrophic Bacteria Fate in Simulated Stream Mesocosms

USDA-ARS?s Scientific Manuscript database

Understanding fecal indicator bacteria persistence in aquatic environments is important when making management decisions to improve instream water quality. Routinely, bacteria fate and transport models that rely on published kinetic decay constants are used to inform such decision making. The object...

Intergroup Relations in Integrated Schools: A Glimpse inside Interdistrict Magnet Schools

ERIC Educational Resources Information Center

Bifulco, Robert; Buerger, Christian; Cobb, Casey

2012-01-01

The frequency and quality of intergroup contact within racially and ethnically diverse schools has potentially important implications for the achievement of desegregation goals. The analyses presented here use survey data to assess intergroup contact within a sample of ten interdistrict magnet schools in Connecticut. Findings indicate frequent…

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

PubMed Central

Petzold, Thomas; Deckert, Stefanie; Williamson, Paula R.; Schmitt, Jochen

2018-01-01

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems. PMID:29591538

Comparison of laboratory and field remote sensing methods to measure forage quality.

PubMed

Guo, Xulin; Wilmshurst, John F; Li, Zhaoqin

2010-09-01

Recent research in range ecology has emphasized the importance of forage quality as a key indicator of rangeland condition. However, we lack tools to evaluate forage quality at scales appropriate for management. Using canopy reflectance data to measure forage quality has been conducted at both laboratory and field levels separately, but little work has been conducted to evaluate these methods simultaneously. The objective of this study is to find a reliable way of assessing grassland quality through measuring forage chemistry with reflectance. We studied a mixed grass ecosystem in Grasslands National Park of Canada and surrounding pastures, located in southern Saskatchewan. Spectral reflectance was collected at both in-situ field level and in the laboratory. Vegetation samples were collected at each site, sorted into the green grass portion, and then sent to a chemical company for measuring forage quality variables, including protein, lignin, ash, moisture at 135 °C, Neutral Detergent Fiber (NDF), Acid Detergent Fiber (ADF), Total Digestible, Digestible Energy, Net Energy for Lactation, Net Energy for Maintenance, and Net Energy for Gain. Reflectance data were processed with the first derivative transformation and continuum removal method. Correlation analysis was conducted on spectral and forage quality variables. A regression model was further built to investigate the possibility of using canopy spectral measurements to predict the grassland quality. Results indicated that field level prediction of protein of mixed grass species was possible (r² = 0.63). However, the relationship between canopy reflectance and the other forage quality variables was not strong.

Selection of quality indicators for nutritional therapy in pediatrics: a cross-sectional study conducted in Brazil.

PubMed

Bertoldi, Julia; Ferreira, Aline; Scancetti, Luiza; Padilha, Patricia

2018-01-01

Quality indicators for nutritional therapy (QINT) are important in assessing care and monitoring of resources. Among the 30 indicators proposed by International Life Sciences Institute, Brazil, there is still no evaluation of the most pertinent for Pediatrics. To list the 10 main quality indicators for nutritional therapies (QINTs) for Pediatrics. This was a two-phase cross-sectional study. Firstly, a questionnaire was answered by physicians, nutritionists, nurses, and pharmacists, all with having experience in nutritional therapy (NT) with Pediatrics, in Rio de Janeiro, Brazil. Participants assessed four attributes of QINT by using the Likert scale. A Top 10 ranked QINT list for Pediatrics was established. To verify the consistency of the questionnaire, Cronbach's Alpha coefficient was calculated. Secondly, the opinions of the participants on the results that were obtained were requested and the percentages of the positive responses were calculated. A total of 33 professionals participated in the first phase and 92% ( n = 23 of 25) in the second phase approved the results of the selected indicators. Among the Top 10 QINTs, the three main ones were: #1: "Frequency of diarrhea in those patients on enteral nutrition" (mean = 13.194; α = 0.827); #2: "Frequency of dietary nutritional prescriptions upon the hospital discharge of the NT patients" (mean = 12.871; α = 0.822); #3: "Frequency of the NT patients who recovered their oral intake" (mean = 12.839; α = 0.859). When considering the consistency and the concordance that were obtained, it can be suggested that the list of Top 10 QINTs as proposed in this study will help in the evaluation of NT quality indicators for Pediatrics.

An examination of water quality indicators in swim sites located in the upper Los Angeles River Watershed

NASA Astrophysics Data System (ADS)

Lee, C. M.; Morris, K.; Fingland, N. K.; Johnstone, K.; Pendleton, L.; Ponce, A.; Tang, C.; Griffith, J. F.; Steele, N. L.

2013-12-01

Multiple sites in the upper Los Angeles River watershed were sampled during summer 2012 and measured for Escherichia coli, enterococci, and Clostridium perfringens (vegetative cells and spores) using culture-based analyses and preserved for quantitative polymerase chain reaction (qPCR) analysis. The objective of this work includes the characterization of how well indicators correlated with each other, with respect to background levels and to 'spikes' from background, possibly indicative of a pollution input, environmental/physicochemical parameters, as well as in the context of recreational water quality standards. The 2nd objective of this work was to evaluate the economic impact of implementing qPCR at our study sites for rapid water quality monitoring. None of the species of indicators correlated well with each other (R2 < 0.1) across sites and dates when the sample set was examined in its entirety, though C. perfringens vegetative cells and spores were moderately correlated (R2 = 0.31, p = 0.07). The observation of concentration 'spikes' against background levels, suggesting a potential input of contamination, were observed on holiday sampling days and will be examined further. In general, the number of swimmers present was not linked with indicator concentrations; however, incidence of water quality exceedances (for E. coli 235 CFU or MPN/100 mL sample) were more likely to occur on the weekend or holidays (for E. coli, , suggesting that the presence/absence of swimmers may be an important variable at our sites. Clostridium perfringens may be a useful indicator at our study sites, as a comparison of vegetative to endospore forms of this organism may be used to understand how recently a contamination event or input occurred.

A model to begin to use clinical outcomes in medical education.

PubMed

Haan, Constance K; Edwards, Fred H; Poole, Betty; Godley, Melissa; Genuardi, Frank J; Zenni, Elisa A

2008-06-01

The latest phase of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges graduate medical education (GME) programs to select meaningful clinical quality indicators by which to measure trainee performance and progress, as well as to assess and improve educational effectiveness of programs. The authors describe efforts to measure educational quality, incorporating measurable patient-care outcomes to guide improvement. University of Florida College of Medicine-Jacksonville education leaders developed a tiered framework for selecting clinical indicators whose outcomes would illustrate integration of the ACGME competencies and their assessment with learning and clinical care. In order of preference, indicators selected should align with a specialty's (1) national benchmarked consensus standards, (2) national specialty society standards, (3) standards of local, institutional, or regional quality initiatives, or (4) top-priority diagnostic and/or therapeutic categories for the specialty, based on areas of high frequency, impact, or cost. All programs successfully applied the tiered process to clinical indicator selection and then identified data sources to track clinical outcomes. Using clinical outcomes in resident evaluation assesses the resident's performance as reflective of his or her participation in the health care delivery team. Programmatic improvements are driven by clinical outcomes that are shown to be below benchmark across the residents. Selecting appropriate clinical indicators-representative of quality of care and of graduate medical education-is the first step toward tracking educational outcomes using clinical data as the basis for evaluation and improvement. This effort is an important aspect of orienting trainees to using data for monitoring and improving care processes and outcomes throughout their careers.

Use of surrogate indicators for the evaluation of potential health risks due to poor urban water quality: A Bayesian Network approach.

PubMed

Wijesiri, Buddhi; Deilami, Kaveh; McGree, James; Goonetilleke, Ashantha

2018-02-01

Urban water pollution poses risks of waterborne infectious diseases. Therefore, in order to improve urban liveability, effective pollution mitigation strategies are required underpinned by predictions generated using water quality models. However, the lack of reliability in current modelling practices detrimentally impacts planning and management decision making. This research study adopted a novel approach in the form of Bayesian Networks to model urban water quality to better investigate the factors that influence risks to human health. The application of Bayesian Networks was found to enhance the integration of quantitative and qualitative spatially distributed data for analysing the influence of environmental and anthropogenic factors using three surrogate indicators of human health risk, namely, turbidity, total nitrogen and fats/oils. Expert knowledge was found to be of critical importance in assessing the interdependent relationships between health risk indicators and influential factors. The spatial variability maps of health risk indicators developed enabled the initial identification of high risk areas in which flooding was found to be the most significant influential factor in relation to human health risk. Surprisingly, population density was found to be less significant in influencing health risk indicators. These high risk areas in turn can be subjected to more in-depth investigations instead of the entire region, saving time and resources. It was evident that decision making in relation to the design of pollution mitigation strategies needs to account for the impact of landscape characteristics on water quality, which can be related to risk to human health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Rheumatologists' perception of systemic lupus erythematosus quality indicators: significant interest and perceived barriers.

PubMed

Casey, Carolyn; Chung, Cecilia P; Crofford, Leslie J; Barnado, April

2017-01-01

Differences in quality of care may contribute to health disparities in systemic lupus erythematosus (SLE). Studies show low physician adherence rates to the SLE quality indicators but do not assess physician perception of SLE quality indicators or quality improvement. Using a cross-sectional survey of rheumatologists in the southeastern USA, we assessed the perception and involvement of rheumatologists in quality improvement and the SLE quality indicators. Using electronic mail, an online survey of 32 questions was delivered to 568 rheumatologists. With a response rate of 19% (n = 106), the majority of participants were male, Caucasian, with over 20 years of experience, and seeing adult patients in an academic setting. Participants had a positive perception toward quality improvement (81%) with a majority responding that the SLE quality indicators would significantly impact quality of care (54%). While 66% of respondents were familiar with the SLE quality indicators, only 18% of respondents reported using them in everyday practice. The most commonly reported barrier to involvement in quality improvement and the SLE quality indicators was time. Rheumatologists had a positive perception of the SLE quality indicators and agreed that use of the quality indicators could improve quality of care in SLE; however, they identified time as a barrier to implementation. Future studies should investigate methods to increase use of the SLE quality indicators.

Open and endovascular aneurysm repair in the Society for Vascular Surgery Vascular Quality Initiative.

PubMed

Spangler, Emily L; Beck, Adam W

2017-12-01

The Society for Vascular Surgery Vascular Quality Initiative is a patient safety organization and a collection of procedure-based registries that can be utilized for quality improvement initiatives and clinical outcomes research. The Vascular Quality Initiative consists of voluntary participation by centers to collect data prospectively on all consecutive cases within specific registries which physicians and centers elect to participate. The data capture extends from preoperative demographics and risk factors (including indications for operation), through the perioperative period, to outcomes data at up to 1-year of follow-up. Additionally, longer-term follow-up can be achieved by matching with Medicare claims data, providing long-term longitudinal follow-up for a majority of patients within the Vascular Quality Initiative registries. We present the unique characteristics of the Vascular Quality Initiative registries and highlight important insights gained specific to open and endovascular abdominal aortic aneurysm repair. Copyright © 2017 Elsevier Inc. All rights reserved.

