Safety considerations in providing allergen immunotherapy in the office.

PubMed

Mattos, Jose L; Lee, Stella

2016-06-01

This review highlights the risks of allergy immunotherapy, methods to improve the quality and safety of allergy treatment, the current status of allergy quality metrics, and the future of quality measurement. In the current healthcare environment, the emphasis on outcomes measurement is increasing, and providers must be better equipped in the development, measurement, and reporting of safety and quality measures. Immunotherapy offers the only potential cure for allergic disease and asthma. Although well tolerated and effective, immunotherapy can be associated with serious consequence, including anaphylaxis and death. Many predisposing factors and errors that lead to serious systemic reactions are preventable, and the evaluation and implementation of quality measures are crucial to developing a safe immunotherapy practice. Although quality metrics for immunotherapy are in their infancy, they will become increasingly sophisticated, and providers will face increased pressure to deliver safe, high-quality, patient-centered, evidence-based, and efficient allergy care. The establishment of safety in the allergy office involves recognition of potential risk factors for anaphylaxis, the development and measurement of quality metrics, and changing systems-wide practices if needed. Quality improvement is a continuous process, and although national allergy-specific quality metrics do not yet exist, they are in development.

Is it nutrients, food items, diet quality or eating behaviours that are responsible for the association of children's diet with sleep?

PubMed

Khan, Mohammad K A; Faught, Erin L; Chu, Yen Li; Ekwaru, John P; Storey, Kate E; Veugelers, Paul J

2017-08-01

Both diet quality and sleep duration of children have declined in the past decades. Several studies have suggested that diet and sleep are associated; however, it is not established which aspects of the diet are responsible for this association. Is it nutrients, food items, diet quality or eating behaviours? We surveyed 2261 grade 5 children on their dietary intake and eating behaviours, and their parents on their sleep duration and sleep quality. We performed factor analysis to identify and quantify the essential factors among 57 nutrients, 132 food items and 19 eating behaviours. We considered these essential factors along with a diet quality score in multivariate regression analyses to assess their independent associations with sleep. Nutrients, food items and diet quality did not exhibit independent associations with sleep, whereas two groupings of eating behaviours did. 'Unhealthy eating habits and environments' was independently associated with sleep. For each standard deviation increase in their factor score, children had 6 min less sleep and were 12% less likely to have sleep of good quality. 'Snacking between meals and after supper' was independently associated with sleep quality. For each standard deviation increase in its factor score, children were 7% less likely to have good quality sleep. This study demonstrates that eating behaviours are responsible for the associations of diet with sleep among children. Health promotion programmes aiming to improve sleep should therefore focus on discouraging eating behaviours such as eating alone or in front of the TV, and snacking between meals and after supper. © 2016 European Sleep Research Society.

Impact of varying area of polluting surface materials on perceived air quality.

PubMed

Sakr, W; Knudsen, H N; Gunnarsen, L; Haghighat, F

2003-06-01

A laboratory study was performed to investigate the impact of the concentration of pollutants in the air on emissions from building materials. Building materials were placed in ventilated test chambers. The experimental set-up allowed the concentration of pollution in the exhaust air to be changed either by diluting exhaust air with clean air (changing the dilution factor) or by varying the area of the material inside the chamber when keeping the ventilation rate constant (changing the area factor). Four different building materials and three combinations of two or three building materials were studied in ventilated small-scale test chambers. Each individual material and three of their combinations were examined at four different dilution factors and four different area factors. An untrained panel of 23 subjects assessed the air quality from the chambers. The results show that a certain increase in dilution improves the perceived air quality more than a similar decrease in area. The reason for this may be that the emission rate of odorous pollutants increases when the concentration in the chamber decreases. The results demonstrate that, in some cases the effect of increased ventilation on the air quality may be less than expected from a simple dilution model.

National Quality Improvement Center on Early Childhood

ERIC Educational Resources Information Center

Browne, Charlyn Harper

2014-01-01

The national Quality Improvement Center on early Childhood (QIC-eC) funded four research and demonstration projects that tested child maltreatment prevention approaches. The projects were guided by several key perspectives: the importance of increasing protective factors in addition to decreasing risk factors in child maltreatment prevention…

[Research on quality regionalization of cultivated Pseudostellaria heterophylla based on climate factors].

PubMed

Kang, Chuan-Zhi; Zhou, Tao; Jiang, Wei-Ke; Guo, Lan-Ping; Zhang, Xiao-Bo; Xiao, Cheng-Hong; Zhao, Dan

2016-07-01

Maxent model was applied in the study to filtering the climate factors layer by layer. Polysaccharides and pseudostellarin B the two internal quality evaluation index were combined to analyse the interlinkages between climate factors and chemical constituents in order to search for the critical climate factors of Pseudostellaria heterophylla. Then based on the key climate factors to explicit the quality spatial distribution of P. heterophylla. The results showed that polysaccharides and climatic factors had no significant correlation, suggesting that the indicator was not climate-driven metabolites. Pseudostellarin B could construct regression model with the precipitation. And quality regionalization results showed that pseudostellarin B content presented firstly increased and then decreased trend from southeast to northwest, which was the consistent change with precipitation. It clearly proposed that precipitation was the key climate factor, which affected the accumulation of cyclopeptide compound for Pseudostellariae Radix. Copyright© by the Chinese Pharmaceutical Association.

Determination of quality factors by microdosimetry

NASA Astrophysics Data System (ADS)

Al-Affan, I. A. M.; Watt, D. E.

1987-03-01

The application of microdose parameters for the specification of a revised scale of quality factors which would be applicable at low doses and dose rates is examined in terms of an original proposal by Rossi. Two important modifications are suggested to enable an absolute scale of quality factors to be constructed. Allowance should be made to allow for the dependence of the saturation threshold of lineal energy on the type of heavy charged particle. Also, an artificial saturation threshold should be introduced for electron tracks as a mean of modifying the measurements made in the microdosimeter to the more realistic site sizes of nanometer dimensions. The proposed absolute scale of quality factors nicely encompasses the high RBEs of around 3 observed at low doses for tritium β rays and is consistent with the recent recommendation of the ICRP that the quality factor for fast neutrons be increased by a factor of two, assuming that there is no biological repair for the reference radiation.

The impact of organizational factors on the urinary incontinence care quality in long-term care hospitals: a longitudinal correlational study.

PubMed

Yoon, Ju Young; Lee, Ji Yun; Bowers, Barbara J; Zimmerman, David R

2012-12-01

With the rapid increase in the number of long-term care hospitals in Korea, care quality has become an important issue. Urinary incontinence is an important condition affecting many residents' quality of life. Thus, it is important that urinary incontinence be amenable to improving conditions with appropriate interventions, since a change in urinary incontinence status can reflect care quality in long-term care facilities if patient level factors are adjusted. We aim to examine the impact of organizational factors on urinary incontinence care quality defined as the improvement of urinary incontinence status or maintenance of continent status post-admission to Korean long-term care hospitals. DESIGN AND DATA: This is a longitudinal correlation study. Data came from two sources: monthly patient assessment reports using the Patient Assessment Instrument and the hospital information system from the Health Insurance Review and Assessment Services. The final analysis includes 5271 elderly adults without indwelling urinary catheter or urostomy who were admitted to 534 Korean long-term care hospitals in April 2008. Multi-level logistic analysis was used to explore the organizational factors that influence urinary incontinence care quality controlling for patient level factors. With respect to the organizational factors, the findings showed that location and RN/total nursing staff ratio variables were statistically significant, controlling for risk factors at the patient level. The odds of urinary incontinence improvement from admission in urban long-term care hospitals were 1.28 times higher than rural long-term care hospitals. In addition, when a long-term care hospital increased one standard deviation (0.19) in the RN ratio, the odds of urinary incontinence status improvement or maintenance of continence status from admission increased about 1.8 times. The most significant finding was that a higher RN to patient ratio and urban location were associated with better resident outcomes of urinary incontinence among organizational factors. For a better understanding of how these significant organizational factors influence positive care outcomes and provide more practical implications, studies should examine concrete care process measures as well as structure and outcome measures based on systematic conceptual models. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Systemic Vision of the Educational Learning

ERIC Educational Resources Information Center

Lima, Nilton Cesar; Penedo, Antonio Sergio Torres; de Oliveira, Marcio Mattos Borges; de Oliveira, Sonia Valle Walter Borges; Queiroz, Jamerson Viegas

2012-01-01

As the sophistication of technology is increasing, also increased the demand for quality in education. The expectation for quality has promoted broad range of products and systems, including in education. These factors include the increased diversity in the student body, which requires greater emphasis that allows a simple and dynamic model in the…

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

DTIC Science & Technology

2007-05-01

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

Improved Sleep Quality is Associated with Reductions in Depression and PTSD Arousal Symptoms and Increases in IGF-1 Concentrations

PubMed Central

Rusch, Heather L.; Guardado, Pedro; Baxter, Tristin; Mysliwiec, Vincent; Gill, Jessica M.

2015-01-01

Study Objectives: One-third of deployed military personnel will be diagnosed with insomnia, placing them at high risk for comorbid depression, posttraumatic stress disorder (PTSD), and medical conditions. The disruption of trophic factors has been implicated in these comorbid conditions, which can impede postdeployment recovery. This study determined if improved sleep quality is associated with (1) reductions in depression and posttraumatic symptoms, as well as enrichments in health-related quality of life (HRQOL), and (2) changes in plasma concentrations of brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1). Methods: Forty-four military personnel diagnosed with insomnia underwent clinical evaluations and blood draws at pretreatment and at posttreatment following cognitive behavioral therapy for insomnia and automatic positive airway pressure treatment. Participants were classified as sleep improved (n = 28) or sleep declined (n = 16) based on their change in pretreatment to posttreatment Pittsburgh Sleep Quality Index (PSQI) score. Both groups were compared on outcomes of depression, PTSD, HRQOL, BDNF, and IGF-1. Results: Paired t-tests of the sleep improved group revealed significant declines in depression (p = 0.005) and posttraumatic arousal (p = 0.006) symptoms, and a significant increase in concentrations of IGF-1 (p = 0.009). The sleep declined group had no relevant change in psychiatric symptoms or trophic factors, and had further declines on five of eight dimensions of HRQOL. Between-group change score differences were significant at p < 0.05. Conclusions: These findings suggest that interventions, which successfully improve sleep quality, are an effective means to reduce the depression and posttraumatic arousal symptoms common to military personnel, as well as increase protective trophic factors implicated in these conditions. Citation: Rusch HL, Guardado P, Baxter T, Mysliwiec V, Gill JM. Improved sleep quality is associated with reductions in depression and PTSD arousal symptoms and increases in IGF-1 concentrations. J Clin Sleep Med 2015;11(6):615–623. PMID:25766717

[Effect of antecedent dry period on water quality of urban storm runoff pollution].

PubMed

Bian, Bo

2009-12-01

Identified the main factor influencing urban rainfall-runoff pollution provides a scientific basis for urban rainfall-runoff pollution control and management. Therefore, starting in May 2006, a study was conducted to characterize water quality from representative land uses types in Zhenjiang to analyse the effect of antecedent dry period on stormwater runoff quality. The results show that the beginning of rainfall, with the increase of antecedent dry periods, the percentages of less than 40 microm is increased, the correlation of the water quality parameters (TN, TP, Zn, Pb, Cu, TSS and COD) and antecedent dry period shows a significant positive correlation, dissolved pollutants in the initial period surface runoff is increased. These findings show that facilitating the recognition of antecedent dry periods is the main factor influencing the change in concentration and partitioning of pollutants to provide the scientific basis for non-point source pollution control and management.

A Multivariate Evaluation of Factors Affecting the Quality of Freshly Frozen Tissue Specimens.

PubMed

Wang, Tong-Hong; Chen, Chin-Chuan; Liang, Kung-Hao; Chen, Chi-Yuan; Chuang, Wen-Yu; Ueng, Shir-Hwa; Chu, Pao-Hsien; Huang, Chung-Guei; Chen, Tse-Ching; Hsueh, Chuen

2017-08-01

Well-prepared and preserved freshly frozen specimens are indispensable materials for clinical studies. To manage specimen quality and to understand the factors potentially affecting specimen quality during preservation processes, we analyzed the quality of RNA and genomic DNA of various tissues collected between 2002 and 2011 in Linkou Chang Gung Memorial Hospital, Taiwan. During this period, a total of 1059 freshly frozen specimens from eight major cancer categories were examined. It was found that preservation duration, organ origin, and tissue type could all influence the quality of RNA samples. The increased preservation period correlated with decreased RNA quality; the brain, breast, and stomach RNA specimens displayed faster degradation rates than those of other organs, and RNA specimens isolated from tumor tissues were apparently more stable than those of other tissues. These factors could all be used as quality predictors of RNA quality. In contrast, almost all analyses revealed that the genomic DNA samples had good quality, which was not influenced by the aforementioned factors. The results assisted us in determining preservation factors that affect specimen quality, which could provide evidence for improving processes of sample collection and preservation. Furthermore, the results are also useful for researchers to adopt as the evaluation criteria for choosing specimen collection and preservation strategies.

Curriculum enactment patterns and associated factors from teachers' perspectives

NASA Astrophysics Data System (ADS)

Son, Ji-Won; Kim, Ok-Kyeong

2016-12-01

As part of a larger effort to improve teacher capacity for high-quality mathematics instruction, we investigated the factors that are associated with different enactment patterns at three levels: contextual (e.g., type and quality of textbook), individual (e.g., teacher knowledge), and teachers' opportunity-to-learn (e.g., professional development experiences). Analysis of 183 teachers' self-reports on their practices revealed three notable findings. First, the factors at the three levels were all found to be significantly related to the different patterns of enacted curriculum. However, the use of quality textbooks and the alignment of teachers' views and instructional goals with curriculum goals were found to be the two factors that are most strongly associated with the enactment pattern of high-level problems and high-level teacher questions in instruction. Furthermore, teachers with the enactment pattern of increasing lower cognitive demand of problems into higher ones tended to rate their curriculum knowledge higher than teachers with the enactment pattern of using low-level problems and teacher questions in their teaching. In particular, deviation from and dissatisfaction with their assigned low-quality textbooks were found to be critical factors that are associated with the enactment pattern of increasing lower cognitive demands of problems in instruction.

Identifying key hospital service quality factors in online health communities.

PubMed

Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki

2015-04-07

The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and classification performance still has room for improvement, but the extraction results are applicable to more detailed analysis. Further analysis of the extracted information reveals that there are differences in the details of social media-based key quality factors for hospitals according to the regions in Korea, and the patterns of change seem to accurately reflect social events (eg, influenza epidemics). These findings could be used to provide timely information to caregivers, hospital officials, and medical officials for health care policies.

Magnetic field dependence of the internal quality factor and noise performance of lumped-element kinetic inductance detectors

NASA Astrophysics Data System (ADS)

Flanigan, D.; Johnson, B. R.; Abitbol, M. H.; Bryan, S.; Cantor, R.; Day, P.; Jones, G.; Mauskopf, P.; McCarrick, H.; Miller, A.; Zmuidzinas, J.

2016-10-01

We present a technique for increasing the internal quality factor of kinetic inductance detectors (KIDs) by nulling ambient magnetic fields with a properly applied magnetic field. The KIDs used in this study are made from thin-film aluminum, they are mounted inside a light-tight package made from bulk aluminum, and they are operated near 150 mK. Since the thin-film aluminum has a slightly elevated critical temperature (Tc = 1.4 K), it therefore transitions before the package (Tc = 1.2 K), which also serves as a magnetic shield. On cooldown, ambient magnetic fields as small as approximately 30 µT can produce vortices in the thin-film aluminum as it transitions because the bulk aluminum package has not yet transitioned and therefore is not yet shielding. These vortices become trapped inside the aluminum package below 1.2 K and ultimately produce low internal quality factors in the thin-film superconducting resonators. We show that by controlling the strength of the magnetic field present when the thin film transitions, we can control the internal quality factor of the resonators. We also compare the noise performance with and without vortices present, and find no evidence for excess noise beyond the increase in amplifier noise, which is expected with increasing loss.

Factors affecting long-term trends in surface-water quality in the Gwynns Falls watershed, Baltimore City and County, Maryland, 1998–2016

USGS Publications Warehouse

Majcher, Emily H.; Woytowitz, Ellen L.; Reisinger, Alexander J.; Groffman, Peter M.

2018-03-30

Factors affecting water-quality trends in urban streams are not well understood, despite current regulatory requirements and considerable ongoing investments in gray and green infrastructure. To address this gap, long-term water-quality trends and factors affecting these trends were examined in the Gwynns Falls, Maryland, watershed during 1998–2016 in cooperation with Blue Water Baltimore. Data on water-quality constituents and potential factors of influence were obtained from multiple sources and compiled for analysis, with a focus on data collected as part of the National Science Foundation funded Long-Term Ecological Research project, the Baltimore Ecosystem Study.Variability in climate (specifically, precipitation) and land cover can overwhelm actions taken to improve water quality and can present challenges for meeting regulatory goals. Analysis of land cover during 2001–11 in the Gwynns Falls watershed indicated minimal change during the study time frame; therefore, land-cover change is likely not a factor affecting trends in water quality. However, a modest increase in annual precipitation and a significant increase in winter precipitation were apparent in the region. A higher proportion of runoff producing storms was observed in the winter and a lower proportion in the summer, indicating that climate change may affect water quality in the watershed. The increase in precipitation was not reflected in annual or seasonal trends of streamflow in the watershed. Nonetheless, these precipitation changes may exacerbate the inflow and infiltration of water to gray infrastructure and reduce the effectiveness of green infrastructure. For streamflow and most water-quality constituents examined, no discernable trends were noted over the timeframe examined. Despite the increases in precipitation, no trends were observed for annual or seasonal discharge at the various sites within the study area. In some locations, nitrate, phosphate, and total nitrogen show downward trends, and total phosphorus and chloride show upward trends.Sanitary sewer overflows (gray infrastructure) and best management practices (green infrastructure) were identified as factors affecting water-quality change. The duration of sanitary sewer overflows was positively correlated with annual loads of nutrients and bacteria, and the drainage area of best management practices was negatively correlated with annual loads of phosphate and sulfate. Results of the study indicate that continued investments in gray and green infrastructure are necessary for urban water-quality improvement. Although this outcome is not unexpected, long-term datasets such as the one used in this study, allow the effects of gray and green infrastructures to be quantified.Results of this study have implications for the Gwynns Falls watershed and its residents and Baltimore City and County managers. Moreover, outcomes are relevant to other watersheds in the metropolitan region that do not have the same long-term dataset. Further, this study has established a framework for ongoing statistical analysis of primary factors affecting urban water-quality trends as regulatory programs mature.

Factors influencing microinjection molding replication quality

NASA Astrophysics Data System (ADS)

Vera, Julie; Brulez, Anne-Catherine; Contraires, Elise; Larochette, Mathieu; Trannoy-Orban, Nathalie; Pignon, Maxime; Mauclair, Cyril; Valette, Stéphane; Benayoun, Stéphane

2018-01-01

In recent years, there has been increased interest in producing and providing high-precision plastic parts that can be manufactured by microinjection molding: gears, pumps, optical grating elements, and so on. For all of these applications, the replication quality is essential. This study has two goals: (1) fabrication of high-precision parts using the conventional injection molding machine; (2) identification of robust parameters that ensure production quality. Thus, different technological solutions have been used: cavity vacuuming and the use of a mold coated with DLC or CrN deposits. AFM and SEM analyses were carried out to characterize the replication profile. The replication quality was studied in terms of the process parameters, coated and uncoated molds and crystallinity of the polymer. Specific studies were processed to quantify the replicability of injection molded parts (ABS, PC and PP). Analysis of the Taguchi experimental designs permits prioritization of the impact of each parameter on the replication quality. A discussion taking into account these new parameters and the thermal and spreading properties on the coatings is proposed. It appeared that, in general, increasing the mold temperature improves the molten polymer fill in submicron features except for the steel insert (for which the presence of a vacuum is the most important factor). Moreover, the DLC coating was the best coating to increase the quality of the replication. This result could be explained by the lower thermal diffusivity of this coating. We noted that the viscosity of the polymers is not a primordial factor of the replication quality.

Analysis of Thickness and Quality factor of a Double Paddle Oscillator at Room Temperature.

PubMed

Shakeel, Hamza; Metcalf, Thomas H; Pomeroy, J M

2016-01-01

In this paper, we evaluate the quality (Q) factor and the resonance frequency of a double paddle oscillator (DPO) with different thickness using analytical, computational and experimental methods. The study is carried out for the 2 nd anti-symmetric resonance mode that provides extremely high experimental Q factors on the order of 10 5 . The results show that both the Q factor and the resonance frequency of a DPO increase with the thickness at room temperature.

Fabrication of an anti-viral air filter with SiO₂-Ag nanoparticles and performance evaluation in a continuous airflow condition.

PubMed

Joe, Yun Haeng; Woo, Kyoungja; Hwang, Jungho

2014-09-15

In this study, SiO2 nanoparticles surface coated with Ag nanoparticles (SA particles) were fabricated to coat a medium air filter. The pressure drop, filtration efficiency, and anti-viral ability of the filter were evaluated against aerosolized bacteriophage MS2 in a continuous air flow condition. A mathematical approach was developed to measure the anti-viral ability of the filter with various virus deposition times. Moreover, two quality factors based on the anti-viral ability of the filter, and a traditional quality factor based on filtration efficiency, were calculated. The filtration efficiency and pressure drop increased with decreasing media velocity and with increasing SA particle coating level. The anti-viral efficiency also increased with increasing SA particle coating level, and decreased by with increasing virus deposition time. Consequently, SA particle coating on a filter does not have significant effects on filtration quality, and there is an optimal coating level to produce the highest anti-viral quality. Copyright © 2014 Elsevier B.V. All rights reserved.

Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus.

PubMed

Osonoi, Yusuke; Mita, Tomoya; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Kanazawa, Akio; Gosho, Masahiko; Fujitani, Yoshio; Watada, Hirotaka

2015-06-18

While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship. The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated. The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors. Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.

Establishing the overall service quality of engineering education: fuzzy logic approach

NASA Astrophysics Data System (ADS)

Shekhar, N. Chandra; Venkatasubbaiah, K.; Kandukuria, N. R.

2012-12-01

Measuring overall service quality (OSQ) is gaining prominence in higher education due to the increased competition among engineering education institutions (EEIs) and growing awareness about value for money among the public. Determination of OSQ on certain institutional aspects is done by various agencies throughout the world. Each system uses a different set of weighted indicators to measure the overall service quality of institutions. Five service quality factors, namely professionalism, integrated education, facilities, responsiveness and empathy are considered in the study. Trapezoidal fuzzy numbers are used to determine the aggregate weights of the factors to handle the vagueness present in the linguistic values of the stakeholders' subjective opinions. Final weights of the factors are assessed by taking the distances of each factor between Fuzzy Positive Ideal Rating and Fuzzy Negative Ideal Rating. An illustrative study is presented to determine the OSQ of EEIs. The results help to focus on the factors which need immediate attention to enhance the quality of EEIs.

Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV.

PubMed

Fekete, Erin M; Williams, Stacey L; Skinta, Matthew D

2018-03-01

People living with HIV (PLWH) commonly report sleep disturbances which are associated with long-term health consequences, including disease progression. PLWH also experience internalised stigma as a result of their HIV status, which can be associated with increased loneliness and depression. Little attention focuses on the impact of these factors on sleep. Therefore, we examined whether internalised HIV-stigma was indirectly related to poorer sleep quality through higher levels of loneliness and depressive symptoms. 181 PLWH from across the United States completed an online survey. Main Study Measures: Internalised HIV-stigma was assessed using the HIV-Stigma Scale, loneliness was assessed using the UCLA-Loneliness Scale-Short Form, depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Index, and Sleep Quality was assessed using the Pittsburgh Sleep Quality Index. Internalised HIV-stigma was indirectly associated with poorer global sleep quality and daytime sleep dysfunction through both loneliness and depressive symptoms. PLWH who experience HIV-related stigma may experience greater feelings of loneliness, which are related to increased depressive symptoms and poorer sleep quality. Interventions focused on improving sleep in PLWH should focus on multiple factors that influence sleep, including psychosocial factors such as stigma, social isolation and depressive symptoms.

Strategies to Increase Adenoma Detection Rates.

PubMed

Brand, Eelco C; Wallace, Michael B

2017-03-01

The adenoma detection rate (ADR), i.e., the proportion of average risk patients with at least one adenoma detected during screening colonoscopy, is inversely associated with the development of interval colorectal cancer. Increasing the ADR is therefore an important proxy for increase in quality and efficacy of (screening) colonoscopy. Several potentially modifiable factors, such as, procedural and technological factors, and quality improvement programs, and their effect on the ADR will be reviewed. Procedural factors, such as, bowel preparation, withdrawal time, and position changes of the patient are associated with the ADR. While the relation of others, such as inspection during insertion, use of antispasmodic agents, and second inspection in the proximal colon, with the ADR is not completely clear. Many new colonoscopy technologies have been evaluated over recent years and are still under evaluation, but no unequivocal positive effect on the ADR has been observed in randomized trials that have mostly been performed by experienced endoscopists with high baseline ADRs. Several quality improvement programs have been evaluated and seem to have a positive effect on endoscopists' ADR. Increase in ADR is important for the protective benefit of colonoscopy. There are now extensive methods to measure, benchmark, and improve ADR but increased awareness of these is critical. We have provided an overview of potential factors that can be used to increase personal ADRs in every day practice.

Quality of medication information in discharge summaries from hospitals: an audit of electronic patient records.

PubMed

Garcia, Beate Hennie; Djønne, Berit Svendsen; Skjold, Frode; Mellingen, Ellen Marie; Aag, Trine Iversen

2017-12-01

Background Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway. Method For each month in 2013, we randomly selected 60 discharge summaries from the Department of Medicine and Surgery (totally 720) and evaluated the medication information using eight Norwegian quality criteria. Main outcome measure Mean score per discharge summary ranging from 0 (lowest quality) to 16 (highest quality). Results Mean score per discharge summary was 7.4 (SD 2.8; range 0-14), significantly higher when evaluating medications used regularly compared to mediations used as needed (7.80 vs. 6.52; p < 0.001). Lowest score was achieved for quality criteria concerning generic names, indications for medication use, reasons why changes had been made and information about the source for information. Factors associated with increased quality scores are increasing numbers of medications and male patients. Increasing age seemed to be associated with a reduced score, while type of department was not associated with the quality. Conclusion In discharge summaries from 2013, we identified a low quality of medication information in accordance with the Norwegian quality criteria. Actions for improvement are necessary and follow-up studies to monitor quality are needed.

Terahertz absorber based on Fano-like resonance of inverted quadrangular frustum pyramid metal grooves and sensor application

NASA Astrophysics Data System (ADS)

Yu, Yingying; Sun, Bo

2018-07-01

We investigate the multi-resonance coupling of inverted quadrangular frustum pyramid (IQFP) groove metal arrays at terahertz frequencies. The surface plasmon resonance (SPR) and groove resonance are induced, resulting in resonance coupling. The dipole of the groove resonance drives the quadrupole of the SPR and creates a sharp Fano-like resonance. The effects of geometry parameters including the width (at the bottom) and height are analyzed in detail. The results show that with the decrease in the sidewall slope of the groove, the confinement of the groove region on the electromagnetic field decreases, thereby increasing the resonance coupling. The Fano-like resonance is enhanced. The sensitivity and quality factor are discussed. The results show that the Fano-like resonance has high sensitivity and quality factor. With the increase in the sidewall slope of the groove, the sensitivity increases, and the quality factor decreases. The results show that the Fano-like resonance of IQFP groove metal arrays has a significant potential for biological monitoring and sensing.

The Influence of Supports Strategies, Environmental Factors, and Client Characteristics on Quality of Life-Related Personal Outcomes

ERIC Educational Resources Information Center

Claes, Claudia; Van Hove, Geert; Vandevelde, Stijn; van Loon, Jos; Schalock, Robert

2012-01-01

The concept of quality of life (QOL) is increasingly being used as a support provision and outcomes evaluation framework in the field of intellectual disability (ID). The present study used a hierarchical multiple regression research design to determine the role that available supports strategies, environmental factors, and client characteristics…

Spatial, Temporal, and Density-Dependent Components of Habitat Quality for a Desert Owl

PubMed Central

Flesch, Aaron D.; Hutto, Richard L.; van Leeuwen, Willem J. D.; Hartfield, Kyle; Jacobs, Sky

2015-01-01

Spatial variation in resources is a fundamental driver of habitat quality but the realized value of resources at any point in space may depend on the effects of conspecifics and stochastic factors, such as weather, which vary through time. We evaluated the relative and combined effects of habitat resources, weather, and conspecifics on habitat quality for ferruginous pygmy-owls (Glaucidium brasilianum) in the Sonoran Desert of northwest Mexico by monitoring reproductive output and conspecific abundance over 10 years in and around 107 territory patches. Variation in reproductive output was much greater across space than time, and although habitat resources explained a much greater proportion of that variation (0.70) than weather (0.17) or conspecifics (0.13), evidence for interactions among each of these components of the environment was strong. Relative to habitat that was persistently low in quality, high-quality habitat buffered the negative effects of conspecifics and amplified the benefits of favorable weather, but did not buffer the disadvantages of harsh weather. Moreover, the positive effects of favorable weather at low conspecific densities were offset by intraspecific competition at high densities. Although realized habitat quality declined with increasing conspecific density suggesting interference mechanisms associated with an Ideal Free Distribution, broad spatial heterogeneity in habitat quality persisted. Factors linked to food resources had positive effects on reproductive output but only where nest cavities were sufficiently abundant to mitigate the negative effects of heterospecific enemies. Annual precipitation and brooding-season temperature had strong multiplicative effects on reproductive output, which declined at increasing rates as drought and temperature increased, reflecting conditions predicted to become more frequent with climate change. Because the collective environment influences habitat quality in complex ways, integrated approaches that consider habitat resources, stochastic factors, and conspecifics are necessary to accurately assess habitat quality. PMID:25786257

Spatial, temporal, and density-dependent components of habitat quality for a desert owl.

PubMed

Flesch, Aaron D; Hutto, Richard L; van Leeuwen, Willem J D; Hartfield, Kyle; Jacobs, Sky

2015-01-01

Spatial variation in resources is a fundamental driver of habitat quality but the realized value of resources at any point in space may depend on the effects of conspecifics and stochastic factors, such as weather, which vary through time. We evaluated the relative and combined effects of habitat resources, weather, and conspecifics on habitat quality for ferruginous pygmy-owls (Glaucidium brasilianum) in the Sonoran Desert of northwest Mexico by monitoring reproductive output and conspecific abundance over 10 years in and around 107 territory patches. Variation in reproductive output was much greater across space than time, and although habitat resources explained a much greater proportion of that variation (0.70) than weather (0.17) or conspecifics (0.13), evidence for interactions among each of these components of the environment was strong. Relative to habitat that was persistently low in quality, high-quality habitat buffered the negative effects of conspecifics and amplified the benefits of favorable weather, but did not buffer the disadvantages of harsh weather. Moreover, the positive effects of favorable weather at low conspecific densities were offset by intraspecific competition at high densities. Although realized habitat quality declined with increasing conspecific density suggesting interference mechanisms associated with an Ideal Free Distribution, broad spatial heterogeneity in habitat quality persisted. Factors linked to food resources had positive effects on reproductive output but only where nest cavities were sufficiently abundant to mitigate the negative effects of heterospecific enemies. Annual precipitation and brooding-season temperature had strong multiplicative effects on reproductive output, which declined at increasing rates as drought and temperature increased, reflecting conditions predicted to become more frequent with climate change. Because the collective environment influences habitat quality in complex ways, integrated approaches that consider habitat resources, stochastic factors, and conspecifics are necessary to accurately assess habitat quality.

Publications by doctoral candidates at Charité University Hospital, Berlin, from 1998-2008.

PubMed

Ziemann, Esther; Oestmann, Jörg-Wilhelm

2012-05-01

One quality parameter of medical theses is the number of articles published by the doctoral candidates. Over the course of the past decade the Charité-Universitätsmedizin Berlin has taken steps to improve the quality of the theses completed by its doctoral students in medicine and increase their publication activity. This study was designed to verify the efficacy of these measures and to detect general trends. Medical theses completed in 1998, 2004 and 2008 (sample size >250 for each year) were retrospectively analyzed with regard to associated publications within a 7-year period (from 5 years before completion to 2 years thereafter). Quality and quantity were recorded. Publications found in the PubMed database were evaluated; the impact factor of the publishing journal was used as quality parameter. The sample sizes were 264 for 1998, 316 for 2004, and 316 for 2008. The number of publications per doctoral student increased from 0.78 to 1.39 over the course of the study period, and the average impact factor rose from 2.42 to 3.62. Analysis using the current impact factors of the publishing journals showed an increase from 3.13 to 3.85. The proportion of case reports fell from 12.7% to 8%. The proportion of first authorships remained about the same. The past decade has seen an increase in the number of publications by doctoral students at the Charité and a rise in the average impact factor of the journals concerned.

Influence of fundamental mode fill factor on disk laser output power and laser beam quality

NASA Astrophysics Data System (ADS)

Cheng, Zhiyong; Yang, Zhuo; Shao, Xichun; Li, Wei; Zhu, Mengzhen

2017-11-01

An three-dimensional numerical model based on finite element method and Fox-Li method with angular spectrum diffraction theoy is developed to calculate the output power and power density distribution of Yb:YAG disk laser. We invest the influence of fundamental mode fill factor(the ratio of fundamental mode size and pump spot size) on the output power and laser beam quality. Due to aspherical aberration and soft aperture effect in laser disk, high beam quality can be achieve with relative lower efficiency. The highest output power of fundamental laser mode is influenced by the fundamental mode fill factor. Besides we find that optimal mode fill factor increase with pump spot size.

Biology and genetic engineering of fruit maturation for enhanced quality and shelf-life.

PubMed

Matas, Antonio J; Gapper, Nigel E; Chung, Mi-Young; Giovannoni, James J; Rose, Jocelyn K C

2009-04-01

Commercial regulation of ripening is currently achieved through early harvest, by controlling the postharvest storage atmosphere and genetic selection for slow or late ripening varieties. Although these approaches are often effective, they are not universally applicable and often result in acceptable, but poor quality, products. With increased understanding of the molecular biology underlying ripening and the advent of genetic engineering technologies, researchers have pursued new strategies to address problems in fruit shelf-life and quality. These have been guided by recent insights into mechanisms by which ethylene and a complex network of transcription factors regulate ripening, and by an increased appreciation of factors that contribute to shelf-life, such as the fruit cuticle.

Influence of Socioeconomic Factors on Daily Life Activities and Quality of Life of Thai Elderly

PubMed Central

Somrongthong, Ratana; Wongchalee, Sunanta; Ramakrishnan, Chandrika; Hongthong, Donnapa; Yodmai, Korravarn; Wongtongkam, Nualnong

2017-01-01

Background The increasing number of older people is a significant issue in Thailand, resulted in growing demands of health and social welfare services. The study aim was to explore the influence of socioeconomic factors on activities of daily living and quality of life of Thai seniors. Design and methods Using randomised cluster sampling, one province was sampled from each of the Central, North, Northeast and South regions, then one subdistrict sampled in each province, and a household survey used to identify the sample of 1678 seniors aged 60 years and over. The Mann-Whitney U-test and binary logistic regression were used to compare and determine the association of socioeconomic variables on quality of life and activities of daily living. Results The findings showed that sociodemographic and socioeconomic factors were significantly related to functional capacity of daily living. Education levels were strongly associated with daily life activities, with 3.55 adjusted ORs for respondents with secondary school education. Gender was important, with females comprising 61% of dependent respondents but only 47% of independent respondents. Seniors with low incomes were more likely to be anxious in the past, present and future and less likely to accept death in the late stage, with 1.40 Adjusted ORs (95%CI: 1.02-1.92), and 0.72 (95%CI: 0.53-0.98), respectively. However, they were more likely to engage in social activities. Conclusions While socioeconomic factors strongly indicated the functional capacity to live independently, a good quality of life also required other factors leading to happiness and life satisfaction. Significance for public health Increasing numbers of ageing population raise a public health concern in Thai society due to the increasing demands of medical and health services regarding chronic diseases and disability. Unfortunately, few studies have mentioned socioeconomic factors on daily living activities and quality of life and none has taken place across regions in Thailand. Epidemiological population-based studies are necessary to identify social determinants and potential contributing factors that influence quality of life and disability which in turn, may utilise information shaping the policy through better support and care. PMID:28785548

[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.

Differentiating the Spatiotemporal Distribution of Natural and Anthropogenic Processes on River Water-Quality Variation Using a Self-Organizing Map With Factor Analysis.

PubMed

Wang, Yeuh-Bin; Liu, Chen-Wuing; Lee, Jin-Jing

2015-08-01

To elucidate the historical improvement and advanced measure of river water quality in the Taipei metropolitan area, this study applied the self-organizing map (SOM) technique with factor analysis (FA) to differentiate the spatiotemporal distribution of natural and anthropogenic processes on river water-quality variation spanning two decades. The SOM clustered river water quality into five groups: very low pollution, low pollution, moderate pollution, high pollution, and very high pollution. FA was then used to extract four latent factors that dominated water quality from 1991 to 2011 including three anthropogenic process factors (organic, industrial, and copper pollution) and one natural process factor [suspended solids (SS) pollution]. The SOM revealed that the water quality improved substantially over time. However, the downstream river water quality was still classified as high pollution because of an increase in anthropogenic activity. FA showed the spatiotemporal pattern of each factor score decreasing over time, but the organic pollution factor downstream of the Tamsui River, as well as the SS factor scores in the upstream major tributary (the Dahan Stream), remained within the high pollution level. Therefore, we suggest that public sewage-treatment plants should be upgraded from their current secondary biological processing to advanced treatment processing. The conservation of water and soil must also be reinforced to decrease the SS loading of the Dahan Stream from natural erosion processes in the future.

The Impact of Operative Approach on Postoperative Complications Following Colectomy for Colon Caner.

PubMed

Mungo, Benedetto; Papageorge, Christina M; Stem, Miloslawa; Molena, Daniela; Lidor, Anne O

2017-08-01

Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach. Univariate and multivariate analyses were used to compare the five groups and identify risk factors for 30-day anastomotic leak, readmission, and mortality. In total, 25,097 patients were included in the study, with a 3.32% anastomotic leak rate, 1.20% mortality rate, and 9.57% readmission rate. After adjusting for other factors, open surgery and conversion to open significantly increased the odds for leak, mortality, and readmission compared to laparoscopy. Additionally, smoking and chemotherapy increased the risk for leak and readmission, while total resection was associated with increased mortality and leak. Operative approach and several other potentially modifiable perioperative factors have a significant impact on risk for adverse postoperative outcomes following colectomy. To improve quality of care for these patients, efforts should be made to identify and minimize the influence of such risk factors.

Premenstrual syndrome and life quality in Turkish health science students.

PubMed

İşik, Hatice; Ergöl, Şule; Aynioğlu, Öner; Şahbaz, Ahmet; Kuzu, Ayşe; Uzun, Müge

2016-04-19

The purpose of the present study was to investigate the incidence of PMS, risk factors affecting PMS symptoms, and life quality in health science students. A total of 608 volunteer female students studying at the health campus of a state university in Turkey were included in the study. The participants were asked to fill out questionnaires on sociodemographic data, PMS symptoms, and SF-36 life quality tests. The overall frequency of PMS among participants was 84.5%. The average PMS and general health SF scores were 118.34 ± 37.3 and 20.03 ± 3.72, respectively. Students who had irregular breakfast, drank ≥2 cups of coffee/day, and consumed alcohol or fast food had higher PMS scores. Irregular menstruation and family history increased PMS scores and decreased life quality (P < 0.05). The life quality of the students significantly decreased as the severity of PMS increased (P < 0.001). Low body mass index, family history, irregular menstruation, bad eating habits such as fast food consumption and irregular breakfasts, and coffee and alcohol consumption increased PMS risk significantly. In order to improve their life quality, students should be informed about the symptoms, risk factors, and management options of PMS.

The Application of Continuous Quality Improvement Models and Methods to Higher Education: Can We Learn from Business?

ERIC Educational Resources Information Center

Downey, Thomas E.

Continuous quality improvement (CQI) models, which were first applied in business, are critical to making new technology-based learning paradigms and flexible learning environments a reality. The following are among the factors that have facilitated CQI's application in education: increased operating costs; increased competition from private…

Organizational Factors Affecting the Likelihood of Cancer Screening Among VA Patients.

PubMed

Chou, Ann F; Rose, Danielle E; Farmer, Melissa; Canelo, Ismelda; Yano, Elizabeth M

2015-12-01

Preventive service delivery, including cancer screenings, continues to pose a challenge to quality improvement efforts. Although many studies have focused on person-level characteristics associated with screening, less is known about organizational influences on cancer screening. This study aims to understand the association between organizational factors and adherence to cancer screenings. This study employed a cross-sectional design using organizational-level, patient-level, and area-level data. Dependent variables included breast, cervical, and colorectal cancer screening. Organizational factors describing resource sufficiency were constructed using factor analyses from a survey of 250 Veterans Affairs primary care directors. We conducted random-effects logistic regression analyses, modeling cancer screening as a function of organizational factors, controlling for patient-level and area-level factors. Overall, 87% of the patients received mammograms, 92% received cervical and 78% had colorectal screening. Quality improvement orientation increased the odds of cervical [odds ratio (OR): 1.27; 95% confidence interval (CI), 1.03-1.57] and colorectal cancer screening (OR: 1.10; 95% CI, 1.00-1.20). Authority in determining primary care components increased the odds of mammography screening (OR: 1.23; 95% CI, 1.03-1.51). Sufficiency in clinical staffing increased the odds of mammography and cervical cancer screenings. Several patient-level factors, serving as control variables, were associated with achievement of screenings. Resource sufficiency led to increased odds of screening possibly because they promote excellence in patient care by conveying organizational goals and facilitate goal achievement with resources. Complementary to patient-level factors, our findings identified organizational processes associated with better performance, which offer concrete strategies in which facilities can evaluate their capabilities to implement best practices to foster and sustain a culture of quality care.

Identifying Key Hospital Service Quality Factors in Online Health Communities

PubMed Central

Jung, Yuchul; Hur, Cinyoung; Jung, Dain

2015-01-01

Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and classification performance still has room for improvement, but the extraction results are applicable to more detailed analysis. Further analysis of the extracted information reveals that there are differences in the details of social media–based key quality factors for hospitals according to the regions in Korea, and the patterns of change seem to accurately reflect social events (eg, influenza epidemics). Conclusions These findings could be used to provide timely information to caregivers, hospital officials, and medical officials for health care policies. PMID:25855612

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

PubMed

Bosaeus, Ingvar; Rothenberg, Elisabet

2016-05-01

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

Assessment and prediction of land ecological environment quality change based on remote sensing-a case study of the Dongting lake area in China

NASA Astrophysics Data System (ADS)

Hu, Wenmin; Wang, Zhongcheng; Li, Chunhua; Zhao, Jin; Li, Yi

2018-02-01

Multi-source remote sensing data is rarely used for the comprehensive assessment of land ecologic environment quality. In this study, a digital environmental model was proposed with the inversion algorithm of land and environmental factors based on the multi-source remote sensing data, and a comprehensive index (Ecoindex) was applied to reconstruct and predict the land environment quality of the Dongting Lake Area to assess the effect of human activities on the environment. The main finding was that with the decrease of Grade I and Grade II quality had a decreasing tendency in the lake area, mostly in suburbs and wetlands. Atmospheric water vapour, land use intensity, surface temperature, vegetation coverage, and soil water content were the main driving factors. The cause of degradation was the interference of multi-factor combinations, which led to positive and negative environmental agglomeration effects. Positive agglomeration, such as increased rainfall and vegetation coverage and reduced land use intensity, could increase environmental quality, while negative agglomeration resulted in the opposite. Therefore, reasonable ecological restoration measures should be beneficial to limit the negative effects and decreasing tendency, improve the land ecological environment quality and provide references for macroscopic planning by the government.

Increasing the Quality and Value of Conferences, Seminars, and Workshops

ERIC Educational Resources Information Center

Hoyt, Jeff E.; Whyte, Chrystine

2011-01-01

The purpose of this best practices article is to provide continuing education administrators with a reliable participant evaluation that measures factors predictive of not only satisfaction, but also perceived value: adequacy of topics, customer service, learning, quality of facilities, image, and quality of presentations, among other variables.…

Influence of spatial and temporal spot distribution on the ocular surface quality and maximum ablation depth after photoablation with a 1050 Hz excimer laser system.

PubMed

Mrochen, Michael; Schelling, Urs; Wuellner, Christian; Donitzky, Christof

2009-02-01

To investigate the effect of temporal and spatial distributions of laser spots (scan sequences) on the corneal surface quality after ablation and the maximum ablation of a given refractive correction after photoablation with a high-repetition-rate scanning-spot laser. IROC AG, Zurich, Switzerland, and WaveLight AG, Erlangen, Germany. Bovine corneas and poly(methyl methacrylate) (PMMA) plates were photoablated using a 1050 Hz excimer laser prototype for corneal laser surgery. Four temporal and spatial spot distributions (scan sequences) with different temporal overlapping factors were created for 3 myopic, 3 hyperopic, and 3 phototherapeutic keratectomy ablation profiles. Surface quality and maximum ablation depth were measured using a surface profiling system. The surface quality factor increased (rough surfaces) as the amount of temporal overlapping in the scan sequence and the amount of correction increased. The rise in surface quality factor was less for bovine corneas than for PMMA. The scan sequence might cause systematic substructures at the surface of the ablated material depending on the overlapping factor. The maximum ablation varied within the scan sequence. The temporal and spatial distribution of the laser spots (scan sequence) during a corneal laser procedure affected the surface quality and maximum ablation depth of the ablation profile. Corneal laser surgery could theoretically benefit from smaller spot sizes and higher repetition rates. The temporal and spatial spot distributions are relevant to achieving these aims.

Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes.

PubMed

Zhang, Pan; Lou, Peian; Chang, Guiqiu; Chen, Peipei; Zhang, Lei; Li, Ting; Qiao, Cheng

2016-04-05

Poor sleep quality and depression negatively impact the health-related quality of life of patients with type 2 diabetes, but the combined effect of the two factors is unknown. This study aimed to assess the interactive effects of poor sleep quality and depression on the quality of life in patients with type 2 diabetes. Patients with type 2 diabetes (n = 944) completed the Diabetes Specificity Quality of Life scale (DSQL) and questionnaires on sleep quality and depression. The products of poor sleep quality and depression were added to the logistic regression model to evaluate their multiplicative interactions, which were expressed as the relative excess risk of interaction (RERI), the attributable proportion (AP) of interaction, and the synergy index (S). Poor sleep quality and depressive symptoms both increased DSQL scores. The co-presence of poor sleep quality and depressive symptoms significantly reduced DSQL scores by a factor of 3.96 on biological interaction measures. The relative excess risk of interaction was 1.08. The combined effect of poor sleep quality and depressive symptoms was observed only in women. Patients with both depressive symptoms and poor sleep quality are at an increased risk of reduction in diabetes-related quality of life, and this risk is particularly high for women due to the interaction effect. Clinicians should screen for and treat sleep difficulties and depressive symptoms in patients with type 2 diabetes.

Application of the PRECEDE model to understanding mental health promoting behaviors in Hong Kong.

PubMed

Mo, Phoenix K H; Mak, Winnie W S

2008-08-01

The burdens related to mental illness have been increasingly recognized in many countries. Nevertheless, research in positive mental health behaviors remains scarce. This study utilizes the Predisposing, Reinforcing, and Enabling Causes in Education Diagnosis and Evaluation (PRECEDE) model to identify factors associated with mental health promoting behaviors and to examine the effects of these behaviors on mental well-being and quality of life among 941 adults in Hong Kong. Structural equation modeling shows that sense of coherence (predisposing factor), social support (reinforcing factor), and daily hassles (enabling factor) are significantly related to mental health promoting behaviors, which are associated with mental well-being and quality of life. Results of bootstrap analyses confirm the mediating role of mental health promoting behaviors on well-being and quality of life. The study supports the application of the PRECEDE model in understanding mental health promoting behaviors and demonstrates its relationships with well-being and quality of life.

Improved wheat for baking.

PubMed

Faridi, H; Finley, J W

1989-01-01

To bakers, wheat quality means the performance characteristics of the flour milled from the wheat when used in specific wheat products. The tremendous increase in the number of wheat cultivars grown in the U.S. in recent years, along with the unusual climate, new advances in milling technology, and increased automation of baking lines, have resulted in bakery production problems partly attributed to wheat flour quality. In this review various factors affecting wheat quality are explained. Concerns of bread and cookie/cracker manufacturers on deterioration of the wheat quality are discussed, and, finally, some solutions are proposed.

Quality management and job related factors predicting satisfaction of dental clinic staff in Estonia.

PubMed

Merisalu, Eda; Männik, Georg; Põlluste, Kaja

2014-01-01

The aim of the study was to explore the role of managerial style, work environment factors and burnout in determining job satisfaction during the implementation of quality improvement activities in a dental clinic. Quantitative research was carried out using a prestructured anonymous questionnaire to survey 302 respondents in Kaarli Dental Clinic, Estonia. Dental clinic staff assessed job satisfaction, managerial style, work stress and burnout levels through the implementation period of ISO 9000 quality management system in 2003 and annually during 2006-2009. Binary logistic regression was used to explain the impact of satisfaction with management and work organisation, knowledge about managerial activities, work environment and psychosocial stress and burnout on job satisfaction. The response rate limits were between 60% and 89.6%. Job satisfaction increased significantly from 2003 to 2006 and the percentage of very satisfied staff increased from 17 to 38 (p<0.01) over this period. In 2007, the proportion of very satisfied people dropped to 21% before increasing again in 2008-2009 (from 24% to 35%). Binary logistic regression analysis resulted in a model that included five groups of factors: managerial support, information about results achieved and progress to goals, work organisation and working environment, as well as factors related to career, security and planning. The average scores of emotional exhaustion showed significant decrease, correlating negatively with job satisfaction (p<0.05). The implementation of quality improvement activities in the Kaarli Dental Clinic has improved the work environment by decreasing burnout symptoms and increased job satisfaction in staff.

Factors associated with quality of life in patients undergoing coronary angioplasty

PubMed Central

Darvishpour, Azar; Javadi-Pashaki, Nazila; Salari, Arsalan; Sadeghi, Tahere; Taleshan-Nejad, Marayam

2017-01-01

Objective: Percutaneous coronary intervention has been effective in increasing longevity of patients with cardiovascular disease. However, the evidence shows that the quality of life after the intervention is still lower than optimal level. The quality of life can be affected by various factors. The aim of this study is to determine the quality of life and its related factors in patients undergoing coronary angioplasty. Methods: This cross-sectional study was performed on 106 patients undergoing coronary angioplasty during 2015-2016. This study population included all patients who referred to a cardiac clinic in Rasht, Iran, were passed 3 months after their angioplasty. Research samples met the inclusion criteria and were willing to participate to the study, were selected gradually (continually). Research tools were a self-structured questionnaire regarding factors associated with the quality of life and the MacNew quality of life questionnaire. Data were collected through asking patients questions and using patient’s medical records. Data analysis was conducted using descriptive and inferential statistics. Results: The results of multivariate linear regression analysis showed that independent variables of age (P = 0.0001), the number of diseased vessels (P = 0.0001), and the number of comorbidities (P < 0.05) were the most important factors associated with the quality of life. Conclusion: Health-care professionals can play an effective role in promoting the quality of life of patients undergoing coronary angioplasty by modifying lifestyle based on the related factors and to provide comprehensive care programs, especially for elderly. PMID:29085266

Quality factor concept in piezoceramic transformer performance description.

PubMed

Mezheritsky, Alex V

2006-02-01

A new general approach based on the quality factor concept to piezoceramic transformer (PT) performance description is proposed. The system's quality factor, material elastic anisotropy, and coupling factors of the input and output sections of an electrically excited and electrically loaded PT fully characterize its resonance and near-resonance behavior. The PT efficiency, transformation ratio, and input and output power were analytically analyzed and simulated as functions of the load and frequency for the simplest classical Langevin-type and Rosen-type PT designs. A new formulation of the electrical input impedance allows one to separate the power consumed by PT from the power transferred into the load. The system's PT quality factor takes into account losses in each PT "input-output-load" functional components. The loading process is changing PT input electrical impedance on the way that under loading the minimum series impedance is increasing and the maximum parallel impedance is decreasing coincidentally. The quality-factors ratio, between the states of fully loaded and nonloaded PT, is one of the best measures of PTs dynamic performance--practically, the lower the ratio is, the better PT efficiency. A simple and effective method for the loaded PT quality factor determination is proposed. As was found, a piezoceramic with low piezoelectric anisotropy is required to provide maximum PT efficiency and higher corresponding voltage gain. Limitations on the PT output voltage and power, caused by nonlinear effects in piezoceramics, were established.

Extracting Information about the Electronic Quality of Organic Solar-Cell Absorbers from Fill Factor and Thickness

NASA Astrophysics Data System (ADS)

Kaienburg, Pascal; Rau, Uwe; Kirchartz, Thomas

2016-08-01

Understanding the fill factor in organic solar cells remains challenging due to its complex dependence on a multitude of parameters. By means of drift-diffusion simulations, we thoroughly analyze the fill factor of such low-mobility systems and demonstrate its dependence on a collection coefficient defined in this work. We systematically discuss the effect of different recombination mechanisms, space-charge regions, and contact properties. Based on these findings, we are able to interpret the thickness dependence of the fill factor for different experimental studies from the literature. The presented model provides a facile method to extract the photoactive layer's electronic quality which is of particular importance for the fill factor. We illustrate that over the past 15 years, the electronic quality has not been continuously improved, although organic solar-cell efficiencies increased steadily over the same period of time. Only recent reports show the synthesis of polymers for semiconducting films of high electronic quality that are able to produce new efficiency records.

Profiles of the evaluators: impact of psychographic variables on the consumer-oriented quality assessment of mobile television

NASA Astrophysics Data System (ADS)

Jumisko-Pyykkö, Satu; Häkkinen, Jukka

2008-02-01

In the product development of services it is important to adjust mobile video quality according to the quality requirements of potential users. Therefore, a careful participant selection is very important. However, in the literature the details of participant selection are often handled without great detail. This is also reflected in the handling of experimental results, where the impact of psychographic factors on quality is rarely reported. As the user attributes potentially have a large effect to the results, we investigated the role of various psychographical variables on the subjective evaluation of audiovisual video quality in two different experiments. The studied variables were age, gender, education, professionalism, television consumption, experiences of different digital video qualities, and attitude towards technology. The results showed that quality evaluations were affected by almost all background factors. The most significant variables were age, professionalism, knowledge of digital quality features and attitude towards technology. The knowledge of these factors can be exploited in careful participant selection, which will in turn increase the validity of results as the subjective evaluations reflect better the requirements of potential users.

Teachers' Incentives and Professional Development in Schools in Mexico. Working Paper.

ERIC Educational Resources Information Center

Lopez-Acevedo, Gladys

Quality of education is a determining factor in a nation's competitiveness. Although Mexico has made tremendous progress toward achieving universal basic education, school quality has not kept pace with enrollment increases, especially in rural areas. Innovations at the federal and state levels to raise the quality of basic education in Mexico…

Constructing a consumption model of fine dining from the perspective of behavioral economics

PubMed Central

Tsai, Sang-Bing

2018-01-01

Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants. PMID:29641554

Constructing a consumption model of fine dining from the perspective of behavioral economics.

PubMed

Hsu, Sheng-Hsun; Hsiao, Cheng-Fu; Tsai, Sang-Bing

2018-01-01

Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants.

Live births achieved via IVF are increased by improvements in air quality and laboratory environment.

PubMed

Heitmann, Ryan J; Hill, Micah J; James, Aidita N; Schimmel, Tim; Segars, James H; Csokmay, John M; Cohen, Jacques; Payson, Mark D

2015-09-01

Infertility is a common disease, which causes many couples to seek treatment with assisted reproduction techniques. Many factors contribute to successful assisted reproduction technique outcomes. One important factor is laboratory environment and air quality. Our facility had the unique opportunity to compare consecutively used, but separate assisted reproduction technique laboratories, as a result of a required move. Environmental conditions were improved by strategic engineering designs. All other aspects of the IVF laboratory, including equipment, physicians, embryologists, nursing staff and protocols, were kept constant between facilities. Air quality testing showed improved air quality at the new IVF site. Embryo implantation (32.4% versus 24.3%; P < 0.01) and live birth (39.3% versus 31.8%, P < 0.05) were significantly increased in the new facility compared with the old facility. More patients met clinical criteria and underwent mandatory single embryo transfer on day 5 leading to both a reduction in multiple gestation pregnancies and increased numbers of vitrified embryos per patient with supernumerary embryos available. Improvements in IVF laboratory conditions and air quality had profound positive effects on laboratory measures and patient outcomes. This study further strengthens the importance of the laboratory environment and air quality in the success of an IVF programme. Published by Elsevier Ltd.

Factors Supporting Implementation of Executive Coaching as Embedded Professional Learning for Superintendents in New York State

ERIC Educational Resources Information Center

Nuciforo, Cheryl A.

2015-01-01

The role of school superintendent has become increasingly complex. As school district leaders deal with new curriculum standards, increased accountability, and limited financial resources, they are in need of quality professional development tailored to their needs. This qualitative study explores personal, cultural, and structural factors that…

Service Quality: A Main Determinant Factor for Health Information System Success in Low-resource Settings.

PubMed

Tilahun, Binyam; Fritz, Fleur

2015-01-01

With the increasing implementation of different health information systems in developing countries, there is a growing need to measure the main determinants of their success. The results of this evaluation study on the determinants of HIS success in five low resource setting hospitals show that service quality is the main determinant factor for information system success in those kind of settings.

The impact of work culture on quality of care in nursing homes--a review study.

PubMed

André, Beate; Sjøvold, Endre; Rannestad, Toril; Ringdal, Gerd I

2014-09-01

The main aim of this review study was to identify which factors that characterise the relationship between work culture and quality of care in nursing homes. This review study was structured through systematic search methods to identify articles that describe the relationship between work culture and quality of care in nursing homes. The database search yielded 14510 hits. Closer examination showed that 10401 of these hits were duplicates. Of the remaining 4109 articles, only 10 were related to our aim for the study. A qualitative method were used to explain and understand phenomena of work culture and quality if care in nursing homes. Nine out of 10 articles in this review study emphasise the importance of leadership style and supportive management to increase quality of care in nursing homes. Increased empowerment, participation and influence were important factors for improving quality of care. Significant associations between work culture and quality of care and between empowerment and quality of care were reported. Nursing management and leaders must take in consideration that work culture is crucial for improving quality of care in nursing homes, and this study can be used to increase the focus on the work culture among healthcare personnel in nursing homes. Changes are necessary to increase healthcare personnel's job satisfaction, empowerment, autonomy and influence in nursing homes. Giving empowerment to the healthcare personnel working in nursing homes is both an organisational and an interpersonal issue. Being given empowerment and influence over their own work situation, the healthcare workers can be more committed and involved in the goal of obtaining best possible care to the residents. © 2013 Nordic College of Caring Science.

Optimizing care in osteoporosis: The Canadian quality circle project

PubMed Central

Ioannidis, George; Thabane, Lehana; Gafni, Amiram; Hodsman, Anthony; Kvern, Brent; Johnstone, Dan; Plumley, Nathalie; Salach, Lena; Jiwa, Famida; Adachi, Jonathan D; Papaioannou, Alexandra

2008-01-01

Background While the Osteoporosis Canada 2002 Canadian guidelines provided evidence based strategies in preventing, diagnosing, and managing this condition, publication and distribution of guidelines have not, in and of themselves, been shown to alter physicians clinical approaches. We hypothesize that primary care physicians enrolled in the Quality Circle project would change their patient management of osteoporosis in terms of awareness of osteoporosis risk factors and bone mineral density testing in accordance with the guidelines. Methods The project consisted of five Quality Circle phases that included: 1) Training & Baseline Data Collection, 2) First Educational Intervention & First Follow-Up Data Collection 3) First Strategy Implementation Session, 4) Final Educational Intervention & Final Follow-up Data Collection, and 5) Final Strategy Implementation Session. A total of 340 circle members formed 34 quality circles and participated in the study. The generalized estimating equations approach was used to model physician awareness of risk factors for osteoporosis and appropriate utilization of bone mineral density testing pre and post educational intervention (first year of the study). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Results After the 1st year of the study, physicians' certainty of their patients' risk factor status increased. Certainty varied from an OR of 1.4 (95% CI: 1.1, 1.8) for prior vertebral fracture status to 6.3 (95% CI: 2.3, 17.9) for prior hip fracture status. Furthermore, bone mineral density testing increased in high risk as compared with low risk patients (OR: 1.4; 95% CI: 1.2, 1.7). Conclusion Quality Circle methodology was successful in increasing both physicians' awareness of osteoporosis risk factors and appropriate bone mineral density testing in accordance with the 2002 Canadian guidelines. PMID:18828906

Change in quality of life of people with dementia recently admitted to long-term care facilities.

PubMed

Beerens, Hanneke C; Zwakhalen, Sandra M G; Verbeek, Hilde; Ruwaard, Dirk; Ambergen, Antonius W; Leino-Kilpi, Helena; Stephan, Astrid; Zabalegui, Adelaida; Soto, Maria; Saks, Kai; Bökberg, Christina; Sutcliffe, Caroline L; Hamers, Jan P H

2015-06-01

To assess which factors are associated with change in quality of life of people with dementia who have recently been admitted to long-term care facilities. Many people with dementia will be admitted to long-term care facilities at some point during their disease. It is currently unknown which factors are associated with improvement and/or deterioration of quality of life immediately following admission. An observational and longitudinal survey. Data on 343 people with dementia who have been recently admitted to long-term care facilities across eight European countries were collected between November 2010-April 2012. Quality of life was assessed by people with dementia and their proxies using the 'Quality of Life-Alzheimer's Disease scale'. Explanatory variables included cognitive status, comorbidities, activities of daily living, depressive symptoms and neuropsychiatric symptoms. Descriptive and multilevel regression analyses were performed. Better cognitive abilities at baseline were associated with a decrease in self-reported quality of life. Greater dependency and more depressive symptoms at baseline were associated with declined proxy-reported quality of life. Furthermore, an increased dependency and an increase of depressive symptoms between baseline and follow-up were associated with a decreased proxy-reported quality of life. On an individual level, three groups were identified, namely people whose quality of life: (1) decreased; (2) stayed the same; and (3) increased. Cognitive functioning, functional rehabilitation and treatment of depressive symptoms should receive special attention. However, quality of life of people with dementia does not necessarily decrease after institutionalization. © 2014 John Wiley & Sons Ltd.

Pain and quality of life in Turkish cancer patients.

PubMed

Ovayolu, Nimet; Ovayolu, Özlem; Serçe, Sibel; Tuna, Döndü; Pirbudak Çöçelli, Lütfiye; Sevinç, Alper

2013-12-01

This study was designed to examine the relationship between patients' pain severity and their self-reported quality of life, to evaluate factors that may affect pain and quality of life, and to assess patients' opinions and practices on the use of analgesics. The study was conducted with 260 cancer patients. Data were collected using a Quality of Life Scale and Visual Analog Scale questionnaire. It was found that mean scores of pain, all subdomains of quality of life, and overall mean scores of patients were at a moderate level, the lowest score in the subdomains of quality of life was in the psychological subdomain and the highest was in the spiritual subdomain. It was also found that as severity of pain experienced by patients increased, their general activities, mood, activeness, sleep, and nutrition were negatively affected. As severity of pain experienced by patients increased, their quality of life worsened. Patients were observed to have insufficient knowledge and a poor understanding with respect to the use of analgesics. In conclusion, it is very important for nurses to assess factors that can complicate pain management and to establish an effective pain control. © 2013 Wiley Publishing Asia Pty Ltd.

School-level factors associated with increased fruit and vegetable consumption among students in California middle and high schools.

PubMed

Gosliner, Wendi

2014-09-01

This study assessed associations between selective school-level factors and students' consumption of fruits and vegetables at school. Better understanding of school factors associated with increased produce consumption is especially important, as students are served more produce items at school. This cross-sectional study included 5439 seventh- and ninth-grade students from 31 schools in California in 2010. Multilevel regression models estimated whether the odds of consuming fruits or vegetables at school among students eating the school lunch were associated with the length of the lunch period, quality/variety of produce options, or other factors. A longer lunch period was associated with increased odds of a student eating fruits (odds ratio [OR] = 1.40) and vegetables (OR = 1.54) at school. Better fruit quality increased the odds of a student consuming fruit (OR = 1.44). Including a salad bar and involving students in food service decisions increased a student's odds of consuming vegetables (OR = 1.48 and OR = 1.34, respectively). This study suggests that institutional factors in schools are positively associated with middle and high school students' consumption of produce items at school. Additional efforts to structure school meal environments to enhance students' consumption of produce items can benefit students' nutrition and health. © 2014, American School Health Association.

Prospective associations of co-rumination with friendship and emotional adjustment: considering the socioemotional trade-offs of co-rumination.

PubMed

Rose, Amanda J; Carlson, Wendy; Waller, Erika M

2007-07-01

Co-ruminating, or excessively discussing problems, with friends is proposed to have adjustment tradeoffs. Co-rumination is hypothesized to contribute both to positive friendship adjustment and to problematic emotional adjustment. Previous single-assessment research was consistent with this hypothesis, but whether co-rumination is an antecedent of adjustment changes was unknown. A 6-month longitudinal study with middle childhood to midadolescent youths examined whether co-rumination is simultaneously a risk factor (for depression and anxiety) and a protective factor (for friendship problems). For girls, a reciprocal relationship was found in which co-rumination predicted increased depressive and anxiety symptoms and increased positive friendship quality over time, which, in turn, contributed to greater co-rumination. For boys, having depressive and anxiety symptoms and high-quality friendships also predicted increased co-rumination. However, for boys, co-rumination predicted only increasing positive friendship quality and not increasing depression and anxiety. An implication of this research is that some girls at risk for developing internalizing problems may go undetected because they have seemingly supportive friendships. Copyright 2007 APA.

Prospective Associations of Co-Rumination with Friendship and Emotional Adjustment: Considering the Socioemotional Trade-Offs of Co-Rumination

PubMed Central

Rose, Amanda J.; Carlson, Wendy; Waller, Erika M.

