Sample records for met data-quality objectives
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2006-01-01
The laboratory for analysis of low-ionic-strength water at the U.S. Geological Survey (USGS) Water Science Center in Troy, N.Y., analyzes samples collected by USGS projects throughout the Northeast. The laboratory's quality-assurance program is based on internal and interlaboratory quality-assurance samples and quality-control procedures that were developed to ensure proper sample collection, processing, and analysis. The quality-assurance/quality-control data for the time period addressed in this report were stored in the laboratory's SAS data-management system, which provides efficient review, compilation, and plotting of data. This report presents and discusses results of quality-assurance and quality- control samples analyzed from July 1997 through June 1999. Results for the quality-control samples for 18 analytical procedures were evaluated for bias and precision. Control charts indicate that data for eight of the analytical procedures were occasionally biased for either high-concentration and (or) low-concentration samples but were within control limits; these procedures were: acid-neutralizing capacity, total monomeric aluminum, total aluminum, ammonium, calcium, chloride, specific conductance, and sulfate. The data from the potassium and sodium analytical procedures are insufficient for evaluation. Results from the filter-blank and analytical-blank analyses indicate that the procedures for 11 of 13 analytes were within control limits, although the concentrations for blanks were occasionally outside the control limits. Blank analysis results for chloride showed that 22 percent of blanks did not meet data-quality objectives and results for dissolved organic carbon showed that 31 percent of the blanks did not meet data-quality objectives. Sampling and analysis precision are evaluated herein in terms of the coefficient of variation obtained for triplicate samples in the procedures for 14 of the 18 analytes. At least 90 percent of the samples met data-quality objectives for all analytes except total aluminum (70 percent of samples met objectives) and potassium (83 percent of samples met objectives). Results of the USGS interlaboratory Standard Reference Sample (SRS) Project indicated good data quality for most constituents over the time period. The P-sample (low-ionic-strength constituents) analysis had good ratings in two of these studies and a satisfactory rating in the third. The results of the T-sample (trace constituents) analysis indicated high data quality with good ratings in all three studies. The N-sample (nutrient constituents) studies had one each of excellent, good, and satisfactory ratings. Results of Environment Canada's National Water Research Institute (NWRI) program indicated that at least 80 percent of the samples met data-quality objectives for 9 of the 13 analytes; the exceptions were dissolved organic carbon, ammonium, chloride, and specific conductance. Data-quality objectives were not met for dissolved organic carbon in two NWRI studies, but all of the samples were within control limits for the last study. Data-quality objectives were not met in 41 percent of samples analyzed for ammonium, 25 percent of samples analyzed for chloride, and 30 percent of samples analyzed for specific conductance. Results from blind reference-sample analyses indicated that data-quality objectives were met by at least 84 percent of the samples analyzed for calcium, chloride, magnesium, pH, and potassium. Data-quality objectives were met by 73 percent of those analyzed for sulfate. The data-quality objective was not met for sodium. The data are insufficient for evaluation of the specific conductance results.
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2009-01-01
The laboratory for analysis of low-ionic-strength water at the U.S. Geological Survey (USGS) Water Science Center in Troy, N.Y., analyzes samples collected by USGS projects throughout the Northeast. The laboratory's quality-assurance program is based on internal and interlaboratory quality-assurance samples and quality-control procedures that were developed to ensure proper sample collection, processing, and analysis. The quality-assurance and quality-control data were stored in the laboratory's Lab Master data-management system, which provides efficient review, compilation, and plotting of data. This report presents and discusses results of quality-assurance and quality control samples analyzed from July 2003 through June 2005. Results for the quality-control samples for 20 analytical procedures were evaluated for bias and precision. Control charts indicate that data for five of the analytical procedures were occasionally biased for either high-concentration or low-concentration samples but were within control limits; these procedures were: acid-neutralizing capacity, total monomeric aluminum, pH, silicon, and sodium. Seven of the analytical procedures were biased throughout the analysis period for the high-concentration sample, but were within control limits; these procedures were: dissolved organic carbon, chloride, nitrate (ion chromatograph), nitrite, silicon, sodium, and sulfate. The calcium and magnesium procedures were biased throughout the analysis period for the low-concentration sample, but were within control limits. The total aluminum and specific conductance procedures were biased for the high-concentration and low-concentration samples, but were within control limits. Results from the filter-blank and analytical-blank analyses indicate that the procedures for 17 of 18 analytes were within control limits, although the concentrations for blanks were occasionally outside the control limits. The data-quality objective was not met for dissolved organic carbon. Sampling and analysis precision are evaluated herein in terms of the coefficient of variation obtained for triplicate samples in the procedures for 18 of the 22 analytes. At least 85 percent of the samples met data-quality objectives for all analytes except total monomeric aluminum (82 percent of samples met objectives), total aluminum (77 percent of samples met objectives), chloride (80 percent of samples met objectives), fluoride (76 percent of samples met objectives), and nitrate (ion chromatograph) (79 percent of samples met objectives). The ammonium and total dissolved nitrogen did not meet the data-quality objectives. Results of the USGS interlaboratory Standard Reference Sample (SRS) Project indicated good data quality over the time period, with ratings for each sample in the satisfactory, good, and excellent ranges or less than 10 percent error. The P-sample (low-ionic-strength constituents) analysis had one marginal and two unsatisfactory ratings for the chloride procedure. The T-sample (trace constituents)analysis had two unsatisfactory ratings and one high range percent error for the aluminum procedure. The N-sample (nutrient constituents) analysis had one marginal rating for the nitrate procedure. Results of Environment Canada's National Water Research Institute (NWRI) program indicated that at least 84 percent of the samples met data-quality objectives for 11 of the 14 analytes; the exceptions were ammonium, total aluminum, and acid-neutralizing capacity. The ammonium procedure did not meet data quality objectives in all studies. Data-quality objectives were not met in 23 percent of samples analyzed for total aluminum and 45 percent of samples analyzed acid-neutralizing capacity. Results from blind reference-sample analyses indicated that data-quality objectives were met by at least 86 percent of the samples analyzed for calcium, chloride, fluoride, magnesium, pH, potassium, sodium, and sulfate. Data-quality objectives were not met by samples analyzed for fluoride.
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2009-01-01
The laboratory for analysis of low-ionic-strength water at the U.S. Geological Survey (USGS) Water Science Center in Troy, N.Y., analyzes samples collected by USGS projects throughout the Northeast. The laboratory's quality-assurance program is based on internal and interlaboratory quality-assurance samples and quality-control procedures that were developed to ensure proper sample collection, processing, and analysis. The quality-assurance and quality-control data were stored in the laboratory's Lab Master data-management system, which provides efficient review, compilation, and plotting of data. This report presents and discusses results of quality-assurance and quality control samples analyzed from July 2001 through June 2003. Results for the quality-control samples for 19 analytical procedures were evaluated for bias and precision. Control charts indicate that data for six of the analytical procedures were occasionally biased for either high-concentration or low-concentration samples but were within control limits; these procedures were: acid-neutralizing capacity, chloride, magnesium, nitrate (ion chromatography), potassium, and sodium. The calcium procedure was biased throughout the analysis period for the high-concentration sample, but was within control limits. The total monomeric aluminum and fluoride procedures were biased throughout the analysis period for the low-concentration sample, but were within control limits. The total aluminum, pH, specific conductance, and sulfate procedures were biased for the high-concentration and low-concentration samples, but were within control limits. Results from the filter-blank and analytical-blank analyses indicate that the procedures for 16 of 18 analytes were within control limits, although the concentrations for blanks were occasionally outside the control limits. The data-quality objective was not met for the dissolved organic carbon or specific conductance procedures. Sampling and analysis precision are evaluated herein in terms of the coefficient of variation obtained for triplicate samples in the procedures for 18 of the 21 analytes. At least 90 percent of the samples met data-quality objectives for all procedures except total monomeric aluminum (83 percent of samples met objectives), total aluminum (76 percent of samples met objectives), ammonium (73 percent of samples met objectives), dissolved organic carbon (86 percent of samples met objectives), and nitrate (81 percent of samples met objectives). The data-quality objective was not met for the nitrite procedure. Results of the USGS interlaboratory Standard Reference Sample (SRS) Project indicated satisfactory or above data quality over the time period, with most performance ratings for each sample in the good-to-excellent range. The N-sample (nutrient constituents) analysis had one unsatisfactory rating for the ammonium procedure in one study. The T-sample (trace constituents) analysis had one unsatisfactory rating for the magnesium procedure and one marginal rating for the potassium procedure in one study and one unsatisfactory rating for the sodium procedure in another. Results of Environment Canada's National Water Research Institute (NWRI) program indicated that at least 90 percent of the samples met data-quality objectives for 10 of the 14 analytes; the exceptions were acid-neutralizing capacity, ammonium, dissolved organic carbon, and sodium. Data-quality objectives were not met in 37 percent of samples analyzed for acid-neutralizing capacity, 28 percent of samples analyzed for dissolved organic carbon, and 30 percent of samples analyzed for sodium. Results indicate a positive bias for the ammonium procedure in one study and a negative bias in another. Results from blind reference-sample analyses indicated that data-quality objectives were met by at least 90 percent of the samples analyzed for calcium, chloride, magnesium, pH, potassium, and sodium. Data-quality objectives were met by 78 percent of
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2001-01-01
A laboratory for analysis of low-ionic strength water has been developed at the U.S. Geological Survey (USGS) office in Troy, N.Y., to analyze samples collected by USGS projects in the Northeast. The laboratory's quality-assurance program is based on internal and interlaboratory quality-assurance samples and quality-control procedures developed to ensure proper sample collection, processing, and analysis. The quality-assurance/quality-control data are stored in the laboratory's SAS data-management system, which provides efficient review, compilation, and plotting of quality-assurance/quality-control data. This report presents and discusses samples analyzed from July 1993 through June 1995. Quality-control results for 18 analytical procedures were evaluated for bias and precision. Control charts show that data from seven of the analytical procedures were biased throughout the analysis period for either high-concentration or low-concentration samples but were within control limits; these procedures were: acid-neutralizing capacity, dissolved inorganic carbon, dissolved organic carbon (soil expulsions), chloride, magnesium, nitrate (colorimetric method), and pH. Three of the analytical procedures were occasionally biased but were within control limits; they were: calcium (high for high-concentration samples for May 1995), dissolved organic carbon (high for highconcentration samples from January through September 1994), and fluoride (high in samples for April and June 1994). No quality-control sample has been developed for the organic monomeric aluminum procedure. Results from the filter-blank and analytical-blank analyses indicate that all analytical procedures in which blanks were run were within control limits, although values for a few blanks were outside the control limits. Blanks were not analyzed for acid-neutralizing capacity, dissolved inorganic carbon, fluoride, nitrate (colorimetric method), or pH. Sampling and analysis precision are evaluated herein in terms of the coefficient of variation obtained for triplicate samples in 14 of the 18 procedures. Data-quality objectives were met by more than 90 percent of the samples analyzed in all procedures except total monomeric aluminum (85 percent of samples met objectives), total aluminum (70 percent of samples met objectives), and dissolved organic carbon (85 percent of samples met objectives). Triplicate samples were not analyzed for ammonium, fluoride, dissolved inorganic carbon, or nitrate (colorimetric method). Results of the USGS interlaboratory Standard Reference Sample Program indicated high data quality with a median result of 3.6 of a possible 4.0. Environment Canada's LRTAP interlaboratory study results indicated that more than 85 percent of the samples met data-quality objectives in 6 of the 12 analyses; exceptions were calcium, dissolved organic carbon, chloride, pH, potassium, and sodium. Data-quality objectives were not met for calcium samples in one LRTAP study, but 94 percent of samples analyzed were within control limits for the remaining studies. Data-quality objectives were not met by 35 percent of samples analyzed for dissolved organic carbon, but 94 percent of sample values were within 20 percent of the most probable value. Data-quality objectives were not met for 30 percent of samples analyzed for chloride, but 90 percent of sample values were within 20 percent of the most probable value. Measurements of samples with a pH above 6.0 were biased high in 54 percent of the samples, although 85 percent of the samples met data-quality objectives for pH measurements below 6.0. Data-quality objectives for potassium and sodium were not met in one study (only 33 percent of the samples analyzed met the objectives), although 85 percent of the sample values were within control limits for the other studies. Measured sodium values were above the upper control limit in all studies. Results from blind reference-sample analyses indicated that data
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2009-01-01
The laboratory for analysis of low-ionic-strength water at the U.S. Geological Survey (USGS) Water Science Center in Troy, N.Y., analyzes samples collected by USGS projects throughout the Northeast. The laboratory's quality-assurance program is based on internal and interlaboratory quality-assurance samples and quality-control procedures that were developed to ensure proper sample collection, processing, and analysis. The quality-assurance and quality-control data were stored in the laboratory's Lab Master data-management system, which provides efficient review, compilation, and plotting of data. This report presents and discusses results of quality-assurance and quality control samples analyzed from July 2005 through June 2007. Results for the quality-control samples for 19 analytical procedures were evaluated for bias and precision. Control charts indicate that data for eight of the analytical procedures were occasionally biased for either high-concentration or low-concentration samples but were within control limits; these procedures were: total aluminum, calcium, magnesium, nitrate (colorimetric method), potassium, silicon, sodium, and sulfate. Eight of the analytical procedures were biased throughout the analysis period for the high-concentration sample, but were within control limits; these procedures were: total aluminum, calcium, dissolved organic carbon, chloride, nitrate (ion chromatograph), potassium, silicon, and sulfate. The magnesium and pH procedures were biased throughout the analysis period for the low-concentration sample, but were within control limits. The acid-neutralizing capacity, total monomeric aluminum, nitrite, and specific conductance procedures were biased for the high-concentration and low-concentration samples, but were within control limits. Results from the filter-blank and analytical-blank analyses indicated that the procedures for 16 of 17 analytes were within control limits, although the concentrations for blanks were occasionally outside the control limits. The data-quality objective was not met for dissolved organic carbon. Sampling and analysis precision are evaluated herein in terms of the coefficient of variation obtained for triplicate samples in the procedures for 18 of the 21 analytes. At least 93 percent of the samples met data-quality objectives for all analytes except acid-neutralizing capacity (85 percent of samples met objectives), total monomeric aluminum (83 percent of samples met objectives), total aluminum (85 percent of samples met objectives), and chloride (85 percent of samples met objectives). The ammonium and total dissolved nitrogen did not meet the data-quality objectives. Results of the USGS interlaboratory Standard Reference Sample (SRS) Project met the Troy Laboratory data-quality objectives for 87 percent of the samples analyzed. The P-sample (low-ionic-strength constituents) analysis had two outliers each in two studies. The T-sample (trace constituents) analysis and the N-sample (nutrient constituents) analysis had one outlier each in two studies. Results of Environment Canada's National Water Research Institute (NWRI) program indicated that at least 85 percent of the samples met data-quality objectives for 11 of the 14 analytes; the exceptions were acid-neutralizing capacity, total aluminum and ammonium. Data-quality objectives were not met in 41 percent of samples analyzed for acid-neutralizing capacity, 50 percent of samples analyzed for total aluminum, and 44 percent of samples analyzed for ammonium. Results from blind reference-sample analyses indicated that data-quality objectives were met by at least 86 percent of the samples analyzed for calcium, magnesium, pH, potassium, and sodium. Data-quality objectives were met by 76 percent of the samples analyzed for chloride, 80 percent of the samples analyzed for specific conductance, and 77 percent of the samples analyzed for sulfate.
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2006-01-01
The laboratory for analysis of low-ionic-strength water at the U.S. Geological Survey (USGS) Water Science Center in Troy, N.Y., analyzes samples collected by USGS projects throughout the Northeast. The laboratory's quality-assurance program is based on internal and interlaboratory quality-assurance samples and quality-control procedures that were developed to ensure proper sample collection, processing, and analysis. The quality-assurance and quality-control data were stored in the laboratory's LabMaster data-management system, which provides efficient review, compilation, and plotting of data. This report presents and discusses results of quality-assurance and quality-control samples analyzed from July 1999 through June 2001. Results for the quality-control samples for 18 analytical procedures were evaluated for bias and precision. Control charts indicate that data for eight of the analytical procedures were occasionally biased for either high-concentration or low-concentration samples but were within control limits; these procedures were: acid-neutralizing capacity, total monomeric aluminum, total aluminum, calcium, chloride and nitrate (ion chromatography and colormetric method) and sulfate. The total aluminum and dissolved organic carbon procedures were biased throughout the analysis period for the high-concentration sample, but were within control limits. The calcium and specific conductance procedures were biased throughout the analysis period for the low-concentration sample, but were within control limits. The magnesium procedure was biased for the high-concentration and low concentration samples, but was within control limits. Results from the filter-blank and analytical-blank analyses indicate that the procedures for 14 of 15 analytes were within control limits, although the concentrations for blanks were occasionally outside the control limits. The data-quality objective was not met for dissolved organic carbon. Sampling and analysis precision are evaluated herein in terms of the coefficient of variation obtained for triplicate samples in the procedures for 17 of the 18 analytes. At least 90 percent of the samples met data-quality objectives for all analytes except ammonium (81 percent of samples met objectives), chloride (75 percent of samples met objectives), and sodium (86 percent of samples met objectives). Results of the USGS interlaboratory Standard Reference Sample (SRS) Project indicated good data quality over the time period, with most ratings for each sample in the good to excellent range. The P-sample (low-ionic-strength constituents) analysis had one satisfactory rating for the specific conductance procedure in one study. The T-sample (trace constituents) analysis had one satisfactory rating for the aluminum procedure in one study and one unsatisfactory rating for the sodium procedure in another. The remainder of the samples had good or excellent ratings for each study. Results of Environment Canada's National Water Research Institute (NWRI) program indicated that at least 89 percent of the samples met data-quality objectives for 10 of the 14 analytes; the exceptions were ammonium, total aluminum, dissolved organic carbon, and sodium. Results indicate a positive bias for the ammonium procedure in all studies. Data-quality objectives were not met in 50 percent of samples analyzed for total aluminum, 38 percent of samples analyzed for dissolved organic carbon, and 27 percent of samples analyzed for sodium. Results from blind reference-sample analyses indicated that data-quality objectives were met by at least 91 percent of the samples analyzed for calcium, chloride, fluoride, magnesium, pH, potassium, and sulfate. Data-quality objectives were met by 75 percent of the samples analyzed for sodium and 58 percent of the samples analyzed for specific conductance.
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Lincoln, Tricia A.; Horan-Ross, Debra A.; McHale, Michael R.; Lawrence, Gregory B.
2005-01-01
Results from blind reference-sample analyses indicated that data-quality objectives were met by at least 90 percent of the calcium, pH, potassium, and sodium samples. Data-quality objectives were met by 77 percent of the chloride samples, 83 percent of the magnesium samples, and 80 percent of the sulfate samples. There is insufficient data to evaluate the specific conductance samples.
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Lumb, Ashok; Halliwell, Doug; Sharma, Tribeni
2006-02-01
All six ecosystem initiatives evolved from many years of federal, provincial, First Nation, local government and community attention to the stresses on sensitive habitats and species, air and water quality, and the consequent threats to community livability. This paper assesses water quality aspect for the ecosystem initiatives and employs newly developed Canadian Council of Ministers of the Environment Water Quality Index (CCME WQI) which provides a convenient mean of summarizing complex water quality data that can be easily understood by the public, water distributors, planners, managers and policy makers. The CCME WQI incorporates three elements: Scope - the number of water quality parameters (variables) not meeting water quality objectives (F(1)); Frequency - the number of times the objectives are not met (F(2)); and Amplitude. the extent to which the objectives are not met (F(3)). The index produces a number between 0 (worst) to 100 (best) to reflect the water quality. This study evaluates water quality of the Mackenzie - Great Bear sub-basin by employing two modes of objective functions (threshold values): one based on the CCME water quality guidelines and the other based on site-specific values that were determined by the statistical analysis of the historical data base. Results suggest that the water quality of the Mackenzie-Great Bear sub-basin is impacted by high turbidity and total (mostly particulate) trace metals due to high suspended sediment loads during the open water season. Comments are also provided on water quality and human health issues in the Mackenzie basin based on the findings and the usefulness of CCME water quality guidelines and site specific values.
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Blanco Mejia, Sonia; Kendall, Cyril W C; Viguiliouk, Effie; Augustin, Livia S; Ha, Vanessa; Cozma, Adrian I; Mirrahimi, Arash; Maroleanu, Adriana; Chiavaroli, Laura; Leiter, Lawrence A; de Souza, Russell J; Jenkins, David J A; Sievenpiper, John L
2014-01-01
Objective To provide a broader evidence summary to inform dietary guidelines of the effect of tree nuts on criteria of the metabolic syndrome (MetS). Design We conducted a systematic review and meta-analysis of the effect of tree nuts on criteria of the MetS. Data sources We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library (through 4 April 2014). Eligibility criteria for selecting studies We included relevant randomised controlled trials (RCTs) of ≥3 weeks reporting at least one criterion of the MetS. Data extraction Two or more independent reviewers extracted all relevant data. Data were pooled using the generic inverse variance method using random effects models and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed by the Cochran Q statistic and quantified by the I2 statistic. Study quality and risk of bias were assessed. Results Eligibility criteria were met by 49 RCTs including 2226 participants who were otherwise healthy or had dyslipidaemia, MetS or type 2 diabetes mellitus. Tree nut interventions lowered triglycerides (MD=−0.06 mmol/L (95% CI −0.09 to −0.03 mmol/L)) and fasting blood glucose (MD=−0.08 mmol/L (95% CI −0.16 to −0.01 mmol/L)) compared with control diet interventions. There was no effect on waist circumference, high-density lipoprotein cholesterol or blood pressure with the direction of effect favouring tree nuts for waist circumference. There was evidence of significant unexplained heterogeneity in all analyses (p<0.05). Conclusions Pooled analyses show a MetS benefit of tree nuts through modest decreases in triglycerides and fasting blood glucose with no adverse effects on other criteria across nut types. As our conclusions are limited by the short duration and poor quality of the majority of trials, as well as significant unexplained between-study heterogeneity, there remains a need for larger, longer, high-quality trials. Trial registration number NCT01630980. PMID:25074070
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Echeverría, Guadalupe; McGee, Emma E; Urquiaga, Inés; Jiménez, Paulina; D'Acuña, Sonia; Villarroel, Luis; Velasco, Nicolás; Leighton, Federico; Rigotti, Attilio
2017-08-11
Obesity and metabolic syndrome (MetS) are key risk factors for chronic disease. Dietary patterns are critical in the incidence and persistence of obesity and MetS, yet there is few data linking diet to obesity and MetS in Chile. Our objective was to use a locally validated diet index to evaluate adherence to a Mediterranean dietary pattern and its correlations with overweight/obesity (OW/O) and MetS prevalence in Chilean adults. We conducted a nationwide, cross-sectional online survey of Chilean adults with complete self-reported diet and body mass index data ( n = 24,882). A subsample of 4348 users (17.5%) had valid MetS data. An inverse association was observed between adherence to Mediterranean diet and OW/O and MetS prevalence. As diet quality decreased from healthy, to moderately-healthy, to unhealthy, prevalence increased from 44.8, 51.1, to 60.9% for OW/O and from 13.4, 18.5, to 28.9% for MetS ( p -values < 0.001). Adjusted odds ratios for OW/O and MetS were significantly higher in moderately-healthy (OR = 1.58 and 1.54) and unhealthy (OR = 2.20 and 2.49, respectively) diet groups in comparison to the healthy diet group. This study represents the first report on the relationship between Mediterranean diet and chronic disease risk in Chile. It suggests that the Mediterranean diet may be applied to manage chronic disease risk beyond the Mediterranean basin.
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Echeverría, Guadalupe; Urquiaga, Inés; Jiménez, Paulina; D’Acuña, Sonia; Villarroel, Luis; Leighton, Federico; Rigotti, Attilio
2017-01-01
Obesity and metabolic syndrome (MetS) are key risk factors for chronic disease. Dietary patterns are critical in the incidence and persistence of obesity and MetS, yet there is few data linking diet to obesity and MetS in Chile. Our objective was to use a locally validated diet index to evaluate adherence to a Mediterranean dietary pattern and its correlations with overweight/obesity (OW/O) and MetS prevalence in Chilean adults. We conducted a nationwide, cross-sectional online survey of Chilean adults with complete self-reported diet and body mass index data (n = 24,882). A subsample of 4348 users (17.5%) had valid MetS data. An inverse association was observed between adherence to Mediterranean diet and OW/O and MetS prevalence. As diet quality decreased from healthy, to moderately-healthy, to unhealthy, prevalence increased from 44.8, 51.1, to 60.9% for OW/O and from 13.4, 18.5, to 28.9% for MetS (p-values < 0.001). Adjusted odds ratios for OW/O and MetS were significantly higher in moderately-healthy (OR = 1.58 and 1.54) and unhealthy (OR = 2.20 and 2.49, respectively) diet groups in comparison to the healthy diet group. This study represents the first report on the relationship between Mediterranean diet and chronic disease risk in Chile. It suggests that the Mediterranean diet may be applied to manage chronic disease risk beyond the Mediterranean basin. PMID:28800091
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Optimization of multi-environment trials for genomic selection based on crop models.
Rincent, R; Kuhn, E; Monod, H; Oury, F-X; Rousset, M; Allard, V; Le Gouis, J
2017-08-01
We propose a statistical criterion to optimize multi-environment trials to predict genotype × environment interactions more efficiently, by combining crop growth models and genomic selection models. Genotype × environment interactions (GEI) are common in plant multi-environment trials (METs). In this context, models developed for genomic selection (GS) that refers to the use of genome-wide information for predicting breeding values of selection candidates need to be adapted. One promising way to increase prediction accuracy in various environments is to combine ecophysiological and genetic modelling thanks to crop growth models (CGM) incorporating genetic parameters. The efficiency of this approach relies on the quality of the parameter estimates, which depends on the environments composing this MET used for calibration. The objective of this study was to determine a method to optimize the set of environments composing the MET for estimating genetic parameters in this context. A criterion called OptiMET was defined to this aim, and was evaluated on simulated and real data, with the example of wheat phenology. The MET defined with OptiMET allowed estimating the genetic parameters with lower error, leading to higher QTL detection power and higher prediction accuracies. MET defined with OptiMET was on average more efficient than random MET composed of twice as many environments, in terms of quality of the parameter estimates. OptiMET is thus a valuable tool to determine optimal experimental conditions to best exploit MET and the phenotyping tools that are currently developed.
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Piloted Evaluation of a UH-60 Mixer Equivalent Turbulence Simulation Model
NASA Technical Reports Server (NTRS)
Lusardi, Jeff A.; Blanken, Chris L.; Tischeler, Mark B.
2002-01-01
A simulation study of a recently developed hover/low speed Mixer Equivalent Turbulence Simulation (METS) model for the UH-60 Black Hawk helicopter was conducted in the NASA Ames Research Center Vertical Motion Simulator (VMS). The experiment was a continuation of previous work to develop a simple, but validated, turbulence model for hovering rotorcraft. To validate the METS model, two experienced test pilots replicated precision hover tasks that had been conducted in an instrumented UH-60 helicopter in turbulence. Objective simulation data were collected for comparison with flight test data, and subjective data were collected that included handling qualities ratings and pilot comments for increasing levels of turbulence. Analyses of the simulation results show good analytic agreement between the METS model and flight test data, with favorable pilot perception of the simulated turbulence. Precision hover tasks were also repeated using the more complex rotating-frame SORBET (Simulation Of Rotor Blade Element Turbulence) model to generate turbulence. Comparisons of the empirically derived METS model with the theoretical SORBET model show good agreement providing validation of the more complex blade element method of simulating turbulence.
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Code of Federal Regulations, 2011 CFR
2011-07-01
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Fazleen, Nur Ezza; Whittaker, Maxine; Mamun, Abdullah
2018-03-16
Polycystic ovarian syndrome (PCOS) is the commonest reproductive disorder in women and is closely associated with the development of metabolic syndrome (MetS). The objective of this systematic review and meta-analysis was to describe the risk of MetS in adolescent with PCOS to help diagnosing and preventing of morbidity and mortality later in life. Pubmed, Medline, EMBASE, CINAHL and other sources were searched for metabolic syndrome in adolescents with polycystic ovarian syndrome using PRISMA guidelines (Moher et al., 2009). All type of study design of women aged 10-20 reported association of PCOS with metabolic syndrome was included in this study. Meta-analysis was conducted for MetS and its individual component using bias adjusted quality effect model and we compare the results from quality effects with random effects and IVhet model. Data were presented as prevalence, odds ratio (95% confidence interval and mean difference (95% confidence interval). This systematic review included 9 studies while the meta-analysis included 7 studies. Meta-analysis showed that the odds of being experiencing MetS in PCOS groups was 2.69 (1.29, 5.60) times than girls without PCOS. The mean difference between girls with PCOS and without PCOS for systolic blood pressure was 5.00 (1.28, 8.72), diastolic blood pressure was 3.50 (0.48, 6.56), triglycerides level was 4.20 (-3.99, 12.45), glucose level was 1.30 (-0.46, 3.05), HDL level was -1.40 (-4.85, 2.00). This systematic review and meta-analysis support the hypothesis that the risk of MetS is much greater in adolescents with PCOS compared to the normal population. It is important to screen PCOS in early age to prevent MetS and its complications which lead to morbidity and mortality later in life. Copyright © 2018. Published by Elsevier Ltd.
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Making Quality Health Websites a National Public Health Priority: Toward Quality Standards
2016-01-01
Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or more out of 6 reliability criteria. For objective HC/HIT-8.2, a total of 42 out of 100 (42.0%) websites followed 10 or more out of 19 established usability principles. On the basis of these baseline data points, ODPHP set targets for the year 2020 that meet the minimal statistical significance—increasing objective HC/HIT-8.1 data point to 70.5% and objective HC/HIT-8.2 data point to 55.7%. Conclusions This research is a critical first step in evaluating the quality of Web-based health information. The criteria proposed by ODPHP provide methods to assess website quality for professionals designing, developing, and managing health-related websites. The criteria, baseline data, and targets are valuable tools for driving quality improvement. PMID:27485512
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Cowley, Alison; Bath-Hextall, Fiona; Cooper, Joanne
2017-03-01
Esophagogastric (EG) cancer is the fifth most common malignancy, and its incidence is increasing. The disease is fast paced, and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence into the most effective service models to support EG cancer patients. The overall objective of this quantitative systematic review was to establish best practice in relation to interventions targeted at healthcare professionals or the structures in which healthcare professionals deliver care (i.e. models of care and practice) and patients (diagnosed with palliative EG cancer) to enhance the quality of life for people diagnosed with palliative EG cancer. The current review considered studies that included patients diagnosed with palliative EG cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting. The current review considered studies that evaluated any intervention or combination of intervention strategies aimed at healthcare professionals, organizations or patients to improve quality of life for people diagnosed with palliative EG cancer. The current review considered both experimental and epidemiological study designs. Studies were excluded that evaluated: screening programs, pharmacology alone, palliative oncology and palliative endoscopy. The primary outcome measure was objectively measured quality of life. A three-step search strategy was utilized. Sixteen databases were searched for papers from the year 2000 onward and followed by hand searching of reference lists. Methodological quality was not assessed as no articles were found that met the inclusion criteria. Data extraction was not possible as no articles were found that met the inclusion criteria. It was not possible to complete data synthesis as no articles were found that met the inclusion criteria. Comprehensive searching and study selection process failed to identify any studies that were eligible for inclusion in the review. There is currently a lack of published evidence to establish which interventions and strategies are most effective in delivering services to patients diagnosed with palliative EG cancer in terms of service structure, process and delivery.
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Making Quality Health Websites a National Public Health Priority: Toward Quality Standards.
Devine, Theresa; Broderick, Jordan; Harris, Linda M; Wu, Huijuan; Hilfiker, Sandra Williams
2016-08-02
Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or more out of 6 reliability criteria. For objective HC/HIT-8.2, a total of 42 out of 100 (42.0%) websites followed 10 or more out of 19 established usability principles. On the basis of these baseline data points, ODPHP set targets for the year 2020 that meet the minimal statistical significance-increasing objective HC/HIT-8.1 data point to 70.5% and objective HC/HIT-8.2 data point to 55.7%. This research is a critical first step in evaluating the quality of Web-based health information. The criteria proposed by ODPHP provide methods to assess website quality for professionals designing, developing, and managing health-related websites. The criteria, baseline data, and targets are valuable tools for driving quality improvement.
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NASA Astrophysics Data System (ADS)
Antón, M.; Loyola, D.; López, M.; Vilaplana, J. M.; Bañón, M.; Zimmer, W.; Serrano, A.
2009-04-01
The main objective of this article is to compare the total ozone data from the new Global Ozone Monitoring Experiment instrument (GOME-2/MetOp) with reliable ground-based measurement recorded by five Brewer spectroradiometers in the Iberian Peninsula. In addition, a similar comparison for the predecessor instrument GOME/ERS-2 is described. The period of study is a whole year from May 2007 to April 2008. The results show that GOME-2/MetOp ozone data already has a very good quality, total ozone columns are on average 3.05% lower than Brewer measurements. This underestimation is higher than that obtained for GOME/ERS-2 (1.46%). However, the relative differences between GOME-2/MetOp and Brewer measurements show significantly lower variability than the differences between GOME/ERS-2 and Brewer data. Dependencies of these relative differences with respect to the satellite solar zenith angle (SZA), the satellite scan angle, the satellite cloud cover fraction (CF), and the ground-based total ozone measurements are analyzed. For both GOME instruments, differences show no significant dependence on SZA. However, GOME-2/MetOp data show a significant dependence on the satellite scan angle (+1.5%). In addition, GOME/ERS-2 differences present a clear dependence with respect to the CF and ground-based total ozone; such differences are minimized for GOME-2/MetOp. The comparison between the daily total ozone values provided by both GOME instruments shows that GOME-2/MetOp ozone data are on average 1.46% lower than GOME/ERS-2 data without any seasonal dependence. Finally, deviations of a priori climatological ozone profile used by the satellite retrieval algorithm from the true ozone profile are analyzed. Although excellent agreement between a priori climatological and measured partial ozone values is found for the middle and high stratosphere, relative differences greater than 15% are common for the troposphere and lower stratosphere.
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Systematic review of scope and quality of electronic patient record data in primary care
Thiru, Krish; Hassey, Alan; Sullivan, Frank
2003-01-01
Objective To systematically review measures of data quality in electronic patient records (EPRs) in primary care. Design Systematic review of English language publications, 1980-2001. Data sources Bibliographic searches of medical databases, specialist medical informatics databases, conference proceedings, and institutional contacts. Study selection Studies selected according to a predefined framework for categorising review papers. Data extraction Reference standards and measurements used to judge quality. Results Bibliographic searches identified 4589 publications. After primary exclusions 174 articles were classified, 52 of which met the inclusion criteria for review. Selected studies were primarily descriptive surveys. Variability in methods prevented meta-analysis of results. Forty eight publications were concerned with diagnostic data, 37 studies measured data quality, and 15 scoped EPR quality. Reliability of data was assessed with rate comparison. Measures of sensitivity were highly dependent on the element of EPR data being investigated, while the positive predictive value was consistently high, indicating good validity. Prescribing data were generally of better quality than diagnostic or lifestyle data. Conclusion The lack of standardised methods for assessment of quality of data in electronic patient records makes it difficult to compare results between studies. Studies should present data quality measures with clear numerators, denominators, and confidence intervals. Ambiguous terms such as “accuracy” should be avoided unless precisely defined. PMID:12750210
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Han, Claire J.; Kohen, Ruth; Jun, Sangeun; Jarrett, Monica E.; Cain, Kevin C.; Burr, Robert; Heitkemper, Margaret M.
2016-01-01
Background Our nurse-delivered Comprehensive Self-Management (CSM) program, a cognitive behavioral therapy intervention, is effective in reducing gastrointestinal and psychological distress symptoms in patients with irritable bowel syndrome (IBS). Findings from non-IBS studies indicate that the catechol-O-methyltransferase (COMT) Val158Met polymorphism may moderate the efficacy of cognitive behavioral therapy. It is unknown whether this COMT polymorphism is associated with symptom improvements in patients with IBS. Objective We tested whether this COMT Val158Met polymorphism influences the efficacy of our two-month CSM intervention. Methods We analyzed data from two published randomized controlled trials of CSM. The combined European-American sample included 149 women and 23 men with IBS (CSM, n =111; Usual Care [UC], n = 61). The primary outcomes were daily reports of abdominal pain, depression, anxiety, and feeling stressed measured three and six months after randomization. Secondary outcomes were additional daily symptoms, retrospective psychological distress, IBS quality of life, and cognitive beliefs about IBS. The interaction between COMT Val158Met polymorphism and treatment group (CSM vs. UC) in a generalized estimating equation model tested the main objective. Results At three months, participants with at least one Val allele benefited more from CSM than did those with the Met/Met genotype (p = .01 for anxiety and feeling stressed, and p < .16 for abdominal pain and depression). The moderating effect of genotype was weaker at six months. Discussion Persons with at least one Val allele may benefit more from CSM than those homozygous for the Met allele. Future studies with larger and more racially diverse samples are needed to confirm these findings. RCT Registration Parent studies were registered at ClinicalTrials.gov (NCT00167635 and NCT00907790). PMID:28252569
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Gallo, Linda C; Gellman, Marc; Hu, Frank B; Siega-Riz, Anna Maria; Kaplan, Robert C
2016-01-01
Background: Healthful diet quality has been associated with a lower risk of metabolic syndrome (MetS) in several populations, but reports on Hispanic and Latino cohorts, grouped or by ethnic background, have been limited and inconsistent. Objective: We aimed to examine diet quality by using the 2010 Alternate Healthy Eating Index [(AHEI) range: 0–110, lowest to highest quality] and its cross-sectional association with MetS and its cardiometabolic components across 6 Hispanic and Latino backgrounds. Methods: We studied 12,406 US Hispanics and Latinos, aged 18–74 y and free of diabetes, from the multicenter, population-based Hispanic Community Health Study/Study of Latinos cohort. Food and nutrients were assessed from two 24-h recalls. MetS was defined by using the 2009 harmonized guidelines. Complex survey procedures were used in multivariable-adjusted linear regression models to test the association of the AHEI with continuous markers and in logistic regression models with MetS as an outcome. Results: The prevalence of MetS was 24.2%. Overall, Hispanics and Latinos had low scores for intakes of sugar-sweetened beverages and fruit juices, whole grains, and fruit and favorable scores for trans fats and nuts and legumes, according to AHEI criteria. Adjusted mean AHEI and its individual components differed by ethnic background (P < 0.001), ranging from 43.0 for Puerto Ricans to 52.6 for Mexicans. Overall, adjusted odds (95% CIs) of having MetS were 22% (9%, 33%) lower for each 10-unit increase in AHEI. This association was modified by ethnic background (P-interaction = 0.03), with significantly lower odds observed only for Mexicans (30%; 95% CIs: 13%, 44%) and Central Americans (42%; 95% CIs: 9%, 64%) for each 10-unit increase in AHEI. AHEI was inversely associated with waist circumference, blood pressure, and glucose among Mexicans and Puerto Ricans and with triglycerides among Mexicans only, and positively associated with HDL cholesterol among Puerto Ricans and Central Americans (all P < 0.05). Conclusions: Diet quality differed by Hispanic or Latino background. Although healthier diet quality was associated with lower odds of MetS in the overall Hispanic and Latino cohort, the association of AHEI and cardiometabolic factors varied by ethnic background. Nutrition-related research and interventions among ethnically diverse groups should consider individual ethnic backgrounds to optimally address diet quality and cardiometabolic health. This trial was registered at clinicaltrials.gov as NCT02060344. PMID:27605403
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Berkowitz, Seth A; Aragon, Katherine; Hines, Jonas; Seligman, Hilary; Lee, Sei; Sarkar, Urmimala
2013-01-01
Objective To determine whether diabetes clinical standards consider increased hypoglycemia risk in vulnerable patients. Data Sources MEDLINE, the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, and supplemental sources. Study Design Systematic review of clinical standards (guidelines, quality metrics, or pay-for-performance programs) for glycemic control in adult diabetes patients. The primary outcome was discussion of increased risk for hypoglycemia in vulnerable populations. Data Collection/Extraction Methods Manuscripts identified were abstracted by two independent reviewers using prespecified inclusion/exclusion criteria and a standardized abstraction form. Principal Findings We screened 1,166 titles, and reviewed 220 manuscripts in full text. Forty-four guidelines, 17 quality metrics, and 8 pay-for-performance programs were included. Five (11 percent) guidelines and no quality metrics or pay-for-performance programs met the primary outcome. Conclusions Clinical standards do not substantively incorporate evidence about increased risk for hypoglycemia in vulnerable populations. PMID:23445498
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Kovner, Christine; Harrington, Charlene; Greene, William; Mezey, Mathy
2009-01-01
Objective To examine the relationships between nursing staffing levels and nursing home deficiencies. Methods This panel data analysis employed random-effect models that adjusted for unobserved, nursing home–specific heterogeneity over time. Data were obtained from California's long-term care annual cost report data and the Automated Certification and Licensing Administrative Information and Management Systems data from 1999 to 2003, linked with other secondary data sources. Results Both total nursing staffing and registered nurse (RN) staffing levels were negatively related to total deficiencies, quality of care deficiencies, and serious deficiencies that may cause harm or jeopardy to nursing home residents. Nursing homes that met the state staffing standard received fewer total deficiencies and quality of care deficiencies than nursing homes that failed to meet the standard. Meeting the state staffing standard was not related to receiving serious deficiencies. Conclusions Total nursing staffing and RN staffing levels were predictors of nursing home quality. Further research is needed on the effectiveness of state minimum staffing standards. PMID:19181692
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Quality Assurance Specifications for Planetary Protection Assays
NASA Astrophysics Data System (ADS)
Baker, Amy
As the European Space Agency planetary protection (PP) activities move forward to support the ExoMars and other planetary missions, it will become necessary to increase staffing of labo-ratories that provide analyses for these programs. Standardization of procedures, a comprehen-sive quality assurance program, and unilateral training of personnel will be necessary to ensure that the planetary protection goals and schedules are met. The PP Quality Assurance/Quality Control (QAQC) program is designed to regulate and monitor procedures performed by labora-tory personnel to ensure that all work meets data quality objectives through the assembly and launch process. Because personnel time is at a premium and sampling schedules are often de-pendent on engineering schedules, it is necessary to have flexible staffing to support all sampling requirements. The most productive approach to having a competent and flexible work force is to establish well defined laboratory procedures and training programs that clearly address the needs of the program and the work force. The quality assurance specification for planetary protection assays has to ensure that labora-tories and associated personnel can demonstrate the competence to perform assays according to the applicable standard AD4. Detailed subjects included in the presentation are as follows: • field and laboratory control criteria • data reporting • personnel training requirements and certification • laboratory audit criteria. Based upon RD2 for primary and secondary validation and RD3 for data quality objectives, the QAQC will provide traceable quality assurance safeguards by providing structured laboratory requirements for guidelines and oversight including training and technical updates, standardized documentation, standardized QA/QC checks, data review and data archiving.
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Cooper, Jeffrey D
2004-01-01
This case study-based on this practice's application for the 2003 HIMSS Davies Award for Primary Care-describes the processes, costs and benefits of the implementation of an EHR in a solo practice. The organization, management and value of an EHR implementation is described, as well as a description of the physician's 15 business objectives, which shows how each objective was met and to what degree and gives specific financial data. An EHR that is implemented in a small practice improves quality of patient care, office efficiency and patient safety. A small practice can realize significant ROI from an EHR.
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Unmet Needs for Cardiovascular Care in Indonesia
Maharani, Asri; Tampubolon, Gindo
2014-01-01
Background In the past twenty years the heaviest burden of cardiovascular diseases has begun to shift from developed to developing countries. However, little is known about the real needs for cardiovascular care in these countries and how well those needs are being met. This study aims to investigate the prevalence and determinants of unmet needs for cardiovascular care based on objective assessment. Methods and Findings Multilevel analysis is used to analyse the determinants of met needs and multilevel multiple imputation is applied to manage missing data. The 2008 Indonesian Family Life Survey (IFLS4) survey is the source of the household data used in this study, while district data is sourced from the Ministry of Health and Ministry of Finance. The data shows that nearly 70% of respondents with moderate to high cardiovascular risk failed to receive cardiovascular care. Higher income, possession of health insurance and residence in urban areas are significantly associated with met needs for cardiovascular care, while health facility density and physician density show no association with them. Conclusions The prevalence of unmet needs for cardiovascular care is considerable in Indonesia. Inequality persists as a factor in meeting needs for cardiovascular care as the needs of people with higher incomes and those living in urban areas are more likely to be met. Alleviation of poverty, provision of health care insurance for the poor, and improvement in the quality of healthcare providers are recommended in order to meet this ever-increasing need. PMID:25148389
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Establishment of Protocols for Global Metabolomics by LC-MS for Biomarker Discovery.
Saigusa, Daisuke; Okamura, Yasunobu; Motoike, Ikuko N; Katoh, Yasutake; Kurosawa, Yasuhiro; Saijyo, Reina; Koshiba, Seizo; Yasuda, Jun; Motohashi, Hozumi; Sugawara, Junichi; Tanabe, Osamu; Kinoshita, Kengo; Yamamoto, Masayuki
2016-01-01
Metabolomics is a promising avenue for biomarker discovery. Although the quality of metabolomic analyses, especially global metabolomics (G-Met) using mass spectrometry (MS), largely depends on the instrumentation, potential bottlenecks still exist at several basic levels in the metabolomics workflow. Therefore, we established a precise protocol initially for the G-Met analyses of human blood plasma to overcome some these difficulties. In our protocol, samples are deproteinized in a 96-well plate using an automated liquid-handling system, and conducted either using a UHPLC-QTOF/MS system equipped with a reverse phase column or a LC-FTMS system equipped with a normal phase column. A normalization protocol of G-Met data was also developed to compensate for intra- and inter-batch differences, and the variations were significantly reduced along with our normalization, especially for the UHPLC-QTOF/MS data with a C18 reverse-phase column for positive ions. Secondly, we examined the changes in metabolomic profiles caused by the storage of EDTA-blood specimens to identify quality markers for the evaluation of the specimens' pre-analytical conditions. Forty quality markers, including lysophospholipids, dipeptides, fatty acids, succinic acid, amino acids, glucose, and uric acid were identified by G-Met for the evaluation of plasma sample quality and established the equation of calculating the quality score. We applied our quality markers to a small-scale study to evaluate the quality of clinical samples. The G-Met protocols and quality markers established here should prove useful for the discovery and development of biomarkers for a wider range of diseases.
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Interim Basis for PCB Sampling and Analyses
DOE Office of Scientific and Technical Information (OSTI.GOV)
BANNING, D.L.
2001-01-18
This document was developed as an interim basis for sampling and analysis of polychlorinated biphenyls (PCBs) and will be used until a formal data quality objective (DQO) document is prepared and approved. On August 31, 2000, the Framework Agreement for Management of Polychlorinated Biphenyls (PCBs) in Hanford Tank Waste was signed by the US. Department of Energy (DOE), the Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) (Ecology et al. 2000). This agreement outlines the management of double shell tank (DST) waste as Toxic Substance Control Act (TSCA) PCB remediation waste based on a risk-based disposalmore » approval option per Title 40 of the Code of Federal Regulations 761.61 (c). The agreement calls for ''Quantification of PCBs in DSTs, single shell tanks (SSTs), and incoming waste to ensure that the vitrification plant and other ancillary facilities PCB waste acceptance limits and the requirements of the anticipated risk-based disposal approval are met.'' Waste samples will be analyzed for PCBs to satisfy this requirement. This document describes the DQO process undertaken to assure appropriate data will be collected to support management of PCBs and is presented in a DQO format. The DQO process was implemented in accordance with the U.S. Environmental Protection Agency EPA QAlG4, Guidance for the Data Quality Objectives Process (EPA 1994) and the Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. 1 A, Vol. IV, Section 4.16 (Banning 1999).« less
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Interim Basis for PCB Sampling and Analyses
DOE Office of Scientific and Technical Information (OSTI.GOV)
BANNING, D.L.
2001-03-20
This document was developed as an interim basis for sampling and analysis of polychlorinated biphenyls (PCBs) and will be used until a formal data quality objective (DQO) document is prepared and approved. On August 31, 2000, the Framework Agreement for Management of Polychlorinated Biphenyls (PCBs) in Hanford Tank Waste was signed by the U.S. Department of Energy (DOE), the Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) (Ecology et al. 2000). This agreement outlines the management of double shell tank (DST) waste as Toxic Substance Control Act (TSCA) PCB remediation waste based on a risk-based disposalmore » approval option per Title 40 of the Code of Federal Regulations 761.61 (c). The agreement calls for ''Quantification of PCBs in DSTs, single shell tanks (SSTs), and incoming waste to ensure that the vitrification plant and other ancillary facilities PCB waste acceptance limits and the requirements of the anticipated risk-based disposal approval are met.'' Waste samples will be analyzed for PCBs to satisfy this requirement. This document describes the DQO process undertaken to assure appropriate data will be collected to support management of PCBs and is presented in a DQO format. The DQO process was implemented in accordance with the U.S. Environmental Protection Agency EPA QA/G4, Guidance for the Data Quality Objectives Process (EPA 1994) and the Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. 1A, Vol. IV, Section 4.16 (Banning 1999).« less
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Nutritional modifications in male infertility: a systematic review covering 2 decades
Mohammadmoradi, Shayan; Javidan, Aida; Sadeghi, Mohammad Reza
2016-01-01
Context: Studies suggest that appropriate nutritional modifications can improve the natural conception rate of infertile couples. Objectives: The purpose of this study was to review the human trials that investigated the relation between nutrition and male infertility. Data Sources: A comprehensive systematic review of published human studies was carried out by searching scientific databases. Article selection was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The American Dietetic Association Research Design and Implementation Checklist was also used for quality assessment. Data Extraction: A total of 502 articles were identified, of which 23 studies met the inclusion criteria. Data Synthesis: Results indicated that a healthy diet improves at least one measure of semen quality, while diets high in lipophilic foods, soy isoflavones, and sweets lower semen quality. Conclusion: The role of daily nutrient exposure and dietary quality needs to be highlighted in male infertility. Mechanistic studies addressing the responsible underlying mechanisms of action of dietary modifications are highly warranted. Systematic Review Registration: PROSPERO 2013: CRD42013005953. Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013005953. PMID:26705308
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Walking the Talk: Continuous Improvement of a Quality Management Field Exercise
ERIC Educational Resources Information Center
Coy, Steven; Adams, Jeffery
2012-01-01
This article provides results from a three semester case study of the pedagogical efficacy of an innovative quality management field exercise. A series of direct and indirect measures were used to assess the extent to which the field exercise met a set of learning objectives. The results indicate that the assessment framework is useful in…
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USDI DCS technical support: Mississippi Test Facility
NASA Technical Reports Server (NTRS)
Preble, D. M.
1975-01-01
The objective of the technical support effort is to provide hardware and data processing support to DCS users so that application of the system may be simply and effectively implemented. Technical support at Mississippi Test Facility (MTF) is concerned primarily with on-site hardware. The first objective of the DCP hardware support was to assure that standard measuring apparatus and techniques used by the USGS could be adapted to the DCS. The second objective was to try to standardize the miscellaneous variety of parameters into a standard instrument set. The third objective was to provide the necessary accessories to simplify the use and complement the capabilities of the DCP. The standard USGS sites have been interfaced and are presently operating. These sites are stream gauge, ground water level and line operated quality of water. Evapotranspiration, meteorological and battery operated quality of water sites are planned for near future DCP operation. Three accessories which are under test or development are the Chu antenna, solar power supply and add-on memory. The DCP has proven to be relatively easy to interface with many monitors. The large antenna is awkward to install and transport. The DCS has met the original requirements well; it has and is proving that an operation, satellite-based data collection system is feasible.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-07
... techniques, provisions for the establishment and operation of appropriate devices necessary to collect data... information.) Ambient air quality monitoring data for the 3-year period must meet a data completeness requirement. The ambient air quality monitoring data completeness requirement is met when the percent of days...
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NASA Astrophysics Data System (ADS)
Mattioli, G. S.; Braun, J. J.; Cabral, E.; Calais, E.; DeMets, C.; Feaux, K.; Mencin, D.; Miller, M. M.; Normandeau, J.; Serra, Y.; Wang, G.
2013-05-01
UNAVCO maintains the NSF-funded Plate Boundary Observatory (PBO), which is the geodetic facility of EarthScope. PBO is largest continuous GPS and borehole geophysical network in the Americas, with ~1130 cGPS sites, including several with multiple monuments, ~80 boreholes, with 75 tensor strainmeters, 79 short-period, 3-component seismometers, and pore pressure sensors at 23 sites. PBO also includes 26 tiltmeters deployed at several volcanoes. Surface meteorological sensors are collocated at 134 GPS sites. UNAVCO provides high-rate (1 Hz), low-latency (<1 s) GPS data streams (RT-GPS) from 348 stations in PBO and has delivered over 62 Tb of geodetic data since PBO's inception in 2004. COCONet is a multi-hazard GPS-Met observatory, which extends PBO infrastructure into the Caribbean basin. In 2010, UNAVCO in collaboration with UCAR, was funded by NSF to build and initially maintain a network of 50 new cGPS/Met sites and incorporate another 50 existing sites in the Caribbean region. The revised siting plan calls for 46 new, 21 refurbished, and 77 existing stations spanning 26 nations in the Caribbean. Data from COCONet sites flow into the UNAVCO archive and are processed by the PBO analysis centers. Three workshops have helped to foster a COCONet science community and provide important guidance to UNAVCO to assure success of this complex multi-national project. A new joint UNAVCO-Mexican multi-hazard GPS-Met observatory, called TLALOCNet, has been proposed based on the outcomes of a NSF-funded workshop held in Puerto Vallarta in 2010. The TLALOCNet plan calls for UNAVCO to install 9 new PBO-quality GPS-Met sites in Mexico and adjacent islands, upgrade 29 sites previously installed with NSF funding along the western subduction boundary, and coordinate with the Mexican National Meteorological Service to federate data from at least another 80 GPS-Met sites distributed across Mexico. All GPS-Met data from TLALOCNet will be freely available at the UNAVCO archive and Mexican mirror sites. The ultimate goal for these networks is to provide free, high-quality, low-latency data and data products for researchers, educators, students, and the private sector. Data from COCONet and TLALOCNet will be used by US and international scientists to study solid earth processes, for example plate kinematics and dynamic as well as plate boundary interactions and deformation, with an emphasis on the earthquake cycle. The networks also serve atmospheric science objectives by providing more precise estimates of tropospheric water vapor thus enabling better forecast of the dynamics of airborne moisture associated with the yearly Caribbean hurricane cycle.
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Lau, Caren; Yu, Ruby; Woo, Jean
2015-01-01
Objective To determine the efficacy of a 12-week Hatha yoga intervention to improve metabolic risk profiles and health-related quality of life (HRQoL) in Chinese adults with and without metabolic syndrome (MetS). Methods We conducted a controlled trial within an university-affiliated hospital. 173 Chinese men and women aged 18 or above were assigned to either the yoga intervention group (n = 87) or the control group (n = 86). Primary outcomes included 12-week change in metabolic risk factors and MetS z score. Secondary outcome was HRQoL (Medical Outcomes Short Form Survey at 12 weeks). Results The mean age of participants was 52.0 (SD 7.4, range 31-71) years. Analysis involving the entire study population revealed that the yoga group achieved greater decline in waist circumference (p<0.001), fasting glucose (p<0.01), triglycerides (p<0.05), and MetS z score (p<0.01). Yoga training also improved general health perceptions (p<0.01), physical component score (p<0.01), and social functioning (p<0.01) domains score of HRQoL. However, no significant differences between groups were observed in the mean change of systolic/diastolic blood pressures or high-density lipid protein cholesterol (all p>0.05). There were no significant differences in the intervention effects on waist circumference and MetS z score between the MetS subgroups (both p>0.05). Conclusion A 12-week Hatha yoga intervention improves metabolic risk profiles and HRQoL in Chinese adults with and without MetS. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12613000816752 PMID:26111165
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ERIC Educational Resources Information Center
Fabac, John N.
The Technology Partnership Organization (TPO) is one of 24 Quality Work Force Planning (QWFP) entities in Texas. The TPO met its objectives through a variety of activities, including the following: (1) establishing a QWFP committee for the region; (2) providing an inventory of key regional industries with the greatest job opening potential and…
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Byrne, M.D.; Jordan, T.R.; Welle, T.
2013-01-01
Objective The objective of this study was to investigate and improve the use of automated data collection procedures for nursing research and quality assurance. Methods A descriptive, correlational study analyzed 44 orthopedic surgical patients who were part of an evidence-based practice (EBP) project examining post-operative oxygen therapy at a Midwestern hospital. The automation work attempted to replicate a manually-collected data set from the EBP project. Results Automation was successful in replicating data collection for study data elements that were available in the clinical data repository. The automation procedures identified 32 “false negative” patients who met the inclusion criteria described in the EBP project but were not selected during the manual data collection. Automating data collection for certain data elements, such as oxygen saturation, proved challenging because of workflow and practice variations and the reliance on disparate sources for data abstraction. Automation also revealed instances of human error including computational and transcription errors as well as incomplete selection of eligible patients. Conclusion Automated data collection for analysis of nursing-specific phenomenon is potentially superior to manual data collection methods. Creation of automated reports and analysis may require initial up-front investment with collaboration between clinicians, researchers and information technology specialists who can manage the ambiguities and challenges of research and quality assurance work in healthcare. PMID:23650488
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Adult Attachment Interview Discourse Patterns Predict Metabolic Syndrome in Midlife
Davis, Cynthia R.; Usher, Nicole; Dearing, Eric; Barkai, Ayelet R.; Crowell-Doom, Cindy; Mantzoros, Christos S.; Crowell, Judith A.
2017-01-01
Objective Adult attachment discourse patterns and current family relationship quality were examined as predictors of health behaviors and number of Metabolic Syndrome (MetS) criteria met. Methods A sample of 215 White/European American and Black/African American adults, aged 35 to 55, were examined cross-sectionally. Discourse was assessed with the Adult Attachment Interview (AAI), specifically: 1) coherence, a marker of attachment security, 2) unresolved trauma/loss, a marker of disorganized and distorted cognition related to trauma, and 3) idealization, the tendency to minimize the impact of stressful experiences. Health behaviors of diet, exercise, smoking and alcohol use were also assessed, as were adverse childhood experiences, current depressive symptoms and relationship functioning. MetS includes hypertension, hyperglycemia, high triglycerides, low HDL cholesterol, and obesity. Results Using path analysis and accounting for childhood adversity and depressive symptoms, AAI coherence and unresolved trauma or loss were directly linked to number of MetS criteria met (β = −.22 and .21 respectively). Idealization was indirectly linked to MetS through poor diet (β = −.26 and −.36 respectively), predicting 21% of the variance in number of MetS criteria met. Conclusions Attachment representations related to stress appraisal and care-seeking behaviors appear to serve as cognitive mechanisms increasing risk of MetS. PMID:25264975
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Family Impacts among Children with Autism Spectrum Disorder: The Role of Health Care Quality
Zuckerman, Katharine E.; Lindly, Olivia J.; Bethell, Christina D.; Kuhlthau, Karen
2014-01-01
Objectives To compare health care quality and family employment and financial impacts among children with special health care needs (CSHCN) with autism spectrum disorder (CSHCN+ASD), CSHCN with functional limitations (CSHCN+FL), and CSHCN lacking these conditions (other CSHCN). To test whether high health care quality was associated with reduced family impacts among CSHCN+ASD. Methods Data from the 2009-2010 National Survey of CSHCN were used to compare 3025 CSHCN+ASD, 6505 CSHCN+FL, and 28 296 other CSHCN. Weighted multivariate logistic regression analyses examined six age-relevant, federally-defined health care quality indicators and five family financial and employment impact indicators. Two composite measures were additionally used: (1) receipt of care that met all age-relevant quality indicators; and (2) had ≥ two of the five adverse family impacts. Results Across all health care quality indicators CSHCN+ASD fared poorly, with only 7.4% meeting all age-relevant indicators. CSHCN+ASD had worse health care quality than other CSHCN, including CSHCN+FL. CSHCN+ASD also had high rates of adverse family impact, with over half experiencing two or more adverse impacts. Rates of adverse family impact were higher in CSHCN+ASD than other CSHCN, including CSHCN+FL. Among CSHCN+ASD, those whose health care that met federal quality standards were less likely to have multiple adverse family impacts than CSHCN+ASD whose health care did not meet federal quality standards. Conclusions CSHCN+ASD are more prone to experience poor health care quality and family impacts than other CSHCN, even CSHCN+FL. Receipt of care meeting federal quality standards may potentially lessen adverse family impacts for CSHCN+ASD. PMID:24976352
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Survey evaluation and design (SED): A case study in Garden Banks, Gulf of Mexico
DOE Office of Scientific and Technical Information (OSTI.GOV)
Johnson, G.; Hannan, A.; Mann, A.D.
1995-12-31
Hydrocarbon exploration in the Gulf of Mexico has reached its mature stages. Exploration objectives such as deep stratigraphic and pre-salt traps are becoming more dominant. As the exploration targets change, earlier 3D seismic surveys, designed for different objectives, become less able to meet the demands of the present day explorations. Some areas of the Gulf of Mexico will require reacquisition of new 3D seismic data, redesigned to meet new objectives. Garden Banks is one such area. A major advantage of performing a survey evaluation design (SED) in a mature area is the amount and diversity of available data. Geological profiles,more » reservoir characterizations, borehole wireline and surface seismic data, all serve to aid in the survey design. Given the exploration history and geological objectives, the geophysical analyses of resolution, signal loss, noise, fold, acquisition geometry, migration aperture, velocity anisotropy and others, may now be carried out in a much more specific manner. A thorough SED ensures that overall survey objectives will be met and reduces the possibility of over design on critical parameters. This generates the highest quality seismic survey for the most reasonable cost.« less
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Day, Sara W.; McKeon, Leslie M.; Garcia, Jose; Wilimas, Judith A.; Carty, Rita M.; de Alarcon, Pedro; Antillon, Federico; Howard, Scott C.
2017-01-01
Background Inadequate nursing care is a major impediment to development of effective programs for treatment of childhood cancer in low-income countries. When the International Outreach Program at St. Jude Children’s Research Hospital established partner sites in low-income countries, few nurses had pediatric oncology skills or experience. A comprehensive nursing program was developed to promote the provision of quality nursing care, and in this manuscript we describe the program’s impact on 20 selected Joint Commission International (JCI) quality standards at the National Pediatric Oncology Unit in Guatemala. We utilized JCI standards to focus the nursing evaluation and implementation of improvements. These standards were developed to assess public hospitals in low-income countries and are recognized as the gold standard of international quality evaluation. Methods We compared the number of JCI standards met before and after the nursing program was implemented using direct observation of nursing care; review of medical records, policies, procedures, and job descriptions; and interviews with staff. Results In 2006, only 1 of the 20 standards was met fully, 2 partially, and 17 not met. In 2009, 16 were met fully, 1 partially, and 3 not met. Several factors contributed to the improvement. The pre-program quality evaluation provided objective and credible findings and an organizational framework for implementing change. The medical, administrative, and nursing staff worked together to improve nursing standards. Conclusion A systematic approach and involvement of all hospital disciplines led to significant improvement in nursing care that was reflected by fully meeting 16 of 20 standards. PMID:23015363
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RISK FACTORS FOR PRESSURE INJURIES AMONG CRITICAL-CARE PATIENTS: A SYSTEMATIC REVIEW
Alderden, Jenny; Rondinelli, June; Pepper, Ginette; Cummins, Mollie; Whitney, JoAnne
2017-01-01
Objective To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients Design We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. Data Sources We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus. There was no language restriction. Method A research librarian coordinated the search strategy. Articles that potentially met inclusion criteria were screened by two investigators. Among the articles that met selection criteria, one investigator extracted data and a second investigator reviewed the data for accuracy. Based on a literature search, we developed a tool for assessing study quality using a combination of currently available tools and expert input. We used the method developed by Coleman and colleagues in 2014 to generate evidence tables and a summary narrative synthesis by domain and subdomain. Results Of 1753 abstracts reviewed, 158 were identified as potentially eligible and 18 fulfilled eligibility criteria. Five studies were classified as high quality, two were moderate quality, nine were low quality, and two were of very low quality. Age, mobility/activity, perfusion, and vasopressor infusion emerged as important risk factors for pressure injury development, whereas results for risk categories that are theoretically important, including nutrition, and skin/pressure injury status, were mixed. Methodological limitations across studies limited the generalizability of the results, and future research is needed, particularly to evaluate risk conferred by altered nutrition and skin/pressure injury status, and to further elucidate the effects of perfusion-related variables. Conclusions Results underscore the importance of avoiding overinterpretation of a single study, and the importance of taking study quality into consideration when reviewing risk factors. Maximal pressure injury prevention efforts are particularly important among critical-care patients who are older, have altered mobility, experience poor perfusion, or who are receiving a vasopressor infusion. PMID:28384533
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Esquivel, C; Patton, L; Walker, S
Purpose: Use Sun Nuclear Quality Reports™ with PlanIQ™ to evaluate different treatment delivery techniques for various treatment sites. Methods: Fifteen random patients with different treatment sites were evaluated. These include the Head/Neck, prostate, pelvis, lung, esophagus, axilla, bladder and abdomen. Initially, these sites were planned on the Pinnacle {sup 3} V9.6 treatment planning system and utilized nine 6MV step-n-shoot IMRT fields. The RT plan, dose and structure sets were sent to Quality Reports™ where a DVH was recreated and the plans were compared to a unique Plan Algorithm for each treatment site. Each algorithm has its own plan quality metricsmore » and objectives, which include the PTV coverage, PTV maximum dose, the prescription dose outside the target, doses to the critical structures, and the global maximum dose and its location. Each plan was scored base on meeting each objective. Plans may have been reoptimized and reevaluated with Quality Reports™ based on the initial score. PlanIQ™ was used to evaluate if any objective not met was achievable or difficult to obtain. A second plan using VMAT delivery was created for each patient and scored with Quality Reports™. Results: There were a wide range of scores for the different treatment sites with some scoring better for IMRT plans and some better for the VMAT deliveries. The variation in the scores could be attributed to the treatment site, location, and shape of the target. Most deliveries were chosen for the VMAT due to the short treatment times and quick patient throughput with acceptable plan scores. Conclusion: The tools are provided for both physician and dosimetrist to objectively evaluate the use of VMAT delivery versus the step-n-shoot IMRT delivery for various sites. PlanIQ validates if objectives can be met. For the physicist, a concise pass/fail report is created for plan evaluation.« less
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Systematic review of cost effectiveness studies of telemedicine interventions
Whitten, Pamela S; Mair, Frances S; Haycox, Alan; May, Carl R; Williams, Tracy L; Hellmich, Seth
2002-01-01
Objectives To systematically review cost benefit studies of telemedicine. Design Systematic review of English language, peer reviewed journal articles. Data sources Searches of Medline, Embase, ISI citation indexes, and database of Telemedicine Information Exchange. Studies selected 55 of 612 identified articles that presented actual cost benefit data. Main outcome measures Scientific quality of reports assessed by use of an established instrument for adjudicating on the quality of economic analyses. Results 557 articles without cost data categorised by topic. 55 articles with data initially categorised by cost variables employed in the study and conclusions. Only 24/55 (44%) studies met quality criteria justifying inclusion in a quality review. 20/24 (83%) restricted to simple cost comparisons. No study used cost utility analysis, the conventional means of establishing the “value for money” that a therapeutic intervention represents. Only 7/24 (29%) studies attempted to explore the level of utilisation that would be needed for telemedicine services to compare favourably with traditionally organised health care. None addressed this question in sufficient detail to adequately answer it. 15/24 (62.5%) of articles reviewed here provided no details of sensitivity analysis, a method all economic analyses should incorporate. Conclusion There is no good evidence that telemedicine is a cost effective means of delivering health care. What is already known on this topicThe use of telemedicine has garnered much attention in the past decadeHundreds of articles have been published claiming that telemedicine is cost effectiveHowever, missing from the literature is a synthesis or meta-analysis of these publicationsWhat this study addsA comprehensive literature search of cost related articles on telemedicine identified more than 600 articles, but only 9% contained any cost benefit dataOnly 4% of these articles met quality criteria justifying inclusion in a formalised quality review, and most of these were small scale, short term, pragmatic evaluations with few generalisable conclusionsThere is little published evidence to confirm whether or not telemedicine is a cost effective alternative to standard healthcare delivery PMID:12065269
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Wickramasinghe, Kremlin; Rayner, Mike; Goldacre, Michael; Townsend, Nick; Scarborough, Peter
2017-01-01
Objectives The aim of this modelling study was to estimate the expected changes in the nutritional quality and greenhouse gas emissions (GHGEs) of primary school meals due to the adoption of new mandatory food-based standards for school meals. Setting Nationally representative random sample of 136 primary schools in England was selected for the Primary School Food Survey (PSFS) with 50% response rate. Participants A sample of 6690 primary students from PSFS who consumed school meals. Outcome measures Primary School Food Plan (SFP) nutritional impact was assessed using both macronutrient and micronutrient quality. The environmental impact was measured by GHGEs. Methods The scenario tested was one in which every meal served in schools met more than half of the food-based standards mentioned in the SFP (SFP scenario). We used findings from a systematic review to assign GHGE values for each food item in the data set. The GHGE value and nutritional quality of SFP scenario meals was compared with the average primary school meal in the total PSFS data set (pre-SFP scenario). Prior to introduction of the SFP (pre-SFP scenario), the primary school meals had mandatory nutrient-based guidelines. Results The percentage of meals that met the protein standard increased in the SFP scenario and the proportion of meals that met the standards for important micronutrients (eg, iron, calcium, vitamin A and C) also increased. However, the SFP scenario did not improve the salt, saturated fat and free sugar levels. The mean GHGE value of meals which met the SFP standards was 0.79 (95% CI 0.77 to 0.81) kgCO2e compared with a mean value of 0.72 (0.71 to 0.74) kgCO2e for all meals. Adopting the SFP would increase the total emissions associated with primary school meals by 22 000 000 kgCO2e per year. Conclusions The universal adoption of the new food-based standards, without reformulation would result in an increase in the GHGEs of school meals and improve some aspects of the nutritional quality, but it would not improve the average salt, sugar and saturated fat content levels. PMID:28381419
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Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P.; Kumar, Ambuj
2011-01-01
Objectives To assess whether reported methodological quality of randomized controlled trials (RCTs) reflect the actual methodological quality, and to evaluate the association of effect size (ES) and sample size with methodological quality. Study design Systematic review Setting Retrospective analysis of all consecutive phase III RCTs published by 8 National Cancer Institute Cooperative Groups until year 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Results 429 RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94, 95%CI: 0.88, 0.99) and 24% (RHR: 1.24, 95%CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. Conclusion The largest study to-date shows poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. PMID:22424985
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Genetic parameters for meat quality traits of Australian lamb meat.
Mortimer, S I; van der Werf, J H J; Jacob, R H; Hopkins, D L; Pannier, L; Pearce, K L; Gardner, G E; Warner, R D; Geesink, G H; Edwards, J E Hocking; Ponnampalam, E N; Ball, A J; Gilmour, A R; Pethick, D W
2014-02-01
Genetic parameters were estimated for a range of meat quality traits recorded on Australian lamb meat. Data were collected from Merino and crossbred progeny of Merino, terminal and maternal meat breed sires of the Information Nucleus programme. Lambs born between 2007 and 2010 (n=8968) were slaughtered, these being the progeny of 372 sires and 5309 dams. Meat quality traits were found generally to be of moderate heritability (estimates between 0.15 and 0.30 for measures of meat tenderness, meat colour, polyunsaturated fat content, mineral content and muscle oxidative capacity), with notable exceptions of intramuscular fat (0.48), ultimate pH (0.08) and fresh meat colour a* (0.08) and b* (0.10) values. Genetic correlations between hot carcass weight and the meat quality traits were low. The genetic correlation between intramuscular fat and shear force was high (-0.62). Several measures of meat quality (fresh meat redness, retail meat redness, retail oxy/met value and iron content) appear to have potential for inclusion in meat sheep breeding objectives. © 2013.
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A Bio-Inspired Herbal Tea Flavour Assessment Technique
Zakaria, Nur Zawatil Isqi; Masnan, Maz Jamilah; Zakaria, Ammar; Shakaff, Ali Yeon Md
2014-01-01
Herbal-based products are becoming a widespread production trend among manufacturers for the domestic and international markets. As the production increases to meet the market demand, it is very crucial for the manufacturer to ensure that their products have met specific criteria and fulfil the intended quality determined by the quality controller. One famous herbal-based product is herbal tea. This paper investigates bio-inspired flavour assessments in a data fusion framework involving an e-nose and e-tongue. The objectives are to attain good classification of different types and brands of herbal tea, classification of different flavour masking effects and finally classification of different concentrations of herbal tea. Two data fusion levels were employed in this research, low level data fusion and intermediate level data fusion. Four classification approaches; LDA, SVM, KNN and PNN were examined in search of the best classifier to achieve the research objectives. In order to evaluate the classifiers' performance, an error estimator based on k-fold cross validation and leave-one-out were applied. Classification based on GC-MS TIC data was also included as a comparison to the classification performance using fusion approaches. Generally, KNN outperformed the other classification techniques for the three flavour assessments in the low level data fusion and intermediate level data fusion. However, the classification results based on GC-MS TIC data are varied. PMID:25010697
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Jahangiry, Leila; Shojaeezadeh, Davoud; Montazeri, Ali; Najafi, Mahdi; Mohammad, Kazem
2016-01-01
Cardiovascular diseases remain the leading cause of death worldwide. Metabolic syndrome (MetS) is the clustering of risk factors for developing the disease. Strong evidence exists for the efficacy of screening for MetS. However, the potential of novel web-based studies for MetS and online assessing of the quality of life (QOL) for these high-risk participants have not been explored. This was a web-based, cross-sectional study. Participants were recruited through online registering on the study website. Then, those who met the study criteria (waist circumference [WC] ≥90 and blood pressure [BP] ≥130/85) were contacted and invited for the clinical assessments, if they wish. Baseline measurements were MetS risk factors (weight, WC, body mass index and BP, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, and fasting blood glucose) and health-related QOL (HRQOL) that was measured using the short form-36 (SF-36). There were 1436 (male: 928, female: 508) registration data on the study website. Reviewing the data, of 317 eligible participants that were invited to the study, 229 persons were responded to invitation in the screening program. The mean age of participants was 43.8 (standard deviation [SD] = 9.9) years. MetS was more frequent in male and married persons. In addition, participants with MetS had lower mean (SD) scores than participants without MetS for the following subscales of HRQOL as: role-physical (with MetS 51.1±35.2; versus without MetS 65.3 ± SD = 40.1), vitality (with MetS 65± 21; versus without MetS 75.3 ± 21.1), mental health (with MetS 49.5±30.1; versus without MetS 34.1±17.2)(P < 0.05 for all). People with MetS experienced lower HRQOL than without MetS. Internet as a powerful medium offers a novel setting for delivery health information. It seems that high BP and abdominal obesity are associated with lower HRQOL in the participants with MetS. A web-based prevention program could make people aware for their vulnerability to MetS and its complications.
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Engels, Yvonne; van den Hombergh, Pieter; Mokkink, Henk; van den Hoogen, Henk; van den Bosch, Wil; Grol, Richard
2006-01-01
Aim To study the effects of a team-based model for continuous quality improvement (CQI) on primary care practice management. Design of study Randomised controlled trial. Setting Twenty-six intervention and 23 control primary care practices in the Netherlands. Method Practices interested in taking part in the CQI project were, after assessment of their practice organisation, randomly assigned to the intervention or control groups. During a total of five meetings, a facilitator helped the teams in the intervention group select suitable topics for quality improvement and follow a structured approach to achieve improvement objectives. Checklists completed by an outreach visitor, questionnaires for the GPs, staff and patients were used to assemble data on the number and quality of improvement activities undertaken and on practice management prior to the start of the intervention and 1 year later. Results Pre-test and post-test data were compared for the 26 intervention and 23 control practices. A significant intervention effect was found for the number of improvement objectives actually defined (93 versus 54, P<0.001) and successfully completed (80 versus 69% of the projects, P<0.001). The intervention group also improved on more aspects of practice management, as measured by our practice visit method, than the control group but none of these differences proved statistically significant. Conclusion The intervention exerted a significant effect on the number and quality of improvement projects undertaken and self-defined objectives met. Failure of the effects of the intervention on the other dimensions of practice management to achieve significance may be due to the topics selected for some of the improvement projects being only partly covered by the assessment instrument. PMID:17007709
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Lin, Shih-Chieh; Sun, Chien-An; You, San-Lin; Hwang, Lee-Ching; Liang, Chun-Yu; Yang, Tsan; Bai, Chyi-Huey; Chen, Chien-Hua; Wei, Cheng-Yu; Chou, Yu-Ching
2016-01-01
Study Objectives: The aims of this study are to investigate the relationships of metabolic syndrome (MetS) with insomnia symptoms and sleep duration in a Chinese adult population. Methods: Data from a nationwide epidemiological survey conducted on residents from randomly selected districts in Taiwan in 2007 were used for this cross-sectional population-based study. A total of 4,197 participants were included in this study. Insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), were assessed using the Insomnia Self-Assessment Inventory questionnaire. Subjects were divided into 3 groups based upon their reported sleep duration (< 7, 7–8, and ≥ 9 h per night). Odds ratios (ORs) and 95% confidence intervals (CIs) derived from multivariable logistic regression were used to evaluate the study aims. Results: The endorsement of DIS and DMS were cross-sectionally associated with the MetS after adjustment for sleep duration (OR [95% CI] was 1.24 [1.01–1.51] and 1.28 [1.02–1.61], respectively). In addition, short sleep duration was significantly associated with the prevalence of MetS independent of insomnia symptoms (OR [95% CI] was 1.54 [1.05–2.47]). However, there was no significant combined effect of insomnia symptoms and sleep duration on the prevalence of MetS. Conclusions: The current investigation shows that short sleep duration and insomnia symptoms, specifically DIS and DMS, were significant correlates of MetS. These findings should be replicated in prospective studies using both sleep duration and sleep quality measures. Citation: Lin SC, Sun CA, You SL, Hwang LC, Liang CY, Yang T, Bai CH, Chen CH, Wei CY, Chou YC. The link of self-reported insomnia symptoms and sleep duration with metabolic syndrome: a Chinese population-based study. SLEEP 2016;39(6):1261–1266. PMID:27070137
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Sleep habits, mental health, and the metabolic syndrome in law enforcement officers.
Yoo, Hyelim; Franke, Warren D
2013-01-01
To assess the association of sleep characteristics and mental health with the metabolic syndrome (MetS) in law enforcement officers (LEOs). Sleep duration (≤6, >6-<8, ≥8 hours/night), sleep quality ("good," "poor"), mental health (stress, burnout, depression), and MetS components were compared in 106 LEOs. The prevalence of MetS was 33%. After covariate adjustment including the mental health measures, long sleep duration was associated with MetS (odds ratio = 4.89, 95% confidence interval = 1.32 to 18.13), whereas sleep quality was not. LEOs with short sleep duration or poor sleep quality reported more stress, burnout, and depression symptoms. In LEOs, sleep duration is more strongly associated with the occurrence of MetS than sleep quality, independent of mental health. Nevertheless, short sleep duration and poor sleep quality may affect mental health in LEOs.
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Deihim, Tina; Amiri, Parisa; Taherian, Reza; Tohidi, Maryam; Ghasemi, Asghar; Cheraghi, Leila; Azizi, Fereidoun
2015-12-09
The superiority of the diagnostic power of different definitions of metabolic syndrome (MetS) in detecting objective and subjective cardiovascular outcomes is under debate. We sought to compare diagnostic values of different insulin resistance (IR)-based definitions of MetS in detecting poor health-related quality of life (HRQoL) in a large sample of Tehranian adults. This cross-sectional study conducted within the framework of the Tehran Lipid and Glucose Study on a total sample of 742 individuals, aged ≥ 20 years. Metabolic syndrome was defined according to the World Health Organization (WHO), the European Group for the study of Insulin Resistance (EGIR), and the American Association of Clinical Endocrinology (AACE). Health-related quality of life was assessed using the Short Form Health Survey (SF-36). Logistic regression analysis and Receiver Operating Characteristic (ROC) curve were used to investigate the impact of the three IR-based definitions of MetS on HRQoL and compare their discriminative powers in predicting poor HRQoL. Compared with other definitions, the WHO definition identified more participants with MetS (41.8 %). Although the AACE definition had higher adjusted odds ratios for reporting poor physical HRQoL (OR: 1.95; CI: 0.84-4.53 and OR: 1.01; CI: 0.55-1.85 in men and women respectively) and mental HRQoL (OR: 0.97; CI: 0.41-2.28 and OR: 1.00; CI: 0.56-1.79 in men and women respectively), none of the three studied definitions were significantly associated with poor physical or mental HRQoL in either gender; nor did ROC curves show any significant difference in the discriminative powers of IR-based definitions in detecting poor HRQoL in either gender. None of the three studied IR-based definitions of MetS could significantly detect poor HRQoL in the physical or mental domains, indicating no significant superior diagnostic value for any of these definitions.
