NASA Astrophysics Data System (ADS)
Gao, Yuanci; Charles, Jones R.; Yu, Guofen; Jyotsna, Dutta M.
2012-03-01
A long loop phase locked backward-wave oscillator (BWO) for a high quality factor resonator system operating at D-band frequencies (130-170GHz) was described, the phase noise of the phased locked BWO was analyzed and measured at typical frequencies. When it used with a high quality factor open resonator for measuring the quality factor of simple harmonic resonators based on the magnitude transfer characteristic, this system has proven to be capable of accurate measuring the quality factor as high as 0.8 million with an uncertainty of less than 1.3% (Lorentzian fitting) at typical frequencies in the range of 130GHz-170GHz.
Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care
Profit, J; Zupancic, JAF; Gould, JB; Pietz, K; Kowalkowski, MA; Draper, D; Hysong, SJ; Petersen, LA
2014-01-01
Objectives To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. Design We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Setting Twenty-two regional NICUs in California. Patients In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Main Outcomes Measures Pneumothorax, growth velocity, health care–associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. Results The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations only 6 were significant (P < .05). Correlations between pairs of quality measures were strong (ρ > .5) for 1 pair, moderate (.3 < |ρ| < .5) for 8 pairs, weak (.1 < |ρ| < .3) for 5 pairs and negligible (|ρ| < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care–associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. Conclusion In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest. PMID:23403539
Sader, John E; Sanelli, Julian; Hughes, Barry D; Monty, Jason P; Bieske, Evan J
2011-09-01
The thermal noise spectrum of nanomechanical devices is commonly used to characterize their mechanical properties and energy dissipation. This spectrum is measured from finite time series of Brownian motion of the device, which is windowed and Fourier transformed. Here, we present a theoretical and experimental investigation of the effect of such finite sampling on the measured device quality factor. We prove that if no spectral window is used, the thermal noise spectrum retains its original Lorentzian distribution but with a reduced quality factor, indicating an apparent enhancement in energy dissipation. A simple analytical formula is derived connecting the true and measured quality factors - this enables extraction of the true device quality factor from measured data. Common windows used to reduce spectral leakage are found to distort the (true) Lorentzian shape, potentially making fitting problematic. These findings are expected to be of particular importance for devices with high quality factors, where spectral resolution can be limited in practice. Comparison and validation using measurements on atomic force microscope cantilevers are presented. © 2011 American Institute of Physics
Correlation of neonatal intensive care unit performance across multiple measures of quality of care.
Profit, Jochen; Zupancic, John A F; Gould, Jeffrey B; Pietz, Kenneth; Kowalkowski, Marc A; Draper, David; Hysong, Sylvia J; Petersen, Laura A
2013-01-01
To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Twenty-two regional NICUs in California. In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Pneumothorax, growth velocity, health care-associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations, 6 were significant (ρ < .05). Correlations between pairs of measures of quality of care were strong (ρ ≥ .5) for 1 pair, moderate (range, ρ ≥ .3 to ρ < .5) for 8 pairs, weak (range, ρ ≥ .1 to ρ < .3) for 5 pairs, and negligible (ρ < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care-associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest.
Kramers-Kronig based quality factor for shear wave propagation in soft tissue
Urban, M W; Greenleaf, J F
2009-01-01
Shear wave propagation techniques have been introduced for measuring the viscoelastic material properties of tissue, but assessing the accuracy of these measurements is difficult for in vivo measurements in tissue. We propose using the Kramers-Kronig relationships to assess the consistency and quality of the measurements of shear wave attenuation and phase velocity. In ex vivo skeletal muscle we measured the wave attenuation at different frequencies, and then applied finite bandwidth Kramers-Kronig equations to predict the phase velocities. We compared these predictions with the measured phase velocities and assessed the mean square error (MSE) as a quality factor. An algorithm was derived for computing a quality factor using the Kramers-Kronig relationships. PMID:19759409
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.
Quality factor and dose equivalent investigations aboard the Soviet Space Station Mir
NASA Astrophysics Data System (ADS)
Bouisset, P.; Nguyen, V. D.; Parmentier, N.; Akatov, Ia. A.; Arkhangel'Skii, V. V.; Vorozhtsov, A. S.; Petrov, V. M.; Kovalev, E. E.; Siegrist, M.
1992-07-01
Since Dec 1988, date of the French-Soviet joint space mission 'ARAGATZ', the CIRCE device, had recorded dose equivalent and quality factor values inside the Mir station (380-410 km, 51.5 deg). After the initial gas filling two years ago, the low pressure tissue equivalent proportional counter is still in good working conditions. Some results of three periods are presented. The average dose equivalent rates measured are respectively 0.6, 0.8 and 0.6 mSv/day with a quality factor equal to 1.9. Some detailed measurements show the increasing of the dose equivalent rates through the SAA and near polar horns. The real time determination of the quality factors allows to point out high linear energy transfer events with quality factors in the range 10-20.
Factor selection for service quality evaluation: a hospital case study.
Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad
2017-02-13
Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.
Safety considerations in providing allergen immunotherapy in the office.
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.
Aalgaard Kelly, Gina
2015-01-01
Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes . Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC).
Aalgaard Kelly, Gina
2015-01-01
Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes. Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC). PMID:28138474
NASA Astrophysics Data System (ADS)
Mundhra, A.; Sain, K.; Shankar, U.
2012-12-01
The Indian National Gas Hydrate Program Expedition (NGHP) 01 discovered gas hydrate in unconsolidated sediments at several drilling sites along the continental margins of Krishna-Godavari Basin, India. Presence of gas hydrate reduces the attenuation of travelling seismic waves which can be measured by estimation of seismic quality factor (Dasgupta and Clark, 1998). Here, we use log spectral ratio method (Sain et al, 2009) to compute quality factor at three locations, among which two have strong and one has no bottom simulating reflector (BSR), along seismic cross-line near one of the drilling site. Interval quality factor for three submarine sedimentary layers bounded by seafloor, BSR, one reflector above and another reflector below the BSR has been measured. To compute quality factor, unprocessed pre-stack seismic data has been used to avoid any influence of processing sequence. We have estimated that interval quality factor lies within 200-220 in the interval having BSR while it varies within 90-100 in other intervals. Thereby, high interval quality factor ascertains that observed BSR is due to presence of gas hydrates. We have performed rock physics modelling by using isotropic and anisotropic models, to quantitatively estimate gas hydrate saturation at one of the location where an interval has high quality factor. Abruptly high measured resistivity and high P-wave velocity in the interval, leads to towering hydrate saturation (Archie,1942 and Helegrud et al, 1999) in comparison to lower gas hydrate saturations estimated by pressure core and chlorinity measurements. Overestimation of saturation is attributed to presence of near vertical fractures that are identified from logging-while-drilling resistivity images. We have carried out anisotropic modeling (Kennedy and Herrick, 2004 and Lee,2009) by incorporating fracture volume and fracture porosity to estimate hydrate saturation and have observed that modeled gas hydrate saturations agree with the lower gas hydrate saturations obtained from pressure core and chlorinity measurements. Therefore, we find that 1) quality factor is significantly higher in the interval bearing gas hydrates and is a useful tool to discover hydrate deposits, 2) anisotropy due to presence of near vertical hydrate filled fractures translates into elevated saturation because of high measured resistivity and velocity and 3) anisotropic model greatly corrects the saturation estimates in fractured medium. References: Archie, G.E., 1942. Petroleum Transactions of AIME, 146, 54-62. Dasgupta, R., Clark, R.A., 1998. Geophysics 63, 2120-2128. Kennedy, W.D., Herrick, D.C., 2004. Petrophysics 45, 38-58. Lee, M.W., 2009. U.S. Geological Survey Scientific Investigations Report 2009-5141, 13. Sain, K., Singh, A.K., Thakur, N.K., Khanna, R.K., 2009.Marine Geophysical Researches 30, 137-145.
Measurement of M²-Curve for Asymmetric Beams by Self-Referencing Interferometer Wavefront Sensor.
Du, Yongzhao
2016-11-29
For asymmetric laser beams, the values of beam quality factor M x 2 and M y 2 are inconsistent if one selects a different coordinate system or measures beam quality with different experimental conditionals, even when analyzing the same beam. To overcome this non-uniqueness, a new beam quality characterization method named as M²-curve is developed. The M²-curve not only contains the beam quality factor M x 2 and M y 2 in the x -direction and y -direction, respectively; but also introduces a curve of M x α 2 versus rotation angle α of coordinate axis. Moreover, we also present a real-time measurement method to demonstrate beam propagation factor M²-curve with a modified self-referencing Mach-Zehnder interferometer based-wavefront sensor (henceforth SRI-WFS). The feasibility of the proposed method is demonstrated with the theoretical analysis and experiment in multimode beams. The experimental results showed that the proposed measurement method is simple, fast, and a single-shot measurement procedure without movable parts.
Measurement of M2-Curve for Asymmetric Beams by Self-Referencing Interferometer Wavefront Sensor
Du, Yongzhao
2016-01-01
For asymmetric laser beams, the values of beam quality factor Mx2 and My2 are inconsistent if one selects a different coordinate system or measures beam quality with different experimental conditionals, even when analyzing the same beam. To overcome this non-uniqueness, a new beam quality characterization method named as M2-curve is developed. The M2-curve not only contains the beam quality factor Mx2 and My2 in the x-direction and y-direction, respectively; but also introduces a curve of Mxα2 versus rotation angle α of coordinate axis. Moreover, we also present a real-time measurement method to demonstrate beam propagation factor M2-curve with a modified self-referencing Mach-Zehnder interferometer based-wavefront sensor (henceforth SRI-WFS). The feasibility of the proposed method is demonstrated with the theoretical analysis and experiment in multimode beams. The experimental results showed that the proposed measurement method is simple, fast, and a single-shot measurement procedure without movable parts. PMID:27916845
Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan.
Cheng, Shao-Yi; Lin, Wen-Yuan; Cheng, Ya-Hui; Huang, Chien Hsiun; Chen, Ching-Yu; Hwang, Shinn-Jang; Tsai, Shih-Tzu; Chiu, Tai-Yuan
2016-02-01
Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. The good death score at admission, clear consciousness, number of admission days beyond 7, better physical care, higher physician-assessed autonomy, better emotional support, better communication, better continuity of life, and physician-reported rate of closure were factors affecting the quality of dying. Further analysis identified age (p = 0.031), consciousness (p = 0.01), and total good death scale score at death (p < 0.001) as determinants of physician-assessed autonomy. We concluded that physician-assessed autonomy would affect a good death and was highly correlated with age, consciousness level, and quality of dying at the end for advanced cancer patients in Taiwan. Copyright © 2015 John Wiley & Sons, Ltd.
Quality of Mental Health Care for Nursing Home Residents: A Literature Review
Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.
2010-01-01
Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943
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.
Scherer, Ronny; Nilsen, Trude; Jansen, Malte
2016-01-01
Students' perceptions of instructional quality are among the most important criteria for evaluating teaching effectiveness. The present study evaluates different latent variable modeling approaches (confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling), which are used to describe these individual perceptions with respect to their factor structure, measurement invariance, and the relations to selected educational outcomes (achievement, self-concept, and motivation in mathematics). On the basis of the Programme for International Student Assessment (PISA) 2012 large-scale data sets of Australia, Canada, and the USA (N = 26,746 students), we find support for the distinction between three factors of individual students' perceptions and full measurement invariance across countries for all modeling approaches. In this regard, bifactor exploratory structural equation modeling outperformed alternative approaches with respect to model fit. Our findings reveal significant relations to the educational outcomes. This study synthesizes different modeling approaches of individual students' perceptions of instructional quality and provides insights into the nature of these perceptions from an individual differences perspective. Implications for the measurement and modeling of individually perceived instructional quality are discussed.
Microcrystalline diamond cylindrical resonators with quality-factor up to 0.5 million
NASA Astrophysics Data System (ADS)
Saito, Daisuke; Yang, Chen; Heidari, Amir; Najar, Hadi; Lin, Liwei; Horsley, David A.
2016-02-01
We demonstrate high quality-factor 1.5 mm diameter batch-fabricated microcrystalline diamond cylindrical resonators (CR) with quality-factors limited by thermoelastic damping (TED) and surface loss. Resonators were fabricated 2.6 and 5.3 μm thick in-situ boron-doped microcrystalline diamond films deposited using hot filament chemical vapor deposition. The quality-factor (Q) of as-fabricated CR's was found to increase with the resonator diameter and diamond thickness. Annealing the CRs at 700 °C in a nitrogen atmosphere led to a three-fold increase in Q, a result we attribute to thinning of the diamond layer via reaction with residual O2 in the annealing furnace. Post-anneal Q exceeding 0.5 million (528 000) was measured at the 19 kHz elliptical wineglass modes, producing a ring-down time of 8.9 s. A model for Q versus diamond thickness and resonance frequency is developed including the effects of TED and surface loss. Measured quality factors are shown to agree with the predictions of this model.
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.
Development of a Mammographic Image Processing Environment Using MATLAB.
1994-12-01
S. .° : i. .... ...... Correctness Reliability Efficiency Integrity Usability Figure 1.2 - McCall’s software quality factors [ Pressman , 1987] 1.4...quality factors [ Pressman , 1987] 3-13 Each quality factor itself is related to independent attributes called criteria [Cooper and Fisher, 1979], or...metrics by [ Pressman , 1987], that can be used to judge, define, and measure quality [Cooper and Fisher, 1979]. Figure 3.9 shows the criteria that are used
Factors affecting dental service quality.
Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia
2015-01-01
Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.
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…
Heinemann, Lutz
2010-11-01
A good understanding of the relevance of interfering factors having an impact on blood glucose (BG) measurement is needed to obtain the required quality. This depends on the application in which meters designed for self-monitoring of BG (SMBG) are used. By means of a literature search all publications (from January 1, 1980 to August 10, 2009) were identified that report about the influence of potentially interfering substances/factors on the measurement quality of BG meters. Certain substances (e.g., maltose) can have a profound and misleading impact on the BG measurement result when the enzymatic reaction embedded on the given test strips cross-reacts. Also, a number of other drugs (e.g., acetaminophen) and factors (like temperature and altitude) affect the reliability of BG measurement massively. However, the susceptibility of the BG meter (depending on the enzyme technology of the test strips) differs significantly. In daily practice the factors that have a relevant impact on the reliability of BG measurements with modern BG meters are rarely met. Clearly this also depends on the intended use (SMBG in patient hands vs. point-of-care testing in hospitals). To avoid misleading measurement results requires adequate training of all people involved.
How to measure the QoS of a web-based EHRs system: development of an instrument.
de la Torre-Díez, Isabel; López-Coronado, Miguel; Rodrigues, Joel J P C
2012-12-01
The quality of service (QoS) can be treated as a set of concepts whose satisfaction/dissatisfaction generates a global positive/negative vision about the service provided by any application. The different nature of the services and its features require an analysis of the factors that have the greatest influence on the users' opinion and, therefore, measuring the quality of service in each application requires a specific instrument. This paper will introduce an instrument to measure the QoS offered to users by a general Web application for Electronic Health Records (EHRs). The collection of opinions from a pilot sample and the performance of an explanatory factor analysis will bring together the factors that best sum up the quality of an EHRs application. Subsequently, a confirmatory factor analysis will be performed to make the study reliable and, as its name suggests, to confirm that indeed the structure of the instrument developed measures the QoS in accordance with the requirements of the users.
Evaluating Journal Quality: Is the H-Index a Better Measure than Impact Factors?
ERIC Educational Resources Information Center
Hodge, David R.; Lacasse, Jeffrey R.
2011-01-01
Objectives: This study evaluates the utility of a new measure--the h-index--that may provide a more valid approach to evaluating journal quality in the social work profession. Method: H-index values are compared with Thomson ISI 5-year impact factors and expert opinion. Results: As hypothesized, the h-index correlates highly with ISI 5-year impact…
Scherer, Ronny; Nilsen, Trude; Jansen, Malte
2016-01-01
Students' perceptions of instructional quality are among the most important criteria for evaluating teaching effectiveness. The present study evaluates different latent variable modeling approaches (confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling), which are used to describe these individual perceptions with respect to their factor structure, measurement invariance, and the relations to selected educational outcomes (achievement, self-concept, and motivation in mathematics). On the basis of the Programme for International Student Assessment (PISA) 2012 large-scale data sets of Australia, Canada, and the USA (N = 26,746 students), we find support for the distinction between three factors of individual students' perceptions and full measurement invariance across countries for all modeling approaches. In this regard, bifactor exploratory structural equation modeling outperformed alternative approaches with respect to model fit. Our findings reveal significant relations to the educational outcomes. This study synthesizes different modeling approaches of individual students' perceptions of instructional quality and provides insights into the nature of these perceptions from an individual differences perspective. Implications for the measurement and modeling of individually perceived instructional quality are discussed. PMID:26903917
Evaluating the beam quality of double-cladding fiber lasers in applications.
Yan, Ping; Wang, Xuejiao; Gong, Mali; Xiao, Qirong
2016-08-10
We put forward a new βFL factor, which is used exclusively in fiber lasers and is suitable to assess beam quality and choose the LP01 mode as the new suitable ideal beam. We present a new simple measurement method and verify the reasonability of the βFL factor in experiment in a 20/400 μm fiber laser. Furthermore, we use the βFL factor to evaluate the beam quality of a 3-kW-level fiber laser. It can be concluded that βFL is a key factor not only for assessing the performance of the high-power fiber laser that is our main focus, but also for the simple measurement.
Microcrystalline diamond cylindrical resonators with quality-factor up to 0.5 million
DOE Office of Scientific and Technical Information (OSTI.GOV)
Saito, Daisuke; Yang, Chen; Lin, Liwei
2016-02-01
We demonstrate high quality-factor 1.5 mm diameter batch-fabricated microcrystalline diamond cylindrical resonators (CR) with quality-factors limited by thermoelastic damping (TED) and surface loss. Resonators were fabricated 2.6 and 5.3 μm thick in-situ boron-doped microcrystalline diamond films deposited using hot filament chemical vapor deposition. The quality-factor (Q) of as-fabricated CR's was found to increase with the resonator diameter and diamond thickness. Annealing the CRs at 700 °C in a nitrogen atmosphere led to a three-fold increase in Q, a result we attribute to thinning of the diamond layer via reaction with residual O{sub 2} in the annealing furnace. Post-anneal Q exceeding 0.5 million (528 000)more » was measured at the 19 kHz elliptical wineglass modes, producing a ring-down time of 8.9 s. A model for Q versus diamond thickness and resonance frequency is developed including the effects of TED and surface loss. Measured quality factors are shown to agree with the predictions of this model.« less
BACKGROUND: Many environmental factors have been independently associated with preterm birth (PTB). However, exposure is not isolated to a single environmental factor, but rather to many positive and negative factors that co-occur. The environmental quality index (EQI), a measur...
Do prominent quality measurement surveys capture the concerns of persons with disability?
Iezzoni, Lisa I; Marsella, Sarah A; Lopinsky, Tiffany; Heaphy, Dennis; Warsett, Kimberley S
2017-04-01
Demonstration programs nationwide aim to control costs and improve care for people dually-eligible for Medicare and Medicaid, including many persons with disability. Ensuring these initiatives maintain or improve care quality requires comprehensive evaluation of quality of care. To examine whether the common quality measures being used to evaluate the Massachusetts One Care duals demonstration program comprehensively address the concerns of persons with disability. Drawing upon existing conceptual frameworks, we developed a model of interrelationships of personal, health care, and environmental factors for achieving wellness for persons with disability. Based on this model, we specified a scheme to code individual quality measurement items and coded the items contained in 12 measures being used to assess Massachusetts One Care, which exclusively enrolls non-elderly adults with disability. Across these 12 measures, we assigned 376 codes to 302 items; some items received two codes. Taken together, the 12 measures contain items addressing most factors in our conceptual model that affect health care quality for persons with disability, including long-term services and supports. Some important gaps exist. No items examine sexual or reproductive health care, peer support, housing security, disability stigmatization, and specific services obtained outside the home like adult day care. Certain key concepts are covered only by a single or several of the 12 quality measures. Common quality metrics cover most - although not all-health care quality concerns of persons with disability. However, multiple different quality measures are required for this comprehensive coverage, raising questions about respondent burden. Copyright © 2017 Elsevier Inc. All rights reserved.
Luther, Lauren; Fukui, Sadaaki; Garabrant, Jennifer M; Rollins, Angela L; Morse, Gary; Henry, Nancy; Shimp, Dawn; Gearhart, Timothy; Salyers, Michelle P
2018-04-12
Measuring quality of care can transform care, but few tools exist to measure quality from the client's perspective. The aim of this study was to create concordant clinician and client self-report quality-of-care scales in a sample of community mental health clinicians (n = 189) and clients (n = 469). The client scale had three distinct factors (Person-Centered Care, Negative Staff Interactions, and Inattentive Care), while the clinician scale had two: Person-Centered Care and Discordant Care. Both versions demonstrated adequate internal consistency and validity with measures related to satisfaction and the therapeutic relationship. These measures are promising, brief quality assessment tools.
The (Mis)Measure of Schools: How Data Affect Stakeholder Knowledge and Perceptions of Quality
ERIC Educational Resources Information Center
Schneider, Jack; Jacobsen, Rebecca; White, Rachel S.; Gehlbach, Hunter
2018-01-01
Purpose/Objective: Under the reauthorized Every Student Succeeds Act (ESSA), states and districts retain greater discretion over the measures included in school quality report cards. Moreover, ESSA now requires states to expand their measurement efforts to address factors like school climate. This shift toward more comprehensive measures of school…
Medical student quality-of-life in the clerkships: a scale validation study.
Brannick, Michael T; Horn, Gregory T; Schnaus, Michael J; Wahi, Monika M; Goldin, Steven B
2015-04-01
Many aspects of medical school are stressful for students. To empirically assess student reactions to clerkship programs, or to assess efforts to improve such programs, educators must measure the overall well-being of the students reliably and validly. The purpose of the study was to develop and validate a measure designed to achieve these goals. The authors developed a measure of quality of life for medical students by sampling (public domain) items tapping general happiness, fatigue, and anxiety. A quality-of-life scale was developed by factor analyzing responses to the items from students in two different clerkships from 2005 to 2008. Reliability was assessed using Cronbach's alpha. Validity was assessed by factor analysis, convergence with additional theoretically relevant scales, and sensitivity to change over time. The refined nine-item measure is a Likert scaled survey of quality-of-life items comprised of two domains: exhaustion and general happiness. The resulting scale demonstrated good reliability and factorial validity at two time points for each of the two samples. The quality-of-life measure also correlated with measures of depression and the amount of sleep reported during the clerkships. The quality-of-life measure appeared more sensitive to changes over time than did the depression measure. The measure is short and can be easily administered in a survey. The scale appears useful for program evaluation and more generally as an outcome variable in medical educational research.
Untas, Aurélie; Thumma, Jyothi; Rascle, Nicole; Rayner, Hugh; Mapes, Donna; Lopes, Antonio A; Fukuhara, Shunichi; Akizawa, Tadao; Morgenstern, Hal; Robinson, Bruce M; Pisoni, Ronald L; Combe, Christian
2011-01-01
This study aimed to investigate the influence of social support and other psychosocial factors on mortality, adherence to medical care recommendations, and physical quality of life among hemodialysis patients. Data on 32,332 hemodialysis patients enrolled in the Dialysis Outcomes and Practice Patterns Study (1996 to 2008) in 12 countries were analyzed. Social support and other psychosocial factors related to ESRD and its treatment were measured by patient self-reports of health interference with social activities, isolation, feeling like a burden, and support from family and dialysis staff. Cox regression and logistic regression were used to examine associations of baseline social support and other psychosocial factors with all-cause mortality and with other measured outcomes at baseline, adjusting for potential confounders. Mortality was higher among patients reporting that their health interfered with social activities, were isolated, felt like a burden, and were dissatisfied with family support. Poorer family support and several psychosocial measures also were associated with lower adherence to the prescribed hemodialysis length and the recommended weight gain between sessions. Some international differences were observed. Poorer self-reported social support and other psychosocial factors were associated with poor physical quality of life. Poorer social support and other psychosocial factors are associated with higher mortality risk, lower adherence to medical care, and poorer physical quality of life in hemodialysis patients. More research is needed to assess whether interventions to improve social support and other psychosocial factors will lengthen survival and enhance quality of life.
The Health and Functioning ICF-60: Development and Psychometric Properties
Tutelyan, V A; Chatterji, S; Baturin, A K; Pogozheva, A V; Kishko, O N; Akolzina, S E
2014-01-01
Background This paper describes the development and psychometric properties of the Health and Functioning ICF-60 (HF-ICF-60) measure, based on the World Health Organization (WHO) ‘International Classification of Functioning, Disability and Health: ICF’ (2001). The aims of the present study were to test psychometric properties of the HF-ICF-60, developed as a measure that would be responsive to change in functioning through changes in health and nutritional status, as a prospective measure to monitor health and nutritional status of populations and to explore the relationship of the HF-ICF-60 with quality of life measures such as the World Health Organization WHOQOL-BREF quality of life assessment in relation to non-communicable diseases. Methods The HF-ICF-60 measure consists of 60 items selected from the ICF by an expert panel, which included 18 items that cover Body Functions, 21 items that cover Activities and Participation, rated on five-point scales, and 21 items that cover Environmental Factors (seven items cover Individual Environmental Factors and 14 items cover Societal Environmental Factors), rated on nine-point scales. The HF-ICF-60 measure was administered to the Russian nationally representative sample within the Russian National Population Quality of Life, Health and Nutrition Survey, in 2004 (n = 9807) and 2005 (n = 9560), as part of the two waves of the Russian Longitudinal Monitoring Survey (RLMS). The statistical analyses were carried out with the use of both classical and modern psychometric methods, such as factor analysis, and based on Item Response Theory, respectively. Results The HF-ICF-60 questionnaire is a new measure derived directly from the ICF and covers the ICF components as follows: Body Functions, Activities and Participation, and Environmental Factors (Individual Environmental Factors and Societal Environmental Factors). The results from the factor analyses (both Exploratory Factor Analyses and Confirmatory Factor Analyses) show good support for the proposed structure together with an overall higher-order factor for each scale of the measure. The measure has good reliability and validity, and sensitivity to change in the health and nutritional status of respondents over time. Normative values were developed for the Russian adult population. Conclusions The HF-ICF-60 has shown good psychometric properties in the two waves of the nationally representative RLMS, which provided considerable support to using the HF-ICF-60 data as the normative health and functioning values for the Russian population. Similarly, the administration of the WHOQOL-BREF in the same two waves of the nationally representative RLMS has allowed the normative quality of life values for the Russian population to be obtained. Therefore, the objective assessment of health and functioning of the HF-ICF-60 could be mapped onto the subjective evaluation of quality of life of the WHOQOL-BREF to increase the potential usefulness of the surveys in relation to non-communicable diseases. © 2014 The Authors. Clinical Psychology & Psychotherapy. Published by John Wiley & Sons, Ltd. Key Practitioner Message The HF-ICF-60 offers a new perspective in measuring change in functioning through changes in lifestyle and diet. The HF-ICF-60 can be combined with the WHOQOL-BREF to map the objective assessment of health and functioning onto the subjective evaluation of quality of life. Combined use of the HF-ICF-60 and the WHOQOL-BREF can be especially useful for national and global monitoring and surveillance of implementation of measures to reduce risk factors of non-communicable diseases and to promote healthy lifestyles and healthy diets. PMID:24931300
Developing a Scale for Quality of Using Learning Strategies
ERIC Educational Resources Information Center
Tasci, Guntay; Yurdugul, Halil
2016-01-01
This study aims to develop a measurement tool to measure the quality of using learning strategies. First, the quality of using learning strategies was described based on the literature. The 32 items in the 5-point Likert scale were then administered to 320 prospective teachers, and they were analysed with exploratory factor analysis using…
Smith, Laura M; Anderson, Wayne L; Lines, Lisa M; Pronier, Cristalle; Thornburg, Vanessa; Butler, Janelle P; Teichman, Lori; Dean-Whittaker, Debra; Goldstein, Elizabeth
2017-01-01
We examined the effects of provider characteristics on home health agency performance on patient experience of care (Home Health CAHPS) and process (OASIS) measures. Descriptive, multivariate, and factor analyses were used. While agencies score high on both domains, factor analyses showed that the underlying items represent separate constructs. Freestanding and Visiting Nurse Association agencies, higher number of home health aides per 100 episodes, and urban location were statistically significant predictors of lower performance. Lack of variation in composite measures potentially led to counterintuitive results for effects of organizational characteristics. This exploratory study showed the value of having separate quality domains.
Public reporting and the quality of care of German nursing homes.
Herr, Annika; Nguyen, Thu-Van; Schmitz, Hendrik
2016-10-01
Since 2009, German nursing homes have been evaluated regularly by an external institution with quality report cards published online. We follow recent debates and argue that most of the information in the report cards does not reliably measure quality of care. However, a subset of up to seven measures does. Do these measures that reflect "risk factors" improve over time? Using a sample of more than 3000 German nursing homes with information on two waves, we assume that the introduction of public reporting is an exogenous institutional change and apply before-after-estimations to obtain estimates for the relation between public reporting and quality. We find a significant improvement of the identified risk factors. Also, the two employed outcome quality indicators improve significantly. The improvements are driven by nursing homes with low quality in the first evaluation. To the extent that this can be interpreted as evidence that public reporting positively affects the (reported) quality in nursing homes, policy makers should carefully choose indicators reflecting care-sensitive quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Improving the Quality and Scientific Understanding of Trophic Magnification Factors (TMFs)
This short 1000 word report presents a series of research needs for improving the measurement and understanding of trophic magnification factors (TMFs). TMFs are useful measures of trophic magnification and represent the diet-weighted average biomagnification factor (BMF) of che...
Xu, Dongjuan; Kane, Robert L; Shippee, Tetyana; Lewis, Teresa M
2016-12-01
There is a general belief that the markers of nursing home quality do not aggregate easily. Identifying consistent and coherent dimensions of quality that usefully summarize the multiplicity of nursing home quality measures is an important goal. It would simplify interpretation and help consumers, their families and advocates to choose nursing facilities. This study uses quality indicators (QIs) from a state nursing home report card to explore the dimensionality of quality in nursing homes and to determine whether aggregation at the resident versus facility level yields the same underlying dimensions. Cross-sectional study. 382 Medicare- and/or Medicaid-certified nursing homes in Minnesota. Residents admitted to the nursing homes during 2011-2012. 16 QIs obtained from the Minimum Data Set 3.0 assessment instrument between 2011 and 2012 were used in the exploratory factor analysis. Factor analysis results suggest four main factors or dimensions to characterize facility performance: continence care (including 4 QIs), restraints and behavioral symptoms (including 3 QIs), care for specific conditions (including 6 QIs), and physical functioning (including 3 QIs). The resident-level and facility-level results generally agreed for 11 QIs. Nursing home quality of care can be captured in summary measures, which can be used by consumers, providers and researchers. Reporting at the resident or facility level will depend on the purpose. These summary measures can be used by policy-makers to identify and reward high-performing facilities and by families to choose nursing facilities for care. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
Baldwin, Richard; Chenoweth, Lynnette; Dela Rama, Marie; Wang, Alex Y
Theory suggests that structural factors such as aged care facility size (bed numbers) will influence service quality. There have been no recent published studies in support of this theory, and consequently, the available literature has not been useful in assisting decision makers with investment decisions on facility size. The study aimed to address that deficit by reviewing the international literature on the relationships between the size of residential aged care facilities, measured by number of beds, and service quality. A systematic review identified 30 studies that reported a relationship between facility size and quality and provided sufficient details to enable comparison. There are three groups of studies based on measurement of quality-those measuring only resident outcomes, those measuring care and resident outcomes using composite tools, and those focused on regulatory compliance. The overall findings support the posited theory to a large extent, that size is a factor in quality and smaller facilities yield the most favorable results. Studies using multiple indicators of service quality produced more consistent results in favor of smaller facilities, as did most studies of regulatory compliance. The theory that aged care facility size (bed numbers) will influence service quality was supported by 26 of the 30 studies reviewed. The review findings indicate that aged care facility size (number of beds) may be one important factor related to service quality. Smaller facilities are more likely to result in higher quality and better outcomes for residents than larger facilities. This has implications for those who make investment decisions concerning aged care facilities. The findings also raise implications for funders and policy makers to ensure that regulations and policies do not encourage the building of facilities inconsistent with these findings.
ERIC Educational Resources Information Center
Sebastianelli, Rose; Swift, Caroline; Tamimi, Nabil
2015-01-01
The authors examined how six factors related to content and interaction affect students' perceptions of learning, satisfaction, and quality in online master of business administration (MBA) courses. They developed three scale items to measure each factor. Using survey data from MBA students at a private university, the authors estimated structural…
ERIC Educational Resources Information Center
Miller, Susan M.; Chan, Fong; Ferrin, James M.; Lin, Chen-Ping; Chan, Jacob Y. C.
2008-01-01
This study examined the factorial structure of the "World Health Organization Quality of Life Questionnaire--Brief Version" in a community sample of Canadians with spinal cord injuries. A confirmatory factor analysis provides evidence that the instrument is a multidimensional measure of quality of life. Additionally, the questionnaire is…
Measuring Authoritative Teaching
ERIC Educational Resources Information Center
Ertesvag, Sigrun K.
2011-01-01
High quality measurements are important to evaluate interventions. The study reports on the development of a measurement to investigate authoritative teaching understood as a two-dimensional construct of warmth and control. Through the application of confirmatory factor analysis (CFA) and structural equation modelling (SEM) the factor structure…
Risk factors for injury in sport climbing and bouldering: a systematic review of the literature.
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.
A Unified Approach for Reporting ARM Measurement Uncertainties Technical Report: Updated in 2016
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sisterson, Douglas
The U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Climate Research Facility is observationally based, and quantifying the uncertainty of its measurements is critically important. With over 300 widely differing instruments providing over 2,500 datastreams, concise expression of measurement uncertainty is quite challenging. ARM currently provides data and supporting metadata (information about the data or data quality) to its users through several sources. Because the continued success of the ARM Facility depends on the known quality of its measurements, ARM relies on Instrument Mentors and the ARM Data Quality Office to ensure, assess, and report measurement quality. Therefore, anmore » easily accessible, well-articulated estimate of ARM measurement uncertainty is needed. This report is a continuation of the work presented by Campos and Sisterson (2015) and provides additional uncertainty information from instruments not available in their report. As before, a total measurement uncertainty has been calculated as a function of the instrument uncertainty (calibration factors), the field uncertainty (environmental factors), and the retrieval uncertainty (algorithm factors). This study will not expand on methods for computing these uncertainties. As before, it will focus on the practical identification, characterization, and inventory of the measurement uncertainties already available to the ARM community through the ARM Instrument Mentors and their ARM instrument handbooks. This study continues the first steps towards reporting ARM measurement uncertainty as: (1) identifying how the uncertainty of individual ARM measurements is currently expressed, (2) identifying a consistent approach to measurement uncertainty, and then (3) reclassifying ARM instrument measurement uncertainties in a common framework.« less
Shop for quality or volume? Volume, quality, and outcomes of coronary artery bypass surgery.
Auerbach, Andrew D; Hilton, Joan F; Maselli, Judith; Pekow, Penelope S; Rothberg, Michael B; Lindenauer, Peter K
2009-05-19
Care from high-volume centers or surgeons has been associated with lower mortality rates in coronary artery bypass surgery, but how volume and quality of care relate to each other is not well understood. To determine how volume and differences in quality of care influence outcomes after coronary artery bypass surgery. Observational cohort. 164 hospitals in the United States. 81,289 patients 18 years or older who had coronary artery bypass grafting from 1 October 2003 to 1 September 2005. Hospital and surgeon case volumes were estimated by using a data set. Quality measures were defined by whether patients received specific medications and by counting the number of measures missed. Hierarchical models were used to estimate effects of volume and quality on death and readmission up to 30 days. After adjustment for clinical factors, lowest surgeon volume and highest hospital volume were associated with higher mortality rates and lower readmission risk, respectively. Patients who did not receive aspirin (odds ratio, 1.89 [95% CI, 1.65 to 2.16) or beta-blockers (odds ratio, 1.29 [CI, 1.12 to 1.49]) had higher odds for death, after adjustment for clinical risk factors and case volume. Adjustment for individual quality measures did not alter associations between volume and readmission or death. However, if no quality measures were missed, mortality rates at the lowest-volume centers (adjusted mortality rate, 1.05% [CI, 0.81% to 1.29%]) and highest-volume centers (adjusted mortality rate, 0.98% [CI, 0.72% to 1.25%]) were similar. Because administrative data were used, the quality measures may not replicate measures collected through chart abstraction. Maximizing adherence to quality measures is associated with improved mortality rates, independent of hospital or surgeon volume. California HealthCare Foundation.
The lack of theoretical support for using person trade-offs in QALY-type models.
Østerdal, Lars Peter
2009-10-01
Considerable support for the use of person trade-off methods to assess the quality-adjustment factor in quality-adjusted life years (QALY) models has been expressed in the literature. The WHO has occasionally used similar methods to assess the disability weights for calculation of disability-adjusted life years (DALYs). This paper discusses the theoretical support for the use of person trade-offs in QALY-type measurement of (changes in) population health. It argues that measures of this type based on such quality-adjustment factors almost always violate the Pareto principle, and so lack normative justification.
Musa, Nor Asma; Moy, Foong Ming; Wong, Li Ping
2018-05-31
This study aimed to determine the prevalence and factors associated with poor sleep quality among secondary school teachers in the state of Selangor, Malaysia. This was a cross sectional study, conducted in two phases. Phase I tested the reliability of the Pittsburgh Sleep Quality Index in the Malay language (M-PSQI), whereas Phase II determined the prevalence and factors associated with poor sleep quality where a total of 1871 secondary school teachers were studied. Participants were recruited using multistage sampling. Self-administered questionnaire was used to collect data on socio-demographic and teaching characteristics, comorbidities and characteristics of sleep. The M-PSQI was used to measure sleep quality. The Depression Anxiety Stress Scale-21 was used to measure mental health status. Results showed that the M-PSQI had a good internal consistency and moderate reliability. The prevalence of poor sleep quality was 61 (95% CI: 54-67) %. Total teaching hours/day, depression and stress were significantly associated with poor sleep quality in the univariate analysis, while only stress (OR 1.04; 95% CI 1.02-1.05%) remained significant in the multivariate analyses. In conclusion, stress level of the secondary school teachers should be reduced to improve sleep quality.
The consumer quality index anthroposophic healthcare: a construction and validation study.
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.
ERIC Educational Resources Information Center
Hong, Jinkuk; Bishop-Fitzpatrick, Lauren; Smith, Leann E.; Greenberg, Jan S.; Mailick, Marsha R.
2016-01-01
We examined factors related to subjective quality of life (QoL) of adults with autism spectrum disorder (ASD) aged 25-55 (n = 60), using the World Health Organization Quality of Life measure (WHOQOL-BREF). We used three different assessment methods: adult self-report, maternal proxy-report, and maternal report. Reliability analysis showed that…
Commentary: measuring quality of care in osteoporosis.
Silverman, Stuart L; Curtis, Jeffrey
2013-12-01
We know improving the quality of care in osteoporosis is an important goal. We have made some strides toward measuring quality of osteoporosis care, focusing on process measures regarding care that is provided. Unfortunately, improving care as measured by these process measures does not always yield improved outcomes. We need to hold health care providers and health care systems responsible not only for health care production but for production of health and well-being. However, there is a multiplicity of factors that will need to be considered to make this next step.
Liu, Yong; Wang, Limin; Pang, Richard; Mo, Nanxun; Hu, Yan; Deng, Qian; Hu, Zhaohui
2015-05-01
The aim of this paper is to describe the designing and implementation of a web-based plasma glucose measurement quality monitoring system to assess the analytical quality of plasma glucose measurements in multicenter population study and provide evidence for the future studies. In the chronic non-communicable disease and related factor surveillance in China, a web based quality monitoring system for plasma glucose measurement was established to conduct evaluation on plasma glucose monitoring quality and effectiveness in 302 surveillance centers, including quality control data entry, transmission and feedback. The majority of the surveillance centers met the quality requirements and passed the evaluation of reproducibility and precision of plasma glucose measurement, only a few centers required intensive training and re-assessment. In order to ensure the completeness and reliability of plasma glucose measurement in the surveillance centers, the establishment of web-based plasma glucose measurement quality control system can facilitate the identification of the qualified surveillance centers and evaluation of plasma glucose measurement quality in different regions. Communication and training are important in ensuring plasma glucose measurement quality. It is necessary to further improve this web-based plasma glucose measurement quality monitoring system in the future to reduce the method specific plasma glucose measurement bias.
DOSIMETRIC response of a REM-500 in low energy neutron fields typical of nuclear power plants.
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.
Cohen-Mansfield, Jiska; Sela, Adi Hannah; Iecovich, Esther; Golander, Hava
2017-11-02
As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers. We interviewed a convenience sample of older persons cared for by migrant live-in caregivers and their relatives. When relatives reported that older persons could not be interviewed due to advanced dementia, only relatives were interviewed. Overall, 72 older persons and 117 relatives were interviewed. We used the Quality of Care Questionnaire (QuCQ) developed for this study to examine the main components of quality of care in this population. Factor analysis using older persons' data revealed two factors. In the first factor, "caretaking," items concerning provision of prompt care exhibited the highest loadings. Items measuring interpersonal aspects of the care dynamic had the highest loadings in the second factor, thus labeled "relationship." The factor analysis based on relatives' data yielded similarities and differences with the one based on older persons' data. Yet, there were significant correlations between relative and older persons' responses when using the older persons' factor structure. According to older persons and relatives, quality of care depends on the extent to which older persons' care-related needs, as well as social ones, are addressed. Appropriate evaluation of quality of care in the live-in setting is important for its improvement.
Jun, M; Peterson, R T; Zsidisin, G A
1998-01-01
The identification and measurement of service quality are critical factors that are responsible for customer satisfaction. This article identifies 11 attributes that define quality of care and patient satisfaction and reveals various gaps among the patient, physician, and administrator groups in the perceived importance of those dimensions. Managerial implications for patient-focused health care are discussed.
Determinants of perceived sleep quality in normal sleepers.
Goelema, M S; Regis, M; Haakma, R; van den Heuvel, E R; Markopoulos, P; Overeem, S
2017-09-20
This study aimed to establish the determinants of perceived sleep quality over a longer period of time, taking into account the separate contributions of actigraphy-based sleep measures and self-reported sleep indices. Fifty participants (52 ± 6.6 years; 27 females) completed two consecutive weeks of home monitoring, during which they kept a sleep-wake diary while their sleep was monitored using a wrist-worn actigraph. The diary included questions on perceived sleep quality, sleep-wake information, and additional factors such as well-being and stress. The data were analyzed using multilevel models to compare a model that included only actigraphy-based sleep measures (model Acti) to a model that included only self-reported sleep measures to explain perceived sleep quality (model Self). In addition, a model based on the self-reported sleep measures and extended with nonsleep-related factors was analyzed to find the most significant determinants of perceived sleep quality (model Extended). Self-reported sleep measures (model Self) explained 61% of the total variance, while actigraphy-based sleep measures (model Acti) only accounted for 41% of the perceived sleep quality. The main predictors in the self-reported model were number of awakenings during the night, sleep onset latency, and wake time after sleep onset. In the extended model, the number of awakenings during the night and total sleep time of the previous night were the strongest determinants of perceived sleep quality, with 64% of the variance explained. In our cohort, perceived sleep quality was mainly determined by self-reported sleep measures and less by actigraphy-based sleep indices. These data further stress the importance of taking multiple nights into account when trying to understand perceived sleep quality.
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
Suda, Hiromi Kimura
2015-10-01
Bone quality, which was defined as "the sum total of characteristics of the bone that influence the bone's resistance to fracture" at the National Institute of Health (NIH) conference in 2001, contributes to bone strength in combination with bone mass. Bone mass is often measured as bone mineral density (BMD) and, consequently, can be quantified easily. On the other hand, bone quality is composed of several factors such as bone structure, bone matrix, calcification degree, microdamage, and bone turnover, and it is not easy to obtain data for the various factors. Therefore, it is difficult to quantify bone quality. We are eager to develop new measurement methods for bone quality that make it possible to determine several factors associated with bone quality at the same time. Analytic methods based on Raman and FTIR spectroscopy have attracted a good deal of attention as they can provide a good deal of chemical information about hydroxyapatite and collagen, which are the main components of bone. A lot of studies on bone quality using Raman and FTIR imaging have been reported following the development of the two imaging systems. Thus, both Raman and FTIR imaging appear to be promising new bone morphometric techniques.
Contribution of indoor and outdoor nitrogen dioxide to indoor air quality of wayside shops.
Shuai, Jianfei; Yang, Wonho; Ahn, Hogi; Kim, Sunshin; Lee, Seokyong; Yoon, Sung-Uk
2013-06-01
Indoor nitrogen dioxide (NO₂) concentration is an important factor for personal exposure despite the wide distribution of its sources. Exposure to NO₂ may produce adverse health effects. The aims of this study were to characterize the indoor air quality of wayside shops using multiple NO₂ measurements, and to estimate the contribution of outdoor NO₂ sources such as vehicle emission to indoor air quality. Daily indoor and outdoor NO₂ concentrations were measured for 21 consecutive days in wayside shops (5 convenience stores, 5 coffee shops, and 5 restaurants). Contributions of outdoor NO₂ sources to indoor air quality were calculated with penetration factors and source strength factors by indoor mass balance model in winter and summer, respectively. Most wayside shops had significant differences in indoor and outdoor NO₂ concentrations both in winter and in summer. Indoor NO₂ concentrations in restaurants were twice more than those in convenience stores and coffee shops in winter. While outdoor NO₂ contributions in indoor convenience stores and coffee shops were dominant, indoor NO₂ contributions were dominant in restaurants. These could be explained that indoor NO₂ sources such as gas range and smoking mainly affect indoor concentrations comparing to outdoor sources such as vehicle emission. The indoor mass balance model by multiple measurements suggests that quantitative contribution of outdoor air on indoor air quality might be estimated without measurements of ventilation, indoor generation and decay rate.
Park, Crystal L; Wortmann, Jennifer H; Hale, Amy E; Cho, Dalnim; Blank, Thomas O
2014-10-01
Scientific advances in treatments and outcomes for those diagnosed with cancer in late adolescence and early adulthood depend, in part, on the availability of adequate assessment tools to measure health-related quality of life (HRQOL) for survivors in this age group. Domains especially relevant to late adolescence and young adulthood (LAYA; e.g., education and career, committed romantic relationships, worldview formation) are typically overlooked in studies assessing the impact of cancer, usually more appropriate for middle-aged or older survivors. Current HRQOL measures also tend to assess issues that are salient during or shortly after treatment rather than reflecting life years after treatment. To develop a new measure to better capture the experience of LAYA cancer survivors in longer-term survivorship (the LAYA Survivorship-Related Quality of Life measure, LAYA-SRQL), we completed an extensive measure development process. After a literature review and focus groups with LAYA cancer survivors, we generated items and ran confirmatory factor and reliability analyses using a sample of 292 LAYA cancer survivors. We then examined validity using existing measures of physical and mental health, quality of life, and impact of cancer. The final model consisted of two domains (satisfaction and impact), each consisting of ten factors: existential/spirituality, coping, relationship, dependence, vitality, health care, education/career, fertility, intimacy/sexuality, and cognition/memory. Confirmatory factor analysis and validity analyses indicated that the LAYA-SRQL is a psychometrically sound instrument with good validity. The LAYA-SRQL fills an important need in survivorship research, providing a way to assess HRQOL in LAYAs in a developmentally informed way.
Factors influencing the quality of life of infertile women in United Arab Emirates.
Khayata, G M; Rizk, D E E; Hasan, M Y; Ghazal-Aswad, S; Asaad, M A N
2003-02-01
To measure the quality of life in a representative sample of infertile women and evaluate their sociocultural attitude to this condition. Two hundred sixty-nine infertile women attending the Assisted Reproduction clinic, Tawam Hospital were consecutively selected. They were interviewed about the effect of infertility on their quality of life using a structured, measurement-specific and pre-tested questionnaire. Parameters mostly affected were mood-related mainly in women above 30 years, with primary and female factor infertility and those in polygamous marriages. Quality of life did not affect sexual performance and was not affected by duration of infertility or cost of treatment. The results highlight the importance of bearing children and the stresses exerted on infertile women in Eastern societies. Thorough counseling and continuing support of infertile women is therefore indicated to improve their quality of life.
Gibbs, Heather D; Ellerbeck, Edward F; Gajewski, Byron; Zhang, Chuanwu; Sullivan, Debra K
2018-03-01
To test the reliability and validity of the Nutrition Literacy Assessment Instrument (NLit) in adult primary care and identify the relationship between nutrition literacy and diet quality. This instrument validation study included a cross-sectional sample participating in up to 2 visits 1 month apart. A total of 429 adults with nutrition-related chronic disease were recruited from clinics and a patient registry affiliated with a Midwestern university medical center. Nutrition literacy was measured by the NLit, which was composed of 6 subscales: nutrition and health, energy sources in food, food label and numeracy, household food measurement, food groups, and consumer skills. Diet quality was measured by Healthy Eating Index-2010 with nutrient data from Diet History Questionnaire II surveys. The researchers measured factor validity and reliability by using binary confirmatory factor analysis; test-retest reliability was measured by Pearson r and the intraclass correlation coefficient, and relationships between nutrition literacy and diet quality were analyzed by linear regression. The NLit demonstrated substantial factor validity and reliability (0.97; confidence interval, 0.96-0.98) and test-retest reliability (0.88; confidence interval, 0.85-0.90). Nutrition literacy was the most significant predictor of diet quality (β = .17; multivariate coefficient = 0.10; P < .001). The NLit is a valid and reliable tool for measuring nutrition literacy in adult primary care patients. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
High quality factor single-crystal diamond mechanical resonators
NASA Astrophysics Data System (ADS)
Ovartchaiyapong, P.; Pascal, L. M. A.; Myers, B. A.; Lauria, P.; Bleszynski Jayich, A. C.
2012-10-01
Single-crystal diamond is a promising material for microelectromechanical systems (MEMs) because of its low mechanical loss, compatibility with extreme environments, and built-in interface to high-quality spin centers. But its use has been limited by challenges in processing and growth. We demonstrate a wafer bonding-based technique to form diamond on insulator, from which we make single-crystal diamond micromechanical resonators with mechanical quality factors as high as 338 000 at room temperature. Variable temperature measurements down to 10 K reveal a nonmonotonic dependence of quality factor on temperature. These resonators enable integration of single-crystal diamond into MEMs technology for classical and quantum applications.
ERIC Educational Resources Information Center
Feldt, Ronald C.; Graham, Melody; Dew, Dennis
2011-01-01
This study employed confirmatory factor analysis to examine the quality of fit of two measurement models of the Student Adaptation to College Questionnaire (N = 305). Following the observation of poor fit, exploratory factor analysis was used. Results indicated six factors that account for the variance in Student Adaptation to College…
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.
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.
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.
ERIC Educational Resources Information Center
Jarwal, Som D.; Brion, Andrew M.; King, Maxwell L.
2009-01-01
This paper examines whether three bibliometric indicators--the journal impact factor, citations per paper and the Excellence in Research for Australia (ERA) initiative's list of "ranked journals"--can predict the quality of individual research articles as assessed by international experts, both overall and within broad disciplinary…
Quality in Inclusive and Noninclusive Infant and Toddler Classrooms
ERIC Educational Resources Information Center
Hestenes, Linda L.; Cassidy, Deborah J.; Hegde, Archana V.; Lower, Joanna K.
2007-01-01
The quality of care in infant and toddler classrooms was compared across inclusive (n=64) and noninclusive classrooms (n=400). Quality was measured using the Infant/Toddler Environment Rating Scale-Revised (ITERS-R). An exploratory and confirmatory factor analysis revealed four distinct dimensions of quality within the ITERS-R. Inclusive…
The Impact of System Factors on Quality and Safety in Arterial Surgery: A Systematic Review.
Lear, R; Godfrey, A D; Riga, C; Norton, C; Vincent, C; Bicknell, C D
2017-07-01
A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery. A systematic review of original research papers in English using MEDLINE, Embase, PsycINFO, and Cochrane databases, was performed according to PRISMA guidelines. Independent reviewers selected papers according to strict inclusion and exclusion criteria, and using predefined data fields, extracted relevant data on team, work environment, and organisational factors, and measures of quality and/or safety, in arterial procedures. Twelve papers met the selection criteria. Study endpoints were not consistent between papers, and most failed to report their clinical significance. A variety of tools were used to measure team skills in five papers; only one paper measured the relationship between team factors and patient outcomes. Two papers reported that equipment failures were common and had a significant impact on operating room efficiency. The influence of hospital characteristics on failure-to-rescue rates was tested in one large study, although their conclusions were limited to the American Medicare population. Five papers implemented changes in the patient pathway, but most studies failed to account for potential confounding variables. A small number of heterogenous studies have evaluated the relationship between system factors and quality or safety in arterial surgery. There is some evidence of an association between system factors and patient outcomes, but there is more work to be done to fully understand this relationship. Future research would benefit from consistency in definitions, the use of validated assessment tools, measurement of clinically relevant endpoints, and adherence to national reporting guidelines. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Psychosocial Factors Associated with Diet Quality in a Working Adult Population
Dunbar, Sandra B.; Higgins, Melinda; Dai, Jun; Ziegler, Thomas R.; Frediani, Jennifer K.; Reilly, Carolyn; Brigham, Kenneth L.
2014-01-01
The associations between specific intra- and inter-personal psychosocial factors and dietary patterns were explored in a healthy, working adult population. Participants (N= 640) were enrolled in a prospective predictive health study and characterized by a mean age of 48(SD = 11) years, 67% women, and 30% minority. Baseline psychosocial measures of perceived stress, depressive symptoms, social support, and family functioning were examined for their relationships with three diet quality indices - AHEI, DASH, and the Mediterranean. Dietary intake was of moderate quality in this high income, well-educated, psychosocially healthy population. Social support was positively associated with better diet quality for all three indices (p< .01). Further research should focus on socio-environmental factors associated with diet quality. PMID:23408456
Rapid Assessment Of The Fundamental Property Variation Of Wood
Chi-Leung So; Leslie H. Groom; Timothy G. Rials; Rebecca Snell; Stephen S. Kelley; Robert Meglen
2002-01-01
Abstract - Genetic variation, site conditions, silvicultural treatments, seasonal effects, and their complex interaction are all vitally-important factors accounting for the variability and quality of the raw material produced - wood. Quality can be measured in several ways that generally influence the end use. The most desirable measure is the...
Technology usage, quality management system, and service quality in Thailand.
Sivabrovornvatana, Nilubon; Siengthai, Sununta; Krairit, Donyaprueth; Paul, Himangshu
2005-01-01
This article aims to explore the relationship between technology and quality management for enhancing Thai hospital service quality. The paper presents the findings of an exploratory study that investigates service quality from the customer and service provider perception. In-depth interviews were conducted with respondents in Thai hospitals. The interviews explored service-related factors that patients and service providers perceive to be important for hospital services. The first interview group consisted of professionals as internal customers in direct contact with external customers, while the second group consisted of external customers of the same hospitals. The study's outcomes clearly suggest factors that make significant contribution to service quality. These factors can be categorized according to five SERVQUAL dimensions (reliability, responsiveness, assurance, empathy, and tangibility), although some factors required slightly different interpretation. The findings suggest that hospitals can develop an appropriate approach to their advantage, which can yield sustainable improvement in service quality as perceived by patients and professionals. Hospitals can make better quality decisions based on structured measurement and knowledge. It is recommended that managers apply this knowledge for successful implementation of activities related to service quality in their organizations.
Measuring Teaching Quality and Student Engagement in South Korea and The Netherlands
ERIC Educational Resources Information Center
van de Grift, Wim J. C. M.; Chun, Seyeoung; Maulana, Ridwan; Lee, Okhwa; Helms-Lorenz, Michelle
2017-01-01
Six observation scales for measuring the skills of teachers and 1 scale for measuring student engagement, assessed in South Korea and The Netherlands, are sufficiently reliable and offer sufficient predictive value for student engagement. A multigroup confirmatory factor analysis shows that the factor loadings and intercepts of the scales are the…
Rantz, Marilyn J; Aud, Myra A; Zwygart-Stauffacher, Mary; Mehr, David R; Petroski, Gregory F; Owen, Steven V; Madsen, Richard W; Flesner, Marcia; Conn, Vicki; Maas, Meridean
2008-01-01
Field test results are reported for the Observable Indicators of Nursing Home Care Quality Instrument-Assisted Living Version, an instrument designed to measure the quality of care in assisted living facilities after a brief 30-minute walk-through. The OIQ-AL was tested in 207 assisted-living facilities in two states using classical test theory, generalizability theory, and exploratory factor analysis. The 34-item scale has a coherent six-factor structure that conceptually describes the multidimensional concept of care quality in assisted living. The six factors can be logically clustered into process (Homelike and Caring, 21 items) and structure (Access and Choice; Lighting; Plants and Pets; Outdoor Spaces) subscales and for a total quality score. Classical test theory results indicate most subscales and the total quality score from the OIQ-AL have acceptable interrater, test-retest, and strong internal consistency reliabilities. Generalizability theory analyses reveal that dependability of scores from the instrument are strong, particularly by including a second observer who conducts a site visit and independently completes an instrument, or by a single observer conducting two site visits and completing instruments during each visit. Scoring guidelines based on the total sample of observations (N = 358) help guide those who want to use the measure to interpret both subscale and total scores. Content validity was supported by two expert panels of people experienced in the assisted-living field, and a content validity index calculated for the first version of the scale is high (3.43 on a four-point scale). The OIQ-AL gives reliable and valid scores for researchers, and may be useful for consumers, providers, and others interested in measuring quality of care in assisted-living facilities.
Bavarnegin, Elham; Sadremomtaz, Alireza; Khalafi, Hossein; Kasesaz, Yaser
2016-01-01
Determination of in-phantom quality factors of Tehran research reactor (TRR) boron neutron capture therapy (BNCT) beam. The doses from thermal neutron reactions with 14N and 10B are calculated by kinetic energy released per unit mass approach, after measuring thermal neutron flux using neutron activation technique. Gamma dose is measured using TLD-700 dosimeter. Different dose components have been measured in a head phantom which has been designed and constructed for BNCT purpose in TRR. Different in-phantom beam quality factors have also been determined. This study demonstrates that the TRR BNCT beam line has potential for treatment of superficial tumors.
Development of a direct observation Measure of Environmental Qualities of Activity Settings.