2012-01-01

Co-ruminating, or excessively discussing problems, with friends is proposed to have adjustment trade-offs. Co-rumination is hypothesized to contribute both to positive friendship adjustment and to problematic emotional adjustment. Previous single-assessment research was consistent with this hypothesis, but whether co-rumination is an antecedent of adjustment changes was unknown. A six-month longitudinal study with middle childhood to mid-adolescent youth examined whether co-rumination is simultaneously a risk factor (for depression and anxiety) and a protective factor (for friendship problems). For girls, a reciprocal relationship was found in which co-rumination predicted increased depressive and anxiety symptoms and increased positive friendship quality over time, which, in turn, contributed to greater co-rumination. For boys, having depressive and anxiety symptoms and high-quality friendships also predicted increased co-rumination. However, for boys, co-rumination predicted only increasing positive friendship quality and not increasing depression and anxiety. An implication of this research is that some girls at risk for developing internalizing problems may go undetected because they have seemingly supportive friendships. PMID:17605532

Understanding critical factors for the quality and shelf-life of MAP fresh meat: a review.

PubMed

Singh, Preeti; Wani, Ali Abas; Saengerlaub, Sven; Langowski, Horst-Christian

2011-02-01

Due to increased demands for greater stringency in relation to hygiene and safety issues associated with fresh food products, coupled with ever-increasing demands by retailers for cost-effective extensions to product shelf-lives and the requirement to meet consumer expectations in relation to convenience and quality, the food packaging industry has rapidly developed to meet and satisfy expectations. One of the areas of research that has shown promise, and had success, is modified atmosphere packaging (MAP). The success of MAP-fresh meat depends on many factors including good initial product quality, good hygiene from the source plants, correct packaging material selection, the appropriate gas mix for the product, reliable packaging equipment, and maintenance of controlled temperatures and humidity levels. Advances in plastic materials and equipment have propelled advances in MAP, but other technological and logistical considerations are needed for successful MAP systems for raw chilled meat. Although several parameters critical for the quality of MA packed meat have been studied and each found to be crucial, understanding of the interactions between the parameters is needed. This review was undertaken to present the most comprehensive and current overview of the widely available, scattered information about the various integrated critical factors responsible for the quality and shelf life of MA packed meat with an interest to stimulate further research to optimize different quality parameters.

Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

PubMed

Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

2013-01-01

In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors.

Sociodemographic factors associated with sleep quality and sleep duration in adolescents from Santa Catarina, Brazil: what changed between 2001 and 2011?

PubMed

Hoefelmann, Luana Peter; Lopes, Adair da Silva; da Silva, Kelly Samara; Moritz, Pablo; Nahas, Markus Vinicius

2013-10-01

We aimed to identify and compare the sociodemographic and economic factors associated with perceived sleep quality and sleep duration in high school students from Santa Catarina, Brazil (2001 and 2011). Our study used a school-based, cross-sectional survey administered in 2001 and 2011 to high school students aged 15-19 years (n=5028 in 2001; n=6529 in 2011) enrolled in public schools in Santa Catarina, Brazil. The students responded to a questionnaire that asked about the number of hours slept on school days (insufficient, <8 h; sufficient, > or = 8 h), perceived sleep quality (adequate or poor), sociodemographic characteristics (gender, age, and area), economic factors (work and family income), and school-related variables (grade and shift). The prevalence of poor sleep quality and insufficient sleep increased by 31.2% and 45.9%, respectively, between 2001 and 2011. Remunerated employment, urban environment, male gender, and high family income were strongly associated with these outcomes. There was a notable increase in insufficient sleep and the perception of poor sleep quality among the students in Santa Catarina in the last decade. Public policies are needed to ameliorate this situation, which has disastrous consequences for the health of adolescents. Copyright © 2013 Elsevier B.V. All rights reserved.

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

PubMed Central

Graffigna, Guendalina; Bonanomi, Andrea

2017-01-01

Background Increasing bodies of scientific research today examines the factors and interventions affecting patients’ ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients’ ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. Objective To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. Material and methods This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 –short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients’ emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. Results According to the theoretical model we hypothesized, research results confirmed that patients’ activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients’ quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Conclusions Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence. PMID:28654686

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model.

PubMed

Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea

2017-01-01

Increasing bodies of scientific research today examines the factors and interventions affecting patients' ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients' ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 -short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients' emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. According to the theoretical model we hypothesized, research results confirmed that patients' activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients' quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence.

Analysis of the Factors Affecting Consumer Acceptance of Accredited Online Health Information

PubMed Central

2017-01-01

With the increasing use of the internet and the spread of smartphones, health information seekers obtain considerable information through the internet. As the amount of online health information increases, the need for quality management of health information has been emphasized. The purpose of this study was to investigate the factors affecting the intention of using accredited online health information by applying the extended technology acceptance model (Extended-TAM). An online survey was conducted from September 15, 2016 to October 3, 2016, on 500 men and women aged 19–69 years. The results showed that the greatest factor influencing the acceptance of the accredited health information was perceived usefulness, and the expectation for the quality of the accreditation system was the most important mediator variable. In order to establish the health information accreditation system as a means to provide easy and useful information to the consumers, it is necessary to carry out quality management and promote the system through the continuous monitoring of the accreditation system. PMID:28960026

Shallow ground-water quality beneath cropland in the Red River of the North Basin, Minnesota and North Dakota, 1993-95

USGS Publications Warehouse

Cowdery, Timothy K.

1997-01-01

Land-use factors that increased nitrate and herbicide concentrations were greater tilled area, chemical application, irrigation, and cropland contiguity. Hydrogeological factors that increased these concentrations were a deeper watertable (higher oxygen concentration and less organic carbon), larger grain-size and degree of sorting of aquifer material (shorter time in the soil zone and aquifer), and fewer sulfur-containing minerals (lignite and pyrite) composing the aquifer. High rainfall, just before sampling of the Sheyenne Delta aquifer, contributed to the relatively low nitrate and pesticide concentrations in the shallow ground water of this aquifer by raising the water table higher into the soil zone, increasing ponded water (increasing biodegradation), preventing some chemical application (flooded fields), and leaching and then displacing nitrate-rich water downward, beneath new recharge. The shallow ground-water quality measured beneath cropland in these land-use study areas covers a large range. The land-use, hydrogeological, and rainfall factors controlling this quality also control shallow ground-water quality in other surficial aquifers in the Red River of the North Basin. Although not used for drinking water, 43% of the shallow ground water from the Otter Tail outwash aquifer was above the U.S. Environmental Protection Agency's nitrate maximum contaminant level of 10 mg/L-N, reducing its potential uses. These high nitrate concentrations do not threaten the Otter Tail outwash aquifer's surface-water bodies with eutrophication however, because significant denitrification occurs beneath riparian wetlands before ground water discharges to surface waters.

Influences on diet quality in older age: the importance of social factors.

PubMed

Bloom, Ilse; Edwards, Mark; Jameson, Karen A; Syddall, Holly E; Dennison, Elaine; Gale, Catharine R; Baird, Janis; Cooper, Cyrus; Aihie Sayer, Avan; Robinson, Sian

2017-03-01

poor diet quality is common among older people, but little is known about influences on food choice, including the role of psychosocial factors at this age. to identify psychosocial correlates of diet quality in a community-dwelling population of men and women aged 59-73 years; to describe relationships with change in diet quality over 10 years. Longitudinal cohort, Hertfordshire Cohort Study (HCS). HCS participants assessed at baseline (1998-2003: 1,048 men, 862 women); 183 men and 189 women re-assessed in 2011. diet was assessed by administered food frequency questionnaire; diet scores were calculated to describe diet quality at baseline and follow-up. A range of psychosocial factors (social support, social network, participation in leisure activities, depression and anxiety, sense of control) were assessed by questionnaire. at baseline, better diet quality was related to a range of social factors, including increased confiding/emotional social support (men and women), practical support (men) and a larger social network (women) (all P < 0.05). For both men and women, greater participation in social and cognitive leisure activities was related to better diet quality (P < 0.005). There were few associations between measured psychosocial factors at baseline and change in diet score over 10 years, in the follow-up sub-group. However, greater participation in leisure activities, especially cognitive activities, at baseline was associated with smaller declines in diet quality over the 10-year follow-up period for both men (P = 0.017) and women (P = 0.014). in community-dwelling older adults, a range of social factors, that includes greater participation in leisure activities, were associated with diets of better quality. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Factors Influencing Food Choices Among Older Adults in the Rural Western USA.

PubMed

Byker Shanks, Carmen; Haack, Sarah; Tarabochia, Dawn; Bates, Kate; Christenson, Lori

2017-06-01

Nutrition is an essential component in promoting health and quality of life into the older adults years. The purpose of this qualitative research is to explore how the rural food environment influences food choices of older adults. Four focus groups were conducted with 33 older adults (50 years of age and older) residing in rural Montana communities. Four major themes related to factors influencing food choices among rural older adults emerged from this study: perception of the rural community environment, support as a means of increasing food access, personal access to food sources, and dietary factors. The findings from this current study warrant further research and promotion of specifically tailored approaches that influence the food choices of older adults in the rural western USA, including the developing and expanding public transportation systems, increasing availability of local grocers with quality and affordable food options, increasing awareness and decreasing stigma surrounding community food programs, and increasing nutrition education targeting senior health issues.

Research on Air Quality Evaluation based on Principal Component Analysis

NASA Astrophysics Data System (ADS)

Wang, Xing; Wang, Zilin; Guo, Min; Chen, Wei; Zhang, Huan

2018-01-01

Economic growth has led to environmental capacity decline and the deterioration of air quality. Air quality evaluation as a fundamental of environmental monitoring and air pollution control has become increasingly important. Based on the principal component analysis (PCA), this paper evaluates the air quality of a large city in Beijing-Tianjin-Hebei Area in recent 10 years and identifies influencing factors, in order to provide reference to air quality management and air pollution control.

Indoor air quality: A psychosocial perspective

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

Boxer, P.A.

1990-05-01

The incidence of indoor air quality problems has increased dramatically over the past decade. Investigation of these problems has yielded a definitive cause in only one third of the cases. Psychosocial factors may play a key role in the development and propagation of symptoms attributed to poor indoor air quality. Guidelines for managing indoor air quality problems from the organizational perspective are based upon psychosocial principles and elements of risk perception.

Can better infrastructure and quality reduce hospital infant mortality rates in Mexico?

PubMed

Aguilera, Nelly; Marrufo, Grecia M

2007-02-01

Preliminary evidence from hospital discharges hints enormous disparities in infant hospital mortality rates. At the same time, public health agencies acknowledge severe deficiencies and variations in the quality of medical services across public hospitals. Despite these concerns, there is limited evidence of the contribution of hospital infrastructure and quality in explaining variations in outcomes among those who have access to medical services provided at public hospitals. This paper provides evidence to address this question. We use probabilistic econometric methods to estimate the impact of material and human resources and hospital quality on the probability that an infant dies controlling for socioeconomic, maternal and reproductive risk factors. As a measure of quality, we calculate for the first time for Mexico patient safety indicators developed by the AHRQ. We find that the probability to die is affected by hospital infrastructure and by quality. In this last regard, having been treated in a hospital with the worse quality incidence doubles the probability to die. This paper also presents evidence on the contribution of other risk factors on perinatal mortality rates. The conclusions of this paper suggest that lower infant mortality rates can be reached by implementing a set of coherent public policy actions including an increase and reorganization of hospital infrastructure, quality improvement, and increasing demand for health by poor families.

Investigation of Demographic Properties and Motivation Factors of Physics Teachers

ERIC Educational Resources Information Center

Guzel, Hatice

2011-01-01

Scientific and technological developments resulted in an increase in the requirement of education in the society. In addition to this, the expectations from teachers differed and the need for more qualified teachers also increased. One of the factors affecting the quality of teachers is their motivation. In this research, it was aimed to reveal…

Physical and sensory quality of Java Arabica green coffee beans

NASA Astrophysics Data System (ADS)

Sunarharum, W. B.; Yuwono, S. S.; Pangestu, N. B. S. W.; Nadhiroh, H.

2018-03-01

Demand on high quality coffee for consumption is continually increasing not only in the consuming countries (importers) but also in the producing countries (exporters). Coffee quality could be affected by several factors from farm to cup including the post-harvest processing methods. This research aimed to investigate the influence of different post-harvest processing methods on physical and sensory quality of Java Arabica green coffee beans. The two factors being evaluated were three different post-harvest processing methods to produce green coffee beans (natural/dry, semi-washed and fully-washed processing) under sun drying. Physical quality evaluation was based on The Indonesian National Standard (SNI 01-2907-2008) while sensory quality was evaluated by five expert judges. The result shows that less defects observed in wet processed coffee as compared to the dry processing. The mechanical drying was also proven to yield a higher quality green coffee beans and minimise losses.

Cotton harvesting emission factors based on source sampling

USDA-ARS?s Scientific Manuscript database

Air quality regulation across the U.S. is intensifying due to increasing public concern for environmental protection. Non-attainment status with Federal particulate matter (PM) air quality standards has forced air pollution regulators in some states to focus emission reduction efforts on previously ...

Upper Illinois River basin

USGS Publications Warehouse

Friedel, Michael J.

1998-01-01

During the past 25 years, industry and government made large financial investments that resulted in better water quality across the Nation; however, many water-quality concerns remain. Following a 1986 pilot project, the U.S. Geological Survey began implementation of the National Water-Quality Assessment (NAWQA) Program in 1991. This program differs from other national water-quality assessment studies in that the NAWQA integrates monitoring of surface- and ground-water quality with the study of aquatic ecosystems. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers (water-bearing sediments and rocks), (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality.The Upper Illinois River Basin National Water- Quality Assessment (NAWQA) study will increase the scientific understanding of surface- and ground-water quality and the factors that affect water quality in the basin. The study also will provide information needed by water-resource managers to implement effective water-quality management actions and evaluate long-term changes in water quality.

Silicon nano-membrane based photonic crystal microcavities for high sensitivity bio-sensing.

PubMed

Lai, Wei-Cheng; Chakravarty, Swapnajit; Zou, Yi; Chen, Ray T

2012-04-01

We experimentally demonstrated photonic crystal microcavity based resonant sensors coupled to photonic crystal waveguides in silicon nano-membrane on insulator for chemical and bio-sensing. Linear L-type microcavities are considered. In contrast to cavities with small mode volumes, but low quality factors for bio-sensing, we showed increasing the length of the microcavity enhances the quality factor of the resonance by an order of magnitude and increases the resonance wavelength shift while retaining compact device characteristics. Q~26760 and sensitivity down to 15 ng/ml and ~110 pg/mm2 in bio-sensing was experimentally demonstrated on silicon-on-insulator devices.

The School Climate Improvement "Process": Essential Elements. School Climate Brief, Number 4

ERIC Educational Resources Information Center

National School Climate Center, 2012

2012-01-01

Student learning and development are a function of both individual and systemic factors. Individual factors include students' motivation as well as their intellectual and social abilities. Systemic factors include teacher quality, administrative leadership, community engagement, and learning environments. The increasing numbers of children living…

The role of exogenous risk factors of antituberculosis treatment failure.

PubMed

Lesnic, Evelina; Ustian, Aurelia; Pop, Carmen Monica

2016-01-01

The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. The study of exogenous risk factors in vulnerable groups will contribute to the precocious detection of patients predisposed to failing the tuberculosis treatment and will permit the initiation of measures centered on patient that will favor the increase of treatment quality and success rate.

The role of exogenous risk factors of antituberculosis treatment failure

PubMed Central

LESNIC, EVELINA; USTIAN, AURELIA; POP, CARMEN MONICA

2016-01-01

Background and aim The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. Methods The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. Results The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. Conclusions The study of exogenous risk factors in vulnerable groups will contribute to the precocious detection of patients predisposed to failing the tuberculosis treatment and will permit the initiation of measures centered on patient that will favor the increase of treatment quality and success rate. PMID:27547060

Perceived Factors Associated with Sustained Improvement Following Participation in a Multicenter Quality Improvement Collaborative.

PubMed

Stone, Sohini; Lee, Henry C; Sharek, Paul J

2016-07-01

The California Perinatal Quality Care Collaborative led the Breastmilk Nutrition Quality Improvement Collaborative from October 2009 to September 2010 to increase the percentage of very low birth weight infants receiving breast milk at discharge in 11 collaborative neonatal ICUs (NICUs). Observed increases in breast milk feeding and decreases in necrotizing enterocolitis persisted for 6 months after the collaborative ended. Eighteen to 24 months after the end of the collaborative, some sites maintained or further increased their gains, while others trended back toward baseline. A study was conducted to assess the qualitative factors that affect sustained improvement following participation. Collaborative leaders at each of the 11 NICUs that participated in the Breastmilk Nutrition Quality Improvement Collaborative were invited to participate in a site-specific one-hour phone interview. Interviews were recorded and transcribed and then analyzed using qualitative research analysis software to identify themes associated with sustained improvement. Eight of 11 invited centers agreed to participate in the interviews. Thematic saturation was achieved by the sixth interview, so further interviews were not pursued. Factors contributing to sustainability included physician involvement within the multidisciplinary teams, continuous education, incorporation of interventions into the daily work flow, and integration of a data-driven feedback system. Early consideration by site leaders of how to integrate best-practice interventions into the daily work flow, and ensuring physician commitment and ongoing education based in continuous data review, should enhance the likelihood of sustaining improvements. To maximize sustained success, future collaborative design should consider proactively identifying and supporting these factors at participating sites.

Meteorological and urban landscape factors on severe air pollution in Beijing.

PubMed

Han, Lijian; Zhou, Weiqi; Li, Weifeng; Meshesha, Derege T; Li, Li; Zheng, Mingqing

2015-07-01

Air pollution gained special attention with the rapid development in Beijing. In January 2013, Beijing experienced extreme air pollution, which was not well examined. We thus examine the magnitude of air quality in the particular month by applying the air quality index (AQI), which is based on the newly upgraded Chinese environmental standard. Our finding revealed that (1) air quality has distinct spatial heterogeneity and relatively better air quality was observed in the northwest while worse quality happened in the southeast part of the city; (2) the wind speed is the main determinant of air quality in the city-when wind speed is greater than 4 m/sec, air quality can be significantly improved; and (3) urban impervious surface makes a contribution to the severity of air pollution-that is, with an increase in the fraction of impervious surface in a given area, air pollution is more severe. The results from our study demonstrated the severe pollution in Beijing and its meteorological and landscape factors. Also, the results of this work suggest that very strict air quality management should be conducted when wind speed less than 4 m/sec, especially at places with a large fraction of urban impervious surface. Prevention of air pollution is rare among methods with controls on meteorological and urban landscape conditions. We present research that utilizes the latest air quality index (AQI) to compare air pollution with meteorological and landscape conditions. We found that wind is the major meteorological factor that determines the air quality. For a given wind speed greater than 4 m/sec, the air quality improved significantly. Urban impervious surface also contributes to the severe air pollution: that is, when the fraction of impervious surface increases, there is more severe air pollution. These results suggest that air quality management should be conducted when wind speed is less than 4 m/sec, especially at places with a larger fraction of urban impervious surface.

Higher-Order Factor Analysis as a Score Validity Evaluation Tool: An Example with a Measure of Perceptions of Library Service Quality.

ERIC Educational Resources Information Center

Cook, Colleen; Thompson, Bruce

The SERVQUAL measure was developed by A. Parasuraman, L. Berry, and V. Zeithaml (1988) to measure perceptions of service quality, originally in the retailing sector. However, libraries and other educational institutions are also service providers. Librarians in particular have increasingly become interested in measuring quality of service as the…

Distributing value gain from three growth factors for yellow-poplar

Treesearch

Roger E. McCay

1969-01-01

A method of apportioning the maximum dollar value gain from tree growth into the amounts contributed by diameter growth, merchantable height increase, and quality improvement is described. The results of this method are presented for various sizes and qualities of yellow-poplar trees.

Near-Road Air Quality Monitoring: Factors Affecting Network Design and Interpretation of Data

EPA Science Inventory

The growing number of health studies identifying adverse health effects for populations spending significant amounts of time near large roadways has increased the interest in monitoring air quality in this microenvironment. Designing near-road air monitoring networks or interpret...

PROJECTING WILDLIFE RESPONSES TO ALTERNATIVE FUTURE LANDSCAPES IN OREGON'S WILLAMETTE VALLEY

EPA Science Inventory

Increasingly, environmental quality is becoming recognized as a critical factor that should constrain land use planning. One important measure of a landscape's quality is its capacity to support viable populations of wildlife species. But the ability of land managers to balance c...

[Clinical trial with educational intervention in perimenopausal women with cardiovascular risk factor].

PubMed

Soto-Rodríguez, Anxela; García-Soidán, José Luís; de Toro-Santos, Manuel; Rodríguez-González, Manuel; Arias-Gómez, M Jesús; Pérez-Fernández, María Reyes

To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. A randomized clinical trial. physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01). A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Is the quality of drinking water a risk factor for self-reported forearm fractures? Cohort of Norway.

PubMed

Dahl, C; Søgaard, A J; Tell, G S; Flaten, T P; Krogh, T; Aamodt, G

2013-02-01

Compared to pH ≥7.0 in Norwegian municipal drinking water, pH <7.0 increased the risk of forearm fractures in the population-based Cohort of Norway (CONOR; n = 127,272). The association was attenuated (p > 0.05) after adjustments for indicators of bacteria and organic matter, which may signify an association between poor drinking water and bone health. The Norwegian population has the highest rate of fractures ever reported. A large variation in fracture rate both between and within countries indicates that an environmental factor, such as the quality of drinking water, could be one of the causes of the disparities. Our aim was to investigate a possible association between pH (an important parameter for water quality) and self-reported forearm fracture and to examine whether other water quality factors could account for this association. Using Geographic Information Systems, information on the quality of drinking water was linked to CONOR (n = 127,272; mean age, 50.2 ± 15.8 years), a database comprising ten regional epidemiological health surveys from across the country in the time period 1994-2003. The highest risk of forearm fracture was found at a pH of around 6.75, with a decreasing risk toward both higher and lower pH values. The increased adjusted odds of forearm fracture in men consuming municipal drinking water with pH <7.0 compared to water with pH ≥7.0 was odds ratio (OR) = 1.19 (95 % CI, 1.14, 1.25), and the corresponding increased odds in women was OR = 1.14 (95 % CI, 1.08, 1.19). This association was attenuated (p > 0.05) after further adjustments for other water quality factors (color grade, intestinal enterococci, and Clostridium perfringens). Our findings indicate a higher risk of fracture when consuming water of an acidic pH; however, the risk does not only seem to be due to the acidity level per se, but also to other aspects of water quality associated with pH.

Quality of life and cost factors in panic disorder.

PubMed

Davidson, J R

1996-01-01

Quality of life encompasses domains of personal happiness, role fulfillment, and health status. Increasing attention has been paid to the relationship between quality of life and panic disorder, with accumulating evidence now available to suggest impairment in several domains among subjects with panic disorder. This review summarizes the results of community-based and treatment-seeking populations of subjects with panic disorder. Impaired personal happiness, restricted role functioning, and increased use of health services are all described. Evidence suggests that accurate diagnosis and effective treatment can significantly lessen health service utilization, resulting in substantial cost offset and also leading to increased work productivity and personal effectiveness.

Quality evaluation of Persian nutrition and diet therapy websites.

PubMed

Gholizadeh, Zahra; Papi, Ahmad; Ashrafi-Rizi, Hasan; Shahrzadi, Leila; Hasanzadeh, Akbar

2017-01-01

Nowadays websites are among the most important information sources used by most people. With the spread of websites, especially those related to health issues, the number of their visitors also increases, more than half of which are about nutritional information. Therefore, quality analysis of nutrition and diet therapy websites is of outmost importance. This study aims to evaluate the quality of Persian nutrition and diet therapy websites. The current work is a survey study and uses an applied study method. The statistical population consists of 51 Persian websites about nutrition and diet therapy and census method was used in order to study them. Data gathering was done using a checklist and with direct visit to each website. Descriptive and analytical statistics were used to analyse the gathered data with the help of SPSS 21 software. Findings showed that content (66.7%), organization (82.4%), user friendly interfaces (52.9%) and total quality (70.6%) of most websites had a mediocre score while the design score for most of the websites (70.6%) was acceptable also organizational websites had better design, organization and quality compared to private websites. The three websites with the highest general quality score were the websites of "Novel Diet Therapy," "Behsite" and "Dr. BehdadiPour" (jointly) and "Dr. Kermani" respectively. Also in the dimension of content the factors of goal, relevance and credibility, in the dimension of design the factors of color, text and sound, pictures and videos, in the dimension of organization the factors of stability and indexing and in the dimension of user friendliness the factors of confidentiality, credibility and personalization had the highest scores. The results showed that the design score was higher than other scores. Also the general quality score of the websites was mediocre and was not desirable. Also websites didn't have suitable scores in every factor. Since most people search the internet for nutritional and diet therapy information, the creators of these websites should endeavor to fix the shortcomings of their websites and increase the quality of their websites in several different areas.

Quality evaluation of Persian nutrition and diet therapy websites

PubMed Central

Gholizadeh, Zahra; Papi, Ahmad; Ashrafi-rizi, Hasan; Shahrzadi, Leila; Hasanzadeh, Akbar

2017-01-01

INTRODUCTION: Nowadays websites are among the most important information sources used by most people. With the spread of websites, especially those related to health issues, the number of their visitors also increases, more than half of which are about nutritional information. Therefore, quality analysis of nutrition and diet therapy websites is of outmost importance. This study aims to evaluate the quality of Persian nutrition and diet therapy websites. METHODS: The current work is a survey study and uses an applied study method. The statistical population consists of 51 Persian websites about nutrition and diet therapy and census method was used in order to study them. Data gathering was done using a checklist and with direct visit to each website. Descriptive and analytical statistics were used to analyse the gathered data with the help of SPSS 21 software. RESULTS: Findings showed that content (66.7%), organization (82.4%), user friendly interfaces (52.9%) and total quality (70.6%) of most websites had a mediocre score while the design score for most of the websites (70.6%) was acceptable also organizational websites had better design, organization and quality compared to private websites. The three websites with the highest general quality score were the websites of “Novel Diet Therapy,” “Behsite” and “Dr. BehdadiPour” (jointly) and “Dr. Kermani” respectively. Also in the dimension of content the factors of goal, relevance and credibility, in the dimension of design the factors of color, text and sound, pictures and videos, in the dimension of organization the factors of stability and indexing and in the dimension of user friendliness the factors of confidentiality, credibility and personalization had the highest scores. CONCLUSION: The results showed that the design score was higher than other scores. Also the general quality score of the websites was mediocre and was not desirable. Also websites didn’t have suitable scores in every factor. Since most people search the internet for nutritional and diet therapy information, the creators of these websites should endeavor to fix the shortcomings of their websites and increase the quality of their websites in several different areas. PMID:28616415

Quality in School Environments: A Multiple Case Study of the Diagnosis, Design and Management of Environmental Quality in Five Elementary Schools in the Baltimore City Public Schools from an Action Research Perspective. Volumes I and II.

ERIC Educational Resources Information Center

Lackney, Jeffery A.

Environmental factors are being increasingly recognized as playing a role in school effectiveness and educational outcomes. Volume 1 examines what is known concerning the diagnosis, design, and management of environmental quality in schools, and the perceived relationship between environmental quality and educational outcomes, as revealed in an…

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

Impact of physical and psychological factors on health-related quality of life in adult patients with liver cirrhosis: a systematic review protocol.

PubMed

Polis, Suzanne; Fernandez, Ritin

2015-01-01

What is the impact of physical and psychological factors on health-related quality of life in adult patients diagnosed with liver cirrhosis? All chronic liver diseases stimulate a degree of repetitive hepatocyte injury that alters the normal liver architecture and ends in cirrhosis.Liver cirrhosis and hepatocellular carcinoma secondary to livercirrhosis are a major public health burden, reporting increasing mortality and morbidity both in Australia and globally.The four leading causes of cirrhosis include harmful alcohol consumption, viral hepatitis B and C and metabolic syndromes related to non-alcoholic fatty liver disease and obesity.A cirrhotic liver is characterized by the presence of regenerative nodules surrounded by fibrous bands that inhibit the passing of molecules between blood and functional units of liver hepatocytes, leading to liver dysfunction.Additionally, the presence of fibrous bands disrupts the normal vascular architecture, increasing resistance within the liver sinusoids and contributing to increased portal vein pressure.The early stages of cirrhosis are referred to as compensated liver disease with no reported symptoms or evidence of impaired liver function.However, the signs and symptoms of liver failure, as well as the mortality rate, increase as the severity of cirrhosis increases.Transition from compensated to decompensated cirrhosis is marked by one or more physiological changes. The physiological changes include increased portal vein pressure, impaired synthetic function, electrolyte imbalance and malnourishment.These physiological changes trigger the development of physical signs and symptoms and impact on the psychological wellbeing of the individual living with cirrhosis. The physical signs and symptoms include esophageal varices, ascites, hepatic encephalopathy, jaundice, irregular sleep patterns, muscle cramps, pruritus, fatigue, impaired mobility, breathlessness, abdominal discomfort, gastrointestinal symptoms, change of body image and pitting edema.Psychological symptoms include stress, depression and anxiety.Living with liver cirrhosis has a marked impact on the quality of life of the individual. Health-related quality of life (HRQOL) is the individual's perception of their physical, cognitive, emotional and social functioning.Studies report that physical and psychological factors affect the quality of life of patients with cirrhosis which can be problematic and debilitating.There is strong evidence which indicates that disease severity is associated with an impairment of the patient's HRQOL.For example, gross ascites causes abdominal discomfort, breathlessness, increased stress and anxiety related to body image, immobility and an increased likelihood of falls. In addition, the management of ascites involves frequent invasive procedures, an increase in pill burden and implementation of dietary restrictions, all of which impact on HRQOL.Despite the clear relationship between HRQOL and severity of disease, there has been no systematic review undertaken to determine the physical, psychological and physiological factors that affect the HRQOL of patients with liver cirrhosis. This systematic review will therefore identify the best available evidence related to the impact of physical, psychological and physiological factors on the health-related quality of life of adult patients with liver cirrhosis. The results of the review will increase clinicians' knowledge and highlight areas of clinical management that may require additional strategies and treatment plans to improve symptom relief and HRQOL.

Illuminating Anaerobic Microbial Community and Cooccurrence Patterns across a Quality Gradient in Chinese Liquor Fermentation Pit Muds

PubMed Central

Hu, Xiaolong; Du, Hai; Ren, Cong

2016-01-01

Fermentation pit mud, an important reservoir of diverse anaerobic microorganisms, is essential for Chinese strong-aroma liquor production. Pit mud quality, according to its sensory characteristics, can be divided into three grades: degraded, normal, and high quality. However, the relationship between pit mud microbial community and pit mud quality is poorly understood, as are microbial associations within the pit mud ecosystem. Here, microbial communities at these grades were compared using Illumina MiSeq sequencing of the variable region V4 of the 16S rRNA gene. Our results revealed that the pit mud microbial community was correlated with its quality and environmental factors. Species richness, biodiversity, and relative and/or absolute abundances of Clostridia, Clostridium kluyveri, Bacteroidia, and Methanobacteria significantly increased, with corresponding increases in levels of pH, NH4+, and available phosphorus, from degraded to high-quality pit muds, while levels of Lactobacillus, dissolved organic carbon, and lactate significantly decreased, with normal samples in between. Furthermore, 271 pairs of significant and robust correlations (cooccurrence and negative) were identified from 76 genera using network analysis. Thirteen hubs of cooccurrence patterns, mainly under the Clostridia, Bacteroidia, Methanobacteria, and Methanomicrobia, may play important roles in pit mud ecosystem stability, which may be destroyed with rapidly increased levels of lactic acid bacteria (Lactobacillus, Pediococcus, and Streptococcus). This study may help clarify the relationships among microbial community, environmental conditions, and pit mud quality, allow the improvement of pit mud quality by using bioaugmentation and controlling environmental factors, and shed more light on the ecological rules guiding community assembly in pit mud. PMID:26896127

Changing Diet Quality in China during 2004–2011

PubMed Central

Huang, Yingying; Wang, Hui; Tian, Xu

2016-01-01

Currently, under- and over-nutrition problems co-exist in China. However, systematic studies on the diet quality of Chinese residents have been scant. This study described the trend in diet quality of Chinese residents over a recent eight-year period and investigated the relevant influential factors. The data of Chinese adults aged 20–59 years was extracted from 2004, 2006, 2009, and 2011 China Health and Nutrition Survey. The China diet quality index (DQI) was employed to assess the diet quality of Chinese adults. The dietary consumption data of each individual was collected using a 24-h dietary recall and weighed food records implemented for three consecutive days. A mixed ordinary least squares regression model was applied to analyze the factors influencing the DQI scores of Chinese residents. Results showed that the diet quality of Chinese residents increased from 2004 to 2006, followed by a decrease in 2009 and 2011. The income, urbanicity index, and southern dummy were positively associated with DQI scores, whereas the size of household and labor intensity were negative predictors of DQI scores. The DQI scores also varied over BMI values. With an increase of the average income level in the future, the diet quality of Chinese residents is estimated to further improve. Moreover, urbanization could also contribute to reaching a more balanced diet. PMID:28029128

Bio-implantable passive on-chip RF-MEMS strain sensing resonators for orthopaedic applications

NASA Astrophysics Data System (ADS)

Melik, Rohat; Kosku Perkgoz, Nihan; Unal, Emre; Puttlitz, Christian; Demir, Hilmi Volkan

2008-11-01

One out of ten bone fractures does not heal properly due to improper load distribution and strain profiles during the healing process. To provide implantable tools for the assessment of bone fractures, we have designed novel, bio-implantable, passive, on-chip, RF-MEMS strain sensors that rely on the resonance frequency shift with mechanical deformation. For this purpose, we modeled, fabricated and experimentally characterized two on-chip sensors with high quality factors for in vivo implantation. One of the sensors has an area of ~0.12 mm2 with a quality factor of ~60 and the other has an area of ~0.07 mm2 with a quality factor of ~70. To monitor the mechanical deformation by measuring the change in the resonance frequencies with the applied load, we employed a controllable, point load applying experimental setup designed and constructed for in vitro characterization. In the case of the sensor with the larger area, when we apply a load of 3920 N, we obtain a frequency shift of ~330 MHz and a quality factor of ~76. For the smaller sensor, the frequency shift and the quality factor are increased to 360 MHz and 95, respectively. These data demonstrate that our sensor chips have the capacity to withstand relatively high physiologic loads, and that the concomitant and very large resonant frequency shift with the applied load is achieved while maintaining a high signal quality factor. These experiments demonstrate that these novel sensors have the capacity for producing high sensitivity strain readout, even when the total device area is considerably small. Also, we have demonstrated that our bio-implantable, passive sensors deliver a telemetric, real-time readout of the strain on a chip. Placing two more resonators on the sides of the sensor to serve as transmitter and receiver antennas, we achieved to transfer contactless power and read out loads in the absence of direct wiring to the sensor. With this model, where telemetric measurements become simpler due to the fact that all sensor system is built on the same chip, we obtain a frequency shift of ~190 MHz with an increase in the quality factor from ~38 to ~46 when a load of 3920 N is applied. Therefore, as a first proof of concept, we have demonstrated the feasibility of our on-chip strain sensors for monitoring the mechanical deformation using telemetry-based systems.

Risk factors for degenerative spondylolisthesis: a systematic review

PubMed Central

DeVine, John G.; Schenk-Kisser, Jeannette M.; Skelly, Andrea C.

2012-01-01

Study design: Systematic literature review. Rationale: Many authors have postulated on various risk factors associated with the pathogenesis of degenerative spondylolisthesis (DS), yet controversies regarding those risk factors still exist. Objective: To critically appraise and summarize evidence on risk factors for DS. Methods: Articles published before October 15, 2011, were systematically reviewed using PubMed and bibliographies of key articles. Each article was subject to quality rating and was analyzed by two independent reviewers. Results: From 382 citations, 30 underwent full-text review. Fourteen studies met inclusion criteria. All but two were considered poor quality. Female gender and higher facet joint angle were consistently associated with an increased risk of DS across multiple studies. Multiple studies also consistently reported no association between back pain and prolonged occupational sitting. Associations between age, parity, lumbosacral angle, lumbar lordosis, facet joint tropism, and pelvic inclination angles were inconsistent. Conclusions: There appears to be consistent evidence to suggest that the risk of DS increases with increasing age and is greater for females and people with a greater facet joint angle. PMID:23230415

Longitudinal associations between resilience and quality of life in eating disorders.

PubMed

Calvete, Esther; Las Hayas, Carlota; Gómez Del Barrio, Andrés

2018-01-01

This study examined the longitudinal reciprocal associations between resilience factors, quality of life (QoL) domains, and symptoms of eating disorders (EDs). Hypotheses included predictive paths from resilience factors of "acceptance of self and life" and "personal competence" to increased QoL and predictive paths from previous levels of QoL to resilience. A total of 184 patients with EDs (mean age = 29.55, SD = 9.17, 94.8% women) completed measures of resilience, QoL, and EDs symptoms over three waves spaced six month apart. Hypotheses were tested by path analysis. Resilience factors predicted improvements in psychological health and social relationship domains of QoL and a reduction of ED symptoms over time. In addition, psychological health increased acceptance of self and life consistently over time, whereas physical health increased the competence component of resilience. The relationships between resilience factors and QoL are reciprocal, with several mediational paths. A spiral of recursive influences between resilience factors and QoL can take place in people with EDs. This possibility offers new perspectives to understanding the process of recovery in patients with ED. Copyright © 2017 Elsevier B.V. All rights reserved.

Ecological evaluation of rangeland quality in dry subtropics of Azerbaijan

NASA Astrophysics Data System (ADS)

Gasanova, A. F.

2014-12-01

The results of ecological evaluation of soil-landscape complexes of winter rangelands of Gobustan with the use of energy criteria are discussed. The diagnostic characteristics of soil fertility and correction coefficients for the thickness of texture of soil horizons, soil salinization, soil erosion, and microelemental composition of soils have been used to separate the soils of winter rangelands into several quality groups. A larger part of the soils belongs to the medium quality group with the mean weighted quality factor (bonitet) of 52. Special assessment scales have been suggested for the differential ecological assessment and monitoring of the rangelands. In the past 40 years, the area of steppe landscapes has decreased from 22.7 to 12%, whereas the area of semideserts has increased up to 64%. The area of best-quality soils within the studied rangelands had decreased by three times, and their average quality factor has decreased from 92 to 86.

[Quality of life and related factors among climacteric women from south Brazil].

PubMed

de Lorenzi, Dino R S; Saciloto, Bruno; Artico, Graziela R; Fontana, Sabrina K R

2009-01-01

This study aimed to evaluate the quality of life in climacteric and associated factor among women from Southeast Brazil. A cross-section study of 506 women aged between 45 and 60 years old attended at a university climacteric clinic from South Brazil from June to October 2002. Hysterectomized women, as well as hormonal therapy or hormonal contraceptive users were excluded. The quality of life was evaluated by the Women's Health Questionnaire (WHQ). Statistical analysis was performed with multiple linear regression analysis. The average of the age among the studied women was 51.3 (+/- 4.5) years old. About 15.4% were premenopausal, 34.4% perimenopausal and 50.2% postmenopausal women. The quality of life showed up deteriorated among the studied women. The factors related with quality of life were: the educational level (p < 0.01), the confirmation of smoking in the last year (p < 0.01), regular physical activity (p < 0.01), the confirmation of previous co-morbidities (p < 0.01) and the menopausal status (p < 0.01). A higher educational level, as well as the confirmation of regular physical activity led to a significant increase on their life quality. Smoking and previous clinical co-morbidities were responsible for the lower scores of quality of life. The pre-menopause was associated with a higher life quality level if compared to peri and post menopause. No differences in relation to the scores of life were identified among the perimenopausal and postmenopausal women. Nevertheless the menopausal status showed up associated to the quality of life, the results of the study pointed out that the climacteric is not just influenced by biological factors, but also by psychosocial and cultural factors.

Factors associated with health-related quality of life among patients with implantable cardioverter defibrillator: identification of foci for nursing intervention.

PubMed

Wong, Florence Mei Fung; Sit, Janet Wing Hung; Wong, Eliza Mi Ling; Choi, Kai Chow

2014-12-01

To explore factors associated with health-related quality of life of patients with implantable cardioverter defibrillators. Substantial evidence indicates that implantable cardioverter defibrillator is proven to increase survival rate by terminating life-threatening arrhythmia. However, this device can negatively affect health-related quality of life. Little is known about factors associated with health-related quality of life of patients with implantable cardioverter defibrillators, particularly in Asian population. A transversal descriptive design was used. Data were collected from a convenience sample of 139 adult patients with implantable cardioverter defibrillators from 4 January-30 April 2012 using the structured questionnaires administered by the researcher and medical record reviews. The Short Form-36 Health Survey version 2 was used to measure health-related quality of life. A total of 139 Chinese patients, including 107 (77·0%) males with a mean age of 63·0 (14·6) years, were selected. The physical component summary was relatively lower, whereas the mental component summary was relatively higher than that of the general Hong Kong Chinese population. Multivariable regression analysis revealed gender, self-care dependence, educational level, atrial fibrillation, diabetes mellitus, anxiety and depression significantly associated with physical or mental quality of life. Depression was a common factor affecting physical and mental quality of life. Self-care dependence, atrial fibrillation, diabetes mellitus, depression and anxiety could be improved. Our findings expand existing knowledge on identifying at-risk patients for having lower quality of life, thus allowing development of appropriate interventions targeting risk factors for improving health-related quality of life of patients with implantable cardioverter defibrillator. © 2014 John Wiley & Sons Ltd.

What Factors Influence States' Capacity to Report Children's Health Care Quality Measures? A Multiple-Case Study.

PubMed

Christensen, Anna L; Petersen, Dana M; Burton, Rachel A; Forsberg, Vanessa C; Devers, Kelly J

2017-01-01

Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services' (CMS) core set of children's health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin's multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state's Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.

Child Health, Maternal Marital and Socioeconomic Factors, and Maternal Health

PubMed Central

Witt, Whitney P.

2012-01-01

While maternal socioeconomic status and health predict in part children’s future health and socioeconomic prospects, it is possible that the intergenerational association flows in the other direction such that child health affects maternal outcomes. Previous research demonstrates that poor child health increases the risk of adverse maternal physical and mental health outcomes. We hypothesize that poor child health may also increase the risk of poor maternal health outcomes through an interaction between child health and factors associated with health outcomes, such as marital status, marital quality, and socioeconomic status. Using data on women in the National Longitudinal Study of Youth 1979 cohort (N = 2,279), we find evidence that the effects of certain maternal marital quality and socioeconomic factors on maternal physical and mental health depend on child health status and vice versa. PMID:23788824

Death Anxiety and Quality of Life in Iranian Caregivers of Patients With Cancer.

PubMed

Soleimani, Mohammad Ali; Lehto, Rebecca H; Negarandeh, Reza; Bahrami, Nasim; Chan, Yiong Huak

Concerns about death may alienate and negatively impact communication among family members of patients with life-threatening illness. Little is known about the relationship of death anxiety to quality of life in cancer family caregivers. The aim of this study was to examine relationships between sociodemographic and patient-related factors, social support, and religiosity with death anxiety and quality of life in Iranian cancer family caregivers. Three hundred thirty family caregivers from an urban regional cancer institute in Iran participated in a descriptive-correlational study that incorporated sociodemographic surveys and validated death anxiety (Templer Scale) and Quality of life (Family Version) instruments. Caregivers reported moderate levels of death anxiety and decrements in QOL. Quality of life was inversely associated with death anxiety (r = -0.30, P < .001). Female caregivers who were daughters had higher death anxiety, whereas male caregivers who were sons reported higher quality of life. Death anxiety is associated with lowered quality of life in Iranian family caregivers. Multiple factors may impact death anxiety and quality of life relevant to the socioreligious milieu. Addressing concerns that increase death anxiety may improve quality of life and lower stress associated with adapting to the family caregiver role. Caregiving responsibilities, added to challenges associated with personal, family, and professional life, impact multiple aspects of QOL. As nurses increasingly care for patients from diverse backgrounds, it becomes more imperative that support for family caregivers that promotes psychological adaptation and quality of life is needed.

Impact of increased collection rates and the use of commingled collection systems on the quality of recovered paper. Part 1: increased collection rates.

PubMed

Miranda, Ruben; Monte, M; Blanco, Angeles

2011-11-01

The recovery and utilization of recovered paper have increased over past decades all over the world due to economic, environmental, and social issues. However, it is well known that an extended recovered paper collection is detrimental to its quality, either by the exploitation of lower quality sources such as households, or the spreading of commingled systems instead of selective collection systems. The influence of these two factors was assessed by analyzing the quality of different recovered paper grades used as raw material in a mill located in Madrid (Spain) producing newsprint and light weight coated paper from recovered paper. Part 1 of the paper deals with the impact of increased collection rates on the quality of recovered paper and Part 2 with the use of commingled collection systems. Results of Part 1 show that increased collection rates have a large impact on the quality of the recovered paper. The quality, measured as total unusable material and moisture contents, had deteriorated very rapidly in only 4 years (2005-2008) as a consequence of increased collection rates. Collection rates increased in Spain from 58.5% to 68.6% during this period, resulting in more than 50% increase of total unusable material and 25% of moisture content. The downgrading of the quality of recovered paper is one of the major threats for extending the current limits of paper recycling. Therefore, future challenge is to increase its availability but maintaining its quality. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Quality of life of older women with dependency and abuse experience].

PubMed

Lang, G; Enzenhofer, E

2013-01-01

Quality of life is largely determined by changing biographical contexts of a person's behavioural action. In later age, health and social relationships are major determinants for a "good life". A decline in health status may lead to the need for support which may result in further dependency; thus, social relations play an even more important role for older people. Relationships characterised by strain and tension may increase the risk of exposure to force and violence. This article investigates the influence of dependency and abuse on the subjective quality of life of older people. The dataset was drawn from an Austrian survey of 593 home-dwelling older women aged 60 and over (71.0 ± 8.1 years). Quality of life was assessed by the EUROHIS-QOL Scale, dependency by the degree of need for support with respect to activities of daily living and by the levels of care allowance received by this cohort. Following the Conflict Tactics Scales (CTS), six different types of abuse have been operationalised by 34 indicators. The data were analysed by descriptive statistics, confirmatory factor analysis and structural equation modelling. With increasing dependency the subjective quality of life of older women decreases. At the same time it is reduced by the experience of abuse in the close social environment. Neglect, psychological abuse and the violation of personal liberties and rights can be identified as factors which have a negative impact on quality of life. It is also noted that neglect can be found particularly among women with a greater need for support and a higher level of care allowance, which is a particularly problematic situation. Dependency and abuse are major risk factors for low quality of life in old age. The results stress the importance of raising general awareness on violence and highlight the social taboos around the issue of abuse against older people, especially in the case of increasing dependency. In addition, the results point to an increasing demand for specific measures of health promotion and prevention activities addressing vulnerable older people.

[Influence of environmental noise on sleep quality and sleeping disorders-implications for health].

PubMed

Kohlhuber, M; Bolte, G

2011-12-01

Environmental noise is a well-known risk factor influencing sleep-wake behavior and sleep quality. Epidemiologic studies have shown that environmental noise is regarded as the most annoying environmental factor. Noise causes modifications in physiologic and mental functions and may result in health outcomes like elevated blood pressure and ischemic heart disease. Reactions to high sound levels during sleep are decreased sleep intensity, arousals, and increased stress hormone secretion. Effects of poor sleep quality are reduced cognitive performance, tiredness, and psychosomatic symptoms. Long-term consequences of recurrent sleep loss due to environmental noise may be heart disease and increased medication intake. Arousals occur especially due to single noise events and intermittent noise. Laboratory and field studies showed no habituation of physiologic parameters to high sound levels. Sleep is especially sensitive to noise; therefore, sound levels during nighttime should be much lower than during daytime.

Dynamic control of the asymmetric Fano resonance in side-coupled Fabry–Pérot and photonic crystal nanobeam cavities

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

Lin, Tong; Chau, Fook Siong; Zhou, Guangya, E-mail: mpezgy@nus.edu.sg

2015-11-30

Fano resonance is a prevailing interference phenomenon that stems from the intersection between discrete and continuum states in many fields. We theoretically and experimentally characterize the asymmetric Fano lineshape in side-coupled waveguide Fabry–Pérot and photonic crystal nanobeam cavities. The measured quality-factor of the Fano resonance before tuning is 28 100. A nanoelectromechanical systems bidirectional actuator is integrated seamlessly to control the shape of the Fano resonance through in-plane translations in two directions without sacrificing the quality-factor. The peak intensity level of the Fano resonance can be increased by 8.5 dB from 60 nW to 409 nW while the corresponding dip intensity ismore » increased by 12.8 dB from 1 nW to 18 nW. The maximum recorded quality-factor throughout the tuning procedure is up to 32 500. Potential applications of the proposed structure include enhancing the sensitivity of sensing, reconfigurable nanophotonics devices, and on-chip intensity modulator.« less

Insomnia in nursing students and related factors: A cross-sectional study.

PubMed

Güneş, Zeynep; Arslantaş, Hülya

2017-10-01

The aim of this study is to determine the factors affecting insomnia in nursing students. This study was conducted with 379 nursing students, studying at a university in western Anatolia/Turkey between 2014 and 2015 as a descriptive and cross-sectional analytic study. Data of the survey were collected using the Personal Inquiry Form, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Trait Anxiety Inventory and the Beck Depression Inventory, and a self-administered questionnaire. The Insomnia Severity Index score for the students is 11.51 ± 5.04 on average. It was found that as anxiety and depression increased, the Insomnia Severity Index score for the students also increased and there was a weak positive correlation. Also, a moderate positive correlation between sleep quality and insomnia severity was found. Significant correlations were found between some of the socio-demographic characteristics (lower socio-economic situation, irregular bedtime, and smoking) and insomnia, sleep quality, anxiety, and depression. Anxiety, depression, irregular bedtime, and lower socio-economic situation are factors that make falling asleep difficult. © 2017 John Wiley & Sons Australia, Ltd.

Analysis of the Factors Affecting Consumer Acceptance of Accredited Online Health Information.

PubMed

Jo, Heui Sug; Song, Tae Min; Kim, Bong Gi

2017-11-01

With the increasing use of the internet and the spread of smartphones, health information seekers obtain considerable information through the internet. As the amount of online health information increases, the need for quality management of health information has been emphasized. The purpose of this study was to investigate the factors affecting the intention of using accredited online health information by applying the extended technology acceptance model (Extended-TAM). An online survey was conducted from September 15, 2016 to October 3, 2016, on 500 men and women aged 19-69 years. The results showed that the greatest factor influencing the acceptance of the accredited health information was perceived usefulness, and the expectation for the quality of the accreditation system was the most important mediator variable. In order to establish the health information accreditation system as a means to provide easy and useful information to the consumers, it is necessary to carry out quality management and promote the system through the continuous monitoring of the accreditation system. © 2017 The Korean Academy of Medical Sciences.

O3, CO2 and chemical fractionation in ponderosa pine saplings

EPA Science Inventory

Environmental factors can affect plant tissue quality which is important for quality of organic matter inputs into soil food webs and decomposition of soil organic matter. Thus the effects of increases in CO2 and O3 and their interactions were determined for various chemical fra...

Picker vs. stripper harvesting in the Texas High Plains: Agronomic implications

USDA-ARS?s Scientific Manuscript database

Many changes have occurred during the last decade in the Texas High Plains which have resulted in increased cotton yields and improved fiber quality. The main factors associated with both higher lint yield and quality include a shift in varieties planted, with virtually no "storm-proof stripper type...

Risk factors for injury in sport climbing and bouldering: a systematic review of the literature.

PubMed

Woollings, Kaikanani Y; McKay, Carly D; Emery, Carolyn A

2015-09-01

Rock climbing is an increasingly popular sport worldwide, as a recreational activity and a competitive sport. Several disciplines including sport climbing and bouldering have developed, each employing specific movements and techniques, leading to specific injuries. To examine risk factors and prevention measures for injury in sport climbing and bouldering, and to assess the methodological quality of existing studies. 12 electronic databases and several other sources were searched systematically using predetermined inclusion and exclusion criteria. Eligible articles were peer-reviewed, based on primary research using original data; outcome measures included injury, morbidity or mortality in rock climbing, and included one or more potential risk factor or injury prevention strategy. Two independent reviewers assessed the methodology of research in each study using the Downs and Black Quality Index. The data extracted is summarised, and appraisals of the articles are presented with respect to the quality of evidence presented. 19 studies met the inclusion criteria, and introduced 35 possible risk factors or injury prevention measures in climbing. Age, increasing years of climbing experience, highest climbing grade achieved (skill level), high climbing intensity score (CIS) and participating in lead climbing are potential risk factors. Results regarding injury prevention measures remain inconclusive. This field is relatively new and, as such, the data are not as robust as for more established sports with a larger research foundation. The key need is establishing modifiable risk factors using prospective studies and high quality methodology, such that injury prevention strategies can be developed. The CIS may be a useful measure in this field of research. 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.

Effectiveness and efficiency of potassium fertilizer application to increase the production and quality of rice in entisols

NASA Astrophysics Data System (ADS)

Hartati, S.; Suryono; Purnomo, D.

2018-03-01

The study aimed to determine the appropriate dose of K-type fertilizer on the production and quality of IR-64 rice varieties in Entisols. The study was conducted on Entisols, Nglarang, Basin, Kebonarum, Klaten, Central Java, Indonesia. Randomized Complete Block Design (RCBD) was used with 2 factors and three replicates. Factor I: types of K fertilizer: KCl, ZK, and KNO3. Factor II: K fertilizer dose consists of four levels: 0, 50, 100 and 150 kg K2O ha-1. The results showed that the type of K fertilizer KCl, ZK, and KNO3 gave similar effect on growth and yield of rice variety IR 64 on Entisols. Dose of K fertilizer increased the growth and yield of rice but an increased dose provides improved meaningful results. K fertilizer with a dose of 50 kg ha-1 K2O is the most efficient, with the agronomic efficiency for dry grain highest yield of 13.6 kg/kg K2O achieved by ZK fertilizer.

A review of Quality of Life studies in Nigerian patients with psychiatric disorders.

PubMed

Aloba, O; Fatoye, O; Mapayi, B; Akinsulore, S

2013-09-01

The concept of Quality of Life is becoming an increasingly important measure of the impact of psychiatric disorders and is now recognized as useful in the healthcare evaluation of patients with psychiatric disorders. The aim of this review was to document and analyze the research data on quality of life in Nigerian patients with psychiatric disorders. The electronic databases, Medline and Pubmed were searched for published articles on quality of life in Nigerian patients with psychiatric disorders. A total of 6 studies met the inclusion criteria. All the studies employed the generic World Health Organization Quality of Life Scale - Brief version, which is the only quality of life instrument whose psychometric properties have been evaluated among Nigerian patients with psychiatric disorders. Some of the studies revealed that quality of life was significantly associated with socio demographic factors such marital and employment status and social support. Poor quality of life was reported to be associated with illness related factors such as co morbid medical problems, presence of anxiety and depressive symptoms and non adherence to medications. All the studies with the exception of two were conducted in centers located in South-western Nigeria. Quality of life in Nigerian patients suffering from psychiatric disorders is under-researched. There is need for more studies to prospectively investigate quality of life and associated factors among Nigerian patients with psychiatric disorders.

POTENTIAL OF BIOLOGICAL MONITORING SYSTEMS TO DETECT TOXICITY IN A FINISHED MATRIX

EPA Science Inventory

Distribution systems of the U.S. are vulnerable to natural and anthropogenic factors affecting quality for use as drinking water. Important factors include physical parameters such as increased turbidity, ecological cycles such as algal blooms, and episodic contamination events ...

How do Housing Subsidies Improve Quality of Life Among Homeless Adults? A Mediation Analysis.

PubMed

O'Connell, Maria; Sint, Kyaw; Rosenheck, Robert

2018-03-01

Supported housing, combining rent subsidies with intensive case management, is associated with improvements in quality of life of homeless adults, but factors mediating their impact on quality of life have not been studied. Twelve-month outcome data from a randomized trial of the Housing and Urban Development- Veterans Affairs Supported Housing program (HUD-VASH) showed that access to a housing rent subsidy plus intensive case management (ICM) was associated with greater improvement in subjective quality of life than ICM alone. Multiple mediation analyses were applied to identify variables that significantly mediated the relationship between receipt of housing voucher and improvements in quality of life. Significant mediating covariates were those whose 95% bias-corrected confidence intervals, when added to the model predicting improvement in quality of life, did not overlap zero. Increases in the number of days housed, size of social network, and availability of emotional support appear to mediate improvement in quality of life and account for 71% of the benefit attributable to having a rent subsidy. Improvement in subjective quality of life though housing subsidies is mediated by gains in both material and psychosocial factors. Mediating factors deserve special attention in supported housing services. © Society for Community Research and Action 2018.

Biomechanical factors associated with mandibular cantilevers: analysis with three-dimensional finite element models.

PubMed

Gonda, Tomoya; Yasuda, Daiisa; Ikebe, Kazunori; Maeda, Yoshinobu

2014-01-01

Although the risks of using a cantilever to treat missing teeth have been described, the mechanisms remain unclear. This study aimed to reveal these mechanisms from a biomechanical perspective. The effects of various implant sites, number of implants, and superstructural connections on stress distribution in the marginal bone were analyzed with three-dimensional finite element models based on mandibular computed tomography data. Forces from the masseter, temporalis, and internal pterygoid were applied as vectors. Two three-dimensional finite element models were created with the edentulous mandible showing severe and relatively modest residual ridge resorption. Cantilevers of the premolar and molar were simulated in the superstructures in the models. The following conditions were also included as factors in the models to investigate changes: poor bone quality, shortened dental arch, posterior occlusion, lateral occlusion, double force of the masseter, and short implant. Multiple linear regression analysis with a forced-entry method was performed with stress values as the objective variable and the factors as the explanatory variable. When bone mass was high, stress around the implant caused by differences in implantation sites was reduced. When bone mass was low, the presence of a cantilever was a possible risk factor. The stress around the implant increased significantly if bone quality was poor or if increased force (eg, bruxism) was applied. The addition of a cantilever to the superstructure increased stress around implants. When large muscle forces were applied to a superstructure with cantilevers or if bone quality was poor, stress around the implants increased.

Soliton compression to few-cycle pulses with a high quality factor by engineering cascaded quadratic nonlinearities.

PubMed

Zeng, Xianglong; Guo, Hairun; Zhou, Binbin; Bache, Morten

2012-11-19

We propose an efficient approach to improve few-cycle soliton compression with cascaded quadratic nonlinearities by using an engineered multi-section structure of the nonlinear crystal. By exploiting engineering of the cascaded quadratic nonlinearities, in each section soliton compression with a low effective order is realized, and high-quality few-cycle pulses with large compression factors are feasible. Each subsequent section is designed so that the compressed pulse exiting the previous section experiences an overall effective self-defocusing cubic nonlinearity corresponding to a modest soliton order, which is kept larger than unity to ensure further compression. This is done by increasing the cascaded quadratic nonlinearity in the new section with an engineered reduced residual phase mismatch. The low soliton orders in each section ensure excellent pulse quality and high efficiency. Numerical results show that compressed pulses with less than three-cycle duration can be achieved even when the compression factor is very large, and in contrast to standard soliton compression, these compressed pulses have minimal pedestal and high quality factor.

Validating the German Version of the Quality of Relationship Inventory: Confirming the Three-Factor Structure and Report of Psychometric Properties

PubMed Central

Reiner, Iris; Beutel, Manfred; Skaletz, Christian; Brähler, Elmar; Stöbel-Richter, Yve

2012-01-01

Research on psychosocial influences such as relationship characteristics has received increased attention in the clinical as well as social-psychological field. Several studies demonstrated that the quality of relationships, in particular with respect to the perceived support within intimate relationships, profoundly affects individuals' mental and physical health. There is, however, a limited choice of valid and internationally known assessments of relationship quality in Germany. We report the validation of the German version of the Quality of Relationships Inventory (QRI). First, we evaluated its factor structure in a representative German sample of 1.494 participants by means of confirmatory factor analysis. Our findings support the previously proposed three-factor structure. Second, importance and satisfaction with different relationship domains (family/children and relationship/sexuality) were linked with the QRI scales, demonstrating high construct validity. Finally, we report sex and age differences regarding the perceived relationship support, conflict and depth in our German sample. In conclusion, the QRI is a reliable and valid measurement to assess social support in romantic relationships in the German population. PMID:22662151

Predictors of Primary Care Physicians’ Self-reported Intention to Conduct Suicide Risk Assessments

PubMed Central

Epstein, Steven A.; Weinfurt, Kevin P.; DeCoster, Jamie; Qu, Lixin; Hannah, Natalie J.

2013-01-01

Primary care physicians play a significant role in depression care, suicide assessment, and suicide prevention. However, little is known about what factors relate to and predict quality of depression care (assessment, diagnosis, and treatment), including suicide assessment. The authors explored the extent to which select patient and physician factors increase the probability of one element of quality of care: namely, intention to conduct suicide assessment. Data were collected from 404 randomly selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying major depression with moderate levels of severity. The authors examined which patient factors and physician factors increase the likelihood of physicians’ intention to conduct a suicide assessment. Data from the study revealed that physician-participants inquired about suicide 36% of the time. A random effects logistic model indicated that several factors were predictive of physicians’ intention to conduct a suicide assessment: patient’s comorbidity status (odds ratio (OR) = 0.61; 95% confidence interval (CI) = 0.37–1.00), physicians’ age (OR = 0.67; 95% CI = 0.49–0.92), physicians’ race (OR = 1.84; 95% CI = 1.08–3.13), and how depressed the physician perceived the virtual patient to be (OR = 0.58; 95% CI = 0.39–0.87). A substantial number of primary care physicians in this study indicated they would not assess for suicide, even though most physicians perceived the virtual patient to be depressed or very depressed. Further study is needed to establish factors that may be modified and targeted to increase the likelihood of physicians’ providing one element of quality of care—suicide assessment—for depressed patients. PMID:22218814

Trajectories of health-related quality of life in children with epilepsy: a cohort study.

PubMed

Ferro, Mark A; Camfield, Carol S; Levin, Simon D; Smith, Mary Lou; Wiebe, Samuel; Zou, Guangyong; Speechley, Kathy N

2013-11-01

Little is known about subgroups of children with epilepsy who may experience less favorable outcomes over time. The objectives of this study were to document trajectories of health-related quality of life (HRQL) and to identify predictors of the trajectory group in children with new-onset epilepsy. Data were obtained from the Health Related Quality of Life in Children with Epilepsy Study, a prospective multisite study of children 4-12 years old with new-onset epilepsy followed for 24 months. Health-related quality of life was measured using the Quality of Life in Childhood Epilepsy questionnaire. Trajectories of HRQL were investigated using latent class trajectory modeling. Multinomial logistic regression was used to identify child, parent, and family predictors of HRQL trajectories. A total of 374 families responded at baseline and 283 (76%) completed the study. Five HRQL trajectories were observed: low-increasing (4%), moderate-decreasing (12%), moderate-increasing (22%), high-increasing (32%), and high-stable (30%). Many children in the low-increasing, moderate-increasing, high-increasing, and high-stable had clinically meaningful improvements in HRQL: 82%, 47%, 63%, and 44%, respectively. In contrast, the majority of children in the moderate-decreasing group (56%) experienced clinically meaningful declines in their HRQL. Factors predicting trajectories were number of antiepileptic drugs prescribed, presence of comorbid behavior or cognitive problems, parent depression, and family functioning and demands. Results suggested that children with epilepsy are not homogenous but rather consist of groups with different trajectories and unique predictors of HRQL. Problems associated with child behavior and cognition were the strongest predictors identified. Given that several risk factors are modifiable, it is important to examine these as potential targets within a family-centered framework to improve HRQL of children with new-onset epilepsy. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Factors associated with the quality of life of nursing home residents in Hong Kong.

PubMed

Lai, C K Y; Leung, D D M; Kwong, E W Y; Lee, R L P

2015-03-01

The quality of life of nursing home residents has increasingly become an important dimension when evaluating care in a nursing home. Not a lot is known about the quality of life of nursing home residents in Hong Kong. To investigate factors associated with the quality of life of nursing home residents to inform care management policies and service delivery. This study reports data from 125 nursing home residents. The Hong Kong Chinese version of the World Health Organization's Quality of Life-Brief version was used. Other measures used include the Mini-Mental State Examination, the Mini-Nutritional Assessment, the Geriatric Depression Scale, the Modified STRATIFY Falls Prediction Tool and the Modified Barthel Index. A univariate analysis and a multiple regression analysis were then performed to identify the influencing factors. The participants reported a moderate level of quality of life, with the exception in the domain of social relationships. A univariate analysis found some associations between demographic and clinical characteristics and quality of life. A multiple regression analysis indicated that pain, being younger (65-74 years), having son(s) or daughter(s), and cognitive impairment were negatively associated factors. The smallness of the sample from a single study site limits the generalizability of the findings. This study provides information that has hitherto been lacking on the quality of life and associated factors among local nursing home residents in Hong Kong. The preliminary findings can help healthcare staff to identify those at risk of suffering from a low quality of life and to design appropriate care interventions to improve the quality of life of such residents. Adequate pain relief, family connectedness and special attention to the needs of those with cognitive impairment are important considerations in ensuring a better quality of life for older people in long-term residential care. © 2014 International Council of Nurses.

DOSIMETRIC response of a REM-500 in low energy neutron fields typical of nuclear power plants.

PubMed

Aslam; Matysiak, W; Atanackovic, J; Waker, A J

2012-06-01

This study investigates the response of a REM-500 to assess neutron quality factor and dose equivalent in low energy neutron fields, which are commonly encountered in the workplace environment of nuclear power stations. The McMaster University 3 MV Van de Graaff accelerator facility was used to measure the response of the instrument in monoenergetic neutron fields in the energy range 51 to 727 keV by bombarding a thin LiF target with 1.93-2.50 MeV protons. The energy distribution of the neutron fields produced in the facility was measured by a (3)He filled gas ionization chamber. The MCA mode of the REM-500 instrument was used to collect lineal energy distributions at varying neutron energies and to calculate the frequency and dose-mean lineal energies. The effective quality factor, Q-, was also calculated using the values of Q(y)listed in the REM-500 operation manual and compared with those of ICRP 60. The authors observed a continuously increasing trend in y - F, y-D, and Q-with an increase in neutron energy. It is interesting to note that standard tissue equivalent proportional counters (TEPCs) filled with tissue equivalent(TE) gas give rise to a similar trend for these microdosimetric quantities of interest in the same energy range; however, the averages calculated in this study are larger by about 15%compared to a TEPC filled with propane-based TE gas probably because of the larger stopping power of protons in propane compared to TE gas. These somewhat larger event sizes did not result in any significant increase in the Q-compared to those obtained from a TEPC filled with TE gas and were found to be in good agreement with other measurements reported earlier at corresponding neutron energies. The instrument quality factor response, R(Q), defined as the ratio of measured quality factor to the calculated quality factor in an ICRU tissue sphere,was found to vary with neutron energy. The instrument response,R(Q), was ~0.6 at 727 keV, which deteriorates further to ~0.3 at 51 keV neutron energy. The counter response based on ICRP 60 was comparable to an ideal response of 1.0 above 600 keV, which dropped to ~0.8 at 159 keV and ~0.4 at 51 keV neutron energy. The decline in counter quality factor response based on ICRP 60 was found to be much steeper than that when using the instrument’s built-in function for quality factor.The REM-500 measures a dose equivalent at 727 keV,which is 60% of the ambient dose equivalent, 40% at 159 keV,and 15% at 51 keV. Two algorithms have been developed, one for real time measurement and another to be used post measurement,and their efficacy is demonstrated in determining the quality factor and the ambient dose equivalent in low energy neutron fields, which are typical for the workplace environment in CANDU® nuclear power generating stations.