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Chiang, Michael F.; Melia, Michele; Buffenn, Angela N.; Lambert, Scott R.; Recchia, Franco M.; Simpson, Jennifer L.; Yang, Michael B.
2013-01-01
Objective To evaluate the accuracy of detecting clinically significant retinopathy of prematurity (ROP) using wide-angle digital retinal photography. Methods Literature searches of PubMed and the Cochrane Library databases were conducted last on December 7, 2010, and yielded 414 unique citations. The authors assessed these 414 citations and marked 82 that potentially met the inclusion criteria. These 82 studies were reviewed in full text; 28 studies met inclusion criteria. The authors extracted from these studies information about study design, interventions, outcomes, and study quality. After data abstraction, 18 were excluded for study deficiencies or because they were superseded by a more recent publication. The methodologist reviewed the remaining 10 studies and assigned ratings of evidence quality; 7 studies were rated level I evidence and 3 studies were rated level III evidence. Results There is level I evidence from ≥5 studies demonstrating that digital retinal photography has high accuracy for detection of clinically significant ROP. Level III studies have reported high accuracy, without any detectable complications, from real-world operational programs intended to detect clinically significant ROP through remote site interpretation of wide-angle retinal photographs. Conclusions Wide-angle digital retinal photography has the potential to complement standard ROP care. It may provide advantages through objective documentation of clinical examination findings, improved recognition of disease progression by comparing previous photographs, and the creation of image libraries for education and research. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references. PMID:22541632
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Drouin-Chartier, Jean-Philippe; Brassard, Didier; Tessier-Grenier, Maude; Côté, Julie Anne; Labonté, Marie-Ève; Desroches, Sophie; Couture, Patrick; Lamarche, Benoît
2016-01-01
The objective of this systematic review was to determine if dairy product consumption is detrimental, neutral, or beneficial to cardiovascular health and if the recommendation to consume reduced-fat as opposed to regular-fat dairy is evidence-based. A systematic review of meta-analyses of prospective population studies associating dairy consumption with cardiovascular disease (CVD), coronary artery disease (CAD), stroke, hypertension, metabolic syndrome (MetS), and type 2 diabetes (T2D) was conducted on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Quality of evidence was rated by using the Grading of Recommendations Assessment, Development, and Evaluation scale. High-quality evidence supports favorable associations between total dairy intake and hypertension risk and between low-fat dairy and yogurt intake and the risk of T2D. Moderate-quality evidence suggests favorable associations between intakes of total dairy, low-fat dairy, cheese, and fermented dairy and the risk of stroke; intakes of low-fat dairy and milk and the risk of hypertension; total dairy and milk consumption and the risk of MetS; and total dairy and cheese and the risk of T2D. High- to moderate-quality evidence supports neutral associations between the consumption of total dairy, cheese, and yogurt and CVD risk; the consumption of any form of dairy, except for fermented, and CAD risk; the consumption of regular- and high-fat dairy, milk, and yogurt and stroke risk; the consumption of regular- and high-fat dairy, cheese, yogurt, and fermented dairy and hypertension risk; and the consumption of regular- and high-fat dairy, milk, and fermented dairy and T2D risk. Data from this systematic review indicate that the consumption of various forms of dairy products shows either favorable or neutral associations with cardiovascular-related clinical outcomes. The review also emphasizes that further research is urgently needed to compare the impact of low-fat with regular- and high-fat dairy on cardiovascular-related clinical outcomes in light of current recommendations to consume low-fat dairy. PMID:28140321
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Drouin-Chartier, Jean-Philippe; Brassard, Didier; Tessier-Grenier, Maude; Côté, Julie Anne; Labonté, Marie-Ève; Desroches, Sophie; Couture, Patrick; Lamarche, Benoît
2016-11-01
The objective of this systematic review was to determine if dairy product consumption is detrimental, neutral, or beneficial to cardiovascular health and if the recommendation to consume reduced-fat as opposed to regular-fat dairy is evidence-based. A systematic review of meta-analyses of prospective population studies associating dairy consumption with cardiovascular disease (CVD), coronary artery disease (CAD), stroke, hypertension, metabolic syndrome (MetS), and type 2 diabetes (T2D) was conducted on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Quality of evidence was rated by using the Grading of Recommendations Assessment, Development, and Evaluation scale. High-quality evidence supports favorable associations between total dairy intake and hypertension risk and between low-fat dairy and yogurt intake and the risk of T2D. Moderate-quality evidence suggests favorable associations between intakes of total dairy, low-fat dairy, cheese, and fermented dairy and the risk of stroke; intakes of low-fat dairy and milk and the risk of hypertension; total dairy and milk consumption and the risk of MetS; and total dairy and cheese and the risk of T2D. High- to moderate-quality evidence supports neutral associations between the consumption of total dairy, cheese, and yogurt and CVD risk; the consumption of any form of dairy, except for fermented, and CAD risk; the consumption of regular- and high-fat dairy, milk, and yogurt and stroke risk; the consumption of regular- and high-fat dairy, cheese, yogurt, and fermented dairy and hypertension risk; and the consumption of regular- and high-fat dairy, milk, and fermented dairy and T2D risk. Data from this systematic review indicate that the consumption of various forms of dairy products shows either favorable or neutral associations with cardiovascular-related clinical outcomes. The review also emphasizes that further research is urgently needed to compare the impact of low-fat with regular- and high-fat dairy on cardiovascular-related clinical outcomes in light of current recommendations to consume low-fat dairy. © 2016 American Society for Nutrition.
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Kline, Christopher E; Hall, Martica H; Buysse, Daniel J; Earnest, Conrad P; Church, Timothy S
2018-05-01
Poor sleep quality has previously been shown to be related to insulin resistance in apparently healthy adults. However, it is unclear whether an association between sleep quality and insulin resistance exists among adults with metabolic syndrome (MetS). Participants included 347 overweight/obese postmenopausal women without type 2 diabetes (age: 57.5 ± 6.5 years; body mass index [BMI]: 31.7 ± 3.7 kg/m 2 ; 54% with MetS). Sleep quality was assessed with the six-item Medical Outcomes Study Sleep Scale; values were categorized into quartiles. Insulin resistance was calculated from fasting glucose and insulin with the homeostasis model assessment of insulin resistance (HOMA2-IR) method. Analysis of covariance models were used to examine the association between sleep quality and HOMA2-IR after accounting for MetS and covariates (e.g., BMI, cardiorespiratory fitness, and energy intake). Women with the worst sleep quality had significantly higher HOMA2-IR values than women in all other quartiles (P ≤ 0.05 for each), and women with MetS had significantly higher HOMA2-IR values than women without MetS (P < 0.0001), but the relationship between sleep quality and HOMA2-IR did not differ between those with or without MetS (P = 0.26). Women with MetS in the worst quartile of sleep quality had higher HOMA2-IR values than all other women (P < 0.02). Taking >30 min to fall asleep, frequent restless sleep, and frequent daytime drowsiness were each related to higher HOMA2-IR values (each P < 0.04). Sleep quality is an important correlate of insulin resistance in postmenopausal women with and without MetS. Intervention studies are needed to determine whether improving sleep improves insulin resistance in populations at elevated cardiometabolic risk.
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Blanco Mejia, Sonia; Kendall, Cyril W C; Viguiliouk, Effie; Augustin, Livia S; Ha, Vanessa; Cozma, Adrian I; Mirrahimi, Arash; Maroleanu, Adriana; Chiavaroli, Laura; Leiter, Lawrence A; de Souza, Russell J; Jenkins, David J A; Sievenpiper, John L
2014-07-29
To provide a broader evidence summary to inform dietary guidelines of the effect of tree nuts on criteria of the metabolic syndrome (MetS). We conducted a systematic review and meta-analysis of the effect of tree nuts on criteria of the MetS. We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library (through 4 April 2014). We included relevant randomised controlled trials (RCTs) of ≥3 weeks reporting at least one criterion of the MetS. Two or more independent reviewers extracted all relevant data. Data were pooled using the generic inverse variance method using random effects models and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed by the Cochran Q statistic and quantified by the I(2) statistic. Study quality and risk of bias were assessed. Eligibility criteria were met by 49 RCTs including 2226 participants who were otherwise healthy or had dyslipidaemia, MetS or type 2 diabetes mellitus. Tree nut interventions lowered triglycerides (MD=-0.06 mmol/L (95% CI -0.09 to -0.03 mmol/L)) and fasting blood glucose (MD=-0.08 mmol/L (95% CI -0.16 to -0.01 mmol/L)) compared with control diet interventions. There was no effect on waist circumference, high-density lipoprotein cholesterol or blood pressure with the direction of effect favouring tree nuts for waist circumference. There was evidence of significant unexplained heterogeneity in all analyses (p<0.05). Pooled analyses show a MetS benefit of tree nuts through modest decreases in triglycerides and fasting blood glucose with no adverse effects on other criteria across nut types. As our conclusions are limited by the short duration and poor quality of the majority of trials, as well as significant unexplained between-study heterogeneity, there remains a need for larger, longer, high-quality trials. NCT01630980. 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.
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Carmichael, Katie; Nolan, Sarah J; Weston, Jennifer; Tudur Smith, Catrin; Marson, Anthony G
2015-08-01
Treatment decisions should be informed by high quality evidence of both the potential benefit and harms of treatment alternatives. Randomised controlled trials (RCTs) provide the best evidence regarding benefits; however information relating to serious, rare and long-term harms is usually available only from non-randomised studies (NRSs). The aim of this study was to use a checklist based on the CONSORT (Consolidating Standards for Reporting Trials) extension for harms recommendations to assess the quality of reporting of harms data in both NRSs and RCTs of antiepileptic drugs, using studies of topiramate as an example. Seventy-eight studies were included from an online search of seven databases. Harms data was extracted from each study using a 25-point checklist. The mean number of items met was 11.5 (SD 2.96) per study. Commercially funded studies met on average 12.7 items and non-commercially funded studies met 10.08 (p value < 0.001). RCTs met on average 13.0 items and NRSs met 10.8 (p = 0.001). Multi-centre studies and commercially funded studies met significantly more items than single centre and non-commercially funded studies respectively. There was no significant difference in the mean number of items met by studies that had included adult vs. child participants, or studies published pre- vs. post-CONSORT extension for harms in 2004. Reporting of harms is significantly better in RCTs than in NRSs of TPM, but is suboptimal overall and has not improved since the publication of CONSORT extension for harms in 2004. There is a need to improve the reporting of harms in order to better inform treatment decisions. Copyright © 2015 Elsevier B.V. All rights reserved.
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Kemple, Angela M; Hartwick, Noelle; Sitaker, Marilyn H; Harmon, Jeanne J; Clark, Kathleen; Norman, Jan
2008-10-01
To provide direction and to support improvements in diabetes care, states must be able to measure the effectiveness of interventions and gain feedback on progress. We wanted to know if data from multiple health clinics that are implementing quality improvement strategies could be combined to provide useful measurements of diabetes care processes and control of intermediate outcomes. We combined and analyzed electronic patient health data from clinic sites across Washington State that used the Chronic Disease Electronic Management System (CDEMS) registry. The data were used to determine whether national and state objectives for diabetes care were met. We calculated the percentage of patients that met standards of care in 2004. The pooled dataset included 17,349 adult patients with diabetes from 90 clinics. More than half of patients were above recommended target levels for hemoglobin A1c testing, foot examination, hemoglobin A1c control, and low-density lipoprotein cholesterol control. Fewer patients met recommendations for nephropathy assessment, eye examinations, and blood pressure control. In terms of meeting these standards, rates of diabetes care varied across clinics. CDEMS rates of care were compared with those reported by other data sources, but no consistent pattern of similarities or differences emerged. With committed staff time, provider support, and resources, data from clinical information systems like CDEMS can be combined to address a deficiency in state-level diabetes surveillance and evaluation systems--specifically, the inability to capture clinical biometric values to measure intermediate health outcomes. These data can complement other surveillance and evaluation data sources to help provide a better picture of diabetes care in a state.
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NASA Astrophysics Data System (ADS)
Liu, Xia; Peyton, Liam; Kuziemsky, Craig
Health care is increasingly provided to citizens by a network of collaboration that includes multiple providers and locations. Typically, that collaboration is on an ad-hoc basis via phone calls, faxes, and paper based documentation. Internet and wireless technologies provide an opportunity to improve this situation via electronic data sharing. These new technologies make possible new ways of working and collaboration but it can be difficult for health care organizations to understand how to use the new technologies while still ensuring that their policies and objectives are being met. It is also important to have a systematic approach to validate that e-health processes deliver the performance improvements that are expected. Using a case study of a palliative care patient receiving home care from a team of collaborating health organizations, we introduce a framework based on requirements engineering. Key concerns and objectives are identified and modeled (privacy, security, quality of care, and timeliness of service). And, then, proposed business processes which use new technologies are modeled in terms of these concerns and objectives to assess their impact and ensure that electronic data sharing is well regulated.
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Soil Moisture Active Passive (SMAP) Calibration and validation plan and current activities
USDA-ARS?s Scientific Manuscript database
The primary objective of the SMAP calibration and validation (Cal/Val) program is demonstrating that the science requirements (product accuracy and bias) have been met over the mission life. This begins during pre-launch with activities that contribute to high quality products and establishing post-...
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Tressou, Jessica; Moulin, Philippe; Vergès, Bruno; Le Guillou, Céline; Simon, Noémie; Pasteau, Stéphane
2016-12-01
Quantity and quality of fatty acids (FA) in diet influence CVD risk. Consequently, health authorities promote recommended dietary intakes for FA, looking for optimal intakes in a primary prevention of CVD perspective. In parallel, a few data are available detailing intakes in national populations. The objective of the present study was to perform a large analysis combining the data of the French National Survey INCA 2 on food consumption performed in 2006 and 2007, and the nutritional content of food consumed in France updated in 2013 by the French Information Centre on Food Quality, to explore in details the FA intakes in French adults using the most recent available data. To compare the discrepancies in the observed intake levels with the French recommended levels, a weighted fat adherence score was built combining intakes of the different FA. Individual scores were computed in relation to official recommendations, and potential explanatory factors were identified. These data show that SFA intakes are persistently higher than national recommendations, combined with low intakes of MUFA and PUFA, particularly long-chain n-3 FA. Only 14·6 % of the French population met DHA intake recommendation, 7·8 % for EPA and 21·6 % for SFA. This situation remains unfavourable in terms of primary prevention of CVD. Consuming fish and other sources of n-3 FA, living in the south of France, being female, having a higher education level, and low alcohol consumption were associated with a healthier fat adherence score.
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Hughes, Abbey J; Parmenter, Brett A; Haselkorn, Jodie K; Lovera, Jesus F; Bourdette, Dennis; Boudreau, Eilis; Cameron, Michelle H; Turner, Aaron P
2017-08-01
Problems with sleep and cognitive impairment are common among people with multiple sclerosis (MS). The present study examined the relationship between self-reported sleep and both objective and perceived cognitive impairment in MS. Data were obtained from the baseline assessment of a multi-centre intervention trial (NCT00841321). Participants were 121 individuals with MS. Nearly half (49%) of participants met the criteria for objective cognitive impairment; however, cognitively impaired and unimpaired participants did not differ on any self-reported sleep measures. Nearly two-thirds (65%) of participants met the criteria for 'poor' sleep, and poorer sleep was significantly associated with greater levels of perceived cognitive impairment. Moreover, the relationships between self-reported sleep and perceived cognitive impairment were significant beyond the influence of clinical and demographic factors known to influence sleep and cognitive functioning (e.g. age, sex, education level, disability severity, type of MS, disease duration, depression and fatigue). However, self-reported sleep was not associated with any measures of objective cognitive impairment. Among different types of perceived cognitive impairment, poor self-reported sleep was most commonly related to worse perceived executive function (e.g. planning/organization) and prospective memory. Results from the present study emphasize that self-reported sleep is significantly and independently related to perceived cognitive impairment in MS. In terms of clinical implications, interventions focused on improving sleep may help improve perceived cognitive function and quality of life in this population; however, the impact of improved sleep on objective cognitive function requires further investigation. © 2017 European Sleep Research Society.
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Macaya Pascual, A; Ferreres Riera, J R; Campoy Sánchez, A
2016-05-01
Countless sex education programs have been implemented worldwide in recent decades, but epidemiological data show no improvement in rates of sexually transmitted infections or unintended pregnancies. To summarize the evidence from higher-quality systematic reviews on the efficacy of behavioral interventions for the prevention of sexually transmitted infections and unintended pregnancies. We conducted an overview of reviews by selecting systematic reviews that met minimum quality criteria in terms of the design of the studies reviewed. We compared the results obtained when the effects of interventions were assessed on the basis of objective criteria (biological data) to those obtained when outcomes were assessed on the basis of subjective criteria (self-reports). The results of Cochrane and non-Cochrane reviews were also compared. We identified 55 systematic reviews. No overall effect on the sexual behavior of program participants was observed in 72.5% of the reviews that used objective criteria and in 48.1% of the reviews based on subjective criteria. In the Cochrane reviews, no evidence of an overall effect was observed in 86% of reviews based on objective variables and in 70.5% of those based on subjective variables. There is no evidence that behavioral interventions modify rates of sexually transmitted infections (including human immunodeficiency virus infections) or unintended pregnancies, particularly when effects are assessed using objective, biological data. Primary prevention strategies for sexually transmitted infections and unintended pregnancies need to be re-evaluated. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.
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A comparison of standard definitions and sagittal abdominal ...
Introduction: Metabolic syndrome (MeTS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MeTS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MeTS for this age group. It is important to estimate MeTS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MeTS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MeTS when utilizing sagittal abdominal diameter (SAD) as a component of MeTS. Methods: Data from U.S. adolescents ages 12–19 years (N=970) in the NHANES (2011–2014) were analyzed. MeTS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MeTS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MeTS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MeTS components. For both sexes, estimated prevalence of componen
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Qualification test of the Ross Double Planetary Mixer
NASA Technical Reports Server (NTRS)
Lueders, Kurt F.
1993-01-01
This test report describes the qualification test of the Ross Double Planetary Mixer used to mix room temperature vulcanized (RTV) silicone (Dow Corning 90-006-2) for the redesigned solid rocket motor (RSRM) nozzle joints. Testing was completed 18 June 1993 in the M-113A Nozzle Fabrication Facility at Thiokol Corporation, Space Operations, Brigham City, Utah. The Ross mixer provides better mixing and better control on temperature and humidity, resulting in better quality RTV and a longer usable pot life. The test began on 3 May 1993 and was stopped due to operator error during the tensile strength and elongation testing. Specimens were ruined without gathering any useful data. A 'no test' was declared, the problem was remedied, and the test was re-run with MSFC approval. The test was run and all pass/fail criteria were met, most with a considerable margin. The Ross Double Planetary Mixer met all certification objectives and is recommended for immediate use for mixing RTV silicone for RSRM nozzle joints.
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Report: Procedural Review of EPA’s Greenhouse Gases Endangerment Finding Data Quality Processes
Report #11-P-0702, September 26, 2011. EPA met statutory requirements for rulemaking and generally followed requirements and guidance related to ensuring the quality of the supporting technical information.
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Kammerer, P.A.
1998-01-01
A cooperative project between the U.S. Geological Survey (USGS) and the Wisconsin Department of Natural Resources (DNR) was begun with the objectives of describing water quality and its relation to the hydrology of Wisconsin's principal aquifers and summarizing instances of ground-water contamination and quality problems from information available in DNR files. The first objective was met by a hydrologic investigation done by the USGS, and the second, by preparation of a report by the DNR, for their internal use, that describes the State's water resources and known ground-water quality and contamination problems and makes policy recommendations for ground-water management.The USGS investigation was divided into two phases. The first phase consisted of compiling available water-quality and hydrogeologic data and collecting new data to describe general regional water-quality and hydrogeologic relations within and between Wisconsin aquifers. The second phase began concurrently with the later part of the first phase and consisted of an areal description of water quality and flow in the State's shallow aquifer system (Kammerer, 1995). The overall purpose of this investigation was to provide a regional framework that could serve as a basis for intensive local and site specific ground-water investigations by State and local government agencies.This report presents the results of the first phase of the USGS investigation. Regional hydrogeologic and water-quality relations within and between aquifers are shown along 15 hydrogeologic sections that traverse the State. Maps are used to show surficial geology of bedrock and unconsolidated deposits and horizontal direction of ground-water flow. Interpretations on the maps and hydrogeologic sections are based on data from a variety of sources and provide the basis for the areal appraisal of water quality in the State's shallow aquifer system in the second phase of the investigation.
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Integration of remote sensing based surface information into a three-dimensional microclimate model
NASA Astrophysics Data System (ADS)
Heldens, Wieke; Heiden, Uta; Esch, Thomas; Mueller, Andreas; Dech, Stefan
2017-03-01
Climate change urges cities to consider the urban climate as part of sustainable planning. Urban microclimate models can provide knowledge on the climate at building block level. However, very detailed information on the area of interest is required. Most microclimate studies therefore make use of assumptions and generalizations to describe the model area. Remote sensing data with area wide coverage provides a means to derive many parameters at the detailed spatial and thematic scale required by urban climate models. This study shows how microclimate simulations for a series of real world urban areas can be supported by using remote sensing data. In an automated process, surface materials, albedo, LAI/LAD and object height have been derived and integrated into the urban microclimate model ENVI-met. Multiple microclimate simulations have been carried out both with the dynamic remote sensing based input data as well as with manual and static input data to analyze the impact of the RS-based surface information and the suitability of the applied data and techniques. A valuable support of the integration of the remote sensing based input data for ENVI-met is the use of an automated processing chain. This saves tedious manual editing and allows for fast and area wide generation of simulation areas. The analysis of the different modes shows the importance of high quality height data, detailed surface material information and albedo.
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Lee, Jeong-Won; Kang, Ji-Hyoun; Lee, Kyung-Eun; Park, Dong-Jin; Kang, Seong Wook; Kwok, Seung-Ki; Kim, Seong-Kyu; Choe, Jung-Yoon; Kim, Hyoun-Ah; Sung, Yoon-Kyoung; Shin, Kichul; Lee, Sang-Il; Lee, Chang Hoon; Choi, Sung Jae; Lee, Shin-Seok
2018-01-01
This study assessed the relationships among the risk factors for and components of metabolic syndrome (MetS) and health-related quality of life (HRQOL) in a hypothesized causal model using structural equation modeling (SEM) in patients with systemic lupus erythematosus (SLE). Of the 505 SLE patients enrolled in the Korean Lupus Network (KORNET registry), 244 had sufficient data to assess the components of MetS at enrollment. Education level, monthly income, corticosteroid dose, Systemic Lupus Erythematosus Disease Activity Index, Physicians' Global Assessment, Beck Depression Inventory, MetS components, and the Short Form-36 at the time of cohort entry were determined. SEM was used to test the causal relationship based on the Analysis of Moment Structure. The average age of the 244 patients was 40.7 ± 11.8 years. The SEM results supported the good fit of the model (χ 2 = 71.629, p = 0.078, RMSEA 0.034, CFI 0.972). The final model showed a direct negative effect of higher socioeconomic status and a positive indirect effect of higher disease activity on MetS, the latter through corticosteroid dose. MetS did not directly impact HRQOL but had an indirect negative impact on it, through depression. In our causal model, MetS risk factors were related to MetS components. The latter had a negative indirect impact on HRQOL, through depression. Clinicians should consider socioeconomic status and medication and seek to modify disease activity, MetS, and depression to improve the HRQOL of SLE patients.
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Childress, Carolyn J. Oblinger; Chaney, Thomas H.; Myers, Donna; Norris, J. Michael; Hren, Janet
1987-01-01
Serious questions have been raised by Congress about the usefulness of water-quality data for addressing issues of regional and national scope and, especially, for characterizing the current quality of the Nation's streams and ground water. In response, the U.S. Geological Survey has undertaken a pilot study in Colorado and Ohio to (1) determine the characteristics of current (1984) water-quality data-collection activities of Federal, regional, State, and local agencies, and academic institutions; and (2) determine how well the data from these activities, collected for various purposes and using different procedures, can be used to improve our ability to answer major broad-scope questions, such as:A. What are (or were) natural or near-natural water-quality conditions?B. What are existing water-quality conditions?C. How has water quality changed, and how do the changes relate to human activities?Colorado and Ohio were chosen for the pilot study largely because they represent regions with different types of waterquality concerns and programs. The study has been divided into three phases, the objectives of which are: Phase I--Inventory water-quality data-collection programs, including costs, and identify those programs that met a set of broad criteria for producing data that are potentially appropriate for water-quality assessments of regional and national scope. Phase II--Evaluate the quality assurance of field and laboratory procedures used in producing the data from programs that met the broad criteria of Phase I. Phase III--Compile the qualifying data and evaluate the adequacy of this data base for addressing selected water-quality questions of regional and national scope.Water-quality data are collected by a large number of organizations for diverse purposes ranging from meeting statutory requirements to research on water chemistry. Combining these individual data bases is an appealing and potentially cost-effective way to attempt to develop a data base adequate for regional or national water-quality assessments. However, to combine data from diverse sources, field and laboratory procedures used to produce the data need to be equivalent and need to meet specific qualityassurance standards. It is these factors that are the focus of Phase II, which is described in this report. In the first phase of this study, an inventory was made of all public organizations and academic institutions that undertook water-quality data-collection activities in Colorado and Ohio in 1984. Water-quality programs identified in Phase I were tested against a set of broad screening criteria. A total of 44 waterquality programs in Colorado and 29 programs in Ohio passed the Phase-I screen and were examined in Phase II. These programs accounted for an estimated 165,000 analyses in Colorado and 76,300 analyses in Ohio for 20 selected constituents and properties. Although qualifying programs included both surface- and ground-water sampling, they emphasized surface waters and produced few groundwater analyses (3,660 for Colorado and 470 for Ohio). For Phase II, information about field and laboratory qualityassurance practices was provided by each organization and its supporting laboratories through questionnaires. This information was evaluated against a set of specific criteria for field and laboratory practices. The criteria were developed from guidelines published by public agencies and professional organizations such as the American Public Health Association, the U.Sc, Environmental Protection Agency, and the U.S. Geological Survey. Each of the eight criteria that comprise the Phase-II screen fall into one of two major categories--field practices or laboratory practices.
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NASA Technical Reports Server (NTRS)
Raiman, Laura B.
1992-01-01
Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .
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NASA Astrophysics Data System (ADS)
Raiman, Laura B.
1992-12-01
Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .
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NARSTO PAC2001 LANGLEY GAS PM MET DATA
Atmospheric Science Data Center
2018-04-09
... Parameters: Atmospheric Pressure Measurements Air Temperature Humidity Surface Winds Ozone Aerosol Particle ... Data: Spatial Coverage: Canada Pacific 2001 Air Quality Study SCAR-B Block: SCAR-B ...
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Cultural and contextual analysis of quality of life among older Nepali women.
Shrestha, Srijana; Zarit, Steven H
2012-06-01
The quality-of-life construct can be used to assess how well an individual's needs are met or being met by the society. However, in the dominant narratives of quality of life in old age, exploration of the impact of cultural differences on how older adults define and assess their quality of life has been limited. Moreover, the examination of heterogeneity within one culture and its influence on quality of life has been largely ignored. The present study compares the quality of life as defined by two samples of Nepali elderly women, those who live with their families and those who live in an old-age home, and presents data on factors associated with quality of life in the two samples. The results show that social and cultural norms, informed by religious principles that prescribe familial elder care, impact how quality of life is described by both groups of women.
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NASA Astrophysics Data System (ADS)
Lin, Hualiang; Liu, Tao; Xiao, Jianpeng; Zeng, Weilin; Li, Xing; Guo, Lingchuan; Xu, Yanjun; Zhang, Yonghui; Vaughn, Michael G.; Nelson, Erik J.; Qian, Zhengmin (Min); Ma, Wenjun
2016-07-01
In 2012, Chinese Environmental Bureau modified its National Ambient Air Quality Standards to include fine particulate matter (PM2.5). Recent air pollution monitoring data shows that numerous locations have exceeded this standard, which may have resulted in avoidable adverse health effects. For example, among the 74 Chinese cities with PM2.5 monitoring data in 2013, only three cities attained the annual air quality standard (35 μg/m3). This study aimed to quantify the potential short- and long-term health benefits from achieving the Chinese ambient air quality standard and WHO's air quality objectives. A generalized additive model was used to estimate the short-term association of mortality with changes in daily PM2.5 concentrations, based on which we estimated the potential premature mortality reduction that would have been achieved during the period of 2012-2015 if the daily air quality standard had been met in Guangzhou, China; we also estimated the avoidable deaths if attaining the annual air quality standard using the relative risk obtained from a previous cohort study. During the study period, there were 160 days exceeding the national daily PM2.5 standard (75 μg/m3) in Guangzhou, and the annual average concentration (47.7 μg/m3) was higher than the air quality standard of 35 μg/m3. Significant associations between PM2.5 and mortality were observed. An increase of 10 μg/m3 in PM2.5 was associated with increases in daily death counts of 0.95% (95% CI: 0.56%, 1.34%) in natural mortality, 1.31% (95% CI: 0.75%, 1.87%) in cardiovascular mortality, and 1.06% (95% CI: 0.19%, 1.94%) in respiratory mortality. The health benefits of attaining the national daily air quality standard of PM2.5 (75 μg/m3) would have prevented 143 [95% confidence interval (CI): 84, 203] fewer natural deaths, including 84 (95% CI: 48, 121) fewer cardiovascular deaths and 27 (95% CI: 5, 49) fewer respiratory deaths. Had the annual PM2.5 levels been reduced to 35 μg/m3, an estimated 3875 (95% CI: 1852, 6074) natural deaths, 2378 (95% CI: 800, 4230) cardiovascular deaths, and 227 (95% CI: -437, 1033) respiratory deaths could have been prevented. Even greater substantial mortality reductions could be achieved if the WHO's air quality objectives were met. Our study suggests that air pollution is significantly associated with mortality in Guangzhou, and more stringent air quality standards would significantly reduce air pollution-related premature mortality.
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Health Promotion in Small Business
McCoy, Kira; Stinson, Kaylan; Scott, Kenneth; Tenney, Liliana; Newman, Lee S.
2015-01-01
Objective To assess the evidence regarding the adoption and efficacy of worksite health promotion programs (WHPPs) in small businesses. Methods Peer-reviewed research articles were identified from a database search. Included articles were published before July 2013, described a study that used an experimental or quasiexperimental design and either assessed adoption of WHPPs or conducted interventions in businesses with fewer than 500 employees. A review team scored the study’s rigor using the WHO-adapted GRADEprofiler “quality of evidence” criteria. Results Of the 84 retrieved articles, 19 met study inclusion criteria. Of these, only two met criteria for high rigor. Conclusions Fewer small businesses adopt WHPPs compared with large businesses. Two high-rigor studies found that employees were healthier postintervention. Higher quality research is needed to better understand why small businesses rarely adopt wellness programs and to demonstrate the value of such programs. PMID:24905421
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NARSTO PAC2001 SLOCAN PARK GAS PM MET DATA
Atmospheric Science Data Center
2018-04-09
... Parameters: Atmospheric Pressure Measurements Air Temperature Humidity Surface Winds Ozone Aerosol Particle ... Data: Spatial Coverage: Canada Pacific 2001 Air Quality Study SCAR-B Block: SCAR-B ...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-06
... input options commensurate with the Regulatory Modeling Guidance. Perform current and post control.... Table 2--Post-Control Modeling Results \\4\\ Sanders lead facility Max 3-mth Background Total Year maximum...\\ (Facility MET data). The post-control analysis resulted in a predicted impact of 0.15 [mu]g/m\\3\\ (NWS MET...
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Survey of bovine colostrum quality and hygiene on northern Victorian dairy farms.
Phipps, A J; Beggs, D S; Murray, A J; Mansell, P D; Stevenson, M A; Pyman, M F
2016-11-01
One of the major challenges for dairy producers is to produce, harvest, and store high-quality colostrum and feed it to their replacement heifer calves. Limited published data are available in Australia regarding the relationship between colostrum management, hygiene, and quality. The objectives of this study were to investigate (1) the colostrum storage and handling practices carried out on farm; (2) the immunoglobulin concentration and bacterial composition of colostrum being fed to replacement dairy heifer calves; (3) the percentage of colostrum being fed to replacement dairy heifer calves that meet industry recommendations; and (4) risk factors for bacterial contamination of colostrum. The study was carried out on 24 dairy farms located near Rochester, Victoria, Australia. Two hundred forty colostrum samples were collected (10 samples per farm). Each farm harvested and stored first-milking colostrum under normal farm conditions. A 10-mL sample of the colostrum was collected in a sterile container immediately before feeding, and a Brix refractometer reading was taken. The samples were then frozen at -4°C and submitted for bacterial concentration analysis. Fifty-eight percent of colostrum samples met the recommended industry standard of a total plate count (TPC) of <100,000cfu/mL, and 94% of colostrum samples met the recommended industry standard of total coliform count (TCC) of 10,000cfu/mL. However, when all the current industry recommendations for TPC, TCC, and Brix refractometer percentage for colostrum quality were considered, only 23% of the samples met all standards. These findings demonstrate that a large number of calves were at risk of receiving colostrum of poor quality, with high bacterial loads that may have interfered with the acquisition of transfer of passive immunity and affected calf health. Further investigation is required to identify the farm-specific factors that may influence the level of bacterial contamination of colostrum. Recommendations as a result of this study include refrigeration of excess colostrum shortly (within 1h) after collection and thorough disinfection of the calf feeding apparatus before use. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
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Byrne, M D; Jordan, T R; Welle, T
2013-01-01
The objective of this study was to investigate and improve the use of automated data collection procedures for nursing research and quality assurance. A descriptive, correlational study analyzed 44 orthopedic surgical patients who were part of an evidence-based practice (EBP) project examining post-operative oxygen therapy at a Midwestern hospital. The automation work attempted to replicate a manually-collected data set from the EBP project. Automation was successful in replicating data collection for study data elements that were available in the clinical data repository. The automation procedures identified 32 "false negative" patients who met the inclusion criteria described in the EBP project but were not selected during the manual data collection. Automating data collection for certain data elements, such as oxygen saturation, proved challenging because of workflow and practice variations and the reliance on disparate sources for data abstraction. Automation also revealed instances of human error including computational and transcription errors as well as incomplete selection of eligible patients. Automated data collection for analysis of nursing-specific phenomenon is potentially superior to manual data collection methods. Creation of automated reports and analysis may require initial up-front investment with collaboration between clinicians, researchers and information technology specialists who can manage the ambiguities and challenges of research and quality assurance work in healthcare.
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Weykamp, Cas; John, Garry; Gillery, Philippe; English, Emma; Ji, Linong; Lenters-Westra, Erna; Little, Randie R.; Roglic, Gojka; Sacks, David B.; Takei, Izumi
2016-01-01
Background A major objective of the IFCC Task Force on implementation of HbA1c standardization is to develop a model to define quality targets for HbA1c. Methods Two generic models, the Biological Variation and Sigma-metrics model, are investigated. Variables in the models were selected for HbA1c and data of EQA/PT programs were used to evaluate the suitability of the models to set and evaluate quality targets within and between laboratories. Results In the biological variation model 48% of individual laboratories and none of the 26 instrument groups met the minimum performance criterion. In the Sigma-metrics model, with a total allowable error (TAE) set at 5 mmol/mol (0.46% NGSP) 77% of the individual laboratories and 12 of 26 instrument groups met the 2 sigma criterion. Conclusion The Biological Variation and Sigma-metrics model were demonstrated to be suitable for setting and evaluating quality targets within and between laboratories. The Sigma-metrics model is more flexible as both the TAE and the risk of failure can be adjusted to requirements related to e.g. use for diagnosis/monitoring or requirements of (inter)national authorities. With the aim of reaching international consensus on advice regarding quality targets for HbA1c, the Task Force suggests the Sigma-metrics model as the model of choice with default values of 5 mmol/mol (0.46%) for TAE, and risk levels of 2 and 4 sigma for routine laboratories and laboratories performing clinical trials, respectively. These goals should serve as a starting point for discussion with international stakeholders in the field of diabetes. PMID:25737535
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Karch, Debra L; Chen, Mi; Tang, Tian
2014-01-01
In 2009, the Centers for Disease Control and Prevention completed migration of all 59 surveillance project areas (PAs) from the case-based HIV/AIDS Reporting System to the document-based Enhanced HIV/AIDS Reporting System. We conducted a PA-level assessment of Enhanced HIV/AIDS Reporting System process and outcome standards for HIV infection cases. Process standards were reported by PAs and outcome standards were calculated using standardized Centers for Disease Control and Prevention SAS code. A total of 59 PAs including 50 US states, the District of Columbia, 6 separately funded cities (Chicago, Houston, Los Angeles County, New York City, Philadelphia, and San Francisco), and 2 territories (Puerto Rico and the Virgin Islands). Cases diagnosed or reported to the PA surveillance system between January 1, 2011, and December 31, 2011, using data collected through December 2012. Process standards for death ascertainment and intra- and interstate case de-duplication; outcome standards for completeness and timeliness of case reporting, data quality, intrastate duplication rate, risk factor ascertainment, and completeness of initial CD4 and viral load reporting. Fifty-five of 59 PAs (93%) reported linking cases to state vital records death certificates during 2012, 76% to the Social Security Death Master File, and 59% to the National Death Index. Seventy percent completed monthly intrastate, and 63% completed semiannual interstate de-duplication. Eighty-three percent met the 85% or more case ascertainment standard, and 92% met the 66% or more timeliness standard; 75% met the 97% or more data quality standard; all PAs met the 5% or less intrastate duplication rate; 41% met the 85% or more risk factor ascertainment standard; 90% met the 50% or more standard for initial CD4; and 93% met the same standard for viral load reporting. Overall, 7% of PAs met all 11 process and outcome standards. Findings support the need for continued improvement in HIV surveillance activities and monitoring of system outcomes.
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Cost-Effectiveness of Saxagliptin versus Acarbose as Second-Line Therapy in Type 2 Diabetes in China
Gu, Shuyan; Zeng, Yuhang; Yu, Demin; Hu, Xiaoqian; Dong, Hengjin
2016-01-01
Objective This study assessed the long-term cost-effectiveness of saxagliptin+metformin (SAXA+MET) versus acarbose+metformin (ACAR+MET) in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on MET alone. Methods Systematic literature reviews were performed to identify studies directly comparing SAXA+MET versus ACAR+MET, and to obtain diabetes-related events costs which were modified by hospital surveys. A Cardiff Diabetes Model was used to estimate the long-term economic and health treatment consequences in patients with T2DM. Costs (2014 Chinese yuan) were calculated from the payer’s perspective and estimated over a patient’s lifetime. Results SAXA+MET predicted lower incidences of most cardiovascular events, hypoglycemia events and fatal events, and decreased total costs compared with ACAR+MET. For an individual patient, the quality-adjusted life-years (QALYs) gained with SAXA+MET was 0.48 more than ACAR+MET at a cost saving of ¥18,736, which resulted in a cost saving of ¥38,640 per QALY gained for SAXA+MET versus ACAR+MET. Results were robust across various univariate and probabilistic sensitivity analyses. Conclusion SAXA+MET is a cost-effective treatment alternative compared with ACAR+MET for patients with T2DM in China, with a little QALYs gain and lower costs. SAXA is an effective, well-tolerated drug with a low incidence of adverse events and ease of administration; it is anticipated to be an effective second-line therapy for T2DM treatment. PMID:27875596
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Methodological and reporting quality of systematic reviews on tuberculosis.
Nicolau, I; Ling, D; Tian, L; Lienhardt, C; Pai, M
2013-09-01
Systematic reviews are used to inform tuberculosis (TB) guidelines. However, there are no data on whether TB systematic reviews are conducted well and reported transparently. We searched four databases for reviews published between 2005 and 2010. Methodological quality was evaluated using AMSTAR and quality of reporting was assessed using PRISMA. Of 152 articles, 137 (90%) met the inclusion criteria. Only 3 of 11 AMSTAR quality items were met in most reviews: appropriate methods to combine findings (67%), comprehensive literature search (72%) and presentation of characteristics of included studies (90%). The other eight items were met in 4-53% of the reviews. Only 4% of the reviews disclosed conflicts of interest. The majority of the PRISMA items were reported in more than 60-76% of the reviews. Only nine items were reported in less than 55% of the reviews, the lowest being the full-search strategy (30%), risk of bias across studies in the Methods (27%) and Results (21%) sections, and indication of a review protocol (15%). Systematic reviews in our survey were well reported but generally of moderate to low quality. Better training, use of reporting guidelines and registration of systematic reviews could improve the quality of TB reviews.
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Economic Benefits of Improved Water Quality: Public Perceptions of Option and Preservation Values
NASA Astrophysics Data System (ADS)
Bouwes, Nicolaas W., Sr.
The primary objective of this book is to report the authors‧ research approach to the estimation of benefits of water quality improvements in the South Platte River of northeastern Colorado. Benefits included a “consumer surplus” from enhanced enjoyment of water-based recreation, an “option value” of assured choice of future recreation use, and a “preservation value” of the ecosystem and its bequest to future generations. Concepts such as preservation and option value benefits have been often mentioned but seldom estimated in natural resources research. The authors have met their objective by providing the reader with a detailed description of their research without being tedious.
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Rethinking OPACS: The Design of Assertive Information Systems.
ERIC Educational Resources Information Center
Culkin, Patricia B.
1989-01-01
Discusses the need to reassess the objectives of online public access catalogs and how those objectives might be met before costly investments are made in electronic versions of "other data" for online catalogs. Several objectives are outlined and their feasibility in the modern telecommunications environment is examined. (two references) (CLB)
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Planned hospital birth versus planned home birth
Olsen, Ole; Clausen, Jette A
2014-01-01
Background Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998. Objectives To assess the effects of planned hospital birth compared with planned home birth in selected low-risk women, assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 March 2012) and contacted editors and authors involved with possible trials. Selection criteria Randomised controlled trials comparing planned hospital birth with planned home birth in low-risk women as described in the objectives. Data collection and analysis The two review authors as independently as possible assessed trial quality and extracted data. We contacted study authors for additional information. Main results Two trials met the inclusion criteria but only one trial involving 11 women provided some outcome data and was included. The evidence from this trial was of moderate quality and too small to allow conclusions to be drawn. Authors’ conclusions There is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. However, the trials show that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice. As the quality of evidence in favour of home birth from observational studies seems to be steadily increasing, it might be as important to prepare a regularly updated systematic review including observational studies as described in the Cochrane Handbook for Systematic Reviews of Interventions as to attempt to set up new randomised controlled trials. PMID:22972043
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Effect of Pharmacotherapy for Anxiety Disorders on Quality of Life: A Meta-Analysis
Hofmann, Stefan G.; Wu, Jade Q.; Boettcher, Hannah; Sturm, Jamie
2013-01-01
Purpose Pharmacotherapy is an effective treatment for anxiety disorders, but its effects on quality of life have not been examined systematically. Our objective was to conduct an effect size analysis of pharmacological interventions on quality of life outcomes in patients with DSM-IV anxiety disorders. Methods Manual and electronic searches using PubMed, PsycINFO, and the Cochrane Library were conducted for records from the first available date through May 1st, 2013 for trials of pharmacological interventions in patients with anxiety disorders, which had measures of quality of life before and after treatment. Of 1,865 entries, 93 studies were identified as potentially relevant and 32 met inclusion criteria, of which results were examined from 22 studies reporting 27 distinct pharmacological trials, representing data from 4,344 anxiety disorder patients. Data were extracted independently by multiple observers to estimate within-group and placebo-controlled random effects of the treatment changes on quality of life. We hypothesized that pharmacotherapy improves quality of life, which is associated with improvement in anxiety symptoms. Results Pharmacological interventions effectively improved quality of life from before to after treatment (Hedges' g = .59), although the controlled effect size is smaller among those trials with placebo interventions (Hedges' g = .32). These effect sizes were robust, increased with publication year, and increased with reductions in anxiety symptoms. Conclusions Pharmacological therapy is effective for improving quality of life in anxiety disorders, and larger symptom reductions are associated with greater improvement in quality of life. PMID:24241771
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Ingvertsen, Simon Toft; Jensen, Marina Bergen; Magid, Jakob
2011-01-01
Urban stormwater runoff is often of poor quality, impacting aquatic ecosystems and limiting the use of stormwater runoff for recreational purposes. Several stormwater treatment facilities (STFs) are in operation or at the pilot testing stage, but their efficiencies are neither well documented nor easily compared due to the complex contaminant profile of stormwater and the highly variable runoff hydrograph. On the basis of a review of available data sets on urban stormwater quality and environmental contaminant behavior, we suggest a few carefully selected contaminant parameters (the minimum data set) to be obligatory when assessing and comparing the efficiency of STFs. Consistent use of the minimum data set in all future monitoring schemes for STFs will ensure broad-spectrum testing at low costs and strengthen comparability among facilities. The proposed minimum data set includes: (i) fine fraction of suspended solids (<63 μm), (ii) total concentrations of zinc and copper, (iii) total concentrations of phenanthrene, fluoranthene, and benzo(b,k)fluoranthene, and (iv) total concentrations of phosphorus and nitrogen. Indicator pathogens and other specific contaminants (i.e., chromium, pesticides, phenols) may be added if recreational or certain catchment-scale objectives are to be met. Issues that need further investigation have been identified during the iterative process of developing the minimum data set. by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
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Code of Federal Regulations, 2011 CFR
2011-07-01
... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...
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Code of Federal Regulations, 2013 CFR
2013-07-01
... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...
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Tibana, Ramires Alsamir; Nascimento, Dahan da Cunha; de Sousa, Nuno Manuel Frade; de Souza, Vinicius Carolino; Durigan, João; Vieira, Amilton; Bottaro, Martim; Nóbrega, Otávio de Toledo; de Almeida, Jeeser Alves; Navalta, James Wilfred; Franco, Octavio Luiz; Prestes, Jonato
2014-01-01
These data describe the effects of combined aerobic plus resistance training (CT) with regards to risk factors of metabolic syndrome (MetS), quality of life, functional capacity, and pro- and anti-inflammatory cytokines in women with MetS. In this context, thirteen women (35.4 ± 6.2 yr) completed 10 weeks of CT consisting of three weekly sessions of ~60 min aerobic training (treadmill at 65-70% of reserve heart rate, 30 min) and resistance training (3 sets of 8-12 repetitions maximum for main muscle groups). Dependent variables were maximum chest press strength; isometric hand-grip strength; 30 s chair stand test; six minute walk test; body mass; body mass index; body adiposity index; waist circumference; systolic (SBP), diastolic and mean blood pressure (MBP); blood glucose; HDL-C; triglycerides; interleukins (IL) 6, 10 and 12, osteoprotegerin (OPG) and serum nitric oxide metabolite (NOx); quality of life (SF-36) and Z-Score of MetS. There was an improvement in muscle strength on chest press (p = 0.009), isometric hand-grip strength (p = 0.03) and 30 s chair stand (p = 0.007). There was a decrease in SBP (p = 0.049), MBP (p = 0.041), Z-Score of MetS (p = 0.046), OPG (0.42 ± 0.26 to 0.38 ± 0.19 ng/mL, p<0.05) and NOx (13.3 ± 2.3 µmol/L to 9.1 ± 2.3 µmol/L; p<0.0005). IL-10 displayed an increase (13.6 ± 7.5 to 17.2 ± 12.3 pg/mL, p < 0.05) after 10 weeks of training. Combined training also increased the perception of physical capacity (p = 0.011). This study endorses CT as an efficient tool to improve blood pressure, functional capacity, quality of life and reduce blood markers of inflammation, which has a clinical relevance in the prevention and treatment of MetS.
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Martin, Erika G; Law, Jennie; Ran, Weijia; Helbig, Natalie; Birkhead, Guthrie S
Government datasets are newly available on open data platforms that are publicly accessible, available in nonproprietary formats, free of charge, and with unlimited use and distribution rights. They provide opportunities for health research, but their quality and usability are unknown. To describe available open health data, identify whether data are presented in a way that is aligned with best practices and usable for researchers, and examine differences across platforms. Two reviewers systematically reviewed a random sample of data offerings on NYC OpenData (New York City, all offerings, n = 37), Health Data NY (New York State, 25% sample, n = 71), and HealthData.gov (US Department of Health and Human Services, 5% sample, n = 75), using a standard coding guide. Three open health data platforms at the federal, New York State, and New York City levels. Data characteristics from the coding guide were aggregated into summary indices for intrinsic data quality, contextual data quality, adherence to the Dublin Core metadata standards, and the 5-star open data deployment scheme. One quarter of the offerings were structured datasets; other presentation styles included charts (14.7%), documents describing data (12.0%), maps (10.9%), and query tools (7.7%). Health Data NY had higher intrinsic data quality (P < .001), contextual data quality (P < .001), and Dublin Core metadata standards adherence (P < .001). All met basic "web availability" open data standards; fewer met higher standards of "hyperlinked to other data." Although all platforms need improvement, they already provide readily available data for health research. Sustained effort on improving open data websites and metadata is necessary for ensuring researchers use these data, thereby increasing their research value.
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Schäfer, Annika Theresia; Damen, Thomas; Uittenboogaard, Aniek; Krolinski, Pauline; Nwosu, Chinyere Vicky; Pinckaers, Florentina Maria Egidius; Rotee, Iris Leah Marije; Ermiş, Ayşegül; Kennedy, James L.; Nieman, Dorien H.; Tiwari, Arun; van Os, Jim
2018-01-01
Background Neither environmental nor genetic factors are sufficient to predict the transdiagnostic expression of psychosis. Therefore, analysis of gene-environment interactions may be productive. Objective A meta-analysis was performed using papers investigating the interaction between cannabis use and catechol-O-methyl transferase (COMT) polymorphism Val158Met (COMTVal158Met). Data sources PubMed, Embase, PsychInfo. Study eligibility criteria All observational studies assessing the interaction between COMTVal158Met and cannabis with any psychosis or psychotic symptoms measure as an outcome. Study appraisal and synthesis methods A meta-analysis was performed using the Meta-analysis of Observational Studies in Epidemiology guidelines and forest plots were generated. Thirteen articles met the selection criteria: 7 clinical studies using a case-only design, 3 clinical studies with a dichotomous outcome, and 3 studies analysing a continuous outcome of psychotic symptoms below the threshold of psychotic disorder. The three study types were analysed separately. Validity of the included studies was assessed using "A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions". Results For case-only studies, a significant interaction was found between cannabis use and COMTVal158Met, with an OR of 1.45 (95% Confidence Interval = 1.05–2.00; Met/Met as the risk genotype). However, there was no evidence for interaction in either the studies including dichotomous outcomes (B = -0.51, 95% Confidence Interval -1.72, 0.70) or the studies including continuous outcomes (B = -0.04 95% Confidence Interval -0.16–0.08). Limitation A substantial part of the included studies used the case-only design, which has lower validity and tends to overestimate true effects. Conclusion The interaction term between cannabis use and COMTVal158Met was only statistically significant in the case-only studies, but not in studies using other clinical or non-clinical psychosis outcomes. Future additional high quality studies might change current perspectives, yet currently evidence for the interaction remains unconvincing. PMID:29444152
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Li, Yuanqing; Zhu, Xiaoshu; Bensussan, Alan; Li, Pingping; Moylan, Eugene; Delaney, Geoff; McPherson, Luke
2016-01-01
Objective. This systematic review was conducted to evaluate the clinical effectiveness and safety of herbal medicine (HM) as an alternative management for hot flushes induced by endocrine therapy in breast cancer patients. Methods. Key English and Chinese language databases were searched from inception to July 2015. Randomized Controlled Trials (RCTs) evaluating the effects of HM on hot flushes induced by endocrine therapy in women with breast cancer were retrieved. We conducted data collection and analysis in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis was performed with the software (Review Manager 5.3). Results. 19 articles were selected from the articles retrieved, and 5 articles met the inclusion criteria for analysis. Some included individual studies showed that HM can relieve hot flushes as well as other menopausal symptoms induced by endocrine therapy among women with breast cancer and improve the quality of life. There are minor side effects related to HM which are well tolerated. Conclusion. Given the small number of included studies and relatively poor methodological quality, there is insufficient evidence to draw positive conclusions regarding the objective benefit of HM. Additional high quality studies are needed with more rigorous methodological approach to answer this question.
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Factors associated with quality of life in patients undergoing coronary angioplasty
Darvishpour, Azar; Javadi-Pashaki, Nazila; Salari, Arsalan; Sadeghi, Tahere; Taleshan-Nejad, Marayam
2017-01-01
Objective: Percutaneous coronary intervention has been effective in increasing longevity of patients with cardiovascular disease. However, the evidence shows that the quality of life after the intervention is still lower than optimal level. The quality of life can be affected by various factors. The aim of this study is to determine the quality of life and its related factors in patients undergoing coronary angioplasty. Methods: This cross-sectional study was performed on 106 patients undergoing coronary angioplasty during 2015-2016. This study population included all patients who referred to a cardiac clinic in Rasht, Iran, were passed 3 months after their angioplasty. Research samples met the inclusion criteria and were willing to participate to the study, were selected gradually (continually). Research tools were a self-structured questionnaire regarding factors associated with the quality of life and the MacNew quality of life questionnaire. Data were collected through asking patients questions and using patient’s medical records. Data analysis was conducted using descriptive and inferential statistics. Results: The results of multivariate linear regression analysis showed that independent variables of age (P = 0.0001), the number of diseased vessels (P = 0.0001), and the number of comorbidities (P < 0.05) were the most important factors associated with the quality of life. Conclusion: Health-care professionals can play an effective role in promoting the quality of life of patients undergoing coronary angioplasty by modifying lifestyle based on the related factors and to provide comprehensive care programs, especially for elderly. PMID:29085266
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Determinants of physical activity and exercise in healthy older adults: A systematic review
2011-01-01
Background The health benefits of regular physical activity and exercise have been widely acknowledged. Unfortunately, a decline in physical activity is observed in older adults. Knowledge of the determinants of physical activity (unstructured activity incorporated in daily life) and exercise (structured, planned and repetitive activities) is needed to effectively promote an active lifestyle. Our aim was to systematically review determinants of physical activity and exercise participation among healthy older adults, considering the methodological quality of the included studies. Methods Literature searches were conducted in PubMed/Medline and PsycINFO/OVID for peer reviewed manuscripts published in English from 1990 onwards. We included manuscripts that met the following criteria: 1) population: community dwelling healthy older adults, aged 55 and over; 2) reporting determinants of physical activity or exercise. The outcome measure was qualified as physical activity, exercise, or combination of the two, measured objectively or using self-report. The methodological quality of the selected studies was examined and a best evidence synthesis was applied to assess the association of the determinants with physical activity or exercise. Results Thirty-four manuscripts reporting on 30 studies met the inclusion criteria, of which two were of high methodological quality. Physical activity was reported in four manuscripts, exercise was reported in sixteen and a combination of the two was reported in fourteen manuscripts. Three manuscripts used objective measures, twenty-two manuscripts used self-report measures and nine manuscripts combined a self-report measure with an objective measure. Due to lack of high quality studies and often only one manuscript reporting on a particular determinant, we concluded "insufficient evidence" for most associations between determinants and physical activity or exercise. Conclusions Because physical activity was reported in four manuscripts only, the determinants of physical activity particularly need further study. Recommendations for future research include the use of objective measures of physical activity or exercise as well as valid and reliable measures of determinants. PMID:22204444
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Brown, Christine; Drosdowsky, Allison; Krishnasamy, Meinir
2017-12-01
Recent advances in cancer therapies offer survival benefit when cure is no longer possible. The contribution of the Medical Emergency Teams (METs) in the context of advancing disease has received little empirical consideration. This study set out to explore MET intervention at the end of life for people with advanced cancer in an Australian comprehensive cancer centre, and its impact on quality of death. A retrospective medical chart review was undertaken to explore MET response for people with advanced (incurable) cancer nearing end of life. Occurrence of MET interventions at the end of life and a quality of death score were recorded for two randomly selected cohorts of patients, those who experienced a MET response within their last week of life (n = 50) and those who did not (n = 50). The cohort who did not receive MET intervention had a significantly higher (better) quality of death score when compared with patients who did receive a MET intervention (p = 0.01). Within the cohort who received a MET intervention, a subgroup (n = 19) where the MET influenced end-of-life decision-making had a significantly higher quality of death score (p = 0.02) than patients in the MET cohort (n = 31) where the MET did not influence end-of-life care. The contribution of the MET to end-of-life care for patients with cancer has not previously been reported. Further research is now needed to prospectively examine MET involvement at the end of life with consideration to quality of patient care and death, family experience, and support requirements of MET members. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Moreno, Alexander; Zidarov, Diana; Raju, Chandhana; Boruff, Jill; Ahmed, Sara
2017-01-01
Introduction There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration. The specific objectives are to: (A) synthesise the needs of individuals with SCI as perceived by themselves, their family caregivers and rehabilitation professionals using two theoretical models, (B) classify needs as met and unmet, (C) explore the evolution of met/unmet needs from the time of rehabilitation admission to community reintegration and (D) provide recommendations to improve SCI care. Methods and analysis (A) identifying the most frequent met and unmet needs reported by adults with traumatic and non-traumatic SCI, their family caregivers and their rehabilitation professionals from the time of rehabilitation admission to community reintegration; (B) identifying relevant studies with a search in electronic databases; (C) charting the data based on categories refined and adjusted with a stakeholder group; (D) collating, summarising and reporting the results using two analytical frameworks (Maslow’s hierarchical model of human needs and the Ferrans et al’s model of health-related quality of life) and (E) a stakeholder consultation phase. Ethics and dissemination The results of this scoping study will allow understanding SCI needs from the time of rehabilitation admission to community reintegration from the perspective of different stakeholders. An integrated master report combining the needs of individuals with SCI from the perspectives of different stakeholders from the time of rehabilitation admission to community reintegration will follow the consultation meetings. PMID:28780539
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Oh, Sang Ho; Son, Sun Han; Kang, Si Hyun; Kim, Don-Kyu; Seo, Kyung Mook; Lee, Sang Yoon
2017-05-01
Metabolic syndrome (MetS) significantly correlates with exercise. MetS also has an independent and inverse correlation to quality of life (QoL). However, few studies have examined the association between exercise and QoL in people with MetS. The aim of this study was to ascertain the relationship between exercise and QoL in a MetS population. This was a cross-sectional study using public data from the Sixth Korean National Health and Nutrition Examination Survey in 2014 (n = 7550). MetS was defined on the basis of the revised National Cholesterol Education Program criteria. Demographic factors, three types of exercise (resistance, flexibility, walking), five subsets of EuroQoL (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), and QoL scores (EQ-VAS), were investigated. Independent associations of each exercise on five subsets of QoL were determined using odds ratios (OR) adjusted for four demographic factors (age group, sex, weight change, and area of residence) using multivariate logistic regression analysis. Prevalence of MetS was 26.4% and the ratio of subjects performing resistance, flexibility, or walking exercise was 17.7%, 45.8%, and 71.5% among this population, respectively. EQ-VAS of exercisers was significantly higher than that of non-exercisers in resistance, flexibility, and walking exercise. Although resistance and flexibility exercise did not correlate with any subsets of QoL, mobility and self-care were significantly associated with walking exercise (OR = 0.635, 95% CI = 0.439-0.919 and OR = 0.577, 95% CI = 0.348-0.958, respectively). All exercisers showed higher QoL scores than non-exercisers. Among QoL subsets, mobility and self-care were independently associated with walking exercise in the MetS population. Regular walking exercise was important to higher QoL in those with MetS. This is the first clinical report to indicate that QoL could be independently influenced by walking exercise.
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[Health economic evaluation of disease management programs].
Greiner, W
2006-01-01
Disease management has become an important element in the improvement of care for people with chronic illnesses and has become embedded in the discussion on health policy in recent years. The approach has been introduced very differently to the health systems worldwide. Since 1 January 2003 accredited disease management programs (DMPs) have been a part of the risk structure compensation scheme of the German statutory health insurance. This is seen as the first step to a morbidity orientation of the risk structure compensation. DMPs have to be evaluated according the German Social Law, especially whether the objectives of the programs and the criteria for inclusion of the patients have been met and the quality of care for the patients is insured. The criteria for evaluation are threefold: medical issues, economic issues and subjective quality of life of the patients. Due to the immense amounts of data which can be expected the evaluation of the German DMPs is a huge logistical challenge. Until now not very much is known about the data quality. The evaluation is focused on the perspective of the sickness funds as e.g. information about indirect cost is not collected. In the article the methods for evaluation are described and critically discussed.
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Identifying positive deviants in healthcare quality and safety: a mixed methods study.
O'Hara, Jane K; Grasic, Katja; Gutacker, Nils; Street, Andrew; Foy, Robbie; Thompson, Carl; Wright, John; Lawton, Rebecca
2018-01-01
Objective Solutions to quality and safety problems exist within healthcare organisations, but to maximise the learning from these positive deviants, we first need to identify them. This study explores using routinely collected, publicly available data in England to identify positively deviant services in one region of the country. Design A mixed methods study undertaken July 2014 to February 2015, employing expert discussion, consensus and statistical modelling to identify indicators of quality and safety, establish a set of criteria to inform decisions about which indicators were robust and useful measures, and whether these could be used to identify positive deviants. Setting Yorkshire and Humber, England. Participants None - analysis based on routinely collected, administrative English hospital data. Main outcome measures We identified 49 indicators of quality and safety from acute care settings across eight data sources. Twenty-six indicators did not allow comparison of quality at the sub-hospital level. Of the 23 remaining indicators, 12 met all criteria and were possible candidates for identifying positive deviants. Results Four indicators (readmission and patient reported outcomes for hip and knee surgery) offered indicators of the same service. These were selected by an expert group as the basis for statistical modelling, which supported identification of one service in Yorkshire and Humber showing a 50% positive deviation from the national average. Conclusion Relatively few indicators of quality and safety relate to a service level, making meaningful comparisons and local improvement based on the measures difficult. It was possible, however, to identify a set of indicators that provided robust measurement of the quality and safety of services providing hip and knee surgery.
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Chaput, Jean-Philippe; Gray, Casey E; Poitras, Veronica J; Carson, Valerie; Gruber, Reut; Olds, Timothy; Weiss, Shelly K; Connor Gorber, Sarah; Kho, Michelle E; Sampson, Margaret; Belanger, Kevin; Eryuzlu, Sheniz; Callender, Laura; Tremblay, Mark S
2016-06-01
The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.
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Cinnamon effects on metabolic syndrome: a review based on its mechanisms
Mollazadeh, Hamid; Hosseinzadeh, Hossein
2016-01-01
Objective(s): Nowadays, cardiovascular diseases (CVDs) are the major risk factors of death globally. One of the most undeniable reasons of CVDs is metabolic syndrome (MetS). MetS is defined as a complex of diseases including insulin resistance, hyperglycemia, obesity, high blood pressure and dyslipidemia. The use of complementary medicine such as traditional herbal species can be effective in treatment of MetS’s complications. Cinnamomum verum (family Lauraceae) is a medicinal global plant which has been used daily by people all over the world. Positive effects of cinnamon in reducing blood pressure, plasma glucose, obesity and ameliorating dyslipidemia which represented in traditional medicine introduced it as probable decreasing MetS’s complications agent. The aim of this review was to investigate the mechanisms of C. verum in reducing the MetS’s complications and CVDs risk factors. Materials and Methods: Various databases such as PubMed, Science Direct, Scopus, Web of Science, Google Scholar and Persian Websites such as www.sid.ir with keywords search of cinnamon, cinnamomum, cinnamaldehyde, atherogenic, hypertension, hyperglycemia, insulin resistance, obesity and dyslipidemia have been included in this search. Results: Clinical data and mechanisms of action of C. verum and its active ingredients that have been shown in this review indicated that cinnamon has protective effects against MetS’s aspects in various ways. Conclusion: The use of this plant can be effective in reducing MetS’s complications and its morbidity and mortality. PMID:28096957
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Long term measurement network for FIFE
NASA Technical Reports Server (NTRS)
Blad, Blaine L.; Walter-Shea, Elizabeth A.; Hays, Cynthia J.
1988-01-01
The objectives were: to obtain selected instruments which were not standard equipment on the Portable Automated Mesometeorological (PAM) and Data Control Platform (DCP) stations; to assist in incorporation of these instruments onto the PAM and DCP stations; to help provide routine maintenance of the instruments; to conduct periodic instrument calibrations; and to repair or replace malfunctioning instruments when possible. All of the objectives were or will be met soon. All instruments and the necessary instrument stands were purchased or made and were available for inclusion on the PAM and DCP stations before the beginning of the IFC-1. Due to problems beyond control, the DCP stations experienced considerable difficulty in becoming operational. To fill some of the gaps caused by the DCP problems, Campbell CR21-X data loggers were installed and the data collected on cassette tapes. Periodic checks of all instruments were made, to maintain data quality, to make necessary adjustments in certain instruments, to replace malfunctioning instruments, and to provide instrument calibration. All instruments will be calibrated before the beginning of the 1988 growing season as soon as the weather permits access to all stations and provides conditions that are not too harsh to work in for extended periods of time.
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A systematic review on the prevalence of metabolic syndrome in Iranian children and adolescents.
Kelishadi, Roya; Hovsepian, Silva; Djalalinia, Shirin; Jamshidi, Fahimeh; Qorbani, Mostafa
2016-01-01
Metabolic syndrome (MetS), a cluster of cardiovascular risk factors, is one of the most common metabolic disorders, which lead to many chronic diseases. The link between childhood MetS and occurrence of atherosclerosis and its sequels in adulthood is well documented. This study aims to systematically review the prevalence of MetS among Iranian children and adolescents. An electronic search was conducted on studies published from January 1990 to January 2015. The main international electronic data sources were PubMed and the NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS. For Persian databases, we used domestic databases. We included all available population-based studies and national surveys conducted in the pediatric age group aged 3-21-year-old. In this review, 2138 articles were identified (PubMed: 265; SCOPUS: 368; ISI: 465; Scientific Information Database: 189; IranMedex: 851; Irandoc: 46). After quality assessment, 13 qualified articles were evaluated. The number of total population and points of data were 24,772 and 125, respectively. Regarding the geographical distribution, we found 2 national, 6 provincial, and 5 district level points of data. The prevalence range of MetS among children was 1-22% using different definitions. Reported range of pediatric MetS defined by different criteria was as follows: National Cholesterol Education Program-Adult Treatment Panel III; 3-16%, International Diabetes Federation; 0-8%, American Heart Association; 4-9.5%, The National Health and Nutrition Examination Survey III; 1-18%, de Ferranti; 0-22%. MetS is a common metabolic disorder among Iranian children and adolescents, with increasing trends during the last decades. This finding provides baseline useful information for health policy makers to implement evidence based-health promotion for appropriate controlling of this growing health problem for the pediatric population.
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Exchange programmes and student mobility: meeting student's expectations or an expensive holiday?
Keogh, Johannes; Russel-Roberts, Eileen
2009-01-01
The Bologna Process aims, amongst other things, to improve the mobility of Students within the EU. Student mobility is supported through programmes such as ERASMUS, and the success of these programmes is measured against quality and quantity of Student mobility within the European Union. This study aimed at establishing, from the students' perspective, the benefits of these programmes. To this purpose, 7 Students who were involved in a German-Finnish exchange programme were interviewed. This population was chosen, because they represented the largest group of students going to the same host university, and were influenced by the same variables, such as language difficulties and climatic conditions. The main objective of this study was to determine whether the educational and personal needs of the students were met during their exchange programme. The data analysis was done using Mayring's content analysis method. The results showed that successful mobility at student level, could lead to a diffusion of knowledge and skills between different countries. It was also found that the students indicated that their personal and educational needs were met irrespective of the language difficulties they experienced.
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Code of Federal Regulations, 2013 CFR
2013-07-01
... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...
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Code of Federal Regulations, 2011 CFR
2011-07-01
... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...
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A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain
Hauser, Ross A.; Lackner, Johanna B.; Steilen-Matias, Danielle; Harris, David K.
2016-01-01
OBJECTIVE The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. DATA SOURCES Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. STUDY SELECTION Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. DATA EXTRACTION Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. DATA SYNTHESIS Fourteen RCTs, 1 case–control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood–Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive objective but not subjective outcomes in two studies. All 15 studies solely using subjective or psychometric measures reported positive findings. CONCLUSION Use of dextrose prolotherapy is supported for treatment of tendinopathies, knee and finger joint OA, and spinal/pelvic pain due to ligament dysfunction. Efficacy in acute pain, as first-line therapy, and in myofascial pain cannot be determined from the literature. PMID:27429562
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Prediction of Quality Change During Thawing of Frozen Tuna Meat by Numerical Calculation I
NASA Astrophysics Data System (ADS)
Murakami, Natsumi; Watanabe, Manabu; Suzuki, Toru
A numerical calculation method has been developed to determine the optimum thawing method for minimizing the increase of metmyoglobin content (metMb%) as an indicator of color changes in frozen tuna meat during thawing. The calculation method is configured the following two steps: a) calculation of temperature history in each part of frozen tuna meat during thawing by control volume method under the assumption of one-dimensional heat transfer, and b) calculation of metMb% based on the combination of calculated temperature history, Arrenius equation and the first-order reaction equation for the increase rate of metMb%. Thawing experiments for measuring temperature history of frozen tuna meat were carried out under the conditions of rapid thawing and slow thawing to compare the experimental data with calculated temperature history as well as the increase of metMb%. The results were coincident with the experimental data. The proposed simulation method would be useful for predicting the optimum thawing conditions in terms of metMb%.
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Hofman, Jelle; Samson, Roeland
2014-09-01
Biomagnetic monitoring of tree leaf deposited particles has proven to be a good indicator of the ambient particulate concentration. The objective of this study is to apply this method to validate a local-scale air quality model (ENVI-met), using 96 tree crown sampling locations in a typical urban street canyon. To the best of our knowledge, the application of biomagnetic monitoring for the validation of pollutant dispersion modeling is hereby presented for the first time. Quantitative ENVI-met validation showed significant correlations between modeled and measured results throughout the entire in-leaf period. ENVI-met performed much better at the first half of the street canyon close to the ring road (r=0.58-0.79, RMSE=44-49%), compared to second part (r=0.58-0.64, RMSE=74-102%). The spatial model behavior was evaluated by testing effects of height, azimuthal position, tree position and distance from the main pollution source on the obtained model results and magnetic measurements. Our results demonstrate that biomagnetic monitoring seems to be a valuable method to evaluate the performance of air quality models. Due to the high spatial and temporal resolution of this technique, biomagnetic monitoring can be applied anywhere in the city (where urban green is present) to evaluate model performance at different spatial scales. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Rosenbaum, Simon; Tiedemann, Anne; Sherrington, Catherine; Curtis, Jackie; Ward, Philip B
2014-09-01
To determine effects of physical activity on depressive symptoms (primary objective), symptoms of schizophrenia, anthropometric measures, aerobic capacity, and quality of life (secondary objectives) in people with mental illness and explore between-study heterogeneity. MEDLINE, Cochrane Controlled Trials Register, PsycINFO, CINAHL, Embase, and the Physiotherapy Evidence Database (PEDro) were searched from earliest record to 2013. Randomized controlled trials of adults with a DSM-IV-TR, ICD-10, or clinician-confirmed diagnosis of a mental illness other than dysthymia or eating disorders were selected. Interventions included exercise programs, exercise counseling, lifestyle interventions, tai chi, or physical yoga. Study methodological quality and intervention compliance with American College of Sports Medicine (ACSM) guidelines were also assessed. Two investigators extracted data. Data were pooled using random-effects meta-analysis. Meta-regression was used to examine sources of between-study heterogeneity. Thirty-nine eligible trials were identified. The primary meta-analysis found a large effect of physical activity on depressive symptoms (n = 20; standardized mean difference (SMD) = 0.80). The effect size in trial interventions that met ACSM guidelines for aerobic exercise did not differ significantly from those that did not meet these guidelines. The effect for trials with higher methodological quality was smaller than that observed for trials with lower methodological quality (SMD = 0.39 vs 1.35); however, the difference was not statistically significant. A large effect was found for schizophrenia symptoms (SMD = 1.0), a small effect was found for anthropometry (SMD = 0.24), and moderate effects were found for aerobic capacity (SMD = 0.63) and quality of life (SMD = 0.64). Physical activity reduced depressive symptoms in people with mental illness. Larger effects were seen in studies of poorer methodological quality. Physical activity reduced symptoms of schizophrenia and improved anthropometric measures, aerobic capacity, and quality of life among people with mental illness. PROSPERO registration #CRD42012002012. © Copyright 2014 Physicians Postgraduate Press, Inc.
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van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle
2015-01-01
Context Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty. Objective To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty. Data Sources A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014). Study Selection We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded. Data Extraction Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations. Data Synthesis Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86%) were full economic evaluations. Cost-effectiveness analysis (CEA) was the most frequent type of economic evaluation, and was present in 11 (52%) studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis. Conclusions This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices. PMID:26661078
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McNaughton, S. A.; Lacy, K. E.; Dunstan, D. W.; Carson, V.; Salmon, J.
2016-01-01
Summary Objective Evidence suggests that TV viewing is associated with body mass index (BMI) and metabolic syndrome (MetS) in adolescents. However, it is unclear whether dietary intake mediates these relationships. Methods A cross‐sectional analysis was conducted in adolescents (12–19 years) participating in the 2003–2006 United States National Health and Nutrition Examination Survey. BMI z scores (zBMI) (n = 3,161) and MetS (n = 1,379) were calculated using age‐ and sex‐specific criteria for adolescents. TV viewing (h/day) was measured via a self‐reported questionnaire, and dietary intake was assessed using two 24‐h recalls. Using the MacKinnon method, a series of mediation analyses were conducted examining five dietary mediators (total energy intake, fruit and vegetable intake, discretionary snacks, sugar‐sweetened beverages and diet quality) of the relationships between TV viewing and zBMI and MetS. Results Small positive relationships were observed between TV viewing and zBMI (β = 0.99, p < 0.001) and TV viewing and MetS (OR = 1.18, p = 0.046). No dietary element appeared to mediate the relationship between TV viewing and zBMI. However, sugar‐sweetened beverage consumption and fruit and vegetable intake partially mediated the relationship between TV viewing and MetS, explaining 8.7% and 4.1% of the relationship, respectively. Conclusions These findings highlight the complexity of the relationships between TV viewing, dietary intake and cardiometabolic health outcomes, and that TV viewing should remain a target for interventions. PMID:27708839
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Putting Laughter in Context: Shared Laughter as Behavioral Indicator of Relationship Well-Being
Kurtz, Laura E.; Algoe, Sara B.
2015-01-01
Laughter is a pervasive human behavior that most frequently happens in a social context. However, data linking the behavior of laughter with psychological or social outcomes is exceptionally rare. Here, we draw attention to shared laughter as a useful objective marker of relationship well-being. Spontaneously-generated laughs of 71 heterosexual romantic couples were coded from a videorecorded conversation about how the couple first met. Multilevel models revealed that, while controlling for all other laughter present, the proportion of the conversation spent laughing simultaneously with the romantic partner was uniquely positively associated with global evaluations of relationship quality, closeness, and social support. Results are discussed with respect to methodological considerations and theoretical implications for relationships and behavioral research more broadly. PMID:26957946
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NASA Astrophysics Data System (ADS)
Mittelmeier, N.; Blodau, T.; Steinfeld, G.; Rott, A.; Kühn, M.
2016-09-01
Atmospheric conditions have a clear influence on wake effects. Stability classification is usually based on wind speed, turbulence intensity, shear and temperature gradients measured partly at met masts, buoys or LiDARs. The objective of this paper is to find a classification for stability based on wind turbine Supervisory Control and Data Acquisition (SCADA) measurements in order to fit engineering wake models better to the current ambient conditions. Two offshore wind farms with met masts have been used to establish a correlation between met mast stability classification and new aggregated statistical signals based on multiple measurement devices. The significance of these new signals on power production is demonstrated for two wind farms with met masts and validated against data from one further wind farm without a met mast. We found a good correlation between the standard deviation of active power divided by the average power of wind turbines in free flow with the ambient turbulence intensity when the wind turbines were operating in partial load.
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Managed care plan performance since 1980: another look at 2 literature reviews.
Sullivan, K
1999-01-01
OBJECTIVES: This article compares the quality of care provided by managed care plans (MCPs) and indemnity (or fee-for-service [FFS]) plans since 1980. METHODS: The 44 studies examined are the studies that Miller and Luft cited in their 1994 and 1997 reviews of the literature comparing MCPs with FFS plans. These studies are examined to determine how well they met Miller and Luft's selection criteria and, in addition, whether they controlled for differences in the breadth of insurance coverage. RESULTS: The 44 studies generated 57 observations. MCPs scored better than FFS plans on 10 of these, equally well on 25, and worse on 22. However, only 44 of these observations met the Miller-Luft criteria plus the coverage criterion. Four of these indicated that MCP care was better, 19 that MCP and FFS care were equivalent, and 21 that MCP care was worse. CONCLUSIONS: The small body of reliable studies comparing the quality of MCP care with that of FFS care indicates that the quality of care provided by MCPs tends to be equal or inferior to that provided by FFS plans. PMID:10394307
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Report of the Federal Advisory Committee on the Bird Banding Laboratory
Haseltine, Susan D.; Schmidt, Paul R.; Bales, Bradley D.; Bonter, David N.; DeSante, David F.; Doherty, Paul F.; Francis, Charles M.; Green, Paul T.; Howes, Lesley-Anne; James, Daniel L.; Lament, J. Jasper; Lancia, Richard A.; Paul, Ellen I.; Ralph, C. John; Rogers, John G.; Young, Richard E.
2008-01-01
In the fall of 2005, the Directors of the U.S. Geological Survey (USGS) and the U.S. Fish and Wildlife Service (FWS) determined that to ensure that the Bird Banding Laboratory (BBL) of the USGS maintains and continues its important support of conservation and management of birds, it should be guided by a clear vision for the future. In order to carry out this task, they impaneled a fourteen-member Federal Advisory Committee (FAC) on the Bird Banding Laboratory. It was made up of representatives of the broad bird-banding community, public and private, and was cochaired by a senior representative from each agency. The Committee met four times and a writing subgroup met three times over the course of its work. The Committee identified a new vision and mission for the BBL and identified six goals that it believes should be integral to the development of a strategic plan to achieve them. Those goals are: 1. Facilitate the identification of individual birds through marking. 2. Create automated, electronic systems that efficiently verify, accept, store, and manage data associated with individually marked birds. 3. Facilitate access to and use of data from marked birds for science, conservation, and management. 4. Administer permits in an efficient, timely, and modern manner, and use them to ensure that bird welfare and data quality remain top priorities. 5. Work closely with national and international partners to achieve the mission of the BBL. 6. Manage the BBL in an efficient, cost-effective manner to maximize use of available resources. Most of the report is structured around these goals. The Committee made 2 programmatic recommendations and identified 23 objectives and 58 specific recommendations. The programmatic recommendations are: (1) that the primary role of the BBL is and should continue to be to support the use of banding and banding data by researchers and managers engaged in science, conservation, and management of birds, and not to play a lead role in original research; and (2) that the BBL be managed nationally by USGS headquarters as a research and operational support unit and provided with the resources appropriate to its national and international functions and responsibilities; it should continue to be located physically at the Patuxent Wildlife Research Center (PWRC). In order to achieve its vision and mission, the Committee believes that the BBL must work towards achieving all of the recommendations in this report. Nevertheless, it identified five objectives that stand out as high priority, and they are as follows: *Objective 1.1?to ensure a continuing, adequate supply of high-quality, Federally issued numeric bands of required sizes, materials, and types; *Objective 2.1?to improve mechanisms for verifying, accepting, storing, and managing bird-banding data; *Objective 2.3?to accommodate recapture data; *Objective 4.1?to ensure through the permitting process that banders know how to safely handle birds, collect data accurately, and maintain birds in humane and healthful conditions; and *Objective 5.3?to encourage the development of banding programs in Latin America and the Caribbean. Finally, this Committee believes that the BBL will be well served if it continues to support a Federal Advisory Committee, composed similarly to this one, to continue offering guidance and direction from the broad bird-banding community.
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Herman, Patricia M; Poindexter, Beth L; Witt, Claudia M; Eisenberg, David M
2012-01-01
Objective A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. Data sources PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. Eligibility criteria for selecting studies Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. Study appraisal methods All recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. Results A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). Conclusions This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies. PMID:22945962
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APPLICATION OF DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES TO RESEARCH PROJECTS
The paper assists systematic planning for research projects. It presents planning concepts in terms that have some utility for researchers. For example, measurement quality objectives are more familiar to researchers than data quality objectives because these quality criteria are...