King, Gillian; Rigby, Patty; Batorowicz, Beata; McMain-Klein, Margot; Petrenchik, Theresa; Thompson, Laura; Gibson, Michelle
2014-08-01
The aim of this study was to develop an observer-rated measure of aesthetic, physical, social, and opportunity-related qualities of leisure activity settings for young people (with or without disabilities). Eighty questionnaires were completed by sets of raters who independently rated 22 community/home activity settings. The scales of the 32-item Measure of Environmental Qualities of Activity Settings (MEQAS; Opportunities for Social Activities, Opportunities for Physical Activities, Pleasant Physical Environment, Opportunities for Choice, Opportunities for Personal Growth, and Opportunities to Interact with Adults) were determined using principal components analyses. Test-retest reliability was determined for eight activity settings, rated twice (4-6wk interval) by a trained rater. The factor structure accounted for 80% of the variance. The Kaiser-Meyer-Olkin Measure of Sampling Adequacy was 0.73. Cronbach's alphas for the scales ranged from 0.76 to 0.96, and interrater reliabilities (ICCs) ranged from 0.60 to 0.93. Test-retest reliabilities ranged from 0.70 to 0.90. Results suggest that the MEQAS has a sound factor structure and preliminary evidence of internal consistency, interrater, and test-retest reliability. The MEQAS is the first observer-completed measure of environmental qualities of activity settings. The MEQAS allows researchers to assess comprehensively qualities and affordances of activity settings, and can be used to design and assess environmental qualities of programs for young people. © 2014 Mac Keith Press.
SELF-STIGMA AND COMING OUT ABOUT ONE’S MENTAL ILLNESS
Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rüsch, Nicolas
2013-01-01
Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person’s quality of life are discussed. PMID:23970807
SELF-STIGMA AND COMING OUT ABOUT ONE'S MENTAL ILLNESS.
Corrigan, Patrick W; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rüsch, Nicolas
2010-04-01
Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person's quality of life are discussed.
What affects the quality of economic analysis for life-saving investments?
Hahn, Robert W; Kosec, Katrina; Neumann, Peter J; Wallsten, Scott
2006-06-01
Economic analysis of life-saving investments in both the public and private sectors has the potential to dramatically improve longevity and the quality of life, but only if the analyses on which decisions are based are done well. In this article, we analyze a data set that provides information on the content and quality of journal articles that measure the cost-effectiveness of life-saving investments. Our study is the first to provide a detailed multivariate analysis of factors affecting objective measures of quality. We also explore whether a series of recommendations by an expert panel convened by the U.S. Public Health Service affect the way analyses of specific life-saving investments are done. Our results suggest that four factors are positively correlated with an index we construct to measure analytical quality: (1) having at least one author affiliated with a university, (2) publication in a journal that has experience in publishing these analyses, (3) if the life-saving investment is located in the United States, and (4) if the analysis considers a measure of social costs or benefits. Somewhat surprisingly, a study's funding source and whether it is affiliated with industry are not significantly correlated with the quality index. Finally, neither time nor the panel guidelines had an impact on the index.
Quality of Informal Care Is Multidimensional
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
Development and application of a statistical quality assessment method for dense-graded mixes.
DOT National Transportation Integrated Search
2004-08-01
This report describes the development of the statistical quality assessment method and the procedure for mapping the measures obtained from the quality assessment method to a composite pay factor. The application to dense-graded mixes is demonstrated...
A Unified Approach for Reporting ARM Measurement Uncertainties Technical Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Campos, E; Sisterson, Douglas
The U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Climate Research Facility is observationally based, and quantifying the uncertainty of its measurements is critically important. With over 300 widely differing instruments providing over 2,500 datastreams, concise expression of measurement uncertainty is quite challenging. The ARM Facility currently provides data and supporting metadata (information about the data or data quality) to its users through a number of sources. Because the continued success of the ARM Facility depends on the known quality of its measurements, the Facility relies on instrument mentors and the ARM Data Quality Office (DQO) to ensure, assess,more » and report measurement quality. Therefore, an easily accessible, well-articulated estimate of ARM measurement uncertainty is needed. Note that some of the instrument observations require mathematical algorithms (retrievals) to convert a measured engineering variable into a useful geophysical measurement. While those types of retrieval measurements are identified, this study does not address particular methods for retrieval uncertainty. As well, the ARM Facility also provides engineered data products, or value-added products (VAPs), based on multiple instrument measurements. This study does not include uncertainty estimates for those data products. We propose here that a total measurement uncertainty should be calculated as a function of the instrument uncertainty (calibration factors), the field uncertainty (environmental factors), and the retrieval uncertainty (algorithm factors). The study will not expand on methods for computing these uncertainties. Instead, it will focus on the practical identification, characterization, and inventory of the measurement uncertainties already available in the ARM community through the ARM instrument mentors and their ARM instrument handbooks. As a result, this study will address the first steps towards reporting ARM measurement uncertainty: 1) identifying how the uncertainty of individual ARM measurements is currently expressed, 2) identifying a consistent approach to measurement uncertainty, and then 3) reclassifying ARM instrument measurement uncertainties in a common framework.« less
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.
Assessing Community Quality of Health Care.
Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J
2016-02-01
To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.
Asker, Martin; Brooke, Hannah L; Waldén, Markus; Tranaeus, Ulrika; Johansson, Fredrik; Skillgate, Eva; Holm, Lena W
2018-03-26
To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports. Systematic review with best-evidence synthesis. Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017. Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria. Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power. All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports. CRD42015026850. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
The effects of RN staffing hours on nursing home quality: a two-stage model.
Lee, Hyang Yuol; Blegen, Mary A; Harrington, Charlene
2014-03-01
Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss). We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States - Colorado. Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences. Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators. The study finding shows the importance of understanding the role of 'nurse staffing' under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. Copyright © 2013 Elsevier Ltd. All rights reserved.
Albright, Benjamin B.; Lewis, Valerie A.; Ross, Joseph S.; Colla, Carrie H.
2015-01-01
Background Accountable Care Organizations (ACOs) are a delivery and payment model aiming to coordinate care, control costs, and improve quality. Medicare ACOs are responsible for eight measures of preventive care quality. Objectives To create composite measures of preventive care quality and examine associations of ACO characteristics with performance. Design Cross-sectional study of Medicare Shared Savings Program and Pioneer participants. We linked quality performance to descriptive data from the National Survey of ACOs. We created composite measures using exploratory factor analysis, and used regression to assess associations with organizational characteristics. Results Of 252 eligible ACOs, 246 reported on preventive care quality, 177 of which completed the survey (response rate=72%). In their first year, ACOs lagged behind PPO performance on the majority of comparable measures. We identified two underlying factors among eight measures and created composites for each: disease prevention, driven by vaccines and cancer screenings, and wellness screening, driven by annual health screenings. Participation in the Advanced Payment Model, having fewer specialists, and having more Medicare ACO beneficiaries per primary care provider were associated with significantly better performance on both composites. Better performance on disease prevention was also associated with inclusion of a hospital, greater electronic health record capabilities, a larger primary care workforce, and fewer minority beneficiaries. Conclusions ACO preventive care quality performance is related to provider composition and benefitted by upfront investment. Vaccine and cancer screening quality performance is more dependent on organizational structure and characteristics than performance on annual wellness screenings, likely due to greater complexity in eligibility determination and service administration. PMID:26759974
Albright, Benjamin B; Lewis, Valerie A; Ross, Joseph S; Colla, Carrie H
2016-03-01
Accountable Care Organizations (ACOs) are a delivery and payment model aiming to coordinate care, control costs, and improve quality. Medicare ACOs are responsible for 8 measures of preventive care quality. To create composite measures of preventive care quality and examine associations of ACO characteristics with performance. This is a cross-sectional study of Medicare Shared Savings Program and Pioneer participants. We linked quality performance to descriptive data from the National Survey of ACOs. We created composite measures using exploratory factor analysis, and used regression to assess associations with organizational characteristics. Of 252 eligible ACOs, 246 reported on preventive care quality, 177 of which completed the survey (response rate=72%). In their first year, ACOs lagged behind PPO performance on the majority of comparable measures. We identified 2 underlying factors among 8 measures and created composites for each: disease prevention, driven by vaccines and cancer screenings, and wellness screening, driven by annual health screenings. Participation in the Advanced Payment Model, having fewer specialists, and having more Medicare ACO beneficiaries per primary care provider were associated with significantly better performance on both composites. Better performance on disease prevention was also associated with inclusion of a hospital, greater electronic health record capabilities, a larger primary care workforce, and fewer minority beneficiaries. ACO preventive care quality performance is related to provider composition and benefitted by upfront investment. Vaccine and cancer screening quality performance is more dependent on organizational structure and characteristics than performance on annual wellness screenings, likely due to greater complexity in eligibility determination and service administration.
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.
Nagata, Yasufumi; Kado, Yuichiro; Onoue, Takeshi; Otani, Kyoko; Nakazono, Akemi; Otsuji, Yutaka; Takeuchi, Masaaki
2018-01-01
Background Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) play important roles in diagnosis and management of cardiac diseases. However, the issue of the accuracy and reliability of LVEF and GLS remains to be solved. Image quality is one of the most important factors affecting measurement variability. The aim of this study was to investigate whether improved image quality could reduce observer variability. Methods Two sets of three apical images were acquired using relatively old- and new-generation ultrasound imaging systems (Vivid 7 and Vivid E95) in 308 subjects. Image quality was assessed by endocardial border delineation index (EBDI) using a 3-point scoring system. Three observers measured the LVEF and GLS, and these values and inter-observer variability were investigated. Results Image quality was significantly better with Vivid E95 (EBDI: 26.8 ± 5.9) than that with Vivid 7 (22.8 ± 6.3, P < 0.0001). Regarding the inter-observer variability of LVEF, the r-value, bias, 95% limit of agreement and intra-class correlation coefficient for Vivid 7 were comparable to those for Vivid E95. The % variabilities were significantly lower for Vivid E95 (5.3–6.5%) than those for Vivid 7 (6.5–7.5%). Regarding GLS, all observer variability parameters were better for Vivid E95 than for Vivid 7. Improvements in image quality yielded benefits to both LVEF and GLS measurement reliability. Multivariate analysis showed that image quality was indeed an important factor of observer variability in the measurement of LVEF and GLS. Conclusions The new-generation ultrasound imaging system offers improved image quality and reduces inter-observer variability in the measurement of LVEF and GLS. PMID:29432198
Nagata, Yasufumi; Kado, Yuichiro; Onoue, Takeshi; Otani, Kyoko; Nakazono, Akemi; Otsuji, Yutaka; Takeuchi, Masaaki
2018-03-01
Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) play important roles in diagnosis and management of cardiac diseases. However, the issue of the accuracy and reliability of LVEF and GLS remains to be solved. Image quality is one of the most important factors affecting measurement variability. The aim of this study was to investigate whether improved image quality could reduce observer variability. Two sets of three apical images were acquired using relatively old- and new-generation ultrasound imaging systems (Vivid 7 and Vivid E95) in 308 subjects. Image quality was assessed by endocardial border delineation index (EBDI) using a 3-point scoring system. Three observers measured the LVEF and GLS, and these values and inter-observer variability were investigated. Image quality was significantly better with Vivid E95 (EBDI: 26.8 ± 5.9) than that with Vivid 7 (22.8 ± 6.3, P < 0.0001). Regarding the inter-observer variability of LVEF, the r -value, bias, 95% limit of agreement and intra-class correlation coefficient for Vivid 7 were comparable to those for Vivid E95. The % variabilities were significantly lower for Vivid E95 (5.3-6.5%) than those for Vivid 7 (6.5-7.5%). Regarding GLS, all observer variability parameters were better for Vivid E95 than for Vivid 7. Improvements in image quality yielded benefits to both LVEF and GLS measurement reliability. Multivariate analysis showed that image quality was indeed an important factor of observer variability in the measurement of LVEF and GLS. The new-generation ultrasound imaging system offers improved image quality and reduces inter-observer variability in the measurement of LVEF and GLS. © 2018 The authors.
Morphological and physiological evaluations of seedling quality
Diane L. Haase
2007-01-01
Seedling quality and subsequent field performance can be influenced by various stress factors. Measuring seedling quality can help to identify possible crop problems in order to make informed decisions for culturing, lifting, storing, and planting. In addition, seedling quality data can help seedling growers and users to better understand annual patterns among species...
Theory and practice for measuring health care quality
Berwick, Donald M.; Knapp, Marian Gilbert
1987-01-01
As competition, cost control, and new modes of delivery emerge in health care, there is a need to reexamine both the traditional definitions of health care quality and the methods by which it is measured. Industries other than health care have much to teach regarding the methods for obtaining, analyzing, and displaying data; techniques for problem identification, problem solving, and reassessment; and ideas about organizational factors that produce a high quality product or service. The Quality-of-Care Measurement Department at the Harvard Community Health Plan has built a program that draws from a distinguished health care quality assurance tradition and incorporates techniques that have been successful in other industries. PMID:10312319
Bassler, A W; Arnould, C; Butterworth, A; Colin, L; De Jong, I C; Ferrante, V; Ferrari, P; Haslam, S; Wemelsfelder, F; Blokhuis, H J
2013-11-01
The objectives of this study were to 1) identify determinants of poor welfare in commercial broiler chicken flocks by studying the associations between selected resource-based measures (RBM, potential risk factors), such as litter quality and dark period, and animal-based welfare indicators (ABM), such as foot pad dermatitis and lameness, and 2) establish the breadth of effect of a risk factor by determining the range of animal welfare indicators associated with each of the risk factors (i.e., the number of ABM related to a specific RBM). Eighty-nine broiler flocks were inspected in 4 European countries (France, Italy, the United Kingdom, and the Netherlands) in a cross-sectional study. The ABM were contact dermatitis (measured using scores of foot-pad dermatitis and hock burn, respectively), lameness (measured as gait score), fear of humans (measured by the avoidance distance test and the touch test), and negative emotional state (measured using qualitative behavior assessment, QBA). In a first step, risk factors were identified by building a multiple linear regression model for each ABM. Litter quality was identified as a risk factor for contact dermatitis. Length of dark period at 3 wk old (DARK3) was a risk factor for the touch test result. DARK3 and flock age were risk factors for lameness, and the number of different stockmen and DARK3 were risk factors for QBA results. Next, the ABM were grouped according to risk factor and counted. Then, in a second step, associations between the ABM were investigated using common factor analysis. The breadth of a risk factor's effect was judged by combining the number (count) of ABM related to this factor and the strength of association between these ABM. Flock age and DARK3 appeared to affect several weakly correlated ABM, thus indicating a broad range of effects. Our findings suggest that manipulation of the predominant risk factors identified in this study (DARK3, litter quality, and slaughter age) could generate improvements in the related ABM and thereby enhance the birds' overall welfare status.
Systematic uncertainties in RF-based measurement of superconducting cavity quality factors
Holzbauer, J. P.; Pischalnikov, Yu.; Sergatskov, D. A.; ...
2016-05-10
Q 0 determinations based on RF power measurements are subject to at least three potentially large systematic effects that have not been previously appreciated. Here, instrumental factors that can systematically bias RF based measurements of Q 0 are quantified and steps that can be taken to improve the determination of Q 0 are discussed.
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.
Using Student Ratings to Measure Quality of Teaching in Six European Countries
ERIC Educational Resources Information Center
Kyriakides, Leonidas; Creemers, Bert P. M.; Panayiotou, Anastasia; Vanlaar, Gudrun; Pfeifer, Michael; Cankar, Gašper; McMahon, Léan
2014-01-01
This paper argues for the value of using student ratings to measure quality of teaching. An international study to test the validity of the dynamic model of educational effectiveness was conducted. At classroom level, the model consists of eight factors relating to teacher behaviour: orientation, structuring, questioning, teaching modelling,…
Dudden, Rosalind Farnam
2008-01-01
Measurement of library systems and services is a multidimensional management task. New paradigms of library service and the context in which libraries operate have made it necessary for librarians to find new measures while at the same time keeping the old. Factors that can be measured, such as needs, inputs, quality processes, outputs, quality of service, outcomes, and impacts, are described. This bibliographic essay covers the current trends while leading readers to resources where they can learn more.
Characterization of the nanoDot OSLD dosimeter in CT.
Scarboro, Sarah B; Cody, Dianna; Alvarez, Paola; Followill, David; Court, Laurence; Stingo, Francesco C; Zhang, Di; McNitt-Gray, Michael; Kry, Stephen F
2015-04-01
The extensive use of computed tomography (CT) in diagnostic procedures is accompanied by a growing need for more accurate and patient-specific dosimetry techniques. Optically stimulated luminescent dosimeters (OSLDs) offer a potential solution for patient-specific CT point-based surface dosimetry by measuring air kerma. The purpose of this work was to characterize the OSLD nanoDot for CT dosimetry, quantifying necessary correction factors, and evaluating the uncertainty of these factors. A characterization of the Landauer OSL nanoDot (Landauer, Inc., Greenwood, IL) was conducted using both measurements and theoretical approaches in a CT environment. The effects of signal depletion, signal fading, dose linearity, and angular dependence were characterized through direct measurement for CT energies (80-140 kV) and delivered doses ranging from ∼5 to >1000 mGy. Energy dependence as a function of scan parameters was evaluated using two independent approaches: direct measurement and a theoretical approach based on Burlin cavity theory and Monte Carlo simulated spectra. This beam-quality dependence was evaluated for a range of CT scanning parameters. Correction factors for the dosimeter response in terms of signal fading, dose linearity, and angular dependence were found to be small for most measurement conditions (<3%). The relative uncertainty was determined for each factor and reported at the two-sigma level. Differences in irradiation geometry (rotational versus static) resulted in a difference in dosimeter signal of 3% on average. Beam quality varied with scan parameters and necessitated the largest correction factor, ranging from 0.80 to 1.15 relative to a calibration performed in air using a 120 kV beam. Good agreement was found between the theoretical and measurement approaches. Correction factors for the measurement of air kerma were generally small for CT dosimetry, although angular effects, and particularly effects due to changes in beam quality, could be more substantial. In particular, it would likely be necessary to account for variations in CT scan parameters and measurement location when performing CT dosimetry using OSLD.
Lai, Jin-Shei; Hammel, Joy; Jerousek, Sara; Goldsmith, Arielle; Miskovic, Ana; Baum, Carolyn; Wong, Alex W; Dashner, Jessica; Heinemann, Allen W
2016-12-01
To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. Not applicable. An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Improved RF Measurements of SRF Cavity Quality Factors
DOE Office of Scientific and Technical Information (OSTI.GOV)
Holzbauer, J. P.; Contreras, C.; Pischalnikov, Y.
SRF cavity quality factors can be accurately measured using RF-power based techniques only when the cavity is very close to critically coupled. This limitation is from systematic errors driven by non-ideal RF components. When the cavity is not close to critically coupled, these systematic effects limit the accuracy of the measurements. The combination of the complex base-band envelopes of the cavity RF signals in combination with a trombone in the circuit allow the relative calibration of the RF signals to be extracted from the data and systematic effects to be characterized and suppressed. The improved calibration allows accurate measurements tomore » be made over a much wider range of couplings. Demonstration of these techniques during testing of a single-spoke resonator with a coupling factor of near 7 will be presented, along with recommendations for application of these techniques.« less
[Development of a scale to measure Korean ego-integrity in older adults].
Chang, Sung Ok; Kong, Eun Sook; Kim, Kwuy Bun; Kim, Nam Cho; Kim, Ju Hee; Kim, Chun Gill; Kim, Hee Kyung; Song, Mi Soon; Ahn, Soo Yeon; Lee, Kyung Ja; Lee, Young Whee; Chon, Si Ja; Cho, Nam Ok; Cho, Myung Ok; Choi, Kyung Sook
2007-04-01
Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was .88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.
[Temporal variation of water quality and driving factors in Yanghe watershed of Zhangjiakou].
Pang, Bo; Wang, Tie-Yu; Lü, Yong-Long; Du, Li-Yu; Luo, Wei
2013-01-01
Yanghe is an important water source for Guanting Reservoir, which once supplied the Beijing city with drinking water, industrial process water and water-use in landscape. Based on the data of water quality monitored by Yanghe watershed monitoring stations from 1992 to 2009, 11 pollutants were selected for analysis. The trends of changes in water quality were figured out, and the major pollutants and driving factors were measured by the integrated standard index and grey correlation analytical methods. The results showed that there were two stages of water quality change in Yanghe watershed of Zhangjiakou. Firstly, the water was polluted seriously but recovered rapidly from 1992 to 1996. Secondly, although light pollution occurred in the watershed from 1997 to 2009, the pollution factors were still above the limits. The main pollution factors are ammonia nitrogen, petroleum, permanganate index, BOD5, Cr6+ and Cd. The main driving factor of water quality is the change of land use type, and the agricultural land showed less impact on water quality than the industrial land.
Zinckernagel, Line; Schneekloth, Nanna; Zwisler, Ann-Dorthe Olsen; Ersbøll, Annette Kjær; Rod, Morten Hulvej; Jensen, Poul Dengsøe; Timm, Helle; Holmberg, Teresa
2017-10-30
Measuring the quality of care as experienced by patients is increasingly recognised as a way of improving healthcare services. However, disease-specific measures that take the patient journey into account are needed. This paper presents the development of such a measure for patients with heart disease and details the psychometric evaluation. The questionnaire was developed based on a literature review, qualitative interviews and a pilot-test. The psychometric evaluation of the measure was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), Cronbach's alpha coefficient and differential item functioning analysis with data from a population-based survey. Denmark in 2013-2014. Nineteen heart patients, four relatives and eight health professionals participated in qualitative interviews in the development phase, and 15 patients participated in the pilot-test. The questionnaire was subsequently sent to a random sample of 5000 heart patients who were diagnosed in 2013. The comprehensive development phase and pilot-testing contributed to high content validity of the questionnaire. Eligible questionnaire responses were received from 2496 patients. EFA indicated a nine-factor model: communication at the hospital, communication with the general practitioner, information on disease and treatment, information on psychosocial aspects, rehabilitation/support, organisation, medication, involvement of relatives and consideration of comorbidity. CFA confirmed the proposed factor structure (eg, goodness-of-fit index=0.88, adjusted goodness-of-fit index=0.86, root mean square error of approximation=0.05), and Cronbach's alpha coefficient revealed good internal consistency of the factors (range: 0.69-0.93). The results suggest that this disease-specific patient-reported experience measure is of good quality when measuring the quality of care among heart patients. The inclusion of patients in the development phase contributed to high content validity, and subsequent psychometric evaluation found high construct validity and internal consistency. This measure may be especially relevant when seeking information about which aspects of care require improvement and the impact on health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Waber, Deborah P; Boiselle, Ellen C; Forbes, Peter W; Girard, Jonathan M; Sideridis, Georgios D
2018-05-01
Learning problems (LP) can have wider implications than the academic deficits per se. The goal of the present series of studies was to develop a reliable and valid quality-of-life measure targeted to children and adolescents with LP. In Study 1, using a 35-item questionnaire, we surveyed 151 parents/guardians of children referred for assessment of learning disorders. Exploratory factor analysis identified a three-factor model: Academic Performance, School Understanding, and Child/Family Psychological. These factors were validated against standardized measures of academic achievement and psychosocial functioning. The questionnaire was then reduced to 15 items-the LD/QOL15 -and administered to a community sample of 325 parents/guardians of children in Grades 1 to 8 (Study 2). The three-factor model was verified with confirmatory factor analysis. Comparison of general education ( n = 232) and LP ( n = 93) groups within the community sample documented substantial group differences ( p < .0001), with the LP group having higher mean scores. These differences were larger for older students (Grades 5-8) than younger students (Grades 1-4; p < .01). The LD/QOL15 is a brief and reliable measure that is valid to assess quality of life and, potentially, outcomes in children and adolescents with LP.
Dosimetry for Small and Nonstandard Fields
NASA Astrophysics Data System (ADS)
Junell, Stephanie L.
The proposed small and non-standard field dosimetry protocol from the joint International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine working group introduces new reference field conditions for ionization chamber based reference dosimetry. Absorbed dose beam quality conversion factors (kQ factors) corresponding to this formalism were determined for three different models of ionization chambers: a Farmer-type ionization chamber, a thimble ionization chamber, and a small volume ionization chamber. Beam quality correction factor measurements were made in a specially developed cylindrical polymethyl methacrylate (PMMA) phantom and a water phantom using thermoluminescent dosimeters (TLDs) and alanine dosimeters to determine dose to water. The TLD system for absorbed dose to water determination in high energy photon and electron beams was fully characterized as part of this dissertation. The behavior of the beam quality correction factor was observed as it transfers the calibration coefficient from the University of Wisconsin Accredited Dosimetry Calibration Laboratory (UWADCL) 60Co reference beam to the small field calibration conditions of the small field formalism. TLD-determined beam quality correction factors for the calibration conditions investigated ranged from 0.97 to 1.30 and had associated standard deviations from 1% to 3%. The alanine-determined beam quality correction factors ranged from 0.996 to 1.293. Volume averaging effects were observed with the Farmer-type ionization chamber in the small static field conditions. The proposed small and non-standard field dosimetry protocols new composite-field reference condition demonstrated its potential to reduce or remove ionization chamber volume dependancies, but the measured beam quality correction factors were not equal to the standard CoP's kQ, indicating a change in beam quality in the small and non-standard field dosimetry protocols new composite-field reference condition relative to the standard broad beam reference conditions. The TLD- and alanine-determined beam quality correction factors in the composite-field reference conditions were approximately 3% greater and differed by more than one standard deviation from the published TG-51 kQ values for all three chambers.
von Thiele Schwarz, Ulrica; Sjöberg, Anders; Hasson, Henna; Tafvelin, Susanne
2014-12-01
To test the factor structure and variance components of the productivity subscales of the Health and Work Questionnaire (HWQ). A total of 272 individuals from one company answered the HWQ scale, including three dimensions (efficiency, quality, and quantity) that the respondent rated from three perspectives: their own, their supervisor's, and their coworkers'. A confirmatory factor analysis was performed, and common and unique variance components evaluated. A common factor explained 81% of the variance (reliability 0.95). All dimensions and rater perspectives contributed with unique variance. The final model provided a perfect fit to the data. Efficiency, quality, and quantity and three rater perspectives are valid parts of the self-rated productivity measurement model, but with a large common factor. Thus, the HWQ can be analyzed either as one factor or by extracting the unique variance for each subdimension.
Quality of Work: Validation of a New Instrument in Three Languages
Steffgen, Georges; Kohl, Diane; Reese, Gerhard; Happ, Christian; Sischka, Philipp
2015-01-01
Introduction and objective: A new instrument to measure quality of work was developed in three languages (German, French and Luxembourgish) and validated in a study of employees working in Luxembourg. Methods and results: A representative sample (n = 1529) was taken and exploratory factor analysis revealed a six-factor solution for the 21-item instrument (satisfaction and respect, mobbing, mental strain at work, cooperation, communication and feedback, and appraisal). Reliability analysis showed satisfying reliability for all six factors and the total questionnaire. In order to examine the construct validity of the new instrument, regression analyses were conducted to test whether the instrument predicted work characteristics’ influence on three components of well-being—burnout, psychological stress and maladaptive coping behaviors. Conclusion: The present validation offers a trilingual inventory for measuring quality of work that may be used, for example, as an assessment tool or for testing the effectiveness of interventions. PMID:26703634
Quality of Work: Validation of a New Instrument in Three Languages.
Steffgen, Georges; Kohl, Diane; Reese, Gerhard; Happ, Christian; Sischka, Philipp
2015-11-26
A new instrument to measure quality of work was developed in three languages (German, French and Luxembourgish) and validated in a study of employees working in Luxembourg. A representative sample (n = 1529) was taken and exploratory factor analysis revealed a six-factor solution for the 21-item instrument (satisfaction and respect, mobbing, mental strain at work, cooperation, communication and feedback, and appraisal). Reliability analysis showed satisfying reliability for all six factors and the total questionnaire. In order to examine the construct validity of the new instrument, regression analyses were conducted to test whether the instrument predicted work characteristics’ influence on three components of well-being -- burnout, psychological stress and maladaptive coping behaviors. The present validation offers a trilingual inventory for measuring quality of work that may be used, for example, as an assessment tool or for testing the effectiveness of interventions.
Public accountability for health: new standards for health system performance.
Lansky, D; Purdy, S
1995-01-01
This article reviews the failure of contemporary quality oversight organizations to respond to the changing health care environment and suggests an overhaul of quality measurement and assurance functions. The authors examine the factors that have limited public accountability for health care, emphasizing the limited agreement that exists on the purpose of American health care, standards for evaluating care, or the appropriate locus of responsibility for quality of care. A five-part quality oversight system is proposed including development of quality measures, promulgation of national standards, validation and accreditation, use of data for purchasing and provider selection, and use of data for quality improvement.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jones, G.; Johnson, B. R.; Abitbol, M. H.
Aluminum lumped-element kinetic inductance detectors (LEKIDs) sensitive to millimeter-wave photons have been shown to exhibit high quality factors, making them highly sensitive and multiplexable. The superconducting gap of aluminum limits aluminum LEKIDs to photon frequencies above 100 GHz. Manganese-doped aluminum (Al-Mn) has a tunable critical temperature and could therefore be an attractive material for LEKIDs sensitive to frequencies below 100 GHz if the internal quality factor remains sufficiently high when manganese is added to the film. To investigate, we measured some of the key properties of Al-Mn LEKIDs. A prototype eight-element LEKID array was fabricated using a 40 nm thickmore » film of Al-Mn deposited on a 500 μm thick high-resistivity, float-zone silicon substrate. The manganese content was 900 ppm, the measured T c = 694 ± 1mK, and the resonance frequencies were near 150 MHz. Using measurements of the forward scattering parameter S 21 at various bath temperatures between 65 and 250 mK, we determined that the Al-Mn LEKIDs we fabricated have internal quality factors greater than 2 × 10 5, which is high enough for millimeter-wave astrophysical observations. In the dark conditions under which these devices were measured, the fractional frequency noise spectrum shows a shallow slope that depends on bath temperature and probe tone amplitude, which could be two-level system noise. In conclusion, the anticipated white photon noise should dominate this level of low-frequency noise when the detectors are illuminated with millimeter-waves in future measurements. The LEKIDs responded to light pulses from a 1550 nm light-emitting diode, and we used these light pulses to determine that the quasiparticle lifetime is 60 μs.« less
Jones, G.; Johnson, B. R.; Abitbol, M. H.; ...
2017-05-29
Aluminum lumped-element kinetic inductance detectors (LEKIDs) sensitive to millimeter-wave photons have been shown to exhibit high quality factors, making them highly sensitive and multiplexable. The superconducting gap of aluminum limits aluminum LEKIDs to photon frequencies above 100 GHz. Manganese-doped aluminum (Al-Mn) has a tunable critical temperature and could therefore be an attractive material for LEKIDs sensitive to frequencies below 100 GHz if the internal quality factor remains sufficiently high when manganese is added to the film. To investigate, we measured some of the key properties of Al-Mn LEKIDs. A prototype eight-element LEKID array was fabricated using a 40 nm thickmore » film of Al-Mn deposited on a 500 μm thick high-resistivity, float-zone silicon substrate. The manganese content was 900 ppm, the measured T c = 694 ± 1mK, and the resonance frequencies were near 150 MHz. Using measurements of the forward scattering parameter S 21 at various bath temperatures between 65 and 250 mK, we determined that the Al-Mn LEKIDs we fabricated have internal quality factors greater than 2 × 10 5, which is high enough for millimeter-wave astrophysical observations. In the dark conditions under which these devices were measured, the fractional frequency noise spectrum shows a shallow slope that depends on bath temperature and probe tone amplitude, which could be two-level system noise. In conclusion, the anticipated white photon noise should dominate this level of low-frequency noise when the detectors are illuminated with millimeter-waves in future measurements. The LEKIDs responded to light pulses from a 1550 nm light-emitting diode, and we used these light pulses to determine that the quasiparticle lifetime is 60 μs.« less
Local environmental quality positively predicts breastfeeding in the UK’s Millennium Cohort Study
Sear, Rebecca
2017-01-01
ABSTRACT Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis—one ‘objective’ (based on an independent assessor’s neighbourhood scores) and one ‘subjective’ (based on respondent’s scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women’s decision making contexts when considering behaviours relevant to public health. PMID:29354262
Local environmental quality positively predicts breastfeeding in the UK's Millennium Cohort Study.
Brown, Laura J; Sear, Rebecca
2017-01-01
Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis-one 'objective' (based on an independent assessor's neighbourhood scores) and one 'subjective' (based on respondent's scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women's decision making contexts when considering behaviours relevant to public health.
Joseph R. Benjamin; Jason B. Dunham; Matthew R. Dare
2007-01-01
Theoretical models and empirical evidence suggest that the invasion of nonnative species in freshwaters is facilitated through the interaction of three factors: habitat quality, biotic resistance, and connectivity. We measured variables that represented each factor to determine which were associated with the occurrence of nonnative brook trout Salvelinus...
Factors Influencing Health-Related Quality of Life of Overweight and Obese Children in South Korea
ERIC Educational Resources Information Center
Kim, Hee Soon; Park, Jiyoung; Ma, Yumi; Ham, Ok Kyung
2013-01-01
The purpose of this study was to identify factors influencing health-related quality of life (HRQoL) of overweight and obese children in Korea. This study employed a cross-sectional descriptive study design. A total of 132 overweight and obese children participated in the study. Anthropometric measurements included body mass index, percent body…
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.
Eating practices and diet quality: a population study of four Nordic countries.
Holm, L; Lund, T B; Niva, M
2015-07-01
Daily practices related to eating are embedded in the social and cultural contexts of everyday life. How are such factors associated with diet quality relative to motivational factors? And, are associations universal or context-specific? We analyze the relationship between diet quality and the following practices: social company while eating, the regularity and duration of eating and the activity of watching TV while eating. A cross-sectional, questionnaire-based internet survey was conducted in April 2012 with stratified random samples of the populations (aged 15-80 years) in Denmark, Finland, Norway and Sweden (N=7531, completion rate 9-13%). The questionnaire elicited detailed accounts of one day of eating focusing on social and practical aspects of eating events. The validated Dietary Quality Score was the dependent variable. This measure is based on eight food frequency questions focusing on fats, vegetables, fruits and fish in the diet. Eating activities were associated with diet quality even when motivation to eat healthily and sociodemographic factors were controlled for. The number of daily eating events and eating main meals was positively correlated with diet quality in all countries. Beyond that, activities that were significantly associated with diet quality varied with country. When measured separately, the association between each activity and diet quality was weaker than motivation to eat healthily, but in combinations that are found in parts of the populations, the association was substantial. Daily practices related to eating are correlated with diet quality. Practices that are important are in part universal but also country-specific. Efforts to promote healthy eating should address not only cognitive factors but also everyday contexts of eating that facilitate or hamper healthy practices.
Estimating Depolarization with the Jones Matrix Quality Factor
NASA Astrophysics Data System (ADS)
Hilfiker, James N.; Hale, Jeffrey S.; Herzinger, Craig M.; Tiwald, Tom; Hong, Nina; Schöche, Stefan; Arwin, Hans
2017-11-01
Mueller matrix (MM) measurements offer the ability to quantify the depolarization capability of a sample. Depolarization can be estimated using terms such as the depolarization index or the average degree of polarization. However, these calculations require measurement of the complete MM. We propose an alternate depolarization metric, termed the Jones matrix quality factor, QJM, which does not require the complete MM. This metric provides a measure of how close, in a least-squares sense, a Jones matrix can be found to the measured Mueller matrix. We demonstrate and compare the use of QJM to other traditional calculations of depolarization for both isotropic and anisotropic depolarizing samples; including non-uniform coatings, anisotropic crystal substrates, and beetle cuticles that exhibit both depolarization and circular diattenuation.
Measuring Workplace Climate in Community Clinics and Health Centers.
Friedberg, Mark W; Rodriguez, Hector P; Martsolf, Grant R; Edelen, Maria O; Vargas Bustamante, Arturo
2016-10-01
The effectiveness of community clinics and health centers' efforts to improve the quality of care might be modified by clinics' workplace climates. Several surveys to measure workplace climate exist, but their relationships to each other and to distinguishable dimensions of workplace climate are unknown. To assess the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and to generate a shorter instrument for future use. We fielded a 106-item survey, which included items from 9 existing instruments, to all clinicians and staff members (n=781) working in 30 California community clinics and health centers, receiving 628 responses (80% response rate). We performed exploratory factor analysis of survey responses, followed by confirmatory factor analysis of 200 reserved survey responses. We generated a new, shorter survey instrument of items with strong factor loadings. Six factors, including 44 survey items, emerged from the exploratory analysis. Two factors (Clinic Workload and Teamwork) were independent from the others. The remaining 4 factors (staff relationships, quality improvement orientation, managerial readiness for change, and staff readiness for change) were highly correlated, indicating that these represented dimensions of a higher-order factor we called "Clinic Functionality." This 2-level, 6-factor model fit the data well in the exploratory and confirmatory samples. For all but 1 factor, fewer than 20 survey responses were needed to achieve clinic-level reliability >0.7. Survey instruments designed to measure workplace climate have substantial overlap. The relatively parsimonious item set we identified might help target and tailor clinics' quality improvement efforts.
Measuring Workplace Climate in Community Clinics and Health Centers
Friedberg, Mark W.; Rodriguez, Hector P.; Martsolf, Grant; Edelen, Maria Orlando; Vargas-Bustamante, Arturo
2018-01-01
Background The effectiveness of community clinics and health centers’ efforts to improve the quality of care might be modified by clinics’ workplace climates. Several surveys to measure workplace climate exist, but their relationships to each other and to distinguishable dimensions of workplace climate are unknown. Objective To assess the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and to generate a shorter instrument for future use. Methods We fielded a 106-item survey, which included items from 9 existing instruments, to all clinicians and staff members (n=781) working in 30 California community clinics and health centers, receiving 628 responses (80% response rate). We performed exploratory factor analysis of survey responses, followed by confirmatory factor analysis of 200 reserved survey responses. We generated a new, shorter survey instrument of items with strong factor loadings. Results Six factors, including 44 survey items, emerged from the exploratory analysis. Two factors (Clinic Workload and Teamwork) were independent from the others. The remaining 4 factors (Staff Relationships, Quality Improvement Orientation, Managerial Readiness for Change, and Staff Readiness for Change) were highly correlated, indicating that these represented dimensions of a higher-order factor we called “Clinic Functionality.” This two-level, six-factor model fit the data well in the exploratory and confirmatory samples. For all but one factor, fewer than 20 survey responses were needed to achieve clinic-level reliability >0.7. Conclusion Survey instruments designed to measure workplace climate have substantial overlap. The relatively parsimonious item set we identified might help target and tailor clinics’ quality improvement efforts. PMID:27326549
Dimensions of service quality in healthcare: a systematic review of literature.
Fatima, Iram; Humayun, Ayesha; Iqbal, Usman; Shafiq, Muhammad
2018-06-13
Various dimensions of healthcare service quality were used and discussed in literature across the globe. This study presents an updated meaningful review of the extensive research that has been conducted on measuring dimensions of healthcare service quality. Systematic review method in current study is based on PRISMA guidelines. We searched for literature using databases such as Google, Google Scholar, PubMed and Social Science, Citation Index. In this study, we screened 1921 identified papers using search terms/phrases. Snowball strategies were adopted to extract published articles from January 1997 till December 2016. Two-hundred and fourteen papers were identified as relevant for data extraction; completed by two researchers, double checked by the other two to develop agreement in discrepancies. In total, 74 studies fulfilled our pre-defined inclusion and exclusion criteria for data analysis. Service quality is mainly measured as technical and functional, incorporating many sub-dimensions. We synthesized the information about dimensions of healthcare service quality with reference to developed and developing countries. 'Tangibility' is found to be the most common contributing factor whereas 'SERVQUAL' as the most commonly used model to measure healthcare service quality. There are core dimensions of healthcare service quality that are commonly found in all models used in current reviewed studies. We found a little difference in these core dimensions while focusing dimensions in both developed and developing countries, as mostly SERVQUAL is being used as the basic model to either generate a new one or to add further contextual dimensions. The current study ranked the contributing factors based on their frequency in literature. Based on these priorities, if factors are addressed irrespective of any context, may lead to contribute to improve healthcare quality and may provide an important information for evidence-informed decision-making.
Carnegie Knowledge Network Concluding Recommendations. What We Know Series
ERIC Educational Resources Information Center
Goldhaber, Dan; Harris Douglas N.; Loeb, Susanna; McCaffrey, Daniel F.; Raudenbush, Stephen W.
2015-01-01
It is common knowledge that teacher quality is a key in-school factor affecting student achievement. While the quality of teaching clearly matters for how much students learn, this quality is challenging to measure. Evaluating teacher quality based on the level of their students' end-of-year test scores has been one method of assessing…
Software cost/resource modeling: Software quality tradeoff measurement
NASA Technical Reports Server (NTRS)
Lawler, R. W.
1980-01-01
A conceptual framework for treating software quality from a total system perspective is developed. Examples are given to show how system quality objectives may be allocated to hardware and software; to illustrate trades among quality factors, both hardware and software, to achieve system performance objectives; and to illustrate the impact of certain design choices on software functionality.
The Quality of Life of Young Men with Asperger Syndrome: A Brief Report
ERIC Educational Resources Information Center
Jennes-Coussens, Marieke; Magill-Evans, Joyce; Koning, Cyndie
2006-01-01
Factors influencing quality of life for persons with Asperger syndrome are not yet understood. Men, ages 18 to 21, completed the World Health Organization Quality Of Life measure, the Perceived Support Network Inventory, and a semi-structured interview. Asperger syndrome affects quality of life beyond the obvious social impact. The 12 men with…
Factors influencing health-related quality of life among Korean cancer survivors.
Kim, KiSook; Kim, Ji-Su
2017-01-01
Early cancer detection and remarkable improvements in cancer treatment have seen the cancer survival rate grow steadily for the past 40 years. Despite expectations regarding treatment effectiveness, acceptable quality of life, and a comfortable death, patients with cancer generally have a decreased quality of life. The study aim was to examine the factors influencing health-related quality of life among South Korean cancer survivors for future development of an intervention to enhance their survivorship. Korea National Health and Nutrition Examination Survey 2008-2012 data regarding 1020 cancer survivors were used for analysis. Health-related quality of life was measured using the EuroQol 5-Dimension. The factors influencing health-related quality of life were age, educational status, employment status, income, smoking, time since diagnosis, subjective health status, stress, depression, and suicidal ideation. Individual-centered clinical interventions that consider dimensional-influencing factors, including subjective health status, are needed to improve cancer survivors' health-related quality of life. Subsequent systematic studies are needed regarding dimension-specific differences according to cancer types and time since diagnosis. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Kadoya, Manabu; Koyama, Hidenori; Kurajoh, Masafumi; Naka, Mariko; Miyoshi, Akio; Kanzaki, Akinori; Kakutani, Miki; Shoji, Takuhito; Moriwaki, Yuji; Yamamoto, Tetsuya; Inaba, Masaaki; Namba, Mitsuyoshi
2016-01-01
Background Sleep quality and awake physical activity are important behavioral factors involved in the occurrence of cardiovascular diseases, potentially through nocturnal blood pressure (BP) changes. However, the impacts of quantitatively measured sleep quality and awake physical activity on BP fluctuation, and their relationships with several candidate causal factors for nocturnal hypertension are not well elucidated. Methods This cross-sectional study included 303 patients registered in the HSCAA study. Measurements included quantitatively determined sleep quality parameters and awake physical activity obtained by actigraph, nocturnal systolic BP (SBP) fall [100 × (1- sleep SBP/awake SBP ratio)], apnea hypopnea index, urinary sodium and cortisol secretion, plasma aldosterone concentration and renin activity, insulin resistance index, parameters of heart rate variability (HRV), and plasma brain-derived neurotrophic factor (BDNF). Results Simple regression analysis showed that time awake after sleep onset (r = -0.150), a parameter of sleep quality, and awake physical activity (r = 0.164) were significantly correlated with nocturnal SBP fall. Among those, time awake after sleep onset (β = -0.179) and awake physical activity (β = 0.190) were significantly and independently associated with nocturnal SBP fall in multiple regression analysis. In a subgroup of patients without taking anti-hypertensive medications, both time awake after sleep onset (β = -0.336) and awake physical activity (β = 0.489) were more strongly and independently associated with nocturnal SBP falls. Conclusion Sleep quality and awake physical activity were found to be significantly associated with nocturnal SBP fall, and that relationship was not necessarily confounded by candidate causal factors for nocturnal hypertension. PMID:27166822
NASA Technical Reports Server (NTRS)
Badhwar, G. D.; Konradi, A.; Atwell, W.; Golightly, M. J.; Cucinotta, F. A.; Wilson, J. W.; Petrov, V. M.; Tchernykh, I. V.; Shurshakov, V. A.; Lobakov, A. P.
1996-01-01
A tissue equivalent proportional counter designed to measure the linear energy transfer spectra (LET) in the range 0.2-1250 keV/micrometer was flown in the Kvant module on the Mir orbital station during September 1994. The spacecraft was in a 51.65 degrees inclination, elliptical (390 x 402 km) orbit. This is nearly the lower limit of its flight altitude. The total absorbed dose rate measured was 411.3 +/- 4.41 microGy/day with an average quality factor of 2.44. The galactic cosmic radiation (GCR) dose rate was 133.6 microGy/day with a quality factor of 3.35. The trapped radiation belt dose rate was 277.7 microGy/day with an average quality factor of 1.94. The peak rate through the South Atlantic Anomaly was approximately 12 microGy/min and nearly constant from one pass to another. A detailed comparison of the measured LET spectra has been made with radiation transport models. The GCR results are in good agreement with model calculations; however, this is not the case for radiation belt particles and again points to the need for improving the AP8 omni-directional trapped proton models.
Janowski, Konrad; Steuden, Stanisława; Bereza, Bernarda
2014-02-01
Skin conditions have a negative impact on quality of life and it is necessary to quantify this impact. Skindex-29 is a self-report questionnaire developed to measure dermatology-specific quality of life. The objective of this study is to adapt this questionnaire to Polish conditions. The adaptation procedure involved the works on the linguistic content of the items and testing psychometric properties of the Polish version of Skindex-29, including item characteristics, factorial structure, aspects of reliability and validity. Two-hundred and ninety patients (63.4% women and 35.2% men) suffering from a range of skin conditions were recruited from several dermatological out-patient and in-patient clinics in Poland. Quality of life was measured using Skindex-29 and appropriate clinical data were collected. The global score of Skindex-29 showed the normal distribution. Cronbach's α reliability coefficients were found to be high to very high for all Skindex-29 indexes. Factor analysis yielded four factors, in contrast to the original version of the questionnaire, for which a three-factor solution had been reported. Skindex-29 validity was demonstrated by showing the differences in the quality of life scores across different diagnostic categories, and between in-patients and out-patients. Skindex-29 global scores were found to be significantly predicted by the localization of the skin lesions on legs, anogenital areas and palms. The findings of this study support reliability and validity of the Polish version of Skindex-29, but they also raise questions to its three-factor structure.
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.…
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
Weighing the impact (factor) of publishing in veterinary journals.
Christopher, Mary M
2015-06-01
The journal in which you publish your research can have a major influence on the perceived value of your work and on your ability to reach certain audiences. The impact factor, a widely used metric of journal quality and prestige, has evolved into a benchmark of quality for institutions and graduate programs and, inappropriately, as a proxy for the quality of individual authors and articles, affecting tenure, promotion, and funding decisions. As a result, despite its many limitations, publishing decisions by authors often are based solely on a journal's impact factor. This can disadvantage journals in small disciplines, such as veterinary medicine, and limit the ability of authors to reach key audiences. In this article, factors that can influence the impact factor of a journal and its applicability, including precision, citation practices, article type, editorial policies, and size of the research community will be reviewed. The value and importance of veterinary journals such as the Journal of Veterinary Cardiology for reaching relevant audiences and for helping shape disciplinary specialties and influence clinical practice will also be discussed. Lastly, the efforts underway to develop alternative measures to assess the scientific quality of individual authors and articles, such as article-level metrics, as well as institutional measures of the economic and social impact of biomedical research will be considered. Judicious use of the impact factor and the implementation of new metrics for assessing the quality and societal relevance of veterinary research articles will benefit both authors and journals. Copyright © 2015 Elsevier B.V. All rights reserved.
The Need for Comprehensive Health Care Quality Measures for Older Adults.
MacLeod, Stephanie; Schwebke, Kay; Hawkins, Kevin; Ruiz, Joann; Hoo, Emma; Yeh, Charlotte S
2017-10-24
Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.
Predictors of mother-child interaction quality and child attachment security in at-risk families.
De Falco, Simona; Emer, Alessandra; Martini, Laura; Rigo, Paola; Pruner, Sonia; Venuti, Paola
2014-01-01
Child healthy development is largely influenced by parent-child interaction and a secure parent-child attachment is predictively associated with positive outcomes in numerous domains of child development. However, the parent-child relationship can be affected by several psychosocial and socio-demographic risk factors that undermine its quality and in turn play a negative role in short and long term child psychological health. Prevention and intervention programs that support parenting skills in at-risk families can efficiently reduce the impact of risk factors on mother and child psychological health. This study examines predictors of mother-child interaction quality and child attachment security in a sample of first-time mothers with psychosocial and/or socio-demographic risk factors. Forty primiparous women satisfying specific risk criteria participated in a longitudinal study with their children from pregnancy until 18 month of child age. A multiple psychological and socioeconomic assessment was performed. The Emotional Availability Scales were used to measure the quality of emotional exchanges between mother and child at 12 months and the Attachment Q-Sort served as a measure of child attachment security at 18 months. Results highlight both the effect of specific single factors, considered at a continuous level, and the cumulative risk effect of different co-occurring factors, considered at binary level, on mother-child interaction quality and child attachment security. Implication for the selection of inclusion criteria of intervention programs that support parenting skills in at-risk families are discussed.
Verdam, Mathilde G. E.; Oort, Frans J.
2014-01-01
Highlights Application of Kronecker product to construct parsimonious structural equation models for multivariate longitudinal data. A method for the investigation of measurement bias with Kronecker product restricted models. Application of these methods to health-related quality of life data from bone metastasis patients, collected at 13 consecutive measurement occasions. The use of curves to facilitate substantive interpretation of apparent measurement bias. Assessment of change in common factor means, after accounting for apparent measurement bias. Longitudinal measurement invariance is usually investigated with a longitudinal factor model (LFM). However, with multiple measurement occasions, the number of parameters to be estimated increases with a multiple of the number of measurement occasions. To guard against too low ratios of numbers of subjects and numbers of parameters, we can use Kronecker product restrictions to model the multivariate longitudinal structure of the data. These restrictions can be imposed on all parameter matrices, including measurement invariance restrictions on factor loadings and intercepts. The resulting models are parsimonious and have attractive interpretation, but require different methods for the investigation of measurement bias. Specifically, additional parameter matrices are introduced to accommodate possible violations of measurement invariance. These additional matrices consist of measurement bias parameters that are either fixed at zero or free to be estimated. In cases of measurement bias, it is also possible to model the bias over time, e.g., with linear or non-linear curves. Measurement bias detection with Kronecker product restricted models will be illustrated with multivariate longitudinal data from 682 bone metastasis patients whose health-related quality of life (HRQL) was measured at 13 consecutive weeks. PMID:25295016
Verdam, Mathilde G E; Oort, Frans J
2014-01-01
Application of Kronecker product to construct parsimonious structural equation models for multivariate longitudinal data.A method for the investigation of measurement bias with Kronecker product restricted models.Application of these methods to health-related quality of life data from bone metastasis patients, collected at 13 consecutive measurement occasions.The use of curves to facilitate substantive interpretation of apparent measurement bias.Assessment of change in common factor means, after accounting for apparent measurement bias.Longitudinal measurement invariance is usually investigated with a longitudinal factor model (LFM). However, with multiple measurement occasions, the number of parameters to be estimated increases with a multiple of the number of measurement occasions. To guard against too low ratios of numbers of subjects and numbers of parameters, we can use Kronecker product restrictions to model the multivariate longitudinal structure of the data. These restrictions can be imposed on all parameter matrices, including measurement invariance restrictions on factor loadings and intercepts. The resulting models are parsimonious and have attractive interpretation, but require different methods for the investigation of measurement bias. Specifically, additional parameter matrices are introduced to accommodate possible violations of measurement invariance. These additional matrices consist of measurement bias parameters that are either fixed at zero or free to be estimated. In cases of measurement bias, it is also possible to model the bias over time, e.g., with linear or non-linear curves. Measurement bias detection with Kronecker product restricted models will be illustrated with multivariate longitudinal data from 682 bone metastasis patients whose health-related quality of life (HRQL) was measured at 13 consecutive weeks.
Buschmann, Robert N; Prochaska, John D; Cutchin, Malcolm P; Peek, M Kristen
2018-03-29
Neighborhood quality is associated with health. Increasingly, researchers are focusing on the mechanisms underlying that association, including the role of stress, risky health behaviors, and subclinical measures such as allostatic load (AL). This study uses mixed-effects regression modeling to examine the association between two objective measures and one subjective measure of neighborhood quality and AL in an ethnically diverse population-based sample (N = 2706) from a medium-sized Texas city. We also examine whether several measures of psychological stress and health behaviors mediate any relationship between neighborhood quality and AL. In this sample, all three separate measures of neighborhood quality were associated with individual AL (P < .01). However, only the subjective measure, perceived neighborhood quality, was associated with AL after adjusting for covariates. In mixed-effects multiple regression models there was no evidence of mediation by either stress or health behaviors. In this study, only one measure of neighborhood quality was related to a measure of health, which contrasts with considerable previous research in this area. In this sample, neighborhood quality may affect AL through other mechanisms, or there may be other health-affecting factors is this area that share that overshadow local neighborhood variation. Copyright © 2018 Elsevier Inc. All rights reserved.
Determinants of physical activity in minimally impaired people with multiple sclerosis.
Kahraman, Turhan; Savci, Sema; Coskuner-Poyraz, Esra; Ozakbas, Serkan; Idiman, Egemen
2015-11-01
Despite the commonly known benefits of physical activity, evidence shows that people with multiple sclerosis (pwMS) are relatively inactive. There are several studies about factors affecting physical activity in pwMS. However, these factors have not investigated in minimally impaired pwMS who do not have remarkable symptoms and walking disturbance. The objective was to determine factors affecting physical activity in minimally impaired pwMS. We recruited 52 minimally impaired pwMS and measured physical activity with Godin Leisure-Time Exercise Questionnaire (GLTEQ) and an accelerometer used for the 7-day period. Demographic data were recorded. Walking (speed, endurance, dexterity, and quality), fatigue, depression, and quality of life were measured. We recruited 52 minimally impaired pwMS and measured physical activity with Godin Leisure-Time Exercise Questionnaire (GLTEQ) and an accelerometer used for the 7-day period. Demographic data were recorded. Walking (speed, endurance, dexterity, and quality), fatigue, depression, and quality of life were measured. The walking speed assessed by the Timed 25-Foot Walk and gender were found the determinants of physical activity level assessed by the GLTEQ and accelerometer, respectively. Walking (speed, endurance, and dexterity), gender, employment status, and quality of life were associated with physical activity. Either female or unemployed participants had significantly less physical activity. There were no significant difference between physical activity levels and the other subgroups. Either to be a female or to have slower walking speed was associated with less physical activity. Strategies to improve walking should be focused on female pwMS with minimal impairment. Copyright © 2015 Elsevier B.V. All rights reserved.
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.
Holden, Richard J.; Scanlon, Matthew C.; Patel, Neal R.; Kaushal, Rainu; Escoto, Kamisha Hamilton; Brown, Roger L.; Alper, Samuel J.; Arnold, Judi M.; Shalaby, Theresa M.; Murkowski, Kathleen; Karsh, Ben-Tzion
2010-01-01
Backgrounds Nursing workload is increasingly thought to contribute to both nurses’ quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualizing and measuring the effects of workload in health care. In contrast, we conceptualized a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes. Methods To test this model, we analyzed results from a cross-sectional survey of a volunteer sample of nurses in six units of two academic tertiary care pediatric hospitals. Results Workload measures were generally correlated with outcomes of interest. A multivariate structural model revealed that: the unit-level measure of staffing adequacy was significantly related to job dissatisfaction (path loading = .31) and burnout (path loading = .45); the task-level measure of mental workload related to interruptions, divided attention, and being rushed was associated with burnout (path loading = .25) and medication error likelihood (path loading = 1.04). Job-level workload was not uniquely and significantly associated with any outcomes. Discussion The human factors engineering model of nursing workload was supported by data from two pediatric hospitals. The findings provided a novel insight into specific ways that different types of workload could affect nurse and patient outcomes. These findings suggest further research and yield a number of human factors design suggestions. PMID:21228071
Holden, Richard J; Scanlon, Matthew C; Patel, Neal R; Kaushal, Rainu; Escoto, Kamisha Hamilton; Brown, Roger L; Alper, Samuel J; Arnold, Judi M; Shalaby, Theresa M; Murkowski, Kathleen; Karsh, Ben-Tzion
2011-01-01
Nursing workload is increasingly thought to contribute to both nurses' quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualising and measuring the effects of workload in healthcare. In contrast, we conceptualised a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes. To test this model, we analysed results from a cross-sectional survey of a volunteer sample of nurses in six units of two academic tertiary care paediatric hospitals. Workload measures were generally correlated with outcomes of interest. A multivariate structural model revealed that: the unit-level measure of staffing adequacy was significantly related to job dissatisfaction (path loading=0.31) and burnout (path loading=0.45); the task-level measure of mental workload related to interruptions, divided attention, and being rushed was associated with burnout (path loading=0.25) and medication error likelihood (path loading=1.04). Job-level workload was not uniquely and significantly associated with any outcomes. The human factors engineering model of nursing workload was supported by data from two paediatric hospitals. The findings provided a novel insight into specific ways that different types of workload could affect nurse and patient outcomes. These findings suggest further research and yield a number of human factors design suggestions.
FACTORS ASSOCIATED WITH INDISCRIMINATE FRIENDLINESS IN HIGH-RISK CHILDREN.
Love, Leighanne; Minnis, Helen; O'connor, Suzy
2015-01-01
Indiscriminate friendliness (IF) refers to a lack of reticence with strangers and is well-documented in neglected children. This risky behavior is distinct from attachment insecurity, and persists when parenting/caregiving improves. A previous review has suggested that caregiving quality is not associated with IF. This review aimed to explore factors associated with IF and whether quality of caregiving is important. Ten articles were reviewed using the S.H. Downs and N. Black (1998) Checklist for randomized and nonrandomized studies. Overall quality was high. Results showed that IF is present in fostered populations and postinstitutionalized children. Attachment security was not associated with IF. Length of time in institution and inhibitory control were associated with IF. Inhibitory control moderated the association between IF and number of caregivers. Genetic factors predispose children to IF and may impact on persistence. Quality of caregiving was associated with IF. Emotional availability (i.e., the degree to which carer and child are able to respond to each other's emotional signals) predicted IF. Limitations across studies included heterogeneity in IF measurement and unreliable measures of preadoptive care. Parenting may be a useful target for intervention. Future research should focus on developing a standardized measure of IF as well as evaluating a parental intervention. © 2015 Michigan Association for Infant Mental Health.
Effect of marital quality on eight-year survival of patients with heart failure.