Source-Based Modeling Of Urban Stormwater Quality Response to the Selected Scenarios Combining Future Changes in Climate and Socio-Economic Factors

NASA Astrophysics Data System (ADS)

Borris, Matthias; Leonhardt, Günther; Marsalek, Jiri; Österlund, Heléne; Viklander, Maria

2016-08-01

The assessment of future trends in urban stormwater quality should be most helpful for ensuring the effectiveness of the existing stormwater quality infrastructure in the future and mitigating the associated impacts on receiving waters. Combined effects of expected changes in climate and socio-economic factors on stormwater quality were examined in two urban test catchments by applying a source-based computer model (WinSLAMM) for TSS and three heavy metals (copper, lead, and zinc) for various future scenarios. Generally, both catchments showed similar responses to the future scenarios and pollutant loads were generally more sensitive to changes in socio-economic factors (i.e., increasing traffic intensities, growth and intensification of the individual land-uses) than in the climate. Specifically, for the selected Intermediate socio-economic scenario and two climate change scenarios (RSP = 2.6 and 8.5), the TSS loads from both catchments increased by about 10 % on average, but when applying the Intermediate climate change scenario (RCP = 4.5) for two SSPs, the Sustainability and Security scenarios (SSP1 and SSP3), the TSS loads increased on average by 70 %. Furthermore, it was observed that well-designed and maintained stormwater treatment facilities targeting local pollution hotspots exhibited the potential to significantly improve stormwater quality, however, at potentially high costs. In fact, it was possible to reduce pollutant loads from both catchments under the future Sustainability scenario (on average, e.g., TSS were reduced by 20 %), compared to the current conditions. The methodology developed in this study was found useful for planning climate change adaptation strategies in the context of local conditions.

Source-Based Modeling Of Urban Stormwater Quality Response to the Selected Scenarios Combining Future Changes in Climate and Socio-Economic Factors.

PubMed

Borris, Matthias; Leonhardt, Günther; Marsalek, Jiri; Österlund, Heléne; Viklander, Maria

2016-08-01

The assessment of future trends in urban stormwater quality should be most helpful for ensuring the effectiveness of the existing stormwater quality infrastructure in the future and mitigating the associated impacts on receiving waters. Combined effects of expected changes in climate and socio-economic factors on stormwater quality were examined in two urban test catchments by applying a source-based computer model (WinSLAMM) for TSS and three heavy metals (copper, lead, and zinc) for various future scenarios. Generally, both catchments showed similar responses to the future scenarios and pollutant loads were generally more sensitive to changes in socio-economic factors (i.e., increasing traffic intensities, growth and intensification of the individual land-uses) than in the climate. Specifically, for the selected Intermediate socio-economic scenario and two climate change scenarios (RSP = 2.6 and 8.5), the TSS loads from both catchments increased by about 10 % on average, but when applying the Intermediate climate change scenario (RCP = 4.5) for two SSPs, the Sustainability and Security scenarios (SSP1 and SSP3), the TSS loads increased on average by 70 %. Furthermore, it was observed that well-designed and maintained stormwater treatment facilities targeting local pollution hotspots exhibited the potential to significantly improve stormwater quality, however, at potentially high costs. In fact, it was possible to reduce pollutant loads from both catchments under the future Sustainability scenario (on average, e.g., TSS were reduced by 20 %), compared to the current conditions. The methodology developed in this study was found useful for planning climate change adaptation strategies in the context of local conditions.

Working conditions, self-perceived stress, anxiety, depression and quality of life: A structural equation modelling approach

PubMed Central

Rusli, Bin Nordin; Edimansyah, Bin Abdin; Naing, Lin

2008-01-01

Background The relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia. Methods The validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation. Results The results of the SEM supported the hypothesized structural model (χ2 = 22.801, df = 19, p = 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF. Conclusion These findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers. PMID:18254966

Working conditions, self-perceived stress, anxiety, depression and quality of life: a structural equation modelling approach.

PubMed

Rusli, Bin Nordin; Edimansyah, Bin Abdin; Naing, Lin

2008-02-06

The relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia. The validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation. The results of the SEM supported the hypothesized structural model (chi2 = 22.801, df = 19, p = 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF. These findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers.

Illuminating Anaerobic Microbial Community and Cooccurrence Patterns across a Quality Gradient in Chinese Liquor Fermentation Pit Muds.

PubMed

Hu, Xiaolong; Du, Hai; Ren, Cong; Xu, Yan

2016-04-01

Fermentation pit mud, an important reservoir of diverse anaerobic microorganisms, is essential for Chinese strong-aroma liquor production. Pit mud quality, according to its sensory characteristics, can be divided into three grades: degraded, normal, and high quality. However, the relationship between pit mud microbial community and pit mud quality is poorly understood, as are microbial associations within the pit mud ecosystem. Here, microbial communities at these grades were compared using Illumina MiSeq sequencing of the variable region V4 of the 16S rRNA gene. Our results revealed that the pit mud microbial community was correlated with its quality and environmental factors. Species richness, biodiversity, and relative and/or absolute abundances of Clostridia,Clostridium kluyveri, Bacteroidia, and Methanobacteria significantly increased, with corresponding increases in levels of pH, NH4 (+), and available phosphorus, from degraded to high-quality pit muds, while levels of Lactobacillus, dissolved organic carbon, and lactate significantly decreased, with normal samples in between. Furthermore, 271 pairs of significant and robust correlations (cooccurrence and negative) were identified from 76 genera using network analysis. Thirteen hubs of cooccurrence patterns, mainly under the Clostridia,Bacteroidia,Methanobacteria, and Methanomicrobia, may play important roles in pit mud ecosystem stability, which may be destroyed with rapidly increased levels of lactic acid bacteria (Lactobacillus,Pediococcus, and Streptococcus). This study may help clarify the relationships among microbial community, environmental conditions, and pit mud quality, allow the improvement of pit mud quality by using bioaugmentation and controlling environmental factors, and shed more light on the ecological rules guiding community assembly in pit mud. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Sleep quality and the risk of work injury: a Swiss case-control study.

PubMed

Uehli, Katrin; Miedinger, David; Bingisser, Roland; Dürr, Selina; Holsboer-Trachsler, Edith; Maier, Sabrina; Mehta, Amar J; Müller, Roland; Schindler, Christian; Zogg, Stefanie; Künzli, Nino; Leuppi, Jörg D

2014-10-01

Sleep problems are a well-known risk factor for work injuries, but less is known about which vulnerable populations are most at risk. The aims of this study were to investigate the association between sleep quality and the risk of work injury and to identify factors that may modify the association. A case-control study including 180 cases and 551 controls was conducted at the University Hospital in Basel, Switzerland, from 1 December 2009 to 30 June 2011. Data on work injuries and sleep quality were collected. Adjusted odds ratios and 95% confidence intervals of the association between sleep quality and work injury were estimated in multivariable logistic regression analyses and were stratified by hypothesized effect modifiers (age, gender, job risk, shift work, sleep duration and working hours). Poor sleep quality was associated significantly with work injury of any type (P < 0.05) and with being caught in particular (P < 0.05). The association between poor sleep quality and work injury was significantly higher for workers older than 30 years (odds ratio>30 1.30 versus odds ratio≤30 0.91, P < 0.01), sleeping 7 h or less per night (odds ratio≤7 1.17 versus odds ratio>7 0.79, P < 0.05) and working 50 h or more per week (odds ratio≥50 1.79 versus odd ratio<50 1.10, P < 0.01). Work injury risk increased with increasing severity of sleep problems (P < 0.05). Prior work injury frequency increased with decreasing sleep quality (P < 0.05). Older age, short sleep duration and long working hours may enhance the risk of work injuries associated with sleep quality. © 2014 European Sleep Research Society.

Leadership, staffing and quality of care in nursing homes

PubMed Central

2011-01-01

Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is complex. Increasing staffing levels or the ratio of registered nurses alone is not likely sufficient for increasing quality of care. PMID:22123029

Factors associated with the relationship between motorcycle deaths and economic growth.

PubMed

Law, Teik Hua; Noland, Robert B; Evans, Andrew W

2009-03-01

This paper examines the Kuznets curve relationship for motorcycle deaths. The Kuznets curve describes the inverted U-shape relationship between economic development and, in this case, motorcycle deaths. In early stages of development we expect deaths to increase with increasing motorization. Eventually deaths decrease as technical, policy and political institutions respond to demands for increased safety. We examine this effect as well as some of the factors which might explain the Kuznets relationship: in particular motorcycle helmet laws, medical care and technology improvements, and variables representing the quality of political institutions. We apply a fixed effects negative binomial regression analysis on a panel of 25 countries covering the period 1970-1999. Our results broadly suggest that implementation of road safety regulation, improvement in the quality of political institutions, and medical care and technology developments have contributed to reduced motorcycle deaths.

Causes and risk factors for male-factor infertility in Nigeria: a review.

PubMed

Abarikwu, Sunny O

2013-12-01

In recent times there has been a decline in the semen quality of young healthy men worldwide, with similar findings being reported in Nigeria. Although little is known about what is responsible for the decline in male sperm count worldwide, significant associations have been reported between impaired semen quality including sperm count, motility as well as morphology and exposures to heavy metals such as cadmium and lead, mycotoxins such as aflatoxins, pesticides, industrial chemicals and endocrine factors. In Nigeria, the problem is further compounded by a variety of factors such as sexually transmitted infections, genito-urinary tract infections/inflammations and deficiencies of dietary antioxidant nutrients, thereby increasing male-factor contribution to infertility in the population. In this article, we analyze data from different sources and present evidence of the possible etiology and risk factors for male-factor infertility in Nigeria.

Connections between voice ergonomic risk factors in classrooms and teachers' voice production.

PubMed

Rantala, Leena M; Hakala, Suvi; Holmqvist, Sofia; Sala, Eeva

2012-01-01

The aim of the study was to investigate if voice ergonomic risk factors in classrooms correlated with acoustic parameters of teachers' voice production. The voice ergonomic risk factors in the fields of working culture, working postures and indoor air quality were assessed in 40 classrooms using the Voice Ergonomic Assessment in Work Environment - Handbook and Checklist. Teachers (32 females, 8 males) from the above-mentioned classrooms recorded text readings before and after a working day. Fundamental frequency, sound pressure level (SPL) and the slope of the spectrum (alpha ratio) were analyzed. The higher the number of the risk factors in the classrooms, the higher SPL the teachers used and the more strained the males' voices (increased alpha ratio) were. The SPL was already higher before the working day in the teachers with higher risk than in those with lower risk. In the working environment with many voice ergonomic risk factors, speakers increase voice loudness and use more strained voice quality (males). A practical implication of the results is that voice ergonomic assessments are needed in schools. Copyright © 2013 S. Karger AG, Basel.

The Influence of Nutritional Factors on Verbal Deficits and Psychopathic Personality Traits: Evidence of the Moderating Role of the MAOA Genotype

PubMed Central

Jackson, Dylan B.; Beaver, Kevin M.

2015-01-01

The current study explores whether: (a) nutritional factors among adolescent males predict their risk of exhibiting verbal deficits and psychopathic traits during adulthood and (b) the link between nutritional factors and these outcomes is conditioned by the MAOA genotype. The study analyzes data from the U.S. National Longitudinal Study of Adolescent Health (Add Health), a nationally representative, genetically informative sample. We find evidence that meal deprivation increases the likelihood of both verbal deficits and psychopathic personality traits, whereas poor quality nutrition increases the risk of verbal deficits. We detect the presence of a number of gene-environment interactions between measures of food quality and MAOA genotype, but no evidence of GxE in the case of meal deprivation. Limitations are noted and avenues for future research are discussed. PMID:26690459

Enhanced quality factors and force sensitivity by attaching magnetic beads to cantilevers for atomic force microscopy in liquid

NASA Astrophysics Data System (ADS)

Hoof, Sebastian; Nand Gosvami, Nitya; Hoogenboom, Bart W.

2012-12-01

Dynamic-mode atomic force microscopy (AFM) in liquid remains complicated due to the strong viscous damping of the cantilever resonance. Here, we show that a high-quality resonance (Q >20) can be achieved in aqueous solution by attaching a microgram-bead at the end of the nanogram-cantilever. The resulting increase in cantilever mass causes the resonance frequency to drop significantly. However, the force sensitivity—as expressed via the minimum detectable force gradient—is hardly affected, because of the enhanced quality factor. Through the enhancement of the quality factor, the attached bead also reduces the relative importance of noise in the deflection detector. It can thus yield an improved signal-to-noise ratio when this detector noise is significant. We describe and analyze these effects for a set-up that includes magnetic actuation of the cantilevers and that can be easily implemented in any AFM system that is compatible with an inverted optical microscope.

Evaluating signal and noise spectral density of a qPlus sensor with an active feedback control

NASA Astrophysics Data System (ADS)

Lee, Manhee; An, Sangmin; Jhe, Wonho

2018-05-01

Q-control technique enables to actively change the quality factor of the probe oscillation in dynamic atomic force microscopy. The Q-control is realized by adding a self-feedback loop into the original actuation-detection system, in which a damping force with controllable damping coefficient in magnitude and sign is applied to the oscillating probe. While the applied force alters the total damping interaction and thus the overall `signal' of the probe motion, the added feedback system changes the `noise' of the motion as well. Here, we systematically investigate the signal, the noise, and the signal-to-noise ratio of the qPlus sensor under the active Q-control. We quantify the noise of the qPlus motion by measuring the noise spectral density, which is reproduced by a harmonic oscillator model including the thermal and the measurement noises. We show that the noise signal increases with the quality factor controlled, scaling as the square root of the quality factor. Because the overall signal is linearly proportional to the quality factor, the signal-to-noise ratio scales as the square root of the quality factor. The Q-controlled qPlus with a highly enhanced Q, up to 10,000 in air, leads to the minimum detectable force gradient of 0.001 N/m, which would enhance the capability of the qPlus sensor for atomic force microscopy and spectroscopy.

Quality of Life Among HIV-Infected Patients in Brazil after Initiation of Treatment

PubMed Central

Campos, Lorenza Nogueira; César, Cibele Comini; Guimarães, Mark Drew Crosland

2009-01-01

INTRODUCTION Despite improvement in clinical treatment for HIV-infected patients, the impact of antiretroviral therapy on the overall quality of life has become a major concern. OBJECTIVE To identify factors associated with increased levels of self-reported quality of life among HIV-infected patients after four months of antiretroviral therapy. METHODS Patients were recruited at two public health referral centers for AIDS, Belo Horizonte, Brazil, for a prospective adherence study. Patients were interviewed before initiating treatment (baseline) and after one and four months. Quality of life was assessed using a psychometric instrument, and factors associated with good/very good quality of life four months after the initiation of antiretroviral therapy were assessed using a cross-sectional approach. Logistic regression was used for analysis. RESULTS Overall quality of life was classified as ‘very good/good’ by 66.4% of the participants four months after initiating treatment, while 33.6% classified it as ‘neither poor nor good/poor/very poor’. Logistic regression indicated that >8 years of education, none/mild symptoms of anxiety and depression, no antiretroviral switch, lower number of adverse reactions and better quality of life at baseline were independently associated with good/very good quality of life over four months of treatment. CONCLUSIONS Our results highlight the importance of modifiable factors such as psychiatric symptoms and treatment-related variables that may contribute to a better quality of life among patients initiating treatment. Considering that poor quality of life is related to non-adherence to antiretroviral therapy, careful clinical monitoring of these factors may contribute to ensuring the long-term effectiveness of antiretroviral regimens. PMID:19759880

Key Factors for a High-Quality Peritoneal Dialysis Program — The Role of the PD Team and Continuous Quality Improvement

PubMed Central

Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

2014-01-01

The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

Age associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life

USDA-ARS?s Scientific Manuscript database

SUMMARY: This 3 year longitudinal study among older adults showed that declining muscle mass, strength, power, and physical performance are independent contributing factors to increased fear of falling, while declines of muscle mass and physical performance contribute to deterioration of quality of ...

Making Movies: The Next Big Thing in Feedback?

ERIC Educational Resources Information Center

Hope, Sheila A.

2011-01-01

Good quality, timely feedback is a key factor to help students achieve their full potential. Increased class sizes have put significant strain on the ability to return work promptly without compromising feedback quality. In the current study, two screencasting technologies were used to produce audiovisual feedback. For essays, Jing was used,…

Factors Determining e-Learning Service Quality

ERIC Educational Resources Information Center

Uppal, Muhammad Amaad; Ali, Samnan; Gulliver, Stephen R.

2018-01-01

e-Learning courses are fast becoming common-place, yet the success of these online courses varies considerably. Since limited research addresses the issue of e-learning quality (ELQ) of service in higher education environments, there is an increasing need to effectively assess ELQ. In this paper, we argue that to obtain a satisfactory e-learning…

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

DTIC Science & Technology

2008-08-01

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

Geospatial data to support analysis of water-quality conditions in basin-fill aquifers in the southwestern United States

USGS Publications Warehouse

McKinney, Tim S.; Anning, David W.

2009-01-01

The Southwest Principal Aquifers study area consists of most of California and Nevada and parts of Utah, Arizona, New Mexico, and Colorado; it is about 409,000 square miles. The Basin-fill aquifers extend through about 201,000 square miles of the study area and are the primary source of water for cities and agricultural communities in basins in the arid and semiarid southwestern United States (Southwest). The demand on limited ground-water resources in areas in the southwestern United States has increased significantly. This increased demand underscores the importance of understanding factors that affect the water quality in basin-fill aquifers in the region, which are being studied through the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) program. As a part of this study, spatial datasets of natural and anthropogenic factors that may affect ground-water quality of the basin-fill aquifers in the southwestern United States were developed. These data include physical characteristics of the region, such as geology, elevation, and precipitation, as well as anthropogenic factors, including population, land use, and water use. Spatial statistics for the alluvial basins in the Southwest have been calculated using the datasets. This information provides a foundation for the development of conceptual and statistical models that relate natural and anthropogenic factors to ground-water quality across the Southwest. A geographic information system (GIS) was used to determine and illustrate the spatial distribution of these basin-fill variables across the region. One hundred-meter resolution raster data layers that represent the spatial characteristics of the basins' boundaries, drainage areas, population densities, land use, and water use were developed for the entire Southwest.

Perceptional and socio-demographic factors associated with household drinking water management strategies in rural Puerto Rico.

PubMed

Jain, Meha; Lim, Yili; Arce-Nazario, Javier A; Uriarte, María

2014-01-01

Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption.

Acoustic Quality Levels of Mosques in Batu Pahat

NASA Astrophysics Data System (ADS)

Azizah Adnan, Nor; Nafida Raja Shahminan, Raja; Khair Ibrahim, Fawazul; Tami, Hannifah; Yusuff, M. Rizal M.; Murniwaty Samsudin, Emedya; Ismail, Isham

2018-04-01

Every Friday, Muslims has been required to perform a special prayer known as the Friday prayers which involve the delivery of a brief lecture (Khutbah). Speech intelligibility in oral communications presented by the preacher affected all the congregation and determined the level of acoustic quality in the interior of the mosque. Therefore, this study intended to assess the level of acoustic quality of three public mosques in Batu Pahat. Good acoustic quality is essential in contributing towards appreciation in prayers and increasing khusyu’ during the worship, which is closely related to the speech intelligibility corresponding to the actual function of the mosque according to Islam. Acoustic parameters measured includes noise criteria (NC), reverberation time (RT) and speech transmission index (STI), and was performed using the sound level meter and sound measurement instruments. This test is carried out through the physical observation with the consideration of space and volume design as a factor affecting acoustic parameters. Results from all 3 mosques as the showed that the acoustic quality level inside these buildings are slightly poor which is at below 0.45 coefficients based on the standard. Among the factors that influencing the low acoustical quality are location, building materials, installation of sound absorption material and the number of occupants inside the mosque. As conclusion, the acoustic quality level of a mosque is highly depends on physical factors of the mosque such as the architectural design and space volume besides other factors as been identified by this study.

Perceptional and Socio-Demographic Factors Associated with Household Drinking Water Management Strategies in Rural Puerto Rico

PubMed Central

Jain, Meha; Lim, Yili; Arce-Nazario, Javier A.; Uriarte, María

2014-01-01

Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption. PMID:24586302

Work stressors, depressive symptoms and sleep quality among US Navy members: a parallel process latent growth modelling approach across deployment.

PubMed

Bravo, Adrian J; Kelley, Michelle L; Swinkels, Cindy M; Ulmer, Christi S

2017-11-03

The present study examined whether work stressors contribute to sleep problems and depressive symptoms over the course of deployment (i.e. pre-deployment, post-deployment and 6-month reintegration) among US Navy members. Specifically, we examined whether depressive symptoms or sleep quality mediate the relationships between work stressors and these outcomes. Participants were 101 US Navy members who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Using piecewise latent growth models, we found that increased work stressors were linked to increased depressive symptoms and decreased sleep quality across all three deployment stages. Further, increases in work stressors from pre- to post-deployment contributed to poorer sleep quality post-deployment via increasing depressive symptoms. Moreover, sleep quality mediated the association between increases in work stressors and increases in depressive symptoms from pre- to post-deployment. These effects were maintained from post-deployment through the 6-month reintegration. Although preliminary, our results suggest that changes in work stressors may have small, but significant implications for both depressive symptoms and quality of sleep over time, and a bi-directional relationship persists between sleep quality and depression across deployment. Strategies that target both stress and sleep could address both precipitating and perpetuating factors that affect sleep and depressive symptoms. © 2017 European Sleep Research Society.

Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India.

PubMed

Kaphle, Sangya; Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal

2015-05-28

mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where an additional point in CommCare proficiency score increased the quality score by around half a point (0.541, P=.07), and experience score by around a third of a point (0.308, P=.03). Age affected CommCare user type negatively, with an increase in age increasing the likelihood of belonging to a lower category of CommCare adoption (-0.105, P=.08). Other individual characteristics did not affect adoption or the predicted values estimating the relationship between adoption and quality and experience of care, although illiteracy was able to affect the relationship negatively. mHealth technology adoption by frontline workers can positively impact the quality and experience of care they provide. Individual characteristics, especially literacy and age, can be important elements affecting technology adoption and the way users leverage the technology for their work. Our formative study provides informed hypotheses and methods for further research.

Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India

PubMed Central

Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal

2015-01-01

Background mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. Objective To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Methods Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Results Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where an additional point in CommCare proficiency score increased the quality score by around half a point (0.541, P=.07), and experience score by around a third of a point (0.308, P=.03). Age affected CommCare user type negatively, with an increase in age increasing the likelihood of belonging to a lower category of CommCare adoption (-0.105, P=.08). Other individual characteristics did not affect adoption or the predicted values estimating the relationship between adoption and quality and experience of care, although illiteracy was able to affect the relationship negatively. Conclusions mHealth technology adoption by frontline workers can positively impact the quality and experience of care they provide. Individual characteristics, especially literacy and age, can be important elements affecting technology adoption and the way users leverage the technology for their work. Our formative study provides informed hypotheses and methods for further research. PMID:26023001

An approach to optimize the batch mixing process for improving the quality consistency of the products made from traditional Chinese medicines*

PubMed Central

Yan, Bin-jun; Qu, Hai-bin

2013-01-01

The efficacy of traditional Chinese medicine (TCM) is based on the combined effects of its constituents. Variation in chemical composition between batches of TCM has always been the deterring factor in achieving consistency in efficacy. The batch mixing process can significantly reduce the batch-to-batch quality variation in TCM extracts by mixing them in a well-designed proportion. However, reducing the quality variation without sacrificing too much of the production efficiency is one of the challenges. Accordingly, an innovative and practical batch mixing method aimed at providing acceptable efficiency for industrial production of TCM products is proposed in this work, which uses a minimum number of batches of extracts to meet the content limits. The important factors affecting the utilization ratio of the extracts (URE) were studied by simulations. The results have shown that URE was affected by the correlation between the contents of constituents, and URE decreased with the increase in the number of targets and the relative standard deviations of the contents. URE could be increased by increasing the number of storage tanks. The results have provided a reference for designing the batch mixing process. The proposed method has possible application value in reducing the quality variation in TCM and providing acceptable production efficiency simultaneously. PMID:24190450

An approach to optimize the batch mixing process for improving the quality consistency of the products made from traditional Chinese medicines.

PubMed

Yan, Bin-jun; Qu, Hai-bin

2013-11-01

The efficacy of traditional Chinese medicine (TCM) is based on the combined effects of its constituents. Variation in chemical composition between batches of TCM has always been the deterring factor in achieving consistency in efficacy. The batch mixing process can significantly reduce the batch-to-batch quality variation in TCM extracts by mixing them in a well-designed proportion. However, reducing the quality variation without sacrificing too much of the production efficiency is one of the challenges. Accordingly, an innovative and practical batch mixing method aimed at providing acceptable efficiency for industrial production of TCM products is proposed in this work, which uses a minimum number of batches of extracts to meet the content limits. The important factors affecting the utilization ratio of the extracts (URE) were studied by simulations. The results have shown that URE was affected by the correlation between the contents of constituents, and URE decreased with the increase in the number of targets and the relative standard deviations of the contents. URE could be increased by increasing the number of storage tanks. The results have provided a reference for designing the batch mixing process. The proposed method has possible application value in reducing the quality variation in TCM and providing acceptable production efficiency simultaneously.

Product quality as the main factor of increase of competitiveness (on the example of JSC “Kazan helicopter plant”)

NASA Astrophysics Data System (ADS)

Khafizov, I. I.; Nurullin, I. G.

2017-09-01

Planning for effective development, and timely research perspectives and opportunities, States, markets, regulations, competition and competitiveness of its production, helps to achieve the stable business success in the market. The relevance of the study of the production of high quality products is that the quality of goods and services should always comply with the requirements established in state regulations, standards, regulations or conditions.

Performance evaluation of public hospital information systems by the information system success model.

PubMed

Cho, Kyoung Won; Bae, Sung-Kwon; Ryu, Ji-Hye; Kim, Kyeong Na; An, Chang-Ho; Chae, Young Moon

2015-01-01

This study was to evaluate the performance of the newly developed information system (IS) implemented on July 1, 2014 at three public hospitals in Korea. User satisfaction scores of twelve key performance indicators of six IS success factors based on the DeLone and McLean IS Success Model were utilized to evaluate IS performance before and after the newly developed system was introduced. All scores increased after system introduction except for the completeness of medical records and impact on the clinical environment. The relationships among six IS factors were also analyzed to identify the important factors influencing three IS success factors (Intention to Use, User Satisfaction, and Net Benefits). All relationships were significant except for the relationships among Service Quality, Intention to Use, and Net Benefits. The results suggest that hospitals should not only focus on systems and information quality; rather, they should also continuously improve service quality to improve user satisfaction and eventually reach full the potential of IS performance.

Recent progress in opto-electronic oscillator

NASA Technical Reports Server (NTRS)

Maleki, Lute

2005-01-01

The optoelectronic oscillator (OEO) is a unique device based on photonics techniques to generate highly spectrally pure microwave signals [1]. The development of the OEO was motivated by the need for high performance oscillators in the frequency range larger than 10 GHz, where conventional electronic oscillators have a number of limitations. These limitations typically stem from the product of fQ, where f is the oscillator frequency and Q is the quality factor of the resonator in the oscillator. In conventional resonators, whether electromagnetic or piezoelectric, this product is usually a constant. Thus, as the oscillator frequency is pushed higher, the quality factor degrades, resulting in degradation of the phase noise of the oscillator. An approach to mitigate the problem is to start with a very high quality signal in the 5 to 100 MHz range generated by a quartz oscillator and multiply the frequency to achieve the desired microwave signal. Here again, frequency multiplication also results in an increase of the phase noise by a factor of 2010gN, where N is the multiplication factor.

Influence of the interaction between environmental quality and T102C SNP in the HTR2A gene on fibromyalgia susceptibility.

PubMed

Mergener, Michelle; Becker, Roze Mary Ribas; dos Santos, Adriana Freitag; dos Santos, Geraldine Alves; de Andrade, Fabiana Michelsen

2011-12-01

This study aimed to investigate the genetic influence of the T102C polymorphism of the 2A serotonin receptor gene (HTR2A) and its interaction with environmental aspects, such as exposure to noise, traffic, climate, and opportunities to acquire new information, physical protection, and security, among others, as possible risk factors for developing fibromyalgia syndrome (FMS). Forty-one FMS patients and 49 controls were evaluated. Environmental factors were evaluated by application of the V domain of the WHOQOL-100 questionnaire. Patients were asked that their answers represented only the periods preceding the onset of symptoms. The T102C variant of the HTR2A gene was determined through PCR/RFLP. Among patients, the frequency of carriers of the 102C allele was higher than in controls (76.5% vs. 50%; P = 0.028). The scores of the V domain were lower in patients than in controls, indicating a worst perception of the environmental quality by patients (P < 0.001). The factor "lack of opportunities for acquiring new information and skills" increased the chance of developing FMS by almost 14-fold (P = 0.009). The factor "low quality of social care and health" together with the presence of the 102C allele also increased this chance by more than 90-fold (P = 0.005). However, carriers of the same allele who have high quality social care and health are not at a higher risk to develop FMS. These data suggest that these factors may predispose to FMS, especially in carriers of the 102C allele. However, studies with larger samples are required to confirm this hypothesis.

Pay for performance: will dentistry follow?

PubMed

Voinea-Griffin, Andreea; Fellows, Jeffrey L; Rindal, Donald B; Barasch, Andrei; Gilbert, Gregg H; Safford, Monika M

2010-04-28

"Pay for performance" is an incentive system that has been gaining acceptance in medicine and is currently being considered for implementation in dentistry. However, it remains unclear whether pay for performance can effect significant and lasting changes in provider behavior and quality of care. Provider acceptance will likely increase if pay for performance programs reward true quality. Therefore, we adopted a quality-oriented approach in reviewing those factors which could influence whether it will be embraced by the dental profession. The factors contributing to the adoption of value-based purchasing were categorized according to the Donabedian quality of care framework. We identified the dental insurance market, the dental profession position, the organization of dental practice, and the dental patient involvement as structural factors influencing the way dental care is practiced and paid for. After considering variations in dental care and the early stage of development for evidence-based dentistry, the scarcity of outcome indicators, lack of clinical markers, inconsistent use of diagnostic codes and scarcity of electronic dental records, we concluded that, for pay for performance programs to be successfully implemented in dentistry, the dental profession and health services researchers should: 1) expand the knowledge base; 2) increase considerably evidence-based clinical guidelines; and 3) create evidence-based performance measures tied to existing clinical practice guidelines. In this paper, we explored factors that would influence the adoption of value-based purchasing programs in dentistry. Although none of these factors were essential deterrents for the implementation of pay for performance programs in medicine, the aggregate seems to indicate that significant changes are needed before this type of program could be considered a realistic option in dentistry.

Comprehensive evaluation and analysis of ecological environment quality ofLaoshan Natural Reservebased on Remote Sensing

NASA Astrophysics Data System (ADS)

Cui, Wenlian; Liu, Shanwei; Liu, Yan; Wang, Yanling; Zhang, Naixin

2016-11-01

We used the remote sensing images of 2001, 2005 and 2010, statistics of reservoir water quality, air quality data, precipitation data and population data to evaluate and analyze the ecological environment quality of Laoshan Natural Reserve. In this decade, the ecological environment of tourism scenic area in Laoshan Natural Reserve becomes significantly better than that of the surrounding area, and it is the urban sprawl and increase of cultivated land area that resulted in the reduction of the scenic plants; Reservoir water quality was stable, but PH value and total nitrogen content still did not meet the standards because of the use of the sewage and pesticide fertilizer in the neighborhood; Air quality decreased slightly, however, the situation of acid rain had improved; Residential population continued to grow in Laoshan district and scenic tourists have increased, so human activity has become the main impacting factor of ecological environment of Laoshan Natural Reserve.

Relationships between psychosocial factors and quality of life for adults who stutter.

PubMed

Boyle, Michael P

2015-02-01

In this study, the author examined the relationship of social support, empowerment, self-help support group participation, and group identification to quality of life in adults who stutter. Two-hundred forty-nine adults who stutter completed a web-based survey, including measures of social support, empowerment, self-help support group participation, group identification, and quality of life. After controlling for demographic and stuttering parameters, both empowerment in the self-esteem/self-efficacy domain and social support from family significantly predicted quality of life in adults in the sample. Increased self-esteem/self-efficacy and social support from family relates to improved quality of life in adults who stutter, independent of stuttering severity. Treatments that increase feelings of self-esteem/self-efficacy and strengthen social support from the family should be considered for individuals who struggle to cope with stuttering in order to enhance their quality of life.

Sleep quality during pregnancy: associations with depressive and anxiety symptoms.

PubMed

Polo-Kantola, Päivi; Aukia, Linda; Karlsson, Hasse; Karlsson, Linnea; Paavonen, E Juulia

2017-02-01

Sleep disturbances are common during pregnancy, yet underdiagnosed and under-investigated. We evaluated sleep quality during pregnancy and assessed associated factors, especially depressive and anxiety symptoms. A total of 78 healthy pregnant women from the FinnBrain Birth Cohort Study were studied twice prospectively during pregnancy (in mid-pregnancy and late pregnancy). Sleep quality was evaluated by the Basic Nordic Sleep Questionnaire, depressive symptoms by the Edinburgh Postnatal Depression Scale, and anxiety symptoms by the State-Trait Anxiety Inventory. Poor general sleep quality, difficulty falling asleep, the number of nocturnal awakenings per night, and too-early morning awakenings increased in late pregnancy compared with mid-pregnancy (all p-values < 0.020). The total insomnia score (p < 0.001) and sleep latency increased (p = 0.005), but sleep duration and preferred sleep duration did not change. Women tended to snore more often in late pregnancy, but apneas remained rare. Almost one-fourth of the women reported both morning and daytime sleepiness, but the frequencies did not increase during the follow up. In late pregnancy, depressive and anxiety symptoms were cross-sectionally related to sleep disturbances, but depressive or anxiety symptoms in mid-pregnancy were not associated with sleep disturbances in late pregnancy. We found deterioration in sleep quality across pregnancy. However, no increase in negative daytime consequences was found, presumably indicating a compensatory capacity against sleep impairment. Additionally, depressive and anxiety symptoms and sleep disturbances were only cross-sectionally associated. Our study calls for further research on the factors that influence sleep disturbances during pregnancy. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

The Library as Factor in Erudition.

ERIC Educational Resources Information Center

Pasiar, Stefan

Libraries have long functioned as institutions which exerted wide-ranging cultural-social activity as determined by the economic and cultural needs of society. Librarianship as an educational factor has become increasingly important during the past half century with respect to its quantitative growth and its quality world-wide. Although the school…

Longitudinal associations between social support and physical and mental health in African American adults

USDA-ARS?s Scientific Manuscript database

African Americans report a greater number of modifiable risk factors, such as overweight/obesity, physical inactivity and poor dietary habits, putting them at increased risk of developing and dying from chronic diseases. These risk factors are also associated with poorer health-related quality of li...

Sociodemographic factors contribute to the depressive affect among African Americans with chronic kidney disease.

PubMed

Fischer, Michael J; Kimmel, Paul L; Greene, Tom; Gassman, Jennifer J; Wang, Xuelei; Brooks, Deborah H; Charleston, Jeanne; Dowie, Donna; Thornley-Brown, Denyse; Cooper, Lisa A; Bruce, Marino A; Kusek, John W; Norris, Keith C; Lash, James P

2010-06-01

Depression is common in end-stage renal disease and is associated with poor quality of life and higher mortality; however, little is known about depressive affect in earlier stages of chronic kidney disease. To measure this in a risk group burdened with hypertension and kidney disease, we conducted a cross-sectional analysis of individuals at enrollment in the African American Study of Kidney Disease and Hypertension Cohort Study. Depressive affect was assessed by the Beck Depression Inventory II and quality of life by the Medical Outcomes Study-Short Form and the Satisfaction with Life Scale. Beck Depression scores over 14 were deemed consistent with an increased depressive affect and linear regression analysis was used to identify factors associated with these scores. Among 628 subjects, 166 had scores over 14 but only 34 were prescribed antidepressants. The mean Beck Depression score of 11.0 varied with the estimated glomerular filtration rate (eGFR) from 10.7 (eGFR 50-60) to 16.0 (eGFR stage 5); however, there was no significant independent association between these. Unemployment, low income, and lower quality and satisfaction with life scale scores were independently and significantly associated with a higher Beck Depression score. Thus, our study shows that an increased depressive affect is highly prevalent in African Americans with chronic kidney disease, is infrequently treated with antidepressants, and is associated with poorer quality of life. Sociodemographic factors have especially strong associations with this increased depressive affect. Because this study was conducted in an African-American cohort, its findings may not be generalized to other ethnic groups.

Climatic factors affecting quantity and quality grade of in vivo derived embryos of cattle.

PubMed

Chinchilla-Vargas, Josué; Jahnke, Marianna M; Dohlman, Tyler M; Rothschild, Max F; Gunn, Patrick J

2018-05-01

The present study investigated the effects of climatic variables on the quality grade and quantity of in vivo derived cattle embryos in the Midwestern United States. Climatic information included greatest and least daily temperature, average daily wind speed and average temperature-humidity index for each of the 765 records. The response variables included the number of ovarian structures, viable embryos, quality grade 1 embryos, quality grade 2 embryos, quality grade 3 embryos, freezable embryos (sum of quality grade 1 and quality grade 2 embryos), transferable embryos (sum of quality grade 1-3 embryos), degenerate embryos and unfertilized ova. Measures for variables among the breeds of donors and sires grouped by geographical origin were compared. A negative effect of greater temperatures during the early embryonic development stage tended (P < 0.10) to be associated with a decrease in the quality of embryos recovered. Interestingly, the greater the Temperature-Humidity Index (THI) during the early ovarian antral follicular development stage 40-45 days prior to ovulation was associated with a tendency for greater numbers of total number of freezable and transferable embryos recovered per uterine flushing (P < 0.10). Increased wind speed at the early antral follicular phase 40-45 days prior to ovulation was associated with an increase in the percentage of quality grade 1 embryos recovered (P < 0.05). Wind speed during the estrous synchronization period was also associated with a lesser number of embryos recovered (P < 0.05). This retrospective study confirms that climatic variables have significant effects on the in vivo production of cattle embryos and that wind speed should be considered in future analyses of factors affecting embryo quality. Copyright © 2018 Elsevier B.V. All rights reserved.

Socioeconomic disadvantage increasing risk for depression among recently diagnosed HIV patients in an urban area in Brazil: cross-sectional study.

PubMed

Nomoto, Silmara Harumi; Longhi, Renata Marrona Praça; de Barros, Bruna Paes; Croda, Julio; Ziff, Edward Benjamin; Castelon Konkiewitz, Elisabete

2015-01-01

Depression is the most common psychiatric co-morbidity among people living with HIV (PLHIV), with prevalence rates ranging from 25% to 36%. Depression impacts negatively upon adherence and response to combined antiretroviral therapy (CART) and the transmission of HIV infection through increased sexually risky behavior. This cross-sectional study presents data from a reference HIV-outpatient service in Dourados (Brazil) that evaluated the association between depressive symptoms, health-related quality of life, and clinical, socioeconomic, and demographic factors in newly diagnosed HIV/AIDS patients. Using the Beck Depression Inventory (BDI), the prevalence of depressive symptoms was 61% with a predominance of self-deprecating and cognitive-affective factors. Depressive symptoms were associated with lower income (p=0.019) and disadvantaged social class (p=0.005). Poorer quality of life was related to depressive symptoms (p<0.0001), low educational level (p=0.05), and lower income (p=0.03). These data suggest that socioeconomic factors, including level of income and education, are mediating the risk of depression and poor quality of life of PLHIV. Possible explanations for this effect are discussed, including the possible role of stigma.

[Cardiac surgery in octogenarian patients: evaluation of predictive factors of mortality, long-term outcome and quality of life].

PubMed

Viana-Tejedor, Ana; Domínguez, Francisco J; Moreno Yangüela, Mar; Moreno, Raúl; López de Sá, Esteban; Mesa, José M; López-Sendón, José

2008-10-04

Increasing life expectancy in Western countries in the last decades has resulted in a significant gradual increasing number of octogenarians referred for cardiac surgery. There is a need for a critical evaluation of the long-term surgical outcome and quality of life in the elderly. The aim of this study is to identify risk factors of mortality in octogenarians undergoing cardiac surgery and to assess the long term survival and quality of life. Data were reviewed on 150 patients aged over 80 years--mean age (standard deviation): 82.7 (2.5) years--who underwent cardiac surgery at our institution in the last 26 years. We analyzed clinical and epidemiological variables included in the European System for Cardiac Operative Risk Evaluation (euroSCORE), in-hospital morbidity and mortality, long term survival and quality of life after cardiac surgery. The 30-day mortality rate was 30.1%, with a mean hospital stay of 16.5 days (13-27). Emergent procedure, reparation of postinfarction ventricular ruptures, New York Heart Association functional class IV, chronic renal failure and previous myocardial infarction were independent predictors of in-hospital mortality. Mean follow up was 72.2 (9.9) months with survival rates of 87.3% and 57% at 1 and 5 years, respectively. Late postoperative quality of life in our 53 long-term survivors was significantly better than prior to surgery. New York Heart Association functional class improved from 2.52 to 1.48. Most survivors (97.7%) were satisfied with present quality of life Cardiac surgery in octogenarians is associated with increased in-hospital mortality rate and longer hospital stay. Our findings support that cardiac surgery can be performed in a selected elderly population with good long-term survival and quality of life.

Production of salted and pressed anchovies (stolephorus sp.) and it's quality evaluation during storage.

PubMed

Siriskar, Dipty A; Khedkar, Gulab Dattarao; Lior, David

2013-12-01

Present study deals with the production of low cost salted and dried product from anchovy fish (Stolephorus spp.) using traditional technology application of different inhibitory factors to achieve a reasonable shelf life at ambient tropical temperature. Microbial safety, nutrient retention and product quality in terms of flavor and texture after rehydration have been tested. This product has been subjected to storage studies, with respect to product quality and microbial status. It can be kept well for a period of 5 weeks. The quality changes during storage are; decrease in sensory scores for the overall acceptance and also for the individual attributes. Increase in nitrogenous components such as Total Volatile Bases Nitrogen (TVB-N), Tri Methyl Amine Nitrogen (TMA-N) and Alpha Amino Nitrogen (AAN) was obtained with the advancement of the storage period. The lipid quality of the fish showed gradual increase in Preoxide Value (PV) and Free Fatty Acid (FFA) accompanied by decrease in flavor and odor scores. Activity of microorganisms showed a marginal increase with increase in storage period.

Power Spectrum of a Noisy System Close to a Heteroclinic Orbit

NASA Astrophysics Data System (ADS)

Giner-Baldó, Jordi; Thomas, Peter J.; Lindner, Benjamin

2017-07-01

We consider a two-dimensional dynamical system that possesses a heteroclinic orbit connecting four saddle points. This system is not able to show self-sustained oscillations on its own. If endowed with white Gaussian noise it displays stochastic oscillations, the frequency and quality factor of which are controlled by the noise intensity. This stochastic oscillation of a nonlinear system with noise is conveniently characterized by the power spectrum of suitable observables. In this paper we explore different analytical and semianalytical ways to compute such power spectra. Besides a number of explicit expressions for the power spectrum, we find scaling relations for the frequency, spectral width, and quality factor of the stochastic heteroclinic oscillator in the limit of weak noise. In particular, the quality factor shows a slow logarithmic increase with decreasing noise of the form Q˜ [ln (1/D)]^2. Our results are compared to numerical simulations of the respective Langevin equations.

Reducing support loss in micromechanical ring resonators using phononic band-gap structures

NASA Astrophysics Data System (ADS)

Hsu, Feng-Chia; Hsu, Jin-Chen; Huang, Tsun-Che; Wang, Chin-Hung; Chang, Pin

2011-09-01

In micromechanical resonators, energy loss via supports into the substrates may lead to a low quality factor. To eliminate the support loss, in this paper a phononic band-gap structure is employed. We demonstrate a design of phononic-crystal (PC) strips used to support extensional wine-glass mode ring resonators to increase the quality factor. The PC strips are introduced to stop elastic-wave propagation by the band-gap and deaf-band effects. Analyses of resonant characteristics of the ring resonators and the dispersion relations, eigenmodes, and transmission properties of the PC strips are presented. With the proposed resonator architecture, the finite-element simulations show that the leaky power is effectively reduced and the stored energy inside the resonators is enhanced simultaneously as the operating frequencies of the resonators are within the band gap or deaf bands. Realization of a high quality factor micromechanical ring resonator with minimized support loss is expected.

Evaluating University-Industry Collaboration: The European Foundation of Quality Management Excellence Model-Based Evaluation of University-Industry Collaboration

ERIC Educational Resources Information Center

Kauppila, Osmo; Mursula, Anu; Harkonen, Janne; Kujala, Jaakko

2015-01-01

The growth in university-industry collaboration has resulted in an increasing demand for methods to evaluate it. This paper presents one way to evaluate an organization's collaborative activities based on the European Foundation of Quality Management excellence model. Success factors of collaboration are derived from literature and compared…

Burnout and Quality of Life among Healthcare Research Faculty

ERIC Educational Resources Information Center

Enders, Felicity; West, Colin P.; Dyrbye, Liselotte; Shanafelt, Tait D.; Satele, Daniel; Sloan, Jeff

2015-01-01

Burnout is increasingly recognized as a problem in the workplace--30% to 50% of physicians experience burnout, but no assessment of burnout has been done among healthcare research faculty. A cross-sectional survey of burnout, quality of life, and related factors was sent to all doctoral-level faculty in a large department of healthcare research.…

Linking Public Attitudes with Perceptions of Factors Impacting Water Quality and Attending Learning Activities

ERIC Educational Resources Information Center

Clay, D. E.; Ren, C.; Reese, C.; Waskom, R.; Bauder, J.; Mesner, N.; Paige, G.; Reddy, K.; Neibauer, M.; Mahler, R.

2007-01-01

Increasingly, people are being asked to make decisions about water use in the semi-arid regions of the United States. "Good decisions" depend on an understanding of the linkages between sustainability of the resource, management, and economic development. This article reports on findings from a water quality survey conducted in Colorado,…

Strategies of Raising the Quality of Higher Education and Attaining Equality of Educational Opportunities

ERIC Educational Resources Information Center

Petrovskiy, Igor V.; Agapova, Elena N.

2016-01-01

The aim of the research is to develop the policy and strategy recommendations to increase the quality of higher education in Russian Federation. The study examines the significance of equal educational opportunities and the influence of this factor on the educational systems of developing countries. Transformational processes in the domain of…

Examining the Factor Structure and Psychometric Properties of the Quality of Life Scale among People with Multiple Sclerosis

ERIC Educational Resources Information Center

Fitzgerald, Shawn M.; Li, Jian; Rumrill, Phillip D., Jr.; Bishop, Malachy; Merchant, William R.

2015-01-01

Rehabilitation counseling researchers seeking to more fully understand the phenomenon of psychosocial adaptation to disability are devoting increased attention to the impact of disability on quality of life (QOL). This impact has been of particular interest among multiple sclerosis (MS) researchers. The complex etiology, unpredictable nature, and…

Parameters for the Design of Group Randomized Studies for Teacher Professional Development

ERIC Educational Resources Information Center

Kelcey, Ben; Phelps, Geoffrey; Jones, Nathan

2013-01-01

Teacher professional development (PD) is seen as critical to improving the quality of US schools (National Commission on Teaching and America's Future, 1997). PD is increasingly viewed as one of the primary levers for improving teaching quality and ultimately student achievement (Correnti, 2007). One factor that is driving interest in PD is…

The Influence of First Impressions on Subsequent Ratings within an OSCE Station

ERIC Educational Resources Information Center

Wood, Timothy J.; Chan, James; Humphrey-Murto, Susan; Pugh, Debra; Touchie, Claire

2017-01-01

Competency-based assessment is placing increasing emphasis on the direct observation of learners. For this process to produce valid results, it is important that raters provide quality judgments that are accurate. Unfortunately, the quality of these judgments is variable and the roles of factors that influence the accuracy of those judgments are…

High Available COTS Based Computer for Space

NASA Astrophysics Data System (ADS)

Hartmann, J.; Magistrati, Giorgio

2015-09-01

The availability and reliability factors of a system are central requirements of a target application. From a simple fuel injection system used in cars up to a flight control system of an autonomous navigating spacecraft, each application defines its specific availability factor under the target application boundary conditions. Increasing quality requirements on data processing systems used in space flight applications calling for new architectures to fulfill the availability, reliability as well as the increase of the required data processing power. Contrary to the increased quality request simplification and use of COTS components to decrease costs while keeping the interface compatibility to currently used system standards are clear customer needs. Data processing system design is mostly dominated by strict fulfillment of the customer requirements and reuse of available computer systems were not always possible caused by obsolescence of EEE-Parts, insufficient IO capabilities or the fact that available data processing systems did not provide the required scalability and performance.

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.

Public Reporting of Primary Care Clinic Quality: Accounting for Sociodemographic Factors in Risk Adjustment and Performance Comparison.

PubMed

Wholey, Douglas R; Finch, Michael; Kreiger, Rob; Reeves, David

2018-01-03

Performance measurement and public reporting are increasingly being used to compare clinic performance. Intended consequences include quality improvement, value-based payment, and consumer choice. Unintended consequences include reducing access for riskier patients and inappropriately labeling some clinics as poor performers, resulting in tampering with stable care processes. Two analytic steps are used to maximize intended and minimize unintended consequences. First, risk adjustment is used to reduce the impact of factors outside providers' control. Second, performance categorization is used to compare clinic performance using risk-adjusted measures. This paper examines the effects of methodological choices, such as risk adjusting for sociodemographic factors in risk adjustment and accounting for patients clustering by clinics in performance categorization, on clinic performance comparison for diabetes care, vascular care, asthma, and colorectal cancer screening. The population includes all patients with commercial and public insurance served by clinics in Minnesota. Although risk adjusting for sociodemographic factors has a significant effect on quality, it does not explain much of the variation in quality. In contrast, taking into account the nesting of patients within clinics in performance categorization has a substantial effect on performance comparison.

Dependency of Optimal Parameters of the IRIS Template on Image Quality and Border Detection Error

NASA Astrophysics Data System (ADS)

Matveev, I. A.; Novik, V. P.

2017-05-01

Generation of a template containing spatial-frequency features of iris is an important stage of identification. The template is obtained by a wavelet transform in an image region specified by iris borders. One of the main characteristics of the identification system is the value of recognition error, equal error rate (EER) is used as criterion here. The optimal values (in sense of minimizing the EER) of wavelet transform parameters depend on many factors: image quality, sharpness, size of characteristic objects, etc. It is hard to isolate these factors and their influences. The work presents an attempt to study an influence of following factors to EER: iris segmentation precision, defocus level, noise level. Several public domain iris image databases were involved in experiments. The images were subjected to modelled distortions of said types. The dependencies of wavelet parameter and EER values from the distortion levels were build. It is observed that the increase of the segmentation error and image noise leads to the increase of the optimal wavelength of the wavelets, whereas the increase of defocus level leads to decreasing of this value.

Is housing quality associated with malaria incidence among young children and mosquito vector numbers? Evidence from Korogwe, Tanzania.

PubMed

Liu, Jenny X; Bousema, Teun; Zelman, Brittany; Gesase, Samwel; Hashim, Ramadhan; Maxwell, Caroline; Chandramohan, Daniel; Gosling, Roly

2014-01-01

Several studies conducted in Northeast Tanzania have documented declines in malaria transmission even before interventions were scaled up. One explanation for these reductions may be the changes in socio-environmental conditions associated with economic development, and in particular improvements in housing construction. This analysis seeks to identify (1) risk factors for malaria incidence among young children and (2) household and environmental factors associated with mosquito vector numbers collected in the child's sleeping area. Both analyses focus on housing construction quality as a key determinant. For 435 children enrolled in a larger trial of intermittent preventive treatment for malaria in infants in the Korogwe District in Tanga, Northeastern Tanzania, detailed information on their dwelling characteristics were collected in the last year of the trial. Principal components analysis was used to construct an index of housing structure quality and converted to quintile units for regression analysis. Univariate and multivariate random effects negative binomial regressions were used to predict risk factors for child malaria incidence and the mean total number of indoor female Anopheles gambiae and funestus mosquitoes collected per household across three occasions. Building materials have substantially improved in Korogwe over time. Multivariate regressions showed that residing in rural areas (versus urban) increased malaria incidence rates by over three-fold and mean indoor female A. gambiae and funestus numbers by nearly two-fold. Compared to those residing in the lowest quality houses, children residing in the highest quality houses had one-third lower malaria incidence rates, even when wealth and rural residence were controlled for. Living in the highest quality houses reduced vector numbers while having cattle near the house significantly increased them. Results corroborate findings from other studies that show associations between malaria incidence and housing quality; associations were concentrated amongst the highest quality houses.

Angle-resolved reflection spectroscopy of high-quality PMMA opal crystal

NASA Astrophysics Data System (ADS)

Nemtsev, Ivan V.; Tambasov, Igor A.; Ivanenko, Alexander A.; Zyryanov, Victor Ya.

2018-02-01

PMMA opal crystal was prepared by a simple hybrid method, which includes sedimentation, meniscus formation and evaporation. We investigated three surfaces of this crystal by angle-resolved reflective light spectroscopy and SEM study. The angle-resolved reflective measurements were carried out in the 400-1100 nm range. We have determined the high-quality ordered surface of the crystal region. Narrow particle size distribution of the surface has been revealed. The average particle diameter obtained with SEM was nearly 361 nm. The most interesting result was that reflectivity of the surface turned out up to 98% at normal light incidence. Using a fit of dependences of the maximum reflectivity wavelength from an angle based on the Bragg-Snell law, the wavelength of maximum 0° reflectivity, the particle diameter and the fill factor have been determined. For the best surface maximum reflectivity wavelength of a 0° angle was estimated to be 869 nm. The particle diameter and fill factor were calculated as 372 nm and 0.8715, respectively. The diameter obtained by fitting is in excellent agreement with the particle diameter obtained with SEM. The reflectivity maximum is assumed to increase significantly when increasing the fill factor. We believe that using our simple approach to manufacture PMMA opal crystals will significantly increase the fabrication of high-quality photonic crystal templates and thin films.

Prenatal Stress as a Risk-and an Opportunity-Factor.

PubMed

Hartman, Sarah; Freeman, Sara M; Bales, Karen L; Belsky, Jay

2018-04-01

Two separate lines of research indicate (a) that prenatal stress is associated with heightened behavioral and physiological reactivity and (b) that these postnatal phenotypes are associated with increased susceptibility to both positive and negative developmental experiences. Therefore, prenatal stress may increase sensitivity to the rearing environment. We tested this hypothesis by manipulating prenatal stress and rearing-environment quality, using a cross-fostering paradigm, in prairie voles. Results showed that prenatally stressed voles, as adults, displayed the highest behavioral and physiological reactivity when cross-fostered to low-contact (i.e., low-quality) rearing but the lowest behavioral and physiological reactivity when cross-fostered to high-contact (i.e., high-quality) rearing; non-prenatally stressed voles showed no effect of rearing condition. Additionally, while neither prenatal stress nor rearing condition affected oxytocin receptor binding, prenatally stressed voles cross-fostered to high-contact rearing showed the highest vasopressin-1a receptor binding in the amygdala. Results indicate that prenatal stress induces greater environmental sensitivity, making it both a risk and an opportunity factor.

Recent Local and State Action in Arizona to Maintain Sky Quality

NASA Astrophysics Data System (ADS)

Hall, Jeffrey C.; Shankland, P. D.; Green, R. F.; Jannuzi, B.

2014-01-01

The large number of observatories in Arizona has led to the development of a number of lighting control ordinances around the state, some quite strict. Several factors are now contributing to an increased need for active effort at the local, County, and State levels in maintaining the quality of these codes; these factors include an expansion of competing interests in the state, the increasing use of LED lighting, and the potential for major new investments through projects such as the Cherenkov Telescope Array (CTA) and enhancements to the Navy Precision Optical Interferometer. I will review recent strategies Arizona's observatories have used to effect maintenance of ordinances and preserve sky quality; cases include (1) a statewide effort in 2012 to curb a proliferation of electronic billboards and (2) engagement of a broad group of local, County, and State officials, as well as individuals from the private sector, in support of projects like CTA, including awareness of and support for dark-sky preservation.

Improved latrine cleanliness through behaviour change and changes in quality of latrine construction: a longitudinal intervention study in rural Burundi.

PubMed

Mosler, Hans-Joachim; Sonego, Ina Lucia

2017-10-01

Latrine cleanliness increased in the intervention group compared to the control group (increase from 21 to 31 % of latrines classified as clean in intervention [N = 198] and decrease from 37 to 27 % in control [N = 91]). Improved habitual latrine cleaning lead to latrines being 3.5 times more likely to improve in observed latrine cleanliness (χ 2  = 16.36, p < .001) and so did improvements in quality of latrine construction, eg households that had installed a lid were 7.39 times more likely to have a cleaner latrine (χ 2  = 4.46, p < .05). Changes in psychosocial factors, namely forgetting, personal norm, satisfaction with cleanliness, explained much of the change in habitual latrine cleaning (adj. r 2  = .46). Behaviour change interventions targeting psychosocial factors and quality of latrine construction seem promising to ensure clean and hygienic latrines.

Wind resource quality affected by high levels of renewables

DOE PAGES

Diakov, Victor

2015-06-17

For solar photovoltaic (PV) and wind resources, the capacity factor is an important parameter describing the quality of the resource. As the share of variable renewable resources (such as PV and wind) on the electric system is increasing, so does curtailment (and the fraction of time when it cannot be avoided). At high levels of renewable generation, curtailments effectively change the practical measure of resource quality from capacity factor to the incremental capacity factor. The latter accounts only for generation during hours of no curtailment and is directly connected with the marginal capital cost of renewable generators for a givenmore » level of renewable generation during the year. The Western U.S. wind generation is analyzed hourly for a system with 75% of annual generation from wind, and it is found that the value for the system of resources with equal capacity factors can vary by a factor of 2, which highlights the importance of using the incremental capacity factor instead. Finally, the effect is expected to be more pronounced in smaller geographic areas (or when transmission limitations imposed) and less pronounced at lower levels of renewable energy in the system with less curtailment.« less

Korean nurses' ethical dilemmas, professional values and professional quality of life.

PubMed

Kim, Kyunghee; Han, Yonghee; Kim, Ji-su

2015-06-01

In the changing medical environment, professional stress continuously increases as the individual's quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants' demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. The nurses' professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses' values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values. © The Author(s) 2014.

Postpartum diet quality in Australian women following a gestational diabetes pregnancy.

PubMed

Morrison, M K; Koh, D; Lowe, J M; Miller, Y D; Marshall, A L; Colyvas, K; Collins, C E

2012-10-01

To describe the diet quality of a national sample of Australian women with a recent history of gestational diabetes mellitus (GDM) and determine factors associated with adherence to national dietary recommendations. A postpartum lifestyle survey with 1499 Australian women diagnosed with GDM ≤3 years previously. Diet quality was measured using the Australian recommended food score (ARFS) and weighted by demographic and diabetes management characteristics. Multinominal logistic regression analysis was used to determine the association between diet quality and demographic characteristics, health seeking behaviours and diabetes-related risk factors. Mean (±s.d.) ARFS was 30.9±8.1 from a possible maximum score of 74. Subscale component scores demonstrated that the nuts/legumes, grains and fruits were the most poorly scored. Factors associated with being in the highest compared with the lowest ARFS quintile included age (odds ratio (OR) 5-year increase=1.40; 95% (confidence interval) CI:1.16-1.68), tertiary education (OR=2.19; 95% CI:1.52-3.17), speaking only English (OR=1.92; 95% CI:1.19-3.08), being sufficiently physically active (OR=2.11; 95% CI:1.46-3.05), returning for postpartum blood glucose testing (OR=1.75; 95% CI:1.23-2.50) and receiving risk reduction advice from a health professional (OR=1.80; 95% CI:1.24-2.60). Despite an increased risk of type 2 diabetes, women in this study had an overall poor diet quality as measured by the ARFS. Women with GDM should be targeted for interventions aimed at achieving a postpartum diet consistent with the guidelines for chronic disease prevention. Encouraging women to return for follow-up and providing risk reduction advice may be positive initial steps to improve diet quality, but additional strategies need to be identified.

Ginsenoside Rg3 improves cardiac mitochondrial population quality: Mimetic exercise training

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

Sun, Mengwei; Huang, Chenglin; Wang, Cheng

Highlights: •Rg3 is an ergogenic aid. •Rg3 improves mitochondrial antioxidant capacity. •Rg3 regulates mitochondria dynamic remodeling. •Rg3 alone matches some the benefits of aerobic exercise. -- Abstract: Emerging evidence indicates exercise training could mediate mitochondrial quality control through the improvement of mitochondrial dynamics. Ginsenoside Rg3 (Rg3), one of the active ingredients in Panax ginseng, is well known in herbal medicine as a tonic and restorative agent. However, the molecular mechanism underlying the beneficial effects of Rg3 has been elusive. In the present study, we compared the effects of Rg3 administration with aerobic exercise on mitochondrial adaptation in cardiac muscle tissuemore » of Sprague–Dawley (SD) rats. Three groups of SD rats were studied: (1) sedentary control, (2) Rg3-treated and (3) aerobic exercise trained. Both aerobic exercise training and Rg3 supplementation enhanced peroxisome proliferator-activated receptor coactivator 1 alpha (PGC-1α) and nuclear factor-E2-related factor 2 (Nrf2) protein levels in cardiac muscle. The activation of PGC-1α led to increased mRNA levels of mitochondrial transcription factor A (Tfam) and nuclear related factor 1(Nrf1), these changes were accompanied by increases in mitochondrial DNA copy number and complex protein levels, while activation of Nrf2 increased levels of phase II detoxifying enzymes, including nicotinamide adenine dinucleotide phosphate:quinone oxidoreductase 1(NQO1), superoxide dismutase (MnSOD) and catalase. Aerobic exercise also enhanced mitochondrial autophagy pathway activity, including increased conversion of LC3-I to LC3-II and greater expression of beclin1 and autophagy-related protein 7 (ATG7), these effects of aerobic exercise are comparable to that of Rg3. These results demonstrate that Rg3 mimics improved cardiac adaptations to exercise by regulating mitochondria dynamic remodeling and enhancing the quantity and quality of mitochondria.« less

Quality and readability of online information resources on insomnia.

PubMed

Ma, Yan; Yang, Albert C; Duan, Ying; Dong, Ming; Yeung, Albert S

2017-09-01

The internet is a major source for health information. An increasing number of people, including patients with insomnia, search for remedies online; however, little is known about the quality of such information. This study aimed to evaluate the quality and readability of insomnia-related online information. Google was used as the search engine, and the top websites on insomnia that met the inclusion criteria were evaluated for quality and readability. The analyzed websites belonged to nonprofit, commercial, or academic organizations and institutions such as hospitals and universities. Insomnia-related websites typically included definitions (85%), causes and risk factors (100%), symptoms (95%), and treatment options (90%). Cognitive behavioral therapy for insomnia (CBT-I) was the most commonly recommended approach for insomnia treatment, and sleep drugs are frequently mentioned. The overall quality of the websites on insomnia is moderate, but all the content exceeded the recommended reading ease levels. Concerns that must be addressed to increase the quality and trustworthiness of online health information include sharing metadata, such as authorship, time of creation and last update, and conflicts of interest; providing evidence for reliability; and increasing the readability for a layman audience.

Assessment of anxiety-depression levels and perceptions of quality of life in adolescents with dysmenorrhea.

PubMed

Sahin, Nilfer; Kasap, Burcu; Kirli, Ulviye; Yeniceri, Nese; Topal, Yasar

2018-01-26

This study aimed to assess the anxiety-depression levels and the perceptions of quality of life, as well as the factors affecting these variables, in adolescents with dysmenorrhea. The participants included 60 adolescents with dysmenorrhea and 41 healthy adolescents between the ages of 12 and 18. This study used the Pediatric Quality of Life Inventory (PedsQL) for assessing the perceptions of quality of life, the State-Trait Anxiety Inventory (STAI) for measuring anxiety levels, and the Children's Depression Inventory (CDI) for measuring depression levels. It was determined that compared to healthy controls, the depression and anxiety scores were higher and the quality of life was impaired in adolescents with dysmenorrhea. In addition, it was shown that the depression and anxiety levels increased and the psychosocial health subscale scores of quality of life decreased with increasing dysmenorrhea severity. However, the likelihood of dysmenorrhea was found to be higher with increasing depression scores, while the anxiety levels had no effect on dysmenorrhea. In dysmenorrhea management, it is important to enhance awareness among pediatric clinicians and gynecologists regarding the associations between dysmenorrhea and mental problems.

Representing and Retrieving Patients' Falls Risk Factors and Risk for Falls among Adults in Acute Care through the Electronic Health Record

ERIC Educational Resources Information Center

Pfaff, Jann

2013-01-01

Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care…

Effect of the quality of dietary amino acids composition on the urea synthesis in rats.

PubMed

Tujioka, Kazuyo; Ohsumi, Miho; Hayase, Kazutoshi; Yokogoshi, Hidehiko

2011-01-01

We have shown that urinary urea excretion increased in rats given a lower quality protein. The purpose of present study was to determine whether the composition of dietary amino acids affects urea synthesis. Experiments were done on three groups of rats given diets containing a 10% gluten amino acid mix diet or 10% casein amino acid mix diet or 10% whole egg protein amino acids mix diet for 10 d. The urinary excretion of urea, the liver concentration of N-acetylglutamate, and the liver concentration of free serine, glutamic acids and alanine were greater in the group given the amino acid mix diet of lower quality. The fractional and absolute rates of protein synthesis in tissues declined with a decrease in quality of dietary amino acids. The hepatic concentration of ornithine and the activities of hepatic urea-cycle enzymes were not related to the urea excretion. These results suggest that the increased concentrations of amino acids and N-acetylglutamate seen in the liver of rats given the amino acid mix diets of lower quality are likely among the factors stimulating urea synthesis. The protein synthesis in tissues is at least partly related to hepatic concentrations of amino acids. The composition of dietary amino acids is likely to be one of the factors regulating urea synthesis when the quality of dietary protein is manipulated.