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Posadzki, Paul; Lee, Myeong Soo; Onakpoya, Igho; Lee, Hye Won; Ko, Byong Seob; Ernst, Edzard
2013-06-01
Dietary supplements are popular among patients with prostate cancer (PC). The objective of this systematic review was to critically examine double-blind, placebo-controlled randomised clinical trials (RCTs) of non-herbal dietary supplements and vitamins (NHDS) for evidence that prostate specific antigen (PSA) levels were reduced in PC patients. Five databases were searched from their inception through December 2012 to identify studies that met our inclusion criteria. Methodological quality was independently assessed by two reviewers using the Cochrane tool. Eight RCTs met the eligibility criteria and were of high methodological quality. The following supplements were tested: isoflavones (genistein, daidzein, and glycitein), minerals (Se) or vitamins (vitamin D) or a combination of antioxidants, bioflavonoids, carotenoids, lycopenes, minerals (Se, Zn, Cu, and Mg), phytoestrogens, phytosterols, vitamins (B2, B6, B9, B12, C, and E), and other substances (CoQ10 and n-acetyl-l cysteine). Five RCTs reported no significant effects compared with placebo. Two RCTs reported that a combination of antioxidants, isoflavones, lycopenes, minerals, plant oestrogens and vitamins significantly decreased PSA levels compared with placebo. One RCT did not report differences in PSA levels between the groups. In conclusion, the hypothesis that dietary supplements are effective treatments for PC patients is not supported by sound clinical evidence. There are promising data for only two specific remedies, which contained a mixture of ingredients, but even for these supplements, additional high quality evidence is necessary before firm recommendations would be justified. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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Validating the Usefulness of Combined Japanese GMS Data For Long-Term Global Change Studies
NASA Technical Reports Server (NTRS)
Simpson, James J.; Dodge, James C. (Technical Monitor)
2001-01-01
The primary objectives of the Geostationary Meteorological Satellite (GMS)-5 Pathfinder Project were the following: (1) to evaluate GMS-5 data for sources of error and develop methods for minimizing any such errors in GMS-5 data; (2) to prepare a GMS-5 Pathfinder data set for the GMS-5 Pathfinder Benchmark Period (1 July 95 - 30 June 96); and (3) show the usefulness of the improved Pathfinder data set in at least one geophysical application. All objectives were met.
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Youth self-report of child maltreatment in representative surveys: a systematic review
Jessica, Laurin*; Caroline, Wallace*; Jasminka, Draca; Sarah, Aterman; Lil, Tonmyr
2018-01-01
Abstract Introduction: This systematic review identified population-representative youth surveys containing questions on self-reported child maltreatment. Data quality and ethical issues pertinent to maltreatment data collection were also examined. Methods: A search was conducted of relevant online databases for articles published from January 2000 through March 2016 reporting on population-representative data measuring child maltreatment. Inclusion criteria were established a priori; two reviewers independently assessed articles to ensure that the criteria were met and to verify the accuracy of extracted information. Results: A total of 73 articles reporting on 71 surveys met the inclusion criteria. A variety of strategies to ensure accurate information and to mitigate survey participants’ distress were reported. Conclusion: The extent to which efforts have been undertaken to measure the prevalence of child maltreatment reflects its perceived importance across the world. Data on child maltreatment can be effectively collected from youth, although our knowledge of best practices related to ethics and data quality is incomplete. PMID:29443484
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Huang, Terry T-K; Nansel, Tonja R.; Belsheim, Allen R.; Morrison, John A.
2008-01-01
Objective To estimate the sensitivity, specificity, and predictive values of pediatric metabolic syndrome (MetS) components (obesity, fasting glucose, triglycerides, high-density lipoprotein, and blood pressure) at various cutoffs in relation to adult MetS. Study design Data from the NHLBI Lipid Research Clinics (LRC) Princeton Prevalence Study (1973–76) and the Princeton Follow-up Study (PFS, 2000-4) were used to calculate sensitivity, specificity, and positive and negative predictive values for each component at a given cutoff, as well as for aggregates of components. Results Individual pediatric components alone showed low to moderate sensitivity, high specificity, and moderate predictive values in relation to adult MetS. When all five pediatric MetS components were considered, the presence of at least one abnormality had higher sensitivity for adult MetS than individual components alone. When multiple abnormalities were mandatory for MetS, positive predictive value was high and sensitivity was low. Childhood body mass alone showed neither high sensitivity nor high positive predictive value for adult MetS. Conclusions Considering multiple metabolic variables in childhood can improve the predictive utility for adult MetS, compared to each component or body mass alone. MetS variables may be useful for identifying some at risk children for prevention interventions. PMID:18206687
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Design of the VLT data flow model
NASA Astrophysics Data System (ADS)
Peron, Michele; Grosbol, Preben
1997-03-01
The basic objective of modern observatories is to globally maximize their efficiency and ensure a high, constant and predictable data quality. These challenges can only be met if the scientific operation of such facilities, from the submission of observing programs to the archiving of all information, is carried out in a consistent and well controlled manner. The size, complexity and long operational lifetime of such systems make it difficult to predict and control their behavior with the necessary accuracy. Moreover they are subject to changes and are cumbersome to maintain. We present in this paper an object-oriented end-to-end operations model which describes the flow of science data associated with the operation of the VLT. The analysis model helped us to get a clear understanding of the problem domain. We were able in the design phase to partition the system into subsystems, each of them being allocated to a team for detailed design and implementation. Each of these subsystems is addressed in this paper. Prototypes will be implemented in the near future and tested on the new technology telescope (NTT). They will allow us to clarify the astronomical requirements and check the new operational concepts introduced to meet the ambitious goals of the VLT.
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Metabolic syndrome among rural Indian adults.
Barik, Anamitra; Das, Kausik; Chowdhury, Abhijit; Rai, Rajesh Kumar
2018-02-01
To prevent an increasing level of mortality due to type 2 diabetes mellitus and cardiovascular disease among the rural Indian population, a management strategy of the metabolic syndrome (MetS) should be devised. This study aims to estimate the burden of MetS and its associated risk factors. Data from the Birbhum Population Project covering 9886 individuals (4810 male and 5076 female population) aged ≥18 years were used. The burden of metabolic syndrome, as defined by the Third Report of the National Cholesterol Education Program Adult Treatment Panel, was determined. Bivariate and multivariate (logistic regression) analyses were used to attain the study objective. Over 10.7% of the males and 20.3% of the females were diagnosed with MetS. Irrespective of sex, older individuals, being overweight/obese (body mass index of ≥23 kg/m 2 ) had higher probability of developing MetS, whereas being underweight is deemed a protective factor against MetS. Low physical activity among women appeared to be a risk factor for MetS. The prevalence of MetS is concerning even in rural India. Any intervention designed to address the issue could emphasize on weight loss, and physical activity, focusing on women and people at an advanced stage of life. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
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Teachers' Perspectives on Online Virtual Labs vs. Hands-On Labs in High School Science
NASA Astrophysics Data System (ADS)
Bohr, Teresa M.
This study of online science teachers' opinions addressed the use of virtual labs in online courses. A growing number of schools use virtual labs that must meet mandated laboratory standards to ensure they provide learning experiences comparable to hands-on labs, which are an integral part of science curricula. The purpose of this qualitative case study was to examine teachers' perceptions of the quality and effectiveness of high school virtual labs. The theoretical foundation was constructivism, as labs provide student-centered activities for problem solving, inquiry, and exploration of phenomena. The research questions focused on experienced teachers' perceptions of the quality of virtual vs. hands-on labs. Data were collected through survey questions derived from the lab objectives of The Next Generation Science Standards . Eighteen teachers rated the degree of importance of each objective and also rated how they felt virtual labs met these objectives; these ratings were reported using descriptive statistics. Responses to open-ended questions were few and served to illustrate the numerical results. Many teachers stated that virtual labs are valuable supplements but could not completely replace hands-on experiences. Studies on the quality and effectiveness of high school virtual labs are limited despite widespread use. Comprehensive studies will ensure that online students have equal access to quality labs. School districts need to define lab requirements, and colleges need to specify the lab experience they require. This study has potential to inspire positive social change by assisting science educators, including those in the local school district, in evaluating and selecting courseware designed to promote higher order thinking skills, real-world problem solving, and development of strong inquiry skills, thereby improving science instruction for all high school students.
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Cyber Physical Intelligence for Oil Spills (CPI)
NASA Astrophysics Data System (ADS)
Lary, D. J.
2015-12-01
The National Academy of Sciences estimate 1.7 to 8.8 million tons of oil are released into global waters every year. The effects of these spills include dead wildlife, oil covered marshlands and contaminated water. Deepwater horizon cost approximately $50 billion and severely challenged response capabilities. In such large spills optimizing a coordinated response is a particular challenge. This challenge can be met in a revolutionary new way by using an objectively optimized Cyber Physical Decision Making System (CPS) for rapid response products and a framework for objectively optimized decision-making in an uncertain environment. The CPS utilizes machine learning for the processing of the massive real-time streams of Big Data from comprehensive hyperspectral remote sensing acquired by a team of low-cost robotic aerial vehicles, providing a real-time aerial view and stream of hyperspectral imagery from the near UV to the thermal infrared, and a characterization of oil thickness, oil type and oil weathering. The objective decision making paradigm is modeled on the human brain and provides the optimal course trajectory for response vessels to achieve the most expeditious cleanup of oil spills using the available resources. In addition, oil spill cleanups often involve surface oil burns that can lead to air quality issues. The aerial vehicles comprehensively characterize air quality in real-time, streaming location, temperature, pressure, humidity, the abundance of 6 criterion pollutants (O3, CO, NO, NO2, SO2, and H2S) and the full size distribution of airborne particulates. This CPS can be readily applied to other systems in agriculture, water conversation, monitoring of stream quality, air quality, diagnosing risk of wild fires, etc..
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DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES FOR RESEARCH PROJECTS
The paper provides assistance with systematic planning using measurement quality objectives to those working on research projects. These performance criteria are more familiar to researchers than data quality objectives because they are more closely associated with the measuremen...
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Hjellset, Victoria Telle; Ihlebæk, Camilla M; Bjørge, Benedikte; Eriksen, Hege R; Høstmark, Arne T
2011-08-01
The increasingly high number of immigrants from South-East Asia with The Metabolic Syndrome (MetS) is an important challenge for the public health sector. Impaired glucose is essential in MetS. The blood glucose concentration is not only governed by diet and physical activity, but also by psychological distress which could contribute to the development of MetS. The aim of this study is to describe health-related quality of life, subjective health complaints (SHC), psychological distress, and coping in Pakistani immigrant women, with and without MetS. As a part of an randomized controlled intervention study in Oslo, Norway, female Pakistani immigrants (n = 198) answered questionnaires regarding health related quality of life, SHC, psychological distress, and coping. Blood variables were determined and a standardized oral glucose tolerance test was performed. The participants had a high score on SHC and psychological distress. About 40% of the participants had MetS, and this group showed significantly lower general health, lower physical function, and more bodily pain, than those without MetS. Those with MetS also had more SHC, depressive symptoms, higher levels of somatisation, and scored significantly lower on the coping strategy of active problem solving. Pakistani immigrant women seem to have a high prevalence of SHC and psychological distress, especially those with MetS.
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ERIC Educational Resources Information Center
Ejuu, Godfrey
2012-01-01
Training of quality early childhood development (ECD) teachers is paramount in ensuring quality ECD service provision. This exploratory study focuses on the gains and challenges met in the implementation of the Uganda ECD teacher training framework. Data were obtained using questionnaires and interviews from principals and tutors of ECD teacher…
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Self-stigma and quality of life in patients with depressive disorder: a cross-sectional study.
Holubova, Michaela; Prasko, Jan; Ociskova, Marie; Marackova, Marketa; Grambal, Ales; Slepecky, Milos
2016-01-01
Self-stigma is a maladaptive psychosocial phenomenon that can affect many areas of patients' lives and have a negative impact on their quality of life (QoL). This study explored the association between self-stigma, QoL, demographic data, and the severity of symptoms in patients with depressive disorder. Patients who met the International Classification of Diseases, 10th revision, research criteria for depressive disorder were enrolled in this cross-sectional study. All outpatients completed the following measurements: the Quality of Life Enjoyment and Satisfaction Questionnaire, the Internalized Stigma of Mental Illness Scale, demographic questionnaire, and the objective and subjective Clinical Global Impression-Severity scales that measure the severity of disorder. A total of 81 depressive disorder patients (with persistent affective disorder - dysthymia, major depressive disorder, or recurrent depressive disorder) and 43 healthy controls participated in this study. Compared with the healthy control group, a lower QoL was observed in patients with depressive disorder. The level of self-stigma correlated positively with total symptom severity score and negatively with QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and score of self-stigma were significantly associated with QoL. This study suggests a lower QoL in patients with depressive disorder in comparison with healthy controls and a negative impact of self-stigma level on QoL in patients suffering from depressive disorders.
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Walter, Kimberly N; Petry, Nancy M
2016-05-01
This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. All patients met the diagnostic criteria for past-year cocaine or opioid use disorders and 27% of patients also had co-occurring alcohol use disorders. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps < .05), but not physical, social, or functional/global quality-of-life scores. Lifetime suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning. © The Author(s) 2016.
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Fournier, Sara B.; Reger, Brian L.; Donley, David A.; Bonner, Daniel E.; Warden, Bradford E.; Gharib, Wissam; Failinger, Conard F.; Olfert, Melissa D.; Frisbee, Jefferson C.; Olfert, I. Mark; Chantler, Paul D.
2013-01-01
MetS is the manifestation of a cluster of cardiovascular (CV) risk factors and is associated with a three-fold increase risk of CV morbidity and mortality, which is suggested to be mediated, in part, by resting left ventricular (LV) systolic dysfunction. However, to what extent resting LV systolic function is impaired in MetS is controversial, and there are no data indicating whether LV systolic function is impaired during exercise. Accordingly, the objective of this study was to comprehensively examine LV and arterial responses to exercise in MetS individuals without diabetes and/or overt CVD compared to a healthy control population. CV function was characterized using Doppler echocardiography and gas exchange in MetS (n=27) vs. healthy controls (n=20) at rest and during peak exercise. At rest, MetS individuals displayed normal LV systolic function but reduced LV diastolic function vs. healthy controls. During peak exercise, individuals with MetS had impaired contractility; pump performance, and vasodilator reserve capacity vs. controls. A blunted contractile reserve response resulted in diminished arterial-ventricular coupling reserve and limited aerobic capacity in MetS vs. controls. These findings possess clinical importance as they provide insight to the pathophysiological changes in MetS that may predispose this population of individuals to an increased risk of CV morbidity and mortality. PMID:24036595
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Performance of a pilot showcase of different wetland systems in an urban setting in Singapore.
Quek, B S; He, Q H; Sim, C H
2015-01-01
The Alexandra Wetlands, part of PUB's Active, Beautiful, Clean Waters (ABC Waters) Programme, showcase a surface flow wetland, an aquatic pond and a sub-surface flow wetland on a 200 m deck built over an urban drainage canal. Water from the canal is pumped to a sedimentation basin, before flowing in parallel to the three wetlands. Water quality monitoring was carried out monthly from April 2011 to December 2012. The order of removal efficiency is sub-surface flow (81.3%) >aquatic pond (58.5%) >surface flow (50.7%) for total suspended solids (TSS); sub-surface (44.9%) >surface flow (31.9%) >aquatic pond (22.0%) for total nitrogen (TN); and surface flow (56.7%) >aquatic pond (39.8%) >sub-surface flow (5.4%) for total phosphorus (TP). All three wetlands achieved the Singapore stormwater treatment objectives (STO) for TP removal, but only the sub-surface flow wetland met the STO for TSS, and none met the STO for TN. Challenges in achieving satisfactory performance include inconsistent feed water quality, undesirable behaviour such as fishing, release of pets and feeding of animals in the wetlands, and canal dredging during part of the monitoring period. As a pilot showcase, the Alexandra Wetlands provide useful lessons for implementing multi-objective wetlands in an urban setting.
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Kikui, Miki; Ono, Takahiro; Kokubo, Yoshihiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Nokubi, Takashi; Watanabe, Makoto; Maeda, Yoshinobu; Miyamoto, Yoshihiro
2017-01-01
An association between metabolic syndrome (MetS) and periodontal status has recently been focused on. However, no study has investigated the relationship between the prevalence of MetS and the decline of masticatory performance. We aimed to clarify the relationship between MetS and objective masticatory performance using the standardized test food in a general urban Japanese population. We studied 1780 Japanese men and women (mean age, 66.5 years) using the Suita study. MetS was defined using the uniform definition proposed in the 2009 Joint Interim Statement. Masticatory performance was evaluated by a chewing test using gummy jelly. Prevalence of MetS among quartiles of masticatory performance was compared using multiple logistic regression analysis adjusting for sex, age, drinking and smoking status, and periodontal status evaluated by the Community Periodontal Index. Compared to the highest quartile of masticatory performance, the 2nd quartile showed a 1.46-fold increase in the prevalence of MetS (trend P=0.159). In addition, Analysis by age showed 1.67-, 1.90- and 1.74-fold increases in the prevalence of MetS in the 3rd, 2nd and 1st quartiles among individuals in their 70s, respectively (trend P=0.094). However, individuals in their 50s and 60s showed no significant relationship between masticatory performance and MetS. These findings suggested that masticatory performance are inversely associated with the prevalence of MetS independent of periodontal disease, especially in the elderly. Declines in objective masticatory performance might be associated with the prevalence of MetS, independent of periodontitis. Given our results, treatments aimed at maintaining and recovering masticatory performance may represent important dental care to mitigate the risk of MetS. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Use of Global Positioning Systems to Study Physical Activity and the Environment
Krenn, Patricia J; Titze, Sylvia; Oja, Pekka; Jones, Andrew; Ogilvie, David
2013-01-01
Context The Global Positioning System (GPS) represents an innovative way to objectively assess the spatial locations of physical activity behavior. Purpose The aim of this systematic review was to determine the capability of GPS to collect high quality data on the location of activities in research on the relationship between physical activity and the environment. Evidence acquisition Published and unpublished articles identified from seven electronic databases, reference lists, bibliographies and websites up to March 2010 were systematically searched for, appraised and analysed in summer 2010. Included studies used GPS to measure the spatial locations of physical activity and some form of environmental analysis related to the GPS data. The capability of GPS was expressed in terms of data quality which in turn was defined as the proportion of GPS data lost in each study. Evidence synthesis 24 studies met the inclusion criteria. Data loss was positively correlated with the measurement period for which participants were asked to wear the GPS device (r=0.81, p<0.001). Major reasons for data loss included signal drop outs, loss of device battery power, and poor adherence of participants to measurement protocols. Data loss did not differ significantly between children and adults or by study sample size, year of publication or GPS device manufacturer. Conclusions GPS is a promising tool for improving our understanding of the spatial context of physical activity. Our findings suggest that the choice of an appropriate device and efforts to maximise participant adherence are key improving data quality, especially over longer study periods. PMID:22011423
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Range-wide assessment of livestock grazing across the sagebrush biome
Veblen, Kari E.; Pyke, David A.; Jones, Christopher A.; Casazza, Michael L.; Assal, Timothy J.; Farinha, Melissa A.
2011-01-01
Domestic livestock grazing occurs in virtually all sagebrush habitats and is a prominent disturbance factor. By affecting habitat condition and trend, grazing influences the resources required by, and thus, the distribution and abundance of sagebrush-obligate wildlife species (for example, sage-grouse Centrocercus spp.). Yet, the risks that livestock grazing may pose to these species and their habitats are not always clear. Although livestock grazing intensity and associated habitat condition may be known in many places at the local level, we have not yet been able to answer questions about use, condition, and trend at the landscape scale or at the range-wide scale for wildlife species. A great deal of information about grazing use, management regimes, and ecological condition exists at the local level (for individual livestock management units) under the oversight of organizations such as the Bureau of Land Management (BLM). However, the extent, quality, and types of existing data are unknown, which hinders the compilation, mapping, or analysis of these data. Once compiled, these data may be helpful for drawing conclusions about rangeland status, and we may be able to identify relationships between those data and wildlife habitat at the landscape scale. The overall objective of our study was to perform a range-wide assessment of livestock grazing effects (and the relevant supporting data) in sagebrush ecosystems managed by the BLM. Our assessments and analyses focused primarily on local-level management and data collected at the scale of BLM grazing allotments (that is, individual livestock management units). Specific objectives included the following: 1. Identify and refine existing range-wide datasets to be used for analyses of livestock grazing effects on sagebrush ecosystems. 2. Assess the extent, quality, and types of livestock grazing-related natural resource data collected by BLM range-wide (i.e., across allotments, districts and regions). 3. Compile and synthesize recommendations from federal and university rangeland science experts about how BLM might prioritize collection of different types of livestock grazing-related natural resource data. 4. Investigate whether range-wide datasets (Objective 1) could be used in conjunction with remotely sensed imagery to identify across broad scales (a) allotments potentially not meeting BLM Land Health Standards (LHS) and (b) allotments in which unmet standards might be attributable to livestock grazing. Objective 1: We identified four datasets that potentially could be used for analyses of livestock grazing effects on sagebrush ecosystems. First, we obtained the most current spatial data (typically up to 2007, 2008, or 2009) for all BLM allotments and compiled data into a coarse, topologically enforced dataset that delineated grazing allotment boundaries. Second, we obtained LHS evaluation data (as of 2007) for all allotments across all districts and regions; these data included date of most recent evaluation, BLM determinations of whether region-specific standards were met, and whether BLM deemed livestock to have contributed to any unmet standards. Third, we examined grazing records of three types: Actual Use (permittee-reported), Billed Use (BLM-reported), and Permitted Use (legally authorized). Finally, we explored the possibility of using existing Natural Resources Conservation Service (NRCS) Ecological Site Description (ESD) data to make up-to-date estimates of production and forage availability on BLM allotments. Objective 2: We investigated the availability of BLM livestock grazing-related monitoring data and the status of LHS across 310 randomly selected allotments in 13 BLM field offices. We found that, relative to other data types, the most commonly available monitoring data were Actual Use numbers (permittee-reported livestock numbers and season-of-use), followed by Photo Point, forage Utilization, and finally, Vegetation Trend measurement data. Data availability and frequency of data collection varied across allotments and field offices. Analysis of the BLM's LHS data indicated 67 percent of allotments analyzed were meeting standards. For those not meeting standards, livestock were considered the causal factor in 45 percent of cases (about 15 percent of all allotments). Objective 3: We sought input from 42 university and federal rangeland science experts about how best to prioritize rangeland monitoring activities associated with ascertaining livestock impacts on vegetation resources. When we presented a hypothetical scenario to these scientists and asked them to prioritize monitoring activities, the most common response was to measure ground and vegetation cover, a variable that in many cases (10 of 13 field offices sampled) BLM had already identified as a monitoring priority. Experts identified several other traditional (for example, photo points) and emerging approaches (for example, high-resolution aerial photography) to monitoring. Objective 4: We used spatial allotment data (described in Objective 1) and remotely sensed vegetation data (sagebrush cover, herbaceous vegetation cover, litter and bare soil) to assess differences in allotment LHS status ("Not met" vs. "Met"; if "Not met" - livestock-caused vs. not). We then developed logistic regression models, using vegetation variables to predict LHS status of BLM allotments in sagebrush steppe habitats in Wyoming and portions of Montana and Colorado. In general, we found that more consistent data collection at the local level might improve suitability of data for broad-scale analyses of livestock impacts. As is, data collection methodologies varied across field offices and States, and we did not find any local-level monitoring data (Actual Use, Utilization, Vegetation Trend) that had been collected consistently enough over time or space for range-wide analyses. Moreover, continued and improved emphasis on monitoring also may aid local management decisions, particularly with respect to effects of livestock grazing. Rangeland science experts identified ground cover as a high monitoring priority for assessing range condition and emphasized the importance of tracking livestock numbers and grazing dates. Ultimately, the most effective monitoring program may entail both increased data collection effort and the integration of alternative monitoring approaches (for example, remote sensing or monitoring teams). In the course of our study, we identified three additional datasets that could potentially be used for range-wide analyses: spatial allotment boundary data for all BLM allotments range-wide, LHS evaluations of BLM allotments, and livestock use data (livestock numbers and grazing dates). It may be possible to use these spatial datasets to help prioritize monitoring activities over the extensive land areas managed by BLM. We present an example of how we used spatial allotment boundary data and LHS data to test whether remotely sensed vegetation characteristics could be used to predict which allotments met or did not meet LHS. This approach may be further improved by the results of current efforts by BLM to test whether more intensive (higher resolution) LHS assessments more accurately describe land health status. Standardized data collection in more ecologically meaningful land units may improve our ability to use local-level data for broad-scale analyses.
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Problematic Internet Use Among US Youth: A Systematic Review
Moreno, Megan A; Jelenchick, Lauren; Cox, Elizabeth; Young, Henry; Christakis, Dimitri A
2011-01-01
Objectives To investigate study quality and reported prevalence among the emergent area of problematic internet use (PIU) research conducted in populations of US adolescents and college students. Data sources We searched PubMed, PsychInfo and Web of Knowledge from inception to July 2010. Study selection Using a keyword search, we evaluated English-language PIU studies with populations of US adolescents and college students. Main outcome measures Using a quality review tool based on the STROBE statement, two reviewers independently extracted data items including study setting, subject population, instrument used and reported prevalence. Results Search results yielded 658 manuscripts. We identified 18 research studies that met inclusion criteria. Quality assessment of studies ranged between 14 and 29 total points out of a possible 42 points, the average score was 23 (SD 5.1). Among these 18 studies, 8 reported prevalence estimates of US college student PIU, prevalence rates ranged from 0 to 26.3%. An additional 10 studies did not report prevalence. Conclusion The evaluation of PIU remains incomplete and is hampered by methodological inconsistencies. The wide range of conceptual approaches may have impacted the reported prevalence rates. Despite the newness of this area of study, most studies in our review were published over 3 years ago. Opportunities exist to pursue future studies adhering to recognized quality guidelines, as well as applying consistency in theoretical approach and validated instruments. PMID:21536950
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Herb–drug interactions: an overview of systematic reviews
Posadzki, Paul; Watson, Leala; Ernst, Edzard
2013-01-01
OBJECTIVES The aim of this overview of systematic reviews (SRs) is to evaluate critically the evidence regarding interactions between herbal medicinal products (HMPs) and synthetic drugs. METHODS Four electronic databases were searched to identify relevant SRs. RESULTS Forty‐six SRs of 46 different HMPs met our inclusion criteria. The vast majority of SRs were of poor methodological quality. The majority of these HMPs were not associated with severe herb–drug interactions. Serious herb–drug interactions were noted for Hypericum perforatum and Viscum album. The most severe interactions resulted in transplant rejection, delayed emergence from anaesthesia, cardiovascular collapse, renal and liver toxicity, cardiotoxicity, bradycardia, hypovolaemic shock, inflammatory reactions with organ fibrosis and death. Moderately severe interactions were noted for Ginkgo biloba, Panax ginseng, Piper methysticum, Serenoa repens and Camellia sinensis. The most commonly interacting drugs were antiplatelet agents and anticoagulants. CONCLUSION The majority of the HMPs evaluated in SRs were not associated with drug interactions with serious consequences. However, the poor quality and the scarcity of the primary data prevent firm conclusions. PMID:22670731
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Drouin, Jillian L.; McAlpine, Caitlin T.; Primak, Kari A.; Kissel, Jaclyn
2013-01-01
Context: The effect of the application of kinesiotape to skin overlying musculature on measurable athletic-based performance outcomes in healthy individuals has not been well established. Objective: To systematically search and assess the quality of the literature on the effect of kinesiotape on athletic-based performance outcomes in healthy, active individuals. Methods: An electronic search strategy was conducted in MANTIS, Cochrane Library and EBSCO databases. Retrieved articles that met the eligibility criteria were rated for methodological quality by using an adaption of the critical appraisal criteria in Clinical Epidemiology by Sackett et al. Results: Ten articles met the inclusion criteria. Seven articles had positive results in at least one athletic-based performance measure compared to controls. Conclusion: Evidence is lacking to support the use of kinesiotape as a successful measure for improving athletic-based performance outcomes in healthy individuals. However, there is no evidence to show that kinesiotape has a negative effect on any of the performace measures. PMID:24302784
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Espinosa de los Monteros, Karla; Elder, John P.; Talavera, Gregory A.
2008-01-01
Objectives. We sought to examine the relationships between individual and area-based indicators of acculturation and metabolic syndrome (MetS) risk among a sample of Mexican American women living in the California–Baja California border region. Methods. We examined data collected between October 2003 and December 2004 from 141 women (mean age = 47.07 years) who completed physical and psychosocial assessments. We reviewed medical records for laboratory values. Results. Individual-level US acculturation was associated with a greater consumption of fruits, vegetables, and fiber; increased odds of engaging in health-enhancing levels of physical activity; and decreased odds of meeting the clinical criteria for MetS. Moreover, beyond the influence of individual-level factors, US neighborhood acculturation was associated with less fat intake. Conclusions. These findings provide preliminary evidence for a relationship between acculturation and the development of MetS in this population. Such information may assist efforts aimed at understanding and eliminating ethnic disparities in MetS risk and related health conditions. PMID:18799765
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Data Quality Assessment of FY-3C MWRI Microwave Imager from CMA, ECMWF and the Met Office
NASA Astrophysics Data System (ADS)
Lu, Q.; WU, S.; Dou, F.; Sun, F.; Lawrence, H.; Geer, A.; English, S.; Newman, S.; Bell, W.; Bormann, N.; Carminati, F.
2017-12-01
MWRI is a conical-scanning microwave imager following on from the heritage of similar instruments such as SSMI/S and AMSR-2, with ten channels at frequencies between 10.65 GHz and 89 GHz. MWRI is flown on the China Meteorological Administration's (CMA's) Feng-Yun-3 (FY-3) satellite series, including on FY-3C and the upcoming FY-3D, scheduled for launch in September 2017. Here we present an evaluation of the data from MWRI on the FY-3C satellite launched in 2013. At CMA, the MWRI instrumental parameters and statistics between observation and simulation from RTTOV and CRTM radiative transfer modeling were monitored to characterise instrumental uncertainty from calibration and assess the data quality. The data were also assessed using model-equivalent brightness temperatures from the ECMWF and Met Office short-range forecasts. The forecasts were first transformed into brightness temperature space using the RTTOV radiative transfer code. By analysing observed minus model background ("O-B") brightness temperature departures we were able to investigate the instrument and geophysical state dependence of biases. We show examples of how biases can impact the data quality, related to ascending/descending node differences and radio frequency interference. We discuss the prospects of assimilation of MWRI data at NWP centres.
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Ethics and quality care in nursing homes: Relatives' experiences.
Jakobsen, Rita; Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Sørlie, Venke
2017-01-01
A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients' relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words. The aim of the study is to investigate relatives of persons with dementia's experiences with quality care in nursing homes. The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological-hermeneutical method for the study of lived experiences. Participants and research context: Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included. Ethical considerations: The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study. Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives' experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt. The results are discussed considering the concepts of trust, power and asymmetry. When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.
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Imaging genetics paradigms in depression research: Systematic review and meta-analysis.
Pereira, Lícia P; Köhler, Cristiano A; Stubbs, Brendon; Miskowiak, Kamilla W; Morris, Gerwyn; de Freitas, Bárbara P; Thompson, Trevor; Fernandes, Brisa S; Brunoni, André R; Maes, Michael; Pizzagalli, Diego A; Carvalho, André F
2018-05-17
Imaging genetics studies involving participants with major depressive disorder (MDD) have expanded. Nevertheless, findings have been inconsistent. Thus, we conducted a systematic review and meta-analysis of imaging genetics studies that enrolled MDD participants across major databases through June 30th, 2017. Sixty-five studies met eligibility criteria (N = 4034 MDD participants and 3293 controls), and there was substantial between-study variability in the methodological quality of included studies. However, few replicated findings emerged from this literature with only 22 studies providing data for meta-analyses (882 participants with MDD and 616 controls). Total hippocampal volumes did not significantly vary in MDD participants or controls carrying either the BDNF Val66Met 'Met' (386 participants with MDD and 376 controls) or the 5-HTTLPR short 'S' (310 participants with MDD and 230 controls) risk alleles compared to non-carriers. Heterogeneity across studies was explored through meta-regression and subgroup analyses. Gender distribution, the use of medications, segmentation methods used to measure the hippocampus, and age emerged as potential sources of heterogeneity across studies that assessed the association of 5-HTTLPR short 'S' alleles and hippocampal volumes. Our data also suggest that the methodological quality of included studies, publication year, and the inclusion of brain volume as a covariate contributed to the heterogeneity of studies that assessed the association of the BDNF Val66Met 'Met' risk allele and hippocampal volumes. In exploratory voxel-wise meta-analyses, MDD participants carrying the 5-HTTLPR short 'S' allele had white matter microstructural abnormalities predominantly in the corpus callosum, while carriers of the BDNF Val66Met 'Met' allele had larger gray matter volumes and hyperactivation of the right middle frontal gyrus compared to non-carriers. In conclusion, few replicated findings emerged from imaging genetics studies that included participants with MDD. Nevertheless, we explored and identified specific sources of heterogeneity across studies, which could provide insights to enhance the reproducibility of this emerging field. Copyright © 2018 Elsevier Inc. All rights reserved.
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Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis
ERIC Educational Resources Information Center
Kim, Hongsoo; Harrington, Charlene; Greene, William H.
2009-01-01
Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…
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Norris, J. Michael; Hren, Janet; Myers, Donna N.; Chaney, Thomas H.; Childress, Carolyn J. Oblinger
1990-01-01
During the past several years, a growing number of questions have been raised by members of Congress and others about the status of current waterquality conditions in the Nation, trends in water quality, and the major factors that affect water-quality conditions and trends. One area of particular interest and concern has been the suitability of existing water-quality data for addressing these types of questions at regional and national scales. In response to these questions and concerns, the U.S. Geological Survey began a pilot study in Colorado and Ohio to (1) determine the characteristics of current water-quality data-collection activities of Federal, State, regional, and local agencies and universities; and (2) determine how well the data from these activities, collected for various purposes and using different procedures, can be used to improve our ability to address the aforementioned questions.Colorado and Ohio were chosen for the pilot study because they represent regions with different types of water-quality issues and programs. The results of the study are specific to the two States and are not intended to be extrapolated to other States.The study was divided into three phases whose objectives were:Phase I Identify and inventory 1984 water-quality data-collection programs, including costs, in Colorado and Ohio, and identify those programs that meet a set of broad criteria for producing data that potentially are appropriate for water-quality assessments of regional and national scope. Phase II Evaluate the quality assurance of field and laboratory procedures used to produce the data from programs that met the broad criteria of Phase I. Phase III Compile the qualifying data from Phase II and evaluate the extent to which the resulting data base can be used to address selected water-quality questions for the two States.This report presents the results of Phase III, focusing on (1) the number of measurements made at each data-collection site for selected constituents, (2) the areal distribution of those sites that have sufficient data for selected types of analyses, and (3) the availability of key ancillary information such as streamflow to address broad-scope questions such as:What are existing water-quality conditions?Has the water quality changed? andHow do existing water-quality conditions and changes in these conditions relate to natural factors and human-induced activities?
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Watanabe, Yoko; Saito, Isao; Asada, Yasuhiko; Kishida, Taro; Matsuo, Tatsuhiro; Yamaizumi, Masamitsu; Kato, Tadahiro
2013-01-01
Objectives: The first objective of this study was to classify men aged 40–74 yrs with metabolic syndrome (MetS) according to daily rice intake, and the second was to investigate physical measurements, physiological examinations, blood biochemical assays, intake of food other than rice and lifestyle and environmental factors in the study group. Methods: We analyzed data from 6095 men aged 40–74 yrs who had undergone full medical examinations. The men were classified into 3 age groups: (1) 40–49 yrs, (2) 50–59 yrs, and (3) 60–74 yrs. The men were classified further into 3 groups according to daily rice intake: group 1 (≤300 g), group 2 (300–450 g), and group 3 (≥450 g). The relationship between daily rice intake and the following factors was analyzed in the three age brackets: (1) physical measurements including waist circumference, (2) physiological measurements, (3) serum biochemical indices, (4) whether or not the person was taking medication for hypertension, diabetes mellitus or serum lipid abnormalities, (5) lifestyle, and (6) consumption of foods other than rice. Results: Daily rice intake was related strongly to the occurrence of MetS in all three age brackets. Multiple logistic regression analysis showed (1) a significant increase in the odds ratio for MetS (1.461 times) for group 3 compared with group 1 in men aged 40–49 yrs and (2) a significant increase in the odds ratio for MetS (1.501 times) for group 3 compared with group 1 in men aged 50–59 yrs. However, there was no significant difference in the odds ratio for MetS among rice intake groups in the 60–74 age bracket. Conclusion: In men aged 40–59 yrs, daily rice intake strongly influenced the incidence of MetS, whereas in men aged 60–74 yrs, there was no relationship between daily rice intake and MetS. PMID:25649461
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Sénéchal, Martin; Johannsen, Neil M; Swift, Damon L; Earnest, Conrad P; Lavie, Carl J; Blair, Steven N; Church, Timothy S
2015-01-01
Type 2 diabetes mellitus (T2DM) is associated with a reduction in muscle quality. However, there is inadequate empirical evidence to determine whether changes in muscle quality following exercise are associated with improvement in cardiorespiratory fitness (CRF) in individuals with T2DM. The objective of this study was to investigate the association between change in muscle quality following a 9-month intervention of aerobic training (AT), resistance training (RT) or a combination of both (ATRT) and cardiorespiratory fitness (CRF) in individuals with T2DM. A total of 196 participants were randomly assigned to a control, AT, RT, or combined ATRT for a 9-months intervention. The exposure variable was change in muscle quality [(Post: leg muscle strength/leg muscle mass)-[(Pre: leg muscle strength/leg muscle mass)]. Dependent variables were change in CRF measures including absolute and relative VO2peak, and treadmill time to exhaustion (TTE) and estimated metabolic equivalent task (METs). Continuous change in muscle quality was independently associated with change in absolute (β = 0.015; p = 0.019) and relative (β = 0.200; p = 0.005) VO2peak, and TTE (β = 0.170; p = 0.043), but not with estimated METs (p > 0.05). A significant trend was observed across tertiles of change in muscle quality for changes in absolute (β = 0.050; p = 0.005) and relative (β = 0.624; p = 0.002) VO2peak following 9 months of exercise training. No such association was observed for change in TTE and estimated METs (p > 0.05). The results from this ancillary study suggest that change in muscle quality following exercise training is associated with a greater improvement in CRF in individuals with T2DM. Given the effect RT has on increasing muscle quality, especially as part of a recommended training program (ATRT), individuals with T2DM should incorporate RT into their AT regimens to optimize CRF improvement. Clinicaltrials.gov NCT00458133.
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Sénéchal, Martin; Johannsen, Neil M.; Swift, Damon L.; Earnest, Conrad P.; Lavie, Carl J.; Blair, Steven N.; Church, Timothy S.
2015-01-01
Introduction Type 2 diabetes mellitus (T2DM) is associated with a reduction in muscle quality. However, there is inadequate empirical evidence to determine whether changes in muscle quality following exercise are associated with improvement in cardiorespiratory fitness (CRF) in individuals with T2DM. The objective of this study was to investigate the association between change in muscle quality following a 9-month intervention of aerobic training (AT), resistance training (RT) or a combination of both (ATRT) and cardiorespiratory fitness (CRF) in individuals with T2DM. Material and Methods A total of 196 participants were randomly assigned to a control, AT, RT, or combined ATRT for a 9-months intervention. The exposure variable was change in muscle quality [(Post: leg muscle strength/leg muscle mass)-[(Pre: leg muscle strength/leg muscle mass)]. Dependent variables were change in CRF measures including absolute and relative VO2peak, and treadmill time to exhaustion (TTE) and estimated metabolic equivalent task (METs). Results Continuous change in muscle quality was independently associated with change in absolute (β = 0.015; p = 0.019) and relative (β = 0.200; p = 0.005) VO2peak, and TTE (β = 0.170; p = 0.043), but not with estimated METs (p > 0.05). A significant trend was observed across tertiles of change in muscle quality for changes in absolute (β = 0.050; p = 0.005) and relative (β = 0.624; p = 0.002) VO2peak following 9 months of exercise training. No such association was observed for change in TTE and estimated METs (p > 0.05). Discussion The results from this ancillary study suggest that change in muscle quality following exercise training is associated with a greater improvement in CRF in individuals with T2DM. Given the effect RT has on increasing muscle quality, especially as part of a recommended training program (ATRT), individuals with T2DM should incorporate RT into their AT regimens to optimize CRF improvement. Trial Registration Clinicaltrials.gov NCT00458133 PMID:26252477
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-23
... missing data. The linear regression relationship is based on time periods in which both monitors were... fill in missing data for the incomplete monitor, so that the normal data completeness requirement of 75 percent of data in each quarter of the three years is met. After the missing data for the site is filled...
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Moreno, Alexander; Zidarov, Diana; Raju, Chandhana; Boruff, Jill; Ahmed, Sara
2017-08-04
There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration. The specific objectives are to: (A) synthesise the needs of individuals with SCI as perceived by themselves, their family caregivers and rehabilitation professionals using two theoretical models, (B) classify needs as met and unmet, (C) explore the evolution of met/unmet needs from the time of rehabilitation admission to community reintegration and (D) provide recommendations to improve SCI care. METHODS AND ANALYSIS: (A) identifying the most frequent met and unmet needs reported by adults with traumatic and non-traumatic SCI, their family caregivers and their rehabilitation professionals from the time of rehabilitation admission to community reintegration; (B) identifying relevant studies with a search in electronic databases; (C) charting the data based on categories refined and adjusted with a stakeholder group; (D) collating, summarising and reporting the results using two analytical frameworks (Maslow's hierarchical model of human needs and the Ferrans et al 's model of health-related quality of life) and (E) a stakeholder consultation phase. The results of this scoping study will allow understanding SCI needs from the time of rehabilitation admission to community reintegration from the perspective of different stakeholders. An integrated master report combining the needs of individuals with SCI from the perspectives of different stakeholders from the time of rehabilitation admission to community reintegration will follow the consultation meetings. © 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.
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Burrows, Tracy; Harries, Simon K.; Williams, Rebecca L.; Lum, Cheryl; Callister, Robin
2016-01-01
Objectives: The aims of the current study were to comprehensively assess the dietary intakes and diet quality of a sample of Australian competitive adolescent rugby union players and compare these intakes with National and Sports Dietitians Association (SDA) Recommendations for adolescent athletes. A secondary aim investigated applying different physical activity level (PAL) coefficients to determine total energy expenditure (TEE) in order to more effectively evaluate the adequacy of energy intakes. Design: Cross-sectional. Methods: Anthropometrics and dietary intakes were assessed in 25 competitive adolescent male rugby union players (14 to 18 years old). Diet was assessed using the validated Australian Eating Survey (AES) food frequency questionnaire and diet quality was assessed through the Australian Recommended Food Score. Results: The median dietary intakes of participants met national recommendations for percent energy (% E) from carbohydrate, protein and total fat, but not carbohydrate intake when evaluated as g/day as proposed in SDA guidelines. Median intakes of fibre and micronutrients including calcium and iron also met national recommendations. Overall diet quality was classified as ‘good’ with a median diet quality score of 34 (out of a possible 73); however, there was a lack of variety within key food groups including carbohydrates and proteins. Non-core food consumption exceeded recommended levels at 38% of the daily total energy intake, with substantial contributions from takeaway foods and sweetened beverages. A PAL coefficient of 1.2–1.4 was found to best balance the energy intakes of these players in their pre-season. Conclusions: Adolescent rugby players met the percent energy recommendations for macronutrients and attained an overall ‘good’ diet quality score. However, it was identified that when compared to specific recommendations for athletes, carbohydrate intakes were below recommendations and these players in their pre-season reported high consumption of non-core foods, particularly sugar sweetened drinks and low intakes of vegetables. PMID:27618089
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Report of the international workshop on quality control of monthly climate data
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1993-12-31
The National Climatic Data Center (NCDC), the US Department of Energy`s Carbon Dioxide Information Analysis Center, and the World Meteorological Organization (WMO) cosponsored an international quality control workshop for monthly climate data, October 5--6, 1993, at NCDC. About 40 scientists from around the world participated. The purpose of the meeting was to discuss and compare various quality control methods and to draft recommendations concerning the most successful systems. The near-term goal to improve quality control of CLIMAT messages for the NCDC/WMO publication Monthly Climatic Data for the World was sucessfully met. An electronic bulletin board was established to post errorsmore » and corrections. Improved communications among Global Telecommunication System hubs will be implemented. Advanced quality control algorithms were discussed and improvements were suggested. Further data exchanges were arranged.« less
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Conference on Workforce Quality Assessment Held in Washington, DC on 8 May 1989
1989-09-01
of Education Statistics Sar Levitan, Director Department of Education Center for Social Policy Studies George Washington University Michael G. Hansen...wO. it’" Merit Systems Protection Board Office of Personnel Management A Federal Government which is staffed by well qualified and motivated ...long been national policy to provide for a merit-based civil service system. The question of whether we have met the objective of a well qualified
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Integration of a Clinical Pharmacist into an Interdisciplinary Palliative Care Outpatient Clinic.
DiScala, Sandra Lee; Onofrio, Sarah; Miller, Maura; Nazario, Mitchell; Silverman, Michael
2017-11-01
The primary objective of this quality improvement (QI) project was to determine if the Interdisciplinary Palliative Care Outpatient Clinic (IPCOC) at the West Palm Beach Veterans Affairs Medical Center offered improved symptom assessment and palliative care treatment outcomes. Secondary objectives were to identify, classify, and resolve medication problems and calculate the number of pharmacist recommendations accepted by prescribing providers. An IPCOC was created by selecting disciplines for a core group including a nurse practitioner, clinical pharmacist, social worker, chaplain, and physician. Consult referrals were recruited by providing educational sessions. The patient assessments were completed using the Edmonton Symptom Assessment System: (revised version; ESAS-R). The clinical pharmacist classified and resolved drug-related problems. The pharmacy resident telephoned veterans for completion of the "Patient Assessment: Overall Satisfaction with Outpatient Palliative Care Clinic." Seventeen consults were received, 6 patients were excluded, and 11 were seen in clinic. One (9%) of 11 patients met the outcomes measure of system assessment documentation in the past year. At completion, 11 (100%) of 11 patients met the outcomes data measure. The Patient Satisfaction Assessment revealed veterans strongly agree to recommend the IPCOC. The clinical pharmacist identified 20 drug-related problems, made 16 recommendations, had a 93.7% implementation rate, and facilitated implementation of medication changes. This QI project demonstrates that an IPCOC improved symptom assessment and palliative care outcomes in addition to resolution of medication prescribing issues in veterans with advanced cancer by integration of a clinical pharmacist into the core team.
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Fournier, Sara B; Reger, Brian L; Donley, David A; Bonner, Daniel E; Warden, Bradford E; Gharib, Wissam; Failinger, Conard F; Olfert, Melissa D; Frisbee, Jefferson C; Olfert, I Mark; Chantler, Paul D
2014-01-01
Metabolic syndrome (MetS) is the manifestation of a cluster of cardiovascular risk factors and is associated with a threefold increase in the risk of cardiovascular morbidity and mortality, which is suggested to be mediated, in part, by resting left ventricular (LV) systolic dysfunction. However, to what extent resting LV systolic function is impaired in MetS is controversial, and there are no data indicating whether LV systolic function is impaired during exercise. Accordingly, the objective of this study was to examine comprehensively the LV and arterial responses to exercise in individuals with MetS without diabetes and/or overt cardiovascular disease in comparison to a healthy control population. Cardiovascular function was characterized using Doppler echocardiography and gas exchange in individuals with MetS (n = 27) versus healthy control subjects (n = 20) at rest and during peak exercise. At rest, individuals with MetS displayed normal LV systolic function but reduced LV diastolic function compared with healthy control subjects. During peak exercise, individuals with MetS had impaired contractility, pump performance and vasodilator reserve capacity versus control subjects. A blunted contractile reserve response resulted in diminished arterial-ventricular coupling reserve and limited aerobic capacity in individuals with MetS versus control subjects. These findings are of clinical importance, because they provide insight into the pathophysiological changes in MetS that may predispose this population of individuals to an increased risk of cardiovascular morbidity and mortality.
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Feldstein Ewing, Sarah W.; LaChance, Heather A.; Bryan, Angela; Hutchison, Kent E.
2010-01-01
Research indicates that motivational enhancement therapy (MET) helps catalyze reductions in problem drinking among emerging adults. However, moderators of this intervention remain relatively unknown. Therefore, the objectives of this study were: (1) to test whether a single session of MET increased motivation to reduce drinking and drinking outcomes; and (2) to examine whether genetic dopamine D4 receptor L (DRD4 L) and individual personality risk factors (impulsivity and novelty seeking) moderated the effects of the MET. These hypotheses were evaluated by randomly assigning a sample of emerging adult problem drinkers (n = 67) to receive a single session of MET or alcohol education. Follow-up data indicated that only individuals who were low in impulsivity, novelty seeking and/or who had the short DRD4 variable number of tandem repeats genotype evidenced differentially increased behavior change (taking steps toward reducing drinking) following the MET. PMID:19298319
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Methamidophos alters sperm function and DNA at different stages of spermatogenesis in mice.
Urióstegui-Acosta, Mayrut; Hernández-Ochoa, Isabel; Sánchez-Gutiérrez, Manuel; Piña-Guzmán, Belem; Rafael-Vázquez, Leticia; Solís-Heredia, M J; Martínez-Aguilar, Gerardo; Quintanilla-Vega, Betzabet
2014-09-15
Methamidophos (MET) is a highly toxic organophosphate (OP) pesticide that is widely used in developing countries. MET has male reproductive effects, including decreased fertility. We evaluated MET effects on sperm quality, fertilization and DNA integrity, exploring the sensitivity of different stages of spermatogenesis. Adult male mice received MET (3.75 or 5mg/kg-bw/ip/day/4 days) and were euthanized 1, 28 or 45 days post-treatment (dpt) to evaluate MET's effects on epididymal maturation, meiosis or mitosis, respectively. Spermatozoa were obtained from the cauda epididymis-vas deferens and were evaluated for sperm quality, acrosome reaction (AR; Coomassie staining), mitochondrial membrane potential (by JC-1), DNA damage (comet assay), oxidative damage (malondialdehyde (MDA) production), in vitro fertilization and protein phosphorylation (immunodetection), and erythrocyte acetylcholinesterase (AChE) activity. At 1-dpt, MET inhibited AChE (43-57%) and increased abnormal cells (6%). While at 28- and 45-dpt, sperm motility and viability were significantly reduced with an increasing MET dose, and abnormal morphology increased at 5mg/kg/day/4 days. MDA and mitochondrial activity were not affected at any dose or time. DNA damage (OTM and %DNA) was observed at 5mg/kg/day/4 days in a time-dependent manner, whereas both parameters were altered in cells from mice exposed to 3.75 mg/kg/day/4 days only at 28-dpt. Depending on the time of collection, initial-, spontaneous- and induced-AR were altered at 5mg/kg/day/4 days, and the fertilization capacity also decreased. Sperm phosphorylation (at serine and tyrosine residues) was observed at all time points. Data suggest that meiosis and mitosis are the more sensitive stages of spermatogenesis for MET reproductive toxicity compared to epididymal maturation. Copyright © 2014 Elsevier Inc. All rights reserved.
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A perspective on the FAA approval process: Integrating rotorcraft displays, controls and workload
NASA Technical Reports Server (NTRS)
Green, David L.; Hart, Jake; Hwoschinsky, Peter
1993-01-01
The FAA is responsible for making the determination that a helicopter is safe for IFR operations in the National Airspace System (NAS). This involves objective and subjective evaluations of cockpit displays, flying qualities, procedures and human factors as they affect performance and workload. After all of the objective evaluations are completed, and all Federal Regulations have been met, FAA pilots make the final subjective judgement as to suitability for use by civil pilots in the NAS. The paper uses the flying qualities and pilot workload characteristics of a small helicopter to help examine the FAA pilot's involvement in this process. The result highlights the strengths of the process and its importance to the approval of new aircraft and equipments for civil IFR helicopter applications. The paper also identifies opportunities for improvement.
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DeBoer, Mark D.; Dong, Lili; Gurka, Matthew J.
2011-01-01
Background Among adolescents uric acid is associated with insulin resistance, hypertension and the metabolic syndrome (MetS) and in adults high uric acid levels are an independent risk factor for cardiovascular disease and diabetes. Objective Determine whether the relationship of uric acid with MetS varies in adolescents by race/ethnicity and gender. Methods We used linear regression to evaluate associations between uric acid and other MetS-associated clinical and laboratory measures among 3,296 non-Hispanic-white, non-Hispanic-black and Hispanic adolescents age 12–19y participating in the National Health and Nutrition Evaluation Survey (1999–2006). Results Overall, non-Hispanic-white males and females had the highest uric acid levels among the three racial/ethnic groups. In each racial/ethnic group there were higher uric acid levels for those adolescents with vs. without MetS. However, the extent of the MetS-related increase in uric acid level varied by race and gender. Among males, MetS was associated with the greatest increases in uric acid among non-Hispanic whites. However, among females, the MetS-related increase in uric acid was greatest among non-whites. Non-Hispanic-white females exhibited the lowest degrees of correlation between levels of uric acid and MetS-associated variables. Uric acid levels did not correlate with insulin levels in non-Hispanic-white females. Conclusions These data suggest the relationship between uric acid and MetS varies by race/ethnicity and gender. In particular, non-Hispanic-white males exhibit a strong relationship and non-Hispanic-white females exhibit a relatively poor correlation between uric acid and MetS-related factors. These data may have implications for the use of uric acid as a marker of future risk among adolescents. PMID:22000606
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NASA Astrophysics Data System (ADS)
Robinson, Niall; Tomlinson, Jacob; Prudden, Rachel; Hilson, Alex; Arribas, Alberto
2017-04-01
The Met Office Informatics Lab is a small multidisciplinary team which sits between science, technology and design. Our mission is simply "to make Met Office data useful" - a deliberately broad objective. Our prototypes often trial cutting edge technologies, and so far have included projects such as virtual reality data visualisation in the web browser, bots and natural language interfaces, and artificially intelligent weather warnings. In this talk we focus on our latest project, Jade, a big data analysis platform in the cloud. It is a powerful, flexible and simple to use implementation which makes extensive use of technologies such as Jupyter, Dask, containerisation, Infrastructure as Code, and auto-scaling. Crucially, Jade is flexible enough to be used for a diverse set of applications: it can present weather forecast information to meteorologists and allow climate scientists to analyse big data sets, but it is also effective for analysing non-geospatial data. As well as making data useful, the Informatics Lab also trials new working practises. In this presentation, we will talk about our experience of making a group like the Lab successful.
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A proposed streamflow-data program for North Dakota
Crosby, O.A.
1970-01-01
An evaluation of the streamflow data available in North Dakota was made to provide guidelines for planning future programs. The basic steps in the evaluation procedure were (1) definition of the long-term goals of the streamflow data program in quantitative form, (2) examination and analysis of all available data to determine which goals have already been met, and (3) consideration of alternate programs and techniques to meet the remaining objectives. None of the goals could be met by generalization of the data for gaged basins by regression analysis. This fact indicates that significant changes should be made in the present data program to obtain better areal coverage to achieve the goals set. A streamflow data program based on the guidelines developed in this study is proposed for the future.
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Rest and treatment/rehabilitation following sport-related concussion: a systematic review.
Schneider, Kathryn J; Leddy, John J; Guskiewicz, Kevin M; Seifert, Tad; McCrea, Michael; Silverberg, Noah D; Feddermann-Demont, Nina; Iverson, Grant L; Hayden, Alix; Makdissi, Michael
2017-06-01
The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). Systematic review. MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically. Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded. Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care. A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit. PROSPERO 2016:CRD42016039570. © 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.
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Social Network Sites as a Mode to Collect Health Data: A Systematic Review
Ramzan, Farzan; Rawaf, Salman; Majeed, Azeem
2014-01-01
Background To date, health research literature has focused on social network sites (SNS) either as tools to deliver health care, to study the effect of these networks on behavior, or to analyze Web health content. Less is known about the effectiveness of these sites as a method for collecting data for health research and the means to use such powerful tools in health research. Objective The objective of this study was to systematically review the available literature and explore the use of SNS as a mode of collecting data for health research. The review aims to answer four questions: Does health research employ SNS as method for collecting data? Is data quality affected by the mode of data collection? What types of participants were reached by SNS? What are the strengths and limitations of SNS? Methods The literature was reviewed systematically in March 2013 by searching the databases MEDLINE, Embase, and PsycINFO, using the Ovid and PubMed interface from 1996 to the third week of March 2013. The search results were examined by 2 reviewers, and exclusion, inclusion, and quality assessment were carried out based on a pre-set protocol. Results The inclusion criteria were met by 10 studies and results were analyzed descriptively to answer the review questions. There were four main results. (1) SNS have been used as a data collection tool by health researchers; all but 1 of the included studies were cross-sectional and quantitative. (2) Data quality indicators that were reported include response rate, cost, timeliness, missing data/completion rate, and validity. However, comparison was carried out only for response rate and cost as it was unclear how other reported indicators were measured. (3) The most targeted population were females and younger people. (4) All studies stated that SNS is an effective recruitment method but that it may introduce a sampling bias. Conclusions SNS has a role in health research, but we need to ascertain how to use it effectively without affecting the quality of research. The field of SNS is growing rapidly, and it is necessary to take advantage of the strengths of this tool and to avoid its limitations by effective research design. This review provides an important insight for scholars who plan to conduct research using SNS. PMID:25048247
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Bragg, Heather M.; Johnston, Matthew W.
2016-04-15
All quality-assurance values exceed the criteria established by the U.S. Army Corps of Engineers TDG monitoring plan. Criteria for data completeness (95-percent) were met at seven of the eight monitoring stations. Deleted data at the John Day tailwater station resulted in data completeness below criteria.
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Bernstam, Elmer V; Shelton, Dawn M; Walji, Muhammad; Meric-Bernstam, Funda
2005-01-01
To find and assess quality-rating instruments that can be used by health care consumers to assess websites displaying health information. Searches of PubMed, the World Wide Web (using five different search engines), reference tracing from identified articles, and a review of the of the American Medical Informatics Association's annual symposium proceedings. Sources were examined for availability, number of elements, objectivity, and readability. A total of 273 distinct instruments were found and analyzed. Of these, 80 (29%) made evaluation criteria publicly available and 24 (8.7%) had 10 or fewer elements (items that a user has to assess to evaluate a website). Seven instruments consisted of elements that could all be evaluated objectively. Of these seven, one instrument consisted entirely of criteria with acceptable interobserver reliability (kappa> or =0.6); another instrument met readability standards. There are many quality-rating instruments, but few are likely to be practically usable by the intended audience.
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NASA Technical Reports Server (NTRS)
King, R. B.; Neustadter, H. E.; Fordyce, J. S.; Burr, J. C., Jr.; Cornett, C. L.
1974-01-01
Air-quality data for metropolitan Cleveland, Ohio, from 1967 through 1972 were collated and statistically analyzed. Total suspended particulates (TSP) departed from lognormal distribution in 1972. Nitrogen dioxide and sulfur dioxide, departed significantly from lognormal distributions in 1972. In Cleveland the Ohio standards were not met. However, the data indicate a general improvement in air quality. Unusually high precipitation (43% above the average in 1972) may be responsible in lowering these values from the 1971 levels. The mean values of TSP, NO2, and SO2 are 104, 191, and 83 microgram/cu m respectively.
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Iowa Central Quality Fuel Testing Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
Heach, Don; Bidieman, Julaine
2013-09-30
The objective of this project is to finalize the creation of an independent quality fuel testing laboratory on the campus of Iowa Central Community College in Fort Dodge, Iowa that shall provide the exploding biofuels industry a timely and cost-effective centrally located laboratory to complete all state and federal fuel and related tests that are required. The recipient shall work with various state regulatory agencies, biofuel companies and state and national industry associations to ensure that training and testing needs of their members and American consumers are met. The recipient shall work with the Iowa Department of Ag and Landmore » Stewardship on the development of an Iowa Biofuel Quality Standard along with the Development of a standard that can be used throughout industry.« less
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Pirkle, Catherine M; Wu, Yan Yan; Zunzunegui, Maria-Victoria; Gómez, José Fernando
2018-01-01
Objective Conceptual models underpinning much epidemiological research on ageing acknowledge that environmental, social and biological systems interact to influence health outcomes. Recursive partitioning is a data-driven approach that allows for concurrent exploration of distinct mixtures, or clusters, of individuals that have a particular outcome. Our aim is to use recursive partitioning to examine risk clusters for metabolic syndrome (MetS) and its components, in order to identify vulnerable populations. Study design Cross-sectional analysis of baseline data from a prospective longitudinal cohort called the International Mobility in Aging Study (IMIAS). Setting IMIAS includes sites from three middle-income countries—Tirana (Albania), Natal (Brazil) and Manizales (Colombia)—and two from Canada—Kingston (Ontario) and Saint-Hyacinthe (Quebec). Participants Community-dwelling male and female adults, aged 64–75 years (n=2002). Primary and secondary outcome measures We apply recursive partitioning to investigate social and behavioural risk factors for MetS and its components. Model-based recursive partitioning (MOB) was used to cluster participants into age-adjusted risk groups based on variabilities in: study site, sex, education, living arrangements, childhood adversities, adult occupation, current employment status, income, perceived income sufficiency, smoking status and weekly minutes of physical activity. Results 43% of participants had MetS. Using MOB, the primary partitioning variable was participant sex. Among women from middle-incomes sites, the predicted proportion with MetS ranged from 58% to 68%. Canadian women with limited physical activity had elevated predicted proportions of MetS (49%, 95% CI 39% to 58%). Among men, MetS ranged from 26% to 41% depending on childhood social adversity and education. Clustering for MetS components differed from the syndrome and across components. Study site was a primary partitioning variable for all components except HDL cholesterol. Sex was important for most components. Conclusion MOB is a promising technique for identifying disease risk clusters (eg, vulnerable populations) in modestly sized samples. PMID:29500203
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Ballemans, Judith; Kempen, Gertrudis IJM; Zijlstra, GA Rixt
2011-01-01
Objective: This study aimed to provide an overview of the development, content, feasibility, and effectiveness of existing orientation and mobility training programmes in the use of the identification cane. Data sources: A systematic bibliographic database search in PubMed, PsychInfo, ERIC, CINAHL and the Cochrane Library was performed, in combination with the expert consultation (n = 42; orientation and mobility experts), and hand-searching of reference lists. Review methods: Selection criteria included a description of the development, the content, the feasibility, or the effectiveness of orientation and mobility training in the use of the identification cane. Two reviewers independently agreed on eligibility and methodological quality. A narrative/qualitative data analysis method was applied to extract data from obtained documents. Results: The sensitive database search and hand-searching of reference lists revealed 248 potentially relevant abstracts. None met the eligibility criteria. Expert consultation resulted in the inclusion of six documents in which the information presented on the orientation and mobility training in the use of the identification cane was incomplete and of low methodological quality. Conclusion: Our review of the literature showed a lack of well-described protocols and studies on orientation and mobility training in identification cane use. PMID:21795405
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Metabolic syndrome and shift work: a systematic review.
Canuto, Raquel; Garcez, Anderson S; Olinto, Maria T A
2013-12-01
The aim of this systematic review was to examine the association between shift work and metabolic syndrome (MetS) as well as the potential confounders investigated. A systematic search was conducted with the aim of finding original articles on the association between shift work and MetS. The included articles were chosen based on established inclusion criteria; their methodological quality was assessed using a validated quality checklist. A total of 10 articles were included in this review. The majority of the studies were classified as having a low risk of bias. The definitions of MetS and shift work varied between studies. Among the ten studies, eight found a positive association between shift work and MetS after controlling for socio-demographic and behavioral factors. Only three studies included sleep duration as a confounder, and these studies presented discordant results. We conclude that there was insufficient evidence regarding the association between shift work and prevalent MetS when the confounders are taken into account. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Jin, Cheng-Long; Wang, Qiang; Zhang, Zong-Ming; Xu, Yin-Long; Yan, Hui-Chao; Li, Hai-Chang; Gao, Chun-Qi; Wang, Xiu-Qi
2018-05-02
This work was designed to investigate the synergistic effects of pioglitazone hydrochloride (PGZ) and chromium methionine (CrMet) on meat quality, muscle fatty acid profile, and antioxidant ability of pigs. Pigs in four groups were fed a basic diet or basic diet supplemented with 15 mg/kg of PGZ, 200 μg/kg of CrMet, or 15 mg/kg of PGZ + 200 μg/kg of CrMet. In comparison to the control group, the average daily feed intake, feed/gain ratio, and serum high-density lipoprotein level decreased in the PGZ + CrMet group. Dietary PGZ + CrMet supplementation increased carcass dressing percentage, intramuscular fat, and marbling score. The percentages of C18:1ω-9c, C18:2ω-6c, C18:3ω-3, and polyunsaturated fatty acid (PUFA) in the longissimus thoracis muscle were increased in the PGZ + CrMet group. Greater superoxide dismutase and glutathione peroxidase activities were observed in the PGZ + CrMet group compared to the control group. Collectively, these findings suggested that feed with PGZ and CrMet improved the growth performance and meat quality, especially for PUFA proportions and antioxidant ability.
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Robins, Stephanie; Barr, Helena J; Idelson, Rachel; Lambert, Sylvie
2016-01-01
Background Many men lack knowledge about male infertility, and this may have consequences for their reproductive and general health. Men may prefer to seek health information online, but these sources of information vary in quality. Objective The objective of this study is to determine if online sources of information regarding male infertility are readable, suitable, and of appropriate quality for Internet users in the general population. Methods This study used a cross-sectional design to evaluate online sources resulting from search engine queries. The following categories of websites were considered: (1) Canadian fertility clinics, (2) North American organizations related to fertility, and (3) the first 20 results of Google searches using the terms “male infertility” and “male fertility preservation” set to the search locations worldwide, English Canada, and French Canada. Websites that met inclusion criteria (N=85) were assessed using readability indices, the Suitability Assessment of Materials (SAM), and the DISCERN tool. The associations between website affiliation (government, university/medical, non-profit organization, commercial/corporate, private practice) and Google placement to readability, suitability, and quality were also examined. Results None of the sampled websites met recommended levels of readability. Across all websites, the mean SAM score for suitability was 45.37% (SD 11.21), or “adequate”, while the DISCERN mean score for quality was 43.19 (SD 10.46) or “fair”. Websites that placed higher in Google obtained a higher overall score for quality with an r (58) value of -.328 and a P value of .012, but this position was not related to readability or suitability. In addition, 20% of fertility clinic websites did not include fertility information for men. Conclusions There is a lack of high quality online sources of information on male fertility. Many websites target their information to women, or fail to meet established readability criteria for the general population. Since men may prefer to seek health information online, it is important that health care professionals develop high quality sources of information on male fertility for the general population. PMID:27769954
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Developing a medical emergency team running sheet to improve clinical handoff and documentation.
Mardegan, Karen; Heland, Melodie; Whitelock, Tifany; Millar, Robert; Jones, Daryl
2013-12-01
During medical emergency team (MET) and cardiac arrest calls, a scribe usually records events on a running sheet. There is more agreement on what data should be recorded in cardiac arrest calls than for MET calls. In addition, handoff (handover) from ward staff to the arriving MET may be variable. In a quality improvement project, a novel MET running sheet was developed to document events and therapies administered during MET calls. Key characteristics of the form were improved form layout, increased space for event documentation, and prompts to assist handoff to the arriving MET using the Identity Situation, Background, Assessment, Request (ISBAR) format. Ward nurses commonly involved in MET activation were surveyed to assess their perceptions of the new MET running sheet. Files of 100 consecutive MET calls were reviewed to assess compliance. Of 109 nurses invited to complete the survey, 103 did so (94.5% response rate). Overall, 87 (84.5%) of the 103 respondents agreed or strongly agreed that the new MET running sheet was better than the previous form for documenting MET management, and 58 (57.4%) of 101 respondents agreed or strongly agreed that it assisted handoff. The form was completed in 91 of a sample of 100 consecutive MET calls. Areas of less complete documentation included aspects of the ISBAR handover to the arriving MET and notification of the next of kin and usual clinicians at the completion of the call. The MET running sheet, tailored to the clinical events that occur during episodes of MET review, may assist handoff from ward nurses to the arriving MET and event documentation.
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Adams, Vanessa M; Pressey, Robert L; Álvarez-Romero, Jorge G
2016-01-01
Development of land resources can contribute to increased economic productivity but can also negatively affect the extent and condition of native vegetation, jeopardize the persistence of native species, reduce water quality, and erode ecosystem services. Spatial planning must therefore balance outcomes for conservation, development, and social goals. One approach to evaluating these trade-offs is scenario planning. In this paper we demonstrate methods for incorporating stakeholder preferences into scenario planning through both defining scenario objectives and evaluating the scenarios that emerge. In this way, we aim to develop spatial plans capable of informing actual land-use decisions. We used a novel approach to scenario planning that couples optimal land-use design and social evaluation of environmental outcomes. Four land-use scenarios combined differences in total clearing levels (10% and 20%) in our study region, the Daly Catchment Australia, with the presence or absence of spatial precincts to concentrate irrigated agriculture. We used the systematic conservation planning tool Marxan with Zones to optimally plan for multiple land-uses that met objectives for both conservation and development. We assessed the performance of the scenarios in terms of the number of objectives met and the degree to which existing land-use policies were compromised (e.g., whether clearing limits in existing guidelines were exceeded or not). We also assessed the land-use scenarios using expected stakeholder satisfaction with changes in the catchment to explore how the scenarios performed against social preferences. There were a small fraction of conservation objectives with high conservation targets (100%) that could not be met due to current land uses; all other conservation and development objectives were met in all scenarios. Most scenarios adhered to the existing clearing guidelines with only marginal exceedances of limits, indicating that the scenario objectives were compatible with existing policy. We found that two key stakeholder groups, agricultural and Indigenous residents, had divergent satisfaction levels with the amount of clearing and agricultural development. Based on the range of benefits and potential adverse impacts of each scenario, we suggest that the 10% clearing scenarios are most aligned with stakeholder preferences and best balance preferences across stakeholder groups. Our approach to scenario planning is applicable generally to exploring the potential conflicts between goals for conservation and development. Our case study is particularly relevant to current discussion about increased agricultural and pastoral development in northern Australia.
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Pressey, Robert L.; Álvarez-Romero, Jorge G.
2016-01-01
Development of land resources can contribute to increased economic productivity but can also negatively affect the extent and condition of native vegetation, jeopardize the persistence of native species, reduce water quality, and erode ecosystem services. Spatial planning must therefore balance outcomes for conservation, development, and social goals. One approach to evaluating these trade-offs is scenario planning. In this paper we demonstrate methods for incorporating stakeholder preferences into scenario planning through both defining scenario objectives and evaluating the scenarios that emerge. In this way, we aim to develop spatial plans capable of informing actual land-use decisions. We used a novel approach to scenario planning that couples optimal land-use design and social evaluation of environmental outcomes. Four land-use scenarios combined differences in total clearing levels (10% and 20%) in our study region, the Daly Catchment Australia, with the presence or absence of spatial precincts to concentrate irrigated agriculture. We used the systematic conservation planning tool Marxan with Zones to optimally plan for multiple land-uses that met objectives for both conservation and development. We assessed the performance of the scenarios in terms of the number of objectives met and the degree to which existing land-use policies were compromised (e.g., whether clearing limits in existing guidelines were exceeded or not). We also assessed the land-use scenarios using expected stakeholder satisfaction with changes in the catchment to explore how the scenarios performed against social preferences. There were a small fraction of conservation objectives with high conservation targets (100%) that could not be met due to current land uses; all other conservation and development objectives were met in all scenarios. Most scenarios adhered to the existing clearing guidelines with only marginal exceedances of limits, indicating that the scenario objectives were compatible with existing policy. We found that two key stakeholder groups, agricultural and Indigenous residents, had divergent satisfaction levels with the amount of clearing and agricultural development. Based on the range of benefits and potential adverse impacts of each scenario, we suggest that the 10% clearing scenarios are most aligned with stakeholder preferences and best balance preferences across stakeholder groups. Our approach to scenario planning is applicable generally to exploring the potential conflicts between goals for conservation and development. Our case study is particularly relevant to current discussion about increased agricultural and pastoral development in northern Australia. PMID:27362347
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Julia, Chantal; Fézeu, Léopold K; Ducrot, Pauline; Méjean, Caroline; Péneau, Sandrine; Touvier, Mathilde; Hercberg, Serge; Kesse-Guyot, Emmanuelle
2015-10-01
Metabolic syndrome (MetS), comprising high waist circumference, blood pressure, glycemia, and triglycerides, and lower HDL cholesterol could in part be prevented by adequate nutrition. Nutrient profiling systems could be useful public health tools to help consumers make healthier food choices. An individual dietary index (DI) based on nutrient profiling of foods consumed could characterize dietary patterns in relation to the onset of MetS. The objective of this study was to prospectively investigate the association between the Food Standards Agency (FSA) Nutrient Profiling System (NPS) DI and the onset of MetS in a middle-aged French cohort. Participants from the SUpplémentation en VItamines et Minéraux AntioXydants cohort (SU.VI.MAX, n = 3741) were included in the present study. The FSA NPS DI was computed by using dietary data from 24 h records at inclusion. MetS was identified at baseline and at year 13 of follow-up with the use of self-reported medication, data from clinical investigations, and biological measurements. A prospective association between the FSA NPS DI (in quartiles and continuous) and the onset of MetS was investigated by using logistic regression. Poorer diets identified with the use of the FSA NPS DI were significantly associated with a higher risk of developing MetS (OR for poorer vs. healthier FSA NPS DI: 1.43; 95% CI: 1.08, 1.89; P-trend across quartiles = 0.02). The FSA NPS DI was significantly associated with the systolic blood pressure (SBP) and diastolic blood pressure (DBP) components of MetS (difference between healthier vs. poorer FSA NPS DI: 2.16 mm Hg for SBP and 1.5 mm Hg for DBP, P-trend across quartiles = 0.02). The FSA NPS DI was prospectively associated with the onset of MetS in a middle-aged French population. The application of NPSs in public health initiatives may help the population make healthier food choices, which might reduce the risk of developing MetS. © 2015 American Society for Nutrition.
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Principles and Practices for Quality Assurance and Quality Control
Jones, Berwyn E.
1999-01-01
Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.
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Adopting and adapting a commercial view of web services for the Navy
NASA Astrophysics Data System (ADS)
Warner, Elizabeth; Ladner, Roy; Katikaneni, Uday; Petry, Fred
2005-05-01
Web Services are being adopted as the enabling technology to provide net-centric capabilities for many Department of Defense operations. The Navy Enterprise Portal, for example, is Web Services-based, and the Department of the Navy is promulgating guidance for developing Web Services. Web Services, however, only constitute a baseline specification that provides the foundation on which users, under current approaches, write specialized applications in order to retrieve data over the Internet. Application development may increase dramatically as the number of different available Web Services increases. Reasons for specialized application development include XML schema versioning differences, adoption/use of diverse business rules, security access issues, and time/parameter naming constraints, among others. We are currently developing for the US Navy a system which will improve delivery of timely and relevant meteorological and oceanographic (MetOc) data to the warfighter. Our objective is to develop an Advanced MetOc Broker (AMB) that leverages Web Services technology to identify, retrieve and integrate relevant MetOc data in an automated manner. The AMB will utilize a Mediator, which will be developed by applying ontological research and schema matching techniques to MetOc forms of data. The AMB, using the Mediator, will support a new, advanced approach to the use of Web Services; namely, the automated identification, retrieval and integration of MetOc data. Systems based on this approach will then not require extensive end-user application development for each Web Service from which data can be retrieved. Users anywhere on the globe will be able to receive timely environmental data that fits their particular needs.
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González-Jiménez, Emilio; Montero-Alonso, Miguel A; Schmidt-RioValle, Jacqueline; García-García, Carmen J; Padez, Cristina
2015-06-01
The metabolic syndrome (MetS) in adolescents is a growing problem. The objectives were to verify the association among early predictors such as birth weight, breastfeeding, maternal weight status, smoking during pregnancy, and the development of MetS. A cross-sectional study was performed of 976 children and adolescents, 10-15 years of age, at schools in the provinces of Granada and Almeria (Spain). For this purpose, we analyzed the physical characteristics as well as the biochemical markers of the participants with a view to ascertaining the prevalence of the MetS. Relevant data were also extracted from the clinical histories of their mothers. It was found that 3.85% of the female subjects and 5.38% of the male subjects in the sample population suffered from MetS. In both sexes, there was an association between birth weight and positive MetS diagnosis (OR 1.27). For both males and females, there was an inverse association between the length of time that they had been breastfed and positive MetS diagnosis (OR1-3 months 3.16; OR4-6 months 1.70; OR(>6 months) 0.13). There was also a significant association between maternal weight (OR(overweight )30.79; OR(obesity) 49.36) and cigarette consumption during pregnancy (OR 1.47) and the subsequent development of MetS in the children of these mothers. Those subjects born with a higher than average birth weight had a greater risk of developing MetS in childhood and adolescence. Breastfeeding children for longer than 6 months protected them from MetS in their early years as well as in their teens. Other risk factors for MetS were maternal smoking during pregnancy as well as maternal overweight and obesity.
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Gender Differences in the Clinical Features of Sleep Apnea Syndrome.
Mieno, Yuki; Hayashi, Masamichi; Sakakibara, Hiroki; Takahashi, Hiroshi; Fujita, Shiho; Isogai, Sumito; Goto, Yasuhiro; Uozu, Sakurako; Okazawa, Mitsushi; Imaizumi, Kazuyoshi
2018-03-30
Objectives Sleep apnea syndrome is more prevalent among men than women and is frequently accompanied by metabolic syndrome (MetS). However, gender differences in the effect of sleep-disordered breathing (SDB) leading to the risk of MetS remain unclear. The aim of our study was to investigate the clinical characteristics of SDB in women and the differential influence of SDB on MetS between genders. Methods In a single-center retrospective study, we compared the data of 1,809 consecutive SDB patients by gender to clarify the characteristics of sleep disorders in women. We also compared the prevalence of MetS and its related abnormalities by gender. A logistic regression analysis was used to determine the contributory factors for MetS. Results The mean age and proportion of patients over 50 years of age were higher in women than in men. SDB was milder in women than in men according to polysomnography findings. Elevated Hemoglobin A1c levels and hyperlipidemia were less frequent in women than in men. The MetS prevalence was similar in women and men (30.0% vs. 35.2%). A logistic regression analysis showed that the apnea-hypopnea index (AHI) was an independent risk factor for MetS in both genders, but that female gender was independently associated with a decreased prevalence of MetS and its related abnormalities. Conclusion Female SDB patients tend to be older with milder apnea and sleepiness than male SDB patients. A higher AHI is a significant risk factor for MetS in both genders, although female gender is an independent inhibitory factor for developing MetS in SDB patients.
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Measurement properties of outcome measures for vitiligo. A systematic review.
Vrijman, Charlotte; Linthorst Homan, May W; Limpens, Jacqueline; van der Veen, Wietze; Wolkerstorfer, Albert; Terwee, Caroline B; Spuls, Phyllis I
2012-11-01
OBJECTIVE To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. DATA SOURCES Electronic databases including PubMed (1948 to July 2011), OVID EMBASE (1980 to July 2011), and CINAHL (EBSCOhost) (1982 to July 2011) were searched. STUDY SELECTION Two authors independently screened all records for eligibility. For inclusion, the study population had to include patients with vitiligo, for which outcome measures were developed or evaluated on their measurement properties. The initial search retrieved 1249 records, of which 14 articles met the inclusion criteria. DATA EXTRACTION Characteristics of the included instruments, study population, and results of the measurement properties were extracted. The Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) 4-point checklist, combined with quality criteria for measurement properties, was used to calculate the overall level of evidence per measurement property of each instrument. Independent extraction and assessment was performed by 2 authors. DATA SYNTHESIS Eleven different measurement instruments were identified. Strong evidence was found for a positive internal consistency of the Dermatology Life Quality Index. For other instruments, the evidence of measurement properties was limited or unknown. CONCLUSIONS Recommendations on the use of specific outcome measures for vitiligo should be formulated with caution because current evidence is insufficient owing to a low number of studies with poor methodological quality and unclear clinical relevance. To recommend outcome measures for vitiligo, further research on measurement properties of clinical relevant outcome measures for vitiligo according to COSMIN quality criteria is needed.
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Karim, Abdool Z
2009-01-01
The regional processing centre at Sunnybrook Health Sciences Centre recently faced the substantial challenge of increasing cleaning capacity to meet the current workload and anticipated future demand without increasing its operating budget. The solution, upgrading its cleaning and decontamination system to a highly automated system, met both objectives. An analysis of the impact of the change found that the new system provided additional benefits, including improved productivity and cleaning quality; decreased costs; reduced water, electricity and chemical use; improved worker safety and morale; and decreased overtime. Investing in innovative technology improved key departmental outcomes while meeting institutional environmental and cost savings objectives.