Rohrbaugh, Michael J; Shoham, Varda; Coyne, James C
2006-10-15
Recent evidence suggests that psychosocial factors such as self-efficacy, psychological distress, perceived social support, and marital quality have prognostic significance for morbidity and mortality after heart failure. Previously, we reported that interview and observational measures of marital quality obtained from 189 patients with heart failure (139 men and 50 women) and their spouses predicted all-cause patient mortality during the next 4 years, independent of the baseline illness severity (New York Heart Association class). We present additional follow-up results for this sample, with Cox regression analyses showing that a couple-level composite measure of marital quality continued to predict survival during an 8-year period (p <0.001), especially when the patient was a woman, and did so substantially better than individual (patient-level) risk and protective factors, such as psychological distress, hostility, neuroticism, self-efficacy, optimism, and breadth of perceived emotional support. In conclusion, relationship factors may be especially relevant in managing a difficult chronic condition such as heart failure, which makes stringent and complex demands on patients and their families.
Factors that influence quality of life in rural children with asthma and their parents.
Walker, Jennifer; Winkelstein, Marilyn; Land, Cassia; Lewis-Boyer, Lapricia; Quartey, Ruth; Pham, Luu; Butz, Arlene
2008-01-01
Among rural children with asthma and their parents, this study examined the relationship between parental and child reports of quality of life and described the relationship of several factors such as asthma severity, missed days of work, and asthma education on their quality of life. Two hundred one rural families with asthma were enrolled in a school-based educational program. Intervention parents and children participated in interactive asthma workshop(s) and received asthma devices and literature. Parent and child quality of life measurements were obtained before and after the intervention using Juniper's Paediatric Caregivers Quality of Life and Juniper's Paediatric Quality of Life Questionnaires. Asthma severity was measured using criteria from the National Asthma Education and Prevention Program guidelines. There was no association between parent and child total quality of life scores, and mean parental total quality of life scores were higher at baseline and follow-up than those of the children. All the parents' quality of life scores were correlated with parental reports of missed days of work. For all children, emotional quality of life (EQOL) was significantly associated with parental reports of school days missed (P = .03) and marginally associated with parental reports of hospitalizations due to asthma (P = .08). Parent's EQOL and activity quality of life (AQOL) were significantly associated with children's asthma severity (EQOL, P = .009; AQOL, P = .03), but not the asthma educational intervention. None of the child quality of life measurements was associated with asthma severity. Asthma interventions for rural families should help families focus on gaining and maintaining low asthma severity levels to enjoy an optimal quality of life. Health care providers should try to assess the child's quality of life at each asthma care visit independently of the parents.
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.
Investigating the CO 2 laser cutting parameters of MDF wood composite material
NASA Astrophysics Data System (ADS)
Eltawahni, H. A.; Olabi, A. G.; Benyounis, K. Y.
2011-04-01
Laser cutting of medium density fibreboard (MDF) is a complicated process and the selection of the process parameters combinations is essential to get the highest quality cut section. This paper presents a means for selecting the process parameters for laser cutting of MDF based on the design of experiments (DOE) approach. A CO 2 laser was used to cut three thicknesses, 4, 6 and 9 mm, of MDF panels. The process factors investigated are: laser power, cutting speed, air pressure and focal point position. In this work, cutting quality was evaluated by measuring the upper kerf width, the lower kerf width, the ratio between the upper kerf width to the lower kerf width, the cut section roughness and the operating cost. The effect of each factor on the quality measures was determined. The optimal cutting combinations were presented in favours of high quality process output and in favours of low cutting cost.
Measuring the qualities of nurses: development and testing of the Qualities of Nurses Scale.
Johnson, Maree; Cowin, Leanne
2013-01-01
This paper reports on the creation, development and testing of a new instrument to measure qualities of nurses, known as the Qualities of Nurses (QON) scale, applicable to student nurses. High attrition rates within nursing programs and during early postgraduate years are an international phenomena. Mismatches between idealized perceptions of nursing and the realities of education and clinical experiences have been identified as contributing factors. A survey method was used to elicit responses to scale items from 678 first-year nursing students at a large university. A one-factor 12-item solution explaining 47 percent of variance in the construct was demonstrated. The QON can assist in the initial assessment and ongoing monitoring of changes in students' perceptions of nurses. Using the QON, researchers and educators can identify initial student nurses' perceptions and any changes associated in educational or other events that ultimately could be manipulated to reduce attrition.
Multilevel Factor Analysis by Model Segregation: New Applications for Robust Test Statistics
ERIC Educational Resources Information Center
Schweig, Jonathan
2014-01-01
Measures of classroom environments have become central to policy efforts that assess school and teacher quality. This has sparked a wide interest in using multilevel factor analysis to test measurement hypotheses about classroom-level variables. One approach partitions the total covariance matrix and tests models separately on the…
Testing of qubit materials and fabrication using superconducting resonators
NASA Astrophysics Data System (ADS)
Kumar, Shwetank; Steffen, Matthias; Divincenzo, David; Keefe, George; Rothwell, Mary Beth; Farinelli, Matthew; Rozen, Jim; Milliken, Frank; Ketchen, Mark
2009-03-01
We will present the results of measurements made on superconducting resonators fabricated using different substrates and superconducting metals. Specifically, the quality factor of these resonators will be shown to be closely related to not only the purity of the substrates and metals used in the process but also to the details of the fabrication. We will demonstrate the change in quality factor of a bare resonator when subjected to the qubit process. Based on our measurements we propose that superconducting resonators may form a test bed for troubleshooting the fabrication process for minimizing the materials related dissipation in the qubits.
Distributor- Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale.
Mehralian, Gholamhossein; Babapour, Jafar; Peiravian, Farzad
2016-01-01
In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor-retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor-retailer interface.
Distributor– Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale
Mehralian, Gholamhossein; Babapour, Jafar; peiravian, farzad
2016-01-01
In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor–retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor–retailer interface. PMID:28243297
Hogg, Lori Hoffman
2014-01-01
Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA.
de Man, H; Leenen, E J T M; van Knapen, F; de Roda Husman, A M
2014-09-01
Splash parks have been associated with infectious disease outbreaks as a result of exposure to poor water quality. To be able to protect public health, risk factors were identified that determine poor water quality. Samples were taken at seven splash parks where operators were willing to participate in the study. Higher concentrations of Escherichia coli were measured in water of splash parks filled with rainwater or surface water as compared with sites filled with tap water, independent of routine inspection intervals and employed disinfection. Management practices to prevent fecal contamination and guarantee maintaining good water quality at splash parks should include selection of source water of acceptable quality.
Aguilar-Raab, Corina; Grevenstein, Dennis; Schweitzer, Jochen
2015-01-01
Social interactions have gained increasing importance, both as an outcome and as a possible mediator in psychotherapy research. Still, there is a lack of adequate measures capturing relational aspects in multi-person settings. We present a new measure to assess relevant dimensions of quality of relationships and collective efficacy regarding interpersonal interactions in diverse personal and professional social systems including couple partnerships, families, and working teams: the EVOS. Theoretical dimensions were derived from theories of systemic family therapy and organizational psychology. The study was divided in three parts: In Study 1 (N = 537), a short 9-item scale with two interrelated factors was constructed on the basis of exploratory factor analysis. Quality of relationship and collective efficacy emerged as the most relevant dimensions for the quality of social systems. Study 2 (N = 558) confirmed the measurement model using confirmatory factor analysis and established validity with measures of family functioning, life satisfaction, and working team efficacy. Measurement invariance was assessed to ensure that EVOS captures the same latent construct in all social contexts. In Study 3 (N = 317), an English language adaptation was developed, which again confirmed the original measurement model. The EVOS is a theory-based, economic, reliable, and valid measure that covers important aspects of social relationships, applicable for different social systems. It is the first instrument of its kind and an important addition to existing measures of social relationships and related outcome measures in therapeutic and other counseling settings involving multiple persons. PMID:26200357
NASA Astrophysics Data System (ADS)
Sinha, Rajan Chandra; Sarkar, Satyaki; Mandal, Nikhil Ranjan
2017-09-01
The issue of the housing quality has been addressed for various stakeholders at different levels. There exist varied opinion about its measurability and possible applications. Thus the study is carried out to have an insight into the concept of housing quality and its relevance in the changing demographics, technological, socio-economic and socio-cultural conditions. This study attempts to summarize the literature that addresses past research concerned with factors related to housing quality, its measurement methodology and critically examines the broad key indicators identified to have impact upon enhancing the housing quality. This work discusses the recent techniques which are extensively used for analysis of housing quality.
A research agenda to advance quality measurement and improvement.
Leatherman, Sheila T; Hibbard, Judith H; McGlynn, Elizabeth A
2003-01-01
In developing a conceptual framework for the design of a national quality measurement and reporting system (NQMRS), the Strategic Framework Board (SFB) recommends that such a system be built on a strong evidence base. To identify critical gaps in the evidence needed for a fully functional NQMRS and to recommend a starting point for the development of a research agenda. Selective review of literature in quality of care measurement and reporting and identification of strategic issues that must be addressed. There is some limited evidence that measurement and reporting can improve quality. Substantial advances have been made in the science of measurement and reporting but important gaps remain, specifically in (1) measurement methods and tools, (2) uses of quality performance data, (3) organizational and cultural factors, (4) information and informatics, and (5) impact evaluation/research. To achieve a sustainable research agenda, three strategic issues will have to be addressed: (1) the policy rationale for the research agenda, (2) adequate levels of public-sector funding, and (3) sustainability in a rapidly changing environment.
ERIC Educational Resources Information Center
Zuna, Nina I.; Selig, James P.; Summers, Jean Ann; Turnbull, Ann P.
2009-01-01
Recently, within the field of special education, attention has been accorded to the conceptualization and measurement of family outcomes. The Family Quality of Life (FQOL) Scale is an instrument that can be used to measure family outcomes for families who have children with disabilities, and it has been demonstrated to have psychometric validity.…
Stelfox, Henry T; Straus, Sharon E
2013-12-01
In this article, we describe one approach for developing and evaluating quality indicators. We focus on describing different conceptual approaches to quality indicator development, review one approach for developing quality indicators, outline how to evaluate quality indicators once developed, and discuss quality indicator maintenance. The key steps for developing quality indicators include specifying a clear goal for the indicators; using methodologies to incorporate evidence, expertise, and patient perspectives; and considering contextual factors and logistics of implementation. The Strategic Framework Board and the National Quality Measure Clearinghouse have developed criteria for evaluating quality indicators that complement traditional psychometric evaluations. Optimal strategies for quality indicator maintenance and dissemination have not been determined, but experiences with clinical guideline maintenance may be informative. For quality indicators to effectively guide quality improvement efforts, they must be developed, evaluated, maintained, and implemented using rigorous evidence-informed practices. Copyright © 2013 Elsevier Inc. All rights reserved.
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.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Balcazar, Mario D.; Yonehara, Katsuya; Moretti, Alfred
Intense neutrino beam is a unique probe for researching beyond the standard model. Fermilab is the main institution to produce the most powerful and widespectrum neutrino beam. From that respective, a radiation robust beam diagnostic system is a critical element in order to maintain the quality of the neutrino beam. Within this context, a novel radiation-resistive beam profile monitor based on a gasfilled RF cavity is proposed. The goal of this measurement is to study a tunable Qfactor RF cavity to determine the accuracy of the RF signal as a function of the quality factor. Specifically, measurement error of themore » Q-factor in the RF calibration is investigated. Then, the RF system will be improved to minimize signal error.« less
Factors associated to quality of life in active elderly.
Alexandre, Tiago da Silva; Cordeiro, Renata Cereda; Ramos, Luiz Roberto
2009-08-01
To analyze whether quality of life in active, healthy elderly individuals is influenced by functional status and sociodemographic characteristics, as well as psychological parameters. Study conducted in a sample of 120 active elderly subjects recruited from two open universities of the third age in the cities of São Paulo and São José dos Campos (Southeastern Brazil) between May 2005 and April 2006. Quality of life was measured using the abbreviated Brazilian version of the World Health Organization Quality of Live (WHOQOL-bref) questionnaire. Sociodemographic, clinical and functional variables were measured through crossculturally validated assessments by the Mini Mental State Examination, Geriatric Depression Scale, Functional Reach, One-Leg Balance Test, Timed Up and Go Test, Six-Minute Walk Test, Human Activity Profile and a complementary questionnaire. Simple descriptive analyses, Pearson's correlation coefficient, Student's t-test for non-related samples, analyses of variance, linear regression analyses and variance inflation factor were performed. The significance level for all statistical tests was set at 0.05. Linear regression analysis showed an independent correlation without colinearity between depressive symptoms measured by the Geriatric Depression Scale and four domains of the WHOQOL-bref. Not having a conjugal life implied greater perception in the social domain; developing leisure activities and having an income over five minimum wages implied greater perception in the environment domain. Functional status had no influence on the Quality of Life variable in the analysis models in active elderly. In contrast, psychological factors, as assessed by the Geriatric Depression Scale, and sociodemographic characteristics, such as marital status, income and leisure activities, had an impact on quality of life.
Assessing the Quality of Parent-Teacher Relationships for Students with ADHD
ERIC Educational Resources Information Center
Mautone, Jennifer A.; Marcelle, Enitan; Tresco, Katy E.; Power, Thomas J.
2015-01-01
Family involvement in education, including the quality of family-school communication, has been demonstrated repeatedly to have a substantial effect on child development and success in school; however, measures of this construct are limited. The purpose this study was to examine the factor structure and concurrent validity of the Quality of the…
CRN5EXP: Expert system for statistical quality control
NASA Technical Reports Server (NTRS)
Hentea, Mariana
1991-01-01
The purpose of the Expert System CRN5EXP is to assist in checking the quality of the coils at two very important mills: Hot Rolling and Cold Rolling in a steel plant. The system interprets the statistical quality control charts, diagnoses and predicts the quality of the steel. Measurements of process control variables are recorded in a database and sample statistics such as the mean and the range are computed and plotted on a control chart. The chart is analyzed through patterns using the C Language Integrated Production System (CLIPS) and a forward chaining technique to reach a conclusion about the causes of defects and to take management measures for the improvement of the quality control techniques. The Expert System combines the certainty factors associated with the process control variables to predict the quality of the steel. The paper presents the approach to extract data from the database, the reason to combine certainty factors, the architecture and the use of the Expert System. However, the interpretation of control charts patterns requires the human expert's knowledge and lends to Expert Systems rules.
Measuring quality of life in patients with stress urinary incontinence: is the ICIQ-UI-SF adequate?
Kurzawa, Zuzanna; Sutherland, Jason M; Crump, Trafford; Liu, Guiping
2018-05-08
The International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) is a widely used four-item patient-reported outcome (PRO) measure. Evaluations of this instrument are limited, restraining user's confidence in the instrument. This study conducts a comprehensive evaluation of the ICIQ-UI-SF on a sample of urological surgery patients in Canada. One hundred and seventy-seven surgical patients with stress urinary incontinence completed the ICIQ-UI-SF pre-operatively. Methods drawing from confirmatory factor analysis (CFA), measures of reliability, item response theory (IRT), and differential item functioning were applied. Ceiling effects were examined. Ceiling effects were identified. In the CFA, the factor loadings of items one and two differed significantly (p < 0.001) from item three indicating possible multidimensionality. The first two items reflect symptom severity not quality of life. Reliability was moderate as measured by Cronbach's alpha (0.63) and McDonald's coefficient (0.65). The IRT found the instrument does not discriminate between individuals with low incontinence-related quality of life. Due to low/moderate reliability, the ICIQ-UI-SF can be used as a complement to other data or used to report aggregated surgical outcomes among surgical patients. If the primary objective is to measure quality of life, other PROs should be considered.
von Koss Torkildsen, Janne; Morken, Frøydis; Helland, Wenche A; Helland, Turid
In this study of third grade school children, we investigated the association between writing process measures recorded with key stroke logging and the final written product. Moreover, we examined the cognitive predictors of writing process and product measures. Analyses of key strokes showed that while most children spontaneously made local online revisions while writing, few revised previously written text. Children with good reading and spelling abilities made more online revisions than their peers. Two process factors, transcription fluency and online revision activity, contributed to explaining variance in narrative macrostructural quality and story length. As for cognitive predictors, spelling was the only factor that gave a unique contribution to explaining variance in writing process factors. Better spelling was associated with more revisions and faster transcription. The results show that developing writers' ability to make online revisions in creative writing tasks is related to both the quality of the final written product and to individual literacy skills. More generally, the findings indicate that investigations of the dynamics of the writing process may provide insights into the factors that contribute to creative writing during early stages of literacy.
Garcia Quiroga, Manuela; Hamilton-Giachritsis, Catherine
2017-08-01
The distribution of attachment styles has been shown to differ between groups of children living with their parents and children placed in alternative care (AC), defined as residential or foster. However, this is the first study in Latin America to explore possible factors affecting the quality of attachment in children living in both residential and foster care. Two groups of children (N=57) were compared: one group living in Residential Homes (RC) and the other in Foster Care (FC) in Chile. Children's, caregivers' and structural factors (e.g., child: caregiver ratios) and their links with attachment styles were investigated. The micro caregiving environment (i.e., the specific individual child caregiver relationship), especially the caregivers' engagement, sensitivity, disciplinary control and affection, as well as some structural factors (i.e., child: caregiver ratios), were linked to attachment security in children. Specifically, better emotional caregiving and lower child-caregiver ratios were associated with higher rates of secure attachment. The association between quality of care (as measured by the HOME inventory) and attachment styles seems to be influenced by caregiver relationships (as measured by CCSERSS). Caregiver relationship factors (i.e., affection, engagement and sensitivity) directly impact the quality of the attachment children establish with them while living in AC. However, the relationships that caregivers establish with children under their care can be facilitated by good quality structural factors, particularly child-caregiver ratios. Copyright © 2017 Elsevier Ltd. All rights reserved.
Rubli Truchard, Eve; Rochat, Etienne; Pasquier, Jérôme; Monod, Stéfanie
2017-01-01
Objectives We investigated whether biopsychosocial and spiritual factors and satisfaction with care were associated with patients’ perceived quality of life. Design This was a cross-sectional analytical study. Setting Data were collected from inpatients at a postacute geriatric rehabilitation centre in a university hospital in Switzerland. Participants Participants aged 65 years and over were consecutively recruited from October 2014 to January 2016. Exclusion criteria included significant cognitive disorder and terminal illness. Of 227 eligible participants, complete data were collected from 167. Main outcome measures Perceived quality of life was measured using WHO Quality of Life Questionnaire—version for older people. Predictive factors were age, sex, functional status at admission, comorbidities, cognitive status, depressive symptoms, living conditions and satisfaction with care. A secondary focus was the association between spiritual needs and quality of life. Results Patients undergoing geriatric rehabilitation experienced a good quality of life. Greater quality of life was significantly associated with higher functional status (rs=0.204, p=0.011), better cognitive status (rs=0.175, p=0.029) and greater satisfaction with care (rs=0.264, p=0.003). Poorer quality of life was significantly associated with comorbidities (rs=−.226, p=0.033), greater depressive symptoms (rs=−.379, p<0.001) and unmet spiritual needs (rs=−.211, p=0.049). Multivariate linear regression indicated that depressive symptoms (β=−0.961; 95% CIs −1.449 to 0.472; p<0.001) significantly predicted quality of life. Conclusions Patient perceptions of quality of life were significantly associated with depression. More research is needed to assess whether considering quality of life could improve care plan creation. PMID:29061633
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
NASA Astrophysics Data System (ADS)
Tabataba-Vakili, Farsane; Roland, Iannis; Tran, Thi-Mo; Checoury, Xavier; El Kurdi, Moustafa; Sauvage, Sébastien; Brimont, Christelle; Guillet, Thierry; Rennesson, Stéphanie; Duboz, Jean-Yves; Semond, Fabrice; Gayral, Bruno; Boucaud, Philippe
2017-09-01
III-nitride-on-silicon L3 photonic crystal cavities with resonances down to 315 nm and quality factors (Q) up to 1085 at 337 nm have been demonstrated. The reduction of the quality factor with decreasing wavelength is investigated. Besides the quantum well absorption below 340 nm, a noteworthy contribution is attributed to the residual absorption present in thin AlN layers grown on silicon, as measured by spectroscopic ellipsometry. This residual absorption ultimately limits the Q factor to around 2000 at 300 nm when no active layer is present.
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.
NASA Astrophysics Data System (ADS)
Luangpaiboon, P.; Suwankham, Y.; Homrossukon, S.
2010-10-01
This research presents a development of a design of experiment technique for quality improvement in automotive manufacturing industrial. The quality of interest is the colour shade, one of the key feature and exterior appearance for the vehicles. With low percentage of first time quality, the manufacturer has spent a lot of cost for repaired works as well as the longer production time. To permanently dissolve such problem, the precisely spraying condition should be optimized. Therefore, this work will apply the full factorial design, the multiple regression, the constrained response surface optimization methods or CRSOM, and Taguchi's method to investigate the significant factors and to determine the optimum factor level in order to improve the quality of paint shop. Firstly, 2κ full factorial was employed to study the effect of five factors including the paint flow rate at robot setting, the paint levelling agent, the paint pigment, the additive slow solvent, and non volatile solid at spraying of atomizing spraying machine. The response values of colour shade at 15 and 45 degrees were measured using spectrophotometer. Then the regression models of colour shade at both degrees were developed from the significant factors affecting each response. Consequently, both regression models were placed into the form of linear programming to maximize the colour shade subjected to 3 main factors including the pigment, the additive solvent and the flow rate. Finally, Taguchi's method was applied to determine the proper level of key variable factors to achieve the mean value target of colour shade. The factor of non volatile solid was found to be one more additional factor at this stage. Consequently, the proper level of all factors from both experiment design methods were used to set a confirmation experiment. It was found that the colour shades, both visual at 15 and 45 angel of measurement degrees of spectrophotometer, were nearly closed to the target and the defective at quality gate was also reduced from 0.35 WDPV to 0.10 WDPV. This reveals that the objective of this research is met and this procedure can be used as quality improvement guidance for paint shop of automotive vehicle.
Quality factor concept in piezoceramic transformer performance description.
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.
Senarat, Upul; Gunawardena, Nalika S
2011-06-01
This study aimed to develop and validate an instrument to measure patient perception of quality of nursing care and related hospital services in a tertiary care setting. We compiled an instrument with 72 items that patients may perceive as quality of nursing care and related hospital services, following an extensive literature search, discussions with patients and care pro-I viders and a brainstorming session with an expert panel. A cross-sectional study was conducted at the National Hospital of Sri Lanka. A sample (n = 120) of patients stayed in general surgical or medical units responded to the interviewer administered instrument upon discharge. Item analysis and principal component factor analysis were performed to assess validity, and internal consistency was calculated to measure reliability. Of the 72 items, 18 had greater than 20% of responses as 'not relevant'. A further 11 items were eliminated since item-total correlations were less than .2. Factor analysis was performed on remaining 43 items which resulted in 36 items classifying into eight factors accounting for 71% of the variation. Factor loadings in the final solution after Varimax rotation were interpersonal aspects (.68-.85), efficiency (.62-.79), competency (.66-.68), comfort (.60-.84), physical environment (.65-.82), cleanliness (.81-.85), personalized information (.76-.83), and general instructions (.61-.78). The instrument had high Internal consistency (Cronbach's alpha = .91). We developed a comprehensive, reliable and valid, 36-item instrument that may be used to measure patient perception of quality of nursing care in tertiary care settings. Copyright © 2011 Korean Society of Nursing Science. Published by Elsevier B.V. All rights reserved.
USDA-ARS?s Scientific Manuscript database
The purpose of this study was to determine the effects of total, chocolate, or sugar candy consumption on intakes of total energy, fat, and added sugars; diet quality; weight/adiposity parameters; and risk factors for cardiovascular disease in children 2–13 years of age (n=7,049) and adolescents 14–...
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.
Sleep and eating behavior in adults at risk for type 2 diabetes.
Kilkus, Jennifer M; Booth, John N; Bromley, Lindsay E; Darukhanavala, Amy P; Imperial, Jacqueline G; Penev, Plamen D
2012-01-01
Insufficient quantity and quality of sleep may modulate eating behavior, everyday physical activity, overall energy balance, and individual risk of obesity and type 2 diabetes. We examined the association of habitual sleep quantity and quality with the self-reported pattern of eating behavior in 53 healthy urban adults with parental history of type 2 diabetes (30 F/23 M; mean (s.d.) age: 27 (4) years; BMI: 23.9 (2.3) kg/m(2)) while taking into consideration the amount of their everyday physical activity. Participants completed 13 (3) days of sleep and physical activity monitoring by wrist actigraphy and waist accelerometry while following their usual lifestyle at home. Overnight laboratory polysomnography was used to screen for sleep disorders. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index. Eating behavior was assessed using the original 51-item and the revised 18-item version of the Three-Factor Eating Questionnaire including measures of cognitive restraint, disinhibition, hunger, and uncontrolled and emotional eating. In multivariable regression analyses adjusted for age, BMI, gender, race/ethnicity, level of education, habitual sleep time measured by wrist actigraphy and physical activity measured by waist accelerometry, lower subjective sleep quality was associated with increased hunger, more disinhibited, uncontrolled and emotional eating, and higher cognitive restraint. There was no significant association between the amount of sleep measured by wrist actigraphy and any of these eating behavior factors. Our findings indicate that small decrements in self-reported sleep quality can be a sensitive indicator for the presence of potentially problematic eating patterns in healthy urban adults with familial risk for type 2 diabetes.
The development and validation of a neuropathy- and foot ulcer-specific quality of life instrument.
Vileikyte, Loretta; Peyrot, Mark; Bundy, Christine; Rubin, Richard R; Leventhal, Howard; Mora, Pablo; Shaw, Jonathan E; Baker, Paul; Boulton, Andrew J M
2003-09-01
The purpose of this study was to develop a questionnaire that measures patients' perceptions of the impact of diabetic peripheral neuropathy and foot ulcers on their quality of life and to assess the psychometric properties of this instrument in a sample of patients with varying severity and symptomatology of diabetic peripheral neuropathy. The neuropathy- and foot ulcer-specific quality of life instrument (NeuroQoL), generated from interviews with patients with (n = 47) and without (n = 15) diabetic peripheral neuropathy, was administered to 418 consecutive patients with diabetic peripheral neuropathy (35% with foot ulcer history) attending either U.K. (n = 290) or U.S. (n = 128) diabetes centers. Psychometric tests of NeuroQoL included factor analyses and internal consistency of scales; a series of multivariate analyses were performed to establish its criterion, construct, and incremental validity. Results were compared with those obtained using the Short Form (SF)-12 measure of health-related functioning. Factor analyses of NeuroQoL revealed three physical symptom measures and two psychosocial functioning measures with good reliability (alpha = 0.86-0.95). NeuroQoL was more strongly associated with measures of neuropathic severity than SF-12, more fully mediated the relationship of diabetic peripheral neuropathy with overall quality of life, and significantly increased explained variance in overall quality of life over SF-12. NeuroQoL reliably captures the key dimensions of the patients' experience of diabetic peripheral neuropathy and is a valid tool for studying the impact of neuropathy and foot ulceration on quality of life.
A new instrument to measure quality of life of heart failure family caregivers.
Nauser, Julie A; Bakas, Tamilyn; Welch, Janet L
2011-01-01
Family caregivers of heart failure (HF) patients experience poor physical and mental health leading to poor quality of life. Although several quality-of-life measures exist, they are often too generic to capture the unique experience of this population. The purpose of this study was to evaluate the psychometric properties of the Family Caregiver Quality of Life (FAMQOL) Scale that was designed to assess the physical, psychological, social, and spiritual dimensions of quality of life among caregivers of HF patients. Psychometric testing of the FAMQOL with 100 HF family caregivers was conducted using item analysis, Cronbach α, intraclass correlation, factor analysis, and hierarchical multiple regression guided by a conceptual model. Caregivers were predominately female (89%), white, (73%), and spouses (62%). Evidence of internal consistency reliability (α=.89) was provided for the FAMQOL, with item-total correlations of 0.39 to 0.74. Two-week test-retest reliability was supported by an intraclass correlation coefficient of 0.91. Using a 1-factor solution and principal axis factoring, loadings ranged from 0.31 to 0.78, with 41% of the variance explained by the first factor (eigenvalue=6.5). With hierarchical multiple regression, 56% of the FAMQOL variance was explained by model constructs (F8,91=16.56, P<.001). Criterion-related validity was supported by correlations with SF-36 General (r=0.45, P<.001) and Mental (r=0.59, P<.001) Health subscales and Bakas Caregiving Outcomes Scale (r=0.73, P<.001). Evidence of internal and test-retest reliability and construct and criterion validity was provided for physical, psychological, and social well-being subscales. The 16-item FAMQOL is a brief, easy-to-administer instrument that has evidence of reliability and validity in HF family caregivers. Physical, psychological, and social well-being can be measured with 4-item subscales. The FAMQOL scale could serve as a valuable measure in research, as well as an assessment tool to identify caregivers in need of intervention.
ERIC Educational Resources Information Center
Mail, Abdul; Pratikto; Suparman, Sudjito; Purnomo; Santoso, Budi
2014-01-01
The study aims to find out the influence of internal quality process on the growth of quality culture in private college. This study is treated toward 178 lecturers of 25 private colleges in Sulawesi, Indonesia by means of questionnaire. Confirmatory factor analysis applied to assess the reliability of validity and measurement model. Relationship…
Characterization of the nanoDot OSLD dosimeter in CT
Scarboro, Sarah B.; Cody, Dianna; Alvarez, Paola; Followill, David; Court, Laurence; Stingo, Francesco C.; Zhang, Di; Kry, Stephen F.
2015-01-01
Purpose: The extensive use of computed tomography (CT) in diagnostic procedures is accompanied by a growing need for more accurate and patient-specific dosimetry techniques. Optically stimulated luminescent dosimeters (OSLDs) offer a potential solution for patient-specific CT point-based surface dosimetry by measuring air kerma. The purpose of this work was to characterize the OSLD nanoDot for CT dosimetry, quantifying necessary correction factors, and evaluating the uncertainty of these factors. Methods: A characterization of the Landauer OSL nanoDot (Landauer, Inc., Greenwood, IL) was conducted using both measurements and theoretical approaches in a CT environment. The effects of signal depletion, signal fading, dose linearity, and angular dependence were characterized through direct measurement for CT energies (80–140 kV) and delivered doses ranging from ∼5 to >1000 mGy. Energy dependence as a function of scan parameters was evaluated using two independent approaches: direct measurement and a theoretical approach based on Burlin cavity theory and Monte Carlo simulated spectra. This beam-quality dependence was evaluated for a range of CT scanning parameters. Results: Correction factors for the dosimeter response in terms of signal fading, dose linearity, and angular dependence were found to be small for most measurement conditions (<3%). The relative uncertainty was determined for each factor and reported at the two-sigma level. Differences in irradiation geometry (rotational versus static) resulted in a difference in dosimeter signal of 3% on average. Beam quality varied with scan parameters and necessitated the largest correction factor, ranging from 0.80 to 1.15 relative to a calibration performed in air using a 120 kV beam. Good agreement was found between the theoretical and measurement approaches. Conclusions: Correction factors for the measurement of air kerma were generally small for CT dosimetry, although angular effects, and particularly effects due to changes in beam quality, could be more substantial. In particular, it would likely be necessary to account for variations in CT scan parameters and measurement location when performing CT dosimetry using OSLD. PMID:25832070
Characterization of the nanoDot OSLD dosimeter in CT
DOE Office of Scientific and Technical Information (OSTI.GOV)
Scarboro, Sarah B.; Graduate School of Biomedical Sciences, The University of Texas Health Science Center Houston, Houston, Texas 77030; The Methodist Hospital, Houston, Texas 77030
Purpose: The extensive use of computed tomography (CT) in diagnostic procedures is accompanied by a growing need for more accurate and patient-specific dosimetry techniques. Optically stimulated luminescent dosimeters (OSLDs) offer a potential solution for patient-specific CT point-based surface dosimetry by measuring air kerma. The purpose of this work was to characterize the OSLD nanoDot for CT dosimetry, quantifying necessary correction factors, and evaluating the uncertainty of these factors. Methods: A characterization of the Landauer OSL nanoDot (Landauer, Inc., Greenwood, IL) was conducted using both measurements and theoretical approaches in a CT environment. The effects of signal depletion, signal fading, dosemore » linearity, and angular dependence were characterized through direct measurement for CT energies (80–140 kV) and delivered doses ranging from ∼5 to >1000 mGy. Energy dependence as a function of scan parameters was evaluated using two independent approaches: direct measurement and a theoretical approach based on Burlin cavity theory and Monte Carlo simulated spectra. This beam-quality dependence was evaluated for a range of CT scanning parameters. Results: Correction factors for the dosimeter response in terms of signal fading, dose linearity, and angular dependence were found to be small for most measurement conditions (<3%). The relative uncertainty was determined for each factor and reported at the two-sigma level. Differences in irradiation geometry (rotational versus static) resulted in a difference in dosimeter signal of 3% on average. Beam quality varied with scan parameters and necessitated the largest correction factor, ranging from 0.80 to 1.15 relative to a calibration performed in air using a 120 kV beam. Good agreement was found between the theoretical and measurement approaches. Conclusions: Correction factors for the measurement of air kerma were generally small for CT dosimetry, although angular effects, and particularly effects due to changes in beam quality, could be more substantial. In particular, it would likely be necessary to account for variations in CT scan parameters and measurement location when performing CT dosimetry using OSLD.« less
Miller, Iben Marie; Vinding, Gabrielle; Zarchi, Kian; Esmann, Solveig; Murrell, Dedee F; Jemec, Gregor B
2016-04-01
Actinic keratosis (AK) negatively influences patient quality of life as measured by the disease-specific Actinic Keratosis Quality of Life (AKQoL) questionnaire. The quality of life in Australian patients was significantly less affected than in Danish patients. We hypothesize that general factors such as public awareness and cultural connotations of AK, may influence the impact of AK on quality of life (QoL).
Reichsman, Ann; Werner, James; Cella, Peggi; Bobiak, Sarah; Stange, Kurt C
2009-01-01
To identify barriers and opportunities for quality diabetes care in safety net practices. In 3 federally qualified health centers and 1 free clinic, 19 primary care clinicians profiled patient and visit characteristics and quality of care measures for 181 consecutive visits by adult type 2 diabetic patients. Open-ended questions assessed patient and clinician perception of barriers to diabetes care and patient report of enabling factors. A multidisciplinary team identified themes from open-ended responses. Logistic regression analyses assessed the association of the identified barriers/enablers with 2 measures of quality care: glycosylated hemoglobin and prophylactic aspirin use. Ranked barriers noted by patients included adherence (40%), financial/insurance (23%), and psychosocial (13%) factors. Clinicians ranked systemic factors, including financial/ insurance (32%) and cultural/psychosocial (29%) factors, as important to adherence (29%) in determining quality diabetes care. Patients reported dietary and medical adherence (37%) and family/health care worker support (17%) as helpful factors. Among 175 patients with available data, glycosylated hemoglobin levels were associated with patient report of financial/insurance factors both as a barrier when visits and medications were unaffordable and as an opportunity when free or low-cost medications and services were provided. Patients' adherence with aspirin prophylaxis was strongly associated with African American race, prior prescription of aspirin and distribution of aspirin at the practice site (p<.001). Patients were less likely than clinicians to identify systemic and contextual factors contributing to poor diabetes care. From the front line's perspective, enabling patient self-management and systemic support is a target for improving diabetes care in safety net practices.
van de Graaf, Elizabeth S; Borsboom, Gerard J J M; van der Sterre, Geertje W; Felius, Joost; Simonsz, Huibert J; Kelderman, Henk
2017-09-01
The Adult Strabismus Quality of Life Questionnaire (AS-20) and the Amblyopia & Strabismus Questionnaire (A&SQ) both measure health-related quality of life in strabismus patients. We evaluated to what extent these instruments cover similar domains by identifying the underlying quality-of-life factors of the combined questionnaires. Participants were adults from a historic cohort with available orthoptic childhood data documenting strabismus and/or amblyopia. They had previously completed the A&SQ and were now asked to complete the AS-20. Factor analysis was performed on the correlation-matrix of the combined AS-20 and A&SQ data to identify common underlying factors. The identified factors were correlated with the clinical variables of angle of strabismus, degree of binocular vision, and visual acuity of the worse eye. One hundred ten patients completed both questionnaires (mean age, 44 years; range, 38-51 years). Six factors were found that together explained 78% of the total variance. The factor structure was dominated by the first four factors. One factor contained psychosocial and social-contact items, and another factor depth-perception items from both questionnaires. A third factor contained seven items-only from the AS-20-on eye strain, stress, and difficulties with reading and with concentrating. A fourth factor contained seven items-only from the A&SQ-on fear of losing the better eye and visual disorientation, specific for amblyopia. Current visual acuity of the worse eye correlated with depth-perception items and vision-related items, whereas current binocular vision correlated with psychosocial and social-contact items, in 93 patients. Factor analysis suggests that the AS-20 and A&SQ measure a similar psychosocial quality-of-life domain. However, functional problems like avoidance of reading, difficulty in concentrating, eye stress, reading problems, inability to enjoy hobbies, and need for frequent breaks when reading are represented only in the AS-20. During the development of the A&SQ, asthenopia items were considered insufficiently specific for strabismus and were excluded a priori. The patients who generated the items for the AS-20 had, in majority, adulthood-onset strabismus and diplopia and were, hence, more likely to develop such complaints than our adult patients with childhood-onset strabismus and/or amblyopia.
Dimensions of patient satisfaction with comprehensive abortion care in Addis Ababa, Ethiopia.
Mossie Chekol, Bekalu; Abera Abdi, Dame; Andualem Adal, Tamirie
2016-12-07
Patient satisfaction is a measure of the extent to which a patient is content with the health care received from health care providers. It has been recognized as one of the most vital indicators of quality. Hence, it has been studied and measured extensively as part of service quality and as a standalone construct. In spite of this, there has been limited or no studies in Ethiopia that describe factors of abortion care contributed to women's satisfaction. This study aimed to identifying the underlying factors that contribute to patient satisfaction with comprehensive abortion care and at exploring relationships between total satisfaction scores and socio-demographic and care-related variables in Addis Ababa, Ethiopia. At the beginning of the study in-depth interviews with 16 participants and a focus group discussion of 8 participants were conducted consecutively at the time of discharge to generate questions used to evaluate women's satisfaction with abortion care. Following generation of the perceived indicators, expert review, pilot study, and item analysis were performed in order to produce the reduced and better 26 items used to measure abortion care satisfaction. A total sample size of 450 participants from eight health facilities completed the survey. Principal component exploratory factor analysis and confirmatory factor analysis were conducted respectively to identify and confirm the factors of abortion care contributing to women's satisfaction. Mean satisfaction scores were compared across socio demographic and care-related variables such as age, educational level, gestational age (first trimester and second trimester), and facility type using analysis of variance. Exploratory factor analysis of the 26 items indicated that satisfaction with abortion care consisted of five main components accounting for 60.48% of the variance in total satisfaction scores. Factor loadings of all items were found to be greater than 0.4. These factors are named as follows: "art of care" which means interpersonal relationships with the care-provider, "physical environment" which means the perceived quality of physical surroundings in which care is delivered, including cleanliness of facilities and equipment, "information" which means the information received related to abortion procedures, "privacy and confidentiality", "quality of care" which refers to technical quality of the care provider. Furthermore, analysis of variance showed that overall satisfaction is found to be related to facility type, relationship status, gestational age, and procedural type. The findings provided support that women's satisfaction with comprehensive abortion care has five major factors. Therefore, to improve the overall quality of comprehensive abortion care, attention should be given to the advancement of these components namely, positive interpersonal communication with care-receiver, pleasantness of physical environment, offering enough information related to the procedure, securing clients' privacy during counseling and treatment, and technical quality of the providers.
NASA Astrophysics Data System (ADS)
Chen, Yuan-Liu; Xu, Yanhao; Shimizu, Yuki; Matsukuma, Hiraku; Gao, Wei
2018-06-01
This paper presents a high quality-factor (Q-factor) quartz tuning fork (QTF) with a glass probe attached, used in frequency modulation tapping mode atomic force microscopy (AFM) for the surface profile metrology of micro and nanostructures. Unlike conventionally used QTFs, which have tungsten or platinum probes for tapping mode AFM, and suffer from a low Q-factor influenced by the relatively large mass of the probe, the glass probe, which has a lower density, increases the Q-factor of the QTF probe unit allowing it to obtain better measurement sensitivity. In addition, the process of attaching the probe to the QTF with epoxy resin, which is necessary for tapping mode AFM, is also optimized to further improve the Q-factor of the QTF glass probe. The Q-factor of the optimized QTF glass probe unit is demonstrated to be very close to that of a bare QTF without a probe attached. To verify the effectiveness and the advantages of the optimized QTF glass probe unit, the probe unit is integrated into a home-built tapping mode AFM for conducting surface profile measurements of micro and nanostructures. A blazed grating with fine tool marks of 100 nm, a microprism sheet with a vertical amplitude of 25 µm and a Fresnel lens with a steep slope of 90 degrees are used as measurement specimens. From the measurement results, it is demonstrated that the optimized QTF glass probe unit can achieve higher sensitivity as well as better stability than conventional probes in the measurement of micro and nanostructures.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kinoshita, N; Kita, A; Yoshioka, C
Purpose: Several clinical reference dosimetry protocols for absorbed-dose to water have recently been published: The American Association of Physicists in Medicine (AAPM) published an Addendum to the AAPM’s TG-51 (Addendum TG-51) in April 2014, and the Japan Society of Medical Physics (JSMP) published the Japan Society of Medical Physics 12 (JSMP12), a clinical reference dosimetry protocol, in September 2012. This investigation compared and evaluated the absorbed-dose to water of high-energy photon beams according to Addendum TG-51, International Atomic Energy Agency Technical Report Series No. 398 (TRS-398), and JSMP12. Methods: Differences in the respective beam quality conversion factors with Addendum TG-51,more » TRS-398, and JSMP12 were analyzed and the absorbed-dose to water using 6- and 10-MV photon beams was measured according to the protocols recommended in Addendum TG-51, TRS-398, and JSMP12. The measurements were conducted using two Farmer-type ionization chambers, Exradin A12 and PTW 30013. Results: The beam quality conversion factors for both the 6- and 10-MV photon beams with Addendum TG-51 were within 0.6%, in agreement with the beam quality conversion factors with TRS-398 and JSMP12. The Exradin A12 provided an absorbed-dose to water ratio from 1.003 to 1.006 with TRS-398 / Addendum TG-51 and from 1.004 to 1.005 with JSMP 12 / Addendum TG-51, whereas the PTW 30013 provided a ratio of 1.001 with TRS-398 / Addendum TG-51 and a range from 0.997 to 0.999 with JSMP 12 / Addendum TG-51. Conclusion: Despite differences in the beam quality conversion factor, no major differences were seen in the absorbed-dose to water with Addendum TG-51, TRS-398, and JSMP12. However, Addendum TG-51 provides the most recent data for beam quality conversion factors based on Monte Carlo simulation and greater detail for the measurement protocol. Therefore, the absorbed-dose to water measured with Addendum TG-51 is an estimate with less uncertainty.« less
Samsa, Greg; Matchar, David B; Dolor, Rowena J; Wiklund, Ingela; Hedner, Ewa; Wygant, Gail; Hauch, Ole; Marple, Cheryl Beadle; Edwards, Roger
2004-01-01
Background Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of anticoagulation management. We describe the development and preliminary validation of such an instrument – the Duke Anticoagulation Satisfaction Scale (DASS). Methods The DASS is a 25-item scale addressing the (a) negative impacts of anticoagulation (limitations, hassles and burdens); and (b) positive impacts of anticoagulation (confidence, reassurance, satisfaction). Each item has 7 possible responses. The DASS was administered to 262 patients currently receiving oral anticoagulation. Scales measuring generic quality of life, satisfaction with medical care, and tendency to provide socially desirable responses were also administered. Statistical analysis included assessment of item variability, internal consistency (Cronbach's alpha), scale structure (factor analysis), and correlations between the DASS and demographic variables, clinical characteristics, and scores on the above scales. A follow-up study of 105 additional patients assessed test-retest reliability. Results 220 subjects answered all items. Ceiling and floor effects were modest, and 25 of the 27 proposed items grouped into 2 factors (positive impacts, negative impacts, this latter factor being potentially subdivided into limitations versus hassles and burdens). Each factor had a high degree of internal consistency (Cronbach's alpha 0.78–0.91). The limitations and hassles factors consistently correlated with the SF-36 scales measuring generic quality of life, while the positive psychological impact scale correlated with age and time on anticoagulation. The intra-class correlation coefficient for test-retest reliability was 0.80. Conclusions The DASS has demonstrated reasonable psychometric properties to date. Further validation is ongoing. To the degree that dissatisfaction with anticoagulation leads to decreased adherence, poorer INR control, and poor clinical outcomes, the DASS has the potential to help identify reasons for dissatisfaction (and positive satisfaction), and thus help to develop interventions to break this cycle. As an instrument designed to be applicable across multiple models of anticoagulation management, the DASS could be crucial in the scientific comparison between those models of care. PMID:15132746
Chou, Kee-Lee; Wong, Winky K F; Chow, Nelson W S
2011-10-01
The goal of the current study is to examine the role of poor migration planning as a moderator for the effects of two post-migration factors, namely acculturation stress and quality of life, on symptoms of depression. Using a random sample of 347 Hong Kong new migrants from a 1-year longitudinal study, we used multiple regression analyses to examine both the direct and interaction effects of poorly planned migration, acculturation stress, and quality of life on depressive symptoms. Although poorly planned migration did not predict depressive symptoms at 1-year follow-up, it did exacerbate the detrimental effect of the two post-migration factors, namely high stress or low quality of life (both also measured at baseline) on depressive symptoms at this stage. Our results indicate that preventive measures must be developed for new immigrants in Hong Kong, especially for those who were not well prepared for migration.
Does point-of-purchase nutrition labeling influence meal selections? A test in an Army cafeteria.
Sproul, Allen D; Canter, Deborah D; Schmidt, Jeffrey B
2003-07-01
This study assessed the effectiveness of nutrition labeling on sales of targeted entrees and measured the perceived influence that factors such as taste, quality, appearance, fat content, calorie content, and price had on meal selection behavior within an Army cafeteria. A quasi-experimental design was used to compare targeted entrée sales between a 1-year baseline period and two 30-day postintervention periods, after the placement of entrée nutrition labels. A brief questionnaire, distributed to 149 patrons, measured the perceived influence of the aforementioned factors on selections. Analysis of variance detected no significant differences in sales between baseline and the two intervention periods; the factors of taste and quality were rated most influential to meal selection (p < 0.000). A marketing campaign focusing on the health attributes of targeted entrée items was not successful in boosting sales. Sensory attributes (i.e., taste, quality, and appearance) appear to be more influential to meal selection.
Physiological ICSI (PICSI) vs. Conventional ICSI in Couples with Male Factor: A Systematic Review.
Avalos-Durán, Georgina; Ángel, Ana María Emilia Cañedo-Del; Rivero-Murillo, Juana; Zambrano-Guerrero, Jaime Enoc; Carballo-Mondragón, Esperanza; Checa-Vizcaíno, Miguel Ángel
2018-04-19
To determine the efficacy of the physiological ICSI technique (PICSI) vs. conventional ICSI in the prognosis of couples, with respect to the following outcome measures: live births, clinical pregnancy, implantation, embryo quality, fertilization and miscarriage rates. A systematic review of the literature, extracting raw data and performing data analysis. Patient(s): Couples with the male factor, who were subjected to in-vitro fertilization. Main Outcome Measures: rates of live births, clinical pregnancy, implantation, embryo quality, fertilization and miscarriage. In the systematic search, we found 2,918 studies and an additional study from other sources; only two studies fulfilled the inclusion criteria for this systematic review. The rates of live births, clinical pregnancy, implantation, embryo quality, fertilization and miscarriage were similar for both groups. There is no statistically significant difference between PICSI vs. ICSI, for any of the outcomes analyzed in this study. Enough information is still not available to prove the efficacy of the PICSI technique over ICSI in couples with male factor.
Goff, Sarah L; Mazor, Kathleen M; Guhn-Knight, Haley; Budway, Yara Youssef; Murphy, Lorna; White, Katharine O; Lagu, Tara; Pekow, Penelope S; Priya, Aruna; Lindenauer, Peter K
2017-12-01
Pediatric practices' scores on healthcare quality measures are increasingly available to the public. However, patients from low-income and racial/ethnic minority populations rarely use these data. We sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. As part of a randomized trial to overcome barriers to using quality data, we recruited women from a prenatal clinic serving an underserved population. Women reported how much 12 factors mattered when they chose a pediatric practice (5-point Likert scale), what other factors mattered to them, and which factors mattered the most. We assessed whether factor importance varied with selected participant characteristics and qualitatively analyzed the "other" factors named. Participants' (n = 367) median age was 23 years, and they were largely Hispanic (60.4%), white (21.2%), or black (16.9%). Insurance acceptance "mattered a lot" to the highest percentage of women (93.2%), while online information about what other parents think of a practice "mattered a lot" to the fewest (7.4%). Major themes from our qualitative analysis of "other" factors that mattered included physicians' interpersonal skills and pediatrician-specific traits. Factors related to access "mattered the most" to the majority of women. Pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics. Aligning both the content and delivery of publicly reported quality data with women's interests may increase use of pediatric quality data. Clinicaltrials.gov NCT01784575.
Multivariate Analyses of Quality Metrics for Crystal Structures in the PDB Archive.
Shao, Chenghua; Yang, Huanwang; Westbrook, John D; Young, Jasmine Y; Zardecki, Christine; Burley, Stephen K
2017-03-07
Following deployment of an augmented validation system by the Worldwide Protein Data Bank (wwPDB) partnership, the quality of crystal structures entering the PDB has improved. Of significance are improvements in quality measures now prominently displayed in the wwPDB validation report. Comparisons of PDB depositions made before and after introduction of the new reporting system show improvements in quality measures relating to pairwise atom-atom clashes, side-chain torsion angle rotamers, and local agreement between the atomic coordinate structure model and experimental electron density data. These improvements are largely independent of resolution limit and sample molecular weight. No significant improvement in the quality of associated ligands was observed. Principal component analysis revealed that structure quality could be summarized with three measures (Rfree, real-space R factor Z score, and a combined molecular geometry quality metric), which can in turn be reduced to a single overall quality metric readily interpretable by all PDB archive users. Copyright © 2017 Elsevier Ltd. All rights reserved.
Sanjeevi, Namrata; Freeland-Graves, Jeanne; Hersh, Matthew
2018-06-01
Obesity is a public health problem that disproportionately affects low-income populations. Moreover, participation in Supplemental Nutrition Assistance Program (SNAP) has been associated with obesity among low-income women. The goal of this study was to determine the impact of intrapersonal, home environment, community and social factors on diet quality and body mass index (BMI) of low-income women participating in SNAP. This study also aimed to examine the role of these factors in mediating the relationship between food insecurity and diet quality, and BMI. A total of 152 women receiving SNAP benefits were recruited from low-income neighborhood centers and housing communities, and administered a demographics questionnaire, the United States adult food security scale, food frequency questionnaire, and multi-dimensional home environment scale (MHES). They also were measured for height and weight to calculate BMI. The Dietary Guidelines Adherence Index 2015 was used to measure diet quality. Regression analyses were conducted to determine the MHES subscales that were significant predictors of diet quality and BMI. The Preacher and Hayes mediation model was used to evaluate the mediation of the relationship between food insecurity and diet quality, and BMI by the MHES. Emotional eating resistance and favorable social eating behaviors were positively associated with diet quality; whereas emotional eating resistance, lower availability of unhealthy food at home, neighborhood safety and favorable social eating behaviors were inversely associated with BMI in women participating in SNAP. The MHES significantly mediated the relationship between food insecurity and BMI. These results emphasize the importance of intrapersonal, home environment, community and social factors in mediating the relationship between food insecurity and BMI in low-income women. Copyright © 2018 Elsevier Ltd. All rights reserved.
Hendry, Melissa C; Douglas, Kevin S; Winter, Elizabeth A; Edens, John F
2013-01-01
Much of the risk assessment literature has focused on the predictive validity of risk assessment tools. However, these tools often comprise a list of risk factors that are themselves complex constructs, and focusing on the quality of measurement of individual risk factors may improve the predictive validity of the tools. The present study illustrates this concern using the Antisocial Features and Aggression scales of the Personality Assessment Inventory (Morey, 1991). In a sample of 1,545 prison inmates and offenders undergoing treatment for substance abuse (85% male), we evaluated (a) the factorial validity of the ANT and AGG scales, (b) the utility of original ANT and AGG scales and newly derived ANT and AGG scales for predicting antisocial outcomes (recidivism and institutional infractions), and (c) whether items with a stronger relationship to the underlying constructs (higher factor loadings) were in turn more strongly related to antisocial outcomes. Confirmatory factor analyses (CFAs) indicated that ANT and AGG items were not structured optimally in these data in terms of correspondence to the subscale structure identified in the PAI manual. Exploratory factor analyses were conducted on a random split-half of the sample to derive optimized alternative factor structures, and cross-validated in the second split-half using CFA. Four-factor models emerged for both the ANT and AGG scales, and, as predicted, the size of item factor loadings was associated with the strength with which items were associated with institutional infractions and community recidivism. This suggests that the quality by which a construct is measured is associated with its predictive strength. Implications for risk assessment are discussed. Copyright © 2013 John Wiley & Sons, Ltd.
Azouvi, Philippe; Ghout, Idir; Bayen, Eleonore; Darnoux, Emmanuelle; Azerad, Sylvie; Ruet, Alexis; Vallat-Azouvi, Claire; Pradat-Diehl, Pascale; Aegerter, Philippe; Charanton, James; Jourdan, Claire
2016-01-01
To assess predictors and indicators of disability and quality-of-life 4 years after severe traumatic brain injury (TBI), using structural equation modelling (SEM). The PariS-TBI study is a longitudinal multi-centre inception cohort study of 504 patients with severe TBI. Among 245 survivors, 147 patients were evaluated upon 4-year follow-up, and 85 completed the full assessment. Two outcome measures were analysed separately using SEM: the Glasgow Outcome Scale-extended (GOS-E), to measure disability, and the QOLIBRI, to assess quality-of-life. Four groups of variables were entered in the model: demographics; injury severity; mood and cognitive impairments; somatic impairments. The GOS-E was directly significantly related to mood and cognition, injury severity, and somatic impairments. Age and education had an indirect effect, mediated by mood/cognition or somatic deficiencies. In contrast, the only direct predictor of QOLIBRI was mood and cognition. Age and somatic impairments had an indirect influence on the QOLIBRI. Although this study should be considered as explorative, it suggests that disability and quality-of-life were directly influenced by different factors. While disability appeared to result from an interaction of a wide range of factors, quality-of-life was solely directly related to psycho-cognitive factors.
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.
The applicability of SERVQUAL in different health care environments.
Dean, A M
1999-01-01
This paper reports on a study that investigates the applicability of a modified SERVQUAL instrument as a means of measuring service quality in two types of health service environments; medical care and health care (incorporating medical, social, cognitive and emotional elements). The research confirms a four factor structure that is stable for both environments, and similar to the service quality dimensions recognised in the literature. However, the relative importance of the dimensions of quality is inconsistent for the two types of health services. These results confirm the suggestion that importance values should be part of the measurement tool. Finally, the extra diagnostic advantage achieved by the use of gap scores to measure service quality, when compared to perception only scores is demonstrated.
Quality of life in Essential Tremor Questionnaire (QUEST): development and initial validation.
Tröster, Alexander I; Pahwa, Rajesh; Fields, Julie A; Tanner, Caroline M; Lyons, Kelly E
2005-09-01
Essential tremor (ET) can diminish functioning and quality of life (QOL) but generic QOL measures may be relatively insensitive to ET and its therapies. We sought to develop an ET-specific measure that might be more sensitive, acceptable to patients, relatively brief, and easily used. A sample of 200 patients (average age 70 years, range 30-91; average disease duration 15 years) rated the extent to which tremor impacts a function or state, tremor severity in various body parts, perceived health, and overall QOL. Responses to this initial questionnaire were subjected to principal components analysis (PCA). Inspection of factor coordinates, Eigenvalues, variance accounted for, and correlation matrices were used to select items for confirmatory PCA. Final scale reliability was assessed using Cronbach's alpha. Validity was evaluated by correlations between QOL scales and self-rated tremor severity. PCA of 65 initial items yielded 11 factors accounting for 71% of variance. Six factors were discarded. Two items were eliminated for not loading on a factor and 33 for perceived redundancy. Confirmatory PCA of the retained 30 items yielded an almost identical factor structure (six factors, 70% of variance accounted for, and similar item loadings). Because two factors had very few items loading on them, these two factors were combined into one scale. The final measure has five scales: Physical, Psychosocial, Communication, Hobbies/Leisure, and Work/Finance. Reliability was excellent for the whole instrument and four scales (> or =0.89), and good for the Work/Finance scale (0.79). Severity of voice and head tremor were the best correlates of Communication (0.70 and 0.35), while the Physical scale was related to right and left upper extremity tremor (0.59 and 0.56). Scales correlated more highly with patients' rating of their overall QOL than their health perception. A brief, 30-item, ET-specific QOL scale with excellent reliability was developed. Preliminary validity data are encouraging. The Quality of Life in Essential Tremor Questionnaire (QUEST) promises to facilitate QOL measurement in ET.
ERIC Educational Resources Information Center
Buell, Martha; Han, Myae; Vukelich, Carol
2017-01-01
Early care and education programme quality is usually assessed at the classroom level. One such measure of classroom quality is the classroom assessment scoring system (CLASS). In an effort to ensure higher quality programming, the CLASS is being used to direct teacher professional development. However, there has been relatively little research on…
Child and Adult Factors Related to Quality of Life in Adults with Autism
ERIC Educational Resources Information Center
Moss, Philippa; Mandy, William; Howlin, Patricia
2017-01-01
The WHO Quality of Life-Brief questionnaire was used to assess quality of life (QoL) among 52 adults with autism (mean age 49 years) followed-up since childhood. Overall, assessments of QOL were more positive than measures of objective social outcome (jobs, independence, relationships etc.) but correlations between caregiver and self-reports were…
Rural-Urban Analyses of Health-Related Quality of Life among People with Multiple Sclerosis
ERIC Educational Resources Information Center
Buchanan, Robert J.; Zhu, Li; Schiffer, Randolph; Radin, Dagmar; James, Wesley
2008-01-01
Context: Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. Purpose: To…
Measuring Educational Quality by Appraising Theses and Dissertations: Pitfalls and Remedies
ERIC Educational Resources Information Center
Hamilton, Patti; Johnson, Robert; Poudrier, Chelsey
2010-01-01
In this paper, we argue that, as indicators of the educational quality of graduate degree programs, student theses and dissertations are best used in specific contexts. High-quality theses and dissertations, that is, may be the result of factors such as verbal skills students already possessed at admission or of complex interactions between…
[Influence of demographic and socioeconomic characteristics on the quality of life].