The evaluation of selected insomnia predictors in adolescents and young adults with cystic fibrosis.

PubMed

Tomaszek, Lucyna; Cepuch, Grazyna; Pawlik, Lidia

2018-03-21

The purpose of the study was to assess the incidence of insomnia in adolescents and young adults with cystic fibrosis and its impact on the quality of life, and to examine whether demographic and clinical factors and negative emotional states are predictors of insomnia in these patients. The study was conducted among 95 cystic fibrosis patients aged 14-25 years. The study used a personal questionnaire survey, the Athens Insomnia Scale, the Cystic Fibrosis Quality of Life Questionnaire, the Hospital Anxiety and Depression Scale, and the Numeric Rating Scale. Insomnia was diagnosed in 38% of cystic fibrosis patients. In patients with insomnia, the level of anxiety (Me: 10 vs. 4; P=0.000) and depression (Me: 6.5 vs. 2; P=0.000) was significantly higher than in the good sleep quality group. The risk of insomnia increases as anxiety (OR: 4.31; 95% CI: 2.20 to 8.41) and depressive symptoms exacerbate (OR: 4.98; 95% CI: 1.84 to 13.43). Insomnia significantly worsens the quality of life in cystic fibrosis patients (ß =-0.5, P=0.000). Insomnia affects a large percentage of cystic fibrosis patients, and anxiety and depression are factors that increase the risk of insomnia. Insomnia decreases the quality of life in cystic fibrosis patients.

Competing pressures on populations: long-term dynamics of food availability, food quality, disease, stress and animal abundance.

PubMed

Chapman, Colin A; Schoof, Valérie A M; Bonnell, Tyler R; Gogarten, Jan F; Calmé, Sophie

2015-05-26

Despite strong links between sociality and fitness that ultimately affect the size of animal populations, the particular social and ecological factors that lead to endangerment are not well understood. Here, we synthesize approximately 25 years of data and present new analyses that highlight dynamics in forest composition, food availability, the nutritional quality of food, disease, physiological stress and population size of endangered folivorous red colobus monkeys (Procolobus rufomitratus). There is a decline in the quality of leaves 15 and 30 years following two previous studies in an undisturbed area of forest. The consumption of a low-quality diet in one month was associated with higher glucocorticoid levels in the subsequent month and stress levels in groups living in degraded forest fragments where diet was poor was more than twice those in forest groups. In contrast, forest composition has changed and when red colobus food availability was weighted by the protein-to-fibre ratio, which we have shown positively predicts folivore biomass, there was an increase in the availability of high-quality trees. Despite these changing social and ecological factors, the abundance of red colobus has remained stable, possibly through a combination of increasing group size and behavioural flexibility. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Modification of spermatozoa quality in mature small ruminants.

PubMed

Martin, G B; de St Jorre, T Jorre; Al Mohsen, F A; Malecki, I A

2011-01-01

This review is based largely, but not entirely, on the assumption that gamete quality is directly linked to sperm output and thus testicular mass, an approach made necessary by the absence of a large body of data on factors that affect gamete quality in ruminants. On the other hand, there is a change in the efficiency of sperm production per gram of testicular tissue when the testis is growing or shrinking, a clear indicator of changes in the rates of cell loss during the process of spermatogenesis, probably through apoptosis. We therefore postulate that the spermatozoa that do survive when the testis is shrinking are of a lower quality than those that are produced when the testis is growing and the rate of sperm survival is increasing. In adult small ruminants in particular, testicular mass and sperm production are highly labile and can be manipulated by management of photoperiod (melatonin), nutrition, genetics and behaviour ('mating pressure'). Importantly, these factors do not act independently of each other - rather, the outcomes in terms of sperm production are dictated by interactions. It therefore seems likely that spermatozoa quality will be affected by these same factors, but definitive answers await detailed studies.

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

PubMed

Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

2013-10-01

The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

Comparison of the mean quality factors for astronauts calculated using the Q-functions proposed by ICRP, ICRU, and NASA

NASA Astrophysics Data System (ADS)

Sato, T.; Endo, A.; Niita, K.

2013-07-01

For the estimation of the radiation risk for astronauts, not only the organ absorbed doses but also their mean quality factors must be evaluated. Three functions have been proposed by different organizations for expressing the radiation quality, including the Q(L), Q(y), and QNASA(Z, E) relationships as defined in International Committee of Radiological Protection (ICRP) Publication 60, International Commission on Radiation Units and Measurements (ICRU) Report 40, and National Aeronautics and Space Administration (NASA) TP-2011-216155, respectively. The Q(L) relationship is the most simple and widely used for space dosimetry, but the use of the latter two functions enables consideration of the difference in the track structure of various charged particles during the risk estimation. Therefore, we calculated the mean quality factors in organs and tissues in ICRP/ICRU reference voxel phantoms for the isotropic exposure to various mono-energetic particles using the three Q-functions. The Particle and Heavy Ion Transport code System PHITS was employed to simulate the particle motions inside the phantoms. The effective dose equivalents and the phantom-averaged effective quality factors for the astronauts were then estimated from the calculated mean quality factors multiplied by the fluence-to-dose conversion coefficients and cosmic-ray fluxes inside a spacecraft. It was found from the calculations that QNASA generally gives the largest values for the phantom-averaged effective quality factors among the three Q-functions for neutron, proton, and lighter-ion irradiation, whereas Q(L) provides the largest values for heavier-ion irradiation. Overall, the introduction of QNASA instead of Q(L) or Q(y) in astronaut dosimetry results in the increase the effective dose equivalents because the majority of the doses are composed of the contributions from protons and neutrons, although this tendency may change by the calculation conditions.

Dietary intake and risk factors for poor diet quality among children in Nova Scotia.

PubMed

Veugelers, Paul J; Fitzgerald, Angela L; Johnston, Elizabeth

2005-01-01

Public health policies promote healthy nutrition but evaluations of children's adherence to dietary recommendations and studies of risk factors of poor nutrition are scarce, despite the importance of diet for the temporal increase in the prevalence of childhood obesity. Here we examine dietary intake and risk factors for poor diet quality among children in Nova Scotia to provide direction for health policies and prevention initiatives. In 2003, we surveyed 5,200 grade five students from 282 public schools in Nova Scotia, as well as their parents. We assessed students' dietary intake (Harvard's Youth Adolescent Food Frequency Questionnaire) and compared this with Canadian food group and nutrient recommendations. We summarized diet quality using the Diet Quality Index International, and used multilevel regression methods to evaluate potential child, parental and school risk factors for poor diet quality. In Nova Scotia, 42.3% of children did not meet recommendations for milk products nor did they meet recommendations for the food groups 'Vegetables and fruit' (49.9%), 'Grain products' (54.4%) and 'Meat and alternatives' (73.7%). Children adequately met nutrient requirements with the exception of calcium and fibre, of which intakes were low, and dietary fat and sodium, of which intakes were high. Skipping meals and purchasing meals at school or fast-food restaurants were statistically significant determinants of poor diet. Parents' assessment of their own eating habits was positively associated with the quality of their children's diets. Dietary intake among children in Nova Scotia is relatively poor. Explicit public health policies and prevention initiatives targeting children, their parents and schools may improve diet quality and prevent obesity.

Factors influencing the success of rural cataract surgery programs in China: the study of hospital administration and relative productivity (SHARP).

PubMed

Liu, Tianyu; Ong, Ee Lin; Yan, Xixi; Guo, Xinxing; He, Mingguang; Friedman, David; Congdon, Nathan

2013-01-09

To explore factors potentially influencing the success or failure of rural Chinese hospitals in increasing cataract surgical output and quality. Focus groups (FGs, n = 10) were conducted with hospital administrators, doctors, and nurses at 28 county hospitals in Guangdong Province. Discussions explored respondents' views on increasing surgical volume and quality and improving patient satisfaction. Respondents numerically ranked possible strategies to increase surgical volume and quality and patient satisfaction. FG transcripts were independently coded by two reviewers utilizing the constant comparative method following the grounded theory approach, and numerical responses were scored and ranked. Ten FGs and 77 ranking questionnaires were completed by 33 administrators, 23 doctors, and 21 nurses. Kappa values for the two coders were greater than 0.7 for all three groups. All groups identified a critical need for enhanced management training for hospital directors. Doctors and nurses suggested reducing surgical fees to enhance uptake, although administrators were resistant to this. Although doctors saw the need to improve equipment, administrators felt current material conditions were adequate. Respondents agreed that patient satisfaction was generally high, and did not view increasing patient satisfaction as a priority. Our findings highlight agreements and disagreements among the three stakeholder groups about improving surgical output and quality, which can inform strategies to improve cataract programs in rural China. Respondents' beliefs about high patient satisfaction are not in accord with other studies in the area, highlighting a potential area for intervention.

Supporting Curriculum Assessment and Development: Implications for the Faculty Role and Institutional Support

ERIC Educational Resources Information Center

Hughes, Julia Christensen

2007-01-01

It has been suggested that growing interest in curriculum assessment and development in higher education is the result of a number of external and internal factors. External factors include increasing government interest in quality assurance, accessibility, and degree completion rates; growing recognition of the important role university graduates…

Biological effectiveness of nuclear fragments produced by high-energy protons interacting in tissues near the bone- soft tissue interface

NASA Astrophysics Data System (ADS)

Shavers, Mark Randall

1999-12-01

High-energy protons in the galactic cosmic rays (GCR)-or generated by nuclear interactions of GCR heavy-ions with material-are capable of penetrating great thicknesses of shielding to irradiate humans in spacecraft or in lunar or Martian habitats. As protons interact with the nuclei of the elemental constituents of soft tissue and bone, low energy nuclei-target fragments-are emitted into the cells responsible for bone development and maintenance and for hematopoiesis. Leukemogenesis is the principal endpoint of concern because it is the most likely deleterious effect, and it has a short latency period and comparatively low survival rate, although other myelo- proliferative disorders and osteosarcoma also may be induced. A one-dimensional proton-target fragment transport model was used to calculate the energy spectra of fragments produced in bone and soft tissue, and present in marrow cavities at distances from a bone interface. In terms of dose equivalent, the target fragments are as significant as the incident protons. An average radiation quality factor was found to be between 1.8 and 2.6. Biological response to the highly non- uniform energy deposition of the target fragments is such that an alternative approach to conventional predictive risk assessment is needed. Alternative procedures are presented. In vitro cell response and relative biological effectiveness were calculated from the radial dose distribution of each fragment produced by 1-GeV protons using parameters of a modified Ion-Gamma- Kill (IGK) model of radiation action. The modelled endpoints were survival of C3H10t 1/2 and V79 cells, neoplastic transformation of C3H10t1/2 cells, and mutation of the X-linked hypoxanthine phosphoribosyltransferase (HPRT) locus in V79 cells. The dose equivalent and cell responses increased by 10% or less near the interface. Since RBE increases with decreasing dose in the IGK model, comparisons with quality factors were made at dose levels 0.01 <= D [Gy] <= 2. Applying average quality factors derived herein to GCR exposures results in a <= 5% increase of in average quality. Calculated RBEs indicate that accepted quality factors for high-energy protons may be too low due to the relatively high effectiveness of the low-charged target fragments. Derived RBEs for target fragments increase the calculated biological effectiveness of GCR by 20% to 180%.

Factors influencing health-related quality of life in chronic liver disease

PubMed Central

Sobhonslidsuk, Abhasnee; Silpakit, Chatchawan; Kongsakon, Ronnachai; Satitpornkul, Patchareeya; Sripetch, Chaleaw; Khanthavit, Anya

2006-01-01

AIM: To investigate the factors contributing to health-related quality of life (HRQL) in chronic liver disease (CLD). METHODS: Patients with CLD and age- and sex-matched normal subjects performed the validated Thai versions of the short-form 36 (SF-36) by health survey and chronic liver disease questionnaire (CLDQ). Stepwise multiple regression analysis was used to assess the impact of disease severity, demography, causes of CLD, socioeconomic factors, and self-rating health perception on HRQL. RESULTS: Two-hundred and fifty patients with CLD and fifty normal subjects were enrolled into the study. Mean age and the numbers of low educated, unemployed, blue-collar career and poor health perception increased significantly from chronic hepatitis to Child’s Classes A to B to C. Advanced stage of CLD was related to deterioration of HRQL. Increasing age and female reduced physical health area. Low socioeconomic factors and financial burden affected multiple areas of HRQL. In overall, the positive impact of self-rating health perception on HRQL was consistently showed. CONCLUSION: Advanced stages of chronic liver disease, old age, female sex, low socioeconomic status and financial burden are important factors reducing HRQL. Good health perception improves HRQL regardless of stages of liver disease. PMID:17203521

Plasticity in Singing Effort and its Relationship with Monoamine Metabolism in the Songbird Telencephalon

PubMed Central

Salvante, Katrina G.; Racke, Danielle M.; Campbell, C. Ryan; Sockman, Keith W.

2010-01-01

Factors intrinsic or extrinsic to individuals, such as their quality or the quality of competition in their social environment, can influence their communication signalling effort. We hypothesized that telencephalic monoamine secretion mediates the effects of a male’s own quality and quality of his social environment on his sexual signalling effort. The duration of a male European starling’s (Sturnus vulgaris) principal sexual signal, his song, positively correlates with several aspects of his quality, including his reproductive success, immunocompetence, and ability to attract mates. Therefore, the length of songs to which he is exposed reflects, in part, the quality of competition in his social environment. We manipulated the quality of the competitive environment by exposing male starlings to long or short songs for one week. We measured the length of songs produced by experimental males to gauge their quality, counted the number of songs they produced to gauge singing effort, and quantified telencephalic monoamine metabolism using HPLC. Singing effort increased with the length of the males’ own songs and with the length of songs to which we exposed them. Norepinephrine metabolism in Area X of the song control system was negatively correlated with the subjects’ mean song length and singing effort. Serotonin metabolism in the caudomedial mesopallium of the auditory telencephalon increased with the length of songs to which we exposed the subjects and with their singing effort. This raises the hypothesis that serotonin and norepinephrine secretion in the telencephalon help mediate the effects of extrinsic and intrinsic factors on signalling effort. PMID:19899137

Caregivers' support needs and factors promoting resiliency after brain injury.

PubMed

Kitter, Bryony; Sharman, Rachael

2015-01-01

This article explores the challenges, support needs and coping strategies of caregivers of people with an acquired brain injury (ABI). Semi-structured interviews were conducted with caregivers (n = 20) to explore their support services received, access barriers, utility of services, needed supports, coping strategies and factors promoting life satisfaction. The team recorded, transcribed verbatim and inductively analysed all interviews. Through thematic data analysis, three central themes were revealed: (a) barriers impeding quality-of-life, (b) support needed to improve quality-of-life and (c) factors enabling quality-of-life. All perspectives from the participants involved are synthesized to provide a rich depiction of caregivers' support needs and coping strategies. Two specific findings of interest include a negative association between severity of brain injury and caregiver's desire to direct treatment, as well as a distinct service gap in assistance for caregivers who are caring for someone with violent/offending behaviours. This study recommends short- and long-term changes, given Australia's upcoming National Disability Insurance Scheme, to increase caregiver quality-of-life, which will ultimately affect the rehabilitation outcomes of persons with ABI.

PRELIMINARY EXPLORATION OF FACTORS THAT MAY INFLUENCE THE ASSOCIATION BETWEEN AIR QUALITY AND THE RISK OF CARDIAC VENTRICULAR SEPTAL DEFECTS, TEXAS, 2000

EPA Science Inventory

Exposure to sulfur dioxide (SO2) during weeks three through eight of pregnancy increased risk for ventricular septal defects in a population-based case-control study of air quality and birth defects in seven Texas counties between 1997 and 2000. As a follow-back, a computer-assi...

Teacher Pay Reforms: The Political Implications of Recent Research. CEDR Working Paper No. 2010-4.0

ERIC Educational Resources Information Center

Goldhaber, Dan

2010-01-01

Education research convincingly shows that teacher quality is the most important "schooling" factor influencing student achievement. A very good teacher as opposed to a very bad one can make as much as a "full year's" difference in learning growth for students. Indeed, the effect of increases in teacher quality swamps the impact of any other…

Modifiable worker risk factors contributing to workplace absence: a stakeholder-centred best-evidence synthesis of systematic reviews.

PubMed

Wagner, Shannon; White, Marc; Schultz, Izabela; Murray, Eleanor; Bradley, Susan M; Hsu, Vernita; McGuire, Lisa; Schulz, Werner

2014-01-01

A challenge facing stakeholders is the identification and translation of relevant high quality research to inform policy and practice. This study engaged academic and community stakeholders in conducting a best evidence-synthesis to identify modifiable risk and protective worker factors across health conditions impacting work-related absence. To identify modifiable worker disability risk and protective factors across common health conditions impacting work-related absence. We searched Medline, Embase, CINHAL, The Cochrane Library, PsycINFO, BusinessSourceComplete, and ABI/Inform from 2000 to 2011. Quantitative, qualitative, or mixed methods systematic reviews of work-focused population were considered for inclusion. Two or more reviewers independently reviewed articles for inclusion and methodological screening. The search strategy, expert input and grey literature identified 2,467 unique records. One hundred and forty-two full text articles underwent comprehensive review. Twenty-four systematic reviews met eligibility criteria. Modifiable worker factors found to have consistent evidence across two or more health conditions included emotional distress, negative enduring psychology/personality factors, negative health and disability perception, decreased physical activity, lack of family support, poor general health, increased functional disability, increased pain, increased fatigue and lack of motivation to return to work. Systematic reviews are limited by availability of high quality studies, lack of consistency of methodological screening and reporting, and variability of outcome measures used.

Vaccine to fibroblast growth factor 23 peptides increases eggshell strength.

PubMed

Ren, Z Z; Piepenburg, A J; Bütz, D E; Claus, J R; Cook, M E

2018-03-01

Strategies that would increase eggshell quality could be of considerable value to egg producers. This research demonstrated the effective use of fibroblast growth factor 23 (FGF-23) peptide vaccines to increase eggshell quality of Single Comb White Leghorn laying hens (from 69 to 72 wk of age). Hens, fed a standard diet (containing 900 IU/kg vitamin D3), were intramuscularly injected (and boosted) with either a control vaccine (n = 14 hens) or one of 2 FGF-23 peptide vaccines (peptides NP1, GMNPPPYS; and NP7, YTSTERNSFH; n = 15 hens for each peptide). During peak antibody titer, eggs were collected for shell and internal quality analysis, hens were artificially inseminated, and the hatchability of fertilized eggs was determined. Laying hens vaccinated with either FGF-23 peptide NP1 or NP7 had increased (P < 0.05) plasma phosphate level (mmol/L; NP1 = 1.74, NP7 = 1.76, control = 1.47), egg specific gravity (NP1 = 1.083, NP7 = 1.083, control = 1.079), and eggshell strength (g of force; NP1 = 4002, NP7 = 4157, control = 3102) when compared to control vaccinated hens. FGF-23 peptide NP1 vaccinated hens also had increased eggshell thickness (mm, P < 0.001), shell weight (g, P = 0.032), and shell index (% of whole egg, P = 0.023) when compared to control vaccinated hens. FGF-23 peptide NP7 vaccinated hens tended to have decreased eggshell weight (P = 0.064) when compared to control vaccinated hens. Hatchability of fertilized eggs was not affected in incubations 1 and 3, but tended to be decreased (P = 0.097) by FGF-23 peptide NP1 vaccination in incubation 2. In conclusion, vaccines to FGF-23 peptides increased eggshell quality of laying hens with minimal adverse effects on egg internal quality. The effect of FGF-23 peptide vaccination on hatchability remains to be clarified.

Large deflection angle, high-power adaptive fiber optics collimator with preserved near-diffraction-limited beam quality.

PubMed

Zhi, Dong; Ma, Yanxing; Chen, Zilun; Wang, Xiaolin; Zhou, Pu; Si, Lei

2016-05-15

We report on the development of a monolithic adaptive fiber optics collimator, with a large deflection angle and preserved near-diffraction-limited beam quality, that has been tested at a maximal output power at the 300 W level. Additionally, a new measurement method of beam quality (M² factor) is developed. Experimental results show that the deflection angle of the collimated beam is in the range of 0-0.27 mrad in the X direction and 0-0.19 mrad in the Y direction. The effective working frequency of the device is about 710 Hz. By employing the new measurement method of the M² factor, we calculate that the beam quality is Mx2=1.35 and My2=1.24, which is in agreement with the result from the beam propagation analyzer and is preserved well with the increasing output power.

Consumer perception of bread quality.

PubMed

Gellynck, Xavier; Kühne, Bianka; Van Bockstaele, Filip; Van de Walle, Davy; Dewettinck, Koen

2009-08-01

Bread contains a wide range of important nutritional components which provide a positive effect on human health. However, the consumption of bread is declining during the last decades. This is due to factors such as changing eating patterns and an increasing choice of substitutes like breakfast cereals and fast foods. The aim of this study is to investigate consumer's quality perception of bread towards sensory, health and nutrition attributes. Four consumer segments are identified based on these attributes. The different consumer segments comprise consumers being positive to all three quality aspects of bread ("enthusiastic") as wells as consumers perceiving bread strongly as "tasteless", "non-nutritious" or "unhealthy". Moreover, factors are identified which influence the consumers' quality perception of bread. The results of our study may help health professionals and policy makers to systematically inform consumers about the positive effects of bread based on its components. Furthermore, firms can use the results to build up tailor-made marketing strategies.

Quality of health news disseminated in the print media in developing countries: a case study in Iran.

PubMed

Ashorkhani, Mahnaz; Gholami, Jaleh; Maleki, Katayoun; Nedjat, Sima; Mortazavi, Jalaledin; Majdzadeh, Reza

2012-08-09

Mass media play an important role in keeping people up-to-date with the latest health news. This study aims at investigating the quality of health news disseminated in the print media, its course of production and factors affecting its quality. In the quantitative section of the study, 410 health-related news items, published during a six-month span in the Iranian public press, underwent content analysis. In the qualitative section, focus group discussions were held with journalists, editors-in-chief and news gatekeepers. The quantitative phase showed that 18% of the news articles were not fit for dissemination in public. The qualitative phase illustrated that multiple factors at various levels affect the quality of news, namely poor knowledge, inadequate motivations and context-related barriers. The quality of health news reporting is not desirable. Educational interventions need to be carried out to raise awareness among researchers and journalists. Also, certain steps should be taken to increase motivations and strengthen infrastructures, including designing guidelines and monitoring news.

Association of journal quality indicators with methodological quality of clinical research articles.

PubMed

Lee, Kirby P; Schotland, Marieka; Bacchetti, Peter; Bero, Lisa A

2002-06-05

The ability to identify scientific journals that publish high-quality research would help clinicians, scientists, and health-policy analysts to select the most up-to-date medical literature to review. To assess whether journal characteristics of (1) peer-review status, (2) citation rate, (3) impact factor, (4) circulation, (5) manuscript acceptance rate, (6) MEDLINE indexing, and (7) Brandon/Hill Library List indexing are predictors of methodological quality of research articles, we conducted a cross-sectional study of 243 original research articles involving human subjects published in general internal medical journals. The mean (SD) quality score of the 243 articles was 1.37 (0.22). All journals reported a peer-review process and were indexed on MEDLINE. In models that controlled for article type (randomized controlled trial [RCT] or non-RCT), journal citation rate was the most statistically significant predictor (0.051 increase per doubling; 95% confidence interval [CI], 0.037-0.065; P<.001). In separate analyses by article type, acceptance rate was the strongest predictor for RCT quality (-0.113 per doubling; 95% CI, -0.148 to -0.078; P<.001), while journal citation rate was the most predictive factor for non-RCT quality (0.051 per doubling; 95% CI, 0.044-0.059; P<.001). High citation rates, impact factors, and circulation rates, and low manuscript acceptance rates and indexing on Brandon/Hill Library List appear to be predictive of higher methodological quality scores for journal articles.

Nutrients content and quality of liquid fertilizer made from goat manure

NASA Astrophysics Data System (ADS)

Sunaryo, Yacobus; Purnomo, Djoko; Theresia Darini, Maria; Ratri Cahyani, Vita

2018-05-01

Quality of liquid fertilizer is determined by the content of nutrients and other chemical factors such as pH and EC. This research aimed to examine nutrient contents and dynamic of pH and EC of liquid fertilizer made from goat manure in combination with sugar and ammonium sulfate (ZA) and using Effective Microorganisms (EM) as the decomposer. This research was conducted by employing 3 x 3 factorial experiment with three replications. Each treatment combination was applied in 20 L of water. The first factor was the quantity of sugar which consisted of 3 levels: 12.5, 25, and 50 g L-1 of water. The second factor was the quantity of ZA which consisted of 3 levels: 25, 37.5, and 50 g L-1 of water. All combinations were added by 100 g of air dried goat manure L-1 of water and EM solution 1 ml L-1 of water, and incubated for five months. Results of the experiment indicated that the increasing concentration of ZA resulted in the significantly increase of N total and S total. Increasing concentration of sugar resulted in decreasing pH and increasing lactic acid; whereas, increasing concentration of ZA followed by increasing Electrical Conductivity (EC). There was no significantly change of pH and EC of the liquid fertilizer during five months incubation.

Growth, photosynthetic acclimation and yield quality in legumes under climate change simulations: an updated survey.

PubMed

Irigoyen, J J; Goicoechea, N; Antolín, M C; Pascual, I; Sánchez-Díaz, M; Aguirreolea, J; Morales, F

2014-09-01

Continued emissions of CO2, derived from human activities, increase atmospheric CO2 concentration. The CO2 rise stimulates plant growth and affects yield quality. Effects of elevated CO2 on legume quality depend on interactions with N2-fixing bacteria and mycorrhizal fungi. Growth at elevated CO2 increases photosynthesis under short-term exposures in C3 species. Under long-term exposures, however, plants generally acclimate to elevated CO2 decreasing their photosynthetic capacity. An updated survey of the literature indicates that a key factor, perhaps the most important, that characteristically influences this phenomenon, its occurrence and extent, is the plant source-sink balance. In legumes, the ability of exchanging C for N at nodule level with the N2-fixing symbionts creates an extra C sink that avoids the occurrence of photosynthetic acclimation. Arbuscular mycorrhizal fungi colonizing roots may also result in increased C sink, preventing photosynthetic acclimation. Defoliation (Anthyllis vulneraria, simulated grazing) or shoot cutting (alfalfa, usual management as forage) largely increases root/shoot ratio. During re-growth at elevated CO2, new shoots growth and nodule respiration function as strong C sinks that counteracts photosynthetic acclimation. In the presence of some limiting factor, the legumes response to elevated CO2 is weakened showing photosynthetic acclimation. This survey has identified limiting factors that include an insufficient N supply from bacterial strains, nutrient-poor soils, low P supply, excess temperature affecting photosynthesis and/or nodule activity, a genetically determined low nodulation capacity, an inability of species or varieties to increase growth (and therefore C sink) at elevated CO2 and a plant phenological state or season when plant growth is stopped. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Individual and organizational predictors of health care aide job satisfaction in long term care.

PubMed

Chamberlain, Stephanie A; Hoben, Matthias; Squires, Janet E; Estabrooks, Carole A

2016-10-13

Unregulated health care aides provide the majority of direct health care to residents in long term care homes. Lower job satisfaction as reported by care aides is associated with increased turnover of staff. Turnover leads to inferior job performance and negatively impacts quality of care for residents. This study aimed to determine the individual and organizational variables associated with job satisfaction in care aides. We surveyed a sample of 1224 care aides from 30 long term care homes in three Western Canadian provinces. The care aides reported their job satisfaction and their perception of the work environment. We used a hierarchical, mixed-effects ordered logistic regression to model the relative odds of care aide job satisfaction for individual, care unit, and facility factors. Care aide exhaustion, professional efficacy, and cynicism were associated with job satisfaction. Factors in the organizational context that are associated with increased care aide job satisfaction include: leadership, culture, social capital, organizational slack-staff, organizational slack-space, and organizational slack-time. Our findings suggest that organizational factors account for a greater increase in care aide job satisfaction than do individual factors. These features of the work environment are modifiable and predict care aide job satisfaction. Efforts to improve care aide work environment and quality of care should focus on organizational context.

The top-ten in journal impact factor manipulation.

PubMed

Falagas, Matthew E; Alexiou, Vangelis G

2008-01-01

A considerable part of the scientific community is, at least to some degree, involved in the "impact factor game". Editors strive to increase their journals' impact factor (IF) in order to gain influence in the fields of basic and applied research and scientists seek to profit from the "added value" of publishing in top IF journals. In this article we point out the most common "tricks" of engineering and manipulating the IF undertaken by a portion of professionals of the scientific publishing industry. They attempt to increase the nominator or decrease the denominator of the IF equation by taking advantage of certain design flaws and disadvantages of the IF that permit a degree of artificial and arbitrary inflation. Some of these practices, if not scientifically unethical, are at least questionable and should be abandoned. Editors and publishers should strive for quality through fair and thoughtful selection of papers forwarded for peer review and editorial comments that enhance the quality and scientific accuracy of a manuscript.

Considering organizational factors in addressing health care disparities: two case examples.

PubMed

Griffith, Derek M; Yonas, Michael; Mason, Mondi; Havens, Betsy E

2010-05-01

Policy makers and practitioners have yet to successfully understand and eliminate persistent racial differences in health care quality. Interventions to address these racial health care disparities have largely focused on increasing cultural awareness and sensitivity, promoting culturally competent care, and increasing providers' adherence to evidence-based guidelines. Although these strategies have improved some proximal factors associated with service provision, they have not had a strong impact on racial health care disparities. Interventions to date have had limited impact on racial differences in health care quality, in part, because they have not adequately considered or addressed organizational and institutional factors. In this article, we describe an emerging intervention strategy to reduce health care disparities called dismantling (undoing) racism and how it has been adapted to a rural public health department and an urban medical system. These examples illustrate the importance of adapting interventions to the organizational and institutional context and have important implications for practitioners and policy makers.

Structural Equation Modelling with Three Schemes Estimation of Score Factors on Partial Least Square (Case Study: The Quality Of Education Level SMA/MA in Sumenep Regency)

NASA Astrophysics Data System (ADS)

Anekawati, Anik; Widjanarko Otok, Bambang; Purhadi; Sutikno

2017-06-01

Research in education often involves a latent variable. Statistical analysis technique that has the ability to analyze the pattern of relationship among latent variables as well as between latent variables and their indicators is Structural Equation Modeling (SEM). SEM partial least square (PLS) was developed as an alternative if these conditions are met: the theory that underlying the design of the model is weak, does not assume a certain scale measurement, the sample size should not be large and the data does not have the multivariate normal distribution. The purpose of this paper is to compare the results of modeling of the educational quality in high school level (SMA/MA) in Sumenep Regency with structural equation modeling approach partial least square with three schemes estimation of score factors. This paper is a result of explanatory research using secondary data from Sumenep Education Department and Badan Pusat Statistik (BPS) Sumenep which was data of Sumenep in the Figures and the District of Sumenep in the Figures for the year 2015. The unit of observation in this study were districts in Sumenep that consists of 18 districts on the mainland and 9 districts in the islands. There were two endogenous variables and one exogenous variable. Endogenous variables are the quality of education level of SMA/MA (Y1) and school infrastructure (Y2), whereas exogenous variable is socio-economic condition (X1). In this study, There is one improved model which represented by model from path scheme because this model is a consistent, all of its indicators are valid and its the value of R-square increased which is: Y1=0.651Y2. In this model, the quality of education influenced only by the school infrastructure (0.651). The socio-economic condition did not affect neither the school infrastructure nor the quality of education. If the school infrastructure increased 1 point, then the quality of education increased 0.651 point. The quality of education had an R2 of 0.418, which indicates that 41.8 percent of variance in the quality of education is explained by the school infrastructure, the remaining 58.2% is explained by the other factors which were not investigated in this work.

Effects of socioeconomic factors on obesity rates in four southern states and Colorado.

PubMed

Akil, Luma; Ahmad, H Anwar

2011-01-01

To examine the association between the increase in body mass index (BMI) and socioeconomic factors (eg, income level, % below poverty line, unemployment rates and persons receiving food stamps) in Mississippi, Alabama, Louisiana, Tennessee and Colorado. Data from Behavioral Risk Factor Surveillance System, United States Department of Agriculture and the United States Department of Labor/Bureau of Labor were obtained and analyzed for the years 1995-2008. Results from this study showed a strong association between obesity and the tested variables (R2 = .767). Factors more closely related with obesity were: income below poverty level; receipt of food stamps; unemployment; and general income level. The coefficient of determination for these variables were 0.438, 0.427, 0.103 and 0.018, respectively. The highest rate of obesity was found in Mississippi (26.5% +/- 4.13%) followed by Alabama (25.18% +/- 4.41%), while Colorado had the lowest rate of obesity (15.4% +/- 2.63%). By ethnicity, African Americans had the highest rate of obesity (32.64 +/- 5.99%). We found a significant effect of consumption of low-quality food, due to economic factors, on increased BMI. Besides physical activity, the quality and the quantity of food are important factors that contribute to obesity rates.

[Clinical applicability of evidence-based orthopedics--a cross-sectional study of the quality of orthopedic evidence].

PubMed

Vavken, P; Culen, G; Dorotka, R

2008-01-01

The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.

Increasing the Adaptive Capacity of the Organism When Exposed to Adverse Environmental Factors Through Phytoadaptogens

NASA Astrophysics Data System (ADS)

Babii, N. V.; Pomozova, V. A.; Kiseleva, T. F.; Romanenko, V. O.

2017-07-01

The Problem of improving the quality of life of the population in modern conditions is the most relevant. The level of human health largely depends on the quality of the environment. Of special importance are the risk factors for the spread of diseases like environmental pollution, social conditions and bad habits. To the emergence of ecologically dependent diseases leads the combined impact of technogenic, social-economic, natural-climatic factors. The introduction of the principles of biotechnology, nanotechnology and innovations in industrial processing of plant resources, especially natural adaptogens, contributes to the production of balanced, ecologically clean food products functional purpose, the use of which will significantly minimize the adverse effects of the environment on humans.

Experienced quality factors: qualitative evaluation approach to audiovisual quality

NASA Astrophysics Data System (ADS)

Jumisko-Pyykkö, Satu; Häkkinen, Jukka; Nyman, Göte

2007-02-01

Subjective evaluation is used to identify impairment factors of multimedia quality. The final quality is often formulated via quantitative experiments, but this approach has its constraints, as subject's quality interpretations, experiences and quality evaluation criteria are disregarded. To identify these quality evaluation factors, this study examined qualitatively the criteria participants used to evaluate audiovisual video quality. A semi-structured interview was conducted with 60 participants after a subjective audiovisual quality evaluation experiment. The assessment compared several, relatively low audio-video bitrate ratios with five different television contents on mobile device. In the analysis, methodological triangulation (grounded theory, Bayesian networks and correspondence analysis) was applied to approach the qualitative quality. The results showed that the most important evaluation criteria were the factors of visual quality, contents, factors of audio quality, usefulness - followability and audiovisual interaction. Several relations between the quality factors and the similarities between the contents were identified. As a research methodological recommendation, the focus on content and usage related factors need to be further examined to improve the quality evaluation experiments.

Lives at Risk: High School Dropouts in the Northern Plains Region

ERIC Educational Resources Information Center

Schumacher, Bruce Ralph

2012-01-01

Education is essential to personal welfare. As educational levels increase, personal income rises, the quality of life improves, and society benefits as criminality declines, tax income increases, and the cost of social programs decreases. Unfortunately, every year thousands of students leave high school without graduating. Various factors place…

Students' Perceptions of a "Quality" Advisory Relationship

ERIC Educational Resources Information Center

Halbert, Kelsey

2015-01-01

The current research education context in Australia is one of increased pressures for timely completion with a spotlight on the scope and depth of training and a profound increase in enrolments. These factors inevitably shape the supervision experiences of doctoral candidates. This paper discusses student perceptions of supervision. Supervision is…

Improving quality of arterial spin labeling MR imaging at 3 Tesla with a 32-channel coil and parallel imaging.

PubMed

Ferré, Jean-Christophe; Petr, Jan; Bannier, Elise; Barillot, Christian; Gauvrit, Jean-Yves

2012-05-01

To compare 12-channel and 32-channel phased-array coils and to determine the optimal parallel imaging (PI) technique and factor for brain perfusion imaging using Pulsed Arterial Spin labeling (PASL) at 3 Tesla (T). Twenty-seven healthy volunteers underwent 10 different PASL perfusion PICORE Q2TIPS scans at 3T using 12-channel and 32-channel coils without PI and with GRAPPA or mSENSE using factor 2. PI with factor 3 and 4 were used only with the 32-channel coil. Visual quality was assessed using four parameters. Quantitative analyses were performed using temporal noise, contrast-to-noise and signal-to-noise ratios (CNR, SNR). Compared with 12-channel acquisition, the scores for 32-channel acquisition were significantly higher for overall visual quality, lower for noise and higher for SNR and CNR. With the 32-channel coil, artifact compromise achieved the best score with PI factor 2. Noise increased, SNR and CNR decreased with PI factor. However mSENSE 2 scores were not always significantly different from acquisition without PI. For PASL at 3T, the 32-channel coil at 3T provided better quality than the 12-channel coil. With the 32-channel coil, mSENSE 2 seemed to offer the best compromise for decreasing artifacts without significantly reducing SNR, CNR. Copyright © 2012 Wiley Periodicals, Inc.

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals

PubMed Central

2018-01-01

Objective To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. Methods A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. Results There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Conclusion Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture. PMID:29560330

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals.

PubMed

Choi, Sehoon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog; Han, Seung Hoon

2018-02-01

To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture.

The more publication, the higher impact factor: citation analysis of top nine gastroenterology and hepatology journals.

PubMed

Karimi Elizee, Pegah; Karimzadeh Ghassab, Romina; Raoofi, Azam; Miri, Seyyed Mohammad

2012-12-01

The impact factor (IF), as the most important criterion for journal's quality measurement, is affected by the self-citation and number of publications in each journal. To find out the relationship between the number of publications and self-citations in a journal, and their correlations with IF. Self-citations and impact factors of nine top gastroenterology and hepatology journals were assessed during the seven recent years (2005-2011) through Journal Citation Reports (JCR, ISI Thomson Reuters). Although impact factors of all journals increased during the study, five out of nine journals increased the number of publications from 2005 to 2011. There was an increase in self-citation only in the journal of HEPATOLOGY (499 in 2005 vs. 707 in 2011). Impact factors of journals (6.5 ± 3.5) were positively correlated with total number of publications (248.6 ± 91.7) (R: 0.688, P < 0.001). Besides, the self-citation rate (238.73 ± 195.317) was highly correlated with total number of publications in each journal (248.6 ± 91.7) (R: 0.861, P < 0.001). On the other hand, impact factor without self-citation (6.08 ± 3.3) had a correlation (R: 0.672, P < 0.001) with the number of published items (248.6 ± 91.7). The number of articles and self-citation have definite effects on IF of a journal and because IF is the most prominent criterion for journal's quality measurement, it would be a good idea to consider factors affecting on IF such as self-citation.

Measuring, evaluating and improving hospital quality parameters/dimensions--an integrated healthcare quality approach.

PubMed

Zineldin, Mosad; Camgöz-Akdağ, Hatice; Vasicheva, Valiantsina

2011-01-01

This paper aims to examine the major factors affecting cumulative summation, to empirically examine the major factors affecting satisfaction and to address the question whether patients in Kazakhstan evaluate healthcare similarly or differently from patients in Egypt and Jordan. A questionnaire, adapted from previous research, was distributed to Kazakhstan inpatients. The questionnaire contained 39 attributes about five newly-developed quality dimensions (5Qs), which were identified to be the most relevant attributes for hospitals. The questionnaire was translated into Russian to increase the response rate and improve data quality. Almost 200 usable questionnaires were returned. Frequency distribution, factor analysis and reliability checks were used to analyze the data. The three biggest concerns for Kazakhstan patients are: infrastructure; atmosphere; and interaction. Hospital staffs concern for patients' needs, parking facilities for visitors, waiting time and food temperature were all common specific attributes, which were perceived as concerns. These were shortcomings in all three countries. Improving health service quality by applying total relationship management and the 5Qs model together with a customer-orientation strategy is recommended. Results can be used by hospital staff to reengineer and redesign creatively their quality management processes and help move towards more effective healthcare quality strategies. Patients in three countries have similar concerns and quality perceptions. The paper describes a new instrument and method. The study assures relevance, validity and reliability, while being explicitly change-oriented. The authors argue that patient satisfaction is a cumulative construct, summing satisfaction as five different qualities (5Qs): object; processes; infrastructure; interaction and atmosphere.

Study of Shell Zone Formation in Lithographic and Anodizing Quality Aluminum Alloys: Experimental and Numerical Approach

NASA Astrophysics Data System (ADS)

Brochu, Christine; Larouche, André; Hark, Robert

Shell thickness is an important quality factor for lithographic and anodizing quality aluminum alloys. Increasing pressure is placed on casting plants to produce a thinner shell zone for these alloys. This study, based on plant trials and mathematical modelling highlights the most significant parameters influencing shell zone formation. Results obtained show the importance of metal temperature and distribution and mould metal level on shell zone formation. As an answer to specific plant problems, this study led to the development of improved metal distribution systems for DC casting of litho and anodizing quality alloys.

Effect of aerobic interval training on serum IL-10, TNFα, and adipokines levels in women with multiple sclerosis: possible relations with fatigue and quality of life.

PubMed

Mokhtarzade, Motahare; Ranjbar, Rouholah; Majdinasab, Nastaran; Patel, Darpan; Molanouri Shamsi, Mehdieh

2017-08-01

Multiple sclerosis is associated with immune system dysfunction and chronic inflammation; however, possible relations between immunologic and metabolic factors and some psychological indexes such as fatigue and quality of life, especially in relation to exercise training, have not yet been investigated. The present study was designed to investigate the effect of aerobic interval training on interleukin-10/tumor necrosis factor ratio and adipokine (leptin and adiponectin) concentrations in women with multiple sclerosis. Furthermore, the relationship between these factors with fatigue and quality of life were assessed. Forty women with multiple sclerosis (Expanded Disability Status Scale ≤3) were randomized into either a non-exercising control or training group. The training group performed 8-weeks of upper and lower limb aerobic interval training. Serum concentrations of tumor necrosis factorα, interleukin-10, leptin, and adiponectin were measured before and after the 8-week intervention. Moreover, antropometric measures and measures for fatigue and quality of life were determined at the onset of and after exercise training. The results revealed that leptin and tumor necrosis factorα levels significantly decreased subsequent to the aerobic interval training. Although blood adiponectin levels considerably increased in the training group, interleukin-10 and interleukin-10/tumor necrosis factorα ratio underwent no substantial change after the exercise training. In addition, the aerobic interval training was associated with improvement in fatigue, quality of life, and maximal oxygen consumption. Our findings suggested that aerobic interval training can be an effective strategy for managing the immune system at least by its significant impact on inflammatory cytokines and adipokines levels in women with multiple sclerosis. Additionally, this positive impact improved fatigue and adipose tissue indicators.

Family quality of life of Chinese families of children with intellectual disabilities.

PubMed

Hu, X; Wang, M; Fei, X

2012-01-01

The concepts of quality of life and family quality of life (FQOL) are increasingly being studied in the field of intellectual disabilities (ID) in China as important frameworks for: (1) assessing families' need for supports and services; (2) guiding organisational and service delivery system changes; and (3) evaluating quality family outcomes. The present study focused on exploring the perceptions of Chinese families who have a child with an ID regarding FQOL as well as examining the factor structure of FQOL concept from Chinese families. The Chinese version of the Family Quality of Life Scale was used to survey Chinese families living in the urban and suburban areas of Beijing who have a child with ID. A total of 442 families participated in this study. Confirmatory factor analysis was used to test the factor structure of FQOL. Multivariate analysis was also used to examine group differences among families in terms of family demographic variables. A five-factor structure of the FQOL construct was found in the Chinese sample, suggesting a similar factor structure found from US families in the literature. Different living conditions (e.g. housing and transportation) tended to affect significantly families' satisfaction ratings of their FQOL. It is also found that family income and severity of disability of the child are predictors of families' satisfaction ratings of FQOL. The preliminary findings of this study suggest a cross-cultural factor structure comparability of FQOL between samples in the USA and China. Results call for further examination of the family-centred service and support as a mediator on the interactive relationship between family characteristics, family needs and FQOL outcomes. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

The impact of stepfamily relationship quality on emerging adult non-medical use of prescription drugs.

PubMed

Ward, Kaitlin P; Dennis, Cory B; Limb, Gordon E

2018-01-01

Emerging adults aged 18 to 25 are most at-risk for non-medical use of prescription drugs (NMUPD). While the literature dedicated to emerging-adult NMUPD has explored risk and protective factors at an individual level, much less is known regarding how interpersonal and familial factors relate to NMUPD. Because interpersonal bonds can have a significant impact on behavior, familial factors may be important predictors of NMUPD among emerging adults. Inasmuch as growing up in a stepfamily is increasingly common for children, this study aimed to determine whether perceived stepfamily quality within three stepfamily subsystems - child-biological parent, child-stepparent, and child-stepsibling - decreased the likelihood of NMUPD in emerging adulthood. Data came from the Stepfamily Experiences Project (STEP), a retrospective survey examining emerging adults' perceptions of their stepfamily life in 2013. A national quota sampling strategy was used, and the final sample consisted of 902 emerging adults (54.1% female). A structural equation model was constructed, with regression paths from each latent construct predicting the ordinal dependent variable, NMUPD. Increased retrospective biological parent relationship quality in childhood significantly decreased the likelihood of intensifying NMUPD in emerging adulthood (e.g. moving from the "None" category to the "Once a month or less" category). However, stepparent and stepsibling relationship quality did not influence NMUPD. Findings underscore the importance of the preservation of the child-biological parent relationship within a stepfamily context, and encourage further research on the impact familial systems and subsystems may have on NMUPD.

The Effects of Insomnia and Sleep Loss on Cardiovascular Disease.

PubMed

Khan, Meena S; Aouad, Rita

2017-06-01

Sleep loss has negative impacts on quality of life, mood, cognitive function, and heath. Insomnia is linked to poor mood, increased use of health care resources, decreased quality of life, and possibly cardiovascular risk factors and disease. Studies have shown increase in cortisol levels, decreased immunity, and increased markers of sympathetic activity in sleep-deprived healthy subjects and those with chronic insomnia. The literature shows subjective complaints consistent with chronic insomnia and shortened sleep can be associated with development of diabetes, hypertension, and cardiovascular disease. This article explores the relationship between insufficient sleep and insomnia with these health conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk Factors on Health-Related Quality of Life in Children With Epilepsy.

PubMed

Liu, Xinjie; Han, Qizheng

2015-12-01

The goal of this study was to evaluate how epilepsy affected the health-related quality of life (HRQOL) in children with epilepsy, as well as the risk factors for poor HRQOL. Parents of epileptic children (n = 223) and parents of healthy children (n = 216) were enrolled. The Child Epilepsy Questionnaire-Parental form was given to all parents. Children with epilepsy had significantly lower HRQOL scores for overall QOL and all subscales. Seizure types were not associated with HRQOL, but the age of the child with epilepsy, disease courses and seizure frequency did influence the quality of life. Epilepsy has a severe impact on children's HRQOL, and age, increased seizure frequency and longer duration of epilepsy are associated with poor HRQOL. © The Author(s) 2015.

Swallowing Disorders in Sjögren's Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life.

PubMed

Pierce, Jenny L; Tanner, Kristine; Merrill, Ray M; Miller, Karla L; Kendall, Katherine A; Roy, Nelson

2016-02-01

This epidemiological investigation examined the prevalence, risk factors, and quality-of-life effects of swallowing disorders in Sjögren's syndrome (SS). One hundred and one individuals with primary or secondary SS (94 females, 7 males; mean age 59.4, SD = 14.1) were interviewed regarding the presence, nature, and impact of swallowing disorders and symptoms. Associations among swallowing disorders and symptoms, select medical and social history factors, SS disease severity, and the M.D. Anderson Dysphagia Inventory (MDADI) and Short Form 36 Health Survey (SF-36) were examined. The prevalence of a current self-reported swallowing disorder was 64.4 %. SS disease severity was the strongest predictor of swallowing disorders, including significant associations with the following swallow symptoms: taking smaller bites, thick mucus in the throat, difficulty placing food in the mouth, and wheezing while eating (p < .05). Additional swallowing disorder risk factors included the presence of a self-reported voice disorder, esophageal reflux, current exposure to secondary tobacco smoke, frequent neck or throat tension, frequent throat clearing, chronic post-nasal drip, and stomach or duodenal ulcers. Swallowing disorders did not differ on the basis of primary or secondary SS. Swallowing disorders and specific swallowing symptoms were uniquely associated with reduced quality of life. Among those with swallowing disorders, 42 % sought treatment, with approximately half reporting improvement. Patient-perceived swallowing disorders are relatively common in SS and increase with disease severity. Specific swallowing symptoms uniquely and significantly reduce swallow and health-related quality of life, indicating the need for increased identification and management of dysphagia in this population.

Photodiode area effect on performance of X-ray CMOS active pixel sensors

NASA Astrophysics Data System (ADS)

Kim, M. S.; Kim, Y.; Kim, G.; Lim, K. T.; Cho, G.; Kim, D.

2018-02-01

Compared to conventional TFT-based X-ray imaging devices, CMOS-based X-ray imaging sensors are considered next generation because they can be manufactured in very small pixel pitches and can acquire high-speed images. In addition, CMOS-based sensors have the advantage of integration of various functional circuits within the sensor. The image quality can also be improved by the high fill-factor in large pixels. If the size of the subject is small, the size of the pixel must be reduced as a consequence. In addition, the fill factor must be reduced to aggregate various functional circuits within the pixel. In this study, 3T-APS (active pixel sensor) with photodiodes of four different sizes were fabricated and evaluated. It is well known that a larger photodiode leads to improved overall performance. Nonetheless, if the size of the photodiode is > 1000 μm2, the degree to which the sensor performance increases as the photodiode size increases, is reduced. As a result, considering the fill factor, pixel-pitch > 32 μm is not necessary to achieve high-efficiency image quality. In addition, poor image quality is to be expected unless special sensor-design techniques are included for sensors with a pixel pitch of 25 μm or less.

The relationship of Alexithymia with anxiety-depression-stress, quality of life, and social support in Coronary Heart Disease (A psychological model).

PubMed

Nekouei, Zohreh Khayyam; Doost, Hamid Taher Neshat; Yousefy, Alireza; Manshaee, Gholamreza; Sadeghei, Masoumeh

2014-01-01

Although psychological factors are now recognized as playing a significant and independent role in the development of coronary heart disease (CHD) and its complications, many of these factors are correlated with each other. The present study is aimed at examining the association between alexithymia and anxiety depression, stress, quality of life, and social support in CHD patients. In this research 398 patients with coronary heart disease (166 females and 232 males) from the city of Isfahan were selected using random sampling. The tools used included depression, anxiety, and stress scale (DASS-21), Health-related to Quality Of Life (HRQOL-26), Multiple Scale Perceived Social Support (MSPSS-12), and the Toronto Alexithymia Scale (TAS-20). The data were analyzed using structural equation modeling by using the Statistical Package for Social Science (SPSS21) (IBM Corp: Armonk, New York.U.S.) and Asset Management Operating System (AMOS21) SPSS, an IBM Company: Chicago, U.S. Software. Results of the structural equation model showed an acceptable goodness of fit, for the explanation alexithymia that was significantly associated with lower HRQOL and social support and increasing anxiety, depression, and stress. Alexithymia may increase anxiety, depression, and stress and can be a predisposing factor to poorer HRQOL and social support.

Improving the Optical Quality Factor of the WGM Resonator

NASA Technical Reports Server (NTRS)

Savchenkov, Anatoliy; Matsko, Andrey; Iltchenko, Vladimir

2008-01-01

Resonators usually are characterized with two partially dependent values: finesse (F) and quality factor (Q). The finesse of an empty Fabry-Perot (FP) resonator is defined solely by the quality of its mirrors and is calculated as F=piR(exp 1/2)/(1-R). The maximum up-to-date value of reflectivity R approximately equal to 1 - 1.6 x 10(exp -6) is achieved with dielectric mirrors. An FP resonator made with the mirrors has finesse F=1.9 x 10(exp 6). Further practical increase of the finesse of FP resonators is problematic because of the absorption and the scattering of light in the mirror material through fundamental limit on the reflection losses given by the internal material losses and by thermodynamic density fluctuations on the order of parts in 109. The quality factor of a resonator depends on both its finesse and its geometrical size. A one-dimensional FP resonator has Q=2 F L/lambda, where L is the distance between the mirrors and lambda is the wavelength. It is easy to see that the quality factor of the resonator is unlimited because L is unlimited. F and Q are equally important. In some cases, finesse is technically more valuable than the quality factor. For instance, buildup of the optical power inside the resonator, as well as the Purcell factor, is proportional to finesse. Sometimes, however, the quality factor is more valuable. For example, inverse threshold power of intracavity hyperparametric oscillation is proportional to Q(exp 2) and efficiency of parametric frequency mixing is proportional to Q(exp 3). Therefore, it is important to know both the maximally achievable finesse and quality factor values of a resonator. Whispering gallery mode (WGM) resonators are capable of achieving larger finesse compared to FP resonators. For instance, fused silica resonators with finesse 2.3 x 10(exp 6) and 2.8 x 10(exp 6) have been demonstrated. Crystalline WGM resonators reveal even larger finesse values, F=6.3 x 10(exp 6), because of low attenuation of light in the transparent optical crystals. The larger values of F and Q result in the enhancement of various nonlinear processes. Low-threshold Raman lasing, optomechanical oscillations, frequency doubling, and hyperparametric oscillations based on these resonators have been recently demonstrated. Theory predicts a possibility of nearly 10(exp 14) room-temperature optical Q-factors of optical crystalline WGM resonators, which correspond to finesse levels higher than 10(exp 9). Experiments have shown numbers a thousand times lower than that. The difference occurs due to media imperfections. To substantially reduce the optical losses caused by the imperfections, a specific, multi-step, asymptotic processing of the resonator is implemented. The technique has been initially developed to reduce microwave absorption in dielectric resonators. One step of the process consists of mechanical polishing performed after high temperature annealing. Several steps repeat one after another to lead to significant reduction in optical attenuation and, as a result, to the increase of Q-factor as well as finesse of the resonator which demonstrates a CaF2 WGM resonator with F greater than 10(exp 7) and Q greater than 10(exp 11).

Characterization of transit ride quality.

DOT National Transportation Integrated Search

2016-08-01

Strategies often proposed to combat the growing traffic congestion problems of urban environments target enhancements to increase the use of bus transit. Therefore, service providers are keen to identify and understand factors that could attract more...

Determinants of quality of life in children with psychiatric disorders.

PubMed

Bastiaansen, Dennis; Koot, Hans M; Ferdinand, Robert F

2005-08-01

To assess factors that, in addition to childhood psychopathology, are associated with Quality of Life (QoL) in children with psychiatric problems. In a referred sample of 252 8 to 18-year-olds, information concerning QoL, psychopathology and a broad range of child, parent, and family/ social network factors was obtained from children, parents, teachers and clinicians. Poor child, parent, and clinician reported QoL was associated with child psychopathology, but given the presence of psychopathology, also with child factors, such as low self-esteem, and poor social skills, and family/social network factors, such as poor family functioning, and poor social support. In multiple linear regression analyses the importance of parent factors, such as parenting stress, was almost negligible. To increase QoL of children with psychiatric problems, treatment of symptoms is important, but outcome might improve if treatment is also focussed on other factors that may affect QoL. Results are discussed in relation to current treatment programs.

Shielded microstrip array for 7T human MR imaging.

PubMed

Wu, Bing; Wang, Chunsheng; Kelley, Douglas A C; Xu, Duan; Vigneron, Daniel B; Nelson, Sarah J; Zhang, Xiaoliang

2010-01-01

The high-frequency transceiver array based on the microstrip transmission line design is a promising technique for ultrahigh field magnetic resonance imaging (MRI) signal excitation and reception. However, with the increase of radio-frequency (RF) channels, the size of the ground plane in each microstrip coil element is usually not sufficient to provide a perfect ground. Consequently, the transceiver array may suffer from cable resonance, lower Q-factors, and imaging quality degradations. In this paper, we present an approach to improving the performance of microstrip transceiver arrays by introducing RF shielding outside the microstrip array and the feeding coaxial cables. This improvement reduced interactions among cables, increased resonance stability, and Q-factors, and thus improved imaging quality. An experimental method was also introduced and utilized for quantitative measurement and evaluation of RF coil resonance stability or "cable resonance" behavior.

Shielded Microstrip Array for 7T Human MR Imaging

PubMed Central

Wu, Bing; Wang, Chunsheng; Kelley, Douglas A. C.; Xu, Duan; Vigneron, Daniel B.; Nelson, Sarah J.

2010-01-01

The high-frequency transceiver array based on the microstrip transmission line design is a promising technique for ultrahigh field magnetic resonance imaging (MRI) signal excitation and reception. However, with the increase of radio-frequency (RF) channels, the size of the ground plane in each microstrip coil element is usually not sufficient to provide a perfect ground. Consequently, the transceiver array may suffer from cable resonance, lower Q-factors, and imaging quality degradations. In this paper, we present an approach to improving the performance of microstrip transceiver arrays by introducing RF shielding outside the microstrip array and the feeding coaxial cables. This improvement reduced interactions among cables, increased resonance stability, and Q-factors, and thus improved imaging quality. An experimental method was also introduced and utilized for quantitative measurement and evaluation of RF coil resonance stability or “cable resonance” behavior. PMID:19822470

Parental Relationships in Fragile Families

PubMed Central

McLanahan, Sara; Beck, Audrey N.

2011-01-01

Summary As nonmarital childbearing escalated in the United States over the past half century, fragile families—defined as unmarried couples with children—drew increased interest from researchers and policy makers. Sara McLanahan and Audrey Beck discuss four aspects of parental relationships in these families: the quality of parents’ intimate relationship, the stability of that relationship, the quality of the co-parenting relationship among parents who live apart, and nonresident fathers’ involvement with their child. At the time of their child’s birth, half of the parents in fragile families are living together and another third are living apart but romantically involved. Despite high hopes at birth, five years later only a third of parents are still together, and new partners and new children are common, leading to high levels of instability and complexity in these families. Drawing on findings from the Fragile Families and Child Wellbeing Study, McLanahan and Beck highlight a number of predictors of low relationship quality and stability in these families, including low economic resources, government policies that discourage marriage, gender distrust and acceptance of single motherhood, sex ratios that favor men, children from previous unions, and psychological factors that make it difficult for parents to maintain healthy relationships. No single factor appears to have a dominant effect. The authors next discuss two types of experiments that attempt to establish causal effects on parental relationships: those aimed at altering economic resources and those aimed at improving relationships. What can be done to strengthen parental relationships in fragile families? The authors note that although economic resources are a consistent predictor of stable relationships, researchers and policy makers lack good causal information on whether increasing fathers’ employment and earnings will increase relationship quality and union stability. They also note that analysts need to know more about whether relationship quality in fragile families can be improved directly and whether doing so will increase union stability, father involvement, and co-parenting quality. PMID:20964130

Parental relationships in fragile families.

PubMed

McLanahan, Sara; Beck, Audrey N

2010-01-01

As nonmarital childbearing escalated in the United States over the past half century, fragile families--defined as unmarried couples with children--drew increased interest from researchers and policy makers. Sara McLanahan and Audrey Beck discuss four aspects of parental relationships in these families: the quality of parents' intimate relationship, the stability of that relationship, the quality of the co-parenting relationship among parents who live apart, and nonresident fathers' involvement with their child. At the time of their child's birth, half of the parents in fragile families are living together and another third are living apart but romantically involved. Despite high hopes at birth, five years later only a third of parents are still together, and new partners and new children are common, leading to high levels of instability and complexity in these families. Drawing on findings from the Fragile Families and Child Wellbeing Study, McLanahan and Beck highlight a number of predictors of low relationship quality and stability in these families, including low economic resources, government policies that discourage marriage, gender distrust and acceptance of single motherhood, sex ratios that favor men, children from previous unions, and psychological factors that make it difficult for parents to maintain healthy relationships. No single factor appears to have a dominant effect. The authors next discuss two types of experiments that attempt to establish causal effects on parental relationships: those aimed at altering economic resources and those aimed at improving relationships. What can be done to strengthen parental relationships in fragile families? The authors note that although economic resources are a consistent predictor of stable relationships, researchers and policy makers lack good causal information on whether increasing fathers' employment and earnings will increase relationship quality and union stability. They also note that analysts need to know more about whether relationship quality in fragile families can be improved directly and whether doing so will increase union stability, father involvement, and co-parenting quality.

Predictive capacity of sperm quality parameters and sperm subpopulations on field fertility after artificial insemination in sheep.

PubMed

Santolaria, P; Vicente-Fiel, S; Palacín, I; Fantova, E; Blasco, M E; Silvestre, M A; Yániz, J L

2015-12-01

This study was designed to evaluate the relevance of several sperm quality parameters and sperm population structure on the reproductive performance after cervical artificial insemination (AI) in sheep. One hundred and thirty-nine ejaculates from 56 adult rams were collected using an artificial vagina, processed for sperm quality assessment and used to perform 1319 AI. Analyses of sperm motility by computer-assisted sperm analysis (CASA), sperm nuclear morphometry by computer-assisted sperm morphometry analysis (CASMA), membrane integrity by acridine orange-propidium iodide combination and sperm DNA fragmentation using the sperm chromatin dispersion test (SCD) were performed. Clustering procedures using the sperm kinematic and morphometric data resulted in the classification of spermatozoa into three kinematic and three morphometric sperm subpopulations. Logistic regression procedures were used, including fertility at AI as the dependent variable (measured by lambing, 0 or 1) and farm, year, month of AI, female parity, female lambing-treatment interval, ram, AI technician and sperm quality parameters (including sperm subpopulations) as independent factors. Sperm quality variables remaining in the logistic regression model were viability and VCL. Fertility increased for each one-unit increase in viability (by a factor of 1.01) and in VCL (by a factor of 1.02). Multiple linear regression analyses were also performed to analyze the factors possibly influencing ejaculate fertility (N=139). The analysis yielded a significant (P<0.05) relationship between sperm viability and ejaculate fertility. The discriminant ability of the different semen variables to predict field fertility was analyzed using receiver operating characteristic (ROC) curve analysis. Sperm viability and VCL showed significant, albeit limited, predictive capacity on field fertility (0.57 and 0.54 Area Under Curve, respectively). The distribution of spermatozoa in the different subpopulations was not related to fertility. Copyright © 2015 Elsevier B.V. All rights reserved.

Diet quality, inflammation, and the ankle brachial index in adults with or without cardiometabolic conditions.

PubMed

Mattei, Josiemer; Sotres-Alvarez, Daniela; Gellman, Marc; Castañeda, Sheila F; Hu, Frank B; Tucker, Katherine L; Siega-Riz, Anna Maria; Kaplan, Robert C

2018-08-01

Diet quality may influence non-traditional cardiovascular disease (CVD) risk factors - namely, C-reactive protein (CRP) and the ankle-brachial index (ABI). Pre-existing traditional cardiometabolic conditions may confound this association. We aimed to determine whether diet quality was associated with high-risk CRP or ABI, independently from traditional cardiometabolic risk factors. Baseline data were analyzed from US-Hispanics/Latinos aged 18-74 y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. Included were 14,623 participants with CRP data, and 7892 participants (≥45 y) with ABI data. Diet quality was measured with the Alternate Healthy Eating Index (AHEI). Nearly 35% of Hispanics/Latinos had high-risk CRP concentration and 6.3% had high-risk ABI (peripheral artery disease (PAD): 4.2%; arterial stiffness: 2.1%). After adjusting for sociodemographic and lifestyle factors, diabetes, hypertension, hypercholesterolemia, and obesity, the odds (95% confidence interval) of having high-risk ABI were 37% (5, 44%) lower per 10-unit increase in AHEI (p = 0.018). The association was marginally significant for PAD (0.77 (0.58, 1.00); p = 0.05), and non-significant for arterial stiffness (p = 0.16). Each 10-unit increase in AHEI was associated with 21% (10, 30%) lower odds of high-risk CRP (p = 0.0002) after similar adjustments. There were no significant interactions between AHEI and age, sex, ethnicity, smoking, or pre-existing cardiometabolic conditions for associations with ABI. The association between AHEI and high-risk CRP was stronger for those with diabetes (p-interaction < 0.0001), obesity (p-interaction = 0.005), or ages 45-74 y (p-interaction = 0.011). Higher diet quality is associated with lower inflammation and less adverse ABI among Hispanics/Latinos, independently from traditional cardiometabolic risk factors. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

PubMed

Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

2018-05-01

The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Exploring Physician Perspectives of Residency Holdover Handoffs: A Qualitative Study to Understand an Increasingly Important Type of Handoff.

PubMed

Duong, Jonathan A; Jensen, Trevor P; Morduchowicz, Sasha; Mourad, Michelle; Harrison, James D; Ranji, Sumant R

2017-06-01

The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. We undertook a qualitative study using structured focus groups and interviews. We analyzed data using qualitative content analysis. IM residents, IM program directors, and hospitalists at a large academic medical center. A nine-question open-ended interview guide. We identified 13 factors describing holdover handoffs. Five factors-physical space, standardization, task accountability, closed-loop verification, and resilience-were similar to those described in prior handoff literature in other specialties. Eight factors were new concepts that may uniquely affect the quality of the holdover handoff in IM. These included electronic health record access, redundancy, unwritten thoughts, different clinician needs, diagnostic uncertainty, anchoring, teaching, and feedback. These factors were organized into five overarching themes: physical environment, information transfer, responsibility, clinical reasoning, and education. The holdover handoff in IM is complex and has unique considerations for achieving high quality. Further exploration of safe, efficient, and educational holdover handoff practices is necessary.

Improving health care quality and safety: the role of collective learning.

PubMed

Singer, Sara J; Benzer, Justin K; Hamdan, Sami U

2015-01-01

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes.

Improving health care quality and safety: the role of collective learning

PubMed Central

Singer, Sara J; Benzer, Justin K; Hamdan, Sami U

2015-01-01

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes. PMID:29355197

Marital quality and diabetes: results from the Health and Retirement Study.