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Effects of aquatic exercise on physical function and fitness among people with spinal cord injury
Li, Chunxiao; Khoo, Selina; Adnan, Athirah
2017-01-01
Abstract Objective: The aim of this review is to synthesize the evidence on the effects of aquatic exercise interventions on physical function and fitness among people with spinal cord injury. Data source: Six major databases were searched from inception till June 2015: MEDLINE, CINAHL, EMBASE, PsychInfo, SPORTDiscus, and Cochrane Center Register of Controlled Trials. Study appraisal and synthesis methods: Two reviewers independently rated methodological quality using the modified Downs and Black Scale and extracted and synthesized key findings (i.e., participant characteristics, study design, physical function and fitness outcomes, and adverse events). Results: Eight of 276 studies met the inclusion criteria, of which none showed high research quality. Four studies assessed physical function outcomes and 4 studies evaluated aerobic fitness as outcome measures. Significant improvements on these 2 outcomes were generally found. Other physical or fitness outcomes including body composition, muscular strength, and balance were rarely reported. Conclusions and implications of key findings: There is weak evidence supporting aquatic exercise training to improve physical function and aerobic fitness among adults with spinal cord injury. Suggestions for future research include reporting details of exercise interventions, evaluating other physical or fitness outcomes, and improving methodological quality. PMID:28296754
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Student Performance Data in the Classroom: Measurement and Evaluation of Student Progress.
ERIC Educational Resources Information Center
Cooke, Nancy L.; And Others
1991-01-01
This survey of 510 special education teachers found that most teachers collect, record, and use data on student performance to determine instructional effectiveness, appropriate time to move students to the next skill, and which objectives have been met. Only one-third of teachers used graphs for displaying and interpreting data. (Author/JDD)
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Keating, Dolores; McWilliams, Stephen; Schneider, Ian; Hynes, Caroline; Cousins, Gráinne; Strawbridge, Judith; Clarke, Mary
2017-01-01
Objectives Clinical practice guidelines (CPGs) support the translation of research evidence into clinical practice. Key health questions in CPGs ensure that recommendations will be applicable to the clinical context in which the guideline is used. The objectives of this study were to identify CPGs for the pharmacological treatment of first-episode schizophrenia; assess the quality of these guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument; and compare recommendations in relation to the key health questions that are relevant to the pharmacological treatment of first-episode schizophrenia. Methods A multidisciplinary group identified key health questions that are relevant to the pharmacological treatment of first-episode schizophrenia. The MEDLINE and EMBASE databases, websites of professional organisations and international guideline repositories, were searched for CPGs that met the inclusion criteria. The AGREE II instrument was applied by three raters and data were extracted from the guidelines in relation to the key health questions. Results In total, 3299 records were screened. 10 guidelines met the inclusion criteria. 3 guidelines scored well across all domains. Recommendations varied in specificity. Side effect concerns, rather than comparative efficacy benefits, were a key consideration in antipsychotic choice. Antipsychotic medication is recommended for maintenance of remission following a first episode of schizophrenia but there is a paucity of evidence to guide duration of treatment. Clozapine is universally regarded as the medication of choice for treatment resistance. There is less evidence to guide care for those who do not respond to clozapine. Conclusions An individual's experience of using antipsychotic medication for the initial treatment of first-episode schizophrenia may have implications for future engagement, adherence and outcome. While guidelines of good quality exist to assist in medicines optimisation, the evidence base required to answer key health questions relevant to the pharmacological treatment of first-episode schizophrenia is limited. PMID:28062471
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Guidelines for quality assurance in multicenter trials: a position paper.
Knatterud, G L; Rockhold, F W; George, S L; Barton, F B; Davis, C E; Fairweather, W R; Honohan, T; Mowery, R; O'Neill, R
1998-10-01
In the wake of reports of falsified data in one of the trials of the National Surgical Adjuvant Project for Breast and Bowel Cancer supported by the National Cancer Institute, clinical trials came under close scrutiny by the public, the press, and Congress. Questions were asked about the quality and integrity of the collected data and the analyses and conclusions of trials. In 1995, the leaders of the Society for Clinical Trials (the Chair of the Policy Committee, Dr. David DeMets, and the President of the Society, Dr. Sylvan Green) asked two members of the Society (Dr. Genell Knatterud and Dr. Frank Rockhold) to act as co-chairs of a newly formed subcommittee to discuss the issues of data integrity and auditing. In consultation with Drs. DeMets and Green, the co-chairs selected other members (Ms. Franca Barton, Dr. C.E. Davis, Dr. Bill Fairweather, Dr. Stephen George, Mr. Tom Honohan, Dr. Richard Mowery, and Dr. Robert O'Neill) to serve on the subcommittee. The subcommittee considered "how clean clinical trial data should be, to what extent auditing procedures are required, and who should conduct audits and how often." During the initial discussions, the subcommittee concluded that data auditing was insufficient to achieve data integrity. Accordingly, the subcommittee prepared this set of guidelines for standards of quality assurance for multicenter clinical trials. We include recommendations for appropriate action if problems are detected.
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A survey of commercial object-oriented database management systems
NASA Technical Reports Server (NTRS)
Atkins, John
1992-01-01
The object-oriented data model is the culmination of over thirty years of database research. Initially, database research focused on the need to provide information in a consistent and efficient manner to the business community. Early data models such as the hierarchical model and the network model met the goal of consistent and efficient access to data and were substantial improvements over simple file mechanisms for storing and accessing data. However, these models required highly skilled programmers to provide access to the data. Consequently, in the early 70's E.F. Codd, an IBM research computer scientists, proposed a new data model based on the simple mathematical notion of the relation. This model is known as the Relational Model. In the relational model, data is represented in flat tables (or relations) which have no physical or internal links between them. The simplicity of this model fostered the development of powerful but relatively simple query languages that now made data directly accessible to the general database user. Except for large, multi-user database systems, a database professional was in general no longer necessary. Database professionals found that traditional data in the form of character data, dates, and numeric data were easily represented and managed via the relational model. Commercial relational database management systems proliferated and performance of relational databases improved dramatically. However, there was a growing community of potential database users whose needs were not met by the relational model. These users needed to store data with data types not available in the relational model and who required a far richer modelling environment than that provided by the relational model. Indeed, the complexity of the objects to be represented in the model mandated a new approach to database technology. The Object-Oriented Model was the result.
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Mercado, Carla I.; Yang, Quanhe; Ford, Earl S.; Gregg, Edward; Valderrama, Amy L.
2017-01-01
Objective Consider all metabolic syndrome (MetS) components [systolic (SBP) and diastolic (DBP) blood pressures, waist circumference, HDL cholesterol, triglycerides (TG), and fasting glucose] and gender/race differential risk when assessing cardiovascular disease (CVD) risk. Methods We estimated a gender- and race-specific continuous MetS score using structural equation modeling and tested its association with CVD mortality using data from National Health and Nutrition Examination Survey III linked with the National Death Index. Cox proportional hazard regression tested the association adjusted for sociodemographic and behavior characteristics. Results For men, continuous MetS components associated with CVD mortality were SBP (hazard ratio =1.50, 95% confidence interval =1.14–1.96), DBP (1.48, 1.16–1.90), and TG (1.15, 1.12–1.16). In women, SBP (1.44, 1.27–1.63) and DBP (1.24, 1.02–1.51) were associated with CVD mortality. MetS score was not significantly associated with CVD mortality in men; but significant associations were found for all women (1.34, 1.06–1.68), non-Hispanic white women (1.29, 1.01–1.64), non-Hispanic black women (2.03, 1.12–3.69), and Mexican-American women (3.57, 2.21–5.76). Goodness-of-fit and concordance were overall better for models with the MetS score than MetS (yes/no). Conclusions When assessing CVD mortality risk, MetS score provided additional information than MetS (yes/no). PMID:26308480
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Carson, Valerie; McNaughton, Sarah A.; Dunstan, David W.; Healy, Genevieve N.; Salmon, Jo
2017-01-01
Objective Examine the mediating role of diet in the relationship between volume and duration of sedentary time with cardiometabolic health in adolescents. Methods Adolescents (12‐19 years) participating in the 2003/04 and 2005/06 U.S. National Health and Nutrition Examination Survey (NHANES) were examined. Cardiometabolic health indicators were body mass index z‐scores (zBMI) (n = 1,797) and metabolic syndrome (MetS) (n = 812). An ActiGraph hip‐worn accelerometer was used to derive total sedentary time and usual sedentary bout duration. Dietary intake was assessed using two 24‐hour dietary recalls. Mediation analyses were conducted to examine five dietary mediators [total energy intake, discretionary foods, sugar‐sweetened beverages (SSB), fruits and vegetables, and dietary quality] of the relationship between total sedentary time and usual sedentary bout duration with zBMI and MetS. Results Total sedentary time was inversely associated with zBMI (β = −1.33; 95% CI −2.53 to −0.13) but attenuated after adjusting for moderate‐to‐vigorous physical activity. No significant associations were observed between usual sedentary bout duration with zBMI or either sedentary measure with MetS. None of the five dietary variables mediated any of the relationships examined. Conclusions Further studies are needed to explore associations of specific time periods (e.g., after school) and bout durations with both cardiometabolic health indicators and dietary behaviors. PMID:28120527
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Pawlak, Tomasz; Potrzebowski, Marek J
2014-03-27
This paper presents a methodology that allows the fine refinement of the crystal and molecular structure for compounds for which the data deposited in the crystallographic bases are of poor quality. Such species belong to the group of samples with molecular disorder. In the Cambridge Crystallographic Data Center (CCDC), there are approximately 22,000 deposited structures with an R-factor over 10. The powerful methodology we present employs crystal data for Leu-enkephalin (two crystallographic forms) with R-factor values of 14.0 and 8.9 and for Met-enkephalin (one form) with an R-factor of 10.5. NMR crystallography was employed in testing the X-ray data and the quality of the structure refinement. The GIPAW (gauge invariant projector augmented wave) method was used to optimize the coordinates of the enkephalins and to compute NMR parameters. As we reveal, this complementary approach makes it possible to generate a reasonable set of new coordinates that better correlate to real samples. This methodology is general and can be employed in the study of each compound possessing magnetically active nuclei.
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Operational trace gas column observations from GOME-2 on MetOp
NASA Astrophysics Data System (ADS)
Valks, Pieter; Hao, Nan; Pinardi, Gaia; Hedelt, Pascal; Liu, Song; Van Roozendael, Michel; De Smedt, Isabelle; Theys, Nicolas; Koukouli, MariLiza; Balis, Dimitris
2017-04-01
This contribution focuses on the operational GOME-2 trace gas column products developed in the framework of EUMETSAT's Satellite Application Facility on Atmospheric Composition Monitoring (AC-SAF). We present an overview of the retrieval algorithms for ozone, OClO, NO2, SO2 and formaldehyde, and we show examples of various applications such as air quality and climate monitoring, using observations from the GOME-2 instruments on MetOp-A and MetOp-B. Total ozone and the minor trace gas columns from GOME-2 are retrieved with the latest version 4.8 of the GOME Data Processor (GDP), which uses an optimized Differential Optical Absorption Spectroscopy (DOAS) algorithm, with air mass factor conversions based on the LIDORT model. Improved total and tropospheric NO2 columns are retrieved in the visible wavelength region between 425 and 497 nm. SO2 emissions from volcanic and anthropogenic sources can be measured by GOME-2 using the UV wavelength region around 320 nm. For formaldehyde, an optimal DOAS fitting window around 335 nm has been determined for GOME-2. The GOME-2 trace gas columns have reached the operational EUMETSAT product status, and are available to the users in near real time (within two hours after sensing by GOME-2). The use of trace gas observations from the GOME-2 instruments on MetOp-A and MetOp-B for air quality purposed will be illustrated, e.g. for South-East Asia and Europe. Furthermore, comparisons of the GOME-2 satellite observations with ground-based measurements will be shown. Finally, the use of GOME-2 trace-gas column data in the Copernicus Atmosphere Monitoring Service (CAMS) will be presented.
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Stress, anger and Mediterranean diet as predictors of metabolic syndrome.
Garcia-Silva, Jaqueline; Navarrete Navarrete, Nuria; Ruano Rodríguez, Ana; Peralta-Ramírez, María Isabel; Mediavilla García, Juan Diego; Caballo, Vicente E
2017-10-30
Metabolic syndrome (MetS) is a cluster of metabolic conditions that include abdominal obesity, reduction in cholesterol concentrations linked to high density lipoproteins (HLDc), elevated triglycerides, increased blood pressure and hyperglycaemia. Given that this is a multicausal disease, the aim of this study is to identify the psychological, emotional and lifestyle variables that can have an influence on the different MetS components. A cross-sectional study with 103 patients with diagnostic criteria for MetS (47 male and 56 female). Anthropometric, clinical and analytical measurements were collected to assess the variables associated with MetS. The main psychological and emotional variables were also assessed. Different multiple linear regression tests were performed to identify which variables were predictive of MetS. The dependent variables were body mass index (BMI), abdominal circumference, HDLc, and quality of life, and the predictive variables were psychological stress, anger and adherence to a Mediterranean diet. The results showed that psychological stress was a predictor of quality of life (β=-0.55, P≤0). Similarly, anger was a predictor of BMI (β=0.23, P=.047) and abdominal circumference (β=0.27, P=.021). As expected, adherence to a Mediterranean diet was a predictor of HDLc (β=0.2, P=.045) and of quality of life (β=-0.18, P=.031). The results confirm a link between adherence to certain dietary habits and lifestyle, however they go one step further and show the importance of psychological and emotional factors like psychological stress and anger in some MetS components. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
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NASA Astrophysics Data System (ADS)
Daughtrey, E. Hunter; Adams, Jeffrey R.; Oliver, Karen D.; Kronmiller, Keith G.; McClenny, William A.
1998-09-01
A trailer-deployed automated gas chromatograph-mass spectrometer (autoGC-MS) system capable of making continuous hourly measurements was used to determine volatile organic compounds (VOCs) in ambient air at New Hendersonville, Tennessee, and Research Triangle Park, North Carolina, in 1995. The system configuration, including the autoGC-MS, trailer and transfer line, siting, and sampling plan and schedule, is described. The autoGC-MS system employs a pair of matched sorbent traps to allow simultaneous sampling and desorption. Desorption is followed by Stirling engine cryofocusing and subsequent GC separation and mass spectral identification and quantification. Quality control measurements described include evaluating precision and accuracy of replicate analyses of independently supplied audit and round-robin canisters and determining the completeness of the data sets taken in Tennessee. Data quality objectives for precision (±10%) and accuracy (±20%) of 10- to 20-ppbv audit canisters and a completeness of >75% data capture were met. Quality assurance measures used in reviewing the data set include retention time stability, calibration checks, frequency distribution checks, and checks of the mass spectra. Special procedures and tests were used to minimize sorbent trap artifacts, to verify the quality of a standard prepared in our laboratory, and to prove the integrity of the insulated, heated transfer line. A rigorous determination of total system blank concentration levels using humidified scientific air spiked with ozone allowed estimation of method detection limits, ranging from 0.01 to 1.0 ppb C, for most of the 100 target compounds, which were a composite list of the target compounds for the Photochemical Assessment Monitoring Station network, those for Environmental Protection Agency method TO-14, and selected oxygenated VOCs.
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Evaluation of the Space Shuttle Transatlantic Abort Landing Atmospheric Sounding System
NASA Technical Reports Server (NTRS)
Leahy, Frank B.
2003-01-01
A study was conducted to determine the quality of thermodynamic and wind data measured by or derived from the Transatlantic Abort Landing (TAL) Atmospheric Sounding System (TASS). The system has Global Positioning System (GPS) tracking capability and includes a helium-filled latex balloon that carries an instrument package (sonde) and various ground equipment that receives and processes the data from the sonde. TASS is used to provide vertical profiles of thermodynamic and low-resolution wind data in support of Shuttle abort landing operations at TAL sites. TASS uses GPS to determine height, wind speed, and wind direction. The TASS sonde has sensors that directly measure air temperature and relative humidity. These are then used to derive air pressure and density. Test flights were conducted where a TASS sonde and a reference sonde were attached to the same balloon and the two profiles were compared. The objective of the testing was to determine if TASS thermodynamic and wind data met Space Shuttle Program (SSP) accuracy requirements outlined in the Space Shuttle Launch and Landing Program Requirements Document (PRD).
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Garcez, Anderson; Leite, Heloísa Marquardt; Weiderpass, Elisabete; Paniz, Vera Maria Vieira; Watte, Guilherme; Canuto, Raquel; Olinto, Maria Teresa Anselmo
2018-05-17
To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I 2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I 2 = 83.1%;p < 0.001). Paradoxically, meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality. This systematic review and meta-analysis does not reveal any association between basal cortisol levels and MetS based on results of observational studies. The results of a random-effect meta-analysis showed no significant difference in basal cortisol levels between subjects with and without MetS. The present findings should be considered in order to help future studies. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Quality of Publicly Available Physical Activity Apps: Review and Content Analysis
Alkhaldi, Ghadah; Slee, April; Hamilton, Fiona L; Murray, Elizabeth
2018-01-01
Background Within the new digital health landscape, the rise of health apps creates novel prospects for health promotion. The market is saturated with apps that aim to increase physical activity (PA). Despite the wide distribution and popularity of PA apps, there are limited data on their effectiveness, user experience, and safety of personal data. Objective The purpose of this review and content analysis was to evaluate the quality of the most popular PA apps on the market using health care quality indicators. Methods The top-ranked 400 free and paid apps from iTunes and Google Play stores were screened. Apps were included if the primary behavior targeted was PA, targeted users were adults, and the apps had stand-alone functionality. The apps were downloaded on mobile phones and assessed by 2 reviewers against the following quality assessment criteria: (1) users’ data privacy and security, (2) presence of behavior change techniques (BCTs) and quality of the development and evaluation processes, and (3) user ratings and usability. Results Out of 400 apps, 156 met the inclusion criteria, of which 65 apps were randomly selected to be downloaded and assessed. Almost 30% apps (19/65) did not have privacy policy. Every app contained at least one BCT, with an average number of 7 and a maximum of 13 BCTs. All but one app had commercial affiliation, 12 consulted an expert, and none reported involving users in the app development. Only 12 of 65 apps had a peer-reviewed study connected to the app. User ratings were high, with only a quarter of the ratings falling below 4 stars. The median usability score was excellent—86.3 out of 100. Conclusions Despite the popularity of PA apps available on the commercial market, there were substantial shortcomings in the areas of data safety and likelihood of effectiveness of the apps assessed. The limited quality of the apps may represent a missed opportunity for PA promotion. PMID:29563080
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Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences.
Sanghani, Ruchi M; Moler, Alexander K
2015-01-01
Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.
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Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences
Sanghani, Ruchi M.; Moler, Alexander K.
2015-01-01
Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients. PMID:26483986
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How organizational learning is associated with patient rights: a qualitative content analysis
Heidari, Shahin; Nayeri, Nahid Dehghan; Ravari, Ali; Sabzevari, Sakineh
2016-01-01
Background Nowadays, patient rights, particularly receiving favorable health care based on modern knowledge, informed consent, and privacy, are important issues in health care delivery systems. Organizational learning is considered an important factor influencing health care quality and patient rights. However, there is little evidence regarding this issue. Objective The present study was conducted to explore the role of organizational learning in patient rights from clinical nurses’ viewpoint. Design This qualitative study was conducted through conventional content analysis. In total, 18 nurses who met the inclusion criteria participated in this study through purposive sampling with maximum variation. Data were gathered through 20 in-depth, semi-structured interviews, which continued until data saturation was achieved. Data collection also included constant and simultaneous comparative analyses. Results Data analysis led to four major themes: conservation of patient safety, providing favorable care, being the patient's advocate, and informing the patients. All the participants believed that organizational learning could play a vital role in respecting patient rights and interests. Conclusions Participants believed that their efforts to conduct organizational learning, tried to improve respecting the patient rights via conservation of patient safety, trying to improve quality of care, being an advocate, and informing the patient. It would be appreciable if nursing managers honored the commitment of the nurses for learning, highlight their role as defenders of patient rights, and encourage them to initiate organizational learning. PMID:27465289
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Prevalence of Metabolic Syndrome and Individual Criteria in College Students
ERIC Educational Resources Information Center
Fernandes, Jill; Lofgren, Ingrid E.
2011-01-01
Metabolic syndrome (MetS) is present in young adults and because coronary heart disease (CHD) is likely, screening to determine MetS prevalence and its criteria is critical. Objective: To determine MetS prevalence and most prevalent criteria in a sample of first-year college students. Participants: First-year college students between 18 and 24…
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Clinical chronic rhinosinusitis outcomes in pediatric patients with cystic fibrosis
2017-01-01
Objectives Chronic rhinosinusitis and nasal polyposis are common conditions in cystic fibrosis (CF). Approximately 2–3% of pediatric CF patients per year have sinus disease requiring surgery. It has been well established that there is a significant negative impact on quality of life associated with chronic rhinosinusitis (CRS) in the non‐CF patient population. However, the impact of CRS on the pediatric CF population remains uncertain. The purpose of this article is to review the current state of outcome measures for CRS in pediatric CF patients. Data Sources PubMed and EMBASE literature review Methods PubMed and EMBASE electronic databases were searched using Boolean searches that incorporated mesh headings and plain language for quality of life, symptom evaluation, pediatric patients, and sinusitis/rhinosinusitis. Studies were included if the study primarily evaluated a pediatric Cystic Fibrosis‐Chronic Rhinosinusitis (CF‐CRS) population and the primary outcome measure was quality of life evaluation. Results The search yielded 34 unique articles. A total of 7 articles met inclusion criteria Conclusions Despite the high frequency of chronic rhinosinusitis in the pediatric CF patient population, its impact on quality of life is not well understood. Currently there is a lack of a validated disease specific quality of life instruments available to assess the impact of CRS on the pediatric CF patient population. Level of Evidence 5. PMID:29094071
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Shim, Unjin; Kim, Han-Na; Sung, Yeon-Ah; Kim, Hyung-Lae
2014-12-01
Metabolic syndrome (MetS) is a complex disorder related to insulin resistance, obesity, and inflammation. Genetic and environmental factors also contribute to the development of MetS, and through genome-wide association studies (GWASs), important susceptibility loci have been identified. However, GWASs focus more on individual single-nucleotide polymorphisms (SNPs), explaining only a small portion of genetic heritability. To overcome this limitation, pathway analyses are being applied to GWAS datasets. The aim of this study is to elucidate the biological pathways involved in the pathogenesis of MetS through pathway analysis. Cohort data from the Korea Associated Resource (KARE) was used for analysis, which include 8,842 individuals (age, 52.2 ± 8.9 years; body mass index, 24.6 ± 3.2 kg/m(2)). A total of 312,121 autosomal SNPs were obtained after quality control. Pathway analysis was conducted using Meta-analysis Gene-Set Enrichment of Variant Associations (MAGENTA) to discover the biological pathways associated with MetS. In the discovery phase, SNPs from chromosome 12, including rs11066280, rs2074356, and rs12229654, were associated with MetS (p < 5 × 10(-6)), and rs11066280 satisfied the Bonferroni-corrected cutoff (unadjusted p < 1.38 × 10(-7), Bonferroni-adjusted p < 0.05). Through pathway analysis, biological pathways, including electron carrier activity, signaling by platelet-derived growth factor (PDGF), the mitogen-activated protein kinase kinase kinase cascade, PDGF binding, peroxisome proliferator-activated receptor (PPAR) signaling, and DNA repair, were associated with MetS. Through pathway analysis of MetS, pathways related with PDGF, mitogen-activated protein kinase, and PPAR signaling, as well as nucleic acid binding, protein secretion, and DNA repair, were identified. Further studies will be needed to clarify the genetic pathogenesis leading to MetS.
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Hajian-Tilaki, K; Heidari, B; Firouzjahi, A; Bagherzadeh, M; Hajian-Tilaki, A; Halalkhor, S
2014-01-01
The metabolic syndrome (MetS) is the main concern of health problem in transition population. The objective was to determine the prevalence of MetS and its association with socio-demographic and physical activity in Iranian adults. A population-based cross-sectional study of 1000 representative samples aged 20-70 years was conducted in urban area in northern Iran. The socio-demographic data were collected by interview and the physical activity was assessed by standard International Physical Activity Questionnaire (IPAQ). Weight, height, waist circumference and the systolic and diastolic blood pressures were measured by standard methods. Fasting plasma glucose, triglycerides, total cholesterol, high density lipoprotein-cholesterol level and low density lipoprotein cholesterol level were measured using enzymatic method. The ATP III criteria were used for diagnosis of MetS. The prevalence rate of MetS was 42.3% (36.5% men and 47.1% women, p=0.001). The higher education at university level was appeared inversely associated with MetS (age adjusted OR=0.34, p=0.001) compared with illiterate. The prevalence rates of MetS were 49.0%, 42.5% and 22.6% in low, moderate and vigorous physical activity level respectively (p=0.001). After adjusting for potential confounding factors, the vigorous physical activity was inversely associated with MetS compared with low level (adjusted OR=0.46, p=0.001). These results highlight an immediate action of preventive measures programs for modification of cardio metabolic risk factors. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.
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Chen, Li-Jung; Lai, Yun-Ju; Sun, Wen-Jung; Fox, Kenneth R; Chu, Dachen; Ku, Po-Wen
2015-01-01
Understanding the risk factors of metabolic syndrome (MetS) is important to public health, since individuals with MetS have an increased risk of health problems. This study examined the associations of exercise, sedentary time and insomnia with incident MetS among older adults 1 year later. A total of 1,359 older adults receiving hospital health examinations in 2012 were studied, and 779 subjects had a follow-up after 1 year. The components of MetS (waist, blood pressure, high-density lipoprotein cholesterol, fasting glucose and triglyceride) were defined by the Program's Adult Treatment Panel III report. Exercise, sedentary time and insomnia data were obtained through self-report questionnaires. Physical fitness (body fatness, balance and hand grip strength) was measured. Two logistic regressions were computed to examine the associations of exercise/physical fitness, sedentary time and insomnia at baseline with incident MetS 1 year later. The first regression included age, sex, smoking and alcohol as covariates. The second regression was further adjusted with the components of MetS. Sex, exercise/balance, sedentary time and insomnia were significant predictors of MetS. The risk of MetS incidence was 3.36 (95% CI 1.96-5.77) for women, 1.92 (95% CI 1.01-3.63) for those who did not exercise, 2.52 (95% CI 1.37-4.63) for those who sat more than 5 h/day, and 2.17 (95% CI 1.13-4.15) for those with insomnia. Poor balance was significantly associated with greater risk of MetS (AOR = 1.07, 95% CI 1.02-1.12). Sex, sedentary time, insomnia and balance remained significant after adjusting with the components of MetS. Cultivating exercise habits, reducing sedentary time and improving sleep quality may be important strategies for MetS prevention among older adults.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Foy, J; Marsh, R; Owen, D
2015-06-15
Purpose: Creating high quality SBRT treatment plans for the spine is often tedious and time consuming. In addition, the quality of treatment plans can vary greatly between treatment facilities due to inconsistencies in planning methods. This study investigates the performance of knowledge-based planning (KBP) for spine SBRT. Methods: Treatment plans were created for 28 spine SBRT patients. Each case was planned to meet strict dose objectives and guidelines. After physician and physicist approval, the plans were added to a custom model in a KBP system (RapidPlan, Varian Eclipse v13.5). The model was then trained to be able to predict estimatedmore » DVHs and provide starting objective functions for future patients based on both generated and manual objectives. To validate the model, ten additional spine SBRT cases were planned manually as well as using the model objectives. Plans were compared based on planning time and quality (ability to meet the plan objectives, including dose metrics and conformity). Results: The average dose to the spinal cord and the cord PRV differed between the validation and control plans by <0.25% demonstrating iso-toxicity. Six out of 10 validation plans met all dose objectives without the need for modifications, and overall, target dose coverage was increased by about 4.8%. If the validation plans did not meet the dose requirements initially, only 1–2 iterations of modifying the planning parameters were required before an acceptable plan was achieved. While manually created plans usually required 30 minutes to 3 hours to create, KBP can be used to create similar quality plans in 15–20 minutes. Conclusion: KBP for spinal tumors has shown to greatly decrease the amount of time required to achieve high quality treatment plans with minimal human intervention and could feasibly be used to standardize plan quality between institutions. Supported by Varian Medical Systems.« less
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Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin
2015-01-01
Objective: To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Methods: Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Results: Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Conclusion: Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria. PMID:26430399
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Metabolic Syndrome among Emirati Adolescents: A School-Based Study
Mehairi, Aaesha E.; Khouri, Aysha A.; Naqbi, Muna M.; Muhairi, Shamma J.; Maskari, Fatima A.; Nagelkerke, Nico; Shah, Syed M.
2013-01-01
Objectives Population-based data on metabolic syndrome (MetS) among children is lacking in the United Arab Emirates which has among the highest rates of diabetes in the world. In this study we determined the prevalence of MetS and its correlates in a sample of adolescents. Materials and Methods A cross-sectional school-based study was conducted on 1,018 adolescents (48.4% girls) aged 12–18 years from Al Ain Abu Dhabi Emirates. A self-administered questionnaire was used to assess socio-demographic characteristics, physical activity and dietary habits. Blood pressure, height, weight, waist circumference, fasting glucose, HDL-cholesterol and triglycerides were measured. MetS was defined using the International Diabetes Federation (IDF) criteria. Results The prevalence of metabolic syndrome was 13%. Boys compared to girls were more likely to have MetS (21% vs. 4%, odds ratio [OR]: 6.57, 95%CI: 4.01 to 10.75). The prevalence of MetS increased with increase in body mass index and reached 59 percent in obese boys. After multivariable adjustment boys who were overweight (adjusted OR: 2.72 [1.37 to 5.35]), or obese (AOR: 12.70 [7.31 to 22.05]), or spent two or more than two hours on screen in a day (AOR: 1.65 [1.01 to 2.69) were more likely to have MetS. Girls who were overweight (AOR: 4.23 [1.32 to 13.62]) or obese (AOR: 8.32 [2.73 to 25.32]) were more likely to have MetS. Conclusions The prevalence of MetS is high among UAE boys. Population-based strategies are needed to address the high burden of metabolic syndrome targeted at the identified risk factors. PMID:23418529
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Repurposing Radiosonde Sensors for UAV Integration
NASA Astrophysics Data System (ADS)
Clowney, F. A.
2015-12-01
Radiosondes provide accurate, high-resolution meteorological data for a variety of purposes but are inefficient for studying the atmospheric boundary layer. Tethered balloons can provide greater temporal resolution but are difficult to acquire, hard to manage and limited in vertical resolution. UAVs appear to offer a more cost-effective method for gathering low-level meteorological data in situ, with a strong possibility of adding atmospheric chemistry. This potential is enhanced by the availability of new generations of small sensors along with dramatic advances in low-cost UAVs, especially rotary-wing. InterMet is using its experience in radiosonde design and manufacturing to develop sensor packages for fixed and rotary-wing UAVs, with the goal of delivering high-quality data at low cost. The challenge is to adapt affordable, high-accuracy sensors to the different UAV flight modes. Equally important is learning from the research community what is required for this data to have useful scientific value. Specific topics to be covered include data sampling and output rates, sensor response times, calibration, sensor placement, data storage and transfer, power consumption, integration with flight management systems and wind calculations. Beta test results for the iMet-XQ and iMet-XF sensor packages will be presented if available.
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[Postgraduate studies in public health: the problem of efficiency evaluation].
Boczkowski, Andrzej
2003-01-01
The satisfaction of customer is the main measure and the most important, generally recognized criterion for evaluating the quality of products and services. In the case of education and training, the quality is frequently understood as effectiveness, i.e., the degree to what educational objectives of a training institution are met; the objectives previously formulated on the basis of analyzed and defined demands and expectations of customers (clients). In the first part of the paper: (1) the problems related to the question who in fact is the customer in the context of an institution providing education in public health are discussed; (2) a proposal for resolving these problems is presented; and (3) the main directions of evaluation activities, which should be undertaken under monitoring and effectiveness assessment of postgraduate training in public health are pointed out. In the years 1998-2002, the students' assessment data on educational programs, curriculum contents and subject teachers in the field of postgraduate studies in the School of Public Health, Nofer Institute of Occupational Medicine, Łódź, were collected with the help of specially-designed evaluation questionnaires. The data on the students' self-assessment of gained professional competencies were also collected. All students who completed the School of Public Health in these years were subjected to the evaluation inquiries. The data collected were analyzed. Due to the analysis it was possible to define: the quality of the curriculum contents, as well as the professional and didactic skills of the teaching staff as perceived by the students; the degree to what particular curriculum in public health contributed to the increase in professional competence as perceived by the students; the degree to what particular teaching subjects influenced the students' knowledge of and skills in Public Health. The results obtained provided information very useful in the teaching process, designing of educational programs and their modification.
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Kiluk, Brian D.; Sugarman, Dawn E.; Nich, Charla; Gibbons, Carly J.; Martino, Steve; Rounsaville, Bruce J.; Carroll, Kathleen M.
2013-01-01
Objective Computer-assisted therapies offer a novel, cost-effective strategy for providing evidence-based therapies to a broad range of individuals with psychiatric disorders. However, the extent to which the growing body of randomized trials evaluating computer-assisted therapies meets current standards of methodological rigor for evidence-based interventions is not clear. Method A methodological analysis of randomized clinical trials of computer-assisted therapies for adult psychiatric disorders, published between January 1990 and January 2010, was conducted. Seventy-five studies that examined computer-assisted therapies for a range of axis I disorders were evaluated using a 14-item methodological quality index. Results Results indicated marked heterogeneity in study quality. No study met all 14 basic quality standards, and three met 13 criteria. Consistent weaknesses were noted in evaluation of treatment exposure and adherence, rates of follow-up assessment, and conformity to intention-to-treat principles. Studies utilizing weaker comparison conditions (e.g., wait-list controls) had poorer methodological quality scores and were more likely to report effects favoring the computer-assisted condition. Conclusions While several well-conducted studies have indicated promising results for computer-assisted therapies, this emerging field has not yet achieved a level of methodological quality equivalent to those required for other evidence-based behavioral therapies or pharmacotherapies. Adoption of more consistent standards for methodological quality in this field, with greater attention to potential adverse events, is needed before computer-assisted therapies are widely disseminated or marketed as evidence based. PMID:21536689
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Methodological review of the quality of reach out and read: does it "work"?
Yeager Pelatti, Christina; Pentimonti, Jill M; Justice, Laura M
2014-04-01
A considerable percentage of American children and adults fail to learn adequate literacy skills and read below a third grade level. Shared book reading is perhaps the single most important activity to prepare young children for success in reading. The primary objective of this manuscript was to critically review the methodological quality of Read Out and Read (ROR), a clinically based literacy program/intervention that teaches parents strategies to incorporate while sharing books with children as a method of preventing reading difficulties and academic struggles. A PubMed search was conducted. Articles that met three criteria were considered. First, the study must be clinically based and include parent contact with a pediatrician. Second, parental counseling ("anticipatory guidance") about the importance of parent-child book reading must be included. Third, only experimental or quasi-experimental studies were included; no additional criteria were used. Published articles from any year and peer-reviewed journal were considered. Study quality was determined using a modified version of the Downs and Black (1998) checklist assessing four categories: (1) Reporting, (2) External Validity, (3) Internal Validity-Bias, and (4) Internal Validity-Confounding. We were also interested in whether quality differed based on study design, children's age, sample size, and study outcome. Eleven studies met the inclusion criteria. The overall quality of evidence was variable across all studies; Reporting and External Validity categories were relatively strong while methodological concerns were found in the area of internal validity. Quality scores differed on the four study characteristics. Implications related to clinical practice and future studies are discussed.
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Bragg, Heather M.; Johnston, Matthew W.
2015-01-01
All quality-assurance values exceed the criteria established by the U.S. Army Corps of Engineers TDG monitoring plan. Criteria for data completeness (95 percent) were met at six of the eight monitoring stations. Deleted data at the John Day tailwater station and missed transmissions at the Camas station resulted in data completeness below criteria.
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A Scoping Review of Peer-led Education in Patient Safety Training
McLachlan, Andrew J.; Chen, Timothy F.
2018-01-01
Objective. To examine the literature pertaining to the use of peer-led education in patient safety. Findings. Four studies met the inclusion criteria: two were conducted in health care students and two in medical practitioners. Three studies used pre-post evaluation, with one containing a comparator group. One study a post-intervention evaluation only. All studies undertook Kirkpatrick Level 2 evaluations, showing significant improvements in attitudes and knowledge. One study undertook Level 3 and 4 evaluations, showing improvement in self-reported behaviors and engagement in quality improvement initiatives. Summary. There are few studies evaluating peer-led education in patient safety and formal and high-quality evaluations are lacking. PMID:29606704
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Ahn, Jaeouk; Kim, Nam Soo; Lee, Byung Kook; Park, Sunmin
2017-09-01
We compared the usual nutrient intake in both the semi-quantitative food frequency questionnaire (SQFFQ) and 24-hour recall methods and determined the association between metabolic syndrome (MetS) risk and nutrient intake calculated by both methods in Korea National Health and Nutrition Examination Survey (KNHANES; 2012-2014) data. Adjusted odds ratios for MetS were calculated according to the intake of macronutrients, measured by the 2 methods in 10,286 adults, while controlling for covariates associated with MetS. Fat and carbohydrate intake (energy percent) calculated by 24-hour recall and SQFFQ was significantly different between the MetS and non-MetS groups, particularly in women. The differences in other nutrient intakes determined by both methods were mainly non-significant. The correlation coefficients between the 2 methods were about 0.4 for most nutrients except total vitamin A and iron (Fe). Energy intake according to gender and MetS presence was similar between the 2 methods. Carbohydrate intake exhibited a positive association with the MetS risk, while fat intake showed a negative association in both methods. The association exhibited a gender interaction with carbohydrate and fat intake calculated by 24-hour recall: women exhibited a significant association. However, for the SQFFQ a gender interaction was evident only for carbohydrate intake. In diet quality index of SQFFQ the adequacy of vegetables and total fat intake was higher in the non-MetS than the MetS. In conclusion, the MetS prevalence exhibited a positive association with carbohydrate intake only in women, as assessed by 24-hour recall and SQFFQ. The SQFFQ can be used to assess the association between usual food intake and MetS risk in large population studies. © 2017 The Korean Academy of Medical Sciences.
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Kołłątaj, Barbara; Gorczyca, Rafał; Kołłątaj, Witold; Jędrych, Marian; Sobieszczańska, Anna; Sobieszczański, Jarosław; Karwat, Irena Dorota
2015-01-01
The elimination of functional barriers resulting from disability through the provision of adequate orthopaedic and rehabilitation equipment, and homes adjusted for disability is the precondition for an efficient and independent functioning, and high quality of life of the disabled. The objective of the study was recognition of the needs of the disabled declared by them, and the degree of satisfaction with these needs. The study covered 478 disabled from the Lublin Region. The research instrument was the 'Questionnaire for the Disabled' designed by the authors. Considering the needs expressed by the respondents concerning the provision of orthopaedic and rehabilitation equipment and meeting these needs, four groups were distinguished: No Needs - 30.1%, Needs Partially Met - 22.4%, Needs Fully Met - 37.7%, Needs Not Met - 9.8%. The group Needs Not Met was characterized by younger age, in the group Needs Partially Met worse indicators of the state of health were noted, more frequent independent living, loneliness and low material standard. Considering the expressed needs for home adjustments adequate to disability and meeting these needs, three groups were distinguished: No Needs - 59.6%, Needs Not Met - 15.9%, and Needs Met - 24.7%. The group Needs Not Met more rarely covered respondents living in residential homes, compared to those living independently in rural or urban areas. The group Needs Met more rarely included rural inhabitants, while more frequently including the disabled who had a high material standard. Both the provision of orthopaedic equipment and adjustment of the home to disability are insufficient with respect to the needs. The meeting of these needs is significantly conditioned by high or very high material standard. The lack or incomplete satisfaction with the needs for rehabilitation equipment is associated with a relatively younger age, independent, single residence and low material standard. Living in an residential home means better adjustment of the living environment, and better provision with orthopaedic and rehabilitation equipment.
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MultiMetEval: Comparative and Multi-Objective Analysis of Genome-Scale Metabolic Models
Gevorgyan, Albert; Kierzek, Andrzej M.; Breitling, Rainer; Takano, Eriko
2012-01-01
Comparative metabolic modelling is emerging as a novel field, supported by the development of reliable and standardized approaches for constructing genome-scale metabolic models in high throughput. New software solutions are needed to allow efficient comparative analysis of multiple models in the context of multiple cellular objectives. Here, we present the user-friendly software framework Multi-Metabolic Evaluator (MultiMetEval), built upon SurreyFBA, which allows the user to compose collections of metabolic models that together can be subjected to flux balance analysis. Additionally, MultiMetEval implements functionalities for multi-objective analysis by calculating the Pareto front between two cellular objectives. Using a previously generated dataset of 38 actinobacterial genome-scale metabolic models, we show how these approaches can lead to exciting novel insights. Firstly, after incorporating several pathways for the biosynthesis of natural products into each of these models, comparative flux balance analysis predicted that species like Streptomyces that harbour the highest diversity of secondary metabolite biosynthetic gene clusters in their genomes do not necessarily have the metabolic network topology most suitable for compound overproduction. Secondly, multi-objective analysis of biomass production and natural product biosynthesis in these actinobacteria shows that the well-studied occurrence of discrete metabolic switches during the change of cellular objectives is inherent to their metabolic network architecture. Comparative and multi-objective modelling can lead to insights that could not be obtained by normal flux balance analyses. MultiMetEval provides a powerful platform that makes these analyses straightforward for biologists. Sources and binaries of MultiMetEval are freely available from https://github.com/PiotrZakrzewski/MetEval/downloads. PMID:23272111
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Nation, Javan; Brigger, Matthew
2017-09-01
Objective Determine the efficacy of adenotonsillectomy in children with Down syndrome. Data Sources Databases included PubMed, EMBASE, CINAHL, and Google Scholar. The search was inclusive of all references available through January 5, 2017. Review Methods A systematic review of the medical literature addressing adenotonsillectomy in treating obstructive sleep apnea in children with Down syndrome was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data were pooled using a random-effects model where possible. The quality of studies was graded using the Methodological Index for Nonrandomized Studies criteria. Results Of the 957 articles screened, 5 met inclusion for the qualitative analysis and 3 met criteria for the quantitative analysis. The findings of the qualitative analysis were that adenotonsillectomy has a positive effect on children with Down syndrome but in many cases is noncurative, up to 75% need postoperative breathing support, there is a high rate of immediate postoperative airway needs, and there is no change in sleep efficiency or architecture. The articles consistently reported moderate success in improving polysomnographic parameters, and limited pooling of the data demonstrated a mean decrease of the apnea-hypopnea index by 51% (95% confidence interval [CI], 46%-55%). Conclusion A 51% reduction in the preoperative apnea-hypopnea index can be expected with the intervention of adenotonsillectomy alone in children with Down syndrome. This information is useful for counseling and managing patient and family expectations. It also serves as a reminder to clinicians to obtain a postoperative sleep study, as many of these patients will need nighttime airway support or secondary sleep surgery.
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Image Processing for Teaching.
ERIC Educational Resources Information Center
Greenberg, R.; And Others
1993-01-01
The Image Processing for Teaching project provides a powerful medium to excite students about science and mathematics, especially children from minority groups and others whose needs have not been met by traditional teaching. Using professional-quality software on microcomputers, students explore a variety of scientific data sets, including…
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Dawson, Jacqueline K; Dorff, Tanya B; Todd Schroeder, E; Lane, Christianne J; Gross, Mitchell E; Dieli-Conwright, Christina M
2018-04-03
Prostate cancer patients on androgen deprivation therapy (ADT) experience adverse effects such as lean mass loss, known as sarcopenia, fat gain, and changes in cardiometabolic factors that increase risk of metabolic syndrome (MetS). Resistance training can increase lean mass, reduce body fat, and improve physical function and quality of life, but no exercise interventions in prostate cancer patients on ADT have concomitantly improved body composition and MetS. This pilot trial investigated 12 weeks of resistance training on body composition and MetS changes in prostate cancer patients on ADT. An exploratory aim examined if a combined approach of training and protein supplementation would elicit greater changes in body composition. Prostate cancer patients on ADT were randomized to resistance training and protein supplementation (TRAINPRO), resistance training (TRAIN), protein supplementation (PRO), or control stretching (STRETCH). Exercise groups (EXE = TRAINPRO, TRAIN) performed supervised exercise 3 days per week for 12 weeks, while non-exercise groups (NoEXE = PRO, STRETCH) performed a home-based stretching program. TRAINPRO and PRO received 50 g⋅day - 1 of whey protein. The primary outcome was change in lean mass assessed through dual energy x-ray absorptiometry. Secondary outcomes examined changes in sarcopenia, assessed through appendicular skeletal mass (ASM) index (kg/m 2 ), body fat %, strength, physical function, quality of life, MetS score and the MetS components of waist circumference, blood pressure, glucose, high-density lipoprotein-cholesterol, and triglyceride levels. A total of 37 participants were randomized; 32 participated in the intervention (EXE n = 13; NoEXE n = 19). At baseline, 43.8% of participants were sarcopenic and 40.6% met the criteria for MetS. Post-intervention, EXE significantly improved lean mass (d = 0.9), sarcopenia prevalence (d = 0.8), body fat % (d = 1.1), strength (d = 0.8-3.0), and prostate cancer-specific quality of life (d = 0.9) compared to NoEXE (p < 0.05). No significant differences were observed between groups for physical function or MetS-related variables except waist circumference (d = 0.8). A 12-week resistance training intervention effectively improved sarcopenia, body fat %, strength and quality of life in hypogonadal prostate cancer patients, but did not change MetS or physical function. PRO did not offer additional benefit in improving body composition. ClinicalTrials.gov: NCT01909440 . Registered 24 July 2013.
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Attachment and the metabolic syndrome in midlife: the role of interview-based discourse patterns.
Davis, Cynthia R; Usher, Nicole; Dearing, Eric; Barkai, Ayelet R; Crowell-Doom, Cynthia; Neupert, Shevaun D; Mantzoros, Christos S; Crowell, Judith A
2014-10-01
Adult attachment discourse patterns and current family relationship quality were examined as correlates of health behaviors and number of metabolic syndrome (MetS) criteria met, and as mediators of the link between childhood adversity and these health outcomes. A sample of 215 white/European American and black/African American adults aged 35 to 55 years were examined using a cross-sectional study design. Discourse was assessed with the Adult Attachment Interview, using coherence (a marker of attachment security), unresolved trauma/loss (a marker of disorganized cognitions related to trauma or loss), and idealization (minimizing stressful experiences and their impact) scores. Relationship quality, adverse childhood experiences, and current depressive symptoms were assessed, as were health behaviors of diet, exercise, and smoking. MetS includes obesity, elevated blood pressure, elevated fasting glucose, high triglycerides, and low high-density lipoprotein cholesterol. Using path analysis and including childhood adversity severity and depressive symptoms in the model, both Adult Attachment Interview coherence and unresolved trauma/loss were directly linked to the number of MetS criteria (r = 0.186 and r = 0.170, respectively). Idealization was indirectly linked to MetS through poor diet (r = 0.183). The final model explained 21% of the variance in scores for the number of MetS criteria met. Insecure adult attachment is associated with increased risk of MetS.
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Programming and Operations Lab 1--Intermediate, Data Processing Technology: 8025.23.
ERIC Educational Resources Information Center
Dade County Public Schools, Miami, FL.
The following course outline has been prepared as a guide toward helping the student develop an understanding of operating principles and procedures necessary in processing data electronically. Students who have met the objectives of Designing the Computer Program should be admitted to this course. The class meets 2 hours per day for 90 clock…
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Gu, Shuyan; Deng, Jing; Shi, Lizheng; Mu, Yiming; Dong, Hengjin
2015-01-01
This study aims to estimate the long-term cost-effectiveness of saxagliptin + metformin (SAXA + MET) vs glimepiride + metformin (GLI + MET) in patients with Type 2 diabetes mellitus (T2DM) inadequately controlled with MET in China. The Cardiff Model was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews and hospital surveys were conducted to obtain patients profiles, clinical data, and costs. Health insurance costs (2014¥) were estimated over a 40-year period. One-way and probabilistic sensitivity analyses were performed. SAXA + MET had lower predicted incidences of cardiovascular and hypoglycemia events and a decreased total cost compared with GLI + MET (¥241,072,807 vs ¥285,455,177). There were increased numbers of quality-adjusted life-years (QALYs; 1.01/patient) and life-years (Lys; 0.03/patient) gained with SAXA + MET compared with GLI + MET, and the incremental cost of SAXA + MET vs GLI + MET (-¥44,382) resulted in -¥43,883/QALY and -¥1,710,926/LY gained with SAXA + MET. Sensitivity analyses confirmed that the results were robust. In patients with T2DM in China, SAXA + MET was more cost-effective and was well tolerated with fewer adverse effects (AEs) compared with GLI + MET. As a second-line therapy for T2DM, SAXA may address some of the unmet medical needs attributable to AEs in the treatment of T2DM.
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Wewege, Michael A; Thom, Jeanette M; Rye, Kerry-Anne; Parmenter, Belinda J
2018-05-03
Exercise is beneficial to individuals with metabolic syndrome (MetS). An understudied group, who represent the majority of the MetS population, are individuals who have not developed diabetes. This review examined aerobic, resistance and combined (aerobic + resistance) exercise for cardiovascular risk factors in MetS without diabetes. Eight electronic databases were searched up to September 2017 for randomised controlled trials >4 weeks in duration that compared an exercise intervention to the non-exercise control in MetS without diabetes. MetS criteria, cardiorespiratory fitness and cardiovascular risk factors were meta-analysed in a random effects model. Eleven studies with 16 interventions were included (12 aerobic, 4 resistance). Aerobic exercise significantly improved waist circumference -3.4 cm (p < 0.01), fasting glucose -0.15 mmol/L (p = 0.03), high-density cholesterol 0.05 mmol/L (p = 0.02), triglycerides -0.29 mmol/L (p < 0.01), diastolic blood pressure -1.6 mmHg (p = 0.01), and cardiorespiratory fitness 4.2 ml/kg/min (p < 0.01), among other outcomes. No significant effects were determined following resistance exercise possibly due to limited data. Sub-analyses suggested that aerobic exercise progressed to vigorous intensity, and conducted 3 days/week for ≥12 weeks offered larger and more widespread improvements. Aerobic exercise following current guidelines offers widespread benefits to individuals with MetS without diabetes. More studies on resistance/combined exercise programs in MetS are required to improve the quality of evidence. Copyright © 2018 Elsevier B.V. All rights reserved.
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Aceituno, Anna M; Stanhope, Kaitlyn K; Rebolledo, Paulina A; Burke, Rachel M; Revollo, Rita; Iñiguez, Volga; Suchdev, Parminder S; Leon, Juan S
2017-11-28
Implementing rigorous epidemiologic studies in low-resource settings involves challenges in participant recruitment and follow-up (e.g., mobile populations, distrust), biological sample collection (e.g., cold-chain, laboratory equipment scarcity) and data collection (e.g., literacy, staff training, and infrastructure). This article describes the use of a monitoring and evaluation (M&E) framework to improve study efficiency and quality during participant engagement, and biological sample and data collection in a longitudinal cohort study of Bolivian infants. The study occurred between 2013 and 2015 in El Alto, Bolivia, a high-altitude, urban, low-resource community. The study's M&E framework included indicators for participant engagement (e.g., recruitment, retention, safety), biological sample (e.g., stool and blood), and data (e.g., anthropometry, questionnaires) collection and quality. Monitoring indicators were measured regularly throughout the study and used for course correction, communication, and staff retraining. Participant engagement indicators suggested that enrollment objectives were met (461 infants), but 15% loss-to-follow-up resulted in only 364 infants completing the study. Over the course of the study, there were four study-related adverse events (minor swelling and bruising related to a blood draw) and five severe adverse events (infant deaths) not related to study participation. Biological sample indicators demonstrated two blood samples collected from 95% (333 of 350 required) infants and stool collected for 61% of reported infant diarrhea episodes. Anthropometry data quality indicators were extremely high (median SDs for weight-for-length, length-for-age and weight-for-age z-scores 1.01, 0.98, and 1.03, respectively), likely due to extensive training, standardization, and monitoring efforts. Conducting human subjects research studies in low-resource settings often presents unique logistical difficulties, and collecting high-quality data is often a challenge. Investing in comprehensive M&E is important to improve participant recruitment, retention and safety, and sample and data quality. The M&E framework from this study can be applied to other longitudinal studies.
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Jassam, Nuthar; Yundt-Pacheco, John; Jansen, Rob; Thomas, Annette; Barth, Julian H
2013-08-01
The implementation of national and international guidelines is beginning to standardise clinical practice. However, since many guidelines have decision limits based on laboratory tests, there is an urgent need to ensure that different laboratories obtain the same analytical result on any sample. A scientifically-based quality control process will be a pre-requisite to provide this level of analytical performance which will support evidence-based guidelines and movement of patients across boundaries while maintaining standardised outcomes. We discuss the finding of a pilot study performed to assess UK clinical laboratories readiness to work to a higher grade quality specifications such as biological variation-based quality specifications. Internal quality control (IQC) data for HbA1c, glucose, creatinine, cholesterol and high density lipoprotein (HDL)-cholesterol were collected from UK laboratories participating in the Bio-Rad Unity QC programme. The median of the coefficient of variation (CV%) of the participating laboratories was evaluated against the CV% based on biological variation. Except creatinine, the other four analytes had a variable degree of compliance with the biological variation-based quality specifications. More than 75% of the laboratories met the biological variation-based quality specifications for glucose, cholesterol and HDL-cholesterol. Slightly over 50% of the laboratories met the analytical goal for HBA1c. Only one analyte (cholesterol) had a performance achieving the higher quality specifications consistent with 5σ. Our data from IQC do not consistently demonstrate that the results from clinical laboratories meet evidence-based quality specifications. Therefore, we propose that a graded scale of quality specifications may be needed at this stage.
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Come together, right now: dynamic overwriting of an object's history through common fate.
Luria, Roy; Vogel, Edward K
2014-08-01
The objects around us constantly move and interact, and the perceptual system needs to monitor on-line these interactions and to update the object's status accordingly. Gestalt grouping principles, such as proximity and common fate, play a fundamental role in how we perceive and group these objects. Here, we investigated situations in which the initial object representation as a separate item was updated by a subsequent Gestalt grouping cue (i.e., proximity or common fate). We used a version of the color change detection paradigm, in which the objects started to move separately, then met and stayed stationary, or moved separately, met, and then continued to move together. We monitored the object representations on-line using the contralateral delay activity (CDA; an ERP component indicative of the number of maintained objects), during their movement, and after the objects disappeared and became working memory representations. The results demonstrated that the objects' representations (as indicated by the CDA amplitude) persisted as being separate, even after a Gestalt proximity cue (when the objects "met" and remained stationary on the same position). Only a strong common fate Gestalt cue (when the objects not just met but also moved together) was able to override the objects' initial separate status, creating an integrated representation. These results challenge the view that Gestalt principles cause reflexive grouping. Instead, the object initial representation plays an important role that can override even powerful grouping cues.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Holladay, S.K.; Anderson, H.M.; Benson, S.B.
Quality assurance (QA) objectives for Phase 2 were that (1) scientific data generated would withstand scientific and legal scrutiny; (2) data would be gathered using appropriate procedures for sample collection, sample handling and security, chain of custody, laboratory analyses, and data reporting; (3) data would be of known precision and accuracy; and (4) data would meet data quality objectives defined in the Phase 2 Sampling and Analysis Plan. A review of the QA systems and quality control (QC) data associated with the Phase 2 investigation is presented to evaluate whether the data were of sufficient quality to satisfy Phase 2more » objectives. The data quality indicators of precision, accuracy, representativeness, comparability, completeness, and sensitivity were evaluated to determine any limitations associated with the data. Data were flagged with qualifiers that were associated with appropriate reason codes and documentation relating the qualifiers to the reviewer of the data. These qualifiers were then consolidated into an overall final qualifier to represent the quality of the data to the end user. In summary, reproducible, precise, and accurate measurements consistent with CRRI objectives and the limitations of the sampling and analytical procedures used were obtained for the data collected in support of the Phase 2 Remedial Investigation.« less
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Governance of quality of care: a qualitative study of health service boards in Victoria, Australia
Bismark, Marie M; Studdert, David M
2014-01-01
Objectives To describe the engagement of health service boards with quality-of-care issues and to identify factors that influence boards’ activities in this area. Methods We conducted semistructured interviews with 35 board members and executives from 13 public health services in Victoria, Australia. Interviews focused on the role currently played by boards in overseeing quality of care. We also elicited interviewees’ perceptions of factors that have influenced their current approach to governance in this area. Thematic analysis was used to identify key themes from interview transcripts. Results Virtually all interviewees believed boards had substantial opportunities to influence the quality of care delivered within the service, chiefly through setting priorities, monitoring progress, holding staff to account and shaping culture. Perceived barriers to leveraging this influence included insufficient resources, gaps in skills and experience among board members, inadequate information on performance and regulatory requirements that miss the mark. Interviewees converged on four enablers of more effective quality governance: stronger regional collaborations; more tailored board training on quality issues; smarter use of reporting and accreditation requirements; and better access to data that was reliable, longitudinal and allowed for benchmarking against peer organisations. Conclusions Although health service boards are eager to establish quality of care as a governance priority, several obstacles are blocking progress. The result is a gap between the rhetoric of quality governance and the reality of month-to-month activities at the board level. The imperative for effective board-level engagement in this area cannot be met until these barriers are addressed. PMID:24327735
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Quality of life and recreational cannabis use.
Goldenberg, Matthew; IsHak, Waguih William; Danovitch, Itai
2017-01-01
Cannabis is now the most commonly used illicit drug in the United States and use is increasing. Frequent cannabis use has been associated with adverse social and health effects. We sought to evaluate the relationship between recreational cannabis use and Quality of Life (QoL), a person-centered measure that characterizes the overall sense of health and wellbeing. We hypothesized that QoL would be unchanged or increased among recreational cannabis users, who did not meet criteria for a Cannabis Use Disorder (CUD) and that QoL would be lower among those who met criteria for a CUD. We conducted a systematic review, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The results were categorized into tables and identified trends. Fourteen studies met our pre-defined selection criteria. The studies were heterogeneous and their quality was low. With one exception, we did not identify any population for whom cannabis use was associated with improved QoL. QoL was lower in persons who used cannabis heavily, or who met criteria for CUD. However, this association was inconsistent and the magnitude was weaker than the relationship between QoL and use of other addictive substances (including tobacco and illicit drugs). In this systematic review, heavy cannabis use or CUD was associated with reduced QoL. It is unknown whether reduced QoL drives cannabis use, or whether cannabis use can lead to reduced QoL. Prospective studies are needed to evaluate the causal relationship between cannabis and QoL. Furthering the understanding of the relationship between cannabis and QoL can inform public policy, prevention efforts, outcomes, and an objective understanding of the effects of cannabis users. (Am J Addict 2017;26:8-25). © 2016 American Academy of Addiction Psychiatry.
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Childhood trauma and metabolic syndrome in men and women.
Lee, Chioun; Tsenkova, Vera; Carr, Deborah
2014-03-01
The long-term effects of childhood trauma on health are well-documented, but few population-based studies have explored how childhood trauma affects the risk of developing metabolic syndrome (MetS) in adulthood. Using data from 1234 adults in the second wave of Midlife in the United States (MIDUS), we investigate (1) the extent to which childhood abuse affects the risk of developing MetS in adulthood; (2) how the severity of different types of abuse (emotional, physical, sexual, or cumulative abuse) affects this risk; and (3) the extent to which adult socioeconomic status (SES), maladaptive stress responses, and unhealthy behaviors mediate the association. We also test whether these associations differ significantly by sex. We find that emotional and physical abuse increase the risk of developing MetS for both sexes, whereas sexual abuse is a predictor for women only. For both sexes, individuals who experienced more cumulative abuse have a greater risk of developing MetS. Adult SES partially explains the association between childhood abuse and MetS. Maladaptive stress responses and unhealthy behaviors further explain the association. Among the potential mediators, poor sleep quality was a significant pathway for men and women, while stress-induced eating was a significant pathway for women only. Our findings suggest that the well-documented health consequences of early life trauma may vary by the nature of the trauma, the victim's sex, and the coping mechanisms that he or she employs. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Human, Lauren J.; Biesanz, Jeremy C.; Miller, Gregory E.; Chen, Edith; Lachman, Margie E.; Seeman, Teresa E.
2013-01-01
Objective Personality change is emerging as an important predictor of health and well-being. Extending previous research, we examined whether two types of personality change, directional and absolute, are associated with both subjective and objective indicators of health. Method Utilizing the longitudinal Midlife in the United States Survey (MIDUS) data, we examined whether both types of change over 10 years were associated with psychological well-being, self-reported global health, and the presence of metabolic syndrome (MetS) components and diagnosis. Results Socially undesirable personality change (e.g., becoming less conscientious and more neurotic) and absolute personality change were independently associated with worse perceived health and well-being at Time 2. Notably, absolute personality change, regardless of the direction, was also associated with having a greater number of MetS components and a greater probability of diagnosis at Time 2. Conclusions In sum, too much personality change may be bad for one’s health: socially undesirable and absolute personality change were both associated with worse psychological health and worse metabolic profiles over 10 years. These findings suggest that personality change may contribute to psychological and physical health, and provide initial insight into potential intermediate links between personality change and distal outcomes such as mortality. PMID:22924900
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DATA QUALITY OBJECTIVES IN RESEARCH PLANNING AT MED: THREE CASE STUDIES
This course will give a quality assurance perspective to research planning by describing the Data Quality Objective Process....Written plans are mandatory for all EPA environmental data collection activities according to EPA Order 5360.1 CHG 1 and Federal Acquisition Regulations,...
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Development of an advanced pitch active control system for a wide body jet aircraft
NASA Technical Reports Server (NTRS)
Guinn, Wiley A.; Rising, Jerry J.; Davis, Walt J.
1984-01-01
An advanced PACS control law was developed for a commercial wide-body transport (Lockheed L-1011) by using modern control theory. Validity of the control law was demonstrated by piloted flight simulation tests on the NASA Langley visual motion simulator. The PACS design objective was to develop a PACS that would provide good flying qualities to negative 10 percent static stability margins that were equivalent to those of the baseline aircraft at a 15 percent static stability margin which is normal for the L-1011. Also, the PACS was to compensate for high-Mach/high-g instabilities that degrade flying qualities during upset recoveries and maneuvers. The piloted flight simulation tests showed that the PACS met the design objectives. The simulation demonstrated good flying qualities to negative 20 percent static stability margins for hold, cruise and high-speed flight conditions. Analysis and wind tunnel tests performed on other Lockheed programs indicate that the PACS could be used on an advanced transport configuration to provide a 4 percent fuel savings which results from reduced trim drag by flying at negative static stability margins.
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Linking consistency with object/thread semantics - An approach to robust computation
NASA Technical Reports Server (NTRS)
Chen, Raymond C.; Dasgupta, Partha
1989-01-01
This paper presents an object/thread based paradigm that links data consistency with object/thread semantics. The paradigm can be used to achieve a wide range of consistency semantics from strict atomic transactions to standard process semantics. The paradigm supports three types of data consistency. Object programmers indicate the type of consistency desired on a per-operation basis and the system performs automatic concurrency control and recovery management to ensure that those consistency requirements are met. This allows programmers to customize consistency and recovery on a per-application basis without having to supply complicated, custom recovery management schemes. The paradigm allows robust and nonrobust computation to operate concurrently on the same data in a well defined manner. The operating system needs to support only one vehicle of computation - the thread.
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Association between dietary patterns and the risk of metabolic syndrome among Lebanese adults.
Naja, F; Nasreddine, L; Itani, L; Adra, N; Sibai, A M; Hwalla, N
2013-02-01
The main objective of this study was to evaluate the association between dietary patterns and the metabolic syndrome (MetS) and its metabolic abnormalities among Lebanese adults, using data from a national nutrition survey. A cross-sectional analysis involving adults aged ≥ 18 years (n = 323) with no prior history of chronic diseases was conducted. Participants completed a brief sociodemographic and 61-item food frequency questionnaire. Anthropometric measurements and fasting blood samples were also obtained. The International Diabetes Federation criteria were used to classify study participants with the metabolic syndrome. Dietary patterns were identified by factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of extracted patterns with MetS and its metabolic abnormalities. Out of 323 participants, 112 (34.6%) were classified as having MetS. Three dietary patterns were identified: "Fast Food/Dessert," "Traditional Lebanese," and "High Protein." Compared with participants in the lowest quintile of the Fast Food/Dessert pattern, those in the highest quintile had significantly higher odds for MetS (OR, 3.13; 95% CI: 1.36-7.22) and hyperglycemia (OR, 3.81; 95% CI: 159-9.14). Subjects with the highest intake of the High Protein pattern had an increased risk for hypertension (OR, 2.98; 95% CI: 1.26-7.02). The Traditional Lebanese pattern showed no association with MetS or its components. The findings of this study demonstrate a positive association of the Fast Food/Dessert pattern with MetS and hyperglycemia among Lebanese adults. These results may guide the development of improved preventive nutrition interventions in this adult population.
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Ancheta, Irma B; Battie, Cynthia A; Tuason, Teresa; Ancheta, Christine V
2012-01-01
Cardiovascular disease (CVD) is a significant cause of morbidity and mortality in women of Filipino ethnicity. The objective of our work was to determine if metabolic syndrome (MetS), a modifiable CVD risk factor, differs in women as a function of country of residency and to determine if, CVD prevention strategies need to differ for these groups of Filipino women. Data were collected in community-based health screenings for this cross-sectional study. PARTICIPANTS were recruited at places of worship in southeast United States (n=60) and Central Visayas, Philippines (n=56). Prevalence of MetS and its component factors as defined by the International Diabetes Federation criteria. The prevalence of MetS in Filipino women (FW) and Filipino American women (FAW) groups was similar (52% vs 55%, P=.08) although the prevalence of elevated waist circumference was greater for FAW (78% vs 59%, P=.03). Conversely, the percentage of FW women with risk-associated high-density lipoprotein (HDL) levels was higher than the FAW group (84% vs 42%, P<.001). Other MetS component factors (blood pressure, glucose and triglycerides) did not significantly differ between groups. Similar high rates of MetS were observed in Filipino women regardless of the country of residency although the FAW tended to have higher rates of central obesity while the FW tended to have higher rates of risk-associated HDL levels. Further research should examine the cause of these differences in order to develop better cardiovascular screening and intervention strategies.
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Association between salivary pH and metabolic syndrome in women: a cross-sectional study.
Tremblay, Monique; Brisson, Diane; Gaudet, Daniel
2012-09-08
The salivary flow rate is an important determinant of salivary pH. It is influenced by several metabolic syndrome (MetS) components as well as the menopausal status. The cluster of cardiometabolic risk factors that characterizes the MetS could be exacerbated following menopause. The objective of this study was therefore to document the association between salivary pH and MetS expression in women according to the menopausal status. In this cross-sectional study, unstimulated saliva collection was performed on 198 Caucasian women of French-Canadian origin of which 55 were premenopausal women (PMW) and 143 menopausal women (MW). Student's t test, ANOVA and correlation analyses were used to assess the association between salivary pH and MetS components. The salivary pH level was significantly correlated with several MetS covariates, namely triglycerides (TG), apolipoprotein B (apo B) and plasma glucose concentrations as well as waist circumference and the number of MetS components present in the whole sample and PMW only. Mean pH levels decreased as the number of MetS components increased (p = 0.004). The correlations between salivary pH and variables associated with MetS components tended to be stronger in PMW. The proportion of the variance (R2) of salivary pH explained by MetS-related variables in PMW, MW and the whole sample was 23.6% (p = 0.041), 18.1% and 17.0% (p < 0.001) respectively. The increasing prevalence of obesity calls for the development of new technologies to more easily monitor health status without increasing the burden of healthcare costs. As such, the salivary pH could be an inexpensive screening tool. These exploratory data suggest that salivary pH may be a significant correlate of the expression of MetS components. However, other studies with different populations are needed to confirm these findings before our observations lead to practical use in clinical settings.
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Liu, Zhao-Min; Ho, Suzanne; Hao, Yuan-Tao; Chen, Yu-Ming; Woo, Jean; Wong, Samuel Yeung-Shan; He, Qiqiang; Xie, Yao Jie; Tse, Lap Ah; Chen, Bailing; Su, Xue-Fen; Lao, Xiang-Qian; Wong, Carmen; Chan, Ruth; Ling, Wen-Hua
2016-09-27
Metabolic syndrome (MetS) is a public health problem in postmenopausal women. Whole soy foods are rich in unsaturated fats, high quality plant protein and various bioactive phytochemicals that may have a beneficial role in the management of MetS. The aim of the study is to examine the effect of whole soy replacement diet on the features of MetS among postmenopausal women. This will be a 12-month, randomised, single-blind, parallel controlled trial among 208 postmenopausal women at risk of MetS or with early MetS. After 4 weeks' run-in, subjects will be randomly allocated to one of two intervention groups, whole soy replacement group or control group, each for 12 months. Subjects in the whole soy group will be required to include four servings of whole soy foods (containing 25 g soy protein) into their daily diet iso-calorically, replacing red or processed meat and high fat dairy products. Subjects in the control group will remain on a usual diet. The outcome measures will include metabolic parameters as well as a 10-year risk for ischaemic cardiovascular disease. We hypothesise that the whole soy substitution diet will notably improve features of MetS in postmenopausal women at risk of MetS or with early MetS. The study will have both theoretical and practical significance. If proven effective, the application of the whole soy replacement diet model will be a safe, practical and economical strategy for MetS prevention and treatment. Ethics approval has been obtained from the Ethics Committee of the Chinese University of Hong Kong. The results will be disseminated via conference presentations and papers in academic peer reviewed journals. Data files will be deposited in an accessible repository. NCT02610322. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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Liu, Zhao-min; Ho, Suzanne; Hao, Yuan-tao; Chen, Yu-ming; Woo, Jean; Wong, Samuel Yeung-shan; He, Qiqiang; Tse, Lap Ah; Chen, Bailing; Su, Xue-fen; Lao, Xiang-qian; Wong, Carmen; Chan, Ruth; Ling, Wen-hua
2016-01-01
Introduction Metabolic syndrome (MetS) is a public health problem in postmenopausal women. Whole soy foods are rich in unsaturated fats, high quality plant protein and various bioactive phytochemicals that may have a beneficial role in the management of MetS. The aim of the study is to examine the effect of whole soy replacement diet on the features of MetS among postmenopausal women. Methods and analysis This will be a 12-month, randomised, single-blind, parallel controlled trial among 208 postmenopausal women at risk of MetS or with early MetS. After 4 weeks' run-in, subjects will be randomly allocated to one of two intervention groups, whole soy replacement group or control group, each for 12 months. Subjects in the whole soy group will be required to include four servings of whole soy foods (containing 25 g soy protein) into their daily diet iso-calorically, replacing red or processed meat and high fat dairy products. Subjects in the control group will remain on a usual diet. The outcome measures will include metabolic parameters as well as a 10-year risk for ischaemic cardiovascular disease. We hypothesise that the whole soy substitution diet will notably improve features of MetS in postmenopausal women at risk of MetS or with early MetS. The study will have both theoretical and practical significance. If proven effective, the application of the whole soy replacement diet model will be a safe, practical and economical strategy for MetS prevention and treatment. Ethics and dissemination Ethics approval has been obtained from the Ethics Committee of the Chinese University of Hong Kong. The results will be disseminated via conference presentations and papers in academic peer reviewed journals. Data files will be deposited in an accessible repository. Trial registration number NCT02610322. PMID:27678545
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Enhancing Battlemind: Preventing PTSD by Coping with Intrusive Thoughts
2014-05-01
to write scoring syntax, etc.). We were optimistic that these two milestones would demonstrate significant progress during the coming quarter...fully met; preparation for data analyses (including familiarizing themselves with background literature and writing of scoring syntax) is complete...quality controlling this data in preparation for analyses and manuscript writing . • Manuscript preparation begins—Phase 1 PROGRESS: Drs. Shipherd
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Lau, Erica Y; Wong, Del P; Ransdell, Lynda
2011-01-01
Background A growing body of research has employed information and communication technologies (ICTs) such as the Internet and mobile phones for disseminating physical activity (PA) interventions with young populations. Although several systematic reviews have documented the effects of ICT-based interventions on PA behavior, very few have focused on children and adolescents specifically. Objectives The present review aimed to systematically evaluate the efficacy and methodological quality of ICT-based PA interventions for children and adolescents based on evidence from randomized controlled trials. Methods Electronic databases Medline, PsycInfo, CINAHL, and Web of Science were searched to retrieve English language articles published in international academic peer-reviewed journals from January 1, 1997, through December 31, 2009. Included were articles that provided descriptions of interventions designed to improve PA-related cognitive, psychosocial, and behavioral outcomes and that used randomized controlled trial design, included only children (6-12 years old) and adolescents (13-18 years old) in both intervention and control groups, and employed Internet, email, and/or short message services (SMS, also known as text messaging) as one or more major or assistive modes to deliver the intervention. Results In total, 9 studies were analyzed in the present review. All studies were published after 2000 and conducted in Western countries. Of the 9 studies, 7 demonstrated positive and significant within-group differences in at least one psychosocial or behavioral PA outcome. In all, 3 studies reported positive and significant between-group differences favoring the ICT group. When between-group differences were compared across studies, effect sizes were small in 6 studies and large in 3 studies. With respect to methodological quality, 7 of the 9 studies had good methodological quality. Failure to report allocation concealment, blinding to outcome assessment, and lack of long-term follow-up were the criteria met by the fewest studies. In addition, 5 studies measured the intervention exposure rate and only 1 study employed objective measures to record data. Conclusion The present review provides evidence supporting the positive effects of ICTs in PA interventions for children and adolescents, especially when used with other delivery approaches (ie, face-to-face). Because ICT delivery approaches are often mixed with other approaches and these studies sometimes lack a comparable control group, additional research is needed to establish the true independent effects of ICT as an intervention delivery mode. Although two-thirds of the studies demonstrated satisfactory methodological quality, several quality criteria should be considered in future studies: clear descriptions of allocation concealment and blinding of outcome assessment, extension of intervention duration, and employment of objective measures in intervention exposure rate. Due to the small number of studies that met inclusion criteria and the lack of consistent evidence, researchers should be cautious when interpreting the findings of the present review. PMID:21749967
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Student nurses' learning on community-based education in Ethiopia.
Salmon, Karen; Keneni, Gutema
2004-07-01
At Jimma University educational goals are to apply the concept of community-oriented education through community-based education (CBE) of health students. This study examined the experiences of student nurses on CBE. The aims of the study were to identify factors that students considered had helped or hindered their learning on CBE and to ascertain if the stated learning objectives were met. A quantitative, descriptive, survey design was adopted, using a single, anonymous questionnaire. Some qualitative data were gained using open questions. A convenience sample of 95 students participated in the research. Participants represented 90% of all students who had completed their CBE placements. Participation, mentors' willingness to answer questions and the relevance of the placement were factors that facilitated learning. Factors reported by students that hindered learning were difficulties of self-expression in a group, mentors emphasising mistakes and weakness and the short time-frame due to ongoing lectures during placement. Students said learning objectives most met were socio-demographic assessment, identifying health problems and action planning. Objectives reported to be least met were identifying environmental health problems, planning preventive health interventions and implementing health interventions. These include the need to develop students' group skills, prepare mentors to facilitate learning, organise CBE in spiral phases, avoid concurrent lectures and improve study facilities.
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Lissiman, Elizabeth; Bhasale, Alice L; Cohen, Marc
2014-11-11
Background Garlic is alleged to have antimicrobial and antiviral properties that relieve the common cold, among other beneficial effects. There is widespread usage of garlic supplements. The common cold is associated with significant morbidity and economic consequences. On average, children have six to eight colds per year and adults have two to four.Objectives To determine whether garlic (Allium sativum) is effective for the prevention or treatment of the common cold, when compared to placebo, no treatment or other treatments.Search methods We searched CENTRAL (2014, Issue 7),OLDMEDLINE (1950 to 1965),MEDLINE (January 1966 to July week 5, 2014), EMBASE(1974 to August 2014) and AMED (1985 to August 2014).Selection criteria Randomised controlled trials of common cold prevention and treatment comparing garlic with placebo, no treatment or standard treatment.Data collection and analysis Two review authors independently reviewed and selected trials from searches, assessed and rated study quality and extracted relevant data.Main results In this updated review, we identified eight trials as potentially relevant from our searches. Again, only one trial met the inclusion criteria.This trial randomly assigned 146 participants to either a garlic supplement (with 180 mg of allicin content) or a placebo (once daily)for 12 weeks. The trial reported 24 occurrences of the common cold in the garlic intervention group compared with 65 in the placebo group (P value < 0.001), resulting in fewer days of illness in the garlic group compared with the placebo group (111 versus 366). The number of days to recovery from an occurrence of the common cold was similar in both groups (4.63 versus 5.63). Only one trial met the inclusion criteria, therefore limited conclusions can be drawn. The trial relied on self reported episodes of the common cold but was of reasonable quality in terms of randomisation and allocation concealment. Adverse effects included rash and odour. Authors' conclusions There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. A single trial suggested that garlic may prevent occurrences of the common cold but more studies are needed to validate this finding. Claims of effectiveness appear to rely largely on poor-quality evidence.
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Stefanovic, Stefan; Wallwiener, Markus; Karic, Uros; Domschke, Christoph; Katic, Luka; Taran, Florin-Andrei; Pesic, Aleksandra; Hartkopf, Andreas; Hadji, Peyman; Teufel, Martin; Schuetz, Florian; Sohn, Christof; Fasching, Peter; Schneeweiss, Andreas; Brucker, Sara
2017-02-01
The capture of adequate treatment outcomes and quality of life (QOL) of advanced breast cancer patients in clinical routine represents a great challenge. Patient-reported outcomes (PROs) are data elements directly reported by patients about experiences with care, including symptoms, functional status, or quality of life. There is growing interest in the medical community for the evaluation and implementation of PROs of adverse events (PRO-AEs). Recent interest in PROs in health care has evolved in the context of patient centeredness. Our primary objective was to identify trials that had implemented PRO-AEs in the breast cancer treatment setting, thereby demonstrating its feasibility. We aimed to identify published studies that used patient reports to assess AEs during and after breast cancer treatment, to identify clinician underreported and modifiable AEs that are important to patients, and to analyze the feasibility and usefulness of PRO instrument implementation in everyday oncological practice with special attention given to electronic-based PRO instruments. We conducted a systematic search of PubMed for studies that used PRO instruments to assess AEs of breast cancer treatment in the metastatic and adjuvant settings. Two authors independently reviewed the search results and decided which studies fully met the predefined inclusion criteria. The search yielded 606 publications. The two reviewers found that 9 studies met the inclusion criteria. Three AEs were identified as important to patients but inadequately reported by health care providers, namely hot flushes, vaginal dryness, and weight gain. PROs and PRO-AEs are the consequence of contemporary concepts of patient-centered medicine and the growing feasibility, utility, and implications of collecting data using modern technology. Furthermore, the willingness of patients to utilize innovative applications for their own health has been increasing in parallel to the enhanced impact of the World Wide Web. Especially, the coverage of the metastatic situation promises numerous findings on the structure and quality of health care, enabling implementation of individually tailored interventions. Remote electronic self-reporting (i.e., home reporting) is feasible and is associated with high compliance levels.
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Evaluation of the Hydrolab HL4 water-quality sonde and sensors
Snazelle, Teri T.