Dispositional optimism and sleep quality: a test of mediating pathways

PubMed Central

Cribbet, Matthew; Kent de Grey, Robert G.; Cronan, Sierra; Trettevik, Ryan; Smith, Timothy W.

2016-01-01

Dispositional optimism has been related to beneficial influences on physical health outcomes. However, its links to global sleep quality and the psychological mediators responsible for such associations are less studied. This study thus examined if trait optimism predicted global sleep quality, and if measures of subjective well-being were statistical mediators of such links. A community sample of 175 participants (93 men, 82 women) completed measures of trait optimism, depression, and life satisfaction. Global sleep quality was assessed using the Pittsburgh Sleep Quality Index. Results indicated that trait optimism was a strong predictor of better PSQI global sleep quality. Moreover, this association was mediated by depression and life satisfaction in both single and multiple mediator models. These results highlight the importance of optimism for the restorative process of sleep, as well as the utility of multiple mediator models in testing distinct psychological pathways. PMID:27592128

Dispositional optimism and sleep quality: a test of mediating pathways.

PubMed

Uchino, Bert N; Cribbet, Matthew; de Grey, Robert G Kent; Cronan, Sierra; Trettevik, Ryan; Smith, Timothy W

2017-04-01

Dispositional optimism has been related to beneficial influences on physical health outcomes. However, its links to global sleep quality and the psychological mediators responsible for such associations are less studied. This study thus examined if trait optimism predicted global sleep quality, and if measures of subjective well-being were statistical mediators of such links. A community sample of 175 participants (93 men, 82 women) completed measures of trait optimism, depression, and life satisfaction. Global sleep quality was assessed using the Pittsburgh Sleep Quality Index. Results indicated that trait optimism was a strong predictor of better PSQI global sleep quality. Moreover, this association was mediated by depression and life satisfaction in both single and multiple mediator models. These results highlight the importance of optimism for the restorative process of sleep, as well as the utility of multiple mediator models in testing distinct psychological pathways.

[Congresses of the Spanish Association of Pediatrics: bibliometric analysis as a springboard for debate].

PubMed

González de Dios, J; Paredes Cencillo, C

2004-12-01

Congresses are periodic meetings that are required to make known and discuss advances in the various fields of medicine. Bibliometric indicators are important tools used to determine the quality of scientific publications. However, this type of study is infrequently performed in free communications of congresses. A bibliometric study of all the free communications published in the congresses of the Spanish Association of Pediatrics over 4 years, divided in two periods (1996-1997 and 2000-2001) (n = 2677) was performed. Bibliometric indicators were classified into quantitative (productivity), qualitative (statistical accessibility) and scientific evidence. Quantitative indicators: There were 928 free communications in 1996, 681 in 1997, 560 in 2000, and 508 in 2001. Eighty-eight percent were in poster format and 87 % were in structured format. There was a median of six authors per communication. The main subject areas were infectology, neonatology, hemato-oncology, neurology and endocrinology. Ninety-five per cent of communications were signed by hospitals with a marked contribution by hospitals in Andalusia and Madrid. Qualitative indicators: Statistical accessibility < 2 in 86 % and > 7 in 2.9 %. Scientific evidence indicators: The quality of scientific evidence was good in only 1 % and was average in 9 %, since 90 % of all the studies were descriptive (mainly clinical cases). Evidence-based methodological concepts were used in only 1.9 %. Compared with 1996-1997, in 2000-2001 there were fewer communications, more posters, and more structured communications, as well as greater statistical accessibility and better scientific evidence indicators, but these differences were not statistically significant. Bibliometric study of the congresses of the Spanish Association of Pediatrics is a good starting point to analyze the quality of pediatric meetings and discuss possible solutions: a rigorous scientific committee with quality criteria, more analytical and/or experimental studies and fewer descriptive studies (especially clinical cases); restricting the number of authors per communication, greater collaboration with epidemiologists and/or biostatisticians, and favoring structured communications would also improve quality.

Modelling Parameters Characterizing Selected Water Supply Systems in Lower Silesia Province

NASA Astrophysics Data System (ADS)

Nowogoński, Ireneusz; Ogiołda, Ewa

2017-12-01

The work presents issues of modelling water supply systems in the context of basic parameters characterizing their operation. In addition to typical parameters, such as water pressure and flow rate, assessing the age of the water is important, as a parameter of assessing the quality of the distributed medium. The analysis was based on two facilities, including one with a diverse spectrum of consumers, including residential housing and industry. The carried out simulations indicate the possibility of the occurrence of water quality degradation as a result of excessively long periods of storage in the water supply network. Also important is the influence of the irregularity of water use, especially in the case of supplying various kinds of consumers (in the analysed case - mining companies).

The relationship between health and mating success in humans

PubMed Central

Rhodes, Gillian 

2017-01-01

Health has been claimed to play an important role in human sexual selection, especially in terms of mate choice. Our preferences for attractive individuals are said to represent evolved adaptations for finding high-quality, healthy mates. If this is true, then we expect health to predict mating success in humans. We tested this hypothesis using several important physiological indicators of health, including immune function, oxidative stress and semen quality, and self-reported measures of sexual behaviour that contribute to mating success. In contrast to our hypothesis, we did not find a relationship between the physiological measures of health and sexual behaviour. Our results provide little support for claims that health, at least the health measures we used, increases mating success in relatively healthy humans. PMID:28280558

Water Environment Assessment as an Ecological Red Line Management Tool for Marine Wetland Protection

PubMed Central

Zhang, Yinan; Chu, Chunli; Liu, Lei; Xu, Shengguo; Ruan, Xiaoxue; Ju, Meiting

2017-01-01

A ‘red line’ was established, identifying an area requiring for ecological protection in Tianjin, China. Within the protected area of the red line area, the Qilihai wetland is an important ecotope with complex ecological functions, although the ecosystem is seriously disturbed due to anthropogenic activities in the surrounding areas. This study assesses the water quality status of the Qilihai wetlands to identify the pollution sources and potential improvements based on the ecological red line policy, to improve and protect the waters of the Qilihai wetlands. An indicator system was established to assess water quality status using single factor evaluation and a comprehensive evaluation method, supported by data from 2010 to 2013. Assessment results show that not all indicators met the requirement of the Environmental Quality Standards for Surface Water (GB3838-2002) and that overall, waters in the Qilihai wetland were seriously polluted. Based on these findings we propose restrictions on all polluting anthropogenic activities in the red line area and implementation of restoration projects to improve water quality. PMID:28767096

Motorcycle helmets in Vietnam: ownership, quality, purchase price, and affordability.

PubMed

Hung, Dang Viet; Stevenson, Mark R; Ivers, Rebecca Q

2008-06-01

This study investigated motorcycle helmet ownership, quality, purchase price, and affordability in Vietnam. A random sample of motorcyclists was interviewed to investigate aspects of helmet ownership, the purchase price, and affordability of a motorcycle helmet. Multivariate modeling conducted to determine factors associated with the purchase price and affordability of motorcycle helmets. Helmet quality was assessed based on current legal requirements in Vietnam. The prevalence of helmet use in Vietnam remains low (23.3%) despite a high level of helmet ownership (94%), indicating that this is an important area for public health intervention. Overall the quality of helmets appeared to be good; however, few helmets displayed legally required information. Motorcyclists with a high income purchase more helmets for their household rather than more expensive helmets. To ensure that helmets are accessible to the community, policy-makers need to consider pricing motorcycle helmets at a price indicated by the results of this study. Prior to universal motorcycle helmet legislation, the government will also need to ensure that standard helmets are available and that enforcement is at a level to ensure that motorcycle helmets are actually used.

Do inclusive work environments matter? Effects of community-integrated employment on quality of life for individuals with intellectual disabilities.

PubMed

Blick, Rachel N; Litz, Katherine S; Thornhill, Monica G; Goreczny, Anthony J

2016-01-01

More individuals with an intellectual disability now possess prerequisite skills and supports necessary for successful work force integration than did previous generations. The current study compared quality of life of community-integrated workers with those participating in sheltered vocational workshops and adult day care programs. We considered numerous indices of quality of life, including inclusion and community participation; satisfaction within professional services, home life, and day activities; dignity, rights, and respect received from others; fear; choice and control; and family satisfaction. Our data revealed several important differences in quality of life across daytime activities; participants involved in community-integrated employment tended to be younger, indicated a greater sense of community integration, and reported more financial autonomy than did those who participated in adult day care programs and sheltered workshops. However, individuals reported no differences in overall satisfaction across daytime activities. We discuss generational differences across employment status as well as possible explanations to account for high levels of satisfaction across daytime activities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Application of advanced data collection and quality assurance methods in open prospective study - a case study of PONS project.

PubMed

Wawrzyniak, Zbigniew M; Paczesny, Daniel; Mańczuk, Marta; Zatoński, Witold A

2011-01-01

Large-scale epidemiologic studies can assess health indicators differentiating social groups and important health outcomes of the incidence and mortality of cancer, cardiovascular disease, and others, to establish a solid knowledgebase for the prevention management of premature morbidity and mortality causes. This study presents new advanced methods of data collection and data management systems with current data quality control and security to ensure high quality data assessment of health indicators in the large epidemiologic PONS study (The Polish-Norwegian Study). The material for experiment is the data management design of the large-scale population study in Poland (PONS) and the managed processes are applied into establishing a high quality and solid knowledge. The functional requirements of the PONS study data collection, supported by the advanced IT web-based methods, resulted in medical data of a high quality, data security, with quality data assessment, control process and evolution monitoring are fulfilled and shared by the IT system. Data from disparate and deployed sources of information are integrated into databases via software interfaces, and archived by a multi task secure server. The practical and implemented solution of modern advanced database technologies and remote software/hardware structure successfully supports the research of the big PONS study project. Development and implementation of follow-up control of the consistency and quality of data analysis and the processes of the PONS sub-databases have excellent measurement properties of data consistency of more than 99%. The project itself, by tailored hardware/software application, shows the positive impact of Quality Assurance (QA) on the quality of outcomes analysis results, effective data management within a shorter time. This efficiency ensures the quality of the epidemiological data and indicators of health by the elimination of common errors of research questionnaires and medical measurements.

Water shortage and quality of fleshy fruits--making the most of the unavoidable.

PubMed

Ripoll, Julie; Urban, Laurent; Staudt, Michael; Lopez-Lauri, Félicie; Bidel, Luc P R; Bertin, Nadia

2014-08-01

Extreme climatic events, including drought, are predicted to increase in intensity, frequency, and geographic extent as a consequence of global climate change. In general, to grow crops successfully in the future, growers will need to adapt to less available water and to take better advantage of the positive effects of drought. Fortunately, there are positive effects associated with drought. Drought stimulates the secondary metabolism, thereby potentially increasing plant defences and the concentrations of compounds involved in plant quality, particularly taste and health benefits. The role of drought on the production of secondary metabolites is of paramount importance for fruit crops. However, to manage crops effectively under conditions of limited water supply, for example by applying deficit irrigation, growers must consider not only the impact of drought on productivity but also on how plants manage the primary and secondary metabolisms. This question is obviously complex because during water deficit, trade-offs among productivity, defence, and quality depend upon the intensity, duration, and repetition of events of water deficit. The stage of plant development during the period of water deficit is also crucial, as are the effects of other stressors. In addition, growers must rely on relevant indicators of water status, i.e. parameters involved in the relevant metabolic processes, including those affecting quality. Although many reports on the effects of drought on plant function and crop productivity have been published, these issues have not been reviewed thus far. Here, we provide an up-to-date review of current knowledge of the effects of different forms of drought on fruit quality relative to the primary and secondary metabolisms and their interactions. We also review conventional and less conventional indicators of water status that could be used for monitoring purposes, such as volatile compounds. We focus on fruit crops owing to the importance of secondary metabolism in fruit quality and the importance of fruits in the human diet. The issue of defence is also briefly discussed. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes.