Grbić, Gordana; Djokić, Dragoljub; Kocić, Sanja; Mitrašinović, Dejan; Rakić, Ljiljana; Prelević, Rade; Krivokapić, Žarko; Miljković, Snežana
2011-01-01
The quality of life is a multidimensional concept, which is best expressed by the subjective well-being. Evaluation of the quality of life is the basis for measuring the well-being, and the determination of factors that determine the quality of life quality is the basis for its improvement. To evaluate and assess the determinants of the perceived quality of life of group distinguishing features which characterize demographic and socioeconomic factors. This was a cross-sectional study of a representative sample of the population in Serbia aged over 20 years (9479 examinees). The quality of life was expressed by the perception of well-being (pleasure of life). Data on the examinees (demographic and socioeconomic characteristics) were collected by using a questionnaire for adults of each household. To process, analyze and present the data, we used the methods of parametric descriptive statistics (mean value, standard deviation, coefficient of variation), variance analysis and factor analysis. Although men evaluated the quality of life with a slightly higher grading, there was no statistically significant difference in the evaluation of the quality of life in relation to the examinee's gender (p > 0.005). Among the examinees there was a high statistically significant difference in grading the quality of life depending on age, level of education, marital status and type of job (p < 0.001). In relation to the number of children, there was no statistically significant difference in he grading of the quality of life (p > 0.005). The quality of life is influenced by numerous factors that characterize each person (demographic and socioeconomic characteristics of individual). Determining factors of the quality of life are numerous and diverse, and the manner and the strength of their influence are variable.
Kirouac, Megan; Stein, Elizabeth R; Pearson, Matthew R; Witkiewitz, Katie
2017-11-01
Quality of life is an outcome often examined in treatment research contexts such as biomedical trials, but has been studied less often in alcohol use disorder (AUD) treatment. The importance of considering QoL in substance use treatment research has recently been voiced, and measures of QoL have been administered in large AUD treatment trials. Yet, the viability of popular QoL measures has never been evaluated in AUD treatment samples. Accordingly, the present manuscript describes a psychometric examination of and prospective changes in the World Health Organization Quality of Life measure (WHOQOL-BREF) in a large sample (N = 1383) of patients with AUD recruited for the COMBINE Study. Specifically, we examined the construct validity (via confirmatory factor analyses), measurement invariance across time, internal consistency reliability, convergent validity, and effect sizes of post-treatment changes in the WHOQOL-BREF. Confirmatory factor analyses of the WHOQOL-BREF provided acceptable fit to the current data and this model was invariant across time. Internal consistency reliability was excellent (α > .9) for the full WHOQOL-BREF for each timepoint; the WHOQOL-BREF had good convergent validity, and medium effect size improvements were found in the full COMBINE sample across time. These findings suggest that the WHOQOL-BREF is an appropriate measure to use in samples with AUD, that the WHOQOL-BREF scores may be examined over time (e.g., from pre- to post-treatment), and the WHOQOL-BREF may be used to assess improvements in quality of life in AUD research.
Understanding Consumer Perceptions and Awareness of Hospital-Based Maternity Care Quality Measures.
Maurer, Maureen; Firminger, Kirsten; Dardess, Pam; Ikeler, Kourtney; Sofaer, Shoshanna; Carman, Kristin L
2016-06-01
To explore factors that may influence use of comparative public reports for hospital maternity care. Four focus groups conducted in 2013 with 41 women and preintervention survey data collected in 2014 to 2015 from 245 pregnant women in North Carolina. As part of a larger randomized controlled trial, we conducted qualitative formative research to develop an intervention that will be evaluated through pre- and postintervention surveys. Analysis of focus group transcripts examined participants' perceptions of high-quality maternity care and the importance of different quality measures. Quantitative analysis included descriptive results of the preintervention survey and subgroup analyses to examine the impact of race, education, and being a first-time mom on outcomes. When describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care." At baseline, 28 percent of survey respondents had used quality information to choose a hospital. Survey respondents were more aware of some quality measures (e.g., breastfeeding support) than others (e.g., episiotomy rates). Public reporting efforts could help increase relevance of maternity care quality measures by creating measures that reflect women's concerns, clearly explaining the hospital's role in supporting quality care, and showing how available quality measures can inform decisions about childbirth. © Health Research and Educational Trust.
Porous silicon ring resonator for compact, high sensitivity biosensing applications
Rodriguez, Gilberto A.; Hu, Shuren; Weiss, Sharon M.
2015-01-01
A ring resonator is patterned on a porous silicon slab waveguide to produce a compact, high quality factor biosensor with a large internal surface area available for enhanced recognition of biological and chemical molecules. The porous nature of the ring resonator allows molecules to directly interact with the guided mode. Quality factors near 10,000 were measured for porous silicon ring resonators with a radius of 25 μm. A bulk detection sensitivity of 380 nm/RIU was measured upon exposure to salt water solutions. Specific detection of nucleic acid molecules was demonstrated with a surface detection sensitivity of 4 pm/nM.
Weinstein, Dana; Bhave, Sunil A
2010-04-14
This paper introduces the resonant body transistor (RBT), a silicon-based dielectrically transduced nanoelectromechanical (NEM) resonator embedding a sense transistor directly into the resonator body. Combining the benefits of FET sensing with the frequency scaling capabilities and high quality factors (Q) of internal dielectrically transduced bar resonators, the resonant body transistor achieves >10 GHz frequencies and can be integrated into a standard CMOS process for on-chip clock generation, high-Q microwave circuits, fundamental quantum-state preparation and observation, and high-sensitivity measurements. An 11.7 GHz bulk-mode RBT is demonstrated with a quality factor Q of 1830, marking the highest frequency acoustic resonance measured to date on a silicon wafer.
Measurement system with high accuracy for laser beam quality.
Ke, Yi; Zeng, Ciling; Xie, Peiyuan; Jiang, Qingshan; Liang, Ke; Yang, Zhenyu; Zhao, Ming
2015-05-20
Presently, most of the laser beam quality measurement system collimates the optical path manually with low efficiency and low repeatability. To solve these problems, this paper proposed a new collimated method to improve the reliability and accuracy of the measurement results. The system accuracy controlled the position of the mirror to change laser beam propagation direction, which can realize the beam perpendicularly incident to the photosurface of camera. The experiment results show that the proposed system has good repeatability and the measuring deviation of M2 factor is less than 0.6%.
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
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.
Selective corneal optical aberration (SCOA) for customized ablation
NASA Astrophysics Data System (ADS)
Jean, Benedikt J.; Bende, Thomas
2001-06-01
Wavefront analysis still have some technical problems which may be solved within the next years. There are some limitations to use wavefront as a diagnostic tool for customized ablation alone. An ideal combination would be wavefront and topography. Meanwhile Selective Corneal Aberration is a method to visualize the optical quality of a measured corneal surface. It is based on a true measured 3D elevation information of a video topometer. Thus values can be interpreted either using Zernike polynomials or visualized as a so called color coded surface quality map. This map gives a quality factor (corneal aberration) for each measured point of the cornea.
Collett, David; Friend, Peter J; Watson, Christopher J E
2017-04-01
A measure of donor liver quality, the donor liver index, was developed and validated for the UK population of transplant recipients. Unlike previously proposed measures, this index is only based on variables that are available at the point of retrieval, and so does not include cold ischemic time. Indices of liver quality were based on data from the UK Transplant Registry on all 7929 liver transplants between January 2000 and December 2014. The donor liver index (DLI) was based on factors shown to affect graft survival, which included donor age, sex, height, type (donor after brain death or circulatory death), bilirubin, smoking history, and whether the liver was split. A separate index (DLI1) looking at 1-year survival showed donor cardiac disease, black ethnicity, and steatosis to be additional risk factors. A strong association was found between DLI and whether or not a surgeon accepts an offered liver for transplant, with a marked fall in acceptance rates for livers with an index greater than 1.31. Since 2000, there has been a notable reduction in the quality of livers transplanted, coupled with variation between the 7 UK liver transplant centers in risk appetite. The DLI is an index of liver quality which enables analysis of the changing trends in liver quality and center behavior. DLI1 enables identification of factors affecting shorter-term survival, and perhaps identifies a cohort of livers that may benefit from novel preservation technologies.
Structural and reliability analysis of quality of relationship index in cancer patients.
Cousson-Gélie, Florence; de Chalvron, Stéphanie; Zozaya, Carole; Lafaye, Anaïs
2013-01-01
Among psychosocial factors affecting emotional adjustment and quality of life, social support is one of the most important and widely studied in cancer patients, but little is known about the perception of support in specific significant relationships in patients with cancer. This study examined the psychometric properties of the Quality of Relationship Inventory (QRI) by evaluating its factor structure and its convergent and discriminant validity in a sample of cancer patients. A total of 388 patients completed the QRI. Convergent validity was evaluated by testing the correlations between the QRI subscales and measures of general social support, anxiety and depression symptoms. Discriminant validity was examined by testing group comparison. The QRI's longitudinal invariance across time was also tested. Principal axis factor analysis with promax rotation identified three factors accounting for 42.99% of variance: perceived social support, depth, and interpersonal conflict. Estimates of reliability with McDonald's ω coefficient were satisfactory for all the QRI subscales (ω ranging from 0.75 - 0.85). Satisfaction from general social support was negatively correlated with the interpersonal conflict subscale and positively with the depth subscale. The interpersonal conflict and social support scales were correlated with depression and anxiety scores. We also found a relative stability of QRI subscales (measured 3 months after the first evaluation) and differences between partner status and gender groups. The Quality of Relationship Inventory is a valid tool for assessing the quality of social support in a particular relationship with cancer patients.
Measuring the quality of health care: state of the art.
Donaldson, M S; Nolan, K
1997-05-01
September 12-13, 1996, in Washington, DC, the Institute of Medicine, as part of its Special Initiative on Health Care Quality, held an invitational conference to illustrate exemplary quality measurement and to discuss the results. Patient reports, innovative uses of outcome measures for quality improvement, risk adjustment, assessment in integrated health plans and health care settings, clinical guidelines, and projects on disseminating information on quality measurement techniques and tools were among the topics represented. Brent James described studies undertaken to reduce adverse drug events (ADEs). When implementing any measurement system where error is a possible factor, it is important to emphasize identifying problems for the purpose of learning, not judgment. Lucian Leape agreed that staff involved must feel that the purpose of the study is to examine system problems, not individuals' mistakes. David Classen described a nonproprietary computerized disease-management program designed to reduce ADEs in infectious diseases. "A QUALITY VISION": Robert Brook said that the relationship between cost or resources devoted to care and quality is not well understood and is certainly not simple. He also said that although investments in measurement strategies are needed to make them better, that doesn't mean we shouldn't attempt to use the measurements we have now. Mark Chassin said that the presentations at the conference provided evidence that should allow us to conclude beyond a reasonable doubt that quality can be measured-with a degree of scientific precision equal to that of most of the measures used to take care of patients every day.
Primary care physicians' use of family history for cancer risk assessment
2010-01-01
Background Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions. Methods Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH. Results Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure. Conclusions Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions. PMID:20525302
Primary care physicians' use of family history for cancer risk assessment.
Flynn, Brian S; Wood, Marie E; Ashikaga, Takamaru; Stockdale, Alan; Dana, Greg S; Naud, Shelly
2010-06-03
Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions. Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH. Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure. Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions.
Medical information on the internet: a tool for measuring consumer perception of quality aspects.
Dubowicz, Arthur; Schulz, Peter J
2015-03-30
Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the "online-diagnosers" independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<.001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. The scale reliably distinguished high- and low-quality of medical advice given on websites.
2013-01-01
Background Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. Study selection: To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or its effectiveness). Forty instruments were included for full review, many with a strong theoretical basis. Evidence supporting measurement properties was limited. Conclusions Existing instruments cover many of the factors hypothesized to contribute to QI success. With further testing, use of these instruments measuring team factors in evaluations could aid our understanding of the influence of teamwork on CQI outcomes. Greater consistency in the factors measured and choice of measurement instruments is required to enable synthesis of findings for informing policy and practice. PMID:23410500
Identifying Items to Assess Methodological Quality in Physical Therapy Trials: A Factor Analysis
Cummings, Greta G.; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd
2014-01-01
Background Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. Objective The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). Design A methodological research design was used, and an EFA was performed. Methods Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Results Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Limitation Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. Conclusions To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor analysis of these results are needed to validate these items. PMID:24786942
Identifying items to assess methodological quality in physical therapy trials: a factor analysis.
Armijo-Olivo, Susan; Cummings, Greta G; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd
2014-09-01
Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). A methodological research design was used, and an EFA was performed. Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor analysis of these results are needed to validate these items. © 2014 American Physical Therapy Association.
Farina, Nicolas; Page, Thomas E; Daley, Stephanie; Brown, Anna; Bowling, Ann; Basset, Thurstine; Livingston, Gill; Knapp, Martin; Murray, Joanna; Banerjee, Sube
2017-05-01
Family carers of people with dementia are their most important support in practical, personal, and economic terms. Carers are vital to maintaining the quality of life (QOL) of people with dementia. This review aims to identify factors related to the QOL of family carers of people with dementia. Searches on terms including "carers," "dementia," "family," and "quality of life" in research databases. Findings were synthesized inductively, grouping factors associated with carer QOL into themes. A total of 909 abstracts were identified. Following screening, lateral searches, and quality appraisal, 41 studies (n = 5539) were included for synthesis. A total of 10 themes were identified: demographics; carer-patient relationship; dementia characteristics; demands of caring; carer health; carer emotional well-being; support received; carer independence; carer self-efficacy; and future. The quality and level of evidence supporting each theme varied. We need further research on what factors predict carer QOL in dementia and how to measure it. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Validation of the "Quality of Life in School" instrument in Canadian elementary school students.
Ghotra, Satvinder; McIsaac, Jessie-Lee D; Kirk, Sara F L; Kuhle, Stefan
2016-01-01
Background. School is an integral component of the life of a child, and thus quality of school life is an important part of the overall quality of life experienced by a child. There are a few instruments available to measure the quality of school life but they are often not available in English, or they are not appropriate for use alongside other instruments in a survey of young children. The Quality of Life in School (QoLS) instrument is a short, self-report measure to assess elementary school students' perception of their quality of school life in four domains. The instrument was developed in Israel and has been validated among Hebrew-speaking children. The aim of the current study was to evaluate the psychometric properties of the QoLS measure in Canadian elementary school children. Methods. A total of 629 children attending grades 4-6 were recruited in a population-based cross-sectional study. The QoLS measure was administered to participating children by trained research assistants. In addition, their socio-demographic details and academic data were also obtained. The psychometric testing included exploratory factor analysis and reliability estimation using internal consistency (Cronbach's Alpha). Construct validity was investigated using the known groups comparisons for discriminative validity and via convergent validity. Results. A four-factor structure was generated explaining 39% of the total variance in the model. The results showed good internal consistency and acceptable floor and ceiling effects. Cronbach's Alpha ranged from 0.75 to 0.93. Known groups comparisons showed that the QoLS measure discriminated well between subgroups on the basis of gender, grade, and academic achievement, thus providing evidence of construct validity. The convergent validity was also appropriate with all the four domains demonstrating moderate to strong correlations to each other and to the total QoLS score. Conclusions. QoLS appears to be a valid and reliable measure for quality of school life assessment in young Canadian children.
ERIC Educational Resources Information Center
Edwards, Mark Evan; Weber, Bruce; Bernell, Stephanie
2007-01-01
An existing measure of food insecurity with hunger in the United States may serve as an effective indicator of quality of life. State level differences in that measure can reveal important differences in quality of life across places. In this study, we advocate and demonstrate two simple methods by which analysts can explore state-specific…
Evaluation of diet quality of the elderly and associated factors.
Pinto de Souza Fernandes, Dalila; Duarte, Maria Sônia Lopes; Pessoa, Milene Cristine; Franceschini, Sylvia do Carmo Castro; Ribeiro, Andréia Queiroz
2017-09-01
Observational studies suggest healthy dietary patterns are associated with risk reduction and better control of various chronic diseases. However, few Brazilian studies have focused on evaluating the quality of the elderly diet and its relationship with diseases. This study aimed to estimate the association between diet quality and socioeconomic factors, health and nutrition of the elderly. This is a cross-sectional population-based study whose target population were non-institutionalized elderly residents in the city of Viçosa, Brazil. Anthropometric, socioeconomic, health conditions, lifestyle and food consumption variables were obtained from a semi-structured questionnaire. The quality of the diet was assessed by the revised Healthy Eating Index classified into tertiles, considering the first tertile as "Poor diet quality," the second as 'Intermediate diet quality' and the third as "Better diet quality." To identify factors independently associated with diet quality model, the works used multinomial logistic regression. In the results of the multivariate analysis, the factors independently associated with "better diet quality" included female gender, higher education, history of one to five medical visits in the past year, history of diabetes mellitus, dyslipidemia and the use of polypharmacy. Our results show that most seniors need to improve the quality of their diet and those of male gender with no or little education, and those who do not seek medical services constitute the group that needs attention concerning the measures to improve the quality of their diet. Copyright © 2017 Elsevier B.V. All rights reserved.
Conway, Lauryn; Widjaja, Elysa; Smith, Mary Lou; Speechley, Kathy N; Ferro, Mark A
2017-04-01
The aim of this study was to validate the newly developed shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) in a sample of children with drug-resistant epilepsy. Data came from 136 children enrolled in the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PEPSQOL), a multicenter prospective cohort study. Confirmatory factor analysis was used to assess the higher-order factor structure of the QOLCE-55. Convergent and divergent validity was assessed by correlating subscales of the KIDSCREEN-27 with the QOLCE-55. Measurement equivalence of the QOLCE-55 was evaluated using multiple-group confirmatory factor analysis of children with drug-resistant epilepsy from PEPSQOL versus children with new-onset epilepsy from HERQULES (Health-Related Quality of Life in Children with Epilepsy Study). The higher-order factor structure of the QOLCE-55 demonstrated adequate fit: Comparative Fit Index (CFI) = 0.948; Tucker-Lewis Index (TLI) = 0.946; Root Mean Square of Approximation (RMSEA) = 0.060 (90% confidence interval [CI] 0.054-0.065); Weighted Root Mean Square Residuals (WRMR) = 1.247. Higher-order factor loadings were strong, ranging from λ = 0.74 to 0.81. Internal consistency reliability was excellent (α = 0.97, subscales α > 0.82). QOLCE-55 subscales demonstrated moderate to strong correlations with similar subscales of the KIDSCREEN-27 (ρ = 0.43-0.75) and weak to moderate correlations with dissimilar subscales (ρ = 0.25-0.42). The QOLCE-55 demonstrated partial measurement equivalence at the level of strict invariance - χ 2 (2,823) = 3,727.9, CFI = 0.961, TLI = 0.962, RMSEA = 0.049 (0.044, 0.053), WRMR = 1.834. The findings provide support for the factor structure of the QOLCE-55 and contribute to its robust psychometric profile as a reliable and valid measure. Researchers and health practitioners should consider the QOLCE-55 as a viable option for reducing respondent burden when assessing health-related quality of life in children with epilepsy. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.
Tsiligianni, Ioanna; Kocks, Janwillem; Tzanakis, Nikolaos; Siafakas, Nikolaos; van der Molen, Thys
2011-09-01
A major goal in the management of chronic obstructive pulmonary disease (COPD) is to ensure that the burden of the disease for patients with COPD is limited and that patients will have the best possible quality of life. To explore all the possible factors that could influence disease-specific quality of life and health status in patients with COPD. A systematic review of the literature and a meta-analysis were performed to explore the factors that could have a positive or negative effect on quality of life and/or health status in patients with COPD. Quality of life and health status are determined by certain factors included gender, disease severity indices, lung function parameters, body mass index, smoking, symptoms, co-morbidity, depression, anxiety, and exacerbations. Factors such as dyspnoea, depression, anxiety and exercise tolerance were found to be more correlated with health status than the widely used spirometric values. Forced expiratory volume in one second had a weak to modest Pearson weighted correlation coefficient which ranged from -0.110 to -0.510 depending on the questionnaire used. The broad range of determining factors suggests that, in order to reach the management goals, health status should be measured in addition to lung function in patients with COPD.
PROJECTING WILDLIFE RESPONSES TO ALTERNATIVE FUTURE LANDSCAPES IN OREGON'S WILLAMETTE VALLEY
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...
The relationship between the content and the form of metaphorical statements.
Xu, Xu
2010-04-01
Recent research suggests that the quality of a metaphorical topic-vehicle pairing should be the determinant to the choice of a proper grammatical form, nominal metaphor versus simile. Two studies examined the relationship between the quality of the content of a metaphorical statement and its grammatical form. Study 1 showed that the two grammatical forms did not differ in aptness when the quality of topic-vehicle pairs and the conventionality of vehicles, a factor associated with the quality of metaphorical expressions, were controlled. With an online comprehension measure, Study 2 found that high quality metaphorical pairings were easier to process than low quality metaphorical pairings in both the metaphor form and the simile form. For high quality metaphorical pairings, information related to both the topics and the vehicles was highly activated at an early stage of processing. The relations among factors involved in the interpretive process of metaphorical language are discussed.
Persson, Maria; Nilsson, Josef; Carlsson Tedgren, Åsa
Establishment of an end-to-end system for the brachytherapy (BT) dosimetric chain could be valuable in clinical quality assurance. Here, the development of such a system using MOSFET (metal oxide semiconductor field effect transistor) detectors and experience gained during 2 years of use are reported with focus on the performance of the MOSFET detectors. A bolus phantom was constructed with two implants, mimicking prostate and head & neck treatments, using steel needles and plastic catheters to guide the 192 Ir source and house the MOSFET detectors. The phantom was taken through the BT treatment chain from image acquisition to dose evaluation. During the 2-year evaluation-period, delivered doses were verified a total of 56 times using MOSFET detectors which had been calibrated in an external 60 Co beam. An initial experimental investigation on beam quality differences between 192 Ir and 60 Co is reported. The standard deviation in repeated MOSFET measurements was below 3% in the six measurement points with dose levels above 2 Gy. MOSFET measurements overestimated treatment planning system doses by 2-7%. Distance-dependent experimental beam quality correction factors derived in a phantom of similar size as that used for end-to-end tests applied on a time-resolved measurement improved the agreement. MOSFET detectors provide values stable over time and function well for use as detectors for end-to-end quality assurance purposes in 192 Ir BT. Beam quality correction factors should address not only distance from source but also phantom dimensions. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
Family Quality of Life: A Key Outcome in Early Childhood Intervention Services--A Scoping Review
ERIC Educational Resources Information Center
Bhopti, Anoo; Brown, Ted; Lentin, Primrose
2016-01-01
A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…
Korst, Lisa M.; Aydin, Carolyn E.; Signer, Jordana M. K.; Fink, Arlene
2011-01-01
Objective The development of readiness metrics for organizational participation in health information exchange is critical for monitoring progress toward, and achievement of, successful inter-organizational collaboration. In preparation for the development of a tool to measure readiness for data-sharing, we tested whether organizational capacities known to be related to readiness were associated with successful participation in an American data-sharing collaborative for quality improvement. Design Cross-sectional design, using an on-line survey of hospitals in a large, mature data-sharing collaborative organized for benchmarking and improvement in nursing care quality. Measurements Factor analysis was used to identify salient constructs, and identified factors were analyzed with respect to “successful” participation. “Success” was defined as the incorporation of comparative performance data into the hospital dashboard. Results The most important factor in predicting success included survey items measuring the strength of organizational leadership in fostering a culture of quality improvement (QI Leadership): 1) presence of a supportive hospital executive; 2) the extent to which a hospital values data; 3) the presence of leaders’ vision for how the collaborative advances the hospital’s strategic goals; 4) hospital use of the collaborative data to track quality outcomes; and 5) staff recognition of a strong mandate for collaborative participation (α = 0.84, correlation with Success 0.68 [P < 0.0001]). Conclusion The data emphasize the importance of hospital QI Leadership in collaboratives that aim to share data for QI or safety purposes. Such metrics should prove useful in the planning and development of this complex form of inter-organizational collaboration. PMID:21330191
Intensity of Anxiety and Depression in Patients with Lung Cancer in Relation to Quality of Life.
Polański, Jacek; Chabowski, Mariusz; Chudiak, Anna; Uchmanowicz, Bartosz; Janczak, Dariusz; Rosińczuk, Joanna; Mazur, Grzegorz
2018-01-01
Psychological factors, such as the anxiety and depression, which often occur in patients with lung cancer might negatively influence their quality of life. The aim of the study was to evaluate the effect of anxiety and depression in lung cancer patients on quality of life. The study included 180 lung patients of the mean age of 62.7 ± 9.7 years. The following scales were employed in the study: Quality of Life Questionnaire QLQ-C30 and LC13 scale, and Hospital Anxiety and Depression scale (HADS). The overall score of quality of life measured by QLQ-C30 was 47.1 ± 23.4 points on a hundred-point scale. Anxiety was diagnosed in 67 patients (37.2%) and depression in 75 patients (41.7%) by HADS. Quality of life was significantly worse in case of anxiety and depression (p < 0.05), which negatively influenced both functional and symptom intensity scales measured with QLQ-C30 and QLQ-LC13. We conclude that early identification of anxiety and depression may help in therapeutic decision-making and may be a useful predictive factor in lung cancer patients.
Ventegodt, Søren; Flensborg-Madsen, Trine; Andersen, Niels Jørgen; Merrick, Joav
2008-07-01
To examine the statistical associations between Global Quality of Life (QOL) and a series of indicators representing health, ability, philosophy of life, sexuality, quality of working life and other medically relevant aspects of life. Cross-sectional comparative study using the self-administered SEQOL questionnaire. The Quality of Life Research Center, the University Hospital Copenhagen, Denmark. (1) A representative sample of 2,500 Danes (18-88 years) randomly selected from the CPR register, (2) Follow-up survey of members of the Copenhagen Perinatal Birth Cohort, 4,648 Danes (31-33 years). The associations were measured qualitatively as well as quantitatively calculating the difference in percentage and using the method of weight modified linear regression. QOL, measured by SEQOL (self-evaluation of quality of life), containing eight global QOL measures: well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life's potentials and objective factors. Strongest was the association between QOL, overall view of life (41.5% / 59.1%), relationship to self (39.3% / 56.8%), partner (32.2% / 31.7%) and friends (33.3% / 42.7%). Different aspects of physical as well as psychological health were also strongly correlated with QOL: self-perceived physical health (33.2% /29.4%), satisfaction with own health (27.3% / 29.0%), self-perceived mental health (38.4/51.0), number of severe health problems (29.8% / 35.3%). Objective factors such as income, age, sex, weight and social group did not have any noteworthy relationship to QOL, and neither did lifestyle factors such as tobacco and alcohol consumption, drug use, exercise, and diet. It seems that the factors important for present QOL and health is derived from good relations, with the close as well as the distant world, and overall view of life. What one possesses in objective terms--money, status, work--does not seem to be important to global quality of life and of little importance to self-assessed health. Our results indicate that what is really important is not what one has, but how he sees, evaluates and experiences what he has. The person's level of consciousness and responsible attitude towards life and others seem far more important for the global quality of life and health.
Influences on diet quality in older age: the importance of social factors.
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
Environmental risk factors for dementia: a systematic review.
Killin, Lewis O J; Starr, John M; Shiue, Ivy J; Russ, Tom C
2016-10-12
Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia. We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed. We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields. Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.
Some Comments on Mapping from Disease-Specific to Generic Health-Related Quality-of-Life Scales
Palta, Mari
2013-01-01
An article by Lu et al. in this issue of Value in Health addresses the mapping of treatment or group differences in disease-specific measures (DSMs) of health-related quality of life onto differences in generic health-related quality-of-life scores, with special emphasis on how the mapping is affected by the reliability of the DSM. In the proposed mapping, a factor analytic model defines a conversion factor between the scores as the ratio of factor loadings. Hence, the mapping applies to convert true underlying scales and has desirable properties facilitating the alignment of instruments and understanding their relationship in a coherent manner. It is important to note, however, that when DSM means or differences in mean DSMs are estimated, their mapping is still of a measurement error–prone predictor, and the correct conversion coefficient is the true mapping multiplied by the reliability of the DSM in the relevant sample. In addition, the proposed strategy for estimating the factor analytic mapping in practice requires assumptions that may not hold. We discuss these assumptions and how they may be the reason we obtain disparate estimates of the mapping factor in an application of the proposed methods to groups of patients. PMID:23337233
PROMIS Peer Relationships Short Form: How Well Does Self-Report Correlate With Data From Peers?
Devine, Katie A; Willard, Victoria W; Hocking, Matthew C; Stapleton, Jerod L; Rotter, David; Bukowski, William M; Noll, Robert B
2018-05-24
To examine the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS®) peer relationships short form (PR-SF), including association with peer-reported friendships, likeability, and social reputation. 203 children (Mage = 10.12 years, SD = 2.37, range = 6-14) in Grades 1-8 completed the 8-item PR-SF and friendship nominations, like ratings, and social reputation measures about their peers during 2 classroom visits approximately 4 months apart, as part of a larger study. A confirmatory factor analysis, followed by an exploratory factor analysis, was conducted to examine the factor structure of the PR-SF. Spearman correlations between the PR-SF and peer-reported outcomes evaluated construct validity. For the PR-SF, a 2-factor solution demonstrated better fit than a 1-factor solution. The 2 factors appear to assess friendship quality (3 items) and peer acceptance (5 items). Reliability was marginal for the friendship quality factor (.66) but adequate for the acceptance factor (.85); stability was .34 for the PR-SF over 4 months. The PR-SF (8 items) and acceptance factor (5 items) both had modest but significant correlations with measures of friendship (rs = .25-.27), likeability (rs = .21-.22), and social reputation (rs = .29-.44). The PR-SF appears to be measuring two distinct aspects of social functioning. The 5-item peer acceptance scale is modestly associated with peer-reported friendship, likeability, and social reputation. Although not a replacement for peer-reported outcomes, the PR-SF is a promising patient-reported outcome for peer relationships in youth.
Exploring constructs of well-being, happiness and quality of life.
Medvedev, Oleg N; Landhuis, C Erik
2018-01-01
Existing definitions of happiness, subjective well-being, and quality of life suggest conceptual overlap between these constructs. This study explored the relationship between these well-being constructs by applying widely used measures with satisfactory psychometric properties. University students ( n = 180) completed widely used well-being measures including the Oxford Happiness Questionnaire (OHQ), the World Health Organization Quality of Life Questionnaire, the Satisfaction with Life Scale, and the Positive and Negative Affect Scale. We analyzed the data using correlation, regression, and exploratory factor analysis. All included well-being measures demonstrated high loadings on the global well-being construct that explains about 80% of the variance in the OHQ, the psychological domain of Quality of Life and subjective well-being. The results show high positive correlations between happiness, psychological and health domains of quality of life, life satisfaction, and positive affect. Social and environmental domains of quality of life were poor predictors of happiness and subjective well-being after controlling for psychological quality of life. Together, these data provide support for a global well-being dimension and interchangeable use of terms happiness, subjective well-being, and psychological quality of life with the current sample and measures. Further investigation with larger heterogeneous samples and other well-being measures is warranted.
Exploring constructs of well-being, happiness and quality of life
Landhuis, C. Erik
2018-01-01
Background Existing definitions of happiness, subjective well-being, and quality of life suggest conceptual overlap between these constructs. This study explored the relationship between these well-being constructs by applying widely used measures with satisfactory psychometric properties. Materials and Methods University students (n = 180) completed widely used well-being measures including the Oxford Happiness Questionnaire (OHQ), the World Health Organization Quality of Life Questionnaire, the Satisfaction with Life Scale, and the Positive and Negative Affect Scale. We analyzed the data using correlation, regression, and exploratory factor analysis. Results All included well-being measures demonstrated high loadings on the global well-being construct that explains about 80% of the variance in the OHQ, the psychological domain of Quality of Life and subjective well-being. The results show high positive correlations between happiness, psychological and health domains of quality of life, life satisfaction, and positive affect. Social and environmental domains of quality of life were poor predictors of happiness and subjective well-being after controlling for psychological quality of life. Conclusion Together, these data provide support for a global well-being dimension and interchangeable use of terms happiness, subjective well-being, and psychological quality of life with the current sample and measures. Further investigation with larger heterogeneous samples and other well-being measures is warranted. PMID:29876148
Anders, Markus P; Breckenkamp, Jürgen; Blettner, Maria; Schlehofer, Brigitte; Berg-Beckhoff, Gabriele
2014-12-01
Good sleep quality is essential for recovery. The risk factors of sleep disorders have been extensively investigated, but there is sparse information on the association of socioeconomic factors with a person's sleep quality. The aim of the present analysis is to investigate this association, taking particularly the effect of health confounders into consideration. The data were extracted from the cross-sectional QUEBEB Study. In total, the study sample consisted of 3281 participants (1817 women and 1464 men, aged 16-72 years). Here socioeconomic status (SES) was collected from the baseline survey taken in 2004. Sleep quality for the same participants was measured with in-depth personal interviews in 2006 using the Pittsburgh Sleep Quality Index, together with other relevant characteristics (e.g. anxiety, depression and health status). Multiple logistic regression analyses were performed. People living in an urban environment with a high or medium SES have a greater probability of good sleep quality (odds ratio 1.65, 95% confidence interval 1.27-2.14; odds ratio 1.40, 95% confidence interval 1.16-1.69) than persons with a low SES. Anxiety and depression, but also health status, are also associated with sleep quality and can influence in part the socioeconomic levels seen in sleep quality. SES and sleep quality are associated. However, there are important additional determinants that influence the level of association between SES and sleep quality. Several factors, such as anxiety, depression and health status, are associated with poorer sleep quality, but at the same time, these factors occur more often within lower social classes. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Micro-optomechanical trampoline resonators
NASA Astrophysics Data System (ADS)
Pepper, Brian; Kleckner, Dustin; Sonin, Petro; Jeffrey, Evan; Bouwmeester, Dirk
2011-03-01
Recently, micro-optomechanical devices have been proposed for implementation of experiments ranging from non-demolition measurements of phonon number to creation of macroscopic quantum superpositions. All have strenuous requirements on optical finesse, mechanical quality factor, and temperature. We present a set of devices composed of dielectric mirrors on Si 3 N4 trampoline resonators. We describe the fabrication process and present data on finesse and quality factor. The authors gratefully acknowledge support from NSF PHY-0804177 and Marie Curie EXT-CT-2006-042580.
Hoerger, Michael; Chapman, Benjamin P; Mohile, Supriya G; Duberstein, Paul R
2016-09-01
In light of recent health care reforms, we have provided an illustrative example of new opportunities available for psychologists to develop patient-reported measures related to health care quality. Patient engagement in health care decision making has been increasingly acknowledged as a vital component of quality cancer care. We developed the 10-item Decisional Engagement Scale (DES-10), a patient-reported measure of engagement in decision making in cancer care that assesses patients' awareness of their diagnosis, sense of empowerment and involvement, and level of information seeking and planning. The National Institutes of Health's ResearchMatch recruitment tool was used to facilitate Internet-mediated data collection from 376 patients with cancer. DES-10 scores demonstrated good internal consistency reliability (α = .80), and the hypothesized unidimensional factor structure fit the data well. The reliability and factor structure were supported across subgroups based on demographic, socioeconomic, and health characteristics. Higher DES-10 scores were associated with better health-related quality of life (r = .31). In concurrent validity analyses controlling for age, socioeconomic status, and health-related quality of life, higher DES-10 scores were associated with higher scores on quality-of-care indices, including greater awareness of one's treatments, greater preferences for shared decision making, and clearer preferences about end-of-life care. A mini-measure, the DES-3, also performed well psychometrically. In conclusion, DES-10 and DES-3 scores showed evidence of reliability and validity, and these brief patient-reported measures can be used by researchers, clinicians, nonprofits, hospitals, insurers, and policymakers interested in evaluating and improving the quality of cancer care. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Sensitivity of the diagnostic radiological index of protection to procedural factors in fluoroscopy.
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.
Shea, Beverley J; Grimshaw, Jeremy M; Wells, George A; Boers, Maarten; Andersson, Neil; Hamel, Candyce; Porter, Ashley C; Tugwell, Peter; Moher, David; Bouter, Lex M
2007-02-15
Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use.
Quality of Care for Work-associated Carpal Tunnel Syndrome
Nuckols, Teryl; Conlon, Craig; Robbins, Michael; Dworsky, Michael; Lai, Julie; Roth, Carol P.; Levitan, Barbara; Seabury, Seth; Seelam, Rachana; Asch, Steven M.
2017-01-01
Objective To evaluate the quality of care provided to individuals with workers’ compensation claims related to CTS and identify patient characteristics associated with receiving better care. Methods We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects’ medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality. Results Overall, 81.6% of care adhered to recommended standards. Certain tasks related to assessing and managing activity were underused. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, gender, and race/ethnicity were not associated with quality. Conclusions Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones. PMID:28045797
Neutrons in proton pencil beam scanning: parameterization of energy, quality factors and RBE
NASA Astrophysics Data System (ADS)
Schneider, Uwe; Hälg, Roger A.; Baiocco, Giorgio; Lomax, Tony
2016-08-01
The biological effectiveness of neutrons produced during proton therapy in inducing cancer is unknown, but potentially large. In particular, since neutron biological effectiveness is energy dependent, it is necessary to estimate, besides the dose, also the energy spectra, in order to obtain quantities which could be a measure of the biological effectiveness and test current models and new approaches against epidemiological studies on cancer induction after proton therapy. For patients treated with proton pencil beam scanning, this work aims to predict the spatially localized neutron energies, the effective quality factor, the weighting factor according to ICRP, and two RBE values, the first obtained from the saturation corrected dose mean lineal energy and the second from DSB cluster induction. A proton pencil beam was Monte Carlo simulated using GEANT. Based on the simulated neutron spectra for three different proton beam energies a parameterization of energy, quality factors and RBE was calculated. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed parameterizations in order to calculate the spatially localized neutron energy, quality factors and RBE for each treated patient. The parameterization represents the simple quantification of neutron energy in two energy bins and the quality factors and RBE with a satisfying precision up to 85 cm away from the proton pencil beam when compared to the results based on 3D Monte Carlo simulations. The root mean square error of the energy estimate between Monte Carlo simulation based results and the parameterization is 3.9%. For the quality factors and RBE estimates it is smaller than 0.9%. The model was successfully integrated into the PSI treatment planning system. It was found that the parameterizations for neutron energy, quality factors and RBE were independent of proton energy in the investigated energy range of interest for proton therapy. The pencil beam algorithm has been extended using the developed parameterizations in order to calculate the neutron energy, quality factor and RBE.
Neutrons in proton pencil beam scanning: parameterization of energy, quality factors and RBE.
Schneider, Uwe; Hälg, Roger A; Baiocco, Giorgio; Lomax, Tony
2016-08-21
The biological effectiveness of neutrons produced during proton therapy in inducing cancer is unknown, but potentially large. In particular, since neutron biological effectiveness is energy dependent, it is necessary to estimate, besides the dose, also the energy spectra, in order to obtain quantities which could be a measure of the biological effectiveness and test current models and new approaches against epidemiological studies on cancer induction after proton therapy. For patients treated with proton pencil beam scanning, this work aims to predict the spatially localized neutron energies, the effective quality factor, the weighting factor according to ICRP, and two RBE values, the first obtained from the saturation corrected dose mean lineal energy and the second from DSB cluster induction. A proton pencil beam was Monte Carlo simulated using GEANT. Based on the simulated neutron spectra for three different proton beam energies a parameterization of energy, quality factors and RBE was calculated. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed parameterizations in order to calculate the spatially localized neutron energy, quality factors and RBE for each treated patient. The parameterization represents the simple quantification of neutron energy in two energy bins and the quality factors and RBE with a satisfying precision up to 85 cm away from the proton pencil beam when compared to the results based on 3D Monte Carlo simulations. The root mean square error of the energy estimate between Monte Carlo simulation based results and the parameterization is 3.9%. For the quality factors and RBE estimates it is smaller than 0.9%. The model was successfully integrated into the PSI treatment planning system. It was found that the parameterizations for neutron energy, quality factors and RBE were independent of proton energy in the investigated energy range of interest for proton therapy. The pencil beam algorithm has been extended using the developed parameterizations in order to calculate the neutron energy, quality factor and RBE.
Kováts, Daniella; Császár, Noémi; Haller, József; Juhos, Vera; Sallay, Viola; Békés, Judit; Kelemen, Anna; Fabó, Dániel; Rásonyi, György; Folyovich, András; Kurimay, Tamás
2017-09-01
We investigated the impact of 19 factors on life quality in Hungarian patients with epilepsy. Wellbeing was evaluated by several inventories to investigate the impact of factors in more detail. A cross-sectional study was performed in 170 patients. Wellbeing was evaluated with the WHO-5 Well-being Index (WHOQOL-5), Diener Satisfaction with Life Scale (SwLS), and the Quality of Life in Epilepsy-31 Questionnaire (Qolie-31). We investigated their association with demographic characteristics, general health status, epilepsy, and its treatment. The impact of these factors on illness perception (Illness Perception Questionnaire, IPQ) was also studied. The four measures correlated highly significantly. In addition, the predictive power of factors was comparable with the four inventories as evaluated by Multiple Regression. Factors explained 52%, 41%, 63% and 46% in the variance of WHOQOL-5, SwLS, Qolie-31, and IPQ scores, respectively. However, associations with particular factors were instrument-specific. The WHOQOL-5 was associated with factors indicative of general health. SwLS scores were associated with health-related and several demographic factors. Neither showed associations with epilepsy-related factors. All four categories of factors were associated with Qolie-31 and IPQ scores. Factors had an additive impact on IPQ, but not on Qolie-31. Our findings reveal interactions between the method of life quality assessment and the factors that are identified as influencing life quality. This appears to be the first study that analyses the factors that influence illness perception in epilepsy patients, and suggests that the IPQ may become a valuable tool in epilepsy research. Copyright © 2017 Elsevier Inc. All rights reserved.
Dielectric properties characterization of saline solutions by near-field microwave microscopy
NASA Astrophysics Data System (ADS)
Gu, Sijia; Lin, Tianjun; Lasri, Tuami
2017-01-01
Saline solutions are of a great interest when characterizations of biological fluids are targeted. In this work a near-field microwave microscope is proposed for the characterization of liquids. An interferometric technique is suggested to enhance measurement sensitivity and accuracy. The validation of the setup and the measurement technique is conducted through the characterization of a large range of saline concentrations (0-160 mg ml-1). Based on the measured resonance frequency shift and quality factor, the complex permittivity is successfully extracted as exhibited by the good agreement found when comparing the results to data obtained from Cole-Cole model. We demonstrate that the near field microwave microscope (NFMM) brings a great advantage by offering the possibility to select a resonance frequency and a quality factor for a given concentration level. This method provides a very effective way to largely enhance the measurement sensitivity in high loss materials.
A NEW MODEL TO ESTIMATE DAILY ENERGY EXPENDITURE FOR WINTERING WATERFOWL
Activity budgets of wintering waterfowl have been widely used to assess habitat quality. However, when factors such as prey abundance or protection from exposure to cold or wind determine quality, measures of daily energy expenditure (DEE) may be more appropriate for this purpos...
NASA Technical Reports Server (NTRS)
Basili, V. R.
1981-01-01
Work on metrics is discussed. Factors that affect software quality are reviewed. Metrics is discussed in terms of criteria achievements, reliability, and fault tolerance. Subjective and objective metrics are distinguished. Product/process and cost/quality metrics are characterized and discussed.
Desai, Vibha; Nau, David; Conklin, Mark; Heaton, Pamela C
2016-07-01
The Medicare star ratings system incentivizes health plan sponsors based on their performance across a measurement system that contains quality measures related to medication use. As health plan sponsors seek to further engage their network providers, specifically network pharmacies, to improve performance on these measures, it is important to consider the effect of environmental factors on the performance of network pharmacies. To determine the effect of environmental factors on pharmacy quality as measured by (a) medication adherence for noninsulin diabetes medications, (b) medication adherence for renin angiotensin receptor antagonists (RASA), (c) medication adherence for cholesterol medications (statins), and (d) use of high-risk medications (HRM) in the elderly. The EQuIPP database, which contains performance information for pharmacies for a nationwide sample of Medicare beneficiaries, was used for this analysis. Environmental factors included regions or characteristics of a community or county. County-level data was obtained from the Area Health Resource Files, a resource product available from the Health Resources & Service Administration. A logistic regression model was developed with performance as the dependent variable and regions and environmental factors as independent variables. Performance and county characteristics, such as proportion of patients in an age group, race, income, or number of outpatient visits, were classified as high and low based on a median cutoff of nationwide performance scores. A total of 28,950 pharmacies were included in this analysis. For most measures, the proportion of low-performing pharmacies was significantly higher in the East South Central, Mid-Atlantic, Mountain, Pacific, and West South Central regions. Pharmacies in counties with high median income, high proportion of elderly population (aged > 84 years), high proportion of elderly patients who were white or Hispanic, high proportion of elderly males, and high proportion of elderly urban patients were less likely to have low performance, whereas those with high proportion of elderly African Americans and high density of independent pharmacies were more likely to have low performance (P < 0.05-0.0001). This study found that environmental characteristics of a region, including pharmacy and sociodemographic characteristics, explained regional variation in quality measures related to medication use for patient populations served by pharmacies. This evaluation serves to further inform the discussion regarding case-mix adjustment of quality measures and provides information that may be important to further refine intervention strategies for pharmacies and pharmacists who serve certain regional populations. Additionally, pharmacies in greatest need of support for quality improvement may be those who serve populations that are predominantly low income and elderly African American. Desai's postdoctoral fellowship was funded by Pharmacy Quality Solutions for conducting this study and writing the manuscript. Nau and Conklin are employed by Pharmacy Quality Solutions. An earlier version of this research was presented as a poster at the Annual Meeting of the Academy of Managed Care Pharmacy; San Diego, CA; April 7-10, 2015. Study concept and design were contributed by Conklin, Nau, Desai, and Heaton. Desai and Conklin took the lead in data collection, assisted by Nau and Heaton. The manuscript was primarily written by Desai and Heaton, with assistance from Conklin and Nau. All authors contributed to data interpretation and manuscript revision.
Service quality in healthcare institutions: establishing the gaps for policy action.
Abuosi, Aaron A; Atinga, Roger A
2013-01-01
The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts used to assess patient perceptions. Questionnaires were administered to 250 patients on admission and follow-up visits. The 22 paired SERVQUAL expectation and perception items were adopted. Repeated t-measures and factor analysis with Varimax rotation were used to analyse data. Results showed that patient expectations were not being met during medical treatment. Perceived service quality was rated lower than expectations for all variables. The mean difference between perceptions and expectations was statistically significant. Contrary to the SERVQUAL five-factor model, four service-quality factors were identified in the study. Findings have practical implications for hospital managers who should consider stepping up staffing levels backed by client-centred training programmes to help clinicians deliver care to patients' expectations. Limited studies are tailored towards patients' service-quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice.
Bellows, Spencer; Smith, Jordan; Mcguire, Peter; Smith, Andrew
2014-01-01
Accurate resuscitation of the critically-ill patient using intravenous fluids and blood products is a challenging, time sensitive task. Ultrasound of the inferior vena cava (IVC) is a non-invasive technique currently used to guide fluid administration, though multiple factors such as variable image quality, time, and operator skill challenge mainstream acceptance. This study represents a first attempt to develop and validate an algorithm capable of automatically tracking and measuring the IVC compared to human operators across a diverse range of image quality. Minimal tracking failures and high levels of agreement between manual and algorithm measurements were demonstrated on good quality videos. Addressing problems such as gaps in the vessel wall and intra-lumen speckle should result in improved performance in average and poor quality videos. Semi-automated measurement of the IVC for the purposes of non-invasive estimation of circulating blood volume poses challenges however is feasible.
Improving Factor Score Estimation Through the Use of Observed Background Characteristics
Curran, Patrick J.; Cole, Veronica; Bauer, Daniel J.; Hussong, Andrea M.; Gottfredson, Nisha
2016-01-01
A challenge facing nearly all studies in the psychological sciences is how to best combine multiple items into a valid and reliable score to be used in subsequent modelling. The most ubiquitous method is to compute a mean of items, but more contemporary approaches use various forms of latent score estimation. Regardless of approach, outside of large-scale testing applications, scoring models rarely include background characteristics to improve score quality. The current paper used a Monte Carlo simulation design to study score quality for different psychometric models that did and did not include covariates across levels of sample size, number of items, and degree of measurement invariance. The inclusion of covariates improved score quality for nearly all design factors, and in no case did the covariates degrade score quality relative to not considering the influences at all. Results suggest that the inclusion of observed covariates can improve factor score estimation. PMID:28757790
Quality of vision in refractive and cataract surgery, indirect measurers: review article.
Parede, Taís Renata Ribeira; Torricelli, André Augusto Miranda; Mukai, Adriana; Vieira Netto, Marcelo; Bechara, Samir Jacob
2013-01-01
Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality. Therefore, refractive and cataract surgeries have the responsibility of achieving quality results. It is difficult to define quality of vision by a single parameter, and the main functional-vision tests are: contrast sensitivity, disability glare, intraocular stray light and aberrometry. In the current review the different components of the visual function are explained and the several available methods to assess the vision quality are described.
McCloskey, Wilfred; Iwanicki, Sierra; Lauterbach, Dean; Giammittorio, David M; Maxwell, Kendal
2015-09-01
Greater social support is predictive of lower depression and higher quality of life (QOL). However, the way in which social support is provided has changed greatly with the expanding role of social networking sites (e.g., Facebook). While there are numerous anecdotal accounts of the benefits of Facebook-based social support, little empirical evidence exists to support these assertions, and there are no empirically validated measures designed to assess social support provided via this unique social networking medium. This study sought to develop an empirically sound measure of Facebook-based social support (Facebook Measure of Social Support [FMSS]) and to assess how this new measure relates to previously established measures of support and two outcome variables: depression and QOL. Following exploratory factor analysis, the FMSS was determined to assess four factors of social support on Facebook (Perceived, Emotional, Negative, Received/Instrumental). The Negative Support factor on the FMSS was most strongly related to both depression and QOL with magnitudes (and direction of relationships) comparable to a traditional measure of perceived social support. However, two FMSS factors (Received/Instrumental and Perceived) were unrelated to both mental health outcomes. Contrary to expectations, elevations in one FMSS factor (Emotional) was associated with worse symptoms of depression and poorer psychological QOL. When taken together, only the absence of negative social support on Facebook is significantly predictive of mental health functioning. Consequently, those hoping to use Facebook as a medium for reducing depression or improving QOL are unlikely to realize significant therapeutic benefits.
ANALYSIS OF MOTOR VEHICLE EMISSIONS IN A HOUSTON TUNNEL DURING THE TEXAS AIR QUALITY STUDY 2000
Measurements from a Houston tunnel were used to develop fuel consumption based emission factors for CO, NOx, and Non-Methane Organic Compound (NMOC) for on-road gasoline vehicles. The Houston NOx emission factor was at the low range of emission factors reported in previous (pr...
Nash, Tracy Jeanne
2017-08-01
Although nurses struggle with the decision to report for work during disaster events, there are no instruments to measure nurses' duty to care for disaster situations. The purpose of this study was to describe the development, testing, and psychometric qualities of the Nash Duty to Care Scale. A convenience sample of 409 registered nurses were recruited from 3 universities in the United States. Exploratory factor analysis resulted in a 19-item, 4-factor model explaining 67.34% of the variance. Internal consistency reliability was supported by Cronbach's alpha ranging from .81 to .91 for the 4-factor subscales and .92 for the total scale. The psychometrically sound instrument for measuring nurses' perceived duty to care for disasters is applicable to contemporary nursing practice, institutional disaster management plans, and patient health outcomes worldwide.
Quality politics: an immaterial investment for companies in (micro)electronics
NASA Astrophysics Data System (ADS)
Bacivarov, I. C.; Lupan, R.; Robledo, C.; Bacivarov, Angelica
2010-11-01
With the globalization of the markets and the growth of competitiveness in the manufacturing sector, quality has become a key factor of success. Quality is particularly important for the companies which activate in the micro(electronics) field. The quality management system holds a vital place in the company's structure. Implementing such a system requires important operating costs. These costs are known as Quality Obtaining Costs (QOC) and may be considered as an investment. Planning an investment, means evaluating its return in order to see if it is profitable or not. Measuring the return of quality politics investment raise some delicate problems. We may calculate some aspects of the return of investment by measuring the shape of non-quality costs. An eventual decrease of these costs could be synonym with a profitable investment. But the advantages of good quality politics cannot be measured only by taking into consideration the non-quality costs (even if they include direct and indirect costs). There are also intangible advantages (like mark image, competences, polyvalence, client's satisfaction...) that derive from quality approaches. How to evaluate this type of consequences / advantages? The idea developed in this article is to considerate the quality politics like un immaterial/intelligent investment. Therefore could it be advantageous / possible to use the immaterial investment's measuring and evaluation techniques for studying the quality politics return of investment?
Iafolla, V; Lefevre, C; Fiorenza, E; Santoli, F; Nozzoli, S; Magnafico, C; Lucente, M; Lucchesi, D; Peron, R; Shapiro, I I; Glashow, S; Lorenzini, E C
2014-01-01
A cryogenic differential accelerometer has been developed to test the weak equivalence principle to a few parts in 10(15) within the framework of the general relativity accuracy test in an Einstein elevator experiment. The prototype sensor was designed to identify, address, and solve the major issues associated with various aspects of the experiment. This paper illustrates the measurements conducted on this prototype sensor to attain a high quality factor (Q ∼ 10(5)) at low frequencies (<20 Hz). Such a value is necessary for reducing the Brownian noise to match the target acceleration noise of 10(-14) g/√Hz, hence providing the desired experimental accuracy.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Renaud, James, E-mail: james.renaud@mail.mcgill.ca; Seuntjens, Jan; Sarfehnia, Arman
Purpose: In this work, the authors describe an electron sealed water calorimeter (ESWcal) designed to directly measure absorbed dose to water in clinical electron beams and its use to derive electron beam quality conversion factors for two ionization chamber types. Methods: A functioning calorimeter prototype was constructed in-house and used to obtain reproducible measurements in clinical accelerator-based 6, 9, 12, 16, and 20 MeV electron beams. Corrections for the radiation field perturbation due to the presence of the glass calorimeter vessel were calculated using Monte Carlo (MC) simulations. The conductive heat transfer due to dose gradients and nonwater materials wasmore » also accounted for using a commercial finite element method software package. Results: The relative combined standard uncertainty on the ESWcal dose was estimated to be 0.50% for the 9–20 MeV beams and 1.00% for the 6 MeV beam, demonstrating that the development of a water calorimeter-based standard for electron beams over such a wide range of clinically relevant energies is feasible. The largest contributor to the uncertainty was the positioning (Type A, 0.10%–0.40%) and its influence on the perturbation correction (Type B, 0.10%–0.60%). As a preliminary validation, measurements performed with the ESWcal in a 6 MV photon beam were directly compared to results derived from the National Research Council of Canada (NRC) photon beam standard water calorimeter. These two independent devices were shown to agree well within the 0.43% combined relative uncertainty of the ESWcal for this beam type and quality. Absorbed dose electron beam quality conversion factors were measured using the ESWcal for the Exradin A12 and PTW Roos ionization chambers. The photon-electron conversion factor, k{sub ecal}, for the A12 was also experimentally determined. Nonstatistically significant differences of up to 0.7% were found when compared to the calculation-based factors listed in the AAPM’s TG-51 protocol. General agreement between the relative electron energy dependence of the PTW Roos data measured in this work and a recent MC-based study are also shown. Conclusions: This is the first time that water calorimetry has been successfully used to measure electron beam quality conversion factors for energies as low as 6 MeV (R{sub 50} = 2.25 cm)« less
Irvine, D
1995-08-01
A study was conducted at two tertiary care hospitals in Canada for the purpose of developing instruments to measure organizational citizenship behaviours (OCB) and changes in job behaviours that occur as a result of participation on hospital quality improvement (CQI) teams. Semi structured interviews were conducted among 52 hospital employees in order to elicit critical incidents of OCB and changes in job behaviours related to CQI. The results of the staff interviews were used to develop a measure of OCB in the hospital setting, and a measure of changes in job behaviours related to CQI. 39 employees, who were drawn from the major departments within the two hospitals on the basis of their membership on CQI teams, participated in a test of the psychometric properties of the two research instruments. Exploratory factor analysis, employing an orthogonal rotation, yielded two factors that accounted for 30% of the variation among the OCB items. The Cronbach alpha for items loading highly on the first factor was .88. The factor was labelled 'OCB directed towards individuals within the organization'. This factor was dominated by items reflecting the kinds of extra-role job behaviours employees engage in to assist patients, family members, visitors, and other employees within the organization. The Cronbach alpha for items loading highly on the second factor was 0.71. The second factor was labelled 'organizationally directed OCB', and consisted of behaviours that reflected an impersonal form of OCB in the hospital setting. Factor analysis, employing an orthogonal rotation, yielded four factors that accounted for 48% of the variation among the items measuring changes in job behaviours related to CQI. The four factors were labelled 'problem-solving', Cronbach alpha 0.82; 'customer awareness', Cronbach alpha 0.79; 'use of CQI knowledge', Cronbach alpha 0.77; and 'organizational interests', Cronbach alpha 0.79. The two OCB factors were moderately correlated, there were no significant correlations among any of the factors measuring changes in job behaviours related to CQI, and the problem-solving job behaviours factor was moderately correlated with the two OCB factors. Directions for future research are discussed.
Development and Validation of a Quality-of-Life Instrument for Infantile Hemangiomas.
Chamlin, Sarah L; Mancini, Anthony J; Lai, Jin-Shei; Beaumont, Jennifer L; Cella, David; Adams, Denise; Drolet, Beth; Baselga, Eulalia; Frieden, Ilona J; Garzon, Maria; Holland, Kristin; Horii, Kimberly A; Lucky, Anne W; McCuaig, Catherine; Metry, Denise; Morel, Kimberly D; Newell, Brandon D; Nopper, Amy J; Powell, Julie; Siegel, Dawn; Haggstrom, Anita N
2015-06-01
Infantile hemangiomas (IH) are common tumors for which there is no validated disease-specific instrument to measure the quality of life in infants and their parents/caregivers during the critical first months of life. This study prospectively developed and validated a quality-of-life instrument for patients with IH and their parents/caregivers and correlated demographic and clinical features to the effects on the quality of life. A total of 220 parents/caregivers completed the 35-item Infantile Hemangioma Quality-of-Life (IH-QoL) instrument and provided demographic information. The dimensionality of the items was evaluated using factor analysis, with results suggesting four factors: child physical symptoms, child social interactions, parent emotional functioning, and parent psychosocial functioning. Each factor fit the Rasch measurement model with acceptable fit index (mean square <1.4) and demonstrated excellent internal consistency, with alpha ranging from 0.76 to 0.88. The final instrument consists of four scales with a total of 29 items. Content validity was verified by analyzing parents' responses to an open-ended question. Test-retest reliability at a 48-hour interval was supported by a total IH-QoL intraclass correlation coefficient of 0.84. Certain clinical characteristics of hemangioma, including those located on the head and neck, in the proliferative stage, and requiring treatment, are associated with a greater impact on QoL.
Development and testing of emergency department patient transfer communication measures.