PubMed

Whisman, Mark A; Li, Angela; Sbarra, David A; Raison, Charles L

2014-08-01

Poor marital quality is associated with many different indicators of poor health, including immunologic and metabolic responses that have relevance for distal disease outcomes such as diabetes. We conducted this study to evaluate whether poor marital quality was associated with the prevalence of diabetes in a population-based sample of Americans over the age of 50. Participants were married adults from the 2006 (N = 3,898) and 2008 (N = 3,452) waves of the Health and Retirement Study. Participants completed an interview and a self-report questionnaire, and current use of diabetes medication and glycosylated hemoglobin obtained from blood spot samples were used to index diabetes status. Marital quality was assessed with items regarding perceived frequency of positive and negative exchanges with partner. Decreasing frequency of positive exchanges and increasing frequency of negative exchanges with one's spouse were associated with higher prevalence of diabetes among men, but not women at both waves; gender significantly moderated the associations between partner exchanges and diabetes status for the 2006 data. The association between frequency of partner exchanges and diabetes status generally remained significant in men after accounting for demographic characteristics and other risk factors (obesity, hypertension, low physical activity). Poor marital quality as operationalized by rates of positive and negative partner exchanges was associated with increased prevalence of diabetes in men. These results are consistent with prior work on marriage and health, and suggest that poor marital quality may be a unique risk factor for diabetes.

Paediatric cerebrovascular CT angiography-towards better image quality.

PubMed

Thust, Stefanie C; Chong, Wui Khean Kling; Gunny, Roxana; Mazumder, Asif; Poitelea, Marius; Welsh, Anna; Ederies, Ash; Mankad, Kshitij

2014-12-01

Paediatric cerebrovascular CT angiography (CTA) can be challenging to perform due to variable cardiovascular physiology between different age groups and the risk of movement artefact. This analysis aimed to determine what proportion of CTA at our institution was of diagnostic quality and identify technical factors which could be improved. a retrospective analysis of 20 cases was performed at a national paediatric neurovascular centre assessing image quality with a subjective scoring system and Hounsfield Unit (HU) measurements. Demographic data, contrast dose, flow rate and triggering times were recorded for each patient. Using a qualitative scoring system, 75% of studies were found to be of diagnostic quality (n=9 'good', n=6 'satisfactory') and 25% (n=5) were 'poor'. Those judged subjectively to be poor had arterial contrast density measured at less than 250 HU. Increased arterial opacification was achieved for cases performed with an increased flow rate (2.5-4 mL/s) and higher intravenous contrast dose (2 mL/kg). Triggering was found to be well timed in nine cases, early in four cases and late in seven cases. Of the scans triggered early, 75% were poor. Of the scans triggered late, less (29%) were poor. High flow rates (>2.5 mL/s) were a key factor for achieving high quality paediatric cerebrovascular CTA imaging. However, appropriate triggering by starting the scan immediately on contrast opacification of the monitoring vessel plays an important role and could maintain image quality when flow rates were lower. Early triggering appeared more detrimental than late.

Factors affecting success of an integrated community-based telehealth system.

PubMed

Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh

2015-01-01

The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

Effects of endurance, circuit, and relaxing training on cardiovascular risk factors in hypertensive elderly patients.

PubMed

Venturelli, Massimo; Cè, Emiliano; Limonta, Eloisa; Schena, Federico; Caimi, Barbara; Carugo, Stefano; Veicsteinas, Arsenio; Esposito, Fabio

2015-10-01

Recommendations for prevention of cardiovascular diseases (CVDs) risk factors among older adults highlighted the importance of exercise-based interventions, including endurance training (ET). However, the evidence of efficacy of other interventions based on short-bouts of exercise (circuit training, CT), and the practice of breath-control and meditation (relaxing training, RT) is growing. The aim of this study was to elucidate if CT or RT are equally effective in CVD risk factors reduction compared to ET. To this purpose, in 40 elderly participants, with clinically diagnosed grade 1 hypertension, resting blood pressure, blood glucose, and cholesterol levels, peak oxygen uptake ([Formula: see text]), mechanical efficiency and quality of life were evaluated before and after 12 weeks of ET, CT, and RT treatments. Resting blood pressure reduced significantly in all groups by ∼11 %. In ET, blood cholesterol levels (-18 %), [Formula: see text] (+8 %), mechanical efficiency (+9 %), and quality of life scores (+36 %) ameliorated. In CT blood glucose levels (-11 %), [Formula: see text] (+7 %) and quality of life scores (+35 %) were bettered. Conversely, in RT, the lower blood pressure went along only with an improvement in the mental component of quality of life (+42 %). ET and CT were both appropriate interventions to reduce CVDs risk factors, because blood pressure reduction was accompanied by decreases in blood glucose and cholesterol levels, increases in [Formula: see text], mechanical efficiency, and quality of life. Although RT influenced only blood pressure and quality of life, this approach would be an attractive alternative for old individuals unable or reluctant to carry out ET or CT.

Dentist-Patient Communication and Denture Quality Associated with Complete Denture Satisfaction Among Taiwanese Elderly Wearers.

PubMed

Chen, Jen-Hao; Huang, Hsiao-Ling; Lin, Ying-Chun; Chou, Tsau-Mau; Ebinger, John; Lee, Huey-Er

2015-01-01

The aim of this study was to explore individual (ie, sociodemographic characteristics, patient personality) and clinical factors (ie, dentist-patient communication, denture quality) associated with complete denture satisfaction among the Taiwanese elderly population. A multistage sampling and cross-sectional design was used to collect data. A total of 387 fully edentulous citizens, aged 65 years and older and who had received new sets of complete dentures, were selected. The participants completed clinical dental examinations and questionnaires by personal interview to collect information on denture satisfaction and associated variables. The relationship among three groups of these participants (satisfied, neutral, and dissatisfied) and potential factors were simultaneously examined using polytomous logistic regression analysis. Overall, 36.7% of the participants were dissatisfied with their dentures. Living status (crude odds ratio [COR] = 2.04), personality (COR = 4.86), dentist-patient communication (COR = 7.46), and denture quality (COR = 5.02) were associated with complete denture satisfaction. The multivariate regression model showed that dentist-patient communication (adjusted odds ratio [AOR] = 6.41) and denture quality (AOR = 4.40) were significant complete denture satisfaction factors that diluted the effect of living status and personality. Inadequate dentistpatient communication and low denture quality were associated with the dissatisfaction of patients with dentures. To increase complete denture satisfaction, the importance of training programs aimed at enhancing dentist-patient communication and denture quality cannot be overemphasized.

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

PubMed

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

2015-04-01

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

Factors Affecting Medical Service Quality.

PubMed

Mosadeghrad, Ali Mohammad

2014-02-01

A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

Living with schizophrenia: Health-related quality of life among primary family caregivers.

PubMed

Hsiao, Chiu-Yueh; Lee, Chun-Te; Lu, Huei-Lan; Tsai, Yun-Fang

2017-12-01

To examine influencing factors of health-related quality of life in primary family caregivers of people with schizophrenia receiving inpatient psychiatric rehabilitation services. Families, particularly primary family caregivers, have become more important than ever in mental health care. Yet, research on health-related quality of life among primarily family caregivers is limited. A correlational study design was used. A convenience sample of 122 primary family caregivers participated in the study. Data were analysed with descriptive statistics, Pearson's product-moment correlation, t test, one-way analysis of variance and a hierarchical multiple regression analysis. Primary family caregivers who were parents, older, less educated, and had a lower monthly household income, increased affiliate stigma and decreased quality of family-centred care experienced poor health-related quality of life. Particularly, monthly household income, affiliate stigma and quality of family-centred care appeared to be the most critical determinants of health-related quality of life. Efforts to enhance satisfaction of life should focus on reducing affiliate stigma as well as increasing monthly household income and strengthening the quality of family-centred care. Findings may assist in the development of culturally integrated rehabilitation programmes to decrease affiliate stigma and increase family engagement as a means of promoting quality of life for primary family caregivers living with people who have schizophrenia. © 2017 John Wiley & Sons Ltd.

The Strategic Management of Store Brand Perceived Quality

NASA Astrophysics Data System (ADS)

Yang, Defeng

Store brand plays a vital role in the success of retailers. Perceived quality is one of important factors influencing consumers' store brand purchase intention. Store brand perceived quality is lower compared with objective quality or national brand. For this end, the purpose of this article is to examine how to manage store brand perceived quality in strategic level. This article firstly discusses how consumers evaluate product quality, and the theoretical background of the reason that store brand perceived quality is lower from the view of cue related theories. Then, consumers' store brand quality evaluation is explored. Finally, this article presents several strategic tactics to increase store brand perceived quality. These tactics include choosing store's name as store brand name, making large advertising investment, improving store brand product package, and strengthening the relationship with store brand product suppliers.

Glaucoma and quality of life: fall and driving risk.

PubMed

Montana, Cynthia L; Bhorade, Anjali M

2018-03-01

Numerous population-based studies suggest that glaucoma is an independent risk factor for falling and motor vehicle collisions, particularly for older adults. These adverse events lead to increased healthcare expenditures and decreased quality of life. Current research priorities, therefore, include identifying factors that predispose glaucoma patients to falling and unsafe driving, and developing screening strategies and targeted rehabilitation. The purpose of this article is to review recent studies that address these priorities. Studies continue to support that glaucoma patients, particularly those with advanced disease, have an increased risk of falling or unsafe driving. Risk factors, however, remain variable and include severity and location of visual field defects, contrast sensitivity, and performance on divided attention tasks. Such variability is likely because of the multifactorial nature of ambulating and driving and compensatory strategies used by patients. Falls and unsafe driving remain a serious public health issue for older adults with glaucoma. Ambulation and driving are complex tasks and there is no consensus yet, regarding the best methods for risk stratification and targeted interventions to increase safety. Therefore, comprehensive and individualized assessments are recommended to most effectively evaluate a patient's risk for falling or unsafe driving.

Taste phenotype associates with cardiovascular disease risk factors via diet quality in multivariate modeling.

PubMed

Sharafi, Mastaneh; Rawal, Shristi; Fernandez, Maria Luz; Huedo-Medina, Tania B; Duffy, Valerie B

2018-05-08

Sensations from foods and beverages drive dietary choices, which in turn, affect risk of diet-related diseases. Perception of these sensation varies with environmental and genetic influences. This observational study aimed to examine associations between chemosensory phenotype, diet and cardiovascular disease (CVD) risk. Reportedly healthy women (n = 110, average age 45 ± 9 years) participated in laboratory-based measures of chemosensory phenotype (taste and smell function, propylthiouracil (PROP) bitterness) and CVD risk factors (waist circumference, blood pressure, serum lipids). Diet variables included preference and intake of sweet/high-fat foods, dietary restraint, and diet quality based on reported preference (Healthy Eating Preference Index-HEPI) and intake (Healthy Eating Index-HEI). We found that females who reported high preference yet low consumption of sweet/high-fat foods had the highest dietary restraint and depressed quinine taste function. PROP nontasters were more likely to report lower diet quality; PROP supertasters more likely to consume but not like a healthy diet. Multivariate structural models were fitted to identify predictors of CVD risk factors. Reliable latent taste (quinine taste function, PROP tasting) and smell (odor intensity) variables were identified, with taste explaining more variance in the CVD risk factors. Lower bitter taste perception was associated with elevated risk. In multivariate models, the HEPI completely mediated the taste-adiposity and taste-HDL associations and partially mediated the taste-triglyceride or taste-systolic blood pressure associations. The taste-LDL pathway was significant and direct. The HEI could not replace HEPI in adequate models. However, using a latent diet quality variable with HEPI and HEI, increased the strength of association between diet quality and adiposity or CVD risk factors. In conclusion, bitter taste phenotype was associated with CVD risk factors via diet quality, particularly when assessed by level of food liking/disliking. Copyright © 2018 Elsevier Inc. All rights reserved.

Perifollicular blood flow and its relationship with endometrial vascularity, follicular fluid EG-VEGF, IGF-1, and inhibin-a levels and IVF outcomes.

PubMed

Vural, Fisun; Vural, Birol; Doğer, Emek; Çakıroğlu, Yiğit; Çekmen, Mustafa

2016-10-01

The aim of this study is to investigate the association of perifollicular blood flow (PFBF) with follicular fluid EG-VEGF, inhibin-a, and insulin-like growth factor-1 (IGF-1) concentrations, endometrial vascularity, and IVF outcomes. Forty women with tubal factor infertility were included in a prospective cohort study. Each woman underwent IVF/ICSI procedure. Individual follicles of ≥16 mm (n = 156) were evaluated by power Doppler analysis and categorized as well-vascularized follicles (WVFs) or poorly vascularized follicles (PVFs). WVFs referred to those with perifollicular vascularity of 51-100 %. Each follicular fluid (FF) was individually aspirated and FF/serum EG-VEGF, inhibin-a, and FF IGF-1 levels were evaluated. Zones III-IV endometrial vascularity was classified as a well-vascularized endometrium (WVE). The presence of a WVE and mature oocytes, in addition to the embryo quality and clinical pregnancy rate (CPR), were recorded for each follicle. The main outcome measures were FF serum EG-VEGF, inhibin-a, IGF-1 levels, and WVE and IVF outcome per PFBF. For WVFs, the level of FF EG-VEGF (p = 0.008), oocyte quality (p = 0.001), embryo quality (p = 0.002), a WVE (p = 0.001), and CPR (p = 0.04) increased significantly. The pregnant group was characterized by increased numbers of WVFs (p = 0.044), a WVE (p = 0.022), and increased levels of FF IGF-1 (p = 0.001) and serum EG-VEGF (p = 0.03). FF IGF-1 >50 ng/mL (AUC 0.72) had 75 % sensitivity and 64 % specificity for predicting CPR. WVFs yield high-quality oocytes and embryos, a WVE, increased FF EG-VEGF levels, and increased CPRs.

Investigating the use of an antiscatter grid in chest radiography for average adults with a computed radiography imaging system

PubMed Central

Wood, T J; Avery, G; Balcam, S; Needler, L; Smith, A; Saunderson, J R; Beavis, A W

2015-01-01

Objective: The aim of this study was to investigate via simulation a proposed change to clinical practice for chest radiography. The validity of using a scatter rejection grid across the diagnostic energy range (60–125 kVp), in conjunction with appropriate tube current–time product (mAs) for imaging with a computed radiography (CR) system was investigated. Methods: A digitally reconstructed radiograph algorithm was used, which was capable of simulating CR chest radiographs with various tube voltages, receptor doses and scatter rejection methods. Four experienced image evaluators graded images with a grid (n = 80) at tube voltages across the diagnostic energy range and varying detector air kermas. These were scored against corresponding images reconstructed without a grid, as per current clinical protocol. Results: For all patients, diagnostic image quality improved with the use of a grid, without the need to increase tube mAs (and therefore patient dose), irrespective of the tube voltage used. Increasing tube mAs by an amount determined by the Bucky factor made little difference to image quality. Conclusion: A virtual clinical trial has been performed with simulated chest CR images. Results indicate that the use of a grid improves diagnostic image quality for average adults, without the need to increase tube mAs, even at low tube voltages. Advances in knowledge: Validated with images containing realistic anatomical noise, it is possible to improve image quality by utilizing grids for chest radiography with CR systems without increasing patient exposure. Increasing tube mAs by an amount determined by the Bucky factor is not justified. PMID:25571914

Review: DNA Barcoding and Chromatography Fingerprints for the Authentication of Botanicals in Herbal Medicinal Products

PubMed Central

2017-01-01

In the last two decades, there has been a tremendous increase in the global use of herbal medicinal products (HMPs) due to their claimed health benefits. This has led to increase in their demand and consequently, also, resulted in massive adulteration. This is due to the fact that most of the traditional methods cannot identify closely related species in a process product form. Therefore the urgent need for simple and rapid identification methods resulted in the discovery of a novel technique. DNA barcoding is a process that uses short DNA sequence from the standard genome for species identification. This technique is reliable and is not affected by external factors such as climates, age, or plant part. The difficulties in isolation of DNA of high quality in addition to other factors are among the challenges encountered using the DNA barcoding in the authentication of HMP. These limitations indicated that using DNA barcoding alone may ineffectively authenticate the HMP. Therefore, the combination of DNA barcoding with chromatographic fingerprint, a popular and generally accepted technique for the assessment and quality control of HMP, will offer an efficient solution to effectively evaluate the authenticity and quality consistency of HMP. Detailed and quality information about the main composition of the HMPs will help to ascertain their efficacy and safety as these are very important for quality control. PMID:28536641

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study.

PubMed

Lucassen, Eliane A; de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M; Rosendaal, Frits R; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R

2017-01-01

Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Cross-sectional analysis of 915 participants (45-65 years, 56% women, BMI 26 (range: 18-56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03-1.14), declined self-rated sleep quality (1.76, 1.03-3.01), sleep latency (1.18, 1.06-1.31), and a one hour later sleep timing (1.51, 1.08-2.11), but not sleep duration (1.05, 0.90-1.23), were associated with osteopenia. PSQI score (1.10, 1.02-1.19) was also associated with sarcopenia; OR's of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99-1.31) and 1.54 (0.91-2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals.

A tool to measure whether business management capacity in general practice impacts on the quality of chronic illness care.

PubMed

Holton, Christine H; Proudfoot, Judith G; Jayasinghe, Upali W; Grimm, Jane; Bubner, Tanya K; Winstanley, Julie; Harris, Mark F; Beilby, Justin J

2010-11-01

Our aim was to develop a tool to identify specific features of the business and financial management of practices that facilitate better quality care for chronic illness in primary care. Domains of management were identified, resulting in the development of a structured interview tool that was administered in 97 primary care practices in Australia. Interview items were screened and subjected to factor analysis, subscales identified and the overall model fit determined. The instrument's validity was assessed against another measure of quality of care. Analysis provided a four-factor solution containing 21 items, which explained 42.5% of the variance in the total scores. The factors related to administrative processes, human resources, marketing analysis and business development. All scores increased significantly with practice size. The business development subscale and total score were higher for rural practices. There was a significant correlation between the business development subscale and quality of care. The indicators of business and financial management in the final tool appear to be useful predictors of the quality of care. The instrument may help inform policy regarding the structure of general practice and implementation of a systems approach to chronic illness care. It can provide information to practices about areas for further development.

Television watching, diet quality, and physical activity and diabetes among three ethnicities in the United States.

PubMed

Huffman, Fatma G; Vaccaro, Joan A; Exebio, Joel C; Zarini, Gustavo G; Katz, Timothy; Dixon, Zisca

2012-01-01

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 diabetes were more likely to watch more than 4 hours of TV per day as compared to their counterparts. Diet quality was inversely associated with physical activity level. Future studies are needed to establish the risk factors of prolonged TV watching in adult populations for the development of diabetes or diabetes-related complications. Although strategies to reduce TV watching have been proven effective among children, few trials have been conducted in adults. Intervention trials aimed at reducing TV viewing targeting people with type 2 diabetes may be beneficial to improve dietary quality and physical activity, which may reduce diabetes complications.

A Monte Carlo study of the quality dependence factors of common TLD materials in photon and electron beams.

PubMed

Mobit, P N; Nahum, A E; Mayles, P

1998-08-01

A Monte Carlo simulation of the quality dependence of different TL materials, in the form of discs 3.61 mm in diameter and 0.9 mm thick, in radiotherapy photon beams relative to 60Co gamma-rays has been performed. The beam qualities ranged from 50 kV to 25 MV x-rays. The TL materials were: CaF2, CaSO4, LiF and Li2B4O7. The effects of the dopants on energy deposition in the TL material have also been determined for the highly sensitive LiF:Mg:Cu:P (TLD-100H) and for CaF2:Mn. It was found that there was a significant difference in the quality dependence factor derived from Monte Carlo simulations between LiF and LiF:Mg:Cu:P but not between CaF2 and CaF2:Mn. The quality dependence factors for Li2B4O7 varied from 0.990 +/- 0.008 (1 sd) for 25 MV x-rays to 0.940 +/- 0.009 (1 sd) for 50 kV x-rays relative to 60Co gamma-rays; Monte Carlo simulations were also performed for Li2B4O7 in megavoltage electron beams. For CaF2, the quality dependence factor varied from 0.927 +/- 0.008 (1 sd) for 25 MV x-rays to 10.561 +/- 0.008 (1 sd) for 50 kV x-rays. The figure for CaSO4 ranged from 0.943 +/- 0.008 (1 sd) for 25 MV x-rays to 9.010 +/- 0.008 (1 sd) for 50 kV x-rays. The quality dependence factor for CaF2 increases by up to 5% with depth and by up to 15% with field size for the kilovoltage x-ray beams. For LiF-TLD, however, there was no significant dependence on the field size or depth of irradiation in the kilovoltage energy range.

Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population.

PubMed

Kwan, Zhenli; Bong, Yii Bonn; Tan, Leng Leng; Lim, Shu Xian; Yong, Adrian Sze Wai; Ch'ng, Chin Chwen; Tan, Maw Pin; Thevarajah, Suganthi; Ismail, Rokiah

2017-02-01

Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ 2 test, Fisher's exact test and multivariate logistic regression were used for statistical analysis to determine independent predictors of depression, anxiety, stress and severe impairment of quality of life. Unadjusted analysis revealed that depression was associated with Indian ethnicity (p = .041) and severe impairment of quality of life was associated with Indian ethnicity (p = .032), higher education (p = .013), higher income (p = .042), and employment status (p = .014). Multivariate analysis revealed that Indian ethnicity was a predictor of depression (p = .024). For stress, tertiary level of education (p = .020) was an independent risk factor while a higher monthly income was a protective factor (p = .042). The ethnic Indians and Malays were significantly more likely than the ethnic Chinese to suffer reduced quality of life (p = .001 and p = .006 respectively) and subjects with tertiary education were more likely to have severe impairment of quality of life (p = .002). Our study was unique in determining sociocultural influences on psychological complications of psoriasis in a South East Asian population. This has provided invaluable insight into factors predictive of adverse effects of psoriasis on psychological distress and quality of life in our patient population. Future studies should devise interventions to specifically target at risk groups in the development of strategies to reduce morbidity associated with psoriasis.

High-quality cardiopulmonary resuscitation.

PubMed

Nolan, Jerry P

2014-06-01

The quality of cardiopulmonary resuscitation (CPR) impacts on outcome after cardiac arrest. This review will explore the factors that contribute to high-quality CPR and the metrics that can be used to monitor performance. A recent consensus statement from North America defined five key components of high-quality CPR: minimizing interruptions in chest compressions, providing compressions of adequate rate and depth, avoiding leaning on the chest between compressions, and avoiding excessive ventilation. Studies have shown that real-time feedback devices improve the quality of CPR and, in one before-and-after study, outcome from out-of-hospital cardiac arrest. There is evidence for increasing survival rates following out-of-hospital cardiac arrest and this is associated with increasing rates of bystander CPR. The quality of CPR provided by healthcare professionals can be improved with real-time feedback devices. The components of high-quality CPR and the metrics that can be measured and fed back to healthcare professionals have been defined by expert consensus. In the future, real-time feedback based on the physiological responses to CPR may prove more effective.

[Measuring health-related quality of life with the SF-8. Normal sample of the German population].

PubMed

Ellert, U; Lampert, T; Ravens-Sieberer, U

2005-12-01

The SF-8, a relatively new instrument for measuring health-related quality of life, was used in the German National Telephone Health Survey 2003. The SF-8 provides results which are comparable to those of the SF-36, the instrument most commonly used internationally. The German National Telephone Health Survey provides nationally representative data for the residential population in Germany aged 18 and older. In addition to the measurement of health-related quality of life, comprehensive information on chronic illnesses and complaints, health care needs, utilisation of health care, risk factors, risk behaviour and social status is also collected, making differentiated analyses possible. According to the data collected, men rate their quality of life in all dimensions higher than women. With increasing age, quality of life for both men and women decreases in the physical dimensions, while increasing in the mental health dimensions. Apart from chronic disease and pain having a negative impact on health-related quality of life, social differences are also observable, in that worse health-related quality of life is reported by respondents with lower socioeconomic status.

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.

Islet product characteristics and factors related to successful human islet transplantation from the Collaborative Islet Transplant Registry (CITR) 1999-2010.

PubMed

Balamurugan, A N; Naziruddin, B; Lockridge, A; Tiwari, M; Loganathan, G; Takita, M; Matsumoto, S; Papas, K; Trieger, M; Rainis, H; Kin, T; Kay, T W; Wease, S; Messinger, S; Ricordi, C; Alejandro, R; Markmann, J; Kerr-Conti, J; Rickels, M R; Liu, C; Zhang, X; Witkowski, P; Posselt, A; Maffi, P; Secchi, A; Berney, T; O'Connell, P J; Hering, B J; Barton, F B

2014-11-01

The Collaborative Islet Transplant Registry (CITR) collects data on clinical islet isolations and transplants. This retrospective report analyzed 1017 islet isolation procedures performed for 537 recipients of allogeneic clinical islet transplantation in 1999-2010. This study describes changes in donor and islet isolation variables by era and factors associated with quantity and quality of final islet products. Donor body weight and BMI increased significantly over the period (p<0.001). Islet yield measures have improved with time including islet equivalent (IEQ)/particle ratio and IEQs infused. The average dose of islets infused significantly increased in the era of 2007-2010 when compared to 1999-2002 (445.4±156.8 vs. 421.3±155.4×0(3) IEQ; p<0.05). Islet purity and total number of β cells significantly improved over the study period (p<0.01 and <0.05, respectively). Otherwise, the quality of clinical islets has remained consistently very high through this period, and differs substantially from nonclinical islets. In multivariate analysis of all recipient, donor and islet factors, and medical management factors, the only islet product characteristic that correlated with clinical outcomes was total IEQs infused. This analysis shows improvements in both quantity and some quality criteria of clinical islets produced over 1999-2010, and these parallel improvements in clinical outcomes over the same period. © 2014 The Authors. American Journal of Transplantation Published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Islet Product Characteristics and Factors Related to Successful Human Islet Transplantation From the Collaborative Islet Transplant Registry (CITR) 1999–2010

PubMed Central

Balamurugan, A N; Naziruddin, B; Lockridge, A; Tiwari, M; Loganathan, G; Takita, M; Matsumoto, S; Papas, K; Trieger, M; Rainis, H; Kin, T; Kay, T W; Wease, S; Messinger, S; Ricordi, C; Alejandro, R; Markmann, J; Kerr-Conti, J; Rickels, M R; Liu, C; Zhang, X; Witkowski, P; Posselt, A; Maffi, P; Secchi, A; Berney, T; O’Connell, P J; Hering, B J; Barton, F B

2014-01-01

The Collaborative Islet Transplant Registry (CITR) collects data on clinical islet isolations and transplants. This retrospective report analyzed 1017 islet isolation procedures performed for 537 recipients of allogeneic clinical islet transplantation in 1999–2010. This study describes changes in donor and islet isolation variables by era and factors associated with quantity and quality of final islet products. Donor body weight and BMI increased significantly over the period (p < 0.001). Islet yield measures have improved with time including islet equivalent (IEQ)/particle ratio and IEQs infused. The average dose of islets infused significantly increased in the era of 2007–2010 when compared to 1999–2002 (445.4 ± 156.8 vs. 421.3 ± 155.4 ×103 IEQ; p < 0.05). Islet purity and total number of β cells significantly improved over the study period (p < 0.01 and <0.05, respectively). Otherwise, the quality of clinical islets has remained consistently very high through this period, and differs substantially from nonclinical islets. In multivariate analysis of all recipient, donor and islet factors, and medical management factors, the only islet product characteristic that correlated with clinical outcomes was total IEQs infused. This analysis shows improvements in both quantity and some quality criteria of clinical islets produced over 1999–2010, and these parallel improvements in clinical outcomes over the same period. PMID:25278159

Reproductive investment when mate quality varies: differential allocation versus reproductive compensation.

PubMed

Harris, W Edwin; Uller, Tobias

2009-04-27

Reproductive investment decisions form an integral part of life-history biology. Selection frequently favours plasticity in investment that can generate maternal effects on offspring development. For example, if females differentially allocate resources based on mate attractiveness or quality, this can create a non-genetic link between mate attractiveness and offspring fitness with potential consequences for ecological and evolutionary dynamics. It is therefore important to understand under what conditions differential investment into offspring in relation to male quality is expected to occur and the direction of the effect. Two opposite predictions, increased investment into offspring produced with high-quality mates (differential allocation (DA)) and increased investment with low-quality males (reproductive compensation (RC)) have been suggested but no formal theoretical treatment justifying the assumptions underlying these two hypotheses has been conducted to date. Here, we used a state-based approach to investigate the circumstances under which the variation in mate quality results in differential female investment into offspring and how this interacts with female energetic resource levels. We found that a pattern of increased investment when mating with high-quality mates (i.e. DA) was the most common optimal investment strategy for females in our model. By contrast, increased investment when mating with low-quality mates (i.e. RC) was predicted only when the relative impact of parental investment on offspring quality was low. Finally, we found that the specific pattern of investment in relation to male quality depends on female energetic state, the likelihood for future mating opportunities and the expected future distribution of mate quality. Thus, the female's age and body condition should be important factors mediating DA and RC, which may help to explain the equivocal results of empirical studies.

Image quality in thoracic 4D cone-beam CT: A sensitivity analysis of respiratory signal, binning method, reconstruction algorithm, and projection angular spacing

PubMed Central

Shieh, Chun-Chien; Kipritidis, John; O’Brien, Ricky T.; Kuncic, Zdenka; Keall, Paul J.

2014-01-01

Purpose: Respiratory signal, binning method, and reconstruction algorithm are three major controllable factors affecting image quality in thoracic 4D cone-beam CT (4D-CBCT), which is widely used in image guided radiotherapy (IGRT). Previous studies have investigated each of these factors individually, but no integrated sensitivity analysis has been performed. In addition, projection angular spacing is also a key factor in reconstruction, but how it affects image quality is not obvious. An investigation of the impacts of these four factors on image quality can help determine the most effective strategy in improving 4D-CBCT for IGRT. Methods: Fourteen 4D-CBCT patient projection datasets with various respiratory motion features were reconstructed with the following controllable factors: (i) respiratory signal (real-time position management, projection image intensity analysis, or fiducial marker tracking), (ii) binning method (phase, displacement, or equal-projection-density displacement binning), and (iii) reconstruction algorithm [Feldkamp–Davis–Kress (FDK), McKinnon–Bates (MKB), or adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS)]. The image quality was quantified using signal-to-noise ratio (SNR), contrast-to-noise ratio, and edge-response width in order to assess noise/streaking and blur. The SNR values were also analyzed with respect to the maximum, mean, and root-mean-squared-error (RMSE) projection angular spacing to investigate how projection angular spacing affects image quality. Results: The choice of respiratory signals was found to have no significant impact on image quality. Displacement-based binning was found to be less prone to motion artifacts compared to phase binning in more than half of the cases, but was shown to suffer from large interbin image quality variation and large projection angular gaps. Both MKB and ASD-POCS resulted in noticeably improved image quality almost 100% of the time relative to FDK. In addition, SNR values were found to increase with decreasing RMSE values of projection angular gaps with strong correlations (r ≈ −0.7) regardless of the reconstruction algorithm used. Conclusions: Based on the authors’ results, displacement-based binning methods, better reconstruction algorithms, and the acquisition of even projection angular views are the most important factors to consider for improving thoracic 4D-CBCT image quality. In view of the practical issues with displacement-based binning and the fact that projection angular spacing is not currently directly controllable, development of better reconstruction algorithms represents the most effective strategy for improving image quality in thoracic 4D-CBCT for IGRT applications at the current stage. PMID:24694143

Association of a Behaviorally Based High School Health Education Curriculum with Increased Exercise

ERIC Educational Resources Information Center

Annesi, James J.; Trinity, John; Mareno, Nicole; Walsh, Stephanie M.

2015-01-01

Increasing exercise in children and adolescents through academic classes is an understudied area. Potential benefits include associated improvements in health, psychosocial, and quality-of-life factors. A sample of 98 students (M[subscript age] = 14.3) from high school health education classes received six, 40-min lessons incorporating…

Implementing a Primary Prevention Social Skills Intervention in Urban Preschools: Factors Associated with Quality and Fidelity

ERIC Educational Resources Information Center

Wenz-Gross, Melodie; Upshur, Carole

2012-01-01

Research Findings: Preschool behavior problems are of increasing concern to early childhood educators. Preventive interventions are being developed, but implementation in underresourced child care programs is challenging. This study describes the implementation of an adapted Second Step curriculum to increase children's social skills and decrease…

Factors Affecting the Quality of Engineering Education in the Four Largest Emerging Economies

ERIC Educational Resources Information Center

Loyalka, Prashant; Carnoy, Martin; Froumin, Isak; Dossani, Raffiq; Tilak, J. B.; Yang, Po

2014-01-01

A huge increase in engineering graduates from the BRIC countries in recent decades potentially threatens the competitiveness of developed countries in producing high value-added products and services, while also holding great promise for substantially increasing the level of global basic and applied innovation. The key question is whether the…

Risk factors and treatment for steroid-related mood and behavior symptoms in preschool children with leukemia: A case series.

PubMed

Samsel, Chase; Muriel, Anna C

2017-02-01

Treatment of pediatric acute lymphoblastic leukemia (ALL) relies on systemic corticosteroids for remission; however, they can cause significant mood and behavior changes that interfere with quality of life and may increase risk for injury. This case series reports on preschool children with preexisting developmental and psychiatric risk factors who presented with behavioral side effects that required intervention. Identification of these vulnerable children may provide opportunities for early intervention, anticipatory guidance, and effective treatment to minimize behavioral side effects and improve quality of life and safety during ALL treatment. © 2016 Wiley Periodicals, Inc.

Prestigious Science Journals Struggle to Reach Even Average Reliability

PubMed Central

Brembs, Björn

2018-01-01

In which journal a scientist publishes is considered one of the most crucial factors determining their career. The underlying common assumption is that only the best scientists manage to publish in a highly selective tier of the most prestigious journals. However, data from several lines of evidence suggest that the methodological quality of scientific experiments does not increase with increasing rank of the journal. On the contrary, an accumulating body of evidence suggests the inverse: methodological quality and, consequently, reliability of published research works in several fields may be decreasing with increasing journal rank. The data supporting these conclusions circumvent confounding factors such as increased readership and scrutiny for these journals, focusing instead on quantifiable indicators of methodological soundness in the published literature, relying on, in part, semi-automated data extraction from often thousands of publications at a time. With the accumulating evidence over the last decade grew the realization that the very existence of scholarly journals, due to their inherent hierarchy, constitutes one of the major threats to publicly funded science: hiring, promoting and funding scientists who publish unreliable science eventually erodes public trust in science. PMID:29515380

Quality of 4-hourly ejaculates--levels of calcium and magnesium.

PubMed

Valsa, J; Skandhan, K P; Gusani, P H; Sahab Khan, P; Amith, S

2013-02-01

A four-hourly ejaculation study was conducted in which eleven normal healthy subjects participated. Five of them discontinued after submitting three samples. One alone was present for submission at the end of 16 h (fifth ejaculate), which was his last submission. Physical exhaustion was the sole reason for all participants for their discontinuation from the study. The result showed a decrease in semen volume and sperm count from first to last ejaculate. The increase in motility was probably due to reduction in exposure time to sperm motility inhibitory factors. In general, total motile spermatozoa as well as actively motile spermatozoa progressively increased from first to last ejaculate at the cost of sluggish spermatozoa. A significant increase in seminal plasma calcium and magnesium was seen as well as a significant increase in magnesium inside the cell from the first to the fourth ejaculate. Considering the quality of semen, which was good in sperm count and excellent in motility, calcium and magnesium may be helpful in cleaning motility inhibitory factors of spermatozoa. © 2012 Blackwell Verlag GmbH.

Quality of Diabetes Care in Germany Improved from 2000 to 2007 to 2014, but Improvements Diminished since 2007. Evidence from the Population-Based KORA Studies

PubMed Central

Knoll, Gabriella; Schunk, Michaela; Meisinger, Christa; Huth, Cornelia; Holle, Rolf

2016-01-01

Objective Little is known about the development of the quality of diabetes care in Germany. The aim of this study is to analyze time trends in patient self-management, physician-delivered care, medication, risk factor control, complications and quality of life from 2000 to 2014. Methods Analyses are based on data from individuals with type 2 diabetes of the population-based KORA S4 (1999–2001, n = 150), F4 (2006–2008, n = 203), FF4 (2013/14, n = 212) cohort study. Information on patient self-management, physician-delivered care, medication, risk factor control and quality of life were assessed in standardized questionnaires and examinations. The 10-year coronary heart disease (CHD) risk was calculated using the UKPDS risk engine. Time trends were analyzed using multivariable linear and logistic regression models adjusted for age, sex, education, diabetes duration, and history of cardiovascular disease. Results From 2000 to 2014 the proportion of participants with type 2 diabetes receiving oral antidiabetic/cardio-protective medication and of those reaching treatment goals for glycemic control (HbA1c<7%, 60% to 71%, p = 0.09), blood pressure (<140/80 mmHg, 25% to 69%, p<0.001) and LDL cholesterol (<2.6 mmol/l, 13% to 27%, p<0.001) increased significantly. However, improvements were generally smaller from 2007 to 2014 than from 2000 to 2007. Modeled 10-year CHD risk decreased from 30% in 2000 to 24% in 2007 to 19% in 2014 (p<0.01). From 2007 to 2014, the prevalence of microvascular complications decreased and quality of life increased, but no improvements were observed for the majority of indicators of self-management. Conclusion Despite improvements, medication and risk factor control has remained suboptimal. The flattening of improvements and deteriorations in quality of (self-) care since 2007 indicate that more effort is needed to improve quality of care and patient self-management. Due to selection or lead time bias an overestimation of quality of care improvements cannot be ruled out. PMID:27749939

T1 colon cancer in the era of screening: risk factors and treatment.

PubMed

Bianco, F; De Franciscis, S; Belli, A; Falato, A; Fusco, R; Altomare, D F; Amato, A; Asteria, C R; Avallone, A; Binda, G A; Boccia, L; Buzzo, P; Carvello, M; Coco, C; Delrio, P; De Nardi, P; Di Lena, M; Failla, A; La Torre, F; La Torre, M; Lemma, M; Luffarelli, P; Manca, G; Maretto, I; Marino, F; Muratore, A; Pascariello, A; Pucciarelli, S; Rega, D; Ripetti, V; Rizzo, G; Serventi, A; Spinelli, A; Tatangelo, F; Urso, E D L; Romano, G M

2017-02-01

The aim of this study was to identify risk factors for lymph node positivity in T1 colon cancer and to carry out a surgical quality assurance audit. The sample consisted of consecutive patients treated for early-stage colon lesions in 15 colorectal referral centres between 2011 and 2014. The study investigated 38 factors grouped into four categories: demographic information, preoperative data, indications for surgery and post-operative data. A univariate and multivariate logistic regression analysis was performed to analyze the significance of each factor both in terms of lymph node (LN) harvesting and LN metastases. Out of 507 patients enrolled, 394 patients were considered for analysis. Thirty-five (8.91%) patients had positive LN. Statistically significant differences related to total LN harvesting were found in relation to central vessel ligation and segmental resections. Cumulative distribution demonstrated that the rate of positive LN increased starting at 12 LN harvested and reached a plateau at 25 LN. Some factors associated with an increase in detection of positive LN were identified. However, further studies are needed to identify more sensitive markers and avoid surgical overtreatment. There is a need to raise the minimum LN count and to use the LN count as an indicator of surgical quality.

Quality of life and uncertainty in Crohn's disease.

PubMed

Niv, Galia; Bar Josef, Simona; Ben Bassat, Ofer; Avni, Irit; Lictenstein, Lev; Niv, Yaron; Barnoy, Sivia

2017-06-01

Crohn's disease impairs patients' perception of health and has a negative impact on health-related quality of life. Although it is apparent that uncertainty is a significant factor that decreases quality of life, it has never been studied in patients with Crohn's disease. The objective of the present study was to examine the association between level of certainty, self-epistemic authority, Internet information gathering habits, and health-related quality of life. A cross-sectional study of 105 Crohn's disease patients was conducted. Data were collected using a questionnaire composed of five parts: (1) demographic and clinical information; (2) health-related quality of life; (3) level of certainty; (4) self-epistemic authority; and (5) Internet information gathering habits regarding Crohn's disease. A significant positive correlation was demonstrated between levels of certainty and health-related quality of life. Self-epistemic authority correlated positively with certainty, while information gathering via the Internet was related to decreased certainty. Multiple regression analysis for factors associated with health-related quality of life showed a positive association with the level of certainty, while negative associations were found between Internet information seeking and disease activity with the quality of life. Level of certainty proved an important variable associated with health-related quality of life in Crohn's disease patients. Improving patients' self-epistemic authority can increase certainty and, thus, improve health-related quality of life.

Rates of urbanisation and the resiliency of air and water quality.

PubMed

Duh, Jiunn-Der; Shandas, Vivek; Chang, Heejun; George, Linda A

2008-08-01

Global human population and urban development are increasing at unprecedented rates and creating tremendous stress on local, regional, and global air and water quality. However, little is known about how urban areas vary in their capacity to address effectively air and water quality impacts associated to urban development. There exists a need to better understanding the factors that mediate the interactions between urbanisation and variations of environmental quality. By synthesizing literatures on the relationship between urban development and air and water quality, we assess the amount of scholarship for each of these cities, characterize population growth rates in one hundred of the largest global cities, and link growth trends to changes in air and water quality. Our results suggest that, while there is a growing literature linking urbanisation and environmental quality, some regions of the globe are better represented than others, and that these trends are consistent with our characterization of population growth rates. In addition, the comparison between population growth rates and air and water quality suggest that multiple factors affect the environmental quality, and that approaching rates of urbanisation through the lens of 'resiliency' can be an effective integrative concept for studying the capacity of urban areas to respond to rapid rates of change. Based on these results we offer a framework for systematically assessing changes in air and water quality in megacities.

Quality of Informal Care Is Multidimensional

PubMed Central

Christie, Juliette; Smith, G. Rush; Williamson, Gail M.; Lance, Charles. E.; Shovali, Tamar E.; Silva, Luciana

2010-01-01

Purpose To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are satisfied on a routine basis. Potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are conceptually distinct dimensions of quality of care. We investigated the extent to which these three dimensions also are empirically distinguishable. Design 237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of depressed affect, life events, cognitive status, and perceived pre-illness relationship quality. Results Confirmatory factor analyses indicated that PHB, adequate care, and EC are empirically distinct factors. Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing further evidence for the distinction between the measures of quality of care used in this study. Conclusions Assessing quality of informal care is a complex endeavor. ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care. PMID:19469607

The factors that affect the frequency of vital sign monitoring in the emergency department.

PubMed

Johnson, Kimberly D; Winkelman, Chris; Burant, Christopher J; Dolansky, Mary; Totten, Vicken

2014-01-01

Vital signs are an important component of the nursing assessment and are used as early warning signs of changes in a patient's condition; however, little research has been conducted to determine how often vital signs are monitored in the emergency department. Additionally, it has not been determined what personal, social, and environmental factors affect the frequency of vital sign monitoring. The purpose of this study was to examine what factors may influence the time between recording vital signs in the emergency department. We performed a descriptive, retrospective chart review of 202 randomly selected adult ED patients' charts from representative times to capture a variety of ED levels of occupancy in an urban, Midwestern, teaching hospital. Descriptive and hierarchical regression analyses were used. The strongest predictor of the increased time between vital signs from the personal health factors was lower patient acuity (Emergency Severity Index). This relationship remained strong even when social factors and environmental factors were included. Increased length of stay and fewer routes of medications also had significant relationships to the increased time between vital sign monitoring. These findings are clinically important because greater time between vital sign recordings can lead to errors of omission by not detecting changes in vital signs that could reveal changes in the patient's condition. The findings of this study provide direction for future research focusing on determining whether higher frequency of vital signs surveillance contributes to higher quality care and linking quality of care to missing vital signs/inadequate monitoring. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Methodology for designing psychological habitability for the space station.

PubMed

Komastubara, A

2000-09-01

Psychological habitability is a critical quality issue for the International Space Station because poor habitability degrades performance shaping factors (PSFs) and increases human errors. However, habitability often receives rather limited design attention based on someone's superficial tastes because systematic design procedures lack habitability quality. To improve design treatment of psychological habitability, this paper proposes and discusses a design methodology for designing psychological habitability for the International Space Station.

Silage review: Factors affecting dry matter and quality losses in silages.

PubMed

Borreani, G; Tabacco, E; Schmidt, R J; Holmes, B J; Muck, R E

2018-05-01

An overview was made of dry matter (DM) and quality losses that occur during the ensiling process from the field through the feeding phase. The aim was to review the relevant published literature of the last 15 yr focusing on developments achieved after the publication of the book Silage Science and Technology. This review discusses the factors affecting DM and quality losses in terms of field and pre-ensiling conditions, respiration and temperature at ensiling, fermentation patterns, methods of covering and weighting the silage cover, and management of aerobic deterioration. The possibility of reducing DM and quality losses during the ensiling process requires knowledge of how to measure losses on farm and establish the status of the silage during the feed-out phase, implementing the most effective management practices to avoid air exposure during conservation and reduce silage aerobic deterioration during feeding. The paper concludes with future perspectives and recommended management practices to reduce losses and increase efficiency over the whole ensiling process in view of increasing sustainability of the livestock production chain. The Authors. Published by FASS Inc. and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

PubMed

Schaal, Tom; Schoenfelder, Tonio; Klewer, Joerg; Kugler, Joachim

2017-01-01

The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

Risk factors for faecal sand excretion in Icelandic horses.

PubMed

Husted, L; Andersen, M S; Borggaard, O K; Houe, H; Olsen, S N

2005-07-01

Sandy soil is often mentioned as a risk factor in the development of sand-related gastrointestinal disease (SGID) in the horse. There are other variables, but few studies confirm any of these. To investigate soil type, pasture quality, feeding practice in the paddock, age, sex and body condition score as risk factors for sand intake in the horse. Faeces were collected from 211 Icelandic horses on 19 different studs in Denmark together with soil samples and other potential risk factors. Sand content in faeces determined by a sand sedimentation test was interpreted as evidence of sand intake. Soil types were identified by soil analysis and significance of the data was tested using logistic analysis. Of horses included in the study, 56.4% showed sand in the faeces and 5.7% had more than 5 mm sand as quantified by the rectal sleeve sedimentation test. Soil type had no significant effect when tested as main effect, but there was interaction between soil type and pasture quality. Significant interactions were also found between paddock feeding practice and pasture quality. To evaluate the risk of sand intake it is important to consider 3 variables: soil type, pasture quality and feeding practice. Pasture quality was identified as a risk factor of both short and long grass in combination with sandy soil, while clay soil had the lowest risk in these combinations. Feeding practice in the paddock revealed feeding directly on the ground to be a risk factor when there was short (1-5 cm) or no grass. Also, no feeding outdoors increased the risk on pastures with short grass, while this had no effect in paddocks with no grass. More than 50% of all horses investigated in this study had sand in the faeces. The identification of risk factors is an important step towards prevention of SGID. Further research is necessary to determine why some horses exhibit more than 5 mm sand in the sedimentation test and whether this is correlated with geophagic behaviour.

Life satisfaction across nations: the effects of women's political status and public priorities.

PubMed

York, Richard; Bell, Shannon Elizabeth

2014-11-01

Feminist scholars suggest that improving the quality of life of individuals living in nations around the world may be more readily achieved by increasing women's political power and by reorienting public-policy priorities, than by focusing primarily on economic growth. These considerations raise the question of which characteristics of societies are associated with the quality of life of the people in those societies. Here, we address this issue empirically by statistically analyzing cross-national data. We assess the effects of gender equality in the political sphere, as well as a variety of other factors, on the subjective well-being of nations, as indicated by average self-reported levels of life satisfaction. We find that people report the highest levels of life satisfaction in nations where women have greater political representation, where military spending is low, and where health care spending is high, controlling for a variety of other factors. GDP per capita, urbanization, and natural resource exploitation are not clearly associated with life satisfaction. These findings suggest that nations may be able to improve the subjective quality of life of people without increasing material wealth or natural resource consumption by increasing gender equality in politics and changing public spending priorities. Copyright © 2014 Elsevier Inc. All rights reserved.

The influence of factors of work environment and burnout syndrome on self-efficacy of medical staff.

PubMed

Nowakowska, Iwona; Rasińska, Renata; Głowacka, Maria Danuta

2016-06-02

Conditions of a healthy, friendly and safe work environment and proper work organisation increase self-efficacy and decrease or eliminate the factors causing the occurrence of burnout symptoms, all of which have a decisive impact on increasing the quality of work. The aim of the study was to analyse and assess the influence of factors of work environment and burnout syndrome on the self-efficacy of medical staff. The study comprised randomly selected professionally-active nurses working on hospital wards (N=405) on the area of two provinces in Poland. The study used the Generalized Self-Efficacy Scale, Copenhagen Burnout Inventory and a questionnaire concerning the factors that influence the process of work organisation at nursing positions in hospitals. Lower scores for self-efficacy resulted in a worse assessment of development opportunities and promotion prospects (r=-0.11), participation in the decision-making process (r=-0.11) and teamwork (r=-0.10). Lower self-efficacy contributed to the occurrence of burnout symptoms r∈[-0.19 - -0.17]. Properly shaped and used organisational factors are stimulating for professional efficiency and effectiveness, and consequently, for the quality of nursing work. Negative assessment of the factors in the work environment contributes to the occurrence of burnout symptoms and decrease in self-efficacy. Nurses with lower self-efficacy more often experienced symptoms of burnout.

Motivational factors associated with physical activity and quality of life in people with severe mental illness.

PubMed

Farholm, Anders; Sørensen, Marit; Halvari, Hallgeir

2017-12-01

There has been increasing interest for investigating the role of motivation in physical activity among people with severe mental illness (SMI). Autonomous motivation has been suggested to have a potentially important role in adoption and maintenance of physical activity. However, the knowledge about factors that facilitate autonomous motivation among people with SMI is scarce. The aim of this study was to examine factors associated with motivation for physical activity as well as the relationships between motivation, physical activity and health-related quality of life in individuals with SMI that were currently physically active. A cross-sectional design was used, and 88 participants were recruited from a public health network promoting physical activity for people with SMI. They answered a questionnaire package consisting of scales measuring psychological need support - psychological need satisfaction - and motivation for physical activity, physical activity and health-related quality of life. The majority of participants reported to be in regular physical activity. Associations between variables were tested according to the self-determination theory process model. Structural equation modelling yielded good fit of the process model to the data. Specifically, a need-supportive environment was positively associated with psychological need satisfaction, while psychological need satisfaction was positively associated with autonomous motivation and mental health-related quality of life, and negatively associated with controlled motivation and amotivation. Physical activity was positively associated with autonomous motivation and physical health-related quality of life, and negatively associated with amotivation. This study indicates that individuals with SMI can be regularly physically active when provided with suitable opportunities. Furthermore, the present results suggest that it is vital for health-care practitioners to emphasise creating a need-supportive environment when organising physical activity because such an environment is associated with both increased autonomous motivation for physical activity and mental health-related quality of life. © 2016 Nordic College of Caring Science.

Design, Fabrication and Testing of Two Dimensional Radio-Frequency Metamaterials

DTIC Science & Technology

2014-03-03

metasurfaces . These antennas are either MTM based or utilize MTMs to increase performance. The benefits of these antennas are: reduced size, lower...reduced size and increased quality factor. Finally, the antennas loaded with metasurfaces are similar to the MTM loading; in the fact that the... metasurface enhances the antenna performance instead of performing the antenna function. This type of antenna has shown increased directionality and

Quality of health news disseminated in the print media in developing countries: a case study in Iran

PubMed Central

2012-01-01

Background Mass media play an important role in keeping people up-to-date with the latest health news. This study aims at investigating the quality of health news disseminated in the print media, its course of production and factors affecting its quality. Methods In the quantitative section of the study, 410 health-related news items, published during a six-month span in the Iranian public press, underwent content analysis. In the qualitative section, focus group discussions were held with journalists, editors-in-chief and news gatekeepers. Results The quantitative phase showed that 18% of the news articles were not fit for dissemination in public. The qualitative phase illustrated that multiple factors at various levels affect the quality of news, namely poor knowledge, inadequate motivations and context-related barriers. Conclusions The quality of health news reporting is not desirable. Educational interventions need to be carried out to raise awareness among researchers and journalists. Also, certain steps should be taken to increase motivations and strengthen infrastructures, including designing guidelines and monitoring news. PMID:22873836

Teaching and Productivity.

ERIC Educational Resources Information Center

Waxman, Hersholt C.; Walberg, Herbert J.

1986-01-01

Describes a theory of educational productivity that demonstrates the relationship between instructional practices and student outcomes. Identifies and discusses nine factors related to increasing student learning: ability, development, motivation, instructional quality, learning time, home environment, classroom social group, peer group, and use…

Cardiovascular hospitalizations and associations with environmental quality

EPA Science Inventory

Cardiovascular disease has been identified as a condition that may be associated with environmental factors. Air pollution in particular has been demonstrated to be associated with cardiovascular disease and atherosclerosis, which can increase the likelihood of cardiovascular eve...

Durability assessment of prefabricated bridge elements and systems : [research summary].

DOT National Transportation Integrated Search

2015-08-01

Many states have instituted Prefabricated Bridge Elements and Systems : (PBES) and Accelerated Bridge Construction (ABC) projects to decrease : onsite construction time, work zone and user costs, and increase safety : factors; however, the quality an...

Training Workers for the Factory of the Future.

ERIC Educational Resources Information Center

Clancy, J. Anthony

1989-01-01

In the factory of the future, emphasis on quality and increased productivity creates a competitive advantage. People and computers work together in all major activities. Training is a major factor in creating that competitive advantage. (JOW)

Software technology insertion: A study of success factors

NASA Technical Reports Server (NTRS)

Lydon, Tom

1990-01-01

Managing software development in large organizations has become increasingly difficult due to increasing technical complexity, stricter government standards, a shortage of experienced software engineers, competitive pressure for improved productivity and quality, the need to co-develop hardware and software together, and the rapid changes in both hardware and software technology. The 'software factory' approach to software development minimizes risks while maximizing productivity and quality through standardization, automation, and training. However, in practice, this approach is relatively inflexible when adopting new software technologies. The methods that a large multi-project software engineering organization can use to increase the likelihood of successful software technology insertion (STI), especially in a standardized engineering environment, are described.

Impact of traffic intensity and pavement aggregate size on road dust particles loading

NASA Astrophysics Data System (ADS)

Amato, F.; Pandolfi, M.; Alastuey, A.; Lozano, A.; Contreras González, J.; Querol, X.

2013-10-01

Road dust emissions severely hamper PM10 urban air quality and their burden is expected to increase relatively to primary motor exhaust emissions. Beside the large influence of climate and meteorology, the emission potential varies widely also from one road to another due to numerous factors such as traffic conditions, pavement type and external sources. Nevertheless none of these factors is sufficiently known for a reliable description in emission modelling and for decision making in air quality management. In this study we carried out intensive road dust measurement campaigns in South Spain, with the aim of investigating the relationship between emission potential (i.e. road dust load) and traffic intensity, pavement aggregate size and distance from braking zones. Results indicate that, while no impact from braking activity can be drawn on the bulk road dust mass, an increase in traffic intensity or mean pavement aggregate size clearly reduce the single vehicle emission potential.

Perceived Neighborhood Quality and HIV-related Stigma among African Diasporic Youth; Results from the African, Caribbean, and Black Youth (ACBY) Study.

PubMed

Kerr, Jelani; Northington, Toya; Sockdjou, Tamara; Maticka-Tyndale, Eleanor

2018-01-01

Socio-environmental factors such as neighborhood quality are increasingly recognized drivers of HIV disparities. Additionally, HIV- related stigma heightens HIV vulnerability among youth in the African Diaspora. However, little research examines the intersection of neighborhood quality and HIV- related stigma. This study uses survey data (N=495) from African, Caribbean, and Black youth in a midsized city in Ontario, Canada to address this research deficit. Analysis of variance and multivariate ordinary least squares regressions were conducted to determine differences in HIV- related stigma by neighborhood quality, experiences of discrimination, HIV- knowledge, and demographic factors. Residents in more socially disordered neighborhoods (p<.05), males (p<.0001), African- Muslim youth (p<.01), and individuals with lower HIV- knowledge (p<.0001) endorsed stigmatizing beliefs more often. Addressing neighborhood disadvantage may have implications for HIV- related stigma. More research should be conducted to understand the impact of socio- environmental disadvantage and HIV- related stigma.

Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy.

PubMed

Jones, A Kyle; Pasciak, Alexander S; Wagner, Louis K

2016-07-01

To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (Eavg) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.

Transitions From Hospitals to Skilled Nursing Facilities for Persons With Dementia: A Challenging Convergence of Patient and System-Level Needs.

PubMed

Gilmore-Bykovskyi, Andrea L; Roberts, Tonya J; King, Barbara J; Kennelty, Korey A; Kind, Amy J H

2017-10-01

To describe skilled nursing facility (SNF) nurses' perspectives on the experiences and needs of persons with dementia (PwD) during hospital-to-SNF transitions and to identify factors related to the quality of these transitions. Grounded dimensional analysis study using individual and focus group interviews with nurses (N = 40) from 11 SNFs. Hospital-to-SNF transitions were largely described as distressing for PwD and their caregivers and dominated by dementia-related behavioral symptoms that were perceived as being purposely under-communicated by hospital personnel in discharge communications. SNF nurses described PwD as having unique transitional care needs, which primarily involved needing additional discharge preplanning to enable preparation of a tailored behavioral/social care plan and physical environment prior to transfer. SNF nurses identified inaccurate/limited hospital discharge communication regarding behavioral symptoms, short discharge timeframes, and limited nursing control over SNF admission decisions as factors that contributed to poorer-quality transitions producing increased risk for resident harm, rehospitalization, and negative resident/caregiver experiences. Engaged caregivers throughout the transition and the presence of high-quality discharge communication were identified as factors that improved the quality of transitions for PwD. Findings from this study provide important insight into factors that may influence transitional care quality during this highly vulnerable transition. Additional research is needed to explore the association between these factors and transitional care outcomes such as rehospitalization and caregiver stress. Future work should also explore strategies to improve inter-setting communication and care coordination for PwD exhibiting challenging behavioral symptoms. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

The pattern space factor and quality factor of cylindrical source antennas

NASA Astrophysics Data System (ADS)

Jarem, John M.

1982-09-01

For the first time the quality factor of cylindrical source antennas is derived by a plane wave expansion. The evanescent energy (and therefore the quality factor) as defined by a plane wave expansion is shown to be different from Collin and Rothschild's [IEEE Trans. Antennas Propagation AP-12, 23 (1964)] quality factor.

Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain.

PubMed

Barth, Kelly S; Balliet, Wendy; Pelic, Christine M; Madan, Alok; Malcolm, Robert; Adams, David; Morgan, Katherine; Owczarski, Stefanie; Borckardt, Jeffrey J

2014-08-01

The objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis. This study utilized a descriptive, quasi-experimental, cross sectional design. Three hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center. Participants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures. Mean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P < 0.0001), increased pain rating at the time of the office visit (β = 0.16, P = 0.03), impairment of psychological quality of life (β = -0.27, P = 0.001) and endorsement of alcohol use (β = 0.16, P = 0.03). These factors accounted for 37% of the variance in current opioid misuse scores. Depression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis. Wiley Periodicals, Inc.

Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents.

PubMed

Lin, Jesun; Hsiao, Chih-Tung; Glen, Robert; Pai, Jar-Yuan; Zeng, Sin-Huei

2014-06-01

To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions. The five-point Likert scale questionnaire administered through facetoface interviews. Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population. One hundred and eighty long-term institutional care residents. Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction. The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. © 2012 John Wiley & Sons Ltd.

Accounting for patient size in the optimization of dose and image quality of pelvis cone beam CT protocols on the Varian OBI system.

PubMed

Wood, Tim J; Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W

2015-01-01

The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined "small pelvis" reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current-time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose.

Parental feeding practices in relation to low diet quality and obesity among LSES children.

PubMed

Entin, Anna; Kaufman-Shriqui, Vered; Naggan, Lechaim; Vardi, Hillel; Shahar, Danit R

2014-01-01

To examine the relationships between parental feeding practices, diet quality, overweight, and obesity among low-socioeconomic status (LSES) preschoolers. A cohort of preschool children (aged 5-6) and their mothers was recruited from November 2009 to December 2009. To overcome seasonal and personal variation in dietary intake, 3 replications of the Food Frequency Questionnaire (FFQ) and a parental Feeding Practices Questionnaire (CFPQ) were obtained in person at baseline, 3 months from baseline, and 6 months from baseline. Anthropometric measurements were attained at preschool class on the same dates. Scores of the 12 factors of the CFPQ were calculated and related to dietary intake. Correlation coefficients between the mean energy and fat intake and CFPQ factors' scores were calculated. One-way analysis of variance with post hoc analyses was used to compare nutrient intake and anthropometric measures across CFPQ tertiles. Preschoolers (n = 63), aged 64.4 ± 5.0 months (47% boys), were recruited. Unhealthy feeding practices including food as a reward for good behavior and food restriction for promoting health were associated with increased consumption of junk food, sweets, and snacks. Among healthy feeding practices, encouraging balance and food variety and healthy eating modeled by parents were associated with increased vegetable consumption and smaller waist circumference. Weight was negatively associated with factors that reflect parental pressure and food restriction for weight control. Our data showed that certain feeding practices relate to a higher diet quality and lower weight and waist circumference. These practices may be encouraged in order to improve diet quality and prevent overweight and obesity.

Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions.

PubMed

Jarrar, Mu'taman; Abdul Rahman, Hamzah; Don, Mohammad Sobri

2015-10-20

Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme "1 Care for 1 Malaysia" in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.

Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions

PubMed Central

Jarrar, Mu’taman; Rahman, Hamzah Abdul; Don, Mohammad Sobri

2016-01-01

Background and Objective: Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Design: Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. Results: The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme “1 Care for 1 Malaysia” in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. Conclusions: There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia. PMID:26755459

Incentives for cooperation in quality improvement among hospitals--the impact of the reimbursement system.

PubMed

Kesteloot, K; Voet, N

1998-12-01

Up to now, few analytical models have studied the incentives for cooperation in quality improvements among hospitals. Only those dealing with reimbursement systems have shown that, from the point of view of individual or competing hospitals, retrospective reimbursement is more likely to encourage quality improvements than prospective financing, while the reverse holds for efficiency improvements. This paper studies the incentives to improve the quality of hospital care, in an analytical model, taking into account the possibility of cooperative agreements, price besides non-price (quality) competition and quality improvements that may simultaneously increase demand, increase or reduce costs and spill over to rival hospitals. In this setting quality improvement efforts rise with the rate of prospective reimbursement, while the impact of the rate of retrospective reimbursement is ambiguous, but likely to be negative for quality improvements that are highly cost-reducting and create large spillovers. Cooperation may lead to more or less quality improvement than non-cooperative conduct, depending on the magnitude of spillovers and the degree of product market competition, relative to the net effect of quality on profits and the share of costs that is reimbursed retrospectively. Finally, the stability of cooperative agreements, supported by grim trigger strategies, is shown to depend upon exactly the opposite interaction between these factors.

An analysis of growth factors of rapeseed at modern resource-saving technology

NASA Astrophysics Data System (ADS)

Filipova, M.; Zheleva, I.; Sulejmenova, N.; Abildaev, E.

2017-10-01

Nowadays the production of rapeseed has grown due to the variety of existing possibilities for its using. This calls the search for new, resource-saving technologies for its growing in Republic of Kazakhstan. For these new technologies it is needed to know which are the factors that influence the production of rapeseed and how each factor influence the production and the quality of this culture. The careful study of these factors is necessary for better understudying the process of the growing aimed increasing the yields and quantity of the rapeseed.

Final report on LDRD project : narrow-linewidth VCSELs for atomic microsystems.

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

Chow, Weng Wah; Geib, Kent Martin; Peake, Gregory Merwin

2011-09-01

Vertical-cavity surface-emitting lasers (VCSELs) are well suited for emerging photonic microsystems due to their low power consumption, ease of integration with other optical components, and single frequency operation. However, the typical VCSEL linewidth of 100 MHz is approximately ten times wider than the natural linewidth of atoms used in atomic beam clocks and trapped atom research, which degrades or completely destroys performance in those systems. This report documents our efforts to reduce VCSEL linewidths below 10 MHz to meet the needs of advanced sub-Doppler atomic microsystems, such as cold-atom traps. We have investigated two complementary approaches to reduce VCSEL linewidth:more » (A) increasing the laser-cavity quality factor, and (B) decreasing the linewidth enhancement factor (alpha) of the optical gain medium. We have developed two new VCSEL devices that achieved increased cavity quality factors: (1) all-semiconductor extended-cavity VCSELs, and (2) micro-external-cavity surface-emitting lasers (MECSELs). These new VCSEL devices have demonstrated linewidths below 10 MHz, and linewidths below 1 MHz seem feasible with further optimization.« less

Lifestyle and semen quality: role of modifiable risk factors.

PubMed

Jurewicz, Joanna; Radwan, Michał; Sobala, Wojciech; Ligocka, Danuta; Radwan, Paweł; Bochenek, Michał; Hanke, Wojciech

2014-02-01

The relationship between exposure to lifestyle factors and adverse effects on human reproductive health is debated in the scientific literature and these controversies have increased public and regulatory attention. The aim of the study was to examine the association between modifiable lifestyle factors and main semen parameters, sperm morphology, and sperm chromatin structure. The study population consisted of 344 men who were attending an infertility clinic for diagnostic purposes with normal semen concentration of 20-300 M/ml or with slight oligozoospermia (semen total concentration of 15-20 M/ml) [WHO 1999]. Participants were interviewed and provided semen samples. The interview included questions about demographics, socio-economic status, medical history, lifestyle factors (consumption of alcohol, tobacco, coffee intake, cell phone and sauna usage), and physical activity. The results of the study suggest that lifestyle factors may affect semen quality. A negative association was found between increased body mass index (BMI) and semen volume (p = 0.03). Leisure time activity was positively associated with sperm concentration (p = 0.04) and coffee drinking with the percentage of motile sperm cells, and the percentage of sperm head and neck abnormalities (p = 0.01, p = 0.05, and p = 0.03, respectively). Drinking red wine 1-3 times per week was negatively related to sperm neck abnormalities (p = 0.01). Additionally, using a cell phone more than 10 years decreased the percentage of motile sperm cells (p = 0.02). Men who wore boxer shorts had a lower percentage of sperm neck abnormalities (p = 0.002) and percentage of sperm with DNA damage (p = 0.02). These findings may have important implications for semen quality and lifestyle.

[Profile of the informal carer associated with the clinical management of the Alzheimer's disease patient refractory to symptomatic treatment of the disease].