PubMed

Driessen, Sara R C; Van Zwet, Erik W; Haazebroek, Pascal; Sandberg, Evelien M; Blikkendaal, Mathijs D; Twijnstra, Andries R H; Jansen, Frank Willem

2016-12-01

The current health care system has an urgent need for tools to measure quality. A wide range of quality indicators have been developed in an attempt to differentiate between high-quality and low-quality health care processes. However, one of the main issues of currently used indicators is the lack of case-mix correction and improvement possibilities. Case-mix is defined as specific (patient) characteristics that are known to potentially affect (surgical) outcome. If these characteristics are not taken into consideration, comparisons of outcome among health care providers may not be valid. The objective of the study was to develop and test a quality assessment tool for laparoscopic hysterectomy, which can serve as a new outcome quality indicator. This is a prospective, international, multicenter implementation study. A web-based application was developed with 3 main goals: (1) to measure the surgeon's performance using 3 primary outcomes (blood loss, operative time, and complications); (2) to provide immediate individual feedback using cumulative observed-minus-expected graphs; and (3) to detect consistently suboptimal performance after correcting for case-mix characteristics. All gynecologists who perform laparoscopic hysterectomies were requested to register their procedures in the application. A patient safety risk factor checklist was used by the surgeon for reflection. Thereafter a prospective implementation study was performed, and the application was tested using a survey that included the System Usability Scale. A total of 2066 laparoscopic hysterectomies were registered by 81 gynecologists. Mean operative time was 100 ± 39 minutes, blood loss 127 ± 163 mL, and the complication rate 6.1%. The overall survey response rate was 75%, and the mean System Usability Scale was 76.5 ± 13.6, which indicates that the application was good to excellent. The majority of surgeons reported that the application made them more aware of their performance, the outcomes, and patient safety, and they noted that the application provided motivation for improving future performance. We report the development and test of a real-time, dynamic, quality assessment tool for measuring individual surgical outcome for laparoscopic hysterectomy. Importantly, this tool provides opportunities for improving surgical performance. Our study provides a foundation for helping clinicians develop evidence-based quality indicators for other surgical procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

Metagenomic sequencing reveals the relationship between microbiota composition and quality of Chinese Rice Wine

PubMed Central

Hong, Xutao; Chen, Jing; Liu, Lin; Wu, Huan; Tan, Haiqin; Xie, Guangfa; Xu, Qian; Zou, Huijun; Yu, Wenjing; Wang, Lan; Qin, Nan

2016-01-01

Chinese Rice Wine (CRW) is a common alcoholic beverage in China. To investigate the influence of microbial composition on the quality of CRW, high throughput sequencing was performed for 110 wine samples on bacterial 16S rRNA gene and fungal Internal Transcribed Spacer II (ITS2). Bioinformatic analyses demonstrated that the quality of yeast starter and final wine correlated with microbial taxonomic composition, which was exemplified by our finding that wine spoilage resulted from a high proportion of genus Lactobacillus. Subsequently, based on Lactobacillus abundance of an early stage, a model was constructed to predict final wine quality. In addition, three batches of 20 representative wine samples selected from a pool of 110 samples were further analyzed in metagenomics. The results revealed that wine spoilage was due to rapid growth of Lactobacillus brevis at the early stage of fermentation. Gene functional analysis indicated the importance of some pathways such as synthesis of biotin, malolactic fermentation and production of short-chain fatty acid. These results led to a conclusion that metabolisms of microbes influence the wine quality. Thus, nurturing of beneficial microbes and inhibition of undesired ones are both important for the mechanized brewery. PMID:27241862

Metagenomic sequencing reveals the relationship between microbiota composition and quality of Chinese Rice Wine.

PubMed

Hong, Xutao; Chen, Jing; Liu, Lin; Wu, Huan; Tan, Haiqin; Xie, Guangfa; Xu, Qian; Zou, Huijun; Yu, Wenjing; Wang, Lan; Qin, Nan

2016-05-31

Chinese Rice Wine (CRW) is a common alcoholic beverage in China. To investigate the influence of microbial composition on the quality of CRW, high throughput sequencing was performed for 110 wine samples on bacterial 16S rRNA gene and fungal Internal Transcribed Spacer II (ITS2). Bioinformatic analyses demonstrated that the quality of yeast starter and final wine correlated with microbial taxonomic composition, which was exemplified by our finding that wine spoilage resulted from a high proportion of genus Lactobacillus. Subsequently, based on Lactobacillus abundance of an early stage, a model was constructed to predict final wine quality. In addition, three batches of 20 representative wine samples selected from a pool of 110 samples were further analyzed in metagenomics. The results revealed that wine spoilage was due to rapid growth of Lactobacillus brevis at the early stage of fermentation. Gene functional analysis indicated the importance of some pathways such as synthesis of biotin, malolactic fermentation and production of short-chain fatty acid. These results led to a conclusion that metabolisms of microbes influence the wine quality. Thus, nurturing of beneficial microbes and inhibition of undesired ones are both important for the mechanized brewery.

Effects of egg size, parental quality and hatch-date on growth and survival of Common Tern Sterna hirundo chicks

USGS Publications Warehouse

Arnold, J.M.; Hatch, J.J.; Nisbet, I.C.T.

2006-01-01

We examined the relative contributions of egg size, parental quality and hatch-date to growth and survival of second-hatched chicks (those chicks making the greatest contribution to differences in productivity among pairs) by exchanging clutches among nests of Common Terns Sterna hirundo matched for lay-date (range 13 May to 9 June). The mass of a second-laid egg in an exchanged clutch ranged from 17.70 to 23.80 g. Growth and survival were studied during three periods: early (days 0-3), middle (days 3-12) and late (days 12-25). Both egg mass and hatch-date were important predictors of hatchling mass (positive relationships), although there was no seasonal trend in egg mass. During the middle period, hatch-date was a significant predictor of mass gain and survival (inverse relationships). After controlling for hatch-date, other indices of parental quality made only small contributions to chick mass gain and survival. Our results suggest that although breeding early generally leads to greater overall survival of chicks, several important interactions among egg 'quality', parental quality and early laying may affect breeding success under specific conditions. ?? 2006 British Ornithologists' Union.

Long story short: an introduction to the short-term and long-term Six Sigma quality and its importance in the laboratory medicine for the management of extra-analytical processes.

PubMed

Ialongo, Cristiano; Bernardini, Sergio

2018-06-18

There is a compelling need for quality tools that enable effective control of the extra-analytical phase. In this regard, Six Sigma seems to offer a valid methodological and conceptual opportunity, and in recent times, the International Federation of Clinical Chemistry and Laboratory Medicine has adopted it for indicating the performance requirements for non-analytical laboratory processes. However, the Six Sigma implies a distinction between short-term and long-term quality that is based on the dynamics of the processes. These concepts are still not widespread and applied in the field of laboratory medicine although they are of fundamental importance to exploit the full potential of this methodology. This paper reviews the Six Sigma quality concepts and shows how they originated from Shewhart's control charts, in respect of which they are not an alternative but a completion. It also discusses the dynamic nature of process and how it arises, concerning particularly the long-term dynamic mean variation, and explains why this leads to the fundamental distinction of quality we previously mentioned.

Perceived School Climate and Chinese Adolescents' Suicidal Ideation and Suicide Attempts: The Mediating Role of Sleep Quality.

PubMed

Li, Dongping; Bao, Zhenzhou; Li, Xian; Wang, Yanhui

2016-02-01

School factors play important roles in adolescent suicide. However, little is known about how school climate is associated with adolescent suicide. This study examined the relationship between perceived school climate and adolescent suicidal ideation and suicide attempts, and whether these relations were explained by adolescent sleep quality. A total of 1529 Chinese adolescents (mean age = 14.74 years; 52% boys) participated in the study. They provided self-report data on control variables, perceived school climate, sleep quality, suicidal ideation, and suicide attempts. After controlling for sex, age, family structure, socioeconomic status, and parent-adolescent attachment, we found that perceived school climate negatively predicted adolescent suicidal ideation (odds ratio [OR] = 0.66, p < .001) and suicide attempts (OR = 0.72, p < .001). Moreover, perceived school climate positively predicated adolescent sleep quality (β = 0.13, p < .001), which in turn, negatively predicted adolescent suicidal ideation (OR = 0.75, p < .001) and suicide attempts (OR = 0.76, p < .001). These findings, although cross-sectional, indicate that perceived school climate plays an important role in adolescent suicidality. Moreover, the relation between perceived school climate and adolescent suicidality was largely mediated by adolescent sleep quality. © 2016, American School Health Association.

Measurement of Health Care Quality in Atopic Dermatitis - Development and Application of a Set of Quality Indicators.

PubMed

Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M

2018-05-15

Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Healthcare preferences of lesbian, gay, bisexual, transgender and questioning youth.

PubMed

Hoffman, Neal D; Freeman, Katherine; Swann, Stephanie

2009-09-01

Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth appear to be at higher risk for certain adverse health outcomes, and to have several personal, cultural and structural barriers to accessing healthcare. Little is known, however, about the experiences of LGBTQ youth with healthcare providers and healthcare services. Our goal was to recruit a sample of LGBTQ youth and to determine their preferences regarding healthcare providers, healthcare settings and the health issues that they consider important to discuss with a healthcare provider. We conducted a cross-sectional Internet-based survey. Respondents ages 13-21 years and living in the U.S. or Canada were asked to review three lists of items pertaining to qualities of healthcare providers, qualities of offices or health centers, and concerns or problems to discuss with a healthcare provider, and then to assign for each item a relative importance. Items in each of the three lists were then ranked, and differences among ranks were assessed. Inter-group differences by age, gender, and race/ethnicity were also assessed. 733 youth met eligibility criteria. Youth indicated as most important competence overall and specifically in issues unique to taking care of youth and LGBTQ persons, as well as being respected and treated by providers the same as other youth. Notably, youth ranked as least important the provider's gender and sexual orientation. Youth ranked accessibility issues higher than specific services provided. As health concerns to discuss with a provider, youth ranked preventive healthcare, nutrition, safe sex, and family as important as common morbidities. Youth placed as much importance on provider qualities and interpersonal skills as provider knowledge and experience, and placed little importance on a provider's gender and sexual orientation. Youth indicated the importance of providers addressing not only health risks, but also wellness and health promotion, and to do so within the context of home and family. Subgroup analyses underscore the need for greater sensitivity to both cultural and developmental differences among LGBTQ youth. These results provide a foundation for further research about healthcare services and delivery systems for youth, training initiatives for healthcare providers, and the role of utilizing the Internet for health research purposes to access and recruit hard-to-reach youth.