Klingner, Jill; Moscovice, Ira
2012-01-01
Communication problems are a major contributing factor to adverse events in hospitals.(1) The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality measurement of interfacility patient transfer communication. Input from existing measures, measurement and health care delivery experts, as well as hospital frontline staff was used to design and modify ED quality measures. Three field tests were conducted to determine the feasibility of data collection and the effectiveness of different training methods and types of partnerships. Measures were evaluated based on their prevalence, ease of data collection, and usefulness for internal and external improvement. It is feasible to collect ED quality measure data. Different data sources, data collection, and data entry methods, training and partners can be used to examine hospital ED quality. There is significant room for improvement in the communication of patient information between health care facilities. Current health care reform efforts highlight the importance of clear communication between organizations held accountable for patient safety and outcomes. The patient transfer communication measures have been tested in a wide range of rural settings and have been vetted nationally. They have been endorsed by the National Quality Forum, are included in the National Quality Measurement Clearinghouse supported by the Agency for Health Care Research and Quality (AHRQ), and are under consideration by the Centers for Medicare and Medicaid Services for future payment determinations beginning in calendar year 2013. © 2011 National Rural Health Association.
What can be Learned from Silage Breeding Programs?
NASA Astrophysics Data System (ADS)
Lorenz, Aaron J.; Coors, James G.
Improving the quality of cellulosic ethanol feedstocks through breeding and genetic manipulation could significantly impact the economics of this industry. Attaining this will require comprehensive and rapid characterization of large numbers of samples. There are many similarities between improving corn silage quality for dairy production and improving feedstock quality for cellulosic ethanol. It was our objective to provide insight into what is needed for genetic improvement of cellulosic feedstocks by reviewing the development and operation of a corn silage breeding program. We discuss the evolving definition of silage quality and relate what we have learned about silage quality to what is needed for measuring and improving feedstock quality. In addition, repeatability estimates of corn stover traits are reported for a set of hybrids. Repeatability of theoretical ethanol potential measured by near-infrared spectroscopy is high, suggesting that this trait may be easily improved through breeding. Just as cell wall digestibility has been factored into the latest measurements of silage quality, conversion efficiency should be standardized and included in indices of feedstock quality to maximize overall, economical energy availability.
Uddin, Mohammed Nazim; Bhar, Sunil; Al Mahmud, Abdullah; Islam, Fakir M Amirul
2017-01-01
Introduction A significant proportion of the global burden of disease has been attributed to mental and behavioural disorders. People with mental disorders (MDs) have lower levels of health-related quality of life than those without MDs. Several studies have shown that in low-resource countries, a range of social determinants including poor health literacy is critical in the epidemiological transition of disease outcome. There is a lack of evidence of MDs literacy, the prevalence and risk factors of common mental health conditions, or any validated instruments to measure psychological distress or evaluate the quality of life in rural areas of Bangladesh. Aims The aims of this study are: (1) report the awareness, knowledge, attitudes and practice (KAP) of MDs; (2) estimate the prevalence of and risk factors for psychological distress; (3) measure association of psychological distress and other socio-demographic factors with quality of life and (4) test the feasibility to use Kessler 10-item (K10) and WHO Quality Of Life-BREF (WHOQOL-BREF) questionnaires in rural Bangladesh for measuring psychological distress and quality of life. Methods and analysis A sample of 1500 adults aged 18–59 years and 1200 older adults aged 60–90 years will be interviewed from a multistage cluster random sample. Each participant will go through a face-to-face interview to assess their awareness and KAP of MDs. Information about the participant’s sociodemographic and socioeconomic status will be collected along with the psychological distress (K10) and quality of life (WHOQOL-BREF) questionnaires. Internal consistency, validity, reliability and item discrimination of K10 and WHOQOL-BREF instruments will be determined by using Rasch analysis and regression techniques. Ethics and dissemination Human Ethics Approval was received from the Swinburne University of Technology Human Ethics Committee. Results of this research will be disseminated via scientific forums including peer-reviewed publications and presentations at national and international conferences. PMID:28864700
Nursing Home Administrator Quality Improvement Self-Efficacy Scale.
Siegel, Elena O; Zisberg, Anna; Bakerjian, Debra; Zysberg, Leehu
Nursing home (NH) quality improvement (QI) is challenging. The critical role of NH leaders in successful QI is well established; however, current options for assessing the QI capabilities of leaders such as the licensed NH administrator are limited. This article presents the development and preliminary validation of an instrument to measure NH administrator self-efficacy in QI. We used a mixed-methods cross-sectional design to develop and test the measure. For item generation, 39 NH leaders participated in qualitative interviews. Item reduction and content validity were established with a sample of eight subject matter experts. A random sample of 211 administrators from NHs with the lowest and highest Centers for Medicare and Medicaid Services Five-Star Quality ratings completed the measure. We conducted exploratory and confirmatory factor analyses and tested the measure for internal reliability and convergent, discriminant, and known group validity. The final measure included five subscales and 32 items. Confirmatory factor analysis reaffirmed the factorial structure with good fit indices. The new measure's subscales correlated with valid measures of self-efficacy and locus of control, supporting the measure's convergent and discriminant validity. Significant differences in most of the subscales were found between the objective (Centers for Medicare and Medicaid Services Five-Star Quality rating) and subjective (Self-Rated Facility QI Index) quality outcomes, supporting the measure's known group validity. The instrument has usefulness to both NH organizations and individual NH administrators as a diagnostic tool to identify administrators with higher/lower chances of successfully implementing QI. Organizations and individuals can use this diagnostic to identify the administrator's professional development needs for QI, in general, and specific to the instrument's five subscales, informing directions for in-house training, mentoring, and outside professional development. Attending to NH administrators' QI professional development needs prior to implementing QI holds promise to enhance the chances for successful implementation of QI, which is urgently needed in many NHs.
Reducing Falls After Electroconvulsive Therapy: A Quality Improvement Project.
Brown, Allana Marie
2017-07-01
Falls after electroconvulsive therapy (ECT) in patients 60 and older have been long recognized as a major clinical care issue across many mental health care settings. The evidence base for fall prevention strategies after receiving ECT is sparse. The risk factors for falls after ECT are vast and complex in nature, especially considering existing comorbid medical conditions. The dearth of research in guiding practitioners on fall reduction interventions for this patient population illuminates a gap in mental health care quality and safety. The purpose of the current nurse-led quality improvement project was to reduce falls in patients undergoing ECT by enhancing safety measures through education and a post-ECT treatment protocol. The project did not prove to be as efficacious as anticipated as measured by fall rate outcomes. Several factors that may account for the project's findings are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 20-29.]. Copyright 2017, SLACK Incorporated.
Genetic and environmental influences on sleep quality in middle-aged men: a twin study.
Genderson, Margo R; Rana, Brinda K; Panizzon, Matthew S; Grant, Michael D; Toomey, Rosemary; Jacobson, Kristen C; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E; Kremen, William S; Lyons, Michael J
2013-10-01
Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (mean age = 55.4 years; range 51-60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 [SD = 3.6; range 0-20]. Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep-a dichotomous measure based on the cut-off of global PSQI>5-was 31%, with no contribution of the common environment. Heritability of six of the seven PSQI component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime dysfunction) ranged from 0.15 to 0.31, whereas no genetic influences contributed to the use of sleeping medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step towards examination of the genetic relationship between sleep and other facets of aging. © 2013 European Sleep Research Society.
Genetic and Environmental Influences on Sleep Quality in Middle-Aged Men: A Twin Study
Genderson, Margo R.; Rana, Brinda K.; Panizzon, Matthew S.; Grant, Michael D.; Toomey, Rosemary; Jacobson, Kristen C.; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E.; Kremen, William S.; Lyons, Michael J.
2013-01-01
SUMMARY Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (VETSA)(mean age=55.4 years; range 51–60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 (SD=3.6; range 0–20). Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep—a dichotomous measure based on the cut-off of global PSQI>5--was 31% with no contribution of the common environment. Heritability of six of the seven PSQI component scores (Subjective Sleep Quality, Sleep Latency, Sleep Duration, Habitual Sleep Efficiency, Sleep Disturbances, and Daytime Dysfunction) ranged from .15 to .31, where as no genetic influences contributed to Use of Sleeping Medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step toward examination of the genetic relationship between sleep and other facets of aging. PMID:23509903
EuroQol 5D Quality of Life in Meniere's Disorder Can Be Explained with Symptoms and Disabilities
ERIC Educational Resources Information Center
Levo, Hilla; Stephens, Dafydd; Poe, Dennis; Kentala, Erna; Rasku, Jyrki; Pyykko, Ilmari
2012-01-01
The purpose of this study was to determine the factors explaining changes in the generic quality of life among patients with Meniere's disorder (MD) and to evaluate the EuroQol 5D (EQ-5D) quality-of-life measures. A questionnaire focusing on symptoms and disabilities caused by MD was collected from 726 individuals. General health-related quality…
Du, Yongzhao; Fu, Yuqing; Zheng, Lixin
2016-12-20
A real-time complex amplitude reconstruction method for determining the dynamic beam quality M2 factor based on a Mach-Zehnder self-referencing interferometer wavefront sensor is developed. By using the proposed complex amplitude reconstruction method, full characterization of the laser beam, including amplitude (intensity profile) and phase information, can be reconstructed from a single interference pattern with the Fourier fringe pattern analysis method in a one-shot measurement. With the reconstructed complex amplitude, the beam fields at any position z along its propagation direction can be obtained by first utilizing the diffraction integral theory. Then the beam quality M2 factor of the dynamic beam is calculated according to the specified method of the Standard ISO11146. The feasibility of the proposed method is demonstrated with the theoretical analysis and experiment, including the static and dynamic beam process. The experimental method is simple, fast, and operates without movable parts and is allowed in order to investigate the laser beam in inaccessible conditions using existing methods.
Assessing the cumulative effects of multiple environmental factors that influence mortality remains a challenging task. This study used the Environmental Quality Index (EQI), and its five domain indices (air, water, land, built and sociodemographic) as a measure of cumulative env...
Developing a Mathematics Education Quality Scale
ERIC Educational Resources Information Center
Ciftci, S. Koza; Karadag, Engin
2016-01-01
The aim of this study was to evaluate students' perceptions of the quality of mathematics education and to develop a reliable and valid measurement tool. The research was conducted with 638 (first study) and 407 (second study) secondary school students in Eskisehir, Turkey. Item discrimination, structural validity (exploratory factor analysis and…
The Food Quality Protection Act of 1996 requires children's risk assessments to be conducted using high quality and high quantity data. Currently, data on children's exposures and exposure factors are limited and insufficient to address risk assessments that do not rely heavil...
Measuring Service Quality in the Information Services Environment.
ERIC Educational Resources Information Center
Maddox-Swan, Ruth
1998-01-01
The purpose of this research was to identify the service factors that influence judgments of customer satisfaction in the academic library/media center. The study, conducted at Florida State University examined the relative importance of these determinants of service quality and compared these results to earlier studies conducted with customers of…
Do Non-Economic Quality of Life Factors Drive Immigration?
ERIC Educational Resources Information Center
Pacheco, Gail Anne; Rossouw, Stephanie; Lewer, Joshua
2013-01-01
This paper contributes to the immigration literature by generating two unique non-economic quality of life (QOL) indices and testing their role on recent migration patterns. Applying the generated QOL indices in conjunction with four independent welfare measures to an augmented gravity model of immigration, this paper finds an insignificant…
Grimbergen, T W; van Dijk, E; de Vries, W
1998-11-01
A new method is described for the determination of x-ray quality dependent correction factors for free-air ionization chambers. The method is based on weighting correction factors for mono-energetic photons, which are calculated using the Monte Carlo method, with measured air kerma spectra. With this method, correction factors for electron loss, scatter inside the chamber and transmission through the diaphragm and front wall have been calculated for the NMi free-air chamber for medium-energy x-rays for a wide range of x-ray qualities in use at NMi. The newly obtained correction factors were compared with the values in use at present, which are based on interpolation of experimental data for a specific set of x-ray qualities. For x-ray qualities which are similar to this specific set, the agreement between the correction factors determined with the new method and those based on the experimental data is better than 0.1%, except for heavily filtered x-rays generated at 250 kV. For x-ray qualities dissimilar to the specific set, differences up to 0.4% exist, which can be explained by uncertainties in the interpolation procedure of the experimental data. Since the new method does not depend on experimental data for a specific set of x-ray qualities, the new method allows for a more flexible use of the free-air chamber as a primary standard for air kerma for any x-ray quality in the medium-energy x-ray range.
Ansuategui Echeita, Jone; van Holland, Berry J; Gross, Douglas P; Kool, Jan; Oesch, Peter; Trippolini, Maurizio A; Reneman, Michiel F
2018-03-09
Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults. A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor's association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods. Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner's fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied. Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance. Implications for Rehabilitation Research on Functional Capacity Evaluation (FCE) performance and its association with biopsychosocial factors have scarcely addressed the impact of social factors, limiting full understanding of FCE results. The social factors, healthcare (examiner's fear behavior and type of instruction), personal or cultural systems (country of FCE, primary or mother language, and ethnicity), workplace system (previous job salary, time of day (workday)), and legislative and insurance system (compensation and litigation status), have a bearing in FCE performance. Better understanding of factors associating with functional capacity provide insights in FCE, allowing clinicians to improve the evaluations and interpretations of the assessment and better design the rehabilitation program. Better understanding of factors that influence FCE performance, and of unstudied factors, will allow researchers guidance to further investigate the construct of functional capacity.
The impacts of reactive terpene emissions from plants on air quality in Las Vegas, Nevada
NASA Astrophysics Data System (ADS)
Papiez, Maria R.; Potosnak, Mark J.; Goliff, Wendy S.; Guenther, Alex B.; Matsunaga, Sou N.; Stockwell, William R.
A three-part study was conducted to quantify the impact of landscaped vegetation on air quality in a rapidly expanding urban area in the arid southeastern United States. The study combines in situ, plant-level measurements, a spatial emissions inventory, and a photochemical box model. Maximum plant-level basal emission rates were moderate: 18.1 μgC gdw -1 h -1 ( Washingtonia spp., palms) for isoprene and 9.56 μgC gdw -1 h -1 ( Fraxinus velutina, Arizona ash) for monoterpenes. Sesquiterpene emission rates were low for plant species selected in this study, with no measurement exceeding 0.1 μgC gdw -1 h -1. The high ambient temperatures combined with moderate plant-level emission factors resulted in landscape emission factors that were low (250-640 μgC m -2 h -1) compared to more mesic environments (e.g., the southeastern United States). The Regional Atmospheric Chemistry Mechanism (RACM) was modified to include a new reaction pathway for ocimene. Using measured concentrations of anthropogenic hydrocarbons and other reactive air pollutants (NO x, ozone), the box model employing the RACM mechanism revealed that these modest emissions could have a significant impact on air quality. For a suburban location that was downwind of the urban core (high NO x; low anthropogenic hydrocarbons), biogenic terpenes increased time-dependent ozone production rates by a factor of 50. Our study demonstrates that low-biomass density landscapes emit sufficient biogenic terpenes to have a significant impact on regional air quality.
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.
Filippov, V L; Nechaeva, E N
2014-01-01
The article presents results of life quality assessment and subjective evaluation data on health state, used for prenosologic evaluation of health state in residents of protective measures area near objects of storage and destruction of chemical weapons. Considering specific features of residence near potentially dangerous objects, the authors conducted qualitative evaluation of satisfaction with various life facets, with taking into account the objects specificity, established correlation between life quality and self-evaluation of health with factors influencing public health state.
The relations among child quality, family structure, and the value of the mother's time in Malaysia.
Leppel, K
1982-10-01
A model of the determinants of child quality and of the value of a woman's time is developed and tested using data from the Malaysian Family Life Survey of 1976-1977. Child quality is measured by educational attainment; factors influencing the value of the mother's time include size and age composition of household, family income, education, and hours worked. The results indicate that size and age composition of household affect a woman's asking wage. However, more data are needed before the effects of family structure on schooling can be measured with confidence.
Organizational Attributes Associated With Medicare ACO Quality Performance.
Zhu, Xi; Mueller, Keith; Huang, Huang; Ullrich, Fred; Vaughn, Thomas; MacKinney, A Clinton
2018-05-08
To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively. Results show that after adjusting for other organizational factors, rural ACOs' average quality score was comparable to that of ACOs serving other geographic categories. ACOs with hospital-system sponsorship, larger beneficiary panels, and higher posthospitalization follow-up rates achieved better quality performance. There is no significant difference in average quality performance between rural ACOs and other ACOs after adjusting for structural and service-provision factors. MSSP ACO quality performance is positively associated with hospital-system sponsorship, beneficiary panel size, and posthospitalization follow-up rate. © 2018 National Rural Health Association.
Wallenhammar, Lena-Marie; Nyfjäll, Mats; Lindberg, Magnus; Meding, Birgitta
2004-06-01
Hand eczema is a disease of long duration, affecting the individual and society. The purpose of this study of 100 patients (51 females and 49 males) at an occupational dermatology clinic was to investigate whether the generic questionnaire Short Form-36 (SF-36), and the dermatology-specific Dermatology Life Quality Index (DLQI) are appropriate for assessing health-related quality of life (HRQL) in patients with hand eczema, and whether gender differences in HRQL could be detected. HRQL was affected by hand eczema, measured with both SF-36 and DLQI. The SF-36 showed more impaired HRQL for females than for males, in the mental health dimension, whereas no gender-related differences were detected with the DLQI. To compare the instruments we used factor analysis, with a polychoric correlation matrix as input, thus taking the ordinal aspect of the data into account. There was a high correlation between the instruments for physical health, but lower for mental health. In this context our interpretation of the factor analysis is that the SF-36 measures mental health better than the DLQI. The SF-36 therefore appears suitable for use in future studies for measuring HRQL, and gender differences in HRQL, in persons with reported hand eczema.
Xia, Jiang-Bao; Liu, Yu-Ting; Zhu, Jin-Fang; Xu, Jing-Wei; Lu, Zhao-Hua; Liu, Jing-Tao; Liu, Qing
2013-06-01
Taking the Tamarix chinensis secondary shrubs in Laizhou Bay of Yellow River Delta as test objects, and by using synthetic factor method, this paper studied the main factors causing the lowly efficiency of T. chinensis secondary shrubs as well as the main parameters for the classification of lowly efficient T. chinensis secondary shrubs. A total of 24 indices including shrubs growth and soil physical and chemical properties were selected to determine the main affecting factors and parameters in evaluating and classifying the lowly efficient shrubs. There were no obvious correlations between the indices reflecting the shrubs growth and soil quality, and thus, only using shrub growth index to reflect the lowly efficiency level of T. chinensis was not enough, and it would be necessary to combine with soil quality factors to make a comprehensive evaluation. The principal factors reflecting the quality level of lowly efficient T. chinensis shrubs included soil salt content and moisture content, stand age, single tree's aboveground stem, leaf biomass, and basal diameter, followed by soil density, porosity, and soil nutrient status. The lowly efficient T. chinensis shrubs in the Bay could be classified into five types, namely, shrub with growth potential, slightly low quality shrub, moderately lowly efficient shrub, moderately low quality and lowly efficient shrub, and seriously low quality and lowly efficient shrub. The main features, low efficiency causes, and management measures of these shrubs were discussed based on the mean cluster value.
Tessarek, C; Sarau, G; Kiometzis, M; Christiansen, S
2013-02-11
Self-assembled GaN rods were grown on sapphire by metal-organic vapor phase epitaxy using a simple two-step method that relies first on a nitridation step followed by GaN epitaxy. The mask-free rods formed without any additional catalyst. Most of the vertically aligned rods exhibit a regular hexagonal shape with sharp edges and smooth sidewall facets. Cathodo- and microphotoluminescence investigations were carried out on single GaN rods. Whispering gallery modes with quality factors greater than 4000 were measured demonstrating the high morphological and optical quality of the self-assembled GaN rods.
Saiki, Lori; Meize-Grochowski, Robin
To explore associations among symptoms of urinary incontinence, severity of symptoms, and measures of psychosocial health that may be assessed during a well-woman screening examination and the possible contribution of these variables to the relationship satisfaction of partnered midlife women living with urinary incontinence. Exploratory correlational design using self-report questionnaires. Community recruitment by posted fliers, advertisements, and social media. Partnered women, ages 45 to 65 years, with urinary incontinence (N = 57). Self-report measures of severity of incontinence symptoms, relationship satisfaction, self-concept/emotional health (self-esteem, body image, depression, anxiety), and relationship factors (sexual quality of life, incontinence-related communication). Data were analyzed using Spearman rho correlation with an exploration of the contribution of study factors to relationship satisfaction through standard multiple regression. The severity of urinary incontinence symptoms had no significant correlation with scores on relationship satisfaction or psychosocial health. Measures of self-concept/emotional health and relationship factors were significantly correlated with each other (r s = .40-.75, p < .01) and with relationship satisfaction (r s = .35-.71, p < .05). Preliminary exploration of the contribution of study factors to relationship satisfaction through exploratory regression analysis showed unique contributions from sexual quality of life (18.7%, p < .001) and depression (8.7%, p = .004). Midlife women with urinary incontinence, regardless of symptom severity, might benefit from screening for poorer sexual quality of life and mild depression symptoms because these two study factors significantly contributed to poorer intimate relationship satisfaction among this study's participants. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
High quality factor indium oxide mechanical microresonators
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bartolomé, Javier, E-mail: j.bartolome@fis.ucm.es; Cremades, Ana; Piqueras, Javier
2015-11-09
The mechanical resonance behavior of as-grown In{sub 2}O{sub 3} microrods has been studied in this work by in-situ scanning electron microscopy (SEM) electrically induced mechanical oscillations. Indium oxide microrods grown by a vapor–solid method are naturally clamped to an aluminum oxide ceramic substrate, showing a high quality factor due to reduced energy losses during mechanical vibrations. Quality factors of more than 10{sup 5} and minimum detectable forces of the order of 10{sup −16} N/Hz{sup 1/2} demonstrate their potential as mechanical microresonators for real applications. Measurements at low-vacuum using the SEM environmental operation mode were performed to study the effect ofmore » extrinsic damping on the resonators behavior. The damping coefficient has been determined as a function of pressure.« less
Systematic review of the quality of prognosis studies in systemic lupus erythematosus.
Lim, Lily S H; Lee, Senq J; Feldman, Brian M; Gladman, Dafna D; Pullenayegum, Eleanor; Uleryk, Elizabeth; Silverman, Earl D
2014-10-01
Prognosis studies examine outcomes and/or seek to identify predictors or factors associated with outcomes. Many prognostic factors have been identified in systemic lupus erythematosus (SLE), but few have been consistently found across studies. We hypothesized that this is due to a lack of rigor of study designs. This study aimed to systematically assess the methodologic quality of prognosis studies in SLE. A search of prognosis studies in SLE was performed using MEDLINE and Embase, from January 1990 to June 2011. A representative sample of 150 articles was selected using a random number generator and assessed by 2 reviewers. Each study was assessed by a risk of bias tool according to 6 domains: study participation, study attrition, measurement of prognostic factors, measurement of outcomes, measurement/adjustment for confounders, and appropriateness of statistical analysis. Information about missing data was also collected. A cohort design was used in 71% of studies. High risk of bias was found in 65% of studies for confounders, 57% for study participation, 56% for attrition, 36% for statistical analyses, 20% for prognostic factors, and 18% for outcome. Missing covariate or outcome information was present in half of the studies. Only 6 studies discussed reasons for missing data and 2 imputed missing data. Lack of rigorous study design, especially in addressing confounding, study participation and attrition, and inadequately handled missing data, has limited the quality of prognosis studies in SLE. Future prognosis studies should be designed with consideration of these factors to improve methodologic rigor. Copyright © 2014 by the American College of Rheumatology.
Giuffrida, Michelle A; Brown, Dorothy Cimino; Ellenberg, Susan S; Farrar, John T
2018-05-01
OBJECTIVE To describe development and initial psychometric testing of an owner-reported questionnaire designed to standardize measurement of general quality of life (QOL) in dogs with cancer. DESIGN Key-informant interviews, questionnaire development, and field trial. SAMPLE Owners of 25 dogs with cancer for item development and pretesting and owners of 90 dogs with cancer for reliability and validity testing. PROCEDURES Standard methods for development and testing of questionnaire instruments intended to measure subjective states were used. Items were generated, selected, scaled, and pretested for content, meaning, and readability. Response items were evaluated with exploratory factor analysis and by assessing internal consistency (Cronbach α) and convergence with global QOL as determined with a visual analog scale. Preliminary tests of stability and responsiveness were performed. RESULTS The final questionnaire-which was named the Canine Owner-Reported Quality of Life (CORQ) questionnaire-contained 17 items related to observable behaviors commonly used by owners to evaluate QOL in their dogs. Several items pertaining to physical symptoms performed poorly and were omitted. The 17 items were assigned to 4 factors-vitality, companionship, pain, and mobility-on the basis of the items they contained. The CORQ questionnaire and its factors had high internal consistency (Cronbach α = 0.68 to 0.90) and moderate to strong correlations (r = 0.49 to 0.71) with global QOL as measured on a visual analog scale. Preliminary testing indicated good test-retest reliability and responsiveness to improvements in overall QOL. CONCLUSIONS AND CLINICAL RELEVANCE The CORQ questionnaire was a valid, reliable owner-reported questionnaire that measured general QOL in dogs with cancer and showed promise as a clinical trial outcome measure for quantifying changes in individual dog QOL occurring in response to cancer treatment and progression.
Smith, Timothy W.; Uchino, Bert N.; Florsheim, Paul; Berg, Cynthia A.; Butner, Jonathan; Hawkins, Melissa; Henry, Nancy J. M.; Beveridge, Ryan M.; Pearce, Gale; Hopkins, Paul N.; Yoon, Hyo-Chun
2011-01-01
Objective Marital disruption and low marital quality confer risk of coronary artery disease (CAD) in some but not all studies. Inconsistencies might reflect limitations of self-reports of marital quality compared to behavioral observations. Also, aspects of marital quality related to CAD might differ for men and women. This study examined behavioral observations of affiliation (i.e., warmth vs. hostility) and control (i.e., dominance vs. submissiveness) and prior divorce as predictors of coronary artery calcification (CAC) in older couples. Methods Couples underwent CT scans for CAC and marital assessments including observations of laboratory-based disagreement. Participants were 154 couples (mean age = 63.5; mean length of marriage = 36.4 years) free of prio diagnosis of CAD. Results Controlling traditional risk factors, behavioral measures of affiliation (low warmth) accounted for 6.2% of variance in CAC for women, p<.01, but not for men. Controlling behavior (dominance) accounted for 6.0% of variance in CAC for men, p<.02, but not for women. Behavioral measures were related to self-reports of marital quality, but the latter were unrelated to CAC. History of divorce predicted CAC for men and women. Conclusions History of divorce and behavioral – but not self-report – measures of marital quality were related to CAD, such that low warmth and high dominance conferred risk for women and men, respectively. Prior research might underestimate the role of marital quality in CAD by relying on global self-reports of this risk factor. PMID:21364198
Smith, Timothy W; Uchino, Bert N; Florsheim, Paul; Berg, Cynthia A; Butner, Jonathan; Hawkins, Melissa; Henry, Nancy J M; Beveridge, Ryan M; Pearce, Gale; Hopkins, Paul N; Yoon, Hyo-Chun
2011-05-01
To examine behavioral observations of affiliation (ie, warmth versus hostility) and control (ie, dominance versus submissiveness) and prior divorce as predictors of coronary artery calcification (CAC) in older couples. In some but not all studies, marital disruption and low marital quality have been shown to confer risk of coronary artery disease (CAD). Inconsistencies might reflect limitations of self-reports of marital quality compared with behavioral observations. Also, aspects of marital quality related to CAD might differ for men and women. Couples underwent computed tomography scans for CAC and marital assessments, including observations of laboratory-based disagreement. Participants were 154 couples (mean age, 63.5 years; mean length of marriage, 36.4 years) free of prior diagnosis of CAD. Controlling traditional risk factors, we found behavioral measures of affiliation (low warmth) accounted for 6.2% of variance in CAC for women, p < .01, but not for men. Controlling behavior (dominance) accounted for 6.0% of variance in CAC for men, p < .02, but not for women. Behavioral measures were related to self-reports of marital quality, but the latter were unrelated to CAC. History of divorce predicted CAC for men and women. History of divorce and behavioral--but not self-report--measures of marital quality were related to CAD, such that low warmth and high dominance conferred risk for women and men, respectively. Prior research might underestimate the role of marital quality in CAD by relying on global self-reports of this risk factor.
Lo, Catherine M H; Lee, Paul H
2012-06-18
Sleep disturbance is a complex health problem in ageing global populations decreasing quality of life among many older people. Geographic, cultural, and ethnic differences in sleep patterns have been documented within and between Western and Asian populations. The aim of this study was to explore sleep problems among Hong Kong seniors by examining the prevalence of poor sleep quality, the relationship between sleep quality and health-related quality of life, and associated factors of good sleepers in different age groups. This cross-sectional study used convenience sampling and gathered data during face-to-face interviews. Older community-dwelling individuals (n = 301) were recruited in community centres in 2010. The Pittsburgh Sleep Quality Index and Medical Outcomes Study Short Form-36 were used to measure sleep quality and health-related quality of life. The Medical Outcomes Study Short Form-36 domain scores were compared between good and bad sleepers and between long and short sleepers using Hotelling's T-Square test. SF-36 domain scores were placed into a logistic regression model that controlled for significant demographic variables (gender, educational level, perceived health). Most (77.7%) participants were poor sleepers. Participants who had global Pittsburgh Sleep Quality Index scores <5 and slept ≥5.5 h/night had better health-related quality of life. Vitality, emotional role, physical functioning, and bodily pain domain scores were associated factors of good sleepers in different age groups. This study found a strong negative association between sleep deprivation (poor quality, short duration) and health-related quality of life. Associated factors for good sleep quality in later life differ among age groups in relation to universal age-related changes, and should be addressed by social policies and health-care programmes.
Cohen, S Robin; Sawatzky, Richard; Russell, Lara B; Shahidi, Javad; Heyland, Daren K; Gadermann, Anne M
2017-02-01
The McGill Quality of Life Questionnaire has been widely used with people with life-threatening illnesses without modification since its publication in 1996. With use, areas for improvement have emerged; therefore, various minor modifications were tested over time. To revise the McGill Quality of Life Questionnaire (McGill Quality of Life Questionnaire-Revised) while maintaining or improving its psychometric properties and length, keeping it as close as possible to the McGill Quality of Life Questionnaire to enable reasonable comparison with existing McGill Quality of Life Questionnaire literature. Data sets from eight studies were used (four studies originally used to develop the McGill Quality of Life Questionnaire, two to develop new McGill Quality of Life Questionnaire versions, and two with unrelated purposes). The McGill Quality of Life Questionnaire-Revised was developed using analyses of measurement invariance, confirmatory factor analysis, and calculation of correlations with the McGill Quality of Life Questionnaire's global quality of life item. Data were from 1702 people with life-threatening illnesses recruited from acute and palliative care units, palliative home care services, and oncology and HIV/AIDS outpatient clinics. The McGill Quality of Life Questionnaire-Revised consists of 14 items (plus the global quality of life item). A new Physical subscale was created combining physical symptoms and physical well-being and a new item on physical functioning. The Existential subscale was reduced to four items. The revised Support subscale, renamed Social, focuses more on relationships. The Psychological subscale remains unchanged. Confirmatory factor analysis results provide support for the measurement structure of the McGill Quality of Life Questionnaire-Revised. The overall scale has good internal consistency reliability ( α = 0.94). The McGill Quality of Life Questionnaire-Revised improves on and can replace the McGill Quality of Life Questionnaire since it contains improved wording, a somewhat expanded repertoire of concepts with fewer items, and a single subscale for the physical domain, while retaining good psychometric properties.
2012-01-01
Background This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children. Methods A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Results The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses. Conclusions The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran. PMID:22221765
Amiri, Parisa; Eslamian, Ghazaleh; Mirmiran, Parvin; Shiva, Niloofar; Jafarabadi, Mohammad Asghari; Azizi, Fereidoun
2012-01-05
This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children. A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses. The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran.
Quality of life in children and teenagers with food hypersensitivity.
MacKenzie, Heather; Dean, Taraneh
2010-08-01
Given that food is essential for life and that there is currently no cure for food hypersensitivity (FHS), quality of life is a key outcome measure for those affected. The quality of life of children and teenagers with FHS is particularly important given that they must learn to manage their FHS while also contending with normal developmental challenges. This article will review the current state of quality of life research in this important area, and discusses the impact of FHS on the quality-of-life of children and teenagers, the availability and suitability of disease-specific health-related quality-of-life measures for this population, and the identification of factors that may influence their health-related quality of life. Two previous reviews have been conducted in this area, and this article aims to extend this work by including recent publications and qualitative studies on this topic.
Schüller, Andreas; Meier, Markus; Selbach, Hans-Joachim; Ankerhold, Ulrike
2015-07-01
The aim of this study was to investigate whether a chamber-type-specific radiation quality correction factor kQ can be determined in order to measure the reference air kerma rate of (60)Co high-dose-rate (HDR) brachytherapy sources with acceptable uncertainty by means of a well-type ionization chamber calibrated for (192)Ir HDR sources. The calibration coefficients of 35 well-type ionization chambers of two different chamber types for radiation fields of (60)Co and (192)Ir HDR brachytherapy sources were determined experimentally. A radiation quality correction factor kQ was determined as the ratio of the calibration coefficients for (60)Co and (192)Ir. The dependence on chamber-to-chamber variations, source-to-source variations, and source strength was investigated. For the PTW Tx33004 (Nucletron source dosimetry system (SDS)) well-type chamber, the type-specific radiation quality correction factor kQ is 1.19. Note that this value is valid for chambers with the serial number, SN ≥ 315 (Nucletron SDS SN ≥ 548) onward only. For the Standard Imaging HDR 1000 Plus well-type chambers, the type-specific correction factor kQ is 1.05. Both kQ values are independent of the source strengths in the complete clinically relevant range. The relative expanded uncertainty (k = 2) of kQ is UkQ = 2.1% for both chamber types. The calibration coefficient of a well-type chamber for radiation fields of (60)Co HDR brachytherapy sources can be calculated from a given calibration coefficient for (192)Ir radiation by using a chamber-type-specific radiation quality correction factor kQ. However, the uncertainty of a (60)Co calibration coefficient calculated via kQ is at least twice as large as that for a direct calibration with a (60)Co source.
Quality measures in applications of image restoration.
Kriete, A; Naim, M; Schafer, L
2001-01-01
We describe a new method for the estimation of image quality in image restoration applications. We demonstrate this technique on a simulated data set of fluorescent beads, in comparison with restoration by three different deconvolution methods. Both the number of iterations and a regularisation factor are varied to enforce changes in the resulting image quality. First, the data sets are directly compared by an accuracy measure. These values serve to validate the image quality descriptor, which is developed on the basis of optical information theory. This most general measure takes into account the spectral energies and the noise, weighted in a logarithmic fashion. It is demonstrated that this method is particularly helpful as a user-oriented method to control the output of iterative image restorations and to eliminate the guesswork in choosing a suitable number of iterations.
Social cognition in schizophrenia: Factor structure of emotion processing and theory of mind.
Browne, Julia; Penn, David L; Raykov, Tenko; Pinkham, Amy E; Kelsven, Skylar; Buck, Benjamin; Harvey, Philip D
2016-08-30
Factor analytic studies examining social cognition in schizophrenia have yielded inconsistent results most likely due to the varying number and quality of measures. With the recent conclusion of Phase 3 of the Social Cognition Psychometric Evaluation (SCOPE) Study, the most psychometrically sound measures of social cognition have been identified. Therefore, the aims of the present study were to: 1) examine the factor structure of social cognition in schizophrenia through the utilization of psychometrically sound measures, 2) examine the stability of the factor structure across two study visits, 3) compare the factor structure of social cognition in schizophrenia to that in healthy controls, and 4) examine the relationship between the factors and relevant outcome measures including social functioning and symptoms. Results supported a one-factor model for the patient and healthy control samples at both visits. This single factor was significantly associated with negative symptoms in the schizophrenia sample and with social functioning in both groups at both study visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Social cognition in schizophrenia: Factor structure of emotion processing and theory of mind
Browne, Julia; Penn, David L.; Raykov, Tenko; Pinkham, Amy E.; Kelsven, Skylar; Buck, Benjamin; Harvey, Philip D.
2018-01-01
Factor analytic studies examining social cognition in schizophrenia have yielded inconsistent results most likely due to the varying number and quality of measures. With the recent conclusion of Phase 3 of the Social Cognition Psychometric Evaluation (SCOPE) Study, the most psychometrically sound measures of social cognition have been identified. Therefore, the aims of the present study were to: 1) examine the factor structure of social cognition in schizophrenia through the utilization of psychometrically sound measures, 2) examine the stability of the factor structure across two study visits, 3) compare the factor structure of social cognition in schizophrenia to that in healthy controls, and 4) examine the relationship between the factors and relevant outcome measures including social functioning and symptoms. Results supported a one-factor model for the patient and healthy control samples at both visits. This single factor was significantly associated with negative symptoms in the schizophrenia sample and with social functioning in both groups at both study visits. PMID:27280525
Validation of the self regulation questionnaire as a measure of health in quality of life research
2009-01-01
Objectives Several epidemiological studies address psychosomatic 'self regulation' as a measure of quality of life aspects. However, although widely used in studies with a focus on complementary cancer treatment, and recognized to be associated with better survival of cancer patients, it is unclear what the 'self regulation' questionnaire exactly measures. Design and setting In a sample of 444 individuals (27% healthy, 33% cancer, 40% other internal diseases), we performed reliability and exploratory factor analyses, and correlated the 16-item instrument with external measures such as the Hospital Anxiety and Depression Scale, the Herdecke Quality of Life questionnaire, and autonomic regulation questionnaire. Results The 16-item pool had a very good internal consistency (Cronbach's alpha = 0.948) and satisfying/good (rrt = 0.796) test-retest reliability after 3 months. Exploratory factor analysis indicated 2 sub-constructs: (1) Ability to change behaviour in order to reach goals, and (2) Achieve satisfaction and well-being. Both sub-scales correlated well with quality of life aspects, particularly with Initiative Power/Interest, Social Interactions, Mental Balance, and negatively with anxiety and depression. Conclusions The Self Regulation Questionnaire (SRQ) was found to be a valid and reliable tool which measures unique psychosomatic abilities. Self regulation deals with competence and autonomy and can be regarded as a problem solving capacity in terms of an active adaptation to stressful situations to restore wellbeing. The tool is an interesting option to be used particularly in complementary medicine research with a focus on behavioural modification. PMID:19541580
Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long
2015-11-01
The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.
Villiers-Tuthill, Amanda; Doulougeri, Karolina; McGee, Hannah; Montgomery, Anthony; Panagopoulou, Efharis; Morgan, Karen
2017-12-01
Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework. We conducted a multi-country cross-sectional study. Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed. Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities. The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.
Efficient system modeling for a small animal PET scanner with tapered DOI detectors.
Zhang, Mengxi; Zhou, Jian; Yang, Yongfeng; Rodríguez-Villafuerte, Mercedes; Qi, Jinyi
2016-01-21
A prototype small animal positron emission tomography (PET) scanner for mouse brain imaging has been developed at UC Davis. The new scanner uses tapered detector arrays with depth of interaction (DOI) measurement. In this paper, we present an efficient system model for the tapered PET scanner using matrix factorization and a virtual scanner geometry. The factored system matrix mainly consists of two components: a sinogram blurring matrix and a geometrical matrix. The geometric matrix is based on a virtual scanner geometry. The sinogram blurring matrix is estimated by matrix factorization. We investigate the performance of different virtual scanner geometries. Both simulation study and real data experiments are performed in the fully 3D mode to study the image quality under different system models. The results indicate that the proposed matrix factorization can maintain image quality while substantially reduce the image reconstruction time and system matrix storage cost. The proposed method can be also applied to other PET scanners with DOI measurement.
Kramer, Jennifer R; Hachem, Christine Y; Kanwal, Fasiha; Mei, Minghua; El-Serag, Hashem B
2011-01-01
Coinfection with hepatitis A virus (HAV) or hepatitis B virus (HBV) in patients with chronic hepatitis C virus (HCV) is associated with increased morbidity and mortality. The Center for Medicare and Medicaid Services has identified HAV and HBV vaccination as a priority area for quality measurement in HCV. It is unclear to what extent patients with HCV meet these recommendations. We used national data from the Department of Veterans Affairs HCV Clinical Case Registry to evaluate the prevalence and predictors of meeting the quality measure (QM) of receiving vaccination or documented immunity to HAV and HBV in patients with chronic HCV. We identified 88,456 patients who had overall vaccination rates of 21.9% and 20.7% for HBV and HAV, respectively. The QM rates were 57.0% and 45.5% for HBV and HAV, respectively. Patients who were nonwhite or who had elevated alanine aminotransferase levels, cirrhosis, or human immunodeficiency virus were more likely to meet the HBV QM. Factors related to HCV care were also determinants of meeting the HBV QM. These factors included receiving a specialist consult, genotype testing, or HCV treatment. Patients who were older, had psychosis, and had a higher comorbidity score were less likely to meet the HBV QM. With a few exceptions, similar variables were related to meeting the HAV QM. The incidence of superinfection with acute HBV and HAV was low, but it was significantly lower in patients who received vaccination than in those who did not. Quality measure rates for HAV and HBV are suboptimal for patients with chronic HCV. In addition, several patient-related factors and receiving HCV-related care are associated with a higher likelihood of meeting QMs. Copyright © 2010 American Association for the Study of Liver Diseases.
Al-Asadi, Ali M; Klein, Britt; Meyer, Denny
2014-10-28
A relative newcomer to the field of psychology, e-mental health has been gaining momentum and has been given considerable research attention. Although several aspects of e-mental health have been studied, 1 aspect has yet to receive attention: the structure of comorbidity of psychological disorders and their relationships with measures of psychosocial adjustment including suicidal ideation in online samples. This exploratory study attempted to identify the structure of comorbidity of 21 psychological disorders assessed by an automated online electronic psychological assessment screening system (e-PASS). The resulting comorbidity factor scores were then used to assess the association between comorbidity factor scores and measures of psychosocial adjustments (ie, psychological distress, suicidal ideation, adequate social support, self-confidence in dealing with mental health issues, and quality of life). A total of 13,414 participants were assessed using a complex online algorithm that resulted in primary and secondary Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) diagnoses for 21 psychological disorders on dimensional severity scales. The scores on these severity scales were used in a principal component analysis (PCA) and the resulting comorbidity factor scores were related to 4 measures of psychosocial adjustments. A PCA based on 17 of the 21 psychological disorders resulted in a 4-factor model of comorbidity: anxiety-depression consisting of all anxiety disorders, major depressive episode (MDE), and insomnia; substance abuse consisting of alcohol and drug abuse and dependency; body image-eating consisting of eating disorders, body dysmorphic disorder, and obsessive-compulsive disorders; depression-sleep problems consisting of MDE, insomnia, and hypersomnia. All comorbidity factor scores were significantly associated with psychosocial measures of adjustment (P<.001). They were positively related to psychological distress and suicidal ideation, but negatively related to adequate social support, self-confidence, and quality of life. This exploratory study identified 4 comorbidity factors in the e-PASS data and these factor scores significantly predicted 5 psychosocial adjustment measures. Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).
Klein, Britt; Meyer, Denny
2014-01-01
Background A relative newcomer to the field of psychology, e-mental health has been gaining momentum and has been given considerable research attention. Although several aspects of e-mental health have been studied, 1 aspect has yet to receive attention: the structure of comorbidity of psychological disorders and their relationships with measures of psychosocial adjustment including suicidal ideation in online samples. Objective This exploratory study attempted to identify the structure of comorbidity of 21 psychological disorders assessed by an automated online electronic psychological assessment screening system (e-PASS). The resulting comorbidity factor scores were then used to assess the association between comorbidity factor scores and measures of psychosocial adjustments (ie, psychological distress, suicidal ideation, adequate social support, self-confidence in dealing with mental health issues, and quality of life). Methods A total of 13,414 participants were assessed using a complex online algorithm that resulted in primary and secondary Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) diagnoses for 21 psychological disorders on dimensional severity scales. The scores on these severity scales were used in a principal component analysis (PCA) and the resulting comorbidity factor scores were related to 4 measures of psychosocial adjustments. Results A PCA based on 17 of the 21 psychological disorders resulted in a 4-factor model of comorbidity: anxiety-depression consisting of all anxiety disorders, major depressive episode (MDE), and insomnia; substance abuse consisting of alcohol and drug abuse and dependency; body image–eating consisting of eating disorders, body dysmorphic disorder, and obsessive-compulsive disorders; depression–sleep problems consisting of MDE, insomnia, and hypersomnia. All comorbidity factor scores were significantly associated with psychosocial measures of adjustment (P<.001). They were positively related to psychological distress and suicidal ideation, but negatively related to adequate social support, self-confidence, and quality of life. Conclusions This exploratory study identified 4 comorbidity factors in the e-PASS data and these factor scores significantly predicted 5 psychosocial adjustment measures. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG). PMID:25351885
Martin, P; Caci, H; Azorin, J M; Daléry, J; Hardy-Baylé, M C; Etienne, D; Gérard, D; Peretti, C S
2005-01-01
RATIONALE/OBJECTIVE: Quality of Life (QOL) has been recognized as an important measure of the outcome of patients by clinicians and policy makers in Mental Health. The emerging consensus in the health field that personal values and the patient's preferences are important in monitoring the quality of medical care outcomes makes it even more important to assess the patient's perspectives. Unfortunately, there is little consensus about what constitutes QOL or how to measure it, particularly in psychotic patients. The objective of this study is to report the stages of development and validation of a QOL questionnaire based on issues pertinent to patients with schizophrenia. During a first phase, identical pattern were identified among interviews (conducted by psychologists) of schizophrenic patients (DSM IV, n = 100), mental health staff (n = 20) and families (n = 20). The data gathered in the first phase were discussed and organized, by 25 experts, into a structure that made up the skeleton of the scale (133 items, 17 factors). Based on a prospective epidemiological study conducted with 337 French psychiatrists, a validation analysis of structural and psychometric proprieties was performed. Finally reliability of the scale was assessed by a second test/retest (D0, D7) study (n = 100). A total of 686 schizophrenic, schizophreniform or schizoaffective patients (DSM IV) were included. Internal consistency analysis identified 14 factors (74 items), all with a Cronbach's alpha of at least 0.75: professional life (0.95), affective and sexual life (0.92), illness knowledge (0.90), relationship (0.92), life satisfaction, (0.87), coping with drugs (0.79), drugs impact on the body (0.87), daily life (0.83), family relationship (0.81), future (0.88), security feeling (0.84), leisure (0.87), money management (0.76) and autonomy (0.75). Construct validity was confirmed (Pearson test) using established clinical (Brief Psychiatry Rating Scale and Clinical Global Improvement), social (Psychological Aptitude Rating Scale) and generic quality of life (Functional Status questionnaire) measures, correlation coefficient was significant for all factors but 2 in the BPRS (illness knowledge and coping with drugs) and 3 in the CGI (illness knowledge, coping with drugs and life satisfaction). Lastly, test/retest indicated high reliability for each factor (p < 0.001), the lower correlation coefficient (r) was 0.526. The Schizophrenia Quality Of Life-scale (SOL), based on a patient's point of view approach, is an efficient, multidimensional instrument designed for the measurement of the consequences of schizophrenia on individuals' lives.
Validation of the Social Provisions Scale in people with multiple sclerosis.
Chiu, Chung-Yi; Motl, Robert W; Ditchman, Nicole
2016-08-01
This study examined the factorial and construct validity of the Social Provisions Scale (SPS) in a sample of people with multiple sclerosis (MS). Participants included 292 individuals with MS (83.9% women) recruited from the Greater Illinois, Gateway, and Indiana chapters of the National Multiple Sclerosis Society. Participants completed the SPS and pain, fatigue, depression, anxiety, MS self-efficacy, quality of life, and satisfaction with life measures. Factorial validity was tested using confirmatory factor analysis (CFA), and construct validity was examined based on the strength of bivariate correlations with scores on related measures. Findings from the CFA indicated that a first-order, 6-factor measurement model provided a good fit for the 24 items of the SPS (CFI = .94, TLI = .93, RMSEA = 0.07) and that the 6 factors could be described by a single, second-order factor of the overall social provisions (CFI = .93, TLI = .92, RMSEA = 0.08). Cronbach's alpha was .89 for the global score and between .66 and .81 for the 6 subscales. The SPS global and subscale scores correlated significantly with satisfaction with life, depression, anxiety, MS self-efficacy, and quality of life measures. Findings from this study support the factorial validity, construct validity, and reliability of the SPS as a measure of social provisions for use with people with MS. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Initial investigation of dietitian perception of plant-based protein quality.
Hughes, Glenna J; Kress, Kathleen S; Armbrecht, Eric S; Mukherjea, Ratna; Mattfeldt-Beman, Mildred
2014-07-01
Interest in plant-based diets is increasing, evidenced by scientific and regulatory recommendations, including Dietary Guidelines for Americans. Dietitians provide guidance in dietary protein selection but little is known about how familiar dietitians are with the quality of plant versus animal proteins or methods for measuring protein quality. Likewise, there is a need to explore their beliefs related to dietary recommendations. The aim of this study was to assess dietitians' perceptions of plant-based protein quality and to determine if these are affected by demographic factors such as age and dietary practice group (DPG) membership. This was a cross-sectional design using an online survey. The survey was sent to all members of the Missouri Dietetic Association. All completed surveys (136) were analyzed. The main outcome measures were responses to belief and knowledge questions about the protein quality of plant-based diets, along with demographic information including age and DPG membership. Descriptive statistics and frequencies were determined, and chi-square analysis was used to determine the associations between belief and knowledge responses and demographic characteristics. Responses to belief statements suggested a high level of support for plant-based diets. No associations were found between any of the belief questions and demographic factors. A majority of respondents were not familiar with protein quality determination methods that are currently recognized by global regulatory and advisory agencies. Potential barriers identified in shifting to a more plant-based diet were lack of interest and perceived difficulty. Knowledge among dietitians of plant-based protein quality in general, and methods of protein quality measurement more specifically, needs to be addressed to enhance their knowledge base for making dietary protein recommendations. Two potential avenues for training are university curricula and continuing education opportunities provided to practitioners who provide dietary advice.
[Influencing factors on HRQOL of physically disabled persons].
Kim, Kye-Ha; Kim, Ok-Soo
2005-06-01
The purpose of this study was to investigate the influencing factors on health-related quality of life of physically disabled persons. Data was collected from 96 persons with a physical disability in three cities in Korea from June to September, 2003. Social support and depression were measured by a Social Support Questionnaire 6 (SSQ6) and Center for Epidemiologic Studies Depression questionnaire (CES-D). The Rosenberg Self-esteem Scale was used to measure self-esteem. Health-related quality of life (HRQOL) was measured using Smith Kline Beecham Quality of Life Scale (SBQOL). The SPSS WIN 11.0 version program was used for data analysis. There were significant differences of HRQOL according to monthly income and economic status. All subjects had a high level of depression and low self-esteem. The findings of this study show that self-esteem and the size of the social support network are significant influencing variables on HRQOL in physically disabled persons. Nursing intervention and counseling programs which improve self-esteem and increase the size of a social support network are needed to promote HRQOL in physically disabled persons.
Petry, Heidi; Suter-Riederer, Susanne; Kerker-Specker, Carmen; Imhof, Lorenz
2014-12-01
Patient centred and individually-tailored counselling of older people with a chronic condition who live at home is a useful intervention to support their independence. The paper presents the development and psychometric testing of the APN-BQ Instrument, to measure patient-centeredness. To measure the quality of an in-home counselling intervention, a 23-item questionnaire was developed and tested with 206 people 80 years and older. Principal component analysis with Varimax Rotation was conducted (n = 206). Analysis revealed a four factor (fs = 0.91) model scoring in 19 items. All factors loaded > 0.45. Cronbach's alpha was 0.86. The utility and acceptance of the instrument was confirmed by the high response rate (100 %) and the fact that participants answered 98.8 % of all questions. The APN-BQ has shown to be a reliable Instrument with good content and construct validity. It is a tool for APNs to measure structure, process, and outcome quality of a patient-centred and individually-tailored counselling program, including the degree of patient participation, and patient empowerment.
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.
Development of a core set of outcome measures for OAB treatment.
Foust-Wright, Caroline; Wissig, Stephanie; Stowell, Caleb; Olson, Elizabeth; Anderson, Anita; Anger, Jennifer; Cardozo, Linda; Cotterill, Nikki; Gormley, Elizabeth Ann; Toozs-Hobson, Philip; Heesakkers, John; Herbison, Peter; Moore, Kate; McKinney, Jessica; Morse, Abraham; Pulliam, Samantha; Szonyi, George; Wagg, Adrian; Milsom, Ian
2017-12-01
Standardized measures enable the comparison of outcomes across providers and treatments giving valuable information for improving care quality and efficacy. The aim of this project was to define a minimum standard set of outcome measures and case-mix factors for evaluating the care of patients with overactive bladder (OAB). The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group (WG) of leading clinicians and patients to engage in a structured method for developing a core outcome set. Consensus was determined by a modified Delphi process, and discussions were supported by both literature review and patient input. The standard set measures outcomes of care for adults seeking treatment for OAB, excluding residents of long-term care facilities. The WG focused on treatment outcomes identified as most important key outcome domains to patients: symptom burden and bother, physical functioning, emotional health, impact of symptoms and treatment on quality of life, and success of treatment. Demographic information and case-mix factors that may affect these outcomes were also included. The standardized outcome set for evaluating clinical care is appropriate for use by all health providers caring for patients with OAB, regardless of specialty or geographic location, and provides key data for quality improvement activities and research.
Lokker, Cynthia; Haynes, R. Brian; Chu, Rong; McKibbon, K. Ann; Wilczynski, Nancy L; Walter, Stephen D
2012-01-01
Objective: Journal impact factor (JIF) is often used as a measure of journal quality. A retrospective cohort study determined the ability of clinical article and journal characteristics, including appraisal measures collected at the time of publication, to predict subsequent JIFs. Methods: Clinical research articles that passed methods quality criteria were included. Each article was rated for relevance and newsworthiness by 3 to 24 physicians from a panel of more than 4,000 practicing clinicians. The 1,267 articles (from 103 journals) were divided 60∶40 into derivation (760 articles) and validation sets (507 articles), representing 99 and 88 journals, respectively. A multiple regression model was produced determining the association of 10 journal and article measures with the 2007 JIF. Results: Four of the 10 measures were significant in the regression model: number of authors, number of databases indexing the journal, proportion of articles passing methods criteria, and mean clinical newsworthiness scores. With the number of disciplines rating the article, the 5 variables accounted for 61% of the variation in JIF (R2 = 0.607, 95% CI 0.444 to 0.706, P<0.001). Conclusion: For the clinical literature, measures of scientific quality and clinical newsworthiness available at the time of publication can predict JIFs with 60% accuracy. PMID:22272156
Burnout, quality of life and emotional profile in general practitioners and psychiatrists.
Vicentic, Sreten; Gasic, Miroslava Jasovic; Milovanovic, Aleksandar; Tosevski, Dusica Lecic; Nenadovic, Milutin; Damjanovic, Aleksandar; Kostic, Bojana Dunjic; Jovanovic, Aleksandar A
2013-01-01
Many studies confirm that psychological factors and burnout in physicians are interconnected. It is however not known, whether quality of life is another factor that plays a role in this connection.The aim of this study was to explore the correlation between quality of life and emotional profile with the level of burnout in physicians. 120 physicians participated in this study, i.e., sixty general practitioners (GPs) and sixty psychiatrists. The General Health Questionnaire (GHQ) and the Maslach Burnout Inventory (MBI) were used to measure the job stress. The Quality of Life (QOL) and the Emotions Profile Index (EPI) were used to determine quality of life and emotional profile. Data were analyzed using methods of single and multiple correlation and regression methods. The QOL was higher in psychiatrists as a direct consequence of questions about finances and friendship. Analysis by gender showed that the growth of the burnout risk level (MBI) correlated with the growth of number of women who had stress coping problems. This research suggests that quality of life and individual factors represent a very significant role in burnout among physicians. Further researches in a bigger sample are required in order to identify key factors of quality of life related to burnout reducing, as well as for improvement of supervision strategies, including more the relevance of psychological profile of physicians.
[Measuring health-related quality of life with the SF-8. Normal sample of the German population].
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.
[Emission Factors of Vehicle Exhaust in Beijing].
Fan, Shou-bin; Tian, Ling-di; Zhang, Dong-xu; Qu, Song
2015-07-01
Based on the investigation of basic data such as vehicle type composition, driving conditions, ambient temperature and oil quality, etc., emission factors of vehicle exhaust pollutants including carbon monoxide (CO), nitrogen oxides (NOx), hydrocarbons (HC) and particulate matter(PM) were calculated using COPERT IV model. Emission factors of typical gasoline passenger cars and diesel trucks were measured using on-board measurement system on actual road. The measured and modeled emission factors were compared and the results showed that: the measured emission factors of CO, NOx and HC were 0. 96, 0. 64 and 4. 89 times of the modeled data for passenger cars conforming to the national IV emission standard. For the light, medium and heavy diesel trucks conforming to the national III emission standard, the measured data of CO emission factors were 1.61, 1. 07 and 1.76 times of the modeled data, respectively, the measured data of NOx emission factors were 1. 04, 1. 21 and 1. 18 times of the modeled data, and the measured data of HC emission factors were 3. 75, 1. 84 and 1. 47 times of the modeled data, while the model data of PM emission factors were 1. 31, 3. 42 and 6. 42 times of the measured data, respectively.
Hagen, Inger Hilde; Svindseth, Marit Følsvik; Nesset, Erik; Orner, Roderick; Iversen, Valentina Cabral
2018-03-27
The experience of having their new-borns admitted to an intensive care unit (NICU) can be extremely distressing. Subsequent risk of post-incident-adjustment difficulties are increased for parents, siblings, and affected families. Patient and next of kin satisfaction surveys provide key indicators of quality in health care. Methodically constructed and validated survey tools are in short supply and parents' experiences of care in Neonatal Intensive Care Units is under-researched. This paper reports a validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian NICUs. Parents' survey returns were collected using the Neonatal Satisfaction Survey (NSS-13). Data quality and psychometric properties were systematically assessed using exploratory factor analysis, tests of internal consistency, reliability, construct, convergent and discriminant validity. Each set of hospital returns were subjected to an apostasy analysis before an overall satisfaction rate was calculated. The survey sample of 568 parents represents 45% of total eligible population for the period of the study. Missing data accounted for 1,1% of all returns. Attrition analysis shows congruence between sample and total population. Exploratory factor analysis identified eight factors of concern to parents,"Care and Treatment", "Doctors", "Visits", "Information", "Facilities", "Parents' Anxiety", "Discharge" and "Sibling Visits". All factors showed satisfactory internal consistency, good reliability (Cronbach's alpha ranged from 0.70-0.94). For the whole scale of 51 items α 0.95. Convergent validity using Spearman's rank between the eight factors and question measuring overall satisfaction was significant on all factors. Discriminant validity was established for all factors. Overall satisfaction rates ranged from 86 to 90% while for each of the eight factors measures of satisfaction varied between 64 and 86%. The NSS-8 questionnaire is a valid and reliable scale for measuring parents' assessment of quality of care in NICU. Statistical analysis confirms the instrument's capacity to gauge parents' experiences of NICU. Further research is indicated to validate the survey questionnaire in other Nordic countries and beyond.