PubMed

Molinuevo, J L; Hernández, B

2011-11-01

Many factors influence the satisfaction and quality of life of informal caregivers of non-responder patients with Alzheimer disease (AD). Among these include, the course of the disease, cognitive impairment and behavioural disturbances of the patient, the level of family support and caregiver inherent factors such as, time commitment, psychological status and awareness of the disease. The aim of this work is to determine the profile of informal caregivers of non-responder AD patients and to evaluate the different factors that affect their quality of life, burden and overall satisfaction with treatment. We carried out a prospective and multicentre study in Spain that included a total of 249 AD patients unresponsive to anticholinesterase treatment, and their informal caregivers. We evaluated caregivers' quality of life with the SF-36 questionnaire and their associated burden with the Zarit scale, both validated for Spain. The severity and progression of the disease was quantified according to Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE). Caregiver burden showed a significant increase with the time elapsed since the start of the study, while treatment satisfaction increased slightly with this factor. Caregiver burden is highly correlated with CDR scale on patient symptoms, both in the initial visit (p<.0001) and final visit (p=.0001). Caregiver satisfaction with treatment was mainly affected by the degree of change in cognitive deterioration experienced by the patient between the two visits (p=.021). Overall satisfaction with the treatment stated by the caregiver does not correlate with compliance to treatment, but it does so with the changes in patient's cognitive impairment, a factor that also influences caregiver's burden. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Quality of physical therapy from a patient's perspective; factor analysis on web-based survey data revealed three dimensions on patient experiences with physical therapy.

PubMed

Scholte, Marijn; Calsbeek, Hilly; Nijhuis-van der Sanden, Maria W G; Braspenning, Jozé

2014-06-18

Assessing quality of care from the patient's perspective has changed from patient satisfaction to the more general term patient experience, as satisfaction measures turned out to be less discriminative due to high scores. Literature describes four to ten dimensions of patient experience, tailored to specific conditions or types of care. Given the administrative burden on patients, less dimensions and items could increase feasibility. Ten dimensions of patient experiences with physical therapy (PT) were proposed in the Netherlands in a consensus-based process with patients, physical therapists, health insurers, and policy makers. The aim of this paper is to detect the number of dimensions from data of a field study using factor analysis at item level. A web-based survey yielded data of 2,221 patients from 52 PT practices on 41 items. Principal component factor analysis at item level was used to assess the proposed distinction between the ten dimensions. Factor analysis revealed two dimensions: 'personal interaction' and 'practice organisation'. The dimension 'patient reported outcome' was artificially established. The three dimensions 'personal interaction' (14 items) (median(practice level) = 91.1; IQR = 2.4), 'practice organisation' (9 items) (median(practice level) = 88.9; IQR = 6.0) and 'outcome' (3 items) (median(practice level) = 80.6; IQR = 19.5) reduced the number of dimensions from ten to three and the number of items by more than a third. Factor analysis revealed three dimensions and achieved an item reduction of more than a third. It is a relevant step in the development process of a quality measurement tool to reduce respondent burden, increase clarity, and promote feasibility.

Patient Factors Associated with Quality of Life in Atrial Fibrillation Randolph—Determinants of Quality of Life in Atrial Fibrillation

PubMed Central

Randolph, Tiffany C.; Simon, DaJuanicia N.; Thomas, Laine; Allen, Larry A.; Fonarow, Gregg C.; Gersh, Bernard J.; Kowey, Peter R.; Reiffel, James A.; Naccarelli, Gerald V.; Chan, Paul S.; Spertus, John A.; Peterson, Eric D.; Piccini, Jonathan P.

2016-01-01

Background As treatment options for atrial fibrillation (AF) increase, more attention is focused on patients’ experiences and quality of life (QoL). However, little is known about the factors associated with these outcomes. Methods The Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) is a disease-specific QoL tool for AF, with domain and summary scores ranging from 0 (the worst QoL) to 100. Using multivariable linear regression, we evaluated factors associated with baseline AFEQT Summary and Subscale Scores in ORBIT AF, a large, community-based AF registry. Independent associations were reported as coefficient estimates in scores and 95% confidence intervals (CI). Results Overall, AFEQT was assessed in 2,007 AF outpatients from 99 sites. Median age (IQR) was 76 years (67-82) and 43% were female. The median AFEQT summary score was 82 (67-94). Female sex, younger age, new onset AF, higher heart rate, obstructive sleep apnea, symptomatic heart failure (HF), chronic obstructive pulmonary disease and coronary artery disease were all independently associated with reduced QoL. Female sex [Estimate −7.03, 95% CI (−9.31, −4.75)] and new onset versus permanent AF [Estimate −7.44, 95% CI (−11.03, −3.84)] were independently associated with increased symptoms. NYHA Class III or IV HF [Estimate -14.44, 95% CI (−19.46, −8.76)] and female sex [Estimate −7.91, 95% CI (−9.95, −5.88)] were most independently associated with impaired daily activities. Conclusions QoL in patients with AF varies widely and is associated with several patient factors. Understanding patient factors independently associated with worse QoL can be a foundation for tailoring treatment. PMID:27914493

The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran.

PubMed

Nejad, Mina Motaghi; Nejad, Ghodratollah Shakeri; Tavakol, Heshmatollah; Cheraghi, Maria

2017-06-01

The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t -test, and χ 2 were used. The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors ( p < 0.001), enabling factors, reinforcing factors and behavioral factors were significantly increased ( p < 0.001) as compared to the control group. A significant difference was observed in the mean scores of quality of life in two groups after the intervention ( p < 0.001), and the quality of life of patients in the experimental group was improved after the training intervention. The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

Assessment of medical care by elderly people: general satisfaction and physician quality.

PubMed Central

Lee, Y; Kasper, J D

1998-01-01

OBJECTIVE: To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. DATA SOURCES/STUDY SETTING: Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. STUDY DESIGN: Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. PRINCIPAL FINDINGS: While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. CONCLUSIONS: Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system. Images Figure 1 PMID:9460484

Quality of non-mydriatic digital fundus photography obtained by nurse practitioners in the emergency department: the FOTO-ED study

PubMed Central

Lamirel, Cédric; Bruce, Beau B.; Wright, David W.; Delaney, Kevin P.; Newman, Nancy J.; Biousse, Valérie

2011-01-01

Objective Non-mydriatic fundus photography by non-ophthalmic trained personnel has recently been shown to be a potential alternative to direct ophthalmoscopy in the emergency department (ED). We evaluated the reliability of a novel quality rating scale and applied this scale to non-mydriatic fundus photographs taken during routine ED patient encounters to determine factors associated with diminished photograph quality. Design Prospective, cross-sectional Participants 350 patients enrolled in the Fundus photography vs. Ophthalmoscopy Trials Outcomes in the Emergency Department (FOTO-ED) study were photographed by nurse practitioners after <30 minutes of training followed by supervision. Methods Photographs of both eyes were graded for quality on two occasions by two neuro-ophthalmologists. Four regions were independently evaluated for quality: optic disc, macula, superior and inferior vascular arcades. Quality as a function of the number of photographs taken was evaluated by Kaplan-Meier analysis. Mixed effects ordinal logistic regression was used to evaluate for predictors of image quality while accounting for the repeated measures design. Main Outcome Measure Overall photographic quality (1–5 scale, 5 best). Results We evaluated 1734 photographs. Inter- and intra-observer agreements between neuro-ophthalmologists were very good (weighted kappa:0.84–0.87). Quality of the optic disc area was better than those of other retinal areas (p<0.002). Kaplan-Meier analysis showed that if a high-quality photograph of an eye was not obtained by the third attempt it was unlikely that one would be obtained at all. A 10 second increase in the inter-photograph interval before a total of forty seconds increased the odds of a one unit higher quality rating by 1.81 times (95%CI: 1.68–1.98), and a ten year increase in age decreased the odds by 0.76 times (95%CI: 0.69–0.85). Black patients had 0.42 times (95%CI: 0.28–0.63) the odds of a one unit higher quality rating compared to whites. Conclusions Our 5-point scale is a reliable measure of non-mydriatic photograph quality. The region of interest, interphotograph interval, age, and race are significant predictors of image quality for non-mydriatic photographs taken by nurse practitioners in the ED. Addressing these factors may have a direct impact on the successful implementation of non-mydriatic fundus photography into the ED. PMID:22218140

Paediatric cerebrovascular CT angiography—towards better image quality

PubMed Central

Thust, Stefanie C.; Chong, Wui Khean Kling; Gunny, Roxana; Mazumder, Asif; Poitelea, Marius; Welsh, Anna; Ederies, Ash

2014-01-01

Background Paediatric cerebrovascular CT angiography (CTA) can be challenging to perform due to variable cardiovascular physiology between different age groups and the risk of movement artefact. This analysis aimed to determine what proportion of CTA at our institution was of diagnostic quality and identify technical factors which could be improved. Materials and methods a retrospective analysis of 20 cases was performed at a national paediatric neurovascular centre assessing image quality with a subjective scoring system and Hounsfield Unit (HU) measurements. Demographic data, contrast dose, flow rate and triggering times were recorded for each patient. Results Using a qualitative scoring system, 75% of studies were found to be of diagnostic quality (n=9 ‘good’, n=6 ‘satisfactory’) and 25% (n=5) were ‘poor’. Those judged subjectively to be poor had arterial contrast density measured at less than 250 HU. Increased arterial opacification was achieved for cases performed with an increased flow rate (2.5-4 mL/s) and higher intravenous contrast dose (2 mL/kg). Triggering was found to be well timed in nine cases, early in four cases and late in seven cases. Of the scans triggered early, 75% were poor. Of the scans triggered late, less (29%) were poor. Conclusions High flow rates (>2.5 mL/s) were a key factor for achieving high quality paediatric cerebrovascular CTA imaging. However, appropriate triggering by starting the scan immediately on contrast opacification of the monitoring vessel plays an important role and could maintain image quality when flow rates were lower. Early triggering appeared more detrimental than late. PMID:25525579

Student-Teacher Relationships As a Protective Factor for School Adjustment during the Transition from Middle to High School

PubMed Central

Longobardi, Claudio; Prino, Laura E.; Marengo, Davide; Settanni, Michele

2016-01-01

A robust body of research has identified school transitions during adolescence, and in particular the transition from middle to high school, as one of the riskiest phases for school failure, being characterized by significant social, emotional and behavioral changes. This transition is critical even with respect to academic achievement: in Italy, the highest frequency of school dropout can be observed in the 9th and 10th grades, partly as a consequence of poor adjustment to the new school context. The impact of students' relationships with their teachers may be particularly relevant during critical developmental periods. Indeed, student-teacher relationships have been widely recognized as protective factors in school adjustment and, in case of negative relationships, also as a factor that increases the risk of maladjustment. Positive and affective student-teacher relationships may play an important role in students' adaptation to the school environment, favoring both academic achievement and adaptive behaviors. The aim of this study was to investigate the effects of the quality of teacher-student relationships, as perceived by pupils, on academic achievement, and problem and prosocial behaviors during the relevant school transition. The sample consisted of 122 students (55% female). We employed a self-report questionnaire to collect information on: demographic characteristics, quality of the relationship with teachers, problem and prosocial behaviors, and academic achievement. Students filled in the questionnaires twice: once during the 8th grade and 1 year later, during their first year of high school (9th grade). Regression analyses indicated that both average and varying levels of closeness with teachers significantly predicted changes in academic achievement: A perceived increase in closeness in 9th grade, as well as a higher mean closeness level, was associated with an increase in academic achievement. In turn, an increase in the level of perceived conflict with teachers significantly predicted an increase in conduct problems and hyperactive behaviors. This study supports the significance of student-teacher relationships as a protective factor during students' transition to high-school. Our findings also highlight the importance of relationship quality in preventing students' risk of school failure. PMID:28066305

Student-Teacher Relationships As a Protective Factor for School Adjustment during the Transition from Middle to High School.

PubMed

Longobardi, Claudio; Prino, Laura E; Marengo, Davide; Settanni, Michele

2016-01-01

A robust body of research has identified school transitions during adolescence, and in particular the transition from middle to high school, as one of the riskiest phases for school failure, being characterized by significant social, emotional and behavioral changes. This transition is critical even with respect to academic achievement: in Italy, the highest frequency of school dropout can be observed in the 9th and 10th grades, partly as a consequence of poor adjustment to the new school context. The impact of students' relationships with their teachers may be particularly relevant during critical developmental periods. Indeed, student-teacher relationships have been widely recognized as protective factors in school adjustment and, in case of negative relationships, also as a factor that increases the risk of maladjustment. Positive and affective student-teacher relationships may play an important role in students' adaptation to the school environment, favoring both academic achievement and adaptive behaviors. The aim of this study was to investigate the effects of the quality of teacher-student relationships, as perceived by pupils, on academic achievement, and problem and prosocial behaviors during the relevant school transition. The sample consisted of 122 students (55% female). We employed a self-report questionnaire to collect information on: demographic characteristics, quality of the relationship with teachers, problem and prosocial behaviors, and academic achievement. Students filled in the questionnaires twice: once during the 8th grade and 1 year later, during their first year of high school (9th grade). Regression analyses indicated that both average and varying levels of closeness with teachers significantly predicted changes in academic achievement: A perceived increase in closeness in 9th grade, as well as a higher mean closeness level, was associated with an increase in academic achievement. In turn, an increase in the level of perceived conflict with teachers significantly predicted an increase in conduct problems and hyperactive behaviors. This study supports the significance of student-teacher relationships as a protective factor during students' transition to high-school. Our findings also highlight the importance of relationship quality in preventing students' risk of school failure.

A Systematic Review of the Factors Influencing Ethnic Minority Women's Cervical Cancer Screening Behavior: From Intrapersonal to Policy Level.

PubMed

Chan, Dorothy N S; So, Winnie K W

Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate. The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified. A literature search was conducted using Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, PsycINFO, and PubMed. Furthermore, 1390 articles were retrieved, of which 24 met the inclusion criteria. Critical appraisal was performed by means of a quality assessment tool. The findings were summarized in tabular and narrative forms. The findings showed that certain factors commonly affected ethnic minority women's screening behavior, including knowledge, attitude and perceptions, physician's recommendation, quality of care and service, language, and acculturation. Culture-related factors, religion, and acculturation exhibited close interrelationships with the attitude and perceptions factor, resulting in behavioral change. The review sheds light on how common or unique are the factors across ethnic minorities and how these factors interact to influence behavior. Further studies are warranted to develop and test empirically a comprehensive model leading to a better understanding of the interrelationships between multiple factors. The model should be useful in informing policy makers about appropriate resource allocation and in guiding the development of culturally relevant programs to increase screening uptake.

Potential for use of environmental factors in urban planning

NASA Astrophysics Data System (ADS)

Teixeira da Silva, Ricardo; van der Ploeg, Martine; van Delden, Hedwig; Fleskens, Luuk

2016-04-01

Projections for population growth estimate, on top of the current 7.4 billion world population, an increase of 2 billion people for the next 40 years. It is also projected that 66 per cent of the world population in 2050 will live in urban areas. To accommodate the urban population growth cities are changing continuously land cover to urban areas. Such changes are a threat for natural resources and food production systems stability and capability to provide food and other functions. However, little has been done concerning a rational soil management for food production in urban and peri-urban areas. This study focuses on the assessment of soil lost due to urban expansion and discusses the potential loss regarding the quality of the soil for food production and environmental functions. It is relevant to increase the knowledge on the role of soils in peri-urban areas and in the interaction of physical, environmental and social factors. The methodology consists of assessing the soil quality in and around urban and peri-urban areas. It focuses particularly on the physical properties and the environmental factors, for two periods of time and account the potential losses due to urban expansion. This project is on-going, therefore current advances will be presented and will look for a discussion on the contribution of soil quality for decision-making and land management in urban and peri-urban areas.

Organizational Factors Associated With Perceived Quality of Patient Care in Closed Intensive Care Units.

PubMed

McIntosh, Nathalie; Oppel, Eva; Mohr, David; Meterko, Mark

2017-09-01

Improving patient care quality in intensive care units is increasingly important as intensive care unit services account for a growing proportion of hospital services. Organizational factors associated with quality of patient care in such units have been identified; however, most were examined in isolation, making it difficult to assess the relative importance of each. Furthermore, though most intensive care units now use a closed model, little research has been done in this specific context. To examine the relative importance of organizational factors associated with patient care quality in closed intensive care units. In a national exploratory, cross-sectional study focused on intensive care units at US Veterans Health Administration acute care hospitals, unit directors were surveyed about nurse and physician staffing, work resources and training, patient care coordination, rounding, and perceptions of patient care quality. Administrative records yielded data on patient volume and facility teaching status. Descriptive statistics, bivariate analyses, and regression modeling were used for data analysis. Sixty-nine completed surveys from directors of closed intensive care units were returned. Regression model results showed that better patient care coordination (β = 0.43; P = .01) and having adequate work resources (β = 0.26; P = .02) were significantly associated with higher levels of patient care quality in such units ( R 2 = 0.22). Augmenting work resources and/or focusing limited hospital resources on improving patient care coordination may be the most productive ways to improve patient care quality in closed intensive care units. ©2017 American Association of Critical-Care Nurses.

The space station: Human factors and productivity

NASA Technical Reports Server (NTRS)

Gillan, D. J.; Burns, M. J.; Nicodemus, C. L.; Smith, R. L.

1986-01-01

Human factor researchers and engineers are making inputs into the early stages of the design of the Space Station to improve both the quality of life and work on-orbit. Effective integration of the human factors information related to various Intravehicular Activity (IVA), Extravehicular Activity (EVA), and teletobotics systems during the Space Station design will result in increased productivity, increased flexibility of the Space Stations systems, lower cost of operations, improved reliability, and increased safety for the crew onboard the Space Station. The major features of productivity examined include the cognitive and physical effort involved in work, the accuracy of worker output and ability to maintain performance at a high level of accuracy, the speed and temporal efficiency with which a worker performs, crewmember satisfaction with their work environment, and the relation between performance and cost.

Positive factors associated with quality of life among Chinese patients with renal carcinoma: a cross-sectional study.

PubMed

Liu, Jiao; Gong, Da-Xin; Zeng, Yu; Li, Zhen-Hua; Kong, Chui-Ze

2018-01-01

Quality of life and positive psychological variables has become a focus of concern in patients with renal carcinoma. However, the integrative effects of positive psychological variables on the illness have seldom been reported. The aims of this study were to evaluate the quality of life and the integrative effects of hope, resilience and optimism on the quality of life among Chinese renal carcinoma patients. A cross-sectional study was conducted at the First Hospital of China Medical University. 284 participants completed questionnaires consisting of demographic and clinical characteristics, EORTC QLQ-C30, Adult Hope Scale, Resilience Scale-14 and Life Orientation Scale-Revised from July 2013 to July 2014. Pearson's correlation and hierarchical regression analyses were performed to explore the effects of related factors. Hope, resilience and optimism were significantly associated with quality of life. Hierarchical regression analyses indicated that hope, resilience and optimism as a whole accounted for 9.8, 24.4 and 21.9% of the variance in the global health status, functioning status and symptom status, respectively. The low level of quality of life for Chinese renal carcinoma patients should receive more attention from Chinese medical institutions. Psychological interventions to increase hope, resilience and optimism may be essential to enhancing the quality of life of Chinese cancer patients.

Quality assessment tools add value.

PubMed

Paul, L

1996-10-01

The rapid evolution of the health care marketplace can be expected to continue as we move closer to the 21st Century. Externally-imposed pressures for cost reduction will increasingly be accompanied by pressure within health care organizations as risk-sharing reimbursement arrangements become more commonplace. Competitive advantage will be available to those organizations that can demonstrate objective value as defined by the cost-quality equation. The tools an organization chooses to perform quality assessment will be an important factor in its ability to demonstrate such value. Traditional quality assurance will in all likelihood continue, but the extent to which quality improvement activities are adopted by the culture of an organization may determine its ability to provide objective evidence of better health status outcomes.

Oocyte holding in the Iberian red deer (Cervus elaphus hispanicus): Effect of initial oocyte quality and epidermal growth factor addition on in vitro maturation.

PubMed

Macías-García, B; González-Fernández, L; Matilla, E; Hernández, N; Mijares, J; Sánchez-Margallo, F M

2018-02-01

Current in vitro embryo production protocols in the Iberian red deer (Cervus elaphus hispanicus) need to be optimized; oocyte harvesting in situ followed by overnight holding could reduce the human effort and shipping costs. In our work, post-mortem ovaries were retrieved, and the oocytes were harvested and allocated to G1 group (good quality) or G2 + G3 group (low quality). The oocytes were separately subjected to immediate in vitro maturation (IVM) or held overnight in a holding medium composed of 40% of TCM 199 with Earle's salts, 40% TCM 199 with Hanks' salts and 20% fetal bovine serum (FBS), at room temperature (16 hr). In vitro maturation was carried out in a basal medium supplemented or not with 50 ng/ml of epidermal growth factor (EGF). Our data showed that addition of EGF to the maturation medium increases the percentage of G1 oocytes reaching metaphase II (3.9% vs. 50%, basal vs. EGF; p < .001) and decreased their degeneration rate (69.9% vs. 22.2%, basal vs. EGF; p < .01) when oocytes were immediately matured. Overnight holding increased the meiotic competence of G1 oocytes (37.5% matured in basal medium) and EGF increased prophase arrest in G2 + G3 oocytes (16.1% vs. 38.8% in germinal vesicle [GV] stage in basal medium vs. EGF added medium; p < .05). Our data demonstrate that oocyte holding can be used in Iberian red deer oocytes. Interestingly, EGF addition increases the oocytes' meiotic competence in immediately matured oocytes but not after oocyte holding depending upon initial oocyte quality. © 2017 Blackwell Verlag GmbH.

Water-quality assessment of part of the Upper Mississippi River basin, Minnesota and Wisconsin - Ground-water quality along a flow system in the Twin Cities metropolitan area, Minnesota, 1997-98

USGS Publications Warehouse

Andrews, William J.; Stark, James R.; Fong, Alison L.; Fallon, James D.

2005-01-01

Although land use had substantial effects on ground-water quality, the distribution of contaminants in the aquifer also is affected by complex combinations of factors and processes that include sources of natural and anthropogenic contaminants, three-dimensional advective flow, physical and hydrologic settings, age and evolution of ground water, and transformation of chemical compounds along the flow system. Compounds such as nitrate and dissolved oxygen were greatest in water samples from the upgradient end of the flow system and near the water table. Specific conductance and dissolved solids increased along the flow system and with depth due to increase in residence time in the flow system and dissolution of aquifer materials.

Conditions of transfer and quality of food.

PubMed

Southern, K J; Rasekh, J G; Hemphill, F E; Thaler, A M

2006-08-01

Many factors contribute to the production of safe foods of animal origin. Initiatives for an integrated approach to food safety recognise the importance of optimising transportation conditions to ensure on-farm interventions are preserved. Physical, microbial, and environmental hazards during the transportation process may adversely affect the safety and quality of meat, poultry, and egg products. Additionally, the stress level in animals can be raised by transportation conditions, potentially causing increased pathogen shedding in carrier animals which exposes other animals to possible contamination. The physiological effects of stress on animals can reduce the quality of meat, poultry, and egg products produced by the animals, thus decreasing the economic value of the animal. Increased globalisation of markets provides an incentive for transportation standards of food animals within a country as well as transportation standards between countries.

Spatial resampling of IDR frames for low bitrate video coding with HEVC

NASA Astrophysics Data System (ADS)

Hosking, Brett; Agrafiotis, Dimitris; Bull, David; Easton, Nick

2015-03-01

As the demand for higher quality and higher resolution video increases, many applications fail to meet this demand due to low bandwidth restrictions. One factor contributing to this problem is the high bitrate requirement of the intra-coded Instantaneous Decoding Refresh (IDR) frames featuring in all video coding standards. Frequent coding of IDR frames is essential for error resilience in order to prevent the occurrence of error propagation. However, as each one consumes a huge portion of the available bitrate, the quality of future coded frames is hindered by high levels of compression. This work presents a new technique, known as Spatial Resampling of IDR Frames (SRIF), and shows how it can increase the rate distortion performance by providing a higher and more consistent level of video quality at low bitrates.

How to improve vital sign data quality for use in clinical decision support systems? A qualitative study in nine Swedish emergency departments.

PubMed

Skyttberg, Niclas; Vicente, Joana; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2016-06-04

Vital sign data are important for clinical decision making in emergency care. Clinical Decision Support Systems (CDSS) have been advocated to increase patient safety and quality of care. However, the efficiency of CDSS depends on the quality of the underlying vital sign data. Therefore, possible factors affecting vital sign data quality need to be understood. This study aims to explore the factors affecting vital sign data quality in Swedish emergency departments and to determine in how far clinicians perceive vital sign data to be fit for use in clinical decision support systems. A further aim of the study is to provide recommendations on how to improve vital sign data quality in emergency departments. Semi-structured interviews were conducted with sixteen physicians and nurses from nine hospitals and vital sign documentation templates were collected and analysed. Follow-up interviews and process observations were done at three of the hospitals to verify the results. Content analysis with constant comparison of the data was used to analyse and categorize the collected data. Factors related to care process and information technology were perceived to affect vital sign data quality. Despite electronic health records (EHRs) being available in all hospitals, these were not always used for vital sign documentation. Only four out of nine sites had a completely digitalized vital sign documentation flow and paper-based triage records were perceived to provide a better mobile workflow support than EHRs. Observed documentation practices resulted in low currency, completeness, and interoperability of the vital signs. To improve vital sign data quality, we propose to standardize the care process, improve the digital documentation support, provide workflow support, ensure interoperability and perform quality control. Vital sign data quality in Swedish emergency departments is currently not fit for use by CDSS. To address both technical and organisational challenges, we propose five steps for vital sign data quality improvement to be implemented in emergency care settings.

Relative importance of local- and large-scale drivers of alpine soil microarthropod communities.

PubMed

Mitchell, Ruth J; Urpeth, Hannah M; Britton, Andrea J; Black, Helaina; Taylor, Astrid R

2016-11-01

Nitrogen (N) deposition and climate are acknowledged drivers of change in biodiversity and ecosystem function at large scales. However, at a local scale, their impact on functions and community structure of organisms is filtered by drivers like habitat quality and food quality/availability. This study assesses the relative impact of large-scale factors, N deposition and climate (rainfall and temperature), versus local-scale factors of habitat quality and food quality/availability on soil fauna communities at 15 alpine moss-sedge heaths along an N deposition gradient in the UK. Habitat quality and food quality/availability were the primary drivers of microarthropod communities. No direct impacts of N deposition on the microarthropod community were observed, but induced changes in habitat quality (decline in moss cover and depth) and food quality (decreased vegetation C:N) associated with increased N deposition strongly suggest an indirect impact of N. Habitat quality and climate explained variation in the composition of the Oribatida, Mesostigmata, and Collembola communities, while only habitat quality significantly impacted the Prostigmata. Food quality and prey availability were important in explaining the composition of the oribatid and mesostigmatid mite communities, respectively. This study shows that, in alpine habitats, soil microarthropod community structure responds most strongly to local-scale variation in habitat quality and food availability rather than large-scale variation in climate and pollution. However, given the strong links between N deposition and the key habitat quality parameters, we conclude that N deposition indirectly drives changes in the soil microarthropod community, suggesting a mechanism by which large-scale drivers indirectly impacts these functionally important groups.

[The Role of Resilience Factors in Informal Caregivers of Dementia Patients - A Review on Selected Factors].

PubMed

Kunzler, Angela; Skoluda, Nadine; Nater, Urs

2018-01-01

In the face of demographic change, the informal care of dementia patients is becoming increasingly important. However, due to dementia symptoms as well as persisting care demands, this subgroup of informal caregivers is confronted with a large number of stressors resulting in chronic stress and impaired physical and mental health in many caregivers. Based on the current research on resilience (i. e., maintaining or regaining health despite stress and adversities), there is increasing interest in identifying resilience factors that may serve as resources to cope with informal care and protect caregivers against health problems. The review discusses the role of resilience factors in the association between ongoing caregiving stress and health. In analyzing the current state of research on resilience factors for dementia caregivers, we focus on the factors self-efficacy, relationship quality, and social support. © Georg Thieme Verlag KG Stuttgart · New York.

Looking beyond patients: Can parents' quality of life predict asthma control in children?

PubMed

Cano-Garcinuño, Alfredo; Mora-Gandarillas, Isabel; Bercedo-Sanz, Alberto; Callén-Blecua, María Teresa; Castillo-Laita, José Antonio; Casares-Alonso, Irene; Forns-Serrallonga, Dolors; Tauler-Toro, Eulàlia; Alonso-Bernardo, Luz María; García-Merino, Águeda; Moneo-Hernández, Isabel; Cortés-Rico, Olga; Carvajal-Urueña, Ignacio; Morell-Bernabé, Juan José; Martín-Ibáñez, Itziar; Rodríguez-Fernández-Oliva, Carmen Rosa; Asensi-Monzó, María Teresa; Fernández-Carazo, Carmen; Murcia-García, José; Durán-Iglesias, Catalina; Montón-Álvarez, José Luis; Domínguez-Aurrecoechea, Begoña; Praena-Crespo, Manuel

2016-07-01

Social and family factors may influence the probability of achieving asthma control in children. Parents' quality of life has been insufficiently explored as a predictive factor linked to the probability of achieving disease control in asthmatic children. Determine whether the parents' quality of life predicts medium-term asthma control in children. Longitudinal study of children between 4 and 14 years of age, with active asthma. The parents' quality of life was evaluated using the specific IFABI-R instrument, in which scores were higher for poorer quality of life. Its association with asthma control measures in the child 16 weeks later was analyzed using multivariate methods, adjusting the effect for disease, child and family factors. The data from 452 children were analyzed (median age 9.6 years, 63.3% males). The parents' quality of life was predictive for asthma control; each point increase on the initial IFABI-R score was associated with an adjusted odds ratio (95% confidence interval) of 0.56 (0.37-0.86) for good control of asthma on the second visit, 2.58 (1.62-4.12) for asthma exacerbation, 2.12 (1.33-3.38) for an unscheduled visit to the doctor, and 2.46 (1.18-5.13) for going to the emergency room. The highest quartile for the IFABI-R score had a sensitivity of 34.5% and a specificity of 82.2% to predict poorly controlled asthma. Parents' poorer quality of life is related to poor, medium-term asthma control in children. Assessing the parents' quality of life could aid disease management decisions. Pediatr Pulmonol. 2016;51:670-677. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Ambient air quality trends and driving factor analysis in Beijing, 1983-2007.

PubMed

Zhang, Ju; Ouyang, Zhiyun; Miao, Hong; Wang, Xiaoke

2011-01-01

The rapid development in Beijing, the capital of China, has resulted in serious air pollution problems. Meanwhile great efforts have been made to improve the air quality, especially since 1998. The variation in air quality under the interaction of pollution and control in this mega city has attracted much attention. We analyzed the changes in ambient air quality in Beijing since the 1980's using the Daniel trend test based on data from long-term monitoring stations. The results showed that different pollutants displayed three trends: a decreasing trend, an increasing trend and a flat trend. SO2, dustfall, B[a]P, NO2 and PM10 fit decreasing trend pattern, while NOx showed an increasing trend, and CO, ozone pollution, total suspended particulate (TSP), as well as Pb fit the flat trend. The cause of the general air pollution in Beijing has changed from being predominantly related to coal burning to mixed traffic exhaust and coal burning related pollution. Seasonally, the pollution level is typically higher during the heating season from November to the following March. The interaction between pollution sources change and implementation of air pollution control measures was the main driving factor that caused the variation in air quality. Changes of industrial structure and improved energy efficiency, the use of clean energy and preferred use of clean coal, reduction in pollution sources, and implementation of advanced environmental standards have all contributed to the reduction in air pollution, particularly since 1998.

Investigation on trophic state index by artificial neural networks (case study: Dez Dam of Iran)

NASA Astrophysics Data System (ADS)

Saghi, H.; Karimi, L.; Javid, A. H.

2015-06-01

Dam construction and surface runoff control is one of the most common approaches for water-needs supply of human societies. However, the increasing development of social activities and hence the subsequent increase in environmental pollutants leads to deterioration of water quality in dam reservoirs and eutrophication process could be intensified. So, the water quality of reservoirs is now one of the key factors in operation and water quality management of reservoirs. Hence, maintaining the quality of the stored water and identification and examination of changes along time has been a constant concern of humans that involves the water authorities. Traditionally, empirical trophic state indices of dam reservoirs often defined based on changes in concentration of effective factors (nutrients) and its consequences (increase in chlorophyll a), have been used as an efficient tool in the definition of dam reservoirs quality. In recent years, modeling techniques such as artificial neural networks have enhanced the prediction capability and the accuracy of these studies. In this study, artificial neural networks have been applied to analyze eutrophication process in the Dez Dam reservoir in Iran. In this paper, feed forward neural network with one input layer, one hidden layer and one output layer was applied using MATLAB neural network toolbox for trophic state index (TSI) analysis in the Dez Dam reservoir. The input data of this network are effective parameters in the eutrophication: nitrogen cycle parameters and phosphorous cycle parameters and parameters that will be changed by eutrophication: Chl a, SD, DO and the output data is TSI. Based on the results from estimation of modified Carlson trophic state index, Dez Dam reservoir is considered to be eutrophic in the early July to mid-November and would be mesotrophic with decrease in temperature. Therefore, a decrease in water quality of the dam reservoir during the warm seasons is expectable. The results indicated that artificial neural network (ANN) is a suitable tool for quality modeling of reservoir of dam and increment and decrement of nutrients in trend of eutrophication. Therefore, ANN is a suitable tool for quality modeling of reservoir of dam.

Piezoelectric micromachined ultrasonic transducers with low thermoelastic dissipation and high quality factor

NASA Astrophysics Data System (ADS)

Chen, Xuying; Liu, Xinxin; Wang, Tao; Le, Xianhao; Ma, Fangyi; Lee, Chengkuo; Xie, Jin

2018-05-01

Thermoelastic dissipation is one of the main dissipative mechanisms in piezoelectric micromachined ultrasonic transducers (pMUTs). In this paper, we firstly propose pMUTs with etching holes to decrease thermoelastic dissipation and enhance quality factor (Q). The etching holes effectively disturb heat flow, and thus reduce thermoelastic loss. Working mechanism based on the Zener’s model is interpreted. The experiment results show that the Q of pMUT with three rows of holes is increased by 139% from 2050 to 4909 compared with the traditional one. Temperature coefficient of frequency (TCF) and vibration performance are also improved. The enhanced pMUT can be widely used in measurement of Doppler shift and relative high power applications.

Sleep habits and road traffic accident risk for Iranian occupational drivers.

PubMed

Ebrahimi, Mohammad Hossein; Sadeghi, Masoumeh; Dehghani, Mohsen; Niiat, Khosro Sadegh

2015-01-01

The aim of this study is to assess the sleep quality and sleep disorders (prevalence of obstructive sleep apnea and sleepiness) among occupational drivers in Iran and to determine which demographic factors and occupational habits are linked to road traffic accidents. In this analytic cross-sectional study 556 occupational road drivers from Shahroud city (in the northeast of Iran) participated, upon a prior verbal informed consent, during 2013-2014. The Pittsburgh Sleep Quality Index (PSQI) standard questionnaire that scored on 7 point scale, the 8-item Epworth Sleepiness Scale (ESS) questionnaire and the 8-question STOP-Bang questionnaire along with demographic information and occupational data were used. To explore the independent factors associated with odds of poor sleep quality and road accident, multiple logistic regression models were used. Prevalence of previous road accidents, sleepiness while driving, and obstructive sleep apnea scored ≥ 3 in the study, and drivers accounted for 23.8%, 29%, and 24.8%, respectively. The global mean score of sleep quality and excessive sleepiness score were 5.2 and 4.8, respectively. The main factors related to the odds of poor sleep quality were snoring (odds ratio (OR) = 2.34; 95% confidence interval (CI): 1.15-4.77), smoking (OR = 2.12; 95% CI: 1.15-3.97), and driving times in a day (OR = 1.12; 95% CI: 1.03-1.21). The Epworth Sleepiness Scale (OR = 1.13; 95% CI: 1.07-1.23) and suffering from apnea (OR = 4.89; 95% CI: 1.07-23.83) were the best predictors for odds (increased risk) of road accidents. A considerable proportion of Iranian drivers had records of road accidents; poor sleep quality, sleepiness while driving, and sleep disorder breathing (obstructive sleep apnea - OSA). Snoring, smoking, driving time in a day, excessive sleepiness, and presumably apnea increase the odds of poor sleep quality and road traffic accident for Iranian occupational drivers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Real-time image-processing algorithm for markerless tumour tracking using X-ray fluoroscopic imaging.

PubMed

Mori, S

2014-05-01

To ensure accuracy in respiratory-gating treatment, X-ray fluoroscopic imaging is used to detect tumour position in real time. Detection accuracy is strongly dependent on image quality, particularly positional differences between the patient and treatment couch. We developed a new algorithm to improve the quality of images obtained in X-ray fluoroscopic imaging and report the preliminary results. Two oblique X-ray fluoroscopic images were acquired using a dynamic flat panel detector (DFPD) for two patients with lung cancer. The weighting factor was applied to the DFPD image in respective columns, because most anatomical structures, as well as the treatment couch and port cover edge, were aligned in the superior-inferior direction when the patient lay on the treatment couch. The weighting factors for the respective columns were varied until the standard deviation of the pixel values within the image region was minimized. Once the weighting factors were calculated, the quality of the DFPD image was improved by applying the factors to multiframe images. Applying the image-processing algorithm produced substantial improvement in the quality of images, and the image contrast was increased. The treatment couch and irradiation port edge, which were not related to a patient's position, were removed. The average image-processing time was 1.1 ms, showing that this fast image processing can be applied to real-time tumour-tracking systems. These findings indicate that this image-processing algorithm improves the image quality in patients with lung cancer and successfully removes objects not related to the patient. Our image-processing algorithm might be useful in improving gated-treatment accuracy.

Providing informal home care for pressure ulcer patients: how it affects carers' quality of life and burden.

PubMed

Rodrigues, Alexandre M; Ferreira, Pedro L; Ferré-Grau, Carmen

2016-10-01

To evaluate the quality of life of informal caregivers of patients with pressure ulcer; to assess their levels of burden; to analyse the variables influencing both their quality of life and burden. Informal caregivers of pressure ulcer patients, besides coping with the natural dependency of these patients, deal with the specificity of caring these types of wounds. This situation has an impact on not only the quality of life and burden felt by informal caregivers but also on individual and familiar dynamics. Descriptive and correlational study. This study focused on 145 informal caregivers providing home care. Measurement instruments were: SF-36v2 and the Burden Interview Scale. Descriptive analysis of the quantitative variables was carried out according to measures of central tendency, and the qualitative variables were described using absolute and relative frequencies. The relationships or associations between variables were explored through correlational analysis and, whenever the data allowed, multivariate techniques were used. Informal caregivers showed low levels of quality of life and, most of them, significant burden. Quality of life decreased with overload, with the increasing number of pressure ulcer and with less experience of informal caregivers, with lack of financial remuneration, with unemployment, with patient positioning and with the direct care of the wound. The burden increased with the number of pressure ulcer in each patient and with the lack of financial remuneration. These informal caregivers have low quality of life and are overburdened. Both situations are positively and negatively influenced by factors related to the pressure ulcer and to the patients' sociodemographic data. The results of this study allow more effective monitoring by health professionals of levels of burden and quality of life encountered in pressure ulcer informal caregivers, as well as direct interventions to inhibit the factors inducing burden and enhance those that improve quality of life. © 2016 John Wiley & Sons Ltd.

Inadequate response to treatment in coronary heart disease : adverse effects of type D personality and younger age on 5-year prognosis and quality of life.

PubMed

Denollet, J; Vaes, J; Brutsaert, D L

2000-08-08

Improvement in treatment of patients with coronary heart disease (CHD) has caused longer survival but also an increase in the number of patients at risk for subsequent cardiac events and impaired quality of life (QOL). We hypothesized that chronic emotional distress confers an increased risk of poor outcome despite appropriate treatment. This prospective study examined the 5-year prognosis of 319 patients with CHD. Baseline assessment included symptoms of depression/anxiety and distressed personality type (type D-ie, high negative affectivity and social inhibition). The main end points were cardiac death or nonfatal myocardial infarction and impaired QOL. There were 22 cardiac events (16 nonfatal); they were related to left ventricular ejection fraction (LVEF)

Factors associated with continued participation in a matched monetary incentive programme at local farmers' markets in low-income neighbourhoods in San Diego, California.

PubMed

Ratigan, Amanda R; Lindsay, Suzanne; Lemus, Hector; Chambers, Christina D; Anderson, Cheryl Am; Cronan, Terry A; Browner, Deirdre K; Wooten, Wilma J

2017-10-01

The Farmers' Market Fresh Fund Incentive Program is a policy, systems and environmental intervention to improve access to fresh produce for participants on governmental assistance in the USA. The current study examined factors associated with ongoing participation in this matched monetary incentive programme. Relationship of baseline factors with number of Fresh Fund visits was assessed using Poisson regression. Mixed-effects modelling was used to explore changes in consumption of fruits and vegetables and diet quality. San Diego, California. Recipients of Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Security Income (SSI) who attended participating farmers' markets from 2010 to 2012 (n 7298). Among those with participation for ≤6 months, factors associated with increased visits included reporting more daily servings of fruits and vegetables (F&V) at baseline, being Vietnamese or Asian/Pacific Islander, and eligibility because of SNAP/CalFresh or SSI (v. WIC). Among those who came for 6-12 months, being Asian/Pacific Islander, eligibility because of SNAP/CalFresh and enrolling in the autumn, winter or spring were associated with a greater number of Fresh Fund visits. Among those who came for >12 months, being male and eligibility because of SSI were associated with a greater number of visits. Overall, the odds of increasing number of servings of F&V consumed increased by 2 % per month, and the odds of improved perception of diet quality increased by 10 % per month. Sustaining and increasing Fresh Fund-type programme operations should be a top priority for future policy decisions concerning farmers' market use in low-income neighbourhoods.

Average sperm count remains unchanged despite reduction in maternal smoking: results from a large cross-sectional study with annual investigations over 21 years.

PubMed

Priskorn, L; Nordkap, L; Bang, A K; Krause, M; Holmboe, S A; Egeberg Palme, D L; Winge, S B; Mørup, N; Carlsen, E; Joensen, U N; Blomberg Jensen, M; Main, K M; Juul, A; Skakkebaek, N E; Jensen, T K; Jørgensen, N

2018-06-01

How are temporal trends in lifestyle factors, including exposure to maternal smoking in utero, associated to semen quality in young men from the general population? Exposure to maternal smoking was associated with lower sperm counts but no overall increase in sperm counts was observed during the study period despite a decrease in this exposure. Meta-analyses suggest a continuous decline in semen quality but few studies have investigated temporal trends in unselected populations recruited and analysed with the same protocol over a long period and none have studied simultaneous trends in lifestyle factors. Cross-sectional population-based study including ~300 participants per year (total number = 6386) between 1996 and 2016. The study is based on men from the Greater Copenhagen area, Denmark, with a median age of 19 years, and unselected with regard to fertility status and semen quality. The men delivered a semen sample, had a blood sample drawn and a physical examination performed and answered a comprehensive questionnaire, including information on lifestyle and the mother's pregnancy. Temporal trends in semen quality and lifestyle were illustrated graphically, and trends in semen parameters and the impact of prenatal and current lifestyle factors were explored in multiple regression analyses. Throughout the study period, 35% of the men had low semen quality. Overall, there were no persistent temporal trends in semen quality, testicular volume or levels of follicle-stimulating hormone over the 21 years studied. The men's alcohol intake was lowest between 2011 and 2016, whereas BMI, use of medication and smoking showed no clear temporal trends. Parental age increased, and exposure in utero to maternal smoking declined from 40% among men investigated in 1996-2000 to 18% among men investigated in 2011-2016. Exposure to maternal smoking was associated with lower sperm counts but no overall increase in sperm counts was observed despite the decrease in this exposure. Information of current and prenatal lifestyle was obtained by self-report, and the men delivered only one semen sample each. The significant decline in in utero exposure to maternal smoking, which was not reflected in an overall improvement of semen quality at the population level, suggest that other unknown adverse factors may maintain the low semen quality among Danish men. The study has received financial support from the ReproUnion; the Research fund of Rigshospitalet, Copenhagen University Hospital; the European Union (Contract numbers BMH4-CT96-0314,QLK4-CT-1999-01422, QLK4-CT-2002-00603, FP7/2007-2013, DEER Grant agreement no. 212844); the Danish Ministry of Health; the Danish Environmental Protection Agency; A.P. Møller and wife Chastine McKinney Møllers foundation; and Svend Andersens Foundation. None of the funders had any role in the study design, collection, analysis or interpretation of data, writing of the paper or publication decisions. N/A.

Methodological quality of meta-analyses of single-case experimental studies.

PubMed

Jamshidi, Laleh; Heyvaert, Mieke; Declercq, Lies; Fernández-Castilla, Belén; Ferron, John M; Moeyaert, Mariola; Beretvas, S Natasha; Onghena, Patrick; Van den Noortgate, Wim

2017-12-28

Methodological rigor is a fundamental factor in the validity and credibility of the results of a meta-analysis. Following an increasing interest in single-case experimental design (SCED) meta-analyses, the current study investigates the methodological quality of SCED meta-analyses. We assessed the methodological quality of 178 SCED meta-analyses published between 1985 and 2015 through the modified Revised-Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. The main finding of the current review is that the methodological quality of the SCED meta-analyses has increased over time, but is still low according to the R-AMSTAR checklist. A remarkable percentage of the studies (93.80% of the included SCED meta-analyses) did not even reach the midpoint score (22, on a scale of 0-44). The mean and median methodological quality scores were 15.57 and 16, respectively. Relatively high scores were observed for "providing the characteristics of the included studies" and "doing comprehensive literature search". The key areas of deficiency were "reporting an assessment of the likelihood of publication bias" and "using the methods appropriately to combine the findings of studies". Although the results of the current review reveal that the methodological quality of the SCED meta-analyses has increased over time, still more efforts are needed to improve their methodological quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Factors affecting breeding soundness classification of beef bulls examined at the Western College of Veterinary Medicine.

PubMed

Barth, Albert D; Waldner, Cheryl L

2002-04-01

Breeding soundness evaluation records from 2110 beef bulls, for the period of 1986 to 1999, were analyzed to determine the prevalence and importance of factors affecting breeding soundness classification. The percentage of all bulls classified as satisfactory ranged from 49.0% in January to 73.3% in May. The percentage of physically normal bulls with satisfactory semen quality ranged from 65.7% in January to 87.5% in June. Poor body condition or excessive body condition, below average or below the recommended minimum scrotal circumference, lameness, and severe scrotal frostbite significantly reduced the probability of a satisfactory breeding soundness classification. The percentage of sperm with midpiece defects declined significantly and the percentage of sperm with head defects increased significantly with the approach of summer. Photoperiod, cold stress, poor or excessive body condition, and reduced feed quality may interact to reduce semen quality in the winter months.

Sleep as an Occupational Need.

PubMed

Tester, Nicole J; Foss, Joanne Jackson

In the same way the human body requires food, hydration, and oxygen, it also requires sleep. Even among healthy people, the amount and quality of sleep substantially influence health and quality of life because sleep helps regulate physiological functioning. Given the impact of sleep on participation, the American Occupational Therapy Association reclassified sleep from an activity of daily living to an occupational domain. Poor sleep is a frequent medical complaint, especially among populations with neurological impairment. Occupational therapy practitioners should consider routinely screening for factors affecting their clients' sleep. By addressing such factors, as well as related routines and habits, practitioners can enhance the effectiveness of rehabilitation, promote health and well-being, and increase engagement and life quality. Practitioners should acknowledge the importance of sleep in practice, and the study of sleep should be prioritized by researchers in the field to meet client needs and establish evidence for interventions. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Revealed variations of air quality in industrial development over a remote plateau of Southwest China: an application of atmospheric visibility data

NASA Astrophysics Data System (ADS)

Zhao, Tianliang; Liu, Di; Zheng, Xiaobo; Yang, Lexin; Gu, Xiaoping; Hu, Jun; Shu, Zhuozhi; Chang, Jiacheng; Wu, Xiasheng

2017-12-01

Since the 1980s, an industrial development has bloomed in China including the Yunnan-Guizhou Plateau (YGP), a remote region in Southwest China. To analyze the regional variations in air quality over YGP during the industrial development, we adopt the equivalent visibility by excluding the influence of natural factors on the observed visibility based on the meteorological data observed at 203 sites over YGP from 1980 to 2010 in this study. The YGP air quality exhibits the tremendous spatial differences in a general distribution from western good to eastern poor air quality. A similar pattern shifts seasonally in the spatial distribution with a typical seasonality of air quality over YGP between summertime low air pollution and wintertime high air pollution. The increasing and decreasing trends in visibility are mostly concentrated, respectively, in the YGP regions with high and low visibility, displaying the phenomenon of polarization in air quality change over YGP during 1980-2010. The regional mean visibility of the YGP presents a significant declining trend with change rate of -1.5 km decade-1 for air quality deterioration. The seasonal differences in visibility between summer (33.6 km) and winter (25.2 km) became obscure with the interannual change trends of visibility with stronger declines (-2.29 km decade-1) in summer and weaker decreases (-0.89 km decade-1) in winter over 1980-2010, which lead to a indistinct seasonality of air quality change over YGP. The remote YGP had experienced more frequent haze pollution, especially in the eastern plateau over 31 years. In accompany of increasing energy consumption in the industrial development, population growth is an important factor influencing the interannual change of YGP air quality. The distinct spatial distribution in the YGP terrain exerts an impact on poor air quality in lower flatlands harbored by mountainous topography with good air quality. Declined monsoon winds could meteorologically drive the air quality change with less regional transport of air pollutant over YGP during 1980-2010. Implications of the climate change for atmospheric environment will be having potential utility for sustainable development in China.

Image quality in thoracic 4D cone-beam CT: A sensitivity analysis of respiratory signal, binning method, reconstruction algorithm, and projection angular spacing

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

Shieh, Chun-Chien; Kipritidis, John; O’Brien, Ricky T.

Purpose: Respiratory signal, binning method, and reconstruction algorithm are three major controllable factors affecting image quality in thoracic 4D cone-beam CT (4D-CBCT), which is widely used in image guided radiotherapy (IGRT). Previous studies have investigated each of these factors individually, but no integrated sensitivity analysis has been performed. In addition, projection angular spacing is also a key factor in reconstruction, but how it affects image quality is not obvious. An investigation of the impacts of these four factors on image quality can help determine the most effective strategy in improving 4D-CBCT for IGRT. Methods: Fourteen 4D-CBCT patient projection datasets withmore » various respiratory motion features were reconstructed with the following controllable factors: (i) respiratory signal (real-time position management, projection image intensity analysis, or fiducial marker tracking), (ii) binning method (phase, displacement, or equal-projection-density displacement binning), and (iii) reconstruction algorithm [Feldkamp–Davis–Kress (FDK), McKinnon–Bates (MKB), or adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS)]. The image quality was quantified using signal-to-noise ratio (SNR), contrast-to-noise ratio, and edge-response width in order to assess noise/streaking and blur. The SNR values were also analyzed with respect to the maximum, mean, and root-mean-squared-error (RMSE) projection angular spacing to investigate how projection angular spacing affects image quality. Results: The choice of respiratory signals was found to have no significant impact on image quality. Displacement-based binning was found to be less prone to motion artifacts compared to phase binning in more than half of the cases, but was shown to suffer from large interbin image quality variation and large projection angular gaps. Both MKB and ASD-POCS resulted in noticeably improved image quality almost 100% of the time relative to FDK. In addition, SNR values were found to increase with decreasing RMSE values of projection angular gaps with strong correlations (r ≈ −0.7) regardless of the reconstruction algorithm used. Conclusions: Based on the authors’ results, displacement-based binning methods, better reconstruction algorithms, and the acquisition of even projection angular views are the most important factors to consider for improving thoracic 4D-CBCT image quality. In view of the practical issues with displacement-based binning and the fact that projection angular spacing is not currently directly controllable, development of better reconstruction algorithms represents the most effective strategy for improving image quality in thoracic 4D-CBCT for IGRT applications at the current stage.« less

Water- and sediment-quality effects on Pimephales promelas spawning vary along an agriculture-to-urban land-use gradient.

PubMed

Corsi, Steven R; Klaper, Rebecca D; Weber, Daniel N; Bannerman, Roger T

2011-10-15

Many streams in the U.S. are "impaired" due to anthropogenic influence. For watershed managers to achieve practical understanding of these impairments, a multitude of factors must be considered, including point and nonpoint-source influence on water quality. A spawning assay was developed in this study to evaluate water- and sediment-quality effects that influenced Pimephales promelas (fathead minnow) egg production over a gradient of urban and agricultural land use in 27 small watersheds in Eastern Wisconsin. Six pairs of reproducing fathead minnows were contained in separate mesh cartridges within one larger flow-through chamber. Water- and sediment quality were sampled for an array of parameters. Egg production was monitored for each pair providing an assessment of spawning success throughout the 21-day test periods. Incidences of low dissolved oxygen (DO) in many of these streams negatively impacted spawning success. Nine of 27 streams experienced DO less than 3.1mg/L and 15 streams experienced DO less than 4.8mg/L. Low DO was observed in urban and agricultural watersheds, but the upper threshold of minimum DO decreased with increasing urban development. An increase in specific conductance was related to a decrease in spawning success. In previous studies for streams in this region, specific conductance had a linear relation with chloride, suggesting the possibility that chloride could be a factor in egg production. Egg production was lower at sites with substantial urban development, but sites with low egg production were not limited to urban sites. Degradation of water- and sediment-quality parameters with increasing urban development is indicated for multiple parameters while patterns were not detected for others. Results from this study indicate that DO must be a high priority watershed management consideration for this region, specific conductance should be investigated further to determine the mechanism of the relation with egg production, and water- and sediment-quality degrade in relation to urban influence. Published by Elsevier B.V.

Water- and sediment-quality effects on Pimephales promelas spawning vary along an agriculture-to-urban land-use gradient

USGS Publications Warehouse

Corsi, S.R.; Klaper, R.D.; Weber, D.N.; Bannerman, R.T.

2011-01-01

Many streams in the U.S. are "impaired" due to anthropogenic influence. For watershed managers to achieve practical understanding of these impairments, a multitude of factors must be considered, including point and nonpoint-source influence on water quality. A spawning assay was developed in this study to evaluate water- and sediment-quality effects that influenced Pimephales promelas (fathead minnow) egg production over a gradient of urban and agricultural land use in 27 small watersheds in Eastern Wisconsin. Six pairs of reproducing fathead minnows were contained in separate mesh cartridges within one larger flow-through chamber. Water- and sediment quality were sampled for an array of parameters. Egg production was monitored for each pair providing an assessment of spawning success throughout the 21-day test periods. Incidences of low dissolved oxygen (DO) in many of these streams negatively impacted spawning success. Nine of 27 streams experienced DO less than 3.1. mg/L and 15 streams experienced DO less than 4.8. mg/L. Low DO was observed in urban and agricultural watersheds, but the upper threshold of minimum DO decreased with increasing urban development. An increase in specific conductance was related to a decrease in spawning success. In previous studies for streams in this region, specific conductance had a linear relation with chloride, suggesting the possibility that chloride could be a factor in egg production. Egg production was lower at sites with substantial urban development, but sites with low egg production were not limited to urban sites. Degradation of water- and sediment-quality parameters with increasing urban development is indicated for multiple parameters while patterns were not detected for others. Results from this study indicate that DO must be a high priority watershed management consideration for this region, specific conductance should be investigated further to determine the mechanism of the relation with egg production, and water- and sediment-quality degrade in relation to urban influence. ?? 2011.

High-resolution magnetic resonance angiography of the lower extremities with a dedicated 36-element matrix coil at 3 Tesla.

PubMed

Kramer, Harald; Michaely, Henrik J; Matschl, Volker; Schmitt, Peter; Reiser, Maximilian F; Schoenberg, Stefan O

2007-06-01

Recent developments in hard- and software help to significantly increase image quality of magnetic resonance angiography (MRA). Parallel acquisition techniques (PAT) help to increase spatial resolution and to decrease acquisition time but also suffer from a decrease in signal-to-noise ratio (SNR). The movement to higher field strength and the use of dedicated angiography coils can further increase spatial resolution while decreasing acquisition times at the same SNR as it is known from contemporary exams. The goal of our study was to compare the image quality of MRA datasets acquired with a standard matrix coil in comparison to MRA datasets acquired with a dedicated peripheral angio matrix coil and higher factors of parallel imaging. Before the first volunteer examination, unaccelerated phantom measurements were performed with the different coils. After institutional review board approval, 15 healthy volunteers underwent MRA of the lower extremity on a 32 channel 3.0 Tesla MR System. In 5 of them MRA of the calves was performed with a PAT acceleration factor of 2 and a standard body-matrix surface coil placed at the legs. Ten volunteers underwent MRA of the calves with a dedicated 36-element angiography matrix coil: 5 with a PAT acceleration of 3 and 5 with a PAT acceleration factor of 4, respectively. The acquired volume and acquisition time was approximately the same in all examinations, only the spatial resolution was increased with the acceleration factor. The acquisition time per voxel was calculated. Image quality was rated independently by 2 readers in terms of vessel conspicuity, venous overlay, and occurrence of artifacts. The inter-reader agreement was calculated by the kappa-statistics. SNR and contrast-to-noise ratios from the different examinations were evaluated. All 15 volunteers completed the examination, no adverse events occurred. None of the examinations showed venous overlay; 70% of the examinations showed an excellent vessel conspicuity, whereas in 50% of the examinations artifacts occurred. All of these artifacts were judged as none disturbing. Inter-reader agreement was good with kappa values ranging between 0.65 and 0.74. SNR and contrast-to-noise ratios did not show significant differences. Implementation of a dedicated coil for peripheral MRA at 3.0 Tesla helps to increase spatial resolution and to decrease acquisition time while the image quality could be kept equal. Venous overlay can be effectively avoided despite the use of high-resolution scans.

A Socio-technical assessment of the success of picture archiving and communication systems: the radiology technologist’s perspective

PubMed Central

2013-01-01

Background With the increasing prevalence of Picture Archiving and Communication Systems (PACS) in healthcare institutions, there is a growing need to measure their success. However, there is a lack of published literature emphasizing the technical and social factors underlying a successful PACS. Methods An updated Information Systems Success Model was utilized by radiology technologists (RTs) to evaluate the success of PACS at a large medical center in Taiwan. A survey, consisting of 109 questionnaires, was analyzed by Structural Equation Modeling. Results Socio-technical factors (including system quality, information quality, service quality, perceived usefulness, user satisfaction, and PACS dependence) were proven to be effective measures of PACS success. Although the relationship between service quality and perceived usefulness was not significant, other proposed relationships amongst the six measurement parameters of success were all confirmed. Conclusions Managers have an obligation to improve the attributes of PACS. At the onset of its deployment, RTs will have formed their own subjective opinions with regards to its quality (system quality, information quality, and service quality). As these personal concepts are either refuted or reinforced based on personal experiences, RTs will become either satisfied or dissatisfied with PACS, based on their perception of its usefulness or lack of usefulness. A satisfied RT may play a pivotal role in the implementation of PACS in the future. PMID:24053458

Computational Features of Flow Modeling in Nanostructured Sensors

NASA Astrophysics Data System (ADS)

Ionescu, Adela; Savu, Dan; Savu, Sorin; Coman, Daniela

2009-04-01

Nowadays the productivity of the welding processes represents an important factor in economy concepts. The technologies which are developed by the researchers are oriented to the increasing of the welding processes' productivity and to the improvement of the products' quality.

World Population Crisis.

ERIC Educational Resources Information Center

Ehrlich, Paul R.; Ehrlich, Anne H.

1986-01-01

Rapid population growth, rising competition for resources, and increasing environmental deterioration are intertwined factors in the human predicament that feed political tensions and conflicts of the late twentieth century. Outlines dimensions of this predicament (including data on population, growth, military spending, quality of life, and…

Depression, Control, and Climate: An Examination of Factors Impacting Teaching Quality in Preschool Classrooms.

PubMed

Sandilos, Lia E; Cycyk, Lauren M; Hammer, Carol Scheffner; Sawyer, Brook E; López, Lisa; Blair, Clancy

This study investigated the relationship of preschool teachers' self-reported depressive symptomatology, perception of classroom control, and perception of school climate to classroom quality as measured by the Classroom Assessment Scoring System Pre-K. The sample consisted of 59 urban preschool classrooms serving low-income and linguistically diverse students in the northeastern and southeastern United States. Results of hierarchical linear modeling revealed that teachers' individual reports of depressive symptomatology were significantly and negatively predictive of the observed quality of their instructional support and classroom organization. The findings of this study have implications for increasing access to mental health supports for teachers in an effort to minimize depressive symptoms and potentially improve classroom quality.

Relationship between water quality and human health: a case study of the Linggi River Basin in Malaysia.

PubMed

Lonergan, S; Vansickle, T

1991-01-01

Due to the increasingly documented prevalence of diarrhoeal diseases in Malaysia, a number of water-related programmes have been implemented in an attempt to improve health status through the reduction of incidence of waterborne communicable diseases associated with poor public water supplies. The implicit assumption underlying these projects is that the enhancement of the physical infrastructure, and subsequent improvements in the quality of the water supply, will substantially reduce water-related disease. The present study questions this hypothesis and uses a socio-ecological model as a framework to assess risk factors associated with the increased probability of waterborne disease. Research is centred on Port Dickson, a district which typifies existing water and sanitation conditions in much of semi-rural Malaysia. Health services utilization data and a 268-household diarrhoeal morbidity survey were used to measure the burden of illness of waterborne disease within the district and to identify predictors of morbidity. It was concluded that although treatment facilities will reduce the health burden in the region, a number of behavioural and sanitation factors may be more important and could act to minimize the potential impacts of improved water quality.

Analysis of psychological factors for quality assessment of interactive multimodal service

NASA Astrophysics Data System (ADS)

Yamagishi, Kazuhisa; Hayashi, Takanori

2005-03-01

We proposed a subjective quality assessment model for interactive multimodal services. First, psychological factors of an audiovisual communication service were extracted by using the semantic differential (SD) technique and factor analysis. Forty subjects participated in subjective tests and performed point-to-point conversational tasks on a PC-based TV phone that exhibits various network qualities. The subjects assessed those qualities on the basis of 25 pairs of adjectives. Two psychological factors, i.e., an aesthetic feeling and a feeling of activity, were extracted from the results. Then, quality impairment factors affecting these two psychological factors were analyzed. We found that the aesthetic feeling is mainly affected by IP packet loss and video coding bit rate, and the feeling of activity depends on delay time and video frame rate. We then proposed an opinion model derived from the relationships among quality impairment factors, psychological factors, and overall quality. The results indicated that the estimation error of the proposed model is almost equivalent to the statistical reliability of the subjective score. Finally, using the proposed model, we discuss guidelines for quality design of interactive audiovisual communication services.

The PQRS-Montreal: a measure of patients' perceptions of the quality of rehabilitation services for persons with a traumatic brain injury.

PubMed

Swaine, Bonnie; Dassa, Clément; Koné, Anna; Dutil, Élisabeth; Demers, Louise; Trempe, Claire

2017-01-01

Purpose To determine the factorial validity, internal consistency, criterion-related and concurrent validity of the Perception of Quality of Rehabilitation Services - Montreal (PQRS-Montreal) questionnaire for persons receiving traumatic brain injury (TBI) rehabilitation services. Design Cross-sectional study. Setting Seventeen facilities providing acute care and intensive inpatient and outpatient TBI adult rehabilitation. Participants Five-hundred thirty adults (GCS  =  3-15; mean age  =  41.5 ± 16.9 years) who received rehabilitation were administered the questionnaire during an interview near time of discharge. Subjects responded to the 61 PQRS-Montreal items (five-point scale of agreement) and to the Client Satisfaction Question (CSQ8). Results Exploratory and confirmatory factor analyses identified three potential subscales (one- and two-factor solutions) explaining 26.1-41% of the variance (ecological approach, quality of team, service organization). The subscales' internal structures were interpretable and their internal consistency varied from 0.51 to 0.90 (Cronbach's α). Rehabilitation phase significantly and positively impacted factor scores and all factor scores were significantly and moderately correlated with CSQ8 scores. Conclusions The PQRS-Montreal possesses adequate psychometric properties supporting its use as a valid tool to measure patients' perception of the quality of TBI rehabilitation services. This tool could help guide the development and monitoring of TBI rehabilitation service delivery. Implications for Rehabilitation The importance of measuring and monitoring quality of care is increasingly important in rehabilitation. Using the experiences and perceptions of care of service users is a valid way of assessing the quality of rehabilitation services. The PQRS-Montreal has adequate psychometric properties supporting its use as a valid tool to measure patients' perception of the quality of TBI rehabilitation services. This tool could help guide the development and monitoring of TBI rehabilitation service delivery.

Influence of Socioeconomic Factors on Daily Life Activities and Quality of Life of Thai Elderly.

PubMed

Somrongthong, Ratana; Wongchalee, Sunanta; Ramakrishnan, Chandrika; Hongthong, Donnapa; Yodmai, Korravarn; Wongtongkam, Nualnong

2017-04-13

The increasing number of older people is a significant issue in Thailand, resulted in growing demands of health and social welfare services. The study aim was to explore the influence of socioeconomic factors on activities of daily living and quality of life of Thai seniors. Using randomised cluster sampling, one province was sampled from each of the Central, North, Northeast and South regions, then one subdistrict sampled in each province, and a household survey used to identify the sample of 1678 seniors aged 60 years and over. The Mann-Whitney U-test and binary logistic regression were used to compare and determine the association of socioeconomic variables on quality of life and activities of daily living. The findings showed that sociodemographic and socioeconomic factors were significantly related to functional capacity of daily living. Education levels were strongly associated with daily life activities, with 3.55 adjusted ORs for respondents with secondary school education. Gender was important, with females comprising 61% of dependent respondents but only 47% of independent respondents. Seniors with low incomes were more likely to be anxious in the past, present and future and less likely to accept death in the late stage, with 1.40 Adjusted ORs (95%CI: 1.02-1.92), and 0.72 (95%CI: 0.53-0.98), respectively. However, they were more likely to engage in social activities. While socioeconomic factors strongly indicated the functional capacity to live independently, a good quality of life also required other factors leading to happiness and life satisfaction.

Primary display latency criteria based on flying qualities and performance data

NASA Technical Reports Server (NTRS)

Funk, John D., Jr.; Beck, Corin P.; Johns, John B.

1993-01-01

With a pilots' increasing use of visual cue augmentation, much requiring extensive pre-processing, there is a need to establish criteria for new avionics/display design. The timeliness and synchronization of the augmented cues is vital to ensure the performance quality required for precision mission task elements (MTEs) where augmented cues are the primary source of information to the pilot. Processing delays incurred while transforming sensor-supplied flight information into visual cues are unavoidable. Relationships between maximum control system delays and associated flying qualities levels are documented in MIL-F-83300 and MIL-F-8785. While cues representing aircraft status may be just as vital to the pilot as prompt control response for operations in instrument meteorological conditions, presently, there are no specification requirements on avionics system latency. To produce data relating avionics system latency to degradations in flying qualities, the Navy conducted two simulation investigations. During the investigations, flying qualities and performance data were recorded as simulated avionics system latency was varied. Correlated results of the investigation indicates that there is a detrimental impact of latency on flying qualities. Analysis of these results and consideration of key factors influencing their application indicate that: (1) Task performance degrades and pilot workload increases as latency is increased. Inconsistency in task performance increases as latency increases. (2) Latency reduces the probability of achieving Level 1 handling qualities with avionics system latency as low as 70 ms. (3) The data suggest that the achievement of desired performance will be ensured only at display latency values below 120 ms. (4) These data also suggest that avoidance of inadequate performance will be ensured only at display latency values below 150 ms.