Health-related quality of life of Chinese people with schizophrenia in Hong Kong and Taipei: a cross-sectional analysis.

PubMed

Chan, Sally Wai-chi; Hsiung, Ping-Chuan; Thompson, David R; Chen, Shin-Chia; Hwu, Hai-Gwo

2007-06-01

Health-related quality of life is an important outcome indicator of mental health. We assessed the perception of health-related quality of life of persons with schizophrenia in Hong Kong and Taipei. In-person survey interviews were conducted using the Chinese World Health Organization Quality of Life Scale--Brief Version. A convenience sample was recruited from psychiatric outpatient departments: 176 from Hong Kong and 80 from Taipei. We found that both groups were significantly less satisfied with their psychological and social relationship domains compared to other domains. Poor mental health predicted poor perception of health-related quality of life. Schizophrenia has an impact on many aspects of a person's functioning. A rehabilitation model that takes into account symptoms, financial situation, family support, and social functioning is required.

Factors influencing the quality of life of infertile women in United Arab Emirates.

PubMed

Khayata, G M; Rizk, D E E; Hasan, M Y; Ghazal-Aswad, S; Asaad, M A N

2003-02-01

To measure the quality of life in a representative sample of infertile women and evaluate their sociocultural attitude to this condition. Two hundred sixty-nine infertile women attending the Assisted Reproduction clinic, Tawam Hospital were consecutively selected. They were interviewed about the effect of infertility on their quality of life using a structured, measurement-specific and pre-tested questionnaire. Parameters mostly affected were mood-related mainly in women above 30 years, with primary and female factor infertility and those in polygamous marriages. Quality of life did not affect sexual performance and was not affected by duration of infertility or cost of treatment. The results highlight the importance of bearing children and the stresses exerted on infertile women in Eastern societies. Thorough counseling and continuing support of infertile women is therefore indicated to improve their quality of life.

Health system frameworks and performance indicators in eight countries: A comparative international analysis

PubMed Central

Braithwaite, Jeffrey; Hibbert, Peter; Blakely, Brette; Plumb, Jennifer; Hannaford, Natalie; Long, Janet Cameron; Marks, Danielle

2017-01-01

Objectives: Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. Few studies make comparative assessments of different countries’ performance indicator frameworks. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Methods: Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Two dimensions of indicators – that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) – were deemed important. Results: The most commonly used domains in performance frameworks were safety, effectiveness and access. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. Of these, 45 indicators are reported in more than one country. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Conclusion: These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets. PMID:28228948

Grip Strength as an Indicator of Health-Related Quality of Life in Old Age-A Pilot Study.

PubMed

Musalek, Christina; Kirchengast, Sylvia

2017-11-24

Over the last century life expectancy has increased dramatically nearly all over the world. This dramatic absolute and relative increase of the old aged people component of the population has influenced not only population structure but also has dramatic implications for the individuals and public health services. The aim of the present pilot study was to examine the impact of physical well-being assessed by hand grip strength and social factors estimated by social contact frequency on health-related quality of life among 22 men and 41 women ranging in age between 60 and 94 years. Physical well-being was estimated by hand grip strength, data concerning subjective wellbeing and health related quality of life were collected by personal interviews based on the WHOQOL-BREF questionnaires. Number of offspring and intergenerational contacts were not related significantly to health-related quality of life, while social contacts with non-relatives and hand grip strength in contrast had a significant positive impact on health related quality of life among old aged men and women. Physical well-being and in particular muscle strength-estimated by grip strength-may increase health-related quality of life and is therefore an important source for well-being during old age. Grip strength may be used as an indicator of health-related quality of life.

Complexity in action: Untangling latent relationships between land quality, economic structures and socio-spatial patterns in Italy.

PubMed

Salvati, Luca; Tombolini, Ilaria; Gemmiti, Roberta; Carlucci, Margherita; Bajocco, Sofia; Perini, Luigi; Ferrara, Agostino; Colantoni, Andrea

2017-01-01

Land quality, a key economic capital supporting local development, is affected by biophysical and anthropogenic factors. Taken as a relevant attribute of economic systems, land quality has shaped the territorial organization of any given region influencing localization of agriculture, industry and settlements. In regions with long-established human-landscape interactions, such as the Mediterranean basin, land quality has determined social disparities and polarization in the use of land, reflecting the action of geographical gradients based on elevation and population density. The present study investigates latent relationships within a large set of indicators profiling local communities and land quality on a fine-grained resolution scale in Italy with the aim to assess the potential impact of land quality on the regional socioeconomic structure. The importance of land quality gradients in the socioeconomic configuration of urban and rural regions was verified analyzing the distribution of 149 socioeconomic and environmental indicators organized in 5 themes and 17 research dimensions. Agriculture, income, education and labour market variables discriminate areas with high land quality from areas with low land quality. While differential land quality in peri-urban areas may reflect conflicts between competing actors, moderate (or low) quality of land in rural districts is associated with depopulation, land abandonment, subsidence agriculture, unemployment and low educational levels. We conclude that the socioeconomic profile of local communities has been influenced by land quality in a different way along urban-rural gradients. Policies integrating environmental and socioeconomic measures are required to consider land quality as a pivotal target for sustainable development. Regional planning will benefit from an in-depth understanding of place-specific relationships between local communities and the environment.

Complexity in action: Untangling latent relationships between land quality, economic structures and socio-spatial patterns in Italy

PubMed Central

Salvati, Luca; Tombolini, Ilaria; Gemmiti, Roberta; Carlucci, Margherita; Bajocco, Sofia; Perini, Luigi; Ferrara, Agostino

2017-01-01

Land quality, a key economic capital supporting local development, is affected by biophysical and anthropogenic factors. Taken as a relevant attribute of economic systems, land quality has shaped the territorial organization of any given region influencing localization of agriculture, industry and settlements. In regions with long-established human-landscape interactions, such as the Mediterranean basin, land quality has determined social disparities and polarization in the use of land, reflecting the action of geographical gradients based on elevation and population density. The present study investigates latent relationships within a large set of indicators profiling local communities and land quality on a fine-grained resolution scale in Italy with the aim to assess the potential impact of land quality on the regional socioeconomic structure. The importance of land quality gradients in the socioeconomic configuration of urban and rural regions was verified analyzing the distribution of 149 socioeconomic and environmental indicators organized in 5 themes and 17 research dimensions. Agriculture, income, education and labour market variables discriminate areas with high land quality from areas with low land quality. While differential land quality in peri-urban areas may reflect conflicts between competing actors, moderate (or low) quality of land in rural districts is associated with depopulation, land abandonment, subsidence agriculture, unemployment and low educational levels. We conclude that the socioeconomic profile of local communities has been influenced by land quality in a different way along urban-rural gradients. Policies integrating environmental and socioeconomic measures are required to consider land quality as a pivotal target for sustainable development. Regional planning will benefit from an in-depth understanding of place-specific relationships between local communities and the environment. PMID:28574984

Smoking Cessation in a Chronic Pancreatitis Population

PubMed Central

Han, Samuel; Kheder, Joan; Bocelli, Lisa; Fahed, Julien; Wachholtz, Amy; Seward, Gregory; Wassef, Wahid

2016-01-01

Objectives Smoking is a known risk factor for developing chronic pancreatitis and accelerates disease progression. Smoking cessation remains an important treatment recommendation, but little is known about its effects. This study evaluated smoking cessation in this population and its impact on quality of life. Methods 27 smokers with chronic pancreatitis participated in a smoking cessation program incorporating the QuitWorks program and individual counseling. Their smoking cessation rates were compared with a control population (n=200) consisting of in-patients without chronic pancreatitis who smoked. Smokers were also compared with non-smokers (n=25) with chronic pancreatitis in terms of quality of life indicators. Results 0/27 patients had quit smoking at 6 months, 1/27 at 12 months, and 0/27 patients at 18 months. There was a 19% quit rate in the control population at the 6-month period. Smokers had a worse quality of life, higher rates of depression and anxiety, and worse coping skills than non-smokers. Conclusions Smoking cessation in the chronic pancreatitis population is extremely challenging, as shown by our 0% quit rate after 18 months. Given that smokers with chronic pancreatitis also experience a worse quality of life, it becomes even more important to stress the importance of smoking cessation in these patients. PMID:27101574

HDP for the Neutralized pH Value Control in the Clarifying Process of Sugar Cane Juice

NASA Astrophysics Data System (ADS)

Lin, Xiaofeng; Yang, Jiaran

2009-05-01

Neutralizing pH value of sugar cane juice is the important craft in the control process in the clarifying process of sugar cane juice, which is the important factor to influence output and the quality of white sugar. On the one hand, it is an important content to control the neutralized pH value within a required range, which has the vital significance for acquiring high quality purified juice, reducing energy consumption and raising sucrose recovery. On the other hand, it is a complicated physical-chemistry process, which has the characteristics of strong non-linearity, time-varying, large time-delay, and multi-input. Therefore, there has not been a very good solution to control the neutralized pH value. Firstly, in this chapter, a neural network model for the clarifying process of sugar juice is established based on gathering 1200 groups of real-time sample data in a sugar factory. Then, the HDP (Heuristic Dynamic Programming) method is used to optimize and control the neutralized pH value in the clarifying process of sugar juice. Simulation results indicate that this method has good control effect. This will build a good foundation for stabilizing the clarifying process and enhancing the quality of the purified juice and lastly enhancing the quality of white sugar.

What is a 'good' job? Modelling job quality for blue collar workers.

PubMed

Jones, Wendy; Haslam, Roger; Haslam, Cheryl

2017-01-01

This paper proposes a model of job quality, developed from interviews with blue collar workers: bus drivers, manufacturing operatives and cleaners (n  =  80). The model distinguishes between core features, important for almost all workers, and 'job fit' features, important to some but not others, or where individuals might have different preferences. Core job features found important for almost all interviewees included job security, personal safety and having enough pay to meet their needs. 'Job fit' features included autonomy and the opportunity to form close relationships. These showed more variation between participants; priorities were influenced by family commitments, stage of life and personal preference. The resulting theoretical perspective indicates the features necessary for a job to be considered 'good' by the person doing it, whilst not adversely affecting their health. The model should have utility as a basis for measuring and improving job quality and the laudable goal of creating 'good jobs'. Practitioner Summary: Good work can contribute positively to health and well-being, but there is a lack of agreement regarding the concept of a 'good' job. A model of job quality has been constructed based on semi-structured worker interviews (n  =  80). The model emphasises the need to take into account variation between individuals in their preferred work characteristics.

Understanding the City Size Wage Gap*

PubMed Central

Baum-Snow, Nathaniel; Pavan, Ronni

2013-01-01

In this paper, we decompose city size wage premia into various components. We base these decompositions on an estimated on-the-job search model that incorporates latent ability, search frictions, firm-worker match quality, human capital accumulation and endogenous migration between large, medium and small cities. Counterfactual simulations of the model indicate that variation in returns to experience and differences in wage intercepts across location type are the most important mechanisms contributing to observed city size wage premia. Variation in returns to experience is more important for generating wage premia between large and small locations while differences in wage intercepts are more important for generating wage premia betwen medium and small locations. Sorting on unobserved ability within education group and differences in labor market search frictions and distributions of firm-worker match quality contribute little to observed city size wage premia. These conclusions hold for separate samples of high school and college graduates. PMID:24273347

Iranian staff nurses' views of their productivity and management factors improving and impeding it: a qualitative study.