2017-12-18
The U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility evaluated three Hydrolab HL4 multiparameter water-quality sondes by OTT Hydromet. The sondes were equipped with temperature, conductivity, pH, dissolved oxygen (DO), and turbidity sensors. The sensors were evaluated for compliance with the USGS National Field Manual for the Collection of Water-Quality Data (NFM) criteria for continuous water-quality monitors and to verify the validity of the manufacturer’s technical specifications. The conductivity sensors were evaluated for the accuracy of the specific conductance (SC) values (conductance at 25 degrees Celsius [oC]), that were calculated by using the vendor default method, Hydrolab Fresh. The HL4’s communication protocols and operating temperature range along with accuracy of the water-quality sensors were tested in a controlled laboratory setting May 1–19, 2016. To evaluate the sonde’s performance in a surface-water field application, an HL4 equipped with temperature, conductivity, pH, DO, and turbidity sensors was deployed June 20–July 22, 2016, at USGS water-monitoring site 02492620, Pearl River at National Space Technology Laboratories (NSTL) Station, Mississippi, located near Bay Saint Louis, Mississippi, and compared to the adjacent well-maintained EXO2 site sonde.The three HL4 sondes met the USGS temperature testing criteria and the manufacturer’s technical specifications for temperature based upon the median room temperature difference between the measured and standard temperatures, but two of the three sondes exceeded the allowable difference criteria at the temperature extremes of approximately 5 and 40 ºC. Two sondes met the USGS criteria for SC. One of the sondes failed the criteria for SC when evaluated in a 100,000-microsiemens-per-centimeter (μS/cm) standard at room temperature, and also failed in a 10,000-μS/cm standard at 5, 15, and 40 ºC. All three sondes met the USGS criteria for pH and DO at room temperature, but one sonde exceeded the allowable difference criteria when tested in pH 5.00 buffer and at 40 ºC. The USGS criteria and the technical specifications for turbidity were met by one sonde in standards ranging from 10 to 3,000 nephelometric turbidity units (NTU). A second sonde met the USGS criteria and the technical specifications except in the 3,000-NTU standard, and the third sonde exceeded the USGS calibration criteria in the 10- and 20-NTU standards and the technical specifications in the 20-NTU standard.Results of the field test showed acceptable performance and revealed that differences in data sample processing between sonde manufacturers may result in variances between the reported measurements when comparing one sonde to another. These variances in data would be more pronounced in dynamic site conditions. The lack of a wiper or other sensor-cleaning device on the DO sensor could prove problematic, and could limit the use of the HL4 to profiling applications or at sites with limited biofouling.
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Henderson, Susan J; Newman, Jeannette; Ferguson, Rennie W; Jung, Paul
2016-12-01
Healthy People 2020 (HP2020) provides a set of quantifiable objectives for improving the health and well-being of Americans. This study examines Peace Corps Volunteers' health metrics in comparison with the Leading Health Indicators (LHIs) in order to set baseline measures for Volunteers' health care and align our measurements with Healthy People 2020 standards. Health data from multiple internal Peace Corps datasets were compared with relevant LHIs and analyzed using descriptive statistics. Seventeen (65%) of the 26 LHIs were relevant to Peace Corps Volunteers. Of these, Volunteers' health measures met or were more favorable than the goals of 13 (76%) of the LHIs. There were no data available for 4 (24%) of the LHIs. The entire Volunteer population has full access to primary care, oral health, and reproductive health services. No suicides or homicides were reported among Volunteers during the analyzed time period. Utilizing the LHIs, we have identified high-priority public health issues relevant for the Peace Corps Volunteer population. We discuss the need for quality data to measure and monitor Volunteers' health progress and outcomes over time, and also to standardize our measurements with Healthy People 2020 benchmarks. This framework may foster greater collaboration to engage in health promotion and disease prevention activities driven by evidence-based information, which may, in turn, encourage healthy behavior among Volunteers.
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[Current situation of health surveys in Spain].
Requena, María Luisa; Suárez, Mónica; Pérez, Óscar
2013-01-01
To describe the evolution of health interview surveys in Spain (as of 01/01/2012), whether national or regional, its main characteristics and methodology, and in the case of general health surveys (GHIS), its contents. An adapted version of Eurostat quality control template European Health Interview Survey Technical and Methodological Report was filled in by those responsible for GHIS in each region (autonomous communities) and at the national level. The first part (11 questions) gathers general information about health surveys, both GHIS and surveys targeted to specific populations or health problems (SHIS). The second part (109 questions) asks about methodological characteristics of most recent GHIS. 1) regional or supra-regional scope; 2) for the second part, GHIS currently active series. Quality control was performed using double data entry and validated by informants.100 HIS were identified. 16 were GHIS and 84 SHIS. 32 (38%) of the latter were national and 52 (62%) regional. Nutrition 21 (25%), drug use 10 (12%), opinion polls 7 (9%) and dental health 7 (9%) were the most frequent topics in SHIS. Highest GHIS density was reached after year 2000, with several surveys on field at a time (mode=3). 11 GHIS (2 national, 9 regional) met inclusion criteria for the second part. All complied with general quality benchmarks. Few differences were observed in content.GHIS show more similarities than differences in objectives, methods and content. Rationalization and harmonization are needed. Physical activity, alcohol consumption, quality of life and mental health instruments are not yet consensual. Valid and comparable data are required on health status and its determinants to inform health policy.
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Khan, Rumana J; Gebreab, Samson Y; Sims, Mario; Riestra, Pia; Xu, Ruihua; Davis, Sharon K
2015-01-01
Objective Both environmental and genetic factors play important roles in the development of metabolic syndrome (MetS). Studies about its associated factors and genetic contribution in African Americans (AA) are sparse. Our aim was to report the prevalence, associated factors and heritability estimates of MetS and its components in AA men and women. Participants and setting Data of this cross-sectional study come from a large community-based Jackson Heart Study (JHS). We analysed a total of 5227 participants, of whom 1636 from 281 families were part of a family study subset of JHS. Methods Participants were classified as having MetS according to the Adult Treatment Panel III criteria. Multiple logistic regression analysis was performed to isolate independently associated factors of MetS (n=5227). Heritability was estimated from the family study subset using variance component methods (n=1636). Results About 27% of men and 40% of women had MetS. For men, associated factors with having MetS were older age, lower physical activity, higher body mass index, and higher homocysteine and adiponectin levels (p<0.05 for all). For women, in addition to all these, lower education, current smoking and higher stress were also significant (p<0.05 for all). After adjusting for covariates, the heritability of MetS was 32% (p<0.001). Heritability ranged from 14 to 45% among its individual components. Relatively higher heritability was estimated for waist circumference (45%), high density lipoprotein-cholesterol (43%) and triglycerides (42%). Heritability of systolic blood pressure (BP), diastolic BP and fasting blood glucose was 16%, 15% and 14%, respectively. Conclusions Stress and low education were associated with having MetS in AA women, but not in men. Higher heritability estimates for lipids and waist circumference support the hypothesis of lipid metabolism playing a central role in the development of MetS and encourage additional efforts to identify the underlying susceptibility genes for this syndrome in AA. PMID:26525420
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Kim, Yoon Jung; Lee, Yo Han; Lee, Yun Jeong; Kim, Kyeong Jin; An, Jee Hyun; Kim, Nam Hoon; Kim, Hee Young; Choi, Dong Seop; Kim, Sin Gon
2016-01-01
Objectives To determine the prevalence of metabolic syndrome (MetS) and its related factors among North Korean refugees (NKR) in South Korea. Design Cross-sectional study conducted using a questionnaire and anthropometric and biochemical data on NKR in South Korea. Setting Seoul, South Korea. Participants A sample of NKR who voluntarily underwent medical examinations in Anam Hospital of Korea University, Seoul, South Korea (N=708, consisting of 161 males and 547 females). To compare the prevalence of MetS, 1416 age- and gender-matched individuals from the South Korean population (SKP, at a ratio of 1:2 to NKR) were randomly selected from the fifth Korean National Health and Nutrition Examination Survey. Main outcome measures The prevalence of MetS and its related factors among NKR in South Korea and comparison with its prevalence among the general SKP. Results The prevalence of MetS among male and female NKR in South Korea was 19.7% and 17.2%, respectively. Although obesity is more prevalent in South than in North Korea, we found no difference in the prevalence of MetS between the female NKR and SKP groups (17.2% vs 16.6%, respectively; p=0.830). As regards the males, the small sample size of the NKR group yielded insufficient evidence of any difference in MetS prevalence between the NKR and SKP groups (19.7% vs 26.2%, respectively; p=0.134). We found that excess weight gain (≥5%) in South Korea was significantly associated with MetS among NKR. Conclusions The prevalence of MetS among NKR did not differ from that in the SKP group despite the lower prevalence of obesity in NKR than in the general SKP. The fact that excess weight gain in South Korea was associated with the risk of MetS suggests that public health policy makers should focus on preventing excess weight gain in NKR during resettlement in South Korea. PMID:27251685
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Dietary Quality and Adherence to Dietary Recommendations in Patients Undergoing Hemodialysis.
Luis, Desiree; Zlatkis, Karyn; Comenge, Beatriz; García, Zoraida; Navarro, Juan F; Lorenzo, Victor; Carrero, Juan Jesús
2016-05-01
The multiple dietary restrictions recommended to hemodialysis patients may be difficult to achieve and, at the same time, may result in nutritional deficiencies rendering a poor dietary quality. We here assess the dietary quality and adherence to renal-specific guideline recommendations among hemodialysis patients from a single center in Canary Islands, Spain. Cross-sectional study, including 91 patients undergoing maintenance hemodialysis. Clinical data and 3-day dietary records were collected. We compared patient's reported nutrients intake with guideline recommendations. We also evaluated their alignment with current American Heart Association dietary guidelines for cardiovascular prevention. Seventy-seven percent and 50% of patients consumed less than the recommended daily energy and protein, respectively. Although half of the patients met the recommendations for dietary fat intake, this was accounted by an excess of saturated fat in 92% of them. Only 22% consumed sufficient fiber. A very small proportion of patients (less than 50%) met the requirements for vitamins and other micronutrients. Insufficient dietary intake was observed in most patients for all vitamins except for cobalamin. Similarly, inadequate dietary intake was observed for many minerals, by both excess (phosphorus, calcium, sodium, and potassium) and defect (magnesium). Most patients met the recommendations for iron and zinc in their diets. A large proportion of hemodialysis patients at our center did not meet current renal-specific dietary recommendations. The quality of the diet was considered poor and proatherogenic according to American Heart Association guidelines. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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Rao, Ajit; Ahmed, Mairaj K.; Taub, Peter J.
2016-01-01
ABSTRACT Objectives The authors performed a systematic review and meta-analysis to investigate the possible correlation between ambient air pollution and orofacial cleft anomalies in newborns. Material and Methods A literature search was performed using the PubMed and Google Scholar, using the keywords “air pollution”, “cleft lip”, “cleft palate”, “carbon monoxide”, “ozone”, “sulfur dioxide”, “nitrogen oxide”, “nitrogen dioxide”, and “aerodynamic diameter”. Eight epidemiologic articles met the criteria of correlating either carbon monoxide (CO), ozone (O3), nitrogen oxides (NOx), airborne particulate matter of less than 10 µm in diameter (PM10), or sulfur dioxide (SO2) exposures with clefting of the palate alone, clefting of the lip alone, or clefting of the lip and palate. Odds ratios were extracted from the eight studies and tabulated in this meta-analysis. Quality analysis showed six high quality, one medium quality, and one low quality study. Results Meta-analysis of the combined data confirmed the association of O3 exposure and risk of orofacial cleft anomalies (OR = 1.08; P = 0.02). NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate. Conclusions Ozone showed the strongest correlation with cleft lip and cleft palate anomalies. However, the studies overall showed an inconsistent correlation between orofacial clefts and air pollutants. PMID:27099696
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Relationship between sleep and pain in adolescents with juvenile primary fibromyalgia syndrome.
Olsen, Margaret N; Sherry, David D; Boyne, Kathleen; McCue, Rebecca; Gallagher, Paul R; Brooks, Lee J
2013-04-01
To investigate sleep quality in adolescents with juvenile primary fibromyalgia syndrome (JPFS) and determine whether sleep abnormalities, including alpha-delta sleep (ADS), correlate with pain intensity. We hypothesized that successful treatment for pain with exercise therapy would reduce ADS and improve sleep quality. Single-center preintervention and postintervention (mean = 5.7 ± 1.0 weeks; range = 4.0-7.3 weeks) observational study. Ten female adolescents (mean age = 16.2 ± 0.65 SD yr) who met criteria for JPFS and completed treatment. Multidisciplinary pain treatment, including intensive exercise therapy. Pain and disability were measured by a pain visual analog scale (VAS) and the functional disability inventory. Subjective sleep measures included a sleep VAS, an energy VAS, and the School Sleep Habits Survey. Objective sleep measures included actigraphy, polysomnography (PSG), and the Multiple Sleep Latency Test. Baseline PSG was compared with that of healthy age- and sex-matched control patients. At baseline, patients had poorer sleep efficiency, more arousals/awakenings, and more ADS (70.3% of total slow wave sleep [SWS] versus 21.9% SWS, P = 0.002) than controls. ADS was unrelated to pain, disability, or subjective sleep difficulty. After treatment, pain decreased (P = 0.000) and subjective sleep quality improved (P = 0.008). Objective sleep quality, including the amount of ADS, did not change. Although perceived sleep quality improved in adolescents with JPFS after treatment, objective measures did not. Our findings do not suggest exercise therapy for pain improves sleep by reducing ADS, nor do they support causal relationships between ADS and chronic pain or subjective sleep quality.
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Xu, Yanjun; Yang, Haixiu; Wu, Tan; Dong, Qun; Sun, Zeguo; Shang, Desi; Li, Feng; Xu, Yingqi; Su, Fei; Liu, Siyao
2017-01-01
Abstract BioM2MetDisease is a manually curated database that aims to provide a comprehensive and experimentally supported resource of associations between metabolic diseases and various biomolecules. Recently, metabolic diseases such as diabetes have become one of the leading threats to people’s health. Metabolic disease associated with alterations of multiple types of biomolecules such as miRNAs and metabolites. An integrated and high-quality data source that collection of metabolic disease associated biomolecules is essential for exploring the underlying molecular mechanisms and discovering novel therapeutics. Here, we developed the BioM2MetDisease database, which currently documents 2681 entries of relationships between 1147 biomolecules (miRNAs, metabolites and small molecules/drugs) and 78 metabolic diseases across 14 species. Each entry includes biomolecule category, species, biomolecule name, disease name, dysregulation pattern, experimental technique, a brief description of metabolic disease-biomolecule relationships, the reference, additional annotation information etc. BioM2MetDisease provides a user-friendly interface to explore and retrieve all data conveniently. A submission page was also offered for researchers to submit new associations between biomolecules and metabolic diseases. BioM2MetDisease provides a comprehensive resource for studying biology molecules act in metabolic diseases, and it is helpful for understanding the molecular mechanisms and developing novel therapeutics for metabolic diseases. Database URL: http://www.bio-bigdata.com/BioM2MetDisease/ PMID:28605773
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Xu, Yanjun; Yang, Haixiu; Wu, Tan; Dong, Qun; Sun, Zeguo; Shang, Desi; Li, Feng; Xu, Yingqi; Su, Fei; Liu, Siyao; Zhang, Yunpeng; Li, Xia
2017-01-01
BioM2MetDisease is a manually curated database that aims to provide a comprehensive and experimentally supported resource of associations between metabolic diseases and various biomolecules. Recently, metabolic diseases such as diabetes have become one of the leading threats to people’s health. Metabolic disease associated with alterations of multiple types of biomolecules such as miRNAs and metabolites. An integrated and high-quality data source that collection of metabolic disease associated biomolecules is essential for exploring the underlying molecular mechanisms and discovering novel therapeutics. Here, we developed the BioM2MetDisease database, which currently documents 2681 entries of relationships between 1147 biomolecules (miRNAs, metabolites and small molecules/drugs) and 78 metabolic diseases across 14 species. Each entry includes biomolecule category, species, biomolecule name, disease name, dysregulation pattern, experimental technique, a brief description of metabolic disease-biomolecule relationships, the reference, additional annotation information etc. BioM2MetDisease provides a user-friendly interface to explore and retrieve all data conveniently. A submission page was also offered for researchers to submit new associations between biomolecules and metabolic diseases. BioM2MetDisease provides a comprehensive resource for studying biology molecules act in metabolic diseases, and it is helpful for understanding the molecular mechanisms and developing novel therapeutics for metabolic diseases. http://www.bio-bigdata.com/BioM2MetDisease/. © The Author(s) 2017. Published by Oxford University Press.
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Interventions to Improve Parental Communication About Sex: A Systematic Review
Holland, Cynthia L.; Bost, James
2011-01-01
CONTEXT: The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. OBJECTIVE: To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. METHODS: We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. RESULTS: Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. CONCLUSIONS: Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators. PMID:21321027
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Hanes, Carissa A; Wong, Keith K H; Saini, Bandana
2014-01-01
Little is known about CPAP services offered in the Australian primary care pharmacy setting, despite the potential influence of service quality on patient adherence. The objective of this study was to provide an overview on a nationwide scale of the range and quality of CPAP and sleep apnoea-related services in Australian pharmacies. A paper-based questionnaire was developed and mailed to all pharmacies in Australia that currently provide CPAP services (as identified by manufacturer's distributor lists or Internet search). A point system was devised to score participants on the quality of their CPAP service. Pharmacies were rated against a list of 23 criteria that were determined by consensus, with one point allocated for each criterion met, allowing for a maximum score of 23. The study response rate was 55% (110/199), and representation was obtained from all eight Australian states and territories. The mean number of criteria met (total score) for pharmacies was 15.7 ± 3.4 (15.7/23 = 68.3%; score range 2-22). Variability was evident in the range of services offered. Eighty-seven per cent of respondents believed that pharmacies supplying CPAP should adhere to a formalized set of professional guidelines. The accessibility of pharmacies may make them a valuable venue for CPAP service provision. However, models of care to guide practice and standardize the variability in services are required. Implementation of such models could improve patient access to quality treatment in the primary care setting. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Farnham, Irene; Rehfeldt, Ken
This report presents the analytical data for the 2015 calendar year (CY) (January 1 through December 31, 2015) and an evaluation of the data to ensure that the Sampling Plan’s objectives are met. Special investigations that took place in 2015 that are relevant to the Sampling Plan are also presented.
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Jeejeebhoy, Khursheed; Dhaliwal, Rupinder; Heyland, Daren K.; Leung, Roger; Day, Andrew G.; Brauer, Paula; Royall, Dawna; Tremblay, Angelo; Mutch, David M.; Pliamm, Lew; Rhéaume, Caroline; Klein, Doug
2017-01-01
Background: Metabolic syndrome (MetS) is a medical condition with major complications and health care costs. Previous research has shown that diet and exercise can improve and reverse this condition. The goal of this study was to test the feasibility and effectiveness of implementing the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program into diverse family medicine practices to improve MetS. Methods: In this longitudinal before-after study, 305 adult patients with MetS were recruited from 3 diverse family medicine team-based organizations to the CHANGE personalized diet and exercise program. Participants were followed for 12 months. Primary outcomes included feasibility and reversal of MetS. Secondary outcomes included improvement in MetS components, changes in diet quality, aerobic fitness and cardiovascular risk. Results: Participants attended 76% and 90% of the kinesiologist and dietitian visits, respectively. At 12 months, 19% of patients (95% confidence interval [CI] 14%-24%) showed reversal of MetS, VO2max increased by 16% (95% CI 13%-18%), and Healthy Eating Index and Mediterranean Diet Scores improved by 9.6% (95% CI 7.6%-11.6%) and 1.4% (1.1%-1.6%), respectively. In addition, the Prospective Cardiovascular Munster (PROCAM) 10-year risk of acute coronary event decreased by 1.4%, from a baseline of 8.6%. Interpretation: A team-based program led by the family physician that educates patients about the risks of MetS, and with a dietitian and kinesiologist, empowers them to undertake an individualized supervised program of diet modification and exercise, is feasible, improves aerobic capacity and diet quality, reverses MetS and improves MetS components at 12 months. PMID:28401139
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Jeejeebhoy, Khursheed; Dhaliwal, Rupinder; Heyland, Daren K; Leung, Roger; Day, Andrew G; Brauer, Paula; Royall, Dawna; Tremblay, Angelo; Mutch, David M; Pliamm, Lew; Rhéaume, Caroline; Klein, Doug
2017-01-01
Metabolic syndrome (MetS) is a medical condition with major complications and health care costs. Previous research has shown that diet and exercise can improve and reverse this condition. The goal of this study was to test the feasibility and effectiveness of implementing the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program into diverse family medicine practices to improve MetS. In this longitudinal before-after study, 305 adult patients with MetS were recruited from 3 diverse family medicine team-based organizations to the CHANGE personalized diet and exercise program. Participants were followed for 12 months. Primary outcomes included feasibility and reversal of MetS. Secondary outcomes included improvement in MetS components, changes in diet quality, aerobic fitness and cardiovascular risk. Participants attended 76% and 90% of the kinesiologist and dietitian visits, respectively. At 12 months, 19% of patients (95% confidence interval [CI] 14%-24%) showed reversal of MetS, VO2max increased by 16% (95% CI 13%-18%), and Healthy Eating Index and Mediterranean Diet Scores improved by 9.6% (95% CI 7.6%-11.6%) and 1.4% (1.1%-1.6%), respectively. In addition, the Prospective Cardiovascular Munster (PROCAM) 10-year risk of acute coronary event decreased by 1.4%, from a baseline of 8.6%. A team-based program led by the family physician that educates patients about the risks of MetS, and with a dietitian and kinesiologist, empowers them to undertake an individualized supervised program of diet modification and exercise, is feasible, improves aerobic capacity and diet quality, reverses MetS and improves MetS components at 12 months.
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Corticospinal excitability in the non-dominant hand is affected by BDNF genotype.
Chang, Won Hyuk; Hwang, Jung Min; Uhm, Kyeong Eun; Pascual-Leone, Alvaro; Kim, Yun-Hee
2017-02-01
The objective of this study was to assess the functional state of corticospinal projections in the non-dominant hand according to brain-derived neurotrophic factor (BDNF) Val66Met polymorphisms. We investigated this in 34 healthy right-handed individuals (12 men, mean age 27.4 ± 3.4 years) who underwent two experimental sessions consisting of corticospinal excitability measurements with single-pulse transcranial magnetic stimulation (TMS) and hand motor function assessments with a sequential finger motor task of the non-dominant hand. Experimental sessions were separated by periods of at least 2 days to avoid carryover effects. Data were analyzed according to BDNF polymorphism (Val/Val vs. Val/Met vs. Met/Met group). Ten (29.4%), seventeen (50.0%), and seven (20.6%) participants were allocated to the Val/Val, Val/Met, and Met/Met groups, respectively. Motor thresholds to TMS did not differ among groups, but the amplitude of the motor-evoked potentials in the non-dominant hand induced by suprathreshold (120% of MT) TMS was significantly lower in the Met/Met group than in the other two groups (p < 0.05). Movement accuracy and reaction time in the sequential finger motor task showed no significant differences among groups. These results indicate that Met/Met BDNF homozygote status affects corticospinal excitability, and should be controlled for in studies of motor system function using brain stimulation. Our findings may have clinical implications regarding further investigation of the impact of BDNF genotype on the human motor system.
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Using Qualitative Research To Define Statewide Professional Personnel Development.
ERIC Educational Resources Information Center
Wichowski, Chester P.; Walker, Thomas J.
The Temple University Center for Vocational Education Professional Personnel Development (PPD), one of three regional centers in Pennsylvania, used qualitative strategies for steering PPD programs. Center personnel found that collecting quantitative data was absolutely necessary to determine whether objectives were being met, but was not always…
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Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P
2015-10-01
Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.
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Bloom, Timothy J; Hall, Julie M; Liu, Qinfeng; Stagner, William C; Adams, Michael L
2016-09-25
Objective. To develop a program-level assessment process for a master's of science degree in a pharmaceutical sciences (MSPS) program. Design. Program-level goals were created and mapped to course learning objectives. Embedded assessment tools were created by each course director and used to gather information related to program-level goals. Initial assessment iterations involved a subset of offered courses, and course directors met with the department assessment committee to review the quality of the assessment tools as well as the data collected with them. Insights from these discussions were used to improve the process. When all courses were used for collecting program-level assessment data, a modified system of guided reflection was used to reduce demands on committee members. Assessment. The first two iterations of collecting program-level assessment revealed problems with both the assessment tools and the program goals themselves. Course directors were inconsistent in the Bloom's Taxonomy level at which they assessed student achievement of program goals. Moreover, inappropriate mapping of program goals to course learning objectives were identified. These issues led to unreliable measures of how well students were doing with regard to program-level goals. Peer discussions between course directors and the assessment committee led to modification of program goals as well as improved assessment data collection tools. Conclusion. By starting with a subset of courses and using course-embedded assessment tools, a program-level assessment process was created with little difficulty. Involving all faculty members and avoiding comparisons between courses made obtaining faculty buy-in easier. Peer discussion often resulted in consensus on how to improve assessment tools.
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Jiménez, Karen M; Pereira-Morales, Angela J; Forero, Diego A
2017-03-22
The identification of genes that are risk factors for major depressive disorder remains a main task for global psychiatric research. The Catechol-O-methyltransferase (COMT) gene has been an important candidate risk factor for several psychiatric disorders. Previous studies have shown that a functional polymorphism (Val158Met) in this gene has an effect on several brain circuits and endophenotypes of psychiatric relevance. The aim of this study was to explore the association of a functional polymorphism in the COMT gene with psychological distress, sleep problems and health-related quality of life. Two hundred seventy young Colombian subjects (mean age: 21.3 years; range: 18-57 years) completed the Patient Health Questionnaire-9, the Perceived Stress Scale, the Oviedo Sleep Questionnaire and the 12-Item Short-Form Health Survey and were genotyped for the Val158Met polymorphism (rs4680) in the COMT gene. A linear regression analysis, adjusting for potential confounding factors, was carried out. Subjects that were Met carriers (Val/Met and Met/Met genotypes) showed higher scores for hypersomnia (p=0.001) and lower scores for mental health-related quality of life (p=0.007), these associations remained significant after correcting for multiple testing. These findings support the hypothesis of a broad effect of the Val158Met polymorphism in the COMT gene on several dimensions of behavior and neuropsychiatric symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.
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Rodríguez-Jareño, Mari Cruz; Molinero, Emilia; De Montserrat, Jaume; Vallès, Antoni; Aymerich, Marta
2016-01-01
To analyze whether examinations for health surveillance in Catalonia are carried out with a high enough degree of quality as to comply with the preventive aim of the regulations, and to identify potential differences by type of prevention service. Qualitative and quantitative techniques. Body of data: Spanish regulations related to health surveillance, and a self-reported questionnaire answered by occupational health professionals who performed health examinations in their usual practice. Content analysis of regulations, identifying concepts, and linking them to survey questions. Quality criteria were established for each concept, referring to the minimum that must be met to ensure that the professional practice can be of quality; quality indicators (percentage of professionals whose practice met the quality criteria) were calculated globally and by type of prevention service; and quality standards (fulfilment of quality criteria by 75% or more of the professionals) were set. The concepts identified were: availability of clinical and exposure information, job-specificity, identification of workers with special susceptibilities, referral to mutual insurance companies for appropriate diagnosis and treatment, development of preventive proposals, and professional independence and non detriment for workers. Quality indicators ranged between 0 and 88%. None of the concepts globally reached the quality standard. The quality of health examinations performed for health surveillance in Catalonia, doesn't seem to be high enough as to comply with the preventive aim of the regulations. The situation is worse in external prevention services. Copyright belongs to the Societat Catalana de Salut Laboral.
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Li, Xin; Xiao, Qing-qing; Ze, Kan; Li, Su; Wang, Yi-fei; Zhou, Min; Yang, Qin-tong; Li, Fu-lun; Li, Bin
2015-01-01
Objective. To evaluate the effectiveness of external application of traditional Chinese medicine (EA-TCM) on venous ulcers. Methods. Seven databases were searched until April 2015 for randomized controlled trials (RCTs) of EA-TCM for venous ulcers. Risk of bias was assessed using Cochrane Handbook guidelines. Study outcomes were presented as risk ratios (RRs) for dichotomous data or mean differences (MDs) for continuous data. Results. Sixteen of 193 potentially relevant trials met the inclusion criteria; however, their methodological qualities were low. Comparison of the same intervention strategies revealed significant differences in total effectiveness rates between EA-TCM and conventional therapy groups (RR = 1.22, 95% confidence interval [CI] = 1.16–1.29, and P < 0.00001). Compared to conventional therapy, EA-TCM combined with conventional therapy had a superior total effectiveness rate (RR = 1.11, 95% CI = 1.04–1.19, and P = 0.003). There were no significant differences in recurrence rates during followup and final pain measurements between the experimental and those in the control groups (RR = 0.86, 95% CI = 0.31–2.39, and P = 0.85; MD −0.75, 95% CI = −2.15–0.65, and P = 0.29). Conclusion. The evidence that EA-TCM is an effective treatment for venous ulcers is encouraging, but not conclusive due to the low methodological quality of the RCTs. Therefore, more high-quality RCTs with larger sample sizes are required. PMID:26435725
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Small astronomy satellite-A, Uhuru data analysis
NASA Technical Reports Server (NTRS)
Koch, D.
1974-01-01
Objectives were to conduct observations with the first satellite entirely devoted to X-ray astronomy and to analyze the results obtained. A catalog of X-ray sources was generated, and results of discoveries and further detailed observations of sources were presented in scientific journals and meetings. A list of how objectives were met, a brief description of the instrument, significant results, the X-ray catalog, and a complete bibliography of results are included.
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Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis
Maher, Chris G; Ferreira, Manuela L; Ferreira, Paulo H; Hancock, Mark; Oliveira, Vinicius C; McLachlan, Andrew J; Koes, Bart
2012-01-01
Objective To investigate the efficacy and tolerability of analgesic and adjuvant pain drugs typically administered in primary care for the management of patients with sciatica. Design Systematic review. Data source International Pharmaceutical Abstracts, PsycINFO, Medline, Embase, Cochrane Central Register of Clinical Trials (CENTRAL), CINAHL, and LILACS. Study selection Randomised controlled trials assessing the efficacy and tolerability of drugs versus placebo or other treatment for sciatica. Data extraction Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability outcomes were converted to a common 0 to 100 scale. Data were pooled with a random effects model, and the GRADE approach was used in summary conclusions. Results Twenty three published reports met the inclusion criteria. The evidence to judge the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antidepressants, anticonvulsants, muscle relaxants, and opioid analgesics ranged from moderate to low quality. Most of the pooled estimates did not favour the active treatment over placebo. The pooled results of two trials of corticosteroids (mean difference in overall and leg pain −12.2, 95% confidence interval −20.9 to −3.4) and a single trial of the anticonvulsant gabapentin for chronic sciatica (mean difference in overall pain relief −26.6, −38.3 to −14.9) showed some benefits but only in the short term. The median rate of adverse events was 17% (interquartile range 10-30%) for the active drugs and 11% (3-23%) for placebo. Trial limitations included failure to use validated outcome measures, lack of long term follow-up, and small sample size. Conclusions As the existing evidence from clinical trials is of low quality, the efficacy and tolerability of drugs commonly prescribed for the management of sciatica in primary care is unclear. PMID:22331277
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Becker, Sara J.; Midoun, Miriam M.
2017-01-01
Objective To systematically analyze the effects of direct-to-consumer advertising (DTCA) on patient requests for medication and physician prescribing across psychiatry-relevant studies. Data Sources MEDLINE, PsychINFO, ISI Thompson's Web of Knowledge, and Google Scholar were searched from 1999 through 2014 using variations of the terms direct-to-consumer advertising and psychiatric. Reference lists and an online repository of DTCA manuscripts were also scrutinized. Study Selection English-language studies collecting data at the point of service, focusing on or including psychiatric medication, and assessing DTCA's effects on patient and/or physician behavior were included. Of 989 articles identified, 69 received full-text review. Four studies across five manuscripts met inclusion criteria. Data Extraction Data were extracted on participants, study design, methodological quality, and results. Methodological quality of individual studies was assessed using adapted criteria from the Effective Public Health Practice Project. Confidence in conclusions across studies was determined using principles from the well-established GRADE system. Findings Due to lack of replication across strong randomized controlled trials (RCTs), no conclusions merited high confidence. With moderate confidence, we concluded that DTCA requests: 1) are granted most of the time [1 RCT, 3 observational]; 2) prompt higher prescribing volume [1 RCT, 1 observational]; 3) promote greater adherence to minimally acceptable treatment guidelines for patients with depression [1 RCT], and 4) stimulate overprescribing among patients with an adjustment disorder [1 RCT]. Conclusions Findings suggest that DTCA requests are typically accommodated, promote higher prescribing volume, and have competing effects on treatment quality. More methodologically strong studies are needed to increase confidence in conclusions. PMID:27631149
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Design and development of a mobile system for supporting emergency triage.
Michalowski, W; Slowinski, R; Wilk, S; Farion, K J; Pike, J; Rubin, S
2005-01-01
Our objective was to design and develop a mobile clinical decision support system for emergency triage of different acute pain presentations. The system should interact with existing hospital information systems, run on mobile computing devices (handheld computers) and be suitable for operation in weak-connectivity conditions (with unstable connections between mobile clients and a server). The MET (Mobile Emergency Triage) system was designed following an extended client-server architecture. The client component, responsible for triage decision support, is built as a knowledge-based system, with domain ontology separated from generic problem solving methods and used for the automatic creation of a user interface. The MET system is well suited for operation in the Emergency Department of a hospital. The system's external interactions are managed by the server, while the MET clients, running on handheld computers are used by clinicians for collecting clinical data and supporting triage at the bedside. The functionality of the MET client is distributed into specialized modules, responsible for triaging specific types of acute pain presentations. The modules are stored on the server, and on request they can be transferred and executed on the mobile clients. The modular design provides for easy extension of the system's functionality. A clinical trial of the MET system validated the appropriateness of the system's design, and proved the usefulness and acceptance of the system in clinical practice. The MET system captures the necessary hospital data, allows for entry of patient information, and provides triage support. By operating on handheld computers, it fits into the regular emergency department workflow without introducing any hindrances or disruptions. It supports triage anytime and anywhere, directly at the point of care, and also can be used as an electronic patient chart, facilitating structured data collection.
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Resistant Behaviors by People with Alzheimer Dementia and Traumatic Brain Injury
2017-09-01
participants has completed the information for the research team to have collected quantitative data on caregiver burden and family quality of life for...those adverse behaviors. The combined qualitative, quantitative , and economic analyses will also provide pertinent information regarding the general...other achievements. Include a discussion of stated goals not met. Description shall include pertinent data and graphs in sufficient detail to explain
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Santos, Rick; van Dam, Jeroen
The objective of the test was to obtain a baseline characterization of the mechanical loads of the DOE 1.5 wind turbine located at NREL. The test was conducted in accordance with the International Electrotechnical Commission (IEC) Technical Specification, IEC 61400-13 Wind Turbine Generator Systems – Part 13: Measurement of mechanical loads; First Edition 2001-06 [1]. The National Wind Technology Center (NWTC) at NREL conducted this test in accordance with its quality system procedures so that the final test report meets the full requirements of its accreditation by the American Association for Laboratory Accreditation (A2LA). NREL’s quality system requires that allmore » applicable requirements specified by A2LA and International Standards Organization/IEC 17025 be met or to note any exceptions in the test report.« less
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Lin, Shih-Chieh; Sun, Chien-An; You, San-Lin; Hwang, Lee-Ching; Liang, Chun-Yu; Yang, Tsan; Bai, Chyi-Huey; Chen, Chien-Hua; Wei, Cheng-Yu; Chou, Yu-Ching
2016-06-01
The aims of this study are to investigate the relationships of metabolic syndrome (MetS) with insomnia symptoms and sleep duration in a Chinese adult population. Data from a nationwide epidemiological survey conducted on residents from randomly selected districts in Taiwan in 2007 were used for this cross-sectional population-based study. A total of 4,197 participants were included in this study. Insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), were assessed using the Insomnia Self-Assessment Inventory questionnaire. Subjects were divided into 3 groups based upon their reported sleep duration (< 7, 7-8, and ≥ 9 h per night). Odds ratios (ORs) and 95% confidence intervals (CIs) derived from multivariable logistic regression were used to evaluate the study aims. The endorsement of DIS and DMS were cross-sectionally associated with the MetS after adjustment for sleep duration (OR [95% CI] was 1.24 [1.01-1.51] and 1.28 [1.02-1.61], respectively). In addition, short sleep duration was significantly associated with the prevalence of MetS independent of insomnia symptoms (OR [95% CI] was 1.54 [1.05-2.47]). However, there was no significant combined effect of insomnia symptoms and sleep duration on the prevalence of MetS. The current investigation shows that short sleep duration and insomnia symptoms, specifically DIS and DMS, were significant correlates of MetS. These findings should be replicated in prospective studies using both sleep duration and sleep quality measures. © 2016 Associated Professional Sleep Societies, LLC.
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Tree Nuts Are Inversely Associated with Metabolic Syndrome and Obesity: The Adventist Health Study-2
Jaceldo-Siegl, Karen; Haddad, Ella; Oda, Keiji; Fraser, Gary E.; Sabaté, Joan
2014-01-01
Objective To examine the relationships of nut consumption, metabolic syndrome (MetS), and obesity in the Adventist Health Study-2, a relatively healthy population with a wide range of nut intake. Research Design and Methods Cross-sectional analysis was conducted on clinical, dietary, anthropometric, and demographic data of 803 adults. MetS was defined according to the American Heart Association and the National Heart, Lung, and Blood Institute diagnostic criteria. We assessed intake of total nuts, tree nuts and peanuts, and also classified subjects into low tree nut/low peanut (LT/LP), low tree/high peanut (LT/HP), high tree nut/high peanut (HT/HP), and high tree/low peanut (HT/LP) consumers. Odds ratios were estimated using multivariable logistic regression. Results 32% of subjects had MetS. Compared to LT/LP consumers, obesity was lower in LT/HP (OR = 0.89; 95% CI = 0.53, 1.48), HT/HP (OR = 0.63; 95% CI = 0.40, 0.99) and HT/LP (OR = 0.54; 95% CI = 0.34, 0.88) consumers, p for trend = 0.006. For MetS, odds ratios (95% CI) were 0.77 (0.47, 1.28), 0.65 (0.42, 1.00) and 0.68 (0.43, 1.07), respectively (p for trend = 0.056). Frequency of nut intake (once/week) had significant inverse associations with MetS (3% less for tree nuts and 2% less for total nuts) and obesity (7% less for tree nuts and 3% less for total nuts). Conclusions Tree nuts appear to have strong inverse association with obesity, and favorable though weaker association with MetS independent of demographic, lifestyle and dietary factors. PMID:24416351
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Gill, Regina; Jackson, Robert T; Duane, Marguerite; Miner, Allison; Khan, Saira A
2017-08-05
The Central and South American populations are growing rapidly in the US; however, there is a paucity of information about their health status. Objectives : we estimated the prevalence of metabolic syndrome (MetS) and its individual components from two cohorts of Central and South Americans. Methods : This cross-sectional, medical record extraction survey sampled 1641 adults from a Washington, D.C clinic. A questionnaire was used to collect socio-demographic, medical history, anthropometric, biochemical, and clinical data. Results : among the 1993-1994 cohort, the MetS prevalence was 19.7%. The most prevalent MetS components were low high-density lipoprotein (HDL) cholesterol (40.4% men and 51.3% women), elevated triglycerides (40.9% men and 33.1% women), and high body mass index (BMI) ≥ 25 kg/m² (27.6% men and 36.6% women). The overall prevalence of MetS in the 2008-2009 cohort was 28%. The most common abnormal metabolic indicator was an elevated BMI ≥ 25 kg/m² (75.6%). 43.2% of men and 50.7% of women had HDL levels below normal, while the prevalence of hypertriglyceridemia was 46.5% and 32.5% for men and women, respectively. Conclusion : the prevalence of MetS was significantly greater in 2008-2009 compared with 1993-1994 ( p ≤ 0.05). Dyslipidemia and high BMI have increased. Although similar components were identified in both the 1993-1994 and 2008-2009 study populations, the risks of MetS have increased over time.
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Kelishadi, Roya; Gheissari, Alaleh; Bazookar, Neda; Motlagh, Mohammad Esmaeil; Taslimi, Mahnaz; Ardalan, Gelayol
2013-01-01
Background: Obesity in accordance with metabolic syndrome (MetS) confronts populations at the higher risk of morbidity and mortality of chronic diseases including, chronic kidney diseases (CKD). The renal complication of obesity and MetS has been less debated in young adolescents. The objective of this study was to assess the kidney function in obese adolescents with or without MetS. Materials and Methods: The data used in this study were collected as part of a national study entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease Study. The present study was conducted on a sub-sample of 113 obese adolescents (body mass index >95th percentile) aged between 10 years and 16 years selected by convenient sampling from the whole population studied. Anthropometric indexes and blood pressure were examined. A 12-h fasting serum was obtained for each participant to measure blood glucose, lipid profile, quantitative C-reactive protein (hs-CRP), Cystatin-c, urea, and creatinine. Fasting spot urine was collected to determine microalbumin and creatinine. Based on the study findings, participants were assigned into two groups with and without MetS. Results: The mean of microalbuminuria was in similar ranges in two groups and while the mean glomerular filtration rate (GFR) calculated by Bokenkamp's, updated and combined Schwartz's formulas were significantly lower in MetS + obese group in comparison with obese group. The similar result was not achieved by Filler's formula. Among MetS components, waist circumference had a correlation with hs-CRP (P = 0.04; r = 0.15). GFR was calculated based on the Schwartz formula and Cystatin-c formulas had no significant correlation with any MetS components. Conclusion: Our findings suggest that MetS can increase the risk of kidney dysfunction in obese adolescents. More studies are suggested in this regard in the pediatric population. PMID:23930111
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Ruiz, J M; Carro, B; Albaina, N; Couceiro, L; Míguez, A; Quintela, M; Barreiro, R
2017-01-30
Imposex is decreasing worldwide after the total ban on tributyltin (TBT) from antifouling paints. In order to assess improvement in the NE Atlantic, the OSPAR Convention designed an Ecological Quality Objective (EcoQO) based on the VDSI (vas deferens sequence index, an agreed measure of imposex) in the rock snail Nucella lapillus; wherever this is not available, the mud snail Nassarius reticulatus was proposed as a proxy. We determined VDSI in Galician populations of rock (n≥34) and mud (n≥18) snails at regular intervals from pre-ban times until 2009 and 2011, respectively. While imposex in the former started decreasing in 2006 and by 2009 the EcoQO had been met in the area, VDSI in the latter was not significantly reduced until 2011 and values contradict such an achievement. This suggests that the OSPAR imposex bi-species scheme may not be of direct application in the current post-ban scenario. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Baker, Hannah M; Meernik, Clare; Ranney, Leah M; Richardson, Amanda; Goldstein, Adam O
2017-01-01
Objective This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults. Data sources English-language peer-reviewed publications indexed in 4 databases were searched through April 2016. Study selection A search strategy was developed related to tobacco products and flavours. Of 1688 articles identified, we excluded articles that were not English-language, were not peer-reviewed, were qualitative, assessed menthol-flavoured tobacco products only and did not contain original data on outcomes that assessed the impact of flavours in tobacco products on perceptions and use behaviour. Data extraction Outcome measures were identified and tabulated. 2 researchers extracted the data independently and used a validated quality assessment tool to assess study quality. Data synthesis 40 studies met the inclusion criteria. Data showed that tobacco product packaging with flavour descriptors tended to be rated as more appealing and as less harmful by tobacco users and non-users. Many tobacco product users, especially adolescents, reported experimenting, initiating and continuing to use flavoured products because of the taste and variety of the flavours. Users of many flavoured tobacco products also showed decreased likelihood of intentions to quit compared with non-flavoured tobacco product users. Conclusions Flavours in most tobacco products appear to play a key role in how users and non-users, especially youth, perceive, initiate, progress and continue using tobacco products. Banning non-menthol flavours from tobacco products may ultimately protect public health by reducing tobacco use, particularly among youth. PMID:27872344
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The effect of input data transformations on object-based image analysis
LIPPITT, CHRISTOPHER D.; COULTER, LLOYD L.; FREEMAN, MARY; LAMANTIA-BISHOP, JEFFREY; PANG, WYSON; STOW, DOUGLAS A.
2011-01-01
The effect of using spectral transform images as input data on segmentation quality and its potential effect on products generated by object-based image analysis are explored in the context of land cover classification in Accra, Ghana. Five image data transformations are compared to untransformed spectral bands in terms of their effect on segmentation quality and final product accuracy. The relationship between segmentation quality and product accuracy is also briefly explored. Results suggest that input data transformations can aid in the delineation of landscape objects by image segmentation, but the effect is idiosyncratic to the transformation and object of interest. PMID:21673829
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A time for change: for the road to excellence for health care professionals.
Nichols, D H
2001-01-01
This article addresses the changes affecting all of health care. Change should first be driven by data--data are what will be used to make clinical and business decisions that will result in better quality care. Employees should be held accountable for results, and celebrations should be provided for these changes. Customers have needs and goals that must be met, and if we do not meet the needs, our competition will. Management must understand the principles of quality and must encourage growth in employees. To bring change to your health care organization, you must embrace and encourage change.
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Measuring quality of life among people living with HIV: a systematic review of reviews.
Cooper, Vanessa; Clatworthy, Jane; Harding, Richard; Whetham, Jennifer
2017-11-15
A systematic review of reviews was conducted to identify and appraise brief measures of health-related quality of life (HRQoL) that have been used in peer-reviewed research with people living with HIV. The review was conducted in two stages: 1) search of electronic databases to identify systematic reviews of tools used to measure HRQoL in adults living with HIV, published since the year 2000; 2) selection of HRQol scales from those identified in the reviews. Inclusion criteria included scales that could be self-administered in 10 min or less, covering at least 3 domains of quality of life (physical function, social/role function and mental/emotional function). For generic scales, inclusion criteria included the availability of normative data while for HIV-specific scales, patient input into the development of the scale was required. Ten reviews met the inclusion criteria. Nine generic scales met the inclusion criteria: the EuroQol five dimensions questionnaire (EQ-5D); Health Utilities Index; McGill Quality of Life questionnaire; Medical Outcomes Study (MOS) Short Form (SF)-12; SF-36; World Health Organisation Quality of Life (WHOQOL- BREF), Questions of Life Satisfaction (FLZM) and SF-20. Available psychometric data supported the EQ-5D and SF-36. Seven HIV-specific scales met the inclusion criteria: the AIDS Clinical Trials Group (ACTG)-21; HIV-QL-31; MOS-HIV; Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV), PROQOL-HIV, Symptom Quality of Life Adherence (HIV-SQUAD) and the WHOQOL-HIV BREF. Of the HIV -specific measures, the MOS-HIV was considered to have the most well-established psychometric properties, however limitations identified in the reviews included insufficient input from people living with HIV in the development of the scale, cross-cultural relevance and continued applicability. Two relatively new measures, the WHOQOL-HIV BREF and PROQOL-HIV, were considered to have promising psychometric properties and may have more relevance to people living with HIV. The findings highlight the need for further validation of HRQoL measures in people living with HIV. The choice of one measure over another is likely to be influenced by the purpose of the quality of life assessment and the domains of HRQoL that are most relevant to the specific research or clinical question.
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Usability of EFBs for Viewing NOTAMs and AIS/MET Data Link Messages
NASA Technical Reports Server (NTRS)
Evans, Emory T.; Young, Steven D.; Daniels, Tammi S.; Myer, Robert R.
2014-01-01
Electronic Flight Bags (EFB) are increasingly integral to flight deck information management. A piloted simulation study was conducted at NASA Langley Research Center, one aspect of which was to evaluate the usability and acceptability of EFBs for viewing and managing Notices to Airmen (NOTAMs) and data linked aeronautical information services (AIS) and meteorological information (MET). The study simulated approaches and landings at Memphis International Airport (KMEM) using various flight scenarios and weather conditions. Ten two-pilot commercial airline crews participated, utilizing the Cockpit Motion Facility's Research Flight Deck (CMF/RFD) simulator. Each crew completed approximately two dozen flights over a two day period. Two EFBs were installed, one for each pilot. Study data were collected in the form of questionnaire/interview responses, audio/video recordings, oculometer recordings, and aircraft/system state data. Preliminary usability results are reported primarily based on pilot interviews and responses to questions focused on ease of learning, ease of use, usefulness, satisfaction, and acceptability. Analysis of the data from the other objective measures (e.g., oculometer) is ongoing and will be reported in a future publication. This paper covers how the EFB functionality was set up for the study; the NOTAM, AIS/MET data link, and weather messages that were presented; questionnaire results; selected pilot observations; and conclusions.
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Yang, Liangle; Xu, Zengguang; He, Meian; Yang, Handong; Li, Xiulou; Min, Xinwen; Zhang, Ce; Xu, Chengwei; Angileri, Francesca; Légaré, Sébastien; Yuan, Jing; Miao, Xiaoping; Guo, Huan; Yao, Ping; Wu, Tangchun; Zhang, Xiaomin
2016-01-01
Study Objectives: Prospective evidence on the association of sleep duration and midday napping with metabolic syndrome (MetS) is limited. We aimed to examine the associations of sleep duration and midday napping with risk of incidence and reversion of MetS and its components among a middle-aged and older Chinese population. Methods: We included 14,399 subjects from the Dongfeng-Tongji (DFTJ) Cohort Study (2008–2013) who were free of coronary heart disease, stroke, and cancer at baseline. Baseline data were obtained by questionnaires and health examinations. Odds ratios (ORs) and 95% confidence interval (CI) were derived from multivariate logistic regression models. Results: After controlling for potential covariates, longer sleep duration (≥ 9 h) was associated with a higher risk of MetS incidence (OR, 1.29; 95% CI, 1.08–1.55) and lower reversion of MetS (OR, 0.80; 95% CI, 0.66–0.96) compared with sleep duration of 7 to < 8 h; whereas shorter sleep duration (< 6 h) was not related to incidence or reversion of MetS. For midday napping, subjects with longer napping (≥ 90 min) was also associated with a higher risk of MetS incidence and a lower risk of MetS reversion compared with those with napping of 1 to < 30 min (OR, 1.48; 95% CI, 1.05–2.10 and OR, 0.70; 95% CI, 0.52–0.94, respectively). Significance for incidence or reversion of certain MetS components remained in shorter and longer sleepers but disappeared across napping categories. Conclusions: Both longer sleep duration and longer midday napping were potential risk factors for MetS incidence, and concurrently exert adverse effects on MetS reversion. Citation: Yang L, Xu Z, He M, Yang H, Li X, Min X, Zhang C, Xu C, Angileri F, Légaré S, Yuan J, Miao X, Guo H, Yao P, Wu T, Zhang X. Sleep duration and midday napping with 5-year incidence and reversion of metabolic syndrome in middle-aged and older Chinese. SLEEP 2016;39(11):1911–1918. PMID:27450688
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Certain dietary patterns are beneficial for the metabolic syndrome: reviewing the evidence.
Calton, Emily K; James, Anthony P; Pannu, Poonam K; Soares, Mario J
2014-07-01
The metabolic syndrome (MetS) is a global public health issue of increasing magnitude. The Asia-Pacific region is expected to be hardest hit due to large population numbers, rising obesity, and insulin resistance (IR). This review assessed the protective effects of dietary patterns and their components on MetS. A literature search was conducted using prominent electronic databases and search terms that included in combination: diet, dietary components, dietary patterns, and metabolic syndrome. Articles were restricted to prospective studies and high quality randomized controlled trials that were conducted on humans, reported in the English language, and within the time period of 2000 to 2012. Traditional factors such as age, gender, physical activity, and obesity were associated with risk of MetS; however, these potential confounders were not always accounted for in study outcomes. Three dietary patterns emerged from the review; a Mediterranean dietary pattern, dietary approaches to stop hypertension diet, and the Nordic Diet. Potential contributors to their beneficial effects on prevalence of MetS or reduction in MetS components included increases in fruits, vegetables, whole grains, dairy and dairy components, calcium, vitamin D, and whey protein, as well as monounsaturated fatty acids, and omega-3 fatty acids. Additional prospective and high quality randomized controlled trial studies that investigate Mediterranean dietary pattern, the dietary approaches to stop hypertension diet, and the Nordic Diet would cement the protective benefits of these diets against the MetS. Copyright © 2014 Elsevier Inc. All rights reserved.
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Metabolic Syndrome: Comparison of Prevalence in Young Adults at 3 Land-Grant Universities
ERIC Educational Resources Information Center
Morrell, Jesse Stabile; Byrd-Bredbenner, Carol; Quick, Virginia; Olfert, Melissa; Dent, Amanda; Carey, Gale B.
2014-01-01
Objective: The study examines metabolic syndrome (MetS) among college students at 3 geographically distinct US campuses. Participants: Undergraduates ("N" = 360; 68% women), 18 to 24 years of age, were recruited at each public university in January and February 2011. MetS prevalence was evaluated in 83% ("n" = 299)…
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Peleias, Munique; Tempski, Patricia; Paro, Helena Bms; Perotta, Bruno; Mayer, Fernanda B; Enns, Sylvia C; Gannam, Silmar; Pereira, Maria Amelia D; Silveira, Paulo S; Santos, Itamar S; Carvalho, Celso Rf; Martins, Milton A
2017-01-01
We evaluated the association between leisure time physical activity (PA) and quality of life (QoL) in medical students. Our hypothesis was that there was a positive association between volume of PA and various domains of perception of QoL. Data were evaluated from a random sample of 1350 medical students from 22 Brazilian medical schools. Information from participants included the WHO Quality of Life questionnaire-short form (WHOQOL-BREF), a questionnaire specifically designed to evaluate QoL in medical students (VERAS-Q) and questions for both global QoL self-assessment and leisure time PA. According to the amount of metabolic equivalents (METs) spend during PA, volunteers were divided into four groups, according to the volume of PA: (a) no PA; (b) low PA, ≤540 MET min/week; (c) moderate PA, from 541 to 1260 MET min/week and (d) high PA, > 1261 MET min/week. Forty per cent of the medical students reported no leisure time PA (46.0% of females and 32.3% of males). In contrast, 27.2% were classified in the group of high PA (21.0% of females and 34.2% of males). We found significant associations between moderate and high levels of PA and better QoL for all measurements. For low levels of PA, this association was also significant for most QoL measurements, with the exceptions of WHOQOL physical health (p=0.08) and social relationships (p=0.26) domains. We observed a strong dose-effect relationship between the volume of leisure time PA and QoL in both male and female medical students.
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Kwetkat, Anja
2016-01-01
Objective This systematic review sought to assess the costs and benefits of interventions preventing hospital-acquired infections and to evaluate methodological and reporting quality. Methods We systematically searched Medline via PubMed and the National Health Service Economic Evaluation Database from 2009 to 2014. We included quasi-experimental and randomized trails published in English or German evaluating the economic impact of interventions preventing the four most frequent hospital-acquired infections (urinary tract infections, surgical wound infections, pneumonia, and primary bloodstream infections). Characteristics and results of the included articles were extracted using a standardized data collection form. Study and reporting quality were evaluated using SIGN and CHEERS checklists. All costs were adjusted to 2013 US$. Savings-to-cost ratios and difference values with interquartile ranges (IQRs) per month were calculated, and the effects of study characteristics on the cost-benefit results were analyzed. Results Our search returned 2067 articles, of which 27 met the inclusion criteria. The median savings-to-cost ratio across all studies reporting both costs and savings values was US $7.0 (IQR 4.2–30.9), and the median net global saving was US $13,179 (IQR 5,106–65,850) per month. The studies’ reporting quality was low. Only 14 articles reported more than half of CHEERS items appropriately. Similarly, an assessment of methodological quality found that only four studies (14.8%) were considered high quality. Conclusions Prevention programs for hospital acquired infections have very positive cost-benefit ratios. Improved reporting quality in health economics publications is required. PMID:26731736
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A national study of the streamflow data-collection program
Benson, Manuel A.; Carter, Rolland William
1973-01-01
The streamflow data program of the U.S. Geological Survey was evaluated in a nationwide study during 1970. The principal elements of the study were (1) establishing the objectives and goals of the program, (2) analyzing all available data to determine which of the goals have already been met, (3) considering alternate means of meeting the remaining goals, and (4) identifying the elements which should be included in the future program.
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Quality of reviews on sugar-sweetened beverages and health outcomes: a systematic review123
Weed, Douglas L; Mink, Pamela J
2011-01-01
Background: Medical and public health decisions are informed by reviews, which makes the quality of reviews an important scientific concern. Objective: We systematically assessed the quality of published reviews on sugar-sweetened beverages (SSBs) and health, which is a controversial topic that is important to public health. Design: We performed a search of PubMed and Cochrane databases and a hand search of reference lists. Studies that were selected were published reviews and meta-analyses (June 2001 to June 2011) of epidemiologic studies of the relation between SSBs and obesity, type 2 diabetes, metabolic syndrome, and coronary heart disease. A standardized data-abstraction form was used. Review quality was assessed by using the validated instrument AMSTAR (assessment of multiple systematic reviews), which is a one-page tool with 11 questions. Results: Seventeen reviews met our inclusion and exclusion criteria: obesity or weight (16 reviews), diabetes (3 reviews), metabolic syndrome (3 reviews), and coronary heart disease (2 reviews). Authors frequently used a strictly narrative review (7 of 17 reviews). Only 6 of 17 reviews reported quantitative data in a table format. Overall, reviews of SSBs and health outcomes received moderately low–quality scores by the AMSTAR [mean: 4.4 points; median: 4 points; range: 1–8.5 points (out of a possible score of 11 points)]. AMSTAR scores were not related to the conclusions of authors (8 reviews reported an association with a mean AMSTAR score of 4.1 points; 9 reviews with equivocal conclusions scored 4.7 points; P value = 0.84). Less than one-third of published reviews reported a comprehensive literature search, listed included and excluded studies, or used duplicate study selection and data abstraction. Conclusion: The comprehensive reporting of epidemiologic evidence and use of systematic methodologies to interpret evidence were underused in published reviews on SSBs and health. PMID:21918218
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Methamidophos alters sperm function and DNA at different stages of spermatogenesis in mice
DOE Office of Scientific and Technical Information (OSTI.GOV)
Urióstegui-Acosta, Mayrut; Hernández-Ochoa, Isabel; Sánchez-Gutiérrez, Manuel
Methamidophos (MET) is a highly toxic organophosphate (OP) pesticide that is widely used in developing countries. MET has male reproductive effects, including decreased fertility. We evaluated MET effects on sperm quality, fertilization and DNA integrity, exploring the sensitivity of different stages of spermatogenesis. Adult male mice received MET (3.75 or 5 mg/kg-bw/ip/day/4 days) and were euthanized 1, 28 or 45 days post-treatment (dpt) to evaluate MET's effects on epididymal maturation, meiosis or mitosis, respectively. Spermatozoa were obtained from the cauda epididymis–vas deferens and were evaluated for sperm quality, acrosome reaction (AR; Coomassie staining), mitochondrial membrane potential (by JC-1), DNA damagemore » (comet assay), oxidative damage (malondialdehyde (MDA) production), in vitro fertilization and protein phosphorylation (immunodetection), and erythrocyte acetylcholinesterase (AChE) activity. At 1-dpt, MET inhibited AChE (43–57%) and increased abnormal cells (6%). While at 28- and 45-dpt, sperm motility and viability were significantly reduced with an increasing MET dose, and abnormal morphology increased at 5 mg/kg/day/4 days. MDA and mitochondrial activity were not affected at any dose or time. DNA damage (OTM and %DNA) was observed at 5 mg/kg/day/4 days in a time-dependent manner, whereas both parameters were altered in cells from mice exposed to 3.75 mg/kg/day/4 days only at 28-dpt. Depending on the time of collection, initial-, spontaneous- and induced-AR were altered at 5 mg/kg/day/4 days, and the fertilization capacity also decreased. Sperm phosphorylation (at serine and tyrosine residues) was observed at all time points. Data suggest that meiosis and mitosis are the more sensitive stages of spermatogenesis for MET reproductive toxicity compared to epididymal maturation. - Highlights: • Methamidophos alters sperm cell function at different stages of spermatogenesis. • Testicular stages of spermatogenesis are more sensitive to methamidophos toxicity. • Methamidophos causes sperm DNA damage at mitosis, meiosis and epididymal maturation. • Sperm cell damage by methamidophos exposure may be related to protein phosphorylation.« less
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Costa, Silvia; Ogilvie, David; Dalton, Alice; Westgate, Kate; Brage, Søren; Panter, Jenna
2015-12-01
Active commuting may help to increase adults' physical activity levels. However, estimates of its energy cost are derived from a small number of studies which are laboratory-based or use self-reported measures. Adults working in Cambridge (UK) recruited through a predominantly workplace-based strategy wore combined heart rate and movement sensors and global positioning system (GPS) devices for one week, and completed synchronous day-by-day travel diaries in 2010 and 2011. Commuting journeys were delineated using GPS data, and metabolic intensity (standard metabolic equivalents; MET) was derived and compared between journey types using mixed-effects linear regression. 182 commuting journeys were included in the analysis. Median intensity was 1.28 MET for car journeys; 1.67 MET for bus journeys; 4.61 MET for walking journeys; 6.44 MET for cycling journeys; 1.78 MET for journeys made by car in combination with walking; and 2.21 MET for journeys made by car in combination with cycling. The value for journeys made solely by car was significantly lower than those for all other journey types (p<0.04). On average, 20% of the duration of journeys incorporating any active travel (equating to 8 min) was spent in moderate-to-vigorous physical activity (MVPA). We have demonstrated how GPS and activity data from a free-living sample can be used simultaneously to provide objective estimates of commuting energy expenditure. On average, incorporating walking or cycling into longer journeys provided over half the weekly recommended activity levels from the commute alone. This may be an efficient way of achieving physical activity guidelines and improving population health. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
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Costa, Silvia; Ogilvie, David; Dalton, Alice; Westgate, Kate; Brage, Søren; Panter, Jenna
2015-01-01
Background Active commuting may help to increase adults' physical activity levels. However, estimates of its energy cost are derived from a small number of studies which are laboratory-based or use self-reported measures. Methods Adults working in Cambridge (UK) recruited through a predominantly workplace-based strategy wore combined heart rate and movement sensors and global positioning system (GPS) devices for one week, and completed synchronous day-by-day travel diaries in 2010 and 2011. Commuting journeys were delineated using GPS data, and metabolic intensity (standard metabolic equivalents; MET) was derived and compared between journey types using mixed-effects linear regression. Results 182 commuting journeys were included in the analysis. Median intensity was 1.28 MET for car journeys; 1.67 MET for bus journeys; 4.61 MET for walking journeys; 6.44 MET for cycling journeys; 1.78 MET for journeys made by car in combination with walking; and 2.21 MET for journeys made by car in combination with cycling. The value for journeys made solely by car was significantly lower than those for all other journey types (p < 0.04). On average, 20% of the duration of journeys incorporating any active travel (equating to 8 min) was spent in moderate-to-vigorous physical activity (MVPA). Conclusions We have demonstrated how GPS and activity data from a free-living sample can be used simultaneously to provide objective estimates of commuting energy expenditure. On average, incorporating walking or cycling into longer journeys provided over half the weekly recommended activity levels from the commute alone. This may be an efficient way of achieving physical activity guidelines and improving population health. PMID:26441297
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ERIC Educational Resources Information Center
Maryland State Dept. of Education, Baltimore. School Facilities Branch.
Telecommunications infrastructure has the dual challenges of maintaining quality while accommodating change, issues that have long been met through a series of implementation standards. This document is designed to ensure that telecommunications systems within the Maryland public school system are also capable of meeting both challenges and…
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Li, Ting-Yuan; Deng, Xue-Jiao; Fan, Shao-Jia; Wu, Dui; Li, Fei; Deng, Tao; Tan, Hao-Bo; Jiang, De-Hai
2012-09-01
Based on the monitoring data of NO2, O3, SO2, PM, visibility, regional air quality index (RAQI) and the atmospheric transport and diffusion data from Nov. 4, 2010 to Dec. 10, 2010 in Guangzhou area, the variations of air quality and meteorological conditions during the Guangzhou Asian Games were analyzed. It was found that, during the Asian Games, the air quality was better than the air quality before or after the Asian Games. The visibility was greater than the visibility before or after the Asian Games, while the concentrations of PM1 and PM2.5 were lower. The correlation coefficient between visibility and the concentrations of PM1, PM2.5 indicated anti-correlation relationships. Daily and hourly concentrations of NO2 and SO2 met the primary ambient air quality standards, whereas the daily concentration of PM10 and hourly concentration of O3 met the secondary ambient air quality standards. Pollutants had been well controlled during the Asian Games. The concentration of SO2 in Guangzhou was influenced by local sources and long distance transmission, while the concentration of NO2 was significantly influenced by local sources. The emissions of NO2, SO2 and PM10 surrounding Guangzhou had a trend to affect the concentrations in Guangzhou, but the situation of O3 was opposite, the relatively high concentration of O3 in Guangzhou had tendency to be transported to the surrounding areas. The pollution meteorology conditions in the period of Asian Games were better than the conditions before or after the Asian Games. The decrease in the concentrations during the Asian Games did not only benefit from the emission control by the government, but also from the good meteorological conditions.
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Engineering and management experience at Texas A&M Transportation Institute
NASA Astrophysics Data System (ADS)
Chowdhury, Arif Tahjibul
This manuscript presents the author's engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development. In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI's deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI's project deliverables, the deliverables' shortcomings, and potential enhancements to expand the deliverables' appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations. Participating in the Texas Department of Transportation's (TxDOT's) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the technical and nontechnical skills required for project management. He noticed some areas for improvement in TxDOT's rater's manual, rater's training class, and acceptance criteria for visual distress data.
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Goetzel, Ron Z; Kent, Karen; Henke, Rachel Mosher; Pack, Cory; D'Arco, Malinda; Thomas, Jordana; Luckett, James; Arthur-Hartranft, Traci
2017-02-01
The aim of this study was to compare estimates of the prevalence and incidence of metabolic syndrome (MetS) using various data sources. We integrated health risk assessment (HRA), claims, and biometric screening data from Lockheed Martin Corporation. We measured the extent to which MetS risk factors measured using HRA and medical claims correlated with biometric screening data. Using biometric data, 24.9% of employees were identified as having MetS. Prevalence estimates were much lower using HRA data (6.8%) and claims (3.7%). Between 2012 and 2014, 10.4% of the sample newly acquired MetS. The number of MetS risk factors per employee was predictive of diabetes, heart disease, health care costs, and utilization. MetS is prevalent and associated with progression to disease. It is more easily tracked with biometric screening data than with HRA or claims data. Employers should consider efforts to manage and prevent this condition in their workforce.
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Use of wetlands for water quality improvement under the USEPA Region V Clean Lakes Program
NASA Astrophysics Data System (ADS)
Landers, Judith C.; Knuth, Barbara A.
1991-03-01
The United States Environmental Protection Agency (USEPA) Region V Clean Lakes Program employs artificial and modified natural wetlands in an effort to improve the water quality of selected lakes. We examined use of wetlands at seven lake sites and evaluated the physical and institutional means by which wetland projects are implemented and managed, relative to USEPA program goals and expert recommendations on the use of wetlands for water quality improvement. Management practices recommended by wetlands experts addressed water level and retention, sheet flow, nutrient removal, chemical treatment, ecological and effectiveness monitoring, and resource enhancement. Institutional characteristics recommended included local monitoring, regulation, and enforcement and shared responsibilities among jurisdictions. Institutional and ecological objectives of the National Clean Lakes Program were met to some degree at every site. Social objectives were achieved to a lesser extent. Wetland protection mechanisms and appropriate institutional decentralization were present at all sites. Optimal management techniques were employed to varying degrees at each site, but most projects lack adequate monitoring to determine adverse ecological impacts and effectiveness of pollutant removal and do not extensively address needs for recreation and wildlife habitat. There is evidence that the wetland projects are contributing to improved lake water quality; however, more emphasis needs to be placed on wetland protection and long-term project evaluation.
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Bernie, Charmaine; Harvey, Adrienne R; McGinley, Jennifer L; Spittle, Alicia J
2017-01-01
Objectives The primary objective is to systematically evaluate the evidence for the effectiveness of task-specific training (TST) of gross motor skills for improving activity and/or participation outcomes in ambulant school-aged children with cerebral palsy (CP). The secondary objective is to identify motor learning strategies reported within TST and assess relationship to outcome. Design Systematic review. Method Relevant databases were searched for studies including: children with CP (mean age >4 years and >60% of the sample ambulant); TST targeting gross motor skills and activity (skill performance, gross motor function and functional skills) and/or participation-related outcomes. Quality of included studies was assessed using standardised tools for risk of bias, study design and quality of evidence across outcomes. Continuous data were summarised for each study using standardised mean difference (SMD) and 95% CIs. Results Thirteen studies met inclusion criteria: eight randomised controlled trials (RCTs), three comparative studies, one repeated-measures study and one single-subject design study. Risk of bias was moderate across studies. Components of TST varied and were often poorly reported. Within-group effects of TST were positive across all outcomes of interest in 11 studies. In RCTs, between-group effects were conflicting for skill performance and functional skills, positive for participation-related outcomes (one study: Life-HABITS performance SMD=1.19, 95% CI 0.3 to 2.07, p<0.001; Life-HABITS satisfaction SMD=1.29, 95% CI 0.40 to 2.18, p=0.001), while no difference or negative effects were found for gross motor function. The quality of evidence was low-to-moderate overall. Variability and poor reporting of motor learning strategies limited assessment of relationship to outcome. Conclusions Limited evidence for TST for gross motor skills in ambulant children with CP exists for improving activity and participation-related outcomes and recommendations for use over other interventions are limited by poor study methodology and heterogeneous interventions. Registration PROSPERO ID42016036727 PMID:29637118
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Ideal Body Weight Calculation in the Bariatric Surgical Population.
Kammerer, Michael R; Porter, Michelle M; Beekley, Alec C; Tichansky, David S
2015-10-01
In bariatric surgery, ideal body weight (IBW) is used to calculate excess body weight (EBW) and percent excess weight lost (%EWL). Bariatric literature typically uses the midpoint of the medium frame from older Metropolitan Life Insurance (MetLife) tables to estimate IBW. This is neither universal nor always clinically accurate. The objective of this study was to determine the accuracy of standard IBW formulas compared to MetLife data. Weight loss data from 200 bariatric surgical patients between 2009 and 2011 was used to assess the accuracy of IBW formulas. IBWs assigned from the midpoint of the medium frame and reassigned using different gender targets were compared to standard formulas and a new formula to assess the accuracy of all formulas to both targets. Using standard MetLife data, the mean IBW was 136 lb, the mean EBW was 153.6 lb, and the mean %EWL was 43.8 %. Using the new target baseline, the mean IBW was 137.1 lb, the mean EBW was 152.6 lb, and the mean %EWL was 44 %. Deitel and Greenstein's formula was accurate to 0.3 % of EBW using the standard method, while our new formula was accurate to 0.03 % of EBW. Deitel and Greenstein's formula is most accurate using standard target IBW. The most accurate is our formula using the new MetLife target IBW.
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NASA Astrophysics Data System (ADS)
Gilmore, Gerard
2018-04-01
In this concluding article I recall the early history of the Gaia mission, showing that the original science case and expectations of wide community interest in Gaia data have been met. The quarter-century long partnership involving some 1,000 scientists, engineers and managers in industry and academia is delivering a large, high-quality and unique data set which will underpin astrophysics across many sub-fields for years to come.
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2008-01-01
Objectives To determine whether advice and training on working techniques and lifting equipment prevent back pain in jobs that involve heavy lifting. Data sources Medline, Embase, CENTRAL, Cochrane Back Group’s specialised register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT were searched up to September-November 2005. Review methods The primary search focused on randomised controlled trials and the secondary search on cohort studies with a concurrent control group. Interventions aimed to modify techniques for lifting and handling heavy objects or patients and including measurements for back pain, consequent disability, or sick leave as the main outcome were considered for the review. Two authors independently assessed eligibility of the studies and methodological quality of those included. For data synthesis, we summarised the results of studies comparing similar interventions. We used odds ratios and effect sizes to combine the results in a meta-analysis. Finally, we compared the conclusions of the primary and secondary analyses. Results Six randomised trials and five cohort studies met the inclusion criteria. Two randomised trials and all cohort studies were labelled as high quality. Eight studies looked at lifting and moving patients, and three studies were conducted among baggage handlers or postal workers. Those in control groups received no intervention or minimal training, physical exercise, or use of back belts. None of the comparisons in randomised trials (17 720 participants) yielded significant differences. In the secondary analysis, none of the cohort studies (772 participants) had significant results, which supports the results of the randomised trials. Conclusions There is no evidence to support use of advice or training in working techniques with or without lifting equipment for preventing back pain or consequent disability. The findings challenge current widespread practice of advising workers on correct lifting technique. PMID:18244957
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Traumatic brain injury: methodological approaches to estimate health and economic outcomes.
Lu, Juan; Roe, Cecilie; Aas, Eline; Lapane, Kate L; Niemeier, Janet; Arango-Lasprilla, Juan Carlos; Andelic, Nada
2013-12-01
The effort to standardize the methodology and adherence to recommended principles for all economic evaluations has been emphasized in medical literature. The objective of this review is to examine whether economic evaluations in traumatic brain injury (TBI) research have been compliant with existing guidelines. Medline search was performed between January 1, 1995 and August 11, 2012. All original TBI-related full economic evaluations were included in the study. Two authors independently rated each study's methodology and data presentation to determine compliance to the 10 methodological principles recommended by Blackmore et al. Descriptive analysis was used to summarize the data. Inter-rater reliability was assessed with Kappa statistics. A total of 28 studies met the inclusion criteria. Eighteen of these studies described cost-effectiveness, seven cost-benefit, and three cost-utility analyses. The results showed a rapid growth in the number of published articles on the economic impact of TBI since 2000 and an improvement in their methodological quality. However, overall compliance with recommended methodological principles of TBI-related economic evaluation has been deficient. On average, about six of the 10 criteria were followed in these publications, and only two articles met all 10 criteria. These findings call for an increased awareness of the methodological standards that should be followed by investigators both in performance of economic evaluation and in reviews of evaluation reports prior to publication. The results also suggest that all economic evaluations should be made by following the guidelines within a conceptual framework, in order to facilitate evidence-based practices in the field of TBI.
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Robins, Stephanie; Barr, Helena J; Idelson, Rachel; Lambert, Sylvie; Zelkowitz, Phyllis
2016-10-21
Many men lack knowledge about male infertility, and this may have consequences for their reproductive and general health. Men may prefer to seek health information online, but these sources of information vary in quality. The objective of this study is to determine if online sources of information regarding male infertility are readable, suitable, and of appropriate quality for Internet users in the general population. This study used a cross-sectional design to evaluate online sources resulting from search engine queries. The following categories of websites were considered: (1) Canadian fertility clinics, (2) North American organizations related to fertility, and (3) the first 20 results of Google searches using the terms "male infertility" and "male fertility preservation" set to the search locations worldwide, English Canada, and French Canada. Websites that met inclusion criteria (N=85) were assessed using readability indices, the Suitability Assessment of Materials (SAM), and the DISCERN tool. The associations between website affiliation (government, university/medical, non-profit organization, commercial/corporate, private practice) and Google placement to readability, suitability, and quality were also examined. None of the sampled websites met recommended levels of readability. Across all websites, the mean SAM score for suitability was 45.37% (SD 11.21), or "adequate", while the DISCERN mean score for quality was 43.19 (SD 10.46) or "fair". Websites that placed higher in Google obtained a higher overall score for quality with an r (58) value of -.328 and a P value of .012, but this position was not related to readability or suitability. In addition, 20% of fertility clinic websites did not include fertility information for men. There is a lack of high quality online sources of information on male fertility. Many websites target their information to women, or fail to meet established readability criteria for the general population. Since men may prefer to seek health information online, it is important that health care professionals develop high quality sources of information on male fertility for the general population.
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Teixeira, Andrei Alkmim; Marrocos, Mauro Sergio; Quinto, Beata Marie Redublo; Dalboni, Maria Aparecida; Rodrigues, Cassio Jose de Oliveira; Carmona, Silmara de Melo; Kuniyoshi, Mariana; Batista, Marcelo Costa
2014-11-20
Hypertension has a significant relevance as a cardiovascular risk factor. A consistent increase on world's Metabolic Syndrome (MetS) incidence has been associated with an epidemic cardiovascular risk in different populations. Dislipidemia plays a major role determining the epidemic CV burden attributed to MetS. Apolipoprotein E (ApoE) is involved on cholesterol and triglycerides metabolism regulation. Once ApoE polymorphism may influence lipid metabolism, it is possible that it brings on individual susceptibility consequences for the development of MetS and cardiovascular risk. The objective of the study is to measure the discriminatory power of ApoE polymorphism in determining cardiovascular risk stratification based on the presence MetS in a cohort of hypertensive patients. It was enrolled 383 patients, divided in two groups, classified by MetS presence (IDF criteria): Group 1: 266 patients with MetS (MetS +) and Group 2: 117 patients without Mets (MetS -). Patient's data were collected by clinical evaluation, physical exam, file reviews and laboratory testing. Polymorphic ApoE analysis was performed by PCR amplification. Groups were compared on clinical and laboratory characteristics as well as allele and genotype distribution towards ApoE polymorphism. Mets CVD prevalence was analysed according to E4 allele prevalence. The results evidenced 184 men (48%), 63,7% whites, 45,1% diabetics and 11,7% of patients were smokers. Mean age was 64,0 ± 12,0 years. When genotypic distribution was analyzed, E3/3 genotype and E3 allele frequencies were more prevalent. Among patients with MetS, we observed an independent association between CVD prevalence and E4 allele frequency (OR 2.42 (1.17- 5.0, p < 0,05)). On the opposite direction, in those without MetS, there was lesser CVD burden in E4 allele carriers (OR 0,14 (0,02-0,75)). These associations remained significant even after confounding factor corrections. The results presented demonstrate that the association between ApoE gene and CVD may be modulated by the presence of MetS, with an increased CV burden observed among E4 allele carriers with the syndrome. On the opposite way, E4 allele carriers without visceral obesity had lesser prevalence of CVD.
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Alexander, Gina K.; Innes, Kim E.; Selfe, Terry K.; Brown, Cynthia J.
2012-01-01
Objective This study was conducted with participants from trials examining the effects of an Iyengar yoga program on cardiovascular disease risk. The objective of the current study was to evaluate the perceived benefits of yoga in a population of older, predominantly overweight adults participating in a gentle 8-week yoga program. Design This study used a constructivist-interpretive approach to naturalistic inquiry. Setting A total of 42 participants completed the intervention and met the inclusion criteria for the current qualitative study. Intervention The 8-week Iyengar yoga program included two 90-minute yoga classes and five 30-minute home sessions per week. Participants completed weekly logs and an exit questionnaire at the end of the study. Main Outcome Measures Qualitative data from weekly logs and exit questionnaires were compiled and conventional content analysis performed with the use of ATLAS.ti to facilitate the process. Results Four broad themes emerged from content analysis: Practicing yoga improved overall physical function and capacity (for 83% of participants); practicing yoga reduced stress/anxiety and enhanced calmness (83% of participants); practicing yoga enriched the quality of sleep (21% of participants); and practicing yoga supported efforts toward dietary improvements (14% of participants). Conclusions These results suggest that yoga may have ancillary benefits in terms of improved physical function, enhanced mental/emotional state, enriched sleep quality, and improved lifestyle choices, and may be useful as a health promotion strategy in the prevention and management of chronic disease. PMID:23374201
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Stevens, Michael R.