A research review of quality assessment for software

NASA Technical Reports Server (NTRS)

1991-01-01

Measures were recommended to assess the quality of software submitted to the AdaNet program. The quality factors that are important to software reuse are explored and methods of evaluating those factors are discussed. Quality factors important to software reuse are: correctness, reliability, verifiability, understandability, modifiability, and certifiability. Certifiability is included because the documentation of many factors about a software component such as its efficiency, portability, and development history, constitute a class for factors important to some users, not important at all to other, and impossible for AdaNet to distinguish between a priori. The quality factors may be assessed in different ways. There are a few quantitative measures which have been shown to indicate software quality. However, it is believed that there exists many factors that indicate quality and have not been empirically validated due to their subjective nature. These subjective factors are characterized by the way in which they support the software engineering principles of abstraction, information hiding, modularity, localization, confirmability, uniformity, and completeness.

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina.

PubMed

González, Lorena; Elgart, Jorge F; Calvo, Héctor; Gagliardino, Juan J

2013-01-01

To measure the impact of a diabetes and cardiovascular risk factors program implemented in a social security institution upon short- and long-term clinical/metabolic outcomes and costs of care. Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female program participants with diabetes before (baseline) and 1 and 3 years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration's database. The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRFs), as well as a decrease of events related to chronic complications. This improvement was associated with an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRFs. The implementation of a diabetes program in real-world conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRFs, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing costs, our results suggest the need to include management-control strategies in these programs for appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.

Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents.

PubMed

Auvinen, Juha P; Tammelin, Tuija H; Taimela, Simo P; Zitting, Paavo J; Järvelin, Marjo-Riitta; Taanila, Anja M; Karppinen, Jaro I

2010-04-01

The quantity and quality of adolescents' sleep may have changed due to new technologies. At the same time, the prevalence of neck, shoulder and low back pain has increased. However, only a few studies have investigated insufficient quantity and quality of sleep as possible risk factors for musculoskeletal pain among adolescents. The aim of the study was to assess whether insufficient quantity and quality of sleep are risk factors for neck (NP), shoulder (SP) and low back pain (LBP). A 2-year follow-up survey among adolescents aged 15-19 years was (2001-2003) carried out in a subcohort of the Northern Finland Birth Cohort 1986 (n = 1,773). The outcome measures were 6-month period prevalences of NP, SP and LBP. The quantity and quality of sleep were categorized into sufficient, intermediate or insufficient, based on average hours spent sleeping, and whether or not the subject suffered from nightmares, tiredness and sleeping problems. The odds ratios (OR) and 95% confidence intervals (CI) for having musculoskeletal pain were obtained through logistic regression analysis, adjusted for previously suggested risk factors and finally adjusted for specific pain status at 16 years. The 6-month period prevalences of neck, shoulder and low back pain were higher at the age of 18 than at 16 years. Insufficient quantity or quality of sleep at 16 years predicted NP in both girls (OR 4.4; CI 2.2-9.0) and boys (2.2; 1.2-4.1). Similarly, insufficient sleep at 16 years predicted LBP in both girls (2.9; 1.7-5.2) and boys (2.4; 1.3-4.5), but SP only in girls (2.3; 1.2-4.4). After adjustment for pain status, insufficient sleep at 16 years predicted significantly only NP (3.2; 1.5-6.7) and LBP (2.4; 1.3-4.3) in girls. Insufficient sleep quantity or quality was an independent risk factor for NP and LBP among girls. Future studies should test whether interventions aimed at improving sleep characteristics are effective in the prevention and treatment of musculoskeletal pain.

Effectiveness of personalized face-to-face and telephone nursing counseling interventions for cardiovascular risk factors: a controlled clinical trial 1

PubMed Central

Vílchez Barboza, Vivian; Klijn, Tatiana Paravic; Salazar Molina, Alide; Sáez Carrillo, Katia Lorena

2016-01-01

Abstract Objective: to evaluate the effect and gender differences of an innovative intervention involving in-person and telephone nursing counseling to control cardiovascular risk factors (arterial hypertension, dyslipidemia, and overweight), improve health-related quality of life and strengthen self-efficacy and social support in persons using the municipal health centers' cardiovascular health program. Method: a randomized controlled clinical trial involving participants randomized into the intervention group who received traditional consultation plus personalized and telephone nursing counseling for 7 months (n = 53) and the control group (n = 56). The study followed the Consolidated Standards of Reporting Trials Statement. Results: women in the intervention group presented a significant increase in the physical and mental health components compared to the control group, with decreases in weight, abdominal circumference, total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index. The effects attributable to the intervention in the men in the intervention group were increased physical and emotional roles and decreased systolic and diastolic pressure, waist circumference, total cholesterol, low-density lipoprotein cholesterol, atherogenic index, cardiovascular risk factor, and 10-year coronary risk. Conclusion: this intervention is an effective strategy for the control of three cardiovascular risk factors and the improvement of health-related quality of life. PMID:27508917

Employment conditions and maternal postpartum mental health: results from the Longitudinal Study of Australian Children.

PubMed

Cooklin, Amanda R; Canterford, Louise; Strazdins, Lyndall; Nicholson, Jan M

2011-06-01

Maternal postpartum mental health is influenced by a broad range of risk and protective factors including social circumstances. Forty percent of Australian women resume employment in the first year postpartum, yet poor quality employment (without security, control, flexibility or leave) has not been investigated as a potential social determinant of maternal psychological distress. This paper examines whether poor quality jobs are associated with an increased risk of maternal postpartum psychological distress. Data were collected from employed mothers of infants ≤12 months (n = 1,300) participating in the Longitudinal Study of Australian Children. Logistic regression analyses estimated the association between job quality and maternal psychological distress, adjusting for prior depression, social support, quality of partner relationship, adverse life events and sociodemographic characteristics. Only 21% of women reported access to all four optimal job conditions. After adjustment for known risk factors for poor maternal mood, mothers were significantly more likely to report psychological distress (adjusted OR = 1.39, 95% CI 1.09, 1.77) with each reduction in the number of optimal employment conditions. Interventions for maternal postpartum affective disorders are unlikely to be successful if major risk factors are not addressed. These results provide strong evidence that employment conditions are associated with maternal postpartum mood, and warrant consideration in psychosocial risk assessments and interventions.

Heat transfer and pressure drop of condensation of hydrocarbons in tubes

NASA Astrophysics Data System (ADS)

Fries, Simon; Skusa, Severin; Luke, Andrea

2018-03-01

The heat transfer coefficient and pressure drop are investigated for propane. Two different mild steel plain tubes and saturation pressures are considered for varying mass flux and vapour quality. The pressure drop is compared to the Friedel-Correlation with two different approaches to determine the friction factor. The first is calculation as proposed by Friedel and the second is through single phase pressure drop investigations. For lower vapour qualities the experimental results are in better agreement with the approach of the calculated friction factor. For higher vapour qualities the experimental friction factor is more precise. The pressure drop increases for a decreasing tube diameter and saturation pressure. The circumferential temperature profile and heat transfer coefficients are shown for a constant vapour quality at varying mass fluxes. The subcooling is highest for the bottom of the tube and lowest for the top. The average subcooling as well as the circumferential deviation decreases for rising mass fluxes. The averaged heat transfer coefficients are compared to the model proposed by Thome and Cavallini. The experimental results are in good agreement with both correlations, however the trend is better described with the correlation from Thome. The experimental heat transfer coefficients are under predicted by Thome and over predicted by Cavallini.

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

PubMed

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

2017-12-31

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

Factors associated with reduced functional outcome and quality of life in patients having limb-sparing surgery for soft tissue sarcomas - a national multicenter study of 128 patients.

PubMed

Saebye, Casper; Fugloe, Hanna M; Nymark, Tine; Safwat, Akmal; Petersen, Michael M; Baad-Hansen, Thomas; Krarup-Hansen, Anders; Keller, Johnny

2017-02-01

Limb-sparing surgery for sarcomas has become possible in most cases. However, the impact of the procedure on the functional outcome has only been investigated in a few studies. The aim of this study has been to identify tumor- and patient-related factors associated with reduced functional outcome and quality of life after limb-sparing surgery in soft tissue sarcoma patients. In total, 128 patients (mean age = 58, female/male = 54/74) who were treated with limb-sparing surgery without bone resection for soft tissue sarcomas in Denmark during the period 1 January 2009 to 31 December 2011 were included. Patients were asked to participate at least one year after surgery, and patients who had experienced local recurrence or metastatic disease were excluded. The Toronto Extremity Salvage Score (TESS) measured functional disability, while the Musculoskeletal Tumor Society Score (MSTS) measured functional impairment. European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 measured quality of life. Tumor- and patient-related factors (age, gender, tumor depth, tumor size, malignancy, comorbidity, location, and radiotherapy) were extracted from the Danish National Sarcoma Database. Wilcoxon rank-sum test and Kruskal-Wallis were used for univariable analysis. Adjusted odds ratios were estimated by using multiple logistic regression models. In the multiple regression analysis, it was found that female gender (p = 0.03), lower extremity tumors (p < 0.01) and radiotherapy (p = 0.02) resulted in an increased risk of a lower TESS score. Initial reduced postoperative function was found to be associated with a lower functional outcome. Patients with reduced functional outcome have increased risk for reduced quality of life (p < 0.01). The results of this study show that patient- and tumor-related factors have an important role in the functional outcome.

[UNHEALTHY FOOD INTAKE IS LINKED TO HIGHER PREVALENCE OF METABOLIC SYNDROME IN CHILEAN ADULT POPULATION: CROSS SECTIONAL STUDY IN 2009-2010 NATIONAL HEALTH SURVEY].

PubMed

Dussaillant, Catalina; Echeverría, Guadalupe; Villarroel, Luis; Marin, Pedro Paulo; Rigotti, Attilio

2015-11-01

metabolic syndrome (MS) is a clustering of risk factors known to promote cardiovascular disease and diabetes. Environmental factors, such as unhealthy diet, play a major role in the development of this condition. In this study, we evaluated the prevalence of MS and its association with food intake quality among Chilean adults. we analyzed data of 2 561 adults (≥ 18 years-old) included in the last National Health Survey (NHS 2009-2010) who had appropriate information to diagnose MS based on ATP III-NCEP guidelines. Consumption frequency of fish, whole grains, dairy, fruits and vegetables was also analyzed and associated with MS prevalence. Using a healthy diet score (HDS), we described the overall diet quality and further correlated it with MS prevalence. we found that lower whole grain intake was associated with greater MS prevalence (OR = 1.78; 95% CI: 1.088-2.919; p = 0.022). HDS showed better diet quality among women and in subjects with increasing age and higher educational level. A HDS < 3 points was associated with an increased risk of MS (OR HDS < 3 / HDS ≥ 3 = 3.69; 95% CI 1.884-7.225, p < 0.001). Chilean adult population exhibits a high prevalence of MS linked to a poor diet quality. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Social identity, perceived urban neighborhood quality, and physical inactivity: A comparison study of China, Taiwan, and South Korea.

PubMed

Chen, Duan-Rung; Lin, Yi-Ching

2016-09-01

Asian countries are currently witnessing unprecedented increase in physical inactivity and subsequent negative health outcomes; however, few cross-country studies documenting this trend exist. This paper presents the findings of a nationally representative sample, based on the East Asian Social Survey in 2011. The study sought to examine the association of social identity factors, such as objective socio-economic position, perceived social status and neighborhood quality with physical inactivity, while controlling for psychosocial and physical health. A sample of 5222 adults living in urban areas across China, Taiwan, and South Korea were surveyed. Multivariate nested logistic regressions were constructed. Perceived social status was positively associated with physical activity. Gender difference in physical activity was significant, and this difference widened as educational levels increased. Class division in physical activity was also found. Perceived physical and social features of neighborhood such as suitability for walking and jogging, air quality, and help from neighbors were to different degrees associated with physical inactivity. Gender, marital status, education and perceived social status were common factors associated with physical inactivity in East Asian countries. Perceived urban neighborhood quality is particularly important for Chinese people to stay physically active. Cultural-behavioral norms for physical activity associated with gender and social status call for more studies on cultural perspective for health behaviors in cross-cultural contexts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of timeliness, representativeness and quality of data reported to Italy's national integrated surveillance system for acute viral hepatitis (SEIEVA).

PubMed

Tosti, M E; Longhi, S; de Waure, C; Mele, A; Franco, E; Ricciardi, W; Filia, A

2015-05-01

Periodic assessment of surveillance systems is recommended to verify whether they are appropriately monitoring the public health problem under surveillance. The aim of this study was to evaluate timeliness, data quality and representativeness of data reported to the Italian Integrated Epidemiological System for Acute Viral Hepatitis (SEIEVA). Cross-sectional analysis of surveillance data. Quantitative indicators were used to evaluate representativeness of reported cases, data quality, and timeliness between surveillance steps, for reports of acute viral hepatitis cases with date of onset of symptoms from 2009 to 2012 (N = 4516). Representativeness was 75%. Over 95% of records reported information on age, sex, city of residence, risk factors for hepatitis A and vaccination status. Information on risk factors for hepatitis B and C were reported less consistently (83%), as was information on early outcome (60%). Wide delays were found between surveillance steps. The system collects high quality data on acute viral hepatitis cases in Italy. Timeliness was found to be the main limit and needs to be improved by optimizing web-based reporting procedures, increasing communication with participating centres, improving feedback and increasing dissemination of surveillance results. The study highlights the importance of reporting timeliness to detect outbreaks of acute viral hepatitis. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effect of hand sanitizer on the performance of fingermark detection techniques.

PubMed

Chadwick, Scott; Neskoski, Melissa; Spindler, Xanthe; Lennard, Chris; Roux, Claude

2017-04-01

Hand sanitizers have seen a rapid increase in popularity amongst the general population and this increased use has led to the belief that hand sanitizers may have an effect on subsequent fingermark detection. Based on this hypothesis, three alcoholic and two non-alcoholic hand sanitizers were evaluated to determine the effect they had on the detection of fingermarks deposited after their use. The following fingermark detection methods were applied: 1,2-indanedione-zinc, ninhydrin, physical developer (porous substrate); and cyanoacrylate, rhodamine 6G, magnetic powder (non-porous substrate). Comparison between hand sanitized fingermarks and non-hand sanitized fingermarks showed that the alcohol-based hand sanitizers did not result in any visible differences in fingermark quality. The non-alcoholic hand sanitizers, however, improved the quality of fingermarks developed with 1,2-indanedione-zinc and ninhydrin, and marginally improved those developed with magnetic powder. Different parameters, including time since hand sanitizer application prior to fingermark deposition and age of deposited mark, were tested to determine the longevity of increased development quality. The non-alcoholic hand sanitized marks showed no decrease in quality when aged for up to two weeks. The time since sanitizer application was determined to be an important factor that affected the quality of non-alcoholic hand sanitized fingermarks. It was hypothesized that the active ingredient in non-alcoholic hand sanitizers, benzalkonium chloride, is responsible for the increase in fingermark development quality observed with amino acid reagents, while the increased moisture content present on the ridges resulted in better powdered fingermarks. Copyright © 2017 Elsevier B.V. All rights reserved.

The science of human factors: separating fact from fiction

PubMed Central

Russ, Alissa L; Fairbanks, Rollin J; Karsh, Ben-Tzion; Militello, Laura G; Saleem, Jason J; Wears, Robert L

2013-01-01

Background Interest in human factors has increased across healthcare communities and institutions as the value of human centred design in healthcare becomes increasingly clear. However, as human factors is becoming more prominent, there is growing evidence of confusion about human factors science, both anecdotally and in scientific literature. Some of the misconceptions about human factors may inadvertently create missed opportunities for healthcare improvement. Methods The objective of this article is to describe the scientific discipline of human factors and provide common ground for partnerships between healthcare and human factors communities. Results The primary goal of human factors science is to promote efficiency, safety and effectiveness by improving the design of technologies, processes and work systems. As described in this article, human factors also provides insight on when training is likely (or unlikely) to be effective for improving patient safety. Finally, we outline human factors specialty areas that may be particularly relevant for improving healthcare delivery and provide examples to demonstrate their value. Conclusions The human factors concepts presented in this article may foster interdisciplinary collaborations to yield new, sustainable solutions for healthcare quality and patient safety. PMID:23592760

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.

Increased biomass and quality and reduced heavy metal accumulation of edible tissues of vegetables in the presence of Cd-tolerant and immobilizing Bacillus megaterium H3.

PubMed

Wang, Qi; Zhang, Wen-Ji; He, Lin-Yan; Sheng, Xia-Fang

2018-02-01

A Cd-resistant and immobilizing Bacillus megaterium H3 was characterized for its impact on the biomass and quality and heavy metal uptake of edible tissues of two vegetables (Brassica campestris L. var. Aijiaohuang and Brassica rapa L. var. Shanghaiqing) grown in heavy metal-polluted soil. The impact of strain H3 on the soil quality was also evaluated. The increase in the edible tissue biomass and the contents of soluble proteins and vitamin C of the vegetables inoculated with strain H3 ranged from 18% to 33%, 17% to 31%, and 15% to 19%, respectively, compared with the controls. Strain H3 significantly decreased the edible tissue Cd and Pb contents of the two greens (41-80%), DTPA-extractable Cd content (35-47%) of the rhizosphere soils, and Cd and Pb translocation factors (25-56%) of the greens compared with the controls. Moreover, strain H3 significantly increased the organic matter content (17-21%) and invertase activity (13-14%) of the rhizosphere soils compared with the controls. Our results demonstrated the increased edible tissue biomass and quality, decreased Cd and Pb uptake of the edible tissues, and improved soil quality in the presence of strain H3. The results also suggested an effective bacterial-enhanced technique for decreased metal uptake of greens and improved vegetable and soil qualities in the metal-contaminated soils. Copyright © 2017 Elsevier Inc. All rights reserved.

Professionalism and professional quality of life for oncology nurses.

PubMed

Jang, Insil; Kim, Yuna; Kim, Kyunghee

2016-10-01

To identify the relationship between professionalism and professional quality of life among oncology nurses working at tertiary hospitals in Korea. Oncology nurses are combined with core competencies and qualities required in cancer patient care. Professionalism that means compassion satisfaction and compassion fatigue is a main concept in problem-solving strategies as motivation. Their satisfaction is representative of professionalism and professional quality of life. However, little research has focused on professionalism and professional quality of life. A cross-sectional study with self-administered questionnaires. A total of 285 nurses from two tertiary hospitals were included. Data collection was undertaken using Korean version of professionalism scale derived from the Hall Professional Inventory Scale and professional quality of life. Data were analysed by spss 21.0 for Windows Program using t-test, anova, and multiple regression. The mean score of professionalism in oncology nurses was 77·98 ± 7·31. The mean professional quality of life score for compassion satisfaction, compassion fatigue and secondary traumatic stress was 33·84 ± 5·62, 28·38 ± 5·36 and 28·33 ± 5·48. Compassion satisfaction was affected by factors of professionalism with an explanatory power of 49·2%. Burnout and secondary traumatic stress were affected by factors of professionalism with an explanatory power of 39·3% and 4·8%. The higher the professionalism leads to the higher the compassion satisfaction, the lower the compassion fatigue. The relationship between professionalism and professional quality of life for a health work environment requires further investigation. Our study supports the idea that enhancing professionalism can increase professional quality of life. It is necessary to develop professionalism by recognised qualifications and applied rewards in advanced nursing organisational culture. Furthermore, compassion satisfaction is increased by continuing ethical and moral education programme for clinical nurses to force professional dedication and encouraging nurses to affiliate themselves with the professional communities. Nurses are connected to professionalism affect the quality of nursing service for patients and professional quality of life for themselves. © 2016 John Wiley & Sons Ltd.

Impact of Various Biofuel Feedstock Production Scenarios on Water Quality in the Upper Mississippi River Basin

NASA Astrophysics Data System (ADS)

Wu, M.; Demissie, Y.; Yan, E.

2010-12-01

The impact of increased biofuel feedstock production on regional water quality was examined. This study focused on the Upper Mississippi River Basin, from which a majority of U.S. biofuel is currently produced. The production of biofuel from both conventional feedstock and cellulosic feedstock will potentially increase in the near future. Historically, this water basin generates the largest nitrogen loading to the waterway in the United States and is often cited as a main contributor to the anoxic zone in the Gulf of Mexico. To obtain a quantitative and spatial estimate of nutrient burdens at the river basin, a SWAT (Soil and Water Assessment Tool) model application was developed. The model was equipped with an updated nutrient cycle feature and modified model parameters to represent current crop and perennial grass yield as a result of advancements in breeding and biotechnology. Various biofuel feedstock production scenarios were developed to assess the potential environmental implications of increased biofuel production through corn, agriculture residue, and perennial cellulosic feedstock (such as Switchgrass). Major factors were analyzed, including land use changes, feedstock types, fertilizer inputs, soil property, and yield. This tool can be used to identify specific regional factors affecting water quality and examine options to meet the requirement for environmental sustainability, thereby mitigating undesirable environmental consequences while strengthening energy security.

Impact of Altering Various Image Parameters on Human Epidermal Growth Factor Receptor 2 Image Analysis Data Quality.

PubMed

Pantanowitz, Liron; Liu, Chi; Huang, Yue; Guo, Huazhang; Rohde, Gustavo K

2017-01-01

The quality of data obtained from image analysis can be directly affected by several preanalytical (e.g., staining, image acquisition), analytical (e.g., algorithm, region of interest [ROI]), and postanalytical (e.g., computer processing) variables. Whole-slide scanners generate digital images that may vary depending on the type of scanner and device settings. Our goal was to evaluate the impact of altering brightness, contrast, compression, and blurring on image analysis data quality. Slides from 55 patients with invasive breast carcinoma were digitized to include a spectrum of human epidermal growth factor receptor 2 (HER2) scores analyzed with Visiopharm (30 cases with score 0, 10 with 1+, 5 with 2+, and 10 with 3+). For all images, an ROI was selected and four parameters (brightness, contrast, JPEG2000 compression, out-of-focus blurring) then serially adjusted. HER2 scores were obtained for each altered image. HER2 scores decreased with increased illumination, higher compression ratios, and increased blurring. HER2 scores increased with greater contrast. Cases with HER2 score 0 were least affected by image adjustments. This experiment shows that variations in image brightness, contrast, compression, and blurring can have major influences on image analysis results. Such changes can result in under- or over-scoring with image algorithms. Standardization of image analysis is recommended to minimize the undesirable impact such variations may have on data output.

What affects the quality of life in autoimmune Addison's disease?

PubMed

Meyer, G; Hackemann, A; Penna-Martinez, M; Badenhoop, K

2013-02-01

Several studies have shown a reduced quality of life in patients with Addison's disease, but little is known about the potential influences. We determined the quality of life in 200 patients with Addison's disease using an Addison's disease-specific quality-of-life questionnaire. Data about first symptoms, time to diagnosis and current medication were collected by questionnaires. With increasing latency between first symptoms and diagnosis of adrenal insufficiency, the quality of life decreased in highly significant manner (p<0.001). Age at manifestation correlated negatively with quality of life (p=0.01). Significantly lower scores were observed in females versus males (141 vs. 159, p<0.001). Quality of life decreased significantly with increasing autoimmune comorbidity (p=0.01). Coeliac disease (p=0.05), atrophic gastritis (p=0.01) and primary ovarian failure (p=0.01) were highly correlated with reduced scores. Quality of life was significantly lower in female patients and in those with manifestation at older ages. With more autoimmune comorbidities, the quality of life scores dropped. The most important factor, however, was latency between first symptoms and diagnosis that affected patients' quality of life even years after manifestation of the disease. These results confirm and extend previous observations and emphasize the importance of a timely diagnosis. Therefore, medical awareness for this rare but easily treatable disorder needs to be sharpened. © Georg Thieme Verlag KG Stuttgart · New York.

[Environment and lifestyle: Impacts on male fertility?

PubMed

Bendayan, M; Alter, L; Swierkowski-Blanchard, N; Caceres-Sanchez, L; Selva, J; Robin, G; Boitrelle, F

2018-01-01

In this last century, an increase of men infertility has been registered. It has been suggested that environmental factors could a negative impact over sperm quality. Among these factors, impact of environmental toxicant has been spread by media. In this review of scientific literature, we identify several environmental factors that could impact men fertility in a negative way. These factors are tobacco, marijuana, weight, body mass index, heat, nutritional state, electromagnetic waves and altitude. For each of these factors, the impact over men fertility, their mechanism, as well their influence over the use of Assisted Reproductive Technics are reported. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

[The influence of pedagogic and discipline training on the teaching quality of university professors].

PubMed

Troncoso G, Diego; Pérez V, Cristhian; Vaccarezza G, Giulietta; Aguilar A, César; Muñoz N, Nadia

2017-05-01

University teachers prioritize acquiring knowledge about their disciplines over pedagogic training. However, the latter is becoming increasingly important in the present teaching scenario. To relate pedagogic practices with pedagogic training of teachers from health care careers of public and private universities. Pedagogic practice and training activities participation questionnaires were answered by 296 teachers of undergraduate students from Chilean public and private universities. There was a direct correlation between discipline training and all pedagogic practice factors. However, pedagogic training correlated with all the factors with the exception of teacher centered learning. Teachers with a master degree had higher scores in factors related to teaching planning and process assessment. Having a doctor degree had no impact on these factors. A multiple regression analysis showed that both discipline and pedagogic training and having a master degree were associated with pedagogic practices of teachers. Both pedagogic and discipline training influence the quality of teaching provided by undergraduate teachers.

Spatial and temporal analysis of Air Pollution Index and its timescale-dependent relationship with meteorological factors in Guangzhou, China, 2001-2011.

PubMed

Li, Li; Qian, Jun; Ou, Chun-Quan; Zhou, Ying-Xue; Guo, Cui; Guo, Yuming

2014-07-01

There is an increasing interest in spatial and temporal variation of air pollution and its association with weather conditions. We presented the spatial and temporal variation of Air Pollution Index (API) and examined the associations between API and meteorological factors during 2001-2011 in Guangzhou, China. A Seasonal-Trend Decomposition Procedure Based on Loess (STL) was used to decompose API. Wavelet analyses were performed to examine the relationships between API and several meteorological factors. Air quality has improved since 2005. APIs were highly correlated among five monitoring stations, and there were substantial temporal variations. Timescale-dependent relationships were found between API and a variety of meteorological factors. Temperature, relative humidity, precipitation and wind speed were negatively correlated with API, while diurnal temperature range and atmospheric pressure were positively correlated with API in the annual cycle. Our findings should be taken into account when determining air quality forecasts and pollution control measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae.

PubMed

Matinnia, Nasrin; Haghighi, Mohammad; Jahangard, Leila; Ibrahim, Faisal B; Rahman, Hejar A; Ghaleiha, Ali; Holsboer-Trachsler, Edith; Brand, Serge

2018-01-01

Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched. A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs. Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support. The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD.

Exposure to Psychosocial Risk Factors at Work and the Incidence of Occupational Injuries: A Cohort Study in Spain.

PubMed

Julià, Mireia; Catalina-Romero, Carlos; Calvo-Bonacho, Eva; Benavides, Fernando G

2016-03-01

The aim of this study is to analyze the association between the exposure to psychosocial risk factors at work and the incidence of occupational injuries (OIs). A prospective dynamic cohort study (n = 16,693) of 1-year follow-up. Psychosocial risk factors at work were assessed with the Spanish version of Copenhagen Psychosocial Questionnaire. Incidence rates of OI per 1000 workers-year were calculated and associations between psychosocial risk factors and OI were estimated by Poisson regression models. Unfavorable levels of esteem in men [rate ratio (RR) = 1.28], and unfavorable levels of social support and quality of leadership (RR = 1.87), psychological demands (RR = 2.20), and active work and possibilities for development (RR = 1.83) among women, were associated with OI incidence. Poor quality of psychosocial work environment increases the incidence of OI. Psychosocial intervention programs could be helpful in order to reduce OI incidence rates and their associated costs.

Care provider order entry (CPOE): a perspective on factors leading to success or to failure.

PubMed

Ozdas, A; Miller, R A

2007-01-01

Authors provide a perspective on factors leading to successful care provider order entry (CPOE) implementations. Viewpoint of authors supported by background literature review. Authors review both benefits and challenges related to CPOE implementation using three guiding principles: (1) a clinical approach to clinical systems, which claims that CPOE implementation is analogous to a "good" clinician delivering care to a patient; (2) a commitment to quality, which advocates that no compromises should be made in implementing system functionality and clinical system content - the highest objective for CPOE implementation is to provide better quality of care and increased safety for patients; (3) a commitment to fairness, as evidenced by respect for individuals and support of local autonomy, which advocates for minimizing disruptions to clinician-users' workflows, and adequate local control over CPOE system design and evolution, including clinical content management. Past experiences with CPOE implementation can inform future installation attempts. Sociocultural factors dominate in determining the success of implementation, and should govern technical factors.

What maternal factors influence the diet of 2-year-old children living in deprived areas? A cross-sectional survey.

PubMed

Crombie, Iain K; Kiezebrink, Kirsty; Irvine, Linda; Wrieden, Wendy L; Swanson, Vivien; Power, Kevin; Slane, Peter W

2009-08-01

To investigate the maternal factors associated with poor diet among disadvantaged children. Survey of 300 mothers of 2-year-old children from areas of high deprivation in Scotland (response rate 81 %). A diet quality score was derived from reported consumption of carbohydrates, protein, fruit and vegetables, dairy products and restriction of sugary fatty foods. Most children (85 %) were classified as having a poor quality diet (low diet quality score). Mothers' general knowledge about healthy eating was high, but did not predict the quality of the children's diet. Lower frequencies of food preparation and serving, such as cooking with raw ingredients, providing breakfast daily and the family eating together, were also associated with a poorer diet. Regression modelling identified five significant factors. An increased risk of a poor diet was associated with mothers being unlikely to restrict sweets (OR = 21.63, 95 % CI 2.70, 173.30) or finding it difficult to provide 2-3 portions of fruit daily (OR = 2.94, 95 % CI 1.09, 7.95). Concern that the child did not eat enough increased the risk of a poor diet (OR = 2.37, 95 % CI 1.09, 5.16). Believing a healthy diet would help the child eat more reduced the risk of having a poor diet (OR = 0.28, 95 % CI 0.11, 0.74), as did providing breakfast daily (OR = 0.22, 95 % CI 0.05, 0.99). Interventions to improve children's diet could promote more positive intentions about preparing and serving of foods, particularly of specific meals at which the family eats together. The benefits of these behaviours to the child (improved diet, weight control) should be emphasised.

Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long‐term care institution residents

PubMed Central

Lin, Jesun; Hsiao, Chih‐Tung; Glen, Robert; Pai, Jar‐Yuan; Zeng, Sin‐Huei

2012-01-01

Abstract Objective  To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long‐term care institutions. Design  The five‐point Likert scale questionnaire administered through facetoface interviews. Setting  Fourteen long‐term care institutions located in central and southern Taiwan stratified according to services and accommodation population. Participants  One hundred and eighty long‐term institutional care residents. Main outcome measures  Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Results  Student’s t‐test on institutional location shows a significant difference between overall satisfaction for central and southern institution long‐term care recipients. The correlation test revealed that the higher a resident’s level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index‐of‐model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long‐term care institutions, is also an important factor in residents’ overall satisfaction. Conclusion  The primary goal of long‐term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost‐effective but high‐quality care. On the basis of the results of in‐depth interviews with long‐term institutional care residents, this study suggests long‐term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. PMID:22429448

Accounting for patient size in the optimization of dose and image quality of pelvis cone beam CT protocols on the Varian OBI system

PubMed Central

Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W

2015-01-01

Objective: The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Methods: Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined “small pelvis” reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current–time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. Results: It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). Conclusion: The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. Advances in knowledge: The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose. PMID:26419892

Patient Navigators and Parent Use of Quality Data: A Randomized Trial.

PubMed

Goff, Sarah L; Mazor, Kathleen M; Pekow, Penelope S; White, Katharine O; Priya, Aruna; Lagu, Tara; Guhn-Knight, Haley; Murphy, Lorna; Youssef Budway, Yara; Lindenauer, Peter K

2016-10-01

Consumers rarely use publicly reported health care quality data. Despite known barriers to use, few studies have explored the effectiveness of strategies to overcome barriers in vulnerable populations. This randomized controlled trial tested the impact of a patient navigator intervention to increase consumer use of publicly reported quality data. Patients attending an urban prenatal clinic serving a vulnerable population enrolled between May 2013 and January 2015. The intervention consisted of 2 in-person sessions in which women learned about quality performance and viewed scores for local practices on the Massachusetts Health Quality Partners Web site. Women in both the intervention and control arms received a pamphlet about health care quality. Primary study outcomes were mean clinical quality and patient experience scores of the practices women selected (range 1-4 stars). Nearly all (726/746; 97.3%) women completed the study, 59.7% were Hispanic, and 65.1% had a high school education or less. In both unadjusted and adjusted models, women in the intervention group chose practices with modestly higher mean clinical quality (3.2 vs 3.0 stars; P = .001) and patient experience (3.0 vs 2.9 stars; P = .05) scores. When asked to rate what factors mattered the most in their decision, few cited quality scores. An intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice. These findings suggest that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose. Copyright © 2016 by the American Academy of Pediatrics.

Quantity and quality of interaction between staff and older patients in UK hospital wards: A descriptive study.

PubMed

Barker, Hannah Ruth; Griffiths, Peter; Mesa-Eguiagaray, Ines; Pickering, Ruth; Gould, Lisa; Bridges, Jackie

2016-10-01

The quality of staff-patient interactions underpins the overall quality of patient experience and can affect other important outcomes. However no studies have been identified that comprehensively explore both the quality and quantity of interactions in general hospital settings. To quantify and characterise the quality of staff-patient interactions and to identify factors associated with negative interaction ratings. Data were gathered at two acute English NHS hospitals between March and April 2015. Six wards for adult patients participated including medicine for older people (n=4), urology (n=1) and orthopaedics (n=1). Eligible patients on participating wards were randomly selected for observation. Staff-patient interactions were observed using the Quality of Interactions Schedule. 120h of care were observed with each 2h observation session determined from a balanced random schedule (Monday-Friday, 08:00-22:00h). Multilevel logistic regression models were used to determine factors associated with negative interactions. 1554 interactions involving 133 patients were observed. The median length of interaction was 36s with a mean of 6 interactions per patient per hour. Seventy three percent of interactions were categorized as positive, 17% neutral and 10% negative. Forty percent of patients had at least one negative interaction (95% confidence interval 32% to 49%). Interactions initiated by the patient (adjusted Odds Ratio [OR] 5.30), one way communication (adjusted OR 10.70), involving two or more staff (adjusted OR 5.86 for 2 staff, 6.46 for 3+ staff), having a higher total number of interactions (adjusted OR 1.09 per unit increase), and specific types of interaction content were associated with increased odds of negative interaction (p<0.05). In the full multivariable model there was no significant association with staff characteristics, skill mix or staffing levels. Patient agitation at the outset of interaction was associated with increased odds of negative interaction in a reduced model. There was no significant association with gender, age or cognitive impairment. There was substantially more variation at ward level (variance component 1.76) and observation session level (3.49) than at patient level (0.09). These findings present a unique insight into the quality and quantity of staff-patient interactions in acute care. While a high proportion of interactions were positive, findings indicate that there is scope for improvement. Future research should focus on further exploring factors associated with negative interactions, such as workload and ward culture. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Multiple transgene traits may create un-intended fitness effects in Brassica napus

EPA Science Inventory

Increasingly, genetically modified crops are being developed to express multiple “stacked” traits for different types of transgenes, for example, herbicide resistance, insect resistance, crop quality and resistance to environmental factors. The release of crops that express mult...

10 CFR 171.11 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... LICENSES, INCLUDING HOLDERS OF CERTIFICATES OF COMPLIANCE, REGISTRATIONS, AND QUALITY ASSURANCE PROGRAM...) Remunerated services to other persons; (iii) Distribution of byproduct material, source material, or special... following factors: (1) Age of the reactor; (2) Number of customers in rate base; (3) Net increase in KWh...

The consumer quality index anthroposophic healthcare: a construction and validation study.

PubMed

Koster, Evi B; Ong, Rob R S; Heybroek, Rachel; Delnoij, Diana M J; Baars, Erik W

2014-04-02

Accounting for the patients' perspective on quality of care has become increasingly important in the development of Evidence Based Medicine as well as in governmental policies. In the Netherlands the Consumer Quality (CQ) Index has been developed to measure the quality of care from the patients' perspective in different healthcare sectors in a standardized manner. Although the scientific accountability of anthroposophic healthcare as a form of integrative medicine is growing, patient experiences with anthroposophic healthcare have not been measured systematically. In addition, the specific anthroposophic aspects are not measured by means of existing CQ Indexes. To enable accountability of quality of the anthroposophic healthcare from the patients' perspective the aim of this study is the construction and validation of a CQ Index for anthroposophic healthcare. Construction in three phases: Phase 1. Determining anthroposophic quality aspects: literature study and focus groups. Phase 2. Adding new questions and validating the new questionnaire. Research population: random sample from 7910 patients of 22 anthroposophic GPs. survey, mixed mode by means of the Dillman method. Measuring instrument: experience questionnaire: CQ Index General Practice (56 items), added with 27 new anthroposophic items added and an item-importance questionnaire (anthroposophic items only). Factor analysis, scale construction, internal consistency (Chronbach's Alpha), inter-item-correlation, discriminative ability (Intra Class Correlation) and inter-factor-correlations. Phase 3. Modulation and selection of new questions based on results. Criteria of retaining items: general: a limited amount of items, statistical: part of a reliable scale and inter-item-correlation <0,7, and theoretical. Phase 1. 27 anthroposophic items. Phase 2. Two new anthroposophic scales: Scale AntroposophicTreatmentGP: seven items, Alpha=0,832, ICC=4,2 Inter-factor-correlation with existing GP-scales range from r=0,24 (Accessibility) to r=0,56 (TailoredCare). Scale InteractionalStyleGP: five items, Alpha=0,810, ICC=5,8, Inter-factor-correlation with existing GP-scales range from r=0,32 (Accessibility) to r=0,76 (TailoredCare). Inter-factor-correlation between new scales: r=0,50. Phase 3: Adding both scales and four single items. Removing eleven items and reformulating two items. The CQ Index Anthroposophic Healthcare measures patient experiences with anthroposophic GP's validly and reliably. Regarding the inter-factor-correlations anthroposophic quality aspects from the patients' perspective are mostly associated with individually tailored care and patient centeredness.

Video quality assessment using a statistical model of human visual speed perception.

PubMed

Wang, Zhou; Li, Qiang

2007-12-01

Motion is one of the most important types of information contained in natural video, but direct use of motion information in the design of video quality assessment algorithms has not been deeply investigated. Here we propose to incorporate a recent model of human visual speed perception [Nat. Neurosci. 9, 578 (2006)] and model visual perception in an information communication framework. This allows us to estimate both the motion information content and the perceptual uncertainty in video signals. Improved video quality assessment algorithms are obtained by incorporating the model as spatiotemporal weighting factors, where the weight increases with the information content and decreases with the perceptual uncertainty. Consistent improvement over existing video quality assessment algorithms is observed in our validation with the video quality experts group Phase I test data set.

[Publication activity at Aalborg Hospital].

PubMed

Andersen, Jens Peter; Skrubbeltrang, Conni; Gregersen, Hans

2010-04-26

In 2003 Aalborg Hospital became part of Aarhus University Hospital and in that context focus on research activities was increased. This article investigates whether the increased focus has led to changes in the quantity and/or quality of research publications in the following period. All scientific articles published by Aalborg Hospital in the period 2002-2008, as well as information about author affiliations comprise the data material for the analysis. Different levels of journal groups are created based on Journal Performance Indicators combined with peer-reviewing as a measure of publication quality, awarding publications in highly esteemed journals a higher score than those published in less recognized journals. Together with the number of publications, a measure of research quality and quantity is thereby achieved. This method is compared to the more traditional journal impact factor method. Data show an increase in total publications per year while the mean number of points per publication decreases during the period. Results also show a relation between the score level of publications and the number of collaborations for the publication, i.e. large collaborations are more frequently published in top journals. The study shows that the increased focus on research has led to increased publication activity without loss of quality, as the decrease in points per publication is associated with the increased mean number of collaborators. The results indicate that the method would benefit from a revision to facilitate clearer conclusions.

Quality of life in thyroid cancer patients: a literature review

PubMed Central

BÃRBUŞ, ELENA; PEŞTEAN, CLAUDIU; LARG, MARIA IULIA; PICIU, DOINA

2017-01-01

Introduction Quality of life (QoL) has received increasing interest in the last years, especially in patients with cancer. This article aims to analyze a selection of medical research papers regarding the quality of life in patients with thyroid carcinoma. We overviewed the main QoL aspects derived from several studies and highlighted those less researched issues, which could represent a solid base for future clinical studies. Method We used an integrative selection method of medical literature, choosing mostly “free access” studies, as it was considered that they could be easily viewed, searched and researched including by patients. Results After an integrative literature review, we selected 16 relevant studies. Patients with thyroid cancer have several factors influencing their QoL, with both physical and psychological impact. The decisive factors are the quality of the surgical act, radioiodine therapy, follow-up using rh-TSH vs. hormonal withdrawal, access to behavioral help and the relationship with their physician. Conclusion We must understand the emotional impact of the cancer diagnosis on the patient and we must collaborate in order to help the patient restore the psychosomatic balance and to recover the quality of life PMID:28559697

Publications as an indicator of increased tobacco control research productivity (quantity and quality) in New Zealand.

PubMed

Kira, Anette; Glover, Marewa; Bullen, Chris; Viehbeck, Sarah

2011-06-01

Tobacco control (TC) research capacity and productivity are critical for developing evidence-informed interventions that will reduce the harmful effects of smoking. The aim of this paper was to investigate New Zealand's (NZ) TC research capacity along with the quantity and quality of publications, following two government initiatives aimed, in part, at improving the quantity and quality of NZ TC research. Scopus was searched for articles with at least one NZ author and where the topic was of primary relevance to TC. Publications were organized into two time periods, following the government initiatives, 1993-2003 and 2004-2009. We analyzed the number of publications, publication journals, type of publications, impact (using the impact factor), and authorship. There has been an increase in number and impact of publications and number of authors. The number of publications has increased from an average of 14 (1994-2003) to 38 per year (2004-2009). The number of journals published increased from 64 to 86. The impact during 2004-2009 was almost threefold than in 1993-2003. The number of authors increased from 212 to 345, and the number of authors who had at least one first-authored publication increased from 80 to 124. These results show an encouraging trend in NZ TC research, with an increase in research productivity, quality, and in research capacity. It is possible that government-initiated and -funded infrastructural support contributed to increasing needed TC research, which supports the worth of such initiatives.

Influence of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain, and quality of recovery after adult spine surgery

PubMed Central

Dunn, Lauren K.; Durieux, Marcel E.; Fernández, Lucas G.; Tsang, Siny; Smith-Straesser, Emily E.; Jhaveri, Hasan F.; Spanos, Shauna P.; Thames, Matthew R.; Spencer, Christopher D.; Lloyd, Aaron; Stuart, Russell; Ye, Fan; Bray, Jacob P.; Nemergut, Edward C.; Naik, Bhiken I.

2018-01-01

OBJECTIVE Perception of perioperative pain is influenced by various psychological factors. The aim of this study was to determine the impact of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain scores, and quality of recovery in adults who underwent spine surgery. METHODS Patients undergoing spine surgery were enrolled in this study, and the preoperatively completed questionnaires included the verbal rating scale (VRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Oswestry Disability Index (ODI). Quality of recovery was assessed using the 40-item Quality of Recovery questionnaire (QoR40). Opioid consumption and pain scores according to the VRS were recorded daily until discharge. RESULTS One hundred thirty-nine patients were recruited for the study, and 101 completed the QoR40 assessment postoperatively. Patients with higher catastrophizing scores were more likely to have higher maximum pain scores postoperatively (estimate: 0.03, SE: 0.01, p = 0.02), without increased opioid use (estimate: 0.44, SE: 0.27, p = 0.11). Preoperative anxiety (estimate: 1.18, SE: 0.65, p = 0.07) and depression scores (estimate: 1.06, SE: 0.71, p = 0.14) did not correlate with increased postoperative opioid use; however, patients with higher preoperative depression scores had lower quality of recovery after surgery (estimate: −1.9, SE: 0.56, p < 0.001). CONCLUSIONS Catastrophizing, anxiety, and depression play important roles in modulating postoperative pain. Preoperative evaluation of these factors, utilizing a validated tool, helps to identify patients at risk. This might allow for earlier psychological intervention that could reduce pain severity and improve the quality of recovery. PMID:29125426

[Evaluation of the quality of care of transient tachypnea in newborns affiliated with the Medical Insurance Siglo XXI program].

PubMed

Pérez-Cuevas, Ricardo; Jasso Gutiérrez, Luis; Doubova, Svetlana; Flores Hernández, Sergio; Mantilla Trollé, Clara; González Guerra, Eduardo; Muñoz Hernández, Onofre

Evaluation of the quality of care of the newborn with complications is an indispensable element for the improvement of strategies directed to reduce newborn mortality rates. The aim of this work was to evaluate the quality of technical and interpersonal care in the management of transient tachypnea of the newborn (TTN) of patients affiliated with the program "Medical Insurance Siglo XXI". A cross-sectional study was conducted in 61 hospitals affiliated with the Health Ministry with at least two cases of TTN during the first semester of 2011. Variables such as mother's health, pregnancy, birth and birth complication characteristics were analyzed. Also, newborn interventions and health conditions upon discharge were included. To measure the quality of care according to prevention, diagnosis and treatment, quality indicators were defined and validated. We analyzed 256 case files with a diagnosis of TTN; 8.9% of the mothers presented risk factors (asthma, diabetes) and 53.5% had complications during pregnancy. There were 60% of cases with TTN born by cesarean delivery; one third of these children had low birth weight and 14% were transferred to another hospital. As for the quality indicators in the area of prevention, more than 90% of risk factors (smoking, asthma, cesarean delivery) were identified. Diagnostic indicators showed that 86-98% of respiratory distress symptoms were sought. Indicators of treatment achieved satisfactory figures for monitoring and support measures. Prevention, diagnosis and treatment indicators made it possible to consider that most TTN cases received appropriate treatment. It is advisable to develop effective strategies to prevent TTN, such as increasing efforts to reduce the increasing rates of cesarean deliveries. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Perception gap in quality-of-life ratings: an empirical investigation of nursing home residents and caregivers.

PubMed

Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, Yongjoo; Kastango, Kari B; Mulsant, Benoit H; Castle, Nick; Rubin, Fred H; Nace, David

2007-04-01

Several studies have previously documented the existence of a perception gap-the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual factors. We calculated the perception gap for 11 quality-of-life domains. Caregivers rated both job satisfaction and their perception of quality of life of residents in the unit where they provided service. Concurrently, residents from these units completed quality-of-life interviews. We computed the perception gap by subtracting the residents' ratings from the caregivers' ratings for each quality-of-life domain. We conducted a hierarchical linear model using 3,850 observations to predict the perception gap. Caregivers perceive quality of life to be lower than residents do across all domains fairly consistently. Caregiver demographics do not directly predict the perception gap. However, satisfaction with work, pay, and promotion were significant predictors (p <.05), and satisfaction with supervisor was a marginally significant predictor (p <.10), of the perception gap. As satisfaction with these job dimensions increased, the perception gap decreased. Additional models show that several caregiver demographics directly influence job-satisfaction dimensions, though they did not influence the perception gap. Job-satisfaction dimensions, rather than caregiver characteristics, are the appropriate predictors of the perception gap. However, caregiver demographics exert their influence indirectly by means of job satisfaction. A key finding is that higher job satisfaction leads to a smaller perception gap. Helson's adaptation-level theory appears to be a useful approach for understanding the antecedents of the perception gap.

Non-genetic risk factors and their influence on the management of patients in the clinic.

PubMed

Álvarez, Teresa; Soto, Immaculada; Astermark, Jan

2015-02-01

The development of inhibitors is the most serious iatrogenic complication affecting patients with haemophilia. This complication is associated with impaired vital or functional prognosis, reduced quality of life and increased cost of treatment. The reasons why some patients develop antibodies to factor replacement and others do not remain unclear. It is however clear that inhibitor development results from a complex multifactorial interaction between genetic and non-genetic risk factors. Environmental influences implicated in increasing the risk of inhibitor formation can be viewed as modifiable risk factors. Therefore, identification of the non-genetic risk factors may offer the possibility of personalising haemophilia therapy by modifying treatment strategies in high-risk patients in the critical early phase of factor VIII exposure. In this article, we review the non-genetic factors reported as well as the potential impact of danger signals and the different scores for inhibitor development risk stratification. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Perspective of Membrane Technology in Dairy Industry: A Review

PubMed Central

Kumar, Pavan; Sharma, Neelesh; Ranjan, Rajeev; Kumar, Sunil; Bhat, Z. F.; Jeong, Dong Kee

2013-01-01

Membrane technology has revolutionized the dairy sector. Different types of membranes are used in the industry for various purposes like extending the shelf life of milk without exposure to heat treatment, standardization of the major components of milk for tailoring new products as well increasing yield and quality of the dairy products, and concentrating, fractionation and purification of milk components especially valuable milk proteins in their natural state. In the cheese industry, membranes increase the yield and quality of cheese and control the whey volume, by concentrating the cheese milk. With the advancement of newer technology in membrane processes, it is possible to recover growth factor from whey. With the introduction of superior quality membranes as well as newer technology, the major limitation of membranes, fouling or blockage has been overcome to a greater extent. PMID:25049918

Perspective of membrane technology in dairy industry: a review.

PubMed

Kumar, Pavan; Sharma, Neelesh; Ranjan, Rajeev; Kumar, Sunil; Bhat, Z F; Jeong, Dong Kee

2013-09-01

Membrane technology has revolutionized the dairy sector. Different types of membranes are used in the industry for various purposes like extending the shelf life of milk without exposure to heat treatment, standardization of the major components of milk for tailoring new products as well increasing yield and quality of the dairy products, and concentrating, fractionation and purification of milk components especially valuable milk proteins in their natural state. In the cheese industry, membranes increase the yield and quality of cheese and control the whey volume, by concentrating the cheese milk. With the advancement of newer technology in membrane processes, it is possible to recover growth factor from whey. With the introduction of superior quality membranes as well as newer technology, the major limitation of membranes, fouling or blockage has been overcome to a greater extent.

The effects of sex, tissue type, and dietary components on stable isotope discrimination factors (Δ13C and Δ15N) in mammalian omnivores.

PubMed

Kurle, Carolyn M; Koch, Paul L; Tershy, Bernie R; Croll, Donald A

2014-01-01

We tested the effects of sex, tissue, and diet on stable isotope discrimination factors (Δ(13)C and Δ(15)N) for six tissues from rats fed four diets with varied C and N sources, but comparable protein quality and quantity. The Δ(13)C and Δ(15)N values ranged from 1.7-4.1‰ and 0.4-4.3‰, respectively. Females had higher Δ(15)N values than males because males grew larger, whereas Δ(13)C values did not differ between sexes. Differences in Δ(13)C values among tissue types increased with increasing variability in dietary carbon sources. The Δ(15)N values increased with increasing dietary δ(15)N values for all tissues except liver and serum, which have fast stable isotope turnover times, and differences in Δ(15)N values among tissue types decreased with increasing dietary animal protein. Our results demonstrate that variability in dietary sources can affect Δ(13)C values, protein source affects Δ(15)N values even when protein quality and quantity are controlled, and the isotope turnover rate of a tissue can influence the degree to which diet affects Δ(15)N values.

A Systematic Narrative Review of Effects of Community-Based Intervention on Rates of Organ Donor Registration.

PubMed

Golding, Sarah Elizabeth; Cropley, Mark

2017-09-01

The demand for organ donation is increasing worldwide. One possible way of increasing the pool of potential posthumous donors is to encourage more members of the general public to join an organ donor registry. A systematic review was conducted to investigate the effectiveness of psychological interventions designed to increase the number of individuals in the community who register as organ donors. PsycINFO and PubMed databases were searched. No date limits were set. Randomized and nonrandomized controlled trials exploring the effects of community-based interventions on organ donor registration rates were included. Methodological quality was assessed using the "Quality Assessment Tool for Quantitative Studies." Twenty-four studies met the inclusion criteria; 19 studies found a positive intervention effect on registration. Only 8 studies were assessed as having reasonable methodological robustness. A narrative synthesis was conducted. Factors influencing registration rates include providing an immediate registration opportunity and using brief interventions to challenge misconceptions and concerns about organ donation. Community-based interventions can be effective at increasing organ donor registrations among the general public. Factors that may increase effectiveness include brief interventions to address concerns and providing an immediate registration opportunity. Particular consideration should be paid to the fidelity of intervention delivery. Protocol registration number: CRD42014012975.

Urban public health assessment and pattern analysis: comparison of four cities in different countries

NASA Astrophysics Data System (ADS)

Su, Meirong; Chen, Chen; Lu, Weiwei; Liu, Gengyuan; Yang, Zhifeng; Chen, Bin

2013-06-01

Urban public health is an important global issue, and receives extensive attention. It is necessary to compare urban public health status among different cities, so that each city can define its own health patterns and limiting factors. The following assessment indicators were established to evaluate urban public health status: living conditions, physical health, education and culture, environmental quality, and social security. A weighted-sum model was used in combination with these indicators to compare the urban public health status in four cities—Beijing, New York, London, and Tokyo—using data for 2000-2009. Although the urban public health level of Beijing was lower than that of the other cities, it showed the greatest increase in this level over the study period. Different patterns of urban public health were identified: London had the most balanced, steady pattern (almost all factors performed well and developed stably); New York and Tokyo showed balanced, but unsteady patterns (most factors remained high, though social security and environmental quality fluctuated); Beijing had the most unbalanced, unsteady pattern (the different factors were at different levels, and education and culture and social security fluctuated). For enhanced urban public health status, environmental quality and education and culture clearly need to be improved in Beijing. This study demonstrates that a comparison of different cities is helpful in identifying limiting factors for urban public health and providing an orientation for future urban development.

Nurses' turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness.

PubMed

Dechawatanapaisal, Decha

2018-06-01

The aim of this study was to examine the influence of three factors on turnover intention: leader-member exchange quality, organizational identification and job embeddedness. This area of inquiry has not been fully investigated in the literature. Employee turnover, particularly of professionals, becomes a very challenging issue. It continually affects organizations in terms of resourcing and developmental costs, manpower instability, day-to-day operations, perception of quality care and efficiency. Therefore, employees' working attitude and behaviour have drawn increasing attention for further research to determine which factors keep them with their employer. A cross-sectional survey was conducted with self-report questionnaires. Data were collected from 1,966 nurses from sixteen private general hospitals in Thailand during February-June 2016. Hypotheses were tested and analysed by means of a confirmatory factor analysis, structural equation modelling and a bootstrapping procedure. The results revealed the direct relationship between leader-member exchange quality and job embeddedness. Organizational identification played an intermediary role that partially mediated the relationship between leader-member exchange quality on job embeddedness. Analysis also provided support for the mediating effect of organizational identification and turnover intention through job embeddedness. This study extends the job embeddedness theory and gains understanding of the antecedent factors that directly and indirectly cause employees to become embedded and lead to predict turnover intention. The findings are pertinent, as few studies have investigated such relationships. The implications provide insights into how organizations can better retain their workforce. © 2018 John Wiley & Sons Ltd.

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study

PubMed Central

de Mutsert, Renée; le Cessie, Saskia; Appelman-Dijkstra, Natasha M.; Rosendaal, Frits R.; van Heemst, Diana; den Heijer, Martin; Biermasz, Nienke R.

2017-01-01

Context Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. Objective To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Design, setting and participants Cross-sectional analysis of 915 participants (45–65 years, 56% women, BMI 26 (range: 18–56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). Results After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03–1.14), declined self-rated sleep quality (1.76, 1.03–3.01), sleep latency (1.18, 1.06–1.31), and a one hour later sleep timing (1.51, 1.08–2.11), but not sleep duration (1.05, 0.90–1.23), were associated with osteopenia. PSQI score (1.10, 1.02–1.19) was also associated with sarcopenia; OR’s of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99–1.31) and 1.54 (0.91–2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. Conclusions These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals. PMID:28459884

Impact of socioeconomic and meteorological factors on reservoirs' air quality: a case in the Three Gorges Reservoir of Chongqing (TGRC), China over a 10-year period.

PubMed

Peng, Ying; Zhou, Fengwu; Cui, Jian; Du, Ke; Leng, Qiangmei; Yang, Fumo; Chan, Andy; Zhao, Hongting

2017-07-01

The Three Gorges Dam's construction and industrial transfer have resulted in a new air pollution pattern with the potential to threaten the reservoir eco-environment. To assess the impact of socioeconomic factors on the pattern of air quality vairation and economical risks, concentrations of SO 2 , NO 2 , and PM 10 , industry genres, and meteorological conditions were selected in the Three Gorges Reservoir of Chongqing (TGRC) during 2006-2015. Results showed that air quality had improved to some extent, but atmospheric NO 2 showed an increased trend during 2011-2015. Spatially, higher atmospheric NO 2 extended to the surrounding area. The primary industry, especially for agriculture, had shown to be responsible for the remarkable increase of atmospheric NO 2 (p < 0.01) due to the direct burning of agricultural straws and the emission of livestock breeding. The improvement of regional industrial structure and industrialization benefited air pollutant reductions, but construction industries had inhibited the improvement of regional air quality. In the tertiary industry, the cargo industry at ports had significantly decreased atmospheric NO 2 as a result of eliminating the obsoleted small ships. Contrarily, the highway transportation had brought more air pollutants. The relative humidity was shown to be the main meteorological factor, which had an extremely remarkable relation with atmospheric SO 2 (p < 0.01) and a significant correlation with atmospheric NO 2 (p < 0.05), respectively. In the future, the development of agriculture and livestock breeding would make regional air quality improvement difficult, and atmospheric SO 2 , NO 2 , and PM 10 deposition would aggravate regional soil and water acidification and reactivate heavy metal in soil and sediment, further to pose a high level of ecological risk in the TGRC and other countries with reservoirs in the world.

2.1 μm high-power laser diode beam combining(Conference Presentation)

NASA Astrophysics Data System (ADS)

Berrou, Antoine P. C.; Elder, Ian F.; Lamb, Robert A.; Esser, M. J. Daniel

2016-10-01

Laser power and brightness scaling, in "eye safe" atmospheric transmission windows, is driving laser system research and development. High power lasers with good beam quality, at wavelength around 2.1 µm, are necessary for optical countermeasure applications. For such applications, focusing on efficiency and compactness of the system is mandatory. In order to cope with these requirements, one must consider the use of laser diodes which emit directly in the desired spectral region. The challenge for these diodes is to maintain a good beam quality factor as the output power increases. 2 µm diodes with excellent beam quality in both axes are available with output powers of 100 mW. Therefore, in order to reach multi-watt of average output power, broad-area single emitters and beam combining becomes relevant. Different solutions have been implemented in the 1.9 to 2 µm wavelength range, one of which is to stack multiple emitter bars reaching more than one hundred watt, while another is a fibre coupled diode module. The beam propagation factor of these systems is too high for long atmospheric propagation applications. Here we describe preliminary results on non-coherent beam combining of 2.1 µm high power Fabry-Perot GaSb laser diodes supplied by Brolis Semiconductors Ltd. First we evaluated single mode diodes (143 mW) with good beam quality (M2 < 1.5 for slow axis and < 1.1 for fast axis). Then we characterized broad-area single emitter diodes (808 mW) with an electrical-to-optical efficiency of 19 %. The emitter width was 90 µm with a cavity length of 1.5 mm. In our experiments we found that the slow axis multimode output beam consisted of two symmetric lobes with a total full width at half maximum (FWHM) divergence angle of 25 degrees, corresponding to a calculated beam quality factor of M2 = 25. The fast axis divergence was specified to be 44 degrees, with an expected beam quality factor close to the diffraction limit, which informed our selection of collimation lenses used in the experiment. We evaluated two broadband (1.8 - 3 µm) AR coated Geltech aspheric lenses with focal lengths of 1.87 mm and 4 mm, with numerical apertures of 0.85 and 0.56, respectively, as an initial collimation lens, followed by an additional cylindrical lens of focal length 100 mm for fully collimating the slow axis. Using D-shaped gold-coated mirrors, multiple single emitter beams are stacked in the fast axis direction with the objective that the combined beam has a beam propagation factor in the stacking direction close to the beam propagation factor of the slow axis of a single emitter, e.g. M2 of 20 to 25 in both axes. We further found that the output beam of a single emitter is highly linearly polarized along the slow axis, making it feasible to implement polarization beam combining techniques to increase the beam power by a factor two while maintaining the same beam quality. Along with full beam characterization, a power scaling strategy towards a multi-watt output power beam combining laser system will be presented.

The quality-value proposition in health care.

PubMed

Feazell, G Landon; Marren, John P

2003-01-01

Powerful forces are converging in US health care to finally cause recognition of the inherently logical relationship between quality and money. The forces, or marketplace "drivers," which are converging to compel recognition of the relationship between cost and quality are: (1) the increasing costs of care; (2) the recurrence of another medical malpractice crisis; and (3) the recognition inside and outside of health care that quality is inconsistent and unacceptable. It is apparent that hospital administrators, financial officers, board members, and medical staff leadership do not routinely do two things: (1) relate quality to finance; and (2) appreciate the intra-hospital structural problems that impede quality attainment. This article discusses these factors and offers a positive method for re-structuring quality efforts and focusing the hospital and its medical staff on quality. The simple but compelling thesis of the authors is that health care must immediately engage in the transformation to making quality of medical care the fundamental business strategy of the organization.

Influence of color on dielectric properties of marinated poultry breast meat.

PubMed

Samuel, D; Trabelsi, S

2012-08-01

The dielectric behavior of foods when exposed to radio-frequency and microwave electric fields is highly influenced by moisture content and the degree of water binding with constituents of the food materials. The ability to correlate specific food quality characteristics with the dielectric properties can lead to the development of rapid, nondestructive techniques for such quality measurements. Water-holding capacity is a critical attribute in meat quality. Up to 50% of raw poultry meat in the United States is marinated with mixtures of water, salts, and phosphates. The objective of this study was to determine if variations in breast meat color would affect the dielectric properties of marinated poultry meat over a broad frequency range from 500 MHz to 50 GHz. Poultry meat was obtained from a local commercial plant in Georgia (USA). Color and pH measurements were taken on the breast filets. Groups of breast filets were sorted into classes of pale and normal before adding marination pickup percentages of 0, 5, 10, and 15. Breast filets were vacuum-tumbled and weighed for pickup percentages. Dielectric properties of the filets were measured with a coaxial open-ended probe on samples equilibrated to 25°C. Samples from pale meat exhibited higher dielectric properties than samples from normal meat. No differences could be observed between samples from pale and normal meat after marination of the samples. Overall, dielectric properties increased as the marination pickup increased (α=0.05). Marination pickup strongly influenced the dielectric loss factor. Differences between samples marinated at different pickup levels were more pronounced at lower frequencies for the dielectric loss factor. As frequency increased, the differences between samples decreased. Differences in dielectric constant between samples were not as consistent as those seen with the dielectric loss factor.

CONSUMER EXPECTATION ON SERVICE QUALITY PROVIDE BY PHARMACIST IN SELF MEDICATION PRACTICES AND ITS ASSOCIATED FACTORS IN BANDUNG, INDONESIA.

PubMed

Alfian, Sofa D; Sinuraya, Rano K; Kautsar, Angga P; Abdulah, Rizky

2016-11-01

Self-medication is the use of medicines for therapeutic intent without a clinician’s advice or prescription. The National Socioeconomic Survey for Indonesia in 2009 found the percentage of the Indonesians engaging in self-medication is increasing. The objectives of this study were to assess consumers’ expectations regarding service quality provide by pharmacist in self-medication practices and determine the factors associated with self-medication in Bandung, Indonesia. We conduct a cross-sectional survey at eight randomly selected community pharmacies during July-November 2012 and purposely sampled 1,200 costumers purchasing medication at those sites. Subjects reported they understood the information about the medicines given by the pharmacist but still wanted more information and time to consult with the pharmacist about their medicines. Factors associated with self-medication were younger age, male gender, greater education and lower income. The intervention is needed to improve appropriate self-medication.

Learning Collaboratives: Insights And A New Taxonomy From AHRQ's Two Decades Of Experience.

PubMed

Nix, Mary; McNamara, Peggy; Genevro, Janice; Vargas, Natalia; Mistry, Kamila; Fournier, Alaina; Shofer, Margie; Lomotan, Edwin; Miller, Therese; Ricciardi, Richard; Bierman, Arlene S

2018-02-01

Learning collaboratives are increasingly used as mechanisms to support and hasten the diffusion and implementation of innovation, clinical evidence, and effective models of care. Factors contributing to the collaboratives' success or failure are poorly understood. The Agency for Healthcare Research and Quality (AHRQ) has sponsored collaboratives for nearly two decades to support improvements in health care quality and value by accelerating the diffusion and implementation of innovation. We examined AHRQ's experience with these collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered. Building on the literature and insights from AHRQ's experience, we propose a taxonomy that can offer guidance to decision makers and funders about the factors they should consider in developing collaboratives and planning their evaluation, as well as to researchers who seek to conduct research that will ultimately help decision makers make better investments in diffusing innovation and evidence.

Organisational quality, nurse staffing and the quality of chronic disease management in primary care: observational study using routinely collected data.

PubMed

Griffiths, Peter; Maben, Jill; Murrells, Trevor

2011-10-01

An association between quality of care and staffing levels, particularly registered nurses, has been established in acute hospitals. Recently an association between nurse staffing and quality of care for several chronic conditions has also been demonstrated for primary care in English general practice. A smaller body of literature identifies organisational factors, in particular issues of human resource management, as being a dominant factor. However the literature has tended to consider staffing and organisational factors separately. We aim to determine whether relationships between the quality of clinical care and nurse staffing in general practice are attenuated or enhanced when organisational factors associated with quality of care are considered. We further aim to determine the relative contribution and interaction between these factors. We used routinely collected data from 8409 English general practices. The data, on organisational factors and the quality of clinical care for a range of long term conditions, is gathered as part of "Quality and Outcomes Framework" pay for performance system. Regression models exploring the relationship of staffing and organisational factors with care quality were fitted using MPLUS statistical modelling software. Higher levels of nurse staffing, clinical recording, education and reflection on the results of patient surveys were significantly associated with improved clinical care for COPD, CHD, Diabetes and Hypothyroidism after controlling for organisational factors. There was some evidence of attenuation of the estimated nurse staffing effect when organisational factors were considered, but this was small. The effect of staffing interacted significantly with the effect of organisational factors. Overall however, the characteristics that emerged as the strongest predictors of quality of clinical care were not staffing levels but the organisational factors of clinical recording, education and training and use of patient experience surveys. Organisational factors contribute significantly to observed variation in the quality of care in English general practices. Levels of nurse staffing have an independent association with quality but also interact with organisational factors. The observed relationships are not necessarily causal but a causal relationship is plausible. The benefits and importance of education, training and personal development of nursing and other practice staff was clearly indicated. Copyright © 2011. Published by Elsevier Ltd.