PubMed

Dehghan Nayeri, Nahid; Nazari, Ali Akbar; Salsali, Mahvash; Ahmadi, Fazlollah; Adib Hajbaghery, Mohsen

2006-03-01

As the biggest proportion of hospital personnel, Iranian nurses have a major role in providing quality care to patients. Nursing managers and nurses no longer feel that nurses' work is valued and they are concerned about their productivity. Nurses' views about productivity and management factors affecting it have been identified as the most important aspects affecting productivity. Thus, this study assesses productivity from the nurse's view. A grounded theory approach was used for this research. Purposive sampling and semistructured interviews were used. The data were analyzed using constant comparative analysis. Most participants felt that the qualitative nature (effectiveness) of productivity is very important. Also, participants indicated that management is the most important factor that can promote or impede their productivity. They suggested that managers' performance and their skill level are the factors influencing productivity. Effective management can improve nurses' productivity and the quality of care that nurses provide.

Understanding the City Size Wage Gap.

PubMed

Baum-Snow, Nathaniel; Pavan, Ronni

2012-01-01

In this paper, we decompose city size wage premia into various components. We base these decompositions on an estimated on-the-job search model that incorporates latent ability, search frictions, firm-worker match quality, human capital accumulation and endogenous migration between large, medium and small cities. Counterfactual simulations of the model indicate that variation in returns to experience and differences in wage intercepts across location type are the most important mechanisms contributing to observed city size wage premia. Variation in returns to experience is more important for generating wage premia between large and small locations while differences in wage intercepts are more important for generating wage premia betwen medium and small locations. Sorting on unobserved ability within education group and differences in labor market search frictions and distributions of firm-worker match quality contribute little to observed city size wage premia. These conclusions hold for separate samples of high school and college graduates.

A Novel Unsupervised Segmentation Quality Evaluation Method for Remote Sensing Images

PubMed Central

Tang, Yunwei; Jing, Linhai; Ding, Haifeng

2017-01-01

The segmentation of a high spatial resolution remote sensing image is a critical step in geographic object-based image analysis (GEOBIA). Evaluating the performance of segmentation without ground truth data, i.e., unsupervised evaluation, is important for the comparison of segmentation algorithms and the automatic selection of optimal parameters. This unsupervised strategy currently faces several challenges in practice, such as difficulties in designing effective indicators and limitations of the spectral values in the feature representation. This study proposes a novel unsupervised evaluation method to quantitatively measure the quality of segmentation results to overcome these problems. In this method, multiple spectral and spatial features of images are first extracted simultaneously and then integrated into a feature set to improve the quality of the feature representation of ground objects. The indicators designed for spatial stratified heterogeneity and spatial autocorrelation are included to estimate the properties of the segments in this integrated feature set. These two indicators are then combined into a global assessment metric as the final quality score. The trade-offs of the combined indicators are accounted for using a strategy based on the Mahalanobis distance, which can be exhibited geometrically. The method is tested on two segmentation algorithms and three testing images. The proposed method is compared with two existing unsupervised methods and a supervised method to confirm its capabilities. Through comparison and visual analysis, the results verified the effectiveness of the proposed method and demonstrated the reliability and improvements of this method with respect to other methods. PMID:29064416

A Dutch Nationwide Bariatric Quality Registry: DATO.

PubMed

Poelemeijer, Youri Q M; Liem, Ronald S L; Nienhuijs, Simon W

2017-12-22

In the Netherlands, the number of bariatric procedures increased exponentially in the 90s. To ensure and improve the quality of bariatric surgery, the nationwide Dutch Audit for Treatment of Obesity (DATO) was established in 2014. The audit was coordinated by the Dutch Institute for Clinical Auditing (DICA). This article provides a review of the aforementioned process in establishing a nationwide registry in the Netherlands. In collaboration with the DATO's scientific committee and other stakeholders, an annual list of several external quality indicators was formulated. This list consists of volume, process, and outcome indicators. In addition to the annual external indicators, the database permits individual hospitals to analyze their own data. The dashboard provides several standardized reports and detailed quality indicators, which are updated on a weekly base. Since the start, all 18 Dutch bariatric centers participated in the nationwide audit. A total of 21,941 cases were registered between 2015 and 2016. By 2016, the required variables were registered in 94.3% of all cases. A severe complicated course was seen in 2.87%, and mortality in 0.05% in 2016. The first-year follow-up shows a > 20% TWL in 86.1% of the registered cases. The DATO has become rapidly a mature registry. The well-organized structure of the national audit institution DICA and governmental funding were essential. However, most important were the bariatric teams themselves. The authors believe reporting the results from the registry has already contributed to more knowledge and acceptance by other health care providers.

Coal resources of New Mexico

USGS Publications Warehouse

Read, Charles Brian; Duffner, R.T.; Wood, G.H.; Zapp, A.D.

1950-01-01

A study of water quality degradation due to brine contamination was made in an area of about 1,700 sq mi in east-central Oklahoma. The study area coincides in part with the outcrop of the Vamoosa-Ada aquifer of Pennsylvanian age. Water samples collected from 180 wells completed in the Vamoosa-Ada aquifer and at 167 sites from streams draining the Vamoosa-Ada aquifer show scattered occurrences of water quality degradation by brine. Degradation of water quality by brine is indicated where: (1) chloride concentration is > or = to 400 mg/L; (2) bromide concentration is > or = 2 mg/L; (3) the ratio of sodium plus chloride to dissolved solids is > or = 0.64. Ratios of secondary importance that also indicate water quality degradation by brine in the area are: (1) a ratio of lithium to bromide < or = 0.01, when the chloride concentration is > or = 400 mg/L; (2) a sodium/chloride ratio of about 0.46; (3) a sodium/bromide ratio of about 92; and (4) a bromide/chloride ratio of about 0.0048. Values for bromide, lithium, strontium, dissolved solids, calcium, magnesium, sodium, chloride, and sulfate concentrations were subjected to analysis of variance based on use of the index values in partition data sets. The analysis of variance showed the significance of the indexes for all constituents except sulfate. The two most reliable brine indicators are chloride and bromide. Statistically, chloride is a slightly more reliable index than bromide. The developed indexes can be used to indicate water quality degradation by brine. Accuracy is improved if both indexes are used. When geophysical logs from 133 pairs of oil and gas wells were analyzed, data from 5 pairs of wells indicated a possible rise in the interface between fresh water and salt water in the Vamoosa-Ada aquifer. Therefore , any rise of the interface is local rather than regional. The criteria developed in this study indicate that brine has degraded water quality at 63 sites on streams draining the Vamoosa-Ada aquifer, at 15 water wells completed in the Vamoosa-Ada aquifer, and at 5 oil and gas wells penetrating the Vamoosa-Ada aquifer. (Author 's abstract)

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

USGS Publications Warehouse

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

2015-01-01

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

Improving cancer patient care: development of a generic cancer consumer quality index questionnaire for cancer patients

PubMed Central

2013-01-01

Background To develop a Consumer Quality Index (CQI) Cancer Care questionnaire for measuring experiences with hospital care of patients with different types of cancer. Methods We derived quality aspects from focus group discussions, existing questionnaires and literature. We developed an experience questionnaire and sent it to 1,498 Dutch cancer patients. Another questionnaire measuring the importance of the quality aspects was sent to 600 cancer patients. Data were psychometrically analysed. Results The response to the experience questionnaire was 50 percent. Psychometric analysis revealed 12 reliable scales. Patients rated rapid and adequate referral, rapid start of the treatment after diagnosis, enough information and confidence in the healthcare professionals as most important themes. Hospitals received high scores for skills and cooperation of healthcare professionals and a patient-centered approach by doctors; and low scores for psychosocial guidance and information at completion of the treatment. Conclusions The CQI Cancer Care questionnaire is a valuable tool for the evaluation of the quality of cancer care from the patient’s perspective. Large scale implementation is necessary to determine the discriminatory powers of the questionnaire and may enable healthcare providers to improve the quality of cancer care. Preliminary results indicate that hospitals could improve their psychosocial guidance and information provision. PMID:23617741

Dietary composition of black drum Pogonias cromis in a hypersaline estuary reflects water quality and prey availability.

PubMed

Rubio, K S; Ajemian, M; Stunz, G W; Palmer, T A; Lebreton, B; Beseres Pollack, J

2018-06-22

The Baffin Bay estuary is a hypersaline system in the Gulf of Mexico that supports an important recreational and commercial fishery for black drum Pogonias cromis, a benthic predator. Seasonal measurements of water quality variables, benthic macrofauna densities and biomass, and determination of P. cromis food sources using stomach-content and stable-isotope analyses were carried out to determine how P. cromis food sources change with water quality and how this may affect P. cromis diet. Gut-content analysis indicated P. cromis selectively consumed bivalves Mulinia lateralis and Anomalocardia auberiana. Isotope compositions demonstrated that P. cromis relied on these benthic food resources produced in the Baffin Bay estuary year-round. Biomass and densities of these bivalves were influenced by changes in water quality variables, particularly salinity and dissolved oxygen. Thus, this paper demonstrates the relationship between water quality variables, benthic macrofauna, and their use as food resources by a carnivorous fish species, and emphasizes the need for integrated assessments when studying the effects of water quality on ecosystem function. Holistic approaches such as these can provide important information for management and conservation of fishery resources and can improve predictions of ecosystem response to climate variability. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Child anthropometry data quality from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and National Nutrition Surveys in the West Central Africa region: are we comparing apples and oranges?

PubMed Central

Corsi, Daniel J.; Perkins, Jessica M.; Subramanian, S. V.

2017-01-01

ABSTRACT Background: There has been limited work comparing survey characteristics and assessing the quality of child anthropometric data from population-based surveys. Objective: To investigate survey characteristics and indicators of quality of anthropometric data in children aged 0–59 months from 23 countries in the West Central Africa region. Methods: Using established methodologies and criteria to examine child age, sex, height, and weight, we conducted a comprehensive assessment and scoring of the quality of anthropometric data collected in 100 national surveys. Results: The Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) collected data from a greater number of younger children than older children while the opposite was found for the National Nutrition Surveys (NNS). Missing or implausible height/weight data proportions were 12% and 8% in MICS and DHS compared to 3% in NNS. Average data quality scores were 14 in NNS, 33 in DHS, and 41 in MICS. Conclusions: Although our metric of data quality suggests that data from the NNS appear more consistent and robust, it is equally important to consider its disadvantages related to access and lack of broader socioeconomic information. In comparison, the DHS and MICS are publicly-accessable for research and provide socioeconomic context essential for assessing and addressing the burden of undernutrition within and between countries. The strengths and weaknesses of data from these three sources should be carefully considered when seeking to determine the burden of child undernutrition and its variation within countries. PMID:28641057

Child anthropometry data quality from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and National Nutrition Surveys in the West Central Africa region: are we comparing apples and oranges?