A qualitative study of contextual factors' impact on measures to reduce surgery cancellations.
Hovlid, Einar; Bukve, Oddbjørn
2014-05-13
Contextual factors influence quality improvement outcomes. Understanding this influence is important when adapting and implementing interventions and translating improvements into new settings. To date, there is limited knowledge about how contextual factors influence quality improvement processes. In this study, we explore how contextual factors affected measures to reduce surgery cancellations, which are a persistent problem in healthcare. We discuss the usefulness of the theoretical framework provided by the model for understanding success in quality (MUSIQ) for this kind of research. We performed a qualitative case study at Førde Hospital, Norway, where we had previously demonstrated a reduction in surgery cancellations. We interviewed 20 clinicians and performed content analysis to explore how contextual factors affected measures to reduce cancellations of planned surgeries. We identified three common themes concerning how contextual factors influenced the change process: 1) identifying a need to change, 2) facilitating system-wide improvement, and 3) leader involvement and support. Input from patients helped identify a need to change and contributed to the consensus that change was necessary. Reducing cancellations required improving the clinical system. This improvement process was based on a strategy that emphasized the involvement of frontline clinicians in detecting and improving system problems. Clinicians shared information about their work by participating in improvement teams to develop a more complete understanding of the clinical system and its interdependencies. This new understanding allowed clinicians to detect system problems and design adequate interventions. Middle managers' participation in the improvement teams and in regular work processes was important for successfully implementing and adapting interventions. Contextual factors interacted with one another and with the interventions to facilitate changes in the clinical system, reducing surgery cancellations. The MUSIQ framework is useful for exploring how contextual factors influence the improvement process and how they influence one another. Discussing data in relation to a theoretical framework can promote greater uniformity in reporting findings, facilitating knowledge-building across studies.
Stochastic Packet Loss Model to Evaluate QoE Impairments
NASA Astrophysics Data System (ADS)
Hohlfeld, Oliver
With provisioning of broadband access for mass market—even in wireless and mobile networks—multimedia content, especially real-time streaming of high-quality audio and video, is extensively viewed and exchanged over the Internet. Quality of Experience (QoE) aspects, describing the service quality perceived by the user, is a vital factor in ensuring customer satisfaction in today's communication networks. Frameworks for accessing quality degradations in streamed video currently are investigated as a complex multi-layered research topic, involving network traffic load, codec functions and measures of user perception of video quality.
Through the Lens of Culture: Quality of Life Among Latina Breast Cancer Survivors
Graves, Kristi D.; Jensen, Roxanne E.; Cañar, Janet; Perret-Gentil, Monique; Leventhal, Kara-Grace; Gonzalez, Florencia; Caicedo, Larisa; Jandorf, Lina; Kelly, Scott; Mandelblatt, Jeanne
2012-01-01
BACKGROUND Latinas have lower quality of life than Caucasian cancer survivors but we know little about factors associated with quality of life in this growing population. METHODS Bilingual staff conducted interviews with a national cross-sectional sample of 264 Latina breast cancer survivors. Quality of life was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). Regression models evaluated associations between culture, social and medical context and overall quality of life and its subdomains. RESULTS Latina survivors were 1-5 years post-diagnosis and reported a lower mean quality of life score compared to other published reports of non-Latina survivors (M=105; SD=19.4 on the FACT-B). Culturally-based feelings of breast cancer-related stigma and shame were consistently related to lower overall quality of life and lower well-being in each quality of life domain. Social and medical contextual factors were independently related to quality of life; together cultural, social and medical context factors uniquely accounted for 62% of the explained model variance of overall quality of life (Adjusted R2=0.53, P<.001). Similar relationships were seen for quality of life subdomains in which cultural, social and medical contextual variables independently contributed to the overall variance of each final model: physical well-being (Adjusted R2=0.23, P <.001), social well-being (Adjusted R2=0.51, P<.001), emotional well-being (Adjusted R2=0.28, P<.001), functional well-being (Adjusted R2=0.41, P<.001) and additional breast concerns (Adjusted R2=0.40, P<.001). CONCLUSIONS Efforts to improve Latinas’ survivorship experiences should consider cultural, social and medical contextual factors to close existing quality of life gaps between Latinas and other survivors. PMID:23085764
ERIC Educational Resources Information Center
Chiu, Chun-Yu; Seo, Hyojeong; Turnbull, Ann P.; Summer, Jean Ann
2017-01-01
The Beach Center Family Quality of Life Scale is an internationally validated instrument for measuring family outcomes. To revise the scale for better alignment with the Family Quality of Life theory, the authors excluded non-outcome items in this revision. In this study, we examined reliability and validity of the revised scale (i.e., the FQoL…
2013-01-01
Background Integrated into the work in health systems strengthening (HSS) is a growing focus on the importance of ensuring quality of the services delivered and systems which support them. Understanding how to define and measure quality in the different key World Health Organization building blocks is critical to providing the information needed to address gaps and identify models for replication. Description of approaches We describe the approaches to defining and improving quality across the five country programs funded through the Doris Duke Charitable Foundation African Health Initiative. While each program has independently developed and implemented country-specific approaches to strengthening health systems, they all included quality of services and systems as a core principle. We describe the differences and similarities across the programs in defining and improving quality as an embedded process essential for HSS to achieve the goal of improved population health. The programs measured quality across most or all of the six WHO building blocks, with specific areas of overlap in improving quality falling into four main categories: 1) defining and measuring quality; 2) ensuring data quality, and building capacity for data use for decision making and response to quality measurements; 3) strengthened supportive supervision and/or mentoring; and 4) operational research to understand the factors associated with observed variation in quality. Conclusions Learning the value and challenges of these approaches to measuring and improving quality across the key components of HSS as the projects continue their work will help inform similar efforts both now and in the future to ensure quality across the critical components of a health system and the impact on population health. PMID:23819662
NASA Astrophysics Data System (ADS)
Akpinar, A.
2017-11-01
This study explores whether specific types of green spaces (i.e. urban green spaces, forests, agricultural lands, rangelands, and wetlands) are associated with physical activity, quality of life, and cardiovascular disease prevalence. A sample of 8,976 respondents from the Behavioral Risk Factor Surveillance System, conducted in 2006 in Washington State across 291 zip-codes, was analyzed. Measures included physical activity status, quality of life, and cardiovascular disease prevalence (i.e. heart attack, angina, and stroke). Percentage of green spaces was derived from the National Land Cover Dataset and measured with Geographical Information System. Multilevel regression analyses were conducted to analyze the data while controlling for age, sex, race, weight, marital status, occupation, income, education level, and zip-code population and socio-economic situation. Regression results reveal that no green space types were associated with physical activity, quality of life, and cardiovascular disease prevalence. On the other hand, the analysis shows that physical activity was associated with general health, quality of life, and cardiovascular disease prevalence. The findings suggest that other factors such as size, structure and distribution (sprawled or concentrated, large or small), quality, and characteristics of green space might be important in general health, quality of life, and cardiovascular disease prevalence rather than green space types. Therefore, further investigations are needed.
Quality of life in breast cancer sufferers.
Shouman, Ahmed Essmat; Abou El Ezz, Nahla Fawzy; Gado, Nivine; Ibrahim Goda, Amal Mahmoud
2016-08-08
Purpose - The purpose of this paper is to measure health-related quality of life (QOL) among patients with early stage cancer breast under curative treatment at department of oncology and nuclear medicine at Ain Shams University Hospitals. Identify factors affecting QOL among these patients. Design/methodology/approach - A cross-sectional study measured QOL among early stage female breast cancer (BC) patients and determined the main factors affecting their QOL. Three interviewer administered questionnaires were used. Findings - The physical domain mostly affected in BC patients and the functional domain least. Socio-demographic factors that significantly affected BC patients QOL scores were patient age, education, having children and family income. Specific patient characteristics include caregiver presence - a factor that affected different QOL scores. Age at diagnosis, affection in the side of the predominant hand, post-operative chemotherapy and difficulty in obtaining the medication were the disease-related factors that affected QOL scores. Originality/value - The final model predicting QOL for early stage female BC patients included age, education and difficulty in obtaining the medication as determinants for total QOL score. Carer presence was the specific patient characteristic that affected different QOL scores.
Some comments on mapping from disease-specific to generic health-related quality-of-life scales.
Palta, Mari
2013-01-01
An article by Lu et al. in this issue of Value in Health addresses the mapping of treatment or group differences in disease-specific measures (DSMs) of health-related quality of life onto differences in generic health-related quality-of-life scores, with special emphasis on how the mapping is affected by the reliability of the DSM. In the proposed mapping, a factor analytic model defines a conversion factor between the scores as the ratio of factor loadings. Hence, the mapping applies to convert true underlying scales and has desirable properties facilitating the alignment of instruments and understanding their relationship in a coherent manner. It is important to note, however, that when DSM means or differences in mean DSMs are estimated, their mapping is still of a measurement error-prone predictor, and the correct conversion coefficient is the true mapping multiplied by the reliability of the DSM in the relevant sample. In addition, the proposed strategy for estimating the factor analytic mapping in practice requires assumptions that may not hold. We discuss these assumptions and how they may be the reason we obtain disparate estimates of the mapping factor in an application of the proposed methods to groups of patients. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Wade, Derick T
2003-10-01
Choosing outcome measures in rehabilitation research depends on the standard research skills of clear thinking, attention to detail, and minimizing the amount of data collected. In rehabilitation, outcome is more difficult to measure because (1) usually several outcomes are relevant, (2) relevant outcomes are affected by multiple factors in addition to treatment, and (3) even good measures rarely reflect the specific interest of any individual patient or member of the rehabilitation team, leading to some dissent. Measurement of general quality of life is not possible because there is little agreement as to the nature of the construct; moreover, measurement of relevant aspects of quality of life would probably give similar results. Cost in terms of resources can be estimated, but there is no validated or even widely accepted method of relating this to benefit in a fair, open, and rational way. Outcome is best measured at the level of behavior (activities), with other measures being used to aid interpretation.
Nuckols, Teryl; Harber, Philip; Sandin, Karl; Benner, Douglas; Weng, Haoling; Shaw, Rebecca; Griffin, Anne; Asch, Steven
2011-03-01
Providing higher quality medical care to workers with occupationally associated carpal tunnel syndrome (CTS) may reduce disability, facilitate return to work, and lower the associated costs. Although many workers' compensation systems have adopted treatment guidelines to reduce the overuse of unnecessary care, limited attention has been paid to ensuring that the care workers do receive is high quality. Further, guidelines are not designed to enable objective assessments of quality of care. This study sought to develop quality measures for the diagnostic evaluation and non-operative management of CTS, including managing occupational activities and functional limitations. Using a variation of the well-established RAND/UCLA Appropriateness Method, we developed draft quality measures using guidelines and literature reviews. Next, in a two-round modified-Delphi process, a multidisciplinary panel of 11 U.S. experts in CTS rated the measures on validity and feasibility. Of 40 draft measures, experts rated 31 (78%) valid and feasible. Nine measures pertained to diagnostic evaluation, such as assessing symptoms, signs, and risk factors. Eleven pertain to non-operative treatments, such as the use of splints, steroid injections, and medications. Eleven others address assessing the association between symptoms and work, managing occupational activities, and accommodating functional limitations. These measures will complement existing treatment guidelines by enabling providers, payers, policymakers, and researchers to assess quality of care for CTS in an objective, structured manner. Given the characteristics of previous measures developed with these methods, greater adherence to these measures will probably lead to improved patient outcomes at a population level.
Patient-centred quality of care in an IVF programme evaluated by men and women.
Holter, Herborg; Sandin-Bojö, Ann-Kristin; Gejervall, Ann-Louise; Wikland, Matts; Wilde-Larsson, Bodil; Bergh, Christina
2014-12-01
Do men and women value the same aspects of quality of care during IVF treatment when measuring rates of importance by the validated instrument, quality from the patient's perspective of in vitro fertilization (QPP-IVF)? Women valued most aspects of care as significantly more important than their partner although men and women evaluated the importance of the different care factors in a similar pattern. A few validated tools measuring patient-centred quality of care during IVF have been developed. Few studies of gender differences concerning experiences of patient-centred quality of care have been reported in the literature to date. A two-centre study was conducted between September 2011 and May 2012. Heterosexual couples (n = 497) undergoing IVF were invited to complete a questionnaire before receiving the result of the pregnancy test. In all, 363 women and 292 men evaluated quality of care by answering the QPP-IVF questionnaire. The measurements consisted of two kinds of evaluations: the rating of the importance of various aspects of treatment (subjective importance) and the rating of perceived quality of care (perceived reality). Comparisons between men and women on importance ratings and perceived reality ratings were performed both on factor (subscale) and single item levels by intra-couple analyses and corrected for age. A stepwise multiple logistic regression analysis was performed in order to select baseline variables independently predicting evaluation at factor level. The response rate was 67.5%, with 363 women (74.2%) and 292 men (60.6%) completing the study. Both the woman and man responded in 251 couples. Women rated the different care aspects as significantly more important than their partner in all factors except the factor, 'Responsibility/continuity'. Both genders gave the factors, 'Medical care' and 'Information after treatment', the highest scores. At item level women rated the majority of items as significantly more important than men. Perceived reality for the majority of factors and items was similarly rated by men and women in the couples. For women, receiving embryo transfer, short duration of infertility, IVF as a method and number of previous cycles were independently correlated to the highest score of importance of certain factors. The lower response rate of men compared with women (60.6 versus 74.2%, respectively) might have influenced the results through selection bias. Only patients who had adequate fluency in the Swedish language participated. This study is an important contribution in comparing the needs of men and women undergoing IVF treatments. The QPP-IVF instrument is a suitable instrument for revealing important care aspects identified by both men and women and a useful tool for stimulating patient-centred quality improvements within and between clinics. The study was supported by the LUA/ALF agreement at Sahlgrenska University Hospital, Gothenburg, Sweden, and by Hjalmar Svensson's Research Foundation. None of the authors declared any conflict of interests. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Li, Yingshuang; Ding, Chunge
2017-01-01
The Adult Carer Quality of Life questionnaire (AC-QoL) is a reliable and valid instrument used to assess the quality of life (QoL) of adult family caregivers. We explored the psychometric properties and tested the reliability and validity of a Chinese version of the AC-QoL with reliability and validity testing in 409 Chinese stroke caregivers. We used item-total correlation and extreme group comparison to do item analysis. To evaluate its reliability, we used a test-retest reliability approach, intraclass correlation coefficient (ICC), together with Cronbach’s alpha and model-based internal consistency index; to evaluate its validity, we used scale content validity, confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) via principal component analysis with varimax rotation. We found that the CFA did not in fact confirm the original factor model and our EFA yielded a 31-item measure with a five-factor model. In conclusions, although some items performed differently in our analysis of the original English language version and our Chinese language version, our translated AC-QoL is a reliable and valid tool which can be used to assess the quality of life of stroke caregivers in mainland China. Chinese version AC-QoL is a comprehensive and good measurement to understand caregivers and has the potential to be a screening tool to assess QoL of caregiver. PMID:29131845
Socioeconomic disparities in outcomes after acute myocardial infarction.
Bernheim, Susannah M; Spertus, John A; Reid, Kimberly J; Bradley, Elizabeth H; Desai, Rani A; Peterson, Eric D; Rathore, Saif S; Normand, Sharon-Lise T; Jones, Philip G; Rahimi, Ali; Krumholz, Harlan M
2007-02-01
Patients of low socioeconomic status (SES) have higher mortality after acute myocardial infarction (AMI). Little is known about the underlying mechanisms or the relationship between SES and rehospitalization after AMI. We analyzed data from the PREMIER observational study, which included 2142 patients hospitalized with AMI from 18 US hospitals. Socioeconomic status was measured by self-reported household income and education level. Sequential multivariable modeling assessed the relationship of socioeconomic factors with 1-year all-cause mortality and all-cause rehospitalization after adjustment for demographics, clinical factors, and quality-of-care measures. Both household income and education level were associated with higher risk of mortality (hazard ratio 2.80, 95% CI 1.37-5.72, lowest to highest income group) and rehospitalization after AMI (hazard ratio 1.55, 95% CI 1.17-2.05). Patients with low SES had worse clinical status at admission and received poorer quality of care. In multivariable modeling, the relationship between household income and mortality was attenuated by adjustment for demographic and clinical factors (hazard ratio 1.19, 95% CI 0.54-2.62), with a further small decrement in the hazard ratio after adjustment for quality of care. The relationship between income and rehospitalization was only partly attenuated by demographic and clinical factors (hazard ratio 1.38, 95% CI 1.01-1.89) and was not influenced by adjustment for quality of care. Patients' baseline clinical status largely explained the relationship between SES and mortality, but not rehospitalization, among patients with AMI.
Physics and material science of ultra-high quality factor superconducting resonator
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vostrikov, Alexander
2015-08-01
The nitrogen doping into niobium superconducting radio frequency cavity walls aiming to improve the fundamental mode quality factor is the subject of the research in the given work. Quantitative nitrogen diffusion into niobium model calculating the concentration profile was developed. The model estimations were confirmed with secondary ion mass spectrometry technique measurements. The model made controlled nitrogen doping recipe optimization possible. As a result the robust reproducible recipe for SRF cavity walls treatment with nitrogen doping was developed. The cavities produced with optimized recipe met LCLS–II requirements on quality factor of 2.7 ∙ 10 10 at acceleration field of 16more » MV/m. The microscopic effects of nitrogen doping on superconducting niobium properties were studied with low energy muon spin rotation technique and magnetometer measurements. No significant effect of nitrogen on the following features was found: electron mean free path, magnetic field penetration depth, and upper and surface critical magnetic fields. It was detected that for nitrogen doped niobium samples magnetic flux starts to penetrate inside the superconductor at lower external magnetic field value compared to the low temperature baked niobium ones. This explains lower quench field of SRF cavities treated with nitrogen. Quality factor improvement of fundamental mode forced to analyze the high order mode (HOM) impact on the particle beam dynamics. Both resonant and cumulative effects caused by monopole and dipole HOMs respectively are found to be negligible within the requirements for LCLS–II.« less
Steptoe, Andrew; Marmot, Michael
2003-01-01
Numerous psychosocial factors are associated with disease risk. This study investigated the possibility that a combination of chronic stress from exposure to multiple sources and absence of protective psychosocial resources would be related to heightened emotional distress, health risk behavior, biological risk factors, and impaired quality of life, independently of socioeconomic position (SEP). Data were analyzed from 227 men and women aged 47 to 59 years from the Whitehall II epidemiological cohort. A psychosocial adversity and vulnerability index (PAVIX) was constructed from high scores on measures of job demands, neighborhood stress, and financial strain, low emotional support, limited social networks, low active coping, and low sense of control. The measures making up the PAVIX were relatively independent of one another. Scores on the PAVIX were greater in lower SEP participants, and in single, separated, or divorced than married participants. The PAVIX was positively associated with psychological distress, depression, hopelessness, sleep problems, hostility, low self-esteem and loneliness, independently of age, sex, SEP, and marital status. There were no associations with health behaviors, but relationships were observed with glycohemoglobin, plasma fibrinogen, plasma viscosity, and body mass (women), that were again independent of covariates. Individuals with high PAVIX scores also reported impaired health-related quality of life. The accumulated burden of life stress coupled with limited protective psychosocial resources is associated with adverse psychological, biological, and quality of life outcomes. This integrated approach to the investigation of psychosocial factors may prove valuable in understanding etiological processes.
Objective quality assessment for multiexposure multifocus image fusion.
Hassen, Rania; Wang, Zhou; Salama, Magdy M A
2015-09-01
There has been a growing interest in image fusion technologies, but how to objectively evaluate the quality of fused images has not been fully understood. Here, we propose a method for objective quality assessment of multiexposure multifocus image fusion based on the evaluation of three key factors of fused image quality: 1) contrast preservation; 2) sharpness; and 3) structure preservation. Subjective experiments are conducted to create an image fusion database, based on which, performance evaluation shows that the proposed fusion quality index correlates well with subjective scores, and gives a significant improvement over the existing fusion quality measures.
A review of Quality of Life studies in Nigerian patients with psychiatric disorders.
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.
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
Psychometric properties of a scale to measure menopause-related symptoms in two ethnicities.
Wang, X; Perry, A C; Elbaum, B E; Burnett, K F; Swaminathan, H
2009-08-01
To evaluate the psychometric properties of a scale we constructed to measure menopause-related symptoms in Hispanic and White non-Hispanic women. Items were generated from the literature and clinical experiences. Hispanic (n = 123, 51.34 +/- 5.14 years) and White (n = 210, 53.36 +/- 4.80 years) women completed the scale and other instruments used to validate respective constructs. A subgroup of 69 women completed our scale a second time. Following exploratory factor analysis using the entire sample, confirmatory factor analysis was conducted for Hispanic and White women, separately. The same four-factor model (vasomotor, psychological symptoms, relationship(s), and other symptoms) fit data for both ethnic groups. The coefficient alpha for internal consistency was 0.852 and 0.849 for the initial and second administration, respectively, and the test-retest reliability was significant (p < 0.001). There were differences in factor scores among groups with different menopausal status. Factor scores were significantly correlated with scores of a global quality-of-life instrument (p < or = 0.001). Our study suggests that the scale is appropriate for use for Hispanic and White non-Hispanic women and is capable of detecting differences among women with different menopause-related symptoms. Menopause-related symptoms measured by the scale were correlated with global quality of life.
Cardona, Beatriz
2018-05-29
Measuring health and wellbeing outcomes of community aged care programs is a complex task given the diverse settings in which care takes place and the intersection of numerous factors affecting an individual's quality of life outcomes. Knowledge of a strong causal relationship between services provided and the final outcome enables confidence in assuming the care provided was largely responsible for the outcome achieved (Courtney et al., Aust J Adv Nurs 26:49-57, 2009). The Department of Health has recently reported on the findings of The National Aged Care Quality Indicator Program - Home Care Pilot (KPMG, National Aged Care Quality Indicator Program - Home Care Pilot, 2017). The Program sought to test various tools to measure quality of life outcomes of their community aged care programs. Some of the key issues raised in the study reiterate the findings from The Australian Community Care Outcome Measurement (ACCOM) pilot study (Cardona et al., Australas J Ageing 36: 69-71, 2017), including the value of the ASCOT SCT4 tool (Adult Social care Outcomes Toolkit, http://www.pssru.ac.uk/ascot/downloads/questionnaires/sct4.pdf ) to measure social care related quality of life (SCRQoL) in community aged care programs in the Australian context, the collection of additional data to map the relationship of various variables such as functional ability, demographic characteristics and quality of life scores and the governance and administration of measurement tools for the purpose of quality reporting and consumer choice.
USDA-ARS?s Scientific Manuscript database
Recent studies have suggested that cottonseed (Gossypium spp.) has the potential to contribute to the effort against world hunger, particularly by providing a high quality protein source. This report analyzed the diversity in protein content and other seed quality factors in the US National Cotton ...
USDA-ARS?s Scientific Manuscript database
Recent studies have suggested that cottonseed (Gossypium spp.) has the potential to contribute to the effort against world hunger, particularly by providing a high-quality protein source. This report analyzed the diversity in protein content and other seed quality factors in the U.S. National Cotton...
Employee Deviance: A Response to the Perceived Quality of the Work Experience.
ERIC Educational Resources Information Center
Hollinger, Richard; Clark, John
1982-01-01
Studies of deviant behavior in the work setting have assumed that an important factor is the employee's perception of the quality of the work experience. This study shows that measures of job satisfaction are significantly related to reported involvement in both property and production deviance in the workplace. (Author/SK)
Comparing Measures of Voice Quality from Sustained Phonation and Continuous Speech
ERIC Educational Resources Information Center
Gerratt, Bruce R.; Kreiman, Jody; Garellek, Marc
2016-01-01
Purpose: The question of what type of utterance--a sustained vowel or continuous speech--is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation.…
ERIC Educational Resources Information Center
Nimmer, Donald N.
1979-01-01
The Quality of School Life Scale (QLS) is an instrument designed to measure students' perceptions of their school experiences. Such an instrument may aid educators in evaluating students' perceptions in the three areas identified by the QSL: satisfaction, commitment to classwork, and reactions to teachers. (Author)
Literacy of Teachers. Indicator of the Month.
ERIC Educational Resources Information Center
National Center for Education Statistics (ED), Washington, DC.
An important issue in the education reform debate is the effect of comparatively low salaries on teacher quality. Prose literacy scores are one of the best available measures of verbal ability, a factor identified by research as being associated with teacher quality. If teachers have lower prose literacy scores relative to college graduates in…
Optimal Item Pool Design for a Highly Constrained Computerized Adaptive Test
ERIC Educational Resources Information Center
He, Wei
2010-01-01
Item pool quality has been regarded as one important factor to help realize enhanced measurement quality for the computerized adaptive test (CAT) (e.g., Flaugher, 2000; Jensema, 1977; McBride & Wise, 1976; Reckase, 1976; 2003; van der Linden, Ariel, & Veldkamp, 2006; Veldkamp & van der Linden, 2000; Xing & Hambleton, 2004). However, studies are…
Peterman, Amy H; Reeve, Charlie L; Winford, Eboni C; Cotton, Sian; Salsman, John M; McQuellon, Richard; Tsevat, Joel; Campbell, Cassie
2014-03-01
The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp; Peterman, Fitchett, Brady, Hernandez, & Cella, 2002) has become a widely used measure of spirituality; however, there remain questions about its specific factor structure and the validity of scores from its separate scales. Specifically, it remains unclear whether the Meaning and Peace scales denote distinct factors. The present study addresses previous limitations by examining the extent to which the Meaning and Peace scales relate differentially to a variety of physical and mental health variables across 4 sets of data from adults with a number of chronic health conditions. Although a model with separate but correlated factors fit the data better, discriminant validity analyses indicated limited differences in the pattern of associations each scale showed with a wide array of commonly used health and quality-of-life measures. In total, the results suggest that people may distinguish between the concepts of Meaning and Peace, but the observed relations with health outcomes are primarily due to variance shared between the 2 factors. Additional research is needed to better understand the separate and joint role of Meaning and Peace in the quality of life of people with chronic illness. 2014 APA
Peterman, Amy H.; Reeve, Charlie L.; Winford, Eboni C.; Salsman, John M.; Tsevat, Joel; Cotton, Sian; McQuellon, Richard; Campbell, Cassie
2014-01-01
The Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT–Sp; Peterman, Fitchett, Brady, Hernandez, & Cella, 2002) has become a widely used measure of spirituality; however, there remain questions about its specific factor structure and the validity of scores from its separate scales. Specifically, it remains unclear whether the Meaning and Peace scales denote distinct factors. The present study addresses previous limitations by examining the extent to which the Meaning and Peace scales relate differentially to a variety of physical and mental health variables across 4 sets of data from adults with a number of chronic health conditions. Although a model with separate but correlated factors fit the data better, discriminant validity analyses indicated limited differences in the pattern of associations each scale showed with a wide array of commonly used health and quality-of-life measures. In total, the results suggest that people may distinguish between the concepts of Meaning and Peace, but the observed relations with health outcomes are primarily due to variance shared between the 2 factors. Additional research is needed to better understand the separate and joint role of Meaning and Peace in the quality of life of people with chronic illness. PMID:24188147
Shi, Peng; Zhou, Guangya; Deng, Jie; Tian, Feng; Chau, Fook Siong
2015-09-29
We report the observations of all-optical electromagnetically induced transparency in nanostructures using waveguide side-coupled with photonic crystal nanobeam cavities, which has measured linewidths much narrower than individual resonances. The quality factor of transparency resonance can be 30 times larger than those of measured individual resonances. When the gap between cavity and waveguide is reduced to 10 nm, the bandwidth of destructive interference region can reach 10 nm while the width of transparency resonance is 0.3 nm. Subsequently, a comb-drive actuator is introduced to tune the line shape of the transparency resonance. The width of the peak is reduced to 15 pm and the resulting quality factor exceeds 10(5).
Szkody, Erica; Rogers, Mary Moussa; McKinney, Cliff
2018-06-16
Parent-child relationship quality is an important factor when examining adolescent's risk for problem behaviors. For this reason, many researchers have explored the impacts of parent-child relationship quality on adolescent and child behavior, yet the parent-child relationship has lasting consequences into adulthood. The current study examined the mediating role of risky sexual behavior (as measured by the Youth Risk Behavior Survey) on the relationship between parent-child relationship quality (as measured by the Parental Environment Questionnaire) and quality of life (as measured by the World Health Organizations Quality of Life Questionnaire) beyond adolescence, during emerging adulthood. The additional moderating effects of gender were examined. Participants consisted of 507 undergraduate students (173 males, 334 females) recruited from a large university in the Southern United States between 18 and 25 years of age. Parent-child relationship quality was positively related to quality of life among both males and females. The indirect pathway from parent-child relationship quality to quality of life, through risky sexual behavior, was significant in females but not in males. Results suggest that the parent-child relationship, specifically for females, may be a target for intervention in the prevention of risky sexual behavior in Emerging Adulthood. Further results, implications, and limitations were discussed.
Research on station management in subway operation safety
NASA Astrophysics Data System (ADS)
Li, Yiman
2017-10-01
The management of subway station is an important part of the safe operation of urban subway. In order to ensure the safety of subway operation, it is necessary to study the relevant factors that affect station management. In the protection of subway safety operations on the basis of improving the quality of service, to promote the sustained and healthy development of subway stations. This paper discusses the influencing factors of subway operation accident and station management, and analyzes the specific contents of station management security for subway operation, and develops effective suppression measures. It is desirable to improve the operational quality and safety factor for subway operations.
Student Perception of Academic Achievement Factors at High School
ERIC Educational Resources Information Center
Bahar, Mustafa
2016-01-01
Measuring the quality of the "product" is elemental in education, and most studies depend on observational data about student achievement factors, focusing overwhelmingly on quantitative data namely achievement scores, school data like attendance, facilities, expenditure class size, etc. But there is little evidence of learner…
Comparison of Prescribed and Measured Dialysate Sodium: A Quality Improvement Project.
Gul, Ambreen; Miskulin, Dana C; Paine, Susan S; Narsipur, Sriram S; Arbeit, Leonard A; Harford, Antonia M; Weiner, Daniel E; Schrader, Ronald; Horowitz, Bruce L; Zager, Philip G
2016-03-01
There is controversy regarding the optimal dialysate sodium concentration for hemodialysis patients. Dialysate sodium concentrations of 134 to 138 mEq/L may decrease interdialytic weight gain and improve hypertension control, whereas a higher dialysate sodium concentration may offer protection to patients with low serum sodium concentrations and hypotension. We conducted a quality improvement project to explore the hypothesis that prescribed and delivered dialysate sodium concentrations may differ significantly. Cross-sectional quality improvement project. 333 hemodialysis treatments in 4 facilities operated by Dialysis Clinic, Inc. Measure dialysate sodium to assess the relationships of prescribed and measured dialysate sodium concentrations. Magnitude of differences between prescribed and measured dialysate sodium concentrations. Dialysate sodium measured pre- and late dialysis. The least square mean of the difference between prescribed minus measured dialysate sodium concentration was -2.48 (95% CI, -2.87 to -2.10) mEq/L. Clinics with a greater number of different dialysate sodium prescriptions (clinic 1, n=8; clinic 2, n=7) and that mixed dialysate concentrates on site had greater differences between prescribed and measured dialysate sodium concentrations. Overall, 57% of measured dialysate sodium concentrations were within ±2 mEq/L of the prescribed dialysate sodium concentration. Differences were greater at higher prescribed dialysate sodium concentrations. We only studied 4 facilities and dialysate delivery machines from 2 manufacturers. Because clinics using premixed dialysate used the same type of machine, we were unable to independently assess the impact of these factors. Pressures in dialysate delivery loops were not measured. There were significant differences between prescribed and measured dialysate sodium concentrations. This may have beneficial or deleterious effects on clinical outcomes, as well as confound results from studies assessing the relationships of dialysate sodium concentrations to outcomes. Additional studies are needed to identify factors that contribute to differences between prescribed and measured dialysate sodium concentrations. Quality assurance and performance improvement (QAPI) programs should include measurements of dialysate sodium. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Momani, Tha'er G; Hathaway, Donna K; Mandrell, Belinda N
2016-01-01
Health-related quality of life (HRQoL) is an important measure to evaluate a child's reported treatment experience. Although there are numerous studies of HRQoL in children undergoing curative cancer treatment, there is limited literature on factors that influence this. To review published studies that describe the HRQoL and associated factors in children undergoing curative cancer treatment. Full-text publications in English from January 2005 to March 2013 were searched in PubMed, PsychINFO, and CINAHL for children ≤18 years of age undergoing curative cancer treatment. HRQoL-associated factors were categorized as cancer diagnosis, treatment, child, family, and community. Twenty-six studies met the inclusion criteria. The most frequently used generic and cancer-specific instruments were PedsQL (Pediatric Quality of Life Inventory) Generic and PedsQL Cancer, respectively. Cancer diagnosis and treatment were the most frequently identified variables; fewer studies measured family and community domains. Gender, treatment intensity, type of cancer treatments, time in treatment, and cancer diagnosis were correlated with HRQoL. Our study highlights the need to develop interventions based on diagnosis and treatment regimen to improve the HRQoL in children undergoing curative cancer treatment. © 2015 by Association of Pediatric Hematology/Oncology Nurses.
Weighting factors for radiation quality: how to unite the two current concepts.
Kellerer, Albrecht M
2004-01-01
The quality factor, Q(L), used to be the universal weighting factor to account for radiation quality, until--in its 1991 Recommendations--the ICRP established a dichotomy between 'computable' and 'measurable' quantities. The new concept of the radiation weighting factor, w(R), was introduced for use with the 'computable' quantities, such as the effective dose, E. At the same time, the application of Q(L) was restricted to 'measurable' quantities, such as the operational quantities ambient dose equivalent or personal dose equivalent. The result has been a dual system of incoherent dosimetric quantities. The most conspicuous inconsistency resulted for neutrons, for which the new concept of wR had been primarily designed. While its definition requires an accounting for the gamma rays produced by neutron capture in the human body, this effect is not adequately reflected in the numerical values of wR, which are now suitable for mice, but are--at energies of the incident neutrons below 1 MeV--conspicuously too large for man. A recent Report 92 to ICRP has developed a proposal to correct the current imbalance and to define a linkage between the concepts Q(L) and wR. The proposal is here considered within a broader assessment of the rationale that led to the current dual system of dosimetric quantities.
Validation of the Family Inpatient Communication Survey.
Torke, Alexia M; Monahan, Patrick; Callahan, Christopher M; Helft, Paul R; Sachs, Greg A; Wocial, Lucia D; Slaven, James E; Montz, Kianna; Inger, Lev; Burke, Emily S
2017-01-01
Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting. The objective of this study was to validate a survey of surrogate-rated communication quality in the hospital that would be useful to clinicians, researchers, and health systems. After expert review and cognitive interviewing (n = 10 surrogates), we enrolled 350 surrogates (250 development sample and 100 validation sample) of hospitalized adults aged 65 years and older from three hospitals in one metropolitan area. The communication survey and a measure of decision quality were administered within hospital days 3 and 10. Mental health and satisfaction measures were administered six to eight weeks later. Factor analysis showed support for both one-factor (Total Communication) and two-factor models (Information and Emotional Support). Item reduction led to a final 30-item scale. For the validation sample, internal reliability (Cronbach's alpha) was 0.96 (total), 0.94 (Information), and 0.90 (Emotional Support). Confirmatory factor analysis fit statistics were adequate (one-factor model, comparative fit index = 0.981, root mean square error of approximation = 0.62, weighted root mean square residual = 1.011; two-factor model comparative fit index = 0.984, root mean square error of approximation = 0.055, weighted root mean square residual = 0.930). Total score and subscales showed significant associations with the Decision Conflict Scale (Pearson correlation -0.43, P < 0.001 for total score). Emotional Support was associated with improved mental health outcomes at six to eight weeks, such as anxiety (-0.19 P < 0.001), and Information was associated with satisfaction with the hospital stay (0.49, P < 0.001). The survey shows high reliability and validity in measuring communication experiences for hospital surrogates. The scale has promise for measurement of communication quality and is predictive of important outcomes, such as surrogate satisfaction and well-being. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Unruh, Mark; Tamura, Manjula Kurella; Larive, Brett; Rastogi, Anjay; James, Sam; Schiller, Brigitte; Gassman, Jennifer; Chan, Christopher; Lockridge, Robert; Kliger, Alan
2011-01-01
Background Poor sleep quality is a common, persistent, and important problem to patients with end-stage renal disease (ESRD). This report examines whether sleep quality is associated with dialysis treatment factors and other modifiable clinical factors in a large group of hemodialysis (HD) patients. Methods Cross-sectional analyses were conducted on baseline data collected from participants in the Frequent Hemodialysis Network trials. Sleep quality was measured using the Medical Outcomes Study Sleep Problems Index II (SPI II), a 9-item measure of sleep quality with higher scores reflecting poorer sleep quality. Results The participants had an age of 51.2 ± 13.6 years, 61% were male, 38% were black, and 42% had diabetes. Higher pre-dialysis serum phosphorus (per 0.5 mg/ml) (OR 0.91; 95% CI 0.85, 0.96) and depression (OR 0.16; 95% CI 0.10, 0.25) were independently associated with decrements in sleep quality. There was also a difference in time to recovery from dialysis for the fourth versus the first SPI II quartile (5.1 h; p < 0.0001). Conclusion These findings underscore the link between sleep and daytime function and suggest that improving sleep may provide an opportunity to improve outcomes in ESRD. Whether sleep problems may be improved by reduction of serum phosphorus or treatment of depression in the HD population merits further investigation. PMID:21474924
Healthcare quality measurement in orthopaedic surgery: current state of the art.
Auerbach, Andrew
2009-10-01
Improving quality of care in arthroplasty is of increasing importance to payors, hospitals, surgeons, and patients. Efforts to compel improvement have traditionally focused measurement and reporting of data describing structural factors, care processes (or 'quality measures'), and clinical outcomes. Reporting structural measures (eg, surgical case volume) has been used with varying degrees of success. Care process measures, exemplified by initiatives such as the Surgical Care Improvement Project measures, are chosen based on the strength of randomized trial evidence linking the process to improved outcomes. However, evidence linking improved performance on Surgical Care Improvement Project measures with improved outcomes is limited. Outcome measures in surgery are of increasing importance as an approach to compel care improvement with prominent examples represented by the National Surgical Quality Improvement Project. Although outcomes-focused approaches are often costly, when linked to active benchmarking and collaborative activities, they may improve care broadly. Moreover, implementation of computerized data systems collecting information formerly collected on paper only will facilitate benchmarking. In the end, care will only be improved if these data are used to define methods for innovating care systems that deliver better outcomes at lower or equivalent costs.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-15
... change the maintenance plan's trigger for contingency measures. Instead of a defined trigger, the revised plan would allow the State to consider several factors in deciding whether contingency measures should... the maintenance plan, the State must commit to implement one or more contingency measures within a set...
Eberts, Sandra M.; Thomas, Mary Ann; Jagucki, Martha L.
2013-01-01
As part of the U.S. Geological Survey National Water-Quality Assessment (NAWQA) Program, a study was conducted from 2001 to 2011 to shed light on factors that affect the vulnerability of water from public-supply wells to contamination (referred to hereafter as “public-supply-well vulnerability”). The study was designed as a follow-up to earlier NAWQA studies that found mixtures of contaminants at low concentrations in groundwater near the water table in urban areas across the Nation and, less frequently, in deeper groundwater typically used for public supply. Beside the factors affecting public-supply-well vulnerability to contamination, this circular describes measures that can be used to determine which factor (or factors) plays a dominant role at an individual public-supply well. Case-study examples are used throughout to show how such information can be used to improve water quality. In general, the vulnerability of the water from public-supply wells to contamination is a function of contaminant input within the area that contributes water to a well, the mobility and persistence of a contaminant once released to the groundwater, and the ease of groundwater and contaminant movement from the point of recharge to the open interval of a well. The following measures described in this circular are particularly useful for indicating which contaminants in an aquifer might reach an individual public-supply well and when, how, and at what concentration they might arrive: * Sources of recharge—Information on the sources of recharge for a well provides insight into contaminants that might enter the aquifer with the recharge water and potentially reach the well. * Geochemical conditions—Information on the geochemical conditions encountered by groundwater traveling to a well provides insight into contaminants that might persist in the water all the way to the well. * Groundwater-age mixtures—Information on the ages of the different waters that mix in a well provides insight into the time lag between contaminant input at the water table and contaminant arrival at the well. It also provides insight into the potential for in-well dilution of contaminated water by unaffected groundwater of a different age that simultaneously enters the well. Preferential flow pathways—pathways that provide little resistance to flow—can influence how all other factors affect public-supply-well vulnerability to contamination. For example, preferential flow pathways can influence whether a contaminant source is physically linked to a well, whether contaminant concentrations are substantially altered before contaminated groundwater reaches a well, and whether contaminated groundwater can arrive at a well within a timeframe of concern to the well owner. Methods for recognizing the influence of preferential flow pathways on the quality of water from a public-supply well are presented in this circular and can provide opportunities to prevent or mitigate the deterioration of a water supply. Knowing what water-quality variables to measure, what spatial and temporal scales on which to measure them, and how to interpret the resulting data makes it possible for samples from public-supply wells to provide a broad window into a well’s past and present water quality—and possibly future water quality. Such insight can enable resource managers to prioritize actions for sustaining a high-quality groundwater source of drinking water.
Quality measures and pediatric radiology: suggestions for the transition to value-based payment.
Heller, Richard E; Coley, Brian D; Simoneaux, Stephen F; Podberesky, Daniel J; Hernanz-Schulman, Marta; Robertson, Richard L; Donnelly, Lane F
2017-06-01
Recent political and economic factors have contributed to a meaningful change in the way that quality in health care, and by extension value, are viewed. While quality is often evaluated on the basis of subjective criteria, pay-for-performance programs that link reimbursement to various measures of quality require use of objective and quantifiable measures. This evolution to value-based payment was accelerated by the 2015 passage of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA). While many of the drivers of these changes are rooted in federal policy and programs such as Medicare and aimed at adult patients, the practice of pediatrics and pediatric radiology will be increasingly impacted. This article addresses issues related to the use of quantitative measures to evaluate the quality of services provided by the pediatric radiology department or sub-specialty section, particularly as seen from the viewpoint of a payer that may be considering ways to link payment to performance. The paper concludes by suggesting a metric categorization strategy to frame future work on the subject.
Evaluating the fair market value of pay for performance.
Johnson, Jen; Higgins, Alexandra
2014-04-01
When assessing a pay-for-performance arrangement, the following factors should be considered: Existence and/or size of minimum savings threshold before savings are allocated. Savings allocation percentage available to physicians. Benchmarks used to measure quality against past performance and/or medical evidence. Ways in which quality outcomes are measured and paid for. Per member per month payments for patient management. Physician investment (participation fee, time, or capital). Existence of downside risk to physicians. Employed compensation structure (if applicable).
Renzaho, Andre M N; Kamara, Joseph Kihika; Kamanga, Gilbert
2016-01-01
While quality of life (QoL) has long been an explicit policy goal for international development programmes, no instruments have specifically been developed for measuring health-related QoL in resource-limited settings. The aim of this study was to develop and validate a QoL instrument for use in international aid and development programmes and to assess factors associated with QoL among youth participating in a civic engagement project in Kampala. Using systematic random sampling, data were collected on 663 participants aged between 13 and 24 years in Kampala. The QoL questionnaire included 36 questions divided into a two-part scale: 18 questions rated for satisfaction (Part 1) and 18 other questions rated on importance (Part 2). The total sample was randomly divided into two split-half samples: one for the exploratory factor analysis (EFA; N=310) and the other for the confirmatorty factor analysis (CFA; N=353). The effect of demographic, socio-economic, and lifestyle factors on QoL was assessed using linear regressions. The EFA yielded three factors: living conditions and lifestyle (seven items, α=0.84), social relationships (five items, α=0.86), and personal independence (five items, α=0.76). In the CFA, the initial model demonstrated a poor to marginal fit model. Its re-specification by examining modification indices resulted in a good model fit: Comparative Fit Index=0.95, Root Mean Square Error of Approximation=0.06, and p of Close Fit >0.05. The model incorporating perceived importance had lower Akaike Information Criteria and Bayesian Information Criteria values than the unweighted model, thereby providing very strong support to weight satisfaction scores with importance ratings when measuring QoL in Uganda. Poor QoL was associated with poor educational attainment, drug and substance misuse, and family disruption. The findings suggest that there is a relationship between QoL and lifestyle and structural issues among youth in Uganda. The study provides the first validated QoL measure to allow government and non-government organisations in low- and middle-income countries to track progress of international aid and development programmes.
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
NASA Astrophysics Data System (ADS)
Santos, J. T.; Holz, T.; Fernandes, A. J. S.; Costa, F. M.; Chu, V.; Conde, J. P.
2015-02-01
Diamond-based microelectromechanical resonators have the potential of enhanced performance due to the chemical inertness of the diamond structural layer and its high Young’s modulus, high wear resistance, low thermal expansion coefficient, and very high thermal conductivity. In this work, the resonance frequency and quality factor of MEMS resonators based on nanocrystalline diamond films are characterized under different air pressures. The dynamic behavior of 50-300 μm long linear bridges and double ended tuning forks, with resonance frequencies between 0.5 and 15 MHz and quality factors as high as 50 000 are described as a function of measurement pressure from high vacuum(~10 mTorr) up to atmospheric conditions. The resonance frequencies and quality factors in vacuum show good agreement with the theoretical models including anchor and thermoelastic dissipation (TED). The Young’s moduli for nanocrystalline diamond films extrapolated from experimental data are between 840-920 GPa. The critical pressure values, at which the quality factor starts decreasing due to dissipation in air, are dependent on the resonator length. Longer structures, with quality factors limited by TED and lower resonance frequencies, have low critical pressures, of the order of 1-10 Torr and go from an intrinsic dissipation, to a molecular dissipation regime and finally to a region of viscous dissipation. Shorter resonators, with higher resonance frequencies and quality factors limited by anchor losses, have higher critical pressures, some higher than atmospheric pressure, and enter directly into the viscous dissipation regime from the intrinsic region.
Application of factor analysis to the water quality in reservoirs
NASA Astrophysics Data System (ADS)
Silva, Eliana Costa e.; Lopes, Isabel Cristina; Correia, Aldina; Gonçalves, A. Manuela
2017-06-01
In this work we present a Factor Analysis of chemical and environmental variables of the water column and hydro-morphological features of several Portuguese reservoirs. The objective is to reduce the initial number of variables, keeping their common characteristics. Using the Factor Analysis, the environmental variables measured in the epilimnion and in the hypolimnion, together with the hydromorphological characteristics of the dams were reduced from 63 variables to only 13 factors, which explained a total of 83.348% of the variance in the original data. After performing rotation using the Varimax method, the relations between the factors and the original variables got clearer and more explainable, which provided a Factor Analysis model for these environmental variables using 13 varifactors: Water quality and distance to the source, Hypolimnion chemical composition, Sulfite-reducing bacteria and nutrients, Coliforms and faecal streptococci, Reservoir depth, Temperature, Location, among other factors.
The Influence of Social Structure on Cancer Pain and Quality of Life.
Ham, Ok-Kyung; Chee, Wonshik; Im, Eun-Ok
2017-12-01
The aim of this study was to investigate whether social structure is associated with cancer pain and quality of life using the Social Structure and Personality Research Framework. This study was a secondary analysis of data from 480 cancer patients. The measurements included socioeconomic variables, self-reported cancer pain using the McGill Pain Questionnaire-Short Form (MPQ-SF), and quality of life measured using the Functional Assessment of Cancer Therapy Scale (FACT-G). The data were analyzed using moderated multiple regression. Cancer pain and quality of life differed significantly with income. The associations between income and pain and quality of life were significant only for the high education group (≥ partial college), and these associations were greater for Caucasians than for their counterparts ( p < .05). When developing interventions, nurses should consider the influence of socioeconomic variables on pain and quality of life while considering possible moderating factors such as education.
Minimizing variability of cascade impaction measurements in inhalers and nebulizers.
Bonam, Matthew; Christopher, David; Cipolla, David; Donovan, Brent; Goodwin, David; Holmes, Susan; Lyapustina, Svetlana; Mitchell, Jolyon; Nichols, Steve; Pettersson, Gunilla; Quale, Chris; Rao, Nagaraja; Singh, Dilraj; Tougas, Terrence; Van Oort, Mike; Walther, Bernd; Wyka, Bruce
2008-01-01
The purpose of this article is to catalogue in a systematic way the available information about factors that may influence the outcome and variability of cascade impactor (CI) measurements of pharmaceutical aerosols for inhalation, such as those obtained from metered dose inhalers (MDIs), dry powder inhalers (DPIs) or products for nebulization; and to suggest ways to minimize the influence of such factors. To accomplish this task, the authors constructed a cause-and-effect Ishikawa diagram for a CI measurement and considered the influence of each root cause based on industry experience and thorough literature review. The results illustrate the intricate network of underlying causes of CI variability, with the potential for several multi-way statistical interactions. It was also found that significantly more quantitative information exists about impactor-related causes than about operator-derived influences, the contribution of drug assay methodology and product-related causes, suggesting a need for further research in those areas. The understanding and awareness of all these factors should aid in the development of optimized CI methods and appropriate quality control measures for aerodynamic particle size distribution (APSD) of pharmaceutical aerosols, in line with the current regulatory initiatives involving quality-by-design (QbD).
Angiogenesis in the degeneration of the lumbar intervertebral disc
David, Gh; Iencean, SM; Mohan, A
2010-01-01
The goal of the study is to show the histological and biochemical changes that indicate the angiogenesis of the intervertebral disc in lumbar intervertebral disc hernia and the existence of epidemiological correlations between these changes and the risk factors of lumbar intervertebral disc hernia, as well as the patient's quality of life (QOL). We have studied 50 patients aged between 18 and 73 years old, who have undergone lumbar intervertebral disc hernia surgery, making fibroblast growth factor and vascular endothelial growth factor level measurements, as elements in the process of appreciating the disc angiogenesis. Also, pre–surgery and post–surgery QOL has been measured, as well as the intensity of the pain syndrome. We have identified factors capable of stimulating vascular endothelial growth (VEGF, FGF–2) for the examined disc material, but histological examination did not show angiogenesis. The process of angiogenesis at the degenerated intervertebral disc level affects the patient's quality of life both pre and postoperatively, and may be a predictive factor for the post–operative results. Patients can prevent the appearance of angiogenesis type degenerative processes of the intervertebral disc by avoiding angiogenesis correlated factors (weight control, physical effort, and smoking). PMID:20968201
Private healthcare quality: applying a SERVQUAL model.
Butt, Mohsin Muhammad; de Run, Ernest Cyril
2010-01-01
This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality. The study consists of 340 randomly selected participants visiting a private healthcare facility during a three-month data collection period. Data were analyzed using means, correlations, principal component and confirmatory factor analysis to establish the modified SERVQUAL scale's reliability, underlying dimensionality and convergent, discriminant validity. Results indicate a moderate negative quality gap for overall Malaysian private healthcare service quality. Results also indicate a moderate negative quality gap on each service quality scale dimension. However, scale development analysis yielded excellent results, which can be used in wider healthcare policy and practice. Respondents were skewed towards a younger population, causing concern that the results might not represent all Malaysian age groups. The study's major contribution is that it offers a way to assess private healthcare service quality. Second, it successfully develops a scale that can be used to measure health service quality in Malaysian contexts.
Factors associated with the quality of life of nursing home residents in Hong Kong.
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.
Factors Associated with Quality of Life among Hemodialysis Patients in Malaysia
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
Thin-slice vision: inference of confidence measure from perceptual video quality
NASA Astrophysics Data System (ADS)
Hameed, Abdul; Balas, Benjamin; Dai, Rui
2016-11-01
There has been considerable research on thin-slice judgments, but no study has demonstrated the predictive validity of confidence measures when assessors watch videos acquired from communication systems, in which the perceptual quality of videos could be degraded by limited bandwidth and unreliable network conditions. This paper studies the relationship between high-level thin-slice judgments of human behavior and factors that contribute to perceptual video quality. Based on a large number of subjective test results, it has been found that the confidence of a single individual present in all the videos, called speaker's confidence (SC), could be predicted by a list of features that contribute to perceptual video quality. Two prediction models, one based on artificial neural network and the other based on a decision tree, were built to predict SC. Experimental results have shown that both prediction models can result in high correlation measures.
The Relationship between Sleep Quality and Brain Amyloid Burden.
Brown, Belinda M; Rainey-Smith, Stephanie R; Villemagne, Victor L; Weinborn, Michael; Bucks, Romola S; Sohrabi, Hamid R; Laws, Simon M; Taddei, Kevin; Macaulay, S Lance; Ames, David; Fowler, Christopher; Maruff, Paul; Masters, Colin L; Rowe, Christopher C; Martins, Ralph N
2016-05-01
To evaluate the association between self-reported sleep quality and levels of brain β-amyloid (Aβ) burden, and to determine the effect of the apolipoprotein E (APOE) ε4 allele on any associations found. This study is a cross-sectional analysis of 184 cognitively healthy men and women aged over 60 y. We measured sleep quality factors: specifically, sleep duration, latency (time taken to fall asleep), disturbances, efficiency, daytime dysfunction, and overall sleep quality, using the Pittsburgh Sleep Quality Index. All participants underwent Aβ positron emission tomography imaging for the quantification of brain Aβ burden and were APOE genotyped. Linear regression analyses were used to evaluate the relationship between sleep quality factors and brain Aβ burden, adjusting for age, body mass index, cardiovascular disease, and symptoms of depression, with APOE ε4 carriage entered as a moderator. Of the sleep factors, longer sleep latency was associated with higher levels of brain Aβ (B = 0.003 [standard error = 0.001], P = 0.02). APOE ε4 allele (carrier/noncarrier) did not moderate the relationship between sleep latency and brain Aβ burden. Our findings suggest a relationship between brain Aβ burden and sleep latency, independent of APOE ε4 genotype. © 2016 Associated Professional Sleep Societies, LLC.
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.
[Long-term results after multiple trauma with ISS ≥ 25. Outcome and predictors of quality of life].
Simmel, S; Drisch, S; Haag, S; Bühren, V
2013-09-01
The survival chances of multiple trauma patients have continually improved over the last decades; therefore, it is often not a question of whether a patient survives a severe accident but rather how the patient survives. In a retrospective study 127 patients were questioned regarding quality of life and health and possible influencing factors using the POLO chart an average of 70 months after suffering severe trauma (ISS Ø 35.6). The quality of life of severely injured patients is significantly reduced compared with the normal population even years after the trauma. In addition to four pretraumatic factors (older age, female gender, low education and previous illnesses) four posttraumatic variables (difficulties with authorities/institutions and unemployment as a consequence of the accident, long duration and subjectively inadequate treatment in hospital) were identified that have a negative impact on long-term quality of life. The self-reported quality of life after multiple trauma no longer permanently achieves the original level despite extensive rehabilitation measures. Post-traumatic factors have a greater impact on the long-term quality of life than the injury severity. A long-term care and specialized rehabilitation services are needed to improve outcome further.
The Measure of Classroom Stress and Burnout among Gifted and Talented Students.
ERIC Educational Resources Information Center
Fimian, Michael J.; And Others
1989-01-01
Subjected gifted student data (N=311) to factor analyses for Student Stress Inventory and Maslach Burnout Inventory to assess factorial validity; five stress and three burnout factors were evident. Found significant relationships between stress, burnout, tedium, and, to a degree, quality of school life variables. (Author/NB)
Latent Factors in Student-Teacher Interaction Factor Analysis
ERIC Educational Resources Information Center
Le, Thu; Bolt, Daniel; Camburn, Eric; Goff, Peter; Rohe, Karl
2017-01-01
Classroom interactions between students and teachers form a two-way or dyadic network. Measurements such as days absent, test scores, student ratings, or student grades can indicate the "quality" of the interaction. Together with the underlying bipartite graph, these values create a valued student-teacher dyadic interaction network. To…
A set of high-quality, age-specific biota-sediment accumulation factors (BSAFs) for polychlorinated biphenyls (PCBs), dibenzo-p-dioxins (PCDDs), and dibenzofurans (PCDFs) have been determined from concentrations measured with high-resolution gas chroma tography/high-resolution ma...
Exploring Non-Instructional Factors in Student Evaluations
ERIC Educational Resources Information Center
Ali, Holi Ibrahim Holi; Al Ajmi, Ahmed Ali Saleh
2013-01-01
The use of student ratings to measure instructors' teaching performance and effectiveness in tertiary education has been an important but controversial tool in the improvement of teaching quality during the past few decades. This is an attempt to explore non-instructional factors of student evaluations by discussing and reviewing relevant…
Assessing Learning in News, Public Relations Curricula.
ERIC Educational Resources Information Center
Caudill, Edward; And Others
1990-01-01
Discusses the University of Tennessee's externally mandated undergraduate exams in public relations and news-editorial skills. Analyzes (1) whether the exams are valid measures of qualities in students that faculty believe are important; (2) what factors are related to scores; and (3) whether these factors are related to specific courses in the…
Duan, Wenjie; Ho, Samuel Mun Yin
2017-02-01
Strengths are positive qualities that significantly contributed to well-being of individuals and community. Therefore, a reliable and valid measure of strengths for research and practice is needed. The Brief Strengths Scale (BSS) is a newly developed tool for measuring the three-dimensional strengths model (i.e., temperance, intellectual, and interpersonal strength). However, empirical support for the measurement invariance of the BSS has not been obtained. This study examined the three-factor structure of BSS across gender, age, education, and marriage groups in a community sample (n = 375) using multi-group confirmatory factor analysis. After removing one item of each subscale from the original version, the revised model provided a good fit to the data at different subgroups. The revised nine-item BSS indicated that measurement invariance across gender and age groups was achieved. In addition, the measurement was more influenced by social-cultural factors than biological factors.