The influence of context on the effectiveness of hospital quality improvement strategies: a review of systematic reviews.

PubMed

Kringos, Dionne S; Sunol, Rosa; Wagner, Cordula; Mannion, Russell; Michel, Philippe; Klazinga, Niek S; Groene, Oliver

2015-07-22

It is now widely accepted that the mixed effect and success rates of strategies to improve quality and safety in health care are in part due to the different contexts in which the interventions are planned and implemented. The objectives of this study were to (i) describe the reporting of contextual factors in the literature on the effectiveness of quality improvement strategies, (ii) assess the relationship between effectiveness and contextual factors, and (iii) analyse the importance of contextual factors. We conducted an umbrella review of systematic reviews searching the following databases: PubMed, Cochrane Database of Systematic Reviews, Embase and CINAHL. The search focused on quality improvement strategies included in the Cochrane Effective Practice and Organisation of Care Group taxonomy. We extracted data on quality improvement effectiveness and context factors. The latter were categorized according to the Model for Understanding Success in Quality tool. We included 56 systematic reviews in this study of which only 35 described contextual factors related with the effectiveness of quality improvement interventions. The most frequently reported contextual factors were: quality improvement team (n = 12), quality improvement support and capacity (n = 11), organization (n = 9), micro-system (n = 8), and external environment (n = 4). Overall, context factors were poorly reported. Where they were reported, they seem to explain differences in quality improvement effectiveness; however, publication bias may contribute to the observed differences. Contextual factors may influence the effectiveness of quality improvement interventions, in particular at the level of the clinical micro-system. Future research on the implementation and effectiveness of quality improvement interventions should emphasize formative evaluation to elicit information on context factors and report on them in a more systematic way in order to better appreciate their relative importance.

Systematic monitoring of male circumcision scale-up in Nyanza, Kenya: exploratory factor analysis of service quality instrument and performance ranking.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2014-01-01

Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of facilities and circumcision procedure using a composite index based on these items indicates that majority performed above average.

Guidelines for performing systematic reviews in the development of toxicity factors.

PubMed

Schaefer, Heather R; Myers, Jessica L

2017-12-01

The Texas Commission on Environmental Quality (TCEQ) developed guidance on conducting systematic reviews during the development of chemical-specific toxicity factors. Using elements from publicly available frameworks, the TCEQ systematic review process was developed in order to supplement the existing TCEQ Guidelines for developing toxicity factors (TCEQ Regulatory Guidance 442). The TCEQ systematic review process includes six steps: 1) Problem Formulation; 2) Systematic Literature Review and Study Selection; 3) Data Extraction; 4) Study Quality and Risk of Bias Assessment; 5) Evidence Integration and Endpoint Determination; and 6) Confidence Rating. This document provides guidance on conducting a systematic literature review and integrating evidence from different data streams when developing chemical-specific reference values (ReVs) and unit risk factors (URFs). However, this process can also be modified or expanded to address other questions that would benefit from systematic review practices. The systematic review and evidence integration framework can improve regulatory decision-making processes, increase transparency, minimize bias, improve consistency between different risk assessments, and further improve confidence in toxicity factor development. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Risk factors and preventive interventions for Alzheimer disease: state of the science.

PubMed

Daviglus, Martha L; Plassman, Brenda L; Pirzada, Amber; Bell, Carl C; Bowen, Phyllis E; Burke, James R; Connolly, E Sander; Dunbar-Jacob, Jacqueline M; Granieri, Evelyn C; McGarry, Kathleen; Patel, Dinesh; Trevisan, Maurizio; Williams, John W

2011-09-01

Numerous studies have investigated risk factors for Alzheimer disease (AD). However, at a recent National Institutes of Health State-of-the-Science Conference, an independent panel found insufficient evidence to support the association of any modifiable factor with risk of cognitive decline or AD. To present key findings for selected factors and AD risk that led the panel to their conclusion. An evidence report was commissioned by the Agency for Healthcare Research and Quality. It included English-language publications in MEDLINE and the Cochrane Database of Systematic Reviews from 1984 through October 27, 2009. Expert presentations and public discussions were considered. Study inclusion criteria for the evidence report were participants aged 50 years and older from general populations in developed countries; minimum sample sizes of 300 for cohort studies and 50 for randomized controlled trials; at least 2 years between exposure and outcome assessment; and use of well-accepted diagnostic criteria for AD. Included studies were evaluated for eligibility and data were abstracted. Quality of overall evidence for each factor was summarized as low, moderate, or high. Diabetes mellitus, hyperlipidemia in midlife, and current tobacco use were associated with increased risk of AD, and Mediterranean-type diet, folic acid intake, low or moderate alcohol intake, cognitive activities, and physical activity were associated with decreased risk. The quality of evidence was low for all of these associations. Currently, insufficient evidence exists to draw firm conclusions on the association of any modifiable factors with risk of AD.

Psychosocial stressors of sickle cell disease on adult patients in Cameroon.

PubMed

Wonkam, Ambroise; Mba, Caryl Zameyo; Mbanya, Dora; Ngogang, Jeanne; Ramesar, Raj; Angwafo, Fru F

2014-12-01

Sickle Cell Disease (SCD) is a debilitating illness that affects quality of life. Studies of the psychosocial burden of SCD on patients have been rarely reported in Africa. We used a quantitative method, with face-to-face administered questionnaires, to study indices of psychosocial stressors on adult SCD patients in Cameroon. The questionnaire included a 36-item stress factors scale evaluating general perceptions of stress and five main stressors' domain: disease factors, hospital factors, financial factors, family factors and quality of personal-life factors. Items pertaining to psychosocial stressors involved four response options with increasing severity: 0, 1, 2 or 3. Non-parametric tests were used for analysis. The majority of the 83 participants were urban dwellers, female, 20-30 years old, single, unemployed, with at least a secondary or tertiary education. Median age at diagnosis was 100 months; 47.8% had >3 painful vaso-oclusive crises annually. Only 4.8% had been treated with hydroxyurea. The majority reported moderate to severe difficulty coping with SCD. The "degree of clinical severity" category displayed the highest median score (2.0), while familial stressors showed the lowest (0.8). Being female, married, with low education level, an additional affected sibling and low direct income were significantly associated with specific stressors' categories. In Cameroon, there is an urgent need to implement policies that ensure affordable access to health-care and practices to reduce SCD morbidity and improve patients' quality of life.

Examining the Factor Structure and Hierarchical Nature of the Quality of Life Construct

ERIC Educational Resources Information Center

Wang, Mian; Schalock, Robert L.; Verdugo, Miguel A.; Jenaro, Christina

2010-01-01

There is considerable debate in the area of individual quality of life research regarding the factor structure and hierarchical nature of the quality of life construct. Our purpose in this study was to test via structural equation modeling an a priori quality of life model consisting of eight first-order factors and one second-order factor. Data…

Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review.

PubMed

Kenny, Sarah J; Whittaker, Jackie L; Emery, Carolyn A

2016-08-01

Preprofessional dancers partake in rigorous training and have high injury prevalence. Attempts to identify risk factors for dance injuries have focused on a diversity of intrinsic and extrinsic factors. To identify and evaluate the evidence examining risk factors for musculoskeletal injury in preprofessional ballet and modern dancers. Fifteen electronic databases were systematically searched to October 2015. Studies selected met a priori inclusion criteria and investigated musculoskeletal injury risk factors in preprofessional (elite adolescent, student, young adult) ballet and modern dancers. Two reviewers independently assessed the quality and level of evidence using the Downs and Black (DB) criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Of 1364 potentially relevant studies, 47 were included and scored. Inconsistent injury definition and methodology precluded meta-analysis. The most common modifiable risk factors investigated were anthropometrics (ie, body mass index, adiposity), joint range of motion (ie, lower extremity), dance exposure (ie, years training, exposure hours) and age. The median DB score across studies was 8/33 (range 2-16). The majority of studies were classified as level 3 evidence and few considered risk factor inter-relationships. There is some level 2 evidence that previous injury and poor psychological coping skills are associated with increased injury risk. Because of the lack of high-quality studies, consensus regarding risk factors for musculoskeletal injury in preprofessional dancers remains difficult. There is a need for injury definition consensus and high-quality prospective studies examining the multifactorial relationship between risk factors and injury in preprofessional dance. 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/

Thermal pasteurization of ready-to-eat foods and vegetables: Critical factors for process design and effects on quality.

PubMed

Peng, Jing; Tang, Juming; Barrett, Diane M; Sablani, Shyam S; Anderson, Nathan; Powers, Joseph R

2017-09-22

Increasing consumer desire for high quality ready-to-eat foods makes thermal pasteurization important to both food producers and researchers. To be in compliance with the Food Safety Modernization Act (FSMA), food companies seek regulatory and scientific guidelines to ensure that their products are safe. Clearly understanding the regulations for chilled or frozen foods is of fundamental importance to the design of thermal pasteurization processes for vegetables that meet food safety requirements. This article provides an overview of the current regulations and guidelines for pasteurization in the U.S. and in Europe for control of bacterial pathogens. Poorly understood viral pathogens, in terms of their survival in thermal treatments, are an increasing concern for both food safety regulators and scientists. New data on heat resistance of viruses in different foods are summarized. Food quality attributes are sensitive to thermal degradation. A review of thermal kinetics of inactivation of quality-related enzymes in vegetables and the effects of thermal pasteurization on vegetable quality is presented. The review also discusses shelf-life of thermally pasteurized vegetables.

A study of the effects of innovative and efficient practices on the performance of hospice care organizations.

PubMed

Kirby, Eric G; Keeffe, Michael J; Nicols, Kay M

2007-01-01

Due to changes in social norms, funding initiatives, and other environmental factors, the business of hospice care has significantly evolved over the past 40 years. There has been an influx of for-profit firms, increased consolidation, and significant funding changes. We have witnessed a growth in utilization rates, an increase in insurance coverage, and improved governmental funding. Hospice care organizations have responded to these pressures by pursuing more efficient and innovative business practices. Drawing upon institutional theory, this study seeks to address whether quality of care provided to hospice patients is affected as organizations respond to environmental pressures for innovative and efficient business practices. This study uses hierarchical regression to analyze data from 111 hospices in California. Innovative practices are positively related to quality of care. However, efficient practices have no significant relationship with quality of care. It appears that incorporating innovative practices is positively related to quality of care. Although cost containment may be necessary for continued survival, efficiency improvement efforts do not seem to lead to improved quality of care.

Linkages between workplace stressors and quality of care from health professionals' perspective - Macedonian experience.

PubMed

Karadzinska-Bislimovska, Jovanka; Basarovska, Vera; Mijakoski, Dragan; Minov, Jordan; Stoleski, Sasho; Angeleska, Nada; Atanasovska, Aneta

2014-05-01

During last two decades, within the process of transition, the socio-economic reforms in Republic of Macedonia reflected on the national health care system. The objective of this article was to identify workplace stressors and factors that influence quality of care, from the perspective of health professionals (HPs), and to understand how they were linked in the context of such social circumstances. A qualitative research based on focus group (FG) methodology was conducted in a general teaching hospital. Two main topics were the subjects of discussion in FGs: workplace stressors and factors that influence quality of care, from the HPs perspective. Six FGs were conducted with a total of 56 HPs (doctors, nurses, interns, and residents) divided into two sets of three FGs for each topic separately. Two sets of data were processed with thematic analysis, and the obtained results were compared with each other. By processing the data, we identified themes relating to factors that generate stress among HPs and factors that influence quality of care, from HPs' perspective. By comparing the two sets of themes, we found that many of them were identical, which means factors that increase workplace stress at the same time reduce quality of care. Implementation of specific organizational interventions in the hospital setting can lead to the prevention of work-related stress and improvement in quality of care. Our research suggests that the prevention of work-related stress will impact positively on the quality of care, which may contribute to establish criteria and recommendations for the improvement in organizational culture and climate in hospitals. What is already known on this subject? Psychosocial stress at work among health professionals is often present and well studied, but relations between job stress and quality of care were rarely examined. Job demands-resources model by Demerouti, Bakker, Nachreiner and Schaufeli (2001), for assessment of job stress includes job demands (working environment, work overload, time pressures, recipient contact, shift work) and job resources (feedback, rewards, job control, participation, job security, supervisor support) was applied in different studies. There is scientific evidence that burned-out physicians have shown depersonalization from their patients, they have withdrawn from patients, demonstrated sub-optimal care, and sometimes burnout has been related to serious mistakes and patient death. Different research has shown that some workplace factors contributed to the development of work-related stress and burnout among HPs whereas others contributed protectively. What does this study add? Similar and overlapping workplace factors in hospital setting produce stress in health professionals and influence quality of care. Impact of specific socioeconomic environment in Macedonia as a country in transition and EU candidate country on job stress among health professionals and quality of care. Development of criteria and recommendations for the job stress prevention and improvement of the organizational culture and climate in hospital settings. © 2013 The British Psychological Society.

Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

PubMed Central

Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

2017-01-01

Background In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided. If any of these factors are missing, mothers and babies are likely to receive suboptimal care. Objectives To explore the views, experiences, and behaviours of skilled birth attendants and those who support them; to identify factors that influence the delivery of intrapartum and postnatal care in low- and middle-income countries; and to explore the extent to which these factors were reflected in intervention studies. Search methods Our search strategies specified key and free text terms related to the perinatal period, and the health provider, and included methodological filters for qualitative evidence syntheses and for low- and middle-income countries. We searched MEDLINE, OvidSP (searched 21 November 2016), Embase, OvidSP (searched 28 November 2016), PsycINFO, OvidSP (searched 30 November 2016), POPLINE, K4Health (searched 30 November 2016), CINAHL, EBSCOhost (searched 30 November 2016), ProQuest Dissertations and Theses (searched 15 August 2013), Web of Science (searched 1 December 2016), World Health Organization Reproductive Health Library (searched 16 August 2013), and World Health Organization Global Health Library for WHO databases (searched 1 December 2016). Selection criteria We included qualitative studies that focused on the views, experiences, and behaviours of SBAs and those who work with them as part of the team. We included studies from all levels of health care in low- and middle-income countries. Data collection and analysis One review author extracted data and assessed study quality, and another review author checked the data. We synthesised data using the best fit framework synthesis approach and assessed confidence in the evidence using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether the factors identified by health workers in our synthesis as important for providing maternity care were reflected in the interventions evaluated in the studies in a related intervention review. Main results We included 31 studies that explored the views and experiences of different types of SBAs, including doctors, midwives, nurses, auxiliary nurses and their managers. The included studies took place in Africa, Asia, and Latin America. Our synthesis pointed to a number of factors affecting SBAs’ provision of quality care. The following factors were based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they were not always given sufficient training during their education or after they had begun clinical work. Also, inadequate staffing of facilities could increase the workloads of skilled birth attendants, make it difficult to provide supervision and result in mothers being offered poorer care. In addition, SBAs did not always believe that their salaries and benefits reflected their tasks and responsibilities and the personal risks they undertook. Together with poor living and working conditions, these issues were seen to increase stress and to negatively affect family life. Some SBAs also felt that managers lacked capacity and skills, and felt unsupported when their workplace concerns were not addressed. Possible causes of staff shortages in facilities included problems with hiring and assigning health workers to facilities where they were needed; lack of funding; poor management and bureaucratic systems; and low salaries. Skilled birth attendants and their managers suggested factors that could help recruit, keep, and motivate health workers, and improve the quality of care; these included good-quality housing, allowances for extra work, paid vacations, continuing education, appropriate assessments of their work, and rewards. Skilled birth attendants’ ability to provide quality care was also limited by a lack of equipment, supplies, and drugs; blood and the infrastructure to manage blood transfusions; electricity and water supplies; and adequate space and amenities on maternity wards. These factors were seen to reduce SBAs’ morale, increase their workload and infection risk, and make them less efficient in their work. A lack of transport sometimes made it difficult for SBAs to refer women on to higher levels of care. In addition, women’s negative perceptions of the health system could make them reluctant to accept referral. We identified some other factors that also may have affected the quality of care, which were based on findings assessed as of low or very low confidence. Poor teamwork and lack of trust and collaboration between health workers appeared to negatively influence care. In contrast, good collaboration and teamwork appeared to increase skilled birth attendants’ motivation, their decision-making abilities, and the quality of care. Skilled birth attendants’ workloads and staff shortages influenced their interactions with mothers. In addition, poor communication undermined trust between skilled birth attendants and mothers. Authors' conclusions Many factors influence the care that SBAs are able to provide to mothers during childbirth. These include access to training and supervision; staff numbers and workloads; salaries and living conditions; and access to well-equipped, well-organised healthcare facilities with water, electricity, and transport. Other factors that may play a role include the existence of teamwork and of trust, collaboration, and communication between health workers and with mothers. Skilled birth attendants reported many problems tied to all of these factors. What factors influence the delivery of care by skilled birth attendants in low- and middle-income countries? Review aim The aim of this Cochrane synthesis of qualitative evidence was to identify factors that influence the provision of care by skilled birth attendants. To answer this question, we searched for and analysed qualitative studies of skilled birth attendants’ views, experiences, and behaviour. This synthesis complements another Cochrane Review assessing the effect of strategies to promote women’s use of healthcare facilities when giving birth. Key messages Many factors influence the care that skilled birth attendants provide to mothers during childbirth. These include access to training and supervision; staff numbers and workloads; salaries and living conditions; and access to well-equipped, well-organised healthcare facilities with water, electricity, and transport. Other factors that may play a role include the existence of teamwork, trust, collaboration, and communication between health workers and with mothers. Skilled birth attendants reported many problems tied to these factors. What did we study in the synthesis? In low- and middle-income countries, many mothers still die during childbirth. Women are encouraged to give birth in health facilities rather than at home so they can receive care from skilled birth attendants. A skilled birth attendant is a health worker such as a midwife, doctor, or nurse who is trained to manage a normal pregnancy and childbirth, and refer the mother and newborn when complications arise. By exploring skilled birth attendants’ views, experiences, and behaviour, this synthesis aimed to identify factors that can influence their ability to provide quality care. Main findings We included 31 studies conducted in Africa, Asia, and Latin America. Participants were skilled birth attendants including doctors, midwives, nurses, auxiliary nurses and their managers. Our synthesis pointed to several factors that affected skilled birth attendants’ provision of quality care. The following factors are based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they sometimes had insufficient training during their education or after they had begun work. Where facilities lacked staff, skilled birth attendants’ workloads could increase, it could become difficult to provide supervision, and mothers could receive poorer care. In addition, skilled birth attendants did not always believe that their salaries and benefits reflected their tasks and responsibilities and the personal risks they undertook. Together with poor living and working conditions, these issues could lead to stress and affect skilled birth attendants' family life. Some skilled birth attendants felt that managers lacked capacity and skills, and they felt unsupported when their workplace concerns were not addressed. Possible causes of staff shortages included problems with hiring and assigning health workers to health facilities; lack of funding; poor management and bureaucratic systems; and low salaries. Skilled birth attendants and their managers suggested factors that could help recruit, keep, and motivate health workers, and improve the quality of their work; these included good-quality housing, allowances for extra work, paid vacations, continued education, proper assessments of their work, and rewards. Skilled birth attendants’ ability to provide quality care was also limited by a lack of equipment, drugs, and supplies; blood and the infrastructure to manage blood transfusions; electricity and water supplies; and adequate space and amenities on maternity wards. These factors were seen to reduce skilled birth attendants’ morale, increase their workload and infection risk, and make them less efficient in their work. A lack of transport sometimes made it difficult for skilled birth attendants to refer women to higher levels of care. In addition, women’s negative perceptions of the health system could make them reluctant to accept referral. We identified some other factors that also may have affected the quality of care, which were based on findings assessed as of low or very low confidence. Poor teamwork and lack of trust and collaboration between health workers appeared to negatively influence care. In contrast, good collaboration and teamwork appeared to increase skilled birth attendants’ motivation, their decision-making abilities, and the quality of care. Skilled birth attendants’ workloads and staff shortages influenced their interactions with mothers. In addition, poor communication undermined trust between skilled birth attendants and mothers. How up-to-date is this review? We searched for studies published before November 2016. PMID:29148566

Who is sleepier on the night shift? The influence of bio-psycho-social factors on subjective sleepiness of female nurses during the night shift.

PubMed

Zion, Nataly; Drach-Zahavy, Anat; Shochat, Tamar

2018-07-01

Sleepiness is a common complaint during the night shift and may impair performance. The current study aims to identify bio-psycho-social factors associated with subjective sleepiness during the night shift. Ninety-two female nurses working rotating shifts completed a sociodemographic questionnaire, the Munich ChronoType Questionaire for shift workers, the Pittsburg Sleep Quality Index, and the Pre-sleep Arousal Scale. Subjective sleepiness was measured hourly during two night shifts using the Karolinska Sleepiness Scale, and activity monitors assessed sleep duration 24-h before each shift. Findings showed that increased sleepiness was associated with increased age in nurses with early chronotypes and with more children. High cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes. The impact of bio-psycho-social factors on night shift sleepiness is complex, and depends on mutual interactions between these factors. Nurses most prone to increased sleepiness must develop personal strategies for maintaining vigilance on the night shift. Practitioner Summary: This study aims to identify bio-psycho-social factors associated with subjective sleepiness of female nurses during the night shift. Increasing sleepiness was associated with increased age in nurses with early chronotypes and with more children. Increased cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes.

Megavoltage planar and cone-beam imaging with low-Z targets: dependence of image quality improvement on beam energy and patient separation.

PubMed

Robar, James L; Connell, Tanner; Huang, Weihong; Kelly, Robin G

2009-09-01

The purpose of this study is to investigate the improvement of megavoltage planar and cone-beam CT (CBCT) image quality with the use of low atomic number (Z) external targets in the linear accelerator. In this investigation, two experimental megavoltage imaging beams were generated by using either 3.5 or 7.0 MeV electrons incident on aluminum targets installed above the level of the carousel in a linear accelerator (2100EX, Varian Medical, Inc., Palo Alto, CA). Images were acquired using an amorphous silicon detector panel. Contrast-to-noise ratio (CNR) in planar and CBCT images was measured as a function of dose and a comparison was made between the imaging beams and the standard 6 MV therapy beam. Phantoms of variable diameter were used to examine the loss of contrast due to beam hardening. Porcine imaging was conducted to examine qualitatively the advantages of the low-Z target approach in CBCT. In CBCT imaging CNR increases by factors as high as 2.4 and 4.3 for the 7.0 and 3.5 MeV/Al beams, respectively, compared to images acquired with 6 MV. Similar factors of improvement are observed in planar imaging. For the imaging beams, beam hardening causes a significant loss of the contrast advantage with increasing phantom diameter; however, for the 3.5 MeV/Al beam and a phantom diameter of 25 cm, a contrast advantage remains, with increases of contrast by factors of 1.5 and 3.4 over 6 MV for bone and lung inhale regions, respectively. The spatial resolution is improved slightly in CBCT images for the imaging beams. CBCT images of a porcine cranium demonstrate qualitatively the advantages of the low-Z target approach, showing greater contrast between tissues and improved visibility of fine detail. The use of low-Z external targets in the linear accelerator improves megavoltage planar and CBCT image quality significantly. CNR may be increased by a factor of 4 or greater. Improvement of the spatial resolution is also apparent.

Total quality management practices in Malaysia healthcare industry

NASA Astrophysics Data System (ADS)

Ahmad, Md Fauzi; Nee, Phoi Soo; Nor, Nik Hisyamudin Muhd; Wei, Chan Shiau; Hassan, Mohd Fahrul; Hamid, Nor Aziati Abdul

2017-10-01

The aim of total quality management (TQM) is to achieve customer satisfaction. Healthcare industry is very important in Malaysia for providing good healthcare services to public. However, failure to improve quality and efficiency is a big challenge in a healthcare industry in order to increase quality healthcare services. The objectives of this research are to identify the extent level of TQM implementation; and to determine the impact of TQM implementation on business sustainable in healthcare industry. Quantitative approach has been chosen as the methodology of this study. The survey respondents targeted in this research are staffs in Malaysia private clinic. 70 respondents have participated in this research. Data were analysed by Statistical Package Social Science (SPSS). Analysis result showed that there was a positive significant relationship between TQM practices and business sustainable (r=0.774, P<0.05). All TQM factors have significant relationship with business sustainable factors. The findings of this research will help healthcare industry to understand a better and deeper valuable information on the impact of TQM implementation towards business sustainable in Malaysia healthcare industry.

Quality Factor Effect on the Wireless Range of Microstrip Patch Antenna Strain Sensors

PubMed Central

Daliri, Ali; Galehdar, Amir; Rowe, Wayne S. T.; John, Sabu; Wang, Chun H.; Ghorbani, Kamran

2014-01-01

Recently introduced passive wireless strain sensors based on microstrip patch antennas have shown great potential for reliable health and usage monitoring in aerospace and civil industries. However, the wireless interrogation range of these sensors is limited to few centimeters, which restricts their practical application. This paper presents an investigation on the effect of circular microstrip patch antenna (CMPA) design on the quality factor and the maximum practical wireless reading range of the sensor. The results reveal that by using appropriate substrate materials the interrogation distance of the CMPA sensor can be increased four-fold, from the previously reported 5 to 20 cm, thus improving considerably the viability of this type of wireless sensors for strain measurement and damage detection. PMID:24451457

Quality factor effect on the wireless range of microstrip patch antenna strain sensors.

PubMed

Daliri, Ali; Galehdar, Amir; Rowe, Wayne S T; John, Sabu; Wang, Chun H; Ghorbani, Kamran

2014-01-02

Recently introduced passive wireless strain sensors based on microstrip patch antennas have shown great potential for reliable health and usage monitoring in aerospace and civil industries. However, the wireless interrogation range of these sensors is limited to few centimeters, which restricts their practical application. This paper presents an investigation on the effect of circular microstrip patch antenna (CMPA) design on the quality factor and the maximum practical wireless reading range of the sensor. The results reveal that by using appropriate substrate materials the interrogation distance of the CMPA sensor can be increased four-fold, from the previously reported 5 to 20 cm, thus improving considerably the viability of this type of wireless sensors for strain measurement and damage detection.

The Impact of Soft Factors on Quality Improvement in Manufacturing Industry

NASA Astrophysics Data System (ADS)

Chan, Shiau Wei; Fauzi Ahmad, Md; Kong, Mei Wan

2017-08-01

Nowadays, soft factors have become the key factors of success in quality improvement of an organisation. Many organisations have neglected the importance of soft factors, this may influence the organisational performance. Hence, the purpose of this research is to examine the impact of soft factors on quality improvement in manufacturing industries. Six hypotheses were examined while considering six dimensions of soft factors including management commitment, customer focus, supplier relationship, employee involvement, training and education, and reward and recognition that have a positive impact on quality improvement. In this study, eighty one managers from the quality department were randomly selected in the manufacturing industry in Batu Pahat, Johor. The questionnaires were distributed to them. The researcher analysed the quantitatively collected data using descriptive analysis and correlation analysis. The findings of this study revealed that all soft factors are correlated to the quality improvement in an organisation with a high significant value but the regression analysis shows that the supplier relationship and employee involvement has more significant impact on quality improvement as compared to other soft factors which contributes of this study.

Psychometric Evaluation of an Instrument for Measuring Organizational Climate for Quality: Evidence From a National Sample of Infection Preventionists.

PubMed

Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M; Schnall, Rebecca; Nelson, Shanelle; Stone, Patricia W

2016-09-01

In recent years, there has been increased interest in measuring the climate for infection prevention; however, reliable and valid instruments are lacking. This study tested the psychometric properties of the Leading a Culture of Quality for Infection Prevention (LCQ-IP) instrument measuring the infection prevention climate in a sample of 972 infection preventionists from acute care hospitals. An exploratory principal component analysis showed that the instrument had structural validity and captured 4 factors related to the climate for infection prevention: Psychological Safety, Prioritization of Quality, Supportive Work Environment, and Improvement Orientation. LCQ-IP exhibited excellent internal consistency, with a Cronbach α of .926. Criterion validity was supported with overall LCQ-IP scores, increasing with the number of evidence-based prevention policies in place (P = .047). This psychometrically sound instrument may be helpful to researchers and providers in assessing climate for quality related to infection prevention. © The Author(s) 2015.

Exogenous γ-aminobutyric acid treatment affects citrate and amino acid accumulation to improve fruit quality and storage performance of postharvest citrus fruit.

PubMed

Sheng, Ling; Shen, Dandan; Luo, Yi; Sun, Xiaohua; Wang, Jinqiu; Luo, Tao; Zeng, Yunliu; Xu, Juan; Deng, Xiuxin; Cheng, Yunjiang

2017-02-01

The loss of organic acids during postharvest storage is one of the major factors that reduces the fruit quality and economic value of citrus. Citrate is the most important organic acid in citrus fruits. Molecular evidence has proved that γ-aminobutyric acid (GABA) shunt plays a key role in citrate metabolism. Here, we investigated the effects of exogenous GABA treatment on citrate metabolism and storage quality of postharvest citrus fruit. The content of citrate was significantly increased, which was primarily attributed to the inhibition of the expression of glutamate decarboxylase (GAD). Amino acids, including glutamate, alanine, serine, aspartate and proline, were also increased. Moreover, GABA treatment decreased the fruit rot rate. The activities of antioxidant enzymes and the content of energy source ATP were affected by the treatment. Our results indicate that GABA treatment is a very effective approach for postharvest quality maintenance and improvement of storage performance in citrus production. Copyright © 2016 Elsevier Ltd. All rights reserved.

A cross-sectional study on quality of life among the elderly in non-governmental organizations' elderly homes in Kuala Lumpur.

PubMed

Onunkwor, Obinna Francis; Al-Dubai, Sami Abdo Radman; George, Philip Parikial; Arokiasamy, John; Yadav, Hemetram; Barua, Ankur; Shuaibu, Hassana Ojonuba

2016-01-12

There is a rapid increase in the population of the elderly globally, and Malaysia is anticipated to become an ageing nation in 2030. Maintaining health, social participation, reducing institutionalization, and improving quality of life of the elderly are public health challenges of the 21(st) century. Quality of life among elderly in Elderly Homes in Malaysia is under researched. This study aims to determine the quality of life and its associated factors among the Elderly in Elderly Homes in Kuala Lumpur. This was a cross-sectional study among 203 residents aged 60 years or more in eight randomly selected Elderly Homes in Kuala Lumpur in September 2014. Stratified simple random sampling was used to select participants. Study instruments included World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF), Multidimensional Scale for Perceived Social Support, and a questionnaire for Socio-demographic variables. Data collection was by face to face interview. Univariate and Multivariate analysis were used to determine associations, and P-value <0.05 was considered statistically significant. The mean (Standard deviation) for the physical domain was 14.3 (±2.7), 13.7 (±2.5) for the psychological domain, 10.8 (±3.4) for the social domain, and 13.0 (±2.5) for the environment domain. Factors significantly associated with quality of life included age, gender, level of education, economic status, outdoor leisure activity, physical activity, duration of residence, type of accommodation, co-morbidities, and social support. This study confirms that multiple factors are associated with quality of life among elderly in elderly homes. Social support, chronic co-morbidities, gender and outdoor leisure activity were significantly associated with all the domains of quality of life. Among the four domains of quality of life, the physical domain had the highest score while the social domain had the lowest score. This emphasizes the need for more social support-related interventions in these homes.

Factors Associated with Quality of Life among Hemodialysis Patients in Malaysia

PubMed Central

Md. Yusop, Nor Baizura; Yoke Mun, Chan; Shariff, Zalilah Mohd; Beng Huat, Choo

2013-01-01

Although hemodialysis treatment has greatly increased the life expectancy of end stage renal disease patients, low quality of life among hemodialysis patients is frequently reported. This cross-sectional study aimed to determine the relationship between medical history, hemodialysis treatment and nutritional status with the mental and physical components of quality of life in hemodialysis patients. Respondents (n=90) were recruited from Hospital Kuala Lumpur and dialysis centres of the National Kidney Foundation of Malaysia. Data obtained included socio-demography, medical history, hemodialysis treatment and nutritional status. Mental and physical quality of life were measured using the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) of the Short-Form Health Survey 36-items, a generic core of the Kidney Disease Quality of Life Short Form. Two summary measures and total SF-36 was scored as 0–100, with a higher score indicating better quality of life. Approximately 26 (30%) of respondents achieved the body mass index (24 kg/m2) and more than 80% (n=77) achieved serum albumin level (>35.0 mg/dL) recommended for hemodialysis patients. The majority of respondents did not meet the energy (n=72, 80%) and protein (n=68,75%) recommendations. The total score of SF-36 was 54.1±19.2, while the score for the mental and physical components were 45.0±8.6 and 39.6±8.6, respectively. Factors associated with a higher MCS score were absence of diabetes mellitus (p=0.000) and lower serum calcium (p=0.004), while higher blood flow (p=0.000), higher serum creatinine (p=0.000) and lower protein intake (p=0.006) were associated with a higher PCS score. To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality of life are warranted to reduce further health complications and to improve quality of life. PMID:24358336

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org

Purpose: To evaluate the sensitivity of the diagnostic radiological index of protection (DRIP), used to quantify the protective value of radioprotective garments, to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams to be used in measuring the DRIP. Methods: Monte Carlo simulations were performed to determine the shape of the scattered x-ray spectra incident on the operator in different clinical fluoroscopy scenarios, including interventional radiology and interventional cardiology (IC). Two clinical simulations studied the sensitivity of the scattered spectrum to gantry angle and patient size, while technical factors were varied according tomore » measured automatic dose rate control (ADRC) data. Factorial simulations studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size, and beam quality for constant technical factors. Average energy (E{sub avg}) was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affect the scattered spectrum indirectly through their effect on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in IC, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusions: The scattered spectrum striking the operator in fluoroscopy is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle.« less

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

Jones, A; Pasciak, A; Wagner, L

Purpose: To evaluate the sensitivity of the Diagnostic Radiological Index of Protection (DRIP) to procedural factors in fluoroscopy in an effort to determine an appropriate set of scatter-mimicking primary beams (SMPB) to be used in measuring the DRIP. Methods: A series of clinical and factorial Monte Carlo simulations were conducted to determine the shape of the scattered X-ray spectra incident on the operator in different clinical fluoroscopy scenarios. Two clinical evaluations studied the sensitivity of the scattered spectrum to gantry angle and patient size while technical factors were varied according to measured automatic dose rate control (ADRC) data. Factorial evaluationsmore » studied the sensitivity of the scattered spectrum to gantry angle, field of view, patient size and beam quality for constant technical factors. Average energy was the figure of merit used to condense fluence in each energy bin to a single numerical index. Results: Beam quality had the strongest influence on the scattered spectrum in fluoroscopy. Many procedural factors affected the scattered spectrum indirectly through their effects on primary beam quality through ADRC, e.g., gantry angle and patient size. Lateral C-arm rotation, common in interventional cardiology, increased the energy of the scattered spectrum, regardless of the direction of rotation. The effect of patient size on scattered radiation depended on ADRC characteristics, patient size, and procedure type. Conclusion: The scattered spectrum striking the operator in fluoroscopy, and therefore the DRIP, is most strongly influenced by primary beam quality, particularly kV. Use cases for protective garments should be classified by typical procedural primary beam qualities, which are governed by the ADRC according to the impacts of patient size, anatomical location, and gantry angle. These results will help determine an appropriate set of SMPB to be used for measuring the DRIP.« less

Water-quality response to a high-elevation wildfire in the Colorado Front Range

USGS Publications Warehouse

Mast, M. Alisa; Murphy, Sheila F.; Clow, David W.; Penn, Colin A.; Sexstone, Graham A.

2016-01-01

Water quality of the Big Thompson River in the Front Range of Colorado was studied for 2 years following a high-elevation wildfire that started in October 2012 and burned 15% of the watershed. A combination of fixed-interval sampling and continuous water-quality monitors was used to examine the timing and magnitude of water-quality changes caused by the wildfire. Prefire water quality was well characterized because the site has been monitored at least monthly since the early 2000s. Major ions and nitrate showed the largest changes in concentrations; major ion increases were greatest in the first postfire snowmelt period, but nitrate increases were greatest in the second snowmelt period. The delay in nitrate release until the second snowmelt season likely reflected a combination of factors including fire timing, hydrologic regime, and rates of nitrogen transformations. Despite the small size of the fire, annual yields of dissolved constituents from the watershed increased 20–52% in the first 2 years following the fire. Turbidity data from the continuous sensor indicated high-intensity summer rain storms had a much greater effect on sediment transport compared to snowmelt. High-frequency sensor data also revealed that weekly sampling missed the concentration peak during snowmelt and short-duration spikes during rain events, underscoring the challenge of characterizing postfire water-quality response with fixed-interval sampling.

Changes in tissue protein synthesis are involved in regulating urea synthesis in rats given proteins of different quality.

PubMed

Tujioka, Kazuyo; Lyou, Sunok; Sano, Atushi; Hayase, Kazutoshi; Yokogoshi, Hidehiko

2004-10-01

The purpose of present study was to determine whether the regulation of urea synthesis is mediated through changes in supply of amino acids by protein synthesis and whether the concentration of ammonia, or activities of amino acid catabolizing enzymes, regulate urea synthesis when the dietary protein quality is manipulated. Experiments were done on three groups of rats given diets containing 10 g gluten, 10 g casein or 10 g whole egg protein/100 g for 10 d. The urinary excretion of urea, and the liver concentrations of glutamate, serine and alanine increased with a decrease in quality of dietary protein. The fractional and absolute rates of protein synthesis in tissues declined with the decrease in quality of dietary protein quality. The ammonia concentration in plasma and liver, and activities of hepatic amino acid catabolizing enzymes was not related to urea excretion under these conditions. These results suggest that the lower protein synthesis seen in tissues of rats given the lower quality of protein is likely to be one of the factors to increasing the supply of amino acids and stimulating urea synthesis.

MapReduce Based Parallel Bayesian Network for Manufacturing Quality Control

NASA Astrophysics Data System (ADS)

Zheng, Mao-Kuan; Ming, Xin-Guo; Zhang, Xian-Yu; Li, Guo-Ming

2017-09-01

Increasing complexity of industrial products and manufacturing processes have challenged conventional statistics based quality management approaches in the circumstances of dynamic production. A Bayesian network and big data analytics integrated approach for manufacturing process quality analysis and control is proposed. Based on Hadoop distributed architecture and MapReduce parallel computing model, big volume and variety quality related data generated during the manufacturing process could be dealt with. Artificial intelligent algorithms, including Bayesian network learning, classification and reasoning, are embedded into the Reduce process. Relying on the ability of the Bayesian network in dealing with dynamic and uncertain problem and the parallel computing power of MapReduce, Bayesian network of impact factors on quality are built based on prior probability distribution and modified with posterior probability distribution. A case study on hull segment manufacturing precision management for ship and offshore platform building shows that computing speed accelerates almost directly proportionally to the increase of computing nodes. It is also proved that the proposed model is feasible for locating and reasoning of root causes, forecasting of manufacturing outcome, and intelligent decision for precision problem solving. The integration of bigdata analytics and BN method offers a whole new perspective in manufacturing quality control.

Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality.

PubMed

Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Kaup, Moritz; Beeres, Martin; Vogl, Thomas J; Scholtz, Jan-Erik

2017-06-01

Most of the applied radiation dose at CT is in the lower photon energy range, which is of limited diagnostic importance. To investigate image quality and effects on radiation parameters of 100-kVp spectral filtration single-energy chest CT using a tin-filter at third-generation dual-source CT in comparison to standard 100-kVp chest CT. Thirty-three children referred for a non-contrast chest CT performed on a third-generation dual-source CT scanner were examined at 100 kVp with a dedicated tin filter with a tube current-time product resulting in standard protocol dose. We compared resulting images with images from children examined using standard single-source chest CT at 100 kVp. We assessed objective and subjective image quality and compared radiation dose parameters. Radiation dose was comparable for children 5 years old and younger, and it was moderately decreased for older children when using spectral filtration (P=0.006). Effective tube current increased significantly (P=0.0001) with spectral filtration, up to a factor of 10. Signal-to-noise ratio and image noise were similar for both examination techniques (P≥0.06). Subjective image quality showed no significant differences (P≥0.2). Using 100-kVp spectral filtration chest CT in children by means of a tube-based tin-filter on a third-generation dual-source CT scanner increases effective tube current up to a factor of 10 to provide similar image quality at equivalent dose compared to standard single-source CT without spectral filtration.

Evidence-based medicine: is translating evidence into practice a solution to the cost-quality challenges facing medicine?

PubMed

Larson, E B

1999-09-01

Evidence-based medicine (EBM) and practice guidelines have been embraced by increasing numbers of scholars, administrators, and medical journalists as an intellectually attractive solution to the dilemma of improving health care quality while reducing costs. However, certain factors have thus far limited the role that EBM might play in resolving cost-quality trade-offs. Beyond the quality of the guideline and the evidence base itself, critical factors for success include local clinician involvement, a unified or closed medical staff, protocols that minimize use of clinical judgment and that call for involvement of so-called physician extenders (such as nurse practitioners and physician assistants), and financial incentive. TROUBLESOME ISSUES RELATED TO COST-QUALITY TRADE-OFFS: Rationing presents many dilemmas, but for physicians one critical problem is determining what is the physician's responsibility. Is the physician to be the patient's advocate, or should the physician be the advocate of all patients (the patients' advocate)? How do we get physicians out of potentially conflicted roles? EBM guidelines are needed to help minimize the number of instances physicians are asked to ration care at the bedside. If the public can decide to share and limit resources--presumably based on shared priorities--physicians would have a basis to act as advocates for all patients. Although EBM alone is not a simple solution to the problems of increasing costs and public expectations, it can be an important source of input and information in relating the value of service and medical technology to public priorities.

Climatic factors directly impact the volatile organic compound fingerprint in green Arabica coffee bean as well as coffee beverage quality.

PubMed

Bertrand, B; Boulanger, R; Dussert, S; Ribeyre, F; Berthiot, L; Descroix, F; Joët, T

2012-12-15

Coffee grown at high elevations fetches a better price than that grown in lowland regions. This study was aimed at determining whether climatic conditions during bean development affected sensory perception of the coffee beverage and combinations of volatile compounds in green coffee. Green coffee samples from 16 plots representative of the broad range of climatic variations in Réunion Island were compared by sensory analysis. Volatiles were extracted by solid phase micro-extraction and the volatile compounds were analysed by GC-MS. The results revealed that, among the climatic factors, the mean air temperature during seed development greatly influenced the sensory profile. Positive quality attributes such as acidity, fruity character and flavour quality were correlated and typical of coffees produced at cool climates. Two volatile compounds (ethanal and acetone) were identified as indicators of these cool temperatures. Among detected volatiles, most of the alcohols, aldehydes, hydrocarbons and ketones appeared to be positively linked to elevated temperatures and high solar radiation, while the sensory profiles displayed major defects (i.e. green, earthy flavour). Two alcohols (butan-1,3-diol and butan-2,3-diol) were closely correlated with a reduction in aromatic quality, acidity and an increase in earthy and green flavours. We assumed that high temperatures induce accumulation of these compounds in green coffee, and would be detected as off-flavours, even after roasting. Climate change, which generally involves a substantial increase in average temperatures in mountainous tropical regions, could be expected to have a negative impact on coffee quality. Copyright © 2012 Elsevier Ltd. All rights reserved.

What contributes to long-term quality of life in breast cancer patients who are undergoing surgery? Results of a multidimensional study.

PubMed

Wittmann, Victoria; Látos, Melinda; Horváth, Zoltán; Simonka, Zsolt; Paszt, Attila; Lázár, György; Csabai, Márta

2017-08-01

This study aims to examine the key determinants of long-term quality of life in breast cancer patients who are undergoing surgery using a multidimensional approach and taking into account preoperative and post-operative psychological characteristics such as anxiety, depression, posttraumatic growth, body image, and physical activity as well as medical parameters. The study involved 63 breast cancer patients from the Department of Surgery at the University of Szeged. Assessments occurred 1 day before surgery as well as 3 days and 18 months after surgery using the Spielberger State and Trait Anxiety Inventory (STAI), Beck's Depression Inventory (BDI), Functional Assessment of Cancer Therapy-Breast Cancer Scale (FACT-B), Posttraumatic Growth Inventory (PTGI) and Breast Impact of Treatment Scale (BITS). Data relating to physical activity, medical parameters and sociodemographic characteristics were also collected. The level of depression did not change over time. State anxiety decreased 18 months after the surgery compared to before the surgery; however, there was a greater decrease immediately after the surgery and then anxiety increased again 18 months later. Trait anxiety was associated with quality of life, posttraumatic growth and body image. Posttraumatic growth and the level of depression were found to be possible contributing factors to the increase in long-term quality of life. The results show that the timely detection and proper management of psychological distress and the enhancement of posttraumatic growth are of great value, as they might be important contributing factors to long-term quality of life in breast cancer patients.

Spices Coffee : Innovation Strategy To Increase Quality On Powder Coffee Farmers

NASA Astrophysics Data System (ADS)

Amir, I. T.; Indah, P. N.; Widayanti, S.

2018-01-01

The purpose of the study is a) to analyze the condition of internal environment industry spices coffee, b) to analyze the condition of the external environment industry spices coffee, and c) to determine the technological innovation strategy spices coffee in order to improve the competitiveness of the coffee people. Most of the coffee grown in Tutur district is cultivated by smallholder farms, resulting in low quality. The strategy of coffee spice agro-industry aims to increase the added value of the products so that farmers obtain higher coffee prices. Activities include the provision of raw materials, processing, supply of final products, and marketing.The results showed that the internal environmental conditions that have the highest value is the strengthen factors. The highest score of strengthen factors is the availability of coffee, availability of labor and communications group. The highest score of opportunity factors is technological assistance from the government and other government support for the development of people’s coffee industry and high market potential. The development of agrotourism should improve as well as expand the network to seize market. The strategy should be applied in the development of spices coffee industry is to support aggressive growth (Growth-oriented strategy).

Analysis of environmental factors influencing salinity patterns, oyster growth, and mortality in lower Breton Sound Estuary, Louisiana using 20 years of data

USGS Publications Warehouse

LaPeyre, Megan K.; Geaghan, James; Decossas, Gary A.; La Peyre, Jerome F.

2016-01-01

Freshwater inflow characteristics define estuarine functioning by delivering nutrients, sediments, and freshwater, which affect biological resources and ultimately system production. Using 20 years of water quality, weather, and oyster growth and mortality data from Breton Sound Estuary (BSE), Louisiana, we examined the relationship of riverine, weather, and tidal influence on estuarine salinity, and the relationship of salinity to oyster growth and mortality. Mississippi River discharge was found to be the most important factor determining salinity patterns over oyster grounds within lower portions of BSE, with increased river flow associated with lowered salinities, while easterly winds associated with increased salinity were less influential. These patterns were consistent throughout the year. Salinity and temperature (season) were found to critically control oyster growth and mortality, suggesting that seasonal changes to river discharge affecting water quality over the oyster grounds have profound impacts on oyster populations. The management of oyster reefs in estuaries (such as BSE) requires an understanding of how estuarine hydrodynamics and salinity are influenced by forcing factors such as winds, river flow, and by the volume, timing, and location of controlled releases of riverine water.

Investigating the impact of mindfulness meditation training on working memory: a mathematical modeling approach.

PubMed

van Vugt, Marieke K; Jha, Amishi P

2011-09-01

We investigated whether mindfulness training (MT) influences information processing in a working memory task with complex visual stimuli. Participants were tested before (T1) and after (T2) participation in an intensive one-month MT retreat, and their performance was compared with that of an age- and education-matched control group. Accuracy did not differ across groups at either time point. Response times were faster and significantly less variable in the MT versus the control group at T2. Since these results could be due to changes in mnemonic processes, speed-accuracy trade-off, or nondecisional factors (e.g., motor execution), we used a mathematical modeling approach to disentangle these factors. The EZ-diffusion model (Wagenmakers, van der Maas, & Grasman, Psychonomic Bulletin & Review 14:(1), 3-22, 2007) suggested that MT leads to improved information quality and reduced response conservativeness, with no changes in nondecisional factors. The noisy exemplar model further suggested that the increase in information quality reflected a decrease in encoding noise and not an increase in forgetting. Thus, mathematical modeling may help clarify the mechanisms by which MT produces salutary effects on performance.

Analytical method development of nifedipine and its degradants binary mixture using high performance liquid chromatography through a quality by design approach

NASA Astrophysics Data System (ADS)

Choiri, S.; Ainurofiq, A.; Ratri, R.; Zulmi, M. U.

2018-03-01

Nifedipin (NIF) is a photo-labile drug that easily degrades when it exposures a sunlight. This research aimed to develop of an analytical method using a high-performance liquid chromatography and implemented a quality by design approach to obtain effective, efficient, and validated analytical methods of NIF and its degradants. A 22 full factorial design approach with a curvature as a center point was applied to optimize of the analytical condition of NIF and its degradants. Mobile phase composition (MPC) and flow rate (FR) as factors determined on the system suitability parameters. The selected condition was validated by cross-validation using a leave one out technique. Alteration of MPC affected on time retention significantly. Furthermore, an increase of FR reduced the tailing factor. In addition, the interaction of both factors affected on an increase of the theoretical plates and resolution of NIF and its degradants. The selected analytical condition of NIF and its degradants has been validated at range 1 – 16 µg/mL that had good linearity, precision, accuration and efficient due to an analysis time within 10 min.

Quality of Undergraduate Management Studies in a Changing University Environment

ERIC Educational Resources Information Center

Skudiene, Vida

2005-01-01

The environment for teaching management in Baltic States' universities has undergone profound changes. The factors involved are: greater interaction between classroom teaching and the "real world", market expansion, internationalization, and increasingly diverse students. The author reports on the survey findings from the three…

Phosphorus recovery and reuse from waste streams

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) is a macronutrient essential for all living organisms. Regrettably, it is a finite resource since phosphate rock (PR) is the main material used for production of P fertilizers. Globally, the demand for quality PR is escalating due to many factors including increasing human population....

Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization.

PubMed

Huang, Hsuan-Ming; Hsiao, Ing-Tsung

2016-01-01

In recent years, there has been increased interest in low-dose X-ray cone beam computed tomography (CBCT) in many fields, including dentistry, guided radiotherapy and small animal imaging. Despite reducing the radiation dose, low-dose CBCT has not gained widespread acceptance in routine clinical practice. In addition to performing more evaluation studies, developing a fast and high-quality reconstruction algorithm is required. In this work, we propose an iterative reconstruction method that accelerates ordered-subsets (OS) reconstruction using a power factor. Furthermore, we combine it with the total-variation (TV) minimization method. Both simulation and phantom studies were conducted to evaluate the performance of the proposed method. Results show that the proposed method can accelerate conventional OS methods, greatly increase the convergence speed in early iterations. Moreover, applying the TV minimization to the power acceleration scheme can further improve the image quality while preserving the fast convergence rate.

Accelerating an Ordered-Subset Low-Dose X-Ray Cone Beam Computed Tomography Image Reconstruction with a Power Factor and Total Variation Minimization

PubMed Central

Huang, Hsuan-Ming; Hsiao, Ing-Tsung

2016-01-01

In recent years, there has been increased interest in low-dose X-ray cone beam computed tomography (CBCT) in many fields, including dentistry, guided radiotherapy and small animal imaging. Despite reducing the radiation dose, low-dose CBCT has not gained widespread acceptance in routine clinical practice. In addition to performing more evaluation studies, developing a fast and high-quality reconstruction algorithm is required. In this work, we propose an iterative reconstruction method that accelerates ordered-subsets (OS) reconstruction using a power factor. Furthermore, we combine it with the total-variation (TV) minimization method. Both simulation and phantom studies were conducted to evaluate the performance of the proposed method. Results show that the proposed method can accelerate conventional OS methods, greatly increase the convergence speed in early iterations. Moreover, applying the TV minimization to the power acceleration scheme can further improve the image quality while preserving the fast convergence rate. PMID:27073853

Injury during U.S. Army basic combat training: a systematic review of risk factor studies.

PubMed

Bulzacchelli, Maria T; Sulsky, Sandra I; Rodriguez-Monguio, Rosa; Karlsson, Lee H; Hill, Maj Owen T

2014-12-01

Approximately one quarter of men and half of women in U.S. Army basic combat training experience an injury. Preventing basic combat training-related injuries would reduce associated human and economic costs and discharges from the Army. Identification of risk factors for such injuries is a crucial step toward their prevention. Although some research has begun to address this need, prior studies of risk factors for training-related injury have not been reviewed systematically. This study systematically reviews the literature on risk factors for injury during U.S. Army basic combat training. Original studies of risk factors for injury during U.S. Army basic combat training published since 1990 in peer-reviewed journals were identified using PubMed and manual searches of reference lists. This search was last performed in May 2013. Nineteen studies met the inclusion criteria. Methodologic quality and potential for bias were assessed. The findings of 11 studies deemed to be of high or medium quality were synthesized to determine the level of evidence supporting the association between each risk factor studied and risk of injury during basic combat training. Quality assessment and evidence synthesis were performed from June to September 2013. There is strong or moderate evidence supporting association of older age, history of smoking, and self-rated low physical activity level prior to basic combat training with increased risk of training-related injury among male trainees. There is limited, mixed, or insufficient evidence to identify risk factors for injury among female trainees. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Internal marketing: creating quality employee experiences in health care organizations.

PubMed

Masri, Maysoun Dimachkie; Oetjen, Dawn; Rotarius, Timothy

2011-01-01

To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

Associations between poor sleep quality and psychosocial stress with obesity in reproductive-age women of lower socioeconomic status.

PubMed

Tom, Sarah E; Berenson, Abbey B

2013-01-01

Prior studies have not examined the role of psychosocial stress in the relationship between poor sleep quality and obesity among women of lower socioeconomic status (SES). We tested the following hypotheses in a sample of reproductive-age women of lower SES: 1) Poor sleep quality is related to increased risk of obesity, and 2) psychosocial stress confounds this association between poor sleep quality and obesity. A total of 927 women age 16 to 40 years attending public health clinics in Southeastern Texas provided information on the Pittsburgh Sleep Quality Index and sociodemographic and health characteristics, including the Perceived Stress Scale. Height, weight, and waist circumference (WC) were measured in clinic. A series of models examined the associations between sleep disturbance, perceived stress, and weight outcomes, accounting for potential confounding factors. Nearly 30% of women were overweight, and 35% were obese. Half of women had a WC of greater than 35 inches. Most women had poor sleep quality and high levels of stress. Sleep quality and perceived stress were not related to body mass index category or WC in models that adjusted for age and race/ethnicity. Adjusting for potential confounding factors did not alter results. Perceived stress did not modify the association between sleep quality and weight outcomes. Poor sleep quality and psychosocial stress were not related to weight in reproductive-aged women of lower SES. However, poor sleep quality, high stress, overweight, and obesity were common in this group. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Effect of different fibers on dough properties and biscuit quality.

PubMed

Blanco Canalis, María S; Steffolani, María E; León, Alberto E; Ribotta, Pablo D

2017-03-01

This study forms part of a broader project aimed at understanding the role of fibers from different sources in high-fat, high-sugar biscuits and at selecting the best fibers for biscuit quality. The main purpose of this work was to understand the rheological and structural properties involved in fiber-enriched biscuit dough. High-amylose corn starch (RSII), chemically modified starch (RSIV), oat fiber (OF) and inulin (IN) were used at two different levels of incorporation (6 and 12 g) in dough formulation. The influence of fiber on the properties of biscuit dough was studied via dynamic rheological tests, confocal microscopy and spreading behavior. Biscuit quality was assessed by width/thickness factor, texture and surface characteristics, total dietary fiber and sensory evaluation. Main results indicated that IN incorporation increased the capacity of dough spreading during baking and thus improved biscuit quality. OF reduced dough spreading during baking and strongly increased its resistance to deformation. RSII and RSIV slightly affected the quality of the biscuits. Sensory evaluation revealed that the panel liked IN-incorporated biscuits as much as control biscuits. The increase in total dietary fiber modified dough behavior and biscuit properties, and the extent of these effects depended on the type of fiber incorporated. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

International red meat trade.

PubMed

Brester, Gary W; Marsh, John M; Plain, Ronald L

2003-07-01

The maturation of the US beef and pork markets and increasing consumer demands for convenience, safety, and nutrition suggests that the beef and pork industries must focus on product development and promotion. New marketing arrangements are developing that help coordinate production with consumer demands. The relative high levels of incomes in the United States are likely to increase the demands for branded products rather than increase total per capita consumption. Foreign markets represent the greatest opportunity for increased demand for commodity beef and pork products. Increasing incomes in developing countries will likely allow consumers to increase consumption of animal-source proteins. Real prices of beef and pork have declined substantially because of sagging domestic demand and increasing farm-level production technologies. Increasing US beef and pork exports have obviated some of the price declines. Pork attained a net export position from a quantity perspective in 1995. The United States continues to be a net importer of beef on a quantity basis but is close to becoming a net exporter in terms of value. By-products continue to play a critical role in determining the red meat trade balance and producer prices. The United States, however, must continue to become cost, price, and quality competitive with other suppliers and must secure additional market access if it is to sustain recent trade trends. Several trade tensions remain in the red meat industry. For example, mandated COOL will undoubtedly have domestic and international effects on the beef and pork sectors. Domestically, uncertainty regarding consumer demand responses or quality perceptions regarding product origin, as well as added processor-retailer costs will be nontrivial. How these factors balance out in terms of benefits versus costs to the industry is uncertain. From an international perspective, some beef and pork export suppliers to the United States could view required labeling as a trade restriction, which could ultimately impact future US red meat exports. Conversely, some countries may view such labeling requirements as an opportunity to brand high-quality products. The US lamb meat industry has experienced declining real prices, domestic production, and demand. The cessation of wool incentive payments, increased environmental regulations, and competition by imports have significantly affected the industry. Import suppliers have capitalized on product quality in this niche market. Trade restrictions initially imposed in 1999 by the US Government were ruled illegal by the WTO. The US Government responded by providing financial assistance to lamb producers. Product quality improvements and promotion aimed at the domestic market, however, will be critical factors in shaping the economic viability of the US lamb meat industry.

How can we improve stroke thrombolysis rates? A review of health system factors and approaches associated with thrombolysis administration rates in acute stroke care.

PubMed

Paul, Christine L; Ryan, Annika; Rose, Shiho; Attia, John R; Kerr, Erin; Koller, Claudia; Levi, Christopher R

2016-04-08

Thrombolysis using intravenous (IV) tissue plasminogen activator (tPA) is one of few evidence-based acute stroke treatments, yet achieving high rates of IV tPA delivery has been problematic. The 4.5-h treatment window, the complexity of determining eligibility criteria and the availability of expertise and required resources may impact on treatment rates, with barriers encountered at the levels of the individual clinician, the social context and the health system itself. The review aimed to describe health system factors associated with higher rates of IV tPA administration for ischemic stroke and to identify whether system-focussed interventions increased tPA rates for ischemic stroke. Published original English-language research from four electronic databases spanning 1997-2014 was examined. Observational studies of the association between health system factors and tPA rates were described separately from studies of system-focussed intervention strategies aiming to increase tPA rates. Where study outcomes were sufficiently similar, a pooled meta-analysis of outcomes was conducted. Forty-one articles met the inclusion criteria: 7 were methodologically rigorous interventions that met the Cochrane Collaboration Evidence for Practice and Organization of Care (EPOC) study design guidelines and 34 described observed associations between health system factors and rates of IV tPA. System-related factors generally associated with higher IV tPA rates were as follows: urban location, centralised or hub and spoke models, treatment by a neurologist/stroke nurse, in a neurology department/stroke unit or teaching hospital, being admitted by ambulance or mobile team and stroke-specific protocols. Results of the intervention studies suggest that telemedicine approaches did not consistently increase IV tPA rates. Quality improvement strategies appear able to provide modest increases in stroke thrombolysis (pooled odds ratio = 2.1, p = 0.05). In order to improve IV tPA rates in acute stroke care, specific health system factors need to be targeted. Multi-component quality improvement approaches can improve IV tPA rates for stroke, although more thoughtfully designed and well-reported trials are required to safely increase rates of IV tPA to eligible stroke patients.

Psychological well-being over time among informal caregivers caring for persons with dementia living at home.

PubMed

Lethin, Connie; Renom-Guiteras, Anna; Zwakhalen, Sandra; Soto-Martin, Maria; Saks, Kai; Zabalegui, Adelaida; Challis, David J; Nilsson, Christer; Karlsson, Staffan

2017-11-01

To investigate informal caregivers' psychological well-being and predicted increase in psychological well-being, when caring for persons with dementia (PwDs) living at home, related to caregiver, PwD and formal care (FC) factors. A cohort study at baseline and 3 months' follow-up in eight European countries. Caregivers included (n = 1223) were caring for PwDs aged ≥ 65 years at home. Data on caregivers, PwDs and FC were collected using standardized instruments. Regression analysis of factors associated with caregiver psychological well-being at baseline and 3 months later was performed. Factors associated with caregiver psychological well-being at baseline were positive experience of caregiving, low caregiver burden, high quality of life (QoL) for caregivers, male gender of PwD, high QoL of PwD, few neuropsychiatric symptoms and depressive symptoms for the PwD. At follow-up, caregivers with increased psychological well-being experienced of quality of care (QoC) higher and were more often using dementia specific service. Predicting factors for caregivers' increased psychological well-being were less caregiver burden, positive experience of caregiving, less supervision of the PwD and higher caregiver QoL, if PwD were male, had higher QoL and less neuropsychiatric symptoms. Furthermore, higher QoC predicted increased caregivers' psychological well-being. Informal caregiving for PwDs living at home is a complex task. Our study shows that caregivers' psychological well-being was associated with, among other things, less caregiver burden and higher QoL. Professionals should be aware of PwD neuropsychiatric symptoms that might affect caregivers' psychological well-being, and provide proper care and treatment for caregivers and PwDs.

Factors associated with family satisfaction with end-of-life care in the ICU: a systematic review.

PubMed

Hinkle, Laura J; Bosslet, Gabriel T; Torke, Alexia M

2015-01-01

Family satisfaction with end-of-life care in the ICU has not previously been systematically reviewed. Our objective was to perform a review, synthesizing published data identifying factors associated with family satisfaction with end-of-life care in critically ill adult populations. The following electronic databases were searched: MEDLINE (Medical Literature Analysis and Retrieval System Online), MEDLINE Updated, EMBASE (Excerpta Medical Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycInfo, and PubMed. Two authors reviewed retrieved titles and abstracts. Studies describing nonadult and non-ICU populations or not addressing end-of-life care, family satisfaction, or factors affecting satisfaction were excluded. The remaining articles underwent full review and data extraction by two authors. Quality was assessed using a checklist based on the recommendations of the Consolidated Standards for Reporting Trials group. The search yielded 1,072 articles, with 23 articles describing 14 studies meeting inclusion criteria. All studies obtained satisfaction data from family members via surveys and structured interviews. Specific communication strategies increasing satisfaction included: expressions of empathy, nonabandonment, and assurances of comfort and provision of written information. Additionally, support for shared decision-making, family presence at time of death, and specific patient-care measures such as extubation before death were associated with increased satisfaction. Good-quality communication, support for shared decision-making, and specific patient-care measures were associated with increased satisfaction with end-of-life care. Assessing the family's desire to participate in shared decision-making may also be an important factor. Few interventions increased satisfaction. Future research is needed to further define optimal communication strategies, understand effective integration of palliative care into the ICU, and define significant score changes in survey instruments.

The quest for quality and productivity in health services.

PubMed

Sahney, V K; Warden, G L

1991-01-01

The leaders of health care organizations across the country are facing significant pressures to improve the quality of their services while reducing the rate of cost increases within the industry. Total Quality Management (TQM) has been credited, by many leaders in the manufacturing industry, as an effective tool to manage their organizations. This article presents key concepts of TQM as discussed by quality experts, namely, Deming, Juran, and Crosby. It discusses 12 key concepts that have formed the foundation of TQM implementation at Henry Ford Health System. The process of implementation is presented in detail, and the role of TQM in clinical applications is discussed. Success factors and visible actions by senior management designed to reinforce the implementation of TQM in any organization are presented.

Depression, Control, and Climate: An Examination of Factors Impacting Teaching Quality in Preschool Classrooms

PubMed Central

Sandilos, Lia E.; Cycyk, Lauren M.; Hammer, Carol Scheffner; Sawyer, Brook E.; López, Lisa; Blair, Clancy

2015-01-01

Research Findings This study investigated the relationship of preschool teachers' self-reported depressive symptomatology, perception of classroom control, and perception of school climate to classroom quality as measured by the Classroom Assessment Scoring System Pre-K. The sample consisted of 59 urban preschool classrooms serving low-income and linguistically diverse students in the northeastern and southeastern United States. Results of hierarchical linear modeling revealed that teachers' individual reports of depressive symptomatology were significantly and negatively predictive of the observed quality of their instructional support and classroom organization. Practice or Policy The findings of this study have implications for increasing access to mental health supports for teachers in an effort to minimize depressive symptoms and potentially improve classroom quality. PMID:26924914

Study on the factors affecting the quality of public bus transportation service in Bali Province using factor analysis

NASA Astrophysics Data System (ADS)

Susilawati, M.; Nilakusmawati, D. P. E.

2017-06-01

The volume of mobility flows are increasing day by day and the condition of the number of people using private transport modes contribute to traffic congestion. With the limited capacity of the road, one of the alternatives solution to reduce congestion is to optimize the use of public transport. The purposes of this study are to determine the factors that influence user’s satisfaction on the quality of public bus transportation service and determine variables that became identifier on the dominant factor affecting user’s satisfaction. The study was conducted for the public bus transportation between districts in the province of Bali, which is among the eight regencies and one municipality, using a questionnaire as a data collection instrument. Service variables determinant of user’s satisfaction in this study, described in 25 questions, which were analyzed using factor analysis. The results showed there were six factors that explain the satisfaction of users of public transport in Bali, with a total diversity of data that can be parsed by 61.436%. These factors are: Safety and comfort, Responsiveness, Capacity, Tangible, Safety, Reliability. The dominant factor affecting public transport user satisfaction is the safety and comfort, with the most influential variable is feeling concerned about the personal safety of users when on the bus.