PubMed

Corsi, Daniel J; Perkins, Jessica M; Subramanian, S V

2017-01-01

There has been limited work comparing survey characteristics and assessing the quality of child anthropometric data from population-based surveys. To investigate survey characteristics and indicators of quality of anthropometric data in children aged 0-59 months from 23 countries in the West Central Africa region. Using established methodologies and criteria to examine child age, sex, height, and weight, we conducted a comprehensive assessment and scoring of the quality of anthropometric data collected in 100 national surveys. The Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) collected data from a greater number of younger children than older children while the opposite was found for the National Nutrition Surveys (NNS). Missing or implausible height/weight data proportions were 12% and 8% in MICS and DHS compared to 3% in NNS. Average data quality scores were 14 in NNS, 33 in DHS, and 41 in MICS. Although our metric of data quality suggests that data from the NNS appear more consistent and robust, it is equally important to consider its disadvantages related to access and lack of broader socioeconomic information. In comparison, the DHS and MICS are publicly-accessable for research and provide socioeconomic context essential for assessing and addressing the burden of undernutrition within and between countries. The strengths and weaknesses of data from these three sources should be carefully considered when seeking to determine the burden of child undernutrition and its variation within countries.

Hydrochemistry, water quality and land use signatures in an ephemeral tidal river: implications in water management in the southwestern coastal region of Bangladesh

NASA Astrophysics Data System (ADS)

Roy, Kushal; Karim, Md. Rezaul; Akter, Farjana; Islam, Md. Safiqul; Ahmed, Kousik; Rahman, Masudur; Datta, Dilip Kumar; Khan, M. Shah Alam

2018-05-01

Despite its complexity and importance in managing water resources in populous deltas, especially in tidal areas, literatures on tidal rivers and their land use linkage in connection to water quality and pollution are rare. Such information is of prior need for Integrated Water Resource Management in water scarce and climate change vulnerable regions, such as the southwestern coast of Bangladesh. Using water quality indices and multivariate analysis, we present here the land use signatures of a dying tidal river due to anthropogenic perturbation. Correlation matrix, hierarchical cluster analysis, factor analysis, and bio-geo-chemical fingerprints were used to quantify the hydro-chemical and anthropogenic processes and identify factors influencing the ionic concentrations. The results show remarkable spatial and temporal variations ( p < 0.05) in water quality parameters. The lowest solute concentrations are observed at the mid reach of the stream where the agricultural and urban wastewater mix. Agricultural sites show higher concentration of DO, Na+ and K+ reflecting the effects of tidal spill-over and shrimp wastewater effluents nearby. Higher level of Salinity, EC, Cl-, HCO3 -, NO3 -, PO4 3- and TSS characterize the urban sites indicating a signature of land use dominated by direct discharge of household organic waste into the waters. The spatial variation in overall water quality suggests a periodic enhancement of quality especially for irrigation and non-drinking purposes during monsoon and post-monsoon, indicating significant influence of amount of rainfall in the basin. We recommend that, given the recent trend of increasing precipitation and ground water table decrease, such dying tidal river basins may serve as excellent surface water reservoir to supplement quality water supply to the region.

A review of randomized controlled trials of medical record powered clinical decision support system to improve quality of diabetes care.

PubMed

Ali, Syed Mustafa; Giordano, Richard; Lakhani, Saima; Walker, Dawn Marie

2016-03-01

A gap between current diabetes care practice and recommended diabetes care standards has consistently been reported in the literature. Many IT-based interventions have been developed to improve adherence to the quality of care standards for chronic illness like diabetes. The widespread implementation of electronic medical/health records has catalyzed clinical decision support systems (CDSS) which may improve the quality of diabetes care. Therefore, the objective of the review is to evaluate the effectiveness of CDSS in improving quality of type II diabetes care. Moreover, the review aims to highlight the key indicators of quality improvement to assist policy makers in development of future diabetes care policies through the integration of information technology and system. Setting inclusion criteria, a systematic literature search was conducted using Medline, Web of Science and Science Direct. Critical Appraisal Skills Programme (CASP) tools were used to evaluate the quality of studies. Eight randomized controlled trials (RCTs) were selected for the review. In the selected studies, seventeen clinical markers of diabetes care were discussed. Three quality of care indicators were given more importance in monitoring the progress of diabetes care, which is consistent with National Institute for Health and Care Excellence (NICE) guidelines. The presence of these indicators in the studies helped to determine which studies were selected for review. Clinical- and process-related improvements are compared between intervention group using CDSS and control group with usual care. Glycated hemoglobin (HbA1c), low density lipid cholesterol (LDL-C) and blood pressure (BP) were the quality of care indicators studied at the levels of process of care and clinical outcome. The review has found both inconsistent and variable results for quality of diabetes care measures. A significant improvement has been found in the process of care for all three measures of quality of diabetes care. However, weak to modest positive results are observed for the clinical measures of the diabetes care indicators. In addition to this, technology adoption of CDSS is found to be consistently low. The review suggests the need to conduct further empirical research using the critical diabetes care indicators (HbA1c, LDL-C and BP) to ascertain if CDSS improves the quality of diabetes care. Research designs should be improved, especially with regard to baseline characteristics, sample size and study period. With respect to implementation of CDSS, rather than a sudden change of clinical work practice, there should instead be an incremental, gradual adoption of technology that minimizes the disruption in clinical workflow. Copyright © 2016. Published by Elsevier Ireland Ltd.

The Importance of Take-Out Food Packaging Attributes: Conjoint Analysis and Quality Function Deployment Approach

NASA Astrophysics Data System (ADS)

Lestari Widaningrum, Dyah

2014-03-01

This research aims to investigate the importance of take-out food packaging attributes, using conjoint analysis and QFD approach among consumers of take-out food products in Jakarta, Indonesia. The conjoint results indicate that perception about packaging material (such as paper, plastic, and polystyrene foam) plays the most important role overall in consumer perception. The clustering results that there is strong segmentation in which take-out food packaging material consumer consider most important. Some consumers are mostly oriented toward the colour of packaging, while another segment of customers concerns on packaging shape and packaging information. Segmentation variables based on packaging response can provide very useful information to maximize image of products through the package's impact. The results of House of Quality development described that Conjoint Analysis - QFD is a useful combination of the two methodologies in product development, market segmentation, and the trade off between customers' requirements in the early stages of HOQ process

Seasonal patterns in reproductive success of temperate-breeding birds: Experimental tests of the date and quality hypotheses.

PubMed

Harriman, Vanessa B; Dawson, Russell D; Bortolotti, Lauren E; Clark, Robert G

2017-04-01

For organisms in seasonal environments, individuals that breed earlier in the season regularly attain higher fitness than their late-breeding counterparts. Two primary hypotheses have been proposed to explain these patterns: The quality hypothesis contends that early breeders are of better phenotypic quality or breed on higher quality territories, whereas the date hypothesis predicts that seasonally declining reproductive success is a response to a seasonal deterioration in environmental quality. In birds, food availability is thought to drive deteriorating environmental conditions, but few experimental studies have demonstrated its importance while also controlling for parental quality. We tested predictions of the date hypothesis in tree swallows ( Tachycineta bicolor ) over two breeding seasons and in two locations within their breeding range in Canada. Nests were paired by clutch initiation date to control for parental quality, and we delayed the hatching date of one nest within each pair. Subsequently, brood sizes were manipulated to mimic changes in per capita food abundance, and we examined the effects of manipulations, as well as indices of environmental and parental quality, on nestling quality, fledging success, and return rates. Reduced reproductive success of late-breeding individuals was causally related to a seasonal decline in environmental quality. Declining insect biomass and enlarged brood sizes resulted in nestlings that were lighter, in poorer body condition, structurally smaller, had shorter and slower growing flight feathers and were less likely to survive to fledge. Our results provide evidence for the importance of food resources in mediating seasonal declines in offspring quality and survival.

Using concept mapping to design an indicator framework for addiction treatment centres.

PubMed

Nabitz, Udo; van Den Brink, Wim; Jansen, Paul

2005-06-01

The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. The setting is the Jellinek Centre based in Amsterdam, the Netherlands, which serves as a prototype for an addiction treatment centre. Concept mapping was used in the construction of the indicator framework. During the 1-day workshop, 16 stakeholders generated, prioritized and sorted 73 items concerning quality and performance. Multidimensional scaling and cluster analysis was applied in constructing a framework consisting of two dimensions and eight clusters. The horizontal axis of the indicator framework is named 'Organization' and has two poles, namely, 'Processes' and 'Results'. The vertical axis is named ' Task' and the poles are named 'Efficient treatment' and 'Prevention programs'. The eight clusters in the two-dimensional framework are arranged in the following, prioritized sequence: 'Efficient treatment network', 'Effective service', ' Target group', 'Quality of life', 'Efficient service', 'Knowledge transfer', 'Reducing addiction related problems', and 'Prevention programs'. The most important items in the framework are: 'patients are satisfied with their treatment', 'early interventions', and 'efficient treatment chain'. The indicator framework aligns with three clusters of the results criteria of the EFQM Excellence Model. It is based on the stakeholders' perspectives and is believed to be specific for addiction treatment centres. The study demonstrates that concept mapping is a suitable strategy for generating indicator frameworks.

Survival potential of Escherichia coli and Enterococci in subtropical beach sand: implications for water quality managers.

PubMed

Hartz, A; Cuvelier, M; Nowosielski, K; Bonilla, T D; Green, M; Esiobu, N; McCorquodale, D S; Rogerson, A

2008-01-01

Fecal bacteria have traditionally been used as indicator organisms to monitor the quality of recreational waters. Recent work has questioned the robustness of traditional indicators, particularly at seawater bathing beaches. For example, a study of Florida beaches found unexpectedly high abundances of Escherichia coli, fecal coliforms, and enterococci in beach sand. The aim of the present study was to explain these abundances by assessing the survival of E. coli and enterococci in beach sand relative to seawater. We used a combination of quantitative laboratory mesocosm experiments and field observations. Results suggested that E. coli and enterococci exhibited increased survivability and growth in sand relative to seawater. Because fecal bacteria are capable of replicating in sand, at least under controlled laboratory conditions, the results suggest that sand may be an important reservoir of metabolically active fecal organisms. Experiments with "natural" mesocosms (i.e., unsterilized sand or water rich in micropredators and native bacteria) failed to show the same increases in fecal indicators as was found in sterile sand. It is postulated that this was due to predation and competition with indigenous bacteria in these "natural" systems. Nonetheless, high populations of indicators were maintained and recovered from sand over the duration of the experiment as opposed to the die-off noted in water. Indicator bacteria may wash out of sand into shoreline waters during weather and tidal events, thereby decreasing the effectiveness of these indicators as predictors of health risk and complicating the interpretations for water quality managers.

The effect of an industrial effluent on an urban stream benthic community: water quality vs habitat quality.