Pettigrew, Jonathan; Graham, John W.; Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Shin, Young Ju
2014-01-01
Poor implementation quality (IQ) is known to reduce program effects making it important to consider IQ for evaluation and dissemination of prevention programs. However, less is known about the ways specific implementation variables relate to outcomes. In this study, two versions of the keepin’ it REAL, 7th grade drug prevention intervention were implemented in 78 classrooms in 25 schools in rural districts in Pennsylvania and Ohio. IQ was measured through observational coding of 276 videos. IQ variables included adherence to the curriculum, teacher engagement (attentiveness, enthusiasm, seriousness, clarity, positivity), student engagement (attention, participation), and a global rating of teacher delivery quality. Factor analysis showed that teacher engagement, student engagement, and delivery quality formed one factor, which was labeled delivery. A second factor was adherence to the curriculum. Self-report student surveys measured substance use, norms (beliefs about prevalence and acceptability of use), and efficacy (beliefs about one’s ability to refuse substance offers) at two waves (pretest, immediate posttest). Mixed model regression analysis which accounted for missing data and controlled for pretest levels examined implementation quality’s effects on individual level outcomes, statistically controlling for cluster level effects. Results show that when implemented well, students show positive outcomes compared to students receiving a poorly implemented program. Delivery significantly influenced substance use and norms, but not efficacy. Adherence marginally significantly predicted use and significantly predicted norms, but not efficacy. Findings underscore the importance of comprehensively measuring and accounting for IQ, particularly delivery, when evaluating prevention interventions. PMID:24442403
2014-01-01
Background The consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited. Purpose To develop a summary score of ‘healthfulness’ composed of nine in-store factors that influence food shopping behaviour, and to assess this score by store type and neighbourhood deprivation. Methods A cross-sectional survey of 601 retail food stores, including supermarkets, grocery stores and convenience stores, was completed in Hampshire, United Kingdom between July 2010 and June 2011. The survey measured nine variables (variety, price, quality, promotions, shelf placement, store placement, nutrition information, healthier alternatives and single fruit sale) to assess the healthfulness of retail food stores on seven healthy and five less healthy foods that are markers of diet quality. Four steps were completed to create nine individual variable scores and another three to create an overall score of healthfulness for each store. Results Analysis of variance showed strong evidence of a difference in overall healthfulness by store type (p < 0.001). Large and premium supermarkets offered the most healthful shopping environments for consumers. Discount supermarkets, ‘world’, convenience and petrol stores offered less healthful environments to consumers however there was variation across the healthfulness spectrum. No relationship between overall healthfulness and neighbourhood deprivation was observed (p = 0.1). Conclusions A new composite measure of nine variables that can influence food choices was developed to provide an overall assessment of the healthfulness of retail food stores. This composite score could be useful in future research to measure the relationship between main food store and quality of diet, and to evaluate the effects of multi-component food environment interventions. PMID:24884529
Black, Christina; Ntani, Georgia; Inskip, Hazel; Cooper, Cyrus; Cummins, Steven; Moon, Graham; Baird, Janis
2014-05-23
The consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited. To develop a summary score of 'healthfulness' composed of nine in-store factors that influence food shopping behaviour, and to assess this score by store type and neighbourhood deprivation. A cross-sectional survey of 601 retail food stores, including supermarkets, grocery stores and convenience stores, was completed in Hampshire, United Kingdom between July 2010 and June 2011. The survey measured nine variables (variety, price, quality, promotions, shelf placement, store placement, nutrition information, healthier alternatives and single fruit sale) to assess the healthfulness of retail food stores on seven healthy and five less healthy foods that are markers of diet quality. Four steps were completed to create nine individual variable scores and another three to create an overall score of healthfulness for each store. Analysis of variance showed strong evidence of a difference in overall healthfulness by store type (p < 0.001). Large and premium supermarkets offered the most healthful shopping environments for consumers. Discount supermarkets, 'world', convenience and petrol stores offered less healthful environments to consumers however there was variation across the healthfulness spectrum. No relationship between overall healthfulness and neighbourhood deprivation was observed (p = 0.1). A new composite measure of nine variables that can influence food choices was developed to provide an overall assessment of the healthfulness of retail food stores. This composite score could be useful in future research to measure the relationship between main food store and quality of diet, and to evaluate the effects of multi-component food environment interventions.
Improvement of the Accuracy of InSAR Image Co-Registration Based On Tie Points - A Review.
Zou, Weibao; Li, Yan; Li, Zhilin; Ding, Xiaoli
2009-01-01
Interferometric Synthetic Aperture Radar (InSAR) is a new measurement technology, making use of the phase information contained in the Synthetic Aperture Radar (SAR) images. InSAR has been recognized as a potential tool for the generation of digital elevation models (DEMs) and the measurement of ground surface deformations. However, many critical factors affect the quality of InSAR data and limit its applications. One of the factors is InSAR data processing, which consists of image co-registration, interferogram generation, phase unwrapping and geocoding. The co-registration of InSAR images is the first step and dramatically influences the accuracy of InSAR products. In this paper, the principle and processing procedures of InSAR techniques are reviewed. One of important factors, tie points, to be considered in the improvement of the accuracy of InSAR image co-registration are emphatically reviewed, such as interval of tie points, extraction of feature points, window size for tie point matching and the measurement for the quality of an interferogram.
Improvement of the Accuracy of InSAR Image Co-Registration Based On Tie Points – A Review
Zou, Weibao; Li, Yan; Li, Zhilin; Ding, Xiaoli
2009-01-01
Interferometric Synthetic Aperture Radar (InSAR) is a new measurement technology, making use of the phase information contained in the Synthetic Aperture Radar (SAR) images. InSAR has been recognized as a potential tool for the generation of digital elevation models (DEMs) and the measurement of ground surface deformations. However, many critical factors affect the quality of InSAR data and limit its applications. One of the factors is InSAR data processing, which consists of image co-registration, interferogram generation, phase unwrapping and geocoding. The co-registration of InSAR images is the first step and dramatically influences the accuracy of InSAR products. In this paper, the principle and processing procedures of InSAR techniques are reviewed. One of important factors, tie points, to be considered in the improvement of the accuracy of InSAR image co-registration are emphatically reviewed, such as interval of tie points, extraction of feature points, window size for tie point matching and the measurement for the quality of an interferogram. PMID:22399966
Heyland, Daren K; Cook, Deborah J; Rocker, Graeme M; Dodek, Peter M; Kutsogiannis, Demetrios J; Skrobik, Yoanna; Jiang, Xuran; Day, Andrew G; Cohen, S Robin
2010-10-01
The purpose of this study was to further validate a novel instrument to measure satisfaction with end-of-life care, called the Canadian Health Care Evaluation Project (CANHELP) questionnaire. Data were collected by a cross-sectional survey of patients who had advanced, life-limiting illnesses and their family caregivers, and who completed CANHELP, a global rating of satisfaction, and a quality of life questionnaire. We conducted factor analysis, assessed internal consistency using Cronbach's alpha, and evaluated construct validity by describing the correlation amongst CANHELP, global rating of satisfaction and the quality of life questionnaire scores. There were 361 patient and 193 family questionnaires available for analysis. In the factor analysis, we identified six easily interpretable factors which explained 55.4% and 60.2% of the variance for the patient and caregiver questionnaire, respectively. For the patient version, the subscales derived from these factors were Relationship with Doctors, Illness Management, Communication, Decision-Making, Role of the Family, and Your Well-being. For the family questionnaire, the factors were Relationship with Doctors, Characteristics of Doctors and Nurses, Illness Management, Communication and Decision-Making, Your Involvement, and Your Well-being. Each subscale for each questionnaire had acceptable to excellent internal consistency (Cronbach's alpha ranged from 0.69-0.94). We observed good correlations between the CANHELP overall satisfaction score and global rating of satisfaction (correlation coefficient 0.49 and 0.63 for patient and family, respectively) which was greater than the correlations between CANHELP and the quality of life instruments. We conclude that the CANHELP Questionnaire is a valid and internally consistent instrument to measure satisfaction with end-of-life care.
Helseth, Sølvi; Lund, Thorleif
2005-06-01
The study presented in this paper is part of a larger Norwegian investigation among adolescents, where the overall aim is to develop methods to promote their quality of life (QoL), to discover risk factors or threats to adolescents' well-being, and finally to prevent the negative effects of such factors. An adequate generic health-related quality of life (HR-QoL) measure is therefore needed. However, only a limited number of well validated instruments that measure HR-QoL in adolescents exist, and to date only a few has been translated into Norwegian. The purpose of this study was therefore to examine some psychometric properties of the first Norwegian version of a simple, generic, German HR-QoL questionnaire for adolescents, KINDL. The instrument consists of 24-items, distributed in six subscales, which correspond to six domains of adolescents' HR-QoL. Based on a sample of 239 healthy adolescents, the internal consistency reliability is satisfactory for both the total scale and the subscales of 'Self-esteem and Family', fairly good for the 'Emotional' subscale, but lower for the subscales 'Physical', 'Friends' and 'School'. Factor analyses, which concerns construct validity, yielded interpretable solutions. The factor solutions at item level were interpreted to be in line with the original subscales, while factor analysis at subscale level indicated that a common QoL core is involved. To conclude, the Norwegian version of KINDL appears, in general, to be a psychometrically acceptable method of measuring HR-QoL in healthy adolescents. However, the alpha-values of some of the subscales are not optimal, and these scales should be used with caution in research and profession. Still KINDL-N is considered suitable for screening purposes in the public health area and especially within school-health care.
An exploratory analysis of the model for understanding success in quality.
Kaplan, Heather C; Froehle, Craig M; Cassedy, Amy; Provost, Lloyd P; Margolis, Peter A
2013-01-01
Experience suggests that differences in context produce variability in the effectiveness of quality improvement (QI) interventions. However, little is known about which contextual factors affect success or how they exert influence. Using the Model for Understanding Success in Quality (MUSIQ), we perform exploratory quantitative tests of the role of context in QI success. We used a cross-sectional design to survey individuals participating in QI projects in three settings: a pediatric hospital, hospitals affiliated with a state QI collaborative, and organizations sponsoring participants in an improvement advisor training program. Individuals participating in QI projects completed a questionnaire assessing contextual factors included in MUSIQ and measures of perceived success. Path analysis was used to test the direct, indirect, and total effects of context variables on QI success as hypothesized in MUSIQ. In the 74 projects studied, most contextual factors in MUSIQ were found to be significantly related to at least one QI project performance outcome. Contextual factors exhibiting significant effects on two measures of perceived QI success included resource availability, QI team leadership, team QI skills, microsystem motivation, microsystem QI culture, and microsystem QI capability. There was weaker evidence for effects of senior leader project sponsors, organizational QI culture, QI team decision-making, and microsystem QI leadership. These initial tests add to the validity of MUSIQ as a tool for identifying which contextual factors affect improvement success and understanding how they exert influence. Using MUSIQ, managers and QI practitioners can begin to identify aspects of context that must be addressed before or during the execution of QI projects and plan strategies to modify context for increased success. Additional work by QI researchers to improve the theory, refine measurement approaches, and validate MUSIQ as a predictive tool in a wider range of QI efforts is necessary.
Tripicchio, Gina L; Borner, Kelsey B; Odar Stough, Cathleen; Poppert Cordts, Katrina; Dreyer Gillette, Meredith; Davis, Ann M
2017-05-01
This study aims to validate an obesity-specific health-related quality of life (HRQOL) measure, Sizing Me Up (SMU), in treatment-seeking Latino youth. Pediatric obesity has been associated with reduced HRQOL; therefore, valid measures are important for use in diverse populations that may be at increased risk for obesity and related comorbidities. Structural equation modeling tested the fit of the 5-subscale, 22-item SMU measure in Latino youth, 5-13 years of age, with obesity ( N = 204). Invariance testing was conducted to examine equivalence between Latino and non-Latino groups ( N = 250). SMU achieved acceptable fit in a Latino population [χ 2 = 428.33, df = 199, p < .001, Root Mean Squared Error of Approximation = 0.072 (0.062-0.082), Comparative Fit Index = 0.915, Tucker-Lewis Index = 0.901, Weighted Root Mean Square Residual = 1.2230]. Additionally, factor structure and factor loadings were invariant across Latino and non-Latino groups, but thresholds were not invariant. SMU is a valid measure of obesity-specific HRQOL in treatment-seeking Latino youth with obesity. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Yang, Ming; Yang, Yuan-Zhen; Wang, Ya-Qi; Wu, Zhen-Feng; Wang, Xue-Cheng; Luo, Jing
2017-03-01
Product quality relies on not only testing methods,but also the design and development, production control and product manufacturing all aspects of logistics management. Quality comes from the process control level.Therefore, it is very important to accurately identify the factors that may induce quality risk in the production process and quality control measures correspondingly.This article systematically analyzes the source of the quality risk of all aspects of the production process in traditional Chinese medicine preparation. Discussing ways and methods of quality risk identification of traditional Chinese medicine preparation and providing references for perfecting the whole process quality management of traditional Chinese medicine preparation. Copyright© by the Chinese Pharmaceutical Association.
Mokarami, Hamidreza; Stallones, Lorann; Nazifi, Morteza; Taghavi, Sayed Mohammad
2016-10-17
The role of psychosocial and physical work factors in predicting health related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present study is designed to assess these relationships among Iranian workers from steel and cosmetic factories. A cross-sectional study was conducted among 280 workers from two factories. Psychosocial and physical work factors and HRQOL were measured by the Persian translations of the following questionnaires: Job Content Questionnaire (JCQ) and the World Health Organization Quality of Life-Brief (WHOQOL-Brief). An instrument was developed to assess socio-demographic, health, and other work-related factors. The data were analyzed using independent t-tests, Pearson product moment correlation and hierarchical multiple regression. Results revealed that the respondents generally had poor HRQOLs especially in the environmental domain. The steel factory workers who were exposed to higher levels of occupational risk factors suffered from poorer HRQOL compared to the cosmetic factory workers. The results of hierarchical regression for all participants revealed that social support, sleep quality, work schedule, smoking and exercise were significant predictors of all domains of HRQOL. To improve the worker's HRQOL, intervention programs should focus on promoting social support, sleep quality, exercise and smoking habits. Moreover, reducing hazardous work environments should be considered an important intervention to promote HRQOL.
Cross-Cultural Perspectives of Service Quality and Risk in Air Transportation
NASA Technical Reports Server (NTRS)
Cunningham, Lawrence F.; Young, Clifford E.; Lee, Moonkyu
2002-01-01
This study compares US and Korean customers in terms of their perceptions of airline service quality based on SERVPERF and industry-based measures, as well as their perceptions of risks involved in the airline choice. SERVPERF is a set of multi-dimensional measures of customer evaluations of service quality. The results indicate that: (1) US passengers are generally more satisfied with their airline service than Korean customers on most of the SERVPERF dimensions; (2) Koreans are generally more satisfied with the bumping procedures whereas US participants feel more satisfied with the airline's baggage handling, operations/safety, and connections; and (3) US participants perceive higher levels of performance and financial risks whereas Koreans feel greater social risk in choosing an airline. This study also examines the SERVPERF, industry-based measure, and perceived risk in predicting customer satisfaction with, and intention to repatronize the airline. The results suggest that US customers consider service reliability, in-flight comfort, and connections as the key factors determining satisfaction with airline service whereas Korean passengers generally regard reliability, assurance, and risk factors as predictors of satisfaction. The determining factors of customer intention to repatronize the airline are reliability and empathy for US, and reliability and overall risk for Korean customers. The study demonstrates the applicability of SERVPERF as a cross-cultural tool and indicates the importance of perceived risk in cross-cultural studies.
Kroemeke, Aleksandra
2015-01-01
Sense of autonomy - the possibility to choose and decide - is one of the markers of positive and active aging. The goal of this study was to examine the Polish adaptation of the Perceived Autonomy in Old Age (PAA) scale and to determine its internal structure and psychometric properties: reliability, as well as construct and discriminant validity. 277 seniors (female=187; male=90), without cognitive function disorders aged 60 to 100 (M=77.4; SD=9.2) took part in the study. Apart from the PAA, the ADL and IADL scales (self-reliance assessment) were used, as well as the Emotional State Questionnaire (a measure for positive and negative emotions) and the WHOQoL-Brief (a measure for health-related quality of life). As a result of an exploratory and confirmation factor analysis a one-factor tool with five items was built. Reliability coefficients of the scale measured with the internal consistency method and test-retest were ≥ 0.80. Positive correlations were found with indicators in the ADL, IADL, as well as in the somatic and psychological domain of life quality, and positive emotions. Negative correlations were found for negative emotions. The obtained results indicated very high reliability and accuracy for the Polish adaptation of the SPA. The tool can be used as a predictor and/or indicator of successful aging and life quality of seniors.
Mainenti, Míriam Raquel Meira; Felicio, Lilian Ramiro; Rodrigues, Erika de Carvalho; Ribeiro da Silva, Dalila Terrinha; Vigário Dos Santos, Patrícia
2014-04-01
[Purpose] Complaint of pain is common in computer workers, encouraging the investigation of pain-related workplace factors. This study investigated the relationship among work-related characteristics, psychosocial factors, and pain among computer workers from a university center. [Subjects and Methods] Fifteen subjects (median age, 32.0 years; interquartile range, 26.8-34.5 years) were subjected to measurement of bioelectrical impedance; photogrammetry; workplace measurements; and pain complaint, quality of life, and motivation questionnaires. [Results] The low back was the most prevalent region of complaint (76.9%). The number of body regions for which subjects complained of pain was greater in the no rest breaks group, which also presented higher prevalences of neck (62.5%) and low back (100%) pain. There were also observed associations between neck complaint and quality of life; neck complaint and head protrusion; wrist complaint and shoulder angle; and use of a chair back and thoracic pain. [Conclusion] Complaint of pain was associated with no short rest breaks, no use of a chair back, poor quality of life, high head protrusion, and shoulder angle while using the mouse of a computer.
The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care.
Chochinov, Harvey Max; Hassard, Thomas; McClement, Susan; Hack, Thomas; Kristjanson, Linda J; Harlos, Mike; Sinclair, Shane; Murray, Alison
2008-12-01
Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test-retest reliability was r = 0.85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concurrent validity was reported by way of significant associations between PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources of distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care.
Effect of Total Quality Management on the Quality and Productivity of Human Resources
NASA Astrophysics Data System (ADS)
Siregar, I.; Nasution, A. A.; Sari, R. M.
2017-03-01
Human resources is the main factor in improving company performance not only in industrial products but also services. Therefore, all of the organization performers involved must work together to achieve product quality services expected by consumers. Educational institutions are the service industries which are educators and instructor involved in it. Quality of product and services produced depends on the education organization performers. This study did a survey of instructors in public and private universities in North Sumatra to obtain the factors that affect quality of human resources and productivity of human resources. Human resources quality is viewed by the elements of TQM. TQM elements that are discussed in this study are leadership, communication, training and education, support structure, measurement and reward and recognition. The results of this study showed a correlation numbers across the exogenous variables on endogenous variables relationships tend to be strong and be positive. In addition, elements of TQM are discussed except the support structure which has a direct influence on the quality of human resources. Variable leadership, reward and recognition and quality of human resources have a significant effect on productivity.
Joseph R. Benjamin
2006-01-01
Theoretical models suggest the invasion of nonnative freshwater species is facilitated through the interaction of three factors: biotic resistance, habitat quality, and connectivity. We measured variables that represented each component to determine which were associated with small (150 mm) brook trout occurrence in Panther Creek, a tributary...
Evaluation of the Factors That Determine Quality in Higher Education: An Empirical Study
ERIC Educational Resources Information Center
Tsinidou, Maria; Gerogiannis, Vassilis; Fitsilis, Panos
2010-01-01
Purpose: The aim of this paper is to identify the quality determinants for education services provided by higher education institutions (HEIs) in Greece and to measure their relative importance from the students' points of view. Design/methodology/approach: A multi-criteria decision-making methodology was used for assessing the relative importance…
The Cerebral Palsy Quality of Life for Children (CP QOL-Child): Evidence of Construct Validity
ERIC Educational Resources Information Center
Chen, Kuan-Lin; Wang, Hui-Yi; Tseng, Mei-Hui; Shieh, Jeng-Yi; Lu, Lu; Yao, Kai-Ping Grace; Huang, Chien-Yu
2013-01-01
The Cerebral Palsy Quality of Life for Children (CP QOL-Child) is the first health condition-specific questionnaire designed for measuring QOL in children with cerebral palsy (CP). However, its construct validity has not yet been confirmed by confirmatory factor analysis (CFA). Hence, this study assessed the construct validity of the caregiver…
Structure of Perceptions of Service Quality in Libraries: A LibQUAL+ Study.
ERIC Educational Resources Information Center
Thompson, Bruce; Cook, Colleen; Heath, Fred
2003-01-01
Used confirmatory factor analysis to evaluate the score integrity of LibQUALl+, an instrument to measure perceptions of library service quality. Results for 60,027 graduate and undergraduate students suggest that the model implied by LibQUAL is reasonable and invariant across independent samples and fits all three major subgroups of library users.…
A Framework for Analysing Quality in Education Settings
ERIC Educational Resources Information Center
Mahapatra, S. S.; Khan, M. S.
2007-01-01
In this paper, an attempt has been made to propose a measuring instrument known as EduQUAL for evaluation of quality in Technical Education System (TES). Factor analysis has been carried out on responses obtained through cross-sectional questionnaire survey on various items to validate dimensionality of the instrument and it is found that 28 items…
How to Improve Your Impact Factor: Questioning the Quantification of Academic Quality
ERIC Educational Resources Information Center
Smeyers, Paul; Burbules, Nicholas C.
2011-01-01
A broad-scale quantification of the measure of quality for scholarship is under way. This trend has fundamental implications for the future of academic publishing and employment. In this essay we want to raise questions about these burgeoning practices, particularly how they affect philosophy of education and similar sub-disciplines. First,…
NASA Astrophysics Data System (ADS)
Diniş, C. M.; Cunţan, C. D.; Rob, R. O. S.; Popa, G. N.
2018-01-01
The paper presents the analysis of a power factor with capacitors banks, without series coils, used for improving power factor for a three-phase and single-phase inductive loads. In the experimental measurements, to improve the power factor, the Roederstein ESTAmat RPR power factor controller can command up to twelve capacitors banks, while experimenting using only six capacitors banks. Six delta capacitors banks with approximately equal reactive powers were used for experimentation. The experimental measurements were carried out with a three-phase power quality analyser which worked in three cases: a case without a controller with all capacitors banks permanently parallel connected with network, and two other cases with power factor controller (one with setting power factor at 0.92 and the other one at 1). When performing experiments with the power factor controller, a current transformer was used to measure the current on one phase (at a more charged or less loaded phase).
Helfrich, Christian D; Li, Yu-Fang; Sharp, Nancy D; Sales, Anne E
2009-01-01
Background The Promoting Action on Research Implementation in Health Services, or PARIHS, framework is a theoretical framework widely promoted as a guide to implement evidence-based clinical practices. However, it has as yet no pool of validated measurement instruments that operationalize the constructs defined in the framework. The present article introduces an Organizational Readiness to Change Assessment instrument (ORCA), organized according to the core elements and sub-elements of the PARIHS framework, and reports on initial validation. Methods We conducted scale reliability and factor analyses on cross-sectional, secondary data from three quality improvement projects (n = 80) conducted in the Veterans Health Administration. In each project, identical 77-item ORCA instruments were administered to one or more staff from each facility involved in quality improvement projects. Items were organized into 19 subscales and three primary scales corresponding to the core elements of the PARIHS framework: (1) Strength and extent of evidence for the clinical practice changes represented by the QI program, assessed with four subscales, (2) Quality of the organizational context for the QI program, assessed with six subscales, and (3) Capacity for internal facilitation of the QI program, assessed with nine subscales. Results Cronbach's alpha for scale reliability were 0.74, 0.85 and 0.95 for the evidence, context and facilitation scales, respectively. The evidence scale and its three constituent subscales failed to meet the conventional threshold of 0.80 for reliability, and three individual items were eliminated from evidence subscales following reliability testing. In exploratory factor analysis, three factors were retained. Seven of the nine facilitation subscales loaded onto the first factor; five of the six context subscales loaded onto the second factor; and the three evidence subscales loaded on the third factor. Two subscales failed to load significantly on any factor. One measured resources in general (from the context scale), and one clinical champion role (from the facilitation scale). Conclusion We find general support for the reliability and factor structure of the ORCA. However, there was poor reliability among measures of evidence, and factor analysis results for measures of general resources and clinical champion role did not conform to the PARIHS framework. Additional validation is needed, including criterion validation. PMID:19594942
Helfrich, Christian D; Li, Yu-Fang; Sharp, Nancy D; Sales, Anne E
2009-07-14
The Promoting Action on Research Implementation in Health Services, or PARIHS, framework is a theoretical framework widely promoted as a guide to implement evidence-based clinical practices. However, it has as yet no pool of validated measurement instruments that operationalize the constructs defined in the framework. The present article introduces an Organizational Readiness to Change Assessment instrument (ORCA), organized according to the core elements and sub-elements of the PARIHS framework, and reports on initial validation. We conducted scale reliability and factor analyses on cross-sectional, secondary data from three quality improvement projects (n = 80) conducted in the Veterans Health Administration. In each project, identical 77-item ORCA instruments were administered to one or more staff from each facility involved in quality improvement projects. Items were organized into 19 subscales and three primary scales corresponding to the core elements of the PARIHS framework: (1) Strength and extent of evidence for the clinical practice changes represented by the QI program, assessed with four subscales, (2) Quality of the organizational context for the QI program, assessed with six subscales, and (3) Capacity for internal facilitation of the QI program, assessed with nine subscales. Cronbach's alpha for scale reliability were 0.74, 0.85 and 0.95 for the evidence, context and facilitation scales, respectively. The evidence scale and its three constituent subscales failed to meet the conventional threshold of 0.80 for reliability, and three individual items were eliminated from evidence subscales following reliability testing. In exploratory factor analysis, three factors were retained. Seven of the nine facilitation subscales loaded onto the first factor; five of the six context subscales loaded onto the second factor; and the three evidence subscales loaded on the third factor. Two subscales failed to load significantly on any factor. One measured resources in general (from the context scale), and one clinical champion role (from the facilitation scale). We find general support for the reliability and factor structure of the ORCA. However, there was poor reliability among measures of evidence, and factor analysis results for measures of general resources and clinical champion role did not conform to the PARIHS framework. Additional validation is needed, including criterion validation.
Measuring quality in community based housing support - the QPC-H instrument.
Lundqvist, Lars-Olov; Rask, Mikael; Brunt, David; Ivarsson, Ann-Britt; Schröder, Agneta
2016-04-18
Purpose - The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents' perception of quality of housing support. Design/methodology/approach - A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings - CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications - The residents' ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value - The QPC-H includes important aspects of residents' assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents' perspective.
Heinemann, Allen W; Miskovic, Ana; Semik, Patrick; Wong, Alex; Dashner, Jessica; Baum, Carolyn; Magasi, Susan; Hammel, Joy; Tulsky, David S; Garcia, Sofia F; Jerousek, Sara; Lai, Jin-Shei; Carlozzi, Noelle E; Gray, David B
2016-12-01
To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments. Cross-sectional, observational cohort. Community. A sample of community-dwelling adults with stroke, spinal cord injury, and traumatic brain injury (N=568). None. EFIB covering domains of the built and natural environment; systems, services, and policies; social environment; and access to information and technology; the Craig Hospital Inventory of Environmental Factors (CHIEF) short form; the Facilitators and Barriers Survey/Mobility (FABS/M) short form; the Home and Community Environment Instrument (HACE); the Measure of the Quality of the Environment (MQE) short form; and 3 of the Patient Reported Outcomes Measurement Information System's (PROMIS) Quality of Social Support measures. The EFIB and legacy instruments assess most of the International Classification of Functioning, Disability and Health (ICF) environmental factors chapters, including chapter 1 (products and technology; 75 items corresponding to 11 codes), chapter 2 (natural environment and human-made changes; 31 items corresponding to 7 codes), chapter 3 (support and relationships; 74 items corresponding to 7 codes), chapter 4 (attitudes; 83 items corresponding to 8 codes), and chapter 5 (services, systems, and policies; 72 items corresponding to 16 codes). Construct validity is provided by moderate correlations between EFIB measures and the CHIEF, MQE barriers, HACE technology mobility, FABS/M community built features, and PROMIS item banks and by small correlations with other legacy instruments. Only 5 of the 66 legacy instrument correlation coefficients are moderate, suggesting they measure unique aspects of the environment, whereas all intra-EFIB correlations were at least moderate. The EFIB measures provide a brief and focused assessment of ICF environmental factor chapters. The pattern of correlations with legacy instruments provides initial evidence of construct validity. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Engstrand, Christina; Krevers, Barbro; Kvist, Joanna
2015-01-01
Prospective cohort study. The evidence of the relationship between functional recovery and impairment after surgery and hand therapy are inconsistent. To explore factors that were most related to functional recovery as measured by DASH in patients with Dupuytren's disease. Eighty-one patients undergoing surgery and hand therapy were consecutively recruited. Functional recovery was measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Explanatory variables: range of motion of the finger joints, five questions regarding safety and social issues of hand function, and health-related quality of life (Euroqol). The three variables "need to take special precautions", "avoid using the hand in social context", and health-related quality of life (EQ-5D index) explained 62.1% of the variance in DASH, where the first variable had the greatest relative effect. Safety and social issues of hand function and quality of life had an evident association with functional recovery. IV. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
Bond, Gary R; Drake, Robert E; Rapp, Charles A; McHugo, Gregory J; Xie, Haiyi
2009-09-01
Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are needed to complement fidelity scales measuring structural aspects of program implementation. As part of the instrumentation developed for the National Implementing Evidence-Based Practices Project, we piloted a new instrument with two 5-item quality scales, Individualization (a client-level quality scale) and Quality Improvement (an organizational-level quality scale). Pairs of independent fidelity assessors conducted fidelity reviews in 49 sites in 8 states at baseline and at four subsequent 6-month intervals over a 2-year follow-up period. The assessors followed a standardized protocol to administer these quality scales during daylong site visits; during these same visits they assessed programs on fidelity to the evidence-based practice that the site was seeking to implement. Assessors achieved acceptable interrater reliability for both Individualization and Quality Improvement. Principal components factor analysis confirmed the 2-scale structure. The two scales were modestly correlated with each other and with the evidence-based practice fidelity scales. Over the first year, Individualization and Quality Improvement improved, but showed little or no improvement during the last year of follow-up. The two newly developed scales showed adequate psychometric properties in this preliminary study, but further research is needed to assess their validity and utility in routine clinical practice.
Joshi, Chandni; Torvaldsen, Siranda; Hodgson, Ray; Hayen, Andrew
2014-03-03
Good quality antenatal care (ANC) reduces maternal and neonatal mortality and improves health outcomes, particularly in low-income countries. Quality of ANC is measured by three dimensions: number of visits, timing of initiation of care and inclusion of all recommended components of care. Although some studies report on predictors of the first two indicators, no studies on the third indicator, which measures quality of ANC received, have been conducted in Nepal. Nepal follows the World Health Organization's recommendations of initiation of ANC within the first four months of pregnancy and at least four ANC visits during the course of an uncomplicated pregnancy. This study aimed to identify factors associated with 1) attendance at four or more ANC visits and 2) receipt of good quality ANC. Data from Nepal Demographic and Health Survey 2011 were analysed for 4,079 mothers. Good quality ANC was defined as that which included all seven recommended components: blood pressure measurement; urine tests for detecting bacteriuria and proteinuria; blood tests for syphilis and anaemia; and provision of iron supplementation, intestinal parasite drugs, tetanus toxoid injections and health education. Half the women had four or more ANC visits and 85% had at least one visit. Health education, iron supplementation, blood pressure measurement and tetanus toxoid were the more commonly received components of ANC. Older age, higher parity, and higher levels of education and household economic status of the women were predictors of both attendance at four or more visits and receipt of good quality ANC. Women who did not smoke, had a say in decision-making, whose husbands had higher levels of education and were involved in occupations other than agriculture were more likely to attend four or more visits. Other predictors of women's receipt of good quality ANC were receiving their ANC from a skilled provider, in a hospital, living in an urban area and being exposed to general media. Continued efforts at improving access to quality ANC in Nepal are required. In the short term, less educated women from socioeconomically disadvantaged households require targeting. Long-term improvements require a focus on improving female education.
Xie, Anping; Carayon, Pascale
2015-01-01
Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified 12 projects representing 23 studies and addressing different physical, cognitive and organisational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care.
An analysis of the ArcCHECK-MR diode array's performance for ViewRay quality assurance.
Ellefson, Steven T; Culberson, Wesley S; Bednarz, Bryan P; DeWerd, Larry A; Bayouth, John E
2017-07-01
The ArcCHECK-MR diode array utilizes a correction system with a virtual inclinometer to correct the angular response dependencies of the diodes. However, this correction system cannot be applied to measurements on the ViewRay MR-IGRT system due to the virtual inclinometer's incompatibility with the ViewRay's multiple simultaneous beams. Additionally, the ArcCHECK's current correction factors were determined without magnetic field effects taken into account. In the course of performing ViewRay IMRT quality assurance with the ArcCHECK, measurements were observed to be consistently higher than the ViewRay TPS predictions. The goals of this study were to quantify the observed discrepancies and test whether applying the current factors improves the ArcCHECK's accuracy for measurements on the ViewRay. Gamma and frequency analysis were performed on 19 ViewRay patient plans. Ion chamber measurements were performed at a subset of diode locations using a PMMA phantom with the same dimensions as the ArcCHECK. A new method for applying directionally dependent factors utilizing beam information from the ViewRay TPS was developed in order to analyze the current ArcCHECK correction factors. To test the current factors, nine ViewRay plans were altered to be delivered with only a single simultaneous beam and were measured with the ArcCHECK. The current correction factors were applied using both the new and current methods. The new method was also used to apply corrections to the original 19 ViewRay plans. It was found the ArcCHECK systematically reports doses higher than those actually delivered by the ViewRay. Application of the current correction factors by either method did not consistently improve measurement accuracy. As dose deposition and diode response have both been shown to change under the influence of a magnetic field, it can be concluded the current ArcCHECK correction factors are invalid and/or inadequate to correct measurements on the ViewRay system. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
Obesity, diet quality and absenteeism in a working population.
Fitzgerald, Sarah; Kirby, Ann; Murphy, Aileen; Geaney, Fiona
2016-12-01
The relationship between workplace absenteeism and adverse lifestyle factors (smoking, physical inactivity and poor dietary patterns) remains ambiguous. Reliance on self-reported absenteeism and obesity measures may contribute to this uncertainty. Using objective absenteeism and health status measures, the present study aimed to investigate what health status outcomes and lifestyle factors influence workplace absenteeism. Cross-sectional data were obtained from a complex workplace dietary intervention trial, the Food Choice at Work Study. Four multinational manufacturing workplaces in Cork, Republic of Ireland. Participants included 540 randomly selected employees from the four workplaces. Annual count absenteeism data were collected. Physical assessments included objective health status measures (BMI, midway waist circumference and blood pressure). FFQ measured diet quality from which DASH (Dietary Approaches to Stop Hypertension) scores were constructed. A zero-inflated negative binomial (zinb) regression model examined associations between health status outcomes, lifestyle characteristics and absenteeism. The mean number of absences was 2·5 (sd 4·5) d. After controlling for sociodemographic and lifestyle characteristics, the zinb model indicated that absenteeism was positively associated with central obesity, increasing expected absence rate by 72 %. Consuming a high-quality diet and engaging in moderate levels of physical activity were negatively associated with absenteeism and reduced expected frequency by 50 % and 36 %, respectively. Being in a managerial/supervisory position also reduced expected frequency by 50 %. To reduce absenteeism, workplace health promotion policies should incorporate recommendations designed to prevent and manage excess weight, improve diet quality and increase physical activity levels of employees.
Effect of masking phase-only holograms on the quality of reconstructed images.
Deng, Yuanbo; Chu, Daping
2016-04-20
A phase-only hologram modulates the phase of the incident light and diffracts it efficiently with low energy loss because of the minimum absorption. Much research attention has been focused on how to generate phase-only holograms, and little work has been done to understand the effect and limitation of their partial implementation, possibly due to physical defects and constraints, in particular as in the practical situations where a phase-only hologram is confined or needs to be sliced or tiled. The present study simulates the effect of masking phase-only holograms on the quality of reconstructed images in three different scenarios with different filling factors, filling positions, and illumination intensity profiles. Quantitative analysis confirms that the width of the image point spread function becomes wider and the image quality decreases, as expected, when the filling factor decreases, and the image quality remains the same for different filling positions as well. The width of the image point spread function as derived from different filling factors shows a consistent behavior to that as measured directly from the reconstructed image, especially as the filling factor becomes small. Finally, mask profiles of different shapes and intensity distributions are shown to have more complicated effects on the image point spread function, which in turn affects the quality and textures of the reconstructed image.
A systematic review of risk factors for methamphetamine-associated psychosis.
Arunogiri, Shalini; Foulds, James A; McKetin, Rebecca; Lubman, Dan I
2018-06-01
Chronic methamphetamine use is commonly associated with the development of psychotic symptoms. The predictors and correlates of methamphetamine-associated psychosis are poorly understood. We sought to systematically review factors associated with psychotic symptoms in adults using illicit amphetamine or methamphetamine. A systematic literature search was performed on MEDLINE (OVID), PsycINFO and EMBASE databases from inception to 8 December 2016. The search strategy combined three concept areas: methamphetamine or amphetamine, psychosis and risk factors. Included studies needed to compare adults using illicit methamphetamine or amphetamine, using a validated measure of psychosis, on a range of risk factors. Of 402 identified articles, we removed 45 duplicates, 320 articles based on abstract/title and 17 ineligible full-text articles, leaving 20 included studies that were conducted in 13 populations. Two co-authors independently extracted the following data from each study: country, setting and design; participant demographic and clinical details; sample size; measure/s used and measures of association between psychosis outcomes and risk factors. Individual study quality was assessed using a modified Newcastle-Ottawa Scale, and strength of evidence was assessed using GRADE criteria. Frequency of methamphetamine use and severity of methamphetamine dependence were consistently found to be associated with psychosis, and sociodemographic factors were not. There was inconsistent evidence available for all other risk factors. Individual study quality was low-moderate for the majority of studies. Heterogeneity in study outcomes precluded quantitative synthesis of outcomes across studies. The most consistent correlates of psychotic symptoms were increased frequency of methamphetamine use and dependence on methamphetamine. The findings of this review highlight the need for targeted assessment and treatment of methamphetamine use in individuals presenting with psychosis.
Algamdi, Maaidah M; Hanneman, Sandra K
2018-02-14
Valid and reliable instruments in Arabic are needed to measure self-efficacy and quality of life for Arabic patients with cancer. The aim of this study was to test the psychometric performance of the Cancer Behavior Inventory-Brief Arabic (CBI-BA), including participant understanding of items, and the Functional Assessment of Cancer Therapy-Breast Arabic (FACT-BA). Using a cross-sectional design, 438 cancer patients completed the CBI-BA, 30 of whom completed cognitive interviews. A subsample 167 women with breast cancer also completed the FACT-BA. Internal consistency evidence was assessed with Cronbach's α and construct validity with principal axis factoring. Internal consistency estimates were acceptable for the total CBI-BA (α = .81) and FACT-BA (α = .88) scales. Exploratory factor analyses showed evidence of construct validity for the CBI-BA; 1 factor was derived, compared with four in the original English version. Cognitive interviews indicated satisfactory patient understanding of CBI-BA items. The Arabic version of the general FACT-General scale had 4 factors according to expectation. The CBI-BA has adequate psychometric performance for the measurement of self-efficacy for coping with cancer in Arabic patients. The FACT-General Arabic has adequate evidence of reliability and validity for the measurement of quality of life in Arabic women with breast cancer. The availability of culturally sensitive and psychometrically sound instruments for Arabic patients diagnosed with cancer should be valuable for healthcare clinicians and researchers to assess self-efficacy for coping with cancer and quality of life.
Klingner, Jill; Moscovice, Ira; Casey, Michelle; McEllistrem Evenson, Alex
2015-01-01
Previously published findings based on field tests indicated that emergency department patient transfer communication measures are feasible and worthwhile to implement in rural hospitals. This study aims to expand those findings by focusing on the wide-scale implementation of these measures in the 79 Critical Access Hospitals (CAHs) in Minnesota from 2011 to 2013. Information was obtained from interviews with key informants involved in implementing the emergency department patient transfer communication measures in Minnesota as part of required statewide quality reporting. The first set of interviews targeted state-level organizations regarding their experiences working with providers. A second set of interviews targeted quality and administrative staff from CAHs regarding their experiences implementing measures. Implementing the measures in Minnesota CAHs proved to be successful in a number of respects, but informants also faced new challenges. Our recommendations, addressed to those seeking to successfully implement these measures in other states, take these challenges into account. Field-testing new quality measure implementations with volunteers may not be indicative of a full-scale implementation that requires facilities to participate. The implementation team's composition, communication efforts, prior relationships with facilities and providers, and experience with data collection and abstraction tools are critical factors in successfully implementing required reporting of quality measures on a wide scale. © 2014 National Rural Health Association.
Ten Ghz YBa2Cu3O(7-Delta) Superconducting Ring Resonators on NdGaO3 Substrates
NASA Technical Reports Server (NTRS)
To, H. Y.; Valco, G. J.; Bhasin, K. B.
1993-01-01
YBa2Cu3O(7-delta) thin films were formed on NdGaO3 substrates by laser ablation. Critical temperatures greater than 89 K and critical current densities exceeding 2 x 10(exp 8) Acm(sub -2) at 77 K were obtained. The microwave performance of films patterned into microstrip ring resonators with gold ground planes was measured. An unloaded quality factor six times larger than that of a gold resonator of identical geometry was achieved. The unloaded quality factor decreased below 70 K for both the superconducting and gold resonators due to increasing dielectric losses in the substrate. The temperature dependence of the loss tangent of NdGaO3 was extracted from the measurements.
Hickman, Ronald L; Clochesy, John M; Hetland, Breanna; Alaamri, Marym
2017-04-01
There are limited reliable and valid measures of the patient- provider interaction among adults with hypertension. Therefore, the purpose of this report is to describe the construct validity and reliability of the Questionnaire on the Quality of Physician-Patient Interaction (QQPPI), in community-dwelling adults with hypertension. A convenience sample of 109 participants with hypertension was recruited and administered the QQPPI at baseline and 8 weeks later. The exploratory factor analysis established a 12-item, 2-factor structure for the QQPPI was valid in this sample. The modified QQPPI proved to have sufficient internal consistency and test- retest reliability. The modified QQPPI is a valid and reliable measure of the provider-patient interaction, a construct posited to impact self-management, in adults with hypertension.
Ultra-High Q Acoustic Resonance in Superfluid ^4He
NASA Astrophysics Data System (ADS)
De Lorenzo, L. A.; Schwab, K. C.
2017-02-01
We report the measurement of the acoustic quality factor of a gram-scale, kilohertz-frequency superfluid resonator, detected through the parametric coupling to a superconducting niobium microwave cavity. For temperatures between 400 mK and 50 mK, we observe a T^{-4} temperature dependence of the quality factor, consistent with a 3-phonon dissipation mechanism. We observe Q factors up to 1.4× 10^8, consistent with the dissipation due to dilute ^3He impurities, and expect that significant further improvements are possible. These experiments are relevant to exploring quantum behavior and decoherence of massive macroscopic objects, the laboratory detection of continuous gravitational waves from pulsars, and the probing of possible limits to physical length scales.
Measuring clinical outcomes of animal-assisted therapy: impact on resident medication usage.
Lust, Elaine; Ryan-Haddad, Ann; Coover, Kelli; Snell, Jeff
2007-07-01
To measure changes in medication usage of as-needed, psychoactive medications and other select as-needed medication usage as a result of a therapy dog residing in the rehabilitation facility. Additional measures are participants' thoughts and feelings on quality-of-life factors. One group, pretest, post-test. Residential rehabilitation facility. Convenience sample, N = 58 residents living at the facility. A certified, trained therapy dog. Changes in as-needed medication usage for the following categories: analgesics, psychoactive medications, and laxatives, as well as changes in vital sign measurements of blood pressure, pulse, respiration rate, and body weight. Additionally, changes in the residents' perception of quality-of-life factors. One of the three monitored drug classes, analgesia, revealed a decrease in medication usage (mean = 2.6, standard deviation [SD] +/- 6.90, P = 0.017), and one of four monitored vital signs, pulse, showed a decrease (mean = 5.8, SD +/-7.39, P = 0.000) in study participants exposed to the therapy dog. Positive changes were reported in study participants' quality of life. The benefits to human welfare as a result of the presence of a therapy dog have the potential to decrease medication usage for certain conditions in long-term care patients as well as decrease costs. Pharmacist involvement in animal-assisted therapy has the potential to make unique and measurable improvements to best patient care.
Predictors of quality of life in AIDS patients.
Kemppainen, J K
2001-01-01
While much work has been completed in relation to measuring and defining the varying dimensions of quality of life in HIV/AIDS, very little research attention has been directed toward identifying factors that influence or enhance quality of life. This study examined whether variables relating to demographic characteristics, severity of illness, psychological status, or level of engagement in nursing care would predict quality of life in persons with advanced or late stage HIV/AIDS. A convenience sample of 162 hospitalized male and female patients with AIDS participated in this study. The participants completed the HIV Symptom Checklist, the Beck Depression Inventory, the HIV-QAM (a measure of changes in the status of hospitalized AIDS patients due to nursing care), and two measures of engagement in nursing care. The Living With HIV Scale was used as the measure of quality of life. The two components of this scale were analyzed independently. The strongest predictor of decreased quality of life scores was depression (accounting for 23% of the variance), with symptoms accounting for 9.75% and female gender accounting for an additional 8%. Two measures of patient engagement with nursing care providers contributed a total of 13.44% of the variance in quality of life scores. The findings emphasize the importance of recognizing and treating depression in persons with HIV/AIDS. The number of symptoms and their frequency also has a profound effect on quality of life. Although modest, study findings suggest that quality of life for an acutely ill, hospitalized patient with AIDS is enhanced through more active involvement or engagement in the process of nursing care.
NASA Technical Reports Server (NTRS)
Lawrence, Stella
1992-01-01
This paper is concerned with methods of measuring and developing quality software. Reliable flight and ground support software is a highly important factor in the successful operation of the space shuttle program. Reliability is probably the most important of the characteristics inherent in the concept of 'software quality'. It is the probability of failure free operation of a computer program for a specified time and environment.
Wang, Jimin; Brudvig, Gary W; Batista, Victor S; Moore, Peter B
2017-12-01
In 2012, Karplus and Diederichs demonstrated that the Pearson correlation coefficient CC 1/2 is a far better indicator of the quality and resolution of crystallographic data sets than more traditional measures like merging R-factor or signal-to-noise ratio. More specifically, they proposed that CC 1/2 be computed for data sets in thin shells of increasing resolution so that the resolution dependence of that quantity can be examined. Recently, however, the CC 1/2 values of entire data sets, i.e., cumulative correlation coefficients, have been used as a measure of data quality. Here, we show that the difference in cumulative CC 1/2 value between a data set that has been accurately measured and a data set that has not is likely to be small. Furthermore, structures obtained by molecular replacement from poorly measured data sets are likely to suffer from extreme model bias. © 2017 The Protein Society.
Assessing Quality of Working Life Among Malaysian Workers.
Sulaiman, Nur Suffia; Choo, Wan Yuen; Mat Yassim, Abdul Rahim; Van Laar, Darren; Chinna, Karuthan; Majid, Hazreen Abdul
2015-11-01
The Work-Related Quality of Life Scale-2 (WRQLS-2) has been used to measure quality of working life (QOWL) in the United Kingdom. In this study, the scale was translated and normalized into Malay. The scale was translated using the back-translation method, pretesting, and pilot testing. It was conducted among health care and office workers. It was tested in 3 stages; confirmatory factor analysis at stages 1 and 3 and exploratory factor analysis at stage 2. The Malaysian WRQLS-2 had 5 factors: "General Well-Being," "Job and Career Satisfaction," "Employee Engagement," "Home-Work Interface," and "Stress at Work." The scale showed good convergent and construct validity and also reliability. Perception of good QOWL may differ because of cultural influences and varying work environments. The validated Malaysian WRQLS-2 can be used to determine the QOWL of Malaysian office and health care workers. © 2015 APJPH.
Frequency dependent Lg attenuation in south-central Alaska
McNamara, D.E.
2000-01-01
The characteristics of seismic energy attenuation are determined using high frequency Lg waves from 27 crustal earthquakes, in south-central Alaska. Lg time-domain amplitudes are measured in five pass-bands and inverted to determine a frequency-dependent quality factor, Q(f), model for south-central Alaska. The inversion in this study yields the frequency-dependent quality factor, in the form of a power law: Q(f) = Q0fη = 220(±30) f0.66(±0.09) (0.75≤f≤12Hz). The results from this study are remarkably consistent with frequency dependent quality factor estimates, using local S-wave coda, in south-central Alaska. The consistency between S-coda Q(f) and Lg Q(f) enables constraints to be placed on the mechanism of crustal attenuation in south-central Alaska. For the range of frequencies considered in this study both scattering and intrinsic attenuation mechanisms likely play an equal role.
Postpartum diet quality in Australian women following a gestational diabetes pregnancy.
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.
Zawadzki, Matthew J; Graham, Jennifer E; Gerin, William
2013-02-01
We examined the mechanisms that underlie the observed relationships between loneliness and depressed mood and poor sleep quality in college students. This study was the first to investigate whether rumination and trait anxiety are psychological mechanisms that mediate this relationship. In Study 1 (n = 1,244), using factor analysis with cross-sectional data, we established that loneliness and rumination are distinct constructs. We then collected survey data in two cross-sectional samples (ns = 300 and 218) and one prospective (n = 334) sample to test whether rumination and anxiety were mediators of the relationship between loneliness and depressed mood and poor sleep quality. Structural equation modeling was used to test the proposed relationships. Participants completed self-report measures of loneliness, rumination, trait anxiety, depressed mood, and sleep quality. In addition, measures of hostility, neuroticism, negative affect, and tobacco use were also assessed and tested as mediators, while social support was assessed and tested as a moderator. Consistent across the three studies, we found that rumination and trait anxiety fully mediated the associations between loneliness and depressed mood as well as poor sleep quality; these relationships held after testing all other factors. This study helps explain how loneliness dynamics relate to poor health and suggests specific points of departure for the development of interventions.
Shortening of an existing generic online health-related quality of life instrument for dogs.
Reid, J; Wiseman-Orr, L; Scott, M
2017-10-11
Development, initial validation and reliability testing of a shortened version of a web-based questionnaire instrument to measure generic health-related quality of life in companion dogs, to facilitate smartphone and online use. The original 46 items were reduced using expert judgment and factor analysis. Items were removed on the basis of item loadings and communalities on factors identified through factor analysis of responses from owners of healthy and unwell dogs, intrafactor item correlations, readability of items in the UK, USA and Australia and ability of individual items to discriminate between healthy and unwell dogs. Validity was assessed through factor analysis and a field trial using a "known groups" approach. Test-retest reliability was assessed using intraclass correlation coefficients. The new instrument comprises 22 items, each of which was rated by dog owners using a 7-point Likert scale. Factor analysis revealed a structure with four health-related quality of life domains (energetic/enthusiastic, happy/content, active/comfortable, and calm/relaxed) accounting for 72% of the variability in the data compared with 64% for the original instrument. The field test involving 153 healthy and unwell dogs demonstrated good discriminative properties and high intraclass correlation coefficients. The 22-item shortened form is superior to the original instrument and can be accessed via a mobile phone app. This is likely to increase the acceptability to dog owners as a routine wellness measure in health care packages and as a therapeutic monitoring tool. © 2017 British Small Animal Veterinary Association.
Taylor, Natalie; Clay-Williams, Robyn; Hogden, Emily; Pye, Victoria; Li, Zhicheng; Groene, Oliver; Suñol, Rosa; Braithwaite, Jeffrey
2015-01-01
Introduction Despite the growing body of research on quality and safety in healthcare, there is little evidence of the association between the way hospitals are organised for quality and patient factors, limiting our understanding of how to effect large-scale change. The ‘Deepening our Understanding of Quality in Australia’ (DUQuA) study aims to measure and examine relationships between (1) organisation and department-level quality management systems (QMS), clinician leadership and culture, and (2) clinical treatment processes, clinical outcomes and patient-reported perceptions of care within Australian hospitals. Methods and analysis The DUQuA project is a national, multilevel, cross-sectional study with data collection at organisation (hospital), department, professional and patient levels. Sample size calculations indicate a minimum of 43 hospitals are required to adequately power the study. To allow for rejection and attrition, 70 hospitals across all Australian jurisdictions that meet the inclusion criteria will be invited to participate. Participants will consist of hospital quality management professionals; clinicians; and patients with stroke, acute myocardial infarction and hip fracture. Organisation and department-level QMS, clinician leadership and culture, patient perceptions of safety, clinical treatment processes, and patient outcomes will be assessed using validated, evidence-based or consensus-based measurement tools. Data analysis will consist of simple correlations, linear and logistic regression and multilevel modelling. Multilevel modelling methods will enable identification of the amount of variation in outcomes attributed to the hospital and department levels, and the factors contributing to this variation. Ethics and dissemination Ethical approval has been obtained. Results will be disseminated to individual hospitals in de-identified national and international benchmarking reports with data-driven recommendations. This ground-breaking national study has the potential to influence decision-making on the implementation of quality and safety systems and processes in Australian and international hospitals. PMID:26644128
Johnson, Dayna A; Lisabeth, Lynda; Hickson, DeMarc; Johnson-Lawrence, Vicki; Samdarshi, Tandaw; Taylor, Herman; Diez Roux, Ana V
2016-09-01
We investigated cross-sectional associations of individual-level socioeconomic position (SEP) and neighborhood characteristics (social cohesion, violence, problems, disadvantage) with sleep duration and sleep quality in 5,301 African Americans in the Jackson Heart Study. All measures were self-reported. Sleep duration was assessed as hours of sleep; sleep quality was reported as poor (1) to excellent (5). SEP was measured by categorized years of education and income. Multinomial logistic and linear regression models were fit to examine the associations of SEP and neighborhood characteristics (modeled dichotomously and tertiles) with sleep duration (short vs. normal, long vs. normal) and continuous sleep duration and quality after adjustment for demographics and risk factors. The mean sleep duration was 6.4 ± 1.5 hours, 54% had a short (≤ 6 h) sleep duration, 5% reported long (≥ 9 h) sleep duration, and 24% reported fair to poor sleep quality. Lower education was associated with greater odds of long sleep (odds ratio [OR] = 2.19, 95% confidence interval [CI] = 1.42, 3.38) and poorer sleep quality (β = -0.17, 95% CI = -0.27, -0.07) compared to higher education after adjustment for demographics and risk factors. Findings were similar for income. High neighborhood violence was associated with shorter sleep duration (-9.82 minutes, 95% CI = -16.98, -2.66) and poorer sleep quality (β = -0.11, 95% CI = -0.20, 0.00) after adjustment for demographics and risk factors. Results were similar for neighborhood problems. In secondary analyses adjusted for depressive symptoms in a subset of participants, most associations were attenuated and only associations of low SEP with higher odds of long sleep and higher neighborhood violence with poorer sleep quality remained statistically significant. Social and environmental characteristics are associated with sleep duration and quality in African Americans. Depressive symptoms may explain at least part of this association. © 2016 Associated Professional Sleep Societies, LLC.
Wong, P K S; Wong, D F K; Schalock, R L; Chou, Y-C
2011-06-01
In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire - Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40-item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self-determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P<0.000, P<0.01 and P<0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α=0.79). Initial validity tests indicated that the Chinese Quality of Life Questionnaire - Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.
Eklund, Mona
2015-01-01
Findings from quality of life studies are often inconclusive for reasons such as: i) estimates may address different aspects of quality of life and thus produce different outcomes; ii) quality of life is largely determined by self-factors; and iii) people with a long-term condition rate their quality of life better than those who have had their condition for a short duration. This makes quality of life a complex phenomenon to measure. The above explanations served as hypotheses for this methodologically oriented paper, based on a longitudinal study on women with stress-related disorders receiving work rehabilitation. Eighty-four women participating in a lifestyle intervention or care as usual were compared. Self-ratings of "general quality of life" and a summarized "satisfaction with different life domains" index (according to Manchester Short Assessment of Quality of Life) and two self-factors (self-esteem and self-mastery) were administered at admission and a 6-month follow-up. Participant age and amount of months on sick leave prior to rehabilitation were used as two proxies of duration of the condition. General quality of life distinguished between the groups, whereas satisfaction with life domains did not. Self-esteem and self-mastery were related to both quality of life aspects. Age was related to both estimates of quality of life, whereas duration of sick leave was unrelated to both. General quality of life and satisfaction with life domains produced different results. Outcome studies should apply more than one operationalization of quality of life and self-factors should be considered as important determinants of quality of life. Duration of the condition needs to be acknowledged as well when interpreting levels of quality of life, although the current study could not present any clear-cut findings in this respect.
Schroeder, R.L.
2006-01-01
It is widely accepted that plans for restoration projects should contain specific, measurable, and science-based objectives to guide restoration efforts. The United States Fish and Wildlife Service (USFWS) is in the process of developing Comprehensive Conservation Plans (CCPs) for more than 500 units in the National Wildlife Refuge System (NWRS). These plans contain objectives for biological and ecosystem restoration efforts on the refuges. Based on USFWS policy, a system was developed to evaluate the scientific quality of such objectives based on three critical factors: (1) Is the objective specific, measurable, achievable, results-oriented, and time-fixed? (2) What is the extent of the rationale that explains the assumptions, logic, and reasoning for the objective? (3) How well was available science used in the development of the objective? The evaluation system scores each factor on a scale of 1 (poor) to 4 (excellent) according to detailed criteria. The biological and restoration objectives from CCPs published as of September 2004 (60 total) were evaluated. The overall average score for all biological and restoration objectives was 1.73. Average scores for each factor were: Factor 1-1.97; Factor 2-1.86; Factor 3-1.38. The overall scores increased from 1997 to 2004. Future restoration efforts may benefit by using this evaluation system during the process of plan development, to ensure that biological and restoration objectives are of the highest scientific quality possible prior to the implementation of restoration plans, and to allow for improved monitoring and adaptive management.
Myers, B; Petersen Williams, P; Johnson, K; Govender, R; Manderscheid, R; Koch, J R
2017-01-30
A performance measurement system - the Service Quality Measures (SQM) initiative - has been developed to monitor the quality of South Africa (SA)'s substance abuse treatment services. Identifying factors associated with readiness to adopt this system may inform strategies to facilitate its robust implementation. To examine factors associated with readiness to adopt a performance measurement system among SA substance abuse treatment providers. We surveyed 81 treatment providers from 13 treatment sites in the Western Cape, SA. The survey examined awareness, resources, organisational climate, leadership support and readiness to adopt the SQM system. Regression analysis was used to identify factors associated with readiness to adopt this system. Readiness to adopt the SQM initiative was high (M=5.64, standard deviation 1.63). In bivariate analyses, caseload size (F=3.73 (degrees of freedom (df)=3.70), p=0.015), awareness (r=0.78, p<0.0001), leadership support (r=0.70, p<0.0001), resources (r=0.65, p<0.0001), openness to change (r=0.372, p=0.001), and external pressure to change were associated with readiness to adopt the SQM. In multivariate analyses, only awareness of the SQM initiative (B=0.34, standard error (SE) 0.08, t=4.4, p<0.0001) and leadership support (B=0.45, SE 0.11, t=4.0, p<0.0001) were significantly associated with readiness to adopt this system. While treatment providers report high levels of readiness to adopt the SQM system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation.