2003-01-01
The U.S. Geological Survey, in an ongoing cooperative monitoring program with the Northern Colorado Water Conservancy District, Bureau of Reclamation, and City of Fort Collins, has collected water-quality data in north-central Colorado since 1969 in reservoirs and conveyances, such as canals and tunnels, related to the Colorado?Big Thompson Project, a water-storage, collection, and distribution system. Ongoing changes in water use among agricultural and municipal users on the eastern slope of the Rocky Mountains in Colorado, changing land use in reservoir watersheds, and other water-quality issues among Northern Colorado Water Conservancy District customers necessitated a reexamination of water-quality trends in the Colorado?Big Thompson system reservoirs and related conveyances. The sampling sites are on reservoirs, canals, and tunnels in the headwaters of the Colorado River (on the western side of the transcontinental diversion operations) and the headwaters of the Big Thompson River (on the eastern side of the transcontinental diversion operations). Carter Lake Reservoir and Horsetooth Reservoir are off-channel water-storage facilities, located in the foothills of the northern Colorado Front Range, for water supplied from the Colorado?Big Thompson Project. The length of water-quality record ranges from approximately 3 to 30 years depending on the site and the type of measurement or constituent. Changes in sampling frequency, analytical methods, and minimum reporting limits have occurred repeatedly over the period of record. The objective of this report was to complete a retrospective water-quality and trend analysis of reservoir profiles, nutrients, major ions, selected trace elements, chlorophyll-a, and hypolimnetic oxygen data from 1969 through 2000 in Lake Granby, Shadow Mountain Lake, and the Granby Pump Canal in Grand County, Colorado, and Horsetooth Reservoir, Carter Lake, Lake Estes, Alva B. Adams Tunnel, and Olympus Tunnel in Larimer County, Colorado. This report summarizes and assesses: Water-quality and field-measurement profile data collected by the U.S. Geological Survey and stored in the U.S. Geological Survey National Water Information System, Time-series trends of chemical constituents and physical properties, Trends in oxygen deficits in the hypolimnion of the reservoirs in the late summer season by the seasonal Kendall trend test method, Nutrient limitation and trophic status indicators, and Water-quality data in terms of Colorado water-quality standards. Water quality was generally acceptable for primary uses throughout the Colorado?Big Thompson system over the site periods of record, which are all within the span of 1969 to 2000. Dissolved solids and nutrient concentrations were low and typical of a forested/mountainous/crystalline bedrock hydrologic setting. Most of the more toxic trace elements were rarely detected or were found in low concentrations, due at least in part to a relative lack of ore-mineral deposits within the drainage areas of the Colorado?Big Thompson Project. Constituent concentrations consistently met water-quality standard thresholds set by the State of Colorado. Trophic-State Index Values indicated mesotrophic conditions generally prevailed at reservoirs, based on available Secchi depth, total phosphorus concentrations, and chlorophyll-a concentrations. Based on plots of time-series values and concentrations and seasonal Kendall nonparametric trends testing, dissolved solids and most major ions are decreasing at most sites. Many of the nutrient data did not meet the minimum criteria for time-series testing; but for those that did, nutrient concentrations were generally stable (no statistical trend) or decreasing (ammonia plus organic nitrogen and total phosphorus). Iron and manganese concentrations were stable or decreasing at most sites that met testing criteria. Chlorophyll-a data were only collected for 11 years but generally indicated quasi-stable or d
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Parent, Andrée-Anne; Gosselin-Boucher, Vincent; Houle-Peloquin, Marilyn; Poirier, Claude; Comtois, Alain-Steve
2018-05-01
Chronic obstructive pulmonary disease (COPD) is a respiratory condition that causes a significant deterioration of the quality of life. However, exercise can improve the quality of life for COPD patients and it is for this reason previous study observed the effects of active video games to increase exercise. Using motion capture devices with short bursts of exercise never been tried with COPD patients. The objective was to observe the feasibility of using this device safely and easily with COPD patients. A total of 14 participants (8 men, 69 ± 6 years, 6 women, 74 ± 6 years), with a moderate to severe COPD diagnosis performed exercise games (Shape-Up, Ubisoft, Mtl) adapted under supervision. Gaming sessions of 10-15 min duration were composed of four games of about 1.5 min separated by rest. Average and peak minute ventilation, and METs peak were, respectively: Stunt Run game (lifting knees on spot) 25.3 ± 6.8, 33.5 ± 8.2 L/min and 4.2 ± 1.5 METs; Arctic Punch game (punching targets): 23.1 ± 5.6, 31.8 ± 9.8 L/min and 3.7 ± 1.2 METs; To the Core game (core twist), 22.2 ± 7.3, 29.2 ± 9.9 L/min and 3.3 ± 1.1 METs; and Squat me to the Moon game (sitting to standing), 27.8 ± 6.7, 36.8 ± 11.1 L/min and 4.4 ± 1.1 METs. Knowing the pleasure reported by the participants, the safety, and the ability to use it with assistance, it seems that the games could be a good tool in order for COPD patients to exercise at home. However, further investigation needs to be completed in order to observe the benefits in comparison to a traditional training program. © 2018 John Wiley & Sons Ltd.
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Patini, Romeo; Gallenzi, Patrizia; Spagnuolo, Gianrico; Cordaro, Massimo; Cantiani, Monica; Amalfitano, Adriana; Arcovito, Alessandro; Callà, Cinzia; Mingrone, Gertrude; Nocca, Giuseppina
2017-01-01
Background and Objective: Metabolic syndrome (MetS) is associated with an increased risk of periodontitis even if the mechanism is unknown. Since both MetS and periodontitis are characterized by an alteration of inflammation status, the aim of this pilot study was to determine if differences in ROS metabolism of phagocytes isolated from (A) patients with MetS, (B) patients with both MetS and mild periodontitis, (C) healthy subjects and (D) normal weight subjects with mild periodontitis, were present. Methods: ROS metabolism was studied by a Chemiluminescence (CL) technique: the system was made up of luminol (100 nmol/L) and cells (1 × 105) in the presence or absence of stimulus constituted by opsonized zymosan (0.5 mg). The final volume (1.0 mL) was obtained using modified KRP buffer. ROS production was measured at 25°C for 2 h, using an LB 953 luminometer (Berthold, EG & G Co, Germany). All the experiments were performed in triplicate. Statistical Analysis: All results are mean ± standard deviation (SD). The group of means was compared by the analysis of variance "(ANOVA)". A value of p < 0.05 was considered significant. Results: Results showed that basal ROS production (both from PMNs and from PBMs) of groups A, B and D was increased with respect to that obtained from group C (p <0.05). Conclusion: These results are congruent with literature data, although the actual clinical relevance of the phenomenon remains to be evaluated. PMID:29290840
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Using flow cytometry to estimate pollen DNA content: improved methodology and applications
Kron, Paul; Husband, Brian C.
2012-01-01
Background and Aims Flow cytometry has been used to measure nuclear DNA content in pollen, mostly to understand pollen development and detect unreduced gametes. Published data have not always met the high-quality standards required for some applications, in part due to difficulties inherent in the extraction of nuclei. Here we describe a simple and relatively novel method for extracting pollen nuclei, involving the bursting of pollen through a nylon mesh, compare it with other methods and demonstrate its broad applicability and utility. Methods The method was tested across 80 species, 64 genera and 33 families, and the data were evaluated using established criteria for estimating genome size and analysing cell cycle. Filter bursting was directly compared with chopping in five species, yields were compared with published values for sonicated samples, and the method was applied by comparing genome size estimates for leaf and pollen nuclei in six species. Key Results Data quality met generally applied standards for estimating genome size in 81 % of species and the higher best practice standards for cell cycle analysis in 51 %. In 41 % of species we met the most stringent criterion of screening 10 000 pollen grains per sample. In direct comparison with two chopping techniques, our method produced better quality histograms with consistently higher nuclei yields, and yields were higher than previously published results for sonication. In three binucleate and three trinucleate species we found that pollen-based genome size estimates differed from leaf tissue estimates by 1·5 % or less when 1C pollen nuclei were used, while estimates from 2C generative nuclei differed from leaf estimates by up to 2·5 %. Conclusions The high success rate, ease of use and wide applicability of the filter bursting method show that this method can facilitate the use of pollen for estimating genome size and dramatically improve unreduced pollen production estimation with flow cytometry. PMID:22875815
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40 CFR Appendix B to Part 132 - Great Lakes Water Quality Initiative
Code of Federal Regulations, 2014 CFR
2014-07-01
... requirements shall be met for field-measured BAFs: 1. The field studies used shall be limited to those... field study should not be so unique that the BAF cannot be extrapolated to other locations where the... quality assurance requirements shall be met for field-measured BSAFs: 1. The field studies used shall be...
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40 CFR Appendix B to Part 132 - Great Lakes Water Quality Initiative
Code of Federal Regulations, 2013 CFR
2013-07-01
... requirements shall be met for field-measured BAFs: 1. The field studies used shall be limited to those... field study should not be so unique that the BAF cannot be extrapolated to other locations where the... quality assurance requirements shall be met for field-measured BSAFs: 1. The field studies used shall be...
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Herts, Kate L; Khaled, Mona M; Stanton, Annette L
2017-03-01
The primary objective of this review was to summarize the literature regarding factors associated with self-efficacy for disease management (SEDM) in cross-sectional studies and the efficacy/effectiveness of psychosocial interventions that are designed to improve SEDM in adolescent and young adult (AYA) cancer survivors. The secondary aim was to assess the quality of included studies. We conducted a systematic review using PsycINFO and PubMed to identify studies for review. Eligible studies were conducted in AYA cancer survivors ages 15 to 39; included a measure of SEDM assessed as an outcome or in a cross-sectional analysis; and were published in a peer-reviewed, English-language journal. From the 2,910 records screened, 7 cross-sectional studies and 4 intervention studies met criteria for inclusion. Eleven of the 12 SEDM measures in the studies were author-constructed, limiting the ability to draw conclusions across studies. All cross-sectional studies met at least 21 of 26 relevant quality assessment criteria, and intervention studies met between 4 and 11 of 14 criteria. Cross-sectional findings indicate that SEDM is positively associated with health-promoting behaviors and inversely related to physical and mental health problems. The intervention studies demonstrated that behavioral and educational interventions have the potential to increase SEDM. Directions for research include the need for validated measures of SEDM for AYA cancer survivors, as well as interventions that target both the health care team's and the patient's role in promoting SEDM. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Mitchison, D; Hay, P; Mond, J; Slewa-Younan, S
2013-03-01
To evaluate the impact of a lifetime history of anorexia nervosa (AN) on current quality of life (QoL) and eating disorder (ED) symptomatology. 3,034 participants from a randomly selected sample of households in the Australian population were interviewed for current ED symptoms and QoL (SF-36). 89 participants (2.9 %) reported a history of AN, 73 of whom were female. These participants scored lower on six of the eight subscales on the SF-36, including all of the mental health subscales, and were more likely to report binge eating and extreme weight or shape concerns than participants who did not report a history of AN. On the other hand, participants who reported a history of AN were less likely to be overweight. None of the participants who reported a history of AN met current criteria for AN; however, one met criteria for bulimia nervosa non-purging subtype and four met criteria for binge eating disorder. The endorsement of current ED symptoms was found to moderate the impact of a history of AN on scores of the social functioning and role limitations due to emotional health SF-36 subscales, such that participants who reported a history of AN scored lower on these subscales if they also reported current ED symptoms. A history of AN has a deleterious impact on current QoL, despite remittance from the disorder. This may be explained in part by the presence of certain ED symptoms, including objective binge eating and the persistence of extreme weight and shape concerns.
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Wickramasinghe, Kremlin; Rayner, Mike; Goldacre, Michael; Townsend, Nick; Scarborough, Peter
2017-04-05
The aim of this modelling study was to estimate the expected changes in the nutritional quality and greenhouse gas emissions (GHGEs) of primary school meals due to the adoption of new mandatory food-based standards for school meals. Nationally representative random sample of 136 primary schools in England was selected for the Primary School Food Survey (PSFS) with 50% response rate. A sample of 6690 primary students from PSFS who consumed school meals. Primary School Food Plan (SFP) nutritional impact was assessed using both macronutrient and micronutrient quality. The environmental impact was measured by GHGEs. The scenario tested was one in which every meal served in schools met more than half of the food-based standards mentioned in the SFP (SFP scenario). We used findings from a systematic review to assign GHGE values for each food item in the data set. The GHGE value and nutritional quality of SFP scenario meals was compared with the average primary school meal in the total PSFS data set (pre-SFP scenario). Prior to introduction of the SFP (pre-SFP scenario), the primary school meals had mandatory nutrient-based guidelines. The percentage of meals that met the protein standard increased in the SFP scenario and the proportion of meals that met the standards for important micronutrients (eg, iron, calcium, vitamin A and C) also increased. However, the SFP scenario did not improve the salt, saturated fat and free sugar levels. The mean GHGE value of meals which met the SFP standards was 0.79 (95% CI 0.77 to 0.81) kgCO 2 e compared with a mean value of 0.72 (0.71 to 0.74) kgCO 2 e for all meals. Adopting the SFP would increase the total emissions associated with primary school meals by 22 000 000 kgCO 2 e per year. The universal adoption of the new food-based standards, without reformulation would result in an increase in the GHGEs of school meals and improve some aspects of the nutritional quality, but it would not improve the average salt, sugar and saturated fat content levels. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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MetNetAPI: A flexible method to access and manipulate biological network data from MetNet
2010-01-01
Background Convenient programmatic access to different biological databases allows automated integration of scientific knowledge. Many databases support a function to download files or data snapshots, or a webservice that offers "live" data. However, the functionality that a database offers cannot be represented in a static data download file, and webservices may consume considerable computational resources from the host server. Results MetNetAPI is a versatile Application Programming Interface (API) to the MetNetDB database. It abstracts, captures and retains operations away from a biological network repository and website. A range of database functions, previously only available online, can be immediately (and independently from the website) applied to a dataset of interest. Data is available in four layers: molecular entities, localized entities (linked to a specific organelle), interactions, and pathways. Navigation between these layers is intuitive (e.g. one can request the molecular entities in a pathway, as well as request in what pathways a specific entity participates). Data retrieval can be customized: Network objects allow the construction of new and integration of existing pathways and interactions, which can be uploaded back to our server. In contrast to webservices, the computational demand on the host server is limited to processing data-related queries only. Conclusions An API provides several advantages to a systems biology software platform. MetNetAPI illustrates an interface with a central repository of data that represents the complex interrelationships of a metabolic and regulatory network. As an alternative to data-dumps and webservices, it allows access to a current and "live" database and exposes analytical functions to application developers. Yet it only requires limited resources on the server-side (thin server/fat client setup). The API is available for Java, Microsoft.NET and R programming environments and offers flexible query and broad data- retrieval methods. Data retrieval can be customized to client needs and the API offers a framework to construct and manipulate user-defined networks. The design principles can be used as a template to build programmable interfaces for other biological databases. The API software and tutorials are available at http://www.metnetonline.org/api. PMID:21083943
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Saunders, Travis John; Gray, Casey Ellen; Poitras, Veronica Joan; Chaput, Jean-Philippe; Janssen, Ian; Katzmarzyk, Peter T; Olds, Timothy; Connor Gorber, Sarah; Kho, Michelle E; Sampson, Margaret; Tremblay, Mark S; Carson, Valerie
2016-06-01
The purpose of this systematic review was to determine how combinations of physical activity (PA), sedentary behaviour (SB), and sleep were associated with important health indicators in children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE, SPORTdiscus, CINAHL, and PsycINFO) were searched for relevant studies examining the relationship between time spent engaging in different combinations of PA, SB, and sleep with the following health indicators: adiposity, cardiometabolic biomarkers, physical fitness, emotional regulation/psychological distress, behavioural conduct/pro-social behaviour, cognition, quality of life/well-being, injuries, bone density, motor skill development, and self-esteem. PA had to be objectively measured, while sleep and SB could be objectively or subjectively measured. The quality of research evidence and risk of bias for each health indicator and for each individual study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. A total of 13 cross-sectional studies and a single prospective cohort study reporting data from 36 560 individual participants met the inclusion criteria. Children and youth with a combination of high PA/high sleep/low SB had more desirable measures of adiposity and cardiometabolic health compared with those with a combination of low PA/low sleep/high SB. Health benefits were also observed for those with a combination of high PA/high sleep (cardiometabolic health and adiposity) or high PA/low SB (cardiometabolic health, adiposity and fitness), compared with low PA/low sleep or low PA/high SB. Of the 3 movement behaviours, PA (especially moderate- to vigorous-intensity PA) was most consistently associated with desirable health indicators. Given the lack of randomized trials, the overall quality of the available evidence was low.
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30 CFR 250.175 - When may the Regional Supervisor grant an SOO?
Code of Federal Regulations, 2010 CFR
2010-07-01
... processing or interpretation of the geophysical information with the objective of identifying a potential... processing or interpretation of existing geophysical data or information; (ii) acquire, process, or interpret... mean sea level (TVD SS) when all of the following conditions are met: (1) The lease was issued with a...
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ATM/cable arch and beam structural test program
NASA Technical Reports Server (NTRS)
Housley, J. A.
1972-01-01
The structural testing is described of an Apollo Telescope Mount (ATM) cable arch and beam assembly, using static loads to simulate the critical conditions expected during transportation and launch of the ATM. All test objectives were met. Stress and deflection data show that the assembly is structurally adequate for use in the ATM.
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Computer Communications and Operations--Intermediate, Data Processing Technology: 8025.21.
ERIC Educational Resources Information Center
Dade County Public Schools, Miami, FL.
The following course outline is a guide which presents students with the basic programing and operation concepts for developing the skills necessary to become proficient in the area of computer communications and operation. The student must have met the objectives of Introduction to Computer Programming prior to enrollment in this course. The…
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Gurka, Matthew J; Filipp, Stephanie L; Musani, Solomon K; Sims, Mario; DeBoer, Mark D
2018-06-01
Estimates of adiposity in evaluating the metabolic syndrome (MetS) have traditionally utilized measures of waist circumference (WC), whereas body mass index (BMI) is more commonly used clinically. Our objective was to determine if a MetS severity Z-score employing BMI as its measure of adiposity (MetS-Z-BMI) would perform similarly to a WC-based score (MetS-Z-WC) in predicting future disease. To formulate the MetS-Z-BMI, we performed confirmatory factor analysis on a sex- and race/ethnicity-specific basis on MetS-related data for 6870 adult participants of the National Health and Nutrition Survey 1999-2010. We then validated this score and compared it to MetS-Z-WC in assessing correlations with future coronary heart disease (CHD) and Type 2 diabetes mellitus (T2DM) using Cox proportional hazard analysis of 13,094 participants of the Atherosclerosis Risk in Communities study and Jackson Heart Study. Loading factors, which represent the relative contribution of each component to the latent MetS factor, were lower for BMI than for WC in formulating the two respective scores (MetS-Z-BMI and MetS-Z-WC). Nevertheless, MetS-Z-BMI and MetS-Z-WC exhibited similar hazard ratios (HR) toward future disease. For each one standard-deviation-unit increase in MetS-Z-BMI, HR for CHD was 1.76 (95% confidence interval [CI]: 1.65, 1.88) and HR for T2DM was 3.39 (CI 3.16, 3.63) (both p < 0.0001). There were no meaningful differences between the MetS-Z-WC and MetS-Z-BMI scores in their associations with future CHD and T2DM. A MetS severity Z-score utilizing BMI as its measure of adiposity operated similarly to a WC-based score in predicting future CHD and T2DM, suggesting overall similarity in MetS-based risk as estimated by both measures of adiposity. This indicates potential clinical usefulness of MetS-Z-BMI in assessing and following MetS-related risk over time. Copyright © 2018 Elsevier Inc. All rights reserved.
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Benchmarking Is Associated With Improved Quality of Care in Type 2 Diabetes
Hermans, Michel P.; Elisaf, Moses; Michel, Georges; Muls, Erik; Nobels, Frank; Vandenberghe, Hans; Brotons, Carlos
2013-01-01
OBJECTIVE To assess prospectively the effect of benchmarking on quality of primary care for patients with type 2 diabetes by using three major modifiable cardiovascular risk factors as critical quality indicators. RESEARCH DESIGN AND METHODS Primary care physicians treating patients with type 2 diabetes in six European countries were randomized to give standard care (control group) or standard care with feedback benchmarked against other centers in each country (benchmarking group). In both groups, laboratory tests were performed every 4 months. The primary end point was the percentage of patients achieving preset targets of the critical quality indicators HbA1c, LDL cholesterol, and systolic blood pressure (SBP) after 12 months of follow-up. RESULTS Of 4,027 patients enrolled, 3,996 patients were evaluable and 3,487 completed 12 months of follow-up. Primary end point of HbA1c target was achieved in the benchmarking group by 58.9 vs. 62.1% in the control group (P = 0.398) after 12 months; 40.0 vs. 30.1% patients met the SBP target (P < 0.001); 54.3 vs. 49.7% met the LDL cholesterol target (P = 0.006). Percentages of patients meeting all three targets increased during the study in both groups, with a statistically significant increase observed in the benchmarking group. The percentage of patients achieving all three targets at month 12 was significantly larger in the benchmarking group than in the control group (12.5 vs. 8.1%; P < 0.001). CONCLUSIONS In this prospective, randomized, controlled study, benchmarking was shown to be an effective tool for increasing achievement of critical quality indicators and potentially reducing patient cardiovascular residual risk profile. PMID:23846810
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Matulewicz, Richard S; Tosoian, Jeffrey J; Stimson, C J; Ross, Ashley E; Chappidi, Meera; Lotan, Tamara L; Humphreys, Elizabeth; Partin, Alan W; Schaeffer, Edward M
2017-05-01
Success in the era of value-based payment will depend on the capacity of health systems to improve quality while controlling costs. Comparative quality performance review can be used to drive improvements in surgical outcomes and thereby reduce costs. We sought to determine the efficacy of a comparative quality performance review to improve a surgeon-level measure of surgical oncologic quality, that is the positive surgical margin rate at the time of radical prostatectomy. Eight surgeons who performed consecutive radical prostatectomies at a single high volume institution between January 1, 2015 and December 31, 2015 were included in analysis. Individual surgeons were provided with confidential report cards every 6 months detailing their case mix, case volume and pT2 radical prostatectomy positive surgical margin rate relative to 1) their own self-matched data, 2) the de-identified data of their colleagues and 3) institutional aggregate data during the study period. Positive surgical margin rates were compared before and after intervention. Hierarchal logistic regression analysis was used to examine the association of study period on the odds of positive surgical margins, adjusted for prostate specific antigen level and National Comprehensive Cancer Network® risk group. Overall, 1,822 (1,392 before and 430 after intervention) radical prostatectomies were performed that met study inclusion criteria. The aggregate departmental unadjusted positive surgical margin rates were 10.6% and 7.4% in the pre-intervention and post-intervention groups, respectively. After adjusting for higher risk cancer in the post-intervention group, there was a significant protective association of post-intervention status on positive margins (OR 0.64, 95% CI 0.43-0.97, p = 0.03). All 5 surgeons with positive surgical margin rates higher than the aggregate department rate in the pre-intervention period showed improvement after intervention. Comparative quality performance review can be implemented at the surgeon level and can promote improvement in an objective measure of surgical oncology quality. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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Urióstegui-Acosta, Mayrut; Hernández-Ochoa, Isabel; Solís-Heredia, María de Jesús; Martínez-Aguilar, Gerardo; Quintanilla-Vega, Betzabet
2014-08-01
Methamidophos (MET), widely used in developing countries, is a highly neurotoxic organophosphate pesticide that has been associated with male reproductive alterations. Commercial formulations of pesticides used by agricultural workers and urban sprayers are responsible for thousands of intoxications in developing countries and may not have the same effects as active pure ingredients. Therefore, we compared effects of MET technical (METt) and commercial (METc) grades on sperm quality and DNA integrity. Male mice were injected (intraperitoneal, i.p.) with METt or METc (3.75, 5, and 7 mg/kg bw/day/4 days) and sacrificed 24 h post-treatment. Sperm cells collected from epididymis-vas deferens were evaluated for quality parameters, DNA damage by the comet assay, and lipoperoxidation by malondialdehyde (MDA) production. Erythrocyte acetylcholinesterase (AChE) activity was evaluated by acetylthiocholine inhibition as an index of overall toxicity. A dose-dependent AChE inhibition was observed with both formulations. Sperm quality was decreased after treatment with both MET compounds, but the commercial formulation showed stronger effects; a similar profile was observed with the DNA damage, being METc more genotoxic. None MET formulation increased MDA, suggesting no peroxidative damage involved. In summary, the commercial formulation of MET was more reprotoxic and genotoxic than the active pure ingredient, highlighting that commercial formulations must be considered for more appropriate risk assessment of pesticide exposures. Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.
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Rathee, Ruchika; Luhrmann, Tanya M; Bhatia, Triptish; Deshpande, Smita N
2018-01-01
Poor cognitive insight in schizophrenia has been linked to delusions, hallucinations, and negative symptoms as well as to depressive/anxiety symptoms. Its impact on quality of life has been less studied, especially in schizophrenia subjects with ongoing auditory hallucinations. The Beck Cognitive Insight Scale (BCIS) and the Quality of Life Scale (QLS) were administered to subjects who met DSM IV criteria for schizophrenia after due translation and validation. All subjects reported ongoing auditory hallucinations at recruitment. Mean composite cognitive insight scores from participants (N = 60) (2.97 ± 2.649) were in the lower range as compared to published literature. Cognitive insight scores as well as self-reflectiveness subscale scores, but not self-certainty scores, correlated significantly with the QLS scores p < 0.001. Results suggest that better cognitive insight, especially self-reflectiveness, may be linked to better quality of life. Self-reflectiveness could be a useful construct to address in psychotherapy to improve rehabilitation. Copyright © 2017. Published by Elsevier B.V.
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Jonsdottir, Svandis Erna; Brader, Lea; Gunnarsdottir, Ingibjorg; Kally Magnusdottir, Ola; Schwab, Ursula; Kolehmainen, Marjukka; Risérus, Ulf; Herzig, Karl-Heinz; Cloetens, Lieselotte; Helgegren, Hannah; Johansson-Persson, Anna; Hukkanen, Janne; Poutanen, Kaisa; Uusitupa, Matti; Hermansen, Kjeld; Thorsdottir, Inga
2013-12-16
The Nordic countries collaborate in setting recommendations for intake of nutrients by publishing the Nordic Nutrition Recommendations (NNR). Studies exploring how well the Nordic population adheres to the NNR are limited and none are available for the metabolic syndrome (MetS) subgroup. Individuals with MetS are a large part of the adult Nordic population and their diet's nutritional quality is of great importance as it can affect the progression of MetS. To evaluate nutritional intake in a cohort of Nordic adults with MetS or MetS risk factors and their adherence to the NNR. A multi-centre study was carried out in six centres in four Nordic countries (SYSDIET CoE). Participants (n=175) were 30-65 years of age, with BMI 27-38 kg/m(2) and had at least two criteria for MetS. The NNR was used to evaluate the baseline nutrient intake calculated from the participants' 4-day food diaries using national nutrient databases. Less than 20% of participants consumed ≤10 E% from saturated fat as recommended in the NNR. Recommended intake (RI) of polyunsaturated fat was met by approximately one-third of participants. Only 20% of men and 26% of women met the RI of dietary fibre. Intake below the defined lower intake level of 2.5 µg/day for vitamin D was observed in nearly 20% of participants. The daily median intake of salt was 8.8 g for men and 6.7 g for women. Dietary quality of this Nordic population with Mets or MetS risk factors is unsatisfactory and characterised by high intakes of SFA and sodium and low intakes of PUFA and dietary fibre. Vitamin D intake was below RI level in a large part of the population. Authorities in the Nordic countries are encouraged to develop intervention programmes for high-risk groups.
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Mudumbai, Seshadri; Ayer, Ferenc; Stefanko, Jerry
2017-08-01
Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development. Methods consisted of semi-structured interviews in 2 phases with a diverse set (n = 9) of support personnel and end users from five facilities across a Veterans Integrated Service Network. Phase 1 identified underlying needs and previous experiences with the analytics platform across various roles and operational responsibilities. Phase 2 validated preliminary feedback, lessons learned, and recommendations for improvement. Emerging themes suggested that the existing system met a small pool of national reporting requirements. However, pain points were identified with accessing data in several information system silos and performing multiple manual validation steps of data content. Notable recommendations included enhancing systems integration to create "one-stop shopping" for data, and developing a capability to perform trends analysis. Our gap analysis suggests that analytics platforms designed for surgical and ICU patients should employ approaches similar to those being used for primary care patients.
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El-Sadig, Mohamed; Ali, Habiba I.; Al-Maskari, Fatma; Campbell, Alan; Ng, Shu Wen; Reeves, Lisa; Chan, Ronna L.; Davidson, Christopher A.; Funk, William E.; Boundy, Maryanne G.; Leith, David; Popkin, Barry; Gibson, Jacqueline MacDonald; Rusyn, Ivan; Olshan, Andrew F.
2012-01-01
Background: The Arabian Gulf nations are undergoing rapid economic development, leading to major shifts in both the traditional lifestyle and the environment. Although the pace of change is brisk, there is a dearth of environmental health research in this region. Objective: We describe challenges and successes of conducting an environmental epidemiologic study in the United Arab Emirates (UAE), a Gulf nation in the Middle East, with an inter-disciplinary team that includes in-country academic and government collaborators as well as U.S. academic collaborators. Discussion: We present several issues, including study and data collection design, exposure assessment, scheduling and time coordination, quality assurance and quality control, and institutional review board protocols. These topics are considered in a cultural context. Benefits of this research included building linkages among multinational, interdisciplinary team members, generating data for local environmental decision making, and developing local epidemiologic research capacity. The Middle Eastern culture of hospitality greatly benefited the project team. Conclusion: Cultural differences impact multiple aspects of epidemiologic research and should be respectfully addressed. Conducting international population-based environmental research poses many challenges; these challenges can be met successfully with careful planning, cultural knowledge, and flexibility. Lessons learned are applicable to interdisciplinary research all over the world. The research conducted will benefit the environmental and public health agencies of the UAE and provide the nation’s leadership with country-specific environmental health data that can be used to protect the public’s health in a rapidly changing environment. PMID:22356946
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DATA QUALITY OBJECTIVES-FOUNDATION OF A SUCCESSFUL MONITORING PROGRAM
The data quality objectives (DQO) process is a fundamental site characterization tool and the foundation of a successful monitoring program. The DQO process is a systematic planning approach based on the scientific method of inquiry. The process identifies the goals of data col...
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Development of the Facial Skin Care Index: A Health-Related Outcomes Index for Skin Cancer Patients
Matthews, B. Alex; Rhee, John S.; Neuburg, Marcy; Burzynski, Mary L.; Nattinger, Ann B.
2006-01-01
BACKGROUND Existing health-related quality-of-life (HRQOL) tools do not appear to capture patients' specific skin cancer concerns. OBJECTIVE To describe the conceptual foundation, item generation, reduction process, and reliability testing for the Facial Skin Cancer Index (FSCI), a HRQOL outcomes tool for skin cancer researchers and clinicians. METHODS Participants in Phases I to III consisted of adult patients (N = 134) diagnosed with biopsy-proven nonmelanoma cervicofacial skin cancer. Data were collected via self-report surveys and clinical records. RESULTS Seventy-one distinct items were generated in Phase I and rated for their importance by an independent sample during Phase II; 36 items representing six theoretical HRQOL domains were retained. Test–retest I results indicated that four subscales showed adequate reliability coefficients (α = 0.60 to 0.91). Twenty-six items remained for test–retest II. Results indicated excellent internal consistency for emotional, social, appearance, and modified financial/work subscales (range 0.79 to 0.95); test–retest correlation coefficients were consistent across time (range 0.81 to 0.97; lifestyle omitted). CONCLUSION Pretesting afforded the opportunity to select items that optimally met our a priori conceptual and psychometric criteria for high data quality. Phase IV testing (validity and sensitivity before surgery and 4 months after Mohs micrographic surgery) for the 20-item FSCI is under way. PMID:16875475
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McCormick, Zachary; Liem, Brian; Jacobs, Geneva; Hwang, Peter; Hornby, Thomas George; Rydberg, Leslie; Roth, Elliot J.
2015-01-01
Background: Energy required for able-bodied individuals to perform common activities is well documented, whereas energy associated with daily activities among people with spinal cord injury (SCI) is less understood. Objective: To determine energy expended during several basic physical tasks specific to individuals with paraplegia due to motor-complete SCI. Methods: Sixteen adults with motor-complete SCI below T2 level and duration of paraplegia greater than 3 months were included. Oxygen consumption (VO2), caloric expenditure, and heart rate were measured at rest and while participants performed lower body dressing (LBD), pop-over transfers (POTs), and manual wheelchair propulsion (MWP) at a self-selected pace. These data were used to calculate energy expenditure in standard metabolic equivalents (METs), as defined by 1 MET = 3.5 mL O2/kg/min, and in SCI METs using the conversion 1 SCI MET = 2.7 mL O2/kg/min. Results: VO2 at rest was 3.0 ± 0.9 mL O2/kg/min, which equated to 0.9 ± 0.3 standard METs and 1.1 ± 0.4 SCI METs in energy expenditure. LBD required 3.2 ± 0.7 METs and 4.1 ± 0.9 SCI METs; POTs required 3.4 ± 1.0 METs and 4.5 ± 1.3 SCI METs; and MWP required 2.4 ± 0.6 METs and 3.1 ± 0.7 SCI METs. Conclusion: Resting VO2 for adults with motor-complete paraplegia is 3.0 mL O2/kg/min, which is lower than standard resting VO2 in able-bodied individuals. Progressively more energy is required to perform MWP, LBD, and POTs, respectively. Use of the standard METs formula may underestimate the level of intensity an individual with SCI uses to perform physical activities. PMID:26364283
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Rationale and operational plan for a U.S. high-altitude magnetic survey
Hildenbrand, Thomas G.; Acuna, Mario; Bracken, Robert E.; Hardwick, Doug; Hinze, William J.; Keller, Gordon R.; Phillips, Jeff; Roest, Walter
2002-01-01
On August 8, 2002, twenty-one scientists from the federal, private and academic sectors met at a workshop in Denver, Co., to discuss the feasibility of collecting magnetic anomaly data on a Canberra aircraft (Figure 1). The need for this 1-day workshop arose because of an exciting and cost-effective opportunity to collect invaluable magnetic anomaly data during a Canberra mission over the U.S. in 2003 and 2004. High Altitude Mapping Missions (HAMM) is currently planning a mission to collect Interferometric Synthetic Aperture Radar (IFSAR) imagery at an altitude of about 15 km and with a flight-line spacing of about 18 km over the conterminous U.S. and Alaska. The additional collection of total and vector magnetic field data would represent a secondary mission objective (i.e., a "piggy-back" magnetometer system). Because HAMM would fund the main flight costs of the mission, the geomagnetic community would obtain invaluable magnetic data at a nominal cost. These unique data would provide new insights on fundamental tectonic and thermal processes and give a new view of the structural and lithologic framework of the crust and possibly the upper mantle. This document highlights: (1) the reasons to conduct this national survey and (2) a preliminary operational plan to collect high-altitude magnetic data of a desired quality and for the expected resources. Although some operational plan issues remain to be resolved, the important conclusions of the workshop are that the Canberra is a very suitable platform to measure the magnetic field and that the planned mission will result in quality high-altitude magnetic data to greatly expand the utility of our national magnetic database.
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Automated ensemble assembly and validation of microbial genomes.
Koren, Sergey; Treangen, Todd J; Hill, Christopher M; Pop, Mihai; Phillippy, Adam M
2014-05-03
The continued democratization of DNA sequencing has sparked a new wave of development of genome assembly and assembly validation methods. As individual research labs, rather than centralized centers, begin to sequence the majority of new genomes, it is important to establish best practices for genome assembly. However, recent evaluations such as GAGE and the Assemblathon have concluded that there is no single best approach to genome assembly. Instead, it is preferable to generate multiple assemblies and validate them to determine which is most useful for the desired analysis; this is a labor-intensive process that is often impossible or unfeasible. To encourage best practices supported by the community, we present iMetAMOS, an automated ensemble assembly pipeline; iMetAMOS encapsulates the process of running, validating, and selecting a single assembly from multiple assemblies. iMetAMOS packages several leading open-source tools into a single binary that automates parameter selection and execution of multiple assemblers, scores the resulting assemblies based on multiple validation metrics, and annotates the assemblies for genes and contaminants. We demonstrate the utility of the ensemble process on 225 previously unassembled Mycobacterium tuberculosis genomes as well as a Rhodobacter sphaeroides benchmark dataset. On these real data, iMetAMOS reliably produces validated assemblies and identifies potential contamination without user intervention. In addition, intelligent parameter selection produces assemblies of R. sphaeroides comparable to or exceeding the quality of those from the GAGE-B evaluation, affecting the relative ranking of some assemblers. Ensemble assembly with iMetAMOS provides users with multiple, validated assemblies for each genome. Although computationally limited to small or mid-sized genomes, this approach is the most effective and reproducible means for generating high-quality assemblies and enables users to select an assembly best tailored to their specific needs.
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Maggi, Stefania; Noale, Marianna; Zambon, Alberto; Limongi, Federica; Romanato, Giovanna; Crepaldi, Gaetano
2008-04-01
The metabolic syndrome (MetS) is represented by the co-occurrence of multiple metabolic and physiologic risk factors for both type 2 diabetes mellitus and atherosclerotic cardiovascular diseases. In spite of its high frequency and association with morbidity and mortality in the adult population, very little is known about its magnitude in the elderly and about the validity of the diagnostic criteria commonly used. The objective of this paper is to assess the prevalence rate of MetS and the validity of the Adult Treatment Panel III (ATP III) diagnostic criteria in an elderly Caucasian cohort, considering data from the Italian Longitudinal Study on Aging (ILSA), a population-based study with a sample of 5632 individuals aged 65-84 years at baseline (1992). Logistic regression models and ROC curve were used to test the validity of the cut off levels proposed. The prevalence of MetS was 31.5% in men, and 59.8% in women. The cut off levels suggested for both men and women by the ATP III panel indicated a significant association with the MetS for all components. Actually, the ROC analysis would suggest lower levels for glycaemia (106 mg/dl) in men, and higher levels for blood pressure in both men and women (145/95 and 135/90, respectively). Concluding, MetS is very common in the aged Caucasians and the diagnostic criteria proposed by the ATP III panel seem to be appropriate in older individuals. Small adjustments in the cut off levels could be suggested for glycaemia (men) and in blood pressure (men and women).
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Cohn, Stephen M.; Lipsett, Pamela A.; Buchman, Timothy G.; Cheadle, William G.; Milsom, Jeffery W.; O’Marro, Steven; Yellin, Albert E.; Jungerwirth, Steven; Rochefort, Estela V.; Haverstock, Daniel C.; Kowalsky, Steven F.
2000-01-01
Objective To compare the safety and efficacy of intravenous (IV) ciprofloxacin plus IV metronidazole (CIP+MET) with that of IV piperacillin/tazobactam (PIP/TAZO) in adults with complicated intraabdominal infections, and to compare the efficacy of sequential IV-to-oral CIP+MET therapy with that of the IV CIP-only regimen. Summary Background Data Treatment of intraabdominal infections remains a challenge, mainly because of their polymicrobial etiology and attendant death and complications. Antimicrobial regimens using sequential IV-to-oral therapy may reduce the length of hospital stay. Methods In this multicenter, randomized, double-blind trial involving 459 patients, clinically improved IV-treated patients were switched to oral therapy after 48 hours. Overall clinical response was the primary efficacy measurement. Results A total of 282 patients (151 CIP+MET, 131 PIP/TAZO) were valid for efficacy. Of these patients, 64% CIP+MET and 57% PIP/TAZO patients were considered candidates for oral therapy. Patients had a mean APACHE II score of 9.6. The most common diagnoses were appendicitis (33%), other intraabdominal infection (29%), and abscess (25%). Overall clinical resolution rates were statistically superior for CIP+MET (74%) compared with PIP/TAZO (63%). Corresponding rates in the subgroup suitable for oral therapy were 85% for CIP+MET and 70% for PIP/TAZO. Postsurgical wound infection rates were significantly lower in CIP+MET (11%) versus PIP/TAZO patients (19%). Mean length of stay was 14 days for CIP+MET and 17 days for PIP/TAZO patients. Conclusion CIP+MET, initially administered IV and followed by CIP+MET oral therapy, was clinically more effective than IV PIP/TAZO for the treatment of patients with complicated intraabdominal infections. PMID:10903605
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Valsangkar, Sameer; Bodhare, Trupti; Bele, Samir; Sai, Surendranath
2011-01-01
BACKGROUND: The effect of infertility on marital and sexual functioning, health-related quality of life (QoL) and the acceptability of the treatment modalities is a poorly researched area in India. AIMS AND OBJECTIVES: To measure and compare the impact of infertility on marital adjustment, sexual functioning, QoL and the acceptability of various treatment modalities in infertility. DESIGN AND SETTING: Hospital-based cross-sectional controlled study. MATERIALS AND METHODS: Data regarding infertility, socio-demographic characteristics and treatment acceptability was obtained via a semi-structured questionnaire. validated, standardized scales were used to measure marital adjustment (abbreviated dyadic adjustment scale), sexual functioning (abbreviated sexual functioning questionnaire) in cases and controls, and quality of life (FertiQol) in cases. Data from 106 women attending tertiary infertility centers who met the definition of primary infertility and 212 controls attending the medical outpatient department in the same centers was obtained. RESULTS: Body mass index and socioeconomic status were significant (P < 0.006 and < 0.0001 respectively) for infertility. Fertility-enhancing regimens and adoption had the highest acceptability with a wide dispersion of range for adoption and least acceptance for sperm, egg, embryo donation and surrogate motherhood. Logistic regression analysis revealed a significant effect size of infertility on marital adjustment (Nagelkerke R2 0.725, Cohen's D 0.86) and sexual functioning (Nagelkerke R2 0.73, Cohen's D 0.815). QoL showed a decrease in mean scores on the FertiQol scale similar to normative data. CONCLUSIONS: Effective counseling, reassurance and measures to reduce the impact of the condition on marital and sexual life, overall QoL are needed to impart a holistic treatment in infertility. PMID:22065832
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Assessment of Version 4 of the SMAP Passive Soil Moisture Standard Product
NASA Technical Reports Server (NTRS)
O'neill, P. O.; Chan, S.; Bindlish, R.; Jackson, T.; Colliander, A.; Dunbar, R.; Chen, F.; Piepmeier, Jeffrey R.; Yueh, S.; Entekhabi, D.;
2017-01-01
NASAs Soil Moisture Active Passive (SMAP) mission launched on January 31, 2015 into a sun-synchronous 6 am6 pm orbit with an objective to produce global mapping of high-resolution soil moisture and freeze-thaw state every 2-3 days. The SMAP radiometer began acquiring routine science data on March 31, 2015 and continues to operate nominally. SMAPs radiometer-derived standard soil moisture product (L2SMP) provides soil moisture estimates posted on a 36-km fixed Earth grid using brightness temperature observations and ancillary data. A beta quality version of L2SMP was released to the public in October, 2015, Version 3 validated L2SMP soil moisture data were released in May, 2016, and Version 4 L2SMP data were released in December, 2016. Version 4 data are processed using the same soil moisture retrieval algorithms as previous versions, but now include retrieved soil moisture from both the 6 am descending orbits and the 6 pm ascending orbits. Validation of 19 months of the standard L2SMP product was done for both AM and PM retrievals using in situ measurements from global core calval sites. Accuracy of the soil moisture retrievals averaged over the core sites showed that SMAP accuracy requirements are being met.
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Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials.
Pittler, M H; Karagülle, M Z; Karagülle, M; Ernst, E
2006-07-01
Low back pain is a major public health concern and complementary treatments are frequently used for this condition. The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain. Systematic searches were conducted on Medline, Embase, Amed Cochrane Central, the UK National Research Register and ClincalTrials.gov (all until July 2005). Hand searches were performed and experts contacted. Methodological quality was assessed using a standard scale. Five randomized clinical trials met all inclusion criteria. Quantitative data synthesis was performed. The data for spa therapy, assessed on a 100 mm visual analogue scale (VAS), suggest significant beneficial effects compared with waiting list control groups (weighted mean difference 26.6 mm, 95% confidence interval 20.4-32.8, n=442) for patients with chronic low back pain. For balneotherapy the data, assessed on a 100 mm VAS, also suggest beneficial effects compared with control groups (weighted mean difference 18.8 mm, 95% confidence interval 10.3-27.3, n=138). Even though the data are scarce, there is encouraging evidence suggesting that spa therapy and balneotherapy may be effective for treating patients with low back pain. These data are not compelling but warrant rigorous large-scale trials.
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1983-05-01
observed end-of-course scores for tasks .- trained to criterion. e MGA software was calibrated to provide retention estimates at two levels of...exceed the MGA estimates. Thirty-five out of forty, or 87.5,o0 of the tasks met this expectation. . * For these first trial data, MGA software predicts...Objective: The objective of this effort was to perform an operational test of the capability of MGA Skill Training and Retention (STAR©) software to
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Cardinal, Thiane Ristow; Vigo, Alvaro; Duncan, Bruce Bartholow; Matos, Sheila Maria Alvim; da Fonseca, Maria de Jesus Mendes; Barreto, Sandhi Maria; Schmidt, Maria Inês
2018-01-01
Waist circumference (WC) has been incorporated in the definition of the metabolic syndrome (MetS) but the exact WC cut-off points across populations are not clear. The Joint Interim Statement (JIS) suggested possible cut-offs to different populations and ethnic groups. However, the adequacy of these cut-offs to Brazilian adults has been scarcely investigated. The objective of the study is to evaluate possible WC thresholds to be used in the definition of MetS using data from the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74 years old) of six Brazilian cities. We analyzed baseline data from 14,893 participants (6772 men and 8121 women). A MetS was defined according to the JIS criteria, but excluding WC and thus requiring 2 of the 4 remaining elements. We used restricted cubic spline regression to graph the relationship between WC and MetS. We identified optimal cut-off points which maximized joint sensitivity and specificity (Youden's index) from Receiver Operator Characteristic Curves. We also estimated the C-statistics using logistic regression. We found no apparent threshold for WC in restricted cubic spline plots. Optimal cut-off for men was 92 cm (2 cm lower than that recommended by JIS for Caucasian/Europids or Sub-Saharan African men), but 2 cm higher than that recommended for ethnic Central and South American. For women, optimal cut-off was 86, 6 cm higher than that recommended for Caucasian/Europids and ethnic Central and South American. Optimal cut-offs did not very across age groups and most common race/color categories (except for Asian men, 87 cm). Sex-specific cut-offs for WC recommended by JIS differ from optimal cut-offs we found for adult men and women of Brazil´s most common ethnic groups.
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Adult-acquired hidden penis in obese patients: a critical survey of the literature.
Cavayero, Chase T; Cooper, Meghan A; Harlin, Stephen L
2015-03-01
Hidden penis is anatomically defined by a lack of firm attachments of the skin and dartos fascia to the underlying Buck fascia. To critically appraise the research evidence that could support the most effective surgical techniques for adult-acquired hidden penis in obese patients. Studies investigating patients with a diagnosis of hidden penis were identified. Of these studies, only those with adult patients classified as overweight or obese (body mass index >25) were included in the review. Three reviewers examined the abstracts of the studies identified in the initial Medline search, and abstracts considered potentially relevant underwent full-text review. Studies that included patients with congenital, iatrogenic (eg, circumcision issues or aesthetic genital surgery), or traumatic causes of hidden penis were excluded. Studies that did not define the diagnostic criteria for hidden penis were excluded to minimize the risk of definition bias. The quality of evidence for each study was determined after considering the following sources of bias: method of allocation to study groups, data analysis, presence of baseline differences between groups, objectivity of outcome, and completeness of follow-up. Using these criteria, studies were then graded as high, moderate, or low in quality. Seven studies with a total of 119 patients met the inclusion criteria. All but 1 of the studies were nonrandomized. One study provided a clear presentation of results and appropriate statistical analysis. Six studies accounted for individual-based differences, and 1 study failed to account for baseline differences altogether. Four studies addressed follow-up. One study was of high quality, 2 were of moderate quality, and 4 were of low quality. Building a clinical practice guideline for the surgical management of hidden penis has proven difficult because of a lack of high-quality, statistically significant data in the research synthesis. The authors elucidate the challenges and epitomize the collective wisdom of surgeons who have investigated this problem and emphasize the need for rigorous evaluative studies. © 2015 The American Osteopathic Association.
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Improving the School Food Environment
CULLEN, KAREN W.; HARTSTEIN, JILL; REYNOLDS, KIM D.; VU, MAIHAN; RESNICOW, KEN; GREENE, NATASHA; WHITE, MAMIE A.
2009-01-01
Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school foodservice programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from six middle schools in three states. Formative assessment with students and school staff was conducted in the spring of 2003 to inform the development of school foodservice policy changes. Thirteen potential policy goals were delineated. These formed the basis for the environmental change pilot intervention implemented during the winter/spring of 2004. Questionnaires were used to assess the extent to which the 13 foodservice goals were achieved. Success was defined as achieving 75% of goals not met at baseline. Daily data were collected on goal achievement using the schools’ daily food production and sales records. Qualitative data were also collected after the pilot study to obtain feedback from students and staff. Formative research with staff and students identified potential environmental changes. Most schools made substantial changes in the National School Lunch Program meal and snack bar/a la carte offerings. Vending goals were least likely to be achieved. Only one school did not meet the 75% goal achievement objective. Based on the objective data as well as qualitative feedback from student focus groups and interviews with students and school staff, healthful school foodservice changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. Implementing longer-term and more ambitious changes and assessing cost issues and the potential enduring impact of these changes on student dietary change and disease risk reduction merits investigation. PMID:17324667
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Methods of Evaluating Child Welfare in Indian Country: An Illustration
ERIC Educational Resources Information Center
Fox, Kathleen; Cross, Terry L.; John, Laura; Carter, Patricia; Pavkov, Thomas; Wang, Ching-Tung; Diaz, Javier
2011-01-01
The poor quality and quantity of data collected in tribal communities today reflects a lack of true community participation and commitment. This is especially problematic for evaluation studies, in which the needs and desires of the community should be the central focus. This challenge can be met by emphasizing indigenous methods and voice. The…
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Increasing Prevalence of Metabolic Syndrome in a Chinese Elderly Population: 2001–2010
Jiang, Bin; Sun, Dongling; Wu, Lei; Yang, Shanshan; Wang, Yiyan; Li, Xiaoying; He, Yao
2013-01-01
Objective The information on the changes of prevalence of MetS in China is limited. Our objective was to assess a 10-year’s change of the prevalence of MetS in a Chinese elderly population between 2001 and 2010. Methods We conducted two cross-sectional surveys in a representative sample of elderly population aged 60 to 95 years in Beijing in 2001 and 2010 respectively. MetS was defined according to the 2009 harmonizing definition. Results A total of 2,334 participants (943 male, 1,391 female) in 2001 and 2,102 participants (848 male, 1,254 female) in 2010 completed the survey. The prevalence of MetS was 50.4% (95%CI: 48.4%–52.4%) in 2001 and 58.1% (95%CI: 56.0%–60.2%) in 2010. The absolute change of prevalence of MetS was 7.7% over the 10-year’s period (p<0.001). The syndrome was more common in female than male in both survey years. Among the five components, hypertriglyceridemia and low HDL-C had increased most, with an increase of 14.8% (from 29.4% to 44.2%) and 9.9% (from 28.3% to 38.2%) respectively. The adjusted ORs of MetS for CHD, stroke and CVD were 1.67(95%CI: 1.39–1.99), 1.50(95%CI: 1.19–1.88) and 1.70(95%CI: 1.43–2.01) respectively in 2001, and were 1.74(95%CI: 1.40–2.17), 1.25(95%CI: 0.95–1.63) and 1.52(95%CI: 1.25–1.86) respectively in 2010. Conclusion The prevalence of MetS is high and increasing rapidly in this Chinese elderly population. Participants with Mets and its individual components are at significantly elevated ORs for CVD. Urgent public health actions are needed to control MetS and its components, especially for dislipidemia. PMID:23824753
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Can managed care plans control health care costs?
Zwanziger, J; Melnick, G A
1996-01-01
The health insurance sector has been transformed in the past fifteen years, with managed care replacing indemnity insurance as the norm. This transformation was intended to change the nature of competition in the health care system so that market forces could be used to control costs. Empirical studies have shown that this objective has been met, as areas with high managed care penetration have tended to have much lower rates of increase in their costs. Creating a more efficient health care system will require additional efforts to produce useful measures of quality and to maintain competitive markets.
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Bauer, Amy M.; Alegría, Margarita
2010-01-01
Objective To determine the effects of limited English proficiency and use of interpreters on the quality of psychiatric care. Methods A systematic literature search for English-language publications was conducted in PubMed, PsycInfo, and CINAHL and by review of the reference lists of included articles and expert sources. Of 321 citations, 26 peer-reviewed articles met inclusion criteria by reporting primary data on the clinical care for psychiatric disorders among patients with limited proficiency in English or in the providers’ language. Results Little systematic research has addressed the impact of language proficiency or interpreter use on the quality of psychiatric care in contemporary US settings. Therefore, the literature to date is insufficient to inform evidence-based guidelines for improving quality of care among patients with limited English proficiency. Nonetheless, evaluation in a patient’s non-primary language can lead to incomplete or distorted mental status assessment whereas assessments conducted via untrained interpreters may contain interpreting errors. Consequences of interpreter errors include clinicians’ failure to identify disordered thought or delusional content. Use of professional interpreters may improve disclosure and attenuate some difficulties. Diagnostic agreement, collaborative treatment planning, and referral for specialty care may be compromised. Conclusions Clinicians should become aware of the types of quality problems that may occur when evaluating patients in a non-primary language or via an interpreter. Given demographic trends in the US, future research should aim to address the deficit in the evidence base to guide clinical practice and policy. PMID:20675834
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Shahsavand-Ananloo, E; Berenji, F; Sadeghniiat, K; Alimadadi, A; Zahiroddin, A R; Tabatabaee, M; Abbasi-Asl, M; Ghaeli, P
2013-05-01
Sleep disturbance is a common complaint in major depressive disorder (MDD) including impairment of both subjective and objective parameters. All antidepressants affect sleep architecture and quality. This trial was designed to compare the effects of short-term use of citalopram with fluoxetine on sleep quality (SQ) of patients with MDD based on Diagnostic and Statistical Manual for Mental Disorders - Text Revision 4th edition (DSM-IV-TR) criteria. Patients who met the study criteria entered this open-label study. Sleep quality and depression severity were evaluated by using Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory-II (BDI-II), respectively. Patients could not have received any antidepressant for at least one month prior entering the study. Subjects were assigned to receive either fluoxetine or citalopram for 8 weeks. The relationships between SQ and severity of depression were also studied at weeks 4 and 8. Data was analyzed by using SPSS 11.5 version. Nineteen patients received fluoxetine 20-40 mg/day and 21 received citalopram 20-40 mg/day. After 4 and 8 weeks treatment with both fluoxetine and citalopram, significant improvements in SQ were noted in both groups. However, no significant difference between the two groups was observed. Additionally, a significant and positive correlation between improvements in SQ and depression was noted after 8 weeks treatment with citalopram but not with fluoxetine. This study noted that both citalopram and fluoxetine improved SQ in outpatients with MDD after 8 weeks without any significant difference between the 2 groups.
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Beckwée, David; Bautmans, Ivan; Swinnen, Eva; Vermet, Yorick; Lefeber, Nina; Lievens, Pierre
2014-01-01
Objective: To evaluate the clinical efficacy of transcutaneous electric nerve stimulation in the treatment of postoperative knee arthroplasty pain and to relate these results to the stimulation parameters used. Data Sources: PubMed, Pedro and Web of Knowledge were systematically screened for studies investigating effects of transcutaneous electric nerve stimulation on postoperative knee arthroplasty pain. Review Methods: Studies were screened for their methodological and therapeutical quality. We appraised the influence of the stimulation settings used and indicated whether or not a neurophysiological and/or mechanistic rationale was given for these stimulation settings. Results: A total of 5 articles met the inclusion criteria. In total, 347 patients were investigated. The number of patients who received some form of transcutaneous electric nerve stimulation was 117, and 54 patients received sham transcutaneous electric nerve stimulation. Pain was the primary outcome in all studies. The stimulation settings used in the studies (n = 2) that reported significant effects differed from the others as they implemented a submaximal stimulation intensity. Stimulation parameters were heterogeneous, and only one study provided a rationale for them. Conclusion: This review reveals that an effect of transcutaneous electric nerve stimulation might have been missed due to low methodological and therapeutical quality. Justifying the choice of transcutaneous electric nerve stimulation parameters may improve therapeutical quality. PMID:26770730
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Revisiting the Procedures for the Vector Data Quality Assurance in Practice
NASA Astrophysics Data System (ADS)
Erdoğan, M.; Torun, A.; Boyacı, D.
2012-07-01
Immense use of topographical data in spatial data visualization, business GIS (Geographic Information Systems) solutions and applications, mobile and location-based services forced the topo-data providers to create standard, up-to-date and complete data sets in a sustainable frame. Data quality has been studied and researched for more than two decades. There have been un-countable numbers of references on its semantics, its conceptual logical and representations and many applications on spatial databases and GIS. However, there is a gap between research and practice in the sense of spatial data quality which increases the costs and decreases the efficiency of data production. Spatial data quality is well-known by academia and industry but usually in different context. The research on spatial data quality stated several issues having practical use such as descriptive information, metadata, fulfillment of spatial relationships among data, integrity measures, geometric constraints etc. The industry and data producers realize them in three stages; pre-, co- and post data capturing. The pre-data capturing stage covers semantic modelling, data definition, cataloguing, modelling, data dictionary and schema creation processes. The co-data capturing stage covers general rules of spatial relationships, data and model specific rules such as topologic and model building relationships, geometric threshold, data extraction guidelines, object-object, object-belonging class, object-non-belonging class, class-class relationships to be taken into account during data capturing. And post-data capturing stage covers specified QC (quality check) benchmarks and checking compliance to general and specific rules. The vector data quality criteria are different from the views of producers and users. But these criteria are generally driven by the needs, expectations and feedbacks of the users. This paper presents a practical method which closes the gap between theory and practice. Development of spatial data quality concepts into developments and application requires existence of conceptual, logical and most importantly physical existence of data model, rules and knowledge of realization in a form of geo-spatial data. The applicable metrics and thresholds are determined on this concrete base. This study discusses application of geo-spatial data quality issues and QA (quality assurance) and QC procedures in the topographic data production. Firstly we introduce MGCP (Multinational Geospatial Co-production Program) data profile of NATO (North Atlantic Treaty Organization) DFDD (DGIWG Feature Data Dictionary), the requirements of data owner, the view of data producers for both data capturing and QC and finally QA to fulfil user needs. Then, our practical and new approach which divides the quality into three phases is introduced. Finally, implementation of our approach to accomplish metrics, measures and thresholds of quality definitions is discussed. In this paper, especially geometry and semantics quality and quality control procedures that can be performed by the producers are discussed. Some applicable best-practices that we experienced on techniques of quality control, defining regulations that define the objectives and data production procedures are given in the final remarks. These quality control procedures should include the visual checks over the source data, captured vector data and printouts, some automatic checks that can be performed by software and some semi-automatic checks by the interaction with quality control personnel. Finally, these quality control procedures should ensure the geometric, semantic, attribution and metadata quality of vector data.
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Lee, Eun-Young; Hesketh, Kylie D; Hunter, Stephen; Kuzik, Nicholas; Rhodes, Ryan E; Rinaldi, Christina M; Spence, John C; Carson, Valerie
2017-11-20
Canada has recently released guidelines that include toddler-specific recommendations for physical activity, screen-based sedentary behaviour, and sleep. This study examined the proportions of toddlers meeting the new Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) and associations with body mass index (BMI) z-scores in a sample from Edmonton, Canada. Participants included 151 toddlers (aged 19.0 ± 1.9 months) for whom there was complete objectively measured physical activity data from the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) project. Toddlers' physical activity was measured using ActiGraph wGT3X-BT monitors. Toddlers' screen time and sleep were measured using the PREPS questionnaire. Toddlers' height and weight were objectively measured by public health nurses and BMI z-scores were calculated using World Health Organization growth standards. Meeting the overall 24-Hour Movement Guidelines was defined as: ≥180 min/day of total physical activity, including ≥1 min/day of moderate- to vigorous-intensity physical activity; no screen time per day (for those aged 12-23 months) or ≤1 h/day of screen time per day (ages 24-35 months); and 11-14 h of sleep per 24-h period. Frequency analyses and linear regression models were conducted. Only 11.9% of toddlers met the overall 24-Hour Movement Guidelines, but this finding was largely driven by screen time. The majority of toddlers met the individual physical activity (99.3%) and sleep (82.1%) recommendations, while only 15.2% of toddlers met the screen time recommendation. No associations were observed between meeting specific and general combinations of recommendations within the guidelines and BMI z-scores. Most toddlers in this sample were meeting physical activity and sleep recommendations but were engaging in more screen time than recommended. Consequently, only a small proportion of toddlers met the overall guidelines. Based on the findings of this study, identifying modifiable correlates of screen time to inform appropriate strategies to reduce screen time appears key for increasing the proportion of toddlers meeting the 24-Hour Movement Guidelines for the Early Years. Future research should examine the associations between meeting the new guidelines and other health indicators. Furthermore, future high-quality studies examining dose-response relationships between movement behaviours and health indicators are needed to inform guideline updates.
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Tetanus toxoid immunization to reduce mortality from neonatal tetanus
Blencowe, Hannah; Lawn, Joy; Vandelaer, Jos; Roper, Martha
2010-01-01
Background Neonatal tetanus remains an important and preventable cause of neonatal mortality globally. Large reductions in neonatal tetanus deaths have been reported following major increases in the coverage of tetanus toxoid immunization, yet the level of evidence for the mortality effect of tetanus toxoid immunization is surprisingly weak with only two trials considered in a Cochrane review. Objective To review the evidence for and estimate the effect on neonatal tetanus mortality of immunization with tetanus toxoid of pregnant women, or women of childbearing age. Methods We conducted a systematic review of multiple databases. Standardized abstraction forms were used. Individual study quality and the overall quality of evidence were assessed using an adaptation of the GRADE approach. Meta-analyses were performed. Results Only one randomised controlled trial (RCT) and one well-controlled cohort study were identified, which met inclusion criteria for meta-analysis. Immunization of pregnant women or women of childbearing age with at least two doses of tetanus toxoid is estimated to reduce mortality from neonatal tetanus by 94% [95% confidence interval (CI) 80–98%]. Additionally, another RCT with a case definition based on day of death, 3 case–control studies and 1 before-and-after study gave consistent results. Based on the consistency of the mortality data, the very large effect size and that the data are all from low/middle-income countries, the overall quality of the evidence was judged to be moderate. Conclusion This review uses a standard approach to provide a transparent estimate of the high impact of tetanus toxoid immunization on neonatal tetanus. PMID:20348112
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Emerging science and therapies in non-small-cell lung cancer: targeting the MET pathway.
Kris, Mark G; Arenberg, Douglas A; Herbst, Roy S; Riely, Gregory J
2014-11-01
During this enduring, learner-driven, interactive CME webseries, lung cancer specialists will address the science and targeted therapies for the MET pathway in non-small cell lung cancer. Over the past decade, research has evolved in the science of identifying targeted biological changes in DNA and individual cancer cells. Along with the advanced understanding of lung cancer mutations, has come the development of specific targeted therapies that improve patient outcomes. The first step in treating a patient with lung cancer is proper diagnosis and staging, applying to the principles of personalize medicine. Our current understanding of lung cancer is that of a collection of diseases individualized through specific mutations. This CME activity reviews the role of the pulmonologist and pathologist in proper tissue acquisition and analysis. This new era of personalized medicine and clinical research advances has changed the way clinicians evaluate and treat patients with lung cancer. The data on lung cancer cell mutations and newer targeted therapies have improved the progression free survival and quality of life of lung cancer patients. This CME activity is designed to present a practical overview of recent evidenced based data of MET targeted therapies for patients with lung cancer. As research continues to evolve, we continue to advance our understanding in the science of lung cancers involving the MET pathway. Evidenced based data supporting newer targeted therapeutics provides insight on applying treatment for optimal outcomes. This CME activity will focus on the individualized treatment strategies using practical decision making for patients with MET expression. This activity has been designed to meet the educational needs of medical oncologists, pathologists, radiation oncologists, surgeons, pulmonologists, internists, and other healthcare clinicians responsible for the care of patients with lung cancer. Online access:http://www.elseviercme.com/516/.
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Kirsch, Florian
2015-04-01
Smoking cessation is the only strategy that has shown a lasting reduction in the decline of lung function in patients with chronic obstructive pulmonary disease. This study aims to evaluate the cost-effectiveness of smoking cessation interventions in patients with chronic obstructive pulmonary disease, to assess the quality of the Markov models and to estimate the consequences of model structure and input data on cost-effectiveness. A systematic literature search was conducted in PubMed, Embase, BusinessSourceComplete and Econlit on June 11, 2014. Data were extracted, and costs were inflated. Model quality was evaluated by a quality appraisal, and results were interpreted. Ten studies met the inclusion criteria. The results varied widely from cost savings to additional costs of €17,004 per quality adjusted life year. The models scored best in the category structure, followed by data and consistency. The quality of the models seems to rise over time, and regarding the results there is no economic reason to refuse the reimbursement of any smoking cessation intervention.
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Freeman, Michele; Kaye, Jeffrey; Vuckovic, Nancy; Buckley, David I.
2014-01-01
Abstract Objective: Remote monitoring technology (RMT) may enhance healthcare quality and reduce costs. RMT adoption depends on perceptions of the end-user (e.g., patients, caregivers, healthcare providers). We conducted a systematic review exploring the acceptability and feasibility of RMT use in routine adult patient care, from the perspectives of primary care clinicians, administrators, and clinic staff. Materials and Methods: We searched the databases of Medline, IEEE Xplore, and Compendex for original articles published from January 1996 through February 2013. We manually screened bibliographies of pertinent studies and consulted experts to identify English-language studies meeting our inclusion criteria. Results: Of 939 citations identified, 15 studies reported in 16 publications met inclusion criteria. Studies were heterogeneous by country, type of RMT used, patient and provider characteristics, and method of implementation and evaluation. Clinicians, staff, and administrators generally held positive views about RMTs. Concerns emerged regarding clinical relevance of RMT data, changing clinical roles and patterns of care (e.g., reduced quality of care from fewer patient visits, overtreatment), insufficient staffing or time to monitor and discuss RMT data, data incompatibility with a clinic's electronic health record (EHR), and unclear legal liability regarding response protocols. Conclusions: This small body of heterogeneous literature suggests that for RMTs to be adopted in primary care, researchers and developers must ensure clinical relevance, support adequate infrastructure, streamline data transmission into EHR systems, attend to changing care patterns and professional roles, and clarify response protocols. There is a critical need to engage end-users in the development and implementation of RMT. PMID:24731239
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Efficacy and safety of Saccharomyces boulardii for acute diarrhea.
Feizizadeh, Sahar; Salehi-Abargouei, Amin; Akbari, Vajihe
2014-07-01
The efficacy of Saccharomyces boulardii for treatment of childhood diarrhea remains unclear. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhea. Our data sources included Medline, Embase, CINAHL, Scopus, and The Cochrane Library up to September 2013 without language restrictions. Randomized controlled trials and non-randomized trials that evaluated effectiveness of S. boulardii for treatment of acute diarrhea in children were included. Two reviewers independently evaluated studies for eligibility and quality and extracted the data. In total, 1248 articles were identified, of which 22 met the inclusion criteria. Pooling data from trials showed that S. boulardii significantly reduced the duration of diarrhea (mean difference [MD], -19.7 hours; 95% confidence interval [CI], -26.05 to -13.34), stool frequency on day 2 (MD, -0.74; 95% CI, -1.38 to -0.10) and day 3 (MD, -1.24; 95% CI, -2.13 to -0.35), the risk for diarrhea on day 3 (risk ratio [RR], 0.41; 95% CI, 0.27 to 0.60) and day 4 (RR, 0.38; 95% CI, 0.24 to 0.59) after intervention compared with control. The studies included in this review were varied in the definition of diarrhea, the termination of diarrhea, inclusion and exclusion criteria, and their methodological quality. This review and meta-analysis show that S. boulardii is safe and has clear beneficial effects in children who have acute diarrhea. However, additional studies using head-to-head comparisons are needed to define the best dosage of S. boulardii for diarrhea with different causes. Copyright © 2014 by the American Academy of Pediatrics.
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Open Access Data Centers as an Essential Partner to a Data Publication Journal
NASA Astrophysics Data System (ADS)
Carlson, D.; Pfeiffenberger, H.
2016-12-01
The success of Earth System Science Data derives in part from key infrastructure: digital object identifiers (doi) and open access data centers. Our concept that a data journal should promote access and exchange through publication of reviewed data descriptions presupposed third parties to hold the data. As minimum criteria for those data centers we expected international reputation for quality of service and an active lifetime extending at least a decade into the future. We also expected modern access interfaces offering geographic, topical and parameter-based browsing - so that users could discover related holdings through an ESSD link or discover ESSD by way of links in data sets revealed through the center's browse tools - and true open access. True open access means one or two clicks from abstract in ESSD to the data itself without barriers. We started with Pangaea and CDIAC. Data providers already used these centers, the staff welcomed the ESSD initiative and all parties cooperated on doi. With this initial support ESSD proved the basic concept of data publication and demonstrated utility to a larger group of data providers, many of whom suggested additional centers. So long as those data centers met expectations for open access and quality and durability of service, ESSD agreed to collaborate. Through back-door collaborations - e.g. service on particular data sets - ESSD developed working partnerships with more than 30 data centers in 13 countries. Data centers ask to join our list. We encourage those centers to stimulate local providers to submit a data set to ESSD, thus preserving our practical data-set by data-set partnership mode. For a few data centers where national policies impose a registration step, center staff and ESSD editors created bypass access routes to facilitate anonymous reviews. For ESSD purposes, open access and doi cooperation leading to reliable curation allows a win, win, win partnership among centers, providers, and journal.
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Creating Quality Improvement Culture in Public Health Agencies
Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon
2014-01-01
Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680
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Micro Weather Stations for Mars
NASA Technical Reports Server (NTRS)
Crisp, David; Kaiser, William J.; VanZandt, Thomas R.; Hoenk, Michael E.; Tillman, James E.
1995-01-01
A global network of weather stations will be needed to characterize the near-surface environment on Mars. Here, we review the scientific and measurement objectives of this network. We also show how these objectives can be met within the cost-constrained Mars Surveyor Program by augmenting the Mars Pathfinder-derived landers with large numbers of very small (less than 5 liter), low-mass (less than 5 kg), low-power, low-cost Mini-meteorological stations. Each station would include instruments for measuring atmospheric. pressures, temperatures, wind velocities, humidity, and airborne dust abundance. They would also include a data handling, telemetry, power, atmospheric entry, and deployment systems in a rugged package capable of direct entry and a high-impact landing. In this paper, we describe these systems and summarize the data-taking strategies and data volumes needed to achieve the surface meteorology objectives for Mars.
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Liu, Ying; Ozodiegwu, Ifeoma D; Yu, Yang; Hess, Rick; Bie, Ronghai
2017-08-01
Both depression and metabolic syndrome (MetS) confer an increased risk of developing type 2 diabetes (T2D) and cardiovascular disease. Accumulating evidence suggests healthy behaviors are crucial to maintain, improve and manage chronical disease and mental health; and unhealthy diet and sedentary behavior were found two major risk factors of MetS. The objective of this study was to investigate whether health behaviors (alcohol consumption, smoking, diet and recreational physical activity) are associated with depression and metabolic syndrome simultaneously. This study included 1300 participants aged 20 years and over who had answered mental health-depression screener questions (PHQ-9) and finished examinations and laboratory tests related to five risk factors of MetS during the U.S. National Health and Nutrition Examination Survey (NHANES) 2007-2014. A set of series of weighted logistic regression models were used to investigate the aforementioned relationship. The prevalence of depression among U.S. adults is 15.08%. The two most often reported depression symptoms were "Trouble sleeping or sleeping too much" and "Feeling tired or having little energy", with rates of14.68% and 13.09%, respectively. Participants who engaged in only light physical activity were more likely to have been identified as experiencing depression and MetS than those who engaged in vigorous physical activity with odd ratios 3.18 (95% CI: 1.59, 6.37) and 3.50 (95%CI: 2.17, 5.63), respectively. Individuals in the study having poor diets were more likely to suffer from depression than those eating good diets (OR=2.17, 95%CI: 1.47, 3.22). Physical activity is strongly and inversely associated with depression and MetS. Diet is significantly associated with depression rather than MetS in this study. Copyright © 2017 Elsevier B.V. All rights reserved.
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A dementia care management intervention: which components improve quality?
Chodosh, Joshua; Pearson, Marjorie L; Connor, Karen I; Vassar, Stefanie D; Kaisey, Marwa; Lee, Martin L; Vickrey, Barbara G
2012-02-01
To analyze whether types of providers and frequency of encounters are associated with higher quality of care within a coordinated dementia care management (CM) program for patients and caregivers. Secondary analysis of intervention-arm data from a dementia CM cluster-randomized trial, where intervention participants interacted with healthcare organization care managers (HOCMs), community agency care managers (CACMs), and/ or healthcare organization primary care providers (HOPCPs) over 18 months. Encounters of 238 patient/caregivers (dyads) with HOCMs, CACMs, and HOPCPs were abstracted from care management electronic records. The quality domains of assessment, treatment, education/support, and safety were measured from medical record abstractions and caregiver surveys. Mean percentages of met quality indicators associated with exposures to each provider type and frequency were analyzed using multivariable regression, adjusting for participant characteristics and baseline quality. As anticipated, for all 4 domains, the mean percentage of met dementia quality indicators was 15.5 to 47.2 percentage points higher for dyads with HOCM--only exposure than for dyads with none (all P < .008); not anticipated were higher mean percentages with increasing combinations of provider-type exposure-up to 73.7 percentage points higher for safety (95% confidence interval 65.2%-82.1%) with exposure to all 3 provider types compared with no exposure. While greater frequency of HOCM-dyad encounters was associated with higher quality (P < .04), this was not so for other provider types. HOCMs' interactions with dyads was essential for dementia care quality improvement. Additional coordinated interactions with primary care and community agency staff yielded even higher quality.
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Calibrating Historical IR Sensors Using GEO, and AVHRR Infrared Tropical Mean Calibration Models
NASA Technical Reports Server (NTRS)
Scarino, Benjamin; Doelling, David R.; Minnis, Patrick; Gopalan, Arun; Haney, Conor; Bhatt, Rajendra
2014-01-01
Long-term, remote-sensing-based climate data records (CDRs) are highly dependent on having consistent, wellcalibrated satellite instrument measurements of the Earth's radiant energy. Therefore, by making historical satellite calibrations consistent with those of today's imagers, the Earth-observing community can benefit from a CDR that spans a minimum of 30 years. Most operational meteorological satellites rely on an onboard blackbody and space looks to provide on-orbit IR calibration, but neither target is traceable to absolute standards. The IR channels can also be affected by ice on the detector window, angle dependency of the scan mirror emissivity, stray-light, and detector-to-detector striping. Being able to quantify and correct such degradations would mean IR data from any satellite imager could contribute to a CDR. Recent efforts have focused on utilizing well-calibrated modern hyper-spectral sensors to intercalibrate concurrent operational IR imagers to a single reference. In order to consistently calibrate both historical and current IR imagers to the same reference, however, another strategy is needed. Large, well-characterized tropical-domain Earth targets have the potential of providing an Earth-view reference accuracy of within 0.5 K. To that effort, NASA Langley is developing an IR tropical mean calibration model in order to calibrate historical Advanced Very High Resolution Radiometer (AVHRR) instruments. Using Meteosat-9 (Met-9) as a reference, empirical models are built based on spatially/temporally binned Met-9 and AVHRR tropical IR brightness temperatures. By demonstrating the stability of the Met-9 tropical models, NOAA-18 AVHRR can be calibrated to Met-9 by matching the AVHRR monthly histogram averages with the Met-9 model. This method is validated with ray-matched AVHRR and Met-9 biasdifference time series. Establishing the validity of this empirical model will allow for the calibration of historical AVHRR sensors to within 0.5 K, and thereby establish a climate-quality IR data record.
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Keeping the Momentum and Nuclear Forensics at Los Alamos National Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
Steiner, Robert Ernest; Dion, Heather M.; Dry, Donald E.
LANL has 70 years of experience in nuclear forensics and supports the community through a wide variety of efforts and leveraged capabilities: Expanding the understanding of nuclear forensics, providing training on nuclear forensics methods, and developing bilateral relationships to expand our understanding of nuclear forensic science. LANL remains highly supportive of several key organizations tasked with carrying forth the Nuclear Security Summit messages: IAEA, GICNT, and INTERPOL. Analytical chemistry measurements on plutonium and uranium matrices are critical to numerous programs including safeguards accountancy verification measurements. Los Alamos National Laboratory operates capable actinide analytical chemistry and material science laboratories suitable formore » nuclear material and environmental forensic characterization. Los Alamos National Laboratory uses numerous means to validate and independently verify that measurement data quality objectives are met. Numerous LANL nuclear facilities support the nuclear material handling, preparation, and analysis capabilities necessary to evaluate samples containing nearly any mass of an actinide (attogram to kilogram levels).« less
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Aromatherapy for treatment of hypertension: a systematic review.
Hur, Myung-Haeng; Lee, Myeong Soo; Kim, Chan; Ernst, Edzard
2012-02-01
The objective of this review is to systematically review the evidence for the effectiveness of aromatherapy in the treatment of high blood pressure. Twelve databases were searched from their inception through December 2009. Controlled trials testing aromatherapy in patients with hypertension of any origin that assessed blood pressure were considered. The selection of studies, data extraction and validations were performed independently by two reviewers. One randomized clinical trial (RCT) and four non-randomized controlled clinical trials (CCTs) met our inclusion criteria. The one RCT included tested the effects of aromatherapy as compared with placebo and showed significant reduction of systolic blood pressure and diastolic blood pressure. All of the four CCTs showed favourable effects of aromatherapy. However, all of the CCTs also had a high risk of bias. The existing trial evidence does not show convincingly that aromatherapy is effective for hypertension. Future studies should be of high quality with a particular emphasis on designing an adequate control intervention. © 2010 Blackwell Publishing Ltd.
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Karabagias, Ioannis K; Louppis, Artemis P; Karabournioti, Sofia; Kontakos, Stavros; Papastephanou, Chara; Kontominas, Michael G
2017-02-15
The objective of the present study was: i) to characterize Mediterranean citrus honeys based on conventional physicochemical parameter values, volatile compounds, and mineral content ii) to investigate the potential of above parameters to differentiate citrus honeys according to geographical origin using chemometrics. Thus, 37 citrus honey samples were collected during harvesting periods 2013 and 2014 from Greece, Egypt, Morocco, and Spain. Conventional physicochemical and CIELAB colour parameters were determined using official methods of analysis and the Commission Internationale de l' Eclairage recommendations, respectively. Minerals were determined using ICP-OES and volatiles using SPME-GC/MS. Results showed that honey samples analyzed, met the standard quality criteria set by the EU and were successfully classified according to geographical origin. Correct classification rates were 97.3% using 8 physicochemical parameter values, 86.5% using 15 volatile compound data and 83.8% using 13 minerals. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Forest recreation research at the Pacific Southwest Forest and Range Experiment Station
Robert H. Twiss; Harry W. Camp
1963-01-01
As a land use, an activity, and an industry, forest recreation is rapidly growing in importance. But it is relatively new in terms of objective data and theory. Critical problems are being met by an interdisciplinary research team drawing on seven fields of knowledge. Research problems, approaches, studies, and plans are summarized.
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Chapter 15: Monitoring the effects of fire on nonnative invasive plant species
Steve Sutherland
2008-01-01
Monitoring, as defined by Elzinga and others (1998), is "the collection and analysis of repeated observations or measurements to evaluate changes in condition and progress towards meeting a management objective." Analyses of monitoring data may indicate that a project is meeting land management goals, or it may indicate that goals are not being met and...
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Deming, Denise M.; Reidy, Kathleen C.
2015-01-01
Introduction Solving the childhood obesity problem will require strategies for changes in policy, the environment, the community, and the family. Filling the data gap for children younger than 4 years could facilitate interventions aimed at this critical age group. The objective of this study was to describe parents’ and caregivers’ perceptions of the healthfulness of their young child’s diet and body weight and to assess their adherence to the American Academy of Pediatrics’ 5-2-1-0 recommendations. Methods We conducted a descriptive analysis of parents’ and caregivers’ survey data for 887 infants younger than 12 months, 925 toddlers aged 12 to 23.9 months, and 1,461 preschoolers aged 24 to 47.9 months. Data were from the national, cross-sectional 2008 Feeding Infants and Toddlers Study (FITS). Results Most parents considered their child’s weight to be about right but were more likely to think their child was underweight (8%–9%) than overweight (2%–3%). Most parents thought their child consumed enough fruits and vegetables: however, only 30% of preschoolers met the recommendation for 5 daily servings. Only 2% of toddlers met the recommendation for no screen time, whereas 79% of preschoolers met the recommendation to limit daily screen time to 2 hours or less. About 56% of toddlers and 71% of preschoolers met the recommendation of at least 1 hour of daily outdoor play. About 56% of toddlers and 52% of preschoolers met the recommendation to limit consumption of sugar-sweetened beverages. Conclusion The FITS 2008 findings underscore the ongoing need for research on policies and strategies to prevent childhood obesity from infancy through preschool. Health care providers can play a vital role because they are an important and early point of contact for parents. PMID:26402049
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Briefel, Ronette R; Deming, Denise M; Reidy, Kathleen C
2015-09-24
Solving the childhood obesity problem will require strategies for changes in policy, the environment, the community, and the family. Filling the data gap for children younger than 4 years could facilitate interventions aimed at this critical age group. The objective of this study was to describe parents' and caregivers' perceptions of the healthfulness of their young child's diet and body weight and to assess their adherence to the American Academy of Pediatrics' 5-2-1-0 recommendations. We conducted a descriptive analysis of parents' and caregivers' survey data for 887 infants younger than 12 months, 925 toddlers aged 12 to 23.9 months, and 1,461 preschoolers aged 24 to 47.9 months. Data were from the national, cross-sectional 2008 Feeding Infants and Toddlers Study (FITS). Most parents considered their child's weight to be about right but were more likely to think their child was underweight (8%-9%) than overweight (2%-3%). Most parents thought their child consumed enough fruits and vegetables: however, only 30% of preschoolers met the recommendation for 5 daily servings. Only 2% of toddlers met the recommendation for no screen time, whereas 79% of preschoolers met the recommendation to limit daily screen time to 2 hours or less. About 56% of toddlers and 71% of preschoolers met the recommendation of at least 1 hour of daily outdoor play. About 56% of toddlers and 52% of preschoolers met the recommendation to limit consumption of sugar-sweetened beverages. The FITS 2008 findings underscore the ongoing need for research on policies and strategies to prevent childhood obesity from infancy through preschool. Health care providers can play a vital role because they are an important and early point of contact for parents.