PubMed

Nedeau, Ethan J; Merritt, Richard W; Kaufman, Michael G

2003-01-01

We studied the effect of an industrial effluent on the water quality, habitat quality, and benthic macroinvertebrates of an urban stream in southwestern Michigan (USA). The effluent affected water quality by raising in-stream temperatures 13-18 degree C during colder months and carrying high amounts of iron (> 20 x higher than ambient) that covered the streambed. The effluent also affected habitat conditions by increasing total stream discharge by 50-150%, causing a significant change in substrate and flow conditions. We used three methods to collect benthic macroinvertebrates in depositional and erosional habitats and to understand the relative importance of habitat quality and water quality alterations. Macroinvertebrate response variables included taxonomic richness, abundance, and proportional abundance of sensitive taxonomic groups. Results indicated that the effluent had a positive effect on macroinvertebrate communities by increasing the quantity of riffle habitat, but a negative effect on macroinvertebrate communities by reducing water quality. Results illustrated the need for careful consideration of habitat quality and water quality in restoration or remediation programs.

Do competition and managed care improve quality?

PubMed

Sari, Nazmi

2002-10-01

In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts. Copyright 2002 John Wiley & Sons, Ltd.

[Health-related quality of life of people with severe traumatic injury: a longitudinal study using the SF-36 health survey].

PubMed

Bauer, J; Beck, B; Wandl, U

2013-06-01

Even though 85 percent of those who have been severely injured in an accident in Germany survive, complex and serious long-term consequences are still a major problem not only for health and care insurance providers but also for the accident victims themselves because their quality of life is affected permanently. Therefore the aim of the current study is to identify factors that significantly improve the quality of life after a severe traumatic injury and to investigate whether the support by a reintegration service has a positive effect on the victims' quality of life. The sample consisted of severely injured accident victims who were supported by a reintegration service. The data collection comprised three data points. At every data point the SF-36 questionnaire was used to assess the participants' quality of life. The results indicate that an individual medical-vocational support by a reintegration service has the potential to significantly and stably improve the physical aspects of quality of life, even if the accident dates back several years. Furthermore it appears to be important to support the independence of the accident victims because assistance by a third person correlates with a lower degree of physical quality of life, regardless of severity or type of injury. Moreover it becomes clear that it is important to pay more attention to the treatment of psychological consequences of severe accidents.

The case for restraint in spinal surgery: does quality management have a role to play?

PubMed Central

Mirza, Sohail K.

2009-01-01

Most quality improvement efforts in surgery have focused on the technical quality of care provided, rather than whether the care was indicated, or could have been provided with a safer procedure. Because risk is inherent in any procedure, reducing the number of unnecessary operations is an important issue in patient safety. In the case of lumbar spine surgery, several lines of evidence suggest that, in at least some locations, there may be excessively high surgery rates. This evidence comes from international comparisons of surgical rates; study of small area variations within countries; increasing surgical rates in the absence of new indications; comparisons of surgical outcomes between geographic areas with high or low surgical rates; expert opinion; the preferences of well-informed patients; and increasing rates of repeat surgery. From a population perspective, reducing unnecessary surgery may have a greater impact on complication rates than improving the technical quality of surgery that is performed. Evidence suggests this may be true for coronary bypass surgery in the US and hysterectomy rates in Canada. Though similar studies have not been done for spine surgery, wide geographic variations in surgical rates suggest that this could be the case for spine surgery as well. We suggest that monitoring geographic variations in surgery rates may become an important aspect of quality improvement, and that rates of repeat surgery may bear special attention. Patient registries can help in this regard, if they are very complete and rigorously maintained. They can provide data on surgical rates; offer post-marketing surveillance for new surgical devices and techniques; and help to identify patient subgroups that may benefit most from certain procedures. PMID:19266220

Assessing Drinking Water Quality and Water Safety Management in Sub-Saharan Africa Using Regulated Monitoring Data.

PubMed

Kumpel, Emily; Peletz, Rachel; Bonham, Mateyo; Khush, Ranjiv

2016-10-18

Universal access to safe drinking water is prioritized in the post-2015 Sustainable Development Goals. Collecting reliable and actionable water quality information in low-resource settings, however, is challenging, and little is known about the correspondence between water quality data collected by local monitoring agencies and global frameworks for water safety. Using 42 926 microbial water quality test results from 32 surveillance agencies and water suppliers in seven sub-Saharan African countries, we determined the degree to which water sources were monitored, how water quality varied by source type, and institutional responses to results. Sixty-four percent of the water samples were collected from piped supplies, although the majority of Africans rely on nonpiped sources. Piped supplies had the lowest levels of fecal indicator bacteria (FIB) compared to any other source type: only 4% of samples of water piped to plots and 2% of samples from water piped to public taps/standpipes were positive for FIB (n = 14 948 and n = 12 278, respectively). Among other types of improved sources, samples from harvested rainwater and boreholes were less often positive for FIB (22%, n = 167 and 31%, n = 3329, respectively) than protected springs or protected dug wells (39%, n = 472 and 65%, n = 505). When data from different settings were aggregated, the FIB levels in different source types broadly reflected the source-type water safety framework used by the Joint Monitoring Programme. However, the insufficient testing of nonpiped sources relative to their use indicates important gaps in current assessments. Our results emphasize the importance of local data collection for water safety management and measurement of progress toward universal safe drinking water access.

The case for restraint in spinal surgery: does quality management have a role to play?

PubMed

Deyo, Richard A; Mirza, Sohail K

2009-08-01

Most quality improvement efforts in surgery have focused on the technical quality of care provided, rather than whether the care was indicated, or could have been provided with a safer procedure. Because risk is inherent in any procedure, reducing the number of unnecessary operations is an important issue in patient safety. In the case of lumbar spine surgery, several lines of evidence suggest that, in at least some locations, there may be excessively high surgery rates. This evidence comes from international comparisons of surgical rates; study of small area variations within countries; increasing surgical rates in the absence of new indications; comparisons of surgical outcomes between geographic areas with high or low surgical rates; expert opinion; the preferences of well-informed patients; and increasing rates of repeat surgery. From a population perspective, reducing unnecessary surgery may have a greater impact on complication rates than improving the technical quality of surgery that is performed. Evidence suggests this may be true for coronary bypass surgery in the US and hysterectomy rates in Canada. Though similar studies have not been done for spine surgery, wide geographic variations in surgical rates suggest that this could be the case for spine surgery as well. We suggest that monitoring geographic variations in surgery rates may become an important aspect of quality improvement, and that rates of repeat surgery may bear special attention. Patient registries can help in this regard, if they are very complete and rigorously maintained. They can provide data on surgical rates; offer post-marketing surveillance for new surgical devices and techniques; and help to identify patient subgroups that may benefit most from certain procedures.

Health-related quality of life and satisfaction with case management in cancer survivors.

PubMed

Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching

2017-12-01

To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.

The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis.

PubMed

Salyers, Michelle P; Bonfils, Kelsey A; Luther, Lauren; Firmin, Ruth L; White, Dominique A; Adams, Erin L; Rollins, Angela L

2017-04-01

Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare. Publications were identified through targeted literature searches in Ovid MEDLINE, PsycINFO, Web of Science, CINAHL, and ProQuest Dissertations & Theses through March of 2015. Two coders extracted data to calculate effect sizes and potential moderators. We calculated Pearson's r for all independent relationships between burnout and quality measures, using a random effects model. Data were assessed for potential impact of study rigor, outliers, and publication bias. Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = -0.26, 95 % CI [-0.29, -0.23]) and safety (r = -0.23, 95 % CI [-0.28, -0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients. Moderators for the quality relationship included dimension of burnout, unit of analysis, and quality data source. Moderators for the relationship between burnout and safety were safety indicator type, population, and country. Rigor of the study was not a significant moderator. This is the first study to systematically, quantitatively analyze the links between healthcare provider burnout and healthcare quality and safety across disciplines. Provider burnout shows consistent negative relationships with perceived quality (including patient satisfaction), quality indicators, and perceptions of safety. Though the effects are small to medium, the findings highlight the importance of effective burnout interventions for healthcare providers. Moderator analyses suggest contextual factors to consider for future study.

Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges

PubMed Central

Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W.

2017-01-01

A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products’ quality, availability, safety, as well as challenges related to a GFD are discussed. PMID:28786929

Microflora of the selected water reservoirs in Swietokrzyskie Voivodship.

PubMed

Adamus-Bialek, Wioletta; Karwacka, Karolina; Bak, Lukasz

2013-01-01

One of the important environmental issues is the quality of surface waters in the world. Poland belongs to countries with a low quality of the inland waters. The sanitary condition of the five water reservoirs of south-east Poland was analyzed. Water and sediment samples were incubated on the selective and/or differential media. High concentrations of many common and pathogenic microbial indicators were shown in those samples. Those reservoirs are used by people, especially during summer. Because of the high epidemiological risk, detailed analysis of all inland waters should be performed routinely.

Predicting Fecal Indicator Bacteria Fate and Removal in Urban Stormwater at the Watershed Scale

NASA Astrophysics Data System (ADS)

Wolfand, J.; Hogue, T. S.; Luthy, R. G.

2016-12-01

Urban stormwater is a major cause of water quality impairment, resulting in surface waters that fail to meet water quality standards and support their designated uses. Of the many stormwater pollutants, fecal indicator bacteria are particularly important to track because they are directly linked to pathogens which jeopardize public health; yet, their fate and transport in urban stormwater is poorly understood. Monitoring fecal bacteria in stormwater is possible, but due to the high variability of fecal indicators both spatially and temporally, single grab or composite samples do not fully capture fecal indicator loading. Models have been developed to predict fecal indicator bacteria at the watershed scale, but they are often limited to agricultural areas, or areas that receive frequent rainfall. Further, it is unclear whether best management practices (BMPs), such as bioretention or engineered wetlands, are able to reduce bacteria to meet water quality standards at watershed outlets. This research seeks to develop a model to predict fecal indicator bacteria in urban stormwater in a semi-arid climate at the watershed scale. Using the highly developed Ballona Creek watershed (89 mi2) located in Los Angeles County as a case study, several existing mechanistic models are coupled with a hydrologic model to predict fecal indicator concentrations (E. coli, enterococci, fecal coliform, and total coliform) at the outfall of Ballona Creek watershed, Santa Monica Bay. The hydrologic model was developed using InfoSWMM Sustain, calibrated for flow from WY 1998-2006 (NSE = 0.94; R2 = 0.95), and validated from WY 2007-2015 (NSE = 0.93; R2 = 0.95). The developed coupled model is being used to predict fecal indicator fate and transport and evaluate how BMPs can be optimized to reduce fecal indicator loading to surface waters and recreational beaches.

Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

PubMed Central

2011-01-01

Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk) and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey). Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD)-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare. PMID:21473758

Race, gender, and language concordance in the primary care setting.

PubMed

Martin, Brian C; Shi, Leiyu; Ward, Ryan D

2009-01-01

The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care. The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported. Adjusting for covariates, the following items remained statistically significant: race--choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender--choosing primary care physician as USC and USC having office hours; and language--lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted. While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross-sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups. This study indicates that more research is needed in this area to determine future resource allocation and policy direction. The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.

Analysis of passenger acceptance of commercial flights having characteristics similar to STOL

NASA Technical Reports Server (NTRS)

Kuhlthau, A. R.; Jacobson, I. D.