49 CFR 37.155 - Factors in decision to grant an undue financial burden waiver.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Service § 37.155 Factors in decision to grant an undue financial burden waiver. (a) In making an undue... reduction in service, measured by service miles; (2) Average number of trips made by the entity's general... and quality of available resources for complementary paratransit service; and (10) Unique...
Code of Federal Regulations, 2010 CFR
2017-10-01
... (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.315... and suppresses the measure value. (5) Establishing SHFFT model reconciliation payment eligibility and... factor for reconciliation payments. (A) A 3.0 percentage point effective discount factor for SHFFT model...
Developing Strategic Leadership for Administrators: Private Vocational College Study
ERIC Educational Resources Information Center
Jumnongya, Areeya; Sirisuthi, Chaiyuth; Chansirisira, Pacharawit
2015-01-01
The purpose of this study is to study and define a number of factors measuring quality and efficiency in administrators of private vocational college, and to test and evaluate the efficiency of the strategic leadership program. Twelve factors and 83 indicators were identified as vital for strategic leadership for private vocational college…
ERIC Educational Resources Information Center
Flowers, Claudia
2006-01-01
This study examines the underlying structure of the Clinical Experience Rubric (CER), which is designed to assess preservice teachers' dispositions during the clinical experiences. Dispositions were conceptualized as being a multidimensional construct with three related factors: (a) professionalism, (b) teaching quality, and (c) relationship with…
Song, Jiangxin; Lin, Jintian; Tang, Jialei; Liao, Yang; He, Fei; Wang, Zhaohui; Qiao, Lingling; Sugioka, Koji; Cheng, Ya
2014-06-16
We report on fabrication of a microtoroid resonator of a high-quality factor (i.e., Q-factor of ~3.24 × 10(6) measured under the critical coupling condition) integrated in a microfluidic channel using femtosecond laser three-dimensional (3D) micromachining. Coupling of light into and out of the microresonator has been realized with a fiber taper that is reliably assembled with the microtoroid. The assembly of the fiber to the microtoroid is achieved by welding the fiber taper onto the sidewall of the microtoroid using CO2 laser irradiation. The integrated microresonator maintains a high Q-factor of 3.21 × 10(5) as measured in air, which should still be sufficient for many sensing applications. We test the functionality of the integrated optofluidic sensor by performing bulk refractive index sensing of purified water doped with tiny amount of salt. It is shown that a detection limit of ~1.2 × 10(-4) refractive index unit can be achieved. Our result showcases the capability of integration of high-Q microresonators with complex microfluidic systems using femtosecond laser 3D micromachining.
Maier, I; Kriston, L; Härter, M; Hölzel, L P; Bermejo, I
2015-10-01
In Germany live a lot of migrants. Cultural and migration specific aspects seem to have an effect on utilisation of health care. There are no instruments that measure such factors of influence. A systematic literature research or article that identify the difficulties of the migrants in using the health care system, was made. The relevant aspects were explored during a health related opinion survey of migrants from former USSR, Turkey, Italy and Spain. The psychometric qualities of this questionnaire were investigated with factor and reliability analyses. There were 24 reasons identified for non-utilisation health care. They were combined in a questionnaire. The factor analysis showed 2-factor structure ("janguage und information related Reasons" Chronbach's α=0.928 and "experience with/attitude toward health care system", Chronbach's α=0.879). Furthermore, there was a total scale with Chronbach's α=0.945. The acceptance was between 80.0 and 96.3%. The results confirm the psychometric quality of this measuring instrument. For further generalisability more verification will be necessary. © Georg Thieme Verlag KG Stuttgart · New York.
The role of exogenous risk factors of antituberculosis treatment failure.
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
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
NASA Astrophysics Data System (ADS)
Sifa, A.; Baskoro, A. S.; Sugeng, S.; Badruzzaman, B.; Endramawan, T.
2018-02-01
Resistance Spot Welding (RSW) is a process of connecting between two worksheet with thermomechanical loading process, RSW is widely used in automotive industry, the quality of splicing spot welding is influenced by several factors. One of the factors at the time of the welding process is pressure. The quality of welding on the nuggets can be determined by undertaking non-destructive testing by using Non Destructive Test (NDT) - Ultrasonic Test. In the NDT test is done by detecting the thickness of the nugget area, the purpose of research conducted to determine the effect of pressure to welding quality with Nugget thickness gauge measurement with Non Destructive Test method and manual measurement with micrometer, Experimental welding process by entering the welding parameters that have been specified and pressure variables 1 -5 bars on the worksheet thickness of 1 mm. The results of testing with NDT show there is addition of thickness in nugget superiority after compare with measurement result of thickness of nugget with micrometer which slightly experience thickness in nugget area, this indicates that the welding results have a connection between worksheet 1 and worksheet 2.
Quality-of-life survey for patients diagnosed with nonmuscle-invasive bladder cancer.
Abáigar-Pedraza, I; Megías-Garrigós, J; Sánchez-Payá, J
2016-05-01
To determine the reliability and validity of a quality-of-life survey for patients with nonmuscle-invasive bladder cancer. A total of 180 patients were included in the study. We developed a survey with 21 questions grouped into 5 areas. The patients filled in this survey and the Functional Assessment of Cancer Therapy - Bladder Cancer (FACT-BL) survey. To assess reliability, we calculated Cronbach's alpha coefficient and the kappa index. To determine criterion validity, we studied the association between the scores obtained from our survey and those from the FACT-BL survey using the Pearson correlation coefficient. To determine the construct validity (factorial and discriminatory), we performed a factor analysis, comparing it with Student's t-test for the scores obtained according to the tumour characteristics of reduced quality of life (e.g., malignancies located at the trigone of the bladder). Cronbach's alpha reliability coefficient was .83, and the kappa index varied between .7 and 1. For the association study between the new survey and the FACT-BL survey, we measured an r=.82 for the overall score and between r=.68 (disease) and r=.97 (sex life) in the various measures. In the factor analysis, we measured a Kaiser-Meyer-Olkin index of .77 and performed the Barlett test (P<.001). The comparison between the scores, in the presence or absence of certain tumour characteristics, has shown a reduced quality of life when those characteristics are present, which was statistically significant (P<.05) in the majority of cases. Our survey to measure the quality of life of patients with nonmuscle-invasive bladder cancer is reliable and valid. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Teacher Dispositions Affecting Self-Esteem and Student Performance
ERIC Educational Resources Information Center
Helm, Carroll
2007-01-01
Research supports several factors related to student success. Darling-Hammond (2000) indicated that the quality of teachers, as measured by whether the teachers were fully certified and had a major in their teaching field, was related to student performance. Measures of teacher preparation and certification were the strongest predictors of student…
Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R
2015-04-01
Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to improve physical therapists' implementation behaviors. © 2015 American Physical Therapy Association.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chofor, N; Poppe, B; Nebah, F
Purpose: In a brachytherapy photon field in water the fluence-averaged mean photon energy Em at the point of measurement correlates with the radiation quality correction factor kQ of a non water-equivalent detector. To support the experimental assessment of Em, we show that the normalized signal ratio NSR of a pair of radiation detectors, an unshielded silicon diode and a diamond detector can serve to measure quantity Em in a water phantom at a Ir-192 unit. Methods: Photon fluence spectra were computed in EGSnrc based on a detailed model of the GammaMed source. Factor kQ was calculated as the ratio ofmore » the detector's spectrum-weighted responses under calibration conditions at a 60Co unit and under brachytherapy conditions at various radial distances from the source. The NSR was investigated for a pair of a p-type unshielded silicon diode 60012 and a synthetic single crystal diamond detector 60019 (both PTW Freiburg). Each detector was positioned according to its effective point of measurement, with its axis facing the source. Lateral signal profiles were scanned under complete scatter conditions, and the NSR was determined as the quotient of the signal ratio under application conditions x and that at position r-ref = 1 cm. Results: The radiation quality correction factor kQ shows a close correlation with the mean photon energy Em. The NSR of the diode/diamond pair changes by a factor of two from 0–18 cm from the source, while Em drops from 350 to 150 keV. Theoretical and measured NSR profiles agree by ± 2 % for points within 5 cm from the source. Conclusion: In the presence of the close correlation between radiation quality correction factor kQ and photon mean energy Em, the NSR provides a practical means of assessing Em under clinical conditions. Precise detector positioning is the major challenge.« less
NASA Astrophysics Data System (ADS)
Alameddine, Ibrahim; Jawhari, Gheeda; El-Fadel, Mutasem
2017-04-01
Perceptions developed by consumers regarding the quality of water reaching their household can affect the ultimate use of the water. This study identified key factors influencing consumers' perception of water quality in a highly urbanized coastal city, experiencing chronic water shortages, overexploitation of groundwater, and accelerated saltwater intrusion. Household surveys were administered to residents to capture views and perceptions of consumed water. Concomitantly, groundwater and tap water samples were collected and analyzed at each residence for comparison with perceptions. People's rating of groundwater quality was found to correlate to the measured water quality both in the dry and wet seasons. In contrast, perceptions regarding the water quality of the public water supply network did not show any correlation with the measured tap water quality indicators. Logistic regression models developed to predict perception based on salient variables indicated that age, apartment ownership, and levels of total dissolved solids play a significant role in shaping perceptions regarding groundwater quality. Perceptions concerning the water quality of the public water supply network appeared to be independent of the measured total dissolved solids levels at the tap but correlated to those measured in the wells. The study highlights misconceptions that can arise as a result of uncontrolled cross-connections of groundwater to the public supply network water and the development of misaligned perceptions based on prior consumption patterns, water shortages, and a rapidly salinizing groundwater aquifer.
Alameddine, Ibrahim; Jawhari, Gheeda; El-Fadel, Mutasem
2017-04-01
Perceptions developed by consumers regarding the quality of water reaching their household can affect the ultimate use of the water. This study identified key factors influencing consumers' perception of water quality in a highly urbanized coastal city, experiencing chronic water shortages, overexploitation of groundwater, and accelerated saltwater intrusion. Household surveys were administered to residents to capture views and perceptions of consumed water. Concomitantly, groundwater and tap water samples were collected and analyzed at each residence for comparison with perceptions. People's rating of groundwater quality was found to correlate to the measured water quality both in the dry and wet seasons. In contrast, perceptions regarding the water quality of the public water supply network did not show any correlation with the measured tap water quality indicators. Logistic regression models developed to predict perception based on salient variables indicated that age, apartment ownership, and levels of total dissolved solids play a significant role in shaping perceptions regarding groundwater quality. Perceptions concerning the water quality of the public water supply network appeared to be independent of the measured total dissolved solids levels at the tap but correlated to those measured in the wells. The study highlights misconceptions that can arise as a result of uncontrolled cross-connections of groundwater to the public supply network water and the development of misaligned perceptions based on prior consumption patterns, water shortages, and a rapidly salinizing groundwater aquifer.
Production of Near-Mirror Surface Quality by Precision Grinding
NASA Technical Reports Server (NTRS)
Dimofte, Florin; Krantz, Timothy
2003-01-01
Mechanical components such as gears and bearings operate with the working surfaces in intimate contact with a mating part. The performance of such components will be influenced by the quality of the working surface. In general, a smoother surface will perform better than a rougher surface since the lubrication conditions are improved. For example, surfaces with a special near-mirror quality finish of low roughness performed better than ground surfaces when tested using a block-on-ring arrangement. Bearings with near-mirror quality have been tested and analyzed; lower running torques were measured and improved fatigue life was anticipated. Experiments have been done to evaluate the performance of gears with improved, low roughness surface finishing. The measured performance improvements include an increased scuffing (scoring) load capacity by a factor of 1.6, a 30-percent reduction of gear tooth running friction, and longer fatigue lives by a factor of about four. One can also anticipate that near-mirror quality surface finishing could improve the performance of other mechanical components such as mechanical seals and heavily loaded journal bearings. Given these demonstrated benefits, capable and economical methods for the production of mechanical components with near-mirror quality surfaces are desired. One could propose the production of near-mirror quality surfaces by several methods such as abrasive polishing, chemical assisted polishing, or grinding. Production of the surfaces by grinding offers the possibility to control the macro-geometry (form), waviness, and surface texture with one process. The present study was carried out to investigate the possibility of producing near-mirror quality surfaces by grinding. The present study makes use of a specially designed grinding machine spindle to improve the surface quality relative to the quality produced when using a spindle of conventional design.
Biondo, Emiliano; Khoury, Marina Claudia
2005-09-01
The daily press is an important source of health information and may influence health care utilization. However, medical reports published in newspapers from developed countries have shown a poor quality. The reliability of the questionnaire Index of Scientific Quality was evaluated by using it to measure the scientific quality of health information published by Argentinian newspapers between 2000 and 2002. It assessed the readability of the texts in grade levels and explored the relationship between quality and other factors. The Spanish adaptation of the instrument consisted in translation, back-traslation and pilot study. The reliability was assessed by applying the instrument to newspaper articles with more than 300 words that discussed therapy, diagnosis, prevention, lifestyle effects, and hazardous exposure. Two physicians independently graded 129 articles. Inter-observer and intra-observer concordance was quantified for each item with the intra-class correlation coefficient (CI95%). To measure scientific quality, a randomized sample of 210 articles was assessed. Each received a mark that ranged from 0 to 100. Readability was determined by the FRY graph method. The relationship between quality and other variables was explored with multiple linear regression analysis. The inter-rater concordance varied between 0.48 (0.34-0.61) and 0.67 (0.56-0.75). Intra-rater concordance varied from 0.51 (0.37-0.63) to 0.95 (0.93-0.96). The internal consistency (Cronbach's alpha) was 0.88. The quality-of-health-information was rated at 25 points (16.7, 33.3) [median (intercuartil range)]. The reading level was assessed to be at the 10.4 grade (10.2-10.6) [mean (CI 95%)]. Quality of the health information was greatly deficient; however, no specific factors were related with quality. Readability was probably a key barrier for access to the health information.
Validation and reliability of the Turkish Utian Quality-of-Life Scale in postmenopausal women.
Abay, Halime; Kaplan, Sena
2016-04-01
There are a limited number of menopause-specific quality-of-life scales for the Turkish population. This study was conducted to evaluate the validity and reliability of the Turkish Utian Quality-of-Life Scale in postmenopausal women. The study group was comprised of 250 postmenopausal women who applied to a training and research hospital's menopause clinic in Turkey. A survey form and the Turkish Utian quality-of-Life Scale were used to collect data, and the Turkish version of Short Form-36 was used to evaluate reliability with an equivalent form. Language-validity, content-validity, and construct-validity methods were used to assess the validity of the scale, and Cronbach's α coefficient calculation and the equivalent-form reliability methods were used to assess the reliability of the scale. The Turkish Utian Quality-of-Life Scale was determined to be a valid and reliable instrument for measuring the quality of life of postmenopausal women. Confirmatory factor analysis demonstrates that the instrument fits well with 23 items and a four-factor model. The Cronbach's α coefficient for the quality-of-life domains were as follows: 0.88 overall, 0.79 health, 0.78 emotional, 0.76 sexual, and 0.75 occupational. Reliability of the instrument was confirmed through significant correlations between scores on the Turkish version of the Utian Quality-of-Life Scale and the Turkish version of the Short Form-36 (r = 0.745, P < 0.001). This research emphasizes that the Turkish Utian Quality-of-Life Scale is reliable and valid in postmenopausal women-it is a useful instrument for measuring quality of life during menopause.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mackenzie, Alistair, E-mail: alistairmackenzie@nhs.net; Dance, David R.; Young, Kenneth C.
Purpose: The aim of this work is to create a model to predict the noise power spectra (NPS) for a range of mammographic radiographic factors. The noise model was necessary to degrade images acquired on one system to match the image quality of different systems for a range of beam qualities. Methods: Five detectors and x-ray systems [Hologic Selenia (ASEh), Carestream computed radiography CR900 (CRc), GE Essential (CSI), Carestream NIP (NIPc), and Siemens Inspiration (ASEs)] were characterized for this study. The signal transfer property was measured as the pixel value against absorbed energy per unit area (E) at a referencemore » beam quality of 28 kV, Mo/Mo or 29 kV, W/Rh with 45 mm polymethyl methacrylate (PMMA) at the tube head. The contributions of the three noise sources (electronic, quantum, and structure) to the NPS were calculated by fitting a quadratic at each spatial frequency of the NPS against E. A quantum noise correction factor which was dependent on beam quality was quantified using a set of images acquired over a range of radiographic factors with different thicknesses of PMMA. The noise model was tested for images acquired at 26 kV, Mo/Mo with 20 mm PMMA and 34 kV, Mo/Rh with 70 mm PMMA for three detectors (ASEh, CRc, and CSI) over a range of exposures. The NPS were modeled with and without the noise correction factor and compared with the measured NPS. A previous method for adapting an image to appear as if acquired on a different system was modified to allow the reference beam quality to be different from the beam quality of the image. The method was validated by adapting the ASEh flat field images with two thicknesses of PMMA (20 and 70 mm) to appear with the imaging characteristics of the CSI and CRc systems. Results: The quantum noise correction factor rises with higher beam qualities, except for CR systems at high spatial frequencies, where a flat response was found against mean photon energy. This is due to the dominance of secondary quantum noise in CR. The use of the quantum noise correction factor reduced the difference from the model to the real NPS to generally within 4%. The use of the quantum noise correction improved the conversion of ASEh image to CRc image but had no difference for the conversion to CSI images. Conclusions: A practical method for estimating the NPS at any dose and over a range of beam qualities for mammography has been demonstrated. The noise model was incorporated into a methodology for converting an image to appear as if acquired on a different detector. The method can now be extended to work for a wide range of beam qualities and can be applied to the conversion of mammograms.« less
Gheorghe, Iuliana Raluca; Gheorghe, Consuela-Mădălina; Purcărea, Victor Lorin
2018-01-01
Nowadays, the competition registered on the Romanian markets regarding the activity of private ophthalmology organizations has raised their interest in developing consumer-oriented strategies. The key factor that assures a differentiation as well as a competitive advantage is the service quality from a marketing perspective. From a marketing perspective, service quality is measured as a perceived discrepancy between the consumers' expectations and was actually performed in health care services. The most widely and validated measurement is the SERVQUAL scale. However, a variety of SERVQUAL scales have been applied in different health care environments without taking into consideration the specialty of the health care service. Thus, the objective of this paper was to measure the service quality in the Romanian ophthalmology private organizations using the SERVQUAL measurement, by identifying the SERVQUAL dimensions, which register the highest and the lowest gap scores. The instrument for data collection was the SERVQUAL self-administered questionnaire that consisted of 22 items measured on a 5-point Likert scale. The sample size encompassed 100 participants and the sampling technique was the snowball. The internal consistency, validity and the reliability of the SERVQUAL scale was determined by the Cronbach's alpha coefficients and factor analysis. The SERVQUAL questionnaire focused on 5 dimensions (tangibles, reliability, assurance, empathy and responsiveness) and each dimension, in its turn, was characterized by different items. The mean age of the participants was 49.52 years, with a mean income of 3031 Romanian Currency and the mean period of wearing eyeglasses was 5 years (±2). Further, there were 47% females and 53% males. The overall internal consistency of the SERVQUAL scale, as well as the dimensions' internal consistency were all above 0.7 and the factor analysis revealed that the items loaded properly on each dimension. Moreover, the gap scores of the SERVQUAL scale's dimensions pinpointed that the highest gap score was registered by the Tangibles dimension and the lowest gap score was registered by the Reliability dimension. Performing the ophthalmology service right the first time, contributes significantly to the improvement of the marketing effectiveness and the operating efficiency.
Gheorghe, Iuliana Raluca; Gheorghe, Consuela-Mădălina; Purcărea, Victor Lorin
2018-01-01
Nowadays, the competition registered on the Romanian markets regarding the activity of private ophthalmology organizations has raised their interest in developing consumer-oriented strategies. The key factor that assures a differentiation as well as a competitive advantage is the service quality from a marketing perspective. Objectives: From a marketing perspective, service quality is measured as a perceived discrepancy between the consumers’ expectations and was actually performed in health care services. The most widely and validated measurement is the SERVQUAL scale. However, a variety of SERVQUAL scales have been applied in different health care environments without taking into consideration the specialty of the health care service. Thus, the objective of this paper was to measure the service quality in the Romanian ophthalmology private organizations using the SERVQUAL measurement, by identifying the SERVQUAL dimensions, which register the highest and the lowest gap scores. Materials and methods: The instrument for data collection was the SERVQUAL self-administered questionnaire that consisted of 22 items measured on a 5-point Likert scale. The sample size encompassed 100 participants and the sampling technique was the snowball. The internal consistency, validity and the reliability of the SERVQUAL scale was determined by the Cronbach’s alpha coefficients and factor analysis. The SERVQUAL questionnaire focused on 5 dimensions (tangibles, reliability, assurance, empathy and responsiveness) and each dimension, in its turn, was characterized by different items. Results: The mean age of the participants was 49.52 years, with a mean income of 3031 Romanian Currency and the mean period of wearing eyeglasses was 5 years (±2). Further, there were 47% females and 53% males. The overall internal consistency of the SERVQUAL scale, as well as the dimensions’ internal consistency were all above 0.7 and the factor analysis revealed that the items loaded properly on each dimension. Moreover, the gap scores of the SERVQUAL scale’s dimensions pinpointed that the highest gap score was registered by the Tangibles dimension and the lowest gap score was registered by the Reliability dimension. Conclusions: Performing the ophthalmology service right the first time, contributes significantly to the improvement of the marketing effectiveness and the operating efficiency. PMID:29796435
Development and validation of a measure of pediatric oral health-related quality of life: the POQL.
Huntington, Noelle L; Spetter, Dante; Jones, Judith A; Rich, Sharron E; Garcia, Raul I; Spiro, Avron
2011-01-01
To develop a brief measure of oral health-related quality of life (OHQL) in children and demonstrate its reliability and validity in a diverse population. We administered the initial 20-item Pediatric Oral Health-Related Quality of Life (POQL) to children (Child Self-Report) and parents (Parent Report on Child) from diverse populations in both school-based and clinic-based settings. Clinical oral health status was measured on a subset of children. We used factor analysis to determine the underlying scales and then reduced the measure to 10 items based on several considerations. Multitrait analysis on the resulting 10-item POQL was used to reaffirm the discrimination of scales and assess the measure's internal consistency and interscale correlations. We established discriminant and convergent validity with clinical status, perceived oral health and responses on the PedsQL, and determined sensitivity to change with children undergoing ECC surgical repair. Factor analysis returned a four-scale solution for the initial items--Physical Functioning, Role Functioning, Social Functioning, and Emotional Functioning. The reduced items represented the same four scales--two each on Physical and Role and three each on Social and Emotional. Good reliability and validity were shown for the POQL as a whole and for each of the scales. The POQL is a valid and reliable measure of OHQL for use in preschool and school-aged children, with high utility for both clinical assessments and large-scale population studies.
Quality evaluation on an e-learning system in continuing professional education of nurses.
Lin, I-Chun; Chien, Yu-Mei; Chang, I-Chiu
2006-01-01
Maintaining high quality in Web-based learning is a powerful means of increasing the overall efficiency and effectiveness of distance learning. Many studies have evaluated Web-based learning but seldom evaluate from the information systems (IS) perspective. This study applied the famous IS Success model in measuring the quality of a Web-based learning system using a Web-based questionnaire for data collection. One hundred and fifty four nurses participated in the survey. Based on confirmatory factor analysis, the variables of the research model fit for measuring the quality of a Web-based learning system. As Web-based education continues to grow worldwide, the results of this study may assist the system adopter (hospital executives), the learner (nurses), and the system designers in making reasonable and informed judgments with regard to the quality of Web-based learning system in continuing professional education.
Rothaug, Judith; Zaslansky, Ruth; Schwenkglenks, Matthias; Komann, Marcus; Allvin, Renée; Backström, Ragnar; Brill, Silviu; Buchholz, Ingo; Engel, Christoph; Fletcher, Dominique; Fodor, Lucian; Funk, Peter; Gerbershagen, Hans J; Gordon, Debra B; Konrad, Christoph; Kopf, Andreas; Leykin, Yigal; Pogatzki-Zahn, Esther; Puig, Margarita; Rawal, Narinder; Taylor, Rod S; Ullrich, Kristin; Volk, Thomas; Yahiaoui-Doktor, Maryam; Meissner, Winfried
2013-11-01
PAIN OUT is a European Commission-funded project aiming at improving postoperative pain management. It combines a registry that can be useful for quality improvement and research using treatment and patient-reported outcome measures. The core of the project is a patient questionnaire-the International Pain Outcomes questionnaire-that comprises key patient-level outcomes of postoperative pain management, including pain intensity, physical and emotional functional interference, side effects, and perceptions of care. Its psychometric quality after translation and adaptation to European patients is the subject of this validation study. The questionnaire was administered to 9,727 patients in 10 languages in 8 European countries and Israel. Construct validity was assessed using factor analysis. Discriminant validity assessment used Mann-Whitney U tests to detect mean group differences between 2 surgical disciplines. Internal consistency reliability was calculated as Cronbach's alpha. Factor analysis resulted in a 3-factor structure explaining 53.6% of variance. Cronbach's alpha at overall scale level was high (.86), and for the 3 subscales was low, moderate, or high (range, .53-.89). Significant mean group differences between general and orthopedic surgery patients confirmed discriminant validity. The psychometric quality of the International Pain Outcomes questionnaire can be regarded as satisfactory. The International Pain Outcomes questionnaire provides an instrument for postoperative pain assessment and improvement of quality of care, which demonstrated good psychometric quality when translated into a variety of languages in a large European and Israeli patient population. This measure provides the basis for the first comprehensive postoperative pain registry in Europe and other countries. Copyright © 2013. Published by Elsevier Inc.
Psychometric Properties of the Persian Translation of the Sexual Quality of Life–Male Questionnaire
Maasoumi, Raziyeh; Mokarami, Hamidreza; Nazifi, Morteza; Stallones, Lorann; Taban, Abrahim; Yazdani Aval, Mohsen; Samimi, Kazem
2016-01-01
Sexual dysfunction has been demonstrated to be related to a poor quality of life. These dysfunctions are especially prevalent among men. This cross-sectional study aimed to investigate the psychometric properties of the Persian translation of the Sexual Quality of Life–Male (SQOL-M), translated and adapted to measure sexual quality of life among Iranian men. Forward–backward procedures were applied in translating the original SQOL-M into Persian, and then the psychometric properties of the Persian translation of the SQOL-M were studied. A total of 181 participants (23-60 years old) were included in the study. Validity was assessed by construct validity using confirmatory factor analysis, convergent validity, and content validity. The international index of erectile function (IIEF) and the work ability index were used to study the convergent validity. Reliability was evaluated through internal consistency and test–retest reliability analyses. The results from confirmatory factor analysis confirmed a one-factor solution for the Persian version of the SQOL-M. Content validity of the translated measure was endorsed by 10 specialists. Pearson correlations indicated that work ability index score, dimensions of the IIEF, and the IIEF total score were positively correlated with the Persian version of the SQOL-M (p < .001). Reliability evaluation indicated a high internal consistency and test–retest reliability. The Cronbach’s alpha coefficient and intraclass correlation coefficients were .96 and .95, respectively. Results indicated that the Persian version of the SQOL-M has good to excellent psychometric properties and can be used to assess the sexual quality of life among Iranian men. PMID:26856758
Psychometric Properties of the Persian Translation of the Sexual Quality of Life-Male Questionnaire.
Maasoumi, Raziyeh; Mokarami, Hamidreza; Nazifi, Morteza; Stallones, Lorann; Taban, Abrahim; Yazdani Aval, Mohsen; Samimi, Kazem
2017-05-01
Sexual dysfunction has been demonstrated to be related to a poor quality of life. These dysfunctions are especially prevalent among men. This cross-sectional study aimed to investigate the psychometric properties of the Persian translation of the Sexual Quality of Life-Male (SQOL-M), translated and adapted to measure sexual quality of life among Iranian men. Forward-backward procedures were applied in translating the original SQOL-M into Persian, and then the psychometric properties of the Persian translation of the SQOL-M were studied. A total of 181 participants (23-60 years old) were included in the study. Validity was assessed by construct validity using confirmatory factor analysis, convergent validity, and content validity. The international index of erectile function (IIEF) and the work ability index were used to study the convergent validity. Reliability was evaluated through internal consistency and test-retest reliability analyses. The results from confirmatory factor analysis confirmed a one-factor solution for the Persian version of the SQOL-M. Content validity of the translated measure was endorsed by 10 specialists. Pearson correlations indicated that work ability index score, dimensions of the IIEF, and the IIEF total score were positively correlated with the Persian version of the SQOL-M ( p < .001). Reliability evaluation indicated a high internal consistency and test-retest reliability. The Cronbach's alpha coefficient and intraclass correlation coefficients were .96 and .95, respectively. Results indicated that the Persian version of the SQOL-M has good to excellent psychometric properties and can be used to assess the sexual quality of life among Iranian men.
Guerrero-Ramírez, Grace; Cumba-Avilés, Eduardo
2018-03-01
People with type 1 diabetes (T1D) may experience significant changes in their daily routines due to this condition, which frequently results in depressive symptoms and the deterioration of their quality of life. We examined the factors associated with suicidal ideation (SI) and diabetes-related quality of life (DRQOL) in adolescents (aged 12 to 17) with T1D. The sample consisted of 51 youths (29 girls) recruited during a treatment study for depression. They completed the Diabetes Quality of Life for Youth questionnaire, the Suicidal Ideation Questionnaire Junior, and other measures that explore emotional, cognitive, somatic, behavioral, and relational aspects. Their caregivers completed the Barriers to Adherence Questionnaire and the Somatic Complaints subscale of the Child Behavior Checklist, among other measures. We used correlation and multiple linear regression analyses to identify the factors associated with the dependent variables. The variables associated with SI were depression, somatic complaints, perceived family emotional support, self care for diabetes, self-deprecation, helplessness, and hopelessness, among others. In a multiple regression analysis, the first 3 accounted for 46% of the variance. Those related to DRQOL included cognitive alterations, barriers to adherence, perceived family emotional support, self-efficacy for diabetes and for depression, helplessness, anxiety, and self-deprecation, among others. The first 4 accounted for 61% of the variance. Our findings highlight the impact of emotional, cognitive, somatic, behavioral, and relational aspects on the quality of mental health and the DRQOL of youth with T1D, as well as their pertinence for the development of psychosocial interventions for this population.
Korst, Lisa M; Aydin, Carolyn E; Signer, Jordana M K; Fink, Arlene
2011-08-01
The development of readiness metrics for organizational participation in health information exchange is critical for monitoring progress toward, and achievement of, successful inter-organizational collaboration. In preparation for the development of a tool to measure readiness for data-sharing, we tested whether organizational capacities known to be related to readiness were associated with successful participation in an American data-sharing collaborative for quality improvement. Cross-sectional design, using an on-line survey of hospitals in a large, mature data-sharing collaborative organized for benchmarking and improvement in nursing care quality. Factor analysis was used to identify salient constructs, and identified factors were analyzed with respect to "successful" participation. "Success" was defined as the incorporation of comparative performance data into the hospital dashboard. The most important factor in predicting success included survey items measuring the strength of organizational leadership in fostering a culture of quality improvement (QI Leadership): (1) presence of a supportive hospital executive; (2) the extent to which a hospital values data; (3) the presence of leaders' vision for how the collaborative advances the hospital's strategic goals; (4) hospital use of the collaborative data to track quality outcomes; and (5) staff recognition of a strong mandate for collaborative participation (α=0.84, correlation with Success 0.68 [P<0.0001]). The data emphasize the importance of hospital QI Leadership in collaboratives that aim to share data for QI or safety purposes. Such metrics should prove useful in the planning and development of this complex form of inter-organizational collaboration. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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.
ERIC Educational Resources Information Center
Slattery, Mary F.
2017-01-01
Educational reform efforts over the past several decades have focused on different ways to address student achievement. Since the quality of the teacher that students have is one of the biggest in-school factors that impact student achievement, schools have focused on identifying, measuring, and improving teacher quality. Some of those reform…
Rural-Urban Differences in End-of-Life Nursing Home Care: Facility and Environmental Factors
ERIC Educational Resources Information Center
Temkin-Greener, Helena; Zheng, Nan Tracy; Mukamel, Dana B.
2012-01-01
Purpose of the study: This study examines urban-rural differences in end-of-life (EOL) quality of care provided to nursing home (NH) residents. Data and Methods: We constructed 3 risk-adjusted EOL quality measures (QMs) for long-term decedent residents: in-hospital death, hospice referral before death, and presence of severe pain. We used…
ERIC Educational Resources Information Center
Hirsh, Stephanie; Hord, Shirley M.
2010-01-01
A school that ensures that all students--regardless of race, creed, color, socioeconomic status, gender, or disabilities--have access to and receive the highest-quality education has achieved a key measure of social justice. Since the most significant factor in whether students learn well is quality teaching, and teaching is enhanced through…
ERIC Educational Resources Information Center
Hurley, John; Bowling, Alison; Griffiths, Jean; Blair, Duncan
2015-01-01
With expectations of academic staff to achieve high quality teaching and research outputs as performance measures it is timely to explore how staff perceive they are being supported to meet these ends. This article presents findings of a multi-method study that explored influences impacting on the quality and quantity of scholarly activity being…
Wind resource quality affected by high levels of renewables
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
Shim, Eun-Jung; Hahm, Bong-Jin; Go, Dong Jin; Lee, Kwang-Min; Noh, Hae Lim; Park, Seung-Hee; Song, Yeong Wook
2018-06-01
To examine factors in the fear-avoidance model, such as pain, pain catastrophizing, fear-avoidance beliefs, physical disability, and depression and their relationships with physical and psychological quality of life in patients with rheumatic diseases. The data were obtained from 360 patients with rheumatic diseases who completed self-report measures assessing study variables. Structural equation modeling was used to examine the hypothesized relationships among factors specified in the fear-avoidance model predicting physical and psychological quality of life. Final models fit the data well, explaining 96% and 82% of the variance in physical and psychological quality of life, respectively. Higher pain catastrophizing was related to stronger fear-avoidance beliefs that had a direct negative association with physical disability and depression, which, in turn, negatively affected physical quality of life. Pain severity was also directly related to physical disability. Physical disability also affected physical quality of life indirectly through depression. The hypothesized relationships specified in the model were also confirmed for psychological quality of life. However, physical disability had an indirect association with psychological quality of life via depression. The current results underscore the significant role of cognitive, affective, and behavioral factors in perceived physical disability and their mediated detrimental effect on physical and psychological quality of life in patients with rheumatic diseases. Implications for rehabilitation The fear-avoidance model is applicable to the prediction of quality of life in patients with rheumatic diseases. As pain-catastrophizing and fear-avoidance beliefs are important factors linked to physical disability and depression, intervening these cognitive factors is necessary to improve physical function and depression in patients with rheumatic diseases. Considering the strong association between depression and physical and psychological quality of life, the assessment and treatment of the former should be included in the rehabilitation of patients with rheumatic diseases. Interventions targeting physical function and depression are likely to be effective in terms of improving physical and psychological quality of life in patients with rheumatic diseases.
NASA Astrophysics Data System (ADS)
Wang, Lizhu; Robertson, Dale M.; Garrison, Paul J.
2007-02-01
We sampled 240 wadeable streams across Wisconsin for different forms of phosphorus and nitrogen, and assemblages of macroinvertebrates and fish to (1) examine how macroinvertebrate and fish measures correlated with the nutrients; (2) quantify relationships between key biological measures and nutrient forms to identify potential threshold levels of nutrients to support nutrient criteria development; and (3) evaluate the importance of nutrients in influencing biological assemblages relative to other physicochemical factors at different spatial scales. Twenty-three of the 35 fish and 18 of the 26 macroinvertebrate measures significantly correlated ( P < 0.05) with at least one nutrient measure. Percentages of carnivorous, intolerant, and omnivorous fishes, index of biotic integrity, and salmonid abundance were fish measures correlated with the most nutrient measures and had the highest correlation coefficients. Percentages of Ephemeroptera-Plecoptera-Trichoptera individuals and taxa, Hilsenhoff biotic index, and mean tolerance value were macroinvertebrate measures that most strongly correlated with the most nutrient measures. Selected biological measures showed clear trends toward degradation as concentrations of phosphorus and nitrogen increased, and some measures showed clear thresholds where biological measures changed drastically with small changes in nutrient concentrations. Our selected environmental factors explained 54% of the variation in the fish assemblages. Of this explained variance, 46% was attributed to catchment and instream habitat, 15% to nutrients, 3% to other water quality measures, and 36% to the interactions among all the environmental variables. Selected environmental factors explained 53% of the variation in macroinvertebrate assemblages. Of this explained variance, 42% was attributed to catchment and instream habitat, 22% to nutrients, 5% to other water quality measures, and 32% to the interactions among all the environmental variables.
Wang, L.; Robertson, Dale M.; Garrison, P.J.
2007-01-01
We sampled 240 wadeable streams across Wisconsin for different forms of phosphorus and nitrogen, and assemblages of macroinvertebrates and fish to (1) examine how macroinvertebrate and fish measures correlated with the nutrients; (2) quantify relationships between key biological measures and nutrient forms to identify potential threshold levels of nutrients to support nutrient criteria development; and (3) evaluate the importance of nutrients in influencing biological assemblages relative to other physicochemical factors at different spatial scales. Twenty-three of the 35 fish and 18 of the 26 macroinvertebrate measures significantly correlated (P < 0.05) with at least one nutrient measure. Percentages of carnivorous, intolerant, and omnivorous fishes, index of biotic integrity, and salmonid abundance were fish measures correlated with the most nutrient measures and had the highest correlation coefficients. Percentages of Ephemeroptera-Plecoptera-Trichoptera individuals and taxa, Hilsenhoff biotic index, and mean tolerance value were macroinvertebrate measures that most strongly correlated with the most nutrient measures. Selected biological measures showed clear trends toward degradation as concentrations of phosphorus and nitrogen increased, and some measures showed clear thresholds where biological measures changed drastically with small changes in nutrient concentrations. Our selected environmental factors explained 54% of the variation in the fish assemblages. Of this explained variance, 46% was attributed to catchment and instream habitat, 15% to nutrients, 3% to other water quality measures, and 36% to the interactions among all the environmental variables. Selected environmental factors explained 53% of the variation in macroinvertebrate assemblages. Of this explained variance, 42% was attributed to catchment and instream habitat, 22% to nutrients, 5% to other water quality measures, and 32% to the interactions among all the environmental variables. ?? 2006 Springer Science+Business Media, Inc.
Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions
McDougall, Janette; Wright, Virginia; Schmidt, Jonathan; Miller, Linda; Lowry, Karen
2011-01-01
Objective The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. Method This article will describe the study’s aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used—and expanded upon—to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths’ QoL. Conclusions Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals’ perceptions of their QoL. PMID:21034288
Khanjari, Sedigheh; Oskouie, Fatemeh; Langius-Eklöf, Ann
2012-02-01
To translate and test the reliability and validity of the Persian version of the Caregiver Quality of Life Index-Cancer scale. Research across many countries has determined quality of life of cancer patients, but few attempts have been made to measure the quality of life of family caregivers of patients with breast cancer. The Caregiver Quality of Life Index-Cancer scale was developed for this purpose, but until now, it has not been translated into or tested in the Persian language. Methodological research design. After standard translation, the 35-item Caregiver Quality of Life Index-Cancer scale was administered to 166 Iranian family caregivers of patients with breast cancer. A confirmatory factor analysis was carried out using LISREL to test the scale's construct validity. Further, the internal consistency and convergent validity of the instrument were tested. For convergent validity, four instruments were used in the study: sense of coherence scale, spirituality perspective scale, health index and brief religious coping scale. The confirmatory factor analysis resulted in the same four-factor structure as the original, though, with somewhat different item loadings. The Persian version of the Caregiver Quality of Life Index-Cancer scales had satisfactory internal consistency (0·72-0·90). Tests of convergent validity showed that all hypotheses were confirmed. A hierarchical multiple regression analysis additionally confirmed the convergent validity between the total Caregiver Quality of Life Index-Cancer score and sense of coherence (β = 0·34), negative religious coping (β = -0·21), education (β = 0·24) and the more severe stage of breast cancer (β = 0·23), in total explaining 41% of the variance. The Persian version of the Caregiver Quality of Life Index-Cancer scale could be a reliable and valid measure in Iranian family caregivers of patients with breast cancer. The Persian version of the Caregiver Quality of Life Index-Cancer scale is simple to administer and will help nurses to identify the nursing needs of family caregivers. © 2011 Blackwell Publishing Ltd.
Writing Quality in Chinese Children: Speed and Fluency Matter
Yan, Cathy Ming Wai; McBride-Chang, Catherine; Wagner, Richard K.; Zhang, Juan; Wong, Anita M. Y.; Shu, Hua
2015-01-01
There were two goals of the present study. The first was to create a scoring scheme by which 9-year-old Chinese children’s writing compositions could be rated to form a total score for writing quality. The second was to examine cognitive correlates of writing quality at age 9 from measures administered at ages 6–9. Age 9 writing compositions were scored using a 7-element rubric; following confirmatory factor analyses, 5 of these elements were retained to represent overall writing quality for subsequent analyses. Measures of vocabulary knowledge, Chinese word dictation, phonological awareness, speed of processing, speeded naming, and handwriting fluency at ages 6–9 were all significantly associated with the obtained overall writing quality measure even when the statistical effect of age was removed. With vocabulary knowledge, dictation skill, age, gender, and phonological awareness included in a regression equation, 35% of the variance in age 9 writing quality was explained. With the variables of speed of processing, speeded naming, and handwriting fluency additionally included as a block, 12% additional variance in the equation was explained. In addition to gender, overall unique correlates of writing quality were dictation, speed of processing, and handwriting fluency, underscoring the importance of both general automaticity and specific writing fluency for writing quality development in children. PMID:25750486
Does strabismus surgery improve quality and mood, and what factors influence this?
McBain, H B; MacKenzie, K A; Hancox, J; Ezra, D G; Adams, G G W; Newman, S P
2016-05-01
AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.
Defining quality metrics and improving safety and outcome in allergy care.
Lee, Stella; Stachler, Robert J; Ferguson, Berrylin J
2014-04-01
The delivery of allergy immunotherapy in the otolaryngology office is variable and lacks standardization. Quality metrics encompasses the measurement of factors associated with good patient-centered care. These factors have yet to be defined in the delivery of allergy immunotherapy. We developed and applied quality metrics to 6 allergy practices affiliated with an academic otolaryngic allergy center. This work was conducted at a tertiary academic center providing care to over 1500 patients. We evaluated methods and variability between 6 sites. Tracking of errors and anaphylaxis was initiated across all sites. A nationwide survey of academic and private allergists was used to collect data on current practice and use of quality metrics. The most common types of errors recorded were patient identification errors (n = 4), followed by vial mixing errors (n = 3), and dosing errors (n = 2). There were 7 episodes of anaphylaxis of which 2 were secondary to dosing errors for a rate of 0.01% or 1 in every 10,000 injection visits/year. Site visits showed that 86% of key safety measures were followed. Analysis of nationwide survey responses revealed that quality metrics are still not well defined by either medical or otolaryngic allergy practices. Academic practices were statistically more likely to use quality metrics (p = 0.021) and perform systems reviews and audits in comparison to private practices (p = 0.005). Quality metrics in allergy delivery can help improve safety and quality care. These metrics need to be further defined by otolaryngic allergists in the changing health care environment. © 2014 ARS-AAOA, LLC.
Campbell, S M; Shield, T; Rogers, A; Gask, L
2004-12-01
While mental health is a core part of primary care, there are few validated quality measures and little relevant internationally published research. Consensus panel methods are a useful means of developing quality measures where evidence is sparse and/or opinions are diverse. However, little is known about the dynamics of consensus techniques and the factors that influence the judgements and ratings of panels and individual panelists. (1) To describe differences in panel ratings on the quality of primary mental health care services by patient, carer, professional and managerial panels within a Delphi procedure; and (2) to explore why different panels and panelists rate quality indicators of primary mental health care differently. Two round postal Delphi technique and exploratory semi-structured interviews. 115 panelists across 11 panels. Eleven panelists were subsequently interviewed. 87 of 334 indicators (26%) were rated face valid by all 11 panels. There was little disagreement within panel ratings but significant differences between panels. The GP panel rated the least number of indicators valid (n = 138, 41%) and carers the most (n = 304, 91%). The way in which panelists interpreted and conceptualised the indicators and their definition of quality of mental health care affected the way in which participants made their ratings. Stakeholders in primary mental health care have diverse views of quality of care and these differences translate into how they rate quality indicators. Exploratory interviews suggest that ratings are influenced by past experience, expectations, definitions of quality of care, and perceived power relationships between stakeholders.
Quality of prenatal care questionnaire: instrument development and testing.
Heaman, Maureen I; Sword, Wendy A; Akhtar-Danesh, Noori; Bradford, Amanda; Tough, Suzanne; Janssen, Patricia A; Young, David C; Kingston, Dawn A; Hutton, Eileen K; Helewa, Michael E
2014-06-03
Utilization indices exist to measure quantity of prenatal care, but currently there is no published instrument to assess quality of prenatal care. The purpose of this study was to develop and test a new instrument, the Quality of Prenatal Care Questionnaire (QPCQ). Data for this instrument development study were collected in five Canadian cities. Items for the QPCQ were generated through interviews with 40 pregnant women and 40 health care providers and a review of prenatal care guidelines, followed by assessment of content validity and rating of importance of items. The preliminary 100-item QPCQ was administered to 422 postpartum women to conduct item reduction using exploratory factor analysis. The final 46-item version of the QPCQ was then administered to another 422 postpartum women to establish its construct validity, and internal consistency and test-retest reliability. Exploratory factor analysis reduced the QPCQ to 46 items, factored into 6 subscales, which subsequently were validated by confirmatory factor analysis. Construct validity was also demonstrated using a hypothesis testing approach; there was a significant positive association between women's ratings of the quality of prenatal care and their satisfaction with care (r = 0.81). Convergent validity was demonstrated by a significant positive correlation (r = 0.63) between the "Support and Respect" subscale of the QPCQ and the "Respectfulness/Emotional Support" subscale of the Prenatal Interpersonal Processes of Care instrument. The overall QPCQ had acceptable internal consistency reliability (Cronbach's alpha = 0.96), as did each of the subscales. The test-retest reliability result (Intra-class correlation coefficient = 0.88) indicated stability of the instrument on repeat administration approximately one week later. Temporal stability testing confirmed that women's ratings of their quality of prenatal care did not change as a result of giving birth or between the early postpartum period and 4 to 6 weeks postpartum. The QPCQ is a valid and reliable instrument that will be useful in future research as an outcome measure to compare quality of care across geographic regions, populations, and service delivery models, and to assess the relationship between quality of care and maternal and infant health outcomes.
Health information technology and physicians' perceptions of healthcare quality.
Fang, Hai; Peifer, Karen L; Chen, Jie; Rizzo, John A
2011-03-01
To investigate the relationship between the use of health information technology (HIT) and physician perceptions of providing high-quality care and to determine whether this relationship has changed over time. We used 2 waves of longitudinal data from the Community Tracking Study Physician Surveys, 2000-2001 and 2004-2005. Three measures of HIT were examined: a binary variable measuring the use of at least 1 type of HIT, a continuous variable measuring the total number of HIT types, and a binary variable measuring use of all 5 HIT types related to "meaningful use" of HIT as defined by Centers for Medicare and Medicaid Services. Three multivariate models were estimated to study the effect of each HIT measure on physicians' perception of providing high-quality care. Individual fixed-effects estimation also was used to control for individual time-invariant factors. Using at least 1 type of HIT significantly enhanced physicians' perception of providing high-quality care in 2000-2001, but not in 2004-2005. The marginal effect of adding 1 extra HIT type was positive and statistically significant in both periods. The association between using all 5 HIT types related to meaningful use and perceived quality was statistically significant in 2000-2001, but not in 2004-2005. Health information technology has become a multifunctional system and appears to have enhanced physicians' perception of providing high-quality care. Physicians' perceptions of medical care quality improved as the number of HIT types used increased. This study supports more extensive use of HIT in physician practices.
Quality of Life in Ecuadorian Patients With Rheumatoid Arthritis: A Cross-sectional Study.
Cruz-Castillo, Yessenia; Montero, Nadia; Salazar-Ponce, Rosa; Villacís-Tamayo, Rómulo
2017-11-01
To evaluate health-related quality of life (HRQoL) and associated clinical, demographic and socioeconomic factors in a cohort of Ecuadorian patients with rheumatoid arthritis (RA). A cross-sectional descriptive study evaluating (HRQoL) with the Spanish version of the Quality of Life Rheumatoid Arthritis (QoL-RA) instrument in patients diagnosed with RA according to the criteria of the American College of Rheumatology and the European League Against Rheumatism. In addition, the following data were obtained: age, sex, marital status, socioeconomic stratum, comorbidities, disease duration, medication, rheumatoid factor positivity, disease activity using the simplified disease activity index and physical functionality measured with the modified Health Assessment Questionnaire (MHAQ). A total of 163 patients were assessed, the mean score of the QoL-RA scale was 6.84±1.5 points. The highest measurements were obtained in the domains of interaction (8.04±1.9) and support (8.01±2). The factors that were associated with the overall quality of life assessment were: functionality measured with MHAQ (r=-0.70; P<.001); disease duration in years (r=-0.178; P<.05); and disease activity (mean difference of 1.5; 95%CI: 1.09 to 1.91). The patients evaluated had a good to moderate HRQoL. The domains related to support and social life were those with the highest scores and the lowest scores were related to pain and nervous tension. Functionality, duration, and disease activity were statistically associated with HRQoL. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Nota, L; Soresi, S; Perry, J
2006-05-01
The construct of quality of life (QoL) has been the focus of a great deal of recent research and has been operationalized in the assessment of the effectiveness of biomedical and rehabilitative interventions. Consequently, the effective measurement of QoL has become a relevant issue. QoL assessment should take account of both objective life conditions and reported satisfaction with those conditions, and should recognize that QoL has multiple domains. There is also evidence to suggest that it is useful to supplement such assessments with the evaluations of significant others within a multidimensional assessment perspective. The current study describes a further stage of testing and refinement of the Evaluation of Quality of Life Instrument (EQLI), which was designed to elicit from staff of health and social care services assessments of the level of satisfaction experienced by adults with an intellectual disability. Specifically, the EQLI's internal consistency, and construct, convergent and discriminant validity were analysed. The EQLI appears to be a psychometrically valid measure for collecting data on the levels of satisfaction which, according to health and social services staff, might be experienced by individuals with an intellectual disability who attend residential institutions and community-based day centres. The factor analyses supported a three-factor structure for the EQLI and reliability estimates of scores on the three factors were in the moderate to high range. The data collected supported convergent and discriminant validity. The results indicate that the EQLI is an effective measure for gaining staff perceptions of individuals who may be at risk of dissatisfaction with various QoL domains. The EQLI is as an instrument which, within a multidimensional assessment, could contribute to the identification of areas of user dissatisfaction with services.
Properties of Superconducting Mo, Mo2n and Trilayer Mo2n-Mo-Mo2n Thin Films
NASA Technical Reports Server (NTRS)
Barrentine, E. M.; Stevenson, T. R.; Brown, A. D.; Lowitz, A. E.; Noroozian, O.; U-Yen, K.; Eshan, N.; Hsieh, W. T.; Moseley, S. H.; Wollack, E. J.
2014-01-01
We present measurements of the properties of thin film superconducting Mo, Mo2N and Mo2N/Mo/Mo2N trilayers of interest for microwave kinetic inductance detector (MKID) applications. Using microwave resonator devices, we investigate the transition temperature, energy gaps, kinetic inductance, and internal quality factors of these materials. We present an Usadel-based interpretation of the trilayer transition temperature as a function of trilayer thicknesses, and a 2-gap interpretation to understand the change in kinetic inductance and internal resonance quality factor (Q) as a function of temperature.
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.
Fares, Souha
2017-01-01
Context. The Pain Catastrophizing Scale (PCS) is the most widely used measure of pain-specific catastrophizing. Objectives. The purpose of the present study was to develop and psychometrically evaluate an Arabic-language version of the PCS. Methods. In Study 1, 150 adult chronic nonmalignant pain patients seeking treatment at a hospital setting completed the PCS-A and a number of self-report measures assessing clinical parameters of pain, symptoms of depression, and quality of life. Study 2 employed a cold pressor pain task to examine the PCS-A in a sample of 44 healthy university students. Results. Exploratory factor analyses suggested a two-factor structure. Confirmatory factor analysis comparing the 2-factor model, Sullivan's original 3-factor model, and a 1-factor model based on the total score all provided adequate fit to the data. Cronbach's alpha coefficients across all models met or exceeded accepted standards of reliability. Catastrophizing was associated with higher levels of depression and increased pain intensity and interference. Catastrophizing predicted decreased quality of life, even after controlling for the contribution of gender, employment, depression, and pain interference. PCS-A scores were positively correlated with heightened experimental pain severity and decreased pain tolerance. Conclusion. The present results provide strong support for the psychometric properties of the PCS-A. PMID:28190958
Intercomparison of methods for image quality characterization. II. Noise power spectrum
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dobbins, James T. III; Samei, Ehsan; Ranger, Nicole T.
Second in a two-part series comparing measurement techniques for the assessment of basic image quality metrics in digital radiography, in this paper we focus on the measurement of the image noise power spectrum (NPS). Three methods were considered: (1) a method published by Dobbins et al. [Med. Phys. 22, 1581-1593 (1995)] (2) a method published by Samei et al. [Med. Phys. 30, 608-622 (2003)], and (3) a new method sanctioned by the International Electrotechnical Commission (IEC 62220-1, 2003), developed as part of an international standard for the measurement of detective quantum efficiency. In addition to an overall comparison of themore » estimated NPS between the three techniques, the following factors were also evaluated for their effect on the measured NPS: horizontal versus vertical directional dependence, the use of beam-limiting apertures, beam spectrum, and computational methods of NPS analysis, including the region-of-interest (ROI) size and the method of ROI normalization. Of these factors, none was found to demonstrate a substantial impact on the amplitude of the NPS estimates ({<=}3.1% relative difference in NPS averaged over frequency, for each factor considered separately). Overall, the three methods agreed to within 1.6%{+-}0.8% when averaged over frequencies >0.15 mm{sup -1}.« less
Modified SPC for short run test and measurement process in multi-stations
NASA Astrophysics Data System (ADS)
Koh, C. K.; Chin, J. F.; Kamaruddin, S.
2018-03-01
Due to short production runs and measurement error inherent in electronic test and measurement (T&M) processes, continuous quality monitoring through real-time statistical process control (SPC) is challenging. Industry practice allows the installation of guard band using measurement uncertainty to reduce the width of acceptance limit, as an indirect way to compensate the measurement errors. This paper presents a new SPC model combining modified guard band and control charts (\\bar{\\text{Z}} chart and W chart) for short runs in T&M process in multi-stations. The proposed model standardizes the observed value with measurement target (T) and rationed measurement uncertainty (U). S-factor (S f) is introduced to the control limits to improve the sensitivity in detecting small shifts. The model was embedded in automated quality control system and verified with a case study in real industry.
Health-related Quality of Life and Associated Factors Among Undergraduate University Students
Nur, Naim; Kıbık, Ahmet; Kılıç, Esma; Sümer, Haldun
2017-01-01
Objectives The aims of this study were to explore factors associated with health-related quality of life (HRQOL) among students of Cumhuriyet University, Turkey. Methods This cross-sectional study involved 1751 undergraduate students. HRQOL was measured using the Turkish version of 36-Item Short Form Health Survey questionnaire. We looked at the effect of sociodemographic characteristics (e.g., gender, age, drinking, and smoking) on the individual HRQOL domains. Results Place of residency (odds ratio (OR) = 3.947 for role emotion dimension), smoking status (OR = -2.756 for role physical dimension), received amount of pocket money (OR = 2.463 for mental health dimension), and body mass index (OR = 1.463 for mental health dimension) were the factors significantly associated with the HRQOL. Conclusions Young students’ HRQOL is affected by socioeconomic, demographic, and behavioral factors. To improve student’s HRQOL, any health-promoting strategies should focus on modifiable risk factors and socioeconomic supports for students. PMID:28804586
Determinants of Marital Quality in an Arranged Marriage Society
Allendorf, Keera
2013-01-01
Drawing on a uniquely large number of items on marital quality, this study explores the determinants of marital quality in Chitwan Valley, Nepal. Marital quality is measured with five dimensions identified through exploratory factor analysis, including satisfaction, communication, togetherness, problems, and disagreements. Gender, education, and spouse choice emerge as the most important determinants of these dimensions of marital quality. Specifically, men, those with more schooling, and those who participated in the choice of their spouse have higher levels of marital quality. By contrast, caste, occupation, age at marriage, marital duration, and number of children have little to no association with marital quality. While gender, education, and spouse choice emerge as key determinants of marital quality in this context, the majority of variation in marital quality remains unexplained. PMID:23146598
Neumann, Lily; Lerner, Ella; Glazer, Yael; Bolotin, Arkady; Shefer, Alexander; Buskila, Dan
2008-12-01
We examined the relationship between body mass index (BMI) and measures of tenderness, quality of life, and physical functioning in female fibromyalgia (FMS) patients. A random sample of 100 female FMS patients from a database of 550 FMS individuals was interviewed and assessed according to a structured questionnaire that included FMS-related symptoms, measures of tenderness (point count and dolorimetry), quality of life (SF-36), physical functioning, and BMI. Weight was defined as normal, overweight, and obesity according to BMI. Twenty-seven percent of the FMS patients had normal BMI, 28% were overweight, and 45% were obese. BMI was negatively correlated with quality of life (r = -0.205, P = 0.044) and tenderness threshold (r = -0.238, P = 0.021) and positively correlated with physical dysfunctioning (r = 0.202, P = 0.047) and point count (r = 0.261, P = 0.011). Obese FMS patients display higher pain sensitivity and lower levels of quality of life. In designing studies that explore factors affecting tenderness, BMI should be included in addition to sex, age, etc.
Beierholm, Anders R; Ottosson, Rickard O; Lindvold, Lars R; Behrens, Claus F; Andersen, Claus E
2011-05-21
A fast-readout dosimetry system based on fibre-coupled organic scintillators has been developed for the purpose of conducting point measurements of absorbed dose in radiotherapy beams involving high spatial and temporal dose gradients. The system measures the dose for each linac radiation pulse with millimetre spatial resolution. To demonstrate the applicability of the system in complex radiotherapy fields, output factors and per cent depth dose measurements were performed in solid water for a 6 MV photon beam and compared with Monte Carlo simulated doses for square fields down to 0.6 cm × 0.6 cm size. No significant differences between measurements and simulations were observed. The temporal resolution of the system was demonstrated by measuring dose per pulse, beam start-up transients and the quality factor for 6 MV. The precision of dose per pulse measurements was within 2.7% (1 SD) for a 10 cm × 10 cm field at 10 cm depth. The dose per pulse behaviour compared well with linac target current measurements and accumulated dose measurements, and the system was able to resolve transient dose delivery differences between two Varian linac builds. The system therefore shows promise for reference dosimetry and quality assurance of complex radiotherapy treatments.