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Cutler, C; Peng, T; Stinson, J; Tucker, L; Boneparth, A; Klein Gitelman, M; Moorthy, L Nandini
2018-04-01
Objective The objective of this article is to examine the quality, content, and readability of information and resources in the English language and accessible on the internet by pediatric patients with systemic lupus erythematosus (SLE) and their families in North America. Methods Keywords relevant to SLE were generated by an undergraduate student, a first-year medical student, and a third-year pediatric resident, and a search was conducted across five commonly used search engines. Quality of information found was evaluated independently by an undergraduate student, a graduate student, a first-year medical student, and a third-year pediatric resident using the DISCERN tool. Two pediatric rheumatologists assessed website accuracy and completeness. Readability of websites was determined using the Flesch-Kincaid grade level and Reading Ease score. Results Out of 2000 websites generated in the search, only 34 unique websites met inclusion criteria. Only 16 of these websites had DISCERN scores above 50% (fair quality). Overall quality of website information was fair with mean ±standard deviation (SD) DISCERN quality score of 44 ± 7 (range: 30-56). Only nine websites of 34 had DISCERN scores above 50 (>66%, indicating greater quality) and were further assessed for completeness. Flesch-Kincaid grade level was 11 ± 1 (mean±SD) and reading ease score was 39 ± 10 (mean±SD, range of 11-61). Conclusion Our study highlights the need for more complete, readable information regarding the unique needs of pediatric patients with childhood-onset SLE and their families.
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NASA Astrophysics Data System (ADS)
Murray, G.; Weihrauch, D.; Kimball, K.; McDonough, C.
2010-12-01
The AMC’s citizen scientist monitoring program, Mountain Watch, engages hikers in observational monitoring while recreating in the northern Appalachian Mountains. The program uses two monitoring activities:1) tracking the phenology of 11 mountain flowers species, and 2) the visitors real world perception of on-mountain visibility and its ‘quality’ with proximate monitored air quality parameters. The Mountain Watch program objectives are a) to engage and educate the public through hands-on monitoring, b) to motivate the participant to take further action towards environmental stewardship, and c) to provide supplemental data to AMC’s ongoing science-based research to further our understanding of the impact of human activity on mountain ecosystems. The Mountain Watch plant monitoring includes recording the time and location of alpine and forest plants flowering and other phenological phases using AMC field guides and datasheets. In the White Mountains of New Hampshire concurrent meteorological data, including soil temperature, is paired with the phenology observations as part of AMC’s research to develop spatial and temporal phenology models with air and soil temperature for northeastern mountains. Mountain Watch’s visibility monitoring program has hikers record visual range and rate the view at select vistas in comparison to a clear day view photo guide when visiting AMC’s backcountry huts. The results are compared to proximate air quality measurements, which assists in determining how White Mountain National Forest air quality related values and natural resources management objectives are being met. Since 2006 the Mountain Watch program has received over 3,500 citizen datasheets for plant reproductive phenology and visibility monitoring. We estimate that we have reached more than 15,000 hikers through our facility based education programming focused on air quality and phenology and field monitoring hikes. While we consider this good success in engaging hikers to date, the ratio of resource expenditures in recruiting volunteers and QA/QCing their data for actual research application has been high. Mountain Watch staff are now refining the program to achieve education and research goals a manner that is sustainable into the future with limited fiscal and staff resources. The quality of our citizen phenology observations, in comparison to staff monitoring, has lead to refinements including directing general audience hikers to well-defined trailside observation stations, growing our more skilled amateur botanist volunteer base, and use of remote cameras for quality controls and better temporal coverage. Visibility monitoring at four mountain vistas has recently been analyzed in the context of policy applications. Refinements will be presented that will further inform natural resource management of air quality in relation to Clean Air Act Air Quality Related Values and a potential visibility focused particulate matter secondary National Ambient Air Quality Standard. Overall lessons learned, regarding audience considerations, resource needs, and long-term sustainability, from our 5-year field based geoscience programs will be discussed.
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National Transonic Facility Characterization Status
NASA Technical Reports Server (NTRS)
Bobbitt, C., Jr.; Everhart, J.; Foster, J.; Hill, J.; McHatton, R.; Tomek, W.
2000-01-01
This paper describes the current status of the characterization of the National Transonic Facility. The background and strategy for the tunnel characterization, as well as the current status of the four main areas of the characterization (tunnel calibration, flow quality characterization, data quality assurance, and support of the implementation of wall interference corrections) are presented. The target accuracy requirements for tunnel characterization measurements are given, followed by a comparison of the measured tunnel flow quality to these requirements based on current available information. The paper concludes with a summary of which requirements are being met, what areas need improvement, and what additional information is required in follow-on characterization studies.
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The ASSET intercomparison of stratosphere and lower mesosphere humidity analyses
NASA Astrophysics Data System (ADS)
Thornton, H. E.; Jackson, D. R.; Bekki, S.; Bormann, N.; Errera, Q.; Geer, A. J.; Lahoz, W. A.; Rharmili, S.
2008-07-01
This paper presents results from the first detailed intercomparison of stratosphere-lower mesosphere water vapour analyses; it builds on earlier results from the "Assimilation of ENVISAT Data" (ASSET) project. With the availability of high resolution, good quality Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) water vapour profiles, the ability of four different atmospheric models to assimilate these data is tested. MIPAS data have been assimilated over September 2003 into the models of the European Centre for Medium Range Weather Forecasts (ECMWF), the Belgian Institute for Space and Aeronomy (BIRA-IASB), the French Service d'Aéronomie (SA-IPSL) and the UK Met Office. The resultant middle atmosphere humidity analyses are compared against independent satellite data from the Halogen Occultation Experiment (HALOE), the Polar Ozone and Aerosol Measurement (POAM III) and the Stratospheric Aerosol and Gas Experiment (SAGE II). The MIPAS water vapour profiles are generally well assimilated in the ECMWF, BIRA-IASB and SA systems, producing stratosphere-mesosphere water vapour fields where the main features compare favourably with the independent observations. However, the models are less capable of assimilating the MIPAS data where water vapour values are locally extreme or in regions of strong humidity gradients, such as the Southern Hemisphere lower stratosphere polar vortex. Differences in the analyses can be attributed to the choice of humidity control variable, how the background error covariance matrix is generated, the model resolution and its complexity, the degree of quality control of the observations and the use of observations near the model boundaries. Due to the poor performance of the Met Office analyses the results are not included in the intercomparison, but are discussed separately. The Met Office results highlight the pitfalls in humidity assimilation, and provide lessons that should be learnt by developers of stratospheric humidity assimilation systems. In particular, they underline the importance of the background error covariances in generating a realistic troposphere to mesosphere water vapour analysis.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Ziemer, B; Shiraishi, S; Hattangadi-Gluth, J
Purpose: Single-isocenter, linac-based SRS for multiple brain metastases (multi-mets) can deliver highly conformal radiation doses and reduce overall patient treatment time compared to other therapy techniques. This study aims to quantify the dosimetric benefits of knowledge-based planning (KBP) for multi-met treatments. Methods: Using a previously-published KBP methodology (an artificial neural network (ANN) trained on single-target linac-based SRS plans), 3D dose distribution predictions for multi-met patients were obtained by treating each brain lesion as a solitary target and subsequently combining individual predictions into a single distribution using a dose-weighted geometric averaging to obtain the best results in the inter-target space. 17more » previously-treated multi-met plans, with target numbers ranging from N=2–5, were used to validate the ANN predictions and subsequent KBP auto-planning routine. The fully-deliverable KBP plans were developed by converting dose distribution predictions into patient-specific optimization objectives while maintaining identical target normalizations (typically PTV V100%=D98%). Plan quality improvements were quantified by the difference between SRS quality metrics (QMs): δdQM=QM(clinical)-QM(KBP). QMs of interest were: gradient measure (GM), conformity index (CI), brain V10 and V5, brainstem D0.1cc and heterogeneity index (HI). Finally, overall plan quality was judged via blinded plan comparison by SRS-specializing physicians. Results: Two clinical plans were found to be significant outliers wherein plan quality was dramatically worse than KBP. Despite indicating KBP superiority, these were removed from the QM analysis to prevent skewing the results. In the remaining cases, clinical and KBP QMs were nearly identical with modest improvements in the KBP sample: δGM=0.12±0.56mm, δCI=−0.01±0.04, Brain δV10=0.8±2.6cc, brain δV5=6.3 ±10.7cc, brainstem δD0.1cc=0.06±1.19Gy and δHI= −0.04±0.05. Ultimately, 13/17 KBP plans were deemed superior to the manual plans in blinded physician review. Conclusion: The results demonstrate that KBP-driven automated planning in linac-based single-isocenter treatments for multiple brain metastases is indistinguishable from, or even better than, traditional manual planning. J. Hattangadi: Research Grant; Varian Medical Systems; K.L. Moore: Research Grant: Varian Medical Systems.« less
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Protein Intake and Growth in Preterm Infants
Tonkin, Emma L.; Collins, Carmel T.
2014-01-01
Objective. This review aimed to investigate the relationship between varying levels of enteral protein intake and growth in preterm infants, regardless of feeding method. Data Sources. Electronic databases were searched for relevant studies, as were review articles, reference lists, and text books. Study Selection. Trials were included if they were randomized or quasirandomized, participants were <37 weeks gestation at birth, and protein intakes were intentionally or statistically different between study groups. Trials reporting weight, length, and head circumference gains in infants fed formula, human milk, or fortified human milk were included. Data Extraction. Studies were categorized by feeding-type and relevant data were extracted into summary tables by one reviewer and cross-checked by a second. Data Synthesis. A meta-analysis could not be conducted due to extensive variability among studies; thus, results were synthesized graphically and narratively. Twenty-four trials met the inclusion criteria and were included in a narrative synthesis and 19 in a graphical synthesis of study results. Conclusions. There was extensive variability in study design, participant characteristics, and study quality. Nonetheless, results are fairly consistent that higher protein intake results in increased growth with graphical representation indicating a potentially linear relationship. Additionally, intakes as high as 4.5 g/kg/day were shown to be safe in infants weighing >1000 g. PMID:27335914
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Pardasaney, Poonam K; Deutsch, Anne; Iriondo-Perez, Jeniffer; Ingber, Melvin J; McMullen, Tara
2018-06-01
To describe the calculation and psychometric properties of the discharge self-care functional status quality measure implemented in the Centers for Medicare & Medicaid Services' (CMS) Inpatient Rehabilitation Facility (IRF) Quality Reporting Program on October 1, 2016. Medicare fee-for-service (FFS) patients from 38 IRFs that participated in the CMS Post-Acute Care Payment Reform Demonstration were included in this cohort study. Data came from the Continuity Assessment Record and Evaluation Item Set, IRF-Patient Assessment Instrument, and Medicare claims. For each patient, we calculated an expected discharge self-care score, risk-adjusted for demographic and baseline clinical characteristics. The performance score of each IRF equaled the percentage of patient stays where the observed discharge self-care score met or exceeded the expected score. We assessed the measure's discriminatory ability across IRFs and reliability. IRFs. Medicare FFS patients aged ≥21 years (N=4769). Not applicable. Facility-level discharge self-care quality measure performance score. A total of 4769 patient stays were included; 57% of stays were in women, and 12.1% were in patients aged <65 years. Stroke was the most common diagnosis (21.8%). The mean±SD performance score was 55.1%±16.6% (range, 25.8%-100%). About 54% of IRFs had scores significantly different from the percentage of stays that met or exceeded the expected discharge self-care score in the overall demonstration sample. The quality measure showed strong reliability, with intraclass correlation coefficients of .91. The discharge self-care quality measure showed strong discriminatory ability and reliability, representing an important initial step in evaluation of IRF self-care outcomes. A wide range in performance scores suggested a gap in quality of care across IRFs. Future work should include testing the measure with nationwide data from all IRFs. Published by Elsevier Inc.
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Working with Teachers to Develop Fair and Reliable Measures of Effective Teaching. MET Project
ERIC Educational Resources Information Center
Bill & Melinda Gates Foundation, 2010
2010-01-01
In fall 2009, the Bill & Melinda Gates Foundation launched the Measures of Effective Teaching (MET) project to develop and test multiple measures of teacher effectiveness. The goal of the MET project is to improve the quality of information about teaching effectiveness available to education professionals within states and districts--information…
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ERIC Educational Resources Information Center
Bill & Melinda Gates Foundation, 2010
2010-01-01
In fall 2009, the Bill & Melinda Gates Foundation launched the Measures of Effective Teaching (MET) project to test new approaches to measuring effective teaching. The goal of the MET project is to improve the quality of information about teaching effectiveness available to education professionals within states and districts--information that…
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Zhou, Zheng; Vailati-Riboni, Mario; Luchini, Daniel N; Loor, Juan J
2016-12-29
The objective of this study was to profile plasma amino acids (AA) and derivatives of their metabolism during the periparturient period in response to supplemental rumen-protected methionine (MET) or rumen-protected choline (CHOL). Forty cows were fed from -21 through 30 days around parturition in a 2 × 2 factorial design a diet containing MET or CHOL. MET supply led to greater circulating methionine and proportion of methionine in the essential AA pool, total AA, and total sulfur-containing compounds. Lysine in total AA also was greater in these cows, indicating a better overall AA profile. Sulfur-containing compounds (cystathionine, cystine, homocystine, and taurine) were greater in MET-fed cows, indicating an enriched sulfur-containing compound pool due to enhanced transsulfuration activity. Circulating essential AA and total AA concentrations were greater in cows supplied MET due to greater lysine, arginine, tryptophan, threonine, proline, asparagine, alanine, and citrulline. In contrast, CHOL supply had no effect on essential AA or total AA, and only tryptophan and cystine were greater. Plasma 3-methylhistidine concentration was lower in response to CHOL supply, suggesting less tissue protein mobilization in these cows. Overall, the data revealed that enhanced periparturient supply of MET has positive effects on plasma AA profiles and overall antioxidant status.
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Okosun, Ike S; Boltri, John M; Lyn, Rodney; Davis-Smith, Monique
2010-08-01
The objective of this study was to determine independent and joint association of body mass index (BMI) percentile and leisure time physical activity (LTPA) with continuous metabolic syndrome (cMetS) risk score in 12- to 17-year-old American children. The 2003 to 2004 US National Health and Nutrition Examination Survey data were used for this investigation. LTPA was determined by self-report. cMetS risk score was calculated using standardized residuals of arterial blood pressure, triglycerides, glucose, waist circumference, and high-density lipoprotein cholesterol. Multiple linear regression analysis was used to evaluate association of BMI percentile and LTPA with cMetS risk score, adjusting for confounders. Increased BMI percentile and LTPA were each associated with increased and decreased cMetS risk score, respectively ((P<.01). There was a gradient of increasing cMetS risk score by BMI percentile cutpoints, from healthy weight (-0.77) to overweight (3.43) and obesity (6.40) ((P<.05). A gradient of decreasing cMetS risk score from sedentary (0.88) to moderate (0.17) and vigorous (-0.42) LTPA levels was also observed (P<.01). The result of this study suggests that promoting LTPA at all levels of weight status may help to reverse the increasing trends of metabolic syndrome in US children. (c) 2010 Wiley Periodicals, Inc.
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Zhou, Zheng; Vailati-Riboni, Mario; Luchini, Daniel N.; Loor, Juan J.
2016-01-01
The objective of this study was to profile plasma amino acids (AA) and derivatives of their metabolism during the periparturient period in response to supplemental rumen-protected methionine (MET) or rumen-protected choline (CHOL). Forty cows were fed from −21 through 30 days around parturition in a 2 × 2 factorial design a diet containing MET or CHOL. MET supply led to greater circulating methionine and proportion of methionine in the essential AA pool, total AA, and total sulfur-containing compounds. Lysine in total AA also was greater in these cows, indicating a better overall AA profile. Sulfur-containing compounds (cystathionine, cystine, homocystine, and taurine) were greater in MET-fed cows, indicating an enriched sulfur-containing compound pool due to enhanced transsulfuration activity. Circulating essential AA and total AA concentrations were greater in cows supplied MET due to greater lysine, arginine, tryptophan, threonine, proline, asparagine, alanine, and citrulline. In contrast, CHOL supply had no effect on essential AA or total AA, and only tryptophan and cystine were greater. Plasma 3-methylhistidine concentration was lower in response to CHOL supply, suggesting less tissue protein mobilization in these cows. Overall, the data revealed that enhanced periparturient supply of MET has positive effects on plasma AA profiles and overall antioxidant status. PMID:28036059
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Metabolic syndrome: An independent risk factor for erectile dysfunction
Sanjay, Saran; Bharti, Gupta Sona; Manish, Gutch; Rajeev, Philip; Pankaj, Agrawal; Puspalata, Agroiya; Keshavkumar, Gupta
2015-01-01
Objective: The objective was to determine the role of various components of metabolic syndrome (MetS) as independent risk factor for erectile dysfunction (ED). Materials and Methods: A total of 113 subjects of MetS, as recommended by recent IDF and AHA/NHLBI joint interim statement were selected for study who presented for ED. After doing Anthropometric examination, fasting laboratory assay for fasting plasma glucose (FPG), fasting insulin, hemoglobin A1c, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and 2 h oral glucose tolerance test (OGTT) was done. Erectile function was assessed by completing questions one through five of the International Index of Erectile Function (IIEF-5). A multiple linear regression analysis was carried out on 66 subjects with IIEF-5 score as dependent variable and components of MetS FPG, 2 h OGTT, TG, HDL, and waist circumference as independent variables. Results: Using a multiple linear regression analysis, we observed that presence of the various components of MetS was associated with ED and a decrease IIEF-5 score and this effect was greater than the effect associated with any of the individual components. Of the individual components of the MetS, HDL (B = 0.136; P = 0.004) and FPG (B = −0.069; P = 0.007) conferred the strongest effect on IIEF-5 score. However, overall age had most significant effect on IIEF-5 score. Conclusion: It is crucial to formulate strategies and implement them to prevent or control the epidemic of the MetS and its consequences. The early identification and treatment of risk factors might be helpful to prevent ED and secondary cardiovascular disease, including diet and lifestyle interventions. PMID:25729692
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Knobel, LeRoy L.
2006-01-01
This report presents qualitative and quantitative comparisons of water-quality data from the Idaho National Laboratory, Idaho, to determine if the change from purging three wellbore volumes to one wellbore volume has a discernible effect on the comparability of the data. Historical water-quality data for 30 wells were visually compared to water-quality data collected after purging only 1 wellbore volume from the same wells. Of the 322 qualitatively examined constituent plots, 97.5 percent met 1 or more of the criteria established for determining data comparability. A simple statistical equation to determine if water-quality data collected from 28 wells at the INL with long purge times (after pumping 1 and 3 wellbore volumes of water) were statistically the same at the 95-percent confidence level indicated that 97.9 percent of 379 constituent pairs were equivalent. Comparability of water-quality data determined from both the qualitative (97.5 percent comparable) and quantitative (97.9 percent comparable) evaluations after purging 1 and 3 wellbore volumes of water indicates that the change from purging 3 to 1 wellbore volumes had no discernible effect on comparability of water-quality data at the INL. However, the qualitative evaluation was limited because only October-November 2003 data were available for comparison to historical data. This report was prepared by the U.S. Geological Survey in cooperation with the U.S. Department of Energy.
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Lam, Ivy T; Keller, Heather H; Duizer, Lisa; Stark, Ken
2015-06-01
Micronutrient (vitamin and mineral) deficiencies may exacerbate prevalent health conditions occurring in long-term care (LTC) residents, and current food provision may potentiate this problem. A micronutrient-focused, food-first approach to menu planning may address this gap by emphasizing nutrient-dense foods. The objectives were to determine if: (i) selected LTC menus met micronutrient and Canada's Food Guide (CFG) recommendations, and (ii) recommendations can be met through food alone with strategic menu planning. Regular, nontherapeutic menus (week 1, all meals) from diverse LTC homes (n = 5) across Canada were analyzed for micronutrient content using Food Processor and CFG servings. Site dietitians confirmed menu analyses. Five super-menus were created and analyzed for comparison. The nutrient content of the menus varied significantly across homes. Micronutrients of greatest concern were (mean ± SD) vitamin D (8.90 ± 5.29 µg/d) and vitamin E (5.13 ± 1.74 mg/d). Folate, magnesium, and potassium were also below recommendations. Super-menus of equal food volume met recommendations for all micronutrients except vitamin D (56%), vitamin E (84%), and potassium (85%). Meeting most micronutrient recommendations is possible with creative and deliberate menu planning. Knowledge translation of best practices is needed.
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Patient satisfaction with out-of-hours GP cooperatives: A longitudinal study
Smits, Marleen; Huibers, Linda; Oude Bos, Anita; Giesen, Paul
2012-01-01
Objective For over a decade, out-of-hours primary care in the Netherlands has been provided by general practitioner (GP) cooperatives. In the past years, quality improvements have been made and patients have become acquainted with the service. This may have increased patient satisfaction. The objective of this study was to examine changes in patient satisfaction with GP cooperatives over time. Design Longitudinal observational study. A validated patient satisfaction questionnaire was distributed in 2003–2004 (T1) and 2007–2008 (T2). Items were rated on a scale from 0 to 10 (1 = very bad; 10 = excellent). Setting Eight GP cooperatives in the Netherlands. Subjects Stratified sample of 9600 patients. Response was 55% at T1 (n = 2634) and 51% at T2 (n = 2462). Main outcome measures Expectations met; satisfaction with triage nurses, GPs, and organization. Results For most patients the care received at the GP cooperative met their expectations (T1: 86.1% and T2: 88.4%). Patients were satisfied with the triage nurses (overall grade T1: 7.73 and T2: 7.99), GPs (T1: 8.04 and T2: 8.25), and organization (overall grade T1: 7.60 and T2: 7.78). Satisfaction with triage nurses showed the largest increase over time. The quality and effectiveness of advice or treatment were given relatively low grades. Of all organizational aspects, the lowest grades were given for waiting times and information about the cooperative. Conclusion In general, patients were initially satisfied with GP cooperatives and satisfaction had even increased four years later. However, there is room for improvement in the content of the advice, waiting times, and information supply. More research is needed into satisfaction of specific patient groups. PMID:23113756
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Gotts, Zoe M.; Ellis, Jason; Deary, Vincent; Rapley, Tim; Ng, Wan-Fai; Newton, Julia L.; Deane, Katherine H. O.
2017-01-01
Abstract Objectives. To identify whether sleep disturbances are more prevalent in primary SS (pSS) patients compared with the general population and to recognize which specific sleep symptoms are particularly problematic in this population. Methods. Electronic searches of the literature were conducted in PubMed, Medline (Ovid), Embase (Ovid), PsychINFO (Ovid) and Web of Science and the search strategy registered a priori. Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria, reference lists were examined and a narrative synthesis of the included articles was conducted. Results. Eight whole-text papers containing nine separate studies met the inclusion criteria and were included in the narrative analysis. Few of these studies met all of the quality assessment criteria. The studies used a range of self-reported measures and objective measures, including polysomnography. Mixed evidence was obtained for some of the individual sleep outcomes, but overall compared with controls, pSS patients reported greater subjective sleep disturbances and daytime somnolence and demonstrated more night awakenings and pre-existing obstructive sleep apnoea. Conclusions. A range of sleep disturbances are commonly reported in pSS patients. Further polysomnography studies are recommended to confirm the increased prevalence of night awakenings and obstructive sleep apnoea in this patient group. pSS patients with excessive daytime somnolence should be screened for co-morbid sleep disorders and treated appropriately. Interventions targeted at sleep difficulties in pSS, such as cognitive behavioural therapy for insomnia and nocturnal humidification devices, have the potential to improve quality of life in this patient group and warrant further investigation. PMID:28013207
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O'Neil, Carol E; Nicklas, Theresa A; Rampersaud, Gail C; Fulgoni, Victor L
2012-12-12
Consumption of 100% orange juice (OJ) has been positively associated with nutrient adequacy and diet quality, with no increased risk of overweight/obesity in children; however, no one has examined these factors in adults. The purpose of this study was to examine the association of 100% OJ consumption with nutrient adequacy, diet quality, and risk factors for metabolic syndrome (MetS) in a nationally representative sample of adults. Data from adults 19+ years of age (n = 8,861) participating in the National Health and Nutrition Examination Survey 2003-2006 were used. The National Cancer Institute method was used to estimate the usual intake (UI) of 100% OJ consumption, selected nutrients, and food groups. Percentages of the population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was measured by the Healthy Eating Index-2005 (HEI-2005). Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese or having risk factors of MetS or MetS. Usual per capita intake of 100% OJ was 50.3 ml/d. Among consumers (n = 2,310; 23.8%), UI was 210.0 ml/d. Compared to non-consumers, consumers had a higher (p < 0.05) percentage (% ± SE) of the population meeting the EAR for vitamin A (39.7 ± 2.5 vs 54.0 ± 1.2), vitamin C (0.0 ± 0.0 vs 59.0 ± 1.4), folate (5.8 ± 0.7 vs 15.1 ± 0.9), and magnesium (51.6 ± 1.6 vs 63.7 ± 1.2). Consumers were also more likely to be above the AI for potassium (4.1 ± 0.8 vs 1.8 ± 0.2). HEI-2005 was significantly (p < 0.05) higher in consumers (55.0 ± 0.4 vs 49.7 ± 0.3). Consumers also had higher intakes of total fruit, fruit juice, whole fruit, and whole grain. Consumers had a lower (p < 0.05) mean body mass index (27.6 ± 0.2 vs 28.5 ± 0.1), total cholesterol levels (197.6 ± 1.2 vs 200.8 ± 0.75 mg/dL), and low density lipoprotein-cholesterol levels (112.5 ± 1.4 vs 116.7 ± 0.93 mg/dL). Finally, compared to non-consumers of 100% OJ, consumers were 21% less likely to be obese and male consumers were 36% less likely to have MetS. The results suggest that moderate consumption of 100% OJ should be encouraged to help individuals meet the USDA daily recommendation for fruit intake and as a component of a healthy diet.
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2012-01-01
Background Consumption of 100% orange juice (OJ) has been positively associated with nutrient adequacy and diet quality, with no increased risk of overweight/obesity in children; however, no one has examined these factors in adults. The purpose of this study was to examine the association of 100% OJ consumption with nutrient adequacy, diet quality, and risk factors for metabolic syndrome (MetS) in a nationally representative sample of adults. Methods Data from adults 19+ years of age (n = 8,861) participating in the National Health and Nutrition Examination Survey 2003-2006 were used. The National Cancer Institute method was used to estimate the usual intake (UI) of 100% OJ consumption, selected nutrients, and food groups. Percentages of the population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was measured by the Healthy Eating Index-2005 (HEI-2005). Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese or having risk factors of MetS or MetS. Results Usual per capita intake of 100% OJ was 50.3 ml/d. Among consumers (n = 2,310; 23.8%), UI was 210.0 ml/d. Compared to non-consumers, consumers had a higher (p < 0.05) percentage (% ± SE) of the population meeting the EAR for vitamin A (39.7 ± 2.5 vs 54.0 ± 1.2), vitamin C (0.0 ± 0.0 vs 59.0 ± 1.4), folate (5.8 ± 0.7 vs 15.1 ± 0.9), and magnesium (51.6 ± 1.6 vs 63.7 ± 1.2). Consumers were also more likely to be above the AI for potassium (4.1 ± 0.8 vs 1.8 ± 0.2). HEI-2005 was significantly (p < 0.05) higher in consumers (55.0 ± 0.4 vs 49.7 ± 0.3). Consumers also had higher intakes of total fruit, fruit juice, whole fruit, and whole grain. Consumers had a lower (p < 0.05) mean body mass index (27.6 ± 0.2 vs 28.5 ± 0.1), total cholesterol levels (197.6 ± 1.2 vs 200.8 ± 0.75 mg/dL), and low density lipoprotein-cholesterol levels (112.5 ± 1.4 vs 116.7 ± 0.93 mg/dL). Finally, compared to non-consumers of 100% OJ, consumers were 21% less likely to be obese and male consumers were 36% less likely to have MetS. Conclusion The results suggest that moderate consumption of 100% OJ should be encouraged to help individuals meet the USDA daily recommendation for fruit intake and as a component of a healthy diet. PMID:23234248
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De Schrijver, Adinda; Devos, Yann; De Clercq, Patrick; Gathmann, Achim; Romeis, Jörg
2016-08-01
The potential risks that genetically modified plants may pose to non-target organisms and the ecosystem services they contribute to are assessed as part of pre-market risk assessments. This paper reviews the early tier studies testing the hypothesis whether exposure to plant-produced Cry34/35Ab1 proteins as a result of cultivation of maize 59122 is harmful to valued non-target organisms, in particular Arthropoda and Annelida. The available studies were assessed for their scientific quality by considering a set of criteria determining their relevance and reliability. As a case-study, this exercise revealed that when not all quality criteria are met, weighing the robustness of the study and its relevance for risk assessment is not obvious. Applying a worst-case expected environmental concentration of bioactive toxins equivalent to that present in the transgenic crop, confirming exposure of the test species to the test substance, and the use of a negative control were identified as minimum criteria to be met to guarantee sufficiently reliable data. This exercise stresses the importance of conducting studies meeting certain quality standards as this minimises the probability of erroneous or inconclusive results and increases confidence in the results and adds certainty to the conclusions drawn.
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McHale, Michael R.; McChesney, Dennis
2007-01-01
In 2003, a study was conducted to evaluate the accuracy and precision of 10 laboratories that analyze water-quality samples for phosphorus concentrations in the Catskill Mountain region of New York State. Many environmental studies in this region rely on data from these different laboratories for water-quality analyses, and the data may be used in watershed modeling and management decisions. Therefore, it is important to determine whether the data reported by these laboratories are of comparable accuracy and precision. Each laboratory was sent 12 samples for triplicate analysis for total phosphorus, total dissolved phosphorus, and soluble reactive phosphorus. Eight of these laboratories reported results that met comparability criteria for all samples; the remaining two laboratories met comparability criteria for only about half of the analyses. Neither the analytical method used nor the sample concentration ranges appeared to affect the comparability of results. The laboratories whose results were comparable gave consistently comparable results throughout the concentration range analyzed, and the differences among methods did not diminish comparability. All laboratories had high data precision as indicated by sample triplicate results. In addition, the laboratories consistently reported total phosphorus values greater than total dissolved phosphorus values, and total dissolved phosphorus values greater than soluble reactive phosphorus values, as would be expected. The results of this study emphasize the importance of regular laboratory participation in sample-exchange programs.
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Breakfast is associated with the metabolic syndrome and school performance among Taiwanese children.
Ho, Chia-Yi; Huang, Yi-Chen; Lo, Yuan-Ting C; Wahlqvist, Mark L; Lee, Meei-Shyuan
2015-01-01
Skipping breakfast is associated with adverse child health profiles including obesity, higher blood pressure, higher serum cholesterol, and poor cognitive function. We aimed to explore the association between breakfast with school performance and the metabolic syndrome (MetS) in Taiwanese children. Participants were enrolled from the representative Elementary School Children's Nutrition and Health Survey in Taiwan (2001-2002). Diet, waist circumference, blood pressure, blood glucose, triglyceride, and high-density lipoprotein cholesterol concentrations were assessed in 1287 boys and 1114 girls. Their school and social performances were examined using the modified Scale for Assessing Emotional Disturbance questionnaire. Logistic and linear regression analyses were used to estimate the risk of MetS and also the association between breakfast consumption frequency and school or social performance. When breakfast consumption was regular, overall dietary quality was better. Children who consumed breakfast daily exhibited lower risks of high blood pressure (OR=0.37, 95% CI=0.19-0.71) and of MetS (OR=0.22, 95% CI=0.09-0.51) compared with children who consumed breakfast 0-4 times per week. Furthermore, children who consumed breakfast daily exhibited a higher overall competence (OC) score (β=0.71, p<0.05) in a dose-response manner (p for trend=0.02). This association was not dependent on overall diet or MetS. In conclusion, consuming breakfast daily is associated with better school performance, a lower risk of high blood pressure, and MetS independent of overall dietary quality. Thus, breakfast on school days is a factor in school performance and health. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Al-Sejari, Maha
2016-01-01
In the past six decades, the Kuwaiti population has been exposed to rapid transformation in the quality of diet intake, daily activities, and career types. This major socioeconomic shift was accompanied by the introduction of both communicable and noncommunicable chronic diseases afflicting people of all ages. This article aims to detect a relationship between sociocultural characteristics—such as physical activity, dietary habits, and smoking—and the prevalence of metabolic syndrome (MetS). A descriptive, cross-sectional survey was conducted among 262 male university students in Kuwait; participants were selected by using a convenient nonrandom opportunistic sample. Associated social and health factors were obtained using a closed-ended questionnaire. BMI and blood tests that include clusters of MetS risk components were drawn from participants in primary health care clinics. More than half of the participants were overweight and obese; 74.4% of the participants reported they did not visit a nutritionist; 69.8% said that they are currently not on a diet; 53.4% of the students were nonsmokers; 42.7% reported moderate to very low daily physical activity. The prevalence of MetS components increased among students with older age, employed, and married (p < .001), higher BMI, higher income, smoking, fewer number of family members living, and belonging to the Shia religious sect (p < .05). The high frequency of MetS among younger students needs to be considered by Kuwaiti community members and the government to highlight the risk factors of MetS on individuals’ well-being, quality of life, and life expectation. PMID:27903953
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Al-Sejari, Maha
2017-03-01
In the past six decades, the Kuwaiti population has been exposed to rapid transformation in the quality of diet intake, daily activities, and career types. This major socioeconomic shift was accompanied by the introduction of both communicable and noncommunicable chronic diseases afflicting people of all ages. This article aims to detect a relationship between sociocultural characteristics-such as physical activity, dietary habits, and smoking-and the prevalence of metabolic syndrome (MetS). A descriptive, cross-sectional survey was conducted among 262 male university students in Kuwait; participants were selected by using a convenient nonrandom opportunistic sample. Associated social and health factors were obtained using a closed-ended questionnaire. BMI and blood tests that include clusters of MetS risk components were drawn from participants in primary health care clinics. More than half of the participants were overweight and obese; 74.4% of the participants reported they did not visit a nutritionist; 69.8% said that they are currently not on a diet; 53.4% of the students were nonsmokers; 42.7% reported moderate to very low daily physical activity. The prevalence of MetS components increased among students with older age, employed, and married ( p < .001), higher BMI, higher income, smoking, fewer number of family members living, and belonging to the Shia religious sect ( p < .05). The high frequency of MetS among younger students needs to be considered by Kuwaiti community members and the government to highlight the risk factors of MetS on individuals' well-being, quality of life, and life expectation.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1995-09-01
The Quality Assurance/Quality Control (QA/QC) Program for Phase 2 of the Clinch River Remedial Investigation (CRRI) was designed to comply with both Department of Energy (DOE) Order 5700.6C and Environmental Protection Agency (EPA) QAMS-005/80 (EPA 1980a) guidelines. QA requirements and the general QA objectives for Phase 2 data were defined in the Phase 2 Sampling and Analysis Plan (SAP)-Quality Assurance Project Plan, and scope changes noted in the Phase 2 Sampling and Analysis Plan Addendum. The QA objectives for Phase 2 data were the following: (1) Scientific data generated will withstand scientific and legal scrutiny. (2) Data will be gatheredmore » using appropriate procedures for sample collection, sample handling and security, chain of custody (COC), laboratory analyses, and data reporting. (3) Data will be of known precision and accuracy. (4) Data will meet data quality objectives (DQOs) defined in the Phase 2 SAP.« less
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Slagter, Sandra N; van Vliet-Ostaptchouk, Jana V; van Beek, André P; Keers, Joost C; Lutgers, Helen L; van der Klauw, Melanie M; Wolffenbuttel, Bruce H R
2015-01-01
Health-related quality of life (HR-QoL) may be compromised in obese individuals, depending on the presence of other complications. The aim of this study is to assess the effect of obesity-related conditions on HR-QoL. These conditions are i) grade of obesity with and without type 2 diabetes (T2D), ii) metabolic syndrome (MetS), and iii) level of inflammation. From the Dutch LifeLines Cohort Study we included 13,686 obese individuals, aged 18-80 years. HR-QoL was measured with the RAND 36-Item Health Survey which encompasses eight health domains. We calculated the percentage of obese individuals with poor HR-QoL, i.e. those scoring below the domain and sex specific cut-off value derived from the normal weight population. Logistic regression analysis was used to calculate the probability of having poor domain scores according to the conditions under study. Higher grades of obesity and the additional presence of T2D were associated with lower HR-QoL, particularly in the domains physical functioning (men: odds ratios (ORs) 1.48-11.34, P<0.005, and women: ORs 1.66-5.05, P<0.001) and general health (men: ORs 1.44-3.07, P<0.005, and women: ORs 1.36-3.73, P<0.001). A higher percentage of obese individuals with MetS had a poor HR-QoL than those without MetS. Furthermore, we observed a linear trend between inflammation and the percentage of obese individuals with poor scores on the HR-QoL domains. Individuals with MetS were more likely to have poor scores in the domains general health, vitality, social functioning and role limitations due to emotional problems. Obese women with increased inflammation levels were more likely to have poor scores on all domains except role limitations due to emotional problems and mental health. The impact of obesity on an individual's quality of life is enhanced by grade of obesity, T2D, MetS and inflammation and are mainly related to reduced physical health. The mental well-being is less often impaired.
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DeVries, J Hans; Meneghini, Luigi; Barnett, Anthony H; Reid, Timothy; Dain, Marie-Paule; Vlajnic, Aleksandra; Traylor, Louise; Bergenstal, Richard M
2014-01-01
Abstract Background: A better understanding of hypoglycaemia risk when insulin is used in combination with one or more oral antidiabetes agents may assist in the treatment decision-making process for the clinician and address concerns regarding hypoglycaemia when initiating or intensifying insulin therapy. The objective of this study was to analyse efficacy and hypoglycaemia outcomes in people with type 2 diabetes receiving insulin glargine (IG) with metformin (MET), sulphonylurea (SU) or MET+SU. Methods: Patient-level data were pooled from 15 randomised, treat-to-target trials (fasting plasma glucose [FPG] targets <5.6 mmol/l) with a duration >24 weeks. Efficacy outcomes included glycated haemoglobin (HbA1c), FPG and HbA1c target achievement. Overall hypoglycaemia events were assessed by a confirmed PG value of <3.9, <3.1 and <2.8 mmol/l or assistance required; daytime, nocturnal (00:01-05:59 AM); and severe (assistance required or with confirmed PG <2.0 mmol/l). Results: Overall, 2,837 IG patients were analysed, with either MET (634), SU (906) or MET+SU (1,297) as background oral antidiabetes agents. Endpoint HbA1c in IG+MET and IG+MET+SU-treated patients was significantly lower than in IG+SU-treated patients (adjusted difference -0.32 %; p=0.0001 and -0.33 %; p=0.0002, respectively). Fewer patients achieved endpoint HbA1c <7.0 % with IG+SU (32 %) versus IG+MET (57 %) or IG+MET+SU (49 %). IG+SU and IG+MET+SU led to significant increases in overall, daytime and nocturnal hypoglycaemia versus IG+MET; severe hypoglycaemia was rare. Weight gain was lowest in IG+MET patients (adjusted difference -1.51 kg versus IG+SU; p<0.0001; -0.78 kg versus IG+MET+SU; p=0.0037) despite higher insulin doses (0.51 U/kg versus 0.43 and 0.42 U/kg, respectively). Conclusions: Better glycaemic goal achievement and reduced risk of hypoglycaemia and weight gain were observed with IG+MET versus IG+SU and IG+MET+SU, albeit with an increased insulin dose requirement. PMID:29872460
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Dennett, Rachel; Gunn, Hilary; Freeman, Jennifer A
2018-05-15
Supporting people with multiple sclerosis (MS) to achieve and maintain recommended levels of physical activity is important but challenging. Web-based interventions are increasingly being used to deliver targeted exercise programs and promote physical activity. The purpose of this study was to systematically review current evidence regarding the effectiveness and user experience of web-based interventions in increasing physical activity in people with MS. MEDLINE, EMBASE, CINAHL, AMED, PEDro, PsychInfo, Web of Sciences, The Cochrane Library, and gray literature were searched from 1990 to September 2016. English language articles reporting the use of web-based interventions to increase physical activity in adults with MS were included. Eligible quantitative studies were of any design and reported a measure of physical activity. Qualitative studies exploring users' experiences in any context were included. Of the 881 articles identified, 9 met the inclusion criteria. Two reviewers independently assessed methodological quality and extracted data using standardized critical appraisal and data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Meta-analysis of self-reported physical activity questionnaire data from 4 studies demonstrated a standardized mean difference of 0.67 (95% CI = 0.43-0.92), indicating a positive effect in favor of the web-based interventions. Narrative review of accelerometry data from 3 studies indicated increases in objectively measured physical activity. No qualitative studies met the inclusion criteria. In the 9 included articles, only 2 different interventions (used with people who were ambulant) were reported. Web-based interventions had a short-term positive effect on self-reported physical activity in people who had MS and were ambulant. Evidence is not currently available to support or refute their use in the long-term or with people who are not ambulant.
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Groschen, George E.; King, Robin B.
2005-01-01
Eight streams, representing a wide range of environmental and water-quality conditions across Illinois, were monitored from July 2001 to October 2003 for five water-quality parameters as part of a pilot study by the U.S. Geological Survey (USGS) in cooperation with the Illinois Environmental Protection Agency (IEPA). Continuous recording multi-parameter water-quality monitors were installed to collect data on water temperature, dissolved-oxygen concentrations, specific conductivity, pH, and turbidity. The monitors were near USGS streamflow-gaging stations where stage and streamflow are continuously recorded. During the study period, the data collected for these five parameters generally met the data-quality objectives established by the USGS and IEPA at all eight stations. A similar pilot study during this period for measurement of chlorophyll concentrations failed to achieve the data-quality objectives. Of all the sensors used, the temperature sensors provided the most accurate and reliable measurements (generally within ?5 percent of a calibrated thermometer reading). Signal adjustments and calibration of all other sensors are dependent upon an accurate and precise temperature measurement. The dissolved-oxygen sensors were the next most reliable during the study and were responsive to changing conditions and accurate at all eight stations. Specific conductivity was the third most accurate and reliable measurement collected from the multi-parameter monitors. Specific conductivity at the eight stations varied widely-from less than 40 microsiemens (?S) at Rayse Creek near Waltonville to greater than 3,500 ?S at Salt Creek at Western Springs. In individual streams, specific conductivity often changed quickly (greater than 25 percent in less than 3 hours) and the sensors generally provided good to excellent record of these variations at all stations. The widest range of specific-conductivity measurements was in Salt Creek at Western Springs in the Greater Chicago metropolitan area. Unlike temperature, dissolved oxygen, and specific conductivity that have been typically measured over a wide range of historical streamflow conditions in many streams, there are few historical turbidity data and the full range of turbidity values is not well known for many streams. Because proposed regional criteria for turbidity in regional streams are based on upper 25th percentiles of concentration in reference streams, accurate determination of the distribution of turbidity in monitored streams is important. Digital data from all five sensors were recorded within each of the eight sondes deployed in the streams and in automated data recorders in the nearby streamflow-gaging houses at each station. The data recorded on each sonde were retrieved to a field laptop computer at each station visit. The feasibility of transmitting these data in near-real time to a central processing point for dissemination on the World-Wide Web was tested successfully. Data collected at all eight stations indicate that a number of factors affect the dissolved-oxygen concentration in the streams and rivers monitored. These factors include: temperature, biological activity, nutrient runoff, and weather (storm runoff). During brief periods usually in late summer, dissolved-oxygen concentrations in half or more of the eight streams and rivers monitored were below the 5 milligrams per liter minimum established by the Illinois Pollution Control Board to protect aquatic life. Because the streams monitored represent a wide range in water-quality and environmental conditions, including diffuse (non-point) runoff and wastewater-effluent contributions, this result indicates that deleterious low dissolved-oxygen concentrations during late summer may be widespread in Illinois streams.
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The effect of nutritional status on myogenic satellite cell proliferation and differentiation.
Powell, D J; McFarland, D C; Cowieson, A J; Muir, W I; Velleman, S G
2013-08-01
Early posthatch satellite cell (SC) mitotic activity is a critical component of muscle development and growth. Satellite cells are stem cells that can be induced by nutrition to follow other cellular developmental pathways. The objective of the current study was to determine the effect of restricting protein synthesis on the proliferation and differentiation of SC, using variable concentrations of Met and Cys to modulate protein synthesis. Broiler pectoralis major SC were cultured and treated with 1 of 6 different Met/Cys concentrations: 60/192, 30/96 (control), 7.5/24, 3/9.6, 1/3.2, or 0/0 mg/L. The effect of Met/Cys concentration on SC proliferation and differentiation was measured, and myonuclear accretion was measured by counting the number of nuclei per myotube during differentiation. The 30/96 mg/L Met/Cys treatment resulted in the highest rate of proliferation compared with all other treatments by 72 h of proliferation (P < 0.05). Differentiation was measured with Met/Cys treatments only during proliferation and the cultures receiving normal differentiation medium (R/N), normal proliferation medium and differentiation medium with variable Met/Cys (N/R), or both proliferation and differentiation receiving variable Met/Cys treatments (R/R). Differentiation responded in a dose-dependent manner to Met/Cys concentration under all 3 of these treatment regimens, with a degree of recovery in the R/N regimen cells following reinstatement of the control medium. Reductions in both proliferation and differentiation were more pronounced as Met/Cys concentrations were further reduced, whereas increased differentiation was observed under the increased Met/Cys concentration treatment when applied during differentiation in the N/R and R/R regimens. The number of nuclei per myotube was significantly decreased in the severely Met/Cys restricted treatments (P < 0.05). These data demonstrate the sensitivity of pectoralis major SC to nutritional availability and the importance of optimal nutrition during both proliferation and differentiation for maximizing SC activity, which will affect subsequent muscle mass accretion.
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Li, Guichen; Yuan, Hua; Zhang, Wei
2014-08-01
To determine the effects of Tai Chi practice on health related quality of life in patients with various chronic medical conditions. One of the characters of chronic illness is life-long condition with the deterioration in health related quality of life. Tai Chi has become a popular mind-body exercise and self-management strategy for patients with chronic conditions regarding its various physical and psychological effects. Eight databases (the Cochrane Library, PubMed, Medline, EBSCO, Web of science and three Chinese databases: CNKI, Wanfang data and VIP) were searched (up to December 2013) for relevant studies. Studies including participants with chronic conditions were selected. All studies were randomized controlled trials reporting the effects of Tai Chi on health related quality of life. Two independent reviewers extracted trial data and assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Of the 2021 papers which were screened, 21 studies including 1200 patients met the eligibility criteria. Most studies (18 of 21 studies) found significant improvements on health related quality of life for participants with chronic conditions in Tai Chi group. No evidence was observed to suggest that Tai Chi was more effective than other types of exercise. And objective measures were not always consistent with self-reported quality of life measures. Tai Chi appears to be safe and has positive effects on health related quality of life in patients with chronic conditions, especially for patients with disorders in Cardio-cerebrovascular and respiratory systems, and musculoskeletal system. However, as the delivery mood of Tai Chi provides multiply benefits, which part of the group provides the most benefit in improving quality of life is unclear. Due to the design limitations of previous studies, more larger and well-designed RCTs are needed to confirm the effects. And qualitative researches are warranted to explore how Tai Chi may work exactly from patients' own perspectives. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Windsor, B; Popovich, I; Jordan, V; Showell, M; Shea, B; Farquhar, C
2012-12-01
Are there differences in the methodological quality of Cochrane systematic reviews (CRs) and non-Cochrane systematic reviews (NCRs) of assisted reproductive technologies? CRs on assisted reproduction are of higher methodological quality than similar reviews published in other journals. The quality of systematic reviews varies. This was a cross-sectional study of 30 CR and 30 NCR systematic reviews that were randomly selected from the eligible reviews identified from a literature search for the years 2007-2011. We extracted data on the reporting and methodological characteristics of the included systematic reviews. We assessed the methodological quality of the reviews using the 11-domain Measurement Tool to Assess the Methodological Quality of Systematic Reviews (AMSTAR) tool and subsequently compared CR and NCR systematic reviews. The AMSTAR quality assessment found that CRs were superior to NCRs. For 10 of 11 AMSTAR domains, the requirements were met in >50% of CRs, but only 4 of 11 domains showed requirements being met in >50% of NCRs. The strengths of CRs are the a priori study design, comprehensive literature search, explicit lists of included and excluded studies and assessments of internal validity. Significant failings in the CRs were found in duplicate study selection and data extraction (67% meeting requirements), assessment for publication bias (53% meeting requirements) and reporting of conflicts of interest (47% meeting requirements). NCRs were more likely to contain methodological weaknesses as the majority of the domains showed <40% of reviews meeting requirements, e.g. a priori study design (17%), duplicate study selection and data extraction (17%), assessment of study quality (27%), study quality in the formulation of conclusions (23%) and reporting of conflict of interests (10%). The AMSTAR assessment can only judge what is reported by authors. Although two of the five authors are involved in the production of CRs, the risk of bias was reduced by not involving these authors in the assessment of the systematic review quality. Not all systematic reviews are equal. The reader needs to consider the quality of the systematic review when they consider the results and the conclusions of a systematic review. There are no conflicts with any commercial organization. Funding was provided for the students by the summer studentship programme of the Faculty of Medical and Health Sciences of the University of Auckland.
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Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met?
Dunlop, Dorothy D; Song, Jing; Semanik, Pamela A; Chang, Rowland W; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Hootman, Jennifer M
2011-11-01
Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity, but objective information about the physical activity of this population is lacking. The aim of this study was to objectively measure levels of physical activity in adults with knee OA and report the prevalence of meeting public health physical activity guidelines. Cross-sectional accelerometry data from 1,111 adults with radiographic knee OA (49-84 years old) participating in the Osteoarthritis Initiative accelerometry monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week moderate-to-vigorous-intensity activity lasting ≥10 minutes). Quantile regression was used to test median sex differences in physical activity levels. Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial proportion of men and women (40.1% and 56.5%, respectively) were inactive, having done no moderate-to-vigorous activity that lasted 10 minutes or more during the 7 days. Although men engaged in significantly more moderate-to-vigorous activity (average daily minutes 20.7 versus 12.3), they also spent more time in no or very-low-intensity activity than women (average daily minutes 608.2 versus 585.8). Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometry monitoring. The proportions of men and women who met public health physical activity guidelines were substantially less than those previously reported based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among people with knee OA. Copyright © 2011 by the American College of Rheumatology.
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The purpose of this report is to describe the outputs of the Data Quality Objectives (DQOs) Process and discussions about developing a statistical design that will be used to implement the research study of recreational beach waters.
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Hofmann, Julia; Kien, Christina; Gartlehner, Gerald
2015-01-01
Evidence-based information materials about the pros and cons of cancer screening are important sources for men and women to decide for or against cancer screening. The aim of this paper was to compare recommendations from different cancer institutions in German-speaking countries (Austria, Germany, and Switzerland) regarding screening for breast, cervix, colon, and prostate cancer and to assess the quality and development process of patient information materials. Relevant information material was identified through web searches and personal contact with cancer institutions. To achieve our objective, we employed a qualitative approach. The quality of 22 patient information materials was analysed based on established guidance by Bunge et al. In addition, we conducted guided interviews about the process of developing information materials with decision-makers of cancer institutes. Overall, major discrepancies in cancer screening recommendations exist among the Austrian, German, and Swiss cancer institutes. Process evaluation revealed that crucial steps of quality assurance, such as assembling a multi-disciplinary panel, assessing conflicts of interest, or transparency regarding funding sources, have frequently not been undertaken. All information materials had substantial quality deficits in multiple areas. Three out of four institutes issued information materials that met fewer than half of the quality criteria. Most patient information materials of cancer institutes in German-speaking countries are fraught with substantial deficits and do not provide an objective source for patients to be able to make an informed decision for or against cancer screening. Copyright © 2015. Published by Elsevier GmbH.
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Sultan, Sadia; Zaheer, Hasan Abbas; Waheed, Usman; Baig, Mohammad Amjad; Rehan, Asma; Irfan, Syed Mohammed
2018-01-01
Internal quality control (IQC) is the backbone of quality assurance program. In blood banking, the quality control of blood products ensures the timely availability of a blood component of high quality with maximum efficacy and minimal risk to potential recipients. The main objective of this study is to analyze the IQC of blood products as an indicator of our blood bank performance. An observational cross-sectional study was conducted at the blood bank of Liaquat National Hospital and Medical College, from January 2014 to December 2015. A total of 100 units of each blood components were arbitrarily chosen during the study. Packed red cell units were evaluated for hematocrit (HCT); random platelet concentrates were evaluated for pH, yield, and culture; fresh frozen plasma (FFP) and cryoprecipitate (CP) were evaluated for unit volume, factor VIII, and fibrinogen concentrations. A total of 400 units were tested for IQC. The mean HCT of packed red cells was 69.5 ± 7.24, and in 98% units, it met the standard (<80% of HCT). The mean platelet yield was 8.8 ± 3.40 × 10 9 /L and pH was ≥6.2 in 98% bags; cultures were negative in 97% of units tested. Mean factor VIII and fibrinogen levels were found to be 84.24 ± 15.01 and 247.17 ± 49.69 for FFP, respectively. For CP, mean factor VIII and fibrinogen level were found to be 178.75 ± 86.30 and 420.7 ± 75.32, respectively. The IQC of blood products at our blood bank is in overall compliance and met recommended international standards. Implementation of standard operating procedures, accomplishment of standard guidelines, proper documentation with regular audit, and staff competencies can improve the quality performance of the transfusion services.
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Kohrt, Brandon A; Rasmussen, Andrew; Kaiser, Bonnie N; Haroz, Emily E; Maharjan, Sujen M; Mutamba, Byamah B; de Jong, Joop TVM; Hinton, Devon E
2014-01-01
Background Burgeoning global mental health endeavors have renewed debates about cultural applicability of psychiatric categories. This study’s goal is to review strengths and limitations of literature comparing psychiatric categories with cultural concepts of distress (CCD) such as cultural syndromes, culture-bound syndromes, and idioms of distress. Methods The Systematic Assessment of Quality in Observational Research (SAQOR) was adapted based on cultural psychiatry principles to develop a Cultural Psychiatry Epidemiology version (SAQOR-CPE), which was used to rate quality of quantitative studies comparing CCD and psychiatric categories. A meta-analysis was performed for each psychiatric category. Results Forty-five studies met inclusion criteria, with 18 782 unique participants. Primary objectives of the studies included comparing CCD and psychiatric disorders (51%), assessing risk factors for CCD (18%) and instrument validation (16%). Only 27% of studies met SAQOR-CPE criteria for medium quality, with the remainder low or very low quality. Only 29% of studies employed representative samples, 53% used validated outcome measures, 44% included function assessments and 44% controlled for confounding. Meta-analyses for anxiety, depression, PTSD and somatization revealed high heterogeneity (I2 > 75%). Only general psychological distress had low heterogeneity (I2 = 8%) with a summary effect odds ratio of 5.39 (95% CI 4.71-6.17). Associations between CCD and psychiatric disorders were influenced by methodological issues, such as validation designs (β = 16.27, 95%CI 12.75-19.79) and use of CCD multi-item checklists (β = 6.10, 95%CI 1.89-10.31). Higher quality studies demonstrated weaker associations of CCD and psychiatric disorders. Conclusions Cultural concepts of distress are not inherently unamenable to epidemiological study. However, poor study quality impedes conceptual advancement and service application. With improved study design and reporting using guidelines such as the SAQOR-CPE, CCD research can enhance detection of mental health problems, reduce cultural biases in diagnostic criteria and increase cultural salience of intervention trial outcomes. PMID:24366490
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Assessment of the quality of medication information for patients in Spain.
Mira, José Joaquín; Lorenzo, Susana; Pérez-Jover, Virtudes; Navarro, Isabel; Martín de Rosales, Ana María; Lara, Catalina
2013-01-01
To analyze the extent to which Spanish leaflets and drug information on the Net met quality criteria. A descriptive study was conducted comparing readability (REA) and comprehensibility (COM) criteria of a random sample of 77 marketed products of the 12 active ingredients most frequently sold in 2010 in Spain. Leaflets were approved by the Spanish Agency for Medication (AEMPS). Flesch index, DISCERN, ELF, MIDAS and CIRF scales were used to evaluate quality criteria. COM assessment yielded between 63 and 77% of the maximum possible scores on the scales. None of the websites or leaflets met all the quality criteria of the DISCERN, CIRF or MIDAS scales. Four (3%) leaflets met all the 22 quality criteria of ELF. The leaflets showed shortcomings regarding: medication benefits (17 required substantial improvements, 31.5%), correct forms of storage (13, 24.1%), contraindications (12, 22.2%), side effects (11, 20.4%) and precautions to be taken (9, 16.7%). The quality of the information approved by the AEMPS is superior to that which can be found by surfing the Net. More specific information on precautions, complications and how to avoid common patient errors would allow patients the best chance to contribute to their own clinical safety.
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Long-term topical corticosteroid use and risk of skin cancer: a systematic review.
Ratib, Sonia; Burden-Teh, Esther; Leonardi-Bee, Jo; Harwood, Catherine; Bath-Hextall, Fiona
2018-06-01
The objective of this systematic review was to synthesize available research evidence to determine the risk of skin cancer in patients with long-term use of topical corticosteroids (TCS). Topical corticosteroids are one of the most commonly prescribed medicines in dermatology and the mainstay of the treatment of atopic dermatitis and other skin conditions such as psoriasis. They are often required for months or years to control the disease and ultimately restore patients' quality of life. In some patients, TCS may have a local immunosuppressive effect and theoretically increase the risk of skin cancer, whilst on the other hand TCS may decrease the risk of skin cancer in patients where TCS are used to treat inflammatory skin disease. To date, no systematic review has been performed to collate evidence on the effect of long-term TCS use on the risk of skin cancer. This review considered studies that included people of all ages, genders and ethnicities, including HIV and transplant participants or participants with genetic diseases (for example, Gorlin-Goltz syndrome) This review considered studies that evaluated long-term use of topical corticosteroids. "Long-term" was defined as using TCS more than once a week for a month or longer. The review included cohort, cross-sectional and case-control observational studies exploring the association between the stated intervention and outcomes. The primary outcome measures of interest were: non-melanoma skin cancer (keratinocyte carcinoma), cutaneous squamous cell carcinoma (cSSC), basal cell carcinoma (BCC) or melanoma skin cancer. Genital and oral skin cancers are considered to be slightly different so we did not include them in this review. We performed a comprehensive search of MEDLINE, Embase and LILACS on November 9, 2017 to identify observational epidemiological studies assessing the association between long-term TCS use and skin cancer. We also searched EThOS at the British Library and three drug safety databases to identify unpublished work. The titles, abstracts and full text identified from the search were assessed independently by two authors against pre-specified inclusion/exclusion criteria. Methodological quality was not assessed as no articles were found which met the inclusion criteria. Data extraction was not possible as no articles were found which met the inclusion criteria. It was not possible to complete data synthesis as no articles were found which met the inclusion criteria. A total of 1703 potentially relevant studies were identified following a comprehensive electronic search. After abstract and title screening, 51 full texts were assessed for eligibility criteria. Of these, no study met the inclusion criteria. No additional records were identified from searching unpublished literature. We did not find any studies that could help us establish if long-term TCS use is associated with skin cancer. Future research using primary care databases might give a better understanding regarding long-term use of TCS and skin cancer.
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Muscat, Priscilla; Chilcot, Joseph; Weinman, John; Hudson, Joanna
2018-05-27
The prevalence of depression is found to increase from early stages to later stages of chronic kidney disease. Research on illness perceptions in patients undergoing dialysis has confirmed that patients' beliefs are associated with important outcomes; one of the most significant being depression. However, the association between illness perceptions and depression in patients in pre-dialysis care remains unclear. The main objective of this systematic review was to explore the associative relationship between illness perceptions and depression in patients with CKD prior to the commencement of dialysis. The inclusion criteria for papers in this review were studies investigating illness perceptions and depression in patients diagnosed with CKD. Eligible studies were identified by searching the following electronic databases; Medline, CENTRAL, Embase, Psych INFO, Web of Science and Scopus. Data on the participants and the severity of kidney disease, illness perceptions and depression were extracted. Sixty-four studies met the criteria for full text review and of these, only four studies met the inclusion criteria following data extraction and quality assessment. Consistent with the common sense model, disease severity was found to be significantly associated with illness perceptions, and both were found to be associated with depression CONCLUSIONS: The results from this review provide further evidence that the illness perceptions and disease severity play a crucial role in the adaption to CKD. This review highlights the lack of research in this area and concludes that more studies are needed to determine the nature and impact of illness perceptions in relation to depression in pre-dialysis CKD. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.
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Sabharwal, Sanjeeve; Carter, Alexander; Darzi, Lord Ara; Reilly, Peter; Gupte, Chinmay M
2015-06-01
Approximately 76,000 people a year sustain a hip fracture in the UK and the estimated cost to the NHS is £1.4 billion a year. Health economic evaluations (HEEs) are one of the methods employed by decision makers to deliver healthcare policy supported by clinical and economic evidence. The objective of this study was to (1) identify and characterize HEEs for the management of patients with hip fractures, and (2) examine their methodological quality. A literature search was performed in MEDLINE, EMBASE and the NHS Economic Evaluation Database. Studies that met the specified definition for a HEE and evaluated hip fracture management were included. Methodological quality was assessed using the Consensus on Health Economic Criteria (CHEC). Twenty-seven publications met the inclusion criteria of this study and were included in our descriptive and methodological analysis. Domains of methodology that performed poorly included use of an appropriate time horizon (66.7% of studies), incremental analysis of costs and outcomes (63%), future discounting (44.4%), sensitivity analysis (40.7%), declaration of conflicts of interest (37%) and discussion of ethical considerations (29.6%). HEEs for patients with hip fractures are increasing in publication in recent years. Most of these studies fail to adopt a societal perspective and key aspects of their methodology are poor. The development of future HEEs in this field must adhere to established principles of methodology, so that better quality research can be used to inform health policy on the management of patients with a hip fracture. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
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Qualification of an Acceptable Alternative to Halon 1211 DOD Flightline Extinguishers
2008-09-01
Minimum Performance Standard MSDS Material Safety Data Sheet NATO North Atlantic Treaty Organization NAWCAD Naval Air Warfare Center Aircraft...included chronic and acute occupational exposure limits and cardiotoxicity. Alternatives that were carcinogens or that had any adverse developmental...gear to fight the fires Does not exceed pain threshold for exposed skin Each unit tested met this performance objective 2. Firefighting
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ERIC Educational Resources Information Center
Kratochvil, Christopher J.; Wilens, Timothy E.; Greenhill, Laurence L.; Gao, Haitao; Baker, Kurt D.; Feldman, Peter D.; Gelowitz, Douglas L.
2006-01-01
Objective: The purpose of this 13-study (seven double-blind/placebo-controlled, six open-label) meta-analysis is to determine the effectiveness and tolerability of long-term atomoxetine treatment among young children with attention-deficit/hyperactivity disorder (ADHD). Method: Data were pooled from 6- and 7-year-olds (N = 272) who met DSM-IV…
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Software IV and V Research Priorities and Applied Program Accomplishments Within NASA
NASA Technical Reports Server (NTRS)
Blazy, Louis J.
2000-01-01
The mission of this research is to be world-class creators and facilitators of innovative, intelligent, high performance, reliable information technologies that enable NASA missions to (1) increase software safety and quality through error avoidance, early detection and resolution of errors, by utilizing and applying empirically based software engineering best practices; (2) ensure customer software risks are identified and/or that requirements are met and/or exceeded; (3) research, develop, apply, verify, and publish software technologies for competitive advantage and the advancement of science; and (4) facilitate the transfer of science and engineering data, methods, and practices to NASA, educational institutions, state agencies, and commercial organizations. The goals are to become a national Center Of Excellence (COE) in software and system independent verification and validation, and to become an international leading force in the field of software engineering for improving the safety, quality, reliability, and cost performance of software systems. This project addresses the following problems: Ensure safety of NASA missions, ensure requirements are met, minimize programmatic and technological risks of software development and operations, improve software quality, reduce costs and time to delivery, and improve the science of software engineering
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Lau, Patrick W C; Lau, Erica Y; Wong, Del P; Ransdell, Lynda
2011-07-13
A growing body of research has employed information and communication technologies (ICTs) such as the Internet and mobile phones for disseminating physical activity (PA) interventions with young populations. Although several systematic reviews have documented the effects of ICT-based interventions on PA behavior, very few have focused on children and adolescents specifically. The present review aimed to systematically evaluate the efficacy and methodological quality of ICT-based PA interventions for children and adolescents based on evidence from randomized controlled trials. Electronic databases Medline, PsycInfo, CINAHL, and Web of Science were searched to retrieve English language articles published in international academic peer-reviewed journals from January 1, 1997, through December 31, 2009. Included were articles that provided descriptions of interventions designed to improve PA-related cognitive, psychosocial, and behavioral outcomes and that used randomized controlled trial design, included only children (6-12 years old) and adolescents (13-18 years old) in both intervention and control groups, and employed Internet, email, and/or short message services (SMS, also known as text messaging) as one or more major or assistive modes to deliver the intervention. In total, 9 studies were analyzed in the present review. All studies were published after 2000 and conducted in Western countries. Of the 9 studies, 7 demonstrated positive and significant within-group differences in at least one psychosocial or behavioral PA outcome. In all, 3 studies reported positive and significant between-group differences favoring the ICT group. When between-group differences were compared across studies, effect sizes were small in 6 studies and large in 3 studies. With respect to methodological quality, 7 of the 9 studies had good methodological quality. Failure to report allocation concealment, blinding to outcome assessment, and lack of long-term follow-up were the criteria met by the fewest studies. In addition, 5 studies measured the intervention exposure rate and only 1 study employed objective measures to record data. The present review provides evidence supporting the positive effects of ICTs in PA interventions for children and adolescents, especially when used with other delivery approaches (ie, face-to-face). Because ICT delivery approaches are often mixed with other approaches and these studies sometimes lack a comparable control group, additional research is needed to establish the true independent effects of ICT as an intervention delivery mode. Although two-thirds of the studies demonstrated satisfactory methodological quality, several quality criteria should be considered in future studies: clear descriptions of allocation concealment and blinding of outcome assessment, extension of intervention duration, and employment of objective measures in intervention exposure rate. Due to the small number of studies that met inclusion criteria and the lack of consistent evidence, researchers should be cautious when interpreting the findings of the present review.
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Woodford Guegan, Eleanor; Cook, Andrew
2014-06-01
The European network for Health Technology Assessment Joint Action (EUnetHTA JA) project's overarching objective was to 'establish an effective and sustainable HTA [Health technology assessment] collaboration in Europe that brings added value at the regional, national and European level'. Specific objectives were to develop a strategy and business model for sustainable European collaboration on HTA, develop HTA tools and methods and promote good practice in HTA methods and processes. We describe activities performed on behalf of the National Institute for Health Research HTA programme; evaluating the project processes and developing a data set for a registry of planned clinical studies of relevance to public funders. Annual self-completion online questionnaires were sent to project participants and external stakeholders to identify their views about the project processes. Documentary review was undertaken at the project end on the final technical reports from the work packages to examine whether or not their deliverables had been achieved. The project's impact was assessed by whether or not the deliverables were produced, the objectives met and additional 'added value' generated. The project's effectiveness was evaluated by its processes, communication, administration, workings of individual work packages and involvement of external stakeholders. A two-stage Delphi exercise was undertaken to identify the data elements that should be included in a registry of planned clinical studies of relevance to public funders. The data set was validated by an efficacy testing exercise. High response rates were achieved for the questionnaires sent to project participants and this was attributed to the evidence-based strategy implemented. Response rates to questionnaires sent to external stakeholders were disappointingly lower. Most of the high-level objectives were achieved, although applying the developed tools in practice will be implemented in the European network for Health Technology Assessment Joint Action 2 (EUnetHTA JA2). Most work packages produced their planned deliverables. Networking emerged as one of the main benefits of the project and face-to-face meetings were important. However, the overarching objective did not appear to have been met because there will be a follow-up EUnetHTA JA2 project (reliant on project funding) before the establishment of any permanent network. Twelve organisations from three continents participated in the Delphi exercise to develop the data set. It was demonstrated that a registry for matching pragmatic clinical studies under consideration by funders could be built on a very small data set. This would include 10 unique items, of which five are required to describe a study and the rest are metadata. In the test sample the data set with an appropriate matching rule was able to deliver a sensitivity of between 50% and 100% and a specificity of between 43% and 86% for matching different elements. A number of recommendations have been made for the next EUnetHTA JA2 project and its evaluation. This included that the evaluation of the EUnetHTA JA2 project should extend beyond the end of the project to allow assessment of its impact; that the quality, usability and cost-effectiveness of tools in 'real-world HTA practice' should be assessed and tangible benefits of international networking should be evaluated. It is worth proceeding to develop a database registry aimed at identifying trials in development based on the data set developed. The study was funded by the National Institute for Health Research Health Technology Assessment programme (50%) and the European Union Commission (50%).
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Woodford Guegan, Eleanor; Cook, Andrew
2014-01-01
BACKGROUND The European network for Health Technology Assessment Joint Action (EUnetHTA JA) project's overarching objective was to 'establish an effective and sustainable HTA [Health technology assessment] collaboration in Europe that brings added value at the regional, national and European level'. Specific objectives were to develop a strategy and business model for sustainable European collaboration on HTA, develop HTA tools and methods and promote good practice in HTA methods and processes. We describe activities performed on behalf of the National Institute for Health Research HTA programme; evaluating the project processes and developing a data set for a registry of planned clinical studies of relevance to public funders. METHODS Annual self-completion online questionnaires were sent to project participants and external stakeholders to identify their views about the project processes. Documentary review was undertaken at the project end on the final technical reports from the work packages to examine whether or not their deliverables had been achieved. The project's impact was assessed by whether or not the deliverables were produced, the objectives met and additional 'added value' generated. The project's effectiveness was evaluated by its processes, communication, administration, workings of individual work packages and involvement of external stakeholders. A two-stage Delphi exercise was undertaken to identify the data elements that should be included in a registry of planned clinical studies of relevance to public funders. The data set was validated by an efficacy testing exercise. RESULTS AND DISCUSSION High response rates were achieved for the questionnaires sent to project participants and this was attributed to the evidence-based strategy implemented. Response rates to questionnaires sent to external stakeholders were disappointingly lower. Most of the high-level objectives were achieved, although applying the developed tools in practice will be implemented in the European network for Health Technology Assessment Joint Action 2 (EUnetHTA JA2). Most work packages produced their planned deliverables. Networking emerged as one of the main benefits of the project and face-to-face meetings were important. However, the overarching objective did not appear to have been met because there will be a follow-up EUnetHTA JA2 project (reliant on project funding) before the establishment of any permanent network. Twelve organisations from three continents participated in the Delphi exercise to develop the data set. It was demonstrated that a registry for matching pragmatic clinical studies under consideration by funders could be built on a very small data set. This would include 10 unique items, of which five are required to describe a study and the rest are metadata. In the test sample the data set with an appropriate matching rule was able to deliver a sensitivity of between 50% and 100% and a specificity of between 43% and 86% for matching different elements. CONCLUSIONS A number of recommendations have been made for the next EUnetHTA JA2 project and its evaluation. This included that the evaluation of the EUnetHTA JA2 project should extend beyond the end of the project to allow assessment of its impact; that the quality, usability and cost-effectiveness of tools in 'real-world HTA practice' should be assessed and tangible benefits of international networking should be evaluated. It is worth proceeding to develop a database registry aimed at identifying trials in development based on the data set developed. FUNDING The study was funded by the National Institute for Health Research Health Technology Assessment programme (50%) and the European Union Commission (50%). PMID:24913263
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DOT National Transportation Integrated Search
2008-06-01
This paper looks at the issue of data quality within the context of transportation operations and management. The objective of this paper is to investigate data quality measures and how they are applied in existing systems. This paper explores the re...
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Wyatt, Laura C.; Kranick, Julie A.; Islam, Nadia S.; Devia, Carlos; Horowitz, Carol; Trinh-Shevrin, Chau
2015-01-01
Objectives. We explored the relationship between health-related quality of life (HRQOL) and adequate physical activity (PA) and fruit and vegetable (F&V) intake among racial/ethnic minority groups aged 60 years or older living in New York City (NYC). Methods. Survey data from 2009 to 2012 targeted minority groups in NYC ethnic enclaves; we analyzed 3594 individuals (Blacks, Hispanics, and Chinese) aged 60 years or older. Descriptive statistics were run; unadjusted and adjusted logistic regression evaluated the relationship of HRQOL with PA and F&V intake. Results. Hispanics were most likely to engage in sufficient PA and eat recommended F&Vs and had significantly worse HRQOL. After multivariable adjustment, significant associations were found between PA and self-reported health, activity limitation and physical health days for all groups, and PA and mental health days for Hispanics. Significant associations were found between F&V intake and physical health days for Hispanics and F&V intake and self-reported health for Chinese. Conclusions. Findings indicated variations between HRQOL and PA by racial/ethnic subgroup. Despite being highly insured, recommendations for PA and F&V intake were not met. There is a need to promote healthy living behaviors among aging NYC racial/ethnic populations. PMID:25905844
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Cost and Cost-Effectiveness of the Mediterranean Diet: Results of a Systematic Review
Saulle, Rosella; Semyonov, Leda; La Torre, Giuseppe
2013-01-01
The growing impact of chronic degenerative pathologies (such as cardiovascular disease, type 2 diabetes and Alzheimer’s disease) requires and pushes towards the development of new preventive strategies to reduce the incidence and prevalence of these diseases. Lifestyle changes, especially related to the Mediterranean diet, have the potential to modify disease outcomes and ultimately costs related to their management. The objective of the study was to perform a systematic review of the scientific literature, to gauge the economic performance and the cost-effectiveness of the adherence to the Mediterranean diet as a prevention strategy against degenerative pathologies. We investigated the monetary costs of adopting Mediterranean dietary patterns by determining cost differences between low and high adherence. Research was conducted using the PubMed and Scopus databases. Eight articles met the pre-determined inclusion criteria and were reviewed. Quality assessment and data extraction was performed. The adherence to the Mediterranean diet has been extensively reported to be associated with a favorable health outcome and a better quality of life. The implementation of a Mediterranean dietary pattern may lead to the prevention of degenerative pathologies and to an improvement in life expectancy, a net gain in health and a reduction in total lifetime costs. PMID:24253053
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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
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LaKind, Judy S; Anthony, Laura G; Goodman, Michael
2017-01-01
Environmental epidemiology data are becoming increasingly important in public health decision making, which commonly incorporates a systematic review of multiple studies. This review addresses two fundamental questions: What is the quality of available reviews on associations between exposure to synthetic organic chemicals and neurodevelopmental outcomes? What is the value (e.g., quality and consistency) of the underlying literature? Published reviews on associations between synthetic organic environmental chemical exposures and neurodevelopmental outcomes in children were systematically evaluated. Seventy-four relevant reviews were identified, and these were evaluated with respect to four methodological characteristics: (1) systematic inclusion/exclusion criteria and reproducible methods for search and retrieval of studies; (2) structured evaluation of underlying data quality; (3) systematic assessment of consistency across specific exposure-outcome associations; and (4) evaluation of reporting/publication bias. None of the 74 reviews fully met the criteria for all four methodological characteristics. Only four reviews met two criteria, and six reviews fulfilled only one criterion. Perhaps more importantly, the higher quality reviews were not able to meet all of the criteria owing to the shortcomings of underlying studies, which lacked comparability in terms of specific research question of interest, overall design, exposure assessment, outcome ascertainment, and analytic methods. Thus, even the most thoughtful and rigorous review may be of limited value if the underlying literature includes investigations that address different hypotheses and are beset by methodological inconsistencies and limitations. Issues identified in this review of reviews illustrate considerable challenges that are facing assessments of epidemiological evidence.
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Design and analytical study of a rotor airfoil
NASA Technical Reports Server (NTRS)
Dadone, L. U.
1978-01-01
An airfoil section for use on helicopter rotor blades was defined and analyzed by means of potential flow/boundary layer interaction and viscous transonic flow methods to meet as closely as possible a set of advanced airfoil design objectives. The design efforts showed that the first priority objectives, including selected low speed pitching moment, maximum lift and drag divergence requirements can be met, though marginally. The maximum lift requirement at M = 0.5 and most of the profile drag objectives cannot be met without some compromise of at least one of the higher order priorities.
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MetNH3: Metrology for ammonia in ambient air
NASA Astrophysics Data System (ADS)
Braban, Christine; Twigg, Marsailidh; Tang, Sim; Leuenberger, Daiana; Ferracci, Valerio; Martin, Nick; Pascale, Celine; Hieta, Tuomas; Pogany, Andrea; Persijn, Stefan; van Wijk, Janneke; Gerwig, Holger; Wirtze, Klaus; Tiebe, Carlo; Balslev-Harder, David; Niederhausen, Bernhardt
2015-04-01
Measuring ammonia in ambient air is a sensitive and priority issue due to its harmful effects on human health and ecosystems. The European Directive 2001/81/EC on 'National Emission Ceilings for Certain Atmospheric Pollutants (NEC)' regulates ammonia emissions in the member states. However, there is a lack of regulation to ensure reliable ammonia measurements namely in applicable analytical technology, maximum allowed uncertainty, quality assurance and quality control (QC/QA) procedures as well as in the infrastructure to attain metrological traceability. Validated ammonia measurement data of high quality from air monitoring networks are vitally important for identifying changes due to implementations of environment policies, for understanding where the uncertainties in current emission inventories are derived from and for providing independent verification of atmospheric model predictions. The new EURAMET project MetNH3 aims to develop improved reference gas mixtures by static and dynamic gravimetric generation methods, develop and characterise laser based optical spectrometric standards and establish the transfer from high-accuracy standards to field applicable methods. MetNH3started in June 2014 and in this presentation the first results from the metrological characterisation of a commercially available cavity ring-down spectrometer (CRDS) will be discussed. Also first tests and results from a new design, Controlled Atmosphere Test Facility (CATFAC), which is to be characterised and used to validate the performance of diffusive samplers, denuders and on-line instruments, will be reported. CAFTEC can be used to control test parameters such as ammonia concentration, relative humidity and wind speed. Outline plans for international laboratory and field intercomparisons in 2016 will be presented.
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Evaluation of outsourcing in nursing services: a case study of kashani hospital, isfahan in 2011.
Ferdosi, Masoud; Farahabadi, Ehsan; Mofid, Maryam; Rejalian, Farzaneh; Haghighat, Maryam; Naghdi, Parnaz
2013-03-01
Hospitals need to focus on their core activities, thus outsourcing of services may be effective in some instances. However, monitoring and supervision is a vital mechanism to preserving and enhancing the quality of outsourced services, and to identify the benefits and losses occurred. The purpose of this study is evaluation of nursing services outsourced in a general hospital from different point of views. This is a descriptive and applied study done by case study (before and after) method. Outsourcing nursing services of clinical wards (ENT and Neurosurgery) of Kashani Hospital in 2011 has been studied. We extracted data from a handmade questionnaire about internal customer's satisfaction and semi-structured interviews with officials, and also survey of financial and administrative documents and records related to the topic. The findings indicate an increased number of graduated nurses per bed to fulfill the main objective of outsourcing in this case. But achieving this objective is accompanied with remarkable increased costs per bed after outsourcing. Besides, we noticed minor changes in internal customer satisfaction rate. While outsourcing should bring about staff and patients' satisfaction and increase the efficiency and effectiveness, outsourcing nursing workforce singly, leaded to a loss of efficiency. Therefore, the applied outsourcing has not met the productivity for the hospital.
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Evaluation of Outsourcing in Nursing Services: A Case Study of Kashani Hospital, Isfahan in 2011
Ferdosi, Masoud; Farahabadi, Ehsan; Mofid, Maryam; Rejalian, Farzaneh; Haghighat, Maryam; Naghdi, Parnaz
2013-01-01
Background: Hospitals need to focus on their core activities, thus outsourcing of services may be effective in some instances. However, monitoring and supervision is a vital mechanism to preserving and enhancing the quality of outsourced services, and to identify the benefits and losses occurred. The purpose of this study is evaluation of nursing services outsourced in a general hospital from different point of views. Methods: This is a descriptive and applied study done by case study (before and after) method. Outsourcing nursing services of clinical wards (ENT and Neurosurgery) of Kashani Hospital in 2011 has been studied. We extracted data from a handmade questionnaire about internal customer’s satisfaction and semi-structured interviews with officials, and also survey of financial and administrative documents and records related to the topic. Results: The findings indicate an increased number of graduated nurses per bed to fulfill the main objective of outsourcing in this case. But achieving this objective is accompanied with remarkable increased costs per bed after outsourcing. Besides, we noticed minor changes in internal customer satisfaction rate. Conclusion: While outsourcing should bring about staff and patients’ satisfaction and increase the efficiency and effectiveness, outsourcing nursing workforce singly, leaded to a loss of efficiency. Therefore, the applied outsourcing has not met the productivity for the hospital. PMID:23678338
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Het SOWNet Experiment (The SOWNet Experiment)
2008-07-01
dat bet energieverbruik van de EQS zenders naar aanleiding van een gem-iddelde voertuigpassage circa 5 keer zo hoog is dan die van de SOWNet-zenders...code (I byte). * Een Belief- parameter (1 byte). * Een geheugenindex (2 bytes). * Lijst met Destination ID-codes, aangevuld met nullen. vaste omvang 10...verwachting voldoende hoog is zal de node alarm slaan. Als een sensor een object detecteert (hetzij als een False Alarm, hetzij doordat een object
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Measuring physical activity during pregnancy.