1973-01-01

Previous work in the development of quantitative models for the prediction of passenger reaction to motion and vehicle environment parameters in flight was extended to include a class of aircraft appropriate for low-density, short-haul service. The results indicate that it is possible to obtain quantitative response inputs from an usually small special test-subject group which will be representative of the general traveling public. Additional data which indicate the importance of comfort as a factor in evaluating ride quality was obtained, and identification of the factors which contribute to judgments regarding comfort level was improved. Seat comfort and seat spacing is very vital in the smaller aircraft. Mathematical modeling applied in conjuction with passenger reaction data was shown to be very useful for establishing ride-quality design criteria.

Chemical properties of forest soils

Treesearch

Charles H. Perry; Michael C. Amacher

2007-01-01

Why Is Soil Chemistry Important? The soil quality indicator was initially developed as a tool for assessing the current status of forest soil resources and predicting potential changes in soil properties. Soil chemistry data can be used to diagnose tree vigor and document the deposition of atmospheric pollutants (e.g., acid rain). This chapter focuses on two chemical...

CLASS Reliability Training as Professional Development for Preschool Teachers

ERIC Educational Resources Information Center

Casbergue, Renée M.; Bedford, April Whatley; Burstein, Karen

2014-01-01

Use of the Classroom Assessment Scoring System (CLASS) is increasing across the United States as an important indicator of the quality of programs for young children. Professional development is required to facilitate teachers' understanding of the instructional behaviors upon which they will be judged. This study investigated the use of the…

An Investigation of U.S. Undergraduate Business School Rankings Using Data Envelopment Analysis with Value-Added Performance Indicators

ERIC Educational Resources Information Center

Palocsay, Susan W.; Wood, William C.

2014-01-01

"Bloomberg Businessweek" ranks U.S. undergraduate business programs annually. These rankings provide a convenient overall measure of quality, which is important in today's environment of concern about higher education costs and employment after graduation. Data envelopment analysis (DEA) has advantages over previous regression…

An important lichen of southeastern Montana rangelands

Treesearch

James G. McCracken; Lynn E. Alexander; Daniel W. Uresk

1983-01-01

The lichen (Parmelia chlorochroa) was most abundant in sagebrush and grassland vegetation associations, less so in the pine, and absent in riparian types. It was significantly associated with drier sites and bare ground. Lichens appear to have value in reducing erosion, as indicators of intensive grazing, and in contributing to the nutrient quality...

Perezhivanie: What Have We Missed about Infant Care?

ERIC Educational Resources Information Center

Brennan, Margaret

2014-01-01

Evidence indicates that the nature of adult-infant attachments will impact on the quality of care the infant receives, although findings are often couched in outcomes for children rather than adult concerns. In this article, the argument is made that the adult's experience of caregiving is also an important area for investigation.…

E. coli release from streambed to water column during base flow periods: a modeling study

USDA-ARS?s Scientific Manuscript database

Microbial quality of stream water is important for recreation, irrigation, and other uses. It is usually evaluated by concentrations of fecal indicator bacteria (FIB) such as E. coli. Streambed sediments have been shown to harbor large FIB populations that could be released into the water column dur...

Prediction of E. coli release from streambed to water column during base flow periods using SWAT model

USDA-ARS?s Scientific Manuscript database

Microbial water quality in streams is of importance for recreation, irrigation, and other uses. The streambed sediment has been shown to harbor large fecal indicator bacteria (FIB) population that can be released to water column during high-flow events when sediments are resuspended. There have been...

Commission on the Future of Florida's Public Universities.

ERIC Educational Resources Information Center

Commission on the Future of Florida's Public Universities, Tallahassee.

A 1977 review is presented of Florida's State University System, which was conducted by the Commission on the Future of Florida's Public Universities--a blue ribbon commission. The current status of the system and some indications of the importance of high quality universities to Florida's future are considered, and recommendations for improving…

The Impact of Mixing Modes on Reliability in Longitudinal Studies

ERIC Educational Resources Information Center

Cernat, Alexandru

2015-01-01

Mixed-mode designs are increasingly important in surveys, and large longitudinal studies are progressively moving to or considering such a design. In this context, our knowledge regarding the impact of mixing modes on data quality indicators in longitudinal studies is sparse. This study tries to ameliorate this situation by taking advantage of a…

New Teacher Mentoring: Hopes and Promise for Improving Teacher Effectiveness

ERIC Educational Resources Information Center

Moir, Ellen; Barlin, Dara; Gless, Janet; Miles, Jan

2009-01-01

Teacher quality is the single most important lever schools have for raising student achievement. A substantial body of research indicates that new teachers are less able than their more experienced colleagues to help students fulfill their academic potential. Yet in many school districts--particularly those in urban settings--as many as half of…

Social Participation among Young Adults with an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Orsmond, Gael I.; Shattuck, Paul T.; Cooper, Benjamin P.; Sterzing, Paul R.; Anderson, Kristy A.

2013-01-01

Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in…

Listening to and Learning from Graduate's Perceptions: Implications for Change?

ERIC Educational Resources Information Center

Kotsifos, Vangelis; Alegakis, Athanasios; Philalithis, Anastas

2013-01-01

The impact of Word of Mouth Communication (WoMC) in attracting new candidates, and thus contributing to the sustainability of Higher Education Institutions, is highlighted in the literature along with its importance as an indicator for quality improvements in course provision. In the present study graduates were questioned concerning their…

Depth-dependent inactivation of Escherichia coli and Enterococcus faecalis in soil after manure application and simulated rainfall

USDA-ARS?s Scientific Manuscript database

E.coli and Enterococcus serve as important water quality indicator organisms. Rainfall action on manured fields and pastures releases these organisms into soil with infiltrating water. They can then be released back to runoff during subsequent rainfall or irrigation events as soil solution interacts...

Self-Determination: A Critical Component of Education

ERIC Educational Resources Information Center

Denney, Stephen C.; Daviso, Alfred W.

2012-01-01

Self-Determination is a central concept in special education practice and policy. Research indicates that students who possess specific self-determination skills have better outcomes and enhanced quality of life. Self-determination is a broad term and can be looked at in a variety of ways with differing values of importance. The concept of…

Quality Control in Christian Higher Education: The Importance of Evaluating What We Do

ERIC Educational Resources Information Center

Bhatia, Sukhwant S.

2009-01-01

In contrast to the long-standing history of assessment in secular higher education, religious institutions have not been at the cutting edge of assessment, evaluation, and research. However, external pressures on institutions have led to a self-examined life, use of reliable indicators of institutional performance, and development of comprehensive…

Ethnicity and Diet of Children: Development of Culturally Sensitive Measures

ERIC Educational Resources Information Center

Bruss, Mozhdeh B.; Applegate, Brooks; Quitugua, Jackie; Palacios, Rosa T.; Morris, Joseph R.

2007-01-01

Obesity is a growing global concern. Examining dietary habits of individuals can facilitate the development of important prevention approaches, which are needed to decrease the incidence of obesity and other related diseases and improve quality of life indices. Because food preferences and dietary habits vary across cultures, it is essential that…

Can You Show You Are a Good Lecturer?

ERIC Educational Resources Information Center

Wood, Leigh N.; Harding, Ansie

2007-01-01

Measurement of the quality of teaching activities is becoming increasingly important since universities are rewarding performance in terms of promotion, awards and bonuses and research is no longer the only key performance indicator. Good teaching is not easy to identify and measure. This paper specifically deals with the issue of good teaching in…

Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007–2010

PubMed Central

Aggarwal, Anju; Rehm, Colin D.; Monsivais, Pablo; Drewnowski, Adam

2017-01-01

Concerns with taste, nutrition, cost, and convenience are said to be key influences on food choices. This study examined the importance of food-related attitudes in relation to diet quality using US national level data. Interactions by socioeconomic status (SES), gender and race/ethnicity were tested. Analyses of 8957 adults from National Health and Nutrition Examination Survey (NHANES 2007–2010) were conducted in 2014–15. Perceived importance of taste, nutrition, cost, and convenience in dietary choices were assessed using 4-point Likert scales. Education and family income-to-poverty ratio (FIPR) were SES indicators. Healthy Eating Index (HEI-2010), a measure of adherence to 2010 dietary guidelines, was the diet quality measure. Survey-weighted regressions examined associations between attitudes and HEI, and tested for interactions. Taste was rated as “very important” by 77.0% of the US adults, followed by nutrition (59.9%), cost (39.9%), and convenience (29.8%). However, it was the perceived importance of nutrition that most strongly predicted HEI (β: +8.0 HEI scores among “very important” vs. “not at all important”). By contrast, greater importance for taste and convenience had a weak inverse relation with HEI (β: −5.1 and −1.5 respectively), adjusting for SES. Significant interactions were observed by race/ethnicity, but not SES and gender. Those who prioritized nutrition during food shopping had higher-quality diets regardless of gender, education and income in the US. Certain racial/ethnic groups managed to eat healthy despite attaching importance to cost and convenience. This is the first evidence of nutrition resilience among US adults using national data, which has huge implications for nutrition interventions. PMID:27374943

Assessment of Air Quality in the International Space Station (ISS) and Space Shuttle Based on Samples Returned Aboard STS-110 (ISS-8A) in April 2002

NASA Technical Reports Server (NTRS)

James, John T.

2002-01-01

The toxicological assessment of grab sample canisters (GSCs) returned aboard STS-110 is reported. Analytical methods have not changed from earlier reports, and surrogate standard recoveries from the GSCs were 77-121%, with one exception. Pressure tracking indicated no leaks in the canisters. Recoveries from lab and trip controls for formaldehyde analyses ranged from 87 to 96%. The two general criteria used to assess air quality are the total-non-methane-volatile organic hydrocarbons (NMVOCs) and the total T-value (minus the CO2 and formaldehyde contributions). Because of the inertness of Freon 218 (octafluoropropane, OFP), its contribution to the NMVOC is subtracted and tabulated separately. Control of atmospheric alcohols is important to the water recovery system engineers, hence total alcohols are also shown for each sample. Because formaldehyde is quantified from sorbent badges, its concentration is listed separately. These five indices of air quality are summarized.

Influence of social dominance on production, welfare and the quality of meat from beef bulls.

PubMed

Miranda-de la Lama, G C; Pascual-Alonso, M; Guerrero, A; Alberti, P; Alierta, S; Sans, P; Gajan, J P; Villarroel, M; Dalmau, A; Velarde, A; Campo, M M; Galindo, F; Santolaria, M P; Sañudo, C; María, G A

2013-08-01

The aim of this study was to assess the effect of social dominance on some indicators of welfare, production and meat quality of young bulls. A total of 60 bulls of the Gasconne breed, 9 months old, housed indoors were used. Indices of success order were calculated to reflect social dominance of each bull into three ranking categories (low, middle and high). Blood samples were taken to measure cortisol, lactate, glucose, creatine kinase, non-esterified fatty acid and neutrophil/lymphocyte ratio (N/L). M. longissimus samples were analysed in terms of pH, water holding capacity (WHC), texture, colour and sensorial attributes. Social rank influenced cattle stress response, which had an effect on productive performance but not on meat quality traits, with the exception of the sensory traits. These results emphasize the importance of implementing best management practices during pre-harvest handling of cattle in order to modulate any possible risk factor for social stress. Copyright © 2013 Elsevier Ltd. All rights reserved.