Harrison, Cheryce L; Thompson, Russell G; Teede, Helena J; Lombard, Catherine B
2011-03-21
Currently, little is known about physical activity patterns in pregnancy with prior estimates predominantly based on subjective assessment measures that are prone to error. Given the increasing obesity rates and the importance of physical activity in pregnancy, we evaluated the relationship and agreement between subjective and objective physical activity assessment tools to inform researchers and clinicians on optimal assessment of physical activity in pregnancy. 48 pregnant women between 26-28 weeks gestation were recruited. The Yamax pedometer and Actigraph accelerometer were worn for 5-7 days under free living conditions and thereafter the International Physical Activity Questionnaire (IPAQ) was completed. IPAQ and pedometer estimates of activity were compared to the more robust and accurate accelerometer data. Of 48 women recruited, 30 women completed the study (mean age: 33.6 ± 4.7 years; mean BMI: 31.2 ± 5.1 kg/m(2)) and 18 were excluded (failure to wear [n = 8] and incomplete data [n = 10]). The accelerometer and pedometer correlated significantly on estimation of daily steps (ρ = 0.69, p < 0.01) and had good absolute agreement with low systematic error (mean difference: 505 ± 1498 steps/day). Accelerometer and IPAQ estimates of total, light and moderate Metabolic Equivalent minutes/day (MET min(-1) day(-1)) were not significantly correlated and there was poor absolute agreement. Relative to the accelerometer, the IPAQ under predicted daily total METs (105.76 ± 259.13 min(-1) day(-1)) and light METs (255.55 ± 128.41 min(-1) day(-1)) and over predicted moderate METs (-112.25 ± 166.41 min(-1) day(-1)). Compared with the accelerometer, the pedometer appears to provide a reliable estimate of physical activity in pregnancy, whereas the subjective IPAQ measure performed less accurately in this setting. Future research measuring activity in pregnancy should optimally encompass objective measures of physical activity. Australian New Zealand Clinical Trial Registry Number: ACTRN12608000233325. Registered 7/5/2008.
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Measuring physical activity during pregnancy
2011-01-01
Background Currently, little is known about physical activity patterns in pregnancy with prior estimates predominantly based on subjective assessment measures that are prone to error. Given the increasing obesity rates and the importance of physical activity in pregnancy, we evaluated the relationship and agreement between subjective and objective physical activity assessment tools to inform researchers and clinicians on optimal assessment of physical activity in pregnancy. Methods 48 pregnant women between 26-28 weeks gestation were recruited. The Yamax pedometer and Actigraph accelerometer were worn for 5-7 days under free living conditions and thereafter the International Physical Activity Questionnaire (IPAQ) was completed. IPAQ and pedometer estimates of activity were compared to the more robust and accurate accelerometer data. Results Of 48 women recruited, 30 women completed the study (mean age: 33.6 ± 4.7 years; mean BMI: 31.2 ± 5.1 kg/m2) and 18 were excluded (failure to wear [n = 8] and incomplete data [n = 10]). The accelerometer and pedometer correlated significantly on estimation of daily steps (ρ = 0.69, p < 0.01) and had good absolute agreement with low systematic error (mean difference: 505 ± 1498 steps/day). Accelerometer and IPAQ estimates of total, light and moderate Metabolic Equivalent minutes/day (MET min-1 day-1) were not significantly correlated and there was poor absolute agreement. Relative to the accelerometer, the IPAQ under predicted daily total METs (105.76 ± 259.13 min-1 day-1) and light METs (255.55 ± 128.41 min-1 day-1) and over predicted moderate METs (-112.25 ± 166.41 min-1 day-1). Conclusion Compared with the accelerometer, the pedometer appears to provide a reliable estimate of physical activity in pregnancy, whereas the subjective IPAQ measure performed less accurately in this setting. Future research measuring activity in pregnancy should optimally encompass objective measures of physical activity. Trial Registration Australian New Zealand Clinical Trial Registry Number: ACTRN12608000233325. Registered 7/5/2008. PMID:21418609
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The 2016 Al-Mishraq sulphur plant fire: Source and health risk area estimation
NASA Astrophysics Data System (ADS)
Björnham, Oscar; Grahn, Håkan; von Schoenberg, Pontus; Liljedahl, Birgitta; Waleij, Annica; Brännström, Niklas
2017-11-01
On October 20, 2016, Daesh (Islamic State) set fire to the sulphur production site Al-Mishraq as the battle of Mosul in northern Iraq became more intense. An extensive plume of toxic sulphur dioxide and hydrogen sulphide caused comprehensive casualties. The intensity of the SO2 release was reaching levels of minor volcanic eruptions and the plume was observed by several satellites. By investigation of the measurement data from instruments on the MetOp-A, MetOp-B, Aura and Soumi satellites we have estimated the time-dependent source term to 161 kilotonnes sulphur dioxide released into the atmosphere during seven days. A long-range dispersion model was utilized to simulate the atmospheric transport over the Middle East. The ground level concentrations predicted by the simulation were compared with observation from the Turkey National Air Quality Monitoring Network. Finally, the simulation data provided, using a probit analysis of the simulated data, an estimate of the health risk area that was compared to reported urgent medical treatments.
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Soil Moisture Active Passive (SMAP) Calibration and Validation Plan and Current Activities
NASA Technical Reports Server (NTRS)
Jackson, T. J.; Cosh, M.; Bindlish, R.; Crow, W.; Colliander, A.; Njoku, E.; McDonald, K.; Kimball, J.; Belair, S.; Walker, J.;
2010-01-01
The primary objective of the SMAP calibration and validation (Cal/Val) program is demonstrating that the science requirements (product accuracy and bias) have been met over the mission life. This begins during pre-launch with activities that contribute to high quality products and establishing post-launch validation infrastructure and continues through the mission life. However, the major focus is on a relatively short Cal/Val period following launch. The general approach and elements of the SMAP Cal/Val plan will be described and along with details on several ongoing or recent field experiments designed to address both near- and long-term Cal/Val.
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Titan/Centaur D-1TTC-5 Helios B flight data report
NASA Technical Reports Server (NTRS)
Adams, K. A.
1976-01-01
The fourth operational flight of the newest NASA unmanned launch vehicle is reported. The spacecraft was the Helios B, the second of two solar probes designed and built by the Federal Republic of Germany. The primary mission objective, to place the Helios spacecraft on a heliocentric orbit in the ecliptic plane with a perihelion distance of 0.29 AU, was successfully accomplished. After successful injection of the Helios spacecraft, a series of experiments were performed with the Centaur stage to demonstrate its operational capabilities. All objectives of the extended mission phase were successfully met. This report presents the analysis of the launch vehicle flight data for the primary mission phase of the TC-5 flight.
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Incentivizing Blood Donation: Systematic Review and Meta-Analysis to Test Titmuss’ Hypotheses
2013-01-01
Objectives: Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Method: Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. Results: The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91–1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). Conclusion: The limited evidence suggests that Titmuss’ hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PMID:24001244
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2014-01-01
Background Integrating rehabilitation services through wearable systems has the potential to accurately assess the type, intensity, duration, and quality of movement necessary for procuring key outcome measures. Objectives This review aims to explore wearable accelerometry-based technology (ABT) capable of assessing mobility-related functional activities intended for rehabilitation purposes in community settings for neurological populations. In this review, we focus on the accuracy of ABT-based methods, types of outcome measures, and the implementation of ABT in non-clinical settings for rehabilitation purposes. Data sources Cochrane, PubMed, Web of Knowledge, EMBASE, and IEEE Xplore. The search strategy covered three main areas, namely wearable technology, rehabilitation, and setting. Study selection Potentially relevant studies were categorized as systems either evaluating methods or outcome parameters. Methods Methodological qualities of studies were assessed by two customized checklists, depending on their categorization and rated independently by three blinded reviewers. Results Twelve studies involving ABT met the eligibility criteria, of which three studies were identified as having implemented ABT for rehabilitation purposes in non-clinical settings. From the twelve studies, seven studies achieved high methodological quality scores. These studies were not only capable of assessing the type, quantity, and quality measures of functional activities, but could also distinguish healthy from non-healthy subjects and/or address disease severity levels. Conclusion While many studies support ABT’s potential for telerehabilitation, few actually utilized it to assess mobility-related functional activities outside laboratory settings. To generate more appropriate outcome measures, there is a clear need to translate research findings and novel methods into practice. PMID:24625308
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A ground-water-quality monitoring program for Nevada
Nowlin, Jon O.
1986-01-01
A program was designed for the systematic monitoring of ground-water quality in Nevada. Basic hydrologic and water-quality principles are discussed in the formulation of a rational approach to developing a statewide monitoring program. A review of ground-water monitoring efforts in Nevada through 1977 indicates that few requirements for an effective statewide program are being met. A suggested program has been developed that consists of five major elements: (1) A Background-Quality Network to assess the existing water quality in Nevada aquifers, (2) a Contamination Source Inventory of known or potential threats to ground-water quality, (3) Surveillance Networks to monitor ground-water quality in selected hydrographic areas, (4) Intensive Surveys of individual instances of known or potential ground-water contamination, and (5) Ground-Water Data File to manage data generated by the other monitoring elements. Two indices have been developed to help assign rational priorities for monitoring ground water in the 255 hydrographic areas of Nevada: (1) A Hydrographic-Area Priority Index for surveillance monitoring, and (2) A Development-Potential Index for background monitoring of areas with little or no current development. Requirements for efficient management of data from ground-water monitoring are discussed and the three major systems containing Nevada ground-water data are reviewed. More than 11,000 chemical analyses of ground water have been acquired from existing systems and incorporated into a prototype data base.
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Sleep positioning systems for children with cerebral palsy.
Blake, Sharon F; Logan, Stuart; Humphreys, Ginny; Matthews, Justin; Rogers, Morwenna; Thompson-Coon, Joanna; Wyatt, Katrina; Morris, Christopher
2015-01-01
Sleep positioning systems can be prescribed for children with cerebral palsy to help reduce or prevent hip migration, provide comfort to ease pain and/or improve sleep. As sleep disturbance is common in children with developmental disabilities, with impact on their carers' sleep, and as sleep positioning systems can be expensive, guidance is needed to support decisions as to their use. To determine whether commercially-available sleep positioning systems, compared with usual care, reduce or prevent hip migration in children with cerebral palsy. Any negative effect of sleep positioning systems on hip migration will be considered within this objective.Secondary objectives were to determine the effect of sleep positioning systems on: (1) number or frequency of hip problems; (2) sleep patterns and quality; (3) quality of life of the child and family; (4) pain; and (5) physical functioning. We also sought to identify any adverse effects from using sleep positioning systems. In December 2014, we searched CENTRAL, Ovid MEDLINE, Embase, and 13 other databases. We also searched two trials registers. We applied no restrictions on date of publication, language, publication status or study design. We checked references and contacted manufacturers and authors for potentially relevant literature, and searched the internet using Google. We included all randomised controlled trials (RCTs) evaluating whole body sleep positioning systems for children and adolescents (up to 18 years of age) with cerebral palsy. Two review authors independently screened reports retrieved from the search against pre-determined inclusion criteria and assessed the quality of eligible studies.Members of the public (parent carers of children with neurodisability) contributed to this review by suggesting the topic, refining the research objectives, interpreting the findings, and reviewing the plain language summary. We did not identify any randomised controlled trials that evaluated the effectiveness of sleep positioning systems on hip migration.We did find two randomised cross-over trials that met the inclusion criteria in respect of secondary objectives relating to sleep quality and pain. Neither study reported any important difference between sleeping in sleep positioning systems and not for sleep patterns or sleep quality (two studies, 21 children, very low quality evidence) and pain (one study, 11 children, very low quality evidence). These were small studies with established users of sleep positioning systems and were judged to have high risk of bias.We found no eligible trials that explored the other secondary objectives (number or frequency of hip problems, quality of life of the child and family, physical functioning, and adverse effects). We found no randomised trials that evaluated the effectiveness of sleep positioning systems to reduce or prevent hip migration in children with cerebral palsy. Nor did we find any randomised trials that evaluated the effect of sleep positioning systems on the number or frequency of hip problems, quality of life of the child and family or on physical functioning.Limited data from two randomised trials, which evaluated the effectiveness of sleep positioning systems on sleep quality and pain for children with cerebral palsy, showed no significant differences in these aspects of health when children were using and not using a sleep positioning system.In order to inform clinical decision-making and the prescription of sleep positioning systems, more rigorous research is needed to determine effectiveness, cost-effectiveness, and the likelihood of adverse effects.
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Automated ground-water monitoring with Robowell: case studies and potential applications
NASA Astrophysics Data System (ADS)
Granato, Gregory E.; Smith, Kirk P.
2002-02-01
Robowell is an automated system and method for monitoring ground-water quality. Robowell meets accepted manual- sampling protocols without high labor and laboratory costs. Robowell periodically monitors and records water-quality properties and constituents in ground water by pumping a well or multilevel sampler until one or more purge criteria have been met. A record of frequent water-quality measurements from a monitoring site can indicate changes in ground-water quality and can provide a context for the interpretation of laboratory data from discrete samples. Robowell also can communicate data and system performance through a remote communication link. Remote access to ground-water data enables the user to monitor conditions and optimize manual sampling efforts. Six Robowell prototypes have successfully monitored ground-water quality during all four seasons of the year under different hydrogeologic conditions, well designs, and geochemical environments. The U.S. Geological Survey is seeking partners for research with robust and economical water-quality monitoring instruments designed to measure contaminants of concern in conjunction with the application and commercialization of the Robowell technology. Project publications and information about technology transfer opportunities are available on the Internet at URL http://ma.water.usgs.gov/automon/
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Automated ground-water monitoring with robowell-Case studies and potential applications
Granato, G.E.; Smith, K.P.; ,
2001-01-01
Robowell is an automated system and method for monitoring ground-water quality. Robowell meets accepted manual-sampling protocols without high labor and laboratory costs. Robowell periodically monitors and records water-quality properties and constituents in ground water by pumping a well or multilevel sampler until one or more purge criteria have been met. A record of frequent water-quality measurements from a monitoring site can indicate changes in ground-water quality and can provide a context for the interpretation of laboratory data from discrete samples. Robowell also can communicate data and system performance through a remote communication link. Remote access to ground-water data enables the user to monitor conditions and optimize manual sampling efforts. Six Robowell prototypes have successfully monitored ground-water quality during all four seasons of the year under different hydrogeologic conditions, well designs, and geochemical environments. The U.S. Geological Survey is seeking partners for research with robust and economical water-quality monitoring instruments designed to measure contaminants of concern in conjunction with the application and commercialization of the Robowell technology. Project publications and information about technology transfer opportunities are available on the Internet at URL http://ma.water.usgs.gov/automon/.
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Goodson, Patricia
2015-01-01
Background. Documented trends in health-related risk behaviors among US adolescents have remained high over time. Studies indicate relationships among mutual friends are a major influence on adolescents’ risky behaviors. Social Network Analysis (SNA) can help understand friendship ties affecting individual adolescents’ engagement in these behaviors. Moreover, a systematic literature review can synthesize findings from a range of studies using SNA, as well as assess these studies’ methodological quality. Review findings also can help health educators and promoters develop more effective programs. Objective. This review systematically examined studies of the influence of friendship networks on adolescents’ risk behaviors, which utilized SNA and the Add Health data (a nationally representative sample). Methods. We employed the Matrix Method to synthesize and evaluate 15 published studies that met our inclusion and exclusion criteria, retrieved from the Add Health website and 3 major databases (Medline, Eric, and PsycINFO). Moreover, we assigned each study a methodological quality score (MQS). Results. In all studies, friendship networks among adolescents promoted their risky behaviors, including drinking alcohol, smoking, sexual intercourse, and marijuana use. The average MQS was 4.6, an indicator of methodological rigor (scale: 1–9). Conclusion. Better understanding of risky behaviors influenced by friends can be useful for health educators and promoters, as programs targeting friendships might be more effective. Additionally, the overall MQ of these reviewed studies was good, as average scores fell above the scale’s mid-point. PMID:26157622
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Kim, Jun H; Lee, Kyung H; Kim, Kyoung-Tae; Ahn, Hyeong S; Kim, Yeo J; Lee, Ha Y; Jeon, Yong S
2016-01-01
Objective: To compare the diagnostic accuracy of digital tomosynthesis (DTS) with that of chest radiography for the detection of pulmonary nodules by meta-analysis. Methods: A systematic literature search was performed to identify relevant original studies from 1 January 1 1976 to 31 August 31 2016. The quality of included studies was assessed by quality assessment of diagnostic accuracy studies-2. Per-patient data were used to calculate the sensitivity and specificity and per-lesion data were used to calculate the detection rate. Summary receiver-operating characteristic curves were drawn for pulmonary nodule detection. Results: 16 studies met the inclusion criteria. 1017 patients on a per-patient basis and 2159 lesions on a per-lesion basis from 16 eligible studies were evaluated. The pooled patient-based sensitivity of DTS was 0.85 [95% confidence interval (CI) 0.83–0.88] and the specificity was 0.95 (0.93–0.96). The pooled sensitivity and specificity of chest radiography were 0.47 (0.44–0.51) and 0.37 (0.34–0.40), respectively. The per-lesion detection rate was 2.90 (95% CI 2.63–3.19). Conclusion: DTS has higher diagnostic accuracy than chest radiography for detection of pulmonary nodules. Chest radiography has low sensitivity but similar specificity, comparable with that of DTS. Advances in knowledge: DTS has higher diagnostic accuracy than chest radiography for the detection of pulmonary nodules. PMID:27759428
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Alali, Aziz S; Burton, Kirsteen; Fowler, Robert A; Naimark, David M J; Scales, Damon C; Mainprize, Todd G; Nathens, Avery B
2015-07-01
Economic evaluations provide a unique opportunity to identify the optimal strategies for the diagnosis and management of traumatic brain injury (TBI), for which uncertainty is common and the economic burden is substantial. The objective of this study was to systematically review and examine the quality of contemporary economic evaluations in the diagnosis and management of TBI. Two reviewers independently searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, Health Technology Assessment Database, EconLit, and the Tufts CEA Registry for comparative economic evaluations published from 2000 onward (last updated on August 30, 2013). Data on methods, results, and quality were abstracted in duplicate. The results were summarized quantitatively and qualitatively. Of 3539 citations, 24 economic evaluations met our inclusion criteria. Nine were cost-utility, five were cost-effectiveness, three were cost-minimization, and seven were cost-consequences analyses. Only six studies were of high quality. Current evidence from high-quality studies suggests the economic attractiveness of the following strategies: a low medical threshold for computed tomography (CT) scanning of asymptomatic infants with possible inflicted TBI, selective CT scanning of adults with mild TBI as per the Canadian CT Head Rule, management of severe TBI according to the Brain Trauma Foundation guidelines, management of TBI in dedicated neurocritical care units, and early transfer of patients with TBI with nonsurgical lesions to neuroscience centers. Threshold-guided CT scanning, adherence to Brain Trauma Foundation guidelines, and care for patients with TBI, including those with nonsurgical lesions, in specialized settings appear to be economically attractive strategies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Ann R. Dallman; Neary, Vincent S.
This report presents met-ocean data and wave energy characteristics at eight U.S. wave energy converter (WEC) test and potential deployment sites. Its purpose is to enable the comparison of wave resource characteristics among sites as well as the selection of test sites that are most suitable for a developer's device and that best meet their testing needs and objectives. It also provides essential inputs for the design of WEC test devices and planning WEC tests, including the planning of deployment, and operations and maintenance. For each site, this report catalogues wave statistics recommended in the International Electrotechnical Commission Technical Specimore » cation (IEC 62600-101 TS) on Wave Energy Characterization, as well as the frequency of occurrence of weather windows and extreme sea states, and statistics on wind and ocean currents. It also provides useful information on test site infrastructure and services.« less
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Landsat-8 Operational Land Imager (OLI) radiometric performance on-orbit
Morfitt, Ron; Barsi, Julia A.; Levy, Raviv; Markham, Brian L.; Micijevic, Esad; Ong, Lawrence; Scaramuzza, Pat; Vanderwerff, Kelly
2015-01-01
Expectations of the Operational Land Imager (OLI) radiometric performance onboard Landsat-8 have been met or exceeded. The calibration activities that occurred prior to launch provided calibration parameters that enabled ground processing to produce imagery that met most requirements when data were transmitted to the ground. Since launch, calibration updates have improved the image quality even more, so that all requirements are met. These updates range from detector gain coefficients to reduce striping and banding to alignment parameters to improve the geometric accuracy. This paper concentrates on the on-orbit radiometric performance of the OLI, excepting the radiometric calibration performance. Topics discussed in this paper include: signal-to-noise ratios that are an order of magnitude higher than previous Landsat missions; radiometric uniformity that shows little residual banding and striping, and continues to improve; a dynamic range that limits saturation to extremely high radiance levels; extremely stable detectors; slight nonlinearity that is corrected in ground processing; detectors that are stable and 100% operable; and few image artifacts.
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Students’ Creativity: Problem Posing in Structured Situation
NASA Astrophysics Data System (ADS)
Amalina, I. K.; Amirudin, M.; Budiarto, M. T.
2018-01-01
This is a qualitative research concerning on students’ creativity on problem posing task. The study aimed at describing the students’ creative thinking ability to pose the mathematics problem in structured situations with varied condition of given problems. In order to find out the students’ creative thinking ability, an analysis of mathematics problem posing test based on fluency, novelty, and flexibility and interview was applied for categorizing students’ responses on that task. The data analysis used the quality of problem posing and categorized in 4 level of creativity. The results revealed from 29 secondary students grade 8, a student in CTL (Creative Thinking Level) 1 met the fluency. A student in CTL 2 met the novelty, while a student in CTL 3 met both fluency and novelty and no one in CTL 4. These results are affected by students’ mathematical experience. The findings of this study highlight that student’s problem posing creativity are dependent on their experience in mathematics learning and from the point of view of which students start to pose problem.
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Is online better than offline for meeting partners? Depends: are you looking to marry or to date?
Paul, Aditi
2014-10-01
Previous studies that compared differences in the outcomes of relationships that begin online compared to traditional offline venues have primarily looked at marital relationships. The present study extends this investigation by including non-marital relationships in the comparison. It further investigates if the breakup rate of relationships (both marital and non-marital) varies as a result of meeting online versus offline, and if other factors outside of the meeting venue predict relationship dissolution. Data are used from Waves I, II, and III of a nationally representative survey of 4,002 respondents. Results suggest that couples who met their partners online were more likely to be involved in dating and romantic relationships than marital relationships compared to couples who met offline. Furthermore, the breakup rates for both marital and non-marital romantic relationships was found to be higher for couples who met online than couples who met through offline venues. In addition to meeting venue, relationship quality and duration of relationship were found to be significant factors that predicted if couples would stay together or break up. Evidence drawn from theory and previous research are used to explain these observed trends.
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Nonalcoholic fatty liver disease and liver transplantation - Where do we stand?
Mikolasevic, Ivana; Filipec-Kanizaj, Tajana; Mijic, Maja; Jakopcic, Ivan; Milic, Sandra; Hrstic, Irena; Sobocan, Nikola; Stimac, Davor; Burra, Patrizia
2018-01-01
Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a challenging and multisystem disease that has a high socioeconomic impact. NAFLD/NASH is a main cause of macrovesicular steatosis and has multiple impacts on liver transplantation (LT), on patients on the waiting list for transplant, on post-transplant setting as well as on organ donors. Current data indicate new trends in the area of chronic liver disease. Due to the increased incidence of metabolic syndrome (MetS) and its components, NASH cirrhosis and hepatocellular carcinoma caused by NASH will soon become a major indication for LT. Furthermore, due to an increasing incidence of MetS and, consequently, NAFLD, there will be more steatotic donor livers and less high quality organs available for LT, in addition to a lack of available liver allografts. Patients who have NASH and are candidates for LT have multiple comorbidities and are unique LT candidates. Finally, we discuss long-term grafts and patient survival after LT, the recurrence of NASH and NASH appearing de novo after transplantation. In addition, we suggest topics and areas that require more research for improving the health care of this increasing patient population. PMID:29662288
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Ogrinc, Greg; Headrick, Linda A; Mutha, Sunita; Coleman, Mary T; O'Donnell, Joseph; Miles, Paul V
2003-07-01
To create a framework for teaching the knowledge and skills of practice-based learning and improvement to medical students and residents based on proven, effective strategies. The authors conducted a Medline search of English-language articles published between 1996 and May 2001, using the term "quality improvement" (QI), and cross-matched it with "medical education" and "health professions education." A thematic-synthesis method of review was used to compile the information from the articles. Based on the literature review, an expert panel recommended educational objectives for practice-based learning and improvement. Twenty-seven articles met the inclusion criteria. The majority of studies were conducted in academic medical centers and medical schools and 40% addressed experiential learning of QI. More than 75% were qualitative case reports capturing educational outcomes, and 7% included an experimental study design. The expert panel integrated data from the literature review with the Dreyfus model of professional skill acquisition, the Institute for Healthcare Improvement's (IHI) knowledge domains for improving health care, and the ACGME competencies and generated a framework of core educational objectives about teaching practice-based learning and improvement to medical students and residents. Teaching the knowledge and skills of practice-based learning and improvement to medical students and residents is a necessary and important foundation for improving patient care. The authors present a framework of learning objectives-informed by the literature and synthesized by the expert panel-to assist educational leaders when integrating these objectives into a curriculum. This framework serves as a blueprint to bridge the gap between current knowledge and future practice needs.
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Secure Intra-Body Wireless Communications (SIWiC) System Project
NASA Technical Reports Server (NTRS)
Ahmad, Aftab; Doggett, Terrence P.
2011-01-01
SIWiC System is a project to investigate, design and implement future wireless networks of implantable sensors in the body. This futuristic project is designed to make use of the emerging and yet-to-emerge technologies, including ultra-wide band (UWB) for wireless communications, smart implantable sensors, ultra low power networking protocols, security and privacy for bandwidth and power deficient devices and quantum computing. Progress in each of these fronts is hindered by the needs of breakthrough. But, as we will see in this paper, these major challenges are being met or will be met in near future. SIWiC system is a network of in-situ wireless devices that are implanted to coordinate sensed data inside the body, such as symptoms monitoring collected internally, or biometric data collected of an outside object from within the intra-body network. One node has the capability of communicating outside the body to send data or alarm to a relevant authority, e.g., a remote physician.
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Olivo, Susan Armijo; Bravo, Jaime; Magee, David J; Thie, Norman M R; Major, Paul W; Flores-Mir, Carlos
2006-01-01
To carry out a systematic review to assess the evidence concerning the association between head and cervical posture and temporomandibular disorders (TMD). A search of Medline, Pubmed, Embase, Web of Science, Lilacs, and Cochrane Library databases was conducted in all languages with the help of a health sciences librarian. Key words used in the search were posture, head posture, cervical spine or neck, vertebrae, cervical lordosis, craniomandibular disorders or temporomandibular disorders, temporomandibular disorders, and orofacial pain or facial pain. Abstracts which appeared to fulfill the initial selection criteria were selected by consensus. The original articles were retrieved and evaluated to ensure they met the inclusion criteria. A methodological checklist was used to evaluate the quality of the selected articles and their references were hand-searched for possible missing articles. Twelve studies met all inclusion criteria and were analyzed in detail for their methodology and information quality. Nine articles that analyzed the association between head posture and TMD included patients with mixed TMD diagnosis; 1 article differentiated among muscular, articular, and mixed symptomatology; and 3 articles analyzed information from patients with only articular problems. Finally, 2 studies evaluated the association between head posture and TMD in patients with muscular TMD. Several methodological defects were noted in the 12 studies. Since most of the studies included in this systematic review were of poor methodological quality, the findings of the studies should be interpreted with caution. The association between intra-articular and muscular TMD and head and cervical posture is still unclear, and better controlled studies with comprehensive TMD diagnoses, greater sample sizes, and objective posture evaluation are necessary.
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The promise and peril of the pharmacological enhancer Modafinil.
Tannenbaum, Julie
2014-10-01
The neuro-enhancement Modafinil promises to dramatically increase users' waking hours without much sacrifice to clarity of thought and without serious side effects (inducing addiction). For Modafinil to be advantageous, its usage must enable access to goods that themselves improve the quality of one's life. I draw attention to a variety of conditions that must be met for an experience, activity or object to improve the quality of one's life, such as positional, relational, and saturation conditions, as well as it's being good for its own sake. I discuss and describe the contexts in which widespread usage (legal or not) of Modafinil would undermine these conditions being met, and thus users would fail to significantly improve the quality of their lives and would in fact potentially make both themselves and nonusers worse off in important respects thus far overlooked by critics. In the right contexts, where free time is protected and prolonged, Modafinil does have a variety of potential benefits including, most interestingly, a distinctive form of agency possible only in free time. The potential disadvantages and advantages highlighted in this article are relevant not only to public institutions deciding whether to legalize Modafinil's use as an enhancement but also to individuals deciding whether to use it illegally, as well as to the questions of how and whether to alter key features of one's context (e.g. regulating work hours or extending social services) rather than, or in addition, to regulating the use of enhancement drugs such as Modafinil. © 2012 John Wiley & Sons Ltd.
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The impact of the TelEmergency program on rural emergency care: An implementation study.
Sterling, Sarah A; Seals, Samantha R; Jones, Alan E; King, Melissa H; Galli, Robert L; Isom, Kristen C; Summers, Richard L; Henderson, Kristi A
2017-07-01
Introduction Timely, appropriate intervention is key to improving outcomes in many emergent conditions. In rural areas, it is particularly challenging to assure quality, timely emergency care. The TelEmergency (TE) program, which utilizes a dual nurse practitioner and emergency medicine-trained, board-certified physician model, has the potential to improve access to quality emergency care in rural areas. The objective of this study was to examine how the implementation of the TE program impacts rural hospital Emergency Department (ED) operations. Methods Methods included a before and after study of the effect of the TE program on participating rural hospitals between January 2007 and December 2008. Data on ED and hospital operations were collected one year prior to and one year following the implementation of TE. Data from participating hospitals were combined and compared for the two time periods. Results Nine hospitals met criteria for inclusion and participated in the study. Total ED volumes did not significantly change with TE implementation, but ED admissions to the same rural hospital significantly increased following TE implementation (6.7% to 8.1%, p-value = 0.02). Likewise, discharge rates from the ED declined post-initiation (87.1% to 80.0%, p-value = 0.003). ED deaths and transfer rates showed no significant change, while the rate of patient discharge against medical advice significantly increased with TE use. Discussion In this analysis, we found a significant increase in the rate of ED admissions to rural hospitals with TE use. These findings may have important implications for the quality of emergency care in rural areas and the sustainability of rural hospitals' EDs.
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Alkhaled, Lina; Kahale, Lara; Nass, Hala; Brax, Hneine; Fadlallah, Racha; Badr, Kamal; Akl, Elie A
2014-07-01
Pharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians. The objective of this study was to systematically review the effects of interventions targeting practising physicians' interactions with pharmaceutical companies. We included observational studies, non-randomised controlled trials (non-RCTs) and RCTs evaluating legislative, educational, policy or other interventions targeting the interactions between physicians and pharmaceutical companies. The search strategy included an electronic search of MEDLINE and EMBASE. Two reviewers performed duplicate and independent study selection, data abstraction and assessment of risk of bias. We assessed the risk of bias in each included study. We summarised the findings narratively because the nature of the data did not allow a meta-analysis to be conducted. We assessed the quality of evidence by outcome using the GRADE methodology. Of 11 189 identified citations, one RCT and three observational studies met the eligibility criteria. All four studies specifically targeted one type of interaction with pharmaceutical companies, that is, interactions with drug representatives. The RCT provided moderate quality evidence of no effect of a 'collaborative approach' between the pharmaceutical industry and a health authority. The three observational studies provided low quality evidence suggesting a positive effect of policies aiming to reduce interaction between physicians and pharmaceutical companies (by restricting free samples, promotional material, and meetings with pharmaceutical company representatives) on prescription behaviour. We identified too few studies to allow strong conclusions. Available evidence suggests a potential impact of policies aiming to reduce interaction between physicians and drug representatives on physicians' prescription behaviour. We found no evidence concerning interventions affecting other types of interaction with pharmaceutical companies. 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.
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Shared decision-making and choice for elective surgical care: A systematic review
Boss, Emily F.; Mehta, Nishchay; Nagarajan, Neeraja; Links, Anne; Benke, James R.; Berger, Zackary; Espinel, Ali; Meier, Jeremy; Lipstein, Ellen A.
2016-01-01
Objective Shared Decision-Making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known however regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources Pubmed, CochraneCENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases Review Methods We searched for English-language studies (1/1/1990 to 8/9/2015) evaluating use of SDM in elective surgical care. Identified studies were independently screened by two reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7/24) followed by joint (5/24) and gynecological surgery (4/24). Twenty studies used decision aids/support tools, including modalities that were multimedia/video (13/20), written (3/20), or personal coaching (4/20). Effect of SDM on preference for surgery were mixed across studies, showing a decrease in surgery (9/24), no difference (8/24), or increase (1/24). SDM tended to improve decision quality (3/3) as well as knowledge/preparation (4/6), while decreasing decision conflict (4/6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained. PMID:26645531
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SST algorithms in ACSPO reanalysis of AVHRR GAC data from 2002-2013
NASA Astrophysics Data System (ADS)
Petrenko, B.; Ignatov, A.; Kihai, Y.; Zhou, X.; Stroup, J.
2014-05-01
In response to a request from the NOAA Coral Reef Watch Program, NOAA SST Team initiated reprocessing of 4 km resolution GAC data from AVHRRs flown onboard NOAA and MetOp satellites. The objective is to create a longterm Level 2 Advanced Clear-Sky Processor for Oceans (ACSPO) SST product, consistent with NOAA operations. ACSPO-Reanalysis (RAN) is used as input in the NOAA geo-polar blended Level 4 SST and potentially other Level 4 SST products. In the first stage of reprocessing (reanalysis 1, or RAN1), data from NOAA-15, -16, -17, -18, -19, and Metop-A and -B, from 2002-present have been processed with ACSPO v2.20, and matched up with quality controlled in situ data from in situ Quality Monitor (iQuam) version 1. The ~12 years time series of matchups were used to develop and explore the SST retrieval algorithms, with emphasis on minimizing spatial biases in retrieved SSTs, close reproduction of the magnitudes of true SST variations, and maximizing temporal, spatial and inter-platform stability of retrieval metrics. Two types of SST algorithms were considered: conventional SST regressions, and recently developed incremental regressions. The conventional equations were adopted in the EUMETSAT OSI-SAF formulation, which, according to our previous analyses, provide relatively small regional biases and well-balanced combination of precision and sensitivity, in its class. Incremental regression equations were specifically elaborated to automatically correct for model minus observation biases, always present when RTM simulations are employed. Improved temporal stability was achieved by recalculation of SST coefficients from matchups on a daily basis, with a +/-45 day window around the current date. This presentation describes the candidate SST algorithms considered for the next round of ACSPO reanalysis, RAN2.
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Allen, Katryn; Yang, Hui-yu; Nan, Bin; Morishita, Masako; Mukherjee, Bhramar; Dvonch, J. Timothy; Spino, Catherine; Fink, Gregory D.; Rajagopalan, Sanjay; Sun, Qinghua; Brook, Robert D.; Harkema, Jack R.
2013-01-01
Background: High ambient levels of ozone (O3) and fine particulate matter (PM2.5) are associated with cardiovascular morbidity and mortality, especially in people with preexisting cardiopulmonary diseases. Enhanced susceptibility to the toxicity of air pollutants may include individuals with metabolic syndrome (MetS). Objective: We tested the hypothesis that cardiovascular responses to O3 and PM2.5 will be enhanced in rats with diet-induced MetS. Methods: Male Sprague-Dawley rats were fed a high-fructose diet (HFrD) to induce MetS and then exposed to O3, concentrated ambient PM2.5, or the combination of O3 plus PM2.5 for 9 days. Data related to heart rate (HR), HR variability (HRV), and blood pressure (BP) were collected. Results: Consistent with MetS, HFrD rats were hypertensive and insulin resistant, and had elevated fasting levels of blood glucose and triglycerides. Decreases in HR and BP, which were found in all exposure groups, were greater and more persistent in HFrD rats compared with those fed a normal diet (ND). Coexposure to O3 plus PM2.5 induced acute drops in HR and BP in all rats, but only ND rats adapted after 2 days. HFrD rats had little exposure-related changes in HRV, whereas ND rats had increased HRV during O3 exposure, modest decreases with PM2.5, and dramatic decreases during O3 plus PM2.5 coexposures. Conclusions: Cardiovascular depression in O3- and PM2.5-exposed rats was enhanced and prolonged in rats with HFrD-induced MetS. These results in rodents suggest that people with MetS may be prone to similar exaggerated BP and HR responses to inhaled air pollutants. Citation: Wagner JG, Allen K, Yang HY, Nan B, Morishita M, Mukherjee B, Dvonch JT, Spino C, Fink GD, Rajagopalan S, Sun Q, Brook RD, Harkema JR. 2014. Cardiovascular depression in rats exposed to inhaled particulate matter and ozone: effects of diet-induced metabolic syndrome. Environ Health Perspect 122:27–33; http://dx.doi.org/10.1289/ehp.1307085 PMID:24169565
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Liu, Cheng-Chieh; Chang, Hsiao-Ting; Chiang, Shu-Chiung; Chen, Harn-Shen; Lin, Ming-Hwai; Chen, Tzeng-Ji; Hwang, Shinn-Jang
2018-04-27
Metabolic syndrome (MetS) is a widespread condition with important effects on public health, in general. There is a lack of relevant research on possible sex differences in the relationship between MetS and health-related quality of life (HRQoL) and also the sex differences in factors associated with HRQoL. The aims of this study were to identify: 1) whether women exhibit greater negative impacts on physical domain HRQoL from MetS compared with men; 2) whether women exhibit greater mental domain impacts compared with men; and 3) whether factors associated with HRQoL scores are different for men and women. This cross-sectional study was conducted in Taipei, Taiwan. Using random sampling, a total of 906 participants aged 35-55 years were recruited. MetS was defined according to the MetS criteria for the Taiwanese population, and HRQoL were assessed using physical component summary (PCS) and mental component summary (MCS) scores of the Short Form Health Survey (SF-36), Taiwan version. Demographics, physical activity, medical history, and blood tests as covariates were recorded and checked. The associations were assessed by multiple linear regression. After adjusting for covariates, women but not men with more components of MetS had significantly lower PCS scores (β = - 0.542, p = 0.036). The number of components of MetS was not a significant factor in MCS score differences between the sexes. Furthermore, there were sex differences regarding age, education level, physical activity, and smoking status in association with PCS scores. For MCS scores, sex differences were found in education level, marital status, and habits of smoking and alcohol consumption. There were sex differences in the relationships between metabolic syndrome components and factors associated with HRQoL among middle-aged adults living in the community in Taiwan. Further research should be conducted to investigate mechanisms of these sex differences.
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Tank 241-AY-101 Privatization Push Mode Core Sampling and Analysis Plan
DOE Office of Scientific and Technical Information (OSTI.GOV)
TEMPLETON, A.M.
2000-01-12
This sampling and analysis plan (SAP) identifies characterization objectives pertaining to sample collection, laboratory analytical evaluation, and reporting requirements for samples obtained from tank 241-AY-101. The purpose of this sampling event is to obtain information about the characteristics of the contents of 241-AY-101 required to satisfy Data Quality Objectives For RPP Privatization Phase I: Confirm Tank T Is An Appropriate Feed Source For High-Level Waste Feed Batch X(HLW DQO) (Nguyen 1999a), Data Quality Objectives For TWRS Privatization Phase I : Confirm Tank T Is An Appropriate Feed Source For Low-Activity Waste Feed Batch X (LAW DQO) (Nguyen 1999b), Low Activitymore » Waste and High-Level Waste Feed Data Quality Objectives (L and H DQO) (Patello et al. 1999), and Characterization Data Needs for Development, Design, and Operation of Retrieval Equipment Developed through the Data Quality Objective Process (Equipment DQO) (Bloom 1996). Special instructions regarding support to the LAW and HLW DQOs are provided by Baldwin (1999). Push mode core samples will be obtained from risers 15G and 150 to provide sufficient material for the chemical analyses and tests required to satisfy these data quality objectives. The 222-S Laboratory will extrude core samples; composite the liquids and solids; perform chemical analyses on composite and segment samples; archive half-segment samples; and provide subsamples to the Process Chemistry Laboratory. The Process Chemistry Laboratory will prepare test plans and perform process tests to evaluate the behavior of the 241-AY-101 waste undergoing the retrieval and treatment scenarios defined in the applicable DQOs. Requirements for analyses of samples originating in the process tests will be documented in the corresponding test plans and are not within the scope of this SAP.« less
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Tank 241-AY-101 Privatization Push Mode Core Sampling and Analysis Plan
DOE Office of Scientific and Technical Information (OSTI.GOV)
TEMPLETON, A.M.
2000-05-19
This sampling and analysis plan (SAP) identifies characterization objectives pertaining to sample collection, laboratory analytical evaluation, and reporting requirements for samples obtained from tank 241-AY-101. The purpose of this sampling event is to obtain information about the characteristics of the contents of 241-AY-101 required to satisfy ''Data Quality Objectives For RPP Privatization Phase I: Confirm Tank T Is An Appropriate Feed Source For High-Level Waste Feed Batch X(HLW DQO)' (Nguyen 1999a), ''Data Quality Objectives For TWRS Privatization Phase I: Confirm Tank T Is An Appropriate Feed Source For Low-Activity Waste Feed Butch X (LAW DQO) (Nguyen 1999b)'', ''Low Activity Wastemore » and High-Level Waste Feed Data Quality Objectives (L&H DQO)'' (Patello et al. 1999), and ''Characterization Data Needs for Development, Design, and Operation of Retrieval Equipment Developed through the Data Quality Objective Process (Equipment DQO)'' (Bloom 1996). Special instructions regarding support to the LAW and HLW DQOs are provided by Baldwin (1999). Push mode core samples will be obtained from risers 15G and 150 to provide sufficient material for the chemical analyses and tests required to satisfy these data quality objectives. The 222-S Laboratory will extrude core samples; composite the liquids and solids; perform chemical analyses on composite and segment samples; archive half-segment samples; and provide sub-samples to the Process Chemistry Laboratory. The Process Chemistry Laboratory will prepare test plans and perform process tests to evaluate the behavior of the 241-AY-101 waste undergoing the retrieval and treatment scenarios defined in the applicable DQOs. Requirements for analyses of samples originating in the process tests will be documented in the corresponding test plans and are not within the scope of this SAP.« less
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Eljaiek, Roberto; Heylbroeck, Christophe; Dubois, Marc-Jacques
2017-02-01
The objective was to systematically review the literature summarizing the effect on mortality of albumin compared to non-albumin solutions during the fluid resuscitation phase of burn injured patients. We searched MEDLINE, EMBASE and CENTRAL and the content of two leading journals in burn care, Burns and Journal of Burn Care and Research. Two reviewers independently selected randomized controlled trials comparing albumin vs. non-albumin solutions for the acute resuscitation of patients with >20% body surface area involvement. Reviewers abstracted data independently and assessed methodological quality of the included trials using predefined criteria. A random effects model was used to assess mortality. We identified 164 trials of which, 4 trials involving 140 patients met our inclusion criteria. Overall, the methodological quality of the included trials was fair. We did not find a significant benefit of albumin solutions as resuscitation fluid on mortality in burn patients (relative risk (RR) 1.6; 95% confidence interval (CI), 0.63-4.08). Total volume of fluid infusion during the phase of resuscitation was lower in patients receiving albumin containing solution -1.00ml/kg/%TBSA (total body surface area) (95% CI, -1.42 to -0.58). The pooled estimate demonstrated a neutral effect on mortality in burn patients resuscitated acutely with albumin solutions. Due to limited evidence and uncertainty, an adequately powered, high quality trial could be required to assess the impact of albumin solutions on mortality in burn patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
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Ishigaki, Erika Y.; Ramos, Lidiane G.; Carvalho, Elisa S.; Lunardi, Adriana C.
2014-01-01
Background Falls are a geriatric syndrome that is considered a significant public health problem in terms of morbidity and mortality because they lead to a decline in functional capacity and an impaired quality of life in the elderly. Lower limb muscle strengthening seems to be an effective intervention for preventing falls; however, there is no consensus regarding the best method for increasing lower limb muscle strength. Objectives To analyze the effectiveness of lower limb muscle strengthening and to investigate and describe the protocols used for preventing falls in elderly subjects. Method We performed a systematic review of randomized and controlled clinical trials published between 2002 and 2012 in the databases PubMed, EMBASE, Scopus, Web of Science, and PEDro that cited some type of lower limb muscle strengthening protocol and that evaluated the incidence of falls as the primary outcome exclusively in elderly subjects. Twelve studies met the inclusion criteria. Qualitative analysis was performed by independent reviewers applying the PEDro scale. Results The data obtained from the selected studies showed lower fall rates in the intervention groups compared to controls. Six studies described the lower limb muscle strengthening protocol in detail. High methodological quality was found in 6 studies (PEDro score ≥7/10 points). Conclusions The methodological quality of the studies in this area appears to leave little doubt regarding the effectiveness of lower limb strengthening exercises for preventing falls in elderly subjects, however the interventions in these studies were poorly reported. PMID:24760166
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Readiness of Primary Care Practices for Medical Home Certification
Clark, Sarah J.; Sakshaug, Joseph W.; Chen, Lena M.; Hollingsworth, John M.
2013-01-01
OBJECTIVES: To assess the prevalence of medical home infrastructure among primary care practices for children and identify practice characteristics associated with medical home infrastructure. METHODS: Cross-sectional analysis of restricted data files from 2007 and 2008 of the National Ambulatory Medical Care Survey. We mapped survey items to the 2011 National Committee on Quality Assurance’s Patient-Centered Medical home standards. Points were awarded for each “passed” element based on National Committee for Quality Assurance scoring, and we then calculated the percentage of the total possible points met for each practice. We used multivariate linear regression to assess associations between practice characteristics and the percentage of medical home infrastructure points attained. RESULTS: On average, pediatric practices attained 38% (95% confidence interval 34%–41%) of medical home infrastructure points, and family/general practices attained 36% (95% confidence interval 33%–38%). Practices scored higher on medical home elements related to direct patient care (eg, providing comprehensive health assessments) and lower in areas highly dependent on health information technology (eg, computerized prescriptions, test ordering, laboratory result viewing, or quality of care measurement and reporting). In multivariate analyses, smaller practice size was significantly associated with lower infrastructure scores. Practice ownership, urban versus rural location, and proportion of visits covered by public insurers were not consistently associated with a practice’s infrastructure score. CONCLUSIONS: Medical home programs need effective approaches to support practice transformation in the small practices that provide the vast majority of the primary care for children in the United States. PMID:23382438
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Baudischova, L; Straznicka, J; Pokladnikova, J; Jahodar, L
2018-02-01
Background The purchase of dietary supplements (DS) via the Internet is increasing worldwide as well as in the Czech Republic. Objective The aim of the study is to evaluate the quality of information on DS available on the Internet. Setting Czech websites related to dietary supplements. Methods A cross-sectional study was carried out involving the analysis of information placed on the websites related to the 100 top-selling DS in the Czech Republic in 2014, according to IMS Health data. Main outcome measure The following criteria were evaluated: contact for the manufacturer, recommended dosage, information on active substances as well as overall composition, permitted health claims, % of the daily reference intake value (DRIV) for vitamins and minerals, link for online counseling, pregnancy/breastfeeding, allergy information, contraindications, adverse reactions, and supplement-drug interactions (some criteria were evaluated from both points of view). Results A total of 199 web domains and 850 websites were evaluated. From the regulatory point of view, all the criteria were fulfilled by 11.3% of websites. Almost 9% of the websites reported information referring to the treatment, cure, or prevention of a disease. From the clinical point of view, all the criteria were only met by one website. Conclusions The quality of information related to DS available on the Internet in the Czech Republic is quite low. The consumers should consult a specialist when using DS purchased online.
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Arcjet thruster research and technology, phase 2
NASA Technical Reports Server (NTRS)
Yano, Steve E.
1991-01-01
The principle objective of Phase 2 was to produce an engineering model N2H4 arcjet system which met typical performance, lifetime, environmental, and interface specifications required to support a 10-year N-S stationkeeping mission for a communications spacecraft. The system includes an N2H4 arcjet thruster, power conditioning unit (PCU), and the interconnecting power cable assembly. This objective was met with the successful conclusion of an extensive system test series.
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Wasson, Lauren T.; Cusmano, Amberle; Meli, Laura; Louh, Irene; Falzon, Louise; Hampsey, Meghan; Young, Geoffrey; Shaffer, Jonathan; Davidson, Karina W.
2016-01-01
Importance There are concerns about the current quality of undergraduate medical education (UME) and its effect on students’ well-being. Objective This systematic review was designed to identify best practices for UME learning environment interventions that are associated with improved emotional well-being of students. Data Sources Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and the ERIC database from the database inception dates to October 2016. Studies examined any intervention designed to promote medical students’ emotional well-being in the setting of a US academic medical school, with an outcome defined as students’ reports of well-being as assessed by surveys, semistructured interviews, or other quantitative methods. Data Extraction and Synthesis Two investigators independently reviewed abstracts and full-text articles. Data were extracted into tables to summarize results. Study quality was assessed by the Medical Education Research Study Quality Instrument (MERQSI), which has a possible range of 5–18; higher scores indicate higher design and methods quality, and a score of ≥ 14 indicates a high-quality study. Findings Twenty-eight articles including at least 8224 participants met eligibility criteria. Study designs included single-group cross-sectional or post-test only (n=10), single-group pre-/post-test (n=2), nonrandomized two-group (n=13), and randomized clinical trial (n=3); 93% were conducted at a single site, and the mean MERSQI score for all studies was 10.3 (range 5–13, SD=2.11). Studies encompassed a variety of types of interventions, including those focused on pass/fail grading systems (n=3, mean MERSQI=12.0), mental health programs (n=4, MERSQI=11.9), mind-body skills programs (n=7, MERSQI=11.2), curriculum structure (n=3, MERSQI=9.5), multicomponent program reform (n=5, MERSQI=9.4), wellness programs (n=4, MERSQI=9.0), and advising/mentoring programs (n=3, MERSQI=8.2). Conclusions and Relevance In this systematic review, limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research. PMID:27923091
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Sultana, Sonia; Halder, Amal K.; Ahsan, Mohammed Ali; Arnold, Benjamin F.; Hubbard, Alan E.; Unicomb, Leanne; Luby, Stephen P.; Colford, John M.
2017-01-01
Objectives. To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. Methods. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Results. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. Conclusions. SHEWA-B did not meet UNICEF’s ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B’s design was suboptimal for improving these outcomes. PMID:28323462
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Sawada, Namie Okino; Nicolussi, Adriana Cristina; de Paula, Juliana Maria; Garcia-Caro, Maria Paz; Marti-Garcia, Celia; Cruz-Quintana, Francisco
2016-01-01
Objective: characterize the scientific production of Brazil and Spain in regard to methodological aspects and aspects of health-related quality of life experienced by cancer patients receiving chemotherapy in both countries. Method: integrative literature review was conducted using the following databases: CINAHL, MEDLINE, SCOPUS and CUIDEN and the electronic libraries PubMed and SciELO, conducted in September 2013. Results: a total of 28 papers met the inclusion criteria. The synthesis of knowledge was presented in three categories of analysis: assessment of quality of life in different types of cancer; sociodemographic factors that influenced quality of life; and type of cancer and interventions that improve quality of life. Chemotherapy affects health-related quality of life and the most important factors were: age, sex, chemotherapy protocol, type of surgery, stage of the disease, educational level, and emotional intelligence. Complementary therapies such as acupuncture, guided visualization, prayers and exercise were positive and reduced side effects. Conclusion: the results showed a poor level of evidence, since 86% of the studies were cross-sectional descriptive studies; the instrument most frequently used to measure health-related quality of life was EORTC QLQ C-30 and more studies were conducted in Brazil than in Spain. PMID:27192414
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City Life: Rankings (Livability) versus Perceptions (Satisfaction)
ERIC Educational Resources Information Center
Okulicz-Kozaryn, Adam
2013-01-01
I investigate the relationship between the popular Mercer city ranking (livability) and survey data (satisfactions). Livability aims to capture "objective" quality of life such as infrastructure. Survey items capture "subjective" quality of life such as satisfaction with city. The relationship between objective measures of quality of life and…
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Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts
Parker, Gene W.; Pinson, Harlow
1993-01-01
A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.
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Joint Sandia/NIOSH exercise on aerosol contamination using the BROOM tool.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ramsey, James L., Jr.; .); Melton, Brad
In February of 2005, a joint exercise involving Sandia National Laboratories (SNL) and the National Institute for Occupational Safety and Health (NIOSH) was conducted in Albuquerque, NM. The SNL participants included the team developing the Building Restoration Operations and Optimization Model (BROOM), a software product developed to expedite sampling and data management activities applicable to facility restoration following a biological contamination event. Integrated data-collection, data-management, and visualization software improve the efficiency of cleanup, minimize facility downtime, and provide a transparent basis for reopening. The exercise was held at an SNL facility, the Coronado Club, a now-closed social club for Sandiamore » employees located on Kirtland Air Force Base. Both NIOSH and SNL had specific objectives for the exercise, and all objectives were met.« less
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Sacko, Ryan S; McIver, Kerry; Brian, Ali; Stodden, David F
2018-04-02
This study examined the metabolic cost (METs) of performing object projection skills at three practice trial intervals (6, 12, and 30 seconds). Forty adults (female n = 20) aged 18-30 (M = 23.7 ± 2.9 years) completed three, nine-minute sessions of skill trials performed at 6, 12, and 30 second intervals. Participants performed kicking, throwing and striking trials in a blocked schedule with maximal effort. Average METs during each session were measured using a COSMED K4b2. A three (interval condition) X two (sex) ANOVA was conducted to examine differences in METs across interval conditions and by sex. Results indicated a main effect for interval condition (F(5,114) = 187.02, p < .001, η 2 = 0.76) with decreased interval times yielding significantly higher METs [30 sec = 3.45, 12 sec = 5.68, 6 sec = 8.21]. A main effect for sex (F(5, 114) = 35.39, p < .001, η 2 = 0.24) also was found with men demonstrating higher METs across all intervals. At a rate of only two trials/min, participants elicited moderate physical activity, with 12 and 6-second intervals exhibiting vigorous PA. Demonstrating MVPA during the performance of object projection skill performance has potential implications for PA interventions.
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Slagter, Sandra N.; van Vliet-Ostaptchouk, Jana V.; van Beek, André P.; Keers, Joost C.; Lutgers, Helen L.; van der Klauw, Melanie M.; Wolffenbuttel, Bruce H. R.
2015-01-01
Background Health-related quality of life (HR-QoL) may be compromised in obese individuals, depending on the presence of other complications. The aim of this study is to assess the effect of obesity-related conditions on HR-QoL. These conditions are i) grade of obesity with and without type 2 diabetes (T2D), ii) metabolic syndrome (MetS), and iii) level of inflammation. Methods From the Dutch LifeLines Cohort Study we included 13,686 obese individuals, aged 18–80 years. HR-QoL was measured with the RAND 36-Item Health Survey which encompasses eight health domains. We calculated the percentage of obese individuals with poor HR-QoL, i.e. those scoring below the domain and sex specific cut-off value derived from the normal weight population. Logistic regression analysis was used to calculate the probability of having poor domain scores according to the conditions under study. Results Higher grades of obesity and the additional presence of T2D were associated with lower HR-QoL, particularly in the domains physical functioning (men: odds ratios (ORs) 1.48–11.34, P<0.005, and women: ORs 1.66–5.05, P<0.001) and general health (men: ORs 1.44–3.07, P<0.005, and women: ORs 1.36–3.73, P<0.001). A higher percentage of obese individuals with MetS had a poor HR-QoL than those without MetS. Furthermore, we observed a linear trend between inflammation and the percentage of obese individuals with poor scores on the HR-QoL domains. Individuals with MetS were more likely to have poor scores in the domains general health, vitality, social functioning and role limitations due to emotional problems. Obese women with increased inflammation levels were more likely to have poor scores on all domains except role limitations due to emotional problems and mental health. Conclusions The impact of obesity on an individual’s quality of life is enhanced by grade of obesity, T2D, MetS and inflammation and are mainly related to reduced physical health. The mental well-being is less often impaired. PMID:26474291
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A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain.
Hauser, Ross A; Lackner, Johanna B; Steilen-Matias, Danielle; Harris, David K
2016-01-01
The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. Fourteen RCTs, 1 case-control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood-Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive objective but not subjective outcomes in two studies. All 15 studies solely using subjective or psychometric measures reported positive findings. Use of dextrose prolotherapy is supported for treatment of tendinopathies, knee and finger joint OA, and spinal/pelvic pain due to ligament dysfunction. Efficacy in acute pain, as first-line therapy, and in myofascial pain cannot be determined from the literature.
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Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar
2009-11-13
Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004-2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD. Recently published diagnostic accuracy studies on commercial tests for TB, malaria and HIV have moderate to low quality and are poorly reported. The more frequent use of tools such as QUADAS and STARD may be necessary to improve the methodological and reporting quality of future diagnostic accuracy studies in infectious diseases.
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Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar
2009-01-01
Background Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. Methods We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004–2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Findings Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD. Conclusion Recently published diagnostic accuracy studies on commercial tests for TB, malaria and HIV have moderate to low quality and are poorly reported. The more frequent use of tools such as QUADAS and STARD may be necessary to improve the methodological and reporting quality of future diagnostic accuracy studies in infectious diseases. PMID:19915664
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Exploration of Objective Functions for Optimal Placement of Weather Stations
NASA Astrophysics Data System (ADS)
Snyder, A.; Dietterich, T.; Selker, J. S.
2016-12-01
Many regions of Earth lack ground-based sensing of weather variables. For example, most countries in Sub-Saharan Africa do not have reliable weather station networks. This absence of sensor data has many consequences ranging from public safety (poor prediction and detection of severe weather events), to agriculture (lack of crop insurance), to science (reduced quality of world-wide weather forecasts, climate change measurement, etc.). The Trans-African Hydro-Meteorological Observatory (TAHMO.org) project seeks to address these problems by deploying and operating a large network of weather stations throughout Sub-Saharan Africa. To design the TAHMO network, we must determine where to locate each weather station. We can formulate this as the following optimization problem: Determine a set of N sites that jointly optimize the value of an objective function. The purpose of this poster is to propose and assess several objective functions. In addition to standard objectives (e.g., minimizing the summed squared error of interpolated values over the entire region), we consider objectives that minimize the maximum error over the region and objectives that optimize the detection of extreme events. An additional issue is that each station measures more than 10 variables—how should we balance the accuracy of our interpolated maps for each variable? Weather sensors inevitably drift out of calibration or fail altogether. How can we incorporate robustness to failed sensors into our network design? Another important requirement is that the network should make it possible to detect failed sensors by comparing their readings with those of other stations. How can this requirement be met? Finally, we provide an initial assessment of the computational cost of optimizing these various objective functions. We invite everyone to join the discussion at our poster by proposing additional objectives, identifying additional issues to consider, and expanding our bibliography of relevant papers. A prize (derived from grapes grown in Oregon) will be awarded for the most insightful contribution to the discussion!
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Come Together, Right Now: Dynamic Overwriting of an Object’s History through Common Fate
Luria, Roy; Vogel, Edward K.
2015-01-01
The objects around us constantly move and interact, and the perceptual system needs to monitor on-line these interactions and to update the object’s status accordingly. Gestalt grouping principles, such as proximity and common fate, play a fundamental role in how we perceive and group these objects. Here, we investigated situations in which the initial object representation as a separate item was updated by a subsequent Gestalt grouping cue (i.e., proximity or common fate). We used a version of the color change detection paradigm, in which the objects started to move separately, then met and stayed stationary, or moved separately, met, and then continued to move together. We monitored the object representations on-line using the contralateral delay activity (CDA; an ERP component indicative of the number of maintained objects), during their movement, and after the objects disappeared and became working memory representations. The results demonstrated that the objects’ representations (as indicated by the CDA amplitude) persisted as being separate, even after a Gestalt proximity cue (when the objects “met” and remained stationary on the same position). Only a strong common fate Gestalt cue (when the objects not just met but also moved together) was able to override the objects’ initial separate status, creating an integrated representation. These results challenge the view that Gestalt principles cause reflexive grouping. Instead, the object initial representation plays an important role that can override even powerful grouping cues. PMID:24564468
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Guide for Improving NRS Data Quality: Procedures for Data Collection and Training.
ERIC Educational Resources Information Center
Condelli, Larry; Castillo, Laura; Seburn, Mary; Deveaux, Jon
This guide for improving the quality of National Reporting System for Adult Education (NRS) data through improved data collection and training is intended for local providers and state administrators. Chapter 1 explains the guide's purpose, contents, and use and defines the following components of data quality: objectivity; integrity;…
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, X; Penagaricano, J; Narayanasamy, G
Purpose: Hippocampus avoidance whole brain radiotherapy (HA-WBRT) has been shown to reduce the risk of neurocognitive dysfunction. This type of treatment has the potential of insurance company payment denial due to increased cost of intensity modulated radiotherapy (IMRT), while the accepted modality for WBRT is three-dimensional conformal radiotherapy (3DCRT). The purpose of this study is to assess HA-WBRT treatment plans using 3DCRT and multi-criteria optimization (MCO) that meets the RTOG 0933 criteria. Methods: Ten patients with brain metastases at least 0.5cm away from the hippocampal avoidance region as defined in RTOG 0933 were selected in this study. HA-WBRT treatment plansmore » with MCO 3DCRT technique (MCO-3D) was generated with beam arrangements and dose constraints following the RTOG 0933 guidelines. MCO-3D plans were compared with plans using MCO IMRT techniques (MCO-IMRT) with same beam arrangements and dose constraints. Evaluation parameters included D98% D2% and dose homogeneity index of PTV, and Dmax and D100% of the hippocampi. The OAR doses were also evaluated. Results: For MCO-IMRT plans, PTV D2% and hippocampi Dmax and D100% met RTOG 0933 objectives in all ten patients (PTV D2%<37.5Gy; Hippocampi Dmax<16Gy and D100%<9Gy). One patient met the RTOG 0933 PTV D98% objective (PTV D98%>25Gy) and 9/10 patients met acceptable variation (PTV D98%<25Gy). For MCO-3D plans, PTV D2% met RTOG 0933 objective for all patients; 1/10 patient for PTV D98% and 6/10 patients for Hippocampi Dmax and 7/10 patients for hippocampi D100% met RTOG 0933 objective. All the other patients met the RTOG 0933 acceptable variation requirement. (PTV D98%<25Gy; Hippocampi Dmax<17Gy and D100%<10Gy). Conclusion: All dosimetric parameters of MCO-3D plans met the criteria of at least acceptable variation per RTOG 0933. This may be helpful in cases where there is denial of patient’s medical insurance coverage due to the use of IMRT for HA-WBRT.« less
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-11
...EPA is issuing a direct final rule to amend the diesel sulfur regulations to allow refiners, importers, distributors, and retailers of highway diesel fuel the option to use an alternative affirmative defense if the Agency finds highway diesel fuel samples above the specified sulfur standard at retail facilities. This alternative defense consists of a comprehensive program of quality assurance sampling and testing that would cover all participating companies that produce and/or distribute highway diesel fuel if certain other conditions are met. The sampling and testing program would be carried out by an independent surveyor. The program would be conducted pursuant to a survey plan approved by EPA that is designed to achieve the same objectives as the current regulatory quality assurance requirement. This rule also amends the gasoline benzene regulations to allow disqualified small refiners the same opportunity to generate gasoline benzene credits as that afforded to non-small refiners.
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Systematic Review of Mindfulness Practice for Reducing Job Burnout
Sammons, Amanda
2016-01-01
OBJECTIVE. A systematic search and critical appraisal of interdisciplinary literature was conducted to evaluate the evidence for practicing mindfulness to treat job burnout and to explore implications for occupational therapy practitioners. METHOD. Eight articles met inclusion criteria. Each study was assessed for quality using the Physiotherapy Evidence Database scale. We used the U.S. Agency for Health Care Policy and Research guidelines to determine strength of evidence. RESULTS. Of the studies reviewed, participants included health care professionals and teachers; no studies included occupational therapy practitioners. Six of the 8 studies demonstrated statistically significant decreases in job burnout after mindfulness training. Seven of the studies were of fair to good quality. CONCLUSION. There is strong evidence for the use of mindfulness practice to reduce job burnout among health care professionals and teachers. Research is needed to fill the gap on whether mindfulness is effective for treating burnout in occupational therapy practitioners. PMID:26943107
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Gardiner, Clare; Brereton, Louise; Frey, Rosemary; Wilkinson-Meyers, Laura; Gott, Merryn
2016-09-01
The economic burden faced by family caregivers of people at the end of life is well recognised. Financial burden has a significant impact on the provision of family care-giving in the community setting, but has seen limited research attention. A systematic review with realist review synthesis and thematic analysis was undertaken to identify literature relating to the financial costs and impact of family care-giving at the end of life. This paper reports findings relating to previously developed approaches which capture the financial costs and implications of caring for family members receiving palliative/end-of-life care. Seven electronic databases were searched from inception to April 2012, for original research studies relating to the financial impact of care-giving at the end of life. Studies were independently screened to identify those which met the study inclusion criteria, and the methodological quality of included studies was appraised using realist review criteria of relevance and rigour. A descriptive thematic approach was used to synthesise data. Twelve articles met the inclusion criteria for the review. Various approaches to capturing data on the financial costs of care-giving at the end of life were noted; however, no single tool was identified with the sole purpose of exploring these costs. The majority of approaches used structured questionnaires and were administered by personal interview, with most studies using longitudinal designs. Calculation of costs was most often based on recall by patients and family caregivers, in some studies combined with objective measures of resource use. While the studies in this review provide useful data on approaches to capturing costs of care-giving, more work is needed to develop methods which accurately and sensitively capture the financial costs of caring at the end of life. Methodological considerations include study design and method of administration, contextual and cultural relevance, and accuracy of cost estimates. © 2015 John Wiley & Sons Ltd.
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Design of freeform optics for an ophthalmological application
NASA Astrophysics Data System (ADS)
Sieber, Ingo; Yi, Allen; Li, Likai; Beckert, Erik; Steinkopf, Ralf; Gengenbach, Ulrich
2014-05-01
Optical freeform surfaces are gaining importance in different optical applications. A huge demand arises e.g. in the fields of automotive and medical engineering. Innovative systems often need high-quality and high-volume optics. Injectionmoulded polymer optics represents a cost-efficient solution. However, it has to be ensured that the tight requirements with respect to the system's performance are met by the replicated freeform optics. To reach this goal, it is not sufficient to only characterise the manufactured optics by peak-to-valley or rms data describing a deviation from the nominal surface. Instead, optical performance of the manufactured freeform optics has to be analysed and compared with the performance of the nominal surface. This can be done by integrating the measured surface data of the manufactured freeform optics into the optical simulation model. The feedback of the measured surface data into the model allows for a simulation of the optical performance of the optical subsystem containing the real freeform optics manufactured. Hence, conclusions can be drawn as to whether the specifications with respect to e.g. imaging quality are met by the real manufactured optics. This approach will be presented using an Alvarez-Humphrey optics as an example of a tuneable optics of an ophthalmological application. The focus of this article will be on design for manufacturing the freeform optics, the integration of the measured surface data into the optical simulation model, simulation of the optical performance, and analysis in comparison to the nominal surface.
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Data Quality Objectives for Regulatory Requirements for Dangerous Waste Sampling and Analysis
DOE Office of Scientific and Technical Information (OSTI.GOV)
MULKEY, C.H.
1999-07-02
This document describes sampling and analytical requirements needed to meet state and federal regulations for dangerous waste (DW). The River Protection Project (RPP) is assigned to the task of storage and interim treatment of hazardous waste. Any final treatment or disposal operations, as well as requirements under the land disposal restrictions (LDRs), fall in the jurisdiction of another Hanford organization and are not part of this scope. The requirements for this Data Quality Objective (DQO) Process were developed using the RPP Data Quality Objective Procedure (Banning 1996), which is based on the U.S. Environmental Protection Agency's (EPA) Guidance for themore » Data Quality Objectives Process (EPA 1994). Hereafter, this document is referred to as the DW DQO. Federal and state laws and regulations pertaining to waste contain requirements that are dependent upon the composition of the waste stream. These regulatory drivers require that pertinent information be obtained. For many requirements, documented process knowledge of a waste composition can be used instead of analytical data to characterize or designate a waste. When process knowledge alone is used to characterize a waste, it is a best management practice to validate the information with analytical measurements.« less
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Jahangiry, L; Montazeri, A; Najafi, M; Yaseri, M; Farhangi, M A
2017-01-09
Physical inactivity and unhealthy nutritional behaviors are recognized as the key factors in the cause and management of metabolic syndrome (MetS). The effectiveness of interactive web-based interventions on dietary intakes, physical activity and health-related quality of life (HRQOL) among people with MetS is currently unknown. The two-arm randomized-controlled trial was conducted for patients with MetS from June through December 2012 in Tehran, Iran. Participants (n=160) were recruited through online registration on the study website. After free clinical assessments of eligible participants for MetS, they were randomly assigned to intervention and control groups (n=80). All participants received general information about cardiovascular diseases and MetS risk factors via the website. The intervention group logged in to interactive part including My Healthy Heart Profile, received tailored calorie-restricted diet and used all parts of the interactive prevention program. Anthropometric measures, glycemic status, lipid profile, physical activity and food intake were evaluated at the beginning and after 6-month follow-up. HRQOL was assessed at beginning, 3- and 6-month follow-up. There were no significant differences between the intervention and control groups on age, gender, education and MetS factors. In comparison with control group, the intervention group showed significant changes in moderate physical activity 260.3±473.6 vs 101.6±213.1 MET-min/week, walking 505.2±505.3 vs 321±884 MET-min per week, cholesterol intake -88.4±158.7 vs -8.3±6 mg per day, total calories -430.2±957.5 vs -392.9±34.7 kcal per day and sodium 1336.9±2467 vs 1342±3200.4 mmol per day. With regard to HRQOL, the intervention group showed greater improvement in general health and vitality (P<0.05 for all). These results indicate the positive impact of a lifestyle intervention by a web-based program on physical activity, dietary intake and several dimension of QoL. The use of web-based approaches is a great interest to manage patients at high cardiovascular risk, especially where the prevalence of obesity, MetS and diabetes is increasing.
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Metabolic syndrome risk factors among a sample of overweight and obese Mexican children.
Elizondo-Montemayor, Leticia; Serrano-González, Mónica; Ugalde-Casas, Patricia A; Cuello-García, Carlos; Borbolla-Escoboza, José R
2010-05-01
The objective of this study was to estimate the prevalence and correlations of components of the metabolic syndrome (MetS) using the International Diabetes Federation (IDF) pediatric definition in a cross-sectional study of 215 overweight/obese Mexican children aged 6 to 12. There are no previous studies of this kind in Mexican children. Clinical, anthropometric, and laboratory measurements were performed. The prevalence of MetS using the pediatric IDF criteria was 6.7% (95% confidence interval, 4.0-11.1). A higher proportion of children in the younger age group had waist circumference above the cutoff, while a higher proportion in the older age group had hyperglycemia. Children with MetS had higher percentages of body fat, body mass index, total cholesterol, and low-density lipoprotein cholesterol. Increased triglycerides, decreased high-density lipoprotein cholesterol, and waist circumference were most highly associated with MetS. This has significant implications for public health.
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Microgravity Combustion Diagnostics Workshop
NASA Technical Reports Server (NTRS)
Santoro, Gilbert J. (Editor); Greenberg, Paul S. (Editor); Piltch, Nancy D. (Editor)
1988-01-01
Through the Microgravity Science and Applications Division (MSAD) of the Office of Space Science and Applications (OSSA) at NASA Headquarters, a program entitled, Advanced Technology Development (ATD) was promulgated with the objective of providing advanced technologies that will enable the development of future microgravity science and applications experimental flight hardware. Among the ATD projects one, Microgravity Combustion Diagnostics (MCD), has the objective of developing advanced diagnostic techniques and technologies to provide nonperturbing measurements of combustion characteristics and parameters that will enhance the scientific integrity and quality of microgravity combustion experiments. As part of the approach to this project, a workshop was held on July 28 and 29, 1987, at the NASA Lewis Research Center. A small group of laser combustion diagnosticians met with a group of microgravity combustion experimenters to discuss the science requirements, the state-of-the-art of laser diagnostic technology, and plan the direction for near-, intermediate-, and long-term programs. This publication describes the proceedings of that workshop.
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NASA Technical Reports Server (NTRS)
Tolson, Robert H.
2000-01-01
The objectives of the cooperative effort with NASA was to conduct research related to aerospace structures and to increase the quality and quantity of highly trained engineers knowledgeable about aerospace structures. The program has successfully met the objectives and has been of significant benefit to NASA LARC, the GWU and the nation. The program was initiated with 3 students in 1994 under the direction of Dr. Robert Tolson as the Principal Investigator. Since initiation, 14 students have been involved in the program, resulting in 11 MS degrees with 2 more expected in 2000. The 11 MS theses and projects are listed. For technology transfer purposes some research is not reported in thesis form. Graduates from the program have been hired at aerospace and other companies across the nation, providing GWU and LARC with important industry and government contacts.
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Ince, Paul; Haddock, Gillian; Tai, Sara
2016-09-01
A systematic review of the literature exploring if the UK recommendations for psychological interventions for schizophrenia were being met was carried out. Rates of implementation for cognitive behavioural therapy (CBT) and family intervention (FI) were compared. The barriers against implementation and described strategies aimed at improving implementation were reviewed. A literature search of electronic bibliography databases (Psychinfo, Medline, Pubmed, AMED, CINHAL, and EMBASE), reference and citation lists, the Evaluation and Review of NICE Implementation (ERNIE) database, a manual search of Clinical Psychology Forum, governmental reports, charity, and service user group reports was conducted. Twenty-six articles met the inclusion criteria, 11 provided data on implementation rates, 13 explored the barriers to implementation, and 10 gave information about improvement strategies. Rates of implementation varied from 4% to 100% for CBT and 0% to 53% for FI, and studies varied in the methodology used and quality of the articles. Previously reported barriers to implementation were found, with organisational barriers being most commonly followed by barriers met by staff members and service users. Implementation strategies discovered included training packages for CBT, FI, and psychosocial interventions as well as empirical evidence suggesting methods for engagement with service users. Rates of implementation for CBT and FI are still below recommended levels with wide variation of rates found. This suggests inequalities in the provision of psychological interventions for schizophrenia are still present. Previously identified barriers to implementation were confirmed. Attempted implementation strategies have been met with modest success. Inequalities in the provision of psychological therapies for schizophrenia persist. Good quality cognitive behavioural therapy and FI training do not ensure implementation. Collaboration at all levels of healthcare is needed for effective implementation. © 2015 The British Psychological Society.
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Harthan, Laura B; McFarland, Douglas C; Velleman, Sandra G
2014-01-01
Posthatch satellite cell mitotic activity is a critical component of muscle development and growth. Satellite cells are myogenic stem cells that can be induced by nutrition to follow other cellular developmental pathways, and whose mitotic activity declines with age. The objective of the current study was to determine the effect of restricting protein synthesis on the proliferation and differentiation, expression of myogenic transcriptional regulatory factors myogenic determination factor 1, myogenin, and myogenic regulatory factor 4, and expression of the heparan sulfate proteoglycans syndecan-4 and glypican-1 in satellite cells isolated from 1-d-, 7-wk-, and 16-wk-old turkey pectoralis major muscle (1 d, 7 wk, and 16 wk cells, respectively) by using variable concentrations of Met and Cys. Four Met concentrations-30 (control), 7.5, 3, or 0 mg/L with 3.2 mg/L of Cys per 1 mg/L of Met-were used for culture of satellite cells to determine the effect of nutrition and age on satellite cell behavior during proliferation and differentiation. Proliferation was reduced by lower Met and Cys concentrations in all ages at 96 h of proliferation. Differentiation was increased in the 1 d Met-restricted cells, whereas the 7 wk cells treated with 3 mg/L of Met had decreased differentiation. Reduced Met and Cys levels from the control did not significantly affect the 16 wk cells at 72 h of differentiation. However, medium with no Met or Cys suppressed differentiation at all ages. The expression of myogenic determination factor 1, myogenin, myogenic regulatory factor 4, syndecan-4, and glypican-1 was differentially affected by age and Met or Cys treatment. These data demonstrate the age-specific manner in which turkey pectoralis major muscle satellite cells respond to nutritional availability and the importance of defining optimal nutrition to maximize satellite cell proliferation and differentiation for subsequent muscle mass accretion.
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NASA Technical Reports Server (NTRS)
Havens, Glen G.
2007-01-01
MRO project is a system of systems requiring system engineering team to architect, design, integrate, test, and operate these systems at each level of the project. The challenge of system engineering mission objectives into a single mission architecture that can be integrated tested, launched, and operated. Systems engineering must translate high-level requirements into integrated mission design. Systems engineering challenges were overcome utilizing a combination by creative designs built into MRO's flight and ground systems: a) Design of sophisticated spacecraft targeting and data management capabilities b) Establishment of a strong operations team organization; c) Implementation of robust operational processes; and d) Development of strategic ground tools. The MRO system has met the challenge of its driving requirements: a) MRO began its two-year primary science phase on November 7, 2006, and by July 2007, met it minimum requirement to collect 15 Tbits of data after only eight months of operations. Currently we have collected 22 Tbits. b) Based on current performance, mission data return could return 70 Tbits of data by the end of the primary science phase in 2008.
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Chaloner, Charlene; Evans, Diana; Mathews, Amy; Cohan, Pejman; Wang, Christina; Swerdloff, Ronald; Sim, Myung-Shin; Lee, Jihey; Wright, Mathew J.; Kernan, Claudia; Barkhoudarian, Garni; Yuen, Kevin C.J.; Guskiewicz, Kevin
2014-01-01
Abstract Hypopituitarism is common after moderate and severe traumatic brain injury (TBI). Herein, we address the association between mild TBI (mTBI) and pituitary and metabolic function in retired football players. Retirees 30–65 years of age, with one or more years of National Football League (NFL) play and poor quality of life (QoL) based on Short Form 36 (SF-36) Mental Component Score (MCS) were prospectively enrolled. Pituitary hormonal and metabolic syndrome (MetS) testing was performed. Using a glucagon stimulation test, growth hormone deficiency (GHD) was defined with a standard cut point of 3 ng/mL and with a more stringent body mass index (BMI)-adjusted cut point. Subjects with and without hormonal deficiency (HD) were compared in terms of QoL, International Index of Erectile Function (IIEF) scores, metabolic parameters, and football career data. Of 74 subjects, 6 were excluded because of significant non-football-related TBIs. Of the remaining 68 subjects (mean age, 47.3±10.2 years; median NFL years, 5; median NFL concussions, 3; mean BMI, 33.8±6.0), 28 (41.2%) were GHD using a peak GH cutoff of <3 ng/mL. However, with a BMI-adjusted definition of GHD, 13 of 68 (19.1%) were GHD. Using this BMI-adjusted definition, overall HD was found in 16 (23.5%) subjects: 10 (14.7%) with isolated GHD; 3 (4.4%) with isolated hypogonadism; and 3 (4.4%) with both GHD and hypogonadism. Subjects with HD had lower mean scores on the IIEF survey (p=0.016) and trended toward lower scores on the SF-36 MCS (p=0.113). MetS was present in 50% of subjects, including 5 of 6 (83%) with hypogonadism, and 29 of 62 (46.8%) without hypogonadism (p=0.087). Age, BMI, median years in NFL, games played, number of concussions, and acknowledged use of performance-enhancing steroids were similar between HD and non-HD groups. In summary, in this cohort of retired NFL players with poor QoL, 23.5% had HD, including 19% with GHD (using a BMI-adjusted definition), 9% with hypogonadism, and 50% had MetS. Although the cause of HD is unclear, these results suggest that GHD and hypogonadism may contribute to poor QoL, erectile dysfunction, and MetS in this population. Further study of pituitary function is warranted in athletes sustaining repetitive mTBI. PMID:24552537